ALLINA MEDICAL CLINIC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ALLINA MEDICAL CLINIC (EIN 41-1781624)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-12
- IRS object ID
- 201213179349301851
- Schema version
- 2011v1.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-12T11:34:58-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411781624 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLINA MEDICAL CLINIC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ALLI | NameControl |
| Phone | 6122620660 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 43 INTERNAL ZIP 10890 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554400043 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LAURIE M LAFONTAINE | Name |
| Title | VP - FINANCE AND TREASURY | Title |
| Phone | 6122625000 | Phone |
| Date Signed | 2012-11-12 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Terminated Return | X | TerminatedReturn |
| Name Of Principal Officer Person | ROBERT WIELAND | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 43 INTERNAL ZIP 10890 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554400043 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 486405008 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ALLINAMEDICALCLINIC.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | THE ALLINA MEDICAL CLINIC (AMC) IS A WHOLLY OWNED SUBSIDIARY OF ALLINA HEALTH SYSTEM. ALLINA HEALTH SYSTEM (ALLINA) TOGETHER WITH ITS SUBSIDIARIES IS DEDICATED TO MEETING THE LIFELONG HEALTHCARE NEEDS OF COMMUNITIES THROUGHOUT MINNESOTA AND WESTERN WISCONSIN. AMC IS A MULTI-SPECIALTY GROUP PRACTICE THAT OWNS AND OPERATES 42 PHYSICIAN CLINICS EMPLOYING OVER 700 PROVIDERS WITH OVER 2,600,000 PATIENT VISITS ANNUALLY. ALLINA AND ITS SUBSIDIARIES PROVIDE A FULL RANGE OF PRIMARY AND SPECIALTY HEALTH CARE SERVICES INCLUDING TECHNICALLY ADVANCED INPATIENT AND OUTPATIENT CARE, 24-HOUR EMERGENCY CARE, MEDICAL TRANSPORTATION, PHARMACY, LABORATORY, HOME CARE AND HOSPICE SERVICES. BECAUSE OF ITS CHARITABLE MISSION, ALLINA AND ITS SUBSIDIARIES PROVIDE THESE HEALTH CARE SERVICES AS WELL AS EDUCATIONAL AND WELLNESS PROGRAMS TO COMMUNITY MEMBERS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. | ActivityOrMissionDescription |
| Termination Or Contraction | X | TerminationOrContraction |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 6 | TotalNbrVolunteers |
| Total Gross UBI | 351738 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 53810 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 4694845 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 14899172 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 448831934 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 459839257 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 200833 | InvestmentIncomePriorYear |
| Investment Income Current Year | 191165 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4990463 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4481647 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 458718075 | TotalRevenuePriorYear |
| Total Revenue Current Year | 479411241 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 23900 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 130086 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 302771904 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 320354992 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 155922271 | OtherExpensePriorYear |
| Other Expenses Current Year | 158926163 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 458718075 | TotalExpensesPriorYear |
| Total Expenses Current Year | 479411241 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 0 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 0 | RevenuesLessExpensesCY |
| Total Assets BOY | 181913985 | TotalAssetsBOY |
| Total Assets EOY | 0 | TotalAssetsEOY |
| Total Liabilities BOY | 134310044 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 47603941 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 0 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | OUR MISSIONWE SERVE OUR COMMUNITIES BY PROVIDING EXCEPTIONAL CARE, AS WE PREVENT ILLNESS,RESTORE HEALTH AND PROVIDE COMFORT TO ALL WHO ENTRUST US WITH THEIR CARE.OUR VISION WE WILL: PUT THE PATIENT FIRST; MAKE A DIFFERENCE IN PEOPLE'S LIVES BY PROVIDING EXCEPTIONAL CARE AND SERVICE; CREATE A HEALING ENVIRONMENT WHERE PASSIONATE PEOPLE THRIVE AND EXCEL; AND LEAD COLLABORATIVE EFFORTS THAT SOLVE OUR COMMUNITY'S HEALTH CARE CHALLENGES.OUR VALUESINTEGRITY, RESPECT, TRUST, COMPASSION, AND STEWARDSHIP | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 1 | SignificantChange |
| Expense | 368183011 | Expense |
| Grants | 130087 | Grants |
| Revenue | 463972823 | Revenue |
| Description | COST OF PROVIDING MEDICAL SERVICES:ALLINA IS COMMITTED TO THE COMMUNITIES IT SERVES AND REFLECTS ITS COMMITMENT BY SERVING AS A CHARITABLE HEALTH RESOURCE. TO THIS END, ALLINA AND THE ALLINA MEDICAL CLINIC (AMC) PROVIDE AND ADVOCATE FOR HIGH-QUALITY, EFFICIENT, AFFORDABLE HEALTH CARE SERVICES AND RELATED EDUCATIONAL AND RESEARCH PROGRAMS TO IMPROVE THE HEALTH STATUS OF PATIENTS AND COMMUNITIES IT SERVES.AS THE PHYSICIAN COMPONENT OF AN INTEGRATED DELIVERY SYSTEM, THE AMC IS RESPONSIBLE FOR DEVELOPING THE PRIMARY CARE SYSTEM FOR THE ALLINA HEALTH SYSTEM IN ORDER TO IMPROVE THE HEALTH OUTCOMES IN THE COMMUNITIES THAT IT SERVES. IT SEEKS TO DEVELOP INNOVATIVE METHODS OF HEALTH CARE DELIVERY AND QUALITY IMPROVEMENT.THE AMC PROVIDES PRIMARY HEALTH CARE SERVICES, WHICH ARE NEEDED TO MEET THE HEALTH CARE NEEDS OF THE COMMUNITIES THAT IT SERVES, WITHOUT FULL REIMBURSEMENT FOR THESE SERVICES.MANY OF THE AMC CLINICS SERVE POPULATIONS WITH SPECIAL AND UNIQUE MEDICAL NEEDS. SOME ARE LOCATED IN AREAS THAT HAVE BEEN DESIGNATED AS HEALTH MANPOWER SHORTAGE AREAS. OTHERS ARE LOCATED IN AND SERVE INNER-CITY POPULATIONS. OTHERS SERVE LARGE NATIVE AMERICAN POPULATIONS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 32469400 | Expense |
