2023-03-10T13:12:31-06:00 2022-04-01 990 2022-01-01 411952989 COURAGE KENNY FOUNDATION COUR 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 LINDA ORTNER P O BOX 43 INTERNAL ZIP 10890 MINNEAPOLIS MN 554400043 4802255 0 X WWW.ALLINAHEALTH.ORG/GIVE X 1999 MN TO RAISE FUNDS AND ENGAGE THE COMMUNITY TO SUPPORT HEALTH AND INDEPENDENCE FOR THOSE WITH FUNCTIONAL LIMITATIONS THROUGH COURAGE KENNY REHAB'S COMPREHENSIVE CONTINUUM OF TRANSFORMATIVE SERVICES, RESEARCH AND INNOVATION, AND PUBLIC ADVOCACY. WITH THE FOUNDATION'S SUPPORT, THE CONTINUUM ENRICHES LIVES AND PROVIDES A LEVEL OF CARE ABOVE AND BEYOND THE CORE MEDICAL SERVICES PROVIDED BY ALLINA HEALTH. X 21 19 0 19 0 0 8003876 1247292 0 0 1154483 115567 -110416 -15865 9047943 1346994 4729921 1290858 0 0 0 0 0 0 152349 1587404 346249 6317325 1637107 2730618 -290113 42769363 0 1073766 0 41695597 0 X TO RAISE FUNDS AND ENGAGE THE COMMUNITY TO SUPPORT HEALTH AND INDEPENDENCE FOR THOSE WITH FUNCTIONAL LIMITATIONS THROUGH COURAGE KENNY REHAB'S COMPREHENSIVE CONTINUUM OF TRANSFORMATIVE SERVICES, RESEARCH AND INNOVATION, AND PUBLIC ADVOCACY. WITH THE FOUNDATION'S SUPPORT, THE CONTINUUM ENRICHES LIVES AND PROVIDES A LEVEL OF CARE ABOVE AND BEYOND THE CORE MEDICAL SERVICES PROVIDED BY ALLINA HEALTH. 0 0 1125984 1125984 $1,100,000 TO SUPPORT THE PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES, INPATIENT REHABILITATIVE SERVICES, COMMUNITY BASED SERVICES, INDEPENDENT LIVING SKILLS (ILS) PROGRAM AND SPORTS AND RECREATION PROGRAMS OF COURAGE KENNY REHABILITATION INSTITUTE, AN UNINCORPORATED DIVISION OF ALLINA HEALTH SYSTEM. COURAGE KENNY REHABILITATION INSTITUTE (CKRI) CKRI REHABILITATIVE PROGRAMS WERE CREATED TO ASSIST PEOPLE ACHIEVE THEIR HIGHEST LEVEL OF INDEPENDENCE, HEALTH AND WELLNESS THROUGH THEIR SERVICES, INNOVATIVE PROGRAMS, GROUND-BREAKING RESEARCH, AND BARRIER-SHATTERING ADVOCACY. THEY OFFER PHYSICAL, OCCUPATIONAL AND SPEECH REHABILITATION THERAPY TO ACHIEVE OUTCOMES TO FUNCTION AS INDEPENDENTLY AS POSSIBLE FOR PEOPLE TO BE ABLE TO LIVE, WORK AND PLAY TO THEIR FULL POTENTIAL. $11,565 PURCHASED EQUIPMENT AND SOFTWARE TO PROVIDE HANDS-ONE JOB SIMULATION IN A SUPPORTIVE ENVIRONMENT FOR YOUTH WHO HAVE NOT WORKED BEFORE.$10,917 PROVIDED AN INTRO TO VIDEO STORYTELLING CLASS: ALONG WITH FILMNORTH, FILMMAKING CLASSES FOR PATIENTS WITH NEWLY ACQUIRED DISABILITIES IN THE TRANSITIONAL REHAB PROGRAM TO RECORD RECOVERY PROCESS AND LEARN ADAPTIVE ARTISTIC SKILLS.$3,502 PURCHASED ADAPTIVE ENVIRONMENTAL CONTROLS TO ALLOW PATIENTS TO CONTROL THEIR SURROUNDING ENVIRONMENT - LIGHTING, TEMP, BODY POSITION AND OTHER ENVIRONMENTAL ELEMENTS FROM BED OR CHAIR WITH ADAPTATIONS FOR MOST PEOPLE WITH DISABILITIES TO BE ACHIEVE THESE CHANGES. 87600 87600 CAPITAL GRANT TO PURCHASE SPECIALIZED THERAPY EQUIPMENT FOR THE EXPANDED TRANSITIONAL REHAB PROGRAM TO IMPROVE AND ACCELERATE CLIENT OUTCOMES. 77274 77274 GRANTS TO OTHERS IN THE AMOUNT OF $77,274 WERE PAID TO SIX 501(C)(3) ORGANIZATIONS. 