2016-11-11T08:22:01-06:00 2015-12-31 990 2015-01-01 411713783 MAYO CLINIC HEALTH SYSTEM - RED WING MAYO 5075381297 701 HEWITT BLVD RED WING MN 55066 JAMES J TARASOVITCH REGION CFO 5075381297 2016-11-11 2015 2017-02-10 21:41:12Z DAVID C AGERTER MD 701 HEWITT BLVD RED WING MN 55066 110708251 0 5983 X WWW.MAYOCLINICHEALTHSYSTEM.ORG X 1992 MN OPERATION OF A HOSPITAL AND THREE CLINICS 11 5 1629 194 0 0 1858918 608663 94700204 109679394 -44729 -166672 496039 377420 97010432 110498805 29955 67878 0 0 63304747 61798982 0 0 0 45908999 50392953 109243701 112259813 -12233269 -1761008 64836916 67629377 64336197 68894676 500719 -1265299 X TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION, AND RESEARCH. 0 0 100231685 109939383 PATIENT CARE (SEE SCHEDULE O):MAYO CLINIC HEALTH SYSTEM-RED WING (MCHS-RED WING) IS A MEMBER OF THE MAYO CLINIC HEALTH SYSTEM. MAYO CLINIC HEALTH SYSTEM IS A FAMILY OF CLINICS, HOSPITALS AND HEALTH CARE FACILITIES SERVING COMMUNITIES IN MINNESOTA, IOWA, WISCONSIN AND GEORGIA. AS PART OF MAYO CLINIC, THE HEALTH SYSTEM OFFERS CARE DESIGNED FOR THE WHOLE BODY CLOSE TO THE PATIENT'S HOME, WHEN THEY NEED IT. A MULTIDISCIPLINARY TEAM OF EXPERTS HAS READY ACCESS TO KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC AND COLLABORATES ON PROVIDING EXACTLY THE CARE THE PATIENT NEEDS. MAYO CLINIC HEALTH SYSTEM SITES EMPLOY APPROXIMATELY 1,000 PHYSICIANS AND 15,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN MORE THAN 60 COMMUNITIES, MAYO CLINIC HEALTH SYSTEM INCLUDES 19 OWNED HOSPITALS, TWO OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH ONE ADDITIONAL HOSPITAL, AND CONTRACT MANAGEMENT AGREEMENTS WITH TWO ADDITIONAL HOSPITALS AND ONE NURSING HOME. SINCE ITS INCEPTION IN 1992, MAYO CLINIC HEALTH SYSTEM HAS GROWN INTO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN THE UNITED STATES. MORE THAN 600,000 UNIQUE PATIENTS ACCOUNT FOR MORE THAN 2.6 MILLION VISITS ANNUALLY IN MAYO CLINIC HEALTH SYSTEM. IT IS ALSO A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS. AS PART OF THE MAYO CLINIC HEALTH SYSTEM, MCHS-RED WING OPERATES A CLINIC, HOSPITAL, SENIOR LIVING FACILITY, AND HOME HEALTH & HOSPICE IN RED WING, MINNESOTA. IN ADDITION, TWO REGIONAL CLINICS ARE OPERATED IN ZUMBROTA, MINNESOTA AND ELLSWORTH, WISCONSIN.THE RED WING LOCATION COMBINES A CLINIC AND HOSPITAL INTO ONE STATE-OF-THE-ART FACILITY. OPENED IN 2001, THE MEDICAL CENTER HAS A 30-BED INPATIENT HOSPITAL CARE UNIT THAT INCLUDES INTENSIVE CARE AND A BIRTHING CENTER. CLINIC SERVICES INCLUDES: PRIMARY FAMILY SERVICES, SPECIALTY MEDICAL AND SPECIALTY SURGICAL SERVICES, URGENT AND EMERGENCY CARE AND REHABILITATION SERVICES. THE MEDICAL CENTER ALSO OFFERS THE LATEST IN DIAGNOSTIC TOOLS (I.E. CT SCAN, MRI, AND FULL LAB SERVICES). MCHS-RED WING IS A COMPLETE HEALTH CARE FACILITY FOR PATIENTS THROUGHOUT GOODHUE AND PIERCE COUNTIES. IN 2015 THE MEDICAL CENTER PROVIDED CARE TO 1,876 INPATIENTS FOR A TOTAL OF 5,074 PATIENT DAYS. PROVIDED TREATMENT FOR 10,603 EMERGENCY ROOM VISITS AND PROVIDED A TOTAL OF 111,595 CLINIC VISITS.MCHS-RED WING PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. SERVICES ARE ALSO PROVIDED TO MEDICAID AND MEDICARE PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN 2015, MCHS-RED WING PROVIDED APPROXIMATELY $706,600 IN FINANCIAL ASSISTANCE TO PATIENTS. THE TOTAL COST OF UNCOMPENSATED CARE PROVIDED TO LOW INCOME PATIENTS THROUGH MEDICAID AND MINNESOTACARE (A STATE PROGRAM FOR PROVIDING MEDICAL CARE TO THE LOW INCOME POPULATION) WAS APPROXIMATELY $5,402,400 WHICH INCLUDES THE MEDICAID SURCHARGE OF $726,589 AND MNCARE TAX OF $1,238,567.THE UNREIMBURSED COST OF SERVICES TO MEDICARE PATIENTS WAS APPROXIMATELY $9,118,200.MCHS-RED WING LEASES SPACE AND PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE OF PROVIDING PATIENT CARE. 539034 67878 COMMUNITY PROGRAMS (SEE SCHEDULE O):AS PART OF ITS ACTIVITIES, MCHS-RED WING PROVIDES VARIOUS SUPPORT GROUPS AND PROGRAMS TO THE COMMUNITY AT NO CHARGE. THESE GROUPS AND CLASSES INCLUDE DIABETIC EDUCATIONAL PROGRAMS, LIVING WELL WITH CHRONIC CONDITIONS CLASSES COORDINATED WITH SHIP PROGRAMS, AND THE CAREGIVER FAMILY AND PATIENT SUPPORT PROGRAM ASSISTED 723 PERSONS. CARDIAC SUPPORT WELLNESS FOR LIFE CLASS WAS OFFERED TO 32 PATIENTS. PRENATAL CLASSES FOR EXPECTANT PARENTS WERE ATTENDED BY 3,113 PERSONS AND INCLUDE 1,466 STAFF HOURS. LACTATION STAFF COORDINATED EVENTS IN LOCAL LIBRARIES AND AT THE GOODHUE COUNTY FAIR TO PROVIDE NUTRITION INFORMATION TO REDUCE OBESITY IN YOUTH. MCHS-RED WING ALSO CONDUCTED FLU SHOT CLINICS AND DURING THE MONTH OF OCTOBER OFFERED DISCOUNTED MAMMOGRAMS TO WOMEN WHO QUALIFIED. MCHS-RED WING STAFF PARTICIPATED IN THE BOOK READ "GOOD FOR YOU AND ME" PROMOTING THE 5-2-1-0 NUTRITION AND ACTIVITY PROGRAM WITH PRIMARY CARE AND PEDIATRIC STAFF AT LOCAL DAY CARES. NUTRITION SERVICES STAFF PREPARED 2,900 MEALS FOR THE SUMMER NUTRITION PROGRAM FOR 60 CHILDREN WITH ECONOMIC AND NUTRITIONAL NEEDS. MCHS-RED WING OFFERED SPORTS PHYSICALS AT A REDUCED RATE FOR 35 HIGH SCHOOL ATHLETES ALONG WITH CONCUSSION MANAGEMENT, AND STAFF COVERAGE AT HOME HIGH SCHOOL FOOTBALL GAMES TO RESPOND TO EMERGENCIES. MCHS-RED WING ALSO OFFERS A PROGRAM THAT ALLOWS 11 HIGH SCHOOL STUDENTS TO COME ON-SITE AND LEARN ABOUT HEALTH CARE CAREERS AND PARTICIPATE IN JOB SHADOWING EXPERIENCES FOR 52 HOURS. MCHS-RED WING PROVIDES EDUCATION OPPORTUNITIES THROUGH RPAP, STUDENT INTERNSHIPS AND NURSING STUDENT TRAINING, 300 STUDENTS CALCULATED 10% OF THE TIME IN THE BUILDING FOR 1641 STAFF HOURS. LEADERSHIP AND DONATIONS STRENGTHENED PARTNERSHIPS WITH LOCAL CHARITIES OR COMMUNITY ORGANIZATIONS PROMOTING HEALTH IN THEIR COMMUNITIES. FUNDS PROVIDED TO COMMUNITY ORGANIZATIONS INCLUDE A $2,000 "LIVE HEALTHY RED WING" SPONSORSHIP. THIS IS A COMMUNITY PARTNERSHIP, MAKING POLICY AND ENVIRONMENTAL CHANGES TO IMPROVE NUTRITION AND ACTIVITY FOR OUR COMMUNITY. MCHS-RED WING ALSO PROVIDED $6,000 TO EVERY HAND JOINED WHICH IS A COMMUNITY PARTNERSHIP COMMITTED TO IMPROVING LIVES CRADLE TO CAREER. MCHS-RED WING SUPPORTS THE CARE CLINIC, A FREE CLINIC IN THE COUNTY, BY PROVIDING SPACE VALUED AT $25,900, LABORATORY AND RADIOLOGY SERVICES BENEFITTING 420 PEOPLE VALUED AT $12,443, AND MALPRACTICE INSURANCE FOR EMPLOYEES WHO DONATED 1,250 HOURS WITH 1,158 PATIENT ENCOUNTERS FOR 693 UNIQUE PATIENTS. MCHS-RED WING PROVIDES SPACE VALUED AT $29,900 TO ADDITIONAL NONPROFIT ORGANIZATIONS IN THE PROFESSIONAL AND COMMUNITY CENTER. MCHS-RED WING EMPLOYEES MEET AND REMAIN IN CLOSE CONTACT WITH ADMINISTRATION AT THE RED WING SCHOOL SYSTEM. AS A RESULT OF THIS CLOSE INTERACTION, MCHS-RED WING PROVIDED SEVERAL SERVICES TO STUDENTS IN 2015 INCLUDING MATURATION CLASSES IN THE ELEMENTARY SCHOOLS AND MIDDLE SCHOOL, SAFE ROUTES TO SCHOOLS DEVELOPMENT AND SEVERAL STAFF PRESENTATIONS ABOUT THEIR JOBS DURING HIGH SCHOOL CAREER CLASSES AT SCHOOL. THE REHABILITATION