2016-11-14T09:41:15-06:00 2015-12-31 135665207 KPMG LLP 4200 WELLS FARGO CTR 90 S 7TH STREET MINNEAPOLIS MN 55402 990 2015-01-01 830379473 STILLWATER MEDICAL GROUP STIL 9528836584 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 DOUGLAS E JOHNSON CFO 9528836584 2016-11-14 1 ANN LAMOUREUX P00691316 6123055000 2015 2017-02-10 21:41:12Z DOUGLAS E JOHNSON 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 53366744 0 X WWW.STILLWATERMEDICALGROUP.COM X 2003 MN TO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEY. 8 1 567 0 0 0 929411 800000 50658317 52135299 5484 552 394520 355611 51987732 53291462 3000 0 0 0 45472090 45809755 0 0 0 14269617 15088920 59744707 60898675 -7756975 -7607213 27527482 25151263 4634446 6007676 22893036 19143587 X TO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEY. 0 0 54097813 0 52135299 SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS 54097813 1 1 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 0 0 0 1 0 0 1 567 1 0 0 0 0 0 0 0 0 0 0 X 8 1 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 STREET WEST STILLWATER MN 55082 X ANDY ROLLWAGEN DIRECTOR 0.04 X 0 0 0 ANDREW E DORWART MD PRESIDENT & CHAIR & DIRECTOR 51.50 2.50 X X 375744 0 51000 BRIAN H RANK MD DIRECTOR 0.50 51.50 X 0 794689 144358 MARTHA SANFORD MD VICE CHAIR & DIRECTOR 49.50 0.50 X 240484 0 40552 STEPHEN M SCALLON MD DIRECTOR 36.00 X 286240 0 29533 THOMAS J STORMONT MD DIRECTOR & SECRETARY 70.00 X 797234 0 57619 DON WESSELL MD DIRECTOR 50.00 X 224131 0 41777 TED WEGLEITNER DIRECTOR 1.00 44.00 X 0 415596 84220 DOUGLAS E JOHNSON DIRECTOR, TREASURER & CFO 4.00 51.00 X 0 296775 36439 MATTHEW RICHIE DIRECTOR & CLINIC ADMINISTRATOR 47.00 X 232927 0 35451 MARK GEORGE MD PHYSICIAN 40.00 X 418199 0 46864 DAVID R HENLY MD PHYSICIAN 45.00 X 527257 0 49665 AMY C FOX MD PHYSICIAN 60.00 X 517640 0 48426 ERIC J SATERBAK MD PHYSICIAN 50.00 X 599035 0 51310 KEVIN J BJORK MD PHYSICIAN 45.00 X 452493 0 47160 JEFFREY J ROBERTSON FORMER DIRECTOR & CEO 0.50 39.50 X 0 543591 37818 4671384 2050651 802192 73 1 1 0 I S S FACILITY SERVICES 4222 PARK GLEN RD ST LOUIS PARK MN 55416 FACILITY MAINTENANCE 316751 METROPOLITAN MECHANICAL CONTRACTORS 7450 FLYING CLOUD DRIVE EDEN PRAIRIE MN 55344 CONSTRUCTION 206412 ST PAUL RADIOLOGY 166 4TH ST E ST PAUL MN 551011421 RADIOLOGY PROFESSIONAL SERVICES 173489 PHILIPS HEALTHCARE PO BOX 100355 ATLANTA GA 303840355 MED. EQUIP. SUPPORT 127134 4 800000 800000 NET PATIENT REVENUES 621400 48399265 48399265 PHYSICIAN COVERAGE 624410 3736034 3736034 52135299 552 552 72288 75282 -2994 -2994 -2994 MISCELLANEOUS REVENUE 900099 358605 358605 358605 53291462 52135299 0 356163 2412692 2412692 37032020 34281033 2750987 1547640 1465404 82236 2996804 2837564 159240 1820599 1723858 96741 523450 457251 66199 21065 1260 19805 954039 532914 421125 254257 174609 79648 1446676 1363117 83559 