PARK NICOLLET HEALTH SERVICES: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
PARK NICOLLET HEALTH SERVICES (EIN 36-3465840)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-14
IRS object ID
201713189349312721
Schema version
2016v3.0
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)
Return2017-11-14T17:40:07-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135665207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14200 WELLS FARGO CENTER 90 S 7THAddressLine1Txt
Address Line2STREETAddressLine2Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN363465840EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PARK NICOLLET HEALTH SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPARKBusinessNameControlTxt
Phone9529933108PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BOULEVARDAddressLine1Txt
CityST LOUIS PARKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55426ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCATHERINE LENAGHPersonNm
Person TitleVP & CFOPersonTitleTxt
Phone9529933108PhoneNum
Signature2017-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

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

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address198.174.110.146IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-14IPDt
IP Tm17:39:46IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id1A39D2BAC3E977A191A219CBBAAA8778AA2E0A5DAtSubmissionCreationDeviceId
At Submission Filing Device Id282CC43464B9830A349574F670F0BA37F913502DAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCATHERINE LENAGHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BLVDAddressLine1Txt
CityST LOUIS PARKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55426ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$94,886,852GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PARKNICOLLET.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1986FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITYActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee10237TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$20,110TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$17,532NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$25,000PYContributionsGrantsAmt
CY Contributions Grants$79,475CYContributionsGrantsAmt
PY Program Service Revenue$93,167,342PYProgramServiceRevenueAmt
CY Program Service Revenue$94,750,408CYProgramServiceRevenueAmt
PY Investment Income$7,736PYInvestmentIncomeAmt
CY Investment Income$37CYInvestmentIncomeAmt
PY Other Revenue$38,380PYOtherRevenueAmt
CY Other Revenue$35,703CYOtherRevenueAmt
PY Total Revenue$93,238,458PYTotalRevenueAmt
CY Total Revenue$94,865,623CYTotalRevenueAmt
PY Grants And Similar Paid$27,550PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$13,422CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$12,544,873PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,668,958CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$79,086,929PYOtherExpensesAmt
CY Other Expenses$77,959,614CYOtherExpensesAmt
PY Total Expenses$91,659,352PYTotalExpensesAmt
CY Total Expenses$92,641,994CYTotalExpensesAmt
PY Revenues Less Expenses$1,579,106PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,223,629CYRevenuesLessExpensesAmt
Total Assets BOY$143,932,712TotalAssetsBOYAmt
Total Assets EOY$182,130,025TotalAssetsEOYAmt
Total Liabilities BOY$140,268,693TotalLiabilitiesBOYAmt
Total Liabilities EOY$166,108,195TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,664,019NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,021,830NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOUR MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$76,249,016ExpenseAmt
Grant$13,422GrantAmt
Revenue$94,765,776RevenueAmt
DescSEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTSDesc
Total Program Service Expenses$76,249,016TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related InvstYes (1)ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
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 EntityYes (1)DisregardedEntityInd
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 Document434IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee10237EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
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 Member0IndependentVotingMemberCnt
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 ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
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 FldCAStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CATHERINE LENAGHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9529933108PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BOULEVARDAddressLine1Txt
CityST LOUIS PARKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55426ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
PARK NICOLLET GROUP RETURN -SEE SCH
DIRECTORS55.00Yes (X)$0$3,811,459$373,439
PARK NICOLLET GROUP RETURN -SEE SCH
OFFICERS55.00$8,135,647$2,378,769$2,145,0145.00Yes (X)
PARK NICOLLET GROUP RETURN -SEE SCH
HIGHEST COMPENSATED EMPLOY1.00$0$5,271,819$296,54655.00Yes (X)
PARK NICOLLET GROUP RETURN -SEE SCH
FORMER0.00$0$521,283$106,696Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,135,647TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$11,983,330TotReportableCompRltdOrgAmt
Total Other Compensation$2,921,695TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K19IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$79,475RelatedOrganizationsAmt
Total Contributions$79,475TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICES621400$80,934,847$80,934,847
SERVICES TO AFFILIATES EXEMPT ORG561000$13,276,922$13,276,922
PREMIER PURCHASING900099$538,639$518,529$20,110
FieldValueIRS element (for citing)
Total Program Service Revenue$94,750,408TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$37TotalRevenueColumnAmt
Exclusion$37ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$454TotalRevenueColumnAmt
Exclusion$454ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$21,000RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$21,229RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$229RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$229TotalRevenueColumnAmt
Exclusion-$229ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS SERVICESDesc
Business541900BusinessCd
Total Revenue Column$35,478TotalRevenueColumnAmt
Related Or Exempt Func Income$35,478RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$35,478OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$94,865,623TotalRevenueColumnAmt
Related Or Exempt Func Income$94,765,776RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$20,110UnrelatedBusinessRevenueAmt
Exclusion$262ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$13,422TotalAmt
Program Services$13,422ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$8,135,647TotalAmt
Management And General$8,135,647ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$908,856TotalAmt
Management And General$908,856ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,125,730TotalAmt
Management And General$3,125,730ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,073,108TotalAmt
Management And General$1,073,108ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$729,692TotalAmt
Management And General$729,692ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$695,925TotalAmt
Management And General$695,925ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$50,628TotalAmt
Management And General$50,628ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$56,401,069TotalAmt
Program Services$46,213,980ProgramServicesAmt
Management And General$10,187,089ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,289,887TotalAmt
Program Services$34,163ProgramServicesAmt
Management And General$1,255,724ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$372,602TotalAmt
Program Services$187,865ProgramServicesAmt
Management And General$184,737ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$234,231TotalAmt
Program Services$194,375ProgramServicesAmt
Management And General$39,856ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,602,398TotalAmt
Program Services$3,003,856ProgramServicesAmt
Management And General$1,598,542ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$30,642TotalAmt
Program Services$20,923ProgramServicesAmt
Management And General$9,719ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$35,232TotalAmt
Program Services$11,300ProgramServicesAmt
Management And General$23,932ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,545,707TotalAmt
Program Services$3,320,646ProgramServicesAmt
Management And General$225,061ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$801,550TotalAmt