DEPARTMENT WORKS WITH THE LOCAL ATHLETIC DEPARTMENTS IN HIGH SCHOOL AND YOUTH SPORTS PROVIDING COMMUNITY ATHLETIC SERVICES TO 500 YOUTH. MCHS-RED WING EMPLOYEES ALSO PARTICIPATE IN "EVERY HAND JOINED" WHICH IS A COLLECTIVE IMPACT INITIATIVE WITH THE SCHOOL TO LIFT THE POTENTIAL OF ALL RED WING CHILDREN.MCHS-RED WING ALSO RECEIVES DONATED SERVICES FROM VOLUNTEERS CONSISTING OF INDIVIDUALS THAT HELP ORGANIZE AND MANAGE ACTIVITIES FOR THE BENEFIT OF MCHS-RED WING'S PATIENTS, PATIENT'S FAMILIES, VISITORS AND STAFF. THE VOLUNTEERS OPERATE A GIFT SHOP, ASSIST PATIENTS AND GREET VISITORS. DURING 2015, 189 AUXILIARY VOLUNTEERS DONATED APPROXIMATELY 12,394 HOURS OF SERVICE. BASED ON 2015 INDEPENDENT SECTOR STATISTICS, THE APPROXIMATE VALUE OF THESE SERVICES WERE $292,003. MAYO CLINIC HEALTH SYSTEM-RED WING (MCHS-RED WING) EMPLOYEES THROUGHOUT THE ORGANIZATION ASSESS THE NEEDS OF RED WING AND THE SURROUNDING COMMUNITIES THROUGH PERSONAL INTERACTION AND INVOLVEMENT WITH LOCAL SCHOOLS, CIVIC GROUPS AND HEALTH DEPARTMENTS AS WELL AS THROUGH THE COLLECTION AND ANALYSIS OF FEEDBACK FROM PATIENTS AND COMMUNITY MEMBERS.MCHS-RED WING EMPLOYEES ARE STRONGLY CONNECTED WITH LOCAL CIVIC GROUPS. MANY EMPLOYEES ARE ACTIVE MEMBERS OF VARIOUS RED WING NON-PROFIT ORGANIZATIONS. MANY PROVIDE LEADERSHIP ON BOARDS WHILE OTHERS GIVE HEALTH CARE PRESENTATIONS TO THESE GROUPS. THIS PARTICIPATION NOT ONLY PROMOTES INVOLVEMENT IN THE COMMUNITY, BUT IT ALSO GIVES COMMUNITY MEMBERS A CHANCE TO ASK QUESTIONS, SHARE COMMENTS, CONCERNS OR OTHER SUGGESTIONS THEY MAY HAVE REGARDING THE MEDICAL CENTER. MCHS-RED WING ALSO WORKS WITH THE GOODHUE PUBLIC HEALTH ORGANIZATION TO DEVELOP RELATIONSHIPS AMONG HEALTH CARE PROVIDERS AND COMMUNITY LEADERS. THIS PARTNERSHIP PROMOTES THE ACTIVE REFERRAL OF PATIENTS TO LOCAL RESOURCES SUCH AS ACCESS TO HIGH QUALITY NUTRITIOUS FOODS, PHYSICAL ACTIVITY AND TOBACCO USE CESSATION PROGRAMS. 100770719 1 1 0 1 0 0 0 0 1 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1629 1 0 0 0 0 0 0 0 0 0 0 X 11 5 1 1 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 0 0 MN X CORPORATE TAX 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 AGERTER MD DAVID C DIRECTOR/CEO 1.00 40.00 X X 0 597592 26206 ANDERST DONNA DIRECTOR 1.00 0.00 X 0 0 0 BECK JENNIFER DIRECTOR 1.00 0.00 X 0 0 0 BODENSTEINER RICHARD DIRECTOR 1.00 0.00 X 0 0 0 DEJONG MD AMY A DIRECTOR 40.00 0.00 X 276934 0 62327 FOOT III SILAS B DIRECTOR 1.00 0.00 X 0 0 0 KETCHAM MD JEFFREY M DIRECTOR 40.00 0.00 X 686547 0 72846 PARKS DOUGLAS A DIRECTOR/SECRETARY/CAO 1.00 40.00 X X 0 239099 50017 RIEGELMAN ROBERT DIRECTOR 1.00 0.00 X 0 0 0 SIMPSON MD HENRY J DIRECTOR 1.00 40.00 X 0 310558 75978 WILLIAMS MD AMY W DIRECTOR 1.00 40.00 X 0 296639 48487 GUDGELL STEPHEN F TREASURER 1.00 40.00 X 0 203028 24335 KOCH MARK B ASS'T SECRETARY 1.00 40.00 X 0 483196 23677 TARASOVITCH JAMES J CFO 1.00 40.00 X 0 309144 66950 WITT MD THOMAS J PRESIDENT 1.00 40.00 X 0 474073 69829 BREHMER MD JESS L PHYSICIAN 40.00 0.00 X 541228 0 46534 EICH MD MATTHEW A PHYSICIAN 40.00 0.00 X 596765 0 49395 HUGHES MD EVERETT M PHYSICIAN 40.00 0.00 X 627720 0 63036 JOHNSON MD MICHAEL R PHYSICIAN 40.00 0.00 X 593507 0 47861 SMITH MD HUGH S PHYSICIAN 40.00 0.00 X 625332 0 59119 DIMUNATION NANCY FORMER KEY EMPLOYEE 40.00 0.00 X 188078 0 34031 4136111 2913329 820628 102 1 1 0 MAYO CLINIC HEALTH SYSTEM - ALBERT LEA A 1000 FIRST DRIVE NW AUSTIN MN 55912 PURCHASED SERVICES 3889577 MAYO FND FOR MEDICAL EDUCATION AND RESEA 200 FIRST STREET SW ROCHESTER TX 55905 PURCHASING AGENT 2083730 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 MEDICAL & ADMIN SERVICES 653609 MCHS-EAU CLAIRE HOSPITAL INC PO BOX 1510 EAU CLAIRE WI 54702 MEDICAL SERVICES 565666 CENTRAL MN DIAGNOSTIC INC 200 NORTH ELM STREET ONAMIA MN 56359 RADIOLOGY SERVICES 300250 11 785 67620 540238 20 608663 NET PATIENT REVENUE 620000 107373723 107373723 RESIDENT REVENUE 623000 1436199 1436199 SHARED SERVICES 561000 845045 845045 EDUCATION REVENUE 611600 15577 15577 RENT FROM AFFILIATES 531120 8850 8850 109679394 -177700 -177700 147821 129376 18445 18445 18445 45380 34352 11028 11028 11028 10439 377 10062 10062 74415 45341 29074 29074 CAFETERIA/VENDING 722210 246377 246377 MEDICAL DIRECTOR FEES 541900 57450 57450 MISCELLANEOUS REVENUE 900099 16012 13612 2400 319839 110498805 109939383 0 -49241 X 26579 26579 41299 41299 1098654 1082654 16000 271838 65594 206244 47267505 45203581 2063924 5038403 4818402 220001 5013065 4794171 218894 3109517 2973741 135776 25591 25591 54 54 7485 7485 20736133 15860580 4875553 891 891 2023418 1637133 386285 33184 31333 1851 16 16 1855722 1574509 281213 762961 633777 129184 10542 9883 659 1917188 1917188 3595320 3186040 409280 572851 39625 533226 MEDICAL SUPPLIES 12155205 12155205 BAD DEBT EXPENSE 4337387 4337387 MN CARE TAX 1238567 1238567 MEDICAID SURCHARGE 726589 726589 393849 325624 68225 112259813 100770719 11489094 0 1231844 310884 17133609 19069494 39594 11183 239850 1429682 921388 2809 89469368 52714448 41307521 36754920 2796669 476612 1695955 178726 8865553 64836916 67629377 13640834 3295825 16356 13206 10178 0 107585 108354 50561244 65477291 64336197 68894676 X 169465 -1588457 331254 212058 111100 500719 -1265299 64836916 67629377 -1761008 -5010 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7485 7485 0 PART II-B, LINE 1: THE AMOUNT IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING. MAYO CLINIC HEALTH SYSTEM-RED WING PROVIDES INFORMATION OR EXPRESSES ITS CONCERN TO LEGISLATIVE BODIES AND GOVERNMENT OFFICIALS ON MATTERS DIRECTLY RELATED TO HEALTH, THE DELIVERY OF HEALTH CARE AND MEDICAL EDUCATION AND/OR RESEARCH. IN 2015, MCHS-RED WING REPRESENTATIVES HAD SEVERAL MEETINGS WITH MEMBERS OF THE LEGISLATIVE AND EXECUTIVE BRANCHES OF GOVERNMENT TO DISCUSS ISSUES RELATING TO HEALTH CARE AND HEALTH CARE REFORM. 0 1 X 100217 16432 984 425 117208 100000 5600 5383 100217 100000 100000 0.95000 0.05000 0 1 1 2174933 2174933 69717 62298027 34566770 27800974 18041 24651516 18147678 6521879 257134 257134 36754920 DUE FROM AFFILIATES 5623146 DEFFERED COMPENSATION 2833526 OTHER LONG-TERM ASSETS 408881 8865553 DUE TO AFFILIATES 62643765 DEFERRED COMPENSATION LIABILITY 2833526 65477291 X PART IV, LINE 2B: DEPOSITS ARE HELD FOR DOWNTOWN PLAZA AND SEMINARY HOME RESIDENTS. PART V, LINE 4: THE ENDOWMENT FUNDS PROVIDE A STABLE FUNDING SOURCE FOR RESEARCH AND EDUCATION PROGRAMS. PART X, LINE 2: AT DECEMBER 31, 2015 AND 2014, THE RESERVE FOR UNRECOGNIZED TAX BENEFITS WAS NOT SIGNIFICANT, AND AS A RESULT, THERE IS NO RESERVE FOR UNRECOGNIZED TAX BENEFITS RECORDED FOR THE FILING ORGANIZATION. 