26498 8663 17835 13113 3997 9116 158964 158964 3202970 2658976 543994 867237 840256 26981 SUPPLIES - MEDICAL 4405812 4401309 4503 MAINTENANCE & REPAIR 1497728 210385 1287343 TAXES & ASSESSMENTS 1001329 13602 987727 RECRUITMENT, TRAINING & 451075 379590 71485 264707 172369 92338 60898675 54097813 6800862 0 1630816 1485888 4099782 3751618 668691 646046 210993 146959 31841884 12721132 20917200 19120752 27527482 25151263 4634446 6007676 4634446 6007676 X 22893036 19143587 22893036 19143587 27527482 25151263 X -7607213 3857764 X 0 1 X 1 0 X 1775103 1824510 1566795 929411 800000 6895819 32822761 43852723 49802312 50658317 52135299 229271412 34597864 45677233 51369107 51587728 52935299 236167231 0 907322 384068 270641 1562031 907322 384068 270641 1562031 234605200 1282 3898 -1278 5484 552 9938 1282 3898 -1278 5484 552 9938 34599146 45681131 51367829 51593212 52935851 236177169 0.99330 0.99350 0.00000 0.00030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 0 0 PART II-B, LINE 1: STILLWATER MEDICAL GROUP PAYS FOR CERTAIN CORPORATE AND EMPLOYEE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES. 746204 746204 24043688 7829578 16214110 72269 27608 44661 6979723 4863946 2115777 19120752 X 53366744 0 53366744 -75282 -75282 53291462 60973957 75282 75282 60898675 0 60898675 PART X, LINE 2: STILLWATER MEDICAL GROUP 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, 2015 OR 2014 FOR UNRECOGNIZED TAX BENEFITS. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSE -75,282. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 75,282. X X X X 1 1 0 0 0 1 1 0 0 ANDREW E DORWART MD PRESIDENT & CHAIR & DIRECTOR 371391 0 0 0 4353 0 19966 0 31034 0 426744 0 0 0 BRIAN H RANK MD DIRECTOR 0 581191 0 156086 0 57412 0 99590 0 44768 0 939047 0 33761 MARTHA SANFORD MD VICE CHAIR & DIRECTOR 240484 0 0 0 0 0 13298 0 27254 0 281036 0 0 0 STEPHEN M SCALLON MD DIRECTOR 279574 0 0 0 6666 0 15752 0 13781 0 315773 0 0 0 THOMAS J STORMONT MD DIRECTOR & SECRETARY 787371 0 0 0 9863 0 22973 0 34646 0 854853 0 0 0 DON WESSELL MD DIRECTOR 224131 0 0 0 0 0 12999 0 28778 0 265908 0 0 0 TED WEGLEITNER DIRECTOR 0 343418 0 72178 0 0 0 48981 0 35239 0 499816 0 0 DOUGLAS E JOHNSON DIRECTOR, TREASURER & CFO 0 273514 0 9643 0 13618 0 5300 0 31139 0 333214 0 0 MATTHEW RICHIE DIRECTOR & CLINIC ADMINISTRATOR 217927 0 15000 0 0 0 9100 0 26351 0 268378 0 0 0 MARK GEORGE MD PHYSICIAN 413618 0 0 0 4581 0 17714 0 29150 0 465063 0 0 0 DAVID R HENLY MD PHYSICIAN 499992 0 0 0 27265 0 18933 0 30732 0 576922 0 0 0 AMY C FOX MD PHYSICIAN 494866 0 0 0 22774 0 19301 0 29125 0 566066 0 0 0 ERIC J SATERBAK MD PHYSICIAN 573318 0 0 0 25717 0 19716 0 31594 0 650345 0 0 0 KEVIN J BJORK MD PHYSICIAN 448115 0 0 0 4378 0 17512 0 29648 0 499653 0 0 0 JEFFREY J ROBERTSON FORMER DIRECTOR & CEO 0 261718 0 500 0 281373 0 5300 0 32518 0 581409 0 0 PART I, LINES 4A-B SCHEDULE