| Description | COST OF PARTICIPATING IN GOVERNMENT PROGRAMS:THE AMC IS COMMITTED TO SERVING ALL PERSONS IN NEED, REGARDLESS OF RACE, CREED, SEX, NATIONALITY, RELIGION, DISABILITY, AGE, OR ABILITY TO PAY. TO PROMOTE ACCESS TO CARE FOR ALL INDIVIDUALS, AMC PARTICIPATES IN THE FOLLOWING PUBLIC HEALTH CARE PROGRAMS: MEDICARE, MEDICAID, MINNESOTACARE, AND GENERAL ASSISTANCE. PAYMENTS FROM THESE PROGRAMS FREQUENTLY DO NOT COVER THE COSTS AMC INCURS TO SERVE PROGRAM BENEFICIARIES. IN 2011, AMC PROVIDED $32,469,400 IN HEALTH CARE SERVICES IN EXCESS OF THE REIMBURSEMENT RECEIVED BY PUBLIC PROGRAMS, AND TAXES AND FEES RELATED TO THESE PROGRAMS. THE FOLLOWING IS A BREAKDOWN OF COSTS RELATED TO THESE PROGRAMS, SERVICES AND ADDITIONAL TAXES AND FEES.COSTS IN EXCESS OF MEDICARE AND MEDICAID PAYMENTSAMC PROVIDES SERVICES TO PUBLIC PROGRAM ENROLLEES. SUCH PUBLIC PROGRAMS HAVE REIMBURSED AT AMOUNTS LESS THAN AMC'S COST. IN 2011, AMC EXPENDED $16,780,552 BEYOND REIMBURSEMENTS TO PROVIDE CARE FOR MEDICARE PATIENTS AND AN ADDITIONAL $5,766,252 BEYOND REIMBURSEMENTS FOR MEDICAID PATIENTS. MINNESOTACARE TAXAMC ALSO PARTICIPATES IN THE FUNDING OF MEDICAL CARE FOR THE UNINSURED THROUGH A MINNESOTACARE TAX OF 2% ON CERTAIN NET REVENUE. PATIENTS WHO ARE UNABLE TO GET INSURANCE THROUGH THEIR EMPLOYER ARE ELIGIBLE TO PARTICIPATE IN MINNESOTACARE. AMC PAID $7,212,562 FOR THE MINNESOTACARE TAX IN 2011.TAXES AND FEESAMC PAYS PROPERTY TAXES TO LOCAL AND STATE GOVERNMENTS USED IN FUNDING CIVIL AND EDUCATION SERVICES TO THE COMMUNITY. IN TOTAL, AMC PAID $2,710,034 MILLION IN TAXES AND FEES IN 2011. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 20534574 | Expense |
| Description | UNCOMPENSATED CARE:CHARITY CAREAMC DEFINES CHARITY CARE AS CARE WHICH IS PROVIDED TO PERSONS WILLING, BUT UNABLE, TO PAY. THIS INCLUDES PATIENTS WHOSE CHARGES ARE REDUCED BECAUSE OF INABILITY TO PAY, PATIENTS WHO ARE UNABLE TO PAY THE BALANCE LEFT BY ANY PAYOR (PRIVATE INSURANCE OR PUBLIC PROGRAMS), AND PATIENTS FOR WHOM UNUSUAL CIRCUMSTANCES, OR SPECIAL FINANCIAL HARDSHIP WARRANT SPECIAL CONSIDERATION. THE AMC'S DEFINITION OF CHARITY CARE DOES NOT INCLUDE BAD DEBT (CHARGES WRITTEN OFF FOR PROVIDING SERVICES TO PERSONS ABLE, BUT UNWILLING, TO PAY FOR THESE SERVICES). PROVIDING CHARITY CARE ENSURES THAT ALL MEMBERS OF THE COMMUNITY RECEIVE QUALITY PRIMARY MEDICAL CARE WHEN THEY NEED IT REGARDLESS OF THEIR ABILITY TO PAY. IN 2011, AMC PROVIDED $7,918,675 IN CHARITY CARE.BAD DEBTAMC PROVIDES MEDICAL CARE TO ALL IN NEED. THERE ARE TIMES WHEN PATIENT ACCOUNT BALANCES GO UNPAID, KNOWN AS BAD DEBT. THESE BAD DEBT AMOUNTS IN 2011 TOTALED $12,590,808. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1089499 | Expense |
| Description | COMMUNITY SERVICES:INCLUDED IN THIS CATEGORY ARE THE SERVICES PROVIDED BY THE AMC TO RESPOND TO SPECIFIC COMMUNITY NEEDS. IN 2011, $1,089,499 WAS SPENT TO RESPOND TO THESE NEEDS. SERVICES PROVIDED THROUGH THE AMC, AT LOW OR NO COST, TO THESE INDIVIDUALS INCLUDE:-IMMUNIZATION CLINICS-MEDICAL DIRECTORS FOR CIVIC ORGANIZATIONS-BLOOD PRESSURE SCREENING CLINICS-HEALTH SERVICES TO GOVERNMENTAL AGENCIES (JAILS, PUBLIC HEALTH DEPARTMENTS, ETC.)-VIOLENCE AWARENESS INITIATIVES-ON-SITE PHYSICIAN SERVICES FOR SCHOOL EVENTS-HEALTH LECTURERS-TOBACCO CESSATION INITIATIVES | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 1089499 | TotalOfOtherProgramServiceExp |
| Total Program Service Expense | 422276484 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 1 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 187 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 16 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TAX SERVICES MAIL ROUTE 10890 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6122620660 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2925 CHICAGO AVENUE | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554071321 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (33 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| WILLIAM BEER | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| GARY BHOJWANI | |||||||||
| DIRECTOR | 2.00 | X | 0 | 2500 | 0 | ||||
| DAVID DURENBERGER | |||||||||
| DIRECTOR | 2.00 | X | 0 | 12500 | 0 | ||||
| NATE GARVIS | |||||||||
| DIRECTOR | 2.00 | X | 0 | 21700 | 0 | ||||
| JOSEPH GOSWITZ MD | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| SUBBARAO INAMPUDI MD | |||||||||
| DIRECTOR | 2.00 | X | 0 | 23175 | 0 | ||||
| MARK JORDAHL | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| REATHA CLARK KING PHD | |||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||||
| CHRISTINE MORRISON | |||||||||
| DIRECTOR/VICE CHAIR/CHAIR | 4.00 | X | 0 | 0 | 0 | ||||
| JEAN DELANEY NELSON | |||||||||
| DIRECTOR | 2.00 | X | 0 | 7000 | 0 | ||||
| HUGH NIERENGARTEN | |||||||||
| DIRECTOR | 2.00 | X | 0 | 14479 | 0 | ||||
| KENNETH PAULUS | |||||||||
| PRESIDENT/CEO AHS | 40.00 | X | 0 | 1522963 | 628189 | X | |||
| GLORIA PEREZ | |||||||||
| DIRECTOR | 2.00 | X | 0 | 15000 | 0 | ||||
| DEAN PHILLIPS | |||||||||
| DIRECTOR/CHAIR | 4.00 | X | 0 | 0 | 0 | ||||
| REBECCA ROLOFF | |||||||||
| DIRECTOR | 2.00 | X | 0 | 21000 | 0 | ||||
| MARK SHEFFERT | |||||||||
| DIRECTOR | 2.00 | X | 0 | 15000 | 0 | ||||
| MICHAEL TATTERSFIELD | |||||||||
| DIRECTOR | 2.00 | X | 0 | 15000 | 0 | ||||
| JOAN THOMPSON | |||||||||
| DIRECTOR | 2.00 | X | 0 | 22000 | 0 | ||||
| RODNEY YOUNG | |||||||||
| DIRECTOR | 2.00 | X | 0 | 22000 | 0 | ||||
| DUNCAN GALLAGHER | |||||||||
| EVP/CFO, AHS | 40.00 | 0 | 819373 | 245331 | X | ||||
| LAURIE LAFONTAINE | |||||||||
| VP, FINANCE/TREASURY, AHS | 40.00 | 0 | 415523 | 96778 | X | ||||
| MICHAEL MARSHALL MD | |||||||||
| SVP/PRES ALLINA MED CL | 40.00 | 32468 | 0 | 600 | X | ||||
| ELIZABETH TRUESDELL SMITH | |||||||||
| SEC. GEN COUNS, AHS | 40.00 | 0 | 471504 | 158143 | X | ||||
| ROBERT WIELAND MD | |||||||||
| EVP - AMBULATORY CARE | 40.00 | 0 | 596528 | 255577 | X | ||||
| RODNEY CHRISTENSEN MD | |||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 383879 | 0 | 86112 | X | ||||
| CHERYL HERMANN | |||||||||
| VP OF OPERATIONS | 40.00 | 336902 | 0 | 59578 | X | ||||
| DEANN WAGNER | |||||||||
| VP FINANCE | 40.00 | 267678 | 0 | 50999 | X | ||||
| RICHARD BIRDWELL MD | |||||||||
| PHYSICIAN | 40.00 | 770307 | 0 | 72790 | X | ||||
| RANDALL CHADWICK JR MD | |||||||||
| PHYSICIAN | 40.00 | 996413 | 0 | 91547 | X | ||||
| DANA HARMS MD | |||||||||
| PHYSICIAN | 40.00 | 935461 | 0 | 83688 | X | ||||
| PAUL HAVEL MD | |||||||||
| PHYSICIAN | 40.00 | 786986 | 0 | 87822 | X | ||||
| JEFFREY NIPPER MD | |||||||||
| PHYSICIAN | 40.00 | 833797 | 0 | 24417 | X | ||||
| ANDREW PUGH | |||||||||
| FORMER VP LEGAL, AHS | 0.00 | 0 | 249196 | 29497 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 5343891 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4266441 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1971068 | TotalOtherCompensation |
