STILLWATER MEDICAL GROUP: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
STILLWATER MEDICAL GROUP (EIN 83-0379473)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-15
IRS object ID
202323199349305087
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-15T09:34:34-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135565207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14200 WELLS FARGO CTR 90 S 7THAddressLine1Txt
Address Line2STREETAddressLine2Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN830379473EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STILLWATER MEDICAL GROUPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSTILBusinessNameControlTxt
Phone9528836584PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line18170 33RD AVENUE SOUTH PO BOX 1309AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554401309ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDOUGLAS E JOHNSONPersonNm
Person TitleCFOPersonTitleTxt
Phone9528836584PhoneNum
Signature2023-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDOUGLASPersonFirstNm
Person LastJOHNSONPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHOLLY K MOENPreparerPersonNm
PTINP01800653PTIN
Phone6123055000PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDOUGLAS E JOHNSONPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line18170 33RD AVENUE SOUTH PO BOX 1309AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP554401309ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$433,953GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.STILLWATERMEDICALGROUP.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2003FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEYActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee373TotalEmployeeCnt
Total Volunteers9TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$10,931CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$192,698CYProgramServiceRevenueAmt
PY Investment Income$44,354PYInvestmentIncomeAmt
CY Investment Income$68,283CYInvestmentIncomeAmt
PY Other Revenue$113,231PYOtherRevenueAmt
CY Other Revenue$162,041CYOtherRevenueAmt
PY Total Revenue$157,585PYTotalRevenueAmt
CY Total Revenue$433,953CYTotalRevenueAmt
PY Grants And Similar Paid$77PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,160,973PYOtherExpensesAmt
CY Other Expenses$6,578,536CYOtherExpensesAmt
PY Total Expenses$5,161,050PYTotalExpensesAmt
CY Total Expenses$6,578,536CYTotalExpensesAmt
PY Revenues Less Expenses-$5,003,465PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$6,144,583CYRevenuesLessExpensesAmt
Total Assets BOY$20,788,259TotalAssetsBOYAmt
Total Assets EOY$19,489,067TotalAssetsEOYAmt
Total Liabilities BOY$3,838,828TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,684,219TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$16,949,431NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,804,848NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$5,977,183ExpenseAmt
Revenue$192,698RevenueAmt
DescSEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTSDesc
Total Program Service Expenses$5,977,183TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee373EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KEVIN J BRANDTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9528836584PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line18170 33RD AVE SAddressLine1Txt
CityBLOOMINGTONCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55440ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MIKE ANDERSON
VICE CHAIR & DIRECTOR0.580.00Yes (X)Yes (X)$0$0$0
ELIZABETH BRADSHAW
DIRECTOR0.580.00Yes (X)$0$0$0
JASON HOWARD
DIRECTOR0.580.00Yes (X)$0$0$0
SHARON TOLVA
TREASURER & DIRECTOR0.580.00Yes (X)Yes (X)$0$0$0
SUE HEDLUND
DIRECTOR0.580.00Yes (X)$0$0$0
JOHN UPPGREN
DIRECTOR0.580.00Yes (X)$0$0$0
NICHOLAS MEYER MD
DIRECTOR0.580.00Yes (X)$0$0$0
DENISE PONTRELLI JAN-DEC
DIRECTOR0.580.00Yes (X)$0$0$0
JULIE SCHMIDT
CHAIR & DIRECTOR0.580.00Yes (X)Yes (X)$0$0$0
KEVIN J BJORK MD
DIRECTOR0.5019.50Yes (X)$0$321,958$45,476
BRETT C HAAKE MD
DIRECTOR0.5056.50Yes (X)$0$610,105$103,510
BRIAN L CRESS MD
DIRECTOR0.5039.50Yes (X)$0$371,054$61,038
MATTHEW A RICHIE
DIRECTOR & VP ADMINISTRATO46.500.50Yes (X)Yes (X)$379,550$0$46,122
PATRICK T COURNEYA
DIRECTOR0.5054.50Yes (X)$0$637,051$148,734
PHAEDRA COFIELD
DIRECTOR0.580.00Yes (X)$0$0$0
STEVEN C HOUSH
DIRECTOR0.5049.50Yes (X)$0$417,571$62,630
DOUGLAS E JOHNSON
CFO4.0051.00Yes (X)$0$501,465$118,928
NATHAN S PULSCHER
VP ANCILLARY SERVICES0.5049.50Yes (X)$0$246,031$47,355
THOMAS S ANDERSON
VP MEDICAL AFFAIRS0.5049.50Yes (X)$0$486,746$63,038
NANCY L EVERT
SEC. & GENERAL COUNCS0.5049.50Yes (X)$0$718,467$195,651
BRANDI L LUNNEBORG
PRESIDENT0.5054.50Yes (X)$0$444,324$104,404
EMILIENNE ANDERSON
VP NURSING SERVICES & CNO50.000.00Yes (X)$0$198,199$16,941
