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Object ID: 201821349349303832 - Rendered 2024-05-07
TIN: 45-3791176
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Information about Schedule R (Form 990) and its instructions is at
www.irs.gov/form990
.
OMB No. 1545-0047
20
16
Open to Public Inspection
Name of the organization
Sanford Group Return
Employer identification number
45-3791176
Part I
Identification of Disregarded Entities
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
(1)
Lincoln County Real Estate Trust
100 S Phillips Ave
Sioux Falls
,
SD
57104
46-6126929
Real Estate
SD
0
583,467
Sanford Health
(2)
PPK Family Trust
100 S Phillips Ave
Sioux Falls
,
SD
57104
20-7317570
Rental Real Estate
SD
96
Sanford Health
(3)
Lynx Trust
PO Box 5186
Sioux Falls
,
SD
57117
26-6167201
Investment
SD
-5
424
Sanford Health
(4)
National Student Housing Trust-SD
PO Box 5186
Sioux Falls
,
SD
57117
20-6831968
Investment
SD
-7
401
Sanford Health
(5)
Sanford HealthCare Accessories LLC
3223 32nd Ave SW
Fargo
,
ND
58103
20-2404179
Sales of Durable Medical Equip
ND
32,100,682
13,969,467
Sanford North
(6)
Healthcare Environmental Services LLC
PO Box 2010
Fargo
,
ND
58122
20-5236701
Retail Enterprises
ND
2,368,684
6,361,106
Sanford North
(7)
North Country Senior Living LLC
1000 Anne St NW
Bemidji
,
MN
56601
26-3862586
Senior Housing
CO
3,339,900
8,078,298
Sanford Health of Northern Minnesota
(8)
1527 Broadway LLC
1527 Broadway
Alexandria
,
MN
56308
41-1336392
Real Estate
MN
673,200
6,778,199
Sanford Clinic North
(9)
Medequip One LLC
626 N 6th Street
Bismarck
,
ND
58501
45-0452639
Durable medical equipment, products, and services
ND
0
0
Sanford West
(10)
Shetek Medical Services LLC
251 5th Street E
Tracy
,
MN
56175
41-2004685
Home Health Services
MN
421,134
430,069
Sanford Health Network
(11)
Sanford Health Mobile Med LLC
2603 E Broadway Avenue
Bismarck
,
ND
58501
47-1209528
Mobile Healthcare
ND
-4,663
744,955
Sanford Health
(12)
Southwest MN Radiation Center LLC
1018 6th Avenue
Worthington
,
MN
56187
46-0447693
Radiation Services
MN
823,742
91,203
Sanford Health Network
Part II
Identification of Related Tax-Exempt Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
Sanford
P O Box 5039 Rte 5218
Sioux Falls
,
ND
58122
27-1218956
Supporting Organization
ND
501(c)(3)
12-II
No
(2)
Sanford Health Foundation
P O Box 5039 Rte 5218
Sioux Falls
,
SD
571175039
36-3297853
Foundation
SD
501(c)(3)
12-II
Sanford Health
Yes
(3)
Edith Sanford Breast Cancer Foundation
P O Box 5039 Rte 5218
Sioux Falls
,
SD
571175039
45-0404126
Foundation
ND
501(c)(3)
12-II
Sanford Health
Yes
(4)
F-M Ambulance Service Inc
P O Box 5039 Rte 5218
Sioux Falls
,
SD
571175039
45-0344371
EMT
ND
501(c)(4)
Sanford North
Yes
(5)
Sanford Health Foundation North
P O Box 5039 Rte 5218
Sioux Falls
,
SD
571175039
45-0398104
Foundation
ND
501(c)(3)
7
Sanford North
Yes
(6)
Sanford Health Foundation Hillsboro
P O Box 5039 Rte 5218
Sioux Falls
,
SD
571175039
36-3542187
Foundation
ND
501(c)(3)
7
Sanford Hillsboro
Yes
(7)
Sanford Health Foundation of Northern Minnesota
P O Box 5039 Rte 5218
Sioux Falls
,
SD
571175039
41-1389317
Foundation
MN
501(c)(3)
12-II
Sanford Health of Northern Minnesota
Yes
(8)
Sanford Health Foundation West
P O Box 5039 Rte 5218
Sioux Falls
,
SD
571175039
45-0397196
Foundation
ND
501(c)(3)
7
Sanford Bismarck
Yes
(9)
Medcenter One Inc Auxiliary
P O Box 5039 Rte 5218
Sioux Falls
,
SD
571175039
23-7293043
Supporting Organization
ND
501(c)(3)
12-II
Sanford Bismarck
Yes
(10)
Sanford Heart of America Health Plan
P O Box 5039 Rte 5218
Sioux Falls
,
SD
571175039
45-0346132
Insurance
ND
501(c)(4)
Sanford Health Plan
Yes
(11)
Sanford Health Foundation Thief River Falls
P O Box 5039 Rte 5218
Sioux Falls
,
SD
571175039
41-1761135
Foundation
MN
501(c)(3)
7
Sanford Medical Center Thief River Falls
