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MeritCare Health Enterprises Inc: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
MeritCare Health Enterprises Inc (EIN 45-0359785)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-13
IRS object ID
201141339349305554
Schema version
2009v1.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-13T16:33:23-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Deloitte Tax LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line150 South Sixth Street Suite 2800AddressLine1
CityMinneapolisCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN450359785EIN

Name Name

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

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameLisa M CarlsonName
TitleCFOTitle
Phone7012344811Phone
Date Signed2011-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone6123974000Phone
Date Prepared2011-05-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

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

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11305 W 18th StreetAddressLine1
CitySioux FallsCity
StateSDState
ZIP Code57117ZIPCode
FieldValueIRS element (for citing)
Gross Receipts12783103GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.sanfordhealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1980YearFormation
State Legal DomicileNDStateLegalDomicile
Activity Or Mission DescriptionDedicated to the work of Health and Healing.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees53TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI550930TotalGrossUBI
Net Unrelated Business Txbl Income41230NetUnrelatedBusinessTxblIncome
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year11746017ProgramServiceRevenuePriorYear
Program Service Revenue CY12783103ProgramServiceRevenueCY
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year11746017TotalRevenuePriorYear
Total Revenue Current Year12783103TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1482320SalariesEtcPriorYear
Salaries Etc Current Year1599652SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9028157OtherExpensePriorYear
Other Expenses Current Year9876049OtherExpensesCurrentYear
Total Expenses Prior Year10510477TotalExpensesPriorYear
Total Expenses Current Year11475701TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1235540RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1307402RevenuesLessExpensesCY
Total Assets BOY3337074TotalAssetsBOY
Total Assets EOY2668430TotalAssetsEOY
Total Liabilities BOY875405TotalLiabilitiesBOY
Total Liabilities EOY400871TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2461669NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY2267559NetAssetsOrFundBalancesEOY
Mission DescriptionThe mission of Sanford "Dedicated to the Work of Health and Healing" and the vision "Improving the Human Condition Through Exceptional Care, Innovation and Discovery", is the constant force that drives the organization's plans, decisions and actions.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense11475701Expense
Revenue12232173Revenue
DescriptionAs part of the Sanford delivery system, MeritCare Health Enterprises supports the other affiliates through the operation of pharmacies for the benefit of patients and employees of Sanford Medical Center Fargo and Sanford Clinic North. The provision of these items to patients aids in the overall promotion of health in the community.Description
Total Program Service Expense11475701TotalProgramServiceExpense
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10963NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees53NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs1ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Doug OklandBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7012342000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 2010AddressLine1
CityFargoCity
StateNDState
ZIP Code58122ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (43 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Kelby Krabbenhoft
President & CEO60.00XX01123846748719
Roger Gilbertson MD
President (Jul-Nov09)60.00XX01004743989160
Ronald Moquist
Trustee/Chairman0.50XX000
Lauris Molbert
Trustee/Vice Chairman0.50XX000
Barbara Stork
Trustee/Secretary0.50XX000
David Beito
Trustee/Treasurer0.50XX000
Ellen-Earle Chaffee PhD
Chairman (Jul-Nov09)0.50XX000
Judy Green
Vice Chairman (Jul-Nov090.50XX000
Terry Baloun
Trustee0.50X000
Michael Olson MD
Trustee60.00X056175053780
Pamela Anderson
Trustee0.50X000
Terrence Grimm MD
Trustee60.00X060720941089
Barry Martin
Trustee0.50X000
John Jambois
Trustee0.50X000
James Entenman
Trustee0.50X000
John Vander Woude Jr MD
Trustee60.00X0213455629404
Jerome Feder
Trustee0.50XX000
Mark Paulson MD
Trustee60.00X022598143832
Ann Christenson
Director (Jul-Nov09)0.50X000
Brent Teiken
Director (Jul-Nov09)0.50X000
Don Morton
Director (Jul-Nov09)0.50X000
David Wilcox MD
Director (Jul-Nov09)60.00X022647446961
Jack Reynolds PhD
Director (Jul-Nov09)0.50X000
Kushal Handa MD
Director (Jul-Nov09)60.00X056177746657
Roxanne Newman MD
Director (Jul-Nov09)60.00X0117711939121
Anton Treuer PhD
Director (Jul-Nov09)0.50X000
Lisa Carlson
Sanford CFO60.00X029405449603
Douglas Okland
Sanford Clinic CFO60.00016237237287X
Linda O'Halloran
Senior Vice President60.0002588305116X
Michael Gibbs
Senior Vice President60.00025934413836X
Robert Biberdorf
Executive Partner60.00015247826091X
Harrison Storandt
Pharmacist60.00107736022190X
LeAnn Ness
Pharmacist60.00101333012224X
Mark Plencher
Pharmacy Coordinator60.00114440013875X
Tammie Dohman
Pharmacy Coordinator60.0012356809124X
Roger Lee
Former Treasurer60.00014138124886X
Bruce Pitts MD
Former Executive VP60.00043988949257X
Rhonda Ketterling MD
Former Sr Vice President60.00030453245498X
Douglas Vang
Former Sr Vice President60.00028500248657X
Paul Richard
Former Executive VP60.00028628249603X
Gregory Post MD
Former Sr Vice President60.00056057650257X
Evelyn Quigley
Former Sr Vice President60.00017663840857X
Jeffrey Hoss
Former Sr Vice President60.00025554950245X
FieldValueIRS element (for citing)
Total Reportable Comp From Org447077TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs11200382TotalReportableCompFrmRltdOrgs
Total Other Compensation2587329TotalOtherCompensation
Number Individuals GT100 K4NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Pharmacy Sales4461101285101212300082550930
East Ottertail Pharmac446110-67909-67909
FieldValueIRS element (for citing)
Total Program Service Revenue12783103TotalProgramServiceRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column12783103TotalRevenueColumn
Related Or Exempt Function Income12232173RelatedOrExemptFunctionIncome
Unrelated Business Revenue550930UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1098911Total
Program Services1098911ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total132745Total
Program Services132745ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total276838Total
Program Services276838ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total91158Total
Program Services91158ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total25294Total
Program Services25294ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total1199Total
Program Services1199ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total132033Total
Program Services132033ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total82034Total
Program Services82034ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total6192Total
Program Services6192ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total300Total
Program Services300ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11910Total
Program Services11910ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Medical Supplies95752729575272
Bad Debt4159641596
Miscellaneous Expenses219219

