2025-08-15T09:33:16-05:00 2024-09-30 420714325 RSM US LLP 227 WEST FIRST STREET SUITE 700 DULUTH MN 55802 990 2023-10-01 461836177 ELY HEALTH AND HOSPITAL FUND ELYH 2183653271 328 WEST CONAN STREET ELY MN 55731 TIMOTHY BALTHAZOR CFO 2183653271 2025-08-13 1 1 JULIE BOYER P01278549 2187275025 2025-08-13 2023 2025-03-06 01:10:19Z PATTI BANKS 328 WEST CONAN STREET ELY MN 55731 2613807 0 X N/A X 2012 MN TO RECEIVE FUNDS AND MAKE DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT ORGANIZATIONS UNDER CODE SECTION 501(C)(3) AND TO PROMOTE THE HEALTH OF THE RESIDENTS OF THE COMMUNITIES SERVED BY THE ELY-BLOOMENSON COMMUNITY HOSPITAL, A MINNESOTA NONPROFIT CORPORATION. 9 9 0 11 8384 7384 0 0 0 0 349616 201325 8384 8384 358000 209709 0 0 0 0 0 0 0 0 0 31117 35335 31117 35335 326883 174374 12952939 15888329 0 0 12952939 15888329 TO RECEIVE FUNDS AND MAKE DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT ORGANIZATIONS UNDER CODE SECTION 501(C)(3) AND TO PROMOTE THE HEALTH OF THE RESIDENTS OF THE COMMUNITIES SERVED BY THE ELY-BLOOMENSON COMMUNITY HOSPITAL, A MINNESOTA NONPROFIT CORPORATION. 0 0 0 0 0 TO RECEIVE FUNDS AND MAKE DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS EXEMPT ORGANIZATIONS UNDER CODE SECTION 501(C)(3), AND TO PROMOTE THE HEALTH OF THE RESIDENTS OF THE COMMUNITIES SERVED BY THE ELY-BLOOMENSON COMMUNITY HOSPITAL, A MINNESOTA NONPROFIT CORPORATION. 1 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 0 MN X PATTI BANKS 2183653271 328 WEST CONAN STREET ELY MN 55731 MARY ANN SMITH DIRECTOR 0.25 1.00 X 0 0 0 RIANA HEGMAN DIRECTOR 0.25 1.25 X 0 0 0 JO LANGAN DIRECTOR UNTIL 12/31/23 0.25 1.25 X 0 0 0 STEPHEN PETERSON SR DIRECTOR 0.25 1.25 X 0 0 0 JOHN SAW DIRECTOR 0.25 1.25 X 0 0 0 ROBERT WILMUNEN DIRECTOR 0.25 1.25 X 0 0 0 TODD HEIMAN TREASURER 0.25 1.25 X X 0 0 0 KELLY KLUN SECRETARY UNTIL 12/31/23 0.25 1.25 X X 0 0 0 BARB SODERBERG SECRETARY 0.25 1.25 X X 0 0 0 DEVON LUTHENS PRESIDENT 0.25 1.25 X X 0 0 0 TIM RILEY VICE PRESIDENT 0.25 1.25 X X 0 0 0 PATTI BANKS CEO 0.25 39.75 X 0 248682 43202 0 248682 43202 0 0 1 0 0 421540 421540 2183883 2404098 -220215 -220215 -220215 FERRELLGAS PARTNERS K-1 ACTIVITY 900099 8384 8384 8384 209709 0 8384 201325 35335 35335 35335 0 35335 0 41180 49621 12904843 15832127 6916 6581 12952939 15888329 0 0 X 12952939 15888329 12952939 15888329 12952939 15888329 X 174374 2769401 -1 -8384 X 0 1 X 0 0 X X 1 ELY-BLOOMENSON COMMUNITY HOSPITAL 410808719 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 X 2970726 2769401 2769401 201325 8384 8384 209709 35335 0 35335 0 35335 PART X, LINE 2: THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. MANAGEMENT EVALUATED THE FOUNDATION'S TAX POSITIONS AND CONCLUDED THE ORGANIZATION HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THE GUIDANCE. GENERALLY, THE ORGANIZATION IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE, OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2021. PART XI, LINE 4B - OTHER ADJUSTMENTS: FERRELLGAS PARTNERS, L.P. K-1 ACTIVITY 8,384. 