SONYA K STEINER
DIRECTOR OF OPERATIONS50.000.00$185,137$0$22,780Yes (X)
CARLA A KNIPPENBERG
SPECIALITY DIRECTOR44.000.00$168,280$0$35,977Yes (X)
NICOLAS P WANNER
PHYSICIAN ASSISTANT36.000.00$230,244$0$34,955Yes (X)
GWENDOLYN M HUNTER
NURSE PRACTITIONER45.000.00$153,685$0$30,891Yes (X)
CHRISTOPHER L KAYE
PHYSICIAN ASSISTANT40.000.00$161,287$0$37,026Yes (X)
ANDREW E DORWART MD
FORMER SMG PRESIDENT0.0050.00$0$271,300$58,176Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,278,183TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,224,271TotReportableCompRltdOrgAmt
Total Other Compensation$1,233,632TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K27IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
INTERIM HEALTHCARE STAFFING
2950 METRO DR STE 11BLOOMINGTONMN55425STAFFING$1,011,554
MIDWEST RADIOLOGY
2355 HWY 36 W STE 100ROSEVILLEMN55113RADIOLOGY PROFESSIONAL SERVICES$541,793
MARSDEN BLDG MAINTENANCE
PO BOX 1150MINNEAPOLISMN55480CONSTRUCTION$450,015
SAGILITI
23505 SMITHTOWN RD STE 280EXCELSIORMN553314550ENERGY CONSULTANT$415,735
GILBERT MECHANICAL CONTRACTORS
5251 W 74TH STEDINAMN55439CONSTRUCTION$412,785
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K10CntrctRcvdGreaterThan100KCnt
Related Organizations$10,931RelatedOrganizationsAmt
Total Contributions$10,931TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescCONTRACT REVENUEDesc
Business624410BusinessCd
Total Revenue Column$192,698TotalRevenueColumnAmt
Related Or Exempt Func Income$192,698RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$192,698TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$68,283TotalRevenueColumnAmt
Exclusion$68,283ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$162,041RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$162,041RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$162,041TotalRevenueColumnAmt
Exclusion$162,041ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$433,953TotalRevenueColumnAmt
Related Or Exempt Func Income$192,698RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$230,324ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,458,623TotalAmt
Program Services$1,417,569ProgramServicesAmt
Management And General$41,054ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,640,639TotalAmt
Program Services$2,375,218ProgramServicesAmt
Management And General$265,421ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,475,493TotalAmt
Program Services$2,180,615ProgramServicesAmt
Management And General$294,878ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS EXPENSEDesc
Total$3,781TotalAmt
Program Services$3,781ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,578,536TotalAmt
Program Services$5,977,183ProgramServicesAmt
Management And General$601,353ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,861,719BOYAmt
EOY$2,632,500EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$163,315BOYAmt
EOY$73,529EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$192,177BOYAmt
EOY$226,418EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$36,247,271LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$19,690,651LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$17,555,532BOYAmt
EOY$16,556,620EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$15,516BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$20,788,259BOYAmt
EOY$19,489,067EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,838,828BOYAmt
EOY$2,684,219EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,838,828BOYAmt
EOY$2,684,219EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$16,949,431BOYAmt
EOY$16,804,848EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,949,431BOYAmt
EOY$16,804,848EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,788,259BOYAmt
EOY$19,489,067EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$6,144,583ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$6,000,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations3SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (3 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC
4113866353Yes (1)$0$0
GROUP HEALTH PLAN INC
4107978533Yes (1)$0$0
LAKEVIEW HEALTH
30022118910Yes (1)$0$0
FieldValueIRS element (for citing)
Supported Organizations Total3SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationYes (1)SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 12G, COLUMNS (V) & (VI) - AMOUNT OF SUPPORTNO DIRECT MONETARY SUPPORT IS INDICATED FROM STILLWATER MEDICAL GROUP TO ITS SUPPORTED ORGANIZATIONS: HOWEVER, STILLWATER MEDICAL GROUP IS EMPLOYING NON-PHYSICIAN STAFF AND OWNING/OPERATING BUILDINGS THAT ARE USED BY ITS SUPPORTED ORGANIZATION GHI TO OPERATE CLINICS IN SUPPORT OF LAKEVIEW HEALTH AND LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION.
