PARK NICOLLET HEALTH SERVICES: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
PARK NICOLLET HEALTH SERVICES (EIN 36-3465840)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-13
IRS object ID
201523179349307222
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)
Return2015-11-13T14:46:33-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135665207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14200 WELLS FARGO CENTER 90 S 7THAddressLine1Txt
Address Line2STREETAddressLine2Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN363465840EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PARK NICOLLET HEALTH SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPARKBusinessNameControlTxt
Phone9529933108PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BOULEVARDAddressLine1Txt
CityST LOUIS PARKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55426ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCATHERINE LENAGHPersonNm
Person TitleCFOPersonTitleTxt
Phone9529933108PhoneNum
Signature2015-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANN LAMOUREUXPreparerPersonNm
PTINP00691316PTIN
Phone6123055000PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCATHERINE LENAGHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BLVDAddressLine1Txt
CityST LOUIS PARKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55426ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$94,642,732GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PARKNICOLLET.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1986FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionTO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITYActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee9508TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$14,963TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$2,979NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$212CYContributionsGrantsAmt
PY Program Service Revenue$93,779,238PYProgramServiceRevenueAmt
CY Program Service Revenue$94,579,879CYProgramServiceRevenueAmt
PY Investment Income-$1,028PYInvestmentIncomeAmt
CY Investment Income$7,529CYInvestmentIncomeAmt
PY Other Revenue$23,583PYOtherRevenueAmt
CY Other Revenue$22,372CYOtherRevenueAmt
PY Total Revenue$93,801,793PYTotalRevenueAmt
CY Total Revenue$94,609,992CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$43,925CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$14,786,933PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,806,324CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$75,061,688PYOtherExpensesAmt
CY Other Expenses$77,460,383CYOtherExpensesAmt
PY Total Expenses$89,848,621PYTotalExpensesAmt
CY Total Expenses$92,310,632CYTotalExpensesAmt
PY Revenues Less Expenses$3,953,172PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,299,360CYRevenuesLessExpensesAmt
Total Assets BOY$123,234,379TotalAssetsBOYAmt
Total Assets EOY$158,432,454TotalAssetsEOYAmt
Total Liabilities BOY$123,194,564TotalLiabilitiesBOYAmt
Total Liabilities EOY$156,143,957TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$39,815NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,288,497NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOUR MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$17,307,426ExpenseAmt
Revenue$18,456,356RevenueAmt
DescPARK NICOLLET HEALTH SERVICES, IN ADDITION TO BEING A SUBSIDIARY OF HEALTHPARTNERS, IS THE PARENT IN A SYSTEM OF RELATED HEALTHCARE ORGANIZATIONS INCLUDING, PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PARK NICOLLET HEALTH CARE PRODUCTS, PARK NICOLLET INSTITUTE, AND TRIA ORTHOPAEDIC CENTER. PARK NICOLLET HEALTH SERVICES IS EMPLOYING AND SOURCING SENIOR LEADERS TO ITS SUBSIDARIES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$62,828,290ExpenseAmt
Grant$43,925GrantAmt
Revenue$76,147,467RevenueAmt
DescTRIA ORTHOPAEDIC CENTER IS A LIMITED LIABILITY COMPANY THAT IS FULLY OWNED BY PARK NICOLLET HEALTH SERVICES, A NONPROFIT INTEGRATED CARE DELIVERY SYSTEM. TRIA ORTHOPAEDIC CENTER IS A LEADER IN ORTHOPAEDIC TREATMENT, PROVIDING COMPREHENSIVE CARE FROM DIAGNOSIS, TO TREATMENT, TO REHABILITATION, EVEN SURGERY AT ONE CONVENIENT LOCATION IN BLOOMINGTON, MINNESOTA. TRIA ORTHOPAEDIC CENTER HAS OVER 40 HIGHLY-TRAINED ORTHOPAEDIC DOCTORS WITH A VARIETY OF SUB-SPECIALTIES SUCH AS SPORTS MEDICINE, ACUTE INJURY, SHOULDER, KNEE, SPINE, HAND AND WRIST, FOOT AND ANKLE, HIP AND FRACTURES. FOR IMMEDIATE ORTHOPAEDIC NEEDS, TRIA OFFERS WALK-IN CARE SEVEN DAYS A WEEK THROUGH THE ACUTE INJURY CLINIC, WITH NO APPOINTMENT NEEDED. TRIA'S SPORTS MEDICINE SPECIALISTS HAVE SERVED AS OFFICIAL TEAM PHYSICIANS FOR MINNESOTA'S PRO SPORTS TEAMS FOR OVER 25 YEARS. TRIA ORTHOPAEDIC CENTER'S MISSION IS TO PROVIDE OUR PATIENTS AND COMMUNITY WITH EXCEPTIONAL ORTHOPAEDIC CARE AND SERVICES SUPPORTED BY INNOVATIVE EDUCATION AND RESEARCH. OUR VISION IS TO BECOME THE NATIONAL LEADER IN PROVIDING MUSCULOSKELETAL CARE, DRIVING INNOVATION IN IMPROVING HEALTH CARE.CORE VALUESPATIENTS:OUR PATIENTS COME FIRSTPEOPLE:OUR PEOPLE ARE OUR GREATEST ASSETORTHOPAEDICS:ORTHOPAEDICS IS OUR FOCUSRESEARCH:RESEARCH IS FUNDAMENTAL TO IMPROVING PATIENT CAREEDUCATION:EDUCATION ENHANCES OUR PROFESSION AND PATIENT CAREGROWTH:SUSTAINABLE GROWTH CREATES VALUECOMMUNITY:WE WILL BE A GOOD NEIGHBOR IN OUR COMMUNITYCOMMUNITY SERVICES SUMMARYANNUALLY, TRIA TRAINS THREE SPORTS MEDICINE FELLOWS. APPROXIMATELY 90 MEDICAL SCHOOL STUDENTS, AND RESIDENTS ROTATE THROUGH TRIA EACH YEAR.TRIA CONTINUES TO LEAD THE WAY IN OUTCOMES MEASUREMENT. PATIENT COMPLETE EXTENSIVE PRE AND POST SURVEYS TO ASSESS FUNCTIONAL OUTCOMES ON EIGHT DIFFERENT PROCEDURE TYPES. SOME OF TRIA'S PATIENT REGISTRIES ARE NOW AMONGST THE MOST EXTENSIVE IN THE INDUSTRY. EVERY TUESDAY MORNING TRIA PROVIDES PROFESSIONAL EDUCATION SESSIONS FOR APPROXIMATELY 950 ATTENDEES, INCLUDING OUR STAFF, FELLOWS, CLINICAL STAFF IN THE AREA, NUMEROUS STUDENTS, AND RESIDENTS TRIA'S ANNUAL ORTHOPAEDIC & SPORTS MEDICINE CONFERENCE DREW OVER 205 PROFESSIONALS.THE TRIA INSTITUTE PROVIDES SEVERAL SESSIONS OF A "DAY IN THE LIFE OF AN ORTHOPAEDIC PROVIDER PROGRAM." THIS EDUCATIONAL PROGRAM IS FOR STUDENTS IN OUR COMMUNITY THAT WOULD LIKE TO LEARN MORE ABOUT THE HEALTHCARE PROFESSION, SPECIFICALLY ORTHOPAEDICS, AND INCLUDES THE SHADOWING OF TRIA CLINICIANS. THERE WERE 222 ATTENDEES IN THESE SESSIONS. OVER 125 FREE HIGH SCHOOL PHYSICALS WERE PROVIDED FOR AREA HIGH SCHOOL ATHLETES PRIOR TO THE FALL SEASON. ADDITIONAL PHYSICALS WERE SUBSIDIZED FOR THE STUDENT ATHLETES AT DAKOTA COUNTY TECHNICAL COLLEGE AND HOCKEY PLAYERS FOR THE MINNESOTA MAGICIANS JUNIOR HOCKEY TEAM.TRIA PROVIDED MEDICAL COVERAGE FOR NUMEROUS MAJOR SPORTING EVENTS IN THE COMMUNITY IN THE PAST YEAR INCLUDING THE U.S. POND HOCKEY CHAMPIONSHIPS AT LAKE NOKOMIS IN JANUARY AND THE NORTH STAR BICYCLE FESTIVAL IN ST. PAUL, MINNEAPOLIS, CANNON FALLS, MENOMONIE, WI AND STILLWATER IN JUNE AND THE MN SENIOR GAMES IN THE TWIN CITIES IN JULY.TRIA EMPLOYEES RAISE MONEY FOR THOSE IN NEED THROUGH THE JEANS FOR A CAUSE PROGRAM. EMPLOYEES WHO CONTRIBUTE $5 ARE ALLOWED TO WEAR JEANS ON FRIDAYS. THE WEARING OF JEANS FOR THE CAUSE BUTTONS SIGNIFIES THE FUND RAISING ASPECT OF THE PROGRAM TO PATIENTS. OVER $5000 WAS RAISED FOR COMMUNITY CHARITIES THROUGHOUT THE YEAR.TRIA TEAM MEMBERS PARTICIPATE IN VOLUNTEER ACTIVITIES INCLUDING PACKING FOOD FOR THE SECOND HARVEST FOOD SHELF. THEY ALSO ARE INVOLVED IN BOTH THE TOY AND SCHOOL SUPPLY DRIVES FOR VOLUNTEERS ENLISTED TO ASSIST PEOPLE (VEAP) WHICH IS A BLOOMINGTON-BASED NON-PROFIT ORGANIZATION SUPPORTING LOW INCOME RESIDENTS IN SURROUNDING COMMUNITIES.TRIA PROVIDED FREE SCREENING AND EDUCATIONAL SUPPORT FOR HUNDREDS OF PEOPLE AT THE PREP 45 DAY EVENT AT THE MINNESOTA STATE FAIR.TRIA'S PHYSICIANS AND PROFESSIONAL STAFF, INCLUDING PHYSICAL THERAPISTS AND HAND THERAPISTS, FREQUENTLY SPEAK TO COMMUNITY GROUPS. THIS PAST YEAR 15 SUCH SESSIONS WERE PROVIDED.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$80,135,716TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
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 Sec0ReportInvestmentsOtherSecInd
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 Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
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 Ent0BusinessRlnWithOfficerEntInd
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 Document118IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee9508EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
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
DAF Excess Business Holdings0DAFExcessBusinessHoldingsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
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 Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CATHERINE LENAGHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9529933108PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BOULEVARDAddressLine1Txt
CityST LOUIS PARKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55426ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
PARK NICOLLET GROUP RETURN -SEE SCH
DIRECTORS30.00Yes (X)$0$2,992,358$391,931
PARK NICOLLET GROUP RETURN -SEE SCH
OFFICERS55.00$9,840,740$3,339,820$1,787,168Yes (X)
PARK NICOLLET GROUP RETURN -SEE SCH
HIGHEST COMPENSATED EMPLOY1.00$0$4,658,656$309,56655.00Yes (X)
PARK NICOLLET GROUP RETURN -SEE SCH
FORMER0.00$0$608,274$16,0740.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$9,840,740TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$11,599,108TotReportableCompRltdOrgAmt
Total Other Compensation$2,504,739TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K26IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$212AllOtherContributionsAmt
Total Contributions$212TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICES621400$76,144,187$76,144,187
SERVICES TO AFFILIATES EXEMPT ORG561000$14,627,480$14,627,480
PREMIER PURCHASING900099$3,808,212$3,828,876-$20,664
FieldValueIRS element (for citing)
Total Program Service Revenue$94,579,879TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,779TotalRevenueColumnAmt
Exclusion$5,779ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$16,205RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$32,740RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$16,535RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$16,535TotalRevenueColumnAmt
Exclusion-$16,535ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$1,750OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$1,750OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,750TotalRevenueColumnAmt
Exclusion$1,750ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS SERVICESDesc
Business541900BusinessCd
Total Revenue Column$38,907TotalRevenueColumnAmt
Related Or Exempt Func Income$3,280RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$35,627UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$38,907OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$94,609,992TotalRevenueColumnAmt
Related Or Exempt Func Income$94,603,823RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$14,963UnrelatedBusinessRevenueAmt
Exclusion-$9,006ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$43,925TotalAmt
Program Services$43,925ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$9,840,740TotalAmt
Management And General$9,840,740ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,852,227TotalAmt
Management And General$1,852,227ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$654,718TotalAmt
Management And General$654,718ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,667,572TotalAmt
Program Services$137,662ProgramServicesAmt
Management And General$1,529,910ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$791,067TotalAmt
Management And General$791,067ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$43,914TotalAmt
Management And General$43,914ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$54,044,458TotalAmt
Program Services$43,439,943ProgramServicesAmt
Management And General$10,604,515ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$771,357TotalAmt
Program Services$4,390ProgramServicesAmt
Management And General$766,967ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$997,652TotalAmt
Program Services$688,296ProgramServicesAmt
Management And General$309,356ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$475,022TotalAmt
Program Services$355,973ProgramServicesAmt
Management And General$119,049ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$5,362,152TotalAmt
Program Services$3,891,038ProgramServicesAmt
Management And General$1,471,114ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$12,497TotalAmt
Program Services$3,411ProgramServicesAmt
Management And General$9,086ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$52,669TotalAmt
Program Services$2,071ProgramServicesAmt
Management And General$50,598ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,156,774TotalAmt
Program Services$2,921,913ProgramServicesAmt
Management And General$234,861ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$543,466TotalAmt
Program Services$12,664ProgramServicesAmt
Management And General$530,802ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES AND EQ$8,071,662$8,056,938$14,724
BAD DEBT$1,927,755$1,927,755
MN CARE TAX$1,338,483$1,338,483
IND EXP ALL - SHARED EX$0$17,307,426-$17,307,426