Program Services$10,372ProgramServicesAmt
Management And General$791,178ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES AND EQ$7,099,099$7,080,937$18,162
TAXES AND ASSESSMENTS$1,400,835$1,371,459$29,376
BAD DEBT$847,000$847,000
IND EXP ALL - SHARED EX$0$13,266,291-$13,266,291

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,248,734TotalAmt
Program Services$672,427ProgramServicesAmt
Management And General$576,307ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$92,641,994TotalAmt
Program Services$76,249,016ProgramServicesAmt
Management And General$16,392,978ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,558,861BOYAmt
EOY$6,303,889EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$91,967,869BOYAmt
EOY$126,811,985EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,231,754BOYAmt
EOY$12,411,085EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$472,939BOYAmt
EOY$424,209EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$678,100BOYAmt
EOY$589,706EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$65,864,058LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$43,846,738LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$25,062,946BOYAmt
EOY$22,017,320EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$9,831,354BOYAmt
EOY$11,886,766EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,128,889BOYAmt
EOY$1,685,065EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$143,932,712BOYAmt
EOY$182,130,025EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$95,651,006BOYAmt
EOY$135,644,235EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$44,617,687BOYAmt
EOY$30,463,960EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$140,268,693BOYAmt
EOY$166,108,195EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,664,019BOYAmt
EOY$16,021,830EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,664,019BOYAmt
EOY$16,021,830EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$143,932,712BOYAmt
EOY$182,130,025EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,223,629ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$10,134,182OtherChangesInNetAssetsAmt
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)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$212CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$25,000CurrentTaxYearMinus1YearAmt
Current Tax Year$79,475CurrentTaxYearAmt
Total$104,687TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$94,357,206CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$93,739,106CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$94,603,823CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$93,195,995CurrentTaxYearMinus1YearAmt
Current Tax Year$80,934,847CurrentTaxYearAmt
Total$456,830,977TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$94,357,206CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$93,739,106CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$94,604,035CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$93,220,995CurrentTaxYearMinus1YearAmt
Current Tax Year$81,014,322CurrentTaxYearAmt
Total$456,935,664TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$456,935,664PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$39,587CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$59,118CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$23,734CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$34,036CurrentTaxYearMinus1YearAmt
Current Tax Year$21,491CurrentTaxYearAmt
Total$177,966TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$39,587CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$59,118CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$23,734CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$34,036CurrentTaxYearMinus1YearAmt
Current Tax Year$21,491CurrentTaxYearAmt
Total$177,966TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$94,396,793CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$93,798,224CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$94,627,769CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$93,255,031CurrentTaxYearMinus1YearAmt
Current Tax Year$81,035,813CurrentTaxYearAmt
Total$457,113,630TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99960PublicSupportCY509Pct
Public Support PY5090.99960PublicSupportPY509Pct
Investment Income CY0.00040InvestmentIncomeCYPct
Investment Income PY0.00040InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Organization Belongs Afflt GrpYes (X)OrganizationBelongsAffltGrpInd

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Affiliated Group Total$27,046AffiliatedGroupTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Affiliated Group Total$27,046AffiliatedGroupTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$92,641,994FilingOrganizationsTotalAmt
Affiliated Group Total$1,399,329,444AffiliatedGroupTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$92,641,994FilingOrganizationsTotalAmt
Affiliated Group Total$1,399,356,490AffiliatedGroupTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Filing Organizations Total$1,000,000FilingOrganizationsTotalAmt
Affiliated Group Total$1,000,000AffiliatedGroupTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Filing Organizations Total$250,000FilingOrganizationsTotalAmt
Affiliated Group Total$250,000AffiliatedGroupTotalAmt

Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt
Affiliated Group Total$0AffiliatedGroupTotalAmt

Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt
Affiliated Group Total$0AffiliatedGroupTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Current Year Minus3$1,000,000CurrentYearMinus3Amt
Current Year Minus2$1,000,000CurrentYearMinus2Amt
Current Year Minus1$1,000,000CurrentYearMinus1Amt
Current Year$1,000,000CurrentYearAmt
Total$4,000,000TotalAmt
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$51,106CurrentYearMinus3Amt
Current Year Minus2$143,687CurrentYearMinus2Amt
Current Year Minus1$87,743CurrentYearMinus1Amt
Current Year$27,046CurrentYearAmt
Total$309,582TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Current Year Minus3$250,000CurrentYearMinus3Amt
Current Year Minus2$250,000CurrentYearMinus2Amt
Current Year Minus1$250,000CurrentYearMinus1Amt
Current Year$250,000CurrentYearAmt
Total$1,000,000TotalAmt
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationPARK NICOLLET HEALTH SERVICES INCURS LOBBYING EXPENSES ON BEHALF OF PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET HEALTH CARE PRODUCTS AND PARK NICOLLET CLINIC. OTHER EXEMPT EXPENSES RELATE TO THE MANAGEMENT EXPENSES INCURRED BY PARK NICOLLET HEALTH SERVICES ON BEHALF OF EACH ENTITY.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$87,731BeginningYearBalanceAmt
Contributions$28,381ContributionsAmt
Grants Or Scholarships$50,000GrantsOrScholarshipsAmt
End Year Balance$66,112EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$105,211BeginningYearBalanceAmt
Contributions$32,020ContributionsAmt
Grants Or Scholarships$49,500GrantsOrScholarshipsAmt
End Year Balance$87,731EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$68,853BeginningYearBalanceAmt
Contributions$36,358ContributionsAmt
End Year Balance$105,211EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$76,400BeginningYearBalanceAmt
Contributions$30,953ContributionsAmt
Grants Or Scholarships$38,500GrantsOrScholarshipsAmt
End Year Balance$68,853EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$52,482BeginningYearBalanceAmt
Contributions$23,918ContributionsAmt
End Year Balance$76,400EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,917,864OtherCostOrOtherBasisAmt
Book Value$1,917,864BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,134OtherCostOrOtherBasisAmt
Depreciation$21,134DepreciationAmt
Book Value$0BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$41,677,575OtherCostOrOtherBasisAmt
Depreciation$23,561,651DepreciationAmt
Book Value$18,115,924BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,247,485OtherCostOrOtherBasisAmt
Depreciation$20,263,953DepreciationAmt
Book Value$1,983,532BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$22,017,320TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp (3 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
INVESTMENT IN TRI-CARE$4,116,403C
INVESTMENT IN PREMIER$7,636,737C
OTHER INVESTMENTS$133,626C
FieldValueIRS element (for citing)
Total Book Value Program Rltd$11,886,766TotalBookValueProgramRltdAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
CONTINGENT MALPRACTICE LIABILITY$28,731,600
POST RETIREMENT OBLIGATION$1,732,360
FieldValueIRS element (for citing)
Total Liability$30,463,960TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE TERM ENDOWMENT FUNDS FOR USE WITHIN PARK NICOLLET HEALTH SERVICES ARE FOR THE CARING FOR COLLEAGUES PROGRAM.