1290858 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 1 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 21 19 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 MODENA HENDERSON DIRECTOR 2.00 40.00 X 0 465179 78725 LINDA ORTNER DIRECTOR/PRESIDENT 32.00 8.00 X X 0 235061 16724 BETH BECKER DIRECTOR 2.00 0.00 X 0 0 0 STEVE COLEMAN DIRECTOR 2.00 0.00 X 0 0 0 JAMES GRESHAM DIRECTOR 2.00 0.00 X 0 0 0 TIM GUNDERSON DIRECTOR 2.00 0.00 X 0 0 0 VALERIE HERRING DIRECTOR 2.00 0.00 X 0 0 0 GARY JOHANSEN DIRECTOR 2.00 0.00 X 0 0 0 ANDY KRANE DIR/CHAIR 2.00 0.00 X 0 0 0 RICHARD LAY DIRECTOR 2.00 0.00 X 0 0 0 NICKI LERITZ DIRECTOR 2.00 0.00 X 0 0 0 MIKE MCPARLAN DIRECTOR/TREASURER 2.00 0.00 X 0 0 0 JOSH ORTIZ DIRECTOR 2.00 0.00 X 0 0 0 JOSH REBHOLZ DIRECTOR 2.00 0.00 X 0 0 0 DAN SEEMAN DIRECTOR 2.00 0.00 X 0 0 0 ERIC SHERMAN DIRECTOR 2.00 0.00 X 0 0 0 BOB SPENCER DIRECTOR/VICE CHAIR/SEC. 2.00 0.00 X 0 0 0 PETER STITELER DIRECTOR 2.00 0.00 X 0 0 0 DARCY SWENSON DIRECTOR 2.00 0.00 X 0 0 0 JOSIE TAYLOR DIRECTOR 2.00 0.00 X 0 0 0 BECKY WALKER DIRECTOR 2.00 0.00 X 0 0 0 RICHARD MAGNUSON CFO 2.00 40.00 X 0 1371096 103314 STEPHEN BARITEAU FORMER DIRECTOR/PRESIDENT 32.00 8.00 X 0 96096 0 0 2167432 198763 0 1 1 0 0 4368 346249 896675 28079 1247292 118822 118822 3429054 3432309 -3255 -3255 -3255 7087 22952 -15865 -15865 1346994 -15865 0 115567 1290858 1290858 35 20 15 61727 34567 27160 291 163 128 400 224 176 FOUNDATION STAFF SVCS 213134 119355 93779 PURCH SVCS - AFFILIATES 93405 52307 41098 -22743 -12736 -10007 1637107 1290858 193900 152349 0 0 270332 0 0 0 0 0 0 0 0 0 39748798 0 0 0 2750233 0 42769363 0 1073766 0 1073766 0 X 8328954 0 33366643 0 41695597 0 42769363 0 X -290113 -1147511 -40257973 X X 0 1 X 1 0 X 6850646 5948398 5697361 8003876 1247293 27747574 6850646 5948398 5697361 8003876 1247293 27747574 1809738 25937836 797613 914167 450396 1154483 115568 3432227 -129875 -45182 670386 -55049 440280 31620081 0.82030 0.85070 X PART II SECTION A (E) AND SECTION B (E) 2022 CALCULATIONS ARE BASED ON SHORT YEAR END 4-1-2022. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 -7959 77274 193239 1 1 22506901 18 86189 830504 21762604 21046623 44581 2073381 657684 22506901 19234790 64764 2382002 634933 21046623 16916529 30120 2626771 338630 19234790 17767748 54124 -448928 456415 16916529 0.45760 0.54240 0 0 0 X PART V, LINE 4: CHARITY AND INDIGENT CARE. EDUCATION AND RESEARCH. BUILDINGS AND EQUIPMENT. PATIENT CARE. 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 COURAGE KENNY REHABILITATION SERVICES 800 E 28TH STREET MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 1125984 0 SUPPORT COURAGE KENNY PROGRAM COSTS AND PROVIDE PATIENT CARE EQUIPMENT ALLINA HEALTH SYSTEM DBA COURAGE KENNY REHABILITATION SERVICES 800 E 28TH STREET MINNEAPOLIS MN 55407 363261413 170(B)(1)(A)(III) 87600 0 SPECIALIZED THERAPY EQUIPMENT FOR THE EXPANDED TRANSITIONAL REHAB PROGRAM TRUE FRIENDS 10509 108TH ST NW ANNANDALE MN 55302 411543013 501(C)(3) 52974 0 GENERAL SUPPORT FOR CAMP PROVIDING EXPERIENCES ENHANCING INDEPENDENCE AND SELF-ESTEEM FOR THOSE WITH DISABILITIES; THERAPEUTIC HORSEBACK RIDING PROGRAM; ENDOWMENT FUND CHILDRENS HEALTH CARE FOUNDATION 2525 CHICAGO AVENUE SOUTH MINNEAPOLIS MN 55404 411814223 501(C)(3) 22000 0 GENERAL SUPPORT FOR CHILDREN'S OF MINNESOTA FOUNDATION, MIDWEST FETAL CARE PART I, LINE 2: COURAGE KENNY 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 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. 1 1 0 0 0 1 1 0 1 0 RICHARD MAGNUSON CFO 0 817342 0 427877 0 125877 0 99028 0 4285 0 1474409 0 0 MODENA HENDERSON DIRECTOR 0 438809 0 0 0 26370 0 68666 0 10059 0 543904 0 0 LINDA ORTNER DIRECTOR/PRESIDENT 0 191508 0 41116 0 2437 0 11874 0 4851 0 251786 0 0 STEPHEN BARITEAU FORMER DIRECTOR/PRESIDENT 0 0 0 37862 0 58234 0 0 0 0 0 96096 0 0 PART I, LINE 3 SEE NARRATIVE ON SCHEDULE O - FOR FORM 990, PART VI, SECTION A, LINE 6. PART I, LINES 4A-B LINE 4(A): STEPHEN BARITEAU - $58,234 LINE 4(B): 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 