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F-M AMBULANCE SERVICE INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
F-M AMBULANCE SERVICE INC (EIN 45-0344371)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-11
IRS object ID
201731319349304853
Schema version
2015v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2017-05-11T15:39:42-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line150 South Sixth Street Suite 2800AddressLine1Txt
CityMinneapolisCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN450344371EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1F-M Ambulance Service IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlF-MABusinessNameControlTxt
Phone7012342000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12215 18th Street SouthAddressLine1Txt
CityFargoCityNm
State AbbreviationNDStateAbbreviationCd
ZIP58103ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJoAnn KunkelPersonNm
Person TitleChief Financial OfficerPersonTitleTxt
Phone6053331000PhoneNum
Signature2017-05-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAnne FultonPreparerPersonNm
PTINP00941863PTIN
Phone6123974000PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKelby KrabbenhoftPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12301 East 60th StAddressLine1Txt
CitySioux FallsCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57104ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$13,000,007GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501cYes (X)Organization501cInd
Website Addresswww.FMAmbulance.comWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1978FormationYr
Legal Domicile StateNDLegalDomicileStateCd
Activity Or Mission"Dedicated to the Work of Health and Healing"ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$245,750PYContributionsGrantsAmt
CY Contributions Grants$74,873CYContributionsGrantsAmt
PY Program Service Revenue$15,552,941PYProgramServiceRevenueAmt
CY Program Service Revenue$12,888,211CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$11,660CYInvestmentIncomeAmt
PY Other Revenue$9,921PYOtherRevenueAmt
CY Other Revenue$3,446CYOtherRevenueAmt
PY Total Revenue$15,808,612PYTotalRevenueAmt
CY Total Revenue$12,978,190CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,232CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,316,733PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,043,106CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,525,495PYOtherExpensesAmt
CY Other Expenses$3,076,183CYOtherExpensesAmt
PY Total Expenses$12,842,228PYTotalExpensesAmt
CY Total Expenses$10,121,521CYTotalExpensesAmt
PY Revenues Less Expenses$2,966,384PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,856,669CYRevenuesLessExpensesAmt
Total Assets BOY$7,127,289TotalAssetsBOYAmt
Total Assets EOY$6,871,525TotalAssetsEOYAmt
Total Liabilities BOY$76,387TotalLiabilitiesBOYAmt
Total Liabilities EOY$123,533TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,050,902NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,747,992NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe Mission of F-M Ambulance, "Dedicated to the Work of Health and Healing and the vision "Improving the Human Condition through Exceptional Care, Innovation and Discovery", is the constant force that drives our plans, decisions and actions.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$8,916,386ExpenseAmt
Grant$2,232GrantAmt
Revenue$12,888,211RevenueAmt
DescAs part of the Sanford integrated delivery system, F-M Ambulance provides emergency medical and special transportation services to the Fargo, North Dakota/Moorhead, Minnesota metro area and other surrounding communities. F-M Ambulance is the largest advanced life support ground ambulance provider in North Dakota and serves as a resource to rescue and ambulance providers throughout the state. F-M Ambulance works closely with the local volunteer service to coordinate the delivery of emergency medical care to the communities in its service area and is a leader in Homeland Defense Preparedness by serving as a regional training, resources partner and responder.Through its Ready Wheels operations, F-M Ambulance provides local and long distance transportation for individuals using wheelchairs. This special transportation service is available 24 hours a day, seven days a week to provide door-to-door wheelchair service. These services allow individuals in the community to access transportation services that accommodate unique individual needs due to health conditions.Education and other services:F-M Ambulance also engages in various activities that promote the health of the community, including providing medical and safety education. F-M Ambulance provides educational programs for members of the community including first aid, automated external defibrillator, CPR and other courses. In addition, F-M Ambulance operates an on-site bookstore that is open to the public. The store sells education texts and reference books, trauma bags, first aid kits and supplies, medical supplies used in delivering emergency medical service outside the hospital and logo wear.F-M Ambulance also works with other organizations in the community to prepare for medical situations by having customized first aid supplies available to respond to workplace medical needs. These services help improve the health and well being of the community at large. F-M Ambulance is also very involved in numerous community activities that help promote health including participation in the national safe kids campaign, participating in bicycle safety helmet programs and providing non-dedicated stand-bys for community events.Desc
