LAKEVIEW HEALTH: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
LAKEVIEW HEALTH (EIN 30-0221189)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-13
IRS object ID
201813179349307706
Schema version
2017v2.2
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)
Return2018-11-13T16:53:33-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

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 Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN300221189EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STILLWATER HEALTH SYSTEMBusinessNameLine1Txt
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
Signature2018-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMONROE J GIERLPreparerPersonNm
PTINP01413237PTIN
Phone6123055000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address198.174.110.146IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-13IPDt
IP Tm15:38:08IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdBC53011EDF70B2E1BD72B439C4A42BAD8A5D7AD2AtSubmissionCreationDeviceId
At Submission Filing Device IdBC53011EDF70B2E1BD72B439C4A42BAD8A5D7AD2AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1LAKEVIEW HEALTHBusinessNameLine1Txt
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$11,368,191GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LAKEVIEW.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2003FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionSEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTSActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$5,193,511PYInvestmentIncomeAmt
CY Investment Income$11,333,511CYInvestmentIncomeAmt
PY Other Revenue$4,539PYOtherRevenueAmt
CY Other Revenue$34,680CYOtherRevenueAmt
PY Total Revenue$5,198,050PYTotalRevenueAmt
CY Total Revenue$11,368,191CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
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$1,091PYOtherExpensesAmt
CY Other Expenses$4,500CYOtherExpensesAmt
PY Total Expenses$1,091PYTotalExpensesAmt
CY Total Expenses$4,500CYTotalExpensesAmt
PY Revenues Less Expenses$5,196,959PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$11,363,691CYRevenuesLessExpensesAmt
Total Assets BOY$98,099,709TotalAssetsBOYAmt
Total Assets EOY$87,723,782TotalAssetsEOYAmt
Total Liabilities BOY$446,827TotalLiabilitiesBOYAmt
Total Liabilities EOY$598,579TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$97,652,882NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$87,125,203NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO SUPPORT ITS SUPPORTED ORGANIZATIONS, LAKVIEW HOSPITAL AND STILLWATER MEDICAL GROUP, IN THEIR DELIVERY OF INTEGRATED PRIMARY AND HOSPITAL CARE TO MEET THE HEALTHCARE NEEDS OF THE SERVICE AREA POPULATION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescSEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTSDesc
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
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
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 With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
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 Line1DOUGLAS JOHNSONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6514304581PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1927 CHURCHILL ST WESTAddressLine1Txt
CitySTILLWATERCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55082ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
SCOTT AEBISCHER
DIRECTOR0.5049.50Yes (X)$0$742,896$160,633
REBECCA BILLINGSLEY
DIRECTOR0.58Yes (X)$0$0$0
ELIZABETH BRADSHAW
SECRETARY & DIRECTOR0.58Yes (X)$0$0$0
DWIGHT CUMMINS
DIRECTOR0.58Yes (X)$0$0$0
PHIL DONALDSON
CHAIR & DIRECTOR0.58Yes (X)$0$0$0
ANDREW ROLLWAGEN
DIRECTOR0.58Yes (X)$0$0$0
MEGAN REMARK
DIRECTOR0.5049.50Yes (X)$0$659,171$173,822
JIM SCHUG
VICE CHAIR & DIRECTOR0.58Yes (X)$0$0$0
JOHN UPPGREN
DIRECTOR0.58Yes (X)$0$0$0
NICK MEYER MD
DIRECTOR0.58Yes (X)$0$0$0
DENISE PONTRELLI
DIRECTOR0.58Yes (X)$0$0$0
JULIE SCHMIDT
DIRECTOR0.58Yes (X)$0$0$0
KEVIN BJORK MD
DIRECTOR0.5049.50Yes (X)$0$490,159$52,219
JOHN MISA MD
DIRECTOR0.5059.50Yes (X)$0$553,128$98,995
MARTHA SANFORD MD
DIRECTOR0.5039.50Yes (X)$0$294,179$50,319
KATHLEEN COONEY
EXECUTIVE VP & CAO0.5055.00Yes (X)$0$991,272$229,887Yes (X)
ANDREW E DORWART MD
PRESIDENT SMG & DIRECTOR0.5049.50$0$481,126$36,065Yes (X)
DOUGLAS E JOHNSON
DIRECTOR & CFO4.0051.00$0$366,499$118,683Yes (X)
TED WEGLEITNER
DIRECTOR & CEO1.0052.00$0$555,832$109,748Yes (X)
