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Nonprofiteer
← CENTRAL MINNESOTA DIAGNOSTIC INC

Form 990 for tax year 2022

Filed by CENTRAL MINNESOTA DIAGNOSTIC INC.

Totals

Total revenue
$44,581,584
Total expenses
$30,817,865
Contributions and grants received
$0
Grants paid
$0
Program services expenses (Part IX)
$29,482,536
Management and general expenses
$1,335,329
Fundraising expenses
$0
Program service expenses (Part III)
$29,482,536

Program services were 95.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • Randy Ulseth

    Chair

    Total calculated
    $0
    Hours/week
    0.5

  • Rick Breuer

    Vice Chair

    Total calculated
    $0
    Hours/week
    0.5

  • Aaron Saude

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Amy Hart

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Ben Koppelman

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Ben Koppelman

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Bill Nelson

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Brad Burris

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Brandon Pietsch

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Bryan Bauck

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Carrie Allex

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Chelsie Falk

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Chuck Hofius

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Dan Enderson

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Dave Nelson

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Gordy Lewis

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Jason Douglas

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Jean MacDonell

    Director

    Total calculated
    $586,650
    From this org
    $0
    From related orgs
    $515,552
    Other
    $71,098
    Hours/week
    0.5 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $372,868 related
    Bonus
    $0 + $142,100 related
    Other
    $0 + $584 related
    Deferred
    $0 + $69,797 related
    Nontaxable benefits
    $0 + $1,302 related
    Filer's total
    $0 + $586,650 related

  • Jim Lyons

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Joel Beiswenger

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • John Hering MD

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Jose Alba

    Director, new 5-2022

    Total calculated
    $0
    Hours/week
    0.5

  • Karen Whiley

    Director

    Total calculated
    $343,142
    From this org
    $0
    From related orgs
    $304,290
    Other
    $38,852
    Hours/week
    0.5 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $269,007 related
    Bonus
    $0 + $33,709 related
    Other
    $0 + $1,574 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $20,552 related
    Filer's total
    $0 + $343,142 related

  • Ken Westman

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Kirk Stensrud

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Kurt Waldbillig

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Michael Coyle

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Rick Ash

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Rob Cunningham

    Director, new 5-2022

    Total calculated
    $0
    Hours/week
    0.5

  • Robb Pastor

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Shelby Medina

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Teresa Debevec

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Thomas Witt MD

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Tim Rice

    Director

    Total calculated
    $0
    Hours/week
    0.5

  • Tim Weir

    Director, ended 5-2022

    Total calculated
    $0
    Hours/week
    0.5

  • Chad Cooper

    President

    Total calculated
    $530,094
    From this org
    $0
    From related orgs
    $445,174
    Other
    $84,920
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $368,562 related
    Bonus
    $0 + $75,499 related
    Other
    $0 + $1,113 related
    Deferred
    $0 + $64,007 related
    Nontaxable benefits
    $0 + $20,913 related
    Filer's total
    $0 + $530,094 related

  • Caity Eggen

    VP

    Total calculated
    $216,299
    From this org
    $0
    From related orgs
    $184,152
    Other
    $32,147
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $158,081 related
    Bonus
    $0 + $25,527 related
    Other
    $0 + $544 related
    Deferred
    $0 + $10,780 related
    Nontaxable benefits
    $0 + $21,367 related
    Filer's total
    $0 + $216,299 related

  • Brent Heemstra

    MRI Tech

    Total calculated
    $149,866
    From this org
    $0
    From related orgs
    $121,290
    Other
    $28,576
    Hours/week
    40

  • Jered Nyquist

    MRI Tech

    Total calculated
    $164,152
    From this org
    $0
    From related orgs
    $144,762
    Other
    $19,390
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $143,640 related
    Bonus
    $0 + $750 related
    Other
    $0 + $372 related
    Deferred
    $0 + $8,764 related
    Nontaxable benefits
    $0 + $10,626 related
    Filer's total
    $0 + $164,152 related

  • Michael Awe

    Nuc Med Tech

    Total calculated
    $147,309
    From this org
    $0
    From related orgs
    $119,650
    Other
    $27,659
    Hours/week
    40

  • Shana Benson

    Ultrasound Supervisor

    Total calculated
    $206,900
    From this org
    $0
    From related orgs
    $190,451
    Other
    $16,449
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $189,243 related
    Bonus
    $0 + $750 related
    Other
    $0 + $458 related
    Deferred
    $0 + $6,965 related
    Nontaxable benefits
    $0 + $9,484 related
    Filer's total
    $0 + $206,900 related

  • Spencer Feldt

    Nuc Medicine Supervisor

    Total calculated
    $158,270
    From this org
    $0
    From related orgs
    $148,125
    Other
    $10,145
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $135,427 related
    Bonus
    $0 + $4,750 related
    Other
    $0 + $7,948 related
    Deferred
    $0 + $8,874 related
    Nontaxable benefits
    $0 + $1,271 related
    Filer's total
    $0 + $158,270 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN: CHAD COOPER, JEAN MACDONELL
Schedule J, Part I, Line 7 Non-fixed payments
Fairview Health Services provides lump sum financial awards based on system-wide, business unit and/or departments financial and quality measures. Annual goals, specifically tied to productivity and quality indicators, are set for the year and an incentive paid out annually if key goals and measures are achieved.
Schedule J, Part I, Line 3 Related Org to establish compensation
THE ORGANIZATION IS PART OF THE FAIRVIEW HEALTH SERVICES SYSTEM AND FAIRVIEW HEALTH SERVICES HUMAN RESOURCES USES COMPARABLES TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR ACCORDING TO MARKET STANDARDS.
Schedule J, Part III Other Additional Information
The Plan is only open to a select group of highly compensated employees. The Plan contributes the difference of what 403(b) employer contributions were missed for participants who earn more than the IRS limit on eligible compensation for qualified retirement plans. The contribution is unfunded. The Plan complies with section 457(f) of the Code.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
26 October 2023
IRS schema version
2022v5.0
Source object
202312999349301036

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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