Total Program Service Expenses$8,916,386TotalProgramServiceExpensesAmt
Described In Section501c30DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible ContributionsYes (1)NondeductibleContributionsInd
Nondeductible Contri DisclYes (1)NondeductibleContriDisclInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JoAnn Kunkel CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6053331000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12301 East 60th StreetAddressLine1Txt
CitySioux FallsCityNm
State AbbreviationSDStateAbbreviationCd
ZIP57104ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeInd
Barb Everist
Trustee0.101.40Yes (X)$0$0$0
Brent Teiken
Trustee0.101.40Yes (X)$0$0$0
David Beito
Trustee0.101.40Yes (X)$0$0$0
Don Jacobs
Trustee0.101.40Yes (X)$0$0$0
Don Morton
Trustee0.101.40Yes (X)$0$0$0
James Cain
Trustee0.101.40Yes (X)$0$0$0
Jim Entenman
Trustee (thru Nov 15)0.101.40Yes (X)$0$0$0
Lauris Molbert
Trustee0.101.40Yes (X)$0$0$0
Maria Bell MD
Trustee/Sanford Physician0.1059.90Yes (X)$0$821,799$37,764
Mark Lundeen MD
Trustee/Sanford Physician0.1059.90Yes (X)$0$948,187$27,126
Mark Paulson MD
Trustee/Sanford Physician0.1059.90Yes (X)$0$234,209$32,587
Melissa Hinton
Trustee0.101.40Yes (X)$0$0$0
Michael LeBeau MD
Trustee/Sanford Physician0.1059.90Yes (X)$0$1,287,761$30,916
Patrick Durick
Trustee0.101.40Yes (X)$0$0$0
Richard Hardie MD
Trustee/Sanford Physician (thru Nov 15)0.1059.90Yes (X)$0$624,505$34,022
Thomas Hruby
Trustee0.101.40Yes (X)$0$0$0
Kelby K Krabbenhoft
Sanford President & CEO0.1059.90Yes (X)$0$3,896,486$21,654Yes (X)
Kelby K Krabbenhoft Deferred Comp
Sanford President & CEO0.1059.90Yes (X)$0$0$717,699Yes (X)
JoAnn L Kunkel
Chief Financial Officer0.1059.90$0$826,615$33,636Yes (X)
Paul Richard
Exec VP Fargo5.0055.00$0$753,169$36,414Yes (X)
Tiffany Lawrence
VP Finance Fargo5.0055.00$0$355,943$31,754Yes (X)
Karen Tobin
VP Operations Fargo (thru July 15)5.0055.00$0$901,777$15,199Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$10,650,451TotReportableCompRltdOrgAmt
Total Other Compensation$1,018,771TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$74,873GovernmentGrantsAmt
Total Contributions$74,873TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Emergency Medical Serv621910$11,854,632$11,854,632
Education900099$880,451$880,451
Special Transportation621910$153,128$153,128
FieldValueIRS element (for citing)
Total Program Service Revenue$12,888,211TotalProgramServiceRevenueAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$11,660OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$11,660OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,660TotalRevenueColumnAmt
Exclusion$11,660ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$25,263GrossSalesOfInventoryAmt
Cost Of Goods Sold$21,817CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,446TotalRevenueColumnAmt
Exclusion$3,446ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,978,190TotalRevenueColumnAmt
Related Or Exempt Func Income$12,888,211RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$15,106ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,232TotalAmt
Program Services$2,232ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,612,619TotalAmt
Program Services$5,272,702ProgramServicesAmt
Management And General$339,917ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$272,520TotalAmt
Program Services$256,419ProgramServicesAmt
Management And General$16,101ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$624,886TotalAmt
Program Services$596,213ProgramServicesAmt
Management And General$28,673ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$533,081TotalAmt
Program Services$384,851ProgramServicesAmt
Management And General$148,230ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$35,439TotalAmt
Program Services$16,914ProgramServicesAmt
Management And General$18,525ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$14,259TotalAmt
Program Services$10,777ProgramServicesAmt
Management And General$3,482ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$143,928TotalAmt
Program Services$76,490ProgramServicesAmt
Management And General$67,438ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$177,239TotalAmt
Program Services$131,061ProgramServicesAmt
Management And General$46,178ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$149,332TotalAmt
Program Services$76,367ProgramServicesAmt
Management And General$72,965ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$224,089TotalAmt
Program Services$215,157ProgramServicesAmt
Management And General$8,932ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$162,404TotalAmt
Program Services$139,378ProgramServicesAmt
Management And General$23,026ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$717,486TotalAmt
Program Services$590,652ProgramServicesAmt
Management And General$126,834ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$232,719TotalAmt
Management And General$232,719ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$626,092$575,818$50,274
Purchased Services$507,494$506,482$1,012
MinnesotaCare Tax$49,593$49,593

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$36,109TotalAmt
Program Services$15,280ProgramServicesAmt
Management And General$20,829ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$10,121,521TotalAmt
Program Services$8,916,386ProgramServicesAmt
Management And General$1,205,135ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,051,350BOYAmt
EOY$1,741,860EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,036BOYAmt
EOY$6,849EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$78,227BOYAmt
EOY$96,165EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$8,870,684LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,237,115LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,602,594BOYAmt
EOY$3,633,569EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$1,393,082BOYAmt
EOY$1,393,082EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$7,127,289BOYAmt
EOY$6,871,525EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$53,221BOYAmt
EOY$86,094EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$23,166BOYAmt
EOY$37,439EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$76,387BOYAmt
EOY$123,533EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,050,902BOYAmt
EOY$6,747,992EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,050,902BOYAmt
EOY$6,747,992EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,127,289BOYAmt
EOY$6,871,525EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,856,669ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$3,159,579OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$481,239OtherCostOrOtherBasisAmt
Book Value$481,239BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,730,568OtherCostOrOtherBasisAmt
Depreciation$1,270,711DepreciationAmt
Book Value$1,459,857BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,523,824OtherCostOrOtherBasisAmt
Depreciation$3,882,263DepreciationAmt
Book Value$1,641,561BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$135,053OtherCostOrOtherBasisAmt
Depreciation$84,141DepreciationAmt
Book Value$50,912BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,633,569TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationCertain controlled organizations are subject to income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. A tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination. The deferred income tax provision or benefit generally reflects the net change in deferred income tax assets and liabilities during the year. The current income tax provision reflects the tax consequences of revenues and expenses currently taxable or deductible on various income tax returns for the year reported. F-M Ambulance Service, Inc did not have an income tax liability at June 30, 2016; some related organizations have established reserves.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Maria Bell MD
Trustee/Sanford Physician$0$767,249$0$0$0$54,550$0$13,250$0$24,514$0$859,563$0$0
Mark Lundeen MD
Trustee/Sanford Physician$0$849,011$0$0$0$99,176$0$13,250$0$13,876$0$975,313$0$0
Mark Paulson MD
Trustee/Sanford Physician$0$234,209$0$0$0$0$0$11,917$0$20,670$0$266,796$0$0
Michael LeBeau MD
Trustee/Sanford Physician$0$1,287,761$0$0$0$0$0$10,600$0$20,316$0$1,318,677$0$0
Richard Hardie MD
Trustee/Sanford Physician (thru Nov$0$618,653$0$0$0$5,852$0$13,250$0$20,772$0$658,527$0$0
Kelby K Krabbenhoft
Sanford President & CEO$0$1,468,928$0$2,352,758$0$74,800$0$0$0$21,654$0$3,918,140$0$0
Kelby K Krabbenhoft Deferred Comp
Sanford President & CEO$0$0$0$0$0$0$0$717,699$0$0$0$717,699$0$0
JoAnn L Kunkel
Chief Financial Officer$0$584,610$0$165,000$0$77,005$0$11,852$0$21,784$0$860,251$0$0
Paul Richard
Exec VP Fargo$0$546,146$0$125,000$0$82,023$0$13,250$0$23,164$0$789,583$0$0
Tiffany Lawrence
VP Finance Fargo$0$302,108$0$22,100$0$31,735$0$13,250$0$18,504$0$387,697$0$0
Karen Tobin
VP Operations Fargo (thru July 15)$0$181,528$0$10,000$0$710,249$0$9,576$0$5,623$0$916,976$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1aCertain items listed on Line 1a are provided by related organizations. Part I, Line 3: The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm annually to review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2016.
