2015-10-19T09:53:08-05:00 2014-12-31 990 2014-01-01 411917516 GOLD CROSS AMBULANCE SERVICE GOLD 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 ROBERT E PEREZ TREASURER 5075381297 2015-10-19 2014 2016-02-25 16:41:14Z SCOTT A SEINOLA 200 FIRST STREET SW ROCHESTER MN 55905 46283407 0 5983 X WWW.MAYOMEDICALTRANSPORT.COM X 1998 MN AMBULANCE SERVICE 8 0 513 0 0 0 28332 26463 42816986 46061340 3152 -15252 168423 179042 43016893 46251593 5000270 5001040 0 0 23095296 24205709 0 0 0 14979766 15188121 43075332 44394870 -58439 1856723 21700248 24041443 7954083 8438555 13746165 15602888 X TO PROVIDE SUPERIOR PATIENT CARE, AT A REASONABLE COST IN A WAY THAT ENGAGES THE WHOLE TEAM, WORKING TOGETHER IN CLINICAL PRACTICE, EDUCATION AND RESEARCH. 0 0 29482697 5001040 40347943 PATIENT CARE - SEE SCHEDULE OPATIENT CARE:GOLD CROSS AMBULANCE SERVICE IS A MEDICAL TRANSPORTATION SERVICE THAT OPERATES AS AN "OUT-OF-HOSPITAL" CARE ORGANIZATION PROVIDING MEDICAL CARE, COMPREHENSIVE MEDICAL TRANSPORTATION AND MEDICAL EDUCATION AND TRAINING TO GROUPS AND INDIVIDUALS IN THE COMMUNITIES SERVED. THE CORE PURPOSE OF THE GOLD CROSS SERVICE IS PROVIDING CARE TO PEOPLE DURING THEIR TIME OF NEED RESULTING FROM ACCIDENTS AND MEDICAL EMERGENCIES. GOLD CROSS RESPONDS TO "911" CALLS IN EACH COMMUNITY SERVED WITHOUT ANY REGARD TO REIMBURSEMENT FOR SERVICES, INCLUDING THE ABILITY OF THE CALLING PARTY TO PAY FOR THE COSTS ASSOCIATED WITH THE SERVICE. GOLD CROSS PROVIDES BASIC LIFE SUPPORT, ADVANCED LIFE SUPPORT, AND CRITICAL CARE SERVICES. ALL GOLD CROSS AMBULANCES ARE STAFFED BY NATIONALLY REGISTERED PARAMEDICS AND EMT'S (EMERGENCY MEDICAL TECHNICIANS). THIS CERTIFICATION REPRESENTS THE HIGHEST LEVEL OF CERTIFICATION FOR OUT-OF-HOSPITAL EMERGENCY CARE PROVIDERS AVAILABLE AND EXCEEDS THE AMBULANCE SERVICE STANDARDS REQUIRED BY MINNESOTA AND WISCONSIN LAW. GOLD CROSS IS ACCREDITED BY THE COMMISSION ON ACCREDITATION OF MEDICAL TRANSPORT SERVICES (CAMTS). THIS ACCREDITATION REQUIRES MEETING AND MAINTAINING THE HIGHEST LEVEL, RIGOROUS STANDARDS FOR SERVICES TO MEET IN THE NATION FOR AMBULANCE SERVICES. BOTH THE NATIONAL REGISTRY STATUS OF GOLD CROSS PARAMEDICS AND EMTS, AS WELL AS THE ACCREDITATION OF GOLD CROSS BY CAMTS DEMONSTRATE THE FINANCIAL AND PRACTICAL COMMITMENT GOLD CROSS HAS MADE TO PROVIDING THE BEST POSSIBLE CARE TO PATIENTS SERVED.GOLD CROSS UTILIZES DISPATCHING SERVICES PROVIDED BY A SOPHISTICATED COMPUTER AIDED DISPATCH SYSTEM HOUSED IN OUR CENTRALIZED EMERGENCY COMMUNICATIONS CENTER (ECC) IN ROCHESTER, MN, WHICH IS LOCATED IN AND OPERATED BY MAYO CLINIC HOSPITAL -- ROCHESTER, A RELATED EXEMPT MAYO ENTITY. THE ECC ENABLES AREA-WIDE DIGITAL PAGING, PROVIDES PRE-ARRIVAL