J, PARK I, LINE 4A THE AMOUNT OF SEVERANCE COPENSATION PROVIDED TO EACH OF THE INDIVIDUALS ON SEVERANCE DURING 2015 IS AS FOLLOWS: JEFFERY ROBERTSON $197,084 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: BRIAN H. RANK $ 33,609 TED WEGLEITNER $ 29,106 -------- TOTAL $ 62,715 ======== PART I, LINE 6 STILLWATER MEDICAL GROUP'S (SMG) OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE EMPLOYED BY SMG, LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. (THE HOSPITAL) OR BY GROUP HEALTH PLAN, INC. (GHI). THE HOSPITAL AND GHI ARE BOTH RELATED ORGANIZATIONS. COMPENSATION REPORTED IN FORM 990, PART VIII INCLUDES ANY COMPENSATION DERIVED FROM EITHER SMG'S, THE HOSPITAL'S, OR GHI'S MANAGEMENT INCENTIVE PROGRAMS, WHICH INCENT AND REWARD BUSINESS LEADERS WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC FISCAL YEAR. THE PROGRAMS ARE A KEY ELEMENT OF THE PARTICIPANT'S TOTAL COMPENSATION PACKAGE. THE MANAGEMENT INCENTIVE PROGRAMS' REWARDS ARE BASED ON POSITION IN THE ORGANIZATION (E.G. SENIOR VICE PRESIDENT, VICE PRESIDENT, DIRECTOR, MANAGER, AND OTHER SPECIFICALLY IDENTIFIED LEADERS) AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATION'S STRATEGIC PLAN AND WILL BE BALANCED. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, EMPLOYEE AND/OR LEADERSHIP DEVELOPMENT, CARE DELIVERY, PATIENT EDUCATION, SIX AIMS, MARKET SHARE, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE (NET MARGIN), ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. A NET MARGIN THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. 990, SCHEDULE J, PART II: PRIOR REPORTED 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 DIRECTOR: BRIAN H. RANK, MD $ 33,761 ANY ANALYSIS OF EARNINGS FOR THE CURRENT YEAR, FOR THIS PARTICIPANT 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 CORPORATE STRUCTURE, PURPOSE, GOVERNANCE STILLWATER MEDICAL GROUP (SMG) 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, ALL AT THE SAME TIME. 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 PLAN'S SERVE MORE THAN 1.5 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,700 PHYSICIANS, SIX HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, AND 93 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN. IN ADDITION, HEALTHPARTNERS DENTAL CARE SYSTEM HAS MORE THAN 60 DENTISTS AND 24 DENTAL CLINICS. HEALTHPARTNERS ALSO CONTRACTS WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS LOCATED PRIMARILY IN MINNESOTA AND WESTERN WISCONSIN. 