MAPLE GROVE HOSPITAL CORPORATION: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MAPLE GROVE HOSPITAL CORPORATION (EIN 20-8316475)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-09
- IRS object ID
- 201613149349301226
- Schema version
- 2015v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-09T10:39:49-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Baker Tilly Virchow Krause LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 S 6th St 2300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208316475 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Maple Grove Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MAPL | BusinessNameControlTxt |
| Phone | 7635811000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9875 Hospital Drive | AddressLine1Txt |
| City | Maple Grove | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55369 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Aaron Bloomquist | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 7635205048 | PhoneNum |
| Signature | 2016-11-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Lawrence H Mohr CPA | PreparerPersonNm |
| PTIN | P00447603 | PTIN |
| Phone | 6128764500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANDREW COCHRANE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9875 Hospital Drive | AddressLine1Txt |
| City | Maple Grove | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55369 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $173,784,604 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.maplegrovehospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | GENERAL ACUTE CARE HOSPITAL PROVIDING EMERGENCY SERVICES, MEDICAL AND SURGICAL SERVICES, OBSTETRICAL SERVICES, AND PEDIATRIC SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 1144 | TotalEmployeeCnt |
| Total Volunteers | 400 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $31,765 | PYContributionsGrantsAmt |
| CY Contributions Grants | $24,874 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $155,758,159 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $173,570,938 | CYProgramServiceRevenueAmt |
| PY Investment Income | $144,618 | PYInvestmentIncomeAmt |
| CY Investment Income | $76,340 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $155,934,542 | PYTotalRevenueAmt |
| CY Total Revenue | $173,672,152 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $55,773,861 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $61,478,627 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $84,733,560 | PYOtherExpensesAmt |
| CY Other Expenses | $87,074,216 | CYOtherExpensesAmt |
| PY Total Expenses | $140,507,421 | PYTotalExpensesAmt |
| CY Total Expenses | $148,552,843 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $15,427,121 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $25,119,309 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $184,132,742 | TotalAssetsBOYAmt |
| Total Assets EOY | $183,066,733 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $152,072,670 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $147,956,493 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $32,060,072 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $35,110,240 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO EMPOWER OUR CUSTOMERS TO ACHIEVE THEIR BEST HEALTH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $127,174,462 | ExpenseAmt |
| Revenue | $172,447,061 | RevenueAmt |
| Desc | Maple Grove Hospital is a GENERAL ACUTE CARE HOSPITAL PROVIDING EMERGENCY SERVICES, MEDICAL AND SURGICAL SERVICES, OBSTETRICAL SERVICES, AND PEDIATRIC SERVICES. IN ADDITION TO CHARITY AND UNCOMPENSATED CARE, MGH ALSO PROVIDES NUMEROUS COMMUNITY BENEFITS (AT NO COST OR BELOW COST) IN FURTHERANCE OF ITS CHARITABLE PURPOSE. MAPLE GROVE HOSPITAL PROVIDES A WIDE VARIETY OF BENEFITS TO THE COMMUNITY INCLUDING PROVIDING HEALTH RELATED EDUCATIONAL PROGRAMS SUCH AS SAFETY FAIR, CAR SEAT CLINICS, MENTAL HEALTH AND FIRST AID CLASSES, AND ASTHMA EDUCATION IN ELEMENTARY SCHOOLS. MAPLE GROVE HOSPITAL ALSO PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED COSTS TO RESIDENTS OF ITS COMMUNITY, PRIMARILY THROUGH (A) THE DIFFERENCE BETWEEN PUBLIC PROGRAM PAYMENTS (PRIMARILY MEDICARE AND MEDICAID) AND THE RELATED COSTS OF PROVIDING SUCH SERVICES, AND (B) SERVICES PROVIDED TO PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT WHO ARE DETERMINED UNABLE TO PAY BECAUSE OF ECONOMIC FACTORS. IN ADDITION, MAPLE GROVE CONTRIBUTES TO FUNDING MEDICAL CARE FOR THE UNINSURED THROUGH PAYMENT OF PATIENT SERVICE TAXES, WHICH INCLUDE THE MEDICAID SURCHARGE AND THE MINNESOTA CARE TAX ON CERTAIN NET REVENUE. | Desc |