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$662,522TotalAmt
Program Services$3,828ProgramServicesAmt
Management And General$658,694ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$92,310,632TotalAmt
Program Services$80,135,716ProgramServicesAmt
Management And General$12,174,916ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,446,785BOYAmt
EOY$2,706,582EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$72,938,150BOYAmt
EOY$108,537,720EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,986,590BOYAmt
EOY$9,575,066EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$457,258BOYAmt
EOY$510,890EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,291,836BOYAmt
EOY$697,673EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$64,033,033LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$37,464,438LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$27,092,489BOYAmt
EOY$26,568,595EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$5,239,411BOYAmt
EOY$7,712,231EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,781,860BOYAmt
EOY$2,123,697EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$123,234,379BOYAmt
EOY$158,432,454EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$89,826,433BOYAmt
EOY$97,153,446EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$33,368,131BOYAmt
EOY$58,990,511EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$123,194,564BOYAmt
EOY$156,143,957EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$39,815BOYAmt
EOY$2,288,497EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$39,815BOYAmt
EOY$2,288,497EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$123,234,379BOYAmt
EOY$158,432,454EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$2,299,360ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$3,364NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$54,042OtherChangesInNetAssetsAmt
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)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year$212CurrentTaxYearAmt
Total$212TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$23,467,780CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$90,025,611CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$94,357,206CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$93,739,106CurrentTaxYearMinus1YearAmt
Current Tax Year$94,603,823CurrentTaxYearAmt
Total$396,193,526TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$23,467,780CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$90,025,611CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$94,357,206CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$93,739,106CurrentTaxYearMinus1YearAmt
Current Tax Year$94,604,035CurrentTaxYearAmt
Total$396,193,738TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$396,193,738PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,090,362CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,337CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$39,587CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$59,118CurrentTaxYearMinus1YearAmt
Current Tax Year$23,734CurrentTaxYearAmt
Total$1,245,138TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,090,362CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,337CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$39,587CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$59,118CurrentTaxYearMinus1YearAmt
Current Tax Year$23,734CurrentTaxYearAmt
Total$1,245,138TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,558,142CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$90,057,948CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$94,396,793CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$93,798,224CurrentTaxYearMinus1YearAmt
Current Tax Year$94,627,769CurrentTaxYearAmt
Total$397,438,876TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99690PublicSupportCY509Pct
Investment Income CY0.00310InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Organization Belongs Afflt GrpYes (X)OrganizationBelongsAffltGrpInd