PART IV SECTION A, LINE 2LAKEVIEW HEALTH ONE OF SMG'S SUPPORTED ORGANIZATIONS IS ALSO A SUPPORTING ORGANIZATION. LAKEVIEW HEALTH IS NOT A 509(A)(1) OR (A)(2) ENTITY - INSTEAD A 509(A)(3).
PART I, LINE 12G, COLUMN (III) - TYPE OF ORGANIZATIONSUPPORTED ORGANIZATION INFORMATION LAKEVIEW HEALTH IS AN ORGANIZATION TYPE 12. DUE TO SOFTWARE LIMITATIONS, THAT BOX IS TYPE 10 INSTEAD OF TYPE 12.

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Total Lobbying Expenditures$0TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationSTILLWATER MEDICAL GROUP PAYS FOR CERTAIN CORPORATE AND EMPLOYEE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$571,589OtherCostOrOtherBasisAmt
Book Value$571,589BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$29,439,157OtherCostOrOtherBasisAmt
Depreciation$16,972,859DepreciationAmt
Book Value$12,466,298BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$649,962OtherCostOrOtherBasisAmt
Depreciation$299,975DepreciationAmt
Book Value$349,987BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,561,260OtherCostOrOtherBasisAmt
Depreciation$2,417,817DepreciationAmt
Book Value$3,143,443BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$25,303OtherCostOrOtherBasisAmt
Book Value$25,303BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$16,556,620TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationSTILLWATER MEDICAL GROUP IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. JUDGMENT IS REQUIRED IN DETERMINING HP'S EFFECTIVE TAX RATE AND IN EVALUATING ITS TAX POSITION. HP ESTABLISHES ACCRUALS FOR UNCERTAIN TAX POSITIONS WHEN, DESPITE THE BELIEF THAT HP'S TAX RETURN POSITIONS ARE FULLY SUPPORTABLE, HP BELIEVES THAT ITS POSITION MAY NOT BE FULLY SUSTAINED, PRIMARILY GIVEN THE RISKS ASSOCIATED WITH TAX LITIGATION OR DISPUTES. THE UNCERTAIN TAX POSITION ACCRUALS ARE ADJUSTED IN LIGHT OF CHANGING FACTS AND CIRCUMSTANCES, SUCH AS THE PROGRESS OF TAX AUDITS, CASE LAW, AND EMERGING LEGISLATION. HP'S EFFECTIVE TAX RATE INCLUDES THE IMPACT OF CHANGES TO THE ACCRUALS FOR UNCERTAIN TAX POSITIONS. HP CLASSIFIES INTEREST AND PENALTIES ON TAX-RELATED MATTERS AS INCOME AND OTHER TAX EXPENSE IN THE CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2022 OR 2021 FOR UNRECOGNIZED TAX BENEFITS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
NANCY L EVERT
SEC. & GENERAL COUNCS$0$500,726$0$174,605$0$43,136$0$167,010$0$28,641$0$914,118$0$37,844
PATRICK T COURNEYA
DIRECTOR$0$454,100$0$164,205$0$18,746$0$106,714$0$42,020$0$785,785$0$0
BRETT C HAAKE MD
DIRECTOR$0$459,752$0$143,189$0$7,164$0$60,762$0$42,748$0$713,615$0$0
DOUGLAS E JOHNSON
CFO$0$346,590$0$91,391$0$63,484$0$82,683$0$36,245$0$620,393$0$0
THOMAS S ANDERSON
VP MEDICAL AFFAIRS$0$335,937$0$17,903$0$132,906$0$22,875$0$40,163$0$549,784$0$0
BRANDI L LUNNEBORG
PRESIDENT$0$415,140$0$25,000$0$4,184$0$65,250$0$39,154$0$548,728$0$0
STEVEN C HOUSH
DIRECTOR$0$310,752$0$96,154$0$10,665$0$22,875$0$39,755$0$480,201$0$0