| Total Program Service Expenses | $127,174,462 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 139 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1144 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Aaron Bloomquist | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7635205200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 Oakdale Avenue North | AddressLine1Txt |
| City | Robbinsdale | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55422 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| LOREN TAYLOR | |||||||||
| Board Chair, Pre April 2015 | 2.00 | 50.00 | Yes (X) | Yes (X) | $0 | $488,513 | $25,829 | ||
| J KEVIN CROSTON MD | |||||||||
| Board Chair, post April 2015 | 2.00 | 50.00 | Yes (X) | Yes (X) | $0 | $937,930 | $47,707 | ||
| Todd Ostendorf | |||||||||
| Treasurer | 2.00 | 50.00 | Yes (X) | Yes (X) | $0 | $518,356 | $44,328 | ||
| Dan Fromm | |||||||||
| Secretary | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| David Murphy | |||||||||
| Board Member, Part year | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Tiffany Zitzewitz | |||||||||
| Board Member | 2.00 | 50.00 | Yes (X) | $0 | $373,289 | $40,917 | |||
| Kelly Macken-Marble | |||||||||
| Board Member | 2.00 | 50.00 | Yes (X) | $0 | $369,512 | $33,612 | |||
| Chuck Mooty | |||||||||
| Board Member, Part year | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Jeff Wicklander | |||||||||
| Board Member | 2.00 | 50.00 | Yes (X) | $0 | $462,441 | $42,971 | |||
| Andrew Cochrane | |||||||||
| PRESIDENT | 50.00 | 0.00 | Yes (X) | $0 | $527,057 | $43,397 | |||
| Colleen Nadeau | |||||||||
| VP Patient Care Operations | 50.00 | 0.00 | $203,333 | $0 | $7,200 | Yes (X) | |||
| Pam Doorenbos | |||||||||
| MGH Medical Doctor | 50.00 | 0.00 | $167,593 | $0 | $6,019 | Yes (X) | |||
| Kelly Hadsall | |||||||||
| Pharmacist | 50.00 | 0.00 | $151,033 | $0 | $17,269 | Yes (X) | |||
| Karen Hall | |||||||||
| Pharmacist | 50.00 | 0.00 | $213,104 | $0 | $22,838 | Yes (X) | |||
| Jennifer Jensen | |||||||||
| Patient Care Facilitator | 50.00 | 0.00 | $142,354 | $0 | $20,444 | Yes (X) | |||
| Letty Tam | |||||||||
| Pharmacist | 50.00 | 0.00 | $155,630 | $0 | $10,316 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,033,047 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,677,098 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $362,847 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 58 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Aramark Healthcare Food | |||||
| 25271 Network place | chiCAGO | IL | 60673 | dietary | $1,417,665 |
| University of Minnesota Physicians | |||||
| 720 Washington Ave STE 200 | Minneapolis | MN | 55414 | Physician Services | $670,531 |
| Crothall Laundry Service Inc | |||||
| 13028 Collections Center Drive | ChiCAGO | IL | 60693 | Laundry | $633,273 |
| American Security LLC | |||||
| PO Box 1150 | Minneapolis | MN | 554801150 | Security | $563,306 |
| Oakdale OBGYN PA | |||||
| 3625 W 65th Street 100 | Edina | MN | 55435 | Physician Services | $322,260 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $24,874 | AllOtherContributionsAmt |
| Total Contributions | $24,874 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Patient Revenue | 621500 | $172,447,061 | $172,447,061 | |
| CONTRACT SERVICES | 900099 | $451,204 | $451,204 | |
| CMS/EHR PAYMENTS & OTHER | 900099 | $328,398 | $328,398 | |
| Gift Shop | 900099 | $275,082 | $275,082 | |
| All Other | 621910 | $69,193 | $69,193 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $173,570,938 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $167,192 | TotalRevenueColumnAmt |
| Exclusion | $167,192 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $21,600 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $112,452 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$90,852 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$90,852 | TotalRevenueColumnAmt |
