2023-11-06T15:15:18-06:00 2022-12-31 135565207 KPMG LLP 90 S 7TH ST STE 4200 MINNEAPOLIS MN 55402 990 2022-01-01 465444821 UNIVERSITY OF MINNESOTA HEALTH CLINICS AND SURGERY CENTER INC UNIV 6128840600 909 FULTON STREET SE MINNEAPOLIS MN 55414 WILLIAM SIBERT CFO 6128840600 2023-11-06 1 WILLIAM SIBERT 999009999 0 HOLLY K MOEN P01800653 6123055000 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z BEVAN YUEH 909 FULTON STREET SE SUITE 200 MINNEAPOLIS MN 55414 151004254 0 X WWW.MHEALTH.ORG X 2015 MN JOINT VENTURE TO PROVIDE BREAKTHROUGH MEDICINE AND TRANSFORM THE HEALTH OF THE COMMUNITY USING THE POWER OF AN INTEGRATED ACADEMIC HEALTH SYSTEM. 6 6 0 0 0 0 88833306 0 144578277 151004254 0 0 0 0 233411583 151004254 0 0 0 0 0 0 0 0 0 187565108 194199203 187565108 194199203 45846475 -43194949 176197118 134296737 170927226 172221794 5269892 -37925057 X UNIVERSITY OF MINNESOTA HEALTH CLINICS & SURGERY CENTER, INC. (CSC) (THE CORPORATION) IS A MINNESOTA CORPORATION COMPRISED OF MULTIPLE PHYSICIAN SPECIALTIES (CLINICAL SERVICE UNITS). THE CORPORATION IS THE RESULT OF A JOINT-VENTURE AGREEMENT BETWEEN ITS MEMBERS, THE UNIVERSITY OF MINNESOTA PHYSICIANS, (UMPHYSICIANS) A MINNESOTA NOT-FOR-PROFIT CORPORATION AND FAIRVIEW HEALTH SERVICES (FAIRVIEW) A NOT-FOR-PROFIT ENTITY, COLLECTIVELY, THE MEMBERS.CSC THRU ITS MEMBER(S) IS AFFILIATED WITH VARIOUS MEDICAL DEPARTMENTS OF THE UNIVERSITY OF MINNESOTA'S SCHOOL OF MEDICINE (MEDICAL SCHOOL). THE RELATIONSHIP AFFILIATION DEFINES THE CORPORATION'S MAIN PURPOSE WHICH IS TO DEVELOP AND OPERATE AN AMBULATORY CARE CENTER DEDICATED TO ADVANCING MEDICAL RESEARCH AND EDUCATION AND PROVIDING HEALTH CARE SERVICES. 0 0 194074595 0 151004254 THE CORPORATION SUPPORTS THE EDUCATION AND RESEARCH MISSION OF THE UNIVERSITY'S ACADEMIC HEALTH CENTER AND ADVANCES EDUCATION AND RESEARCH EFFORTS OF THE UNIVERSITY'S MEDICAL SCHOOL AND OTHER SCHOOLS IN THE ACADEMIC HEALTH CENTER. SEE SCHEDULE O. 194074595 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 23 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X SEAN FREDRICKSON 6128840600 720 WASHINGTON AVENUE SE SUITE 200 MINNEAPOLIS MN 55414 X JAKUB TOLAR MD BOARD CHAIR 1.00 0.00 X X 0 0 0 JAMES HEREFORD TREASURER AND SECRETARY 1.00 0.00 X X 0 0 0 BEVAN YUEH DIRECTOR 1.00 0.00 X 0 0 0 MYRON FRANS DIRECTOR 1.00 0.00 X 0 0 0 HAYES BATSON DIRECTOR THRU AUG 2022 1.00 0.00 X 0 0 0 LAURA REED DIRECTOR 1.00 0.00 X 0 0 0 MARK WELTON DIRECTOR 1.00 0.00 X 0 0 0 PETER MITSCH DIRECTOR THRU AUG 2022 1.00 0.00 X 0 0 0 0 0 0 0 0 0 0 FAIRVIEW HEALTH SERVICES PO BOX 1496 MINNEAPOLIS MN 55440 CLINICAL SERVICES 106725525 UNIVERSITY OF MINNESOTA PHYSICIANS 720 WASHINGTON AVENUE SE MINNEAPOLIS MN 55440 LEASED EMPLOYEES 43057561 HHS LLC 12495 SILVER CREEK ROAD DRIPPING SPRINGS TX 78620 FACILITIES MGMT 2295912 SIEMENS MEDICAL SOLUTIONS USA INC 40 LIBERTY BLVD MALVERN PA 19355 EQUIP RENTAL/MAINT 929334 OLYMPUS AMERICA INC PO BOX 200183 PITTSBURGH PA 152510183 EQUIP RENTAL/MAINT 368543 14 PATIENT REVENUE 621400 149068320 149068320 OTHER REVENUE 621400 1935934 1935934 151004254 151004254 151004254 0 0 41054 41054 83554 83554 14790779 14790779 2432 2432 2183881 2183881 49282 49282 7746054 7746054 13384 13384 3939313 3939313 2577736 2577736 72284 72284 LEASED EMPLOYEES 117402860 117402860 MEDICAL SUPPLIES/DRUGS 25748749 25748749 GENERAL AND ADMIN EXPEN 14208491 14208491 ALL OTHER EXPENSES 2819387 2819387 2519963 2519963 194199203 194074595 124608 0 43014216 13746836 0 0 0 0 30555191 17978643 0 0 0 0 0 0 2265615 2405747 8406810 8076790 41103898 34439757 91955286 6664141 0 0 0 0 0 0 0 0 0 85424580 176197118 134296737 79739359 78715659 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91187867 93506135 170927226 172221794 X 5269892 -37925057 0 0 5269892 -37925057 176197118 134296737 -43194949 0 X 0 1 X 1 0 X PART 1: UNIVERSITY OF MINNESOTA HEALTH CLINICS AND SURGERY CENTER, INC. (CSC) IS RECOGNIZED AS A HOSPITAL BY THE INTERNAL REVENUE SERVICE UNDER IRC SECTION 170(B)(1)(A)(III). HOWEVER, CSC DOES NOT CURRENTLY OPERATE ANY LICENSED HOSPITAL FACILITIES; THEREFORE, NO SCHEDULE H IS REQUIRED. 