Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2019 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | WOODWINDS HEALTH CAMPUS OPENED IN WOODBURY IN 2000 AND IS THE ONLY HOSPITAL IN THE SOUTHEAST METRO AREA, OFFERING 86 LICENSED BEDS. AT WOODWINDS, PATIENTS FIND TRADITIONAL MEDICINE AND STATE-OF-THE-ART TECHNOLOGY WORKING IN PARTNERSHIP WITH NATURAL APPROACHES TO WELLNESS AND HEALTH. THE CALMING AMBIANCE PATIENTS EXPERIENCE AT WOODWINDS IS ENHANCED BY THE HOSPITAL'S SURROUNDING OF WOODS AND WETLANDS. WOODWINDS WAS AWARDED A 4-STAR RATING IN THE 2019 CENTERS FOR MEDICARE & MEDICAID "HOSPITAL COMPARE" QUALITY SURVEY. KEY SERVICES INCLUDE ORTHOPEDICS, MATERNITY, SPINE, INTEGRATIVE SERVICES, AND CANCER CARE. AT WOODWINDS, WE PARTNER WITH PATIENTS AND FAMILIES TO: SUPPORT FAMILIES IN THEIR NATURAL CARE GIVING ROLES PROMOTE NORMAL PATTERNS OF LIVING OFFER COLLABORATION AND CHOICES IN A HEALING ENVIRONMENT HOSPITAL REVENUE INCLUDES PAYMENT FROM THE MEDICARE AND MEDICAID PROGRAMS. THE MEDICAL SERVICES RELATE DIRECTLY TO THE EXEMPT PURPOSE OF CARING FOR SICK, INFIRM, AGED AND INJURED PERSONS REGARDLESS OF THEIR RACE, COLOR, CREED, RELIGION, NATIONAL ORIGIN, SEX, MARITAL STATUS, STATUS WITH REGARD TO PUBLIC ASSISTANCE, MEMBERSHIP OR ACTIVITY IN A LOCAL COMMISSION, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION, AGE OR GENETIC INFORMATION. THIS ORGANIZATION PROVIDES EMERGENCY AND MEDICALLY NECESSARY NON-EMERGENCY SERVICES REGARDLESS OF ABILITY TO PAY. ADDITIONALLY, THIS ORGANIZATION OFFERS FINANCIAL AID FOR ELIGIBLE SERVICES IN THE FORM OF FREE OR DISCOUNTED CARE TO THOSE LOW INCOME, UNDERINSURED OR UNINSURED INDIVIDUALS WHO MEET QUALIFICATION CRITERIA. WOODWINDS HOSPITAL IS PART OF FAIRVIEW HEALTH SERVICES. FAIRVIEW HEALTH SERVICES IS AN AWARD-WINNING, NONPROFIT, INTEGRATED HEALTH SYSTEM PROVIDING EXCEPTIONAL HEALTH CARE ACROSS THE FULL SPECTRUM OF HEALTH CARE SERVICES. FOUNDED IN 1906, FAIRVIEW PROVIDES EXCEPTIONAL CARE TO PATIENTS AND COMMUNITIES AS ONE OF THE MOST COMPREHENSIVE AND GEOGRAPHICALLY ACCESSIBLE SYSTEMS IN MINNESOTA. THE FAIRVIEW SYSTEM CONTROLS AND OPERATES UNIVERSITY OF MINNESOTA MEDICAL CENTER, THE ADULT AND PEDIATRIC TEACHING HOSPITAL OF THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOL; 10 COMMUNITY-BASED GENERAL ACUTE CARE HOSPITALS; 1 LONG-TERM ACUTE CARE HOSPITAL; 56 PRIMARY CARE CLINICS; OVER 100 SPECIALTY CARE SERVICES; 10 URGENT CARE CLINICS; OCCUPATIONAL HEALTH CLINICS; 36 RETAIL AND SPECIALTY PHARMACIES; PHARMACY BENEFIT MANAGEMENT SERVICES; REHABILITATION CENTERS; COUNSELING; HOME CARE AND HOSPICE SERVICES; 90 OWNED AND MANAGED SENIOR CARE FACILITIES AND LONG-TERM CARE HOUSING FACILITIES (THROUGH EBENEZER SOCIETY, A FAIRVIEW SUBSIDIARY); EMERGENCY MEDICAL TRANSPORTATION; AN INTEGRATED PROVIDER NETWORK; AND HEALTH INSURER PREFERREDONE. FAIRVIEW'S 34,000+ EMPLOYEES AND NETWORK OF 5,000+ PROVIDERS EMBRACE INNOVATION AND NEW THINKING TO DRIVE A HEALTHIER FUTURE THROUGH HEALING, DISCOVERY AND EDUCATION. IN JUNE 2017, FAIRVIEW