PART X, LINE 2:PARK NICOLLET HEALTH SERVICES' 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. TRIA ORTHOPAEDIC CENTER RESEARCH RECORDED NO LIABILITIES AT DECEMBER 31, 2016 OR 2015 FOR UNRECOGNIZED TAX BENEFITS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
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 PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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
PARK NICOLLET GROUP RETURN -SEE SCH
DIRECTORS$0$1,924,158$0$219,012$0$1,668,289$0$249,304$0$124,135$0$4,184,898$0$1,563,465
PARK NICOLLET GROUP RETURN -SEE SCH
OFFICERS$6,748,329$1,695,426$1,210,215$500,484$177,103$182,859$1,014,793$461,948$557,275$110,998$9,707,715$2,951,715$371,522$102,406
PARK NICOLLET GROUP RETURN -SEE SCH
HIGHEST COMPENSATED EMPLOY$0$5,110,384$0$151,751$0$9,684$0$118,915$0$177,631$0$5,568,365$0$0
PARK NICOLLET GROUP RETURN -SEE SCH
FORMER$0$380,178$0$130,432$0$10,673$0$74,602$0$32,094$0$627,979$0$6,196

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE PARK NICOLLET HEALTH SERVICES' BOARD OF DIRECTORS IS RESPONSIBLE FOR ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S CEO AND OTHER EXECUTIVES.
PART I, LINE 4BDETAILED INFORMATION ON PARK NICOLLET HEALTH SERVICES COMPENSATION CAN BE FOUND ON THE PARK NICOLLET GROUP RETURN (EIN 45-5023260). SCHEDULE J, PART I, LINE 4B: SENIOR LEADERS OF PARK NICOLLET HEALTH SERVICES AND AFFILIATES ARE GIVEN THE OPPORTUNITY TO PARTICIPATE IN THE CAPITAL ACCUMULATION ACCOUNT PLAN. THE CAPITAL ACCUMULATION ACCOUNT PLAN (CAA PLAN) PARTICIPATION IS LIMITED TO SENIOR LEADERS AND ALL THE VICE PRESIDENTS. EACH PARTICIPANT RECEIVES AN ANNUAL ALLOWANCE EQUAL TO THE SUM OF (I) A STATED PERCENT OF SALARY, (II) VOLUNTARY SALARY DEFERRALS. THE ALLOWANCE IS CREDITED TO A BOOKKEEPING ACCOUNT. EARNINGS ARE CREDITED TO THE ACCOUNT BASED ON THE PERFORMANCE OF SIMULATED INVESTMENTS. BENEFITS VEST UPON THE EARLIEST OF REMAINING EMPLOYED TO AN ELECTIVE VESTING DATE (TWO YEARS TO AGE 68), INVOLUNTARY TERMINATION WITHOUT CAUSE, DISABILITY, DEATH, OR NOT COMPETING FOR 24 MONTHS FOLLOWING VOLUNTARY OR FOR-CAUSE TERMINATION. BENEFITS ARE PAID IN A SINGLE LUMP SUM UPON VESTING. PARTICIPANTS ARE GENERAL CREDITORS OF THE EMPLOYER FOR THE PAYMENT OF THE BENEFITS. THE FOLLOWING PARTICIPANTS RECEIVED PAYOUTS FROM A PARK NICOLLET HEALTH SERVICES, RELATED TO CAA PLAN: STEVEN CONNELLY, MD $ 61,263 LAURA FRAZIER $ 29,157 ROXANNA GAPSTUR $ 39,981 CATHERINE LENAGH $ 35,566 JOHN MISA, MD $ 47,843 JOAN SANDSTROM $ 28,456 THEODORE WEGLEITNER $ 6,196 CATHERINE KLUGHERZ $ 20,657 CHRISTA GETCHELL $ 17,716 JOSHUA ZIMMERMAN MD $ 26,927 KRISTI LYON $ 16,746 CURT BOEHM, MD $ 33,568 MELISSA SCHOENHERR $ 19,837 OFFICERS AND DIRECTORS EMPLOYED BY HEALTHPARTNERS, INC HAVE DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II WHICH INCLUDE AMOUNTS FROM A NONQUALIFIED 457(F) PLAN, THE FOLLOWING PARTICIPANTS RECEIVED PAYOUTS: BABETTTE APLAND $ 9,408 BRIAN RANK, MD $ 1,563,465 NANCY MCCLURE $ 29,263 BARBARA TRETHEWAY $ 63,735
PART I, LINE 7SCHEDULE J, PART I, LINE 7: ALL PHYSICIANS, EMPLOYED BY AND SEEING PATIENTS FOR PARK NICOLLET HEALTH SERVICES AND AFFILIATES, ARE ELIGIBLE FOR A 3% ACCESS INCENTIVE PAYOUT BASED ON THEIR DEPARTMENT REACHING CERTAIN GOALS INCLUDING ACCESS FOR PATIENTS AND QUALITY INITIATIVES. IN THEIR ROLES AS EXECUTIVES EMPLOYED BY PARK NICOLLET HEALTH SERVICES, THE EXECUTIVES ARE ELIGIBLE FOR INCENTIVE PAYOUTS. THE INCENTIVE AWARD WILL BE 30% FOR THE CFO, COO, CMO AND 25% FOR ALL OTHER EXECUTIVES WITH AN OPPORTUNITY FOR INCENTIVE CREDIT ABOVE THE TARGET LEVEL. THE ULTIMATE PAYOUT INCLUDES A REDUCTION/INCREASE MULTIPLIER DEPENDING ON WHETHER THE CONSOLIDATED PARK NICOLLET HEALTH SERVICES ORGANIZATION REACHED THAT YEAR'S OPERATING MARGIN GOAL AS SET BY THE BOARD OF DIRECTORS. EACH PARTICIPANT WILL BE RESPONSIBLE FOR TWO FINANCIAL GOALS, AND NOT LESS THAN