NORTH MEMORIAL HEALTH CARE: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
NORTH MEMORIAL HEALTH CARE (EIN 41-0729979)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-12
IRS object ID
201513169349306006
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-11-12T17:31:33-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY VIRCHOW KRAUSE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1225 S 6TH ST 2300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410729979EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTH MEMORIAL HEALTH CAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone7635205200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1Txt
CityROBBINSDALECityNm
State AbbreviationMNStateAbbreviationCd
ZIP55422ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTODD OSTENDORFPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone7635205200PhoneNum
Signature2015-11-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLAWRENCE H MOHR CPAPreparerPersonNm
PTINP00447603PTIN
Phone6128764500PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJ KEVIN CROSTON MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1Txt
CityROBBINSDALECityNm
State AbbreviationMNStateAbbreviationCd
ZIP55422ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$789,488,003GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.NORTHMEMORIAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1954FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionGENERAL ACUTE CARE HOSPITAL PROVIDING HIGHLY SPECIALIZED TRAUMA AND EMERGENCY SERVICES, CORONARY CARE OPEN HEART SURGERY, ONCOLOGY, HIGH RISK MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL-SURGICAL, OBSTETRICAL, PEDIATRIC REHABILITATIVE, AND BEHAVIORAL SERVICES.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee5275TotalEmployeeCnt
Total Volunteers669TotalVolunteersCnt
Total Gross UBI$9,540,702TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,250,375PYContributionsGrantsAmt
CY Contributions Grants$755,248CYContributionsGrantsAmt
PY Program Service Revenue$631,102,778PYProgramServiceRevenueAmt
CY Program Service Revenue$655,017,004CYProgramServiceRevenueAmt
PY Investment Income$14,778,356PYInvestmentIncomeAmt
CY Investment Income$18,475,881CYInvestmentIncomeAmt
PY Other Revenue-$490,606PYOtherRevenueAmt
CY Other Revenue-$1,569,444CYOtherRevenueAmt
PY Total Revenue$646,640,903PYTotalRevenueAmt
CY Total Revenue$672,678,689CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$370,462,198PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$405,110,904CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$263,129,622PYOtherExpensesAmt
CY Other Expenses$269,506,611CYOtherExpensesAmt
PY Total Expenses$633,591,820PYTotalExpensesAmt
CY Total Expenses$674,617,515CYTotalExpensesAmt
PY Revenues Less Expenses$13,049,083PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,938,826CYRevenuesLessExpensesAmt
Total Assets BOY$581,188,207TotalAssetsBOYAmt
Total Assets EOY$598,327,991TotalAssetsEOYAmt
Total Liabilities BOY$220,859,367TotalLiabilitiesBOYAmt
Total Liabilities EOY$244,073,385TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$360,328,840NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$354,254,606NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionINSPIRING EACH OTHER TO GIVE OUR PATIENTS AND THEIR FAMILIES COMPASSIONATE, REMARKABLE CARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$592,041,141ExpenseAmt
Revenue$591,638,698RevenueAmt
DescNORTH MEMORIAL HEALTH CARE (NMHC) IS A GENERAL ACUTE CARE HOSPITAL PROVIDING HIGHLY SPECIALIZED TRAUMA AND EMERGENCY SERVICES, CORONARY CARE, OPEN HEART SURGERY, ONCOLOGY, HIGH RISK MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL- SURGICAL, OBSTETRICAL, PEDIATRIC, REHABILITATION, BEHAVIORAL HEALTH, MEDICAL TRANSPORTATION AND HOME HEALTH AND HOSPICE SERVICES. IN ADDITION TO CHARITY AND UNCOMPENSATED CARE, NMHC ALSO PROVIDES NUMEROUS COMMUNITY BENEFITS (AT NO COST OR BELOW COST) IN FURTHERANCE OF ITS CHARITABLE PURPOSE. NORTH MEMORIAL PROVIDES A WIDE VARIETY OF BENEFITS TO THE COMMUNITY, INCLUDING OFFERING VARIOUS COMMUNITY BASED PROGRAMS, SUCH AS HEALTH SCREENINGS, SUPPORT COUNSELING FOR PARENTS AND FAMILIES, PASTORAL CARE, CRISIS INTERVENTION, TRANSPORTATION TO AND FROM THE HOSPITAL CAMPUSES, AND THE DONATION OF SPACE FOR USE BY COMMUNITY GROUPS. ADDITIONALLY A LARGE NUMBER OF HEALTH-RELATED EDUCATIONAL PROGRAMS ARE PROVIDED FOR THE BENEFIT OF THE COMMUNITY, INCLUDING HEALTH ENHANCEMENTS AND WELLNESS, CLASSES ON SPECIFIC CONDITIONS, UNREIMBURSED COSTS OF MEDICAL EDUCATION, TELEPHONE INFORMATION SERVICES, AND COST RELATED TO PROGRAMS DESIGNED TO IMPROVE THE GENERAL STANDARDS OF THE HEALTH OF THE COMMUNITY. NORTH MEMORIAL ALSO PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED COSTS TO RESIDENTS OF ITS COMMUNITY, PRIMARILY THROUGH (A) THE DIFFERENCE BETWEEN PUBLIC PROGRAM PAYMENTS (PRIMARILY MEDICARE AND MEDICAID) AND THE RELATED COSTS OF PROVIDING SUCH SERVICES, AND (B) SERVICES PROVIDED TO PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT WHO ARE DETERMINED UNABLE TO PAY BECAUSE OF ECONOMIC FACTORS. IN ADDITION, NORTH MEMORIAL CONTRIBUTES TO FUNDING MEDICAL CARE FOR THE UNINSURED THROUGH PAYMENT OF PATIENT SERVICE TAXES, WHICH INCLUDE THE MEDICAID SURCHARGE AND THE MINNESOTA CARE TAX ON CERTAIN NET REVENUE.Desc
Total Program Service Expenses$592,041,141TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document505IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee5275EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial AccountYes (1)ForeignFinancialAccountInd
Foreign CountryBDForeignCountryCd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TODD OSTENDORFBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7635205200PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1Txt
CityROBBINSDALECityNm
State AbbreviationMNStateAbbreviationCd
ZIP55422ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
LOREN TAYLOR
CEO NORTH MEMORIAL50.005.00Yes (X)Yes (X)$863,098$0$24,403
ROBERT POTTS
CHAIRMAN OF BOARD2.000.00Yes (X)Yes (X)$3,600$0$0
TIMOTHY BAYLOR
BOARD MEMBER2.000.00Yes (X)$3,600$0$0
DANA CARLSON MD
BOARD MEMBER2.000.00Yes (X)$3,600$0$0
JOHN GRAY MD
BOARD MEMBER2.000.00Yes (X)$0$0$0
SCOTT COLSON MD
BOARD MEMBER2.000.00Yes (X)$3,600$0$0
ROBERT DAHL
BOARD MEMBER2.000.00Yes (X)$3,600$0$0
MATTHIAS FELDKAMP MD
BOARD MEMBER2.000.00Yes (X)$3,600$0$0
WARREN MACK
BOARD MEMBER2.000.00Yes (X)$3,600$0$0
PATRICK MCHALE
BOARD MEMBER2.000.00Yes (X)$0$0$0
ROBERT N PRENTISS JR
BOARD MEMBER2.000.00Yes (X)$3,600$0$0
MICHAEL STEINHAUSER
BOARD MEMBER2.000.00Yes (X)$0$0$0
RAHUL TAMHANE MD
BOARD MEMBER2.000.00Yes (X)$3,600$0$0
WILLIAM TOBIN
BOARD MEMBER2.000.00Yes (X)$1,800$0$0
TED FERRARA
BOARD MEMBER2.000.00Yes (X)$2,700$0$0
KEVIN S RAFF MD
BOARD MEMBER2.000.00Yes (X)$0$0$0
TODD OSTENDORF
VP FINANCE, CFO50.002.00Yes (X)$428,011$0$21,773
J KEVIN CROSTON MD
CHIEF MEDICAL OFFICER50.002.00$511,017$0$23,841Yes (X)
JEFF WICKLANDER
VP OPERATIONS50.000.00$294,542$0$25,605Yes (X)
ANDREW COCHRANE
CEO - MAPLE GROVE HOSPITAL0.0050.00$401,997$0$26,478Yes (X)
KELLY WHITE
VP INPATIENT CARE/CNO50.000.00$167,595$0$11,469Yes (X)
PATRICK TAFFE
CHIEF INFORMATION OFFICER50.000.00$322,074$0$24,383Yes (X)
DAVID ABRAMS
VP HUMAN RESOURCES50.000.00$289,700$0$25,352Yes (X)