ROBBI A HAGELBERG
VP OF OPERATIONS & CNO0.5049.50$0$221,834$19,597Yes (X)
NATE PULSCHER
VP ANCILLARY SERVICES0.5049.50$0$191,070$38,691Yes (X)
THOMAS ANDERSON
VP MEDICAL AFFAIRS0.5049.50$0$371,740$31,194Yes (X)
PAUL ERICKSON
EXEC. DIR. DEVELOPMENT1.0051.00$0$127,279$64,906Yes (X)
CALVIN ALLEN
DIRECTOR0.5039.50$0$683,082$192,419Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,729,267TotReportableCompRltdOrgAmt
Total Other Compensation$1,377,178TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PAVILION ADVISORY GROUP INC
227 W MONROE ST STE 2020CHICAGOIL60606INVESTMENT CONSULTANT$166,513
KRUSKOPF & COMPANY
310 4TH AVE S FLR 2MINNEAPOLISMN55415ADVERTISING$135,973
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,333,511TotalRevenueColumnAmt
Exclusion$11,333,511ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$34,680RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$34,680RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,680TotalRevenueColumnAmt
Exclusion$34,680ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,368,191TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$11,368,191ExclusionAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS EXPENSEDesc
Total$4,500TotalAmt
Management And General$4,500ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$4,500TotalAmt
Program Services$0ProgramServicesAmt
Management And General$4,500ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,260,298BOYAmt
EOY$1,752,879EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$165,130BOYAmt
EOY$261,200EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$24,558BOYAmt
EOY$27,159EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$171,122LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$36,882LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$282,273BOYAmt
EOY$134,240EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$95,289,250BOYAmt
EOY$84,723,808EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$1,078,200BOYAmt
EOY$824,496EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$98,099,709BOYAmt
EOY$87,723,782EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$446,827BOYAmt
EOY$598,579EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$446,827BOYAmt
EOY$598,579EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$97,652,882BOYAmt
EOY$87,125,203EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$97,652,882BOYAmt
EOY$87,125,203EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$98,099,709BOYAmt
EOY$87,723,782EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$11,363,691ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$791,370NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$21,100,000OtherChangesInNetAssetsAmt
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 Type2Yes (X)SupportingOrgType2Ind
Supported Organizations2SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (2 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC
4108116973Yes (1)$0$0
STILLWATER MEDICAL GROUP
83037947310Yes (1)$0$0
FieldValueIRS element (for citing)
Supported Organizations Total2SupportedOrganizationsTotalCnt
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 Determination0SuprtOrgNoIRSDeterminationInd
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
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (1)MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
990, SCHEDULE A, PART I, LINE 11 H, COL. (VII): MONETARY SUPNO DIRECT MONETARY SUPPORT IS INDICATED FROM STILLWATER HEALTH SYSTEM (SHS) TO ITS SUPPORTED ORGANIZATIONS: HOWEVER, SHS PROVIDES CORPORATE PLANNING AND OVERSIGHT, WHICH INCLUDES SHS INITIALLY INCURRING ADMINISTRATIVE EXPENSES THAT ARE ALLOCATED TO ITS SUPPORTED ORGANIZATIONS. SHS' RELATIONSHIP WITH ITS SUPPORTED ORGANIZATIONS IS DESCRIBED IN SCHEDULE O "FORM 990, PART III, LINE 4A, EXEMPT PURPOSE AND ACHIEVEMENTS."
990, SCH A, PART IV, SECT C, LINE 1: BOARD MEMBERSSHS IS A TYPE II SUPPORTING ORGANIZATION TO LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (HOSPITAL)AND STILLWATER MEDICAL GROUP, BECAUSE THERE IS SUBSTANTIAL OVERLAP OF DIRECTORS AND OFFICERS AMONG THE ORGANIZATIONS. ALL OF THE DIRECTORS ON THE 2017 HOSPITAL BOARD ARE ALSO DIRECTORS ON THE 2017 SHS BOARD. FURTHER, THE SAME PERSONS ARE IN THE POSITIONS OF CFO AND CHIEF MEDICAL OFFICER ACROSS BOTH ENTITIES AND ARE RESPONSIVE TO THE HOSPITAL AND MAINTAINS INVOLVEMENT IN THEIR OPERATIONS.