| Number Individuals GT100 K | 704 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| KRAUS-ANDERSON CONSTRUCTION CO | |||||
| 525 SOUTH 8TH STREET | MINNEAPOLIS | MN | 55404 | CONSTRUCTION SERVICES | 5247588 |
| CONSULTING RADIOLOGISTS LTD | |||||
| 1221 NICOLLET MALL STE 600 | MINNEAPOLIS | MN | 55403 | PROFESSIONAL SERVICES - PHYSICIAN | 4221541 |
| JE DUNN CONSTRUCTION | |||||
| 9855 W 78TH STREET SUITE 270 | EDEN PRAIRIE | MN | 55344 | CONSTRUCTION SERVICES | 2927540 |
| RJM CONSTRUCTION LLC | |||||
| 7003 WEST LAKE STREET | ST LOUIS PARK | MN | 55426 | CONSTRUCTION SERVICES | 1647486 |
| SUBURBAN RADIOLOGIC CONSULTANTS LTD | |||||
| 4801 WEST 81ST STREET SUITE 108 | BLOOMINGTON | MN | 55437 | PROFESSIONAL SERVICES - MEDICAL | 1605794 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 41 | NumberOfContractorsGT100K |
| Related Organizations | 14612902 | RelatedOrganizations |
| Government Grants | 286270 | GovernmentGrants |
| Total Contributions | 14899172 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PROG.SERV.REVENUE-RELA | Description |
| Business Code | 621990 | BusinessCode |
| Total Revenue Column | 459839257 | TotalRevenueColumn |
| Related Or Exempt Function Income | 459839257 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 459839257 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3657 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3657 | RelatedOrExemptFunctionIncome |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 780355 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 780355 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 780355 | TotalRevenueColumn |
| Related Or Exempt Function Income | 780355 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 7181275 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 6993767 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 187508 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 187508 | TotalRevenueColumn |
| Exclusion | $187,508 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| OTHER INVESTMENT INCOM | 621990 | 3349554 | 3349554 | |
| OPTICAL SHOP | 446199 | 351738 | 351738 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3701292 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 479411241 | TotalRevenueColumn |
| Related Or Exempt Function Income | 463972823 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 351738 | UnrelatedBusinessRevenue |
| Exclusion | $187,508 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 126486 | Total |
| Program Services | 126486 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3600 | Total |
| Program Services | 3600 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1172121 | Total |
| Program Services | 469991 | ProgramServices |
| Management And General | 702130 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 254932610 | Total |
| Program Services | 240599715 | ProgramServices |
| Management And General | 14332895 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13738852 | Total |
| Program Services | 12932291 | ProgramServices |
| Management And General | 806561 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35903216 | Total |
| Program Services | 33795462 | ProgramServices |
| Management And General | 2107754 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14608193 | Total |
| Program Services | 13750596 | ProgramServices |
| Management And General | 857597 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14291 | Total |
| Management And General | 14291 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20079 | Total |
| Management And General | 20079 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20048892 | Total |
| Program Services | 19493395 | ProgramServices |
| Management And General | 555497 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43324 | Total |
| Management And General | 43324 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34249142 | Total |
| Program Services | 34033085 | ProgramServices |
| Management And General | 216057 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54551 | Total |
| Program Services | 47830 | ProgramServices |
| Management And General | 6721 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16256451 | Total |
| Program Services | 15629590 | ProgramServices |
| Management And General | 626861 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1380375 | Total |
| Program Services | 1203722 | ProgramServices |
| Management And General | 176653 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 648829 | Total |
| Program Services | 596255 | ProgramServices |
| Management And General | 52574 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5816224 | Total |
| Program Services | 5816224 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2750 | Total |
| Program Services | 2750 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11286915 | Total |
| Program Services | 10364840 | ProgramServices |
| Management And General | 922075 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6206855 | Total |
| Program Services | 5957583 | ProgramServices |
| Management And General | 249272 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCHASED SERVICES | 39581066 | 5055685 | 34525381 |
| BAD DEBT | 12590808 | 12590808 | |
| MINNESOTACARE TAX | 7212562 | 7212562 | |
| INCOME TAX - UBI | 34481 | 34481 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3478568 | Total |
| Program Services | 2594014 | ProgramServices |
| Management And General | 884554 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 479411241 | Total |
| Program Services | 422276484 | ProgramServices |
| Management And General | 57134757 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10025 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40360567 | BOY |
| EOY | 0 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 542300 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6000 | BOY |
| EOY | 0 | EOY |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97191566 | BOY |
| EOY | 0 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1610737 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42192790 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 181913985 | BOY |