COLLEEN NADEAU
VP PATIENT CARE OPERATIONS - MGH0.0050.00$0$195,323$4,996Yes (X)
CRAIG MATTICKS
STAFF EMERGENCY PHYSICIAN50.000.00$531,923$0$26,591Yes (X)
TIFFANY ZITZEWITZ
VP BUSINESS DEVELOPMENT50.002.00$308,174$0$26,708Yes (X)
ANDREW HOULTON
VP MEDICAL AFFAIRS50.000.00$401,662$0$24,189Yes (X)
MICHAEL PARRISH
VP EMERGENCY & ENTERPRISE OPERATIONS50.000.00$332,992$0$24,135Yes (X)
GAYLE MATTSON
PRESIDENT OF NORTH MEMORIAL50.000.00$747,008$0$18,812Yes (X)
TRACY KIRBY
VP INPATIENT CARE/CNO50.000.00$334,774$0$8,893Yes (X)
ROBERT KING
CARDIAC SURGEON50.000.00$732,870$0$26,724Yes (X)
ALOK MAHESHWARI
CARDIOLOGIST50.000.00$785,062$0$26,112Yes (X)
STEVEN ROH
CARDIOLOGIST50.000.00$779,332$0$26,654Yes (X)
THOMAS ROSSINI
STAFF EMERGENCY PHYSICIAN50.000.00$683,489$0$26,572Yes (X)
JOSEPH VAN CAMP
CARDIAC SURGEON50.000.00$743,693$0$18,200Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$9,695,913TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$195,323TotReportableCompRltdOrgAmt
Total Other Compensation$441,890TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K490IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
NORTH CLINIC
3366 OAKDALE AVE N 601ROBBINSDALEMN55422PHYSICIAN SERVICES$8,359,544
DJ KRANZ COMPANY INCORPORATED
725 HIGHWAY 169 NORTHPLYMOUTHMN554416403CONSTRUCTION$6,183,103
RESPIRATORY CONSULTANTS PA
3366 OAKDALE AVE N 605ROBBINSDALEMN55422INTENSIVISTS STAFFING$3,164,028
ARAMARK HEALTHCARE FOOD
25271 NETWORK PLACECHICAGOIL60673MANAGEMENT SUPPORT FOR DIETARY$2,077,378
UNIVERSITY OF MINNESOTA PHYSICIANS
720 WASHINGTON AVE SE STE 200MINNEAPOLISMN55414PHYSICIAN SERVICES$1,801,661
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K40CntrctRcvdGreaterThan100KCnt
Related Organizations$436,289RelatedOrganizationsAmt
All Other Contributions$318,959AllOtherContributionsAmt
Noncash Contributions$16,817NoncashContributionsAmt
Total Contributions$755,248TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
HOSPITAL PATIENT REVENUE621500$597,482,451$587,941,749$9,540,702
CONTRACT REVENUE900099$32,604,675$32,604,675
EHR/MEDICARE & OTHER900099$12,291,949$12,291,949
JOINT VENTURE REVENUE900099$5,266,393$5,266,393
PHARMACY900099$5,074,380$5,074,380

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,297,156TotalRevenueColumnAmt
Exclusion$2,297,156ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$655,017,004TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,411,204TotalRevenueColumnAmt
Exclusion$5,411,204ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,627TotalRevenueColumnAmt
Exclusion$1,627ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$11,064,317RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$12,633,761RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$1,569,444RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,569,444TotalRevenueColumnAmt
Related Or Exempt Func Income-$1,569,444RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$116,165,691SecuritiesAmt
Other$1,072,912OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$103,821,643SecuritiesAmt
Other$353,910OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$12,344,048SecuritiesAmt
Other$719,002OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,063,050TotalRevenueColumnAmt
Exclusion$13,063,050ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$672,678,689TotalRevenueColumnAmt
Related Or Exempt Func Income$591,638,698RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$9,540,702UnrelatedBusinessRevenueAmt
Exclusion$70,744,041ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,702,065TotalAmt
Management And General$6,702,065ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$306,349,510TotalAmt
Program Services$270,182,768ProgramServicesAmt
Management And General$36,166,742ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$32,698,401TotalAmt
Program Services$28,838,122ProgramServicesAmt
Management And General$3,860,279ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$38,894,035TotalAmt
Program Services$34,302,317ProgramServicesAmt
Management And General$4,591,718ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$20,466,893TotalAmt
Program Services$18,050,630ProgramServicesAmt
Management And General$2,416,263ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,453,478TotalAmt
Program Services$1,281,885ProgramServicesAmt
Management And General$171,593ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$325,759TotalAmt
Program Services$287,301ProgramServicesAmt
Management And General$38,458ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$103,593TotalAmt
Management And General$103,593ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$793,407TotalAmt
Management And General$793,407ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$57,994,776TotalAmt
Program Services$51,148,079ProgramServicesAmt
Management And General$6,846,697ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,469,397TotalAmt
Program Services$2,266,061ProgramServicesAmt
Management And General$203,336ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,854,444TotalAmt
Program Services$5,163,285ProgramServicesAmt
Management And General$691,159ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$9,363,789TotalAmt
Program Services$8,258,327ProgramServicesAmt
Management And General$1,105,462ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$17,137,735TotalAmt
Program Services$15,114,503ProgramServicesAmt
Management And General$2,023,232ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$3,702,440TotalAmt
Program Services$3,265,341ProgramServicesAmt
Management And General$437,099ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$30,277,654TotalAmt
Program Services$26,788,045ProgramServicesAmt
Management And General$3,489,609ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,297,867TotalAmt
Program Services$4,672,416ProgramServicesAmt
Management And General$625,451ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$83,796,953$73,904,127$9,892,826
BAD DEBT EXPENSE$21,275,990$21,275,990
MAINTENANCE & REPAIR$13,011,366$11,475,282$1,536,084
GOVERNMENT TAXES$9,156,077$9,156,077

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$7,491,886TotalAmt
Program Services$6,610,585ProgramServicesAmt
Management And General$881,301ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$674,617,515TotalAmt
Program Services$592,041,141ProgramServicesAmt
Management And General$82,576,374ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$18,424BOYAmt
EOY$12,174EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$8,446,193BOYAmt
EOY$14,970,298EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$128,351EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$83,422,384BOYAmt
EOY$97,938,989EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$6,250,000EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$6,582,936BOYAmt
EOY$6,391,600EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$3,962,207BOYAmt
EOY$4,505,563EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$610,999,739LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$405,044,943LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$212,607,567BOYAmt
EOY$205,954,796EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$205,615,544BOYAmt
EOY$214,845,345EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$38,756,112BOYAmt