Part I, Lines 4a-bThe following individual participated in a severance arrangement and received payments during the year: Karen Tobin $689,284 Certain executives participate in a defined benefit SERP Plan. There were no individuals who received payments during the year.
Part I, Line 6Sanford physicians are compensated based on the professional services they perform within the clinic in which they provide care. Generally, the model is based on production.
Part I, Line 7Certain employees are eligible for a discretionary incentive bonus. Bonuses are paid based on the achievement of financial and other goals.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2The following officers, board members, and key employees are employees of Sanford or its related organizations. Many of these employees also serve on other related Sanford boards, or have business relationships with each other that span the organization as a whole: Maria Bell, Mark Lundeen, Mark Paulson, Michael LeBeau, Richard Hardie, Kelby Krabbenhoft, JoAnn Kunkel, Tiffany Lawrence, Paul Richard and Karen Tobin.
Form 990, Part VI, Section A, line 6Sanford North is the sole stockholder of F-M Ambulance.
Form 990, Part VI, Section A, line 7aBoard members are appointed by the President and CEO of Sanford North.
Form 990, Part VI, Section A, line 7bSanford North must approve the following actions: * Modifying the purpose of the Corporation * Unbudgeted capital expenses in excess of 1/2 of 1% of approved operating budgets *Adoption of capital and operating budgets *Acquisition, sale, lease, disposition, or mortgaging of real property *Guarantee of debts or obligations of any other person, firm, corporation, partnership, association, or other entity which if held in default would obligate the corporation to an aggregate amount in excess of $100,000 *Merger or consolidation of the Corporation *Incurring a loan or other obligation in an agreement in excess of $500,000 for more than 60 days *Making of a gift, grant or other donation in an amount in excess of $5,000 to an organization not related to the Corporation or Member *Member has the authority to direct the Corporation regardless of the vote by the Corporation's Board of Directors to transfer assets and/or funds to the health system to satisfy obligations of the health system.
Form 990, Part VI, Section B, line 11The Form 990 is prepared internally by Finance and reviewed by executive management. An external accounting firm reviews the return prior to filing and prepares return highlights and key disclosures for the Board of Trustees meeting prior to the return filing date. Before the return is filed, a complete copy is provided to the current Board of Trustees.
Form 990, Part VI, Section B, line 12cThe annual Conflict of Interest disclosure process is managed by the Chief Compliance Officer (CCO). The CCO is responsible for assuring that all completed forms are returned in a timely and complete manner. Conflict of Interest questionnaires are sent to System Trustees, members of the governing boards for subsidiary entities, officers, and key employees for all entities subject to the IRS Form 990 filings. The disclosures are summarized for review by the executive committee of the Board of Trustees, pursuant to policy. This review allows: 1) The Board to acquire an awareness of financial relationships of board members and key management employees and can invoke the recusal process on a case-by-case basis if potential conflicts are implicated in Board decisions and deliberations, and, 2) Gives the Board the opportunity to seek additional information and clarification about disclosures to determine potential conflicts of interest and how to manage them.