THREE AND NOT MORE THAN FIVE INDIVIDUAL STRATEGIC OBJECTIVES. IN THEIR ROLES AS MANAGEMENT EMPLOYED BY PARK NICOLLET HEALTH SERVICES, CERTAIN MANAGERS ARE ELIGIBLE FOR INCENTIVE PAYOUTS. THE INCENTIVE AWARD WILL BE 15% OF THEIR ANNUAL BASE PAY COMPENSATION WITH AN OPPORTUNITY FOR INCENTIVE CREDIT ABOVE THE TARGET LEVEL. THE ULTIMATE PAYOUT INCLUDES A REDUCTION/INCREASE MULTIPLIER DEPENDING ON WHETHER THE CONSOLIDATED PARK NICOLLET HEALTH SERVICES ORGANIZATION REACHED THAT YEAR'S OPERATING MARGIN GOAL AS SET BY THE BOARD OF DIRECTORS. INCENTIVE PAYMENTS ARE A FUNCTION OF BOTH INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. THE PARTICIPANT MUST BE ASSIGNED AT LEAST THREE, AND NOT MORE THAN FOUR FOCUSED INCENTIVE OBJECTIVE, ONE OF WHICH MUST BE FINANCIAL IN NATURE.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 4A, EXEMPT PURPOSE AND ACHIEVEMENTSCORPORATE STRUCTURE, PURPOSE, GOVERNANCE PARK NICOLLET HEALTH SERVICE (PNHS) 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 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 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 INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS WITH HEALTH CARE ACTIVITIES PRIMARILY OPERATING IN MINNESOTA AND WESTERN WISCONSIN. 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 1.6 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,700 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 24 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 HEALTH CARE PROVIDERS LOCATED PRIMARILY IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUNDRAISING 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 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 CONTINUING IN 2016 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). PNHS IS THE PARENT ORGANIZATION TO AN INTEGRATED CARE SYSTEM THAT INCLUDES PARK NICOLLET METHODIST HOSPITAL (PNMH) , PARK NICOLLET CLINIC (PNC), PARK NICOLLET HEALTH CARE PRODUCTS (PNHCP), PARK NICOLLET FOUNDATION (PNF) AND TRIA ORTHOPEADIC CENTER (TRIA). PNHS IS A NONPROFIT, INTEGRATED CARE DELIVERY SYSTEM. IT IS STAFFED BY NATIONALLY RECOGNIZED HOSPITAL AND CLINIC DOCTORS, CLINICAL PROFESSIONALS, NURSES AND OTHER TEAM MEMBERS WHO HELP PATIENTS STAY HEALTHY AND TAKE CARE OF THEM WHEN THEY ARE SICK. TRIA IS A DISREGARDED ENTITY OF PNHS. TRIA'S MISSION IS TO PROVIDE OUR PATIENTS AND COMMUNITY WITH EXCEPTIONAL AND INNOVATIVE ORTHOPAEDIC AND SPORTS MEDICINE CARE ADVANCED BY RESEARCH AND EDUCATION. OUR VISION IS TO BE RECOGNIZED NATIONALLY FOR DRIVING INNOVATION AND DISCOVERIES WITH A FOCUS ON: PROVIDING AN UNPARALLELED PATIENT EXPERIENCE ACHIEVING LEADING CLINICAL OUTCOMES VIA EXPERT TEAMS, AND, DELIVERING THE HIGHEST VALUE FOR OUR SERVICES TRIA'S VALUES INCLUDE: PARTNERSHIP, EXCELLENCE, INTEGRITY AND COMPASSION OUR CORE BELIEFS INCLUDE: PATIENTS: OUR PATIENTS COME FIRST. PEOPLE: OUR PEOPLE ARE OUR GREATEST STRENGTH INNOVATION: WE THRIVE ON CHALLENGES, NEW ENDEAVORS, CREATIVE SOLUTIONS AND WE EMBRACE CHANGE. RESEARCH: RESEARCH IS FUNDAMENTAL TO IMPROVING PATIENT CARE. EDUCATION: EDUCATION ENHANCES OUR PROFESSION AND PATIENT CARE COMMUNITY: WE WILL BE A GOOD NEIGHBOR AND BUILD STRONG RELATIONSHIPS TO SUPPORT GROWTH AND ENHANCE VALUE. GROWTH: PROFITABLE GROWTH SUPPORTS OUR MISSION AND HELPS ATTAIN OUR VISION. COMMUNITY AND SUBSIDIZED HEALTH SERVICES ONE OF TRIA'S CORE VALUES IS: COMMUNITY: WE WILL BE A GOOD NEIGHBOR AND BUILD STRONG RELATIONSHIPS TO SUPPORT GROWTH AND ENHANCE VALUE. TRIA CONTINUES TO LEAD THE WAY IN OUTCOMES MEASUREMENT. PATIENTS COMPLETE EXTENSIVE PRE AND POST SURVEYS TO ASSESS FUNCTIONAL OUTCOMES ON EIGHT DIFFERENT PROCEDURE TYPES. SOME OF TRIA'S PATIENT REGISTRIES ARE NOW AMONGST THE MOST EXTENSIVE IN THE INDUSTRY. IN 2016, TRIA PROVIDED 191 FREE MINNESOTA STATE HIGH SCHOOL LEAGUE PRE-PARTICIPATION EXAMS FOR AREA HIGH SCHOOL ATHLETES PRIOR TO THE FALL SEASON. IN