2025-11-13T08:42:56-06:00 2024-12-31 346565596 ERNST & YOUNG US LLP 155 N WACKER DRIVE CHICAGO IL 60606 990 2024-01-01 450344371 F-M AMBULANCE SERVICE INC F-MA 7012342000 PO BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 NICHOLAS OLSON EVP, CFO 6053331000 2025-11-13 1 0 JESS WAGENER P01622613 3128792000 2024 2025-03-06 01:10:19Z SANFORD AMBULANCE FARGO BILL GASSEN 2301 EAST 60TH ST SIOUX FALLS SD 57104 17749353 0 X WWW.FMAMBULANCE.COM X 1978 ND TO CARE, COMFORT AND CURE 12 8 0 0 0 0 258925 438293 15775616 17297109 0 0 7149 12063 16041690 17747465 0 0 0 0 13677966 14800641 0 0 0 3337147 3950524 17015113 18751165 -973423 -1003700 7813842 9843196 107549 770774 7706293 9072422 X THE MISSION OF F-M AMBULANCE (DBA SANFORD AMBULANCE FARGO), " TO CARE, COMFORT AND CURE FOR OUR PATIENTS, PEOPLE AND COMMUNITIES AND THE VISION "TO BE THE PREMIER RURAL HEALTH SYSTEM IN THE UNITED STATES, IS THE CONSTANT FORCE THAT DRIVES OUR PLANS, DECISIONS AND ACTIONS." 0 0 16317650 17297109 AS PART OF THE SANFORD HEALTH INTEGRATED DELIVERY SYSTEM, FM AMBULANCE, DBA SANFORD AMBULANCE FARGO (SA-F), PROVIDES EMERGENCY MEDICAL CARE AND SPECIALTY CARE TRANSPORTATION SERVICES TO FARGO, NORTH DAKOTA/MOORHEAD, MINNESOTA METRO AREA AND SURROUNDING COMMUNITIES. SA-F IS ACCREDITED BY THE COMMISSION ON ACCREDITATION OF AMBULANCE SERVICES (CAAS) AND IS THE LARGEST ADVANCED LIFE SUPPORT GROUND AMBULANCE PROVIDER IN NORTH DAKOTA AND OUTSTATE MINNESOTA. SA-F RESPONDS TO MORE THAN 32,000 CALLS FOR SERVICE ANNUALLY WHICH RESULTED IN TRANSPORTING MORE THAN 23,000 PEOPLE AND OVER 9,000 CALLS THAT DID NOT RESULT IN A PATIENT TRANSPORT. SA-F SERVES AS A RESOURCE TO RESCUE SQUADS, LOCAL AND REGIONAL FIRE DEPARTMENTS, AND ALL LAW ENFORCEMENT AGENCIES AND AMBULANCE PROVIDERS THROUGHOUT THE STATE. SA-F PROVIDES TACTICAL PARAMEDICS FOR THE REGIONAL S.W.A.T. TEAM AND PROVIDES FIREFIGHTER REHABILITAION SERVICES PRO-BONO. SA-F WORKS CLOSELY WITH LOCAL VOLUNTEER SERVICES TO COORDINATE THE DELIVERY OF EMERGENCY MEDICAL CARE TO COMMUNITIES IN ITS SERVICE AREA AND IS A LEADER IN HOMELAND DEFENSE PREPAREDNESS BY SERVING AS A REGIONAL TRAINING SITE, RESOURCES PARTNER AND FIRST RESPONDER.THROUGH ITS READY WHEELS OPERATIONS (A SPECIALTY CARE TRANSPORTATION SERVICE), SA-F PROVIDES LOCAL AND LONG DISTANCE TRANSPORTATION FOR INDIVIDUALS CONFINED TO WHEELCHAIRS. THIS SPECIALTY CARE TRANSPORTATION SERVICE IS AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK TO PROVIDE DOOR-TO-DOOR SERVICE. THESE SERVICES ALLOW INDIVIDUALS IN THE COMMUNITY TO ACCESS TRANSPORTATION SERVICES THAT ACCOMMODATE UNIQUE INDIVIDUAL NEEDS DUE TO HEALTH CONDITIONS.EDUCATION AND OTHER SERVICES:SA-F PROMOTES COMMUNITY HEALTH AND INJURY PREVENTION WITH MORE THAN 4,000 MEMBERS OF THE PUBLIC EACH YEAR PARTICIPATING IN FIRST AID, AUTOMATED EXTERNAL DEFIBRILLATOR, CPR, BABYSITTER TRAINING AND OTHER COMMUNITY WELLNESS COURSES. SA-F IS ALSO THE HOME TO THE REGION'S LARGEST INITIAL EMS CERTIFICATION CENTER. EMERGENCY MEDICAL RESPONDER CLASSES ARE TAUGHT TO AREA HIGH SCHOOL STUDENTS, FIRE