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MeritCare Health Enterprises Inc: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MeritCare Health Enterprises Inc (EIN 45-0359785)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201201369349301260
Schema version
2010v3.4
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)
Timestamp2012-05-15T08:38:00-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

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 Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN450359785EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MeritCare Health Enterprises IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMERINameControl
Phone7012342000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 2010AddressLine1
CityFargoCity
StateNDState
ZIP Code58122ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLisa M CarlsonName
TitleCFOTitle
Phone7012344811Phone
Date Signed2012-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKristina RasmussenName
Phone6123974000Phone
Date Prepared2012-05-11DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11305 W 18th StreetAddressLine1
CitySioux FallsCity
StateSDState
ZIP Code57117ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14838757GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.sanfordhealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1980YearFormation
State Legal DomicileNDStateLegalDomicile
Activity Or Mission DescriptionDedicated to the work of Health and Healing.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees54TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI551818TotalGrossUBI
Net Unrelated Business Txbl Income53532NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year12783103ProgramServiceRevenuePriorYear
Program Service Revenue CY14838757ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year12783103TotalRevenuePriorYear
Total Revenue Current Year14838757TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1599652SalariesEtcPriorYear
Salaries Etc Current Year1733365SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9876049OtherExpensePriorYear
Other Expenses Current Year11455771OtherExpensesCurrentYear
Total Expenses Prior Year11475701TotalExpensesPriorYear
Total Expenses Current Year13189136TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1307402RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1649621RevenuesLessExpensesCY
Total Assets BOY2668430TotalAssetsBOY
Total Assets EOY4343788TotalAssetsEOY
Total Liabilities BOY400871TotalLiabilitiesBOY
Total Liabilities EOY528092TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2267559NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3815696NetAssetsOrFundBalancesEOY
Mission DescriptionThe mission of Sanford "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 the organization's plans, decisions and actions.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense13189136Expense
Revenue14838757Revenue
DescriptionAs part of the Sanford delivery system, MeritCare Health Enterprises supports the other affiliates through the operation of pharmacies for the benefit of patients and employees of Sanford Medical Center Fargo and Sanford Clinic North. The provision of these items to patients aids in the overall promotion of health in the community.Description
Total Program Service Expense13189136TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
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 Invest1ReportProgRelInvest
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 Entity1TransactionRelatedEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees54NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
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 Body0Form990ProvidedToGoverningBody
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 Line1Doug OklandBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7012342000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 2010AddressLine1
CityFargoCity
StateNDState
ZIP Code58122ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (42 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Ann Christenson
Trustee0.50X000
Barb Everist
Trustee0.50X000
Barbara Stork
Trustee0.50X000
Barry Martin
Trustee0.50X000
Brent Teiken
Trustee0.50X000
David Beito
Trustee0.50X000
Don Morton
Trustee0.50X000
Jerome Feder
Trustee0.50X000
Jim Entenman
Trustee0.50X000
John C Vanderwoude
Trustee60.00X0118456030701
John Jambois
Trustee0.50X000
Lauris Molbert
Trustee0.50X000
Mark Paulson MD
Trustee60.00X022003646521
Michael L Olson
Trustee60.00X05184556998
Michael L Olson Deferred Comp
Trustee60.00X0046935
Mikal Claar
Trustee0.50X000
Pamela Anderson
Trustee0.50X000
Richard D Hardie
Trustee60.00X044443418343
Ronald Moquist
Trustee0.50X000
Terrence Grimm MD
Trustee60.00X058588742328
Terry Baloun
Trustee0.50X000
Kelby K Krabbenhoft
Sanford Health President & CEO60.00X0127451419513X
Kelby K Krabbenhoft Deferred Comp
Sanford Health President & CEO60.00X00565838X
Lisa Carlson
Chief Financial Officer Corp60.00041811251907X
Douglas Okland
CFO - Sanford Clinic60.00017759032160X
Ellen Cooke
COO - Sanford Clinic60.00023156534031X
Linda O'Halloran
Senior Vice President60.00034152138178X
Michael Gibbs
Senior Vice President60.00030831038810X
Robert Biberdorf
Executive Partner60.00017256323488X
Tammie Dohman
Pharmacy Coordinator60.0012702609701X
Mark Plencner
Pharmacy Coordinator60.00115783010165X
Harrison Storandt
Pharmacist60.00109657012676X
LeAnn Ness
Pharmacist60.0010347108134X
Roger Gilbertson MD
Former President60.0005491170X
Roger Lee
Former Treasurer60.00015519421659X
Paul Richard
Former Executive VP60.00039592641452X
Bruce Pitts MD
Former Executive VP60.00055764740890X
Gregory Post MD
Former SR Vice President60.00043136841890X
Rhonda Ketterling MD
Former SR Vice President60.00035795737740X
Jeffrey Hoss
Former SR Vice President60.00028175141878X
Evelyn Quigley
Former SR Vice President60.00020734235995X
Douglas Vang
Former SR Vice President60.0007608034058X
FieldValueIRS element (for citing)
Total Reportable Comp From Org455937TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs9574652TotalReportableCompFrmRltdOrgs
Total Other Compensation1301989TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Pharmacy Sales4461101473040414178586551818
East Ottertail Pharmac446110108353108353
FieldValueIRS element (for citing)
Total Program Service Revenue14838757TotalProgramServiceRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14838757TotalRevenueColumn
Related Or Exempt Function Income14286939RelatedOrExemptFunctionIncome
Unrelated Business Revenue551818UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1198725Total
Program Services1198725ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total127452Total
Program Services127452ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total295757Total
Program Services295757ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total111431Total
Program Services111431ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total41824Total
Program Services41824ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total637Total
Program Services637ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total239068Total
Program Services239068ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total85329Total
Program Services85329ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total5103Total
Program Services5103ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11239Total
Program Services11239ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Medical Supplies1104515311045153
Miscellaneous Expenses1634616346
Bad Debt1107211072