ADDITION, TRIA GAVE FAMILIES THE OPTION TO ALSO HAVE A BASELINE IMPACT TEST AND FUNCTIONAL MOVEMENT SCREEN AT THE TIME OF THE EXAM. ADDITIONAL PRE-PARTICIPATION PHYSICALS WERE SUBSIDIZED FOR STUDENT ATHLETES AT DAKOTA COUNTY TECHNICAL COLLEGE AND HOCKEY PLAYERS FOR THE MINNESOTA MAGICIANS JUNIOR HOCKEY TEAM. TRIA PROVIDED MEDICAL COVERAGE FOR NUMEROUS SPORTING EVENTS IN THE COMMUNITY IN 2016, INCLUDING: U.S. POND HOCKEY CHAMPIONSHIP AT LAKE NOKOMIS NORTH STAR COLLEGE CUP, NCHH COLLEGE HOCKEY TOURNAMENTS PINKYSWEAR KIDS TRIATHLON AT LAKE NOKOMIS AND LAKE ANN PINKYSWEAR MESS FEST NUMEROUS YOUTH SPORT TOURNAMENTS IN MULTIPLE SPORTS SUCH AS FOOTBALL, SOCCER, SOFTBALL, HOCKEY, JUDO, GYMNASTICS, AND BASKETBALL THROUGHOUT THE YEAR. TRIA PROVIDED FREE GRIP STRENGTH SCREENINGS, EDUCATION AROUND SPORTS MEDICINE AND ORTHOPAEDIC INJURIES, AND INTERACTIVE GAMES FOR THOUSANDS OF PEOPLE AT THE PREP 45 DAY AT THE MINNESOTA STATE FAIR. HEALTH PROFESSIONAL EDUCATION ANNUALLY, TRIA TRAINS THREE SPORTS MEDICINE FELLOWS. APPROXIMATELY 100 MEDICAL STUDENTS, AND RESIDENTS ROTATE THROUGH TRIA EACH YEAR. TRIA CONTINUES TO LEAD THE WAY IN OUTCOMES MEASUREMENT. PATIENTS COMPLETE EXTENSIVE PRE AND POST SURVEYS TO ASSESS FUNCTIONAL OUTCOMES ON EIGHT DIFFERENT PROCEDURE TYPES. SOME OF TRIA'S PATIENT REGISTRIES ARE NOW AMONGST THE MOST EXTENSIVE IN THE INDUSTRY. EVERY TUESDAY MORNING THROUGHOUT THE ACADEMIC YEAR TRIA PROVIDES PROFESSIONAL EDUCATION SESSIONS FOR OVER 1,000 ATTENDEES, INCLUDING OUR STAFF, FELLOWS, AND CLINICAL STAFF IN THE AREA, NUMEROUS STUDENTS AND RESIDENTS. TRIA'S ANNUAL ORTHOPAEDIC AND SPORTS MEDICINE CONFERENCE DREW OVER 250 PROFESSIONALS ACROSS THE U.S. TRIA'S PHYSICIANS AND STAFF HAD 11 PUBLICATIONS, 19 PRESENTATIONS, AND 1 BOOK CHAPTER. THEIR OUTCOMES PROGRAM ENROLLED 1,614 PATIENTS. THE TRIA INSTITUTE PROVIDES SEVERAL SESSIONS OF "A DAY IN THE LIFE OF AN ORTHOPAEDIC SPECIALIST" PROGRAM. THIS EDUCATIONAL PROGRAM IS FOR STUDENTS IN THE COMMUNITY THAT WOULD LIKE TO LEARN MORE ABOUT THE HEALTHCARE PROFESSION, SPECIFICALLY ORTHOPAEDICS, AND INCLUDES THE SHADOWING OF TRIA CLINICIANS. THERE WERE 128 ATTENDEES IN THESE SESSIONS. VOLUNTEER ACTIVITIES TRIA EMPLOYEES RAISED MORE THAN $4,000 THROUGH THE JEANS FOR A CAUSE PROGRAM. EMPLOYEES WHO CONTRIBUTED $5 WERE ALLOWED TO WEAR JEANS ON FRIDAYS. WEARING THE JEANS FOR A CAUSE STICKER SIGNIFIES THE FUND RAISING ASPECT OF THE PROGRAM TO PATIENTS. THE MONEY RAISED WENT TO COMMUNITY CHARITIES SUCH AS: DYNOMITES, VEAP (VOLUNTEERS ENLISTED TO ASSIST PEOPLE), OASIS FOR YOUTH, PRICELESS FOR PURPOSE, AND A NUMBER OF TRIA EMPLOYEES STRUGGLING WITH MEDICAL ISSUES. TRIA TEAM MEMBERS PARTICIPATE IN VOLUNTEER ACTIVITIES INCLUDING: PACKING FOOD FOR SECOND HARVEST HEARTLAND FOOD SHELF MATTRESS RACING DOWN BUCK HILL SUPPORTING THE BIRTHDAY PARTY PROJECT COLLECTING DONATIONS FOR FOOD DRIVES, BOOK DRIVES AND HOLIDAY TOY DRIVES FOR VEAP RUNNING THE JINGLE BELL RUN FOR THE ARTHRITIS FOUNDATION HOSTING A BLOOD DRIVE AT TRIA FOR MEMORIAL BLOOD CENTERS SUPPORTING VEAP BY ATTENDING THE YEARLY GALA AND THE A TOAST TO VEAP EVENT. TRIA PHYSICIANS AND PROFESSIONAL STAFF, INCLUDING PHYSICAL THERAPISTS AND HAND THERAPISTS FREQUENTLY SPEAK TO COMMUNITY GROUPS. THIS PAST YEAR 15 SUCH SESSIONS WERE PROVIDED.
FORM 990, PART VI, SECTION A, LINE 6HEALTHPARTNERS, INC IS THE SOLE MEMBER OF PARK NICOLLET HEALTH SERVICES.
FORM 990, PART VI, SECTION A, LINE 7ATHE PERSONS WHO SERVE AS THE BOARD OF DIRECTORS OF HEALTHPARTNERS, INC. ALSO SERVE AS THE BOARD OF DIRECTORS OF PNHS. HEALTHPARTNERS, INC. IS A MINNESOTA LICENSED HEALTH MAINTENANCE ORGANIZATION. THE BOARD OF HEALTHPARTNERS, INC. IS COMPRISED OF A MAJORITY OF DIRECTORS WHO ARE ELECTED BY HMO MEMBERS (PERSONS HOLDING HMO CONTRACTS), AND A MINORITY OF DIRECTORS WHO ARE EITHER HEALTH CARE PROFESSIONALS APPOINTED BY THE BOARD OR WHO ARE SERVING EX OFFICIO.