53.4958-4(A)(3). FROM TIME TO TIME, ALLINA HEALTH SYSTEM ENTERS INTO CONTRACTUAL ARRANGEMENTS THAT MAY QUALIFY FOR THE INITIAL CONTRACT EXCEPTION BASED ON THE TERMS AND UNDERSTANDINGS OF THE CONTRACTUAL AGREEMENTS. SCHEDULE J, LINE 4(A) & (B) ADDITIONAL DISCLOSURES: 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 (ERBRP) 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. X 2 28079 FAIR MARKET VALUE 0 1 1 PART I, LINE 32B: COURAGE KENNY FOUNDATION MAY FROM TIME TO TIME AND IN THE ORDINARY COURSE OF ITS CHARITABLE ACTIVITIES ACCEPT NONCASH CONTRIBUTIONS OF PUBLICLY TRADED SECURITIES. COURAGE KENNY FOUNDATION USES THIRD PARTIES SUCH AS SECURITIES BROKERAGE FIRMS TO LIQUIDATE THE PUBLICLY TRADED SECURITIES TO CASH ON THE OPEN SECURITIES MARKET. THE SALE OF PUBLICLY TRADED SECURITIES ARE GENERALLY SUBJECT TO MARKET RATE BROKERAGE COMMISSIONS AND FEES OF THE THIRD PARTY SECURITIES BROKER. COURAGE KENNY FOUNDATION CASH AND INVESTMENTS ARE POOLED WITH ITS SOLE MEMBER ORGANIZATION, ALLINA HEALTH SYSTEM, AND ITS RELATED ORGANIZATIONS. ALL ASSETS AND LIABILITIES OF THE ORGANIZATION VIA MERGER 2022-04-01 40237803 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 CKF/AHF MERGER: AS MORE FULLY DESCRIBED IN THE ARTICLES OF MERGER FILED WITH THE MINNESOTA SECRETARY OF STATE, COURAGE KENNY FOUNDATION ("CKF") 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 COURAGE KENNY FOUNDATION TRANSFERRED TO ALLINA HEALTH FOUNDATION, THE SURVIVING AND SUCCESSOR ORGANIZATION. THIS WILL BE THE FINAL FILING FOR COURAGE KENNY 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: COURAGE KENNY 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 CKF 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 ON APRIL 1, 2022, ALLINA HEALTH SYSTEM AND THE COURAGE KENNY FOUNDATION BOARDS FILED ARTICLES OF MERGER WITH THE MINNESOTA SECRETARY OF STATE REFLECTING THE MERGERS OF COURAGE KENNY 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 COURAGE KENNY FOUNDATION. SEE SCHEDULE R FOR FURTHER DETAILS. ALLINA HEALTH SYSTEM PROVIDES COURAGE KENNY FOUNDATION WITH ADMINISTRATIVE AND STAFF SERVICES AT NO COST. THE VALUE OF THE SERVICES PROVIDED BY ALLINA HEALTH SYSTEM TO COURAGE KENNY FOUNDATION DURING 2022 WERE ESTIMATED AT $346,249 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. COURAGE KENNY 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 COURAGE KENNY FOUNDATION. THE RESERVED POWERS ARE FULLY DESCRIBED IN COURAGE KENNY 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 FORM 990, PART VI, SECTION A, LINE 7A AND THE DESCRIPTION ABOVE RELATED TO IT IN SCHEDULE O. FORM 990, PART VI, SECTION B, LINE 11B COURAGE KENNY FOUNDATION'S FORM 990 WAS PREPARED BY THE TAX SERVICES FUNCTION OF ALLINA HEALTH SYSTEM, COURAGE KENNY 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 COURAGE KENNY 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 COURAGE KENNY 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, FORM 990, PART VI, SECTION B, LINES 15A AND 15B ARE NOT APPLICABLE TO COURAGE KENNY FOUNDATION. FORM 990, PART VI, SECTION C, LINE 19 COURAGE KENNY 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: COURAGE KENNY 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. FORM 990, PART XI, LINE 9: FUND BALANCE TRANSFER TO ALLINA HEALTH FOUNDATION -40,237,803. CHANGE IN VALUE OF SPLIT INTEREST -20,170. 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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