SUPPORTED ORGANIZATION INFORMATIONSTILLWATER MEDICAL GROUP IS AN ORGANIZAITON TYPE CODE 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 HEALTH SYSTEM 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$100,000OtherCostOrOtherBasisAmt
Book Value$100,000BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$71,122OtherCostOrOtherBasisAmt
Depreciation$36,882DepreciationAmt
Book Value$34,240BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$134,240TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationSTILLWATER HEALTH SYSTEM IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. HP'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2017 OR 2016 FOR UNRECOGNIZED TAX BENEFITS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
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 Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 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
SCOTT AEBISCHER
DIRECTOR$0$365,607$0$103,924$0$273,365$0$124,486$0$36,147$0$903,529$0$243,159
MEGAN REMARK
DIRECTOR$0$464,292$0$138,528$0$56,351$0$139,402$0$34,420$0$832,993$0$25,086
KEVIN BJORK MD
DIRECTOR$0$389,833$0$0$0$100,326$0$20,250$0$31,969$0$542,378$0$0
JOHN MISA MD
DIRECTOR$0$397,709$0$85,939$0$69,480$0$72,940$0$26,055$0$652,123$0$51,124
MARTHA SANFORD MD
DIRECTOR$0$154,022$0$9,625$0$130,532$0$20,250$0$30,069$0$344,498$0$0
KATHLEEN COONEY
EXECUTIVE VP & CAO$0$597,250$0$228,611$0$165,411$0$189,710$0$40,177$0$1,221,159$0$129,768
ANDREW E DORWART MD
PRESIDENT SMG & DIRECTOR$0$383,024$0$70,427$0$27,675$0$20,250$0$15,815$0$517,191$0$0
DOUGLAS E JOHNSON
DIRECTOR & CFO$0$276,955$0$60,289$0$29,255$0$89,960$0$28,723$0$485,182$0$0
TED WEGLEITNER
DIRECTOR & CEO$0$408,444$0$110,594$0$36,794$0$75,885$0$33,863$0$665,580$0$31,729
ROBBI A HAGELBERG
VP OF OPERATIONS & CNO$0$191,829$0$27,720$0$2,285$0$11,643$0$7,954$0$241,431$0$0
NATE PULSCHER
VP ANCILLARY SERVICES$0$174,327$0$16,743$0$0$0$6,293$0$32,398$0$229,761$0$0
THOMAS ANDERSON
VP MEDICAL AFFAIRS$0$243,730$0$16,762$0$111,248$0$0$0$31,194$0$402,934$0$0
PAUL ERICKSON
EXEC. DIR. DEVELOPMENT$0$120,935$0$6,344$0$0$0$36,183$0$28,723$0$192,185$0$0
CALVIN ALLEN
DIRECTOR$0$484,091$0$146,977$0$52,014$0$156,711$0$35,708$0$875,501$0$45,414

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4BSCHEDULE J, PART I, LINE 4B DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II INCLUDES AMOUNTS FROM A NONQUALIFIED 457(F) PLAN FOR THE FOLLOWING DIRECTORS AND OFFICERS: SCOTT A. AEBISCHER $ 15,340 KATHLEEN COONEY 59,031 CALVIN ALLEN 58,382 JOHN MISA, MD 47,964 TED WEGLEITNER 36,634 MEGAN REMARK 25,490
990, SCH J, PART II: PRIOR REPORTED COMPENSATIONCOLUMN (F) INCLUDES AMOUNTS PAID TO PARTICIPANTS IN THE CURRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEARS' 990'S, AS RETIREMENT AND DEFERRED COMPENSATION, FOR THE FOLLOWING DIRECTORS AND OFFICERS: SCOTT A. AEBISCHER $ 243,159 KATHLEEN COONEY $ 129,768 CALVIN ALLEN $ 45,414 JOHN MISA, MD $ 51,124 TED WEGLEITNER $ 31,729 MEGAN REMARK $ 25,086 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 (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
990, PART III, LINE 4A: EXEMPT PURPOSE AND ACHIEVEMENTSI. CORPORATE STRUCTURE, PURPOSE, GOVERNANCE STILLWATER HEALTH SYSTEM (SHS) IS A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND IS PART OF THE FAMILY OF HEALTHPARTNERS ORGANIZATIONS "HEALTHPARTNERS". FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED SYSTEM OF HEALTH CARE DELIVERY AND HEALTH CARE FINANCING ORGANIZATIONS, AND IS ONE OF THE LARGEST CONSUMER-GOVERNED ORGANIZATIONS IN THE COUNTRY. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTHCARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY. HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS WITH HEALTH CARE ACTIVITIES PRIMARILY OPERATING IN MINNESOTA, WESTERN WISCONSIN AND EXPANDING TO OTHER MIDWESTERN STATES. 