2024-11-14T14:11:34-06:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 2689 COMMERCE DRIVE NW SUITE 201 ROCHESTER MN 55901 990 2023-01-01 411989509 NAEVE HEALTH CARE FOUNDATION NAEV 5074341595 404 WEST FOUNTAIN ST ALBERT LEA MN 56007 DANIEL KOLKER PRESIDENT 5074341595 2024-10-29 1 0 KATHERINE LUTZKE CPA P01760889 5072802300 2024-10-29 2023 2024-10-15 13:58:12Z DANIEL KOLKER 404 WEST FOUNTAIN ST ALBERT LEA MN 56007 2470363 0 X WWW.NAEVEFOUNDATION.COM X 2000 MN RAISING PHILANTHROPIC DOLLARS FOR HIGH QUALITY COST EFFECTIVE HEALTHCARE AT MCHS IN ALBERT LEA. 13 13 0 13 0 0 26357 8997 0 0 111744 294680 0 0 138101 303677 235459 252702 0 0 0 0 0 0 0 41808 45573 277267 298275 -139166 5402 4688945 5053753 0 0 4688945 5053753 X SEE SCHEDULE O 0 0 252702 252702 0 NAEVE HEALTH CARE FOUNDATION SUPPORTS PROJECTS WITHIN MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA. 252702 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 MN X MARK CHRISTOPHERSON 5074341069 1000 FIRST DRIVE NW AUSTIN MN 55912 DANIEL KOLKER PRESIDENT 12.00 0.00 X X 0 0 0 CORRINE TIMS VICE CHAIR 6.00 0.00 X X 0 0 0 DIANE CLARK SECRETARY 10.00 0.00 X X 0 0 0 SHANNON STEENSMA TREASURER 10.00 0.00 X X 0 0 0 DIANE DAMEROW TRUSTEE 6.00 0.00 X 0 0 0 DIANE WICHMANN TRUSTEE 6.00 0.00 X 0 0 0 GARY SCHINDLER TRUSTEE 6.00 0.00 X 0 0 0 KAREN CONN TRUSTEE 6.00 0.00 X 0 0 0 NICK SCHILTZ TRUSTEE 6.00 0.00 X 0 0 0 MATTHEW GREIBROK TRUSTEE 6.00 0.00 X 0 0 0 DR TIMOTHY KOZELSKEY TRUSTEE 6.00 40.00 X 0 0 0 DR HEIDI GASTON TRUSTEE 6.00 40.00 X 0 515370 57967 DR SUMIT BHAGRA EX-OFFICIO OFFICER 10.00 40.00 X 0 388285 40462 0 903655 98429 0 0 1 0 0 8997 8997 89549 89549 2371817 2166686 205131 205131 205131 303677 0 0 294680 252702 252702 2000 2000 33774 33774 OTHER FEES 5962 5962 FOREIGN TAXES PAID 3837 3837 298275 252702 45573 0 45036 53923 4634271 4989908 9638 9922 4688945 5053753 0 0 X 4141001 4433143 547944 620610 4688945 5053753 4688945 5053753 5402 359406 0 X 0 0 0 X X X 1 MAYO CLINIC HEALTH SYSTEMS 411404075 3 1 252702 0 1 252702 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 12195 0 0 0 99549 89549 111744 89549 0 0 41808 33774 0 0 69936 55775 5060605 4861830 33328 52111 0 0 5093933 4913941 0 0 0 5093933 4913941 76409 73709 5017524 4840232 175613 169408 0 0 175613 169408 69936 59446 175613 175613 0 175613 252702 0 0 0 0 0 252702 252702 175613 100.000000000000 175613 0 0 0 0 155241 235459 390700 0 175613 0 215087 252702 0 252702 0 0 467789 0 0 0 215087 252702 PART IV, SECTION D, LINE 3 - ROLE OF SUPPORTED ORGANIZATIONS: THE CEO OF THE FOUNDATION'S SUPPORTED ORGANIZATION, MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN (THE "MEDICAL CENTER"), SERVES AS AN EX OFFICIO VOTING MEMBER OF THE BOARD OF TRUSTEES OF THE FOUNDATION. THE MEDICAL CENTER'S CEO ALSO SERVES AS AN EX OFFICIO MEMBER OF THE BOARD OF DIRECTORS OF THE MEDICAL CENTER, THUS PROVIDING REPRESENTATION OF MEDICAL CENTER LEADERSHIP ON THE BOARD OF THE FOUNDATION AT BOTH THE OFFICER AND GOVERNING BODY LEVELS OF THE MEDICAL CENTER. THE MEDICAL CENTER CEO IS COMMITTED TO ENSURING THAT THE FOUNDATION'S FACILITIES ARE MANAGED AND OPERATED IN A MATTER THAT REFLECTS THE MEDICAL CENTER'S CHARITABLE PURPOSES AND MISSION. HE IS ACTIVELY ENGAGED AS A BOARD MEMBER IN THE FOUNDATION'S GOVERNANCE AND PARTICIPATES IN DECISIONS AND DISCUSSIONS AT THE BOARD LEVEL AND WITH THE FOUNDATION'S LEADERSHIP IN ALL ASPECTS OF THE FOUNDATION'S MANAGEMENT AND USE OF ITS INCOME AND ASSETS FOR THE BENEFIT OF THE MEDICAL CENTER. IN ADDITION, THE FOUNDATION'S BYLAWS PROVIDE THAT THE FOUNDATION MUST MAINTAIN A CLOSE AND CONTINUOUS WORKING RELATIONSHIP WITH THE MEDICAL CENTER'S OFFICERS AND DIRECTORS IN ORDER TO ENSURE THAT THE MEDICAL CENTER'S LEADERSHIP HAS A SIGNIFICANT VOICE IN THE FOUNDATION'S OPERATIONS AND ITS ACQUISITION, USE, AND MANAGEMENT OF ITS INCOME AND ASSETS. 