2012-05-15T08:56:59-05:00 2011-06-30 Deloitte Tax LLP 50 South Sixth Street Suite 2800 Minneapolis MN 55402 990 2010-07-01 363297853 Sanford Health Foundation SANF 6053331000 1305 West 18th Street PO Box 5039 Sioux Falls SD 571175039 Lisa Carlson 6053331000 2012-05-15 1 Kristina Rasmussen 6123974000 2010 2016-02-24 21:20:13Z Brian Mortenson 1305 West 18th Street PO Box 5039 Sioux Falls SD 571175039 242437621 0 X www.sanfordhealthfoundation.org X 1983 SD Sanford Health Foundation's purpose is to encourage and assist Sanford Health in its activities. 20 7 0 311 0 0 43345806 103369402 0 0 19728051 25935262 272966 14169 63346823 129318833 18221636 31843515 0 0 1452221 1665962 0 0 1555367 573184 1054329 20247041 34563806 43099782 94755027 467712989 589943671 6192861 7320245 461520128 582623426 Sanford Health Foundation was incorporated for the purpose of encouraging and assisting Sanford Health in its activities and to encourage and assist other exempt entities associated with Sanford Health in providing health care, medical, or educational services. 0 0 4194127 4194127 The Foundation continues its proud tradition of supporting the programs, services and operations of Sanford Health as it continues its growth regionally, nationally and internationally. Specifically, grants helped provide patient care and family support ($1,070,098), equipment and renovation projects ($3,097,363) and other internal programs ($26,666). 227879 227879 Additional grants helped support healthcare education and research programs. Sanford Health is dedicated to providing continuing training and education for its employees, ensuring that patients are receiving the very best, and latest, in care. 27421509 27421509 Grants continually help support the Sanford Initiatives. These special project areas include: Investment in Children-to develop services and facilities and recruit physicians specifically focused on children; Sanford Research-to allow significant growth in all areas of Sanford Research and creation of the Sanford Children's Health Research Center; Healthcare Campus of the Future-to implement a new approach to healthcare campus and facility design; and the Sanford Project-the research effort to cure type 1 diabetes. Additionally, a grant was made to the Burnham research project, another collaboration effort of Sanford Health. 31843515 1 1 0 0 0 0 0 1 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 15 2 1 0 0 0 0 0 0 1 1 0 0 0 0 0 X 20 7 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 OR X Marlin Van Peursem Director of Fin 6053285704 1305 West 18th Street PO Box 5039 Sioux Falls SD 571175039 X Ronald M Moquist 0.50 X 0 0 0 Lauris Molbert 0.50 X 0 0 0 Barbara J Stork 0.50 X 0 0 0 David Beito 0.50 X 0 0 0 Pamela Anderson 0.50 X 0 0 0 Terry D Baloun 0.50 X 0 0 0 Ann Christenson 0.50 X 0 0 0 Mikal L Claar 0.50 X 0 0 0 Jim Entenman 0.50 X 0 0 0 Barbara M Everist 0.50 X 0 0 0 Jerome D Feder 0.50 X 0 0 0 Terrence Grimm MD 60.00 X 0 585887 42328 Richard D Hardie MD 60.00 X 0 444434 18343 John C Jambois 0.50 X 0 0 0 Kelby K Krabbenhoft 60.00 X X 0 1274514 19513 Kelby K Krabbenhoft Def Comp 60.00 X X 0 0 565838 Barry L Martin 0.50 X 0 0 0 Don Morton 0.50 X 0 0 0 Michael L Olson MD 60.00 X 0 518455 6998 Michael L Olson MD Def Comp 60.00 X 0 0 46935 Mark Paulson MD 60.00 X 0 220036 46521 Brent Teiken 0.50 X 0 0 0 John VanderWoude Jr MD 60.00 X 0 1184560 30701 Lisa Carlson 60.00 X 0 418112 51907 Brian Mortenson 60.00 X 314403 0 26676 Deborah Koski 60.00 X 134928 0 26965 Marlin Van Peursem 60.00 X 101258 0 21543 550589 4645998 904268 3 0 1 0 Best Western Ramkota Hotel 3200 W Maple Street Sioux Falls SD 57107 Event Vendor 128665 1 60606 60000 103248796 3045 103369402 22354969 22354969 116697419 113117126 3580293 3580293 3580293 2845 60606 1662 1183 1183 Other Operating Rev 525990 12986 12986 12986 129318833 0 0 25949431 31843515 31843515 324306 162150 162156 1079703 512515 567188 28725 16284 12441 157492 82936 74556 75736 38628 37108 13998 13998 393416 216998 