WELCOMED THE HEALTHEAST CARE SYSTEM INTO THE FAIRVIEW FAMILY. IN PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA, FAIRVIEW IS COMMITTED TO PARTICIPATING IN NATION-LEADING RESEARCH AND EDUCATING TOMORROW'S PHYSICIANS AND HEALTH CARE PROFESSIONALS. WE SERVE PATIENTS FROM ACROSS THE STATE OF MINNESOTA, THE UPPER MIDWEST AND BEYOND. IN ADDITION TO OUR EMPLOYED PHYSICIANS, WE WORK CLOSELY WITH THE ACADEMIC PHYSICIANS AT UNIVERSITY OF MINNESOTA PHYSICIANS AND WITH FAIRVIEW PHYSICIAN ASSOCIATES, A NETWORK OF INDEPENDENT PHYSICIANS. FAIRVIEW HAS ENJOYED A LONG PARTNERSHIP WITH THE UNIVERSITY OF MINNESOTA AND UNIVERSITY OF MINNESOTA PHYSICIANS, WHICH IS REPRESENTED IN THE UNIVERSITY OF MINNESOTA HEALTH BRAND. IN 2019, WE EXTENDED OUR PARTNERSHIPWE EXTENDED OUR PARTNERSHIP BY BUILDING M HEALTH FAIRVIEW AN ACADEMIC HEALTH SYSTEM DRIVING TO DELIVER BREAKTHROUGH CARE CLOSE TO HOME. THE HEALTH CARE AND MEDICAL SERVICES WHICH FAIRVIEW PROVIDES TO THE COMMUNITY INCLUDE, BUT ARE NOT LIMITED TO: PRIMARY, SPECIALTY, TERTIARY, AND QUATERNARY CARE; HOSPITAL AND PHYSICIAN SERVICES; SENIOR SERVICES; ASSISTED LIVING; HOME CARE AND HOSPICE; LONG-TERM CARE; URGENT CARE AND EMERGENCY SERVICES; PHARMACY; CARE OF MOTHERS AND CHILDREN; PHYSICAL THERAPY/SPORTS MEDICINE; REHABILITATION SERVICES; AND INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH CARE AND CHEMICAL DEPENDENCY SERVICES. FAIRVIEW PROVIDES SPECIALIZED CARE FOR THE TREATMENT OF CANCER, HEART DISEASE, DIABETES, WOUND CARE, CHRONIC CONDITIONS, SOLID ORGAN TRANSPLANT, BLOOD AND MARROW TRANSPLANT, AND MANY OTHER SPECIALTIES. FAIRVIEW ALSO OFFERS SOCIAL WORK SERVICES, HEALTH EDUCATION AND SUPPORT GROUPS, AND SERVICES FOR VARIOUS HEALTH ISSUES. FOR THE COMMUNITY HEALTH PROGRAM & SERVICES FOR 2019, WE HAD 80,607 ENCOUNTERS WITH COMMUNITY MEMBERS. |
| FORM 990, PAGE 6, PART VI, LINE 6 | THE MEMBERS OF THE CORPORATION ARE THE INDIVIDUALS WHO CONSTITUTE THE DIRECTORS OF THIS CORPORATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | THE BOARD HAS THREE CATEGORIES OF DIRECTORS: 1) 3 EX OFFICIO WHO ARE FAIRVIEW'S CEO AND THE UNIVERSITY'S VICE PRESIDENT OF MEDICAL SCHOOL AND A SENIOR LEADER OF THE UNIVERSITY MEDICAL SCHOOL OR OF THE UNIVERSITY APPOINTED, FROM TIME TO TIME, BY THE VICE PRESIDENT 2) 10 ELECTED DIRECTORS WHO ARE 1 DIRECTOR ELECTED BY THE REGENTS OF THE UNIVERSITY OF MINNESOTA AND 9 ELECTED BY THE BOARD AFTER NOMINATION FROM CERTAIN COMPONENTS OF THE FAIRVIEW SYSTEM; AND 3) BETWEEN 3 TO 8 AT-LARGE DIRECTORS ELECTED BY THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 7B | THE REGENTS OF THE UNIVERSITY OF MINNESOTA HAVE THE RIGHT TO APPROVE PROPOSED AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THE CORPORATION IF THE AMENDMENT WOULD ADVERSELY AFFECT THEIR RIGHTS AND CERTAIN SALES OF SUBSTANTIALLY ALL OF FAIRVIEW'S ASSETS. AN ASSOCIATION OF APPROXIMATELY 70 LUTHERAN CHURCHES ELECTS MOST OF THE FAIRVIEW SOUTHDALE HOSPITAL, FAIRVIEW RIDGES HOSPITAL AND PART OF THE UMMC BOARDS OF TRUSTEES, AS WELL AS