| (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 | |||||
| (A)
UCARE MINNESOTA |
363573805 | 10 | Yes | 520,720 | 0 | |
|
Total 1
|
520,720 | 0 | ||||
| Calendar year (or fiscal year beginning in) | (a) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (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) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (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) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (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) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (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 on 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6Total annual distributions. Add lines 1 through 5. | 6 | |
|
7
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
7 | |
| 8 Distributable amount for 2025 from Section C, line 6 | 8 | |
| 9 Line 7 amount divided by Line 8 amount | 9 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2025 |
(iii) Distributable Amount for 2025 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2025 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2025 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2025: | ||||
| a From 2020....... | ||||
| b From 2021....... | ||||
| c From 2022....... | ||||
| d From 2023....... | ||||
| e From 2024....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2025 distributable amount | ||||
|
i
Carryover from 2020 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2025 from Section D, line 6: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2025 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2025, 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 2025. 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 2026. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2021..... | ||||
| b Excess from 2022..... | ||||
| c Excess from 2023..... | ||||
| d Excess from 2024..... | ||||
| e Excess from 2025..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SECTION A, LINE 6: | UCARE FOUNDATION MAKES GRANTS TO COMMUNITY CHARITIES AND GOVERNMENT AGENCIES AS DIRECTED BY THE BOARD OF DIRECTORS AND MANAGEMENT OF UCARE MINNESOTA. ALL GRANTS ARE INTENDED TO SUPPORT THE CHARITABLE PROGRAMS OF THESE ORGANIZATIONS AS THEY SEEK TO IMPROVE THE HEALTH OF INDIVIDUALS. |
| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 4A | IN 2025, THE UCARE FOUNDATION APPROVED AND DISBURSED $396,800 IN GRANT FUNDING TO 15 MINNESOTA ORGANIZATIONS AND COUNTY/TRIBAL GOVERNMENTS WORKING TO IMPROVE HEALTH THROUGH INNOVATIVE SERVICES AND EDUCATION IN THE AREAS OF: FOOD SECURITY ASSISTANCE, MOBILE CLINIC VACCINE DELIVERY, HEALTH CARE PROFESSIONAL DEVELOPMENT, AND COMMUNITY LEADERSHIP AT THE INTERSECTION OF SUBSTANCE USE DISORDERS AND HOMELESSNESS. UCARE FOUNDATION HAS A FORMAL BOARD UCARE FOUNDATION COUNCIL THAT OVERSEES AND APPROVES ANNUAL GRANT AWARDS. THE BOARD MEETS ANNUALLY TO DETERMINE PRIORITY AREAS OF FOCUS FOR OPEN SOLICITATIONS. GRANTEES APPLY VIA AN ONLINE GRANT SYSTEM, AND ALL ORGANIZATIONS MUST MEET FUNDING ELIGIBILITY GUIDELINES. GRANT APPLICATIONS ARE REVIEWED BY UCARE MINNESOTA-ASSIGNED INDIVIDUALS AND OFTEN SOME MEMBERS OF THE UCARE FOUNDATION COUNCIL. ONCE APPROVED, GRANTEES SIGN A CONDITION OF GRANT AGREEMENT AND ARE RESPONSIBLE FOR SUBMITTING INTERIM AND FINAL REPORTS AS WELL AS AGREEING TO PARTICIPATE IN A SITE VISIT BY UCARE STAFF. THE BOARD OF DIRECTORS RECEIVES AN ANNUAL REPORT ON THE USE OF THE FUNDS. UCARE ENSURES THE RECIPIENT IS A QUALIFIED CHARITY OR GOVERNMENT AGENCY AND RECEIVES PERIODIC REPORTS FROM THE ORGANIZATIONS. THE UCARE FOUNDATION SUPPORTED FAIRVIEW HEALTH SERVICES' (FHS) MOBILE HEALTH COLLABORATION PILOT, WHICH SERVED AN ESTIMATED 500 COMMUNITY MEMBERS AT 18 COMMUNITY-BASED CLINICS ACROSS 13 UNIQUE SITES IN THE TWIN CITIES METRO. THROUGH THE PILOT, FHS ADMINISTERED 295 VACCINES, COMPLETED 271 BLOOD PRESSURE CHECKS, 48 DIABETES SCREENINGS, AND 142 FLUORIDE VARNISH APPLICATIONS FOR CHILDREN AND ADULTS. UCARE FOUNDATION SUPPORTED BOUNTIFUL BASKET FOOD SHELF'S FOOD SUPPORT PROGRAM SERVING COMMUNITIES IN CARVER COUNTY THROUGH LOCATIONS IN CHASKA AND COLOGNE. THE GRANT HELPED TO FUND MOBILE FOOD DELIVERY, CULTURALLY SPECIFIC ASSISTANCE, SCHOOL SNACK PROGRAMS, AND EMERGENCY FOOD SUPPORT FOR FOSTER CARE. OVER 7000 COUNTY RESIDENTS ARE ESTIMATED TO HAVE BEEN HELPED. A GRANT FOR ROUTE 1 MN BOLSTERED THE ORGANIZATION'S EMERGING FARMER INSTITUTE, A NO COST 10-WEEK PROGRAM THAT SUPPORTS AND EMPOWERS FARMERS FROM A VARIETY OF BACKGROUNDS. PARTICIPANTS ARE PROVIDED WITH ESSENTIAL TOOLS, RESOURCES, AND NETWORKING OPPORTUNTIIES TO IMPROVE CROP PRODUCTION, DEVELOP FARM BUSINESS SKILLS, AND PRODUCE NUTRITIOUS FOOD FOR SALE TO LOCAL BUSINESSES AND SHARED WITH UNDERSERVED COMMUNITIES STATEWIDE. |