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11475701Total
Program Services11475701ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY27455BOY
EOY17279EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1289043BOY
EOY968565EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY953989BOY
EOY1232031EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY391EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis276175LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec219385LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY68894BOY
EOY56790EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY498783BOY
EOY393374EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY498910BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY3337074BOY
EOY2668430EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY403115BOY
EOY400871EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY472290BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY875405BOY
EOY400871EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2461669BOY
EOY2267559EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2461669BOY
EOY2267559EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3337074BOY
EOY2668430EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis276175OtherCostOrOtherBasis
Depreciation219385Depreciation
Book Value56790BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings56790TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionInvestment in East Ottertail PharmacyDescription
Book Value393374BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related393374TotalOfBookValueProgramRelated

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart X:Identifier
Return ReferenceDescription of Uncertain Tax Positions Under FIN 48:ReturnReference
ExplanationCertain controlled organizations are subject to income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. A tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination. The deferred income tax provision or benefit generally reflects the net change in deferred income tax assets and liabilities during the year. The current income tax provision reflects the tax consequences of revenues and expenses currently taxable or deductible on various income tax returns for the year reported. MeritCare Health Enterprises, Inc had no tax liability at June 30, 2010; some related party organizations report accrued and deferred taxaes payable at June 30, 2010.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement1EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (22 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Kelby Krabbenhoft
0746924000376922073058701813201872565079234
Roger Gilbertson MD
0567216000437527097351501564501993903048624
Michael Olson MD
0535584014560247100397480140320615530015838
Terrence Grimm MD
049742401082010158403272008369064829800
John Vander Woude Jr MD
01038461000109609507350022054021639600920379
Mark Paulson MD
01803760450530552028836014996026981300
David Wilcox MD
01943300315920552029078017883027343500
Kushal Handa MD
05278340335830360032720013937060843400
Roxanne Newman MD
011288860478730360032720064010121624000
Lisa Carlson
02921970001857032720016883034365700
Douglas Okland
01471320150000240020112017175019965900
Linda O'Halloran
025779800010320005116026394600
Michael Gibbs
0256916000242800013836027318000
Robert Biberdorf
0143728000875002012605965017856900
Roger Lee
0134513000686801846906417016626700
Bruce Pitts MD
04343190005570032720016537048914600
Rhonda Ketterling MD
03045320000032720012778035003000
Douglas Vang
02817690003233032720015937033365900
Paul Richard
02852500001032032720016883033588500
Gregory Post MD
05566920003884032720017537061083300
Evelyn Quigley
01704890006149025112015745021749500
Jeffrey Hoss
02533280002221032720017525030579400

Form990 Schedule J Part III Form990ScheduleJPartIII (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 1aOn Part I, Questions Regarding Compensation, Sanford checked several of the items as provided to listed persons: First Class or Charter Travel - Charter travel for business purposes is provided for individuals as needed and as cost appropriate. These costs are not included in the W-2's of the individuals as they meet the business purpose of Sanford. Travel for Companions - Limited travel for companions is required for an annual meeting. These costs are not included in the W-2's of the individuals as they meet the business purpose of Sanford. Tax Indemnification and gross-up payments - Compensation may