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RENVILLE HEALTH SERVICES: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
RENVILLE HEALTH SERVICES (EIN 20-2581924)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-02-13
IRS object ID
201440449349302014
Schema version
2012v2.3
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)
Timestamp2014-02-13T15:26:44-06:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CONWAY DEUTH & SCHMIESING PLLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1401 ATLANTIC AVEAddressLine1
CityMORRISCity
StateMNState
ZIP Code562671324ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN202581924EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1RENVILLE HEALTH SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlRENVNameControl
Phone3205894902Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1205 SE ELM AVEAddressLine1
CityRENVILLECity
StateMNState
ZIP Code56284ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLUVERNE HOFFMANName
TitlePRESIDENTTitle
Phone3205894902Phone
Date Signed2014-02-09DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAMES A GILMAN CPAName
Phone3205892602Phone
Date Prepared2014-02-09DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLUVERNE HOFFMANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1801 NEVADA AVEAddressLine1
CityMORRISCity
StateMNState
ZIP Code56267ZIPCode
FieldValueIRS element (for citing)
Gross Receipts4719349GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SFHS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2005YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionWE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES RENVILLE HEALTH SERVICES AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE ARE DEDICATED TO PROMOTING THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees159TotalNbrEmployees
Total Nbr Volunteers100TotalNbrVolunteers
Total Gross UBI39642TotalGrossUBI
Contributions Grants Prior Year6359ContributionsGrantsPriorYear
Contributions Grants Current Year1450ContributionsGrantsCurrentYear
Program Service Revenue Prior Year4844185ProgramServiceRevenuePriorYear
Program Service Revenue CY4707228ProgramServiceRevenueCY
Investment Income Prior Year-1516InvestmentIncomePriorYear
Investment Income Current Year75InvestmentIncomeCurrentYear
Other Revenue Current Year8271OtherRevenueCurrentYear
Total Revenue Prior Year4849028TotalRevenuePriorYear
Total Revenue Current Year4717024TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year6000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY8785GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2138715SalariesEtcPriorYear
Salaries Etc Current Year2237773SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year2613TotalFundrsngExpCurrentYear
Other Expense Prior Year2545968OtherExpensePriorYear
Other Expenses Current Year2446976OtherExpensesCurrentYear
Total Expenses Prior Year4690683TotalExpensesPriorYear
Total Expenses Current Year4693534TotalExpensesCurrentYear
Revenues Less Expenses Prior Year158345RevenuesLessExpensesPriorYear
Revenues Less Expenses CY23490RevenuesLessExpensesCY
Total Assets BOY8656149TotalAssetsBOY
Total Assets EOY8513802TotalAssetsEOY
Total Liabilities BOY7333938TotalLiabilitiesBOY
Total Liabilities EOY7568101TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1322211NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY945701NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionWE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES RENVILLE HEALTH SERVICES AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE ARE DEDICATED TO PROMOTING THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense4235133Expense
Grants8785Grants
Revenue4717024Revenue
DescriptionRENVILLE HEALTH SERVICES CONSISTS OF A 52 BED SKILLED NURSING FACILITY, A 42 UNIT INDEPENDENT LIVING CENTER/ASSISTED LIVING CENTER IN RURUAL MINNESOTA. THE FACILITY PROVIDES MEDICAL, SOCIAL, AND SPIRITUAL CARE TO ITS RESIDENTS WITHOUT REGARD TO RACE, COLOR, CREED, OR NATIONAL ORIGIN, IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT STATUS. DURING THE CURRENT REPORTING YEAR, THE ORGANIZATION HAD 31,123 PATIENT DAYS AND PROVIDED SERVICES TO MORE THAN 89 PATIENTS IN THE NURSING HOME AND PROVIDED HOUSING FOR MORE THAN 49 TENANTS AT THE INDEPENDENT/ASSISTED LIVING CENTER. ALSO DURING THIS TIME PERIOD, THE ORGANIZATION EMPLOYED ABOUT 66 FULL TIME EQUIVALENT EMPLOYEES AND GROSS WAGES PAID OUT WERE MORE THAN 1.8 MILLION DOLLARS. THIS WAS ALL PROVIDED IN AN AREA WHERE MEDICAL AND EMPLOYMENT OPPORTUNITIES ARE LIMITED.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
DescriptionMANAGEMENT SERVICES PROVIDED TO RELATED ORGANIZATIONS IN SUPPORT OF EACH ORGANIZATION'S EXEMPT PURPOSE.Description
FieldValueIRS element (for citing)
Total Program Service Expense4235133TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingtrueCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109619NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees159NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSHERRY WAGNERNamePerson
Telephone Number3205894919TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1801 NEVADA AVENUEAddressLine1
CityMORRISCity
StateMNState
ZIP Code56267ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedHighest Compensated EmployeeHighestCompensatedEmployee
DON GIESELMANN
CHAIR1.00XX000
MAGGIE FLETCHER
TRUSTEE1.00X000
STEVE LIENEMANN
TRUSTEE1.00X000
KATIE ERDMAN
TRUSTEE1.00X000
VIVIAN HELTEMES
TRUSTEE-STAR1.00X000
BARBARA SPAULDING
TRUSTEE1.00X000
DOUGLAS WARTNER
TRUSTEE1.00X000
ANDY LOPEZ
VICE CHAIR1.00XX000
KENNY WESTBROCK
TRUSTEE - DE1.00X000
KEN KELLER
TRUSTEE1.00X000
RANDY SUTTER
SECRETARY/TR1.00XX000
REV ROBERT KIEFFER
TRUSTEE1.00X000
ROSE MURPHY
TRUSTEE1.00X000
NEIL SCHMIDGALL
TRUSTEEX000
LUVERNE HOFFMAN
PRES/CEO1.00X03520114471639.00
CAROL RAW
VP SENIOR SVX01315741732840.00
SHERRY WAGNER
CFO1.00X0101964604039.00
DENNIS LINDOR
VP BEHAV SVCX0811552083240.00
GEOFFREY RYAN
ADMIN - CHC0116061577040.00X
SCOTT JACKSON
DIRECTOR OF01048211264640.00X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs887586TotalReportableCompFrmRltdOrgs
Total Other Compensation107332TotalOtherCompensation
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ST FRANCIS HEALTH SERVICES OF MORRI
801 NEVADA AVEMORRISMN56267MGMT FEES & OTH373879
AEGIS THERAPIES INC
PO BOX 8103FORT SMITHAR72902THERAPY356030
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions1450AllOtherContributions
Total Contributions1450TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeBusiness CodeBusinessCodeUnrelated Business RevenueUnrelatedBusinessRevenue
RESIDENT SERVICE REVENUE45373894537389
MEALS121732121732
MANAGEMENT AGENT3964256100039642
RENTAL56755675
OTHER27902790
FieldValueIRS element (for citing)
Total Program Service Revenue4707228TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column75TotalRevenueColumn
Exclusion$75ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events10596GrossIncomeFundraisingEvents
Fundraising Direct Expenses2325FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column8271TotalRevenueColumn
Exclusion$8,271ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column4717024TotalRevenueColumn
Related Or Exempt Function Income4667586RelatedOrExemptFunctionIncome
Unrelated Business Revenue39642UnrelatedBusinessRevenue
Exclusion$8,346ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total8785Total
Program Services8785ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1821231Total
Program Services1756395ProgramServices
Management And General64836ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total38212Total
Program Services36881ProgramServices
Management And General1331ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total239578Total
Program Services231231ProgramServices
Management And General8347ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total138752Total
Program Services133918ProgramServices
Management And General4834ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total243600Total
Management And General243600ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6420Total
Program Services415ProgramServices
Management And General6005ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total9230Total
Program Services2400ProgramServices
Management And General6830ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total22876Total
Program Services9441ProgramServices
Management And General13435ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total19092Total
Program Services2232ProgramServices
Management And General16860ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total229946Total
Program Services229946ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total5613Total
Program Services612ProgramServices
Management And General5001ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total5389Total
Program Services550ProgramServices
Management And General4839ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total307344Total
Program Services307344ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total380771Total
Program Services380771ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total62575Total
Program Services42057ProgramServices
Management And General20518ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
MEDICAL PROFESSIONAL FEES445787445787
SUPPLIES232678232678
PURCHASED SERVICES135437135437
MEDICAL SURCHARGE133712133712

