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F-M AMBULANCE SERVICE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
F-M AMBULANCE SERVICE INC (EIN 45-0344371)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-09
IRS object ID
201421299349300842
Schema version
2012v2.1
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)
Timestamp2014-05-09T10:01:09-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line150 South Sixth Street Suite 2800AddressLine1
CityMinneapolisCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN450344371EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1F-M Ambulance Service IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlF-MANameControl
Phone7012342000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12215 18th Street SouthAddressLine1
CityFargoCity
StateNDState
ZIP Code58103ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJoAnn KunkelName
TitleChief Financial OfficerTitle
Phone6053331000Phone
Date Signed2014-05-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKristina RasmussenName
PTINP00143920PTIN
Phone6123974000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKelby KrabbenhoftNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11305 W 18th StAddressLine1
CitySioux FallsCity
StateSDState
ZIP Code57117ZIPCode
FieldValueIRS element (for citing)
Gross Receipts12748206GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.FMAmbulance.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileNDStateLegalDomicile
Activity Or Mission Description"Dedicated to the Work of Health and Healing"ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees157TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year15300ContributionsGrantsPriorYear
Contributions Grants Current Year189438ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11847776ProgramServiceRevenuePriorYear
Program Service Revenue CY12458341ProgramServiceRevenueCY
Investment Income Prior Year21109InvestmentIncomePriorYear
Investment Income Current Year6648InvestmentIncomeCurrentYear
Other Revenue Prior Year37880OtherRevenuePriorYear
Other Revenue Current Year37351OtherRevenueCurrentYear
Total Revenue Prior Year11922065TotalRevenuePriorYear
Total Revenue Current Year12691778TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY550GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year5173641SalariesEtcPriorYear
Salaries Etc Current Year5610438SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4618426OtherExpensePriorYear
Other Expenses Current Year5128751OtherExpensesCurrentYear
Total Expenses Prior Year9792067TotalExpensesPriorYear
Total Expenses Current Year10739739TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2129998RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1952039RevenuesLessExpensesCY
Total Assets BOY7048918TotalAssetsBOY
Total Assets EOY8105069TotalAssetsEOY
Total Liabilities BOY945834TotalLiabilitiesBOY
Total Liabilities EOY1092101TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY6103084NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7012968NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense9054855Expense
Grants550Grants
Revenue12458341Revenue
DescriptionAs 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.Description
Total Program Service Expense9054855TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees157NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions1NonDeductibleContributions
Non Deductible Disclosure1NonDeductibleDisclosure
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JoAnn Kunkel CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6053331000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11305 West 18th StreetAddressLine1
CitySioux FallsCity
StateSDState
ZIP Code57117ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployee
Barb Everist
Trustee0.105.30X000
Barbara Stork
Trustee0.105.30X000
Barry Martin thru Nov 12
Trustee0.105.30X000
Brent Teiken
Trustee0.105.30X000
Christopher Meeker MD
Trustee0.1059.90X021382131035
David Beito
Trustee0.105.30X000
Don Morton
Trustee0.105.30X000
Jerome Feder
Trustee0.105.30X000
Jim Entenman
Trustee0.105.30X000
Lauris Molbert
Trustee0.105.30X000
Mark Paulson MD
Trustee0.1059.90X024849632936
Mikal Claar thru Nov 12
Trustee0.105.30X000
Patrick Durick
Trustee0.105.30X000
Richard Hardie MD
Trustee0.1059.90X074742333818
Ronald Moquist
Trustee0.105.30X000
Thomas Hruby
Trustee0.105.30X000
Kelby K Krabbenhoft
Sanford Health President & CEO0.1059.90X0153942122054X
Kelby K Krabbenhoft Deferred Comp
Sanford Health President & CEO0.1059.90X00589623X
JoAnn L Kunkel
Chief Financial Officer Corp0.1059.90043804833700X
Lisa Carlson thru Oct 12
Chief Financial Officer Corp0.1059.90064418631847X
Dennis Millirons
President - Sanford Medical Center Fargo5.0055.00063811918006X
Tiffany Lawrence
CFO - Sanford Medical Center Fargo5.0055.00025406630544X
Linda O'Halloran thru Mar 13
COO - Sanford Medical Center Fargo5.0055.00039852218344X
Karen Tobin
COO - Sanford Medical Center Fargo5.0055.00022307119379X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs5345173TotalReportableCompFrmRltdOrgs
Total Other Compensation861286TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Government Grants60040GovernmentGrants
All Other Contributions129398AllOtherContributions
Total Contributions189438TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Emergency Medical Serv6219101164967111649671
Education900099694478694478
Special Transportation621910114192114192
FieldValueIRS element (for citing)
Total Program Service Revenue12458341TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column154TotalRevenueColumn
Exclusion$154ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real8450Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real8450Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column8450TotalRevenueColumn
Exclusion$8,450ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other8500Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2006Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other6494Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column6494TotalRevenueColumn