1 1 X 1 X 1 X 1 0 1 1 706578 706578 0.00650 13542097 8139768 5402329 0.05010 14248675 8139768 6108907 0.05660 178053 2650 175403 0.00160 131975 131975 0.00120 7100874 4702098 2398776 0.02220 181190 181190 0.00170 7592092 4704748 2887344 0.02670 21840767 12844516 8996251 0.08330 45681 45681 0.00040 470 470 0.00000 4315 4315 0.00000 50466 50466 0.00040 0 4337387 19848694 23167367 -3318673 X 1 1 1 1 MAYO CLINIC HEALTH SYSTEM - RED WING 701 HEWITT BLVD RED WING MN 55066 WWW.MAYOCLINICHEALTHSYSTEM.ORG 21423 X X X MAYO CLINIC HEALTH SYSTEM - RED WING 1 0 0 1 X X X X X X X 13 1 1 0 1 X MAYOCLINICHEALTHSYSTEM.ORG X 1 13 0 1 0 1 X 200.000000000000 400.000000000000 X X X X X X X 1 1 X X X 1 X MAYOCLINICHEALTHSYSTEM.ORG X MAYOCLINICHEALTHSYSTEM.ORG X MAYOCLINICHEALTHSYSTEM.ORG X X X X X X 1 X 0 X X X X X 1 X 0 0 MAYO CLINIC HEALTH SYSTEM - RED WING PART V, SECTION B, LINE 5: INPUT WAS PROVIDED BY THE HEALTHY COMMUNITIES SUPERVISOR AND COMMUNITY HEALTH SPECIALIST OF THE PUBLIC HEALTH DIVISION OF GOODHUE COUNTY HEALTH AND HUMAN SERVICES AND THE DIRECTOR OF WABASHA COUNTY PUBLIC HEALTH. IN ADDITION, INPUT WAS RECEIVED FROM KEY INFORMANT INTERVIEWS, COUNTY-WIDE MAIL SURVEYS, LOCAL FOCUS GROUPS, AND SURVEYS COMPLETED BY THE SCHOOL DISTRICTS, AND THE CHEMICAL INITIATIVE. MAYO CLINIC HEALTH SYSTEM - RED WING PART V, SECTION B, LINE 6A: MAYO CLINIC HEALTH SYSTEM - CANNON FALLS, MAYO CLINIC HEALTH SYSTEM - LAKE CITY, AND MAYO CLINIC HEALTH SYSTEM - RED WING COLLABORATED ON THE CHNA WHICH ENCOMPASSES THE COUNTIES THAT THE THREE HOSPITALS SERVE. MAYO CLINIC HEALTH SYSTEM - RED WING PART V, SECTION B, LINE 11: MAYO CLINIC HEALTH SYSTEM (MCHS) IN LAKE CITY, CANNON FALLS AND RED WING IDENTIFIED THREE SIGNIFICANT HEALTH NEEDS IN GOODHUE COUNTY IN PARTNERSHIP WITH GOODHUE COUNTY HEALTH AND HUMAN SERVICES. OBESITY- RELATED TO ACTIVITY, NUTRITION AND CHRONIC DISEASE, MENTAL HEALTH AND ACCESS TO CARE WERE CHOSEN AS THE TOP THREE HEALTH PRIORITIES. ONGOING PARTNERSHIPS WITH LOCAL PUBLIC HEALTH, SENIOR SERVICE PROGRAMS, NON PROFITS AND OTHER COMMUNITY ORGANIZATIONS ARE INTEGRAL TO IMPROVING THE HEALTH AND QUALITY OF LIFE FOR AREA RESIDENTS.MAYO CLINIC HEALTH SYSTEM IN CANNON FALLS, LAKE CITY, AND RED WING COLLABORATED ON A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, IDENTIFIED COMMON NEEDS, AND DEVELOPED THE FOLLOWING JOINT IMPLEMENTATION PLANS TO ADDRESS THE NEEDS IDENTIFIED IN THE ASSESSMENT.IDENTIFIED NEED: OBESITYGOAL: INCREASE AWARENESS OF INDIVIDUAL HEALTH AND OBESITY MANAGEMENT OPTIONS FOR YOUTH AND FAMILIES.SOCIAL MEDIA STRATEGY - MCHS-RED WING UTILIZED SOCIAL MEDIA TO PROMOTE THE MAYO MESSAGES FOR HEALTHY ACTIVITY AND NUTRITION. PINS AND POSTS THAT FOLLOW TRENDS AND HEALTH EVENTS ARE UPDATED DAILY. THE MEDIA TEAM CONTINUES TO WORK ON HOW TO QUANTIFY THE EFFECT THESE HEALTHY AND POSITIVE MESSAGES HAVE ON THE REGION. SOCIAL MEDIA ALLOWS VARIOUS DEMOGRAPHIC AUDIENCES THAT INCLUDE MALES AND FEMALES AGES 18-64 TO RECEIVE EDUCATION AND ENGAGE ONLINE WITH MAYO CLINIC HEALTH SYSTEM. MCHS SOCIAL MEDIA CHANNELS INCLUDE: FACEBOOK, TWITTER, YOUTUBE, PINTEREST AND GOOGLE PLUS. EXAMPLES OF STRATEGIC SOCIAL MEDIA CAMPAIGNS INCLUDE RUNNING TIPS, HEALTHY RECIPES, HEART HEALTH TIPS, EXERCISE, AND WELLNESS INFORMATION. WRITTEN CONTENT, PHOTOS AND VIDEOS ARE INCORPORATED AS APPLICABLE IN EACH SOCIAL MEDIA CHANNEL. BLOGS WRITTEN BY PROVIDERS INCORPORATE KEY WELLNESS MESSAGES AND REACH IS TRACKED BY THE NUMBER OF LIKES EACH RECEIVES. 5210 STRATEGY - THE 5210 PROGRAM HAS BEEN PROMOTED IN PEDIATRICS AND FAMILY PRACTICE THROUGH 5210 FLYERS AND "HEALTHY KIDS EAT WELL TO GROW STRONG" BOOKLET AT COMMUNITY EVENTS AND IN CLINIC VISITS. THE 5210 PROGRAM WAS PROMOTED IN A COMMUNITY BOOK READ THAT TOOK PLACE IN LOCAL DAY CARE HOMES AND CENTERS. THE MAYER MERCER BOOK, "GOOD FOR YOU AND ME" WAS READ TO CHILDREN, 5210 CARDS AND RIVER CITY KIDS FUN RUN INFORMATION WAS DISTRIBUTED. CHILDREN WERE INVITED TO BRING THEIR PARENTS TO THE PARK AND WALK WITH LOCAL PEDIATRICIANS ON MONDAYS IN JUNE AND JULY. THE FUN RUN ATTENDANCE INCREASED BY 2/3 TO 150 PARTICIPANTS AFTER THIS PROMOTION. COMMUNITY EVENT SPONSORSHIP AND PROGRAMMING - MCHS IN CANNON FALLS, LAKE CITY AND RED WING PARTNERED WITH LOCAL NONPROFITS TO ENCOURAGE HEALTHY LIVING COMMUNITY EVENTS INCLUDING BIKE RALLIES, RUN/WALKS, AND YOUTH ACTIVITIES SUCH AS "GET READY TO RAMBLE", THE CANNON VALLEY TRAIL, AND LIVE HEALTHY RED WING'S "OPEN YOUR DOOR" CAMPAIGN FOR MAPS AND TRAILS. IN ORDER TO ROLE MODEL ACTIVITY, MINI FRISBEES ARE DISTRIBUTED RATHER THAN TREATS AT YOUTH EVENTS, BIKE HELMETS ARE USED AS GIVE A WAYS, AND COOKBOOKS ARE DISTRIBUTED WITH THE MAYO CLINIC GUIDE TO SELFCARE. MCHS SPONSORS NUTRITIONAL EDUCATION AT COMMUNITY EVENTS AND MEETINGS, EMPHASIZING PLATE SIZE, NUTRITION NEEDS AND WEIGHT LOSS EDUCATION. THE SUMMER FOOD PROGRAM FOR LOW INCOME CHILDREN IN RED WING SERVED 2,900 MEALS TO OVER 60 PARTICIPANTS THROUGHOUT THE SUMMER. WEEKLY EDUCATION ON HEALTHY SNACKS AND LEARNING ABOUT FRUITS AND VEGETABLES WERE PROVIDED BY MCHS NUTRITION EDUCATORS. CHILDHOOD OBESITY- LACTATION STAFF WORK WITH CHILDBIRTH EDUCATION (197 PARTICIPANTS IN BABY NUTRITION), THE BABY CAF (107 VISITS) AND THE BREAST FEEDING COALITION (COMMUNITY EDUCATION AND GOODHUE COUNTY FAIR BOOTH) TO PROVIDE ONGOING EDUCATION FOR NEW MOMS AND FAMILIES. PEDIATRIC STUDIES INDICATE BREAST FEEDING IS A FIRST STEP TO REDUCE OBESITY IN CHILDREN. LACTATION STAFF PRESENTED NUTRITION AND WEIGHT INFORMATION TO 120 PARTICIPANTS IN THE DAYCARE COALITION.IDENTIFIED NEED: ACCESSGOAL: TO SUPPORT AND PROMOTE COMMUNITY HEALTH CARE ACCESS.MCHS CANNON FALLS/LAKE CITY/RED WING PARTNERS WITH LOCAL VOLUNTEERS, COUNTY SERVICES, THE FREE CARE CLINIC BOARD OF DIRECTORS AND CARE CLINIC STAFF TO MAINTAIN THE FREE CLINIC FOR OUR SERVICE AREA. MALPRACTICE INSURANCE IS PROVIDED FOR ALL MCHS EMPLOYEES WHO VOLUNTEER AT THE CLINIC. MCHS PROVIDES $15,000 IN LAB AND RADIOLOGY SERVICES BILLED AT A MEDICARE LEVEL FOR CARE PATIENTS SO THE CARE CLINIC CAN INCREASE THE SCOPE OF SERVICES THEY PROVIDE WITHOUT ADDITIONAL FEES TO THE PATIENTS. THE CARE CLINIC IS LOCATED IN THE MCHS BUILDING THAT WAS PREVIOUSLY THE RED WING HOSPITAL EMERGENCY ROOM. THE SPACE IS PROVIDED FREE OF CHARGE AND IS VALUED AT $25,900. TECHNOLOGY IS PROVIDED TO CONNECT THE VOLUNTEER PROVIDERS WITH THE PATIENT RECORDS AND TEST RESULTS WHILE MAINTAINING THE HIGHEST LEVEL OF PATIENT CONFIDENTIALITY. SPECIALTY SERVICES (DENTAL HEALTH, DERMATOLOGY, DIABETES, OPHTHALMOLOGY, ORTHOPEDICS, PODIATRY, WOMENS HEALTH) AT THE CLINICS ARE SUPPORTED WITH TIME AND EQUIPMENT. THE CARE CLINIC SERVED 693 UNIQUE PATIENTS WITH 1,158 ENCOUNTERS IN 2015. LAB AND RADIOLOGY SERVICES WERE PROVIDED TO SUPPORT THE CARE CLINIC WITH 377 LAB TESTS AND 43 RADIOLOGY TESTS PROVIDED IN 2015.TRANSPORTATION TO SERVICES IN OUR COMMUNITY AND OUTSIDE OUR AREA AND TRANSPORTATION FOR THOSE WITHOUT RELIABLE TRANSPORTATION IS PROVIDED THROUGH BUS TOKENS, CAB REIMBURSEMENT AND TRANSPORTATION REIMBURSEMENT PROVIDED TO LOCAL EMERGENCY SERVICES. FAITH IN ACTION PROVIDES TRANSPORTATION TO SENIORS AND COMMUNITY MEMBERS WHO ARE HOME BOUND. SUPPORT FOR FAITH IN ACTION INCLUDES