DEPARTMENTS, LAW ENFORCEMENT AGENCIES AND VOLUNTEER RESCUE SQUADS. EMT CLASSES ARE HELD MULTIPLE TIMES A YEAR AND SUPPLY STAFFING FOR FULL-TIME AND VOLUNTEER AGENCIES ACROSS OUR AREA. IN CONJUNCTION WITH THE NORTH DAKOTA STATE COLLEGE OF SCIENCE, SA-F'S PARAMEDIC PROGRAM OFFERS AN ASSOCIATE DEGREE LEVEL COURSE ACCREDITED BY THE COMMISSION ON ACCREDITATION OF ALLIED HEALTH EDUCATION PROGRAMS (ONE OF 3 IN ND). SA-F ALSO OFFERS RECERTIFICATION COURSES IN-PERSON AND VIRTUALLY THAT ARE ACCREDITED THROUGH THE COMMISSION ON ACCREDITATION FOR PRE-HOSPITAL CONTINUING EDUCATION (ONLY ONE IN ND). NEW IN 2024, SANFORD AMBULANCE FARGO WILL TRAIN UP TO 15 PARAMEDICS IN AN ACADEMY MODEL IN WHICH THE STUDENTS WILL BE EMPLOYEES OF THE AMBULANCE SERVICE AND BE PAID FOR THEIR TRAINING. THIS IS THE ONLY PARAMEDIC APPRENTICESHIP PROGRAM IN THE TRI-STATE REGION WHERE THE STUDENTS ARE EMPLOYEES AND ALL EXPENSES ARE COVERED BY SANFORD HEALTH. 16317650 0 1 0 0 0 0 0 0 0 1 0 0 1 1 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 1 0 0 0 0 0 0 0 0 0 0 0 X 12 8 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X NICHOLAS OLSON EVP CFO 6053331000 2301 EAST 60TH STREET SIOUX FALLS SD 57104 X BILL GASSEN TRUSTEE, PRESIDENT & CEO 0.15 59.85 X X 0 4414119 585241 ANDY NORTH TRUSTEE, SECRETARY, INDEP CONTRACTOR 0.00 4.90 X X 0 379383 0 LAURIS MOLBERT TRUSTEE, CHAIRPERSON 0.00 4.90 X X 0 107199 0 BRENT TEIKEN TRUSTEE 0.00 4.90 X 0 84246 0 JAMES CAIN TRUSTEE, TREASURER 0.00 4.90 X X 0 81651 0 MARNIE HERMANN TRUSTEE, VICE CHAIR 0.00 4.90 X X 0 80382 0 NEIL GULSVIG TRUSTEE, PAST CHAIR 0.00 4.90 X X 0 80055 0 MARK LUNDEEN MD TRUSTEE 0.00 4.90 X 0 80000 0 DAVID SHULKIN TRUSTEE 0.00 4.90 X 0 79826 0 STEPHANIE HERSETH SANDLIN TRUSTEE 0.00 4.90 X 0 78750 0 WESLEY ENGBRECHT TRUSTEE 0.00 4.90 X 0 77594 0 DANA DYKHOUSE TRUSTEE 0.00 4.90 X 0 76727 0 SCOTT WOOTEN EVP, CFO (END 4/24) 0.15 59.85 X 0 2525208 51220 NICK OLSON EVP, CFO (BEG 4/24) 0.15 59.85 X 0 1047876 123386 BILL MARLETTE INTERIM, EVP, CFO (END 1/24) 0.15 59.85 X 0 894301 275 TIFFANY LAWRENCE PRESIDENT & CEO, FARGO 5.00 55.00 X 0 1426252 179445 DON JACOBS FORMER TRUSTEE 0.00 0.00 X 0 13502 0 MICHELLE BRUHN FORMER EVP, CFO & TREASURER 0.00 0.00 X 0 293725 0 BRYAN NERMOE FORMER PRESIDENT & CEO, FARGO 0.00 0.00 X 0 252724 0 0 12073520 939567 0 1 1 0 FORD FLEET 1 AMERICAN ROAD DEERBORN MI 48126 VEHICLE REPAIR 191133 ZOLL DATA SYSTEMS 11802 RIDGE PARKWAY STE 400 BROOMFIELD CO 80021 SOFTWARE DATA SOLUTIONS 184263 BOUND TREE MEDICAL 23537 NETWORK PL CHICAGO IL 60673 DISTRIBUTION COMPANY 113783 3 6598 431695 438293 EMERGENCY MEDICAL SERV 621910 16535645 16535645 EDUCATION 611430 537869 537869 CONTRACT/OUTREACH 624230 254549 254549 SPECIAL TRANSPORTATION 621910 -30954 -30954 17297109 13951 1888 12063 12063 17747465 17297109 0 12063 12279694 11670064 609630 554618 524818 29800 1054600 959603 94997 911729 867577 44152 203201 158200 45001 92659 78623 14036 210512 173903 36609 454553 265709 188844 509116 386367 122749 404232 392082 12150 288448 276555 11893 942162 904888 37274 515133 515133 