FORM 990, PART VI, SECTION A, LINE 7BPNHS' BYLAWS ESTABLISH THAT THE PERSONS SERVING AS THE BOARD OF DIRECTORS OF THE SOLE MEMBER, ALSO SERVE AS THE BOARD OF DIRECTORS OF PNHS. IN THE EVENT THAT THE PNHS BOARD OF DIRECTORS WERE EVER COMPOSED OF PERSONS WHO ARE NOT ALSO CONTEMPORANEOUSLY SERVING AS THE DIRECTORS OF THE SOLE MEMBER, THEN THE SOLE MEMBER WOULD EXERCISE CUSTOMARY RESERVE POWERS WITH RESPECT TO THE PNHS BOARD OF DIRECTORS (E.G. APPROVAL OF BUDGETS, APPROVAL OF MERGER, APPROVAL OF APPOINTMENT OF THE CHIEF EXECUTIVE OFFICER, APPROVAL OF DISSOLUTION, ETC.).
FORM 990, PART VI, SECTION B, LINE 11BPARK NICOLLET HEALTH SERVICES PREPARES THE FORM 990 WITHIN THE FINANCE DEPARTMENT WITH ASSISTANCE FROM INDIVIDUALS IN HUMAN RESOURCES, MARKETING, AND OPERATIONS. UPON COMPLETION OF GATHERING THE NECESSARY INFORMATION FOR THE RETURN, THE FORM WAS COMPILED AND DRAFTS WERE REVIEWED BY THE ASSISTANT CONTROLLER - ACCOUNTING OPERATIONS, VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER, THE LAW DEPARTMENT, THE AUDIT AND COMPLIANCE COMMITTEE AND PARK NICOLLET'S ACCOUNTING FIRM. AFTER ALL REVIEWS WERE COMPLETE; THE FORM 990 WAS GIVEN TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12CAT PARK NICOLLET HEALTH SERVICES ALL KEY EMPLOYEES, DIRECTORS, AND OFFICERS ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST DISCLOSURE STATEMENT EACH YEAR; HOWEVER THE OBLIGATION TO REPORT POTENTIAL CONFLICTS IS ONGOING. PARK NICOLLET HEALTH SERVICES BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES PURSUANT TO ITS CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS AND OFFICERS ANNUALLY ARE PROVIDED A COPY OF THE POLICY AND REQUIRED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNSEL REVIEWS THE COMPLETED QUESTIONNAIRES AND PROVIDES A REPORT TO THE GOVERNANCE COMMITTEE OF THE BOARD. THE REPORT IDENTIFIES ANY SIGNIFICANT POTENTIAL CONFLICTS DISCLOSED IN THE COMPLETED QUESTIONNAIRES. A WRITTEN REPORT IS PROVIDED TO THE CHAIR AND CHIEF EXECUTIVE OFFICER (CEO). BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY.
FORM 990, PART VI, SECTION B, LINE 15PARK NICOLLET HAS AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF ITS PRESIDENT AND ITS OTHER OFFICERS. EVERY THREE YEARS, UNDER THE DIRECTION OF THE BOARD OF DIRECTORS' COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE (COMPENSATION COMMITTEE), A TOTAL COMPENSATION MARKET REVIEW IS COMPLETED BY AN EXTERNAL COMPENSATION CONSULTANT. THE REVIEW INCLUDES ALL COMPONENTS OF COMPENSATION; BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE INDEPENDENT BOARD COMPENSATION COMMITTEE. BASED ON THIS MARKET DATA, THE COMPENSATION COMMITTEE DETERMINES MINIMUM AND MAXIMUM TOTAL COMPENSATION RANGES FOR EACH OFFICER. IN INTERIM YEARS, GROUP HEALTH PLAN, INC. (AN AFFILIATE OF PNHS) HUMAN RESOURCES STAFF, UNDER THE DIRECTION OF THE COMPENSATION COMMITTEE, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION CONSULTANT FOR THE COMPENSATION COMMITTEE. FOR CERTAIN POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED TO SET SALARY RANGES BASED ON THE COMPETITIVE MARKET DATA SPECIFIC TO THOSE POSITIONS. THE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S COMPENSATION RESULTS. IN ALL CASES, COMMITTEE MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMPENSATION COMMITTEE 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. THE BOARD HAS DELEGATED TO THE TO THE PRESIDENT & CEO (WITH AUTHORITY TO FURTHER DELEGATE TO EXECUTIVES WITH LEADERSHIP ROLES OF PARK NICOLLET OFFICERS) THE ACCOUNTABILITY TO CONDUCT ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL PARK NICOLLET OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMPENSATION COMMITTEE. ANY EXCEPTIONS TO COMPENSATION IN EXCESS OF THE APPROVED RANGES ARE APPROVED BY THE COMPENSATION COMMITTEE. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND W2 STATEMENTS.
FORM 990, PART VI, SECTION C, LINE 19PARK NICOLLET HEALTH SERVICES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. PARK NICOLLET HEALTH SERVICES MAILS ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS TO FINANCIAL INSTITUTIONS, GOVERNMENTAL INSTITUTIONS, BOARD MEMBERS, MEDIA REPRESENTATIVES, VENDORS, AND THE MINNESTOA HOSPITAL ASSOCIATIONS(MHA) PARK NICOLLET HEALTH SERVICES DISCLOSES QUARTERLY FINANCIAL STATEMENTS TO BONDHOLDERS AND MHA. THE ANNUAL AUDITED AND QUARTERLY FINANCIAL STATEMENTS ARE ALSO POSTED AT EMMA.MSRB.ORG. THE FORMS 990 ARE AVAILABLE UPON REQUEST OR FROM THE STATE OF MINNESOTA OR AT GUIDESTAR.ORG.