Exclusion$6,494ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory83323GrossSalesOfInventory
Cost Of Goods Sold54422CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column28901TotalRevenueColumn
Exclusion$28,901ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column12691778TotalRevenueColumn
Related Or Exempt Function Income12458341RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$43,999ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total550Total
Program Services550ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4161281Total
Program Services3837496ProgramServices
Management And General323785ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total492683Total
Program Services172932ProgramServices
Management And General319751ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total566099Total
Program Services513554ProgramServices
Management And General52545ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total390375Total
Program Services284981ProgramServices
Management And General105394ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total62244Total
Program Services18782ProgramServices
Management And General43462ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total17561Total
Program Services14337ProgramServices
Management And General3224ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total128149Total
Program Services56063ProgramServices
Management And General72086ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total93757Total
Program Services52863ProgramServices
Management And General40894ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total137397Total
Program Services52782ProgramServices
Management And General84615ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total334471Total
Program Services327437ProgramServices
Management And General7034ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total83114Total
Program Services80827ProgramServices
Management And General2287ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total13659Total
Program Services13183ProgramServices
Management And General476ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total574185Total
Program Services455349ProgramServices
Management And General118836ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total199104Total
Program Services739ProgramServices
Management And General198365ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debt27565232756523
Medical Supplies36049633401426482
Purchased Services29487624245270631
Certs/Licenses/Fees314872106810419

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total41728Total
Program Services37130ProgramServices
Management And General4598ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total10739739Total
Program Services9054855ProgramServices
Management And General1684884ManagementAndGeneral
Fundraising0Fundraising

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1805998BOY
EOY2854361EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY51392BOY
EOY59863EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY28958BOY
EOY39525EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis8623730LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4865492LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3769488BOY
EOY3758238EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY1393082BOY
EOY1393082EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7048918BOY
EOY8105069EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY579367BOY
EOY904091EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY44887BOY
EOY24844EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY321580BOY
EOY163166EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY945834BOY
EOY1092101EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY6103084BOY
EOY7012968EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6103084BOY
EOY7012968EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7048918BOY
EOY8105069EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1952039ReconcilationRevenueExpenses
Reconcilation Other Changes-1042155ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis481239OtherCostOrOtherBasis
Book Value481239BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2762068OtherCostOrOtherBasis
Depreciation1001655Depreciation
Book Value1760413BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis135053OtherCostOrOtherBasis
Depreciation63649Depreciation
Book Value71404BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2513343OtherCostOrOtherBasis
Depreciation1888078Depreciation
Book Value625265BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2732027OtherCostOrOtherBasis
Depreciation1912110Depreciation
Book Value819917BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3758238TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X, Line 2:ReturnReference
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, 2013; some related organizations have established reserves.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Christopher Meeker MD
Trustee0213821000008842022193024485600
Mark Paulson MD
Trustee020074700047749012500020436028143200
Richard Hardie MD
Trustee07437060003717015000018818078124100
Kelby K Krabbenhoft
Sanford Health President & CEO094188503325000265036000220540156147500
Kelby K Krabbenhoft Deferred Comp
Sanford Health President & CEO000000058962300058962300
JoAnn L Kunkel
Chief Financial Officer Corp0321232080000036816014146019554047174800
Lisa Carlson thru Oct 12
Chief Financial Officer Corp04342530129600080333012500019347067603300
Dennis Millirons
President - Sanford Medical Center F0443522011000008459702500015506065612500
Tiffany Lawrence
CFO - Sanford Medical Center Fargo02321590300021607011673018871028461000
Linda O'Halloran thru Mar 13
COO - Sanford Medical Center Fargo033827001030004995201250005844041686600
Karen Tobin
COO - Sanford Medical Center Fargo0195179030002759201172907650024245000

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 1aPart I, Line 1a: Certain 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 to annually 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 2013.