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Affiliated Group Total$143,687AffiliatedGroupTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Affiliated Group Total$143,687AffiliatedGroupTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$92,354,334FilingOrganizationsTotalAmt
Affiliated Group Total$1,242,992,633AffiliatedGroupTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$92,354,334FilingOrganizationsTotalAmt
Affiliated Group Total$1,243,136,320AffiliatedGroupTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Filing Organizations Total$1,000,000FilingOrganizationsTotalAmt
Affiliated Group Total$1,000,000AffiliatedGroupTotalAmt

Grassroots Nontaxable GrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Filing Organizations Total$250,000FilingOrganizationsTotalAmt
Affiliated Group Total$250,000AffiliatedGroupTotalAmt

Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt
Affiliated Group Total$0AffiliatedGroupTotalAmt

Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp

FieldValueIRS element (for citing)
Filing Organizations Total$0FilingOrganizationsTotalAmt
Affiliated Group Total$0AffiliatedGroupTotalAmt

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

FieldValueIRS element (for citing)
Current Year Minus3$1,000,000CurrentYearMinus3Amt
Current Year Minus2$1,000,000CurrentYearMinus2Amt
Current Year Minus1$1,000,000CurrentYearMinus1Amt
Current Year$1,000,000CurrentYearAmt
Total$4,000,000TotalAmt
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmt

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$191,800CurrentYearMinus3Amt
Current Year Minus2$210,630CurrentYearMinus2Amt
Current Year Minus1$51,106CurrentYearMinus1Amt
Current Year$143,687CurrentYearAmt
Total$597,223TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

FieldValueIRS element (for citing)
Current Year Minus3$250,000CurrentYearMinus3Amt
Current Year Minus2$250,000CurrentYearMinus2Amt
Current Year Minus1$250,000CurrentYearMinus1Amt
Current Year$250,000CurrentYearAmt
Total$1,000,000TotalAmt
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationPARK NICOLLET HEALTH SERVICES INCURS LOBBYING EXPENSES ON BEHALF OF PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET INSTITUTE, PARK NICOLLET HEALTH CARE PRODUCTS AND PARK NICOLLET CLINIC. OTHER EXEMPT EXPENSES RELATE TO THE MANAGEMENT EXPENSES INCURRED BY PARK NICOLLET HEALTH SERVICES ON BEHALF OF EACH ENTITY.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$68,853BeginningYearBalanceAmt
Contributions$36,358ContributionsAmt
End Year Balance$105,211EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$76,400BeginningYearBalanceAmt
Contributions$30,953ContributionsAmt
Grants Or Scholarships$38,500GrantsOrScholarshipsAmt
End Year Balance$68,853EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$52,482BeginningYearBalanceAmt
Contributions$23,918ContributionsAmt
End Year Balance$76,400EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$40,627BeginningYearBalanceAmt
Contributions$11,855ContributionsAmt
End Year Balance$52,482EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$145,133BeginningYearBalanceAmt
Contributions$15,494ContributionsAmt
Grants Or Scholarships$120,000GrantsOrScholarshipsAmt
End Year Balance$40,627EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
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$1,917,864OtherCostOrOtherBasisAmt
Book Value$1,917,864BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,134OtherCostOrOtherBasisAmt
Depreciation$21,134DepreciationAmt
Book Value$0BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$39,574,698OtherCostOrOtherBasisAmt
Depreciation$18,698,813DepreciationAmt
Book Value$20,875,885BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,519,337OtherCostOrOtherBasisAmt
Depreciation$18,744,491DepreciationAmt
Book Value$3,774,846BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$26,568,595TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO AND FROM RELATED PARTIES$40,700,964
CONTINGENT MALPRACTICE LIABILITY$16,538,712
POST RETIREMENT OBLIGATION$1,750,835
FieldValueIRS element (for citing)
Total Liability$58,990,511TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE TERM ENDOWMENT FUNDS FOR USE WITHIN PARK NICOLLET HEALTH SERVICES ARE FOR THE CARING FOR COLLEAGUES PROGRAM.
PART X, LINE 2:HPIC, HPSI, HPA, HPAI, HPCMC, PNE, AND DSI, (THE TAXABLE GROUP) ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. DEFERRED INCOME TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE DIFFERENCES BETWEEN THE FINANCIAL AND INCOME TAX REPORTING BASIS OF ASSETS AND LIABILITIES BASED ON ENACTED TAX RATES AND LAWS. THE DEFERRED INCOME TAX PROVISION OR BENEFIT GENERALLY REFLECTS THE NET CHANGE IN DEFERRED INCOME TAX ASSETS AND LIABILITIES DURING THE YEAR. THE CURRENT INCOME TAX PROVISION REFLECTS THE TAX CONSEQUENCES OF REVENUES AND EXPENSES CURRENTLY TAXABLE OR DEDUCTIBLE ON VARIOUS INCOME TAX RETURNS FOR THE YEAR REPORTED. PARK NICOLLET HEALTH SERVICES' ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. TRIA ORTHOPAEDIC CENTER RESEARCH RECORDED NO LIABILITIES AT DECEMBER 31, 2014 OR 2013 FOR UNRECOGNIZED TAX BENEFITS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
REGIONS HOSPITAL FOUNDATION
640 JACKSON STREETST PAULMN55101411888902501C3$10,000HOSPITAL PROGRAM SUPPORT
ST FRANCIS REGIONAL MEDICAL CENTER
1455 ST FRANCIS AVESHAKOPEEMN55379410907986501C3$25,000SAINTS HEALTHCARE PROGRAM SUPPORT.
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I LINE 2FormAndLineReferenceDesc
ExplanationOCCASIONALLY PARK NICOLLET HEALTH SERVICES GRANTS MONIES TO OTHER TAX-EXEMPT ORGANIZATIONS CONDUCTING PROGRAMS AND/OR RESEARCH THAT WILL ULTIMATELY BENEFIT THOSE SERVED BY PARK NICOLLET HEALTH SERVICES AND AFFILIATES.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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
PARK NICOLLET GROUP RETURN -SEE SCH
DIRECTORS$0$2,525,347$0$220,747$0$246,264$0$255,013$0$136,918$0$3,384,289$0$32,856
PARK NICOLLET GROUP RETURN -SEE SCH
OFFICERS$6,321,250$2,242,273$1,312,086$726,044$2,207,404$371,503$1,102,467$601,704$684,701$181,115$11,627,908$4,122,639$685,406$307,287
PARK NICOLLET GROUP RETURN -SEE SCH
HIGHEST COMPENSATED EMPLOY$0$4,068,345$0$135,967$0$454,344$0$121,680$0$187,886$0$4,968,222$0$0
PARK NICOLLET GROUP RETURN -SEE SCH
FORMER$0$19,276$0$79,648$0$509,350$0$0$0$16,074$0$624,348$0$54,582

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE PARK NICOLLET HEALTH SERVICES' BOARD OF DIRECTORS IS RESPONSIBLE FOR ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S CEO AND EXECUTIVE DIRECTORS.
PART I, LINES 4A-BTHE AMOUNT OF SEVERANCE COMPENSATION AND BENEFITS PROVIDED TO EACH OF THE INDIVIDUAL ON SEVERANCE DURING 2014 IS AS FOLLOWS: SHEILA MCMILLAN $454,846 MICHAEL KAUPA $1,060,000 JULIE FLASCHENRIEM $115,455 SCHEDULE J, PART I, LINE 4B: SENIOR LEADERS OF PARK NICOLLET HEALTH SERVICES AND AFFILIATES ARE GIVEN THE OPPORTUNITY TO PARTICIPATE IN THE CAPITAL ACCUMULATION ACCOUNT PLAN. THE CAPITAL ACCUMULATION ACCOUNT PLAN (CAA PLAN) PARTICIPATION IS LIMITED TO SENIOR LEADERS AND ALL THE VICE PRESIDENTS. EACH PARTICIPANT RECEIVES AN ANNUAL ALLOWANCE EQUAL TO THE SUM OF (I) A STATED PERCENT OF SALARY, (II) VOLUNTARY SALARY DEFERRALS. THE ALLOWANCE IS CREDITED TO A BOOKKEEPING ACCOUNT. EARNINGS ARE CREDITED TO THE ACCOUNT BASED ON THE PERFORMANCE OF SIMULATED INVESTMENTS. BENEFITS VEST UPON THE EARLIEST OF REMAINING EMPLOYED TO AN ELECTIVE VESTING DATE (TWO YEARS TO AGE 68), INVOLUNTARY TERMINATION WITHOUT CAUSE, DISABILITY, DEATH, OR NOT COMPETING FOR 24 MONTHS FOLLOWING VOLUNTARY OR FOR-CAUSE TERMINATION. BENEFITS ARE PAID IN A SINGLE LUMP SUM UPON VESTING. PARTICIPANTS ARE GENERAL CREDITORS OF THE EMPLOYER FOR THE PAYMENT OF THE BENEFITS. THE FOLLOWING PARTICIPANTS RECEIVED PAYOUTS FROM A RELATED ORGANIZATION, PARK NICOLLET HEALTH SERVICES, RELATED TO CAA PLAN: CONNELLY STEVEN, MD $ 64,180 FLASCHENRIEM JULIE $ 40,059 FRAZIER LAURA $ 19,894 GAPSTUR ROXANNA $ 29,405 HOMANS DAVID, MD $ 44,108 KAUPA MICHAEL $ 184,640 LENAGH CATHERINE $ 17,553 LONG BRETT $ 18,453 MCMILLAN SHEILA $ 54,582 MISA JOHN, MD $ 50,613 SPIEGLE DUANE $ 22,330 WEGLEITNER THEODORE $ 31,366 KLUGHERZ, KATE $ 15,972 GETCHELL, CHRISTA $ 13,728 TARVESTAD, KATHERINE $ 42,271 TOHER, CYNTHIA, MD $ 80,888 SCHOENHERR, MELISSA $ 9,977 OFFICERS AND DIRECTORS EMPLOYED BY HEALTHPARTNERS, INC HAVE DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II WHICH INCLUDE AMOUNTS FROM A NONQUALIFIED 457(F) PLAN, THE FOLLOWING PARTICIPANTS RECEIVED PAYOUTS: DAVID ABELSON, MD $ 135,325 BABETTE APLAND $ 8,716 NANCE MCCLURE $ 125,058 BRIAN RANK, MD $ 32,856 BARBARA TRETHEWAY $ 38,188
PART I, LINE 7SCHEDULE J, PART I, LINE 7: ALL PHYSICIANS, EMPLOYED BY AND SEEING PATIENTS FOR PARK NICOLLET HEALTH SERVICES AND AFFILIATES, ARE ELIGIBLE FOR A 3% ACCESS INCENTIVE PAYOUT BASED ON THEIR DEPARTMENT REACHING CERTAIN GOALS INCLUDING ACCESS FOR PATIENTS AND QUALITY INITIATIVES. IN THEIR ROLES AS EXECUTIVES EMPLOYED BY PARK NICOLLET HEALTH SERVICES, THE EXECUTIVES ARE ELIGIBLE FOR INCENTIVE PAYOUTS. THE INCENTIVE AWARD WILL BE 30% FOR THE CFO, COO, CMO AND 25% FOR ALL OTHER EXECUTIVES WITH AN OPPORTUNITY FOR INCENTIVE CREDIT ABOVE THE TARGET LEVEL. THE ULTIMATE PAYOUT INCLUDES A REDUCTION/INCREASE MULTIPLIER DEPENDING ON WHETHER THE CONSOLIDATED PARK NICOLLET HEALTH SERVICES ORGANIZATION REACHED THAT YEAR'S OPERATING MARGIN GOAL AS SET BY THE BOARD OF DIRECTORS. EACH PARTICIPANT WILL BE RESPONSIBLE FOR TWO FINANCIAL GOALS, AND NOT LESS THAN THREE AND NOT MORE THAN FIVE INDIVIDUAL STRATEGIC OBJECTIVES. IN THEIR ROLES AS MANAGEMENT EMPLOYED BY PARK NICOLLET HEALTH SERVICES, CERTAIN MANAGERS ARE ELIGIBLE FOR INCENTIVE PAYOUTS. THE INCENTIVE AWARD WILL BE 15% OF THEIR ANNUAL BASE PAY COMPENSATION WITH AN OPPORTUNITY FOR INCENTIVE CREDIT ABOVE THE TARGET LEVEL. THE ULTIMATE PAYOUT INCLUDES A REDUCTION/INCREASE MULTIPLIER DEPENDING ON WHETHER THE CONSOLIDATED PARK NICOLLET HEALTH SERVICES ORGANIZATION REACHED THAT YEAR'S OPERATING MARGIN GOAL AS SET BY THE BOARD OF DIRECTORS. INCENTIVE PAYMENTS ARE A FUNCTION OF BOTH INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. THE PARTICIPANT MUST BE ASSIGNED AT LEAST THREE, AND NOT MORE THAN FOUR FOCUSED INCENTIVE OBJECTIVE, ONE OF WHICH MUST BE FINANCIAL IN NATURE.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
CITY OF ST LOUIS PARK
A416005519791748EE22008-08-14$223,727,818REFINANCE SERIES 2003 A BONDS ISSUED 11/13/2003000
CITY OF ST LOUIS PARK
B416005519791748EG72009-12-31$182,727,701REFINANCE SERIES 2008A AND 2008B BONDS ISSUED 08/14/2008000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$53,900,000$223,727,818$31,034,356$1,580,827$6,863,730$194,800,0002008Yes (1)0Yes (1)Yes (1)
B$182,727,701$24,178,444$1,861,956$18,543,816$144,049,1592009Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndEngage Bond Counsel ResearchEngageBondCounselResearchIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)Yes (1)Yes (1)Yes (1)Yes (1)0.000000.000000.0000000Yes (1)
B0Yes (1)Yes (1)Yes (1)Yes (1)Yes (1)0.000000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 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
A0Yes (1)000000Yes (1)
B0Yes (1)000000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

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

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE KPURSUANT TO A LOAN AGREEMENT WITH THE CITY OF ST. LOUIS PARK, MINNESOTA, PARK NICOLLET HEALTH SERVICES IS NAMED AS A MEMBER OF THE "OBLIGATED GROUP" ALONG WITH PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PNMC HOLDINGS, PARK NICOLLET INSTITUTE, AND PARK NICOLLET HEALTH CARE PRODUCTS. EACH MEMBER OF THE OBLIGATED GROUP IS AN OBLIGOR UNDER THE LOAN AGREEMENT. PARK NICOLLET HEALTH SERVICES DID NOT USE BOND FUNDS; THEREFORE THERE ARE NO BONDS ON THE BALANCE SHEET.
PART I COLUMN C LINE A:THE CUSIP ON FORM 8038 IS 791740EE2 WHICH IS INCORRECT, THE CORRECT VALUE IS 791748EE2 WHICH IS SHOWN HERE.
PART II LINE 4THE AMOUNT IN COLUMN A CONSISTS OF $20,691,070 IN A DEBT SERVICE RESERVE FUND PLUS $10,343,285 IN A DEBT SERICE FUND. THE AMOUNT SHOWN IN COLUMN B CONSISTS OF $18,791,780 IN A DEBT SERVICE RESERVE FUND PLUS $5,386,664 IN A DEBT SERICE FUND.
SCHEDULE K, PART II, LINE 13PARK NICOLLET HEALTH SERVICES DETERMINED THE YEAR OF SUBSTANTIAL COMPLETION FOR EACH ISSUE AS FOLLOWS: THE PURPOSE OF THE ISSUES IN COLUMN A WAS TO REFUND PRIOR ISSUES FOR WHICH THE ORIGINAL CAPITAL PROJECT WAS COMPLETE PRIOR TO REFUNDING. THEREFORE THE YEAR OF SUBSTANTIAL COMPLETION IS THE YEAR OF ISSUANCE. THE PURPOSE OF THE BOND ISSUE IN COLUMN B WAS TO REFUND THE 2008 A AND B BOND ISSUE SINCE THE RELATED CAPITAL PROJECT OF THE 2008 B ISSUE WAS NOT YET COMPLETE AS OF 12/31/2008 THE YEAR OF SUBSTANTIAL COMPLETION WAS 2009.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6HEALTHPARTNERS, INC IS THE SOLE MEMBER OF PARK NICOLLET HEALTH SERVICES.
FORM 990, PART VI, SECTION A, LINE 7ATHE PERSONS WHO SERVE AS THE BOARD OF DIRECTORS OF HEALTHPARTNERS, INC. ALSO SERVE AS THE BOARD OF DIRECTORS OF PNHS. HEALTHPARTNERS, INC. IS A MINNESOTA LICENSED HEALTH MAINTENANCE ORGANIZATION. THE BOARD OF HEALTHPARTNERS, INC. IS COMPRISED OF A MAJORITY OF DIRECTORS WHO ARE ELECTED BY HMO MEMBERS (PERSONS HOLDING HMO CONTRACTS), AND A MINORITY OF DIRECTORS WHO ARE EITHER HEALTH CARE PROFESSIONALS APPOINTED BY THE BOARD OR WHO ARE SERVING EX OFFICIO.
FORM 990, PART VI, SECTION A, LINE 7BPNHS' BYLAWS WERE FURTHER AMENDED TO ESTABLISH THAT THE PERSONS SERVING AS THE BOARD OF DIRECTORS OF THE SOLE MEMBER, ALSO SERVE AS THE BOARD OF DIRECTORS OF PNHS. IN THE EVENT THAT THE PNHS BOARD OF DIRECTORS WERE EVER COMPOSED OF PERSONS WHO ARE NOT ALSO CONTEMPORANEOUSLY SERVING AS THE DIRECTORS OF THE SOLE MEMBER, THEN THE SOLE MEMBER WOULD EXERCISE CUSTOMARY RESERVE POWERS WITH RESPECT TO THE PNHS BOARD OF DIRECTORS (E.G. APPROVAL OF BUDGETS, APPROVAL OF MERGER, APPROVAL OF APPOINTMENT OF THE CHIEF EXECUTIVE OFFICER, APPROVAL OF DISSOLUTION, ETC.). NO ADDITIONAL SIGNIFICANT CHANGES WERE MADE TO PNHS' ARTICLES AND BYLAWS OTHER THAN THOSE NECESSARY TO GIVE EFFECT TO THE RELATIONSHIP OF PNHS TO HEALTHPARTNERS, INC. DESCRIBED ABOVE.
FORM 990, PART VI, SECTION B, LINE 11PARK NICOLLET HEALTH SERVICES PREPARES THE FORM 990 WITHIN THE FINANCE DEPARTMENT WITH ASSISTANCE FROM INDIVIDUALS IN HUMAN RESOURCES, MARKETING, AND OPERATIONS. UPON COMPLETION OF GATHERING THE NECESSARY INFORMATION FOR THE RETURN, THE FORM WAS COMPILED AND DRAFTS WERE REVIEWED BY THE ASSISTANT CONTROLLER - ACCOUNTING OPERATIONS, VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER, THE LAW DEPARTMENT, THE AUDIT AND COMPLIANCE COMMITTEE AND PARK NICOLLET'S ACCOUNTING FIRM. AFTER ALL REVIEWS WERE COMPLETE; THE FORM 990 WAS GIVEN TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12CAT PARK NICOLLET HEALTH SERVICES ALL KEY EMPLOYEES, DIRECTORS, AND OFFICERS ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST DISCLOSURE STATEMENT EACH YEAR; HOWEVER THE OBLIGATION TO REPORT POTENTIAL CONFLICTS IS ONGOING. PARK NICOLLET HEALTH SERVICES BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES PURSUANT TO ITS CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS AND OFFICERS ANNUALLY ARE PROVIDED A COPY OF THE POLICY AND REQUIRED TO COMPLETE A QUESTIONNAIRE INDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNCEL REVIEWS THE COMPLETED QUESTIONNAIRES AND PROVIDES A REPORT TO THE GOVERNANCE COMMITTEE OF THE BOARD. THE REPORT IDENTIFIES ANY SIGNIFICANT POTENTIAL CONFLICTS DISCLOSED IN THE COMPLETED QUESTIONNAIRES. A WRITTEN REPORT IS PROVIDED TO THE CHAIR AND CHIEF EXECUTIVE OFFICER (CEO). BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE PARK NICOLLET HEALTH SERVICES' BOARD OF DIRECTORS IS RESPONSIBLE FOR THE IMPLEMENTATION AND OVERSIGHT OF EXECUTIVE COMPENSATION AND BENEFIT PLANS. PARK NICOLLET USES AN OUTSIDE CONSULTANT TO PROVIDE A YEARLY MARKET BASED INDEX OF SALARY ADJUSTMENTS FOR EXECUTIVES IN SIMILAR LEADERSHIP POSITIONS. THE BOARD OF DIRECTORS REVIEWS THE SALARY RANGES AND RECOMMENDS SALARY INCREASES FOR EACH EXECUTIVE, INCLUDING THE CEO, BASED UPON THE BOARD OF DIRECTORS' EVALUATION OF JOB PERFORMANCE AND EXPERIENCE LEVEL OF THE INDIVIDUAL WITHIN THE ORGANIZATION. THE AVERAGE SALARY INCREASES FOR ALL PARK NICOLLET EXECUTIVES CANNOT EXCEED THE AVERAGE MARKET SALARY INCREASE REPORTED FOR EXECUTIVES BY THE CONSULTANT. THE COMPENSATION COMMITTEE THEN REVIEWS AND APPROVES COMPENSATION ADJUSTMENTS BASED ON THE INFORMATION PROVIDED BY THE OUTSIDE CONSULTANTS AND THE BOARD OF DIRECTORS' RECOMMENDATIONS. FOR CERTAIN PHYSICIANS, THE MAJORITY OF PAY DISCLOSED IS FOR HIS/HER WORK AS A PHYSICIAN FOR PARK NICOLLET INSTITUTE OR PARK NICOLLET CLINIC. A SMALL STIPEND IS ADDED FOR SERVING ON THE BOARD OF DIRECTORS. THE FOLLOWING IS A DESCRIPTION OF HOW PAY FOR PHYSICIANS' PATIENT CARE WORK IS DETERMINED. THE PARK NICOLLET HEALTH SERVICES' BOARD OF DIRECTORS IS RESPONSIBLE FOR THE IMPLEMENTATION AND OVERSIGHT OF THE PHYSICIAN COMPENSATION AND BENEFIT PLANS. THE BOARD OF DIRECTORS DELEGATES THE DAY-TO-DAY ADMINISTRATION OF THE PHYSICIAN COMPENSATION PLAN TO THE CEO. THE CHIEF MEDICAL OFFICER, WHO REPORTS DIRECTLY TO THE CEO, ADMINISTERS THE COMPENSATION PROGRAM. A COMPENSATION AND BENEFITS COMMITTEE SERVES IN AN ADVISORY CAPACITY TO THE CMO IN ORDER TO ADMINISTER PHYSICIAN COMPENSATION WITHIN THE BUDGET TO ENSURE FAIRNESS AND ALIGNMENT WITH PARK NICOLLET HEALTH SERVICES' GOALS. THE RESPONSIBILITIES OF THE CMO: RECOMMENDING COMPENSATION POLICIES AND PLAN DESIGNS FOR PHYSICIANS TO THE CEO AND BOARD OF DIRECTORS; OVERSEEING COMPENSATION PLAN OPERATION AND PAYMENTS TO CLINICAL DEPARTMENTS; EVALUATING COMPENSATION PLAN FOR PERFORMANCE ON A PERIODIC BASIS; SERVING AS FINAL APPEAL PROCESS FOR ISSUES UNRESOLVED BY INDIVIDUALS, DEPARTMENT CHAIRS AND CHIEFS OF SERVICES. ANNUALLY, INFORMATION ON EACH PHYSICIAN'S PAY AND PRODUCTIVITY IS GRAPHED AGAINST THE SURVEY RESULTS FOR THE SAME YEAR. THIS INFORMATION IS PRESENTED TO THE COMPENSATION COMMITTEE OF THE PARK NICOLLET HEALTH SERVICES BOARD OF DIRECTORS FOR REVIEW. PARK NICOLLET HEALTH SERVICES' PHYSICIAN PAY PROGRAM IS DESIGNED TO ENSURE MARKET BASED PAY FOR MARKET BASED PRODUCTIVITY STANDARDS. THE MARKET IS DETERMINED BY THE AMERICAN MEDICAL GROUP ASSOCIATION (AMGA) NATIONAL PHYSICIAN COMPENSATION SURVEY DATA, WHICH PROVIDES MARKET DATA FOR BOTH COMPENSATION AND PRODUCTIVITY. WHEN APPROPRIATE, THE CMO MAY RECOMMEND ADJUSTMENTS TO THESE GUIDELINES WITH EVIDENCE OF LOCAL MARKET DATA.
FORM 990, PART VI, SECTION C, LINE 19PARK NICOLLET HEALTH SERVICES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. PARK NICOLLET HEALTH SERVICES MAILS ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS TO FINANCIAL INSTITUTIONS, GOVERNMENTAL INSTITUTIONS, BOARD MEMBERS, MEDIA REPRESENTATIVES, VENDORS, AND THE MINNESTOA HOSPITAL ASSOCIATIONS(MHA) PARK NICOLLET HEALTH SERVICES DISCLOSES QUARTERLY FINANCIAL STATEMENTS TO BONDHOLDERS AND MHA. THE ANNUAL AUDITED AND QUARTERLY FINANCIAL STATEMENTS ARE ALSO POSTED AT EMMA.MSRB.ORG. THE FORMS 990 ARE AVAILABLE UPON REQUEST OR FROM THE STATE OF MINNESOTA OR AT GUIDESTAR.ORG.
FORM 990PURSUANT TO TREASURY REG SECTION 1.6033-2(D)(5), PARK NICOLLET HEALTH SERVICES HAS ELECTED TO REPORT INFORMATION ABOUT CONTRIBUTIONS, GIFTS & GRANTS, COMPENSATION, AND OTHER INFORMATION ABOUT OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, FORMER EMPLOYEES, CERTAIN OTHER HIGHLY PAID EMPLOYEES, CERTAIN PROFESSIONAL CONTRACTORS AND CERTAIN OTHER CONTRACTORS ON A CONSOLIDATED BASIS FOR ALL MEMBERS OF THE GROUP, INCLUDING THE PARENT ORGANIZAITON, ON THE GROUP RETURN OF PARK NICOLLET GROUP RETURN (EIN 45-5023260).
FORM 990, PART IX, LINE 11GEMPLOYEES OF AFFILIATES: PROGRAM SERVICE EXPENSES 32,379,653. MANAGEMENT AND GENERAL EXPENSES 3,359,160. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 35,738,813. MANAGEMENT CONSULTANTS: PROGRAM SERVICE EXPENSES 660. MANAGEMENT AND GENERAL EXPENSES 2,383,189. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,383,849. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 11,059,630. MANAGEMENT AND GENERAL EXPENSES 4,862,166. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,921,796.
FORM 990, PART XI, LINE 9:POST RETIREMENT OBLIGATION -54,042.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDirect Controlling NADirectControllingNACd
DEFERRED COMPENSATION TRUST
6500 EXCELSIOR BLVDST LOUIS PARKMN55426411809020INVESTMENTSMN$1,618,268PARK NICOLLET HEALTH SERVICES
TRIA ORTHOPEDIC CENTER LLC
8100 NORTHLAND DRIVEBLOOMINGTONMN55431200034003HEALTH CAREMNPARK NICOLLET HEALTH SERVICES
HEALTHPARTNERS EAST SIDE HOLDING LLC
8170 33RD AVENUE SOUTH PO BOX 1309MINNEAPOLISMN554401309201282428REAL ESTATE HOLDING COMPANYDEN/A
HEALTHPARTNERS PROPERTY DEVELOPMENT COMPANY LLC
8170 33RD AVE S PO BOX 1309MPLSMN554401309455122853PROPERTY DEVELOPMENTMNN/A