0 0 0 0 0 0 0 0 0 PATTI BANKS CEO 0 248553 0 0 0 129 0 10255 0 32947 0 291884 0 0 PART I, LINE 3 ELY HEALTH AND HOSPITAL FUND DOES NOT COMPENSATE ANY EMPLOYEES. THE CEO IS COMPENSATED BY THE ELY-BLOOMENSON COMMUNITY HOSPITAL, A RELATED ORGANIZATION. THE COMPENSATION IS ESTABLISHED USING: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVERY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 6 THE ELY HEALTH AND HOSPITAL FOUNDATION IS THE SOLE MEMBER OF ELY HEALTH AND HOSPITAL FUND. FORM 990, PART VI, SECTION A, LINE 7A ELY HEALTH AND HOSPITAL FOUNDATION (THE SOLE MEMBER OF ELY HEALTH AND HOSPITAL FUND) SHALL ELECT THREE OR MORE PERSONS ON THE FUND'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B ALL POWERS AFFORDED BY LAW TO VOTING MEMBERS OF NONPROFIT CORPORATIONS SHALL BE VESTED SOLELY AND EXCLUSIVELY IN THE CORPORATE MEMBER. THE CORPORATE MEMBER SHALL VOTE OR OTHERWISE ACT THROUGH ITS BOARD OF DIRECTORS OR ANY PERSON DESIGNATED BY ITS BOARD OF DIRECTORS. THE POWER TO ADOPT, AMEND OR REPEAL THE BYLAWS IS VESTED SOLELY IN THE BOARD OF DIRECTORS OF THE CORPORATE MEMBER. NOTICE OF ANY AMENDMENT OR MODIFICATION OF THE BYLAWS SHALL BE PROVIDED BY THE CORPORATE MEMBER TO THE BOARD OF DIRECTORS AND THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 8B NO COMMITTEE EXISTS WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE 990 WILL BE REVIEWED BY THE ELY-BLOOMENSON COMMUNITY HOSPITAL'S CFO AND SUBMITTED TO THE BOARD OF DIRECTORS FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS AND BOARD MEMBERS OF THE ORGANIZATION ARE REQUIRED TO COMPLY WITH THE CONFLICT OF INTEREST POLICY SET FORTH BY THE GOVERNING BODY. 1. DUTY TO DISCLOSE - AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBER OF COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. 2. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS - AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. 3. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST - - AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING, BUT AFTER SUCH PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT THAT RESULTS IN THE CONFLICT OF INTEREST. - THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. - AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. - IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. 4. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY - - IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. - IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. PERIODIC REVIEWS - TO ENSURE THAT THE CORPORATION OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX, PERIODIC REVIEWS SHALL BE CONDUCTED IF APPROPRIATE. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: - WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE AND ARE THE RESULT OF ARM'S-LENGTH BARGAINING; AND - WHETHER PARTNERSHIP AND JOINT VENTURE ARRANGEMENTS AND ARRANGEMENTS WITH MANAGEMENT SERVICE ORGANIZATIONS CONFORM TO WRITTEN POLICIES, ARE PROPERTY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE CORPORATION'S CHARITABLE PURPOSE AND DO NOT RESULT IN INUREMENT OR IMPERMISSIBLE PRIVATE BENEFIT. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON- - HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, - HAS READ AND UNDERSTANDS THE POLICY, - HAS AGREED TO COMPLY WITH THE POLICY, AND - UNDERSTANDS THAT THE CORPORATION IS A CHARIABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, CONFLICT OF INTEREST, AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART XI, LINE 9: FERRELLGAS PARTNERS, L.P. K-1 ACTIVITY -8,384. ELY-BLOOMENSON COMMUNITY HOSPITAL 328 WEST CONAN STREET ELY MN 55731 410808719 TO PROVIDE HEALTHCARE TO THE RESIDENTS AND VISITORS TO THE ELY, MN AREA MN 501(C)(3) LINE 3 ELY HEALTH AND HOSPITAL FOUNDATION 0 ELY HEALTH & HOSPITAL FOUNDATION 328 WEST CONAN STREET ELY MN 55731 412001411 TO PROVIDE SUPPORT TO ELY-BLOOMENSON COMMUNITY HOSPITAL FOR HEALTHCARE MN 501(C)(3) LINE 12B, II N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0