BRIAN L CRESS MD
DIRECTOR$0$215,844$0$8,000$0$147,210$0$22,875$0$38,163$0$432,092$0$0
MATTHEW A RICHIE
DIRECTOR & VP ADMINISTRATO$296,822$0$0$0$82,728$0$15,722$0$30,400$0$425,672$0$0$0
KEVIN J BJORK MD
DIRECTOR$0$216,925$0$0$0$105,033$0$22,875$0$22,601$0$367,434$0$0
ANDREW E DORWART MD
FORMER SMG PRESIDENT$0$231,115$0$0$0$40,185$0$21,137$0$37,039$0$329,476$0$0
NATHAN S PULSCHER
VP ANCILLARY SERVICES$0$188,129$0$36,241$0$21,661$0$13,083$0$34,272$0$293,386$0$0
NICOLAS P WANNER
PHYSICIAN ASSISTANT$126,516$0$150$0$103,578$0$8,291$0$26,664$0$265,199$0$0$0
EMILIENNE ANDERSON
VP NURSING SERVICES & CNO$0$198,197$0$0$0$2$0$4,000$0$12,941$0$215,140$0$0
SONYA K STEINER
DIRECTOR OF OPERATIONS$158,129$0$0$0$27,008$0$10,368$0$12,412$0$207,917$0$0$0
CARLA A KNIPPENBERG
SPECIALITY DIRECTOR$143,439$0$0$0$24,841$0$8,026$0$27,951$0$204,257$0$0$0
CHRISTOPHER L KAYE
PHYSICIAN ASSISTANT$132,877$0$200$0$28,210$0$9,171$0$27,855$0$198,313$0$0$0
GWENDOLYN M HUNTER
NURSE PRACTITIONER$132,543$0$7,700$0$13,442$0$3,141$0$27,750$0$184,576$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE STILLWATER MEDICAL GROUP (SMG) PRESIDENT AND OTHER OFFICERS ARE EMPLOYED BY GROUP HEALTH PLAN, INC. (GHI), LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. (THE HOSPITAL), BOTH OF WHICH ARE RELATED ORGANIZATIONS, OR SMG. GHI, THE HOSPITAL, AND SMG HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF THE SMG'S PRESIDENT AND OTHER OFFICERS.
PART I, LINE 4BDEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II INCLUDES AMOUNTS FROM A NONQUALIFIED 457(F) PLAN FOR THE FOLLOWING DIRECTORS AND OFFICERS: NANCY L. EVERT $ 47,347 PATRICK T. COURNEYA $44,511 BRANDI LUNNEBORG $31,500
PART I, LINE 6SMG'S OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE EMPLOYED BY SMG, LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. (THE HOSPITAL) OR BY GROUP HEALTH PLAN, INC. (GHI). THE HOSPITAL AND GHI ARE BOTH RELATED ORGANIZATIONS. COMPENSATION REPORTED IN FORM 990, PART VIII INCLUDES ANY COMPENSATION DERIVED FROM EITHER SMG'S, THE HOSPITAL'S, OR GHI'S MANAGEMENT INCENTIVE PROGRAMS, WHICH INCENT AND REWARD BUSINESS LEADERS WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC FISCAL YEAR. THE PROGRAMS ARE A KEY ELEMENT OF THE PARTICIPANT'S TOTAL COMPENSATION PACKAGE. THE MANAGEMENT INCENTIVE PROGRAMS' REWARDS ARE BASED ON POSITION IN THE ORGANIZATION (E.G. SENIOR VICE PRESIDENT, VICE PRESIDENT, DIRECTOR, MANAGER, AND OTHER SPECIFICALLY IDENTIFIED LEADERS) AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. THESE AREAS MAY INCLUDE, BUT ARE NOT LIMITED TO, PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, HEALTH EQUITY, HEALTHCARE AFFORDABILITY MEASURES, HEALTH CARE AND CARE DELIVERY MARKET SHARE, STRATEGIC CAPABILITIES, HOSPITAL AND CLINIC QUALITY MEASURES, FINANCIAL PERFORMANCE (OPERATING INCOME), ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. AN OOPERATING INCOME THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT.