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 2015 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, STILLWATER HEALTH SYSTEM (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 ASSOCIATION(HOSPITAL), LAKEVIEW HOSPITAL FOUNDATION(FOUNDATION), AND SGM. ALL THREE ENTITIES ARE MINNESOTA 501(C) (3) TAX EXEMPT ORGANIZATIONS. CHARITY CARE: TOTAL CHARITY CARE PROVIDED (CALCULATED AT COST) WAS $99,714 DURING THIS REPORTING PERIOD. CHARITY CARE IS DEFINED AS THE COST OF CARE DELIVERED TO PATIENTS WHO ARE WILLING, BUT UNABLE TO PAY FOR THE SERVICES THEY RECEIVE. THIS INCLUDES PATIENTS WHOSE CHARGES ARE FORGIVEN OR REDUCED BECAUSE OF INABILITY TO PAY, PATIENTS WHO ARE UNABLE TO PAY THE BALANCE LEFT BY ANY PAYER, AND PATIENTS FOR WHOM UNUSUAL CIRCUMSTANCES OR SPECIAL FINANCIAL HARDSHIP WARRANT SPECIAL CONSIDERATION. BENEFIT TO THE COMMUNITY: SMG CONTINUES TO WORK IN PARTNERSHIP WITH OTHER HEALTHPARTNERS ORGANIZATIONS AND THE COMMUNITY TO PROMOTE COMMUNITY HEALTH THROUGH CLINICAL INITIATIVES, EDUCATION AND OUTREACH, AND COMMUNITY HEALTH IMPROVEMENT EFFORTS SUCH AS THE POWERUP INITIATIVE. SMG CONTINUES TO BE AN INTEGRAL PART OF THE STILLWATER COMMUNITY AND SURROUNDING AREA. SMG OFFERS PRIMARY AND SPECIALTY SERVICES WITH MEDICAL CLINICS LOCATED IN STILLWATER, OAK PARK HEIGHTS AND MAHTOMEDI, MN AND SOMERSET, WI. IN ADDITION, SMG PROVIDES OUTREACH SPECIALTY SERVICES TO WHITE BEAR LAKE, MN AND HUDSON, NEW RICHMOND AND OSCEOLA, WI. SMG OFFERS URGENT CARE, FAMILY MEDICINE, EMERGENCY MEDICINE, HOSPITALISTS, INTERNAL MEDICINE, NEUROLOGY, PEDIATRICS AND ADOLESCENT MEDICINE, OB/GYN, GENERAL SURGERY, PODIATRY, ENT, AUDIOLOGY, GASTROENTEROLOGY, PULMONOLOGY, RHEUMATOLOGY, OCCUPATIONAL HEALTH, RETAIL MEDICINE, SPORTS MEDICINE, ENDOCRINOLOGY, UROLOGY, ONCOLOGY AND CARDIOLOGY MEDICAL SERVICES. IN ADDITION TO PROFESSIONAL SERVICES, SMG ALSO OFFERS LABORATORY, IMAGING, HEARING AIDS, RETAIL PHARMACY AND PHYSICAL THERAPY ANCILLARY SERVICES. COMMUNITY HEALTH SERVICES: SMG HOSTS AND SPONSORS THE FOLLOWING COMMUNITY EVENTS: - COMMUNITY VEGGIE GIVEAWAY - FRESH VEGETABLES GROWN BY LOCAL PRODUCERS ARE GIVEN TO COMMUNITY MEMBERS AT ALL CLINIC CAMPUSES. APPROXIMATE COSTS FOR VEGETABLES GIVEN AWAY: - 2011 - $2,800 - 2012 - $2,900 - 2013 - $5,337 - 2014 - $6,017 - 2015 - $2,635 - NOTE: LEFTOVER PRODUCE FROM GIVEAWAYS GOES TO LOCAL COMMUNITY FOOD SHELVES - HOPS FOR HEALTH - ANNUAL MEN'S HEALTH BENEFIT TO COMMUNITY MEMBERS, INCLUDING FREE BLOOD PRESSURE AND BLOOD SUGAR CHECKS, AND THE OPPORTUNITY TO TALK WITH PROVIDERS ABOUT MEN'S HEALTH ISSUES. - PARTICIPATION IN POWERUP CANDY TRADE-IN - COMMUNITY MEMBERS CAN TRADE IN THEIR HALLOWEEN CANDY FOR HEALTHY, NON-CANDY PRIZES. CANDY IS THEN SENT TO MEMBERS OF THE MILITARY. - PARTICIPATION IN AMERICAN RED CROSS BLOOD DRIVES (TWO TIMES PER YEAR) - HOSTED AT THE MAIN CAMPUS FOR STAFF AND COMMUNITY DONATIONS. - LADIES NIGHT OUT - ANNUAL WOMEN'S HEALTH BENEFIT TO COMMUNITY MEMBERS, INCLUDING FREE BLOOD PRESSURE AND BLOOD SUGAR CHECKS, SCHEDULING OF MAMMOGRAMS, AND THE OPPORTUNITY TO TALK WITH PROVIDERS ABOUT WOMEN'S HEALTH ISSUES. - PARTNERSHIP WITH POWERUP FOR CHILDREN ACTIVITIES AND HEALTHY FOOD CHOICES. - PRESCRIPTION ASSISTANCE PROGRAM - HOUSED ON THE