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13189136Total
Program Services13189136ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY17279BOY
EOY6883EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY968565BOY
EOY2371670EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1232031BOY
EOY1449705EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY391BOY
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis281926LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec230623LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY56790BOY
EOY51303EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY393374BOY
EOY464227EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2668430BOY
EOY4343788EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY400871BOY
EOY528092EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY400871BOY
EOY528092EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2267559BOY
EOY3815696EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2267559BOY
EOY3815696EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2668430BOY
EOY4343788EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses1649621ReconcilationRevenueExpenses
Reconcilation Other Changes-101484ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis281926OtherCostOrOtherBasis
Depreciation230623Depreciation
Book Value51303BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings51303TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionInvestment in East Ottertail PharmacyDescription
Book Value464227BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related464227TotalOfBookValueProgramRelated

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X: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. MeritCare Health Enterprises, Inc did not have a material income tax liability at June 30, 2011; some related organizations have established reserves.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement1EquityBasedCompArrangement
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 Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (23 entries)

Base 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
John C Vanderwoude
01000000000184560073500233510121526100
Mark Paulson MD
019643200023604031527014994026655700
Michael L Olson
0504486000139690006998052545300
Michael L Olson Deferred Comp
0000000469350004693500
Richard D Hardie
04144730002996107350010993046277700
Terrence Grimm MD
05000040008588303492807400062821500
Kelby K Krabbenhoft
0789232000485282000195130129402700
Kelby K Krabbenhoft Deferred Comp
000000056583800056583800
Lisa Carlson
033581100082301034928016979047001900
Douglas Okland
0167951000963902519906962020975100
Ellen Cooke
02034850002808003295101080026559600
Linda O'Halloran
02993790004214203492803250037969900
Michael Gibbs
02730000003531003492803882034712000
Robert Biberdorf
0154817000177460228080680019605100
Roger Gilbertson MD
000005491170000054911700
Roger Lee
01410700001412402025301406017685300
Paul Richard
03144180008150803492806524043737800
Bruce Pitts MD
04579140009973303492805962059853700
Gregory Post MD
0431368000003492806962047325800
Rhonda Ketterling MD
03147020004325503492802812039569700
Jeffrey Hoss
02600000002175103492806950032362900
Evelyn Quigley
01818190002552302903306962024333700
Douglas Vang
071916700041636055203506076486100

