2018-11-13T16:53:33-06:00 2017-12-31 135565207 KPMG LLP 4200 WELLS FARGO CTR 90 S 7TH STREET MINNEAPOLIS MN 55402 990 2017-01-01 300221189 STILLWATER HEALTH SYSTEM STIL 9528836584 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 DOUGLAS E JOHNSON CFO 9528836584 2018-11-13 1 MONROE J GIERL P01413237 6123055000 198.174.110.146 2018-11-13 15:38:08 CS P BC53011EDF70B2E1BD72B439C4A42BAD8A5D7AD2 BC53011EDF70B2E1BD72B439C4A42BAD8A5D7AD2 2017 2019-02-21 02:37:17Z LAKEVIEW HEALTH DOUGLAS E JOHNSON 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 11368191 0 X WWW.LAKEVIEW.ORG X 2003 MN SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS 15 10 0 10 0 0 0 0 0 0 5193511 11333511 4539 34680 5198050 11368191 0 0 0 0 0 0 0 0 0 1091 4500 1091 4500 5196959 11363691 98099709 87723782 446827 598579 97652882 87125203 X TO 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. 0 0 SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X DOUGLAS JOHNSON 6514304581 927 CHURCHILL ST WEST STILLWATER MN 55082 X SCOTT AEBISCHER DIRECTOR 0.50 49.50 X 0 742896 160633 REBECCA BILLINGSLEY DIRECTOR 0.58 X 0 0 0 ELIZABETH BRADSHAW SECRETARY & DIRECTOR 0.58 X 0 0 0 DWIGHT CUMMINS DIRECTOR 0.58 X 0 0 0 PHIL DONALDSON CHAIR & DIRECTOR 0.58 X 0 0 0 ANDREW ROLLWAGEN DIRECTOR 0.58 X 0 0 0 MEGAN REMARK DIRECTOR 0.50 49.50 X 0 659171 173822 JIM SCHUG VICE CHAIR & DIRECTOR 0.58 X 0 0 0 JOHN UPPGREN DIRECTOR 0.58 X 0 0 0 NICK MEYER MD DIRECTOR 0.58 X 0 0 0 DENISE PONTRELLI DIRECTOR 0.58 X 0 0 0 JULIE SCHMIDT DIRECTOR 0.58 X 0 0 0 KEVIN BJORK MD DIRECTOR 0.50 49.50 X 0 490159 52219 JOHN MISA MD DIRECTOR 0.50 59.50 X 0 553128 98995 MARTHA SANFORD MD DIRECTOR 0.50 39.50 X 0 294179 50319 KATHLEEN COONEY EXECUTIVE VP & CAO 0.50 55.00 X X 0 991272 229887 ANDREW E DORWART MD PRESIDENT SMG & DIRECTOR 0.50 49.50 X 0 481126 36065 DOUGLAS E JOHNSON DIRECTOR & CFO 4.00 51.00 X 0 366499 118683 TED WEGLEITNER DIRECTOR & CEO 1.00 52.00 X 0 555832 109748 ROBBI A HAGELBERG VP OF OPERATIONS & CNO 0.50 49.50 X 0 221834 19597 NATE PULSCHER VP ANCILLARY SERVICES 0.50 49.50 X 0 191070 38691 THOMAS ANDERSON VP MEDICAL AFFAIRS 0.50 49.50 X 0 371740 31194 PAUL ERICKSON EXEC. DIR. DEVELOPMENT 1.00 51.00 X 0 127279 64906 CALVIN ALLEN DIRECTOR 0.50 39.50 X 0 683082 192419 0 6729267 1377178 0 1 1 0 PAVILION ADVISORY GROUP INC 227 W MONROE ST STE 2020 CHICAGO IL 60606 INVESTMENT CONSULTANT 166513 KRUSKOPF & COMPANY 310 4TH AVE S FLR 2 MINNEAPOLIS MN 55415 ADVERTISING 135973 2 11333511 11333511 34680 0 34680 34680 34680 11368191 0 0 11368191 MISCELLANEOUS EXPENSE 4500 4500 4500 0 4500 0 1260298 1752879 165130 261200 24558 27159 171122 36882 282273 134240 95289250 84723808 1078200 824496 98099709 87723782 446827 598579 446827 598579 X 97652882 87125203 97652882 87125203 98099709 87723782 X 11363691 -791370 -21100000 X 0 1 X 1 0 X X 2 LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC 410811697 3 1 0 0 STILLWATER MEDICAL GROUP 830379473 10 1 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 990, SCHEDULE A, PART I, LINE 11 H, COL. (VII): MONETARY SUP NO 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 MEMBERS SHS 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 INFORMATION STILLWATER MEDICAL GROUP IS AN ORGANIZAITON TYPE CODE 12. DUE TO SOFTWARE LIMITATIONS, THAT BOX IS TYPE 10 INSTEAD OF TYPE 12. 0 0 0 0 0 0 0 0 1 0 0 PART II-B, LINE 1: STILLWATER 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. 100000 100000 71122 36882 34240 134240 X PART X, LINE 2: STILLWATER 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. X X X X 0 1 0 0 0 0 0 0 0 SCOTT AEBISCHER DIRECTOR 0 365607 0 103924 0 273365 0 124486 0 36147 0 903529 0 243159 MEGAN REMARK DIRECTOR 0 464292 0 138528 0 56351 0 139402 0 34420 0 832993 0 25086 KEVIN BJORK MD DIRECTOR 0 389833 0 0 0 100326 0 20250 0 31969 0 542378 0 0 JOHN MISA MD DIRECTOR 0 397709 0 85939 0 69480 0 72940 0 26055 0 652123 0 51124 MARTHA SANFORD MD DIRECTOR 0 154022 0 9625 0 130532 0 20250 0 30069 0 344498 0 0 KATHLEEN COONEY EXECUTIVE VP & CAO 0 597250 0 228611 0 165411 0 189710 0 40177 0 1221159 0 129768 ANDREW E DORWART MD PRESIDENT SMG & DIRECTOR 0 383024 0 70427 0 27675 0 20250 0 15815 0 517191 0 0 DOUGLAS E JOHNSON DIRECTOR & CFO 0 276955 0 60289 0 29255 0 89960 0 28723 0 485182 0 0 TED WEGLEITNER DIRECTOR & CEO 0 408444 0 110594 0 36794 0 75885 0 33863 0 665580 0 31729 ROBBI A HAGELBERG VP OF OPERATIONS & CNO 0 191829 0 27720 0 2285 0 11643 0 7954 0 241431 0 0 NATE PULSCHER VP ANCILLARY SERVICES 0 174327 0 16743 0 0 0 6293 0 32398 0 229761 0 0 THOMAS ANDERSON VP MEDICAL AFFAIRS 0 243730 0 16762 0 111248 0 0 0 31194 0 402934 0 0 PAUL ERICKSON EXEC. DIR. DEVELOPMENT 0 120935 0 6344 0 0 0 36183 0 28723 0 192185 0 0 CALVIN ALLEN DIRECTOR 0 484091 0 146977 0 52014 0 156711 0 35708 0 875501 0 45414 PART I, LINE 4B SCHEDULE 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 COMPENSATION COLUMN (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. 