MAIN CAMPUS. - FREE COMMUNITY CLASSES HEALTH PROFESSIONAL EDUCATION: SMG OFFERS A TUITION REIMBURSEMENT PLAN TO ITS' CLINICAL AND NON-CLINICAL EMPLOYEES. TOTAL AMOUNT REIMBURSED TO EMPLOYEES IN 2015 WAS $32,164. SMG SUPPORTS HIGHER EDUCATION AND THE PROGRAM OFFERS EMPLOYEES TO FURTHER GROW THEIR KNOWLEDGE BASE AND WORK TOWARDS AN ADVANCED PROFESSIONAL DEGREE. SUBSIDIZED HEALTH SERVICES: SMG DOES NOT PROVIDE CLINICAL PROGRAMS THAT ARE PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDICAID SHORTFALLS. COMMUNITY BENEFIT OPERATIONS: SMG IS NOT REQUIRED TO COMPLETE A COMMUNITY NEEDS ASSESSMENT. FORM 990, PART III, LINE 4A ORGANIZATION AWARDS AND ACHIEVEMENTS: - RECOGNIZED BY HEALTHPARTNERS WITH PARTNERS IN EXCELLENCE GOLD PERFORMANCE AWARD IN ATTRIBUTED TOTAL COST OF CARE (2014) - RECOGNIZED BY HEALTHPARTNERS WITH PARTNERS IN EXCELLENCE GOLD PERFORMANCE AWARD IN OPTIMAL DIABETES CARE (2014) - RECOGNIZED BY HEALTHPARTNERS WITH PARTNERS IN EXCELLENCE GOLD PERFORMANCE AWARD IN OPTIMAL VASCULAR CARE (PRIMARY CARE) (2014) - TWO PHYSICIANS RECOGNIZED IN MPLS ST. PAUL MAGAZINE AS "TOP DOCTORS" 2015 - ONE PHYSICIAN RECOGNIZED IN MPLS ST. PAUL MAGAZINE AS "BEST DOCTOR" 2015 - RECOGNIZED BY THE MINNESOTA HEALTH ACTION GROUP WITH A MINNESOTA BRIDGES TO EXCELLENCE AWARD, FOR DELIVERING OPTIMAL CARE AND IMPROVING SPECIFIC PATIENT OUTCOMES (2014). - RECOGNIZED BY HEALTHPARTNERS PARTNERS IN EXCELLENCE WITH A GOLD PERFORMANCE AWARD IN ATTRIBUTED TOTAL COST OF CARE AND MNCM PEDIATRIC IMMUNIZATIONS (2013). - RECOGNIZED BY HEALTHPARTNERS PARTNERS IN EXCELLENCE WITH A SILVER PERFORMANCE AWARD IN OPTIMAL DEPRESSION CARE (2013). - RECOGNIZED BY HEALTHPARTNERS PARTNERS IN EXCELLENCE WITH A SILVER PERFORMANCE AWARD IN OPTIMAL LIFESTYLES (2013). - RECOGNIZED FOR PROVIDING TOP-QUALITY HEALTH CARE TO UCARE'S MEDICAID AND MINNESOTA SENIOR HEALTH OPTIONS (MSHO) MEMBERS (2013). - RECIPIENT OF A PARTNERS IN EXCELLENCE TOTAL COST OF CARE GOLD PERFORMANCE AWARD FROM HEALTHPARTNERS (2012). - RECIPIENT OF AN EXCELLENCE IN HEALTH CARE AWARD FROM UCARE FOR OUTSTANDING QUALITY RESULTS (2011). - THIRTEEN PROVIDERS WERE NAMED 'BEST DOCTORS FOR WOMEN' IN MINNESOTA MONTHLY (OCT 2011) - RECIPIENT OF INNOVATIONS IN HEALTH CARE WARD FOR REDUCING RISK IN VENOUS THROMBOEMBOLISM USING A TEAM APPROACH FROM HEALTHPARTNERS (2011) - RECOGNIZED BY CONSUMER REPORTS "GUIDE TO MINNESOTA PHYSICIAN'S" FOR HIGH QUALITY OF CARE (PRIMARY CARE) 2016 - TWO PHYSICIANS RECOGNIZED IN MPLS ST PAUL MAGAZINE AS "TOP DOCTORS RISING STAR'S " LIST 2016 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS STILLWATER HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER HAS THE POWER TO RATIFY APPROVE AND REMOVE ALL MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS RESERVED TO ITSELF THE FOLLOWING POWERS CONCERNING THE GOVERNANCE OF THE CORPORATION: 1. RATIFICATION, APPROVAL AND REMOVAL ALL MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE. 2. APPROVAL OF ANY MISSION OR VISION STATEMENT OR STATEMENT OF CORPORATE PURPOSE ADOPTED BY THE ORGANIZATION. 3. APPROVAL OF THE ORGANIZATION'S STRATEGIC PLANS, CAPITAL BUDGETS, OPERATING BUDGETS AND FINANCIAL POLICIES. 4. APPROVAL OF ANY PLANS OF MERGER OR CONSOLIDATION BY THE ORGANIZATION WITH ANY FOREIGN OR DOMESTIC ORGANIZATION VOLUNTARY DISSOLUTION OF THE ORGANIZATION, OR SALE, LEASE OR TRANSFER OF THE ORGANIZATION'S REAL ESTATE OR A SIGNIFICANT PORTION OF THE OPERATIONS OR ASSETS OF THE ORGANIZATION. 5. APPROVAL OF THE GRANT OF A SECURITY INTEREST IN ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS, OR THE INCURRENCE OF INDEBTEDNESS OR THE GUARANTEE OF ANY INDEBTEDNESS. 6. APPROVAL OF INDIVIDUAL CAPITAL EXPENDITURES BY THE ORGANIZATION, WHETHER BUDGETED OR UNBUDGETED, IN EXCESS OF $500,000. 7. RATIFICATION OF SELECTION AND EVALUATION, AND TERMINATION, OF THE PRESIDENT OF THE ORGANIZATION. 8. APPROVAL OF PHYSICIAN, EMPLOYEE AND EXECUTIVE COMPENSATION PLANS FOR THE ORGANIZATION, INCLUDING CRITERIA FOR INCENTIVE COMPENSATION ARRANGEMENTS. 9. APPROVAL OF ALL SUBSTANTIVE AFFILIATIONS BETWEEN THE ORGANIZATION AND A THIRD PARTY. 10. APPROVAL OF CONFLICTS OF INTEREST POLICIES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 SMG'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF SMG. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF SMG, GHI'S INTERNAL LEGAL DEPARTMENT AND SMG'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF SMG. SMG MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY WILL BE PROVIDED IN A MAILING TO THE BOARD MEMBERS PRIOR TO THE FILING OF THE 990. EACH BOARD MEMBER WILL HAVE AN OPPORTUNITY TO COMMENT OR ASK QUESTIONS ABOUT THE 990 BEFORE IT IS FILED. THIS PROCESS WILL BE NOTED AND DOCUMENTED IN A WRITTEN MEMO IN THE FILES OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C SMG'S BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS AND OFFICERS ANNUALLY ARE PROVIDED WITH 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. A WRITTEN REPORT IS PROVIDED TO THE GOVERNANCE COMMITTEE, CHAIR AND CHIEF EXECUTIVE OFFICER (CEO). BOARD AGENDAS AND EXECUTIVE DECISIONS ARE DOCUMENTED IN RELATION TO THIS POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE STILLWATER MEDICAL GROUP (SMG) PRESIDENT AND OTHER OFFICERS ARE EMPLOYED BY SHS, A RELATED ORGANIZATION, OR BY SMG. SHS AND SMG HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF THE SMG'S PRESIDENT AND OTHER OFFICERS. EVERY THREE YEARS, THE INDEPENDENT COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF GROUP HEALTH PLAN, INC. (GHI) (A RELATED ORGANIZATION) (THE "COMMITTEE"), RETAINS AN EXTERNAL COMPENSATION EXPERT TO CONDUCT AN EXTENSIVE MARKET COMPARABILITY REVIEW FOR ALL OFFICERS OF THE ORGANIZATION. THE REVIEW INCLUDES ALL COMPONENTS OF TOTAL COMPENSATION: BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE APPROPRIATE COMMITTEE. BASED ON THIS DATA, EITHER THE COMPENSATION COMMITTEE OF THE STILLWATER HEALTH SYSTEM OR THE COMPENSATION COMMITTEE OF GHI (THE "COMMITTEES") DETERMINE MINIMUM AND MAXIMUM TOTAL COMPENSATION RANGES ARE DETERMINED FOR EACH EMPLOYED OFFICER. IN INTERIM YEARS, GHI'S HUMAN RESOURCES STAFF, UNDER THE COMMITTEES' DIRECTION, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION CONSULTANT FOR THE COMMITTEE. FOR CERTAIN POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED TO SET SALARY RANGES BASED ON THE COMPETITIVE MARKET DATA SPECIFIC TO THOSE POSITIONS. THE COMMITTEES REVIEW AND APPROVE EACH YEAR'S COMPENSATION RESULTS. IN ALL CASES, THE COMMITTEES' MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMMITTEES MEMBERS' INDEPENDENCE AND THIS IS UPDATED AT ANY MEETING AT WHICH DECISIONS ARE BEING MADE. STAFF (OTHER THAN THE SECRETARY TO THE BOARD) IS NOT IN THE ROOM DURING DELIBERATIONS OR VOTE INCLUDING EXECUTIVE SESSIONS, AND CONTEMPORANEOUS MINUTES ARE KEPT. WITH SMG'S BOARD OF DIRECTORS INPUT, THE CEO OF THE STILLWATER HEALTH SYSTEM CONDUCTS THE ANNUAL PERFORMANCE REVIEW AND, WITH THE COMPENSATION COMMITTEE OF THE SHS'S APPROVAL, DETERMINES THE COMPENSATION OF THE SMG PRESIDENT. THE SMG BOARD HAS DELEGATED TO THE CEO OF STILLWATER HEALTH SYSTEM THE ACCOUNTABILITY TO CONDUCT ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL SMG-EMPLOYED OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMMITTEE. ANY EXCEPTIONS TO COMPENSATION IN EXCESS OF THE APPROVED RANGES ARE APPROVED BY THE COMPENSATION COMMITTEE OF THE STILLWATER HEALTH SYSTEM. FORM 990, PART VI, SECTION C, LINE 19 SMG'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM SMG'S OR HEALTHPARTNERS. SMG'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE MINNESOTA SECRETARY OF STATE'S OFFICE. 990, PART VII, SEC A, LINE 1A, COL B: AVERAGE HOURS - RELATED ORGANIZATIONS THE COMPENSATED BOARD MEMBERS AND OFFICERS FREQUENTLY DEVOTE THEIR TIME TO MULTIPLE RELATED ORGANIZATIONS IN A PARTICULAR WEEK. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. FORM 990, PART XI, LINE 9: NET ASSET TRANSFER FROM LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. 3,857,764. 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 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 FOR EDUCATION AND RESEARCH 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411670163 HEALTHCARE EDUCATION & 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 POST HOSPITALIZATION PATIENT CARE 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 HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 170(B)(1) (A)(VI) HPI - 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CLAIMSHEALTHCARE SERVICES L 2241571 CASH AMOUNT