2024-11-11T09:32:11-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 121 WEST BRIDGE STREET OWATONNA MN 55060 990 2023-01-01 411328097 RIDGEVIEW FOUNDATION RIDG 9524426010 500 SOUTH MAPLE STREET WACONIA MN 55387 AARON BLOOMQUIST CFO 9524426010 2024-11-08 1 0 JUSTIN HARTERT P02236744 5074467100 2024-11-08 2023 2024-10-15 13:58:12Z MICHAEL PHELPS 500 SOUTH MAPLE STREET WACONIA MN 55387 5767975 0 X WWW.RIDGEVIEWMEDICAL.ORG X 1978 MN TO MAKE A POSITIVE DIFFERENCE IN THE QUALITY OF LIFE AND HEALTH FOR THE PEOPLE OF OUR AREA. 25 25 0 102 0 0 2323370 3520250 0 0 249054 719320 -414225 -106600 2158199 4132970 2401000 2555141 0 0 0 0 0 0 0 362503 220709 2763503 2775850 -605304 1357120 22122176 24276496 1163844 615193 20958332 23661303 RIDGEVIEW FOUNDATION IS AN INDEPENDENT NONPROFIT ORGANIZATION THAT PARTNERS WITH RIDGEVIEW MEDICAL CENTER IN ITS MISSION TO MAKE A POSITIVE DIFFERENCE IN THE QUALITY OF LIFE AND HEALTH FOR THE PEOPLE OF OUR AREA. 0 0 2631705 2555141 0 TO RAISE FUNDS FOR THE BENEFIT OF RIDGEVIEW MEDICAL CENTER, A NOT-FOR-PROFIT HOSPITAL IN WACONIA, MINNESOTA. DURING 2023, RIDGEVIEW FOUNDATION EXPENDED $2,132,956 TO RIDGEVIEW MEDICAL CENTER. OF THIS, $1,615,033 WAS TRANSFERRED TO OUR "CAUSE FOR COMMUNITY" CAMPAIGN, WHICH IS A FUND THAT ALLOWS US TO BETTER MEDICALLY SUPPORT THE 300,000 RESIDENTS WITHIN OUR SEVEN-COUNTY SERVICE AREA, $129.998 WAS TRANSFERRED TO SUPPORT WOMEN & CHILDREN IN NEED, AND $208,921 WAS TRANSFERRED TO THE HOSPITAL TO SUPPORT THE BUILDING AND FURNISHING OF AN EMERGENCY DEPARTMENT EXPANSION. THE REMAINING $179,004 WAS TRANSFERRED TO THE HOSPITAL FOR VARIOUS PROJECTS AND PROGRAMS DURING 2023. 2631705 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 41 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 25 25 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X AARON BLOOMQUIST 9524422191 500 SOUTH MAPLE STREET WACONIA MN 55387 JON CROW BOARD MEMBER 0.50 0.00 X 0 0 0 CARLA STRUBLE CHAIR 0.50 0.00 X X 0 0 0 KATHRYN BARNES BOARD MEMBER 0.50 0.00 X 0 0 0 JENNIFER TREGARTHEN VICE CHAIR 0.50 0.00 X X 0 0 0 TROY WERK SECRETARY 0.50 0.00 X X 0 0 0 MIKE BAUER BOARD MEMBER 0.50 0.00 X 0 0 0 BRIAN BENIEK BOARD MEMBER 0.50 0.00 X 0 0 0 TIM FOSTER BOARD MEMBER 0.50 0.00 X 0 0 0 JOHN HAYES BOARD MEMBER 0.50 0.00 X 0 0 0 JOHN TAYLOR BOARD MEMBER 0.50 0.00 X 0 0 0 DR BRUCE HUBBARD BOARD MEMBER 0.50 0.00 X 0 0 0 RYAN JOHNSON BOARD MEMBER 0.50 0.00 X 0 0 0 KEVIN KOEMPTGEN FINANCE CHAIR 0.50 0.00 X X 0 0 0 MELISSA TRIMM BOARD MEMBER 0.50 0.00 X 0 0 0 JESSICA MONARCH BOARD MEMBER 0.50 0.00 X 0 0 0 JEAN MURRAY BOARD MEMBER 0.50 0.00 X 0 0 0 TIM SAMUELSON BOARD MEMBER 0.50 0.00 X 0 0 0 TIM SCHMIDT BOARD MEMBER 0.50 0.00 X 0 0 0 HANS SIEFKER BOARD MEMBER 0.50 0.00 X 0 0 0 DR MICHAEL SMITH BOARD MEMBER 0.50 0.00 X 0 0 0 CHUCK SPEVACEK BOARD MEMBER 0.50 0.00 X 0 0 0 NIKKI VANECEK BOARD MEMBER 0.50 0.00 X 0 0 0 DAVID WINDSCHITL BOARD MEMBER 0.50 0.00 X 0 0 0 RUTH VOLTHERMS BOARD MEMBER 0.50 0.00 X 0 0 0 ALLIE NEWMAN BOARD MEMBER 0.50 0.00 X 0 0 0 MICHAEL