THE FPA COMMUNITY DIRECTORS AND THE EBENEZER SOCIETY BOARD OF DIRECTORS AND HAS THE RIGHT TO APPROVE CERTAIN FAIRVIEW BYLAW AMENDMENTS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE TAX DEPARTMENT CONDUCTS A DETAILED REVIEW OF THE COMPLETED RETURN. THE RETURN IS ALSO REVIEWED BY FAIRVIEW'S GENERAL COUNSEL, FAIRVIEW'S CHIEF FINANCIAL OFFICER, CONTROLLER, AND VICE PRESIDENT AND TREASURER. THE FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW OF CONTENT. THE FORM 990 IS SUBSEQUENTLY PROVIDED TO THE MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO FILING. UPON APPROVAL FROM THE BOARD OF DIRECTORS, THE FORM 990 IS FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | MANAGERS, DIRECTORS AND SENIOR MANAGEMENT OF FAIRVIEW ARE REQUIRED TO ANNUALLY COMPLETE FAIRVIEW'S DUTY OF LOYALTY AND CONFLICT OF INTEREST STATEMENT IN COMPLIANCE WITH FAIRVIEW'S CONFLICT OF INTEREST POLICY. DISCLOSURES ARE REVIEWED BY THE COMPLIANCE DEPARTMENT. CONFLICTS OF INTERESTS BY BOARD MEMBERS AND SENIOR MANAGEMENT ARE BROUGHT TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD, ALONG WITH ADDITIONAL DETAILED INFORMATION, FOR REVIEW. IN ADDITION, THE COMPLIANCE OFFICER COMPILES A SCHEDULE SHOWING REPORTED CONFLICTS OF INTEREST BY MANAGERS AND KEY EMPLOYEES IS ALSO PRESENTED TO THE CONFLICT OF INTEREST REVIEW COMMITTEE FOR REVIEW AND DISCUSSION. ANY PROBLEMATIC ISSUES ARISING FROM THESE DISCLOSURES ARE DISCUSSED AND RESOLVED BY THE COMMITTEE. BOARD MEMBERS AND MANAGEMENT EMPLOYEES ARE EXPECTED TO UPDATE THEIR CONFLICTS, AS NECESSARY, DURING THE YEAR. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE DETERMINATION OF EXECUTIVE COMPENSATION OF THE ORGANIZATION IS PROCESSED BY THE BOARD'S HUMAN RESOURCES COMMITTEE AND INCLUDES A REVIEW OF COMPARABILITY DATA, REVIEW BY INDEPENDENT EXPERTS AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION PROCESS. THE FULL BOARD APPROVES EXECUTIVE COMPENSATION. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE DETERMINATION OF OFFICER AND KEY EMPLOYEE COMPENSATION OF THE ORGANIZATION IS PROCESSED BY THE BOARD'S HUMAN RESOURCES COMMITTEE AND INCLUDES A REVIEW OF COMPARABILITY DATA, REVIEW BY INDEPENDENT EXPERTS AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ARTICLES OF INCORPORATION FOR THIS ORGANIZATION ARE AVAILABLE TO THE PUBLIC THROUGH THE SECRETARY OF STATE OFFICE. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND OTHER GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS FOR THIS ORGANIZATION ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE ATTORNEY GENERAL'S OFFICE AND ARE ALSO |
| FORM 990, PART VII | SECTION B: INDEPENDENT CONTRACTORS FORM 1099'S WERE FILED BY A RELATED ORGANIZATION FAIRVIEW HEALTH SERVICES, A 501(C)(3) NON-PROFIT, TAX-EXEMPT ORGANIZATIONS. |
| FORM 990, PART XI, LINE 9 | TRANSFERS FROM D&T FACILITY MANAGEMENT 23,227,545 OTHER 310 TRANSFERS TO PARENT ORGANIZATION 0 PURCHASE ACCOUNTING ADJUSTMENT 0 CHANGE IN MINORITY INTEREST 0 TOTAL 23,227,855 |
| Software ID: | |
| Software Version: |