| EOY | 0 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29480124 | BOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6000 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104823920 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 134310044 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47603941 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47603941 | BOY |
| EOY | 0 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 181913985 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 0 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -47603941 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Total Lobbying Expenditures IIB | 0 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | ALLINA MEDICAL CLINIC IS A WHOLLY OWNED SUBSIDIARY OF ALLINA HEALTH SYSTEM. ALLINA HEALTH SYSTEM EMPLOYS VARIOUS INDIVIDUALS AS WELL AS CONTRACTS WITH VARIOUS LOBBYISTS TO MONITOR LEGISLATIVE ACTS IMPORTANT TO ALL OF THE ALLINA SYSTEM ON BOTH A NATIONAL AND STATE LEVEL. ANY AND ALL LOBBYING EXPENSES INCURRED ARE BORNE BY ALLINA HEALTH SYSTEM ON BEHALF OF ITSELF AND VARIOUS RELATED ENTITIES INCLUDING ALLINA MEDICAL CLINIC. | Explanation |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | ALLNA HEALTH SYSTEM FIN 48 (ASC 740) FOOTNOTE (AMOUNTS IN THOUSANDS): (17) TAXES - THE SYSTEM HAS BEEN DETERMINED TO QUALIFY AS A TAX EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE SYSTEM HAS ALSO BEEN DETERMINED TO BE EXEMPT FROM FEDERAL AND STATE INCOME TAX ON RELATED INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AND MINNESOTA STATUTE SECTION 290.05, SUBDIVISION 2. CERTAIN OF THE SYSTEM'S SUBSIDIARIES AND AFFILIATES QUALIFY AS TAX EXEMPT ORGANIZATIONS, WHILE OTHERS ARE TAXABLE. THE SYSTEM AND ITS SUBSIDIARIES PAID TAXES OF $1,270 AND $1,279 IN 2011 AND 2010, RESPECTIVELY. AS OF DECEMBER 31, 2011 AND 2010, THE TAXABLE SUBSIDIARIES OF THE SYSTEM'S CONTINUING OPERATIONS HAD A GROSS DEFERRED TAX ASSET OF $76,553 AND $74,064, RESPECTIVELY, RESULTING FROM NET OPERATING LOSS CARRYFORWARDS, EMPLOYEE COMPENSATION AND BENEFITS ACCRUALS, PROVISION FOR BAD DEBTS, AND LIMITATION OF CHARITABLE CONTRIBUTIONS, OFFSET BY VALUATION ALLOWANCES OF $75,746 AND $73,766, RESPECTIVELY, AND A GROSS DEFERRED TAX LIABILITY OF $806 AND $298, RESPECTIVELY, PRIMARILY ATTRIBUTABLE TO DEPRECIATION AND A CHANGE IN ACCOUNTING METHOD OF A TAXABLE SUBSIDIARY. THE VALUATION ALLOWANCE INCREASED BY $1,980 AND $2,577 DURING 2011 AND 2010, RESPECTIVELY. AS OF DECEMBER 31, 2011, THE CONTINUING OPERATIONS OF THE SYSTEM AND ITS SUBSIDIARIES HAD NET OPERATING LOSS CARRYFORWARDS OF $156,593 FOR INCOME TAX PURPOSES, WHICH EXPIRE IN VARIOUS YEARS THROUGH 2031. INCOME TAXES ARE ACCOUNTED FOR UNDER THE ASSET AND LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES ATTRIBUTABLE TO DIFFERENCES BETWEEN THE FINANCIAL STATEMENT AND TAX RETURN METHODS OF ACCOUNTING. DEFERRED TAX ASSETS AND LIABILITIES ARE MEASURED USING THE ENACTED TAX RATES EXPECTED TO APPLY TO TAXABLE INCOME IN THE YEARS IN WHICH THOSE TEMPORARY DIFFERENCES ARE EXPECTED TO BE RECOVERED OR SETTLED. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | A PLACE FOR YOU INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 270 | AddressLine1 |
| City | PINE CITY | City |
| State | MN | State |
| ZIP Code | 55063 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 451680589 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Non Cash Assistance | 112607 | AmountOfNonCashAssistance |
| Method Of Valuation | BOOK VALUE | MethodOfValuation |
| Description Of Non Cash Assistance | DONATION OF AMC PINE CITY CLINIC TO A PLACE FOR YOU INC | DescriptionOfNonCashAssistance |
| Purpose Of Grant | SHELTER FOR THE HOMELESS | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: SCHEDULE I, PART I, LINE 2 ALLINA MEDICAL CLINIC STRICTLY MONITORS GRANT FUNDS TO ENSURE THAT SUCH GRANTS ARE USED FOR PROPER AND INTENDED PURPOSES AND ARE NOT OTHERWISE DIVERTED FROM THE INTENDED USE. THE ORGANIZATION HAS PROCESS WHICH INCLUDES A WRITTEN APPLICATION WHICH REQUIRES SUPPORTING DOCUMENTATION AND SUBSTANTIATION PRIOR TO A GRANT BEING APPROVED AND DISBURSED. IN ADDITION AND DEPENDING ON THE FACTS AND CIRCUMSTANCE OF THE GRANT, THE ORGANIZATION EMPLOYS VARIOUS METHODS TO ENSURE PROPER AND INTENDED USE SUCH AS; PERIODIC REPORTING TO THE ORGANIZATION, FIELD INVESTIGATIONS, CONTRACTS WITH REPAYMENT CLAUSES, REQUIRING ADDITIONAL SUBSTANTIATION AND DOCUMENTATION NOT AVAILABLE AT THE TIME OF THE GRANT, PAYING THIRD PARTIES DIRECTLY ON BEHALF OF THE GRANTEE ORGANIZATION, AND OTHER METHODS AS APPROPRIATE AND WARRANTED. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 1 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 1 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 1 | InitialContractException |
| Rebuttable Presumption Procedure | 1 | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH PAULUS | |||||||||||||
| 0 | 833744 | 0 | 631010 | 0 | 58209 | 0 | 601666 | 0 | 26523 | 0 | 2151152 | 0 | 263827 |
| DUNCAN GALLAGHER | |||||||||||||
| 0 | 571562 | 0 | 193509 | 0 | 54302 | 0 | 219532 | 0 | 25799 | 0 | 1064704 | 0 | 40746 |
| LAURIE LAFONTAINE | |||||||||||||
| 0 | 265458 | 0 | 86057 | 0 | 64008 | 0 | 69703 | 0 | 27075 | 0 | 512301 | 0 | 55786 |
| ELIZABETH TRUESDELL SMITH | |||||||||||||
| 0 | 314539 | 0 | 106512 | 0 | 50453 | 0 | 136806 | 0 | 21337 | 0 | 629647 | 0 | 36349 |
| ROBERT WIELAND MD | |||||||||||||
| 0 | 423944 | 0 | 147702 | 0 | 24882 | 0 | 228202 | 0 | 27375 | 0 | 852105 | 0 | 18700 |
| RODNEY CHRISTENSEN MD | |||||||||||||
| 301839 | 0 | 72614 | 0 | 9426 | 0 | 68688 | 0 | 17425 | 0 | 469992 | 0 | 0 | 0 |
| CHERYL HERMANN | |||||||||||||
| 235602 | 0 | 68026 | 0 | 33274 | 0 | 55756 | 0 | 3822 | 0 | 396480 | 0 | 27412 | 0 |
| DEANN WAGNER | |||||||||||||
| 184751 | 0 | 54392 | 0 | 28535 | 0 | 37185 | 0 | 13815 | 0 | 318678 | 0 | 18683 | 0 |
| RICHARD BIRDWELL MD | |||||||||||||
| 705025 | 0 | 0 | 0 | 65282 | 0 | 49578 | 0 | 23213 | 0 | 843098 | 0 | 52645 | 0 |
| RANDALL CHADWICK JR MD | |||||||||||||
| 921204 | 0 | 0 | 0 | 75209 | 0 | 67355 | 0 | 24192 | 0 | 1087960 | 0 | 53207 | 0 |
| DANA HARMS MD | |||||||||||||
| 929710 | 0 | 0 | 0 | 5751 | 0 | 59105 | 0 | 24583 | 0 | 1019149 | 0 | 0 | 0 |
| PAUL HAVEL MD | |||||||||||||
| 765751 | 0 | 0 | 0 | 21235 | 0 | 62511 | 0 | 25312 | 0 | 874809 | 0 | 0 | 0 |
| JEFFREY NIPPER MD | |||||||||||||
| 457993 | 0 | 0 | 0 | 375804 | 0 | 15925 | 0 | 8492 | 0 | 858214 | 0 | 250638 | 0 |