FORM 990, PART VIIPURSUANT TO TREASURY REG SECTION 1.6033-2(D)(5), PARK NICOLLET HEALTH SERVICES HAS ELECTED TO REPORT INFORMATION ABOUT CONTRIBUTIONS, GIFTS & GRANTS, COMPENSATION, AND OTHER INFORMATION ABOUT OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, FORMER EMPLOYEES, CERTAIN OTHER HIGHLY PAID EMPLOYEES, CERTAIN PROFESSIONAL CONTRACTORS AND CERTAIN OTHER CONTRACTORS ON A CONSOLIDATED BASIS FOR ALL MEMBERS OF THE GROUP, INCLUDING THE PARENT ORGANIZATION, ON THE GROUP RETURN OF PARK NICOLLET GROUP RETURN (EIN 45-5023260.
FORM 990, PART IX, LINE 11GEMPLOYEES OF AFFILIATES: PROGRAM SERVICE EXPENSES 44,899,655. MANAGEMENT AND GENERAL EXPENSES 5,543,573. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 50,443,228. MANAGEMENT CONSULTANTS: PROGRAM SERVICE EXPENSES 396. MANAGEMENT AND GENERAL EXPENSES 1,860,522. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,860,918. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,313,929. MANAGEMENT AND GENERAL EXPENSES 2,782,994. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,096,923.
FORM 990, PART XI, LINE 9:POST RETIREMENT OBLIGATION 213,657. CAPITAL CONTRIBUTION 10,000,000. CONTRIBUTION FROM PNF -79,475.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDirect Controlling NADirectControllingNACd
DEFERRED COMPENSATION TRUST
6500 EXCELSIOR BLVDST LOUIS PARKMN55426411809020INVESTMENTSMN$14,257$1,686,596PARK NICOLLET HEALTH SERVICES
TRIA ORTHOPEDIC CENTER LLC
8100 NORTHLAND DRIVEBLOOMINGTONMN55431200034003HEALTH CAREMNPARK NICOLLET HEALTH SERVICES
HEALTHPARTNERS EAST SIDE HOLDING LLC
8170 33RD AVENUE SOUTH PO BOX 1309MINNEAPOLISMN554401309201282428REAL ESTATE HOLDING COMPANYDEN/A
HEALTHPARTNERS PROPERTY DEVELOPMENT COMPANY LLC
8170 33RD AVE S PO BOX 1309MPLSMN554401309455122853PROPERTY DEVELOPMENTMNN/A

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (27 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BLVDST LOUIS PARKMN55426410132080HEALTH CAREMN501(C)(3)170(B)(1) (A)(III)PARK NICOLLET HEALTH SERVICESYes (1)
PARK NICOLLET FOUNDATION
6500 EXCELSIOR BLVDST LOUIS PARKMN55426237346465GRANTS TO SERVE THE COMMUNITYMN501(C)(3)170(B)(1) (A)(VI)PARK NICOLLET HEALTH SERVICESYes (1)
PARK NICOLLET CLINIC
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416410834920HEALTH CAREMN501(C)(3)170(B)(1) (A)(III)PARK NICOLLET HEALTH SERVICESYes (1)
PARK NICOLLET HEALTH CARE PRODUCTS
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416010638901HEALTH CARE PRODUCTSMN501(C)(3)509(A)(3) TYPE IPARK NICOLLET HEALTH SERVICESYes (1)
PNMC HOLDINGS
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416101741792HEALTH CARE REAL ESTATEMN501(C)(3)509(A)(3) TYPE IIPARK NICOLLET HEALTH SERVICESYes (1)
TRIA ORTHOPEADIC CENTER RESEARCH INSTITUTE
8100 NOIRTHLAND DRIVEBLOOMINGTONMN55431200033919HEALTH CARE RESEARCH AND EDUCATIONMN501(C)(3)509(A)(3) TYPE IPARK NICOLLET HEALTH SERVICESYes (1)
HEALTHPARTNERS INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411693838HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATIONMN501(C)(4)0N/A
HPI - RAMSEY
8170 33RD AVE S PO BOX 1309MPLSMN554401309411793333CORPORATE PLANNING AND OVERSIGHTMN501(C)(3)509(A)(3) TYPE IHEALTHPARTNERS INC0
GROUP HEALTH PLAN INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309410797853STAFF MODEL HEALTH MAINTENANCE ORGANIZATIONMN501(C)(3)170(B)(1) (A)(III)HEALTHPARTNERS INC0
HEALTHPARTNERS INSTITUTE
8170 33RD AVE S PO BOX 1309MPLSMN554401309411670163HEALTHCARE EDUCATION & RESEARCHMN501(C)(3)509(A)(3) TYPE IHEALTHPARTNERS INC0
CAPITOL VIEW TRANSITIONAL CARE CENTER
8170 33RD AVE S PO BOX 1309MPLSMN554401309412011453POST HOSPITALIZATION PATIENT CAREMN501(C)(3)170(B)(1) (A)(III)HPI - RAMSEY0
REGIONS HOSPITAL
8170 33RD AVE S PO BOX 1309MPLSMN554401309410956618HOSPITALMN501(C)(3)170(B)(1) (A)(III)HPI - RAMSEY0
REGIONS HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309411888902PROVIDE SUPPORT TO HOSPITAL AND TO IMPROVE COMMUNITY HEALTHMN501(C)(3)170(B)(1) (A)(VI)HPI - RAMSEY0
RHSC INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411891928HEALTHCARE STAFFINGMN501(C)(3)509(A)(3) TYPE IIHEALTHPARTNERS INC0
RH-WISCONSIN
8170 33RD AVE S PO BOX 1309MPLSMN554401309202287016CORPORATE PLANNING AND OVERSIGHTWI501(C)(3)509(A)(3) TYPE IHPI - RAMSEY0
PHYSICIANS NECK AND BACK CLINICS
8170 33RD AVE S PO BOX 1309MPLSMN554401309270684883SPECIALTY PATIENT CAREMN501(C)(3)509(A)(3) TYPE IIGROUP HEALTH PLAN INC0
HUDSON HOSPITAL INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309390804125HOSPITALWI501(C)(3)170(B)(1) (A)(III)RH-WISCONSIN0
HUDSON HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391279567PROVIDE SUPPORT TO HOSPITAL AND TO IMPROVE COMMUNITY HEALTHWI501(C)(3)170(B)(1) (A)(VI)HUDSON HOSPITAL INC0
LAKEVIEW MEMORIAL HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309411386635PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTMN501(C)(3)509(A)(3) TYPE IISTILLWATER HEALTH SYSTEM0