Part I, Line 4bPart I, Line 4b/Schedule J, Part II, Column C: In addition to employer contributions to pension plans, amounts representing increases and decreases in actuarial value (actuarial value factors include age, tenure and salary) of defined contribution and defined benefit SERP Plans are included in Column C. Participants and changes in values include: Kelby Krabbenhoft $433,820
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, based on financial targets and other goals.
Part IIICompensation reported on Schedule J, Part II includes: (B)(i) Base compensation - salaries are based on the experience and performance of each executive and bench-marked using independent compensation survey information. (B)(ii) Bonus & incentive compensation - as part of executive compensation, individuals may be eligible for incentive performance compensation, however if the organization does not make its financial targets, incentive payments are not paid regardless of performance. (B)(iii) Other Reportable Compensation - generally includes taxable executive benefits. (C) Deferred Compensation - includes employer contributions to pension plans and the increase (or decrease) in the actuarial value (actuarial value factors include age, tenure and salary) of the benefit plans. (D) Nontaxable Benefits - generally includes health insurance premiums. A memo regarding executive compensation, written by the Chairman of the Sanford Board of Trustees, is on file and available upon request. Compensation paid to trustees is for full-time professional responsibilities as physicians, administrators or employees of the organization. The total compensation paid to Kelby Krabbenhoft of $1,539,421 is comprised of Base Salary of $941,885, Incentive Compensation of $332,500 and Other Taxable Earnings of $265,036. In addition, an amount of $589,623 has been reported for the estimated amount of ratable increase in value of the defined benefit pension plan, defined benefit SERP and a Gift Agreement Management Continuity Retention plan.Supplemental Information

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
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: Christopher Meeker Mark Paulson Richard Hardie Kelby Krabbenhoft JoAnn Kunkel Lisa Carlson Tiffany Lawrence Dennis Millirons Linda O'Halloran 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 deafult 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 transger 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 the finance department 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 when 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 15The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm to annually 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 2013. Additionally, Sanford periodically engages an independent compensation consultant to review and issue a report regarding the reasonableness of the total compensation arrangements of all physicians employed by the organization. The most recent study of the physician total compensation was completed in 2009.
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.
Sanford Board of Trustees has ultimate governance responsibilities for each entity within the Sanford system. In addition, a Board of Directors is established for each entity, which has specific delegated responsibilities from the Board of Trustees related to the oversight of day-to-day operations of that entity.Form 990, Part VII
Form 990, Part XI, line 9:Transfer from related tax-exempt org for payroll and operating expenses -1,042,155.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (30 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Sanford
801 Broadway DriveFargoND58122271218956Supporting OrganizationND501(c)(3)11-II0
Sanford Health
1305 West 18th StreetSioux FallsSD57117311527032Supporting OrganizationSD501(c)(3)11-II1Sanford
Sanford USD Medical Center
1305 West 18th Street PO Box 5039Sioux FallsSD571175039460227855HospitalSD501(c)(3)31Sanford Health
Sanford Health Foundation
1305 West 18th StreetSioux FallsSD57117363297853Supporting OrganizationSD501(c)(3)11-II1Sanford Health
Edith Sanford Breast Cancer Foundation
2301 60th Street NSioux FallsSD57104450404126FoundationND501(c)(3)11-II1Sanford Health
Sanford Clinic