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 1aOn Part I, Questions Regarding Compensation, Sanford checked several of the items as provided to listed persons: First Class or Charter Travel - Charter travel for business purposes is provided for individuals as needed and as cost appropriate. These costs are not included in the W-2's of the individuals as they meet the business purpose of Sanford. Travel for Companions - Limited travel for companions is required for certain annual meetings. These costs are not included in the W-2's of the individuals as they are incurred for business purposes of Sanford. Tax Indemnification and gross-up payments - Certain compensation may be grossed up to include appropriate tax amounts. Health or social club dues or initiation fees - All Sanford employees are eligible for discounted wellness memberships, a portion of these discounts and other club dues are included as fringe benefits, and taxed as such. Personal services - Individuals may have benefits which include tax preparation or planning, this benefit is included in income and taxed. Part I, Line 3: The Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm to annually review the total compensation of arrangements of the officers of the organization, and to report findings and recommendations to the Sanford Board of Trustees for deliberation and action. The most recent study was completed in 2011.
Part I, Lines 4a-cPart I, Lines 4a-c: Roger Gilbertson, former MeritCare President and CEO, received a payment of $549,117 upon his retirement, per employment contract. Douglas Vang received a severance payment of $478,906. Part 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 $420,519 Part I, Line 6b: Sanford physicians are compensated based on the professional services they perform within the clinic in which they provide care. Generally, the model is revenue less expenses. Physicians listed that were paid on this model include: Michael L Olson Richard Hardie Part I, Line 7: Certain Executives are eligible for a discretionary incentive bonus, based on financial targets and other goals.
Part IIICompensation reported on Schedule J 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. It also includes the one-time payout of previously deferred compensation (which was also reported as compensation in the earned period). To be in compliance with the IRS regulatory environment, listed individuals compensation includes a one-time payment of deferred compensation; this compensation was earned over multiple periods, and should be treated as earned over that length of time in exchange for services provided. (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.Supplemental Information
Part IIIA memo regarding executive compensation, written by the Chairman of the Sanford Board of Trustees, is on file and available upon request.Supplemental Information
Part IIICompensation 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 $1,274,514 is comprised of Base salary of $789,232, and Other Taxable Earnings of $485,282. In addition, an amount of $565,838 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.Supplemental Information