176418 546 546 152231 48723 103508 1378 1378 25820 25820 64071 2339 61732 9807 939 8868 34174 34174 6404 4205 2199 Uncollectible Pledges 132798 132798 Donor Stewardship 98841 98841 Professional Dues 73482 495 72987 Fundraising Materials 42643 42643 Miscellaneous Expense 4720 4720 34563806 31843515 1164924 1555367 187620 184162 35667309 31509339 660 0 571 164429 673555 375969 272958 297586 431000144 557136666 583727 651489 467712989 589943671 30131 117413 602 993300 5281465 5467873 880663 741659 6192861 7320245 X 383258497 412369910 51698148 141003027 26563483 29250489 461520128 582623426 467712989 589943671 X 94755027 26348271 X 0 1 1 X 0 X X X 0 0 0 Sanford USD Medical Center 460227855 501(c)3 1 31843515 1 31843515 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 26563483 2527154 159852 29250489 23816626 2689481 57376 26563483 23464847 323063 33882 5166 23816626 1.00000 0 0 88835 88835 259132 115878 143254 325588 260091 65497 297586 Annuities payable 741659 741659 Part IV, Line 2b: The organization manages custodial accounts owned by related organizations of Sanford Health with the funds balance co-mingled with other investment assets of the organization. The use of the fund's balance will be overseen and expended by the owner. Description of Intended Use of Endowment Funds: Part V, Line 4: The organization's use of the endowment funds is to meet the donors intent in providing health care, medical, or educational services to Sanford Health. Description of Uncertain Tax Positions Under FIN 48: Part X: Line 2: Certain 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. Sanford Health Foundation did not have an income tax liability at June 30, 2011; however, some related organizations have established reserves. Half Marathon 32056 32056 Radiology Golf Tourney 14000 14000 2 17395 14550 2845 1662 63451 60606 2845 1662 1662 1183 1 Sanford USD Medical Center 1305 W 18th Street Sioux Falls SD 57117 460227855 501(c)(3) 31843515 See Form 990, Page 2, Part III 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Grants are disbursed by supporting organization only after the expenditure has been made and properly authorized by the supported organization along with related documentation indicating the fulfillment of donor wishes. 0 1 0 0 0 0 1 0 0 Terrence Grimm MD 0 500004 0 0 0 85883 0 34928 0 7400 0 628215 0 0 Richard D Hardie MD 0 414473 0 0 0 29961 0 7350 0 10993 0 462777 0 0 Kelby K Krabbenhoft 0 789232 0 0 0 485282 0 0 0 19513 0 1294027 0 0 Kelby K Krabbenhoft Def Comp 0 0 0 0 0 0 0 565838 0 0 0 565838 0 0 Michael L Olson MD 0 504486 0 0 0 13969 0 0 0 6998 0 525453 0 0 Michael L Olson MD Def Comp 0 0 0 0 0 0 0 46935 0 0 0 46935 0 0 Mark Paulson MD 0 196432 0 0 0 23604 0 31527 0 14994 0 266557 0 0 John VanderWoude Jr MD 0 1000000 0 0 0 184560 0 7350 0 23351 0 1215261 0 0 Lisa Carlson 0 335811 0 0 0 82301 0 34928 0 16979 0 470019 0 0 Brian Mortenson 225302 0 0 0 89101 0 7350 0 19326 0 341079 0 0 0 Deborah Koski 130176 0 300 0 4452 0 3952 0 23013 0 161893 0 0 0 Part I, Line 1a Certain items listed on Line 1a are provided by related organizations. Part I, Line 3: Sanford's 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 Trustees for deliberation and action. The most recent study was completed in 2011. Part I, Line 4b Schedule J, Part II, Column C: Employer contributions to pension plans, amounts representing increases and decreases in actuarial value (actuarial value factors include age, tenure and salary) of defined benefit SERP Plans are included in Column C. Participants and changes in values include: Kelby Krabbenhoft $420,519 Part I, Line 6 Sanford physicians are compensated based on the professional services they perform within the clinic in which they provide care. Generally, the model is revenues less expenses. Physicians listed that were paid on this model include: Dr. Richard Hardie, Dr. Michael Olson. Supplemental Information Part III Supplemental: Compensation 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 meet 