| Exclusion | -$90,852 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $173,672,152 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $172,447,061 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,200,217 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,319 | TotalAmt |
| Management And General | $200,319 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,989,539 | TotalAmt |
| Program Services | $42,130,192 | ProgramServicesAmt |
| Management And General | $7,859,347 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $954,729 | TotalAmt |
| Program Services | $805,588 | ProgramServicesAmt |
| Management And General | $149,141 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,791,879 | TotalAmt |
| Program Services | $5,701,884 | ProgramServicesAmt |
| Management And General | $1,089,995 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,542,161 | TotalAmt |
| Program Services | $2,973,644 | ProgramServicesAmt |
| Management And General | $568,517 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,495,399 | TotalAmt |
| Program Services | $15,526,887 | ProgramServicesAmt |
| Management And General | $2,968,512 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,381 | TotalAmt |
| Program Services | $52,369 | ProgramServicesAmt |
| Management And General | $10,012 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,900 | TotalAmt |
| Program Services | $41,052 | ProgramServicesAmt |
| Management And General | $7,848 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,606,335 | TotalAmt |
| Program Services | $12,262,018 | ProgramServicesAmt |
| Management And General | $2,344,317 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,368 | TotalAmt |
| Program Services | $418,380 | ProgramServicesAmt |
| Management And General | $79,988 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,774,993 | TotalAmt |
| Program Services | $1,490,107 | ProgramServicesAmt |
| Management And General | $284,886 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,675,176 | TotalAmt |
| Program Services | $1,406,310 | ProgramServicesAmt |
| Management And General | $268,866 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,280 | TotalAmt |
| Program Services | $34,655 | ProgramServicesAmt |
| Management And General | $6,625 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,025,289 | TotalAmt |
| Program Services | $7,025,289 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,416,634 | TotalAmt |
| Program Services | $7,065,764 | ProgramServicesAmt |
| Management And General | $1,350,870 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $938,219 | TotalAmt |
| Program Services | $787,635 | ProgramServicesAmt |
| Management And General | $150,584 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Supplies | $21,707,347 | $18,223,318 | $3,484,029 |
| Government Taxes | $4,260,057 | $4,260,057 | |
| Bad Debt Expense | $4,068,857 | $4,068,857 | |
| Maintenance and Repairs | $2,551,102 | $2,141,650 | $409,452 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $903,879 | TotalAmt |
| Program Services | $758,806 | ProgramServicesAmt |
| Management And General | $145,073 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,552,843 | TotalAmt |
| Program Services | $127,174,462 | ProgramServicesAmt |
| Management And General | $21,378,381 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,450 | BOYAmt |
| EOY | $1,450 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,524,380 | BOYAmt |
| EOY | $30,389,819 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,973,894 | BOYAmt |
| EOY | $29,415,436 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,983,019 | BOYAmt |
| EOY | $2,342,653 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $580,655 | BOYAmt |
| EOY | $576,968 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $145,248,197 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $39,079,277 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,840,150 | BOYAmt |
| EOY | $106,168,920 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,204,436 | BOYAmt |
| EOY | $9,325,879 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,607,000 | BOYAmt |
| EOY | $3,607,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $417,758 | BOYAmt |