Form 990, Part VI, Section B, line 15A related party, Sanford Health, does have a process for determining compensation of the persons listed on Part VII Section A, including a review and approval by independent persons, review of comparability data and contemporaneous substantiation of the deliberation and decision for such compensation. The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm annually to review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2016.
Form 990, Part VI, Section C, line 19Although the organization does not maintain a website where the public can access these documents, it would respond individually to any requests or inquiries from the public for these documents.
Form 990, Part XI, line 9:Transfer from related tax-exempt org for payroll and operating expenses -3,159,579.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Sanford
801 Broadway DriveFargoND58122271218956Supporting OrganizationND501(c)(3)11-II0
Sanford Health Foundation
101 S Reid StreetSioux FallsSD57103363297853FoundationSD501(c)(3)11-IIYes (1)Sanford Health
Edith Sanford Breast Cancer Foundation
101 S Reid StreetSioux FallsSD57103450404126FoundationND501(c)(3)11-IIYes (1)Sanford Health
Sanford Health Foundation North
PO Box 2010FargoND58122450398104FoundationND501(c)(3)7Yes (1)Sanford North
Sanford Health Foundation Hillsboro
PO Box 609HillsboroND58045363542187FoundationND501(c)(3)7Yes (1)Sanford Hillsboro
Sanford Health Foundation of Northern Minnesota
1300 Anne St NWBemidjiMN56601411389317FoundationMN501(c)(3)11-IIYes (1)Sanford Health of Northern Minnesota
Sanford Health Foundation West
300 North 7th StreetBismarckND58501450397196FoundationND501(c)(3)7Yes (1)Sanford Bismarck
Medcenter One Inc Auxiliary
300 North 7th StreetBismarckND58501237293043Supporting OrganizationND501(c)(3)11-IYes (1)Sanford Bismarck
Sanford Heart of America Health Plan
810 South MainRugbyND58368450346132InsuranceND501(c)(4)Yes (1)Sanford Health Plan
Sanford Health Foundation Thief River Falls
120 Labree Ave SThief River FallsMN56701411761135FoundationMN501(c)(3)7Yes (1)Sanford Medical Center Thief River Falls

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
National Student Housing-South Dakota LLC
100 S Phillips AveSioux FallsSD57104202129839InvestmentSDN/A
RAC Rentals LLC
100 S Phillips AveSioux FallsSD57104261961077InvestmentSDN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
Sanford Home Medical Equipment Inc
2710 W 12th StreetSioux FallsSD57105460388597Healthcare EquipmentSDN/ACYes (1)
Sanford Health Plan
300 Cherapa PlaceSioux FallsSD57103911842494InsuranceSDN/ACYes (1)
Sanford Health Plan of MN
300 Cherapa PlaceSioux FallsSD57103460445852InsuranceMNN/ACYes (1)
Sanford Frontiers
1305 W 18th Street PO Box 5039Sioux FallsSD571175039455436599Weight Loss/FitnessSDN/ACYes (1)
SOB Inc
2701 S Minnesota Avenue Suite 2Sioux FallsSD57105460442628Air TransportationSDN/ACYes (1)
Sanford Affiliated Services Inc
300 N 7th StreetBismarckND58501450403146Investment ActivityNDN/ACYes (1)
Sanford World Clinics - Ghana
HealthcareN/ACYes (1)Sarbah Road Tantri Lorry StationCape CoastGHGH
Shanghai Sanford Healthcare Management Consulting Co Ltd
HealthcareN/ACYes (1)188 Yesheng Road Room A-862 GuomaShanghaiCHCH
Sanford International - Munich GmbH
HealthcareN/ACYes (1)Nymphenburger Strasse 3MunichGMGM
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Sanford Health
R$632,951Cost Method
Sanford Medical Center Fargo
S$1,159,749Cost Method
Sanford Clinic North
S$62,200Cost Method
Sanford Hillsboro
R$183,708Cost Method