1681577 355902 1325675 37401887 32132215 5269672 2020434 1951640 68794 6664141 FINANCE LEASE ROU ASSET 82629092 OPERATING LEASE ROU ASSET 2795488 85424580 LT LEASE LIABILITY 89477681 ST LEASE LIABILITY 4028454 93506135 X 148484291 0 148484291 2519963 2519963 151004254 191679240 0 191679240 2519963 2519963 194199203 PART X, LINE 2: THE COMPANY IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. THE COMPANY IS ALSO EXEMPT FROM STATE INCOME TAXES UNDER SIMILAR PROVISIONS IN THE MINNESOTA STATUTES. THE COMPANY HAS ADOPTED GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE STANDARD REQUIRES AN ORGANIZATION TO DETERMINE WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE COMPANY EVALUATES ITS UNCERTAIN TAX POSITIONS. THERE ARE NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2022 AND 2021. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 2,519,963. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 2,519,963. PART IV, LINE 34: AS PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION, FAIRVIEW AND UMPHYSICIANS ARE THE SOLE MEMBERS OF THE CORPORATION. BOTH FAIRVIEW AND UMPHYSICIANS ARE MINNESOTA NONPROFIT CORPORATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAXATION AS ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. EACH MEMBER HAS A 50% MEMBERSHIP INTEREST IN THE CORPORATION. THE MEMBERS ARE NOT RELATED PER THE SCHEDULE R INSTRUCTIONS, BECAUSE NEITHER HAS A MAJORITY OWNERSHIP IN THE ORGANIZATION, AND THEREFORE ARE NOT LISTED ON SCHEDULE R, PART II. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATION IS THE RESULT OF A JOINT-VENTURE AGREEMENT ENTERED INTO ON DECEMBER 20, 2013 BETWEEN ITS MEMBERS, THE UNIVERSITY OF MINNESOTA PHYSICIANS, (UMPHYSICIANS) A MINNESOTA NOT-FOR-PROFIT CORPORATION AND FAIRVIEW HEALTH SERVICES (FAIRVIEW) A NOT-FOR-PROFIT ENTITY, COLLECTIVELY, THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7A AS PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION, FAIRVIEW AND UMPHYSICIANS ARE THE SOLE MEMBERS OF THE CORPORATION. EACH MEMBER APPOINTS 50% OF THE GOVERNING BOARD, WITH UMP'S 50% OF APPOINTMENTS INCLUDING TWO REPRESENTATIVES OF THE MEDICAL SCHOOL, THE DEAN AND AN APPOINTEE OF THE DEAN. FORM 990, PART VI, SECTION B, LINE 11B CSC WILL DELIVER A DRAFT OF THE FORM 990 TO MEMBERS OF ITS GOVERNING BODY, ELECTRONICALLY OR IN HARD COPY, BEFORE FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND OFFICERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM WHICH IS ANNUALLY REVIEWED BY MANAGEMENT AND OUTSIDE LEGAL COUNSEL IF NECESSARY. IF ANY OFFICER, DIRECTOR OR COMMITTEE MEMBER OF THE CORPORATION IS CONSIDERED TO HAVE CONFLICT OF INTEREST, THEY SHOULD GIVE THE BOARD OF THE CORPORATION NOTICE OF SUCH INTEREST OR RELATIONSHIP AND SHALL THEREAFTER REFRAIN FROM VOTING OR OTHERWISE ATTEMPTING TO EXERT ANY INFLUENCE ON THE CORPORATION TO AFFECT ITS DECISION TO PARTICIPATE OR NOT PARTICIPATE IN SUCH TRANSACTION. THE INTERESTED OFFICER, DIRECTOR OR COMMITTEE MEMBER SHALL LEAVE ANY MEETING DURING ANY DISCUSSION OF A MATTER IN WHICH SUCH INDIVIDUAL IS CONSIDERED TO HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC FOR VIEWING AT THE MAIN OFFICE DURING NORMAL BUSINESS HOURS. INTEGRATED STRUCTURE LLC 720 WASHINGTON AVE SE STE 200 MINNEAPOLIS MN 554142924 HOLDING COMPANY MN NONE 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0