Skip to content
Nonprofiteer
← ST MARYS INNOVIS HEALTH

Form 990 for tax year 2022

Filed by ST MARYS INNOVIS HEALTH.

Totals

Total revenue
$7,511,723
Total expenses
$5,900,792
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$7,457,711
Investment income
-$23,907
Other revenue
$77,919
Total assets, end of year
$4,680,640
Total liabilities, end of year
$2,017,424
Net assets or fund balances, end of year
$2,663,216
Program services expenses (Part IX)
$5,628,211
Management and general expenses
$272,581
Fundraising expenses
$0
Program service expenses (Part III)
$5,628,211

Program services were 95.4% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: PHARMACY

    total $7,457,711 · related or exempt $7,457,711

  • 3 · Investment income

    total $16 · excluded $16

  • 7b · Less cost or other basis and sales expenses

    other assets $23,923

  • 7c · Gain or loss

    other assets -$23,923

  • 7d · Net gain or loss

    total -$23,923 · excluded -$23,923

  • 10a · Gross sales of inventory

    $381,498

  • 10b · Cost of goods sold

    $303,579

  • 10c · Net income from sales of inventory

    total $77,919 · unrelated business $77,919

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $725,093 · program services $725,093

  • 8 · Pension plan contributions

    total $34,335 · program services $34,335

  • 9 · Other employee benefits

    total $99,978 · program services $98,962 · management and general $1,016

  • 10 · Payroll taxes

    total $51,788 · program services $51,617 · management and general $171

  • 11g · Fees: other

    total $8,502 · program services $7,186 · management and general $1,316

  • 13 · Office expenses

    total $38,806 · program services $37,289 · management and general $1,517

  • 14 · Information technology

    total $16,250 · program services $16,250

  • 16 · Occupancy

    total $120,000 · program services $120,000

  • 17 · Travel

    total $1,052 · program services $1,052

  • 19 · Conferences, conventions and meetings

    total $130 · program services $130

  • 20 · Interest

    total $65,424 · program services $65,424

  • 22 · Depreciation, depletion and amortization

    total $42,872 · program services $42,872

  • 23 · Insurance

    total $21,336 · program services $21,336

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $4,111,185 · program services $4,111,185

  • 24b · Other expenses: AFFILIATE SUPPORT FEE

    total $517,908 · program services $251,341 · management and general $266,567

  • 24c · Other expenses: MN CARE TAX

    total $66,341 · program services $66,341

  • 24d · Other expenses: REPAIRS & MAINTENANCE

    total $2,784 · program services $2,700 · management and general $84

  • 24e · All other expenses

    total -$22,992 · program services -$24,902 · management and general $1,910

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $1,552 · end of year $1,550

  • 2 · Savings and temporary cash investments

    beginning of year $1,147,545 · end of year $2,441,715

  • 4 · Accounts receivable

    beginning of year $368,362 · end of year $536,045

  • 8 · Inventories for sale or use

    beginning of year $426,432 · end of year $479,591

  • 10a · Land, buildings and equipment: cost or other basis

    $1,886,908

  • 10b · Land, buildings and equipment: accumulated depreciation

    $665,169

  • 10c · Land, buildings and equipment, net

    beginning of year $1,263,598 · end of year $1,221,739

  • 12 · Investments: other securities

    beginning of year $3,926

  • 17 · Accounts payable and accrued expenses

    beginning of year $76,206 · end of year $83,705

  • 19 · Deferred revenue

    beginning of year $12,549

  • 20 · Tax-exempt bond liabilities

    beginning of year $1,239,292 · end of year $1,134,532

  • 23 · Secured mortgages and notes payable

    beginning of year $827,156 · end of year $799,187

  • 25 · Other liabilities

    beginning of year $74,334

  • 27 · Net assets without donor restrictions

    beginning of year $981,878 · end of year $2,663,216

Mission and programs · 2022

Mission

WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES.

  • ST. MARY'S INNOVIS HEALTH IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL & SCIENTIFIC PURPOSES. MORE SPECIFICALLY, ST. MARY'S INNOVIS HEALTH IS CREATED & ORGANIZED TO OWN, MAINTAIN, OPERATE & CONDUCT, DIRECTLY OR INDIRECTLY, AND TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, CARE FOR THE AGED AND SOCIAL SERVICES, INCLUDING CHARITABLE CARE TO PERSONS UNABLE TO PAY.ST. MARY'S INNOVIS HEALTH HAS A RETAIL PHARMACY SERVING BOTH PATIENTS AND NON-PATIENTS OF ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, A RELATED ORGANIZATION. THE PHARMACY FILLED OVER 82,000 PRESCRIPTIONS DURING THE FISCAL YEAR ENDED JUNE 30, 2023.

    Expenses $5,628,211 · Revenue $7,457,711

As filed on the 2022 return.

Listed in Part VII

  • Tanner Goodrich

    PRESIDENT

    Total calculated
    $533,933
    From this org
    $0
    From related orgs
    $436,762
    Other
    $97,171
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $307,909 related
    Bonus
    $0 + $127,876 related
    Other
    $0 + $977 related
    Deferred
    $0 + $68,855 related
    Nontaxable benefits
    $0 + $28,316 related
    Filer's total
    $0 + $533,933 related

  • Ryan Hill

    FORMER INTERIM PRESIDENT

    Total calculated
    $277,142
    From this org
    $0
    From related orgs
    $229,092
    Other
    $48,050
    Hours/week
    0 + 60 related

    Schedule J breakdown matched by us

    Base
    $0 + $228,517 related
    Bonus
    $0
    Other
    $0 + $575 related
    Deferred
    $0 + $11,079 related
    Nontaxable benefits
    $0 + $36,971 related
    Filer's total
    $0 + $277,142 related

  • Kimberly Bodensteiner

    FINANCE DIRECTOR

    Total calculated
    $203,161
    From this org
    $0
    From related orgs
    $180,104
    Other
    $23,057
    Hours/week
    1 + 59 related

    Schedule J breakdown matched by us

    Base
    $0 + $179,431 related
    Bonus
    $0
    Other
    $0 + $673 related
    Deferred
    $0 + $9,212 related
    Nontaxable benefits
    $0 + $13,845 related
    Filer's total
    $0 + $203,161 related

  • Alyson Larson

    PHARMACY SITE SUPERVISOR

    Total calculated
    $168,249
    From this org
    $152,509
    From related orgs
    $0
    Other
    $15,740
    Hours/week
    60

    Schedule J breakdown matched by us

    Base
    $152,398
    Bonus
    $0
    Other
    $111
    Deferred
    $7,945
    Nontaxable benefits
    $7,795
    Filer's total
    $168,249

  • Adrienne Fiedler

    PHARMACIST - AMBULATORY CARE

    Total calculated
    $114,862
    From this org
    $107,549
    From related orgs
    $0
    Other
    $7,313
    Hours/week
    60

  • James Anderson

    BOARD SECRETARY/TREASURER

    Total calculated
    $20,500
    From this org
    $0
    From related orgs
    $20,500
    Other
    $0
    Hours/week
    2 + 7 related

  • Dennis Miley

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    2 + 4 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, and on a Form 990-PF Part VIII's — 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

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan

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
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ST. MARY'S INNOVIS HEALTH'S PRESIDENT'S COMPENSATION: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ESSENTIA HEALTH'S NONQUALIFIED RETIREMENT PLAN IS OFFERED TO DESIGNATED ESSENTIA HEALTH EXECUTIVES. THERE IS A MINIMUM FOUR YEAR VESTING DATE, OR VESTING IS AUTOMATIC UPON REACHING RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. BENEFITS ARE SUBJECT TO INCOME TAXES UPON VESTING AND PAYABLE FROM ESSENTIA HEALTH'S GENERAL ASSETS. REPORTED AS RETIREMENT AND OTHER DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C, ESSENTIA HEALTH MADE CONTRIBUTIONS, SUBJECT TO THE VESTING TERMS, DURING THE YEAR INTO THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A: TANNER GOODRICH $45,923

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.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • PMC-GATEWAY IMAGING LLC THRU 1132022

    N/A · IMAGING SERVICES · MN

  • HORSESHOE SURGERY CENTER LLC

    N/A · SURGERY CENTER · MN

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • ESSENTIA HEALTH INSURANCE SERVICES SPC LTD

    C · SELF INSURANCE · CJ · controlled entity

  • MID DAKOTA CLINIC INC

    C · CLINIC OPERATIONS CEASED 9/30/22 · ND · controlled entity

Provenance

Return type
form_990
Tax year
2022
Filed
3 May 2024
IRS schema version
2022v5.0
Source object
202431249349300808

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

The source document this was parsed from is served over the API, which is where bulk and document access live.