| ANDREW PUGH | |||||||||||||
| 0 | 153955 | 0 | 67452 | 0 | 27789 | 0 | 13333 | 0 | 16165 | 0 | 278694 | 0 | 24674 |
Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 1A | PART I, LINE 1A: TAX INDEMNIFICATION AND GROSS-UP PAYMENTS; ALLINA HEALTH SYSTEM PROVIDES THIS TYPE OF PAYMENT AS IT RELATES TO TAXABLE MOVING EXPENSE REIMBURSEMENTS ON CERTAIN EXECUTIVES. MICHAEL MARSHALL, MD - $2,853 HOUSING ALLOWANCE OR RESIDENCE FOR PERSONAL USE: ALLINA HEALTH SYSTEM PROVIDES THIS TYPE OF PAYMENT AS IT RELATES TO TEMPORARY HOUSING FOR CERTAIN EXECUTIVES WHO ARE RELOCATING DUE TO EMPLOYMENT WITH ALLINA AND DO NOT INITIALLY HAVE A PERMANENT RESIDENCE. | |
| PART I, LINES 4A-B | PART I, LINES 4A-B: DUNCAN GALLAGHER - $26,984; LAURIE LAFONTAINE - $47,328; ELIZABETH SMITH - $39,604; CHERYL HERMANN - $26,669; DEANN WAGNER - $25,340; RICHARD BIRDWELL, MD - $61,506; RANDALL CHADWICK JR, MD - $67,957; JEFFREY NIPPER, MD - $372,104 | |
| PART I, LINE 6 | MANAGEMENT INCENTIVE PLAN (MIP) ALLINA HEALTH SYSTEM PROVIDES AN ANNUAL INCENTIVE COMPENSATION OPPORTUNITY TO MOST MANAGERS, SOME HIGH-LEVEL INDIVIDUAL CONTRIBUTORS AND EXECUTIVES. UNDER THIS PLAN, THE TARGET AWARD IS EXPRESSED AS A FUNCTION OF THE PARTICIPANT'S SALARY PAID DURING THE CALENDAR YEAR AND REQUIRES AT LEAST FOUR MONTHS OF SERVICE IN AN ELIGIBLE POSITION DURING THE YEAR. ACTUAL AWARDS CAN RANGE FROM 0% TO 150% OF THE TARGET AWARD, BASED ON ALLINA'S PERFORMANCE OVER THE CALENDAR YEAR. PERFORMANCE MEASURES INCLUDE FINANCIAL PERFORMANCE, SERVICE QUALITY, PATIENT SATISFACTION, PATIENT SAFETY AND COMMUNITY SERVICE. NO AWARDS ARE PROVIDED UNLESS THRESHOLD FINANCIAL PERFORMANCE IS ACHIEVED. PARTICIPANTS WHO HAVE LEFT EMPLOYMENT PRIOR TO THE END OF THE YEAR AS THE RESULT OF VOLUNTARY TERMINATION OR TERMINATION FOR POOR PERFORMANCE ARE NOT ELIGIBLE FOR AN AWARD. LONG-TERM INCENTIVE PLAN (LTIP) ALLINA HEALTH SYSTEM HAS A LONG-TERM INCENTIVE PLAN THAT PROVIDES A CASH AWARD OPPORTUNITY TO A SMALL NUMBER OF TOP EXECUTIVES APPROVED FOR PARTICIPATION BY THE COMPENSATION COMMITTEE OF THE BOARD. THE AWARD OPPORTUNITY IS BASED ON ALLINA HEALTH SYSTEM PERFORMANCE DURING OVERLAPPING THREE-YEAR CYCLES. PERFORMANCE MEASURES AND TARGETS ARE DEFINED BY THE COMMITTEE FOR EACH THREE-YEAR PERIOD AND CAN VARY FROM ONE PERIOD TO ANOTHER DEPENDING ON THE COMMITTEE'S JUDGMENT OF THE MOST IMPORTANT MEASURES OF SUCCESS. AWARDS CAN RANGE FROM 0% TO 150% OF TARGET AWARDS. | |
| PART I, LINE 8 | - CERTAIN AMOUNTS REPORTED ON FORM 990, PART VII WERE PAID OR ACCRUED PURSUANT TO A CONTRACT THAT WAS SUBJECT TO THE INITIAL CONTRACT EXCEPTION DESCRIBED IN REGULATION SECTION 53.4958-4(A)(3). FROM TIME TO TIME, ALLINA MEDICAL CLINIC ENTERS INTO CONTRACTUAL ARRANGEMENTS THAT MAY QUALIFY FOR THE INITIAL CONTRACT EXCEPTION BASED ON THE TERMS AND UNDERSTANDINGS OF THE CONTRACTUAL AGREEMENTS. | |
| PART III | DEFERRED COMPENSATION PLANS TERMS AND CONDITIONS: ALLINA HOSPITALS & CLINICS EXECUTIVE BENEFIT PLAN ALLINA HOSPITALS & CLINICS PHYSICIANS BENEFIT PLAN EXECUTIVE MUTUAL FUND ACCOUNT PLAN THESE ACCOUNTS GIVE THE PARTICIPANT THE OPPORTUNITY FOR CAPITAL ACCUMULATION NOT FULLY AVAILABLE TO THEM THROUGH SOCIAL SECURITY OR THE GENERAL EMPLOYEE RETIREMENT PLANS BECAUSE OF MAXIMUMS PLACED ON COMPENSATION THAT CAN BE RECOGNIZED UNDER FEDERAL LAW FOR PURPOSES OF CONTRIBUTIONS. THEY ALSO SERVE AS AN IMPORTANT NON-COMPETE INCENTIVE TO PARTICIPANTS. PRIOR TO THE YEAR IN WHICH CONTRIBUTIONS ARE MADE, THE PARTICIPANT MUST DESIGNATE A VESTING/PAYOUT DATE CONSISTENT WITH THE CONSTRAINTS OF THE PLANS AND FEDERAL DEFERRED COMPENSATION REGULATIONS. AFTER THE CONTRIBUTIONS ARE MADE, THE PARTICIPANT HAS A ONE-TIME LIMITED OPPORTUNITY TO EXTEND THE ELECTED PAYMENT DATE FOR AT LEAST FIVE YEARS. ONCE THE VESTING/PAYOUT DATE HAS BEEN REACHED, ALLINA WILL WITHHOLD THE APPROPRIATE TAXES AND THE BALANCE WILL BE PAID TO THE PARTICIPANT ON THEIR PAYCHECK AS SOON AS ADMINISTRATIVELY FEASIBLE. IF THE PARTICIPANT TERMINATES EMPLOYMENT VOLUNTARILY BEFORE AN AMOUNT IS PAID, PAYMENT WILL BE SUBJECT TO THE PARTICIPANT'S COMPLIANCE WITH A NON-COMPETE AGREEMENT WITH ALLINA FOR TWO YEARS AFTER TERMINATION. THE PARTICIPANT MAY ELECT FROM AMONG INVESTMENT ALTERNATIVES THAT ARE SIMILAR TO THOSE AVAILABLE IN THE RETIREMENT SAVINGS PLAN. UNLIKE THE RETIREMENT SAVINGS PLAN, THE PARTICIPANT HAS THE STATUS AN UNSECURED CREDITOR OF ALLINA AND WILL NOT HAVE A PREFERRED CLAIM TO PAYMENT IN THE CASE OF THE COMPANY'S INABILITY TO PAY. HOWEVER, THE COMPANY DOES SET ASIDE ASSETS FOR ITS OBLIGATIONS BY ACTUALLY INVESTING THE PROMISED ASSETS CONSISTENT WITH PARTICIPANT ELECTIONS. ALLINA SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) THIS PLAN WAS AMENDED EFFECTIVE DECEMBER 31, 2008, SUCH THAT NO FUTURE BENEFITS ACCRUE FOR SERVICE AFTER THAT DATE. ELIGIBLE ALLINA EXECUTIVES PARTICIPATED IN A DEFINED CONTRIBUTION SERP. EMPLOYER CREDITS WERE MADE EACH YEAR TO THEIR SERP BALANCE ACCORDING TO THE FOLLOWING SCHEDULE: EXEC YRS OF SERVICE CONTRIBUTION % OF PENSIONABLE EARNINGS 0-5 2.75% 6-10 3.50% 11+ 4.75% EXECUTIVES WERE ALSO CREDITED AN AMOUNT EQUAL TO THE EXCESS AMOUNT THAT WOULD HAVE BEEN CREDITED TO THE PENSION ACCOUNT PLAN WERE IT NOT FOR THE QUALIFIED PLAN COMPENSATION LIMITS. DEPOSITS EARN THE INVESTMENT RATE OF RETURN EQUAL TO THE PENSION ACCOUNT PLAN CREDITING RATE AS DECLARED BY ALLINA. THE CURRENT RATE IS 4%. THE PARTICIPANT VESTS AFTER THREE YEARS OF EXECUTIVE SERVICE PROVIDED THAT IF THE PARTICIPANT TERMINATES EMPLOYMENT WITH ALLINA PRIOR TO AGE 65 FOR ANY REASON OTHER THAN ELIMINATION OF POSITION, THE PARTICIPANT MUST FULFILL THE TERMS OF A COVENANT NOT TO COMPETE BENEFITS ARE PAID AS A SINGLE LUMP-SUM AMOUNT UPON AGE 65 RETIREMENT OR JOB POSITION ELIMINATION. IN THE CASE OF OTHER VOLUNTARY TERMINATIONS, PAYMENT IS DELAYED UNTIL COMPLETION OF THE TWO-YEAR NON-COMPETE PERIOD. THE SERP IS PAYABLE FROM ALLINA'S GENERAL ASSETS. IF ALLINA BECOMES INSOLVENT, THE PARTICIPANT WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. ALLINA EXECUTIVE RETIREMENT BENEFIT RESTORATION PLAN ELIGIBLE ALLINA EXECUTIVES PARTICIPATE IN A DEFERRED COMPENSATION RETIREMENT PLAN. EXECUTIVES ARE CREDITED AN AMOUNT EQUAL TO THE EXCESS AMOUNT THAT WOULD HAVE BEEN CREDITED TO THE ALLINA RETIREMENT SAVINGS PLAN WERE IT NOT FOR THE QUALIFIED PLAN COMPENSATION LIMITS. EMPLOYER CREDITS ARE MADE EACH YEAR TO THEIR ACCOUNT BALANCE ACCORDING TO