281543 281543 281543 281543 281543 281543 281543 281543 281543 281543 0.00000 1.00000 0.00000 0 0 0 WELLS FARGO INVESTMENTS 4989908 F 4989908 PART V, LINE 4: TO SUPPORT PATIENTS OF MAYO CLINIC HEALTH SYSTEM IN ALBERT LEA. 0 MAYO CLINIC HEALTH SYSTEM 404 FOUNTAIN STREET ALBERT LEA MN 56007 411404075 501(C)(3) 252702 0 ACTUAL AMOUNT MEDICAL SUPPLIES & EQUIPMENT SUPPORT PROGRAMS 1 0 0 1 0 0 0 0 0 0 0 DR HEIDI GASTON TRUSTEE 0 490089 0 0 0 25281 0 25033 0 32934 0 573337 0 0 DR SUMIT BHAGRA EX-OFFICIO OFFICER 0 380019 0 0 0 8266 0 34495 0 5967 0 428747 0 0 SCHEDULE J, PART III, SUPPLEMENTAL INFORMATION: THE SUBORDINATES WITHIN THE MAYO CLINIC GROUP RETURN FILING HAVE A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE MAYO PENSION PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(A)(17). STARTING JANUARY 1, 2011, ALL SRP BENEFITS ARE PAID AS AN ANNUAL TAXABLE CASH PAYMENT. THE FOLLOWING INDIVIDUALS PARTICIPATED IN OR RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). GASTON, HEIDI $9,961 BHAGRA, SUMIT $7,254 FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSION: TO ENSURE THE FUTURE OF LOCAL, QUALITY HEALTH CARE THROUGH THE CONTINUED DEVELOPMENT OF A PERMANENT ENDOWMENT FUND AND OTHER PHILANTHROPIC RELATIONSHIPS AND ACTIVITIES AS MAY BE DEEMED APPROPRIATE FOR THE GROWTH AND DEVELOPMENT OF MCHS IN ALBERT LEA AND SURROUNDING COMMUNITIES. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DOES NOT HAVE ANY COMMITTEES THAT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY A NATIONAL CPA OFFICE. A COPY OF THE FORM 990 IS PROVIDED TO ALL BOARD MEMBERS OF THE ORGANIZATION FOR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C IN ACCORDANCE WITH THE FILING ORGANIZATION'S CONFLICT OF INTEREST POLICY, THE FOLLOWING INDIVIDUALS ARE REQUIRED TO ANNUALLY SIGN A CONFLICT OF INTEREST ACKNOWLEDGEMENT: -BOARD OF TRUSTEE MEMBERS -MEMBERS OF THE MAJOR NAEVE HEALTH CARE FOUNDATION COMMITTEES ANY INDIVIDUAL FROM THE ABOVE GROUPS MAY BE ASKED TO ABSTAIN FROM VOTING OR PARTICIPATING IN THE DECISION MAKING ACTIVITIES AFFECTED BY THE CONFLICT OF INTEREST DISCLOSURE. AN INDIVIDUAL MAY BE ASKED TO LEAVE A MEETING WHERE THE DECISION MAKING ACTIVITIES WOULD BE AFFECTED BY THE CONFLICT OF INTEREST DISCLOSURE. IF AN INDIVIDUAL NEGLECTS TO DISCLOSE APPROPRIATELY, DISCIPLINARY ACTION WILL BE CONSIDERED UP TO AND INCLUDING TERMINATION OF EMPLOYMENT AND/OR POSITION ON THE FOUNDATION BOARD. THE COMPLIANCE OFFICER OF MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN ASSISTS THE BOARD IN DISTRIBUTION AND COLLECTION OF ANNUAL CONFLICT OF INTEREST DISCLOSURE FORMS. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS ARE AVAILABLE TO THE PUBLIC. MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 416011702 PATIENT CARE, RESEARCH, AND EDUCATION MN 501(C)(3) LINE 10 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0