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total206506Total
Program Services144541ProgramServices
Management And General59352ManagementAndGeneral
Fundraising2613Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total4693534Total
Program Services4235133ProgramServices
Management And General455788ManagementAndGeneral
Fundraising2613Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY471114BOY
EOY482710EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY351190BOY
EOY416271EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY22557BOY
EOY19889EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis9644882LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2166315LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY7688699BOY
EOY7478567EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY122589BOY
EOY116365EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8656149BOY
EOY8513802EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY299074BOY
EOY307948EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY6971716BOY
EOY6700107EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY30464BOY
EOY33537EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
EOY526509EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY32684BOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY7333938BOY
EOY7568101EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1322211BOY
EOY945701EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1322211BOY
EOY945701EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8656149BOY
EOY8513802EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses23490ReconcilationRevenueExpenses
Reconcilation Other Changes-400000ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years21318CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years16185CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8891CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6359CurrentTaxYearMinus1Year
Current Tax Year1450CurrentTaxYear
Total54203Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4194721CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4156315CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4535723CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4808733CurrentTaxYearMinus1Year
Current Tax Year4667586CurrentTaxYear
Total22363078Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4216039CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4172500CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4544614CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4815092CurrentTaxYearMinus1Year
Current Tax Year4669036CurrentTaxYear
Total22417281Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1003639CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years811708CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years828005CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year758038CurrentTaxYearMinus1Year
Current Tax Year793156CurrentTaxYear
Total4194546Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1003639CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years811708CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years828005CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year758038CurrentTaxYearMinus1Year
Current Tax Year793156CurrentTaxYear
Total4194546Total
FieldValueIRS element (for citing)
Public Support Total50918222735PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year22CurrentTaxYearMinus1Year
Current Tax Year75CurrentTaxYear
Total97Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year22CurrentTaxYearMinus1Year
Current Tax Year75CurrentTaxYear
Total97Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Current Tax Year5658CurrentTaxYear
Total5658Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4216039CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4172500CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years4544614CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4815114CurrentTaxYearMinus1Year
Current Tax Year4674769CurrentTaxYear
Total22423036Total
FieldValueIRS element (for citing)
Public Support Percentage5090.81270PublicSupportPercentage509
Prior Year Support Percentage0.81900PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee EtctrueAgentTrusteeEtc
Beginning Balance30464BeginningBalance
Additions During Year21614AdditionsDuringYear
Distributions During Year18541DistributionsDuringYear
Ending Balance33537EndingBalance
Included On FStrueIncludedOnFS
Explanation In Part XIIIXExplanationInPartXIII