LEADERSHIP, OFFICE SPACE AND DONATIONS. THE NURSE TRIAGE LINE PROMOTES ACCESS TO SERVICES FOR COMMUNITY MEMBERS WHETHER THEY ARE CURRENT OR NON-CURRENT PATIENTS. THE TRIAGE STAFF ARE ABLE TO DIRECT INDIVIDUALS WHO CALL ASKING FOR ADVICE TO APPROPRIATE LEVELS OF SERVICE AND MANY TIMES ARE ABLE TO SAVE THEM FROM AN APPOINTMENT BY PROVIDING OVER THE COUNTER OPTIONS. LIMITED PROTOCOLS CAN BE SHARED WITH NON PATIENTS INCREASING THEIR ACCESS TO CARE. THE QUANTITATIVE VALUE OF THIS SERVICE IS NOT TRACKED BY ZIP CODE AND VALUES CAN NOT BE ATTRIBUTED TO SPECIFIC SITES.IDENTIFIED NEED: MENTAL HEALTHGOAL: EDUCATE AND PROVIDE RESOURCES FOR THE COMMUNITY BY UTILIZING SOCIAL MEDIA TO EDUCATE THE COMMUNITY.DR. SOOD'S "GUIDE TO STRESS FREE LIVING" BOOK HAS HAD MULTIPLE FACEBOOK POSTS TO PROMOTE MENTAL HEALTH AND PERSONAL STRESS MANAGEMENT. DR. SOOD'S BOOK IS USED TO PROMOTE MENTAL HEALTH AT COMMUNITY EVENTS AND HIS BLOG IS SHARED ACROSS THE REGION. A COMMUNITY COLLABORATION LED BY MCHS CANNON FALLS/LAKE CITY/RED WING AND THE RED WING SHOE FOUNDATION SUCCEEDED IN MEETING THEIR THREE ESTABLISHED GOALS - 1) COUNTY WIDE RESOURCE LISTS WERE DEVELOPED AND SHARED, 2) NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) CHAPTER WAS REINSTATED IN GOODHUE COUNTY, AND 3) ESTABLISHED THE "MAKE IT OK" ANTI STIGMA PROGRAM. "MAKE IT OK" HAS BECOME A COUNTY WIDE TRAINING PROGRAM FOR MENTAL HEALTH FIRST AID AND TRAINING WAS HELD IN COUNTY SCHOOL DISTRICTS. "MAKE IT OK" ANTI STIGMA EDUCATION CONTINUES AS A PARTNERSHIP WITH GOODHUE COUNTY HEALTH AND HUMAN SERVICES. MENTAL HEALTH CLINICAL SERVICES EXPANDED IN SOUTHEAST MINNESOTA BY BLENDING THE CMS COMPASS CARE COORDINATION MODEL INTO THE ADULT COMPLEX CARE COORDINATION MODEL TO IDENTIFY PEOPLE WITH MENTAL HEALTH ISSUES AT CLINIC VISITS FOR OTHER HEALTH ISSUES.THE COMPASS MODEL IS BUILT ON A REFERRAL PROCESS WHERE PATIENTS WITH CHRONIC DISEASE ARE IDENTIFIED, SCREENED AND REFERRED FOR MENTAL HEALTH CARE. AS THE PRIORITY HEALTH NEED IDENTIFIED, ADDRESSING MENTAL HEALTH IS CRUCIAL TO MAKING IMPROVEMENT IN CHRONIC DISEASES OR OBESITY. BEGINNING IN 2015, ALL PATIENTS NEEDING CARE COORDINATION HAVE A PSYCHIATRIST ENGAGED IN THE CARE COORDINATION TEAM. TO FURTHER ASSIST WITH THE ENORMITY OF MENTAL HEALTH NEEDS IDENTIFIED IN THE 2013 CHNA AND TO INCREASE ACCESS TO CARE, NEW LICENSED SOCIAL WORKERS AND MENTAL HEALTH PROVIDERS WERE HIRED TO ACCOMMODATE PATIENT NEEDS.THE CARE CLINIC PARTNERSHIP RECEIVED A GRANT FOR A HISPANIC MENTAL HEALTH PROGRAM. THIS COUNTY WIDE BENEFIT HAS IMPACTED 230 PATIENTS IN 2015 WITH A BILINGUAL THERAPIST AND MCHS-RED WING'S INCREASED SPACE GIFT TO HISPANIC OUTREACH FOR THIS SERVICE. THIS IS IN ADDITION TO THE PSYCHOLOGY SERVICES OFFERED AT THE FREE CLINIC. NEEDS NOT BEING ADDRESSED: CHEMICAL HEALTH: A TEN YEAR GOVERNMENT GRANT CONCLUDED IN OCTOBER. THE WORK FROM THE GOODHUE COUNTY FAMILY SERVICE COLLABORATIVE HAS MOVED INTO MENTAL HEALTH ASSESSMENT FOR THE COUNTY SCHOOL SYSTEM. MCHS-RED WING PROVIDED OFFICE SPACE AND LEADERSHIP FOR THIS GRANT DURING THEIR TEN YEARS IN GOODHUE COUNTY TOBACCO: PROGRAMS ARE SUPPORTED IN THE COUNTY THROUGH HEALTH AND HUMAN SERVICES. MCHS DOES HAVE A CESSATION PROGRAM AND WORKS WITH OTHER STATE AND LOCAL REDUCTION EDUCATION PROGRAMS. MAYO CLINIC HEALTH SYSTEM - RED WING PART V, SECTION B, LINE 13B: IF A PATIENT BALANCE EXCEEDS 25% OF THE ANNUAL HOUSEHOLD INCOME, BUT THE PATIENT DOES NOT QUALIFY BASED ON FPG, CHARITY WILL BE ADJUSTED TO A MINIMUM OF THE AMOUNT GENERALLY BILLED (AGB). THE AGB IS DETERMINED USING THE LOOK-BACK METHOD AND CALCULATED USING ALL CLAIMS ALLOWED BY PRIVATE PAY INSURERS (INCLUDING MEDICARE ADVANTAGE) AND MEDICARE (TRADITIONAL) FOR INPATIENT AND OUTPATIENT SERVICES FOR THE YEAR. MAYO CLINIC HEALTH SYSTEM - RED WING PART V, SECTION B, LINE 13H: THE REGIONAL PROXIMITY OF A PATIENT'S RESIDENCY IS A FACTOR FOR PRESCHEDULED SERVICES ONLY AND SECONDARY TO MEDICAL NEED. REGIONAL PROXIMITY IS NOT A FACTOR FOR EMERGENCY CARE PROVIDED. MAYO CLINIC HEALTH SYSTEM - RED WING PART V, SECTION B, LINE 16I: WITH REGARD TO THE POSTINGS WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE ARE DISCUSSED WITH THE PATIENT. MAYO CLINIC HEALTH SYSTEM - RED WING PART V, SECTION B, LINE 20E: FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE TO EVERY PATIENT VIA MAYO'S PUBLIC WEBSITE, FROM CUSTOMER SERVICE AND PATIENT ACCESS LOCATIONS, AND IS REFERENCED ON MAYO'S AUTHORIZATION FORMS AND STATEMENTS. IN ADDITION, BROCHURES ARE AVAILABLE IN THE ADMISSIONS AREA AND THE PROCESS OF HOW TO APPLY IS AVAILABLE ON THE MAYO CLINIC WEBSITE.UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, MAYO DISCUSSES ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE.MONTHLY STATEMENTS ARE SENT TO PATIENTS THAT OUTLINE CURRENT CHARGES AND ACTIONS WITH INSURANCE AND INCLUDES INFORMATION ABOUT MAYO'S CHARITY CARE POLICY. SOME MAYO SITES UTILIZE ADVOCATES TO CONTACT THE PATIENT UPON DISCHARGE TO HELP THEM SECURE GOVERNMENTAL ASSISTANCE OR FINANCIAL ASSISTANCE. EACH CHARITY CARE REVIEW IS DOCUMENTED IN MAYO'S BILLING SYSTEM AND COMMUNICATED TO THE PATIENT. COMPLETED CHARITY CARE FORMS ARE MAINTAINED EITHER IN PAPER OR ELECTRONIC FORMAT. THE PATIENT IS INFORMED REGARDING THE OUTCOME OF THE REVIEW.MAYO OFTEN IDENTIFIES CHARITY CARE OPPORTUNITIES AFTER THE PATIENT HAS BEEN DISMISSED. IN MANY CASES, THIS IS DUE TO LIMITED INSURANCE COVERAGE OR INSURANCE DENIALS AFTER THE SERVICE WAS PERFORMED. IN THESE CASES, WHEN A PATIENT EXPRESSES AN INABILITY TO PAY FOR THEIR SERVICES, STAFF WILL INITIATE A CHARITY REVIEW AS INDICATED BY THE FINANCIAL ASSISTANCE POLICY, WHICH IS AVAILABLE FOR EVERY PATIENT AT MAYOCLINIC.ORG. MAYO CLINIC HEALTH SYSTEM - RED WING PART V, SECTION B, LINE 22D: THE POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 40% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN USING THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE. 5 1 - MCHS-RED WING 701 HEWITT BOULEVARD RED WING MN 55066 CLINIC 2 - MCHS-RED WING HOME HEALTH & HOSPICE 1407 W 4TH STREET RED WING MN 55066 HOME HEALTH & HOSPICE 3 - MCHS-RED WING IN ZUMBROTA 1350 JEFFERSON DRIVE ZUMBROTA MN 55992 CLINIC 4 - MCHS-RED WING IN ELLSWORTH 530 CAIRNS STREET ELLSWORTH WI 54011 CLINIC 5 - DOWNTOWN PLAZA 434 W 4TH STREET RED WING MN 55066 SENIOR LIVING FACILITY PART I, LINE 3C: MEDICAL INDIGENCY MAY BE USED TO DETERMINE ELIGIBILITY. IF A PATIENT BALANCE EXCEEDS 25% OF THE ANNUAL HOUSEHOLD INCOME, BUT THE PATIENT DOES NOT QUALIFY BASED ON FPG, CHARITY WILL BE ADJUSTED TO A MINIMUM OF THE AMOUNT GENERALLY BILLED (AGB). THE AGB IS DETERMINED USING THE LOOK-BACK METHOD AND CALCULATED USING ALL CLAIMS ALLOWED BY PRIVATE PAY INSURERS (INCLUDING MEDICARE ADVANTAGE) AND MEDICARE (TRADITIONAL) FOR INPATIENT AND OUTPATIENT SERVICES FOR THE YEAR. PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO. PART I, LINE 7G: THE FOLLOWING NET COMMUNITY BENEFIT COST ATTRIBUTED TO A PHYSICIAN CLINIC WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES: $1,176,622. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4,337,387. SCHEDULE H, PART I, LINE 5A THE FILING ORGANIZATION ESTIMATES CHARITY CARE FOR FINANCIAL PLANNING PURPOSES ONLY. THE ESTIMATED AMOUNT OF CHARITY CARE DOES NOT INFLUENCE OR HAVE ANY IMPACT ON THE AMOUNT OF CHARITY CARE PROVIDED. PART II, COMMUNITY BUILDING ACTIVITIES: THROUGH IN-KIND DONATIONS AND GRANTS TO PUBLIC, PRIVATE AND NONPROFIT ORGANIZATIONS, THE FILING ORGANIZATION ASSISTS WITH SUSTAINING AND ENHANCING THE COMMUNITIES IT SERVES. PART III, LINE 2: PART III, SECTION A, LINE 1:THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP. PART III, LINE 4: METHODOLOGY FOR SCHEDULE H, PART III, LINE 2:BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED IN THE ACCOUNTS RECEIVABLE FOOTNOTE OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS.FOOTNOTES RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS CAN BE FOUND ON PAGES 5, 7, 8 AND 9 OF MAYO CLINIC'S 2015 CONSOLIDATED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SHORTFALL REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY). HOWEVER, USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY ACTUALLY RESULTS IN A MEDICARE SHORTFALL OF APPROXIMATELY $9,118,139 AS REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS.THE MOST COMMON REASONS FOR A DIFFERENCE BETWEEN THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H AND THE MEDICARE SHORTFALL REPORTED ON THE CORE FORM, PART III INCLUDE: (1) INCLUSION OF MEDICARE ADVANTAGE REVENUE AND EXPENSES; (2) INCLUSION OF PART B REVENUE AND EXPENSES; (3) INCLUSION OF OTHER FEE SCHEDULE REVENUE; AND (4) SOME TIMING ISSUES.REASONS WHY MEDICARE SHORTFALL REPORTED ON LINE 7, IF ANY, SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING REASONABLE ATTEMPTS TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN ADDITION, MAYO CLINIC AND ITS AFFILIATES ACCEPT REASONABLE PAYMENT PLANS FROM PATIENTS WHEN AN ACCOUNT IS THE PATIENT'S RESPONSIBILITY AND TRY TO IDENTIFY THOSE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS OFFERED TO ANY PATIENT IF THE FACTS AND CIRCUMSTANCES SUGGEST THAT THE PATIENT DOES NOT HAVE THE ABILITY TO PAY THEIR BILL IN WHOLE OR IN PART. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED; INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS POTENTIALLY MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY BASED ON SUBMISSION OF REQUESTED INFORMATION. COLLECTION ACTIVITY WOULD ONLY RESUME IF THE PATIENT IS DETERMINED TO BE INELIGIBLE FOR FINANCIAL ASSISTANCE OR IS ELIGIBLE FOR ONLY PARTIAL FINANCIAL ASSISTANCE AND DOES NOT AGREE TO PAY THE REMAINING BALANCE. PART VI, LINE 2: MAYO CLINIC HEALTH SYSTEM-RED WING (MCHS-RED WING) EMPLOYEES THROUGHOUT THE ORGANIZATION ASSESS THE NEEDS OF RED WING AND THE SURROUNDING COMMUNITIES THROUGH PERSONAL INTERACTION AND INVOLVEMENT WITH LOCAL SCHOOLS, CIVIC GROUPS AND HEALTH DEPARTMENTS AS WELL AS THROUGH THE COLLECTION AND ANALYSIS OF FEEDBACK FROM PATIENTS AND COMMUNITY MEMBERS.MCHS-RED WING EMPLOYEES ARE STRONGLY CONNECTED WITH LOCAL CIVIC GROUPS. MANY EMPLOYEES ARE ACTIVE MEMBERS OF VARIOUS RED WING NON-PROFIT ORGANIZATIONS. MANY PROVIDE LEADERSHIP ON BOARDS WHILE OTHERS GIVE HEALTH CARE PRESENTATIONS TO THESE GROUPS. THIS PARTICIPATION NOT ONLY PROMOTES INVOLVEMENT IN THE COMMUNITY, BUT IT ALSO GIVES COMMUNITY MEMBERS A CHANCE TO ASK QUESTIONS, SHARE COMMENTS, CONCERNS OR OTHER SUGGESTIONS THEY MAY HAVE REGARDING THE MEDICAL CENTER. MCHS-RED WING ALSO WORKS WITH THE GOODHUE PUBLIC HEALTH ORGANIZATION TO DEVELOP RELATIONSHIPS AMONG HEALTH CARE PROVIDERS AND COMMUNITY LEADERS. THIS PARTNERSHIP PROMOTES THE ACTIVE REFERRAL OF PATIENTS TO LOCAL RESOURCES SUCH AS ACCESS TO HIGH QUALITY NUTRITIOUS FOODS, PHYSICAL ACTIVITY AND TOBACCO USE CESSATION PROGRAMS. MCHS-RED WING EMPLOYEES MEET AND REMAIN IN CLOSE CONTACT WITH ADMINISTRATION AT THE RED WING SCHOOL SYSTEM. AS A RESULT OF THIS CLOSE INTERACTION, MCHS-RED WING PROVIDED SEVERAL SERVICES TO STUDENTS IN 2015 INCLUDING MATURATION CLASSES IN THE ELEMENTARY SCHOOLS AND MIDDLE SCHOOL, SAFE ROUTES TO SCHOOLS DEVELOPMENT AND SEVERAL STAFF PRESENTATIONS ABOUT THEIR JOBS DURING HIGH SCHOOL CAREER CLASSES AT SCHOOL. THE REHABILITATION DEPARTMENT WORKS WITH THE LOCAL ATHLETIC DEPARTMENTS IN HIGH SCHOOL AND YOUTH SPORTS. MCHS-RED WING EMPLOYEES ALSO PARTICIPATE IN "EVERY HAND JOINED" WHICH IS A COLLECTIVE IMPACT INITIATIVE TO LIFT THE POTENTIAL OF ALL RED WING CHILDREN.MCHS-RED WING ACTIVELY SEEKS FEEDBACK FROM PATIENTS AND COMMUNITY MEMBERS THROUGH ITS PATIENT ADVISORY COUNCIL (PAC) AND PATIENT SATISFACTION SURVEYS. THE PAC IS A GROUP OF TEN COMMUNITY MEMBERS WHO SERVE AS A MCHS-CANNON FALLS/LAKE CITY/RED WING FOCUS GROUP TO PROVIDE FEEDBACK PRIOR TO THE IMPLEMENTATION OF NEW PROGRAMS AND SERVICES, ASSIST IN THE IDENTIFICATION OF OPPORTUNITIES THAT WILL IMPROVE PATIENT AND FAMILY SATISFACTION, PROVIDE TIMELY AND DIRECT INPUT INTO MCHS-RED WING SYSTEM AND PROCESS CHANGES, OFFER INPUT TO LEADERSHIP IN THE PLANNING AND EVALUATION OF SERVICES, AND SERVE AS A VITAL LINK BETWEEN MCHS-RED WING AND THE COMMUNITY.MCHS-RED WING STAFF IS TRAINED TO IDENTIFY PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE PROGRAMS. THE ORGANIZATION HAS PROGRAMS IN PLACE FOR FINANCIAL ASSISTANCE TO HELP THOSE WHO ARE IN NEED OF HEALTH CARE BUT HAVE NO INSURANCE OR ARE NOT ABLE TO RECEIVE OTHER FINANCIAL ASSISTANCE. MCHS-RED WING ALSO PROVIDES FREE OR REDUCED COST SERVICES TO COMMUNITY MEMBERS THROUGH PREVENTATIVE HEALTH, SUPPORT FOR THE COUNTY WIDE FREE CLINIC (CARE CLINIC) AND FOOT CLINICS. AS THESE EXAMPLES OF INVOLVEMENT DEMONSTRATE, MCHS-RED WING IS CLOSELY CONNECTED WITH THE COMMUNITY. IN ADDITION TO THIS, MCHS-RED WING ACTIVELY SEEKS FEEDBACK FROM PATIENTS AND COMMUNITY MEMBERS THROUGH PRESS GANEY SURVEYS. THE SURVEY, WHICH IS ADMINISTERED BY PRESS GANEY, IS SENT TO A CROSS SECTION OF PATIENTS TO COMPILE USEFUL FEEDBACK ON WAYS MCHS-RED WING CAN IMPROVE CUSTOMER SERVICES AND DETERMINE WHETHER OR NOT THERE IS A NEED FOR NEW OR EXPANDED SERVICES. THE DATA FROM THE PRESS GANEY SURVEY IS REVIEWED AND ANALYZED BY MEMBERS OF QUALITY AND ADMINISTRATION DEPARTMENTS AS WELL AS MCHS-RED WING'S EMERGENCY ROOM (ER)/INPATIENT SATISFACTION TEAM, A TEAM DEDICATED TO IMPROVING PATIENT SATISFACTION IN THE ER AND HOSPITAL.THROUGH THESE VARIOUS AVENUES, MCHS-RED WING STAFF MEMBERS ACROSS MANY DEPARTMENTS STAY CONNECTED WITH THE COMMUNITY TO ASSESS THE HEALTH CARE NEEDS OF RED WING AND SURROUNDING AREAS. PART VI, LINE 3: MEASURES TO PUBLICIZE FINANCIAL ASSISTANCE POLICY:MAYO CLINIC IS COMMITTED TO OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY FOR THEIR MEDICAL SERVICES IN WHOLE OR IN PART. IN ORDER TO ACCOMPLISH THIS CHARITABLE GOAL, MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM SITES WIDELY PUBLICIZE THIS POLICY IN THE COMMUNITIES THAT THE INDIVIDUAL MAYO CLINIC AFFILIATED SITES SERVE. MAYO CLINIC AFFILIATED SITES MAKE COPIES OF THIS POLICY AND APPLICATIONS AVAILABLE BY POSTING IT ON THEIR WEBPAGE INCLUDING THE ABILITY TO DOWNLOAD A COPY OF THE POLICY AND APPLICATION FREE OF CHARGE. INDIVIDUALS IN THE COMMUNITY SERVED WILL BE ABLE TO OBTAIN A COPY OF THE POLICY IN LOCATIONS THROUGHOUT EACH MAYO CLINIC AFFILIATED SITE OR UPON REQUEST. THE POLICY EXPLAINS THE FINANCIAL ASSISTANCE PROGRAM AND FACTORS AFFECTING ELIGIBILITY. WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED. ADDITIONALLY, CHARITABLE CARE AND FINANCIAL ASSISTANCE IS REFERENCED ON PATIENT CORRESPONDENCE INCLUDING: THE MONTHLY STATEMENT OF ACCOUNT, ACCOUNT BALANCE LETTERS, AND LATE PAYMENT NOTIFICATIONS. ALL PATIENT CORRESPONDENCE REFERENCING CHARITABLE CARE AND FINANCIAL ASSISTANCE INCLUDE INTERNET, PHONE, AND MAILING ADDRESS CONTACT INFORMATION. PART VI, LINE 4: MAYO CLINIC HEALTH SYSTEM-RED WING (MCHS-RED WING) HAS LOCATIONS IN RED WING AND ZUMBROTA, MINNESOTA AND ELLSWORTH, WISCONSIN. THE MAJORITY OF MCHS-RED WING SERVICE AREAS INCLUDE GOODHUE COUNTY IN SOUTHEASTERN MINNESOTA AND PIERCE COUNTY IN WEST CENTRAL WISCONSIN. THE MAIN CAMPUS, LOCATED IN RED WING, INCLUDES A HOSPITAL LICENSED FOR 50 BEDS AND A MULTI-SPECIALTY HOSPITAL-BASED CLINIC WITH 89 PROVIDERS SERVING RED WING AND SURROUNDING COMMUNITIES. ACCORDING TO THE UNITED STATES CENSUS BUREAU THE ESTIMATED POPULATION OF GOODHUE COUNTY (WHICH COMPRISES MOST OF RED WING SERVICE AREA) IS 46,435. AN ESTIMATED 22.5% OF THE POPULATION IS LESS THAN 18 YEARS OF AGE AND 18.9% IS 65 YEARS OLD OR OLDER. THE MEDIAN HOUSEHOLD INCOME IS BASED ON 2010-2014 IS $57,229, AND AN ESTIMATED 9.6% INDIVIDUALS ARE LIVING BELOW POVERTY LEVEL. PART VI, LINE 5: THE FILING ORGANIZATION IS AN AFFILIATE OF THE MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION - EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO CLINIC HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY - IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.SURPLUS FUNDS - MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE.COMMUNITY REPRESENTATION ON GOVERNING BODYTHE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, WHETHER IN HEALTH CARE POLICY, BUSINESS, GOVERNMENT OR ANOTHER FIELD. IN ADDITION TO THIS COMMUNITY REPRESENTATION AT THE PARENT ENTITY, THE FILING ORGANIZATION ALSO INVOLVES LOCAL COMMUNITY MEMBERS ON ITS GOVERNING BODY.OPEN VS. CLOSED STAFF MODEL - STAFF PRIVILEGES ARE GENERALLY EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.EMERGENCY ROOM - THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK, WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY. PART VI, LINE 6: THIS ORGANIZATION IS A PART OF MAYO CLINIC HEALTH SYSTEM (WHICH IS PART OF A LARGER GROUP OF ENTITIES AFFILIATED WITH MAYO CLINIC). THE MAYO CLINIC HEALTH SYSTEM IS DESCRIBED IN RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O). THAT STATEMENT ALSO DESCRIBES THE ROLES OF THE VARIOUS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. PART VI, LINE 7 NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO A STATE HOSPITAL ASSOCIATION. 1 THE JONES FAMILY FOUNDATION 101 EAST FIFTH STREET STE 2400 SAINT PAUL MN 55101 453069865 501(C)(3) 6000 SUPPORT CHARITABLE PROGRAMS 1 0 CHARITABLE SUPPORT OF INDIVIDUALS 26 33799 SCHOLARSHIPS 5 7500 PART I, LINE 2: THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY, AND EQUALITY OF OPPORTUNITY. NO ADDITIONAL MONITORING IS PERFORMED. TRANSFERS OR GRANTS TO TAX-EXEMPT ORGANIZATIONS AND/OR AFFILIATED TAX-EXEMPT ORGANIZATIONS WILL BE USED PURSUANT TO THE POLICIES AND PROCEDURES OF THE GRANTEE ORGANIZATIONS AND TO FURTHER THE EXEMPT PURPOSES OF THE GRANTEE ORGANIZATIONS. BOTH THE FILING ORGANIZATION AND THE GRANTEE ORGANIZATION MAINTAIN ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED. SHORT-TERM FINANCIAL ASSISTANCE WAS PROVIDED TO INDIVIDUALS EXPERIENCING TEMPORARY HARDSHIPS. GRANTS ARE PROVIDED BASED ON A PROVEN NEED AND ARE NOT MONITORED. SCHOLARSHIPS ARE AWARDED TO INDIVIDUALS PURSUING A DEGREE IN A HEALTHCARE FIELD. THESE SCHOLARSHIPS ARE PAID DIRECTLY TO THE COLLEGE OR UNIVERSITY. 0 1 1 0 0 0 0 0 0 AGERTER MD DAVID C DIRECTOR/CEO 0 523301 0 0 0 74291 0 10639 0 15567 0 623798 0 0 DEJONG MD AMY A DIRECTOR 276239 0 0 0 695 0 38740 0 23587 0 339261 0 0 0 KETCHAM MD JEFFREY M DIRECTOR 683027 0 0 0 3520 0 48558 0 24288 0 759393 0 0 0 PARKS DOUGLAS A DIRECTOR/SECRETARY/CAO 0 236962 0 0 0 2137 0 28462 0 21555 0 289116 0 0 SIMPSON MD HENRY J DIRECTOR 0 308600 0 0 0 1958 0 61746 0 14232 0 386536 0 0 WILLIAMS MD AMY W DIRECTOR 0 281672 0 0 0 14967 0 45478 0 3009 0 345126 0 0 GUDGELL STEPHEN F TREASURER 0 201637 0 0 0 1391 0 8287 0 16048 0 227363 0 0 KOCH MARK B ASS'T SECRETARY 0 446213 0 0 0 36983 0 10710 0 12967 0 506873 0 0 TARASOVITCH JAMES J CFO 0 301807 0 0 0 7337 0 47461 0 19489 0 376094 0 0 WITT MD THOMAS J PRESIDENT 0 425606 0 0 0 48467 0 52327 0 17502 0 543902 0 0 BREHMER MD JESS L PHYSICIAN 522987 0 0 0 18241 0 26338 0 20196 0 587762 0 0 0 EICH MD MATTHEW A PHYSICIAN 584531 0 0 0 12234 0 31814 0 17581 0 646160 0 0 0 HUGHES MD EVERETT M PHYSICIAN 626101 0 0 0 1619 0 39341 0 23695 0 690756 0 0 0 JOHNSON MD MICHAEL R PHYSICIAN 580773 0 0 0 12734 0 28913 0 18948 0 641368 0 0 0 SMITH MD HUGH S PHYSICIAN 623997 0 0 0 1335 0 34926 0 24193 0 684451 0 0 0 DIMUNATION NANCY FORMER KEY EMPLOYEE 176915 0 0 0 11163 0 18148 0 15883 0 222109 0 0 0 PART I, LINE 3 THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990 PART VI SECTION B LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED. PART I, LINES 4B-C THIS ENTITY OR ITS AFFILIATE HAS A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE MAYO PENSION PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(A)(17). STARTING JANUARY 1, 2011, ALL SRP BENEFITS ARE PAID AS AN ANNUAL TAXABLE CASH PAYMENT. THE FOLLOWING INDIVIDUALS PARTICIPATED IN OR RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). AGERTER M.D., DAVID C. $ 67,586 BREHMER M.D., JESS L. $ 0 DEJONG M.D., AMY A. $ 0 EICH M.D., MATTHEW A. $ 0 HUGHES M.D., EVERETT M. $ 0 JOHNSON M.D., MICHAEL R. $ 0 KETCHAM M.D., JEFFREY M. $ 0 KOCH, MARK B. $ 33,730 SIMPSON M.D., HENRY J. $ 0 SMITH M.D., HUGH S. $ 0 TARASOVITCH, JAMES J. $ 0 WILLIAMS M.D., AMY W. $ 12,546 WITT M.D., THOMAS J. $ 42,856 UNDER MAYO CLINIC'S ROYALTY SHARING POLICY, INVENTORS, INCLUDING LISTED PERSONS, ARE ENTITLED TO SHARE IN A PORTION OF ROYALTIES RECEIVED BY MAYO INCLUDING INSTANCES WHERE SUCH ROYALTIES ARE IN THE FORM OF EQUITY-BASED INSTRUMENTS SUCH AS STOCK, WARRANTS, OR PARTNERSHIP INTERESTS. THE FOLLOWING INDIVIDUALS PARTICIPATED IN AN EQUITY-BASED COMPENSATION ARRANGEMENT: GUDGELL, STEPHEN F. PART II: COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. JESS L BREHMER MD HIGHEST COMPENSATED EMPLOYEE SIGNING BONUS IN THE FORM OF A FORGIVABLE LOAN X 50000 11183 0 0 1 11183 FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUAL(S) IS/ARE EMPLOYED BY A RELATED ORGANIZATION: TARASOVITCH, JAMES J. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL(S) WHO IS/ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: KOCH, MARK B. THE FOLLOWING INDIVIDUAL(S) IS/ARE EMPLOYED BY A RELATED ORGANIZATION: WITT M.D., THOMAS J. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL(S) WHO IS/ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: TARASOVITCH, JAMES J., GUDGELL, STEPHEN F., PARKS, DOUGLAS A., KOCH, MARK B., AGERTER M.D., DAVID C. THE FOLLOWING INDIVIDUAL(S) IS/ARE EMPLOYED BY A RELATED ORGANIZATION: SIMPSON M.D., HENRY J. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL(S) WHO IS/ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: WITT M.D., THOMAS J. FORM 990, PART VI, SECTION A, LINE 3 MAYO CLINIC, MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, AND OTHER RELATED COMPANIES PROVIDE MANAGEMENT SERVICES TO THE ENTIRE SYSTEM OF ENTITIES. SINCE THE ENTITIES ARE RELATED ORGANIZATIONS, COMPENSATION FOR THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES HAS BEEN DISCLOSED IN PART VII AND SCHEDULE J AS REQUIRED. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER IS MAYO CLINIC. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER ELECTS THE MEMBER DIRECTORS. THE MEMBER ELECTS COMMUNITY PHYSICIAN DIRECTORS FROM A SLATE NOMINATED BY THE MEDICAL STAFF. FORM 990, PART VI, SECTION A, LINE 7B THE ARTICLES AND BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, BUDGET, DEBT, AMENDMENT OF THE ARTICLES AND BYLAWS, AND GENERAL OPERATION DECISIONS. FORM 990, PART VI, SECTION A, LINE 8B THE FILING ORGANIZATION HAS NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE REGION CHIEF FINANCIAL OFFICER AND FINANCE DIRECTOR, ALONG WITH SITE FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C MAYO CLINIC AND ITS AFFILIATES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS, EXECUTIVE AND SENIOR ADMINISTRATIVE LEADERSHIP, ALONG WITH ALLIED HEALTH STAFF. IN ADDITION TO ANY REVIEW AND APPROVAL THAT MAY TAKE PLACE AT THE LOCAL ENTITY OR REGIONAL LEVEL, THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY PRIOR TO IMPLEMENTATION OF THE RESPECTIVE COMPENSATION INCREASE. THE SALARIES AND BENEFIT PROGRAMS OF THE CHIEF EXECUTIVE OFFICER (CEO) AND THE CHIEF ADMINISTRATIVE OFFICER (CAO) WERE REVIEWED AND APPROVED BY THE PROCESS DESCRIBED BELOW FOR SENIOR ADMINISTRATIVE LEADERSHIP. THE COMPENSATION AND BENEFIT PROGRAMS FOR SENIOR ADMINISTRATIVE LEADERSHIP FOR ALL CAMPUSES, INCLUDING THE MAYO CLINIC HEALTH SYSTEM LOCATIONS, ARE REVIEWED AND APPROVED BY THE MAYO CLINIC BOARD OF TRUSTEES GOVERNANCE AND NOMINATING COMMITTEE. THE MAYO CLINIC BOARD OF TRUSTEES GOVERNANCE AND NOMINATING COMMITTEE IS COMPRISED OF NINE OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. THIS GROUP REVIEWS AND APPROVES THE COMPENSATION AND BENEFIT PROGRAMS FOR PHYSICIANS FROM ALL CAMPUSES, AS WELL AS CERTAIN SENIOR ADMINISTRATIVE AND EXECUTIVE LEADERSHIP (INCLUDING ALL PERSONS BELIEVED TO BE DISQUALIFIED PERSONS). THIS PROCESS ESTABLISHES ACCEPTABLE RANGES FOR VARIOUS POSITIONS, LEVELS, AND SPECIALTIES. THE COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. THE FILING ORGANIZATION IS A HOSPITAL AFFILIATED WITH MAYO CLINIC. AS SUCH, MAYO CLINIC'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FILING ORGANIZATION'S FORM 990 AND WOULD BE AVAILABLE UPON REQUEST OF THE FORM 990. FORM 990, PART IX, LINE 11G IC PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 12,417,838. MANAGEMENT AND GENERAL EXPENSES 4,533,417. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,951,255. OTHER PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 3,442,742. MANAGEMENT AND GENERAL EXPENSES 342,136. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,784,878. FILING OF CERTAIN FOREIGN FORMS DISCLOSURE STATEMENT RELATED TO FORMS 5713: FORM 5713 HAS BEEN FILED BY THE FOLLOWING MEMBERS OF THE CONTROLLED GROUP: MAYO CLINIC (EIN: 41-6011702) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH (EIN: 41-1506440) DISCLOSURE STATEMENT RELATED TO FORMS 5471: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 4 AND 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED TAXPAYER NAME: MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-1506440 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED DISCLOSURE STATEMENT RELATED TO FORMS 8865: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 8865, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS, AS A CATEGORY 2 AND 3 FILER. THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 8865 FOR THESE PARTNERSHIPS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 8865 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED BLOOMER LAKEVIEW INC 2110 DUNCAN ROAD BLOOMER WI 54724 391450617 LOW INCOME HOUSING WI 501(C)(3) 7 MCHS--CHIPPEWA VALLEY INC 1 CHARTERHOUSE INC 200 FIRST STREET SW ROCHESTER MN 55905 411405254 RETIREMENT LIVING CENTER MN 501(C)(3) 9 MAYO CLINIC 1 DESTINATION MEDICAL CENTER EDA 50 SOUTH SIXTH STREET SUITE 1500 MINNEAPOLIS MN 554021498 464893585 ECONOMIC DEVELOPMENT MN 501(C)(3) 11-I MAYO CLINIC 1 GOLD CROSS AMBULANCE SERVICE 200 FIRST STREET SW ROCHESTER MN 55905 411917516 AMBULANCE SERVICE MN 501(C)(3) 9 MFMER 1 LUTHER LAKESIDE APARTMENTS INC PO BOX 1510 EAU CLAIRE WI 54702 391409024 LOW INCOME HOUSING FOR ELDERLY WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 416011702 PATIENT CARE - CLINIC MN 501(C)(3) 9 N/A 1 MAYO CLINIC ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 860800150 HOSPITAL AND CLINIC AZ 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 590714831 HOSPITAL FL 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MAYO CLINIC HOSPITAL -- ROCHESTER 200 FIRST STREET SW ROCHESTER MN 55905 410944601 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC JACKSONVILLE 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 593337028 PATIENT CARE - CLINIC FL 501(C)(3) 7 MAYO CLINIC 1 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 200 FIRST STREET SW ROCHESTER MN 55905 411506440 CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES MN 501(C)(3) 9 MAYO CLINIC 1 MAYO CLINIC STIFTUNG 60486 FRANKFURT AM MAIN FRANKFURT GM FUNDRAISING FOUNDATION GM MFMER 1 MCHS IN WAYCROSS INC 1900 TEBEAU STREET WAYCROSS GA 31501 581667166 HOSPITAL GA 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MCHS--ALBERT LEA AND AUSTIN 1000 FIRST DRIVE NW AUSTIN MN 55912 411404075 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--AUSTIN FOUNDATION 1000 FIRST DRIVE NW AUSTIN MN 55912 300107471 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--ALBERT LEA AND AUSTIN 1 MCHS--CANNON FALLS 32021 COUNTY ROAD 24 BLVD CANNON FALLS MN 55009 204156428 