990, SCHEDULE J, PART II: PRIOR REPORTED COMPENSATIONCOLUMN (F) INCLUDES AMOUNTS PAID TO PARTICIPANTS IN THE C URRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEARS' 990'S, AS RETIREMENT AND DEFERRED COMPENSATION, FOR THE FOLLOWING DIRECTORS AND OFFICERS: NANCY L. EVERT $ 37,844 ANY ANALYSIS OF EARNINGS FOR THE CURRENT YEAR, FOR THESE PARTICIPANTS OF THE PLAN, SHOULD EXCLUDE THE AMOUNT IN COLUMN F AS PART OF THE ANALYSIS SINCE THOSE EARNINGS WERE ALREADY REPORTED IN COLUMN (C) OF PREVIOUS YEARS' 990'S.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
990, PART III, LINE 4A: EXEMPT PURPOSE AND ACHIEVEMENTSCORPORATE STRUCTURE, PURPOSE, GOVERNANCE STILLWATER MEDICAL GROUP (SMG) IS A MINNESOTA NONPROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND IS PART OF THE HEALTHPARTNERS ORGANIZATION (HEALTHPARTNERS). FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED HEALTH CARE ORGANIZATION, PROVIDING HEALTH CARE SERVICES AND HEALTH PLAN FINANCING AND ADMINISTRATION. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTH CARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY. HEALTHPARTNERS, INC. (HPI) IS A MINNESOTA NONPROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4) AND IS THE PARENT ENTITY OF HEALTHPARTNERS ORGANIZATIONS REFERRED TO COLLECTIVELY AS "HEALTHPARTNERS". HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS. HEALTHPARTNERS PROVIDES A FULL RANGE OF HEALTH CARE DELIVERY AND HEALTH PLAN SERVICES INCLUDING INSURANCE, PATIENT CARE, ADMINISTRATION AND HEALTH AND WELL-BEING PROGRAMS. HEALTHPARTNERS HEALTH PLANS SERVE MORE THAN 1.8 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,900 EMPLOYED PHYSICIANS AND DENTISTS, EIGHT OWNED HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, OVER 100 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES AND DENTAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN SERVING MORE THAN 1.34 MILLION PATIENTS. HEALTHPARTNERS HEALTH PLANS CONTRACT WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS TO SERVE PLAN MEMBERS. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUNDRAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. HEALTHPARTNERS COLLABORATES WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES ARE TOTAL COST OF CARE MEASUREMENTS (A NATIONALLY RECOGNIZED METRIC, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), EQUITY, INCLUSION, AND ANTI-RACISM (ADDRESSING HEALTH EQUITY, ELIMINATING HEALTH CARE DISPARITIES, INCREASING DIVERSITY AND INCLUSION IN OUR WORKPLACES, BUILDING AN ANTI-RACIST CULTURE, AND DEEPENING OUR COLLECTIVE UNDERSTANDING OF CULTURAL HUMILITY) AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN HEALTHPARTNERS, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL, REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, LAKEVIEW HEALTH, AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). LAKEVIEW HEALTH IS THE SOLE CORPORATE MEMBER OF SMG, LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (LAKEVIEW HOSPITAL) AND LAKEVIEW HEALTH FOUNDATION. SMG IS A SUPPORTING ORGANIZATION TO LAKEVIEW HEALTH, LAKEVIEW HOSPITAL, AND GROUP HEALTH PLAN, INC. INFORMATION ABOUT THE EXEMPT ACTIVITIES OF SMG'S SUPPORTED ORGANIZATIONS MAY BE FOUND IN THE FORM 990S OF THE SUPPORTED ORGANIZATIONS.
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER IS LAKEVIEW HEALTH.
FORM 990, PART VI, SECTION A, LINE 7ATHE MEMBER HAS THE POWER TO RATIFY APPROVE AND REMOVE ALL MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE.