be grossed up to include appropriate tax amounts in certain circumstances. Health or social club dues or initiation fees - All Sanford employees are eligible for discounted wellness memberships, a portion of these discounts and other club dues are taxed as fringe benefits. Personal services - Individuals may have benefits which include tax preparation or planning, this benefit is included in income and taxed. Part I, Line 3: The Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm to annually review the total compensation of arrangements of the officers of the organization, and to report findings and recommendations to the Sanford Board of Trustees for deliberation and action. The most recent study was completed in 2010.
Part I, Line 4aPart I, Line 4a: 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. These amounts were already reported in previous years as compensation. Distributions were paid to the following individuals: Kelby Krabbenhoft $79,234 Michael Olson, MD $15,838 Dr. Roger Gilbertson was President and CEO of MeritCare Health System. MeritCare and Sanford Health merged on November 2, 2009 at which time Dr. Gilbertson retired. Upon retirement Dr. Gilbertson received a separation payment of $1,000,920 of which $48,624 was paid during the calendar year and $952,295 was accrued to be paid monthly through November 1, 2011. The payment was consistent with the President's Employment Agreement effective January 1, 2007. Part I, Line 4b/Schedule J, Part II, Column C: In addition to employer contributions to pension plans, amounts representing increases and decreases in actuarial value (actuarial value factors include age, tenure and salary) of defined contribution and defined benefit SERP Plans are included in Column C. Participants and changes in values include: Kelby Krabbenhoft $706,194 Roger Gilbertson, MD $ 94,324 Part I, Line 4c: Several listed individuals received payment distributions from a benefit plan that falls within the definition of an "equity based" compensation plan. These amounts were deferred over multiple year periods, and were included in compensation in those periods. Distributions were paid to: John Vander Woude, MD $920,379
Part I, Line 6Sanford physicians are compensated based on the professional services they perform within the clinic in which they provide care. Generally, the model is revenues less expenses. Physicians listed that were paid on this model include: Michael Olson, MD
Part IIICompensation reported on Schedule J includes: (B)(i) Base compensation - salaries are based on the experience and performance of each executive and bench-marked using independent compensation survey information. (B)(ii) - Bonus & incentive compensation - as part of executive compensation, individuals may be eligible for incentive performance compensation, however if the organization does not make its financial budget, the Executive does not receive an incentive payment regardless of performance. (B)(iii) Other Reportable Compensation - generally includes taxable executive benefits. It also includes the one-time payout of previously deferred compensation (which was also reported as compensation in the earned period). To be in compliance with the IRS regulatory environment, listed individuals compensation includes a one-time payment of deferred compensation; this compensation was earned over multiple periods, and should be treated as earned over that length of time in exchange for services provided. (C) Deferred Compensation includes employer contributions to pension plans and the increase (or decrease) in the actuarial value (actuarial value factors include age, tenure and salary) of the benefit plans. (D) Nontaxable Benefits generally includes health insurance premiums.Supplemental Information
Part IIIThe Sanford Board of Trustees is comprised of 15 members, including nine volunteer community members, five physicians and the CEO. Compensation paid to any trustee is for full-time professional responsibilities as physicians or administrators of the organization.Supplemental Information
Part IIIA memo regarding executive compensation, written by the Chairman of the Sanford Board of Trustees, is on file and available upon request.Supplemental Information
Part IIIThe total compensation paid to Kelby Krabbenhoft of $1,123,846 is comprised of Base salary of $746,924, the one-time payment of previously deferred compensation of $79,234 (see also explanation above) and Other Taxable Earning of $297,688.Supplemental Information

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 2Pamela Anderson, Trustee, and Lisa Carlson, CFO, have a business relationship. Board members also serve on the boards of Sanford and/or related entities.
Form 990, Part VI, Section A, line 4Sanford North is the sole shareholder of MeritCare Health Enterprises, Inc. The Board of Directors of MeritCare Health Enterprises, Inc. consist of the Board of Governors of Sanford Clinic North. The officers are the President of Sanford Clinic North, the CMO of Sanford Clinic North and the officers of the Sanford Clinic North Board of Governors.
Form 990, Part VI, Section A, line 6Sanford North is the sole shareholder of the organization.
Form 990, Part VI, Section A, line 7aBoard members are members of the Board of Governors of Sanford Clinic North.
Form 990, Part VI, Section A, line 7bSanford North, as sole shareholder, reviews the actions of MeritCare Health Enterprises, Inc.
Form 990, Part VI, Section B, line 11The Form 990 is prepared internally by the finance department and reviewed by executive management, including both the System CEO and CFO. An external accounting firm reviews the return prior to filing and presents return highlights and key disclosures to the Board of Trustees at the 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 12cThe annual Conflict of Interest disclosure process is managed by the Chief Compliance Officer (CCO). The CCO is responsible for assuring that all completed forms are returned in a timely and complete manner. Conflict of Interest questionnaires are sent to Sanford Trustees, members of the governing boards for subsidiary entities, officers, and key employees. The disclosures are summarized for review by the executive committee of the Board of Trustees, pursuant to policy. This review allows: 1) The Board to acquire an awareness of financial relationships of board members and key management employees and can invoke the recusal process on a case-by-case basis when potential conflicts are implicated in Board decisions and deliberations, and, 2) Gives the Board the opportunity to seek additional information and clarification about disclosures to determine potential conflicts of interest and how to manage such.
Form 990, Part VI, Section B, line 15aThe Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm to annually review the total compensation arrangements of the officers and operating unit executives of the organization, including the CEO, and to report the findings and recommendations to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2010.
Form 990, Part VI, Section C, line 19Although the organization does not maintain a website where the public can access these documents, it would respond individually to any requests or inquiries from the public for these documents.
Form 990, Part VIIBoard members of Sanford provide services to Sanford subsidiaries. Hours reported for each individual reflect the time spent on work related to either the filing organization or related organization. Sanford Board of Trustees has ultimate governance responsibilities for each entity within the Sanford system. In addition, a Board of Directors is established for each entity, which has specific delegated responsibilities from the Board of Trustees related to the oversight of day to day operations of that entity.
Form 990, Schedule R, Part VOccupancy charges from Sanford Medical Center Fargo are recorded at cost.Costing Method for Related Party Transactions