THE FOLLOWING SCHEDULE AS OF THE END OF THE PLAN YEAR: PARTICIPANT'S YEARS OF VESTING SERVICE APPLICABLE PERCENTAGE LESS THAN 1 0% 1-5 5.0% 6-10 5.5% 11-15 6.0% 16 OR MORE 6.5% DEPOSITS EARN THE INVESTMENT RATE OF RETURN EQUAL TO THE INVESTMENT OPTIONS SELECTED BY THE PARTICIPANT WHICH ARE THE SAME OPTIONS AVAILABLE UNDER THE QUALIFIED PLAN. A PARTICIPANT WHO HAS COMPLETED AT LEAST TWO YEARS OF SERVICE BECOMES VESTED IN THE PORTION OF HIS OR HER ACCOUNT ATTRIBUTABLE TO THE ANNUAL RESTORATION CREDIT FOR A PARTICULAR YEAR AS OF JANUARY 15 OF THE YEAR FOLLOWING THE CALENDAR YEAR IN WHICH THE ANNUAL RESTORATION CREDIT IS EARNED. IN THE EVENT OF TERMINATION (OTHER THAN BECAUSE OF DEATH) PRIOR TO AGE 67, THE DISTRIBUTION DATE SHALL BE AS SOON AS ADMINISTRATIVELY POSSIBLE AFTER TERMINATION IN THE FORM OF A LUMP SUM PAYMENT. THE PLAN IS PAYABLE FROM ALLINA'S GENERAL ASSETS. IF ALLINA BECOMES INSOLVENT, THE PARTICIPANT WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PREFERRED CLAIM TO ANY ASSETS. THIS PLAN WAS EFFECTIVE JANUARY 1, 2009. EXECUTIVE SEVERANCE PLAN ALLINA PROVIDES SALARY CONTINUATION FOR EXECUTIVES WHOSE EMPLOYMENT HAS BEEN INVOLUNTARILY TERMINATED FOR REASONS OTHER THAN CAUSE OR POOR PERFORMANCE. THE LENGTH OF THE SEVERANCE PAY PERIOD IS DEFINED BY THE PLAN AND DEPENDS ON THE LEVEL OF THE EXECUTIVE POSITION. UNDER THE PLAN THE SEVERED EXECUTIVE ALSO COULD CONTINUE CERTAIN BENEFITS FOR A LIMITED PERIOD OF TIME. IN 2009 THE PLAN WAS AMENDED TO FURTHER RESTRICT SEVERANCE BENEFITS IN THE CASE THAT THE EXECUTIVE OBTAINS OTHER EMPLOYMENT DURING THE SEVERANCE PERIOD. | SUPPLEMENTAL INFORMATION |
Schedule N IRS990ScheduleN
Liquidation Table LiquidationTable
Liquidation Detail LiquidationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Asset | ALL ASSETS AND LIABILITIES OF THE ORGANIZATION VIA MERGER | DescriptionOfAsset |
| Date Of Distribution | 2011-12-31 | DateOfDistribution |
| FMV Of Asset | 189714407 | FMVOfAsset |
| Method Of FMV Determination | NET BOOK VALUE | MethodOfFMVDetermination |
| EIN | 363261413 | EIN |
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLINA HEALTH SYSTEM | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2925 CHICAGO AVENUE | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554071321 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRC Section | 501 (C)(3) | IRCSection |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | 1 | DirectorOfSuccessor |
| Employee Of Successor | 1 | EmployeeOfSuccessor |
| Owner Of Successor | 0 | OwnerOfSuccessor |
| Receive Compensation | 0 | ReceiveCompensation |
| Assets Distributed | 1 | AssetsDistributed |
| Required To Notify AG | 1 | RequiredToNotifyAG |
| AG Notified | 1 | AGNotified |
| Liabilities Paid | 1 | LiabilitiesPaid |
| Bonds Outstanding | 0 | BondsOutstanding |
| Bond Liabilities Discharged | 0 | BondLiabilitiesDischarged |
Form990 Schedule N Part III Form990ScheduleNPartIII (2 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 2E: EXPLANATION FOR PART I - LINE 2 A - THE BOARD OF DIRECTORS FOR ALLINA HEALTH SYSTEM AND ALLINA MEDICAL CLINIC CONSIST OF EXACTLY THE SAME MEMBERS PRIOR TO THE 12/31/2011 MERGER TRANSACTION DESCRIBED HEREIN. ALLINA MEDICAL CLINIC MERGED WITH AND INTO ALLINA HEALTH SYSTEM, THE SURVIVING AND SUCCESSOR ORGANIZATION. THEREFORE, ALLINA MEDICAL CLINIC DIRECTORS WILL REMAIN DIRECTORS OF ALLINA HEALTH SYSTEM, THE SURVIVING ORGANIZATION. EXPLANATION FOR PART I - LINE 2 B - ALLINA MEDICAL CLINIC OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES WILL GENERALLY CONTINUE TO BE EMPLOYED BY ALLINA HEALTH SYSTEM, THE SURVIVING AND SUCCESSOR ORGANIZATION. |
| DETAILS OF ALLINA HEALTH SYSTEM/ALLINA MEDICAL CLINIC MERGER:AS MORE FULLY DESCRIBED IN THE ATTACHED ARTICLES OF MERGER, ALLINA MEDICAL CLINIC MERGED WITH AND INTO ITS PARENT ORGANIZATION ALLINA HEALTH SYSTEM, A MINNESOTA 317A NONPROFIT CORPORATION AND 501(C)(3) TAX EXEMPT ORGANIZATION, ON DECEMBER 31, 2011. ALLINA HEALTH SYSTEM IS THE SURVIVING AND SUCCESSOR ORGANIZATION. AS A RESULT AND FOR TAX REPORTING PURPOSES, ALL ASSETS AND LIABILITIES OF ALLINA MEDICAL CLINIC HAVE BEEN TRANSFERRED TO ALLINA HEALTH SYSTEM AS OF DECEMBER 31, 2011. THE FUND BALANCE TRANSFERRED WAS $47,603,941. FOLLOWING THE MERGER TRANSACTION, THE PROGRAM SERVICES AND ACTIVITIES CONDUCTED BY ALLINA MEDICAL CLINIC SHALL BE CONDUCTED BY ALLINA HEALTH SYSTEM. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| CHANGES IN PROGRAM SERVICES | FORM 990, PART III, LINE 3 | AS MORE FULLY DESCRIBED IN THE ATTACHED ARTICLES OF MERGER, ALLINA MEDICAL CLINIC MERGED WITH AND INTO ITS PARENT ORGANIZATION ALLINA HEALTH SYSTEM, A MINNESOTA 317A NONPROFIT CORPORATION AND 501(C)(3) TAX EXEMPT ORGANIZATION, ON DECEMBER 31, 2011. ALLINA HEALTH SYSTEM IS THE SURVIVING AND SUCCESSOR ORGANIZATION. AS A RESULT AND FOR TAX REPORTING PURPOSES, ALL ASSETS AND LIABILITIES OF ALLINA MEDICAL CLINIC HAVE BEEN TRANSFERRED TO ALLINA HEALTH SYSTEM AS OF DECEMBER 31, 2011. THE FUND BALANCE TRANSFERRED WAS $47,603,941. FOLLOWING THE MERGER TRANSACTION, THE PROGRAM SERVICES AND ACTIVITIES CONDUCTED BY ALLINA MEDICAL CLINIC SHALL BE CONDUCTED BY ALLINA HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 2 | MARK SHEFFERT AND RODNEY YOUNG - BUSINESS RELATIONSHIP | |
| FORM 990, PART VI, SECTION A, LINE 6 | ALLINA HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER ORGANIZATION AND PARENT ORGANIZATION OF ALLINA MEDICAL CLINIC. SEE SCHEDULE R FOR FURTHER DETAILS. | |
| FORM 990, PART VI, SECTION A, LINE 7A | AS THE SOLE CORPORATE MEMBER ORGANIZATION, ALLINA HEALTH SYSTEM HOLDS CERTAIN RESERVED POWERS OVER ALLINA MEDICAL CLINIC. THE RESERVED POWERS ARE FULLY DESCRIBED IN ALLINA MEDICAL CLINIC'S GOVERNING DOCUMENTS AND INCLUDE SUCH POWERS AS ELECTION AND APPROVAL OF DIRECTORS, FINAL APPROVAL OF AMENDMENTS TO ARTICLES OF INCORPORATION OR BYLAWS, APPROVAL OF STRATEGIC PLANS AND CAPITAL AND OPERATING BUDGETS, APPROVAL OF PLANS OF MERGER OR CONSOLIDATION, APPROVAL OF INCURRENCE OF DEBT OR EXPENDITURES IN EXCESS OF CERTAIN AMOUNTS, AND VARIOUS OTHER RESERVED POWERS AS DESCRIBED THEREIN. | |