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis144534OtherCostOrOtherBasis
Book Value144534BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8851711OtherCostOrOtherBasis
Depreciation1757551Depreciation
Book Value7094160BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis536555OtherCostOrOtherBasis
Depreciation357455Depreciation
Book Value179100BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis112082OtherCostOrOtherBasis
Depreciation51309Depreciation
Book Value60773BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings7478567TotalOfBookValueLandBuildings

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
EXPLANATION FOR UNREPORTED CONTRIBUTIONS OR ASSETSSCHEDULE D, PAGE 2, PART IV, LINE 1BTHE ORGANIZATION ACTED AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS.
ESCROW LIABILITY ARRANGEMENT EXPLANATIONSCHEDULE D, PAGE 2, PART IV, LINE 2BTHE ORGANIZATION ACTED AS A CUSTODIAN FOR THE FUNDS OF THE RESIDENTS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSCHOLARSHIPTypeOfGrant
Number Of Recipients3NumberOfRecipients
Amount Of Cash Grant8785AmountOfCashGrant

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonLUVERNE HOFFMANNamePerson
TitlePRESCEOTitle
Comp Based On Related Orgs352011CompBasedOnRelatedOrgs
Deferred Comp Related Orgs27716DeferredCompRelatedOrgs
Nontaxable Benefits Related Orgs17000NontaxableBenefitsRelatedOrgs
Total Compensation Related Orgs396727TotalCompensationRelatedOrgs

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdBusiness Name Line2IssuerName/BusinessNameLine2Issuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
MINNWEST BANK
AREV NOTE 2009B4160050152009-12-105165000REFINANCING TAXABLEfalsefalsefalse
MINNWEST BANK
BREV NOTE 2009B4160050152009-12-102445000REFINANCING TAXABLEfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
Afalsefalsefalsefalse
Bfalsefalsefalsefalse

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
Afalsefalsefalsefalsefalsefalsefalsefalse
Bfalsefalsefalsefalsefalsefalsefalsefalse

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
Afalsefalsefalsefalsefalsefalsefalsefalsefalse
Bfalsefalsefalsefalsefalsefalsefalsefalsefalse