EOY$42,745,377EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$21,776,840BOYAmt
EOY$4,585,498EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$581,188,207BOYAmt
EOY$598,327,991EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$62,622,331BOYAmt
EOY$80,221,606EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$699,070BOYAmt
EOY$418,209EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$138,985,212BOYAmt
EOY$131,974,673EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,552,754BOYAmt
EOY$31,458,897EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$220,859,367BOYAmt
EOY$244,073,385EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$360,328,840BOYAmt
EOY$354,254,606EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$360,328,840BOYAmt
EOY$354,254,606EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$581,188,207BOYAmt
EOY$598,327,991EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,938,826ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$4,135,408NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or ManagementYes (1)PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other OrganizationsYes (1)GrantsOtherOrganizationsInd
Grants Other Organizations$40,000GrantsOtherOrganizationsAmt
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$80,000DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$120,000TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationCONTACTS AND VISITS WERE MADE WITH STATE LEVEL LEGISLATORS TO PROMOTE HEALTH CARE RELATED ISSUES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,446,092BeginningYearBalanceAmt
Contributions$76,703ContributionsAmt
Investment Earnings Or Losses$118,858InvestmentEarningsOrLossesAmt
Other Expenditures$50,230OtherExpendituresAmt
End Year Balance$3,591,423EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,683,970BeginningYearBalanceAmt
Contributions$710,628ContributionsAmt
Investment Earnings Or Losses$85,294InvestmentEarningsOrLossesAmt
Other Expenditures$33,800OtherExpendituresAmt
End Year Balance$3,446,092EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,382,667BeginningYearBalanceAmt
Contributions$270,795ContributionsAmt
Investment Earnings Or Losses$92,571InvestmentEarningsOrLossesAmt
Other Expenditures$62,063OtherExpendituresAmt
End Year Balance$2,683,970EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,251,229BeginningYearBalanceAmt
Contributions$72,500ContributionsAmt
Investment Earnings Or Losses$71,751InvestmentEarningsOrLossesAmt
Other Expenditures$12,813OtherExpendituresAmt
End Year Balance$2,382,667EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,737,891BeginningYearBalanceAmt
Contributions$513,452ContributionsAmt
Investment Earnings Or Losses$25,341InvestmentEarningsOrLossesAmt
Other Expenditures$25,455OtherExpendituresAmt
End Year Balance$2,251,229EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.94820PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.05180TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,494,381OtherCostOrOtherBasisAmt
Book Value$15,494,381BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$234,409,773OtherCostOrOtherBasisAmt
Depreciation$126,192,941DepreciationAmt
Book Value$108,216,832BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,348,364OtherCostOrOtherBasisAmt
Depreciation$10,679,673DepreciationAmt
Book Value$3,668,691BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$337,020,134OtherCostOrOtherBasisAmt
Depreciation$261,872,092DepreciationAmt
Book Value$75,148,042BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,727,087OtherCostOrOtherBasisAmt
Depreciation$6,300,237DepreciationAmt
Book Value$3,426,850BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$205,954,796TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (5 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
RREEF AMERICA REIT II$23,123,885F
MELLON AGGREGATE BOND INDEX FUND$12,195,817F
CASH ON DEPOSIT WITH BOND TRUSTEE$5,726,167F
AGENCY ACCOUNT$2,508F
CASUALTY INSURANCE SECURITY$1,697,000F
FieldValueIRS element (for citing)
Total Book Value Securities$42,745,377TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)

DescDescAmtAmt
EXECUTIVE PENSION PLAN$3,937,223
RESTORATION PENSION PLAN$57,767
PY PENSION LIABILITY$16,755,156
POST RETIREMENT HEALTH INSURANCE$1,365,085
SECURITIES LENDING$3,538,291
CAA DEPOSIT RESERVE$114,747
SETTLEMENTS AND CLAIMS PAYABLE$357,295
DEFERRED INCOME LONG TERM$5,333,333
FieldValueIRS element (for citing)
Total Liability$31,458,897TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:ALL ENDOWMENT FUNDS ARE HELD BY A RELATED ENTITY: NORTH MEMORIAL FOUNDATION. 1) RALPH ROSSEN ENDOWMENT: THIS ENDOWMENT WAS ESTABLISHED IN 1986 TO PROVIDE RECOGNITION TO NURSING STAFF THAT PROVIDE REMARKABLE SERVICE TO NORTH MEMORIAL PATIENTS AND THEIR FAMILIES. MEMBERS OF THE ROSSEN FAMILY SERVE ON A COMMITTEE ALONG WITH THE VP AND CHIEF NURSING OFFICER OF NORTH MEMORIAL TO SELECT THE RECIPIENTS. 2) HAROLD B. KAISER HONORARY LECTURESHIP ENDOWMENT: DR KAISER IS THE FOUNDER OF ALLERGY & ASTHMA SPECIALISTS, P.A. ESTABLISHED IN 1966. THE HAROLD B KAISER HONORARY LECTURESHIP ENDOWMENT PROVIDES FUNDING FOR A KEYNOTE SPEAKER FOR THE ANNUAL ALLERGY & ASTHMA CONFERENCE HELD IN THE MINNEAPOLIS AREA IN MARCH. 3) HAROLD ECKER ENDOWMENT: ESTABLISHED IN 1994 IN HONOR OF THE EXCELLENT CARE THAT MR. ECKER RECEIVED AS A PATIENT AT NORTH MEMORIAL, THE HAROLD ECKER ENDOWMENT PROVIDES A $500 AWARD TO THREE NORTH MEMORIAL EMPLOYEES RECOGNIZING THEIR OUTSTANDING PERFORMANCE AND PERSONAL ATTITUDE. THE AWARD IS OPENED TO ALL EMPLOYEES AND THE WINNERS ARE SELECTED BY A COMMITTEE OF NORTH MEMORIAL EMPLOYEES AND PRESENTED AT THE ANNUAL QUALITY AWARDS LUNCHEON IN NOVEMBER EACH YEAR. 4) RESIDENTIAL HOSPICE ENDOWMENT: THE RESIDENTIAL HOSPICE ENDOWMENT WAS ESTABLISHED BY DR. JOHN AND PATTY MANION TO PROVIDE ASSISTANCE TO THE RESIDENTIAL HOSPICE PROGRAM AT NORTH MEMORIAL. FUNDS ARE USED TO UPGRADE THE FACILITIES AND EQUIPMENT AT THE NORTH RESIDENTIAL HOSPICE FACILITY IN BROOKLYN CENTER, PROVIDE ADDITIONAL PROGRAM SUPPORT, STAFF TRAINING AND TO ASSIST THOSE FAMILIES THAT CANNOT AFFORD THIS SERVICE. 5) HELEN MURRAY MEMORIAL ENDOWMENT THIS ENDOWMENT WAS ESTABLISHED WITH AN IRREVOCABLE CHARITABLE REMAINDER TRUST BY JEANNE MITHUN TO RECOGNIZE THE OUTSTANDING SERVICE THAT NORTH RESIDENTIAL HOSPICE PROVIDED TO HER MOTHER (HELEN MURRAY) AND HER FAMILY. FUNDS ARE USED TO PROVDE CARE TO INDIVIDUALS UNABLE TO PAY FOR SERVICES AT THE FACILITY. 6) PAY IT FORWARD THE PAY IT FORWARD FUND WAS ESTABLISHED BY BREAST CANCER SURVIVOR MICHELLE MOREY AND HER HUSBAND SCOTT BISSEN. MICHELLE RECOGNIZED A NEED TO HELP WOMEN STRUGGLING FINANCIALLY WHILE GOING THROUGH CANCER TREATMENT. PATIENTS ELIGIBLE FOR ASSISTANCE ARE FROM NORTH MEMORIAL, UNITY AND MONTICELLO HOSPITALS. THE FUND IS ADMINISTERED AT NO FEE THROUGH THE NORTH MEMORIAL FOUNDATION. 7) MEDICAL STAFF ENDOWMENT THIS ENDOWMENT WAS ESTABLISHED IN 2010 BY THE NORTH MEMORIAL MEDICAL STAFF EXECUTIVE COMMITTEE. PROCEEDS FROM THE ENDOWMENT WILL FUND NORTH MEMORIAL PROGRAMS SUCH AS JUNIOR VOLUNTEER SCHOLARSHIP, SAFEJOURNEY, PASTORAL CARE, ETC. 8) MAPLE GROVE MEDICAL STAFF ENDOWMENT WAS ESTABLISHED IN 2013 BY THE MAPLE GROVE MEDICAL STAFF EXECUTIVE COMMITTEE. PROCEEDS FROM THE ENDOWMENT WILL FUND MAPLE GROVE PROGRAMS.