| FORM 990, PART VI, SECTION A, LINE 7B | 7B - SAME AS LINE 7A DESCRIPTION ABOVE. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ALLINA MEDICAL CLINIC FORM 990 WAS PREPARED BY THE TAX SERVICES FUNCTION OF ALLINA HEALTH SYSTEM, ALLINA MEDICAL CLINIC'S SOLE CORPORATE MEMBER AND PARENT ORGANIZATION. THE FORM 990 FILING WAS SUBJECTED TO A RIGOROUS REVIEW PROCESS BY ALLINA'S TAX MANAGER AND TAX DIRECTOR. ALLINA'S VICE PRESIDENT OF FINANCE & TREASURY ALSO PERFORMED AN EXECUTIVE REVIEW OF THE FORM 990. AFTER THE MANAGEMENT REVIEW PROCESS DESCRIBED ABOVE WAS COMPLETED, THE FINAL FORM 990, AS ULTIMATELY FILED WITH THE INTERNAL REVENUE SERVICE [IRS], WAS PROVIDED TO EACH VOTING MEMBER OF ALLINA MEDICAL CLINIC'S BOARD OF DIRECTORS. AN ALLINA MEDICAL CLINIC BOARD OF DIRECTORS MEETING WAS HELD ON NOVEMBER 1, 2012 TO REVIEW AND DISCUSS THE FORM 990 FILING. THE ALLINA MEDICAL CLINIC BOARD OF DIRECTORS VOTED ON AND APPROVED A RESOLUTION APPROVING THE FORM 990 AND THE MINNESOTA CHARITABLE TRUST ANNUAL REPORT TO BE FILED WITH THE MINNESOTA ATTORNEY GENERAL. THE BOARD OF DIRECTORS RESOLUTION ALSO DIRECTED OFFICERS TO FILE THE FORM 990 WITH THE IRS AND THE CHARITABLE TRUST ANNUAL REPORT WITH THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. THE ABOVE STATED REVIEW AND APPROVAL PROCESS OCCURRED PRIOR TO FILING THE ALLINA MEDICAL CLINIC FORM 990 WITH THE IRS AND MINNESOTA CHARITABLE TRUST ANNUAL REPORT WITH THE MINNESOTA ATTORNEY GENERAL. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS SEVERAL METHODS OF MONITORING AND ENFORCING COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. FIRST, THE ORGANIZATION REGULARLY DISTRIBUTES CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRES TO ITS OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES. THESE INDIVIDUALS ARE REQUIRED TO DISCLOSE ANNUALLY ANY INTEREST THAT COULD GIVE RISE TO CONFLICTS, INCLUDING ANY FAMILY OR BUSINESS RELATIONSHIP. SECOND, THE GENERAL COUNSEL'S OFFICE ANNUALLY DELIVERS A REPORT TO ALLINA'S BOARD OF DIRECTORS WHICH INCLUDES, AMONG OTHER THINGS, THE RESULTS OF THE CONFLICT OF INTEREST QUESTIONNAIRE, AN ANALYSIS OF POTENTIAL CONFLICTS, AND GUIDANCE FOR SATISFACTORILY RESOLVING CONFLICTS. THIRD, THE ORGANIZATION UNDERTAKES MANDATORY COMPLIANCE TRAINING OF ALL ITS EMPLOYEES WHICH INCLUDES TRAINING ON CONFLICTS OF INTEREST. FOURTH, ALL EMPLOYEES RECEIVE, AND ARE EXPECTED TO CONDUCT THEMSELVES IN ACCORDANCE WITH ALLINA'S CODE OF CONDUCT. THE CODE OF CONDUCT CONTAINS EDUCATIONAL MATERIALS AND GUIDANCE TO RESOLVE POTENTIAL CONFLICTS OF INTEREST. FIFTH, ALLINA MAINTAINS A CORPORATE INTEGRITY HOTLINE, A CONFIDENTIAL 24 HOUR EXTERNAL RESOURCE TO HELP ANSWER QUESTIONS RELATED TO ETHICAL BUSINESS CONDUCT. ALL CALLS TO THE INTEGRITY LINE ARE KEPT CONFIDENTIAL. | |
| FORM 990, PART VI, SECTION B, LINE 15 | ALLINA MEDICAL CLINIC'S COMPENSATION AND BENEFITS PROGRAMS ARE VESTED IN AND ADMINISTERED IN CONJUNCTION WITH ALLINA HEALTH SYSTEM, ALLINA MEDICAL CLINIC'S SOLE MEMBER PARENT ORGANIZATION. THE COMPENSATION COMMITTEE OF THE ALLINA HEALTH SYSTEM BOARD OF DIRECTORS IS RESPONSIBLE FOR ALL COMPENSATION AND BENEFITS PROGRAM ELEMENTS FOR NON-COLLECTIVELY BARGAINED ALLINA MEDICAL CLINIC AND ALLINA HEALTH SYSTEM EMPLOYEES. ALLINA HEALTH SYSTEM USES A PROCESS FOR DETERMINING COMPENSATION FOR THE ALLINA MEDICAL CLINIC PRESIDENT, THE ALLINA HEALTH SYSTEM CHIEF EXECUTIVE OFFICER, AND CERTAIN OTHER OFFICERS AND KEY EMPLOYEES THAT INCLUDED ALL OF THE FOLLOWING ELEMENTS: REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, THE MEMBERS OF WHICH ARE INDEPENDENT AND WITHOUT A CONFLICT OF INTEREST AS DEFINED IN REGULATION SECTION 53.4958-6(C)(1)(III). ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT SPECIALIZING IN EXECUTIVE COMPENSATION USE OF DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS CONTEMPORANEOUS DOCUMENTATION, SUBSTANTIATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT THE ABOVE DESCRIBED PROCESS AND AN ASSESSMENT IS PERFORMED AT LEAST ANNUALLY FOR THE FOLLOWING ALLINA HEALTH SYSTEM POSITIONS: CHIEF EXECUTIVE OFFICER/PRESIDENT, CHIEF FINANCIAL OFFICER, CHIEF CLINICAL OFFICER, EXECUTIVE VICE PRESIDENT - ALLINA HOSPITALS, PRESIDENT - ABBOTT NORTHWESTERN HOSPITAL, PRESIDENT - UNITED HOSPITAL, PRESIDENT - MERCY HOSPITAL, PRESIDENT - UNITY HOSPITAL, EXECUTIVE VICE PRESIDENT - AMBULATORY CARE, PRESIDENT - ALLINA CLINICS, SENIOR VICE PRESIDENT - GENERAL COUNSEL, SENIOR VICE PRESIDENT - CLINICAL SERVICES LINES, SENIOR VICE PRESIDENT - CHIEF COMPLIANCE OFFICER. IN ADDITION, THE COMPENSATION COMMITTEE REVIEWS AND APPROVES ALL COMPENSATION CHANGES OF THE ALLINA MEDICAL CLINIC PRESIDENT, ALLINA HEALTH SYSTEM CHIEF EXECUTIVE OFFICER AND THE OTHER AFOREMENTIONED POSITIONS LISTED IN ADVANCE OF THE CHANGE. | |
| FORM 990, PART VI, SECTION C, LINE 19 | ALLINA MEDICAL CLINIC MAKES ITS FORM 990, FORM 1023, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. TO ARRANGE AN INSPECTION OR RECEIVE A COPY, PLEASE CONTACT THE FOLLOWING: ALLINA MEDICAL CLINIC TAX SERVICES MAIL ROUTE 10890 P.O. BOX 43 MINNEAPOLIS, MN 55407-0043 TELEPHONE: 612-262-0660 PHYSICAL ADDRESS: 2925 CHICAGO AVENUE MINNEAPOLIS, MN 55407-1321 THE FORM 990 AND FORM 1023 ARE ALSO AVAILABLE DIRECTLY FROM THE INTERNAL REVENUE SERVICE. THE FORM 990 IS ALSO AVAILABLE FROM THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. | |
| FORM 990, PART VII, SECTION A | COMPENSATION OF $13,000 FOR SERVICES JOSEPH GOSWITZ, MD PROVIDED AS A MEMBER OF THE BOARD OF DIRECTORS AND AS CHAIRMAN OF THE ALLINA PHYSICIAN GOVERNANCE COMMITTEE WAS PAID TO HOSPITAL PATHOLOGY ASSOCIATES, A PHYSICIAN PRACTICE FOR WHICH DR. GOSWITZ IS A MEMBER. | |
| FINANCIAL STATEMENTS AUDITED BY AN INDEPENDENT ACCOUNTANT | FORM 990, PART XII, LINE 2B | ALLINA MEDICAL CLINIC'S FINANCIAL STATEMENTS WERE INCLUDED AS A COMPONENT PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF ITS PARENT ORGANIZATION, ALLINA HEALTH SYSTEM. THE CONSOLIDATED ALLINA HEALTH SYSTEM FINANCIAL STATEMENTS WERE AUDITED BY THE INDEPENDENT PUBLIC ACCOUNTING FIRM KPMG, LLP. THE AUDIT WAS CONDUCTED IN ACCORDANCE WITH AUDITING STANDARDS GENERALLY ACCEPTED IN THE UNITED STATES. KPMG, LLP ISSUED AN UNQUALIFIED OPINION ON THE CONSOLIDATED FINANCIAL STATEMENTS MEANING THE 2011 CONSOLIDATED FINANCIAL STATEMENTS OF ALLINA HEALTH SYSTEM PRESENT FAIRLY, IN ALL MATERIAL RESPECTS, THE FINANCIAL POSITION OF ALLINA HEALTH SYSTEM AS OF DECEMBER 31, 2011 AND THE RESULTS OF ITS OPERATIONS AND ITS CASH FLOWS FOR THE YEAR THEN ENDED IN CONFORMITY WITH U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. |
| PART XII, LINE 2C EXPLANATION | THIS PROCESS REMAINS UNCHANGED FROM PRIOR YEAR. | |
