Civic Intelligence

Faribault Area Hospice Foundation

990 • Fiscal year 2015 • EIN 47-1693199

Jan 01, 2015 to Dec 31, 2015 • Filed on Nov 10, 2016

200 State AvenueFaribault, MN 55021

(507) 332-4731

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

13th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Liabilities / Revenue

13th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Net Margin

99th percentile

100%

Higher net margin than 99% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Top Officer Pay

35th percentile

$0

Higher top officer pay than 35% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Source year 2015

Asset Growth

94th percentile

86%

Faster asset growth than 94% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2014 to 2015

Revenue Growth

18th percentile

-14%

Faster revenue growth than 18% of similar nonprofits.

2015 filings • 501(c)3 • $1M-$5M nonprofits • Annualized from 2014 to 2015

Assets

Up

$1,333,761

Up $614,790 (+86%) from 2014

Net Assets

Up

$1,333,761

Up $614,790 (+86%) from 2014

Liabilities

Flat

$0

Flat from 2014

Revenue

Down

$614,874

Down $104,128 (-14%) from 2014

Expenses

Up

$84

Up $53 (+171%) from 2014

Net Income

Down

$614,790

Down $104,181 (-14%) from 2014

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$1.5M$1.0M$500K$0Assets 2014: $718,971Liabilities 2014: $0Net Assets 2014: $718,9712014Assets 2015: $1,333,761Liabilities 2015: $0Net Assets 2015: $1,333,7612015Assets 2016: $1,328,706Liabilities 2016: $0Net Assets 2016: $1,328,7062016Assets 2017: $1,245,780Liabilities 2017: $0Net Assets 2017: $1,245,7802017Assets 2018: $1,067,376Liabilities 2018: $0Net Assets 2018: $1,067,3762018Assets 2019: $969,078Liabilities 2019: $0Net Assets 2019: $969,0782019Assets 2020: $923,061Liabilities 2020: $0Net Assets 2020: $923,0612020Assets 2021: $875,384Liabilities 2021: $0Net Assets 2021: $875,3842021Assets 2022: $833,499Liabilities 2022: $0Net Assets 2022: $833,4992022Assets 2023: $899,218Liabilities 2023: $0Net Assets 2023: $899,2182023Assets 2024: $966,308Liabilities 2024: $0Net Assets 2024: $966,3082024

Highlighted filing

2015

Assets$1,333,761
Liabilities$0
Net Assets$1,333,761

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$1.0M$500K$0-$500KRevenue 2014: $719,002Expenses 2014: $31Net Income 2014: $718,9712014Revenue 2015: $614,874Expenses 2015: $84Net Income 2015: $614,7902015Revenue 2016: $25,684Expenses 2016: $30,739Net Income 2016: -$5,0552016Revenue 2017: $22,759Expenses 2017: $105,685Net Income 2017: -$82,9262017Revenue 2018: $27,120Expenses 2018: $205,524Net Income 2018: -$178,4042018Revenue 2019: $50,024Expenses 2019: $148,322Net Income 2019: -$98,2982019Revenue 2020: $53,297Expenses 2020: $99,314Net Income 2020: -$46,0172020Revenue 2021: $40,966Expenses 2021: $88,643Net Income 2021: -$47,6772021Revenue 2022: $33,865Expenses 2022: $75,750Net Income 2022: -$41,8852022Revenue 2023: $48,682Expenses 2023: $49,385Net Income 2023: -$7032023Revenue 2024: $48,262Expenses 2024: $31,015Net Income 2024: $17,2472024

Highlighted filing

2015

Revenue$614,874
Expenses$84
Net Income$614,790
Jump To
Filing Snapshot
Filing Period
Jan 1, 2015 to Dec 31, 2015
Signed
Nov 10, 2016
Return Version
2015v2.1
Gross Receipts
$614,874
Mission and Program Overview

Mission

To improve the quality of life for patients and their loved ones in the district one hospital area.

To improve the quality of life through comfort care, support and compassion for patients and their loved ones in the district one hospital service area.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cash and Non-Interest-Bearing Accounts$718,971$1,333,761▲ $614,790
Total Assets$718,971$1,333,761▲ $614,790
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Unrestricted Net Assets$718,971$1,333,761▲ $614,790
Total Net Assets Fund Balance$718,971$1,333,761▲ $614,790
Total Liabilities and Net Assets / Fund Balance$718,971$1,333,761▲ $614,790
Compensation and Service Providers

Board Members and Trustees

NameTitle
Ken BetsingerChair
Patty VoegeleVice Chair
Audrey TeboVoting Board Member
Calista VosVoting Board Member
Craig BriemhorstVoting Board Member
Kris DrevlowVoting Board Member
Norman ShultzVoting Board Member
Gary VoegeleSecretary
Ken KangasTreasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$614,159
Program Service Revenue
$0
Investment Income
$715
Other Revenue
$0
All Other Contributions
$614,159
Change in Net Assets
$614,790
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$84
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Fees for Services Other-$84-$84
Total Functional Expenses$0$84$0$84
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Backup withholding compliance
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section B, Line 11

Form 990 is reviewed by rick miller of district one hospital on behalf of the board of directors prior to filing with the irs.

Form 990, Part VI, Section B, Line 12C

Board members are required to sign the conflict of interest acknowledgement/questionaire annually.

Form 990, Part VI, Section B, Line 15

Officers and directors of the foundation do not receive compensation.

Form 990, Part VI, Section C, Line 19

Financial statements, conflict of interest policy and governing documents are available upon request for the same period of disclosure as set forth in section 6104(d).

Filing and Contact Details

Filer

Filer Name
Faribault Area Hospice Foundation
EIN
47-1693199
Phone
5073324731
Address
200 STATE AVENUE, FARIBAULT, MN 55021

Signing Officer

Name
Ken Betsinger
Title
Chair
Phone
5073324731
Signed
2016-11-10
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Ken Betsinger
Formed
2014
Legal Domicile
Mn
Voting Board Members
9
Independent Board Members
9
Employees
0
Volunteers
9

Preparer

Firm
Rsm US Llp
Address
801 NICOLLET MALL SUITE 1100, MINNEAPOLIS, MN 55402
Preparer
Todd a Jackson
Phone
6123324300
Supplemental Narrative

Additional Explanations

Form 990, Part IX, Line 11G

Bank account fees: program service expenses 0. Management and general expenses 84. Fundraising expenses 0. Total expenses 84.