PART X, LINE 2:NORTH MEMORIAL EVALUATES ITS UNCERTAIN POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2014 OR 2013. NORTH MEMORIAL IS CURRENTLY UNDER EXAMINATION BY THE STATE OF MINNESOTA FOR A SALES TAX AUDIT FOR THE PERIOD OF SEPTEMBER 2010 THROUGH DECEMBER 2013.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,052,693TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$10,052,693NetCommunityBenefitExpnsAmt
Total Expense0.01490TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$85,524,225TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$55,167,688DirectOffsettingRevenueAmt
Net Community Benefit Expns$30,356,537NetCommunityBenefitExpnsAmt
Total Expense0.04500TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$95,576,918TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$55,167,688DirectOffsettingRevenueAmt
Net Community Benefit Expns$40,409,230NetCommunityBenefitExpnsAmt
Total Expense0.05990TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,867,151TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,867,151NetCommunityBenefitExpnsAmt
Total Expense0.00280TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,424,985TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$736,777DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,688,208NetCommunityBenefitExpnsAmt
Total Expense0.00840TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$54,403,723TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$41,430,918DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,972,805NetCommunityBenefitExpnsAmt
Total Expense0.01920TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$96,815TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$88,398DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,417NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$856,551TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$856,551NetCommunityBenefitExpnsAmt
Total Expense0.00130TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$63,649,225TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$42,256,093DirectOffsettingRevenueAmt
Net Community Benefit Expns$21,393,132NetCommunityBenefitExpnsAmt
Total Expense0.03170TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$159,226,143TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$97,423,781DirectOffsettingRevenueAmt
Net Community Benefit Expns$61,802,362NetCommunityBenefitExpnsAmt
Total Expense0.09160TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$7,878,236BadDebtExpenseAmt
Reimbursed By Medicare$143,166,758ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$192,948,669CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$49,781,911MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (12 entries)

Primary ActivitiesPrimaryActivitiesTxtOrg Profit Or OwnershipOrgProfitOrOwnershipPctOfcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPctPhysicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 MAPLE GROVE HOSPITAL
HOSPITAL0.750000.000000.00000
2 NM SURGERY CENTER MAPLE GROVE
OUTPATIENT SURG CTR0.500000.000000.50000
3 MN DIAGNOSTIC IMAGING PARTNERS
OUTPATIENT IMAGING CTR0.600000.000000.40000
4 PREFERRED ONE ADMINISTRATIVE SERVICES
CLAIMS ADMINISTRATOR0.250000.000000.25000
5 PREFERRED ONE COMMUNITY HEALTH PLAN
INSURANCE COMPANY0.500000.000000.00000
6 INSTITUTE OF ATHLETIC MEDICINE
CLINIC0.370000.000000.00000
7 MONTICELLO CANCER CENTER
OPTNT CANCER CLINIC0.400000.000000.00000
8 NORTH RADIATION ONCOLOGY
OPTNT RADIATION ONC CLNC0.500000.000000.50000
9 BLAINE URGENCY CENTER
URGENT CARE0.500000.000000.50000
10 PLYMOUTH CITY CENTER MEDICAL BUILDING
MEDICAL OFFICE BUILDING0.500000.000000.00000
11 MINNETONKA AMBULATORY SURGERY CENTER
OUTPATIENT SURGERY CENTER1.000000.000000.00000
12 FAIRVIEW HOME INFUSION
HOME INFUSION CARE0.490000.000000.00000
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTH MEMORIAL MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1Txt
CityROBBINSDALECityNm
State AbbreviationMNStateAbbreviationCd
ZIP55422ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.NORTHMEMORIAL.COMWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NORTH MEMORIAL MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.NORTHMEMORIAL.COMOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.NORTHMEMORIAL.COMStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross ChargesYes (1)GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
NORTH MEMORIAL MEDICAL CENTERPART V, SECTION B, LINE 5: ONE OF THE KEY OBJECTIVES IN CONDUCTING THE 2013 CHNA WAS TO IDENTIFY HEALTH ISSUES MOST IMPORTANT TO OUR COMMUNITY MEMBERS. THIS WAS ACCOMPLISHED IN SEVERAL WAYS. NORTH MEMORIAL HEALTH CARE CONVENED 4 FOCUS GROUPS FROM TARGET POPULATIONS FROM THROUGHOUT THE COMMUNITY. WE FURTHER INTERVIEWED COMMUNITY LEADERS REPRESENTING LOCAL GOVERNMENT, LAW ENFORCEMENT, EDUCATION, RELIGIOUS ORGANIZATION, PUBLIC HEALTH AND COMMUNITY-BASED ORGANIZATIONS. LASTLY, WE CONDUCTED AN ONLINE SURVEY FOR COMMUNITY MEMBERS AND NORTH MEMORIAL EMPLOYEES. WE RETAINED AN OUTSIDE CONSULTING FIRM TO LEAD THE FOCUS GROUPS.
NORTH MEMORIAL MEDICAL CENTERPART V, SECTION B, LINE 11: PRIORITY AREA 1-ACCESS & AFFORDABILITY1.1-EDUCATION OF COMMUNITY MEMBERS ON HOW TO ENGAGE AND INTERACT WITH HEALTH CARE RESOURCESNORTH MEMORIAL HEALTH CARE HAS HOSTED A NUMBER OF EVENTS TO EDUCATE OUR COMMUNITY MEMBERS ABOUT HOW TO ENGAGE AND INTERACT WITH HEALTH CARE RESOURCES. THESE EVENTS INCLUDED SEMINARS ON: VASCULAR HEALTH AND TREATMENT OPTIONS; TREATMENT OPTIONS FOR ED; AND MINIMALLY INVASIVE SURGERY OPTIONS. 1.2-STRATEGIC PARTNERSHIP WITH COMMUNITY-BASED RESOURCES THAT SUPPORT ACCESS AND ENROLLMENT IN HEALTH INSURANCE PROGRAMS TO ADDRESS THIS PRIORITY WE TRAINED AND CERTIFIED EIGHT NORTH MEMORIAL EMPLOYEES AS MNSURE NAVIGATORS AND EXPANDED ACCESS TO EMERGENCY DEPARTMENT-BASED RESOURCES RELATED TO SUPPORTING PATIENTS' SOCIAL AND FINANCIAL NEEDS. WE ENGAGED PORTICO TO HOST 6 ENROLLMENT SESSIONS AT NORTH MEMORIAL MEDICAL CENTER, MAPLE GROVE HOSPITAL AND SELECT PRIMARY CARE CLINICS. 1.3-DELIVERY OF CARE TO THE COMMUNITY: SCREENINGS, EDUCATION, ETC. NORTH MEMORIAL HEALTH CARE REGULARLY WRITES HEALTH INFORMATION ARTICLES FOR OUR COMMUNITY NEWSPAPERS, OUR ONLINE CONSUMER BLOG AND OUR MONTHLY E-NEWSLETTER. THE CONTENT IS EDUCATIONAL IN NATURE AND THE TOPICS VARY FROM THE IMPORTANCE OF GETTING THE FLU VACCINATION TO HOW TO REDUCE ALLERGY SYMPTOMS AT HOME. THESE HEALTH MESSAGES ARE AUGMENTED WITH HEALTH INFORMATION DISSEMINATED THROUGH DIRECT MAIL NEWSLETTERS REACHING 400,000 HOUSEHOLDS EACH QUARTER, AND LOCAL ADVERTISING IN COMMUNITY NEWSPAPERS. PRIORITY AREA 2-COMMUNITY COLLABORATION & CONNECTING COMMUNITY RESOURCES2.1-QUARTERLY MEETINGS BETWEEN NMMC PRESIDENT AND COMMUNITY LEADERSA COMMUNITY HEALTH STEERING COMMITTEE WAS ESTABLISHED IN SEPTEMBER OF 2014. THE COMMITTEE IS COMPOSED OF COMMUNITY LEADERS WHO REPRESENT VARIOUS AREAS OF THE COMMUNITY. THE MISSION OF THIS COMMUNITY HEALTH STEERING COMMITTEE IS TO PROVIDE GUIDANCE FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT, MONITOR THE WORK THAT IS BEING CONDUCTED TO ADDRESS THE IDENTIFIED PRIORITIES AND HELP IDENTIFY POTENTIAL COMMUNITY PARTNERSHIPS. 