Yes
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2016
Schedule R (Form 990) 2016
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
(1)
National Student Housing-South Dakota LLC
100 S Phillips Ave
Sioux Falls
,
SD
57104
20-2129839
Investment
SD
Sanford Health
Related
-70,857
3,922,469
No
No
99.990 %
(2)
RAC Rentals LLC
100 S Phillips Ave
Sioux Falls
,
SD
57104
26-1961077
Investment
SD
Sanford Health
Related
-30,365
3,913,971
No
No
99.990 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
Sanford Home Medical Equipment Inc
2710 W 12th Street
Sioux Falls
,
SD
57105
46-0388597
Healthcare Equipment
SD
Sanford Health
C
2,942,830
15,295,183
100.000 %
Yes
(2)
Sanford Health Plan
300 Cherapa Place
Sioux Falls
,
SD
57103
91-1842494
Insurance
SD
Sanford Health
C
-22,630,887
230,483,996
100.000 %
Yes
(3)
Sanford Health Plan of MN
300 Cherapa Place
Sioux Falls
,
SD
57103
46-0445852
Insurance
MN
Sanford Health
C
-232,518
2,207,898
100.000 %
Yes
(4)
Sanford Frontiers
1305 W 18th Street PO Box 5039
Sioux Falls
,
SD
571175039
45-5436599
Weight Loss Management
SD
Sanford Health
C
-64,813,291
61,019,858
100.000 %
Yes
(5)
SOB Inc
2701 S Minnesota Avenue Suite 2
Sioux Falls
,
SD
57105
46-0442628
Air Transportation
SD
N/A
C
Yes
(6)
Sanford Affiliated Services Inc
300 N 7th Street
Bismarck
,
ND
58501
45-0403146
Investment Activity
ND
Sanford West
C
-6,781
1,913,735
100.000 %
Yes
(7)
Sanford World Clinics - Ghana
Sarbah Road Tantri Lorry Station
Cape Coast
GH
Healthcare
GH
Sanford World Clinics
C
-3,400,638
4,557,628
100.000 %
Yes
(8)
Shanghai Sanford Healthcare Management Consulting Co Ltd
188 Yesheng Road Room A-862 Guoma
Shanghai
CH
Healthcare
CH
Sanford World Clinics
C
-276,389
425,413
100.000 %
Yes
(9)
Sanford International - Munich GmbH
Nymphenburger Strasse 3
Munich
GM
Healthcare
GM
Sanford World Clinics
C
-258,135
17,163
100.000 %
Yes
Schedule R (Form 990) 2016
Schedule R (Form 990) 2016
Page
3
Part V
Transactions With Related Organizations
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
No
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
No
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
No
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
No
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
Yes
s
Other transfer of cash or property from related organization(s)
............................
1s
Yes
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
Sanford Health Foundation
C
41,623,300
Cash Basis
(2)
Sanford Health Foundation North
C
2,654,325
Cash Basis
(3)
Sanford Health Foundation West
C
137,901
Cash Basis
(4)
Edith Sanford Breast Cancer Foundation
C
589,011
Cash Basis
(5)
Sanford Health Foundation Hillsboro
C
117,167
Cash Basis
(6)
Sanford Heart of America Health Plan
P
495,788
Cash Basis
(7)
Sanford Heart of America Health Plan
Q
430,357
Cash Basis
(8)
Sanford Health Foundation
R
8,653,620
Cost
(9)
Sanford Health Foundation North
R
1,992,639
Cost
(10)
Sanford Health Foundation Thief River Falls
R
81,941
Cost
(11)
Sanford Health Foundation of Northern Minnesota
R
401,515
Cost
(12)
Sanford Health Foundation Hillsboro
R
95,934
Cost
(13)
Edith Sanford Breast Cancer Foundation
R
430,511
Cost
(14)
Sanford Health Foundation West
R
1,186,017
Cost
(15)
Sanford Health Plan
R
51,180,967
Cost
(16)
SOB Inc
S
425,093
Cash Basis
(17)
F-M Ambulance Service Inc
S
3,876,590
Cost
(18)
Sanford Frontiers
S
11,179,822
Cash Basis
(19)
Sanford Health Foundation North
B
50,075
Cost
(20)
Edith Sanford Breast Cancer Foundation
B
1,160,936
Cost
Schedule R (Form 990) 2016
Schedule R (Form 990) 2016
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2016
Schedule R (Form 990) 2016
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference
Explanation
Schedule R (Form 990) 2016
Additional Data
Software ID:
Software Version: