MAYO CLINIC HEALTH SYSTEM-CANNON FALLS: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- MAYO CLINIC HEALTH SYSTEM-CANNON FALLS (EIN 20-4156428)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-10
- IRS object ID
- 201503149349302275
- Schema version
- 2014v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-10T12:28:05-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204156428 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAYO CLINIC HEALTH SYSTEM-CANNON FALLS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MAYO | BusinessNameControlTxt |
| Phone | 5075381297 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 32021 COUNTY ROAD 24 BLVD | AddressLine1Txt |
| City | CANNON FALLS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55009 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES J TARASOVITCH | PersonNm |
| Person Title | REGION CFO | PersonTitleTxt |
| Phone | 5072634221 | PhoneNum |
| Signature | 2015-11-10 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | DAVID C AGERTER MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 32021 COUNTY ROAD 24 BLVD | AddressLine1Txt |
| City | CANNON FALLS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55009 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $28,314,825 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 5983 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MAYOCLINICHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | OPERATION OF A HOSPITAL AND CLINIC. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 225 | TotalEmployeeCnt |
| Total Volunteers | 32 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,418,739 | PYContributionsGrantsAmt |
| CY Contributions Grants | $395,892 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $23,357,673 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $27,284,171 | CYProgramServiceRevenueAmt |
| PY Investment Income | $841,129 | PYInvestmentIncomeAmt |
| CY Investment Income | $439,950 | CYInvestmentIncomeAmt |
| PY Other Revenue | $57,591 | PYOtherRevenueAmt |
| CY Other Revenue | $53,160 | CYOtherRevenueAmt |
| PY Total Revenue | $26,675,132 | PYTotalRevenueAmt |
| CY Total Revenue | $28,173,173 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $9,750 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $7,917 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,848,634 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,040,096 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $15,000 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $15,000 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $15,000 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,835,311 | PYOtherExpensesAmt |
| CY Other Expenses | $12,428,761 | CYOtherExpensesAmt |
| PY Total Expenses | $22,708,695 | PYTotalExpensesAmt |
| CY Total Expenses | $25,491,774 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,966,437 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,681,399 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $23,875,577 | TotalAssetsBOYAmt |
| Total Assets EOY | $47,754,061 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,901,070 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $24,096,108 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $20,974,507 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,657,953 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $21,054,443 | ExpenseAmt |
| Revenue | $27,321,815 | RevenueAmt |
| Desc | PATIENT SERVICES (HOSPITAL & CLINIC) - SEE SCHEDULE OMAYO 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 NEARLY 70 COMMUNITIES, MAYO CLINIC HEALTH SYSTEM INCLUDES 19 OWNED HOSPITALS, FIVE 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.MAYO CLINIC HEALTH SYSTEM IN CANNON FALLS (MCHS-CF) MOVED TO A NEW STATE-OF-THE-ART FACILITY IN 2014. THE NEW MEDICAL CENTER IS 92,000 SQUARE FEET AND INCLUDES A CLINIC, HOSPITAL AND A 24/7 EMERGENCY DEPARTMENT IN A SINGLE FACILITY DESIGNED TO PROVIDE A MORE SEAMLESS HEALTH CARE EXPERIENCE. PATIENTS AND VISITORS CAN EXPECT AN IMPROVED OVERALL EXPERIENCE BEYOND THE CONTINUED PRESENCE OF DEPENDABLE, HIGH-QUALITY HEALTH CARE. THE NEW FACILITY HAS THREE TIMES MORE SPACE THAN THE PREVIOUS ONE ALLOWING MCHS-CF TO EXPAND PRIMARY AND SPECIALTY SERVICES, IMPROVE PRIVACY AND ADD NEW TECHNOLOGY. HEALTH CARE TEAMS WILL BE ABLE TO COLLABORATE MORE EASILY TO MEET PATIENT NEEDS.IN 2014, MAYO CLINIC HEALTH SYSTEM-CANNON FALLS (MCHS-CF) HAD 325 MEDICAL/SURGICAL ADMISSIONS AND 111 SWING BED ADMISSIONS WITH AN AVERAGE DAILY CENSUS OF 9.1. THERE WERE ALSO 3,370 EMERGENCY ROOM VISITS AND 211 OUTPATIENT SURGERIES. MCHS-CF PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. IN 2014, THE COST OF CHARITY CARE PROVIDED BY MCHS-CF WAS APPROXIMATELY $103,600.SERVICES ARE ALSO PROVIDED TO MEDICAID AND MEDICARE PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN ADDITION, SERVICES ARE PROVIDED TO PATIENTS UNDER OTHER MEANS-TESTED GOVERNMENT PROGRAMS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. THE COST OF UNCOMPENSATED CARE PROVIDED TO LOW INCOME PATIENTS THROUGH MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS WAS APPROXIMATELY $1,251,000. THIS AMOUNT INCLUDES A MEDICAID SURCHARGE OF $200,222 AND $261,150 PAID TO MINNESOTA CARE (A PROGRAM THAT PROVIDES HEALTH CARE FOR LOW INCOME POPULATIONS).MCHS-CF ALSO LEASES SPACE TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE OF PROVIDING PATIENT CARE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $161,430 | ExpenseAmt |
| Grant | $7,917 | GrantAmt |
| Revenue | $13,968 | RevenueAmt |
| Desc | COMMUNITY OUTREACH - SEE SCHEDULE OMAYO CLINIC HEALTH SYSTEM-CANNON FALLS (MCHS-CF) PARTICIPATES IN COMMUNITY AND WELLNESS EVENTS WHERE FREE OR NOMINAL FEE SCREENING TESTS ARE OFFERED AS WELL AS FREE PATIENT EDUCATION MATERIALS. THESE EVENTS INCLUDE FIRST THURSDAYS, SHEPHERDS CENTER, AND TWIN RIVERS. FLU SHOTS WERE GIVEN TO VOLUNTEER FIREFIGHTERS AND AMBULANCE RESPONDERS. EMERGENCY PREPAREDNESS TRAINING WAS PROVIDED TO 28 FIRE FIGHTERS THROUGH USE OF THE PREVIOUS MEDICAL FACILITY. FREE COMMUNITY SCREENING FOR DIABETES IS DONE THROUGH A PARTNERSHIP WITH THE LOCAL LIONS CLUB AT THE MEDICAL CENTER ON AN ANNUAL BASIS. MCHS-CF MEALS ON WHEELS PROGRAM PROVIDES FREE HOME DELIVERED NOON MEALS TO HOMEBOUND SENIORS OVER 60 WITH A MODERATE TO HIGH NUTRITIONAL RISK. THIS PROGRAM IS AVAILABLE ON AN ANNUAL BASIS, MONDAY THROUGH FRIDAY TO APPROXIMATELY 12-15 DAILY PARTICIPANTS WITH MORE THAN 185 DIFFERENT COMMUNITY MEMBERS RECEIVING MEALS DURING 2014. MCHS-CANNON FALLS OFFERED SPORTS PHYSICALS AT A REDUCED RATE FOR 17 STUDENTS WHO ARE PARTICIPATING IN SPORTS THROUGH THE LOCAL SCHOOLS AND COMPLETED CONCUSSION ASSESSMENTS FOR 7 STUDENT ATHLETES. MCHS-CF AUXILIARY PROVIDES APPROXIMATELY 28 VOLUNTEERS TO GREET AND DIRECT PATIENTS DURING HIGH-VOLUME SURGERY WEEKDAYS AND OFFERS CLERICAL SUPPORT TO STAFF. THE AUXILIARY VOLUNTEERS PROVIDED APPROXIMATELY 891 HOURS OF VOLUNTEER SERVICES. BASED ON THE 2014 INDEPENDENT SECTOR STATISTICS, THE APPROXIMATE VALUE OF THESE SERVICES IS $20,555. THE AUXILIARY ALSO SPONSORS A SCHOLARSHIP PROGRAM FOR LOCAL STUDENTS PURSUING A CAREER IN A HEALTH-CARE RELATED FIELD; IN 2014 $3,000 WAS GIVEN OUT IN SCHOLARSHIPS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $21,215,873 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | 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 | 0 | TaxExemptBondsInd |
| 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 | Yes (1) | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 225 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | 0 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | 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 | MAYO CORPORATE TAX UNIT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5075381297 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 FIRST STREET SW | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55905 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| ALTRICHTER MD PAUL M | |||||||||
| VICE CHAIR / DIRECTOR | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $237,245 | $54,876 | ||
| BAILEY TED | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BERNARD MD MATTHEW E | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $262,980 | $53,837 | |||
| BREKKEN KATHLEEN A | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| PARKS DOUGLAS A | |||||||||
| DIRECTOR / REGION CAO | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $232,013 | $50,759 | ||
| SJOQUIST MARK E | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| WHITED MD BRIAN L | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $444,464 | $39,145 | |||
| WITT MD THOMAS J | |||||||||
| CHAIR / CEO / DIRECTOR | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $456,792 | $66,580 | ||
| WULF GREG | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| AGERTER MD DAVID C | |||||||||
| REGION CEO | 1.00 | 40.00 | Yes (X) | $0 | $555,112 | $18,208 | |||
| CHRISTIAN GLENN P | |||||||||
| SECRETARY (1/1-3/17/14) | 40.00 | 0.00 | Yes (X) | $177,403 | $0 | $44,054 | |||
| GUDGELL STEPHEN F | |||||||||
| CORRIDOR CAO/TREASURER (3/17-12/31) | 1.00 | 40.00 | Yes (X) | $0 | $196,790 | $19,698 | |||
| KOCH MARK B | |||||||||
| ASST SECRETARY | 1.00 | 40.00 | Yes (X) | $0 | $395,727 | $18,025 | |||
| PRIEST WILLIAM F | |||||||||
| SECRETARY (3/17-12/31/14) | 40.00 | 0.00 | Yes (X) | $191,580 | $0 | $52,234 | |||
| TARASOVITCH JAMES J | |||||||||
| REGION CFO | 1.00 | 40.00 | Yes (X) | $0 | $354,461 | $28,513 | |||
| TUSA EDWARD A | |||||||||
| SITE CFO / TREASURER (1/1-3/17/14) | 40.00 | 0.00 | Yes (X) | $130,062 | $0 | $44,927 | |||
| CHESTNUT MD JANET S | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $343,700 | $0 | $70,580 | Yes (X) | |||
| JOHNSTON-FLANDERS MD MEGAN S | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $257,733 | $0 | $46,404 | Yes (X) | |||
| NORDAHL MD THOMAS W | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $614,256 | $0 | $73,689 | Yes (X) | |||
| STRICKER MD ALEXANDER W | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $272,979 | $0 | $24,720 | Yes (X) | |||
| TURNA MD TARLOCHAN S | |||||||||
| FAMILY MEDICINE PHYSICIAN | 40.00 | 0.00 | $356,443 | $0 | $43,822 | Yes (X) | |||
| LOHR MD ROBERT H | |||||||||
| FMR INTERIM CHAIR / CEO | 0.00 | 40.00 | $0 | $260,876 | $70,445 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,344,156 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,396,460 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $820,516 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| TW WALTER ANESTHESIA SERVICES INC | |||||
| 17189 COUNTY 27 BLVD | PINE ISLAND | MN | 55963 | ANESTHESIA (CRNA) | $273,381 |
| MAYO CLINIC | |||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | LAB & OTHER SUPPORT SERVICES | $238,193 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $219,600 | RelatedOrganizationsAmt |
| Government Grants | $176,292 | GovernmentGrantsAmt |
| Total Contributions | $395,892 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 620000 | $27,268,103 | $27,268,103 |
| MEALS ON WHEELS | 624210 | $13,968 | $13,968 |
| RENT FROM AFFILIATE | 531120 | $2,100 | $2,100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $27,284,171 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $478,726 | TotalRevenueColumnAmt |
| Exclusion | $478,726 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $102,876 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $141,652 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$38,776 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$38,776 | TotalRevenueColumnAmt |
| Exclusion | -$38,776 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| CAFETERIA / VENDING | 722210 | $52,232 | $51,184 | $1,048 |
| MEDICAL DIRECTOR FEES | 541900 | $500 | $500 | |
| MEDICAL RECORDS | 541900 | $418 | $418 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $53,160 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,173,173 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,335,783 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $441,498 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,917 | TotalAmt |
| Program Services | $4,917 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,000 | TotalAmt |
| Program Services | $3,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $640,260 | TotalAmt |
| Management And General | $640,260 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,184,382 | TotalAmt |
| Program Services | $1,184,382 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,522,047 | TotalAmt |
| Program Services | $8,522,047 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $592,181 | TotalAmt |
| Program Services | $592,181 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,479,435 | TotalAmt |
| Program Services | $1,479,435 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $621,791 | TotalAmt |
| Program Services | $593,265 | ProgramServicesAmt |
| Management And General | $28,526 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,378 | TotalAmt |
| Management And General | $14,378 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,028 | TotalAmt |
| Program Services | $1,028 | ProgramServicesAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,000 | TotalAmt |
| Fundraising | $15,000 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,080,036 | TotalAmt |
| Program Services | $2,043,950 | ProgramServicesAmt |
| Management And General | $3,036,086 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500 | TotalAmt |
| Management And General | $500 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,089,585 | TotalAmt |
| Program Services | $1,038,038 | ProgramServicesAmt |
| Management And General | $51,547 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,341 | TotalAmt |
| Program Services | $65,341 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $519,740 | TotalAmt |
| Program Services | $519,170 | ProgramServicesAmt |
| Management And General | $570 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,802 | TotalAmt |
| Program Services | $55,581 | ProgramServicesAmt |
| Management And General | $9,221 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,507 | TotalAmt |
| Program Services | $34,437 | ProgramServicesAmt |
| Management And General | $5,070 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,056 | TotalAmt |
| Program Services | $8,056 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,886,017 | TotalAmt |
| Program Services | $1,522,417 | ProgramServicesAmt |
| Management And General | $363,600 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,967 | TotalAmt |
| Program Services | $1,195 | ProgramServicesAmt |
| Management And General | $69,772 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| BAD DEBT EXPENSE | $1,657,320 | $1,657,320 |
| MEDICAL SUPPLIES | $1,395,813 | $1,395,813 |
| MN CARE TAX | $261,151 | $261,151 |
| MEDICAID SURCHARGE | $200,220 | $200,220 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,300 | TotalAmt |
| Program Services | $32,929 | ProgramServicesAmt |
| Management And General | $41,371 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,491,774 | TotalAmt |
| Program Services | $21,215,873 | ProgramServicesAmt |
| Management And General | $4,260,901 | ManagementAndGeneralAmt |
| Fundraising | $15,000 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $750 | BOYAmt |
| EOY | $496 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,032,700 | BOYAmt |
| EOY | $2,107,557 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,743,185 | BOYAmt |
| EOY | $6,252,510 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,302 | BOYAmt |
| EOY | $285,199 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $134,977 | BOYAmt |
| EOY | $64,178 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $33,019,943 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,402,713 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,270,233 | BOYAmt |
| EOY | $30,617,230 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,462,430 | BOYAmt |
| EOY | $8,426,891 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,875,577 | BOYAmt |
| EOY | $47,754,061 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,102,677 | BOYAmt |
| EOY | $3,289,541 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $798,393 | BOYAmt |
| EOY | $20,806,567 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,901,070 | BOYAmt |
| EOY | $24,096,108 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,659,168 | BOYAmt |
| EOY | $21,585,758 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,262,759 | BOYAmt |
| EOY | $2,019,615 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,580 | BOYAmt |
| EOY | $52,580 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,974,507 | BOYAmt |
| EOY | $23,657,953 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,875,577 | BOYAmt |
| EOY | $47,754,061 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,681,399 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,047 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,028 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,028 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE AMOUNT IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $52,580 | BeginningYearBalanceAmt |
| End Year Balance | $52,580 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $52,580 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,087 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,087 | OtherExpendituresAmt |
| End Year Balance | $52,580 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $52,580 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,066 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,066 | OtherExpendituresAmt |
| End Year Balance | $52,580 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $52,580 | BeginningYearBalanceAmt |
| End Year Balance | $52,580 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $52,580 | BeginningYearBalanceAmt |
| End Year Balance | $52,580 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $770,066 | OtherCostOrOtherBasisAmt |
| Book Value | $770,066 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,425,461 | OtherCostOrOtherBasisAmt |
| Depreciation | $673,232 | DepreciationAmt |
| Book Value | $25,752,229 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,580,018 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,729,481 | DepreciationAmt |
| Book Value | $3,850,537 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $244,398 | OtherCostOrOtherBasisAmt |
| Book Value | $244,398 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $30,617,230 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| HOSPITAL DISTRICT INVESTMENT | $21,783 | F |
| MAYO POOLED INVESTMENTS | $8,405,108 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $8,426,891 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $172,465 |
| DUE TO AFFILIATES | $20,634,102 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $20,806,567 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENT FUNDS PROVIDE A STABLE FUNDING SOURCE TO SUPPORT THE MISSION OF THE ORGANIZATION. |
| PART X, LINE 2: | AT DECEMBER 31, 2014 AND 2013, THE RESERVE FOR UNRECOGNIZED TAX BENEFITS WAS NOT SIGNIFICANT, AND AS A RESULT, THERE IS NO LONGER A RESERVE FOR UNRECOGNIZED TAX BENEFITS RECORDED FOR THE FILING ORGANIZATION. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| 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 | $103,636 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $103,636 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00430 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,653,534 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $720,855 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $932,679 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03910 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $572,930 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $254,582 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $318,348 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01340 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,330,100 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $975,437 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,354,663 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05680 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35,643 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,968 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,675 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $120,873 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $120,873 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $156,516 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,968 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $142,548 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00600 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,486,616 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $989,405 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,497,211 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06280 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,750 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,750 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $100 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $100 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,567 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,567 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,917 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,917 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,657,320 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $10,466,870 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,544,977 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$78,107 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | MAYO CLINIC HEALTH SYSTEM-CANNON FALLS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 32021 COUNTY ROAD 24 BLVD | AddressLine1Txt |
| City | CANNON FALLS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55009 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | MAYOCLINICHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| State License | 140 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAYO CLINIC HEALTH SYSTEM-CANNON FALLS | 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 |
| 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 |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | 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 | MAYOCLINICHEALTHSYSTEM.ORG/ABOUT-US | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | 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 |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| 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 Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MAYO CLINIC HEALTH SYSTEM-CANNON FALLS | 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 HEALTH INITIATIVE. |
| MAYO CLINIC HEALTH SYSTEM-CANNON FALLS | 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-CANNON FALLS | PART V, SECTION B, LINE 11: MAYO CLINIC IS A NOT-FOR-PROFIT ORGANIZATION WITH THE MISSION 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. AS PART OF MAYO CLINIC, MAYO CLINIC HEALTH SYSTEM OFFERS A VARIETY OF HEALTH CARE OPTIONS TO THE COMMUNITIES IT SERVES, RANGING FROM PRIMARY AND SPECIALTY CARE TO MORE COMPLEX CARE AT MAYO CLINIC. THE RESIDENTS OF CANNON FALLS, LAKE CITY AND RED WING ALSO BENEFIT FROM MAYO CLINIC EDUCATION AND RESEARCH EFFORTS SO BEST PRACTICES IDENTIFIED ARE IMPLEMENTED LOCALLY TO ASSURE THE HIGHEST STANDARDS OF CARE, QUALITY AND SAFETY. 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. WITH THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND SUBSEQUENT SURVEYS, COMMUNITY MEETINGS AND INTERVIEWS, OUR CONTINUING WORK WITH OUR COMMUNITY PARTNERS HAVE NEVER BEEN MORE IMPORTANT. WE APPRECIATE THE UNIQUE PERSPECTIVES AND INSIGHTS THAT ALL COMMUNITY GROUPS CONTRIBUTE AS WE COLLECTIVELY IDENTIFY HEALTH AND SOCIAL ISSUES AND WORK TOWARD IMPROVING THE HEALTH STATUS OF OUR COMMUNITY. MAYO CLINIC HEALTH SYSTEM IN CANNON FALLS, LAKE CITY, AND RED WING (MCHS-CANNON FALLS/LAKE CITY/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.IMPLEMENTATION PLAN UPDATE:SOCIAL MEDIA STRATEGY - MCHS- CANNON FALLS/LAKE CITY/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 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. 5210 STRATEGY - THE 5210 PROGRAM HAS BEEN PROMOTED IN PEDIATRICS AND FAMILY PRACTICE THROUGHOUT WABASHA COUNTY BY WORKING WITH THE HEALTH DEPARTMENT'S STATE HEALTH IMPROVEMENT PROGRAM. THE 5210 PROGRAM IS A SPECIFIC PROGRAM TO REDUCE SCREEN TIME (TV, COMPUTER, IPAD AND GAMES) AND INCREASE EXERCISE AND ACTIVITY OF ELEMENTARY STUDENTS FOR ONE MONTH. BIKES WERE GIVEN AS REWARDS FOR THOSE WHO SUCCESSFULLY ELIMINATED EXCESS SCREEN TIME FROM THEIR DAY. COMMUNITY EVENT SPONSORSHIP - MCHS CANNON FALLS/LAKE CITY/RED WING PARTNERED WITH LOCAL NONPROFITS TO ENCOURAGE YOUTH ACTIVITY SUCH AS THE LAKE CITY SCHOOLS BIKE PROGRAM, CANNON FALLS BIKE EVENT, "GET READY TO RAMBLE", THE CANNON VALLEY TRAIL, AND RED WING'S "OPEN YOUR DOOR" CAMPAIGN FOR MAPS AND TRAILS. NUTRITION AND COOKING EVENTS WERE HELD AT THE FARMERS MARKET WITH THE SUSTAINABILITY COMMISSION. FREE EDUCATION AND SCREENINGS WERE GIVEN BY THE OUTREACH NURSES WHO HAD INDIVIDUAL CONTACT WITH 1,822 PERSONS. IN ORDER TO ROLE MODEL ACTIVITY, MINI FRISBEES ARE DISTRIBUTED RATHER THAN TREATS AT YOUTH EVENTS, BIKE HELMETS ARE USED AS GIVE A WAYS, COOKBOOKS ARE DISTRIBUTED AND MCHS SPONSORS HEALTHY LIVING COMMUNITY EVENTS INCLUDING BIKE RALLYS AND RUN/WALKS.IMPROVE EMPLOYEE HEALTH STRATEGY - MCHS CANNON FALLS/LAKE CITY/RED WING EMPLOYEES MODEL HEALTH STRATEGIES AND ARE INFLUENCERS IN ALL THE COMMUNITIES MCHS SERVES. EMPLOYEE HEALTH AND WELLNESS CONDUCTED A "TAKE YOUR BREAK" EXERCISE PROGRAM WITH 60 EMPLOYEES ATTENDING AND CHANGING DAILY OFFICE HABITS. WALKING MEETING TRAINING WAS HELD AT A LEADERSHIP DEVELOPMENT INSTITUTE AND EMPLOYEES ARE ENCOURAGED TO CONDUCT WALKING MEETINGS. MCHS CANNON FALLS AND LAKE CITY HAVE PATHS MAPPED IN AND AROUND THEIR FACILITIES TO ENCOURAGE WALKING BREAKS FOR ALL STAFF. IDENTIFIED NEED: ACCESSGOAL: TO SUPPORT AND PROMOTE COMMUNITY HEALTH CARE ACCESS.IMPLEMENTATION PLAN UPDATE: MCHS CANNON FALLS/LAKE CITY/RED WING PARTNERS WITH LOCAL VOLUNTEERS, COUNTY SERVICES, THE CARE FREE 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. 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 (DIABETES, OPHTHALMOLOGY) CLINICS ARE SUPPORTED WITH TIME AND EQUIPMENT. MCHS-CANNON FALLS INVITED NONPROFIT ORGANIZATIONS TO CHOOSE ITEMS THEY NEEDED FROM THE EQUIPMENT THAT WAS NOT MOVED TO THE NEW FACILITY. 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. THIS SERVICE IS STILL BEING ASSESSED AND WILL BE EVALUATED IN THE 2015 CHNA IMPLEMENTATION REVIEW.IDENTIFIED NEED: MENTAL HEALTHGOAL: EDUCATE AND PROVIDE RESOURCES FOR THE COMMUNITY BY UTILIZING SOCIAL MEDIA TO EDUCATE THE COMMUNITY.IMPLEMENTATION PLAN UPDATE: DR. SOOD'S "GUIDE TO STRESS FREE LIVING" BOOK HAS HAD MULTIPLE FACEBOOK POSTS TO PROMOTE MENTAL HEALTH AND PERSONAL STRESS MANAGEMENT. 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) THE "MAKE IT OK" ANTI STIGMA PROGRAM WAS PROMOTED TO 1,263 PERSONS THROUGH EMPLOYERS AND IN TWELVE COMMUNITY SESSIONS. MENTAL HEALTH FIRST AID TRAINING WAS HELD IN TWO LOCATIONS IN GOODHUE COUNTY AND ADDITIONAL PARTICIPANTS ATTENDED TRAINING IN A NEIGHBORING COUNTY. IN TOTAL 42 COMMUNITY MEMBERS COMPLETED THE 8 HOUR TRAINING. THE GOAL OF "EVERY HAND JOINED" IS TO HELP YOUNG PEOPLE REACH THEIR FULL POTENTIAL FROM CRADLE TO CAREER. THE PROGRAM GIVES THEM THE KNOWLEDGE AND STRENGTHS NEEDED TO SUCCEED IN THE 21ST CENTURY. "EVERY HAND JOINED" FOCUSES ON THREE AREAS WHERE EXTRA SUPPORT WILL MAKE A LONG-TERM IMPACT ON SUCCESS. IT CURRENTLY INCLUDES: KINDERGARTEN READINESS, 3RD GRADE READING SKILLS, AND MATH SCORES. IMPROVE EMPLOYEE MENTAL HEALTH: UNDER THE EMPLOYEE ASSISTANCE (EAP) PROGRAM, NEWSLETTERS AND EDUCATIONAL FLYERS ARE DISTRIBUTED TO EMPLOYEES. THE EAP STAFF ATTEND AN ANNUAL EMPLOYEE HEALTH FAIR, IN ADDITION TO, ANTI STIGMA TRAINING AND BEHAVIORAL HEALTH PROMOTIONS INCLUDING CHAIR MASSAGES AND YOGA PROGRAMS.IDENTIFIED NEED: HIGHWAY SAFETYIMPLEMENTATION PLAN UPDATE: THE CITY OF CANNON FALLS SPECIFICALLY ASSESSED THE NEED TO INCREASE SAFETY ON HIGHWAY 52. AFTER THE ASSESSMENT WAS COMPLETE, THE STATE REVEALED PLANS TO ELIMINATE ALL CROSSOVER TRAFFIC IN CANNON FALLS. THESE CHANGES WERE IMPLEMENTED AS PART OF THE HIGHWAY 52 RECONSTRUCTION DURING 2014. A COMMUNITY GROUP HAS BEEN FORMED TO LEAD DISCUSSIONS ON REOPENING ONE OF THE HIGHWAY 52 CROSSINGS. IF THIS HAPPENS, THIS SAFETY NEED WILL NEED TO BE ADDRESSED AT THAT TIME. NEEDS NOT BEING ADDRESSED WITH ADDITIONAL RESOURCES: CHEMICAL HEALTH: THIS NEED IS BEING ADDRESSED IN THE COUNTY. MCHS-CANNON FALLS AND MCHS-RED WING ARE PARTNERS WITH THE GOODHUE COUNTY CHEMICAL HEALTH INITIATIVE AND THEY ARE IN THE FINAL YEAR OF A TEN YEAR GRANT PROCESS. THIS NEED MAY RESURFACE IN THE NEXT ASSESSMENT AND WILL BE EVALUATED AT THAT TIME.TOBACCO: PROGRAMS ARE SUPPORTED IN THE COUNTY THROUGH HEALTH AND HUMAN SERVICES. MCHS-RED WING DOES HAVE A CESSATION PROGRAM AND WORKS WITH OTHER STATE AND LOCAL REDUCTION EDUCATION PROGRAMS. |
| MAYO CLINIC HEALTH SYSTEM-CANNON FALLS | 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-CANNON FALLS | 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-CANNON FALLS | 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-CANNON FALLS | PART V, SECTION B, LINE 22D: OUR POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 10% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE. |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| MAYO CLINIC HEALTH SYSTEM-CANNON FALLS PART V, SECTION B, LINE 16A WEBSITE: | SEE PART VI |
| MAYO CLINIC HEALTH SYSTEM-CANNON FALLS PART V, SECTION B, LINE 16B WEBSITE: | SEE PART VI |
| MAYO CLINIC HEALTH SYSTEM-CANNON FALLS PART V, SECTION B, LINE 16C WEBSITE: | SEE PART VI |
| 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 | MAYO CLINIC HEALTH SYSTEM-CANNON FALLS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 32021 COUNTY ROAD 24 BLVD | AddressLine1Txt |
| City | CANNON FALLS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55009 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | CLINIC, SWING BED, DME | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 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 $ 1,657,320. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THROUGH 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: | 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.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. |
| PART III, LINE 4: | FOOTNOTES RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS CAN BE FOUND ON PAGES 5, 7, 8 AND 9 OF MAYO CLINIC'S 2014 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).REASONS WHY MEDICARE SHORTFALL 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-CANNON FALLS (MCHS-CANNON FALLS) DETERMINES PATIENT NEEDS THROUGH A VARIETY OF MEANS: DIRECT FEEDBACK FROM PATIENTS TO EMPLOYEES AT POINT OF CARE AND AT OTHER OPPORTUNITIES, THROUGH COMMUNITY REPRESENTATION ON THE MEDICAL CENTER COMMUNITY ADVISORY COUNCIL AND THROUGH CONTINUAL, RANDOM, CONFIDENTIAL PATIENT SATISFACTION SURVEYS WHICH ARE PART OF THE DECISION-MAKING PROCESSES FOR IMPROVING PATIENT CARE AND CUSTOMER SERVICE.MCHS-CANNON FALLS EMPLOYEES ARE ALSO STRONGLY CONNECTED WITH LOCAL CIVIC GROUPS. MANY EMPLOYEES ARE ACTIVE MEMBERS OF VARIOUS CANNON FALLS ORGANIZATIONS, WHILE OTHERS GIVE HEALTHCARE PRESENTATIONS TO THESE GROUPS. THIS PARTICIPATION NOT ONLY PROMOTES INVOLVEMENT IN THE COMMUNITY, BUT ALSO GIVES COMMUNITY MEMBERS A CHANCE TO ASK QUESTIONS, SHARE COMMENTS, CONCERNS OR OTHER SUGGESTIONS THEY MAY HAVE REGARDING THE MEDICAL CENTER. MCHS-CANNON FALLS EMPLOYEES PROMOTE THE ACTIVE REFERRAL OF PATIENTS TO LOCAL RESOURCES SUCH AS ACCESS TO HIGH QUALITY NUTRITIOUS FOODS, PHYSICAL ACTIVITY AND TOBACCO USE CESSATION PROGRAMS. MCHS-CANNON FALLS 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-CANNON FALLS SYSTEM AND PROCESS CHANGES, OFFER INPUT TO LEADERSHIP IN THE PLANNING AND EVALUATION OF SERVICES, AND SERVE AS A VITAL LINK BETWEEN MCHS-CANNON FALLS AND THE COMMUNITY.MCHS-CANNON FALLS 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.AS THESE EXAMPLES OF INVOLVEMENT DEMONSTRATE, MCHS-CANNON FALLS IS CLOSELY CONNECTED WITH THE COMMUNITY. IN ADDITION TO THIS, MCHS-CANNON FALLS ACTIVELY SEEKS FEEDBACK FROM PATIENTS AND COMMUNITY MEMBERS THROUGH AVATAR SURVEYS. THE SURVEY IS SENT TO A CROSS SECTION OF PATIENTS TO COMPILE USEFUL FEEDBACK ON WAYS MCHS-CANNON FALLS CAN IMPROVE CUSTOMER SERVICE AND DETERMINE WHETHER OR NOT THERE IS A NEED FOR NEW OR EXPANDED SERVICES. THE DATA FROM THE SURVEY IS REVIEWED AND ANALYZED BY MEMBERS OF QUALITY AND ADMINISTRATION DEPARTMENTS AS WELL AS MCHS-CANNON FALLS EMERGENCY ROOM (ER)/INPATIENT SATISFACTION TEAM, A TEAM DEDICATED TO IMPROVING PATIENT SATISFACTION IN THE ER AND HOSPITAL.THROUGH THESE VARIOUS AVENUES, MCHS-CANNON FALLS STAFF MEMBERS ACROSS MANY DEPARTMENTS STAY CONNECTED WITH THE COMMUNITY TO ASSESS THE HEALTHCARE NEEDS OF CANNON FALLS 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. |
| PART VI, LINE 4: | MAYO CLINIC HEALTH SYSTEM-CANNON FALLS (MCHS-CF) IS LOCATED IN CANNON FALLS, MINNESOTA. MCHS-CF SERVES CANNON FALLS AND THE SURROUNDING AREA WITHIN GOODHUE COUNTY. THE MCHS-CF CAMPUS INCLUDES A HOSPITAL LICENSED FOR 21 BEDS WITH 15 CURRENTLY IN SERVICE AND A MULTI-SPECIALTY HOSPITAL-BASED CLINIC SERVING CANNON FALLS.ACCORDING TO THE U.S. CENSUS BUREAU AND THE MINNESOTA COMPASS MOST RECENT DATA: CANNON FALLS IS A RURAL COMMUNITY WITH A POPULATION OF 4,090, GOODHUE COUNTY POPULATION WAS ESTIMATED AT 46,464. THE POPULATION IS 49.2% MALE AND 50.8% FEMALE WITH THE MEDIAN RESIDENT AGE BEING 38.5 YEARS OF AGE. THE ESTIMATED MEDIAN HOUSEHOLD INCOME IN CANNON FALLS WAS $45,500, 8.5% OF RESIDENTS HAVE AN INCOME BELOW THE POVERTY LEVEL. |
| PART VI, LINE 5: | THIS FILING ORGANIZATION IS AN AFFILIATE OF 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 ORGANIZATIONS 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 BODY:THE 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 CLINICS 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 V. 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. |
| PART V, SECTION B, LINES 16A, 16B, & 16C | URL OF THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY (BROCHURE):MAYOCLINICHEALTHSYSTEM.ORG/LOCATIONS/CANNON-FALLS/BILLING |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | Yes (1) | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALTRICHTER MD PAUL M | ||||||||||||||
| VICE CHAIR / DIRECTOR | $0 | $236,378 | $0 | $0 | $0 | $867 | $0 | $27,402 | $0 | $27,474 | $0 | $292,121 | $0 | $0 |
| BERNARD MD MATTHEW E | ||||||||||||||
| DIRECTOR | $0 | $261,254 | $0 | $0 | $0 | $1,726 | $0 | $30,720 | $0 | $23,117 | $0 | $316,817 | $0 | $0 |
| PARKS DOUGLAS A | ||||||||||||||
| DIRECTOR / REGION CAO | $0 | $230,653 | $0 | $0 | $0 | $1,360 | $0 | $24,478 | $0 | $26,281 | $0 | $282,772 | $0 | $0 |
| WHITED MD BRIAN L | ||||||||||||||
| DIRECTOR | $0 | $427,369 | $0 | $0 | $0 | $17,095 | $0 | $13,000 | $0 | $26,145 | $0 | $483,609 | $0 | $0 |
| WITT MD THOMAS J | ||||||||||||||
| CHAIR / CEO / DIRECTOR | $0 | $408,368 | $0 | $0 | $0 | $48,424 | $0 | $44,943 | $0 | $21,637 | $0 | $523,372 | $0 | $0 |
| AGERTER MD DAVID C | ||||||||||||||
| REGION CEO | $0 | $499,015 | $0 | $0 | $0 | $56,097 | $0 | $675 | $0 | $17,533 | $0 | $573,320 | $0 | $0 |
| CHRISTIAN GLENN P | ||||||||||||||
| SECRETARY (1/1-3/17/14) | $177,403 | $0 | $0 | $0 | $0 | $0 | $25,891 | $0 | $18,163 | $0 | $221,457 | $0 | $0 | $0 |
| GUDGELL STEPHEN F | ||||||||||||||
| CORRIDOR CAO/TREASURER (3/17-12/31) | $0 | $195,549 | $0 | $0 | $0 | $1,241 | $0 | $311 | $0 | $19,387 | $0 | $216,488 | $0 | $0 |
| KOCH MARK B | ||||||||||||||
| ASST SECRETARY | $0 | $378,314 | $0 | $0 | $0 | $17,413 | $0 | $533 | $0 | $17,492 | $0 | $413,752 | $0 | $0 |
| PRIEST WILLIAM F | ||||||||||||||
| SECRETARY (3/17-12/31/14) | $191,580 | $0 | $0 | $0 | $0 | $0 | $24,732 | $0 | $27,502 | $0 | $243,814 | $0 | $0 | $0 |
| TARASOVITCH JAMES J | ||||||||||||||
| REGION CFO | $0 | $293,754 | $0 | $0 | $0 | $60,707 | $0 | $10,400 | $0 | $18,113 | $0 | $382,974 | $0 | $0 |
| TUSA EDWARD A | ||||||||||||||
| SITE CFO / TREASURER (1/1-3/17/14) | $130,062 | $0 | $0 | $0 | $0 | $0 | $22,048 | $0 | $22,879 | $0 | $174,989 | $0 | $0 | $0 |
| CHESTNUT MD JANET S | ||||||||||||||
| PHYSICIAN | $342,867 | $0 | $833 | $0 | $0 | $0 | $53,609 | $0 | $16,971 | $0 | $414,280 | $0 | $0 | $0 |
| JOHNSTON-FLANDERS MD MEGAN S | ||||||||||||||
| PHYSICIAN | $236,400 | $0 | $21,333 | $0 | $0 | $0 | $15,467 | $0 | $30,937 | $0 | $304,137 | $0 | $0 | $0 |
| NORDAHL MD THOMAS W | ||||||||||||||
| PHYSICIAN | $613,506 | $0 | $750 | $0 | $0 | $0 | $44,189 | $0 | $29,500 | $0 | $687,945 | $0 | $0 | $0 |
| STRICKER MD ALEXANDER W | ||||||||||||||
| PHYSICIAN | $252,146 | $0 | $20,833 | $0 | $0 | $0 | $24,116 | $0 | $604 | $0 | $297,699 | $0 | $0 | $0 |
| TURNA MD TARLOCHAN S | ||||||||||||||
| FAMILY MEDICINE PHYSICIAN | $355,110 | $0 | $1,333 | $0 | $0 | $0 | $27,408 | $0 | $16,414 | $0 | $400,265 | $0 | $0 | $0 |
| LOHR MD ROBERT H | ||||||||||||||
| FMR INTERIM CHAIR / CEO | $0 | $246,481 | $0 | $0 | $0 | $14,395 | $0 | $53,198 | $0 | $17,247 | $0 | $331,321 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). AGERTER M.D., DAVID C. $49,966 BERNARD M.D., MATTHEW E. $ 759 CHESTNUT M.D., JANET S. $15,647 KOCH, MARK B. $14,770 NORDAHL M.D., THOMAS W. $26,570 TURNA M.D., TARLOCHAN S. $15,553 WITT M.D., THOMAS J. $38,983 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. |
| 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 II COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RYAN SCHRAMM | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SON-IN-LAW OF BOARD OFFICER, GLENN CHRISTIAN | RelationshipDescriptionTxt |
| Transaction | $96,171 | TransactionAmt |
| Transaction | EMPLOYMENT | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE FOLLOWING INDIVIDUAL IS EMPLOYED BY A RELATED ORGANIZATION: WITT M.D., THOMAS J. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: PARKS, DOUGLAS A. KOCH, MARK B. GUDGELL, STEPHEN F. AGERTER M.D., DAVID C. TARASOVITCH, JAMES J. THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: WHITED M.D., BRIAN L. TARASOVITCH, JAMES J. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: KOCH, MARK B. WHITED M.D., BRIAN L. TARASOVITCH, JAMES J. THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: PARKS, DOUGLAS A. GUDGELL, STEPHEN F. BERNARD M.D., MATTHEW E. ALTRICHTER M.D., PAUL M. AGERTER M.D., DAVID C. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL WHO IS ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: KOCH, MARK B. |
| 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 MEMBER OF THE CORPORATION IS MAYO CLINIC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE GOVERNING BODY, THE BOARD OF TRUSTEES, CONSISTS OF NINE PERSONS ELECTED AS FOLLOWS: (A) FOUR COMMUNITY TRUSTEES ELECTED BY THE CANNON FALLS HOSPITAL DISTRICT; (B) CHAIR/CEO AND VICE CHAIR ELECTED BY THE BOARD OF TRUSTEES AND APPROVED BY AND ELECTED BY THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BYLAWS ALSO PROVIDE THE SOLE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS OPERATIONS, CAPITAL, BUDGET, AMENDMENT OF ARTICLES OR BYLAWS AND DEBT 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 OR HIS DELEGATE, 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 | I/C PURCHASED SERVICES - PS : PROGRAM SERVICE EXPENSES 1,149,985. MANAGEMENT AND GENERAL EXPENSES 3,004,135. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,154,120. OTHER PURCHASED SERVICES - PS : PROGRAM SERVICE EXPENSES 893,965. MANAGEMENT AND GENERAL EXPENSES 31,951. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 925,916. |
| 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) MAYO CLINIC ARIZONA (EIN: 86-0800150) MAYO CLINIC JACKSONVILLE (EIN: 59-3337028) 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 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (42 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 | Direct Controlling NADirectControllingNACd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLOOMER LAKEVIEW INC | |||||||||||||||
| 2110 DUNCAN ROAD | BLOOMER | WI | 54724 | 391450617 | LOW INCOME HOUSING | WI | 501(C)(3) | 7 | MCHS--CHIPPEWA VALLEY INC | Yes (1) | |||||
| CHARTERHOUSE INC | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411405254 | RETIREMENT LIVING CENTER | MN | 501(C)(3) | 9 | MAYO CLINIC | Yes (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 | Yes (1) | |||||
| GOLD CROSS AMBULANCE SERVICE | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411917516 | AMBULANCE SERVICE | MN | 501(C)(3) | 9 | MFMER | Yes (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 | Yes (1) | |||||
| MAYO CLINIC | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 416011702 | PATIENT CARE - CLINIC | MN | 501(C)(3) | 9 | Yes (1) | N/A | |||||
| MAYO CLINIC ARIZONA | |||||||||||||||
| 13400 EAST SHEA BOULEVARD | SCOTTSDALE | AZ | 85259 | 860800150 | HOSPITAL AND CLINIC | AZ | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) | |||||||||||||||
| 4500 SAN PABLO ROAD | JACKSONVILLE | FL | 32224 | 590714831 | HOSPITAL | FL | 501(C)(3) | 3 | MAYO CLINIC JACKSONVILLE | Yes (1) | |||||
| MAYO CLINIC HOSPITAL -- ROCHESTER | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 410944601 | HOSPITAL | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MAYO CLINIC JACKSONVILLE | |||||||||||||||
| 4500 SAN PABLO ROAD | JACKSONVILLE | FL | 32224 | 593337028 | PATIENT CARE - CLINIC | FL | 501(C)(3) | 7 | MAYO CLINIC | Yes (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 | Yes (1) | |||||
| MAYO KLINIK STIFTUNG | |||||||||||||||
| FUNDRAISING FOUNDATION | MFMER | Yes (1) | 60486 FRANKFURT AM MAIN | FRANKFURT | GM | GM | |||||||||
| MCHS IN WAYCROSS INC | |||||||||||||||
| 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | 581667166 | HOSPITAL | GA | 501(C)(3) | 3 | MAYO CLINIC JACKSONVILLE | Yes (1) | |||||
| MCHS--ALBERT LEA AND AUSTIN | |||||||||||||||
| 1000 FIRST DRIVE NW | AUSTIN | MN | 55912 | 411404075 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--AUSTIN FOUNDATION | |||||||||||||||
| 1000 FIRST DRIVE NW | AUSTIN | MN | 55912 | 300107471 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MCHS--ALBERT LEA AND AUSTIN | Yes (1) | |||||
| MCHS--CANNON FALLS | |||||||||||||||
| 32021 COUNTY ROAD 24 BLVD | CANNON FALLS | MN | 55009 | 204156428 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (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 | Yes (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 | 0 | |||||
| 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 | 0 | |||||
| MCHS--EAU CLAIRE HOSPITAL INC | |||||||||||||||
| 1221 WHIPPLE STREET | EAU CLAIRE | WI | 54703 | 390813418 | HOSPITAL | WI | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--FAIRMONT | |||||||||||||||
| 800 MEDICAL CENTER DRIVE PO BOX 800 | FAIRMONT | MN | 56031 | 410760836 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (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 | Yes (1) | |||||
| MCHS--FRANCISCAN HEALTHCARE FOUNDATION-SPARTA INC | |||||||||||||||
| 310 WEST MAIN STREET | SPARTA | WI | 54656 | 391423234 | FUNDRAISING FOUNDATION | WI | 501(C)(3) | 9 | MCHS--FRANCISCAN HEALTHCARE INC | Yes (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 | Yes (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 | Yes (1) | |||||
| MCHS--HOME HEALTH & HOSPICE INC | |||||||||||||||
| PO BOX 2060 | EAU CLAIRE | WI | 54702 | 391491516 | HOME HEALTH AND HOSPICE CARE | WI | 501(C)(3) | 9 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MCHS--LAKE CITY | |||||||||||||||
| 500 WEST GRANT STREET | LAKE CITY | MN | 55041 | 411906820 | HOSPITAL | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--MANKATO | |||||||||||||||
| 1025 MARSH STREET | MANKATO | MN | 56002 | 411236756 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--MANKATO HEALTH CARE FOUNDATION | |||||||||||||||
| 1025 MARSH STREET | MANKATO | MN | 56002 | 411663357 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MCHS--MANKATO | Yes (1) | |||||
| MCHS--NEW PRAGUE | |||||||||||||||
| 301 SECOND STREET NE | NEW PRAGUE | MN | 56071 | 410723639 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (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 | Yes (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 | Yes (1) | |||||
| MCHS--OWATONNA | |||||||||||||||
| 134 SOUTHVIEW ST | OWATONNA | MN | 55060 | 411862132 | PATIENT CARE - CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--RED CEDAR INC | |||||||||||||||
| 2321 STOUT ROAD | MENOMONIE | WI | 54751 | 510190875 | HOSPITAL AND CLINIC | WI | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--RED WING | |||||||||||||||
| 701 HEWITT BOULEVARD | RED WING | MN | 55066 | 411713783 | PATIENT CARE SERVICES | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--SPRINGFIELD | |||||||||||||||
| 625 NORTH JACKSON AVENUE | SPRINGFIELD | MN | 56087 | 411893827 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (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 | Yes (1) | |||||
| MCHS--ST JAMES HEALTH CARE FOUNDATION | |||||||||||||||
| 1101 MOULTON PARSONS DR PO BOX 460 | ST JAMES | MN | 56081 | 411444129 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MCHS--ST JAMES | Yes (1) | |||||
| MCHS--SUPPORTIVE HOMECARE INC | |||||||||||||||
| PO BOX 2060 | EAU CLAIRE | WI | 54702 | 391686673 | HOME HEALTH CARE | WI | 501(C)(3) | 9 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MCHS--WASECA | |||||||||||||||
| 501 NORTH STATE STREET | WASECA | MN | 56093 | 363606405 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (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 | Yes (1) | |||||
| POVERELLO FOUNDATION | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411494881 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MAYO CLINIC HOSPITAL - ROCHESTER | Yes (1) | |||||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| 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 |
| PHYSICIAN SOFTWARE SYSTEMS LLC | |||||||
| 3333 WARRENVILLE ROAD SUITE 200 | LISLE | IL | 60532 | 453414836 | HEALTHCARE RELATED SOFTWARE | IL | N/A |
| WATERSHED CAP INSTL PRTNRS III LP | |||||||
| ONE MARITIME PLAZA SUITE 1525 | SAN FRANCISCO | CA | 94111 | 462982848 | INVESTMENT ACTIVITIES | DE | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (40 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BWL HOLDINGS INC | |||||||||||||
| 1209 ORANGE STREET | WILMINGTON | DE | 19801 | 472413749 | OIL & GAS EXPLORATION | DE | N/A | C | Yes (1) | ||||
| AMBIENT CLINICAL ANALYTICS INC | |||||||||||||
| 221 1ST AVE SW SUITE 202 | ROCHESTER | MN | 55902 | 800928405 | SOFTWARE | DE | N/A | C | Yes (1) | ||||
| CAVALRY CLO III LTD | |||||||||||||
| INVESTMENT ACTIVITIES | N/A | C | Yes (1) | PO BOX 1093 GT QUEENSGATE HOUSE S | GRAND CAYMAN | CJ | CJ | ||||||
| CAVALRY CLO IV LTD | |||||||||||||
| INVESTMENT ACTIVITIES | N/A | C | Yes (1) | PO BOX 1093 GT QUEENSGATE HOUSE S | GRAND CAYMAN | CJ | CJ | ||||||
| GMO GLOBAL BOND INVESTMENT FUND | |||||||||||||
| OTHER FINANCIAL INVESTMENT ACTIVITIES | N/A | Yes (1) | 78 SIR JOHN ROGERSONS QUAY | DUBLIN 2 | EI | EI | |||||||
| HEALTH TRADITION HEALTH PLAN | |||||||||||||
| 1808 EAST MAIN STREET | ONALASKA | WI | 54650 | 391545987 | MEDICAL SERVICES COMPANY | WI | N/A | C | Yes (1) | ||||
| LOBSS NETWORK SUPPORT 2002 INC | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 481276150 | ADMINISTRATIVE SERVICES | MN | N/A | C | Yes (1) | ||||
| MAYO CLINIC GBS MAURITIUS | |||||||||||||
| HEALTHCARE MANAGEMENT | N/A | C | Yes (1) | 2ND FLOOR EBENE MEWS 57 | EBENE CYBERCITY | MP | MP | ||||||
| MAYO CLINIC SUPPORT SERVICES TEXAS | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 471751102 | HEALTH SERVICES | TX | N/A | C | Yes (1) | ||||
| MAYO HOLDING COMPANY | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411578020 | HOLDING COMPANY | MN | N/A | C | Yes (1) | ||||
| MAYO INSURANCE COMPANY LTD | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | SELF INSURANCE POOL | N/A | C | Yes (1) | CJ | |||||
| MCHS--DECORAH CLINIC PHYSICIANS | |||||||||||||
| 907 MONTGOMERY STREET | DECORAH | IA | 52101 | 411711329 | PATIENT CARE - CLINIC | IA | N/A | C | Yes (1) | ||||
| MCHS--PHARMACY & HOME MEDICAL INC | |||||||||||||
| 1221 WHIPPLE STREET | EAU CLAIRE | WI | 54703 | 391528920 | PHARMACY SERVICES | WI | N/A | C | Yes (1) | ||||
| MMSI INC | |||||||||||||
| 21 FIRST STREET SW | ROCHESTER | MN | 55905 | 411547003 | THIRD PARTY ADMINISTRATION SERVICES | MN | N/A | C | Yes (1) | ||||
| RESOUNDANT INC | |||||||||||||
| 221 1ST AVE SW | ROCHESTER | MN | 55902 | 461661978 | MANUFACTURING MEDICAL DEVICE COMPONENT | MN | N/A | C | Yes (1) | ||||
| ROCHESTER AIRPORT COMPANY | |||||||||||||
| ROUTE 2 | ROCHESTER | MN | 55902 | 410506870 | AIRPORT MANAGEMENT | MN | N/A | C | Yes (1) | ||||
| SATILLA HEALTHNET INC | |||||||||||||
| 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | 582151076 | HEALTH SERVICES | GA | N/A | C | Yes (1) | ||||
| SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION | |||||||||||||
| 13400 E SHEA BLVD | SCOTTSDALE | AZ | 85259 | 860870505 | COMMERCIAL PROPERTY OWNERS ASSOCIATION | AZ | N/A | C | Yes (1) | ||||
| THE STABILE BUILDING OWNERS' ASSOCIATION | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 208994499 | COMMERCIAL PROPERTY OWNERS ASSOCIATION | MN | N/A | C | Yes (1) | ||||
| CHARITABLE LEAD TRUST | |||||||||||||
| CHARITABLE TRUST | CA | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | ND | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | AZ | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | LA | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST (2) | |||||||||||||
| CHARITABLE TRUST | MA | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | MO | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | AZ | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | CO | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (9) | |||||||||||||
| CHARITABLE TRUST | FL | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | LA | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (73) | |||||||||||||
| CHARITABLE TRUST | MN | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | NC | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | NM | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | NV | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | NY | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | TX | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | WI | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | CO | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | IL | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | MI | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (70) | |||||||||||||
| CHARITABLE TRUST | MN | N/A | T | Yes (1) | |||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | 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 | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MCHS-ALBERT LEA AND AUSTIN | ||
| P | $3,876,661 | GAAP |
| MCHS-LAKE CITY | ||
| R | $276,635 | GAAP |
| MCHS-OWATONNA | ||
| S | $121,222 | GAAP |
| MCHS-RED WING | ||
| A | $2,100 | GAAP |
| MMSI INC | ||
| R | $1,748,977 | GAAP |
| MMSI INC | ||
| S | $1,153,952 | GAAP |
Comments