| EOY | $1,238,608 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $184,132,742 | BOYAmt |
| EOY | $183,066,733 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,311,850 | BOYAmt |
| EOY | $15,361,361 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,760,820 | BOYAmt |
| EOY | $132,595,132 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,072,670 | BOYAmt |
| EOY | $147,956,493 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,060,072 | BOYAmt |
| EOY | $35,110,240 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,060,072 | BOYAmt |
| EOY | $35,110,240 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $184,132,742 | BOYAmt |
| EOY | $183,066,733 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $25,119,309 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$119,141 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$21,950,000 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $110,079,635 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,507,892 | DepreciationAmt |
| Book Value | $90,571,743 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,168,562 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,571,385 | DepreciationAmt |
| Book Value | $15,597,177 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $106,168,920 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | MAPLE GROVE HOSPITAL EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2015 OR 2014. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,915,981 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,915,981 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01960 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,690,458 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,388,469 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,301,989 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03570 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,606,439 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,388,469 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,217,970 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05530 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $143,601 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $143,601 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,395,149 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,771,068 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$375,919 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,538,750 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,771,068 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$232,318 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35,145,189 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $27,159,537 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,985,652 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05630 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,426,437 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $30,630,891 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $32,348,224 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,717,333 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAPLE GROVE HOSPITAL CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9875 Hospital Drive | AddressLine1Txt |
| City | Maple Grove | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55369 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAPLE GROVE HOSPITAL CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.maplegrovehospital.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.maplegrovehospital.org | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.MAPLEGROVEHOSPITAL.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MAPLE GROVE HOSPITAL CORPORATION | Part V, Section B, Line 5: One of the key objectives in conducting the 2013 CHNA was to identify health issues which are most important to our community members and establish or strengthen community relationships to help address these health issues. This was accomplished in several ways. A Steering Committee composed of community leaders, social service providers, health care providers, school district employees, business representatives and a public health representative guided the assessment process and identification of health needs. Maple Grove Hospital convened 5 focus groups from target populations throughout the community. We further interviewed key stakeholders from local government, law enforcement, education, religious and community-based organizations. Lastly we conducted an online survey for business groups, the faith community and community members. The assessment was completed working in conjunction with Fairview Maple Grove Medical Center. |
| MAPLE GROVE HOSPITAL CORPORATION | Part V, Section B, Line 11: MAPLE GROVE HOSPITAL IDENTIFIED FOUR PRIORITY AREAS IN THE COMMUNITY HEALTH ASSESSMENT CONDUCTED IN 2013. THESE PRIORITY AREAS AND A SUMMARY OF SOME OF THE ACTIVITIES CONDUCTED TO ADDRESS THESE AREAS ARE:1. MENTAL HEALTH/BEHAVIORAL HEALTH - MAPLE GROVE HOSPITAL TOOK THE LEAD AND WORKED WITH NAMI AND OTHER COMMUNITY PARTNERS TO OFFER MENTAL HEALTH FIRST AID CLASSES TO COMMUNITY MEMBERS AND PROFESSIONALS IN THE COMMUNITY. MAPLE GROVE HOSPITAL CONTINUED INVOLVEMENT IN PARTNERSHIP FOR CHANGE AND JOINED PARTNERS IN PREVENTION TO WORK TO ADDRESS SUBSTANCE USE AMONG YOUTH IN THE COMMUNITY.2. INJURY PREVENTION - EVERY SPRING WE PARTNER WITH FAIRVIEW MAPLE GROVE MEDICAL CENTER TO OFFER THE BE HEALTHY, BE ACTIVE, BE SAFE: SAFETY FAIR AND BIKE RODEO. THE EVENT IS A PARTNERSHIP WITH THE MEDICAL CENTER AND LOCAL ORGANIZATIONS WHOSE GOAL IS TO PROVIDE SAFETY INFORMATION, EDUCATION AND RESOURCES TO THE COMMUNITY. MAPLE GROVE HOSPITAL CONTINUES TO BE ACTIVELY INVOLVED WITH THE LOCAL SAFE KIDS STEERING COMMITTEE. THIS COMMITTEE IS CHARGED WITH COLLABORATING WITH COMMUNITY PARTNERS TO PROVIDE INJURY PREVENTION EDUCATION ON VARIOUS TOPICS TO THE COMMUNITY. MAPLE GROVE HOSPITAL ALSO SENT ONE OF OUR CHILDBIRTH EDUCATORS TO CAR SEAT TECHNICIAN TRAINING. SHE HAS WORKED WITH SAFE KIDS AT CAR SEAT CLINICS AND PROVIDED CAR SEAT EDUCATION TO OUR FAMILY BIRTH CENTER STAFF. MAPLE GROVE HOSPITAL ALSO WORKED WITH SAFE KIDS TO OFFER TWO CAR SEAT CLINICS TO THE COMMUNITY AT MAPLE GROVE HOSPITAL.3. WELLNESS/BALANCE/EDUCATION - MAPLE GROVE HOSPITAL IN PARTNERSHIP WITH FAIRVIEW MAPLE GROVE MEDICAL CENTER TRAINED TWO STAFF MEMBERS TO BECOME ACTIVE LIVING EVERYDAY FACILITATORS. ACTIVE LIVING EVERYDAY CLASSES WERE OFFERED TO STAFF MEMBERS AND THE COMMUNITY. MAPLE GROVE HOSPITAL CURRENTLY WORKS WITH THE UNIVERSITY OF MINNESOTA AND AUGSBURG COLLEGE TO OFFER TRAINING SITES FOR HEALTH PROFESSIONAL STUDENTS. MAPLE GROVE HOSPITAL DISTRIBUTES INFORMATION ON LOCAL PUBLIC SCHOOL'S ECFE (EARLY CHILDHOOD AND FAMILY EDUCATION) PROGRAMS IN OUR CHILDBIRTH EDUCATION CLASSES AND TO ALL FAMILY BIRTH CENTER AND PEDIATRIC PATIENTS. MAPLE GROVE HOSPITAL HAS A STRONG WORKING RELATIONSHIP WITH THE MARCH OF DIMES AND PARTNERS WITH THEM ON THEIR ANNUAL "WALK FOR BABIES". MAPLE GROVE HOSPITAL IS ALSO WORKING WITH THE CITY OF MAPLE GROVE TO MAKE MAPLE GROVE AN AGE FRIENDLY CITY. MAPLE GROVE HOSPITAL IN PARTNERSHIP WITH UNIVERSITY OF MINNESOTA HEALTH MAPLE GROVE CLINICS OFFERED ACTIVE LIVING CLASSES THROUGH THE MAPLE GROVE PARKS AND RECREATION DEPARTMENT. UNFORTUNATELY THESE CLASSES WERE CANCELLED DUE TO LACK OF REGISTRATION.4. ASTHMA - MAPLE GROVE HOSPITAL FORMED AN ASTHMA TASK FORCE COMPOSED OF COMMUNITY MEMBERS AND LOCAL SCHOOL NURSES. A PARTNERSHIP WAS FORMED WITH FAIRVIEW MAPLE GROVE MEDICAL CENTER TO OFFER EDUCATION ON ASTHMA MANAGEMENT TO LOCAL SCHOOL DISTRICT SCHOOL NURSES. THIS EDUCATION WAS PROVIDED BY A PEDIATRICIAN FROM MAPLE GROVE HOSPITAL AND RESPIRATORY THERAPIST FROM FAIRVIEW MAPLE GROVE MEDICAL CENTER. EDUCATION ON ASTHMA WAS ALSO OFFERED TO PARENTS AND STUDENTS AT ONE OF THE ELEMENTARY SCHOOLS BY A PEDIATRICIAN FROM MAPLE GROVE HOSPITAL. |
| MAPLE GROVE HOSPITAL CORPORATION | Part V, Section B, Line 22d: The Minnesota Attorney General's Office requires hospitals to render services to those patients who do not have insurance at a reduced rate equal to the discount incurred from the highest volume managed care plan. |
| MAPLE GROVE HOSPITAL CORPORATION | Part V, Section B, Line 24: All services are charged to all patients at the same process per procedure regardless of insurance status. Payments for those services will vary depending on existing insurance arrangements, eligibility for charity and uninsured discounts. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - MINNESOTA DIAGNOSTIC IMAGING PARTNERS LL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2955 XENIUM LANE SUITE 40 | AddressLine1Txt |
| City | PLYMOUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55441 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | OUTPATIENT RADIOLOGY | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part III, Line 4: | Bad Debt Expense Ln 2 amount represents the hospital's bad debt provision reduced by the hospital's cost to charge ratio which represents the best estimate of cost for the bad debt provision. |
| Part III, Line 8: | The shortfall reported represents the amount the Medicare reimbursement is less than the estimated cost of providing services to those patients. The method used to estimate those costs is the Cost to Charge Ratio approach which calculates the ratio of total hospital costs / total hospital gross revenue and them applies that ratio to total Medicare gross revenue. |
| Part III, Line 9b: | Maple Grove Hospital Corporation has policies and procedures in place for collection practices that include identification and screening for charity care and financial assistance. The policies are available on the organization's intranet and each patient is given a brochure upon admission. |
| Part VI, Line 2: | Maple Grove Hospital works closely with community members to determine areas of interest and need in healthcare services. We are currently addressing the needs identified in our 2013 Community Health Needs Assessment. A new Community Health Needs Assessment will be conducted in 2016. |
| Part VI, Line 3: | Patient Financial Advocates at Maple Grove Hospital work with patients to identify assistance programs if they are determined to be uninsured. Maple Grove Hospital provides a patient reference document that covers this and describes that we "provide financial aid to patients based on their income, assets, and needs." |
| Part VI, Line 4: | WE SERVE A 27 ZIP-CODE AREA IN THE NORTHWEST SIDE OF THE TWIN CITIES. THIS IS BASED ON THE HOME ZIP CODES FOR 80% OF OUR INPATIENT PATIENT POPULATION. WE WORK WITH THE COMMUNITY TO ADDRESS COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. |
| Part VI, Line 5: | Maple Grove Hospital provides educational opportunities for community members to attend such as Health Care Directives, Kids Safety Fairs, and seminars on health topics. |
| Part VI, Line 6: | Maple Grove Hospital is a part of North Memorial Health System, which is committed to improving the health of the communities we serve. Through targeted outreach, education and partnerships, we improve the health of our communities by listening to their needs and responding with appropriate programs and services. Our programs, many of which have been nationally recognized, range from health education and free screenings to training health professionals. |
| Part VI, Line 7: | MAPLE GROVE HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE STATE OF MINNESOTA. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LOREN TAYLOR | ||||||||||||||
| Board Chair, Pre April 2015 | $0 | $208,239 | $0 | $272,516 | $0 | $7,758 | $0 | $18,550 | $0 | $7,279 | $0 | $514,342 | $0 | $0 |
| J KEVIN CROSTON MD | ||||||||||||||
| Board Chair, post April 2015 | $0 | $597,577 | $0 | $335,538 | $0 | $4,815 | $0 | $18,550 | $0 | $29,157 | $0 | $985,637 | $0 | $0 |
| Todd Ostendorf | ||||||||||||||
| Treasurer | $0 | $362,712 | $0 | $153,673 | $0 | $1,971 | $0 | $18,937 | $0 | $25,391 | $0 | $562,684 | $0 | $0 |
| Tiffany Zitzewitz | ||||||||||||||
| Board Member | $0 | $259,615 | $0 | $113,000 | $0 | $674 | $0 | $18,550 | $0 | $22,367 | $0 | $414,206 | $0 | $0 |
| Kelly Macken-Marble | ||||||||||||||
| Board Member | $0 | $314,232 | $0 | $53,803 | $0 | $1,477 | $0 | $13,212 | $0 | $20,400 | $0 | $403,124 | $0 | $0 |
| Jeff Wicklander | ||||||||||||||
| Board Member | $0 | $313,948 | $0 | $147,381 | $0 | $1,112 | $0 | $18,899 | $0 | $24,072 | $0 | $505,412 | $0 | $0 |
| Andrew Cochrane | ||||||||||||||
| PRESIDENT | $0 | $342,692 | $0 | $181,758 | $0 | $2,607 | $0 | $18,550 | $0 | $24,847 | $0 | $570,454 | $0 | $0 |
| Colleen Nadeau | ||||||||||||||
| VP Patient Care Operations | $174,131 | $0 | $28,560 | $0 | $642 | $0 | $5,067 | $0 | $2,133 | $0 | $210,533 | $0 | $0 | $0 |
| Pam Doorenbos | ||||||||||||||
| MGH Medical Doctor | $167,272 | $0 | $0 | $0 | $321 | $0 | $0 | $0 | $6,019 | $0 | $173,612 | $0 | $0 | $0 |
| Kelly Hadsall | ||||||||||||||
| Pharmacist | $133,954 | $0 | $16,984 | $0 | $95 | $0 | $4,502 | $0 | $12,767 | $0 | $168,302 | $0 | $0 | $0 |
| Karen Hall | ||||||||||||||
| Pharmacist | $193,042 | $0 | $19,797 | $0 | $265 | $0 | $6,385 | $0 | $16,453 | $0 | $235,942 | $0 | $0 | $0 |
| Jennifer Jensen | ||||||||||||||
| Patient Care Facilitator | $138,549 | $0 | $3,741 | $0 | $64 | $0 | $4,269 | $0 | $16,175 | $0 | $162,798 | $0 | $0 | $0 |
| Letty Tam | ||||||||||||||
| Pharmacist | $155,186 | $0 | $357 | $0 | $87 | $0 | $4,666 | $0 | $5,650 | $0 | $165,946 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | The Chief Executive Officer is an employee of North Memorial Health Care. Other board members listed with compensation from a related organization are officers and key employees of North Memorial Health Care who provide services to Maple Grove Hospital as well as to all or some related entities as identified on Schedule R. As such, their compensation levels incorporate services provided to multiple North Memorial entities. |
| Part I, Line 6 | North Memorial Health Care's annual incentive plan requires achievement of stated performance metrics, which include operating cash flow margin. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF MAPLE GROVE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 410873250 | BondIssuerEIN |
| CUSIP | 00056516M | CUSIPNum |
| Bond Issued | 2007-05-25 | BondIssuedDt |
| Issue Price | $149,139,758 | IssuePriceAmt |
| Purpose | Construction of a hospital facility | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | Yes (1) | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $9,265,000 | RetiredAmt |
| Total Proceeds | $149,139,758 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $2,686,779 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $146,452,979 | CapitalExpendituresAmt |
| Substantial Completion | 2009 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Date Rebate Computation Performed | FormAndLineReferenceDesc |
| Explanation | Issuer Name: CITY OF MAPLE GROVE Date the Rebate Computation was Performed: 06/05/2012 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | North Memorial Health Care, a related party, performs management duties on behalf of Maple Grove Hospital. |
| Form 990, Part VI, Section A, line 6 | Maple Grove Hospital has one class of members. North Memorial Health Care ("North Memorial") and Fairview Health Services ("Fairview") are the only members of the Corporation and both members are nonprofit, tax-exempt organizations under Section 501(c)(3) of the Internal Revenue Code. |
| Form 990, Part VI, Section A, line 7a | The Board of Directors is comprised of seven voting directors and one non-voting director, as follows: (a) The chief executive officer of North Memorial and four other directors appointed annually by North Memorial (b) The chief executive officer of Fairview and one other director appointed annually by Fairview and (c) the Maple Grove Hospital Chief Executive Officer. |
| Form 990, Part VI, Section A, line 7b | The members, and only the members, may take direct action on the following matters by unanimous member approval: (a) Amendments to the Articles of Incorporation; (b) Amendments to the bylaws; (c) merger or consolidation of the corporation (d) sale, lease or transfer or other disposition of all or substantially all of the assets of the Corporation; (e) joint ventures affecting substantially all of the assets or operations of the Corporation; (f) determination of the name under which the Hospital conducts business; (g) certain mortgages or other security interests; (h) issuance of capital calls; and (i) dissolution and liquidation of the Corporation. |
| Form 990, Part VI, Section B, line 11 | The management company and the board of directors review the Form 990 before it is filed. Representatives from the hospital's independent accounting firm review the Form 990 with the management company in detail and notes for the committee any changes in the Form 990 from prior years. After thorough discussion, the management company approves the Form 990 and forwards it to the board for its review. |