1305 West 18th Street PO Box 5039Sioux FallsSD571175039460447693Clinical ServicesSD501(c)(3)31Sanford Health
Sanford Home Health
1305 West 18th Street PO Box 5039Sioux FallsSD571175039460282134Home Health ServicesSD501(c)(3)91Sanford Health
Sanford Health Network
1305 West 18th Street PO Box 5039Sioux FallsSD571175039460388596Hospitals/ClinicsSD501(c)(3)31Sanford Health
Sanford ResearchUSD
1305 West 18th Street PO Box 5039Sioux FallsSD571175039460450378ResearchSD501(c)(3)31Sanford Health
Sanford World Clinics
1305 West 18th StreetSioux FallsSD57117262707628HealthcareSD501(c)(3)31Sanford Health
Sanford North
PO Box 2010FargoND58122450385890Supporting OrganizationND501(c)(3)11-II1Sanford
Sanford Medical Center Fargo
PO Box 2010FargoND58122450226909HospitalND501(c)(3)31Sanford North
Sanford Health Foundation North
PO Box 2010FargoND58122450398104FundraisingND501(c)(3)71Sanford North
Sanford Clinic North
PO Box 2010FargoND58122911770748ClinicsND501(c)(3)91Sanford North
Sanford Health Network North
PO Box 2010FargoND58122450409348Hospitals/ClinicsND501(c)(3)11-II1Sanford North
Sanford Hillsboro
PO Box 609HillsboroND58045450230400HospitalND501(c)(3)31Sanford Health Network North
Sanford Health Foundation Hillsboro
PO Box 609HillsboroND58045363542187FundraisingND501(c)(3)71Sanford Hillsboro
Sanford Medical Center Mayville
42 6th Ave SEMayvilleND58257450228899HospitalND501(c)(3)31Sanford Health Network North
Sanford Medical Center Thief River Falls
120 Labree Ave SThief River FallsMN56701410709579HospitalMN501(c)(3)31Sanford Health Network North
MeritCare Minnesota
1720 South Highway 59Thief River FallsMN56701261530302Promotion of healthMN501(c)(3)31Sanford North
Sanford Medical Center Wheaton
401 12th Street NorthWheatonMN56296272042143Hospital/ClinicMN501(c)(3)31Sanford Health Network North
Sanford Health of Northern Minnesota
1300 Anne St NWBemidjiMN56601411266009HospitalMN501(c)(3)31Sanford North
Sanford Health Foundation of Northern Minnesota
1300 Anne St NWBemidjiMN56601411389317Fundraising - SupportMN501(c)(3)11-II1Sanford Health of Northern Minnesota
Baker Park Inc
803 Dewey Ave NWBemidjiMN56601411372480Low Income Senior HousingMN501(c)(3)91Sanford Health of Northern Minnesota
North Country Medical Clinic
1300 Anne St NWBemidjiMN56601411753855Family Practice Medical ClinicMN501(c)(3)31Sanford Health of Northern Minnesota
Sanford West
300 North 7th StreetBismarckND58501450397195Supporting OrganizationND501(c)(3)11-II1Sanford
Sanford Bismarck
300 North 7th StreetBismarckND58501450226700HospitalND501(c)(3)31Sanford West
Sanford Living Centers
1000 18th Street NW Suite 1BismarckND58554450416454Long-term Care FacilityND501(c)(3)91Sanford Bismarck
Sanford West Foundation
300 North 7th StreetBismarckND58501450397196FundraisingND501(c)(3)71Sanford Bismarck
Medcenter One Inc Auxiliary
300 North 7th StreetBismarckND58501237293043Supporting OrganizationND501(c)(3)11-I1Sanford Bismarck

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
National Student Housing-South Dakota LLC
100 S Phillips AveSioux FallsSD57104202129839InvestmentSDN/A
RAC Rentals LLC
100 S Phillips AveSioux FallsSD57104261961077InvestmentSDN/A
Shetek Medical Services LLC
251 5th Street EastTracyMN56175412004685Home Health ServicesMNN/A
Southwest MN Radiation Center LLC
1018 6th AvenueWorthingtonMN56187460447693Radiation ServicesMNN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
Sanford Home Medical Equipment Inc
2710 W 12th StreetSioux FallsSD57105460388597Healthcare EquipmentSDN/AC1
Sanford Health Plan
300 Cherapa PlaceSioux FallsSD57103911842494InsuranceSDN/AC1
Sanford Health Plan of MN
300 Cherapa PlaceSioux FallsSD57103460445852InsuranceMNN/AC1
Bemidji Medical Equipment Inc
1300 Anne Street NWBemidjiMN56601411551725Retail Sales of DMEMNN/AC1
North Country Management Inc
1300 Anne Street NWBemidjiMN56601411820025Management ServicesMNN/AC1
Sanford Frontiers
1305 W 18th Street PO Box 5039Sioux FallsSD571175039455436599Weight Loss ManagementSDN/AC1
SOB Inc
2701 S Minnesota Avenue Suite 2Sioux FallsSD57105460442628Air TransportationSDN/AC1
Sanford Affiliated Services Inc
300 N 7th StreetBismarckND58501450403146Investment ActivityNDN/AC1
Sanford World Clinics - Ghana
HealthcareN/AC1Sarbah Road Tantri Lorry StationCape CoastGHGH
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg