2023-03-10T13:12:31-06:00 2022-04-01 990 2022-01-01 300086426 MERCY AND UNITY HOSPITALS FOUNDATION MERC 6122620660 P O BOX 43 INTERNAL ZIP 10890 MINNEAPOLIS MN 554400043 RICHARD E MAGNUSON CHIEF FINANCIAL OFFICER 6122620660 2023-03-09 RICHARD MAGNUSON 999009999 0 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X MERCY HOSPITAL FOUNDATION LINDA ORTNER P O BOX 43 INTERNAL ZIP 10890 MINNEAPOLIS MN 554400043 1015550 0 X WWW.ALLINAHEALTH.ORG/GIVE X 2002 MN TO RAISE, STEWARD, AND DISTRIBUTE PHILANTHROPIC FUNDS TO SUPPORT THE HEALTH AND QUALITY OF CARE OF MERCY HOSPITAL PATIENTS AND FAMILIES, AND THE HEALTH AND WELLNESS OF THE COMMUNITY WE SERVE. X 15 11 0 11 0 0 1433172 223504 0 0 103048 8963 42197 0 1578417 232467 466587 356489 0 0 0 0 0 0 70284 638843 144917 1105430 501406 472987 -268939 8494318 0 111523 0 8382795 0 X THE MERCY HOSPITAL FOUNDATION EXISTS TO ENHANCE THE HEALTH OF THE PATIENTS OF MERCY HOSPITAL AND THE COMMUNITIES THAT WE SERVE. THE FOUNDATION SUPPORTS THE EFFORTS OF THE HOSPITAL IN PROVIDING EXCEPTIONAL PATIENT CARE, ADVANCED TECHNOLOGY, AND A HEALTHY WORK ENVIRONMENT THROUGH FUNDRAISING.THE MERCY HOSPITAL FOUNDATION SUPPORTS THE AWARD-WINNING CARE THAT IS PROVIDED TO THE PATIENTS OF OUR HOSPITAL BY RAISING MONEY FROM INDIVIDUALS, CORPORATIONS, AND FOUNDATIONS.THE FUND RAISING CONDUCTED BY MERCY HOSPITAL FOUNDATION SUPPORTS THE PROGRAMS OF THE HOSPITAL. THESE PROGRAMS ARE DESIGNED TO MEET THE NEEDS OF OUR PATIENTS, STAFF AND COMMUNITY MEMBERS. ULTIMATELY, OUR PATIENTS BENEFIT FROM THE LATEST TECHNOLOGY AVAILABLE AND THE MOST INNOVATIVE CARE POSSIBLE. OUR STAFF BENEFITS FROM WORKING IN A SAFE ENVIRONMENT THAT SUPPORTS THEIR NEEDS. OUR COMMUNITY BENEFITS BY HAVING EXCEPTIONAL CARE AVAILABLE CLOSE TO HOME. 0 0 295000 295000 CAPITAL CAMPAIGN COMMITMENTCAPITAL GRANTS AS PART OF THE $4.687 MILLION CAPITAL CAMPAIGN COMMITMENT IN SUPPORT OF VARIOUS PROJECTS TO ENHANCE PATIENT CARE AT BOTH MERCY AND UNITY HOSPITAL CAMPUSES WITH THE FOCUS TO ALIGN AS "ONE HOSPITAL WITH TWO CAMPUSES" WHILE CONTINUING TO PROVIDE EXCELLENT PATIENT CARE AND EXPERIENCE AND REMOVING DUPLICATE SERVICES WITH MERCY HOSPITAL AS THE TERTIARY HOSPITAL FOR THE NORTH METROPOLITAN AREA. THESE 2022 CAPITAL GRANTS INCLUDE: $100,000 FOR MENTAL HEALTH CONSOLIDATION; $100,000 FOR XI DAVINCI SURGICAL SYSTEM ROBOT FOR CANCER SERVICES; $ 95,000 FOR 5TH FLOOR RENOVATION OF THE ORTHO/SPINE UNIT. 61489 61489 STAFF AND EMPLOYEE WELLNESS, EDUCATION AND TRAINING - $39,831PROVIDING STRESS REDUCING TREATMENT AND EDUCATIONAL TRAINING FOR EMPLOYEES AND STAFF. TRAINING INCLUDES MRI CERTIFICATION AS WELL AS NATIONAL TRAUMA CARE BEST PRACTICES AND IMPROVEMENT COURSES TO MAINTAIN COMPETENCY IN OPTIMAL TRAUMA CARE FOR PATIENTS SERVED BY MERCY HOSPITALS. WORKSPACE IMPROVEMENTS - $11,225CREATE A MORE STREAMLINED SPACE FOR STAFF TO BETTER ASSIST PATIENTS. PATIENT AND COMMUNITY CARE $5,600FUNDING INCLUDES A SOCIAL WORKER PARTNERSHIP WITH BLAINE/COON RAPIDS POLICE DEPARTMENT. NEWBORN SWADDLES - $4,833PROVIDES ONESIES FOR NEWBORNS BORN WITHIN MERCY/UNITY HOSPITALS. 356489 1 1 0 0 0 1 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 11 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN WI X TAX SERVICES MAIL ROUTE 10890 6122620660 2925 CHICAGO AVENUE MINNEAPOLIS MN 554071321 X SARA CRIGER DIRECTOR/PRES. MERCY HOSP. 2.00 40.00 X 0 1581404 100099 SARA H SCHOEL MD DIRECTOR 2.00 40.00 X 0 448304 22575 LINDA ORTNER DIRECTOR/EXEC DIR FNDTN 2.00 40.00 X X 0 235061 16724 PAULA INMAN DIRECTOR/TREASURER 2.00 40.00 X 0 166098 46234 DARCY BOARD DIRECTOR 2.00 0.00 X 0 0 0 ROSEMARIE DONLIN DIRECTOR 2.00 0.00 X 0 0 0 KYLE JOHANSEN DIRECTOR 2.00 0.00 X 0 0 0 STEVE KALINA DIRECTOR 2.00 0.00 X 0 0 0 JOHN KNOLL DIRECTOR 2.00 0.00 X 0 0 0 SCOTT PETERSON DO DIRECTOR 2.00 0.00 X 0 0 0 EVA RASMUSSEN DIRECTOR 2.00 0.00 X 0 0 0 TAMMY SCHEMMEL DIRECTOR 2.00 0.00 X 0 0 0 DONNA SCOLLON DIRECTOR 2.00 0.00 X 0 0 0 D BRENT SIMONS MD DIRECTOR 2.00 0.00 X 0 0 0 CHRIS WEINHOLD DIRECTOR 2.00 0.00 X 0 0 0 RICHARD MAGNUSON CFO 2.00 40.00 X 0 1371096 103314 0 3801963 288946 0 0 1 0 0 144918 78586 223504 16795 16795 775251 783083 -7832 -7832 -7832 232467 0 0 8963 356489 356489 769 308 461 2400 960 1440 191 76 115 STAFF SERVICES 113760 45504 68256 PURCH SVCS - AFFILIATES 27777 27777 20 8 12 501406 356489 74633 70284 0 0 1741483 0 0 0 0 0 0 0 0 0 6752835 0 0 0 0 8494318 0 111523 0 111523 0 X 2898020 0 5484775 0 8382795 0 8494318 0 X -268939 -139133 -7974723 X X 0 1 X 1 0 X 3336954 1958467 2197440 1433172 223504 9149537 3336954 1958467 2197440 1433172 223504 9149537 2366416 6783121 162230 122202 70152 65467 16795 436846 32568 16574 20907 42197 112246 9698629 0.69940 0.74800 X PART II SECTION A (E) AND B (E) 2022 CALCULATIONS ARE BASED ON SHORT YEAR END 4-1-2022. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5 0 4583 200441 1 1 759416 -13694 -121 745601 747493 22734 10811 759416 1067270 550 27708 348035 747493 1013477 64686 10893 1067270 1024231 -254 10500 1013477 0.59610 0.40390 0 0 0 X PART V, LINE 4: EDUCATION AND RESEARCH PATIENT CARE PURCHASE OF PROPERTY AND EQUIPMENT TIME OTHER PART X, LINE 2: THE FOLLOWING IS A COPY OF 2021 ALLINA HEALTH SYSTEM AUDITED FINANCIAL STATEMENTS FOOTNOTE (NOTE: 2022 AUDITED FINANCIALS FORTHCOMING): "ALLINA HEALTH SYSTEM CONSOLIDATED FIN 48 (ASC740) 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. AS OF DECEMBER 31, 2021 AND 2020, THE TAXABLE SUBSIDIARIES OF THE SYSTEM'S CONTINUING OPERATIONS HAD A GROSS DEFERRED TAX ASSET OF $55,996 AND $55,367, RESPECTIVELY, RESULTING FROM NET OPERATING LOSS CARRYFORWARDS, EMPLOYEE COMPENSATION AND BENEFITS ACCRUALS, AND DEPRECIATION, OFFSET BY VALUATION ALLOWANCES OF $33,726 AND $34,913, RESPECTIVELY, AND A GROSS DEFERRED TAX LIABILITY OF $0 AND $354, RESPECTIVELY, RESULTING FROM JOINT VENTURE INVESTMENTS AND EMPLOYEE COMPENSATION AND BENEFITS. AS OF DECEMBER 31, 2021 AND 2020, THE CONTINUING OPERATIONS OF THE SYSTEM AND ITS SUBSIDIARIES HAD NET OPERATING LOSS CARRYFORWARDS OF $119,473 AND $121,683, RESPECTIVELY, FOR INCOME TAX PURPOSES, OF WHICH $93,148 WILL EXPIRE IN VARIOUS YEARS THROUGH 2029 WITH $26,325 HAVING AN INDEFINITE CARRYOVER PERIOD. THE SYSTEM HAS ANALYZED INCOME TAX POSITIONS TAKEN FOR FILING WITH THE INTERNAL REVENUE SERVICE AND ALL STATE JURISDICTIONS WHERE IT OPERATES. THE SYSTEM BELIEVES THAT INCOME TAX FILING POSITIONS WILL BE SUSTAINED UPON EXAMINATION AND DOES NOT ANTICIPATE ANY ADJUSTMENTS THAT WOULD RESULT IN A MATERIAL ADVERSE EFFECT ON THE SYSTEM'S CONSOLIDATED FINANCIAL STATEMENTS. AS OF DECEMBER 31, 2021 AND 2020, THE SYSTEM DOES NOT HAVE ANY SIGNIFICANT LIABILITIES FOR UNCERTAIN TAX BENEFITS. THE FILINGS FOR THE YEARS ENDED 2017 TO 2020 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES." 1 ALLINA HEALTH SYSTEM (DBA MERCY HOSPITAL) 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 501(C)3 50264 0 MERCY AND UNITY CAMPUS OPERATIONS INCLUDING STAFF AND EMPLOYEE EDUCATION AND TRAINING, WELLNESS, AND NEWBORN SWADDLES. ALLINA HEALTH SYSTEM (DBA MERCY HOSPITAL) 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 501(C)3 100000 0 CAPITAL IMPROVEMENT TO CONSOLIDATE MENTAL HEALTH SERVICES ON THE MERCY AND UNITY HOSPITAL CAMPUSES. ALLINA HEALTH SYSTEM (DBA MERCY HOSPITAL) 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 501(C)3 100000 0 CAPITAL FUNDING FOR THE XI DAVINCI SURGICAL SYSTEM ROBOT FOR CANCER SERVICES. ALLINA HEALTH SYSTEM (DBA MERCY HOSPITAL) 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 501(C)3 95000 0 CAPITAL CAMPAIGN TO SUPPORT 5TH FLOOR RENOVATIONS OF THE ORTHO/SPINE UNIT TO ENHANCE PATIENT CARE AT BOTH MERCY AND UNITY HOSPITAL CAMPUSES TO ALIGN AS "ONE HOSPITAL WITH TWO CAMPUSES". ALLINA HEALTH SYSTEM (DBA MERCY HOSPITAL) 2925 CHICAGO AVENUE MINNEAPOLIS MN 55407 363261413 501(C)3 11225 0 WORK SPACE IMPROVEMENTS FOR EFFICIENT PATIENT CARE. PART I, LINE 2: MERCY & UNITY HOSPITALS FOUNDATION 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 A PROCESS THAT INCLUDES A WRITTEN APPLICATION REQUIRING 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. 0 1 0 0 0 1 1 0 1 0 SARA CRIGER DIRECTOR/PRES. MERCY HOSP. 0 783849 0 356045 0 441510 0 75655 0 24444 0 1681503 0 292321 RICHARD MAGNUSON CFO 0 817342 0 427877 0 125877 0 99028 0 4285 0 1474409 0 0 SARA H SCHOEL MD DIRECTOR 0 432785 0 0 0 15519 0 19825 0 2750 0 470879 0 0 LINDA ORTNER DIRECTOR/EXEC DIR FNDTN 0 191508 0 41116 0 2437 0 11874 0 4851 0 251786 0 0 PAULA INMAN DIRECTOR/TREASURER 0 144561 0 20445 0 1092 0 11493 0 34741 0 212332 0 0 PART I, LINE 3 SEE NARRATIVE ON SCHEDULE O - FOR FORM 990, PART VI, SECTION A, LINE 6. PART I, LINE 4B 4(B): SARA CRIGER - $405,906; SARAH SCHOEL, MD - $13,372; RICHARD MAGNUSON - $96,521. PART I, LINE 6 DEFERRED COMPENSATION PLANS TERMS AND CONDITIONS: ALLINA INCENTIVE PLAN ALLINA PROVIDES AN ANNUAL INCENTIVE COMPENSATION OPPORTUNITY FOR EXECUTIVES, MANAGEMENT AND KEY INDIVIDUAL CONTRIBUTOR STAFF. 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 FINANCIAL AND NON-FINANCIAL PERFORMANCE OVER THE CALENDAR YEAR. NON-FINANCIAL PERFORMANCE MEASURES INCLUDE PATIENT & EMPLOYEE SAFETY, QUALITY, PATIENT EXPERIENCE AND FINANCIAL HEALTH. 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 ALLINA HAS A LONG-TERM INCENTIVE PLAN THAT PROVIDES A CASH AWARD OPPORTUNITY TO A SMALL NUMBER OF TOP EXECUTIVES APPROVED FOR PARTICIPATION BY THE HUMAN RESOURCES & COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF ALLINA HEALTH ("THE COMMITTEE"). THE AWARD OPPORTUNITY IS BASED ON ALLINA 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 53.49589-4(A)(3). IN SUCH INSTANCES, THE REBUTTABLE PRESUMPTION PROCEDURE DESCRIBED IN REGULATION SECTION 53.4958-6 (C) WERE FOLLOWED. FROM TIME TO TIME, MERCY & UNITY HOSPITALS FOUNDATION ENTERS INTO CONTRACTUAL ARRANGEMENTS THAT MAY QUALIFY FOR THE INITIAL CONTRACT EXCEPTION BASED ON THE TERMS AND UNDERSTANDINGS OF THE CONTRACTUAL AGREEMENTS AND THE APPROVAL PROCESS USED. SCHEDULE J, LINE 4(A) & (B) ADDITIONAL COMPENSATION DISCLOSURE: DEFERRED COMPENSATION PLANS - TERMS AND CONDITIONS: EXECUTIVE MUTUAL FUND ACCOUNT PLAN PHYSICIAN 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 OF AN UNSECURED CREDITOR OF ALLINA AND WILL NOT HAVE A PRIORITY 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. THE MUTUAL FUND PLANS TERMINATED EFFECTIVE DECEMBER 31, 2018. ALL MUTUAL FUND ACCOUNTS SHALL BE DISTRIBUTED IN A LUMP SUM NO LATER THAN JANUARY 2021, OR IF ELECTED BY THE PARTICIPANT IN DECEMBER 2018, IN THREE ANNUAL INSTALLMENTS WITH THE FIRST HAVING BEEN MADE FEBRUARY 2019 (33.33 PERCENT OF ACCOUNT BALANCE), THE SECOND MADE FEBRUARY 2020 (50 PERCENT OF REMAINING BALANCE), AND THE THIRD MADE JANUARY 2021 (REMAINING BALANCE). 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 CREDIT FOR A PARTICULAR YEAR AS OF JANUARY 15 OF THE YEAR FOLLOWING THE CALENDAR YEAR IN WHICH THE ANNUAL 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 PRIORITY CLAIM TO ANY ASSETS. THIS PLAN WAS EFFECTIVE JANUARY 1, 2009 AND IS NOW FROZEN AS OF DECEMBER 31, 2018. 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 PHYSICIAN AND EXECUTIVE SAVINGS PLAN THIS PLAN'S PURPOSE IS TO PROVIDE A SELECT GROUP OF PHYSICIANS AND EXECUTIVES WITH ADDITIONAL DEFERRED COMPENSATION. AMOUNTS DEFERRED UNDER THE PLAN ARE INTENDED TO BE EXEMPT FROM CODE SECTION 409A AND 457(F). ANNUAL CONTRIBUTIONS ARE MADE EACH FEBRUARY AND ARE BASED ON PREVIOUS YEAR'S ELIGIBLE COMPENSATION. PARTICIPANT'S APPLICABLE CONTRIBUTION PERCENTAGE FOLLOWS: PARTICIPANT APPLICABLE PERCENTAGE PHYSICIANS 5% VP'S 12% SVP | EVP 15% CEO 20% OF BASE SALARY + 10% OF BASE SALARY OVER IRS PAY LIMIT IF PARTICIPANT IS FULLY VESTED, THE CONTRIBUTION IS PAID DIRECTLY TO PARTICIPANT, LESS TAXES IN LATE JANUARY. IF PARTICIPANT IS UNVESTED, THE CONTRIBUTION IS DEPOSITED WITH FIDELITY. THE VESTING SCHEDULE FOR THIS PLAN FOLLOWS: FOR 2019 CONTRIBUTION, ONLY - IT WAS DEPOSITED IN FEBRUARY 2020, 50% VESTING AFTER 2 YEARS - I.E. 2021, PAID OUT 01/2021; AND, 50% VESTING IN 2022, PAID OUT 01/2022. FOR 2020 CONTRIBUTIONS AND AFTER - VESTING OCCURS AFTER 3 YEARS - I.E. 2020 CONTRIBUTION VESTS IN 2023, THE 2021 CONTRIBUTION VESTS IN 2024, ETC. PARTICIPANTS ARE 100% VESTED AT THE EARLIER OF AT LEAST AGE 60 WITH 7 YEARS OF SERVICE OR AGE 65. GRANDFATHERED PROVISION - FOR THOSE AGE 54 OR OLDER AND EMPLOYED AS OF 12/31/2018: EARLIER OF AT LEAST AGE 60 WITH 3 YEARS OF SERVICE OR AGE 65. THIS PLAN WAS EFFECTIVE JANUARY 1, 2019. A NON-COMPETE CLAUSE DOES NOT APPLY TO THIS PLAN. ALLINA HEALTH PHYSICIAN DEFERRED AWARD PLAN ALLINA HEALTH ESTABLISHED THIS EMPLOYEE BENEFIT PLAN TO PROVIDE DESIGNATED PHYSICIANS WITH ADDITIONAL DEFERRED COMPENSATION TO PROVIDE LONG TERM INCENTIVES TO REMAIN WITH THE COMPANY AND CONTRIBUTE TO ITS' SUCCESSFUL PERFORMANCE. SELECT PHYSICIANS ARE ELIGIBLE TO PARTICIPATE AFTER ONE FULL CALENDAR YEAR OF EMPLOYMENT AND BE WORKING A .5 FTE OR GREATER AS OF THE DECEMBER 31ST OF THE PLAN YEAR FOR WHICH THE CONTRIBUTION IS PROVIDED. THE PLAN ANNUAL FUNDING AWARD POOL IS DISCRETIONARY AND WILL BE DETERMINED AT THE END OF THE PLAN YEAR AND MUST BE APPROVED BY THE ALLINA HEALTH BOARD COMPENSATION COMMITTEE. ONCE THE AWARD POOL IS DETERMINED, THE AMOUNTS WILL BE ALLOCATED EQUALLY WITH ADJUSTMENTS MADE BASED ON THE PARTICIPANT'S FTE STATUS. A PARTICIPANT'S ACCOUNT SHALL BECOME VESTED AND NON-FORFEITABLE UPON THE EARLIEST OF THE FOLLOWING: THE DATE THE PARTICIPANT HAS ATTAINED AGE 65 THE DATE A TERMINATED PARTICIPANT HAS REACHED AGE 55, COMPLETED TEN YEARS OF VESTING SERVICE AND SATISFIED A TWO-YEAR NON-COMPETE RESTRICTION THE DATE OF THE PARTICIPANT'S DEATH ALL ASSETS AND LIABILITIES OF THE ORGANIZATION VIA MERGER 2022-04-01 7974722 FMV 274116873 ALLINA HEALTH FOUNDATION (FKA ALLINA ASSOCIATED FOUNDATION) PO BOX 43 MINNEAPOLIS MN 55440 501(C)(3) 0 0 0 0 1 1 1 1 0 EXPLANATION OF MHF/AHF MERGER: AS MORE FULLY DESCRIBED IN THE ARTICLES OF MERGER FILED WITH THE MINNESOTA SECRETARY OF STATE, MERCY & UNITY HOSPITALS FOUNDATION ("MUHF") MERGED INTO ALLINA HEALTH FOUNDATION("AHF"), FKA ALLINA ASSOCIATED FOUNDATION (EIN: 27-4116873), A 501(C)(3) TAX EXEMPT ORGANIZATION AND MINNESOTA 317A NONPROFIT CORPORATION AS OF APRIL 1, 2022. AS A RESULT, AND FOR TAX REPORTING PURPOSES, ALL ASSETS AND LIABILITIES OF MERCY & UNITY HOSPITALS FOUNDATION TRANSFERRED TO ALLINA HEALTH FOUNDATION, THE SURVIVING AND SUCCESSOR ORGANIZATION. THIS WILL BE THE FINAL FILING FOR MERCY & UNITY HOSPITALS FOUNDATION.AS REQUIRED PURSUANT TO MINNESOTA STATUTES, CHAPTER: 317A, THE ORGANIZATION FILED A CERTIFICATE OF MERGER WITH THE OFFICE OF THE MINNESOTA SECRETARY OF STATE NAMING MERGING MINNESOTA ENTITIES: MERCY & UNITY HOSPITALS FOUNDATION AND ALLINA HEALTH FOUNDATION. NAME OF SURVIVING ENTITY: ALLINA HEALTH FOUNDATION. THE CERTIFICATE WAS ACCEPTED AND SIGNED ON MARCH 25, 2022. A COPY OF THE CERTIFICATE OF MERGER SHALL BE FILED WITH THE MINNESOTA ATTORNEY GENERAL PURSUANT TO MINNESOTA STATUTES SECTION 317A.811.AS STATED ON EXHIBIT A - EXECUTIVE SUMMARY, ALL MUHF FUNDS WILL BE USED TO SUPPORT AHF WITH RESTRICTED FUNDS CONTINUING TO SUPPORT SPECIFIC INTENT OF THE DONORS. FORM 990, PART VI, SECTION A, LINE 4 FORM 990, PART VI, SECTION A, LINE 4: ON APRIL 1, 2022, ALLINA HEALTH SYSTEM AND THE MERCY AND UNITY HOSPITALS FOUNDATION BOARDS FILED ARTICLES OF MERGER WITH THE MINNESOTA SECRETARY OF STATE REFLECTING THE MERGERS OF MERCY AND UNITY HOSPITALS FOUNDATION, A MINNESOTA NONPROFIT CORPORATION, INTO ALLINA HEALTH FOUNDATION, A MINNESOTA NONPROFIT CORPORATION. THE FOUNDATION WAS EXEMPT FROM FEDERAL INCOME TAX AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND THE RESULTING UNIFIED FOUNDATION CONTINUES TO BE EXEMPT UNDER SECTION 501(C)(3). THE MERGER WAS EFFECTIVE APRIL 1, 2022. PURSUANT TO MINNESOTA STATUTES, SECTION 317A.811, SUBD. 6, AND THE SECRETARY OF STATE ISSUED CERTIFICATES OF MERGER EFFECTIVE APRIL 1, 2022 FORM 990, PART VI, SECTION A, LINE 6 PARENT ORGANIZATION ALLINA HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER ORGANIZATION OF MERCY & UNITY HOSPITALS FOUNDATION. SEE SCHEDULE R FOR FURTHER DETAILS. ALLINA HEALTH SYSTEM PROVIDES MERCY & UNITY HOSPITALS FOUNDATION WITH ADMINISTRATIVE AND STAFF SERVICES AT NO COST. THE VALUE OF THE SERVICES PROVIDED BY ALLINA HEALTH SYSTEM TO MERCY & UNITY HOSPITALS FOUNDATION DURING 2022 WERE ESTIMATED AT $144,918 AND HAVE BEEN RECORDED AS CONTRIBUTION REVENUE FROM A RELATED ORGANIZATION IN THE STATEMENT OF REVENUE AND AS ADMINISTRATIVE AND FUNDRAISING EXPENSES IN THE STATEMENT OF FUNCTIONAL EXPENSES. MERCY & UNITY HOSPITALS FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. COMPENSATION DISCLOSED AS PAID BY A RELATED ORGANIZATION IS DETERMINED SOLELY BY THE RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE CORPORATE MEMBER ORGANIZATION, ALLINA HEALTH SYSTEM HOLDS CERTAIN RESERVED POWERS OVER MERCY & UNITY HOSPITALS