FORM 990, PART VI, SECTION A, LINE 7BTHE MEMBER HAS RESERVED TO ITSELF THE FOLLOWING POWERS CONCERNING THE GOVERNANCE OF THE CORPORATION: 1. RATIFICATION, APPROVAL AND REMOVAL ALL MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE. 2. APPROVAL OF ANY MISSION OR VISION STATEMENT OR STATEMENT OF CORPORATE PURPOSE ADOPTED BY THE ORGANIZATION. 3. APPROVAL OF THE ORGANIZATION'S STRATEGIC PLANS, CAPITAL BUDGETS, OPERATING BUDGETS AND FINANCIAL POLICIES. 4. APPROVAL OF ANY PLANS OF MERGER OR CONSOLIDATION BY THE ORGANIZATION WITH ANY FOREIGN OR DOMESTIC ORGANIZATION VOLUNTARY DISSOLUTION OF THE ORGANIZATION, OR SALE, LEASE OR TRANSFER OF THE ORGANIZATION'S REAL ESTATE OR A SIGNIFICANT PORTION OF THE OPERATIONS OR ASSETS OF THE ORGANIZATION. 5. APPROVAL OF THE GRANT OF A SECURITY INTEREST IN ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS, OR THE INCURRENCE OF INDEBTEDNESS OR THE GUARANTEE OF ANY INDEBTEDNESS. 6. APPROVAL OF INDIVIDUAL CAPITAL EXPENDITURES BY THE ORGANIZATION, WHETHER BUDGETED OR UNBUDGETED, IN EXCESS OF $500,000. 7. RATIFICATION OF SELECTION AND EVALUATION, AND TERMINATION, OF THE PRESIDENT OF THE ORGANIZATION. 8. APPROVAL OF PHYSICIAN, EMPLOYEE AND EXECUTIVE COMPENSATION PLANS FOR THE ORGANIZATION, INCLUDING CRITERIA FOR INCENTIVE COMPENSATION ARRANGEMENTS. 9. APPROVAL OF ALL SUBSTANTIVE AFFILIATIONS BETWEEN THE ORGANIZATION AND A THIRD PARTY. 10. APPROVAL OF CONFLICTS OF INTEREST POLICIES FOR THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11BSMG'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF SMG. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF SMG, GHI'S INTERNAL LEGAL DEPARTMENT AND SMG'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF SMG. SMG MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY IS PROVIDED TO THE FULL BOARD OF DIRECTORS IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT THE MEETING. THIS PROCESS IS DOCUMENTED IN THE WRITTEN MEETING MINUTES.
FORM 990, PART VI, SECTION B, LINE 12CTHE SMG BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, AND KEY EMPLOYEES ("COVERED PERSONS") BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, COVERED PERSONS ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND ASKED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTERESTS. THE LEGAL DEPARTMENT OF HEALTHPARTNERS REVIEWS THE QUESTIONNAIRE RESPONSES AND DEVELOPS A REPORT DETAILING ANY POTENTIALLY MATERIAL CONFLICTS FOR THE PRESIDENT AND CHAIR OF THE BOARD. A VERBAL SUMMARY IS ALSO GIVEN TO THE FULL BOARD OR APPROPRIATE COMMITTEE ENDING WITH A REMINDER TO COVERED PERSONS OF THE POLICY'S MANDATE THAT EACH PERSON IS OBLIGATED TO DISCLOSE ANY NEW POTENTIAL CONFLICTS AS THEY MAY ARISE THROUGHOUT THE YEAR. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY.
FORM 990, PART VI, SECTION B, LINE 15SMG'S PRESIDENT AND OTHER OFFICERS ARE EMPLOYED BY GROUP HEALTH PLAN, INC. (GHI), LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. (THE HOSPITAL), BOTH OF WHICH ARE RELATED ORGANIZATIONS, OR BY SMG. GHI, THE HOSPITAL AND SMG HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF THE SMG'S PRESIDENT AND OTHER OFFICERS. EVERY THREE YEARS, THE INDEPENDENT COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF GHI (THE "COMMITTEE"), RETAINS AN EXTERNAL COMPENSATION EXPERT TO CONDUCT AN EXTENSIVE MARKET COMPARABILITY REVIEW FOR ALL OFFICERS OF THE ORGANIZATION. THE REVIEW INCLUDES ALL COMPONENTS OF TOTAL COMPENSATION: BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE APPROPRIATE COMMITTEE. BASED ON THIS DATA, EITHER THE EXECUTIVE COMMITTEE OF THE HOSPITAL OR THE COMPENSATION COMMITTEE OF GHI (THE "COMMITTEES") DETERMINE MINIMUM AND MAXIMUM TOTAL COMPENSATION RANGES ARE DETERMINED FOR EACH EMPLOYED OFFICER. IN INTERIM YEARS, GHI'S HUMAN RESOURCES STAFF, UNDER THE COMMITTEES' DIRECTION, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION CONSULTANT FOR THE COMMITTEE. FOR CERTAIN POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED TO SET SALARY RANGES BASED ON THE COMPETITIVE MARKET DATA SPECIFIC TO THOSE POSITIONS. THE COMMITTEES REVIEW AND APPROVE EACH YEAR'S COMPENSATION RESULTS. IN ALL CASES, THE COMMITTEES' MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMMITTEES MEMBERS' INDEPENDENCE AND THIS IS UPDATED AT ANY MEETING AT WHICH DECISIONS ARE BEING MADE. STAFF (OTHER THAN THE SECRETARY TO THE BOARD) IS NOT IN THE ROOM DURING DELIBERATIONS OR VOTE INCLUDING EXECUTIVE SESSIONS, AND CONTEMPORANEOUS MINUTES ARE KEPT. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND ON THE EMPLOYEE'S W-2.