MEDICAL SUPPLIES 1240836 1219951 20885 CERTIFICATES, LIC, DUES 75563 29991 45572 MINNESOTACARE TAX 48771 48771 0 NON-PATIENT BAD DEBT 19063 19063 -1053725 -1639452 585727 18751165 16317650 2433515 0 1406722 2002349 5122 3234 -13597 18342 13954519 8184384 4186239 5770135 1393082 1393082 836274 656054 7813842 9843196 107549 168753 0 602021 107549 770774 X 7706293 9072422 7706293 9072422 7813842 9843196 X -1003700 2369829 X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 410810 410810 2341912 1515370 826542 169295 59234 110061 5384442 3278948 2105494 5648060 3330832 2317228 5770135 OTHER ASSETS-CIP 656054 656054 OPERATING LEASE PAYABLE 602021 602021 X PART X, LINE 2: CERTAIN CONTROLLED ORGANIZATIONS ARE SUBJECT TO INCOME TAXES. DEFERRED INCOME TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE DIFFERENCES BETWEEN THE FINANCIAL AND INCOME TAX REPORTING BASIS OF ASSETS AND LIABILITIES BASED ON ENACTED TAX RATES AND LAWS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION. THE DEFERRED INCOME TAX PROVISION OR BENEFIT GENERALLY REFLECTS THE NET CHANGE IN DEFERRED INCOME TAX ASSETS AND LIABILITIES DURING THE YEAR. THE CURRENT INCOME TAX PROVISION REFLECTS THE TAX CONSEQUENCES OF REVENUES AND EXPENSES CURRENTLY TAXABLE OR DEDUCTIBLE ON VARIOUS INCOME TAX RETURNS FOR THE YEAR REPORTED. F-M AMBULANCE SERVICE, INC DID NOT HAVE AN INCOME TAX LIABILITY AT DECEMBER 31, 2024; SOME RELATED ORGANIZATIONS HAVE ESTABLISHED RESERVES. 1 1 0 0 0 0 0 1 0 BILL GASSEN TRUSTEE, PRESIDENT & CEO 0 2334458 0 1624395 0 455266 0 584349 0 892 0 4999360 0 0 SCOTT WOOTEN EVP, CFO (END 4/24) 0 245207 0 0 0 2280001 0 43522 0 7698 0 2576428 0 0 TIFFANY LAWRENCE PRESIDENT & CEO, FARGO 0 832476 0 456270 0 137506 0 143293 0 36152 0 1605697 0 0 NICK OLSON EVP, CFO (BEG 4/24) 0 783688 0 138354 0 125834 0 122494 0 892 0 1171262 0 0 BILL MARLETTE INTERIM, EVP, CFO (END 1/24) 0 420002 0 470299 0 4000 0 0 0 275 0 894576 0 0 ANDY NORTH TRUSTEE, SECRETARY, INDEP CONTRACTOR 0 379383 0 0 0 0 0 0 0 0 0 379383 0 0 MICHELLE BRUHN FORMER EVP, CFO & TREASURER 0 0 0 293725 0 0 0 0 0 0 0 293725 0 0 BRYAN NERMOE FORMER PRESIDENT & CEO, FARGO 0 0 0 0 0 252724 0 0 0 0 0 252724 0 0 DON JACOBS FORMER TRUSTEE 0 13502 0 0 0 0 0 0 0 0 0 13502 0 0 PART I, LINE 1A CERTAIN ITEMS LISTED ON LINE 1A ARE PROVIDED BY RELATED ORGANIZATIONS. PART I, LINE 3 SANFORD ENGAGES A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY TO REVIEW THE TOTAL COMPENSATION ARRANGEMENTS OF THE OFFICERS AND EXECUTIVES OF THE ORGANIZATION, INCLUDING THE CEO. THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES APPROVES ALL COMPENSATION CHANGES FOR THE CEO IN ADVANCE, RELIES ON THE MARKET DATA PROVIDED BY THE INDEPENDENT CONSULTING FIRM IN MAKING CHANGES, AND DOCUMENTS THE BASIS FOR ANY CHANGES IN COMMITTEE MINUTES. PART I, LINES 4A-B LINE 4A - SEVERANCE OR CHANGE OF CONTROL PAYMENT UPON HIRE OR PROMOTION, SELECT OFFICERS AND KEY EMPLOYEES SIGN AN EXECUTIVE SEVERANCE AGREEMENT (THE "AGREEMENT"). THE AGREEMENT PROVIDES THAT THE EXECUTIVE WILL RECEIVE A MULTIPLE OF HIS OR