2.2-LINKING PATIENTS TO COMMUNITY-BASED RESOURCES NORTH MEMORIAL PARTNERED WITH THE METRO AREA AGENCY ON AGING PARTNERSHIP WITH A COMMUNITY ORGANIZATION THAT HAS HAD AN IMPACT ON THE OVERALL HEALTH OF A POPULATION. PROGRAMS INCLUDE COMMUNITY CARE TRANSITIONS PLUS PROGRAM TO REDUCE READMISSIONS, CHRONIC DISEASE SELF-MANAGEMENT PROGRAM, SENIOR FALLS PREVENTION DAY AND DEVELOPMENT OF DIRECT COMMUNICATION CHANNELS BETWEEN SENIOR LINKAGE LINE AND CLINIC CARE COORDINATORS. 2.3-LUTHERAN SOCIAL SERVICES SENIOR CORPS PROGRAMS NORTH MEMORIAL MEDICAL CENTER HAS A DIRECT PARTNERSHIP WITH LUTHERAN SOCIAL SERVICES THAT ALLOWS US TO ACCESS SIX DEDICATED VOLUNTEERS THAT WORK WITH HIGH-RISK SENIORS THAT RECEIVE CARE AT OUR CLINICS. EACH VOLUNTEER IS ABLE TO ENGAGE FIVE OR MORE SENIORS.PRIORITY AREA 3-CULTURAL COMPETENCY IN TREATMENT INTERACTIONS3.1-CLAS ASSESSMENT TO REVIEW ORGANIZATIONAL SYSTEMS, POLICIES AND PRACTICES THAT AFFECT THE CARE OF DIVERSE PATIENTS AN EXTERNAL VENDOR COMPLETED A LANGUAGE PRO PROFICIENCY AND CULTURAL COMPETENCY EVALUATION FOR NMMC. AT THAT TIME THE RECOMMENDATION FROM THE VENDOR AFTER THE ASSESSMENT WAS THAT ALL ED STAFF, INCLUDING PROVIDERS, REGISTRATION, EVS, LEADERSHIP, ATTEND A CULTURAL COMPETENCY TRAINING TO ENHANCE THE UNDERSTANDING AND PARTNERSHIP WITH PATIENTS OF DIFFERENT CULTURAL BACKGROUNDS.3.2-PHASE II: CULTURALLY-COMPETENT NURSE MIDWIFE PROGRAMWE CURRENTLY HAVE FOUR MIDWIVES, WHICH HAVE PROVIDED WELL WOMEN VISITS IN PARTNERSHIP WITH OUR HOPE CHEST BREAST CENTER FOR OUR LAOTIAN POPULATION IN 2014. WE HAVE PARTNERED WITH THE MINNEAPOLIS SCHOOL DISTRICT TO PROVIDE PRENATAL EDUCATION TO THEIR PREGNANT STUDENTS, MANY OF WHICH ARE IN A MINORITY POPULATION. THE MIDWIFE PROGRAM IS PARTNERING WITH EVERYDAY MIRACLES TO PROVIDE DOULA'S TO OUR LABORING PATIENTS STARTING NOVEMBER OF 2015. PRIORITY AREA 4-SOCIAL & EMOTIONAL WELLBEING4.1-POST-INCIDENCE CRISIS RESPONSE PROGRAM THAT ASSISTS IN COMMUNITY RESPONSE AFTER A VIOLENT CRIME OUR POST INCIDENCE CRISIS RESPONSE PROGRAM IS WHERE WE GATHER NECESSARY RESOURCES FROM VARIOUS HOSPITAL DEPARTMENTS AND POOL THOSE RESOURCES TOGETHER TO DEAL WITH A SUDDEN, OFTEN TRAUMATIC SITUATION THAT OCCURS IN OUR COMMUNITY AND ENDS UP AT THE HOSPITAL. MOST LIKELY THIS IS A SITUATION THAT STEMS FROM A VIOLENT INCIDENT. 4.2-PSYCH SERVICES FOR COMMUNITY: PARTIAL HOSPITAL PROGRAM AND PSYCH INTEGRATION IN PRIMARY CARENORTH MEMORIAL MEDICAL CENTER OFFERS THE FOLLOWING PSYCH SERVICES TO THE COMMUNITY WE SERVE: A PARTIAL HOSPITAL PROGRAM; AN INTENSIVE OUTPATIENT PROGRAM; INTEGRATED BEHAVIORAL HEALTH IN PRIMARY CARE; HEALTH PSYCHOLOGIST AVAILABLE TO PAIN, SLEEP AND SPECIALTY CLINICS; PSYCH ASSESSMENTS BY LICENSED MH PROFESSIONALS IN ED; A LIMITED OUTPATIENT PSYCHIATRY CLINIC; AND A KETAMINE CLINIC.4.3-CATHOLIC CHARITIES TRANSITIONAL RECOVERY-CARE: PROGRAM FOR DISCHARGING HOMELESS PATIENTSTHE CATHOLIC CHARITIES TRANSITIONAL RECOVERY-CARE PROGRAM IS A PARTNERSHIP BETWEEN NORTH MEMORIAL MEDICAL CENTER AND CATHOLIC CHARITIES. NORTH MEMORIAL MEDICAL CENTER PAYS FOR TWO STAFFED BEDS AT EXODUS HOUSE TO ENSURE A SAFE DISPOSITION FOR OUR HOMELESS POPULATION WHO ARE MEDICALLY STABLE BUT NEED TIME TO TRANSITION TO PERMANENT HOUSING. 4.4-SAFEJOURNEY PROGRAMSAFEJOURNEY IS AN INNOVATIVE, VOLUNTEER-DRIVEN PROGRAM THAT PROVIDES VICTIMS OF DOMESTIC VIOLENCE WITH SAFETY PLANNING, INJURY DOCUMENTATION, IMMEDIATE EMOTIONAL SUPPORT, LEGAL ADVOCACY, AND OPTIONS FOR LONGER-TERM SUPPORT. TRAINED VOLUNTEER ADVOCATES PROVIDE 24-HOUR ON SITE ADVOCACY TO PATIENTS AT NORTH MEMORIAL AND MAPLE GROVE HOSPITAL AS WELL AS INDIVIDUALS IN OUR COMMUNITIES. ON-GOING SUPPORT IS PROVIDED BY WEEKLY SUPPORT GROUPS, INDIVIDUAL COUNSELING, AND FOLLOW UP CALLS. PRIORITY AREA 5-HEALTH INFORMATION5.1-INJURY PREVENTION: SAFE KIDS NW METRO MINNEAPOLIS COALITION AND THE PARTNERSHIP FOR CHANGE:PARTNERSHIP FOR CHANGE (PFC) IS A COMMUNITY BASED COALITION WHOSE MISSION IS TO LEVERAGE COMMUNITY PARTNERSHIPS TO PREVENT AND REDUCE ALCOHOL AND OTHER DRUG USE AMONG YOUTH AND REDUCE SUBSTANCE ABUSE IN THE COMMUNITY. PFC SERVES THE BROOKLYN CENTER, OSSEO, AND ROBBINSDALE SCHOOL DISTRICTS IN HENNEPIN COUNTY, MN. THE PFC COALITION MET 12 TIMES IN 2014, WITH ADDITIONAL STEERING COMMITTEE MEETINGS AND SUB-COMMITTEE MEETINGS. SOME OF THE MAJOR ACTIVITIES CARRIED OUT INCLUDE: THREE PRESENTATIONS ON THE PLACE OF LAST DRINK INITIATIVE AT NATIONAL CONFERENCES AND OTHERS THROUGHOUT MN. THE HIGH SCHOOL YOUTH LEADERSHIP GROUP MET 10 TIMES AND CARRIED OUT A GREEN BEAN "SOCIAL MARKETING CAMPAIGN" PROMOTING THE MESSAGE THAT MOST STUDENTS DO NOT DRINK ALCOHOL. SOCIAL HOST ORDINANCE REMINDER CARDS WERE DISTRIBUTED TO PARENTS AND CARING ADULTS TO REMIND THEM IT IS ILLEGAL TO PROVIDE A PLACE FOR YOUTH TO DRINK.SAFE KIDS NW METRO MINNEAPOLIS IS A COMMUNITY COALITION THAT WORKS TO PREVENT INJURIES IN CHILDREN. IN 2014 WE HOSTED 4 SAFE KIDS EXECUTIVE MEETINGS AND 6 MN WATER SAFETY COALITION MEETINGS. THROUGH COMMUNITY PARTNERSHIPS WE DISTRIBUTED 1,000 BIKE HELMETS. SAFE KIDS COORDINATED 7 CAR SEAT CLINICS WITH COMMUNITY PARTNERS, TEACHING PARENTS AND GRANDPARENTS TO CORRECTLY INSTALL 142 CAR SEATS5.2-STROKE AWARENESS & PREVENTION:THE NORTH MEMORIAL STROKE PROGRAM PARTICIPATED IN MULTIPLE COMMUNITY EVENTS, SCREENINGS, NEWS REPORTS AND OFFERED TWO STROKE EDUCATION CLASSES FOR STROKE SURVIVORS. WE HAVE AN ACTIVE STOKE SUPPORT GROUP WITH OVER 900 PARTICIPATES IN 2014. IN 2014, 254 STROKE SCREENINGS OCCURRED AT 3 COMMUNITY EVENTS. 33 PEOPLE PARTICIPATED IN 2 STROKE RELATED COMMUNITY OUTREACH PROGRAMS. 5.3-CANCER SCREENING & PREVENTION:MELANOMA SCREENINGS WERE PERFORMED AT NORTH MEMORIAL ON MAY 5, 2014 AND SEPTEMBER 27, 2014 UNDER THE AUSPICES OF THE SPOT SKIN CANCER CAMPAIGN, 150 PERSONS SERVED. THIS PROGRAM STIPULATES THAT SCREENING CLINICIANS SHOULD NOT PREFERENTIALLY FUNNEL REFERRALS TO THEIR OWN PRACTICE. THE PATIENTS WHO PARTICIPATED IN THE MELANOMA SCREENING EVENTS WERE PROVIDED A SHEET LISTING THE NEAREST 5 REPUTABLE DERMATOLOGY GROUPS OF WHICH CLARUS DERMATOLOGY WAS ONE.THERE WAS A BREAST CANCER SCREENING EVENING PROGRAM IN OCTOBER 2014 FOR THE LAO COMMUNITY AT THE BREAST CENTER. SCREENING MAMMOGRAMS WERE COMPLETED AND SOME OF THE WOMEN ALSO UNDERWENT CERVICAL CANCER SCREENING. THERE WERE APPROXIMATELY 10 PATIENTS WHO PARTICIPATED IN THE EVENT. WOMEN'S NIGHT OUT: AN INFORMATIONAL EVENING FOR WOMEN TOOK PLACE IN OCTOBER 2014. THERE WERE THREE SPEAKERS THROUGHOUT THE EVENING, INCLUDING TOPICS ON NUTRITION, GENETIC LINKS AND THE EXPERIENCE OF THE PATIENT. THERE WAS A SCHEDULER AVAILABLE THROUGHOUT THE EVENING TO SCHEDULE PATIENTS FOR THEIR MAMMOGRAMS.5.4-ADVANCE CARE PLANNING (ACP):FROM JANUARY TO NOVEMBER APPROXIMATELY 12 HOURS A WEEK WAS SPENT IN DIRECT PATIENT ACP CONTACT. IN OCTOBER 2014 AN ADVANCE CARE PLANNING FACILITATOR WAS HIRED AND TRAINED IN ACP.