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 PLAN'S SERVE MORE THAN 1.8 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,800 PHYSICIANS AND DENTISTS, SIX OWNED HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, OVER 100 OWNED AND LEASED PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES AND 25 DENTAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS ALSO CONTRACTS WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS LOCATED PRIMARILY IN MINNESOTA, WESTERN WISCONSIN AND EXPANDING TO OTHER MIDWESTERN STATES. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUND RAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN THE HEALTHPARTNERS FAMILY, 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 IS DRIVING CHANGE THAT HELPS OUR MEMBERS AND PATIENTS LIVE HEALTHIER LIVES. HEALTHPARTNERS COLLABORATE 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 CONTINUING IN 2017 ARE TOTAL COST OF CARE MEASUREMENTS (DEVELOPMENT OF A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, 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), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). 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, SHS, RAMSEY INTEGRATED HEALTH SERVICES AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). SHS IS THE SOLE CORPORATE MEMBER OF LAKEVIEW MEMORIAL HOSPITAL (HOSPITAL), LAKEVIEW MEMORIAL HOSPITAL FOUNDATION (FOUNDATION) AND STILLWATER MEDICAL GROUP (SMG). ALL THREE ENTITIES ARE MINNESOTA 501(C) (3) TAX EXEMPT ORGANIZATIONS. SHS IS A TYPE II SUPPORTING ORGANIZATION TO THE HOSPITAL, FOUNDATION AND SMG BECAUSE THERE IS SUBSTANTIAL OVERLAP OF DIRECTORS AND OFFICERS AMONG THE ORGANIZATIONS. THE BOARDS OF DIRECTORS OF SHS, THE HOSPITAL AND SMG ARE COMPRISED OF THE SAME PEOPLE. FURTHER, THE SAME PERSONS ARE IN THE POSITIONS OF CHIEF FINANCIAL OFFICER AND CHIEF MEDICAL OFFICER AT SHS, THE HOSPITAL AND SMG. SHS APPOINTS ALL MEMBERS OF THE FOUNDATION BOARD OF DIRECTORS. SEVERAL MEMBERS OF THE SHS BOARD OF DIRECTORS ARE ALSO FOUNDATION DIRECTORS. PLEASE SEE THE FORM 990 FILINGS FOR EACH ENTITY. II. PROGRAM SERVICE ACCOMPLISHMENTS HEALTHPARTNERS AND SHS COLLABORATE WITH OTHER PLANS, CARE PROVIDERS AND NON-PROFIT ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION; TO INCREASE ACCESS, CREATE AND DISSEMINATE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY AND COLLABORATE ON SYSTEM IMPROVEMENTS.
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER IS HPI-RAMSEY, INC.
FORM 990, PART VI, SECTION A, LINE 7AHPI-RAMSEY HAS THE POWER TO APPOINT THREE DIRECTORS TO THE SHS BOARD OF DIRECTORS. HPI-RAMSEY ALSO APPOINTS THE OTHER MEMBERS OF THE SHS BOARD FROM NOMINEES SUBMITTED BY THE SHS BOARD OF DIRECTORS. HPI-RAMSEY CAN REMOVE SUCH OTHER MEMBERS OF THE SHS BOARD ONLY UPON HIS OR HER CONVICTION OF A FELONY OR TO ASSURE ONGOING COMPLIANCE WITH APPLICABLE LAW.
FORM 990, PART VI, SECTION A, LINE 7BHPI-RAMSEY HAS THE POWER TO APPROVE THE FOLLOWING ACTIONS OF THE SHS BOARD OF DIRECTORS: - CHANGE IN MISSION, INCLUDING CONSOLIDATION, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS - AMENDMENT TO ARTICLES OF INCORPORATION OR BYLAWS - ISSUANCE OF DEBT THAT OBLIGATES THE MEMBER OR MEMBER AFFILIATE, OR, THAT IS NOT IN THE APPROVED BUDGET - ANNUAL CAPITAL AND OPERATING BUDGETS - LONG RANGE STRATEGIC PLANS - SIGNIFICANT AFFILIATIONS AND JOINT VENTURES
FORM 990, PART VI, SECTION B, LINE 11BSHS'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF SHS. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF SHS, GHI'S INTERNAL LEGAL DEPARTMENT AND SHS'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 SHS. SHS 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 SHS 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 REQUESTED 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, AND REINFORCES 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 15SHS HAS NO EMPLOYEES AND DOES NOT PAY COMPENSATION. SHS'S CEO AND ITS OFFICERS ARE PAID BY GROUP HEALTH PLAN, INC. (GHI), LAKEVIEW MEMORIAL HOSPITAL, AND STILLWATER MEDICAL GROUP (SMG), RELATED ORGANIZATIONS. ANY COMPENSATION DISCLOSED IS PAID AND DETERMINED SOLELY BY THE RELATED ORGANIZATIONS. THEREFORE, PART VI, SECTION B, QUESTION 15 IS NOT APPLICABLE TO SHS.