PHELPS PRESIDENT/CEO 0.50 49.50 X 0 1117159 89808 AARON BLOOMQUIST CFO 4.00 46.00 X 0 606487 81944 KELLY MULLEADY EXECUTIVE DIRECTOR 47.50 2.50 X 0 219276 10179 0 1942922 181931 0 0 1 0 0 476429 3043821 256578 3520250 408439 408439 1534486 1223605 310881 310881 310881 100479 476429 389582 -289103 -289103 84299 21818 62481 62481 GROUP LIFE INSURANCE 900099 120022 120022 120022 4132970 0 0 612720 2509141 2509141 46000 46000 20195 20195 123950 123950 29772 29772 MISCELLANEOUS EXPENSES 46792 46792 2775850 2631705 144145 0 918303 2295850 232732 319373 1152604 1090171 57857 64857 9697 9697 0 0 14664396 14956579 5096284 5549666 22122176 24276496 184786 188081 979058 427112 1163844 615193 X 13756157 15315849 7202175 8345454 20958332 23661303 22122176 24276496 1357120 1345851 0 X X 0 1 X 1 0 X 3204981 3293420 3295578 2323370 3520250 15637599 3204981 3293420 3295578 2323370 3520250 15637599 1232068 14405531 288703 241726 323707 328792 408439 1591367 197431 70606 141759 151546 304800 866142 18095108 0.79610 0.84500 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: SPECIAL FUNDRAISING EVENTS CHARITABLE GAMING ACTIVITIES GROUP LIFE INSURANCE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6633585 6633585 6633585 6633585 6107027 526558 287550 287550 6633585 6081425 25602 355046 355046 6107027 6041811 39614 429578 429578 6081425 0.45220 0.54780 0.00000 0 0 9697 9697 0 0 ASSETS HELD IN CHARITABLE REMAINDER TRUST 327733 CASH SURRENDER VALUE LIFE INSURANCE POLICY 5221933 5549666 DUE TO RIDGEVIEW MEDICAL CENTER 427112 427112 X 6796373 1345851 1111485 330017 2787353 4009020 123950 123950 4132970 4093402 1111485 330017 1441502 2651900 123950 123950 2775850 PART V, LINE 4: THE EARNING FROM THE ENDOWMENT FUNDS ARE INTENDED TO BE USED FOR THE BENEFIT OF RIDGEVIEW MEDICAL CENTER, A NOT-FOR-PROFIT HOSPITAL IN WACONIA, MINNESOTA. PART X, LINE 2: THE FOUNDATION HAS RECEIVED NOTIFICATION THAT IT QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING PROVISIONS OF STATE LAW AND, ACCORDINGLY, IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, ANY UNRELATED BUSINESS INCOME MAY BE SUBJECT TO TAXATION. DURING 2010, THE FOUNDATION REQUESTED AND WAS APPROVED TO RECLASSIFY FROM 509(A)(3) STATUS TO 509(A)(1) AND 170(B)(1)(A)(VI) STATUS WITH THE INTERNAL REVENUE SERVICE. THE FOUNDATION HAS ELECTED TO ADOPT GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE FOUNDATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES FOR EVALUATING UNCERTAIN TAX POSITIONS. THE ADOPTION OF THIS STANDARD HAD NO EFFECT ON THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 330,017. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EVENT EXPENSES 330,017. PIFF CASINO NIGHT 432885 432885 17167 22699 GOLF TOURNAMENT 85934 33534 52400 1785 58059 32716 1610 142370 4 58089 10010 48079 23949 27800 34182 6980 20265 576908 476429 100479 25734 103026 66898 8590 185334 389582 -289103 6090 3043 0 78209 18775 0 84299 21818 21818 62481 MN 1 0 0 0 1.00000 AARON BLOOMQUIST 500 SOUTH MAPLE STREET WACONIA MN 55387 0 BRIAN MASTEL 67938 GAMING MANAGER SUPERVISES ALL FUNDRAISING EVENTS AND FILLS OUT ALL OF THE PAPERWORK RELATED TO GAMING ACTIVITIES. X 0 1 RIDGEVIEW MEDICAL CENTER 500 SOUTH MAPLE STREET WACONIA MN 55387 311667875 501(C)(3) 2405783 0 FUNDRAISING SUPPORT OF RIDGEVIEW MEDICAL CENTER SIBLEY MEDICAL CENTER 601 WEST CHANDLER STREET ARLINGTON MN 55307 411801967 501(C)(3) 59747 0 FUNDRAISING SUPPORT OF SIBLEY MEDICAL CENTER MINNESOTA VALLEY HEALTH CENTER 621 SOUTH 4TH STREET LE SUEUR MN 56058 410837659 501(C)(3) 38307 0 FUNDRAISING SUPPORT OF MINNESOTA VALLEY HEALTH CENTER 3 0 SCHOLARSHIPS 23 46000 PART I, LINE 2: GRANTS AND OTHER ASSISTANCE TO ENTITIES IN THE U.S.: TRANSFERS ARE TO RELATED ENTITIES UNDER COMMON MANAGEMENT AND TRACKED THROUGH THE INTERNAL FINANCIAL REPORTING PROCESS. GRANTS AND OTHER ASSISTANCE TO INDIVIDUALS IN THE U.S.: SCHOLARSHIP PAYMENTS ARE MADE DIRECTLY TO THE SCHOOL THAT THE STUDENT IS ATTENDING. 0 1 0 0 0 1 1 0 0 MICHAEL PHELPS PRESIDENT/CEO 0 1113043 0 0 0 4116 0 30630 0 59178 0 1206967 0 0 AARON BLOOMQUIST CFO 0 605045 0 0 0 1442 0 23957 0 57987 0 688431 0 0 KELLY MULLEADY EXECUTIVE DIRECTOR 0 191374 0 0 0 27902 0 10179 0 0 0 229455 0 0 PART I, LINE 3 THE PRESIDENT/CEO IS COMPENSATED BY RIDGEVIEW MEDICAL CENTER, THE SOLE MEMBER. THE FOLLOWING WERE USED BY RIDGEVIEW MEDICAL CENTER TO DETERMINE THE PRESIDENT/CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE (EXECUTIVE COMMITTEE) 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) WRITTEN EMPLOYMENT CONTRACT 5) COMPENSATION SURVEY OR STUDY 6) APROVAL BY THE BOARD OR COMPENSATION COMMITTEE (EXECUTIVE COMMITTEE) PART I, LINE 4B MICHAEL PHELPS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AT RIDGEVIEW MEDICAL CENTER. DURING 2023, $197,412 WAS CONTRIBUTED TO THE PLAN, $74,970 ACCRUED WITHIN THE PLAN, AND $0 WAS PAID OUT OF THE PLAN. AARON BLOOMQUIST PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AT RIDGEVIEW MEDICAL CENTER. DURING 2023, $231,049 WAS CONTRIBUTED TO THE PLAN, $10,720 ACCRUED WITHIN THE PLAN, AND $0 WAS PAID OUT OF THE PLAN. THESE DEFERRED COMPENSATION AMOUNTS ARE REPORTED ON A PRO-RATA BASIS WITHOUT REGARD TO THE INDIVIDUAL'S VESTING SCHEDULE. CURRENTLY, THE MAJORITY OF DEFERRED COMPENSATION IS NOT VESTED. PART I, LINE 6 THE OFFICERS OF RIDGEVIEW MEDICAL CENTER AND AFFILIATES RECEIVE BONUSES CONTINGENT ON THE NET EARNINGS OF THE CONSOLIDATED ENTITY AND GOALS ACHIEVED. BONUSES WERE EARNED IN 2023 AND PAID IN 2024. X 1 256578 FAIR MARKET VALUE 0 0 0 0 PART I, COLUMN (B): THE FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTIONS IN COLUMN (B). FORM 990, PART VI, SECTION A, LINE 1A THE BOARD OF DIRECTORS OF THE FOUNDATION DESIGNATED SEVEN BOARD MEMBERS AS AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE ACTS ONLY DURING INTERVALS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS OF THE FOUNDATION AND IS AT ALL TIMES SUBJECT TO THE CONTROL AND DIRECTION OF THE BOARD OF DIRECTORS OF THE FOUNDATION. DURING SUCH INTERVALS AND SUBJECT TO SUCH CONTROL