990, PART III, LINE 4A: EXEMPT PURPOSE AND ACHIEVEMENTS I. 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 6 THE SOLE MEMBER IS HPI-RAMSEY, INC. FORM 990, PART VI, SECTION A, LINE 7A HPI-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 7B HPI-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 11B SHS'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 12C THE 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 15 SHS 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 19 SHS'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 WEEK AVERAGE 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. HEALTHPARTNERS INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411693838 HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(4) N/A 0 RH-WISCONSIN 8171 33RD AVE S PO BOX 1309 MPLS MN 554401309 202287016 CORPORATE PLANNING AND OVERSIGHT WI 501(C)(3) 509(A)(3) TYPE I HPI - RAMSEY 0 HPI-RAMSEY 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411793333 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 GROUP HEALTH PLAN INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410797853 STAFF MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(3) 170(B)(1) (A)(III) HEALTHPARTNERS INC 0 HEALTHPARTNERS INSTITUTE 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411670163 HEALTHCARE EDUCATION AND RESEARCH MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 CAPITOL VIEW TRANSITIONAL CARE CENTER 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 412011453 TRANSITIONAL CARE SERVICES, STEP DOWN FROM INPATIENT HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 0 REGIONS HOSPITAL 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410956618 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 0 REGIONS HOSPITAL FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411888902 PROVIDE SUPPORT TO HOSPITAL AND IMPORVE COMMUNITY HEALTH MN 501(C)(3) 170(B)(1) (A)(VI) HPI - RAMSEY 0 RHSC INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411891928 HEALTHCARE STAFFING AND INTENSE REHAB SERVICES MN 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY 0 PHYSICIANS NECK AND BACK CLINICS 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 270684883 SPECIALTY PATIENT CARE MN 501(C)(3) 509(A)(3) TYPE II GROUP HEALTH PLAN INC 0 HUDSON HOSPITAL INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 390804125 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN 0 HUDSON HOSPITAL FOUNDATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 391279567 PROVIDE SUPPORT TO HOSPITAL AND IMPORVE COMMUNITY HEALTH WI 501(C)(3) 170(B)(1) (A)(VI) HUDSON HOSPITAL INC 0 LAKEVIEW MEMORIAL HOSPITAL FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411386635 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 509(A)(3) TYPE II STILLWATER HEALTH SYSTEM 1 LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410811697 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) STILLWATER HEALTH SYSTEM 1 STILLWATER MEDICAL GROUP 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 830379473 CLINIC STAFF AND FACILITIES MN 501(C)(3) 509(A)(3) TYPE I STILLWATER HEALTH SYSTEM 1 WESTFIELDS HOSPITAL INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 390808442 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN 0 WESTFIELDS HOSPITAL FOUNDATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 391770913 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT WI 501(C)(3) 170(B)(1) (A)(VI) WESTFIELDS HOSPITAL INC 0 RAMSEY INTEGRATED HEALTH SERVICES 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411503090 HOME CARE AND HOSPICE MN 501(C)(3) 509(A)(2) HPI - 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