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective ActionfalseProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierPURPOSE OF ISSUE DESCRIPTIONIdentifier
Return ReferenceSCHEDULE KReturnReference
ExplanationMINNWEST BANK INDEBTEDNESS INCURRED TO FINANCE A ACQUISITION OF RHS B CAPITAL IMPROVEMENTS TO RHS AND C CONSTRUCTION OF A 24BED ATRIUM ADDITION TO RHS AND RELATED REMODELING AND SITE IMPROVEMENTS MINNWEST BANK INDEBTEDNESS INCURRED TO FINANCE A ACQUISITION OF RHS B CAPITAL IMPROVEMENTS TO RHS AND C CONSTRUCTION OF A 24BED ATRIUM ADDITION TO RHS AND RELATED REMODELING AND SITE IMPROVEMENTSExplanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (10 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
MARK HOFFMAN
SON OF45483EMPLOYED INfalse
(no name)
LUVERNE HOFFMANMAINTENANCEfalse
(no name)
PRES & CEOfalse
ELIZABETH LETICH
DAUGHTER OF77642EMPLOYED AS ANfalse
(no name)
CAROL RAW, VPADMINISTRATORfalse
ANDREW RAW
SON OF32010EMPLOYED INfalse
(no name)
CAROL RAW, VPMAINTENANCEfalse
DAWN BJORGE
WIFE OF DENNIS71331EMPLOYED AS RN/PDfalse
(no name)
LINDOR, VP OFfalse
(no name)
BEHAV. SVCfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE L PART VReturnReference
ExplanationDURING THE YEAR THE ORGANIZATION MAY EMPLOY INDIVIDUALS WHO MAY BE RELATED TO AN OFFICER DIRECTOR TRUSTEE OR KEY EMPLOYEE PAYMENTS FOR SERVICES WOULD BE MADE ACCORDING TO EMPLOYMENT POLICY AND DONE AT ARMS LENGTH DUE TO THE RURAL LOCATION OF THE ORGANIZATION AND THE NEED TO FIND QUALIFIED STAFF THESE EMPLOYEMENT RELATIONSHIPS WOULD BE NECESSARY TO FURTHER THE ORGANIZATIONS EXEMPT PURPOSEExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONWE ARE COMMITTED TO EXPRESS CHRIST'S MESSAGE OF LOVE AND HOPE BY PROVIDING FOR HEALTH, RESIDENTIAL, COMMUNITY, AND ALLIED SERVICES IN A HOLISTIC, COMPETENT, AND CARING MANNER THAT RECOGNIZES THE VALUE AND DIGNITY IN EVERY HUMAN LIFE. ST FRANCIS HEALTH SERVICES CONTROLS AND OPERATES RENVILLE HEALTH SERVICES AND IS SPONSORED BY THE CATHOLIC DIOCESE OF ST CLOUD. WE ARE DEDICATED TO PROMOTING THE ETHICAL AND RELIGIOUS DIRECTIVE FOR CATHOLIC HEALTH CARE SERVICES.
FIRST ACCOMPLISHMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4ATHE ORGANIZATION EMPLOYED ABOUT 66 FULL TIME EQUIVALENT EMPLOYEES AND GROSS WAGES PAID OUT WERE MORE THAN 1.8 MILLION DOLLARS. THIS WAS ALL PROVIDED IN AN AREA WHERE MEDICAL AND EMPLOYMENT OPPORTUNITIES ARE LIMITED.
ALL OTHER ACCOMPLISHMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4DMANAGEMENT SERVICES PROVIDED TO RELATED ORGANIZATIONS IN SUPPORT OF EACH ORGANIZATION'S EXEMPT PURPOSE.
MANAGEMENT DELEGATEDFORM 990, PAGE 6, PART VI, LINE 3ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION WITH COMMON CONTROL) MANAGES THE FACILITY.
CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PAGE 6, PART VI, LINE 6THE ORGANIZATION IS ORGANIZED WITH MEMBERS. THE MEMBERS OF THE CORPORATION SHALL CONSIST OF THE BOARD OF DIRECTORS OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE CFO OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC REVIEWS THE TAX RETURN AS PART OF THE MANAGEMENT SERVICES.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CANNUALLY THE ORGANIZATION CONDUCTS IN-SERVICE TRAINING REVIEWING THE POLICY ON CONFLICTS OF INTEREST AND REQUIRES THE BOARD MEMBERS, MANAGEMENT STAFF, AND KEY EMPLOYEES TO DISCLOSE CONFLICTS.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE CEO AND OFFICERS ARE EMPLOYEES OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION AND UNDER COMMON CONTROL). THE COMPENSATION PROCESS FOR THE CEO - ANNUALLY THE HR DIRECTOR SUBMITS THE CEO'S JOB DESCRIPTION, PERFORMANCE EVALUATION FORM, ST. FRANCIS HEALTH SERVICES OF MORRIS, INC'S PAY GRADE SCHEDULE AND COMPARABLE WAGE SURVEY(S) TO THE CHAIRMAN OF THE BOARD. THE CHAIRMAN AND THE EVALUATION COMMITTEE OF THE BOARD REVIEWS THE PERFORMANCE AND DETERMINES THE SALARY OF THE CEO.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE CEO AND OFFICERS ARE EMPLOYEES OF ST. FRANCIS HEALTH SERVICES OF MORRIS, INC (A RELATED ORGANIZATION AND UNDER COMMON CONTROL). THE COMPENSATION PROCESS FOR OFFICERS - CEO AND THE HR DIRECTOR REVIEWS COMPARABLE WAGE SURVEY INFORMATION, REVIEWS PERFORMANCE (WITH INPUT FROM THE VP, IF APPROPRIATE) AND DETERMINES SALARY.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON AN AS REQUESTED BASIS
RELATED ORGANIZATIONSFORM 990, PAGE 7, PART VIIST. FRANCIS HEALTH SERVICES OF MORRIS, INC HAS A MANAGEMENT AGREEMENT WITH THE RELATED ENTITY.
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 9INTERCOMPANY TRANSFER 400,000