FORM 990, PART VI, SECTION C, LINE 19SHS'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM SHS OR HEALTHPARTNERS. SHS' 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, COL (B): AVERAGE HOURS PER WEEKAVERAGE WEEKLY HOURS: THE COMPENSATED BOARD MEMBERS AND OFFICERS FREQUENTLY DEVOTE THEIR TIME TO MULTIPLE RELATED ORGANIZATIONS IN A PARTICULAR WEEK. EACH INDIVIDUAL WORKS AN AVERAGE OF APPROXIMATELY 55 HOURS PER WEEK FOR SHS AND ITS RELATED ORGANIZATIONS.
FORM 990, PART XI, LINE 9:NET ASSET TRANSFERS TO OTHER ORGANIZATION -21,100,000.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 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
RH-WISCONSIN
8171 33RD AVE S PO BOX 1309MPLSMN554401309202287016CORPORATE PLANNING AND OVERSIGHTWI501(C)(3)0509(A)(3) TYPE IHPI - RAMSEY
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
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 IMPORVE 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 IIHPI - RAMSEY
PHYSICIANS NECK AND BACK CLINICS
8170 33RD AVE S PO BOX 1309MPLSMN554401309270684883SPECIALTY PATIENT CAREMN501(C)(3)0509(A)(3) TYPE IIGROUP HEALTH PLAN INC
HUDSON HOSPITAL INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309390804125HOSPITALWI501(C)(3)0170(B)(1) (A)(III)RH-WISCONSIN
HUDSON HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391279567PROVIDE SUPPORT TO HOSPITAL AND IMPORVE COMMUNITY HEALTHWI501(C)(3)0170(B)(1) (A)(VI)HUDSON HOSPITAL INC
LAKEVIEW MEMORIAL HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309411386635PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTMN501(C)(3)Yes (1)509(A)(3) TYPE IISTILLWATER HEALTH SYSTEM
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309410811697HOSPITALMN501(C)(3)Yes (1)170(B)(1) (A)(III)STILLWATER HEALTH SYSTEM
STILLWATER MEDICAL GROUP
8170 33RD AVE S PO BOX 1309MPLSMN554401309830379473CLINIC STAFF AND FACILITIESMN501(C)(3)Yes (1)509(A)(3) TYPE ISTILLWATER HEALTH SYSTEM
WESTFIELDS HOSPITAL INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309390808442HOSPITALWI501(C)(3)0170(B)(1) (A)(III)RH-WISCONSIN
WESTFIELDS HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391770913PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTWI501(C)(3)0170(B)(1) (A)(VI)WESTFIELDS HOSPITAL INC
RAMSEY INTEGRATED HEALTH SERVICES
8170 33RD AVE S PO BOX 1309MPLSMN554401309411503090HOME CARE AND HOSPICEMN501(C)(3)0509(A)(2)HPI - RAMSEY
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 TO IMPROVE 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 , PHARMACY 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
AMERY REGIONAL MEDICAL CENTER FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391726539PROVIDE SUPPORT TO HOSPITAL AND IMPORVE COMMUNITY HEALTHWI501(C)(3)0170(B)(1) (A)(VI)AMERY REGIONAL MEDICAL CENTER INC

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 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
HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411236798MEDICAL CLINIC STAFFINGMNHEALTHPARTNERS ADMINISTRATORS INCC0
PARK NICOLLET ENTERPRISES
6500 EXCELSIOR BLVDST LOUIS PARKMN55426411656735REAL ESTATE FOR RELATED ORGANIZATIONSMNPARK NICOLLET HEALTH SERVICESC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset ExchangeYes (1)AssetExchangeInd
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 Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC
Q$1,918,670
LAKEVIEW MEMORIAL HOSPITAL FOUNDATION
Q$60,000
STILLWATER MEDICAL GROUP
Q$1,145,269

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