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 2Pamela Anderson, Trustee, and Lisa Carlson, CFO, have a business relationship. The 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: John Vanderwoude Mark Paulson Michael Olson Richard Hardie Terrence Grimm Kelby Krabbenhoft Lisa Carlson Douglas Okland Ellen Cooke Linda O'Halloran Michael Gibbs
Form 990, Part VI, Section A, line 6Sanford North is the sole shareholder of the organization.
Form 990, Part VI, Section A, line 7aBoard members are members of the Board of Governors of Sanford North.
Form 990, Part VI, Section A, line 7bSanford North, as sole shareholder, reviews the actions of MeritCare Health Enterprises, Inc.
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 immediately following the return filing date. After the return is filed, a complete copy is made available to the current trustees.
The 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 of subsidiary entities, officers, and key employees for all the 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 such.Form 990, Part VI, Section B, line 12c
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 operating unit executives of the organization, including the CEO, and to report the findings and recommendations 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 2011. 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 physician total compensation arrangements was completed in 2009.Form 990, Part VI, Section B, line 15
Although 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 VI, Section C, line 19
Board members of Sanford provide services to Sanford subsidiaries. Hours reported for each individual reflect the time spent on work related to either the filing organization or related organization. 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
Changes in Net Assets or Fund Balances:Net Asset Transfers (AP Intercompany) -101,484. Total to Form 990, Part XI, Line 5: -101,484.Form 990, Part XI, line 5:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (25 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Sanford Health
1305 West 18th StreetSioux FallsSD57117311527032Supporting OrganizationSD501(c)(3)11-IIISanford0
Sanford Health Foundation
1305 West 18th StreetSioux FallsSD57117363297853Supporting OrganizationSD501(c)(3)11-ISanford Health1
Sanford
801 Broadway DriveFargoND58122271218956Supporting OrganizationND501(c)(3)11-II0
SHM-Sanford
1305 West 18th StreetSioux FallsSD57105271213769Supporting OrganizationSD501(c)(3)11-II0
SHM-MeritCare
801 Broadway DriveFargoND58122271213717Supporting OrganizationND501(c)(3)11-II0
Sanford North
PO Box 2010FargoND58122450385890Supporting OrganizationND501(c)(3)11-IISanford0
Sanford Medical Center Fargo
PO Box 2010FargoND58122450226909HospitalND501(c)(3)3Sanford North1
Sanford Clinic North
PO Box 2010FargoND58122911770748ClinicsND501(c)(3)9Sanford North1
Sanford Health Network North
PO Box 2010FargoND58122450409348Hospitals/ClinicsND501(c)(3)11-IISanford North1
Sanford Medical Center Wheaton
401 12th Street NorthWheatonMN56296272042143Hospital/ClinicMN501(c)(3)3Sanford North1
Sanford Health Foundation North
PO Box 2010FargoND58122450398104Supporting OrganizationND501(c)(3)7Sanford North1
Sanford Medical Center Thief River Falls
120 Labree Ave SThief River FallsMN56701410709579HospitalMN501(c)(3)3Sanford North1
Sanford Medical Center Mayville
42 6th Ave SEMayvilleND58257450228899HospitalND501(c)(3)3Sanford North1
MeritCare Minnesota
1720 South Highway 59Thief River FallsMN56701261530302Promotion of healthMN501(c)(3)3Sanford North1
Agassiz Assurance Company
100 Bankd Street Suite 610BurlingtonVT05401743121855InsuranceVT501(c)(3)11-IISanford North1
FM Ambulance Service
2215 18th St SouthFargoND58103450344371EMTND501(c)(4)Sanford North1
Sanford Health of Northern Minnesota
1300 Anne St NWBemidjiMN56601411266009HospitalMN501(c)(3)3Sanford North1
Baker Park Inc
803 Dewey Ave NWBemidjiMN56601411372480Low Income Senior HousingMN501(c)(3)9Sanford Health of Northern Minnesota1
Sanford Health Foundation of Northern Minnesota
1300 Anne St NWBemidjiMN56601411389317Fundraising - SupportMN501(c)(3)11-ISanford Health of Northern Minnesota1
North Country Medical Clinic
1300 Anne St NWBemidjiMN56601411753855Family Practice Medical ClinicMN501(c)(3)3Sanford Health of Northern Minnesota1
Sanford ResearchUSD
1305 West 18th St PO Box 5039Sioux FallsSD571175039460450378ResearchSD501(c)(3)3Sanford Health1
Sanford USD Medical Center
1305 West 18th St PO Box 5039Sioux FallsSD571175039460227855HospitalSD501(c)(3)3Sanford Health1
Sanford Clinic
1305 West 18th St PO Box 5039Sioux FallsSD571175039460447693Clinical ServicesSD501(c)(3)3Sanford Health1
Sanford Health Network
1305 West 18th St PO Box 5039Sioux FallsSD571175039460388596Hospitals/ClinicsSD501(c)(3)11-ISanford Health1
Sanford Home Health
1305 West 18th St PO Box 5039Sioux FallsSD571175039460282134Home Health ServicesSD501(c)(3)9Sanford Health1

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
National Student Housing - South Dakota LLC
100 S Phillips AveSioux FallsSD57104202129839InvestmentSDSandford HealthRelated000.00000
RAC Rentals LLC
100 S Phillips AveSioux FallsSD57104261961077InvestmentSDSandford HealthRelated000.00000

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
Heart Partners at Sanford
1305 W 18th StreetSioux FallsSD57117460449572HealthcareSDSanford HealthC
Sanford Home Medical Equipment Inc
2710 W 12th StreetSioux FallsSD57105460388597Healthcare EquipmentSDSanford HealthC
Sanford Health Plan
300 Cherapa PlaceSioux FallsSD57103911842494InsuranceSDSanford HealthC
Sanford Health Plan of MN
300 Cherapa PlaceSioux FallsSD57103460445852InsuranceMNSanford HealthC
Healthcare Environmental Services Inc
1420 40th St NWFargoND58102450336598Laundry and Incineration ServicesNDSanford NorthC
Bemidji Medical Equipment Inc
1300 Anne St NWBemidjiMN56601411551725Retail Sales of DMEMNSanford Health of Northern MinnesotaC
North Country Management Inc
1300 Anne St NWBemidjiMN56601411820025Management ServicesMNSanford Health of Northern MinnesotaC
Sanford World Clinics
1305 West 18th StreetSioux FallsSD57117262707628HealthcareSDSanford HealthC
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
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 Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Sanford Medical Center FargoBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeMTransactionType
Amount Involved85000AmountInvolved
Method Of Amt DeterminationCostMethodOfAmtDetermination