FORM 990, PART VI, SECTION C, LINE 19SMG'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO WHO REQUESTS THE INFORMATION FROM SMG OR HEALTHPARTNERS. SMG'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE MINNESOTA SECRETARY OF STATE'S OFFICE.
990, PART VII, SEC A, LINE 1A, COL B: AVERAGE HOURS - RELATED ORGANIZATIONSTHE COMPENSATED BOARD MEMBERS AND OFFICERS FREQUENTLY DEVOTE THEIR TIME TO MULTIPLE RELATED ORGANIZATIONS IN A PARTICULAR WEEK. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS.
FORM 990, PART IX, LINE 11GPURCHASED PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 1,417,569. MANAGEMENT AND GENERAL EXPENSES 41,054. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,458,623.
FORM 990, PART XI, LINE 9:NET ASSET TRANSFER FROM LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. 6,000,000.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
HEALTHPARTNERS INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411693838HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATIONMN501(C)(4)N/A0
HPI-RAMSEY
8170 33RD AVE S PO BOX 1309MPLSMN554401309411793333CORPORATE PLANNING AND OVERSIGHTMN501(C)(3)0509(A)(3) TYPE IHEALTHPARTNERS INC
GROUP HEALTH PLAN INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309410797853STAFF MODEL HEALTH MAINTENANCE ORGANIZATIONMN501(C)(3)0170(B)(1) (A)(III)HEALTHPARTNERS INC
RH WISCONSIN INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309202287016CORPORATE PLANNING AND OVERSIGHTWI501(C)(3)0509(A)(3) TYPE IHPI - RAMSEY
HEALTHPARTNERS INSTITUTE
8170 33RD AVE S PO BOX 1309MPLSMN554401309411670163HEALTHCARE EDUCATION AND RESEARCHMN501(C)(3)0509(A)(3) TYPE IHEALTHPARTNERS INC
CAPITOL VIEW TRANSITIONAL CARE CENTER
8170 33RD AVE S PO BOX 1309MPLSMN554401309412011453TRANSITIONAL CARE SERVICES, STEP DOWN FROM INPATIENT HOSPITALMN501(C)(3)0170(B)(1) (A)(III)HPI - RAMSEY
REGIONS HOSPITAL
8170 33RD AVE S PO BOX 1309MPLSMN554401309410956618HOSPITALMN501(C)(3)0170(B)(1) (A)(III)HPI - RAMSEY
REGIONS HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309411888902PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTHMN501(C)(3)0170(B)(1) (A)(VI)HPI - RAMSEY
RHSC INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411891928HEALTHCARE STAFFING AND INTENSE REHAB SERVICESMN501(C)(3)0509(A)(3) TYPE IIHEALTHPARTNERS INC
HUDSON HOSPITAL INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309390804125HOSPITALWI501(C)(3)0170(B)(1) (A)(III)RH-WISCONSIN INC
HUDSON HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391279567PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTHWI501(C)(3)0170(B)(1) (A)(VI)HUDSON HOSPITAL INC
LAKEVIEW HEALTH FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309411386635PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTHMN501(C)(3)0170(B)(1) (A)(VI)LAKEVIEW HEALTH
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309410811697HOSPITALMN501(C)(3)0170(B)(1) (A)(III)LAKEVIEW HEALTH
LAKEVIEW HEALTH
8170 33RD AVE S PO BOX 1309MPLSMN554401309300221189CORPORATE PLANNING AND OVERSIGHTMN501(C)(3)0509(A)(3) TYPE IIHPI - RAMSEY