FOUNDATION. THE RESERVED POWERS ARE FULLY DESCRIBED IN MERCY & UNITY HOSPITALS FOUNDATION'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 SEE PART VI, SECTION A, LINE 7A DESCRIPTION ABOVE FORM 990, PART VI, SECTION B, LINE 11B MERCY & UNITY HOSPITALS FOUNDATION'S FORM 990 WAS PREPARED BY THE TAX SERVICES FUNCTION OF ALLINA HEALTH SYSTEM, MERCY & UNITY HOSPITALS FOUNDATION'S SOLE CORPORATE MEMBER. THE FORM 990 FILING WAS SUBJECTED TO A RIGOROUS REVIEW PROCESS BY ALLINA'S TAX MANAGER AND TAX DIRECTOR. ALLINA'S CHIEF FINANCIAL OFFICER 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 HEALTH FOUNDATION'S BOARD OF DIRECTORS, AS THE SUCCESSOR IN MERGER. ALLINA HEALTH FOUNDATION'S BOARD OF DIRECTORS VOTED ON AND APPROVED A RESOLUTION APPROVING THE FORM 990, THE MINNESOTA CHARITABLE ORGANIZATION ANNUAL REPORT TO BE FILED WITH THE MINNESOTA ATTORNEY GENERAL, AND THE WISCONSIN CHARITABLE ORGANIZATION ANNUAL REPORT TO BE FILED WITH THE WISCONSIN DEPARTMENT OF FINANCIAL INSTITUTIONS. THE BOARD OF DIRECTORS RESOLUTION ALSO DIRECTED OFFICERS TO FILE THE FORM 990 WITH THE IRS, THE MINNESOTA CHARITABLE ORGANIZATION ANNUAL REPORT WITH THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL, AND THE WISCONSIN CHARITABLE ORGANIZATION ANNUAL REPORT WITH THE WISCONSIN DEPARTMENT OF FINANCIAL INSTITUTIONS. THE ABOVE STATED REVIEW AND APPROVAL PROCESS OCCURRED PRIOR TO FILING MERCY & UNITY HOSPITALS FOUNDATION'S FORM 990 WITH THE IRS, MINNESOTA CHARITABLE ORGANIZATION ANNUAL REPORT WITH THE MINNESOTA ATTORNEY GENERAL, AND WISCONSIN CHARITABLE ORGANIZATION ANNUAL REPORT WITH THE WISCONSIN DEPARTMENT OF FINANCIAL INSTITUTIONS. 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 MERCY & UNITY HOSPITALS FOUNDATION HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. ANY COMPENSATION DISCLOSED AS PAID BY A RELATED ORGANIZATION IS DETERMINED SOLELY BY THE RELATED ORGANIZATION. THEREFORE, PART VI, SECTION B, LINE 15A AND LINE 15B ARE NOT APPLICABLE TO MERCY & UNITY HOSPITALS FOUNDATION. FORM 990, PART VI, SECTION C, LINE 19 MERCY & UNITY HOSPITALS FOUNDATION 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: MERCY & UNITY HOSPITALS FOUNDATION 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 AND FINANCIAL STATEMENTS ARE ALSO AVAILABLE FROM THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. PART VII THE AMOUNTS REPORTED FOR PART VII COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND INDEPENDENT CONTRACTORS ARE FOR THE FULL CALENDAR YEAR 2022. FORM 990, PART XI, LINE 9: FUND BALANCE TRANSFER TO ALLINA HEALTH FOUNDATION -7,974,723. FORM 990, PART XII, LINE 2C: AS A RESULT OF THE MERGER WITH AND INTO ALLINA HEALTH FOUNDATION, THE ALLINA HEALTH FOUNDATION ASSUMED AUTHORITY, RESPONSIBILITY AND OVERSIGHT. 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