AND DIRECTION, THE EXECUTIVE COMMITTEE HAS ALL OF THE AUTHORITY AND POWER OF THE BOARD OF DIRECTORS OF THE FOUNDATION IN THE MANAGEMENT OF THE BUSINESS OF THE FOUNDATION, SUBJECT TO SUCH LIMITATIONS AS THE BOARD OF DIRECTORS OF THE FOUNDATION MAY IMPOSE FROM TIME TO TIME. FORM 990, PART VI, SECTION A, LINE 3 ALL MANAGEMENT SERVICES ARE PROVIDED BY RIDGEVIEW MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 6 RIDGEVIEW MEDICAL CENTER IS THE SOLE MEMBER OF RIDGEVIEW FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A EACH PERSON ELECTED BY THE BOARD OF DIRECTORS OF RIDGEVIEW FOUNDATION IS RATIFIED OR REJECTED BY THE BOARD OF DIRECTORS OF RIDGEVIEW MEDICAL CENTER, THE FOUNDATION'S SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION TO THE APPOINTMENT OF DIRECTORS TO THE BOARD OF DIRECTORS OF RIDGEVIEW FOUNDATION, AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FOUNDATION REQUIRE APPROVAL OF RIDGEVIEW MEDICAL CENTER, THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B THE CFO REVIEWED THE FORM 990 AND PROVIDED COPIES TO THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS ANNUALLY REVIEW AND SIGN THE STATEMENTS FOR POTENTIAL CONFLICTS OF INTEREST POLICY. EACH MEMBER IS EXPECTED TO DISCLOSE ANY CONFLICT OF INTEREST THAT MAY ARISE DURING THE YEAR. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, THE SITUATION WILL BE EXAMINED AND HANDLED APPROPRIATELY BY THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 RIDGEVIEW FOUNDATION DOES NOT COMPENSATE ITS OFFICERS OR BOARD MEMBERS. ANY COMPENSATION RECEIVED BY THOSE INDIVIDUALS IS DETERMINED BY RIDGEVIEW MEDICAL CENTER, THE FOUNDATION'S PARENT. FORM 990, PART VI, SECTION C, LINE 19 RIDGEVIEW FOUNDATION'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C THE PROCESS FOR OVERSIGHT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. RIDGEVIEW CLINICS 500 SOUTH MAPLE STREET WACONIA MN 55387 411651783 HEALTH CARE SERVICES MN 501(C)(3) LINE 12A, I RIDGEVIEW MEDICAL CENTER 0 RIDGEVIEW MEDICAL CENTER 500 SOUTH MAPLE STREET WACONIA MN 55387 311667875 HEALTH CARE SERVICES MN 501(C)(3) LINE 3 N/A 0 RIDGEVIEW INSURANCE COMPANY 60 E SOUTH TEMPLE STE 1800 SALT LAKE CITY UT 84111 454109041 CAPTIVE INSURANCE COMPANY UT 501(C)(3) LINE 12A, I RIDGEVIEW MEDICAL CENTER 0 SIBLEY MEDICAL CENTER 601 W CHANDLER ST ARLINGTON MN 55307 411801967 CRITICAL ACCESS HOSPITAL MN 501(C)(3) LINE 3 RIDGEVIEW MEDICAL CENTER 0 MINNESOTA VALLEY HEALTH CENTER 621 S 4TH STREET LE SUEUR MN 56058 410837659 HEALTH CARE SERVICES MN 501(C)(3) LINE 3 RIDGEVIEW MEDICAL CENTER 0 MINNEAPOLIS HEART INSTITUTE AT RIDGEVIEW HEART CENTER LCC 500 S MAPLE ST WACONIA MN 55387 205785920 CARDIOLOGY SERVICES MN N/A 0 0 CHASKA PLAZA SURGERY CENTER 3000 HUNDERTMARK ROAD CHASKA MN 55318 450975783 SURGERY SERVICES MN N/A 0 0 EXECUTIVE HEALTH MANAGEMENT SERVICES 500 SOUTH MAPLE STREET WACONIA MN 55387 411760239 MANAGEMENT SERVICES MN N/A C 0 CHARITABLE REMAINDER TRUST (1) CHARITABLE TRUST MN 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 0