HER SALARY (BASED ON YEARS OF SERVICE OR POSITION) AS A PAYMENT IN THE EVENT OF A DEFINED SEPARATION EVENT, WHICH CAN INCLUDE AN INVOLUNTARY SEPARATION OR AN EMPLOYEE VOLUNTARILY LEAVING FOR A DEFINED CONTRACTUAL REASON. EXECUTIVE MAY ALSO QUALIFY FOR A PAYMENT FOR SATISFYING A NON-COMPETE. FINAL SEPARATION PAYMENTS MIGHT VARY FROM THE AMOUNT PROVIDED IN THE AGREEMENT AS A RESULT OF NEGOTIATIONS SURROUNDING POST-SEPARATION OBLIGATIONS AND INCENTIVES (THE "SEPARATION" PAYMENT). LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS FOR EXECUTIVES, A PORTION OF THE RETIREMENT AND OTHER DEFERRED COMPENSATION REPORTED RELATES TO A 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THIS PLAN PROVIDES FOR A SUBSTANTIAL RISK OF FORFEITURE AND THERE IS NO GUARANTEE THAT ANY AMOUNT WILL ULTIMATELY BE PAID. SANFORD SPONSORS NONQUALIFIED RETIREMENT PLANS FOR SELECT OFFICERS OR KEY EMPLOYEES. CERTAIN OF THE BELOW OFFICERS OR KEY EMPLOYEES WERE PAID AS A RESULT OF A VESTING EVENT. LINES 4A AND 4B - PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE OR CHANGE OF CONTROL PAYMENTS AND/OR SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS: SCOTT WOOTEN: SEPARATION..................................$2,143,876 NONQUALIFIED RETIREMENT PLAN...................$33,255 TOTAL.......................................$2,177,131 BRYAN NERMOE: NON-COMPETE PAYMENT...........................$252,724 PART I, LINE 7 A MATERIAL PORTION OF EXECUTIVE COMPENSATION IS LINKED TO ACHIEVING ORGANIZATIONAL GOALS RELATED TO QUALITY OF CARE, PATIENT EXPERIENCE, EMPLOYEE EXPERIENCE AND FINANCIAL PERFORMANCE. THE GOALS ARE SET IN ADVANCE AND APPROVED BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING OFFICERS, BOARD MEMBERS, AND KEY EMPLOYEES ARE EMPLOYEES OF SANFORD OR ITS RELATED ORGANIZATIONS. MANY OF THESE EMPLOYEES ALSO SERVE ON OTHER RELATED SANFORD BOARDS, OR HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER THAT SPAN THE ORGANIZATION AS A WHOLE: BILL GASSEN, NICK OLSON, SCOTT WOOTEN, BILL MARLETTE, AND TIFFANY LAWRENCE. FORM 990, PART VI, SECTION A, LINE 6 SANFORD NORTH IS THE SOLE STOCKHOLDER OF F-M AMBULANCE. FORM 990, PART VI, SECTION A, LINE 7A BOARD MEMBERS ARE APPOINTED BY THE PRESIDENT AND CEO OF SANFORD. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS BY THE BOARD OF DIRECTORS SHALL ALSO REQUIRE THE APPROVAL OF THE SHAREHOLDER: A. AMENDMENT OF THE CORPORATION'S GOVERNING DOCUMENTS INCLUDING, BUT NOT LIMITED TO, THE ARTICLES OF INCORPORATION OR BYLAWS; B. APPROVAL OF ANY MERGER, CONSOLIDATION, DISSOLUTION, OR LIQUIDATION OF THE CORPORATION; C. THE SALE OF THE CORPORATION'S ASSETS OR OPERATIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS; D. THE CORPORATION BECOMING A PARTY TO OR OTHERWISE PARTICIPATING IN A JOINT VENTURE OR PARTNERSHIP WITH ANOTHER ENTITY OR INDIVIDUAL; E. ANY CHANGE IN THE CORPORATION'S MISSION, VISION OR STRATEGIC PLAN; F. DISCONTINUATION, CLOSURE OR TRANSFER OF OWNERSHIP OF SUBSTANTIALLY ALL OF THE ASSETS, OR MEMBERSHIP INTEREST IN, A CORPORATION SITE OF OPERATION; G. APPROVAL OF THE NAMES OR CHANGES TO THE NAMES OF THE CORPORATION'S ENTITIES AND FACILITIES; H. UNLESS CONTEMPLATED BY A PREVIOUSLY APPROVED BUDGET OR PLAN, THE SALE LEASE, TRANSFER, PLEDGE, ENCUMBRANCE, EXCHANGE OR OTHER DISPOSITION OF ASSETS OF THE CORPORATION; I. INCURRENCE OF AN UNBUDGETED DEBT OR UNBUDGETED CAPITAL LEASE OBLIGATION BY THE CORPORATION; AND, J. ADOPTION OF AN ANNUAL OPERATING BUDGET, MODIFICATION OF AN APPROVED ANNUAL OPERATING BUDGET, ADOPTION OF AN ANNUAL CAPITAL BUDGET OR MODIFICATION OF AN APPROVED ANNUAL CAPITAL BUDGET. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY BY THE TAX DEPARTMENT AND REVIEWED BY EXECUTIVE MANAGEMENT. THE TAX DEPARTMENT PREPARES RETURN HIGHLIGHTS AND KEY DISCLOSURES FOR THE EXECUTIVE MANAGEMENT TEAM. AN EXTERNAL ACCOUNTING FIRM REVIEWS AND SIGNS THE RETURN. BEFORE THE RETURN IS FILED, A COMPLETE COPY IS PROVIDED TO THE CURRENT BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C THE ANNUAL CONFLICT OF INTEREST DISCLOSURE PROCESS IS MANAGED BY THE CHIEF COMPLIANCE OFFICER (CCO). THE CCO IS RESPONSIBLE FOR ASSURING THAT ALL COMPLETED FORMS ARE RETURNED IN A TIMELY AND COMPLETE MANNER. CONFLICT OF INTEREST QUESTIONNAIRES ARE SENT TO SYSTEM TRUSTEES, MEMBERS OF THE GOVERNING BOARDS FOR SUBSIDIARY ENTITIES, OFFICERS, AND KEY EMPLOYEES FOR ALL ENTITIES SUBJECT TO THE IRS FORM 990 FILINGS. THE DISCLOSURES ARE SUMMARIZED FOR REVIEW BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES, PURSUANT TO POLICY. THIS REVIEW ALLOWS: 1) THE BOARD TO ACQUIRE AN AWARENESS OF FINANCIAL RELATIONSHIPS OF BOARD MEMBERS AND KEY MANAGEMENT EMPLOYEES AND CAN INVOKE THE RECUSAL PROCESS ON A CASE-BY-CASE BASIS IF POTENTIAL CONFLICTS ARE IMPLICATED IN BOARD DECISIONS AND DELIBERATIONS, AND, 2) GIVES THE BOARD THE OPPORTUNITY TO SEEK ADDITIONAL INFORMATION AND CLARIFICATION ABOUT DISCLOSURES TO DETERMINE POTENTIAL CONFLICTS OF INTEREST AND HOW TO MANAGE THEM. FORM 990, PART VI, SECTION B, LINE 15 SANFORD HAS A PROCESS FOR DETERMINING COMPENSATION OF THE PERSONS LISTED ON PART VII, SECTION A. THIS INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, REVIEW OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION FOR SUCH COMPENSATION. SANFORD ENGAGES A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY TO REVIEW THE TOTAL COMPENSATION ARRANGEMENTS OF THE OFFICERS AND EXECUTIVES OF THE ORGANIZATION, INCLUDING THE CEO. THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES APPROVES ALL COMPENSATION CHANGES FOR THE CEO IN ADVANCE, RELIES ON THE MARKET DATA PROVIDED BY THE INDEPENDENT CONSULTING FIRM IN MAKING CHANGES, AND DOCUMENTS THE BASIS FOR ANY CHANGES IN COMMITTEE MINUTES. FORM 990, PART VI, SECTION C, LINE 19 ALTHOUGH THE ORGANIZATION DOES NOT MAINTAIN A WEBSITE WHERE THE PUBLIC CAN ACCESS THESE DOCUMENTS, IT WOULD RESPOND INDIVIDUALLY TO ANY REQUESTS OR INQUIRIES FROM THE PUBLIC FOR THESE DOCUMENTS. FORM 990, PART VII THE SANFORD BOARD OF TRUSTEES HAS ULTIMATE GOVERNANCE RESPONSIBILITIES FOR EACH MAJOR OPERATING ENTITY WITHIN SANFORD. IN ADDITION, A BOARD OF DIRECTORS IS ESTABLISHED FOR EACH MAJOR OPERATING ENTITY. THIS BOARD HAS SPECIFIC RESPONSIBILITIES DELEGATED FROM THE BOARD OF TRUSTEES. GENERALLY THESE RESPONSIBILITIES ARE RELATED TO THE OVERSIGHT OF THE DAY TO DAY OPERATIONS OF THAT ENTITY. FORM 990, PART XI, LINE 9: REIMBURSEMENT FROM SANFORD HEALTH FOR CASH FLOW INCURRED BY F-M AMBULANCE 2,369,829. ADAMS COUNTY GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 461495572 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 ARLINGTON GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 371805492 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 BOISE GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 363370371 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) PF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 COLLISTER DRIVE HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 300872973 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) PF THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 GOOD SAMARITAN SOCIETY INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460349951 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 271212446 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 HOWARD LAKE GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 364885253 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 LEA COUNTY GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 453946645 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 LILAC WAY GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 465740381 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 LOVINGTON GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460392944 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 MILLARD GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460396332 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 OLATHE GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460396398 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 PRESCOTT GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 275114421 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 PROPHETSTOWN GOOD SAMARITAN HOUSING INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460392943 PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD 501(C)(3) 10 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 RAPID CITY GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 461579750 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 SANFORD P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 271218956 SUPPORTING ORGANIZATION ND 501(C)(3) 12-II 0 SANFORD HEALTH FOUNDATION P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 363297853 FOUNDATION SD 501(C)(3) 12-II SANFORD HEALTH 0 SANFORD HEALTH FOUNDATION NORTH P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 450398104 FOUNDATION ND 501(C)(3) 7 SANFORD NORTH 0 SANFORD HEALTH FOUNDATION OF NORTHERN MINNESOTA P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 411389317 FOUNDATION MN 501(C)(3) 7 SANFORD HEALTH OF NORTHERN MINNESOTA 0 SANFORD HEALTH FOUNDATION