TY 2023 Form 990 Schedule O

efile Public Visual Render ObjectId: 202403039349302065 - Submission: 2024-10-29 TIN: 41-2017315

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

ALLINA HEALTH RESTORATIVE SUITES

Employer identification number

41-2017315

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 3	CASSIA OVERSEES THE DAY-TO-DAY OPERATIONS OF ALLINA HEALTH RESTORATIVE SUITES. DURING THE FISCAL YEAR, CASSIA WAS PAID $83,333 FOR THESE SERVICES.
FORM 990, PART VI, SECTION A, LINE 6	THE MEMBERS OF THE ORGANIZATION ARE EMPLOYEES OF ALLINA HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7A	ALLINA HEALTH SYSTEM APPOINTS THE MEMBERS. THE BOARD SHALL HAVE NO LESS THAN THREE AND NO MORE THAN SEVEN MEMBERS
FORM 990, PART VI, SECTION A, LINE 7B	THE MEMBERS MAKE THE FOLLOWING GOVERNANCE DECISIONS: APPROVAL OF MINUTES, ANNUAL BUDGET AND FINANCIALS.
FORM 990, PART VI, SECTION B, LINE 11B	PRIOR TO FILING, THE FORM 990 WAS REVIEWED BY THE BOARD'S PRESIDENT, THEN BY THE FULL BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C	ANNUAL WRITTEN DISCLOSURES ARE RECEIVED FROM MEMBERS AND EVALUATED BY MANAGEMENT. IF A CONFLICT ARISES, THEN NECESSARY STEPS ARE TAKEN TO RESOLVE IT.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION IS DETERMINED BY THE MARKET AND INFLATION WHICH IS CONDUCTED BY HR AND REVIEWED BY THE REGIONAL DIRECTOR. THE DELIBERATION AND DECISION IS DOCUMENTED IN THE BUDGET WHICH IS THEN APPROVED BY THE BOARD. THIS PROCESS WAS COMPLETED IN 2023.
FORM 990, PART VI, SECTION C, LINE 19	ALLINA'S FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. ALLINA'S GOVERNING DOCUMENTS ARE OPEN FOR PUBLIC INSPECTION THROUGH THE OFFICE OF THE MINNESOTA SECRETARY OF STATE. THE FOUNDATION'S CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11G	NURSING SERVICES: PROGRAM SERVICE EXPENSES 78,865. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 78,865. THERAPY SERVICES: PROGRAM SERVICE EXPENSES 408,870. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 408,870. OTHER SERVICES: PROGRAM SERVICE EXPENSES 217,663. MANAGEMENT AND GENERAL EXPENSES 5,008. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 222,671.

Return Reference

Explanation

FORM 990, PART VI, SECTION A, LINE 3

CASSIA OVERSEES THE DAY-TO-DAY OPERATIONS OF ALLINA HEALTH RESTORATIVE SUITES. DURING THE FISCAL YEAR, CASSIA WAS PAID $83,333 FOR THESE SERVICES.

FORM 990, PART VI, SECTION A, LINE 6

THE MEMBERS OF THE ORGANIZATION ARE EMPLOYEES OF ALLINA HEALTH SYSTEM.

FORM 990, PART VI, SECTION A, LINE 7A

ALLINA HEALTH SYSTEM APPOINTS THE MEMBERS. THE BOARD SHALL HAVE NO LESS THAN THREE AND NO MORE THAN SEVEN MEMBERS

FORM 990, PART VI, SECTION A, LINE 7B

THE MEMBERS MAKE THE FOLLOWING GOVERNANCE DECISIONS: APPROVAL OF MINUTES, ANNUAL BUDGET AND FINANCIALS.

FORM 990, PART VI, SECTION B, LINE 11B

PRIOR TO FILING, THE FORM 990 WAS REVIEWED BY THE BOARD'S PRESIDENT, THEN BY THE FULL BOARD OF DIRECTORS.

FORM 990, PART VI, SECTION B, LINE 12C

ANNUAL WRITTEN DISCLOSURES ARE RECEIVED FROM MEMBERS AND EVALUATED BY MANAGEMENT. IF A CONFLICT ARISES, THEN NECESSARY STEPS ARE TAKEN TO RESOLVE IT.

FORM 990, PART VI, SECTION B, LINE 15

COMPENSATION IS DETERMINED BY THE MARKET AND INFLATION WHICH IS CONDUCTED BY HR AND REVIEWED BY THE REGIONAL DIRECTOR. THE DELIBERATION AND DECISION IS DOCUMENTED IN THE BUDGET WHICH IS THEN APPROVED BY THE BOARD. THIS PROCESS WAS COMPLETED IN 2023.

FORM 990, PART VI, SECTION C, LINE 19

ALLINA'S FINANCIAL STATEMENTS ARE AVAILABLE FOR PUBLIC INSPECTION THROUGH THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. ALLINA'S GOVERNING DOCUMENTS ARE OPEN FOR PUBLIC INSPECTION THROUGH THE OFFICE OF THE MINNESOTA SECRETARY OF STATE. THE FOUNDATION'S CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST.

FORM 990, PART IX, LINE 11G

NURSING SERVICES: PROGRAM SERVICE EXPENSES 78,865. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 78,865. THERAPY SERVICES: PROGRAM SERVICE EXPENSES 408,870. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 408,870. OTHER SERVICES: PROGRAM SERVICE EXPENSES 217,663. MANAGEMENT AND GENERAL EXPENSES 5,008. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 222,671.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

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