NORTH MEMORIAL MEDICAL CENTERPART V, SECTION B, LINE 22D: THE MINNESOTA ATTORNEY GENERAL'S OFFICE REQUIRES HOSPITALS TO RENDER SERVICES TO THOSE PATIENTS WHO DO NOT HAVE INSURANCE AT A REDUCED RATE EQUAL TO THE DISCOUNT INCURRED FROM THE HIGHEST VOLUME MANAGED CARE PLAN.
NORTH MEMORIAL MEDICAL CENTERPART V, SECTION B, LINE 24: PER THE MINNESOTA ATTORNEY GENERAL'S AGREEMENT, THIRD PARTY LIABILITY AND PROCEDURES THAT ARE NOT MEDICALLY NECESSARY ARE NOT COVERED UNDER THE MINNESOTA ATTORNEY GENERAL'S AGREEMENT AND THOSE PATIENTS CAN BE BILLED FULL CHARGES.
PART V, SECTION B, LINE 16FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
NORTH MEMORIAL MEDICAL CENTER PART V, SECTION B, LINE 16B WEBSITE:WWW.NORTHMEMORIAL.COM
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
MINNESOTA DIAGNOSTIC IMAGING PARTNERS LL
2955 XENIUM LANE SUITE 40PLYMOUTHMN55441OUTPATIENT RADIOLOGY
BLAINE URGENCY CENTER
480 OSBORNE RD NEFRIDLEYMN55432URGENT CARE
NM SURGERY CENTER MAPLE GROVE
9875 HOSPITAL DRIVEMAPLE GROVEMN55369OUTPATIENT SURGERY
NORTH RADIATION THERAPY CENTER
6950 FRANCE AVE S SUITE 200EDINAMN55435OUTPATIENT RADIOLOGY

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 2:AMOUNT REPRESENTS THE HOSPITAL'S BAD DEBT PROVISION REDUCED BY THE HOSPITAL'S COST TO CHARGE RATIO WHICH REPRESENTS THE BEST ESTIMATE OF COST FOR THE BAD DEBT PROVISION.
PART III, LINE 4:NORTH MEMORIAL'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DESCRIPTION ABOUT BAD DEBT EXPENSE. THE COST TO CHARGE RATIO WAS USED TO DETERMINE THE AMOUNT ON PART III, SECTION A, LINE 2. WE DO NOT HAVE THE INFORMATION NECESSARY TO DETERMINE WHICH PORTION OF THE AMOUNT REPORTED ON LINE 2 IS COMMUNITY BENEFIT.
PART III, LINE 8:THE SHORTFALL REPORTED REPRESENTS THE AMOUNT MEDICARE REIMBURSEMENT IS LESS THAN THE ESTIMATED COST OF PROVIDING SERVICES TO THOSE PATIENTS. THE METHOD USED TO ESTIMATE THOSE COSTS IS THE COST TO CHARGE RATIO APPROACH WHICH CALCULATES THE RATIO OF TOTAL HOSPITAL COSTS / TOTAL HOSPITAL GROSS REVENUE AND THEM APPLIES THAT RATIO TO TOTAL MEDICARE GROSS REVENUE.
PART III, LINE 9B:NORTH MEMORIAL HAS POLICIES AND PROCEDURES IN PLACE FOR COLLECTION PRACTICES THAT INCLUDE IDENTIFICATION AND SCREENING FOR CHARITY CARE AND FINANCIAL ASSISTANCE. THE POLICIES ARE AVAILABLE ON THE ORGANIZATIONS INTRANET AND PERTAIN TO ALL ENTITIES UNDER THE NORTH MEMORIAL CORPORATE UMBRELLA.
PART VI, LINE 2:NORTH MEMORIAL WORKS CLOSELY WITH COMMUNITY MEMBERS TO DETERMINE AREAS OF INTEREST AND NEED IN HEALTHCARE SERVICES. STARTING IN LATE 2012 AND INTO 2013 WE STARTED COMPLETING A FULL COMMUNITY NEEDS ASSESSMENT, INCLUDING COMMUNITY FOCUS GROUPS, TO BETTER UNDERSTAND THE COMMUNITY'S HEALTH NEEDS. WE ARE CURRENTLY ADDRESSING THE NEEDS IDENTIFIED IN OUR 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. A NEW COMMUNITY HEATH NEEDS ASSESSMENT WILL BE CONDUCTED IN 2016.
PART VI, LINE 3:NORTH MEMORIAL HEALTH CARE HAS A VERY PROACTIVE PROGRAM TO ASSIST UNINSURED AND UNDERINSURED PATIENTS WITH THEIR MEDICAL BILLS. WE COMPLY WITH THE ATTORNEY GENERAL'S REQUIREMENT TO PROVIDE AN IMMEDIATE DISCOUNT TO UNINSURED MINNESOTA RESIDENTS. WE HAVE PATIENT FINANCIAL ADVOCATES AS WELL AS A CONTRACTED VENDOR THAT MEETS WITH ALL OF OUR UNINSURED INPATIENTS AND SPECIFIC OUTPATIENTS TO ASSIST THEM IN MEDICAL ASSISTANCE ELIGIBILITY AND APPLICATIONS. THIS COULD INCLUDE A VISIT TO THEIR RESIDENCE IF THEY NEED HELP IN COMPLETING ASSISTANCE APPLICATIONS. SHOULD THEY NOT QUALIFY FOR STATE OR FEDERAL ASSISTANCE PROGRAMS, WE OFFER AND ASSIST THEM IN APPLYING FOR THE HOSPITAL'S FINANCIAL ASSISTANCE (CHARITY CARE) PROGRAM.OUR CHARITY CARE PROGRAM IS PUBLISHED IN THE CORPORATE POLICIES AND PROCEDURES AND PROVIDES FOR 100% COVERAGE OF MEDICAL BILLS FOR ANYONE WHOSE INCOME IS LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES AND NEEDS ASSISTANCE IN RESOLVING THEIR FINANCIAL OBLIGATION TO THE HOSPITAL. THERE IS A GRADUAL REDUCTION IN THE CHARITY COVERAGE BETWEEN THE 201% AND 400% OF THE FEDERAL POVERTY GUIDELINES.IF WE ARE UNABLE TO MEET WITH THE PATIENT BEFORE DISCHARGE FROM NORTH MEMORIAL, THE PATIENT IS GIVEN A PAMPHLET THAT LISTS CONTACT NUMBERS TO OUR BUSINESS OFFICE CUSTOMER SERVICE AREA TO DISCUSS OPTIONS FOR ASSISTANCE WITH THEIR MEDICAL BILLS. THIS CONTACT INFORMATION IS ALSO PROVIDED ON EVERY STATEMENT THAT IS SENT TO OUR CUSTOMERS. IN ADDITION, OUR INTERNAL COLLECTIONS DEPARTMENT AND OUR COLLECTION AGENCIES ARE WELL VERSED IN OUR ASSISTANCE PROGRAMS AND WILL ASSESS DURING THEIR CONVERSATIONS WITH PATIENTS IF REFERRAL TO EITHER A STATE OR FEDERAL PROGRAM OR OUR CHARITY CARE PROGRAM WOULD BE APPROPRIATE.
PART VI, LINE 4:NORTH MEMORIAL SERVES A GEOGRAPHIC AREA THAT INCLUDES 42 ZIP CODES IN THE NORTHWEST QUADRANT OF THE TWIN CITIES METRO. THIS SERVICE AREA INCLUDES BOTH URBAN, SUBURBAN, EX-URBAN, AND RURAL AREAS. THIS SERVICE AREA INCLUDES A DIVERSE POPULATION OF MORE THAN 900,000 PEOPLE LIVING IN HENNEPIN, WRIGHT, SHERBURNE AND RAMSEY COUNTIES.