| FORM 990, PART VI, SECTION A, LINE 3 | UCARE FOUNDATION HAS AN ADMINISTRATIVE SERVICE AGREEMENT WITH UCARE MINNESOTA TO PROVIDE OVERALL MANAGEMENT AND ADMINISTRATION OF UCARE FOUNDATION'S BUSINESS. ON DECEMBER 17, 2025, UCARE WAS PLACED INTO REHABILITATION AND THE COMMISSIONER OF THE MINNESOTA DEPARTMENT OF HEALTH WAS APPOINTED REHABILITATOR. EXAMINATION RESOURCES WAS APPOINTED SPECIAL DEPUTY COMMISSIONER AND IS MANAGING THE OPERATIONS OF UCARE MINNESOTA AND THE UCARE FOUNDATION. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THIS CORPORATION IS UCARE MINNESOTA, A MINNESOTA NONPROFIT CORPORATION. ON DECEMBER 17, 2025, UCARE WAS PLACED INTO REHABILITATION AND THE COMMISSIONER OF THE MINNESOTA DEPARTMENT OF HEALTH WAS APPOINTED REHABILITATOR. EXAMINATION RESOURCES WAS APPOINTED SPECIAL DEPUTY COMMISSIONER. UPON THE APPOINTMENT OF THE REHABILITATOR, THE BOARD OF DIRECTORS WAS DISSOLVED. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE CORPORATE MEMBER OF UCARE FOUNDATION IS UCARE MINNESOTA, WHICH ELECTS THE DIRECTORS FOR THE UCARE FOUNDATION. ON DECEMBER 17, 2025, UCARE WAS PLACED INTO REHABILITATION AND THE COMMISSIONER OF THE MINNESOTA DEPARTMENT OF HEALTH WAS APPOINTED REHABILITATOR. EXAMINATION RESOURCES WAS APPOINTED SPECIAL DEPUTY COMMISSIONER. UPON THE APPOINTMENT OF THE REHABILITATOR, THE BOARD OF DIRECTORS WAS DISSOLVED. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING RIGHTS ARE RESERVED TO THE POWER OF THE MEMBER OF THE ORGANIZATION: (1) THE NUMBER OF BOARD OF MEMBERS, (2) THE TERMS OF EACH BOARD MEMBER, (3) ANY ELECTED OR APPOINTED DIRECTOR MAY BE REMOVED FROM OFFICE WITH OR WITHOUT CAUSE BY THE MEMBER, (4) VACANCIES IN THE BOARD OF DIRECTORS SHALL BE FILLED BY THE MEMBER, (5) APPOINT AN EXECUTIVE COMMITTEE, (6) APPOINT A FINANCE AND AUDIT COMMITTEE, (7) APPOINT INDIVIDUALS TO SERVE AS THE UCARE FOUNDATION COUNCIL. ON DECEMBER 17, 2025, UCARE WAS PLACED INTO REHABILITATION AND THE COMMISSIONER OF THE MINNESOTA DEPARTMENT OF HEALTH WAS APPOINTED REHABILITATOR. EXAMINATION RESOURCES WAS APPOINTED SPECIAL DEPUTY COMMISSIONER. UPON THE APPOINTMENT OF THE REHABILITATOR, THE BOARD OF DIRECTORS WAS DISSOLVED. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PREPARED BY THE CONTROLLER AND REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM. UCARE PROVIDED A COPY AND REVIEWED THE DETAIL OF THE COMPLETED 990 FORM WITH THE SPECIAL DEPUTY COMMISSIONER. UPON APPROVAL BY THE SPECIAL DEPUTY COMMISSIONER, THE 990 FORM WAS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | UCARE FOUNDATION REQUIRES COMPLETION OF AN ANNUAL QUESTIONNAIRE BY ITS BOARD MEMBERS, OFFICERS, AND SENIOR EXECUTIVES, WHICH IS DESIGNED TO SURFACE POTENTIAL CONFLICTS OF INTEREST. IN ADDITION, UCARE'S POLICY REQUIRES DISCLOSURE TO THE BOARD CHAIR AND/OR CEO OF A POTENTIAL CONFLICT INVOLVING A DIRECTOR, OFFICER, OR MANAGEMENT STAFF WHEN A PARTICULAR TRANSACTION ARISES. IF THE BOARD OR DESIGNATED BOARD COMMITTEE DETERMINES THAT A POTENTIAL CONFLICT EXISTS RELATED TO A TRANSACTION REQUIRING ACTION BY THE BOARD, THE POLICY CALLS FOR THE BOARD MEMBER WITH THE POTENTIAL CONFLICT TO ABSTAIN FROM VOTING. IN ADDITION, A MAJORITY OF THE DISINTERESTED DIRECTORS MUST FIND THAT THE TRANSACTION IS FAIR AND REASONABLE TO THE OPERATION AND THAT THE ORGANIZATION COULD NOT REASONABLY FIND A MORE ADVANTAGEOUS TRANSACTION FROM ANOTHER ENTITY WITHOUT A POTENTIAL CONFLICT. THE POLICY REQUIRES DISCLOSURE OF POTENTIAL CONFLICTS TO THE BOARD OR DESIGNATED COMMITTEE EVEN FOR TRANSACTIONS NOT REQUIRING BOARD ACTION. |
| FORM 990, PART VI, SECTION C, LINE 18 | UCARE FOUNDATION'S 990 FORM IS AVAILABLE ON THIRD-PARTY WEBSITES SUCH AS GUIDESTAR AND PROPUBLICA, IN ADDITION TO BEING MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | UCARE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 112,500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 112,500. |
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