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--CHIPPEWA VALLEY INC 1501 THOMPSON STREET BLOOMER WI 54724 390980343 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MCHS--EAU CLAIRE CLINIC INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE WI 54702 391735831 PATIENT CARE - CLINIC WI 501(C)(3) 3 MAYO CLINIC 1 MCHS--EAU CLAIRE FOUNDATION INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE WI 54702 391633407 GRANTMAKING FOUNDATION WI 501(C)(3) 11-I MCHS--EAU CLAIRE CLINIC INC 1 MCHS--EAU CLAIRE HOSPITAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 390813418 HOSPITAL WI 501(C)(3) 3 MAYO CLINIC 1 MCHS--FAIRMONT 800 MEDICAL CENTER DRIVE PO BOX 800 FAIRMONT MN 56031 410760836 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MCHS--FRANCISCAN HEALTHCARE FOUNDATION INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391186647 FUNDRAISING FOUNDATION WI 501(C)(3) 7 MCHS--FRANCISCAN HEALTHCARE INC 1 MCHS--FRANCISCAN HEALTHCARE INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391411999 HEALTHCARE SYSTEM PARENT WI 501(C)(3) 11-I MAYO CLINIC 1 MCHS--FRANCISCAN MEDICAL CENTER INC 700 WEST AVE SOUTH LA CROSSE WI 54601 390806374 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--FRANCISCAN HEALTHCARE INC 1 MCHS--LAKE CITY 500 WEST GRANT STREET LAKE CITY MN 55041 411906820 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--MANKATO 1025 MARSH STREET MANKATO MN 56002 411236756 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--MANKATO HEALTH CARE FOUNDATION 1025 MARSH STREET MANKATO MN 56002 411663357 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--MANKATO 1 MCHS--NEW PRAGUE 301 SECOND STREET NE NEW PRAGUE MN 56071 410723639 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MCHS--NORTHLAND INC 1222 EAST WOODLAND AVENUE BARRON WI 54812 390920634 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MCHS--OAKRIDGE INC 13025 EIGHTH STREET PO BOX 70 OSSEO WI 54758 391029430 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MCHS--OWATONNA 134 SOUTHVIEW ST OWATONNA MN 55060 411862132 PATIENT CARE - CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--RED CEDAR INC 2321 STOUT ROAD MENOMONIE WI 54751 510190875 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MCHS--RED WING 701 HEWITT BOULEVARD RED WING MN 55066 411713783 PATIENT CARE SERVICES MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--SPRINGFIELD 625 NORTH JACKSON AVENUE SPRINGFIELD MN 56087 411893827 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MCHS--ST JAMES 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 410797368 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MCHS--WASECA 501 NORTH STATE STREET WASECA MN 56093 363606405 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES 200 FIRST STREET SW ROCHESTER MN 55905 412020392 SUPPORT RESEARCH, PRACTICE & EDUCATION MN 501(C)(3) 11-I MAYO CLINIC 1 POVERELLO FOUNDATION 200 FIRST STREET SW ROCHESTER MN 55905 411494881 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC HOSPITAL - ROCHESTER 1 FRANKLIN HEATING STATION 119 THIRD ST SW ROCHESTER MN 55902 410264830 UTILITY MN N/A LATIGO PETROLEUM LLC PO BOX 14230 ODESSA TX 79768 364767494 OIL & GAS EXPLORATION DE N/A WATERSHED CAP INSTL PRTNRS III LP ONE MARITIME PLAZA SUITE 1525 SAN FRANCISCO CA 94111 462982848 INVESTMENT ACTIVITIES DE N/A AMBIENT CLINICAL ANALYTICS INC 221 1ST AVE SW SUITE 202 ROCHESTER MN 55902 800928405 SOFTWARE DE N/A C 1 BWL HOLDINGS INC 1209 ORANGE STREET WILMINGTON DE 19801 472413749 OIL & GAS EXPLORATION DE N/A C 1 CAVALRY CLO III LTD PO BOX 1093 GT QUEENSGATE HOUSE S GRAND CAYMAN CJ INVESTMENT ACTIVITIES CJ N/A C 1 CAVALRY CLO IV LTD PO BOX 1093 GT QUEENSGATE HOUSE S GRAND CAYMAN CJ INVESTMENT ACTIVITIES CJ N/A C 1 GMO GLOBAL BOND INVESTMENT FUND 78 SIR JOHN ROGERSONS QUAY DUBLIN 2 EI OTHER FINANCIAL INVESTMENT ACTIVITIES EI N/A 1 HEALTH TRADITION HEALTH PLAN 1808 EAST MAIN STREET ONALASKA WI 54650 391545987 MEDICAL SERVICES COMPANY WI N/A C 1 LOBSS NETWORK SUPPORT 2002 INC 200 FIRST STREET SW ROCHESTER MN 55905 481276150 ADMINISTRATIVE SERVICES MN N/A C 1 MAYO CLINIC GBS MAURITIUS 2ND FLOOR EBENE MEWS 57 EBENE CYBERCITY MP HEALTHCARE MANAGEMENT MP N/A C 1 MAYO CLINIC SUPPORT SERVICES TEXAS 200 FIRST STREET SW ROCHESTER MN 55905 471751102 HEALTH SERVICES TX N/A C 1 MAYO HOLDING COMPANY 200 FIRST STREET SW ROCHESTER MN 55905 411578020 HOLDING COMPANY MN N/A C 1 MAYO INSURANCE COMPANY LTD 200 FIRST STREET SW ROCHESTER MN 55905 SELF INSURANCE POOL CJ N/A C 1 MCHS--DECORAH CLINIC PHYSICIANS 907 MONTGOMERY STREET DECORAH IA 52101 411711329 PATIENT CARE - CLINIC IA N/A C 1 MCHS--PHARMACY & HOME MEDICAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 391528920 PHARMACY SERVICES WI N/A C 1 MMSI INC 200 FIRST STREET SW ROCHESTER MN 55905 411547003 THIRD PARTY ADMINISTRATION SERVICES MN N/A C 1 RESOUNDANT INC 221 1ST AVE SW SUITE 202 ROCHESTER MN 55902 461661978 MANUFACTURING MEDICAL DEVICE COMPONENT MN N/A C 1 ROCHESTER AIRPORT COMPANY 200 FIRST STREET SW ROCHESTER MN 55905 410506870 AIRPORT MANAGEMENT MN N/A C 1 SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION 13400 E SHEA BLVD SCOTTSDALE AZ 85259 860870505 COMMERCIAL PROPERTY OWNERS ASSOCIATION AZ N/A C 1 THE STABILE BUILDING OWNERS' ASSOCIATION 200 FIRST STREET SW ROCHESTER MN 55905 208994499 COMMERCIAL PROPERTY OWNERS ASSOCIATION MN N/A C 1 CHARITABLE LEAD TRUST CHARITABLE TRUST CA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST ND N/A T 1 PERPETUAL TRUST CHARITABLE TRUST AZ N/A T 1 PERPETUAL TRUST CHARITABLE TRUST LA N/A T 1 PERPETUAL TRUST (2) CHARITABLE TRUST MA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST MO N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST AZ N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST CO N/A T 1 CHARITABLE REMAINDER TRUST (8) CHARITABLE TRUST FL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST LA N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST MA N/A T 1 CHARITABLE REMAINDER TRUST (77) CHARITABLE TRUST MN N/A T 1 CHARITABLE REMAINDER TRUST (2) CHARITABLE TRUST NC N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST TX N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST CO N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST IL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST MI N/A T 1 CHARITABLE REMAINDER TRUST (64) CHARITABLE TRUST MN N/A T 1 CHARITABLE REMAINDER TRUST (7) CHARITABLE TRUST MN N/A T 1 1 0 1 0 1 0 0 0 0 0 0 1 1 1 0 1 1 1 1 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH A 8850 GAAP MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH P 37168216 GAAP MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH S 187120 GAAP MCHS-ALBERT LEA AND AUSTIN M 3889577 GAAP MCHS-ALBERT LEA AND AUSTIN P 9958442 GAAP MCHS-ALBERT LEA AND AUSTIN R 6888351 GAAP MCHS-EAU CLAIRE CLINIC INC M 207735 GAAP MCHS-EAU CLAIRE HOSPITAL INC M 565666 GAAP MMSI INC S 5766282 GAAP