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309410811697HOSPITALMN501(C)(3)170(B)(1) (A)(III)STILLWATER HEALTH SYSTEM0
STILLWATER MEDICAL GROUP
8170 33RD AVE S PO BOX 1309MPLSMN554401309830379473PHYSICIANS GROUPMN501(C)(3)509(A)(3) TYPE ISTILLWATER HEALTH SYSTEM0
STILLWATER HEALTH SYSTEM
8170 33RD AVE S PO BOX 1309MPLSMN554401309300221189CORPORATE PLANNING AND OVERSIGHTMN501(C)(3)509(A)(3) TYPE IIHPI - RAMSEY0
WESTFIELDS HOSPITAL INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309390808442HOSPITALWI501(C)(3)170(B)(1) (A)(III)RH-WISCONSIN0
WESTFIELDS HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391770913PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTWI501(C)(3)509(A)(3) TYPE IWESTFIELDS HOSPITAL INC0
RAMSEY INTEGRATED HEALTH SERVICES
8170 33RD AVE S PO BOX 1309MPLSMN554401309411503090IN-HOME PATIENT CAREMN501(C)(3)509(A)(2)HPI - RAMSEY0
AMERY REGIONAL MEDICAL CENTER INC -
8170 33RD AVE S PO BOX 1309MPLSMN554401309390908320HOSPITALWI501(C)(3)170(B)(1) (A)(III)RH-WISCONSIN0
AMERY REGIONAL MEDICAL CENTER FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309391726539PROVIDE SUPPORT TO HOSPITAL AND TO IMPROVE COMMUNITY HEALTHMN501(C)(3)170(B)(1) (A)(VI)AMERY REGIONAL MEDICAL CENTER INC0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1METHODIST BRAIN LAB LEASING LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BLVDAddressLine1Txt
CityST LOUIS PARKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55426ZIPCd
FieldValueIRS element (for citing)
EIN208725994EIN
Primary ActivitiesHEALTH CAREPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PARK NICOLLET METHODIST HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
PARK NICOLLET ENTERPRISES
6500 EXCELSIOR BLVDST LOUIS PARKMN55426411656735REAL ESTATE FOR RELATED ORGANIZATIONMNPARK NICOLLET HEATLH SERVICESC$56,437$13,281,0481.000000
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 SPECIALITIES INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309451297583PROFESSIONAL DENTAL SERVICESMNHEALTHPARTNERS ADMINISTRATORS INCC0
HEALTHPARTNERS CENTRAL MINNESOTA CLINICSINC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411236798MEDICAL CLINIC STAFFINGMNHEALTHPARTNERS 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 OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (22 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
PARK NICOLLET HEALTH CARE PRODUCTS
S$40,941,915COST
PARK NICOLLET HEALTH CARE PRODUCTS
L$306,147COST
PARK NICOLLET HEALTH CARE PRODUCTS
Q$160,199,938COST
PARK NICOLLET ENTERPRISES
Q$4,521,837COST
PARK NICOLLET METHODIST HOSPITAL
Q$524,820,216COST
PARK NICOLLET METHODIST HOSPITAL
K$1,418,743COST
PARK NICOLLET METHODIST HOSPITAL
L$5,196,050COST
PARK NICOLLET METHODIST HOSPITAL
S$217,788,313COST
PARK NICOLLET CLINIC
Q$588,607,061COST
PARK NICOLLET CLINIC
L$7,764,715COST
PARK NICOLLET CLINIC
S$760,635,619COST
PARK NICOLLET CLINIC
K$11,408,752COST
PNMC HOLDINGS
Q$1,651,528COST
PARK NICOLLET METHODIST HOSPITAL (TRIA)
P$103,909COST
PARK NICOLLET METHODIST HOSPITAL (TRIA)
M$2,340,785COST
PARK NICOLLET HEALTH CARE PRODUCTS (TRIA)
P$1,472,783COST
PARK NICOLLET CLINIC (TRIA)
P$6,333,564COST
PARK NICOLLET ENTERPRISES (TRIA)
P$2,723,354COST
PARK NICOLLET ENTERPRISES (TRIA)
K$2,279,155COST
TRIA ORTHOPAEDIC CENTER RESEARCH INSTITUTE (TRIA)
J$234,147COST
PARK NICOLLET HEALTH CARE PRODUCTS (TRIA)
K$202,016COST
PARK NICOLLET HEALTH SERVICES
B$79,475COST

Affiliated Group Schedule AffiliatedGroupSchedule

Affiliated Schedule AffiliatedScheduleGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINElecting OrganizationElectingOrganizationIndTotal Grassroots LobbyTotalGrassrootsLobbyAmtTotal Direct LobbyTotalDirectLobbyAmtTotal Lobby ExpenditureTotalLobbyExpenditureAmtOther Exempt Purpose ExpendOtherExemptPurposeExpendAmtTotal Exempt Purpose ExpendTotalExemptPurposeExpendAmtLobby NontxLobbyNontxAmtGrassroots NontxGrassrootsNontxAmtTotal Lobby Grssroot Mns NontxTotalLobbyGrssrootMnsNontxAmtTot Lbby Expend Mns Lobby NontxTotLbbyExpendMnsLobbyNontxAmtShare Excess Lobby ExpendShareExcessLobbyExpendAmt
PARK NICOLLET HEALTH SERVICES
6500 EXCELSIOR BOULVARDST LOUIS PARKMN55426363465840Yes (X)$0$0$0$91,641,994$91,641,994$1,000,000$250,000$0$0$0
PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BOULVARDST LOUIS PARKMN55426410132080$0$28,766$28,766$533,821,341$533,850,107$1,000,000$250,000$0$0$0
PARK NICOLLET CLINIC
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416410834920$0$59,712$59,712$789,358,206$789,417,918$1,000,000$250,000$0$0$0
PARK NICOLLET HEALTH CARE PRODUCTS
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416010638901$0$0$0$76,068,439$76,068,439$1,000,000$250,000$0$0$0
PNMC HOLDINGS
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416411741792$0$0$0$20,025$20,025$4,005$1,001$0$0$0

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