| Form 990, Part VI, Section B, line 12c | All members of the board of directors and all employees receive a copy of the conflict of interest policy each year. Each board member and staff member fills out a conflict of interest questionnaire in which they are asked to identify any relationship that would create a conflict of interest. The results are summarized and reviewed to determine any actual or potential conflict and are reported to the board of directors. |
| Form 990, Part VI, Section B, line 15 | Compensation for key positions are reviewed by the executive committee of North Memorial working in conjunction with an outside consultant. The executive committee of North Memorial insures that the salary and benefit administration review process is being followed, which includes salary and benefit surveys and comparisons of all positions. The CEO's compensation is sent to the full board for approval. The compensation of all other key positions is approved by the CEO. |
| Form 990, Part VI, Section C, line 19 | Governing documents and the conflict of interest policy are available upon request. Financial statements are available online through the office of the attorney general via the charity report filed with the state of Minnesota. |
| Form 990, Part XI, line 9: | Return of Capital to members -21,950,000. |
| FORM 990, PART XII, LINE 2C: | Neither the oversight process of the audit or the selection process of the independent accountant changed during the current tax year. |
| Form 990, Part XI, Line 9: | Return of Capital to Members: A RETURN OF CAPITAL IN THE AMOUNT OF $21,950,000 WAS MADE TO the MEMBERS OF THE ORGANIZATION. THE MEMBERS CONSIST OF NORTH MEMORIAL HEATH CARE AND FAIRVIEW HEALTH SERVICES. ALL MEMBERS ARE REQUIRED TO BE NON-PROFIT, TAX EXEMPT ORGANIZATIONS UNDER IRC SECTION 501(C)(3) PER THE BYLAWS OF THE ORGANIZATION. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTH MEMORIAL HEALTH CARE | |||||||||||
| 3300 Oakdale Avenue North | Robbinsdale | MN | 55422 | 410729979 | Acute Care | MN | 501(c)(3) | Line 3 | North Memorial | 0 | |
| NORTH MEMORIAL FOUNDATION | |||||||||||
| 3300 Oakdale Avenue North | Robbinsdale | MN | 55422 | 411777966 | FUNDRAISING | MN | 501(c)(3) | Line 7 | North Memorial | 0 | |
| Associated Health Assurance | |||||||||||
| 3300 Oakdale Avenue North | Robbinsdale | MN | 55422 | 980343815 | Insurance | 501(c)(3) | Line 11a, I | North Memorial | 0 | BD | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE LLC | |||||||
| 9855 HOSPITAL DRIVE | MAPLE GROVE | MN | 55369 | 260393039 | OUTPATIENT SURGERY | MN | N/A |
| MINNESOTA DIAGNOSTIC IMAGING PARTNERS LLC | |||||||
| 2955 XENIUM LANE SUITE 40 | PLYMOUTH | MN | 55441 | 352162215 | RADIOLOGY | MN | N/A |
| NORTH RADIATION THERAPY CENTER | |||||||
| 6950 FRANCE AVE S SUITE 200 | EDINA | MN | 55435 | 743069974 | RADIOLOGY | MN | N/A |
| BLAINE URGENCY CENTER LLC | |||||||
| 480 OSBORNE RD NE | FRIDLEY | MN | 55432 | 461630126 | URGENT CARE | MN | N/A |
| Plymouth City Center Medical Building | |||||||
| 5700 Smetana Drive Suite 120 | Minnetonka | MN | 55343 | 463883617 | Medical Office Building | MN | N/A |
| MInnetonka ambulatory surgery center | |||||||
| 3300 oakdale ave north | robbinsdale | MN | 55422 | 465653486 | outPATIENT SURGERY | MN | N/A |
| Crystal Imaging Center LLC | |||||||
| 2955 XENIUM LANE SUITE 40 | PLYMOUTH | MN | 55441 | 454265124 | RadIOLOGY | MN | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| OAKDALE HEALTH ENTERPRISES INC | |||||||||
| 3300 OAKDALE AVENUE NORTH | ROBBINSDALE | MN | 55422 | 411546422 | AMBULANCE | MN | N/A | C | 0 |
| NORTH COLLABORATIVE CARE | |||||||||
| 3300 Oakdale Avenue North | Robbinsdale | MN | 55422 | 461680666 | PRIMARY CARE | MN | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| North Memorial Health Care (cash transfer) | ||
| B | $16,462,500 | CASH |
| North Memorial Health Care (Debt Guarantee) | ||
| E | $100,755,000 | AMOUNT GUARANTEE |
| North Memorial Health Care (Lease payments) | ||
| K | $458,957 | AMOUNT PAID |
| North Memorial Health Care (Management fee) | ||
| R | $16,613,642 | AMOUNT PAID |
| North Memorial Health Care (Salary reimbursement) | ||
| P | $7,847,823 | AMOUNT PAID |
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