PART VI, LINE 5:NORTH MEMORIAL MEDICAL CENTER IS A GENERAL ACUTE CARE HOSPITAL PROVIDING SPECIALIZED TRAUMA AND EMERGENCY SERVICES, CARDIOVASULAR AND OPEN HEART SERVICES, ONCOLOGY, HIGH RISK MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL-SURGICAL, OBSTETRICAL, PEDIATRIC, REHABILITATIVE AND BEHAVIORAL SERVICES. NMHC ALSO PROVIDES AN ARRAY OF HEALTH CARE SERVICES TO OUR COMMUNITY INCLUDING PRIMARY CARE, AMBULANCE TRANSPORTATION AND HOME HEALTH AND HOSPICE SERVICES. NORTH MEMORIAL IS GOVERNED BY A BOARD OF 15 REPRESENTATIVES CONSISTING OF PHYSICIANS AND VARIOUS LEADERS FROM THROUGHOUT THE COMMUNITY. BOARD MEMBERS ARE ELECTED TO SERVE THREE-YEAR TERMS FOR A TOTAL OF FIVE TERMS. THE MEDICAL CENTER ALSO SUPPORTS AN OPEN MEDICAL STAFF ORGANIZATION INCLUDING APPROXIMATELY 900 BOARD CERTIFIED PHYSICIANS AND 300 ALLIED HEALTH PROFESSIONSALS. THE NORTH MEMORIAL BOARD OF TRUSTEES ESTABLISHES AN ANNUAL MARGIN TARGET FOR MANAGEMENT. PER BOARD POLICY 75% OF ANY EXCESS AVAILABLE CASH FLOW IS REINVESTED IN THE FORM OF CAPITAL IMPROVEMENTS TO THE CENTER. THE REMAINING 25% IS REINVESTED TO SUPPORT LONG TERM OPERATIONS. WE PROVIDE EDUCATION TO THE COMMUNITY ON CHILD SAFETY, STROKE RISK FACTORS, HEART DISEASE RISK FACTORS AND OTHER HEALTH PROMOTION INFORMATION.
PART VI, LINE 6:NORTH MEMORIAL HEALTH SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. THROUGH TARGETED OUTREACH, EDUCATION AND PARTNERSHIPS, WE IMPROVE THE HEALTH OF OUR COMMUNITIES BY LISTENING TO THEIR NEEDS AND RESPONDING WITH APPROPRIATE PROGRAMS AND SERVICES.OUR PROGRAMS, MANY OF WHICH HAVE BEEN NATIONALLY RECOGNIZED, RANGE FROM HEALTH EDUCATION AND FREE SCREENINGS TO TRAINING HEALTH PROFESSIONALS.
PART VI, LINE 7:NORTH MEMORIAL HEALTH CARE FILES A COMMUNITY BENEFIT REPORT WITH THE STATE OF MINNESOTA.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
LOREN TAYLOR
CEO NORTH MEMORIAL$659,362$0$20,000$0$183,736$0$18,200$0$6,203$0$887,501$0$0$0
TODD OSTENDORF
VP FINANCE, CFO$335,010$0$20,000$0$73,001$0$13,492$0$8,281$0$449,784$0$0$0
J KEVIN CROSTON MD
CHIEF MEDICAL OFFICER$426,538$0$20,000$0$64,479$0$18,200$0$5,641$0$534,858$0$0$0
JEFF WICKLANDER
VP OPERATIONS$244,186$0$15,000$0$35,356$0$17,347$0$8,258$0$320,147$0$0$0
ANDREW COCHRANE
CEO - MAPLE GROVE HOSPITAL$330,000$0$20,000$0$51,997$0$18,200$0$8,278$0$428,475$0$0$0
KELLY WHITE
VP INPATIENT CARE/CNO$140,861$0$7,000$0$19,734$0$4,206$0$7,263$0$179,064$0$0$0
PATRICK TAFFE
CHIEF INFORMATION OFFICER$252,261$0$20,000$0$49,813$0$18,460$0$5,923$0$346,457$0$0$0
DAVID ABRAMS
VP HUMAN RESOURCES$225,000$0$20,000$0$44,700$0$17,150$0$8,202$0$315,052$0$40,759$0
COLLEEN NADEAU
VP PATIENT CARE OPERATIONS - MGH$0$166,771$0$28,230$0$322$0$4,875$0$121$0$200,319$0$0
CRAIG MATTICKS
STAFF EMERGENCY PHYSICIAN$528,089$0$0$0$3,834$0$18,200$0$8,391$0$558,514$0$0$0
TIFFANY ZITZEWITZ
VP BUSINESS DEVELOPMENT$250,000$0$20,000$0$38,174$0$18,488$0$8,220$0$334,882$0$0$0
ANDREW HOULTON
VP MEDICAL AFFAIRS$344,856$0$0$0$56,806$0$18,200$0$5,989$0$425,851$0$0$0
MICHAEL PARRISH
VP EMERGENCY & ENTERPRISE OPERATIONS$272,002$0$15,000$0$45,990$0$18,200$0$5,935$0$357,127$0$0$0
GAYLE MATTSON
PRESIDENT OF NORTH MEMORIAL$283,256$0$20,000$0$443,752$0$18,552$0$260$0$765,820$0$0$0
TRACY KIRBY
VP INPATIENT CARE/CNO$62,455$0$15,000$0$257,319$0$5,891$0$3,002$0$343,667$0$0$0
ROBERT KING
CARDIAC SURGEON$672,400$0$50,000$0$10,470$0$18,200$0$8,524$0$759,594$0$0$0
ALOK MAHESHWARI
CARDIOLOGIST$782,416$0$0$0$2,646$0$18,200$0$7,912$0$811,174$0$0$0
STEVEN ROH
CARDIOLOGIST$776,666$0$0$0$2,666$0$18,200$0$8,454$0$805,986$0$0$0
THOMAS ROSSINI
STAFF EMERGENCY PHYSICIAN$553,668$0$127,175$0$2,646$0$18,200$0$8,372$0$710,061$0$0$0
JOSEPH VAN CAMP
CARDIAC SURGEON$672,400$0$66,774$0$4,519$0$18,200$0$0$0$761,893$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1ATHE ORGANIZATION REIMBURSES ONE OF THE EXECUTIVE MEMBERS FOR THE MONTHLY SOCIAL DUES AT THE GOLDEN VALLEY COUNTRY CLUB. THE DUES FOR 2014 WERE $90 PER MONTH OR $1,080 PER YEAR. THE NORTH MEMORIAL COMMUNITY FOUNDATION UTILIZES THE COUNTRY CLUB TO HOST VARIOUS FUNDRAISING EVENTS THROUGH-OUT THE YEAR THAT SUPPORT VARIOUS ACTIVITIES FOR NORTH MEMORIAL.
PART I, LINE 4AA PORTION OF THE AMOUNTS REPORTED IN "OTHER REPORTABLE COMPENSATION" REFLECTS PAYMENTS MADE IN 2014 PURSUANT TO SEVERANCE AGREEMENTS WITH 2 EMPLOYEES AS FOLLOWS: GAYLE MATTSON - $359,840 TRACY KIRBY - $241,434
PART I, LINE 6NORTH MEMORIAL HEALTH CARE'S ANNUAL INCENTIVE PLAN REQUIRES ACHIEVEMENT OF STATED PERFORMANCE METRICS, WHICH INCLUDE OPERATING CASH FLOW MARGIN.