Raw XML Appendix322 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/Form990PartVIISectionAGrp/TitleTxt1VICE CHAIR
IRS990/Form990PartVIISectionAGrp/TitleTxt2SECRETARY
IRS990/Form990PartVIISectionAGrp/TitleTxt3TREASURER
IRS990/Form990PartVIISectionAGrp/TitleTxt4VOTING BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt5VOTING BOARD MEMBER
IRS990/Form990PartVIISectionAGrp/TitleTxt6VOTING BOARD MEMBER
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IRS990/MissionDesc0FARIBAULT AREA HOSPICE FOUNDATION IS ORGANIZED AND OPERATED IN ACCORDANCE WITH IRC 501(C)(3) TO RAISE FUNDS FROM THE PUBLIC THAT ARE USED TO ENHANCE THE SCOPE AND QUALITY AND OTHERWISE SUPPORT THE MISSION OF FARIBAULT AREA HOSPICE, WHICH IS TO IMPROVE THE QUALITY OF LIFE THROUGH COMFORT CARE, SUPPORT AND COMPASSION FOR PATIENTS AND THEIR LOVED ONES IN THE DISTRICT ONE HOSPITAL SERVICE AREA.
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IRS990/ProgSrvcAccomActy2Grp/Desc0THE FOUNDATION MAY ALSO MAKE DISTRIBUTIONS TO ORGANIZATIONS THAT QUALIFY AS PUBLIC CHARITIES TO SUPPORT THE EXEMPT PURPOSE OF PROVIDING FINANCIAL SUPPORT FOR ENHANCING THE SCOPE AND QUALITY AND OTHERWISE SUPPORTING THE MISSION OF THE FARIBAULT AREA HOSPICE, WHICH IS TO IMPROVE THE QUALITY OF LIFE THROUGH COMFORT CARE, SUPPORT AND COMPASSION FOR PATIENTS AND THEIR LOVED ONES IN THE DISTRICT ONE HOSPITAL SERVICE AREA.
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IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt0DESCRIPTION: DATE: 12/31/14 AMOUNT: 719000. DESCRIPTION: DATE: 06/01/15 AMOUNT: 578112.
IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt1THE FOUNDATION WAS INCORPORATED JULY 7, 2014; THEREFORE THE INITIAL 2014 RETURN IS THE SHORT PERIOD FROM 7/1/14 - 12/31/14.
IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt2THE FOUNDATION RECEIVED THE FOLLOWING UNUSUAL GRANTS FROM A TRUST: 12/31/2014 - $719,000 6/1/2015 - $578,111.53
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc0SCHEDULE A, PART VI, LIST OF UNUSUAL GRANTS:
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc1SCHEDULE A - 2014 SHORT YEAR
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IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0FORM 990 IS REVIEWED BY RICK MILLER OF DISTRICT ONE HOSPITAL ON BEHALF OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1BOARD MEMBERS ARE REQUIRED TO SIGN THE CONFLICT OF INTEREST ACKNOWLEDGEMENT/QUESTIONAIRE ANNUALLY.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2OFFICERS AND DIRECTORS OF THE FOUNDATION DO NOT RECEIVE COMPENSATION.
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D).
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4BANK ACCOUNT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 84. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0FORM 990, PART VI, SECTION B, LINE 11
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1FORM 990, PART VI, SECTION B, LINE 12C
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2FORM 990, PART VI, SECTION B, LINE 15
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3FORM 990, PART VI, SECTION C, LINE 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4FORM 990, PART IX, LINE 11G
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IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt01333761
IRS990/TotalOtherCompensationAmt00
IRS990/TotalReportableCompFromOrgAmt00
IRS990/TotalRevenueGrp/ExclusionAmt0715
IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt00
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0614874
IRS990/TotalRevenueGrp/UnrelatedBusinessRevenueAmt00
IRS990/TotalVolunteersCnt09
IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt0718971
IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt01333761
IRS990/TotReportableCompRltdOrgAmt00
IRS990/TrnsfrExmptNonChrtblRltdOrgInd00
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd00
IRS990/UnrestrictedNetAssetsGrp/BOYAmt0718971
IRS990/UnrestrictedNetAssetsGrp/EOYAmt01333761
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt0200 STATE AVENUE
IRS990/USAddress/CityNm0FARIBAULT
IRS990/USAddress/StateAbbreviationCd0MN
IRS990/USAddress/ZIPCd055021
IRS990/VotingMembersGoverningBodyCnt09
IRS990/VotingMembersIndependentCnt09
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd00
ReturnHeader/BuildTS02017-02-10 21:41:12Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd01
ReturnHeader/BusinessOfficerGrp/PersonNm0KEN BETSINGER
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0CHAIR
ReturnHeader/BusinessOfficerGrp/PhoneNum05073324731
ReturnHeader/BusinessOfficerGrp/SignatureDt02016-11-10
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0FARIBAULT AREA HOSPICE FOUNDATION
ReturnHeader/Filer/BusinessNameControlTxt0FARI
ReturnHeader/Filer/EIN0471693199
ReturnHeader/Filer/PhoneNum05073324731
ReturnHeader/Filer/USAddress/AddressLine1Txt0200 STATE AVENUE
ReturnHeader/Filer/USAddress/CityNm0FARIBAULT
ReturnHeader/Filer/USAddress/StateAbbreviationCd0MN
ReturnHeader/Filer/USAddress/ZIPCd055021
ReturnHeader/PreparerFirmGrp/PreparerFirmEIN0420714325
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0RSM US LLP
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt0801 NICOLLET MALL SUITE 1100
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0MINNEAPOLIS
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0MN
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd055402
ReturnHeader/PreparerPersonGrp/PhoneNum06123324300
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0TODD A JACKSON
ReturnHeader/ReturnTs02016-11-15T15:11:36-06:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02015-01-01
ReturnHeader/TaxPeriodEndDt02015-12-31
ReturnHeader/TaxYr02015

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Peer Organizations

Similar nonprofits based on the same Siviq industry and scale cohort. 2015 filings • 501(c)3 • $1M-$5M nonprofits