| GENERAL NARRATIVE | ALLINA HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER ORGANIZATION AND PARENT ORGANIZATION OF ALLINA MEDICAL CLINIC. SEE SCHEDULE R FOR FURTHER DETAILS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (14 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| ALLINA HEALTH SYSTEM | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 363261413 | HEALTHCARE SERVICES | MN | 501(C)(3) | LINE 11A, I | ALLINA HEALTH SYSTEM | 0 |
| ABBOTT NORTHWESTERN HOSPITAL FOUNDATION | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 043643816 | SUPPORTING ORGANIZATION | MN | 501(C)(3) | LINE 11A, I | ALLINA HEALTH SYSTEM | 0 |
| MERCY & UNITY HOSPITALS FOUNDATION | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 300086426 | SUPPORTING ORGANIZATION | MN | 501(C)(3) | LINE 11A, I | ALLINA HEALTH SYSTEM | 0 |
| PHILLIPS EYE INSTITUTE FOUNDATION | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 411613017 | SUPPORTING ORGANIZATION | MN | 501(C)(3) | LINE 11A, I | ALLINA HEALTH SYSTEM | 0 |
| SISTER KENNY FOUNDATION | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 411952989 | SUPPORTING ORGANIZATION | MN | 501(C)(3) | LINE 11A, I | ALLINA HEALTH SYSTEM | 0 |
| UNITED HOSPITAL FOUNDATION | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 237420998 | SUPPORTING ORGANIZATION | MN | 501(C)(3) | LINE 11A, I | ALLINA HEALTH SYSTEM | 0 |
| CENTER FOR HEALTHCARE INNOVATION FOUNDATION | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 263553868 | SUPPORTING ORGANIZATION | MN | 501(C)(3) | LINE 11A, I | ALLINA HEALTH SYSTEM | 0 |
| ALLINA ASSOCIATED FOUNDATION | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 274116873 | SUPPORTING ORGANIZATION | MN | 501(C)(3) | LINE 11A, I | ALLINA HEALTH SYSTEM | 0 |
| ASPEN ASSET CORPORATION | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 411788674 | HOLDING TITLE TO PROPERTY | MN | 501(C)(2) | ALLINA HEALTH SYSTEM | 0 | |
| ASPEN MEDICAL GROUP | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 411452624 | HEALTHCARE SERVICES | MN | 501(C)(4) | ALLINA HEALTH SYSTEM | 0 | |
| ALLINA INTEGRATED MEDICAL NETWORK | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 275129095 | SUPPORTING ORGANIZATION | MN | 501(C)(3) | LINE 11A, I | ALLINA HEALTH SYSTEM | 0 |
| UNITED AND CHILDRENS AMBULATORY SURGERY CENTER ASSOCIATION | ||||||||||
| 310 NORTH SMITH AVENUE | ST PAUL | MN | 55102 | 411694626 | SUPPORTING ORGANIZATION | MN | 501(C)(3) | LINE 11A, I | ALLINA HEALTH SYSTEM | 0 |
| MBP FACILITY LLC | ||||||||||
| PO BOX 43 MR 10890 | MINNEAPOLIS | MN | 554400043 | 454078371 | SUPPORTING ORGANIZATION | MN | 501(C)(3) | LINE 11A, I | ALLINA HEALTH SYSTEM | 0 |
| WESTHEALTH INC | ||||||||||
| 2855 CAMPUS DRIVE | PLYMOUTH | MN | 55441 | 411768814 | HEALTHCARE SERVICES | MN | 501(C)(3) | LINE 3 | ALLINA HEALTH SYSTEM | 0 |
Form990 Schedule R Part III Form990ScheduleRPartIII (11 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| APPLE VALLEY BUILDING ASSOCIATES LLC | ||||||||||||||
| 14655 GALAXIE AVENUE S | APPLE VALLEY | MN | 55124 | 411677072 | RENTAL REAL ESTATE | MN | N/A | |||||||
| METROPOLITAN INTEGRATED CANCER CARE LLC | ||||||||||||||
| 16825 NORTHCHASE DRIVE SUITE 1300 | HOUSTON | TX | 77060 | 205068485 | RADIOLOGY | TX | N/A | |||||||
| SOUTHWEST SURGICAL CENTER LLC | ||||||||||||||
| 920 EAST 28TH STREET SUITE 500 | MINNEAPOLIS | MN | 55407 | 412013700 | SURGICAL SERVICES | MN | N/A | |||||||
| MAGNETO LEASING LLC | ||||||||||||||
| 225 SMITH AVE N SUITE 201 | ST PAUL | MN | 55102 | 201582501 | RENTAL EQUIPMENT | MN | N/A | |||||||
| WEST SUBURBAN HEALTH CAMPUS | ||||||||||||||
| 2855 CAMPUS DRIVE | PLYMOUTH | MN | 55441 | 411730888 | RENTAL REAL ESTATE | MN | N/A | |||||||
| ASPEN SLEEP CENTER LLC | ||||||||||||||
| 1010 BANDANA BOULEVARD WEST | ST PAUL | MN | 55108 | 261850227 | HEALTHCARE SERVICES | MN | N/A | |||||||
| GERIATRIC SERVICES OF MINNESOTA LLC | ||||||||||||||
| 3366 OAKDALE AVE NORTH SUITE 551 | ROBBINSDALE | MN | 55422 | 453357936 | HEALTHCARE SERVICES | MN | N/A | |||||||
| NORTHSTAR SLEEP CENTER LLC | ||||||||||||||
| 920 EAST 28TH STREET SUITE 700 | MINNEAPOLIS | MN | 55407 | 452532456 | HEALTHCARE SERVICES | MN | N/A | |||||||
| DISTRICT ONE CANCER CENTER LLC | ||||||||||||||
| 200 STATE AVENUE | FAIRBAULT | MN | 55021 | 451258847 | HEALTHCARE SERVICES | MN | ALLINA MEDICAL CLINIC | RELATED | -9381 | 507565 | 0 | 1 | 0.50000 | |
| CROSBY CARDIOVASCULAR SERVICES LLC | ||||||||||||||
| 920 E 28TH STREET SUITE 500 | MINNEAPOLIS | MN | 55407 | HEALTHCARE SERVICES | MN | N/A | ||||||||
| MOBILE IMAGING SERVICES LLC | ||||||||||||||
| 1221 NICOLLET MALL SUITE 600 | MINNEAPOLIS | MN | 55403 | 411883212 | RADIOLOGY | MN | N/A | |||||||
Form990 Schedule R Part IV Form990ScheduleRPartIV (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| HEALTHSPAN SERVICES CORPORATION | ||||||||
| PO BOX 43 | MINNEAPOLIS | MN | 55440 | 411716415 | DEBT COLLECTION | MN | N/A | C |
| ALLINA SPECIALTY ASSOCIATES | ||||||||
| PO BOX 43 | MINNEAPOLIS | MN | 55440 | 411802815 | HEALTHCARE SERVICES | MN | N/A | C |
| ALLINA CLINIC HOLDINGS LTD | ||||||||
| PO BOX 43 | MINNEAPOLIS | MN | 55407 | 263954371 | HOLDING COMPANY | MN | N/A | C |
| QUELLO CLINIC LIMITED | ||||||||
| PO BOX 43 | MINNEAPOLIS | MN | 55407 | 410874754 | HEALTHCARE SERVICES | MN | N/A | C |
| ALLINA HEALTH SYSTEM TRUST | ||||||||
| 500 GRANT STREET SUITE 0625 | PITTSBURGH | PA | 15258 | 274612988 | TRUST | PA | N/A | T |
| ALLINA HEALTH SYSTEM DEFINED BENEFIT MASTER TRUST | ||||||||
| 500 GRANT STREET SUITE 0625 | PITTSBURGH | PA | 15258 | 376520273 | TRUST | PA | N/A | T |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DETAILS OF ALLINA HEALTH SYSTEM/ALLINA MEDICAL CLINIC MERGER: | Identifier |
| Explanation | AS MORE FULLY DESCRIBED IN THE ATTACHED ARTICLES OF MERGER, ALLINA MEDICAL CLINIC MERGED WITH AND INTO ITS PARENT ORGANIZATION ALLINA HEALTH SYSTEM, A MINNESOTA 317A NONPROFIT CORPORATION AND 501(C)(3) TAX EXEMPT ORGANIZATION, ON DECEMBER 31, 2011. ALLINA HEALTH SYSTEM IS THE SURVIVING AND SUCCESSOR ORGANIZATION. AS A RESULT AND FOR TAX REPORTING PURPOSES, ALL ASSETS AND LIABILITIES OF ALLINA MEDICAL CLINIC HAVE BEEN TRANSFERRED TO ALLINA HEALTH SYSTEM AS OF DECEMBER 31, 2011. THE FUND BALANCE TRANSFERRED WAS $47,603,941. FOLLOWING THE MERGER TRANSACTION, THE PROGRAM SERVICES AND ACTIVITIES CONDUCTED BY ALLINA MEDICAL CLINIC SHALL BE CONDUCTED BY ALLINA HEALTH SYSTEM. | Explanation |