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (29 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BLVDST LOUIS PARKMN55426410132080HEALTH CAREMN501(C)(3)170(B)(1) (A)(III)PARK NICOLLET HEALTH SERVICESYes (1)
PARK NICOLLET FOUNDATION
6500 EXCELSIOR BLVDST LOUIS PARKMN55426237346465GRANTS TO SERVE THE COMMUNITYMN501(C)(3)170(B)(1) (A)(VI)PARK NICOLLET HEALTH SERVICESYes (1)
PARK NICOLLET CLINIC
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416410834920HEALTH CAREMN501(C)(3)170(B)(1) (A)(III)PARK NICOLLET HEALTH SERVICESYes (1)
PARK NICOLLET INSTITUTE
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416410961862HEALTH CARE RESEARCHMN501(C)(3)170(B)(1) (A)(III)PARK NICOLLET HEALTH SERVICESYes (1)
PARK NICOLLET HEALTH CARE PRODUCTS
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416010638901HEALTH CARE PRODUCTSMN501(C)(3)509(A)(3) TYPE IIPARK NICOLLET HEALTH SERVICESYes (1)
PNMC HOLDINGS
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416101741792HEALTH CARE REAL ESTATEMN501(C)(3)509(A)(3) TYPE IIPARK NICOLLET HEALTH SERVICESYes (1)
TRIA ORTHOPEADIC CENTER RESEARCH INSTITUTE
8100 NOIRTHLAND DRIVEBLOOMINGTONMN55431200033919HEALTH CARE RESEARCH AND EDUCATIONMN501(C)(3)509(A)(3) TYPE IPARK NICOLLET HEALTH SERVICESYes (1)
HEALTHPARTNERS INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411693838HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATIONMN501(C)(4)Yes (1)N/A
HPI - RAMSEY
8170 33RD AVE S PO BOX 1309MPLSMN554401309411793333CORPORATE PLANNING AND OVERSIGHTMN501(C)(3)509(A)(3) TYPE IHEALTHPARTNERS INCYes (1)
GROUP HEALTH PLAN INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309410797853STAFF MODEL HEALTH MAINTENANCE ORGANIZATIONMN501(C)(3)170(B)(1) (A)(III)HEALTHPARTNERS INCYes (1)
HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH
8170 33RD AVE S PO BOX 1309MPLSMN554401309411670163HEALTHCARE EDUCATION & RESEARCHMN501(C)(3)509(A)(3) TYPE IGROUP HEALTH PLAN INCYes (1)
CAPITOL VIEW TRANSITIONAL CARE CENTER
8170 33RD AVE S PO BOX 1309MPLSMN554401309412011453POST HOSPITALIZATION PATIENT CAREMN501(C)(3)170(B)(1) (A)(III)HPI - RAMSEYYes (1)
REGIONS HOSPITAL
8170 33RD AVE S PO BOX 1309MPLSMN554401309410956618HOSPITALMN501(C)(3)170(B)(1) (A)(III)HPI - RAMSEYYes (1)
REGIONS HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309411888902PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTMN501(C)(3)170(B)(1) (A)(VI)HPI - RAMSEYYes (1)
RHSC INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411891928HEALTHCARE STAFFINGMN501(C)(3)509(A)(3) TYPE IIHEALTHPARTNERS INCYes (1)
RH-WISCONSIN
8170 33RD AVE S PO BOX 1309MPLSMN554401309202287016CORPORATE PLANNING AND OVERSIGHTWI501(C)(3)509(A)(3) TYPE IIHPI - RAMSEYYes (1)
PHYSICIANS NECK AND BACK CLINICS
8170 33RD AVE S PO BOX 1309MPLSMN554401309270684883SPECIALTY PATIENT CAREMN501(C)(3)509(A)(3) TYPE IIGROUP HEALTH PLAN INCYes (1)
HUDSON HOSPITAL INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309390804125HOSPITALWI501(C)(3)170(B)(1) (A)(III)RH-WISCONSINYes (1)
HUDSON HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391279567PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTWI501(C)(3)170(B)(1) (A)(VI)HUDSON HOSPITAL INCYes (1)
WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY
8170 33RD AVE S PO BOX 1309MPLSMN554401309263616590PROVIDE MEDICAL TRANSPORT SERVICESWI501(C)(3)509(A)(3) TYPE IIRH-WISCONSINYes (1)
LAKEVIEW MEMORIAL HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309411386635PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTMN501(C)(3)509(A)(3) TYPE IISTILLWATER HEALTH SYSTEMYes (1)
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309410811697HOSPITALMN501(C)(3)170(B)(1) (A)(III)STILLWATER HEALTH SYSTEMYes (1)
STILLWATER MEDICAL GROUP
8170 33RD AVE S PO BOX 1309MPLSMN554401309830379473PHYSICIANS GROUPMN501(C)(3)509(A)(2)STILLWATER HEALTH SYSTEMYes (1)
STILLWATER HEALTH SYSTEM
8170 33RD AVE S PO BOX 1309MPLSMN554401309300221189CORPORATE PLANNING AND OVERSIGHTMN501(C)(3)509(A)(3) TYPE IIHPI - RAMSEYYes (1)
WESTFIELDS HOSPITAL INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309390808442HOSPITALWI501(C)(3)170(B)(1) (A)(III)RH-WISCONSINYes (1)
WESTFIELDS HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391770913PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTWI501(C)(3)509(A)(3) TYPE IWESTFIELDS HOSPITAL INCYes (1)
RAMSEY INTEGRATED HEALTH SERVICES
8170 33RD AVE S PO BOX 1309MPLSMN554401309411503090IN-HOME PATIENT CAREMN501(C)(3)509(A)(2)HPI - RAMSEYYes (1)
AMERY REGIONAL MEDICAL CENTER INC -
8170 33RD AVE S PO BOX 1309MPLSMN554401309390908320HOSPITALWI501(C)(3)170(B)(1) (A)(III)RH-WISCONSINYes (1)
AMERY REGIONAL MEDICAL CENTER FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309391726539PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTMN501(C)(3)170(B)(1) (A)(VI)AMERY REGIONAL MEDICAL CENTER INCYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1METHODIST BRAIN LAB LEASING LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BLVDAddressLine1Txt
CityST LOUIS PARKCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55426ZIPCd
FieldValueIRS element (for citing)
EIN208725994EIN
Primary ActivitiesHEALTH CAREPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PARK NICOLLET METHODIST HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
PARK NICOLLET ENTERPRISES
6500 EXCELSIOR BLVDST LOUIS PARKMN55426411656735REAL ESTATE FOR RELATED ORGANICATIONMNPARK NICOLLET HEATLH SERVICESC-$56,888$15,311,0931.000000
HEALTHPARTNERS ADMINISTRATORS INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411629390THIRD PARTY ADMINISTRATORMNHEALTHPARTNERS INCC0
HEALTHPARTNERS ASSOCIATES INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309522365151MEDICAL CLINIC STAFFING AND ASSET MANAGEMENTMNHEALTHPARTNERS ADMINISTRATORS INCC0
HEALTHPARTNERS SERVICES INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411683568MEDICAL CLINIC STAFFING AND ASSET MANAGEMENTMNHEALTHPARTNERS ADMINISTRATORS INCC0
HEALTHPARTNERS INSURANCE COMPANY
8170 33RD AVE S PO BOX 1309MPLSMN554401309411683523MEDICAL AND DENTAL INSURANCEMNHEALTHPARTNERS ADMINISTRATORS INCC0
DENTAL SPECIALITIES INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309451297583PROFESSIONAL DENTAL SERVICESMNHEALTHPARTNERS ADMINISTRATORS INCC0
HEALTHPARTNERS CENTRAL MINNESOTA CLINICSINC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411236798MEDICAL CLINIC STAFFINGMNHEALTHPARTNERS ADMINISTRATORS INCC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
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 Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
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 (25 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
PARK NICOLLET HEALTH CARE PRODUCTS
S$45,273,041COST
PARK NICOLLET HEALTH CARE PRODUCTS
L$865,081COST
PARK NICOLLET HEALTH CARE PRODUCTS
Q$109,401,024COST
PARK NICOLLET ENTERPRISES
Q$4,632,790COST
PARK NICOLLET METHODIST HOSPITAL
Q$543,422,811COST
PARK NICOLLET METHODIST HOSPITAL
K$263,062COST
PARK NICOLLET METHODIST HOSPITAL
L$5,367,597COST
PARK NICOLLET METHODIST HOSPITAL
S$480,034,593COST
PARK NICOLLET INSTITUTE
Q$11,216,638COST
PARK NICOLLET INSTITUTE
L$207,532COST
PARK NICOLLET INSTITUTE
S$11,358,255COST
PARK NICOLLET CLINIC
Q$503,673,695COST
PARK NICOLLET CLINIC
L$7,662,590COST
PARK NICOLLET CLINIC
S$678,239,268COST
PARK NICOLLET CLINIC
K$256,047COST
PNMC HOLDINGS
Q$2,902,352COST
PARK NICOLLET METHODIST HOSPITAL (TRIA)
P$542,498COST
PARK NICOLLET METHODIST HOSPITAL (TRIA)
M$2,095,200COST
PARK NICOLLET HEALTH CARE PRODUCTS (TRIA)
P$1,397,627COST
PARK NICOLLET CLINIC (TRIA)
P$12,740,631COST
PARK NICOLLET CLINIC (TRIA)
M$58,196COST
PARK NICOLLET CLINIC (TRIA)
R$68,085COST
PARK NICOLLET ENTERPRISESTRIA)
P$2,577,801COST
PARK NICOLLET ENTERPRISESTRIA)
K$2,090,554COST
TRIA ORTHOPAEDIC CENTER RESEARCH INSTITUTE (TRIA)
J$211,734COST