WESTFIELDS HOSPITAL INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309390808442HOSPITALWI501(C)(3)0170(B)(1) (A)(III)RH-WISCONSIN INC
WESTFIELDS HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391770913PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTHWI501(C)(3)0170(B)(1) (A)(VI)WESTFIELDS HOSPITAL INC
PARK NICOLLET HEALTH SERVICES
6500 EXCELSIOR BLVDST LOUIS PARKMN55426363465840CORPORATE PLANNING AND OVERSIGHTMN501(C)(3)0509(A)(2)HEALTHPARTNERS INC
PARK NICOLLET FOUNDATION
6500 EXCELSIOR BLVDST LOUIS PARKMN55426237346465SUPPORT TO RELATED ENTITIES AND COMMUNITY HEALTHMN501(C)(3)0170(B)(1) (A)(VI)PARK NICOLLET HEALTH SERVICES
PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BLVDST LOUIS PARKMN55426410132080HOSPITALMN501(C)(3)0170(B)(1) (A)(III)PARK NICOLLET HEALTH SERVICES
PARK NICOLLET HEALTH CARE PRODUCTS
6500 EXCELSIOR BLVDST LOUIS PARKMN55426010638901DURABLE MEDICAL EQUIPMENT, AND OTHER HEALTH CARE RETAIL SALESMN501(C)(3)0509(A)(3) TYPE IPARK NICOLLET HEALTH SERVICES
PARK NICOLLET CLINIC
6500 EXCELSIOR BLVDST LOUIS PARKMN55426410834920CLINIC SERVICESMN501(C)(3)0170(B)(1) (A)(III)PARK NICOLLET HEALTH SERVICES
PNMC HOLDINGS
6500 EXCELSIOR BLVDST LOUIS PARKMN55426411741792HEALTHCARE REAL ESTATEMN501(C)(3)0509(A)(3) TYPE IPARK NICOLLET HEALTH SERVICES
AMERY REGIONAL MEDICAL CENTER INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309390908320HOSPITALWI501(C)(3)0170(B)(1) (A)(III)RH-WISCONSIN INC
AMERY REGIONAL MEDICAL CENTER FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391726539PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTHWI501(C)(3)0170(B)(1) (A)(VI)AMERY REGIONAL MEDICAL CENTER INC
HUTCHINSON HEALTH
8170 33RD AVE S PO BOX 1309MPLSMN554401309841715908HOSPITALMN501(C)(3)0170(B)(1) (A)(III)PARK NICOLLET HEALTH SERVICES
HUTCHINSON HEALTH FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309363317820PROVIDE SUPPORT TO HOSPITALMN501(C)(3)0170(B)(1) (A)(VI)HUTCHINSON HEALTH
HEALTHPARTNERS RC
8170 33RD AVE S PO BOX 1309MPLSMN554401309844261122HOSPITALMN501(C)(3)0170(B)(1)(A)(III)PARK NICOLLET HEALTH SERVICES
OLIVIA HOSPITAL & CLINIC FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309411839619PROVIDE SUPPORT TO HOSPITALMN501(C)(3)0509(A)(3) TYPE IHEALTHPARTNERS RC

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
HEALTHPARTNERS ADMINISTRATORS INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411629390THIRD PARTY ADMINISTRATORMNHEALTHPARTNERS INCC0
HEALTHPARTNERS ASSOCIATES INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309522365151MEDICAL CLINIC STAFFING AND ASSET MANAGEMENTMNHEALTHPARTNERS ADMINISTRATORS INCC0
HEALTHPARTNERS SERVICES INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411683568MEDICAL CLINIC STAFFING AND ASSET MANAGEMENTMNHEALTHPARTNERS ADMINISTRATORS INCC0
HEALTHPARTNERS INSURANCE COMPANY
8170 33RD AVE S PO BOX 1309MPLSMN554401309411683523MEDICAL AND DENTAL INSURANCEMNHEALTHPARTNERS ADMINISTRATORS INCC0
DENTAL SPECIALTIES INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309451297583PROFESSIONAL DENTAL SERVICESMNHEALTHPARTNERS ADMINISTRATORS INCC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

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