PART III, LINE 2:ALL EXPENSES ARE REVIEWED PRIOR TO REIMBURSEMENT AND APPROVED BY THE CEO. NORTH MEMORIAL REPORTS EXECUTIVE EXPENSE REIMBURSEMENT DATA TO THE BOARD OF TRUSTEES ON A PERIODIC BASIS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
CITY OF MAPLE GROVE
A41087325056516TAD72005-09-22$55,000,000CONSTRUCTION OF OUTPATIENT CENTER0Yes (1)0
CITY OF ROBBINSDALE
B7160054962011-06-07$60,000,000REFUND SERIES 2008 BONDS0Yes (1)0
CITY OF ROBBINSDALE
C7160054962011-06-07$15,000,000REFUND SERIES 2008 BONDS0Yes (1)0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$805,000$54,851,782$1,083,801$49,000,001200700Yes (1)Yes (1)
B$10,806,517$60,000,000$749,350$58,710,6502011Yes (1)0Yes (1)Yes (1)
C$2,115,000$15,000,000$15,000,0002011Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)0000Yes (1)
B000000Yes (1)
C000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)00000
B0Yes (1)0000000
C0Yes (1)0000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDATE REBATE COMPUTATION PERFORMEDFormAndLineReferenceDesc
ExplanationISSUER NAME: CITY OF MAPLE GROVE DATE THE REBATE COMPUTATION WAS PERFORMED: 08/31/2010ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROBIN DRUG AND MERWIN PHARMACIESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionBOARD MEMBER IS THE OWNER OF ROBIN DRUG AND MERWIN PHARMACIESRelationshipDescriptionTxt
Transaction$442,886TransactionAmt
TransactionMICHAEL STEINHAUSER, A BOARD MEMBER, IS THE OWNER OF ROBIN DRUG AND MERWIN PHARMACIES, WHICH SUPPLIES DRUGS AND PHARMACEUTICALS TO NORTH MEMORIAL HEALTH CARE.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2LOREN TAYLOR AND BOB POTTS - BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION'S FINANCE AND AUDIT COMMITTEE REVIEWS THE FORM 990 BEFORE IT IS FILED. REPRESENTATIVES FROM THE HOSPITAL'S INDEPENDENT ACCOUNTING FIRM REVIEW THE FORM 990 WITH THE FINANCE AND AUDIT COMMITTEE IN DETAIL AND NOTES FOR THE COMMITTEE ANY CHANGES IN THE FORM 990 FROM PRIOR YEARS. AFTER THOROUGH DISCUSSION, THE FINANCE AND AUDIT COMMITTEE APPROVES THE FORM 990 AND FORWARDS IT TO THE FULL BOARD FOR ITS REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CALL MEMBERS OF THE BOARD OF DIRECTORS AND ALL EMPLOYEES RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY EACH YEAR. EACH BOARD MEMBER AND STAFF MEMBER FILLS OUT A CONFLICT OF INTEREST QUESTIONNAIRE IN WHICH THEY ARE ASKED TO IDENTIFY ANY RELATIONSHIP THAT WOULD CREATE A CONFLICT OF INTEREST. THE RESULTS ARE SUMMARIZED AND REVIEWED TO DETERMINE ANY ACTUAL OR POTENTIAL CONFLICT AND ARE REPORTED TO THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION FOR KEY POSITIONS IS REVIEWED BY THE COMPENSATION COMMITTEE COMMITTEE WORKING IN CONJUNCTION WITH AN OUTSIDE CONSULTANT. THE COMPENSATION COMMITTEE INSURES THAT THE SALARY AND BENEFIT ADMINISTRATION REVIEW PROCESS IS BEING FOLLOWED, WHICH INCLUDES SALARY AND BENEFIT SURVEYS AND COMPARISONS OF ALL POSITIONS. THE CEO'S COMPENSATION IS SENT TO THE FULL BOARD FOR APPROVAL. THE COMPENSATION OF ALL OTHER KEY POSITIONS IS APPROVED BY THE CEO.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FINANCIAL STATEMENTS ARE AVAILABLE ONLINE THROUGH THE OFFICE OF THE ATTORNEY GENERAL VIA THE CHARITY REPORT FILED WITH THE STATE OF MINNESOTA.
FORM 990, PART XII, LINE 2C:NEITHER THE OVERSIGHT OF THE AUDIT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT WERE CHANGED DURING THE TAX YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1OAKDALE MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1Txt
CityROBBINSDALECityNm
State AbbreviationMNStateAbbreviationCd
ZIP55422ZIPCd
FieldValueIRS element (for citing)
EIN320022819EIN
Primary ActivitiesLEASE MEDICAL OFFICE SPACEPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd
Total Income$777,581TotalIncomeAmt
End Of Year Assets$15,133,081EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NORTH MEMORIALBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
NORTH MEMORIAL FOUNDATION
3300 OAKDALE AVENUE NORTHROBBINSDALEMN55422411777966FUNDRAISINGMN501(C)(3)7NORTH MEMORIAL0
ASSOCIATED HEALTH ASSURANCE
3300 OAKDALE AVENUE NORTHROBBINSDALEMN55422980343815INSURANCE501(C)(3)LINE 11A, INORTH MEMORIALYes (1)BD
MAPLE GROVE HOSPITAL CORPORATION
9875 HOSPITAL DRIVEMAPLE GROVEMN55369208316475ACUTE CAREMN501(C)(3)3NORTH MEMORIALYes (1)
NORTH COLLABORATIVE CARE
3300 OAKDALE AVE NROBBINSDALEMN55422461680666PRIMARY CAREMN501(C)(3)70

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE
9855 HOSPITAL DRIVEMAPLE GROVEMN55369260393039OUTPATIENT SURGERYMNRELATED$1,928,513$3,487,3670Yes (1)0.50000
MINNESOTA DIAGNOSTIC IMAGING PARTNERS LLC
2955 XENIUM LANE SUITE 40PLYMOUTHMN55441352162215RADIOLOGYMNRELATED-$1,177,860$2,184,1800Yes (1)0.60000
NORTH RADIATION THERAPY CENTER LLC
6950 FRANCE AVE S SUITE 200EDINAMN55435743069974RADIOLOGYMNRELATED$1,118,383$1,971,3830Yes (1)0.50000
BLAINE URGENCY CENTER
480 OSBORNE RD NEFRIDLEYMN55432461630126URGENT CAREMNRELATED$18,459$775,5180Yes (1)0.50000
PLYMOUTH CITY CENTER MEDICAL BUILDING
5700 SMETANA DRIVE SUITE 120MINNETONKAMN55343463883617MEDICAL OFFICE BUILDINGMNRELATED-$7,336$9,552,747000.50000
MINNETONKA AMBULATORY SURGERY CENTER
3300 OAKDALE AVE NORTHROBBINSDALEMN55422465653486OUTPATIENT SURGERYMNRELATED0Yes (1)1.00000

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1OAKDALE HEALTH ENTERPRISES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13300 OAKDALE AVENUE NORTHAddressLine1Txt
CityROBBINSDALECityNm
State AbbreviationMNStateAbbreviationCd
ZIP55422ZIPCd
FieldValueIRS element (for citing)
EIN411546422EIN
Primary ActivitiesAMBULANCEPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NORTH MEMORIALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$589,249ShareOfTotalIncomeAmt
Share Of EOY Assets$1,627,791ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (20 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
NORTH MEMORIAL FOUNDATION (CONTRIBUTIONS)
C$503,869FMV
MAPLE GROVE HOSPITAL CORPORATION (RETURN OF CAPITAL)
C$12,900,000FMV
MAPLE GROVE HOSPITAL CORPORATION (DEBT GUARANTEE)
D$103,188,750FMV
MAPLE GROVE HOSPITAL CORPORATION (LEASE PMTS)
J$458,957FMV
MAPLE GROVE HOSPITAL CORPORATION (MGMT FEE)
S$14,814,561FMV
MAPLE GROVE HOSPITAL CORPORATION (SALARY REIMBURSMENT)
Q$7,347,273FMV
ASSOCIATED HEALTH ASSURANCE (PREMUIMS)
M$2,673,833FMV
OAKDALE HEALTH ENTERPRISES (PAYROLL)
P$1,611,296FMV
OAKDALE HEALTH ENTERPRISES (MGMT FEES)
S$312,297FMV
OAKDALE HEALTH ENTERPRISES (INTEREST ON LOAN)
S$24,839FMV
OAKDALE MEDICAL OFFICE BUILDING (LEASE PAYMENTS)
J$782,200FMV
OAKDALE MEDICAL OFFICE BUILDING (EXPENSE REIMBURSMENTS)
Q$406,059FMV
MINNEAPOLIS RADIATION ONCOLOGY (LEASE PMTS)
J$227,186FMV
NORTH MEMORIAL AMBULATORY SURGERY CENTER (LEASE PMTS)
J$1,602,455FMV
NORTH MEMORIAL AMBULATORY SURGERY CENTER (RETURN OF CAPITAL)
C$1,170,278FMV
MINNEAPOLIS RADIATION ONCOLOGY (DIVIDEND)
R$1,240,000FMV
NORTH MEMORIAL FOUNDATION (STAFF SUPPORT)
O$534,035FMV
BLAINE URGENCY CENTER (LINE OF CREDIT)
D$1,398,581FMV
MINNESOTA DIAGNOSTIC IMAGING PARTNERS (LEASE PAYMENTS)
S$1,020,000FMV
MONTICELLO CANCER CENTER (DISTRIBUTIONS)
S$1,800,000FMV

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