Affiliated Group Schedule AffiliatedGroupSchedule

Affiliated Schedule AffiliatedScheduleGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINElecting OrganizationElectingOrganizationIndTotal Grassroots LobbyTotalGrassrootsLobbyAmtTotal Direct LobbyTotalDirectLobbyAmtTotal Lobby ExpenditureTotalLobbyExpenditureAmtOther Exempt Purpose ExpendOtherExemptPurposeExpendAmtTotal Exempt Purpose ExpendTotalExemptPurposeExpendAmtLobby NontxLobbyNontxAmtGrassroots NontxGrassrootsNontxAmtTotal Lobby Grssroot Mns NontxTotalLobbyGrssrootMnsNontxAmtTot Lbby Expend Mns Lobby NontxTotLbbyExpendMnsLobbyNontxAmtShare Excess Lobby ExpendShareExcessLobbyExpendAmt
PARK NICOLLET HEALTH SERVICES
6500 EXCELSIOR BOULVARDST LOUIS PARKMN55426363465840Yes (X)$0$0$0$92,310,632$92,310,632$1,000,000$250,000$0$0$0
PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BOULVARDST LOUIS PARKMN55426410132080$0$91,501$91,501$399,477,723$399,569,224$1,000,000$250,000$0$0$0
PARK NICOLLET CLINIC
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416410834920$0$51,947$51,947$748,752,918$748,804,865$1,000,000$250,000$0$0$0
PARK NICOLLET HEALTH CARE PRODUCTS
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416010638901$0$239$239$79,329,056$79,329,295$1,000,000$250,000$0$0$0
PARK NICOLLET INSTITUTE
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416410961862$0$0$0$15,462,936$15,462,936$923,147$230,787$0$0$0
PNMC HOLDINGS
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416411741792$0$0$0$0$0$0$0$0$0$0

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