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (12 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
AITKIN HEALTH SERVICES
301 MINNESOTA AVENUEAITKINMN56431203367397CAREGIVERMN501C39SFHSfalse
BROWNS VALLEY HEALTH CENTER
RR 1 BOX 182D SOUTH JEFFERSONBROWNS VALLEYMN56219411668347CAREGIVERMN501C39SFHSfalse
FRANCISCAN HEALTH CENTER
3910 MINNESOTA AVENUEDULUTHMN55802411799268CAREGIVERMN501C39SFHSfalse
FARMINGTON HEALTH SERVICES
3410 23RD STREET WFARMINGTONMN55024200100365CAREGIVERMN501C39SFHSfalse
GUARDIAN ANGELS HEALTH & REHAB CENT
1500 3RD AVENUE EHIBBINGMN55746411810369CAREGIVERMN501C39SFHSfalse
PRAIRIE COMMUNITY SERVICES
801 NEVADA AVENUEMORRISMN56267411598442CAREGIVERMN501C39SFHSfalse
PENNINGTON HEALTH SERVICES
130 LABREE AVENUE STHIEF RIVER FALLSMN56701205617275CAREGIVERMN501C39SFHSfalse
ST FRANCIS HEALTH SERVICES (SFHS)
801 NEVADA AVENUEMORRISMN56267411484416MGMT COMPMN501C39falseN/A
WEST WIND VILLAGE
1001 SCOTT AVENUEMORRISMN56267237625632CAREGIVERMN501C39SFHSfalse
ZUMBROTA HEALTH SERVICES
433 MILL STREETZUMBROTAMN55992510487275CAREGIVERMN501C39SFHSfalse
CHISHOLM HEALTH CENTER
321 NE 8TH STREETCHISHOLMMN55719411879639CAREGIVERMN501C39SFHSfalse
VIEWCREST HEALTH CENTER
3111 CHRUCH PLACEDULUTHMN55811411843283CAREGIVERMN501C39SFHSfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
ST FRANCIS HEALTH SERVICES OF MORR
M243600AMOUNT PAID OR ACCRUED
ST FRANCIS HEALTH SERVICES OF MORR
R400000AMOUNT PAID OR ACCRUED
ST FRANCIS HEALTH SERVICES OF MORR
E545000AMOUNT PAID OR ACCRUED

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE RReturnReference
ExplanationST FRANCIS HEALTH SERVICES OF MORRIS INC HAS GUARANTEED LOANS OF 6700107 AS SHOWN IN FORM 990 PART X LINE 20 AND THERE WERE NO NEW LOAN GUARANTEES DURING THIS FISCAL YEAR THE ORGANIZATION ALSO HAS INTERCOMPANY LOAN PAYABLE TO ST FRANCIS HEALTH SERVICES OF MORRIS INC OF 526509 AS SHOWN ON 990 PART X LINE 24 THE ORGANIZATION HAS PAID 14758 TO ST FRANCIS HEALTH SERVICES OF MORRIS INCExplanation