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. A memo regarding executive compensation, written by the Chairman of Sanford's Trustees, is on file and available upon request. Compensation paid to trustees is for full-time professional responsibilities as physicians, administrators or employees of the organization. The total compensation paid to Kelby Krabbenhoft of $1,274,514 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. Form 990, Part VI, Section A, line 2 Lisa Carlson and Pamela Anderson 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: Dr. Terrence Grimm, Dr. Richard Hardie, Kelby Krabbenhoft, Dr. Michael Olson, Dr. Mark Paulson, Dr. John VanderWoude,Jr., Lisa Carlson, Brian Mortenson, Deborah Koski, Marlin VanPeursem. Form 990, Part VI, Section A, line 6 Sanford is governed by a Board of Trustees that has ultimate strategic and decision making authority. Sanford's Trustees delegates certain activities and responsibilities to Boards of each of Sanford's subsidiaries. The unique nature and complexity of the subsidiaries requires each to have a delegated Board with a singular entity focus. Such bodies, referred to as Boards of Directors and Boards of Governors, address matters such as credentialing, accreditation standards, developing budgets, programs and facilities on an entity-specific basis, and generally consist of individuals distinct from Sanford's Trustees. These Boards function much like committees in a traditional corporate structure. Sanford's Trustees then acts as a holding company Board, synthesizing and reconciling each entity's programs and budgets into a system-wide strategic plan. This structure of governance produces a significant number of trustees, governors and directors, creating a 400+ person collective which acts as a team of ambassadors for Sanford in their respective communities. Form 990, Part VI, Section A, line 7a Sanford's Trustees appoints the board members for the Board of Directors of Sanford Health Foundation. Form 990, Part VI, Section A, line 7b Sanford's Trustees approve the actions approved by the Board of Directors of Sanford Health Foundation. Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by the finance department and reviewed by executive management. An external accouting firm reviews the return prior to filing and prepares return highlights and key disclosures for the Trustees meeting immediately following the return filing date. After the return is filed, a complete copy is made available to the current Trustees. Form 990, Part VI, Section B, line 12c 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 Sanford's Trustees, members of the governing boards of subsidiary entities, officers, and key employees for all entities subject to the IRS Form 990 filings. The disclosures are summarized for review by the executive committee of its 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 15 Sanford's 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's 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 C, line 19 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 VII, Section A: Sanford's Trustees provide services to Sanford and its subsidiaries. Hours reported for each individual reflect the time spent on work related to either the filing organization or a related organization. Sanford's 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 Trustees related to the oversight of day to day operations of that entity. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 5,866,302. Change in value of split-interest agreements 85,163. Transfers from supported organization 20,396,806. Total to Form 990, Part XI, Line 5: 26,348,271. Sanford Health 1305 W 18th Street Sioux Falls SD 57117 311527032 Supporting Organization SD 501(c)(3) Line 11 Type III Sanford 0 Sanford ResearchUSD 1305 W 18th Street Sioux Falls SD 57117 460450378 Research SD 501(c)(3) Line 3 Sanford Health 1 Sanford USD Medical Center 1305 W 18th Street Sioux Falls SD 57117 460227855 Hospital SD 501(c)(3) Line 3 Sanford Health 1 Sanford Clinic 1305 W 18th Street Sioux Falls SD 57117 460447693 Clinics SD 501(c)(3) Line 3 Sanford Health 1 Sanford Health Network 1305 W 18th Street Sioux Falls SD 57117 460388596 Hospitals/Clinics SD 501(c)(3) Line 11 Type I Sanford Health 1 Sanford Home Health 1305 W 18th Street Sioux Falls SD 57117 460282134 Home Health Services SD 501(c)(3) Line 9 Sanford Health 1 Sanford 801 Broadway Drive Fargo ND 58122 271218956 Supporting Organization ND 501(c)(3) Line 11 Type II N/A 0 SHM-Sanford 1305 W 18th Street Sioux Falls SD 57105 271213769 Supporting Organization SD 501(c)(3) Line 11 Type II N/A 0 SHM-MeritCare 801 Broadway Drive Fargo ND 58122 271213717 Supporting Organization ND 501(c)(3) Line 11 Type II N/A 0 Sanford North PO Box 2010 Fargo ND 58122 450385890 Supporting Organization ND 501(c)(3) Line 11 Type II Sanford 0 Sanford Medical Center Fargo PO Box 2010 Fargo ND 58122 450226909 Hospital ND 501(c)(3) Line 3 Sanford North 1 Sanford Clinic North PO Box 2010 Fargo ND 58122 911770748 Clinics ND 501(c)(3) Line 9 Sanford North 1 Sanford Health Network North PO Box 2010 Fargo ND 58122 450409348 Hospitals/Clinics ND 501(c)(3) Line 11 Type II Sanford North 1 Sanford Health Foundation North PO Box 2010 Fargo ND 58122 450398104 Supporting Organization ND 501(c)(3) Line 7 Sanford North 1 Sanford Medical Center Wheaton 401 12th Street N Wheaton MN 56296 272042143 Hospital/Clinic MN 501(c)(3) Line 3 Sanford North 1 Sanford Medical Center Thief River Falls 120 Labree Ave S Thief River Falls ND 56701 410709579 Hospital MN 501(c)(3) Line 3 Sanford North 1 Sanford Medical Center Mayville 42 6th Avenue SE Mayville ND 58257 450228899 Hospital ND 501(c)(3) Line 3 Sanford North 1 MeritCare Minnesota 1720 South Highway 59 Thief River Falls MN 56701 261530302 Promotion of Health MN 501(c)(3) Line 3 Sanford North 1 Agassiz Assurance Company 100 Bank Street Suite 610 Burlington VT 05401 743121855 Insurance VT 501(c)(3) Line 11 Type II Sanford North 1 MeritCare Health Enterprises Inc PO Box 2010 Fargo ND 58122 450359785 Prescription Drugs ND 501(c)(4) Sanford North 1 FM Ambulance Service 2215 18th Street S Fargo ND 58103 450344371 Emergency Medical Transport Services ND 501(c)(4) Sanford North 1 Sanford Health of Northern Minnesota 1300 Anne Street NW Bemidji MN 56601 411266009 Hospital MN 501(c)(3) Line 3 Sanford North 1 Baker Park Inc 803 Dewey Avenue NW Bemidji MN 56601 411372480 Low Income Senior Housing MN 501(c)(3) Line 9 Sanford Health of Northern Minnesota 1 Sanford Health Foundation of Northern Minnesota 1300 Anne Street NW Bemidji MN 56601 411389317 Supporting Organization MN 501(c)(3) Line 11 Type I Sanford Health of Northern Minnesota 1 North Country Medical Clinic 1300 Anne Street NW Bemidji MN 56601 411753855 Clinic MN 501(c)(3) Line 3 Sanford Health of Northern Minnesota 1 National Student Housing-South Dakota LLC 100 S Phillips Ave Sioux Falls SD 57104 202129839 Investment SD N/A RAC Rentals LLC 100 S Phillips Ave Sioux Falls SD 57104 261961077 Investment SD N/A Heart Partners at Sanford 1305 W 18th Street Sioux Falls SD 57117 460449572 Healthcare SD N/A C Sanford Home Medical Equipment Inc 2710 W 12th Street Sioux Falls SD 57105 460388597 Healthcare Equipment SD N/A C Sanford Health Plan 300 Cherapa Place Sioux Falls SD 57103 911842494 Insurance SD N/A C Sanford Health Plan of MN 300 Cherapa Place Sioux Falls SD 57103 460445852 Insurance MN N/A C Healthcare Environmental Services Inc 1420 40th Street NW Fargo ND 58102 450336598 Laundry & Incineration Services ND N/A C Bemidji Medical Equipment Inc 1300 Anne Street NW Bemidji MN 56601 411551725 Retail Sales of DME MN N/A C North Country Management Inc 1300 Anne Street NW Bemidji MN 56601 411820025 Management Services MN N/A C Sanford World Clinics 1305 W 18th Street Sioux Falls SD 57117 262707628 Healthcare SD N/A C 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Sanford USD Medical Center B 31843515 Cash Method Sanford USD Medical Center C 60000 Accrual Method