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (22 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Sanford North
PO Box 2010FargoND58122450385890Supporting OrganizationND501(c)(3)11-IISanford
Sanford Clinic North
PO Box 2010FargoND58122911770748Clinical ServicesND501(c)(3)9Sanford North
MeritCare Minnesota
1720 South Highway 59Thief River FallsMN56701261530302Promotion of healthMN501(c)(3)3Sanford North
Sanford Medical Center Fargo
PO Box 2010FargoND58122450226909HospitalND501(c)(3)3Sanford North
Sanford Health Foundation North
PO Box 2010FargoND58122450398104Supporting OrganizationND501(c)(3)7Sanford North
Sanford Health Network North
PO Box 2010FargoND58122450409348Hospitals / ClinicsND501(c)(3)11-IISanford North
FM Ambulance Service
2215 18th St SouthFargoND58103450344371Emergency Medical Transport ServicesND501(c)(4)Sanford North
Sanford Medical Center Thief River Falls
120 Labree Ave SThief River FallsMN56701410709579HospitalMN501(c)(3)3Sanford North
Sanford Medical Center Mayville
42 6th Ave SEMayvilleND58257450228899HospitalND501(c)(3)3Sanford North
Sanford Medical Center Wheaton
401 12th St NWheatonMN56296272042143Hospitals / ClinicsMN501(c)(3)3Sanford North
Agassiz Assurance Company
100 Bank Street No 610BurlingtonVT05401743121855Malpractice InsuranceVT501(c)(3)11-IISanford North
Sanford Health
1305 W 18th St PO Box 5039Sioux FallsSD571175039311527032Supporting OrganizationSD501(c)(3)11-IIISanford
Sanford USD Medical Center
1305 W 18th St PO Box 5039Sioux FallsSD571175039460227855HospitalSD501(c)(3)3Sanford Health
Sanford Clinic
1305 W 18th St PO Box 5039Sioux FallsSD571175039460447693ClinicsSD501(c)(3)3Sanford Health
Sanford Health Network
1305 W 18th St PO Box 5039Sioux FallsSD571175039460388596Hospitals / ClinicsSD501(c)(3)11-ISanford Health
Sanford Home Health
1305 W 18th St PO Box 5039Sioux FallsSD571175039460282134Home Health ServicesSD501(c)(3)9Sanford Health
Sanford Health Foundation
1305 W 18th St PO Box 5039Sioux FallsSD571175039363297853Supporting OrganizationSD501(c)(3)11-ISanford Health
Sanford Research USD
1305 W 18th St PO Box 5039Sioux FallsSD571175039460450378ResearchSD501(c)(3)4Sanford Health
Sanford World Clinics
1305 W 18th St PO Box 5039Sioux FallsSD571175039262707628HealthcareSD501(c)(3)3Sanford Health
Sanford
801 N Broadway DriveFargoND58122271218956Supporting OrganizationND501(c)(3)11-II
SHM-MeritCare
801 N Broadway DriveFargoND58122271213717Supporting OrganizationND501(c)(3)11-II
SHM-Sanford
1305 W 18th St PO Box 5039Sioux FallsSD571175039271213769Supporting OrganizationSD501(c)(3)11-II

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
National Student Housing - South Dakota LLC
100 S Phillips AveSioux FallsSD57104202129839InvestmentSDSandford HealthRelated00
RAC Rentals LLC
100 S Phillips AveSioux FallsSD57104261961077InvestmentSDSandford HealthRelated00

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
Healthcare Environmental Services Inc
1420 40th St NWFargoND58102450336598Laundry & Incineration ServicesNDSanford NorthC
Heart Partners at Sanford
1305 West 18th StSioux FallsSD57117460449572HealthcareSDSanford HealthC
Sanford Home Medical Equipment Inc
2710 West 12th St NSioux FallsSD571043701460388597Healthcare EquipmentSDSanford HealthC
Sanford Health Plan
300 Cherapa Place 201Sioux FallsSD57103911842494InsuranceSDSanford HealthC
Sanford Health Plan of Minnesota
300 Cherapa Place 201Sioux FallsSD57103460445852InsuranceMNSanford HealthC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Sanford Medical Center FargoBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeMTransactionType
Amount Involved82000AmountInvolved