WEST P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 450397196 FOUNDATION ND 501(C)(3) 7 SANFORD BISMARCK 0 SIOUX FALLS DOWNTOWN GOOD SAMARITAN HOUSING GP INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 452473519 LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD 501(C)(3) 12-I THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY 0 THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 460422866 FOUNDATION MN 501(C)(3) 12-I SANFORD HEALTH 0 THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 450228055 LONG-TERM CARE, SENIOR HOUSING & HOME AND COMMUNITY BASED SERVICES ND 501(C)(3) 10 SANFORD 0 COLLISTER DRIVE HOUSING LLC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 611752929 LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD N/A 0 0 HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 271212511 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 OLATHE GOOD SAMARITAN HOUSING LP P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 205297369 PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS SD N/A 0 0 RUTH STREET GOOD SAMARITAN HOUSING LLC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 611748321 LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD N/A 0 0 TEXAS GOOD SAMARITAN HOUSING LLC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 371774574 LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP SD N/A 0 0 GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 815037667 INSURANCE NE N/A C 0 GOOD SAMARITAN SOCIETY INSURANCE LTD P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 980379099 INSURANCE CJ N/A C 0 HERITAGE HEALTHCARE OF NORTHERN NEW MEXICO INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 900491537 PROVIDE HOME AND COMMUNITY BASED SERVICES NM N/A S 0 HERITAGE HEALTHCARE SERVICES INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 850418562 PROVIDE HOME AND COMMUNITY BASED SERVICES NM N/A S 0 HERITAGE HOME HEALTHCARE & HOSPICE INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 850463468 PROVIDE HOME AND COMMUNITY BASED SERVICES NM N/A S 0 HERITAGE HOME HEALTHCARE OF ARIZONA INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 204243949 PROVIDE HOME AND COMMUNITY BASED SERVICES NM N/A S 0 HERITAGE HOME HEALTHCARE SERVICES INC P O BOX 5039 RTE 5218 SIOUX FALLS SD 571175039 850463469 PROVIDE HOME AND COMMUNITY BASED SERVICES NM N/A S 0 SANFORD FRONTIERS 1305 W 18TH STREET PO BOX 5039 SIOUX FALLS SD 571175039 455436599 SPORTS/ALTERNATIVE INVESTMENTS SD N/A C 0 SANFORD HEALTH PLAN 300 CHERAPA PLACE SIOUX FALLS SD 57103 911842494 INSURANCE SD N/A C 0 SANFORD HEALTH PLAN OF MN 300 CHERAPA PLACE SIOUX FALLS SD 57103 460445852 INSURANCE MN N/A C 0 SANFORD INTERNATIONAL - MUNICH GMBH NYMPHENBURGER STRASSE 3 MUNICH GM HEALTHCARE GM N/A C 0 SANFORD WORLD CLINICS - GHANA LBG SARBAH ROAD TANTRI LORRY STATION CAPE COAST GH HEALTHCARE GH N/A C 0 SHANGHAI SANFORD HEALTHCARE MANAGEMENT CONSULTING CO LTD 188 YESHENG ROAD ROOM A-862 GUOMA SHANGHAI CH HEALTHCARE CH N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1