MEDICAL INSTRUCTIONS TO CALLERS, AND ENSURES TIMELY AND EFFICIENT DISPATCH FOR ALL GOLD CROSS UNITS. WHEN PATIENT CARE REQUIRES IT, GOLD CROSS TEAMS UP WITH SPECIALLY TRAINED STAFF, INCLUDING REGISTERED NURSES FROM REGIONAL MEDICAL HELICOPTER PROGRAMS TO PROVIDE A HIGHER LEVEL OF CARE FOR THE PATIENT - CRITICAL CARE. THE STANDARDIZATION OF PATIENT CARE, SERVICES AND SUPPLIES ACROSS THE SYSTEM AND THE INTEGRATION OF GROUND AND AIR RESPONSE THROUGH A CENTRALIZED EMERGENCY COMMUNICATIONS CENTER HAS ENABLED GOLD CROSS TO PREPARE AN EFFICIENT PLAN OF ACTION FOR MULTIPLE INJURY INCIDENTS. IN ADDITION, GOLD CROSS FILLS A VARIETY OF PUBLIC SAFETY SERVICES IN EACH COMMUNITY SERVED.IN 2014, GOLD CROSS AMBULANCE PROVIDED MEDICAL TRANSPORTATION TO ALMOST 59,600 PATIENTS, OFTEN INVOLVING COMPREHENSIVE MEDICAL CARE DURING TRANSPORTATION. IN ADDITION, GOLD CROSS RESPONDED TO OVER 21,000 EMERGENT REQUESTS FOR SERVICE THAT DID NOT RESULT IN THE TRANSPORTATION OF A PATIENT. THESE NO TRANSPORT REQUESTS CONSUME A SIGNIFICANT AMOUNT OF FINANCIAL RESOURCES, WITHOUT A MEANS OF BILLING FOR AND COLLECTING REVENUE, AS GOLD CROSS FULFILLS ONE OF ITS ROLES AS A PUBLIC SAFETY PROVIDER IN THE COMMUNITIES SERVED. APPROXIMATELY 500 OF THESE NO TRANSPORTS ARE SPECIFIC REQUESTS FOR US TO PROVIDE EMERGENCY MEDICAL STANDBY AS OTHER PUBLIC SAFETY PROVIDERS CONDUCT THEIR NORMAL BUSINESS SUCH AS FIGHTING FIRES, DOING HIGH-RISK POLICE ENTRIES AND ACTIVITIES, ETC., WHICH CAN OFTEN CONSUME SEVERAL HOURS OF UNPAID SERVICE BY OUR CREWS FOR EACH STANDBY. IN ADDITION, GOLD CROSS SERVES THE NEEDS OF VETERANS THROUGH CONTRACTS FOR AMBULANCE SERVICE WITH THE VETERANS ADMINISTRATION IN ST. CLOUD AND DULUTH, IN MINNESOTA AND SUPERIOR, IN WISCONSIN.GOLD CROSS PROVIDES CHARITY CARE FOR PATIENTS FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. SERVICES ARE ALSO PROVIDED TO PATIENTS COVERED BY MEDICARE, MEDICAID, AND OTHER GOVERNMENTAL PROGRAMS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. CHARITY CARE IS AN ADDITIONAL FINANCIAL STRAIN ON AMBULANCE SERVICES. A RECENT GAO STUDY ON MEDICARE REIMBURSEMENT INDICATED REIMBURSEMENT FOR AMBULANCE SERVICES FALLS SHORT OF ACTUAL COSTS BY 6% IN URBAN AND RURAL AREAS AND 17% IN SUPER-RURAL AREAS. THE COST OF CHARITY CARE PROVIDED IN 2014 WAS APPROXIMATELY $46,000 AND THE COST OF UNCOMPENSATED CARE PROVIDED TO LOW INCOME PATIENTS THROUGH MEDICAID IN 2014 WAS APPROXIMATELY $915,000. THE UNREIMBURSED COST OF MEDICARE WAS APPROXIMATELY $1,294,000. GCMN PAID $387,500 TO MNCARE, A PROGRAM THAT PROVIDES HEALTH CARE TO BENEFIT ELIGIBLE MINNESOTA RESIDENTS. 1400382 546835 EDUCATION AND TRAINING - SEE SCHEDULE O: EDUCATION AND TRAINING:GOLD CROSS HAS BEEN DESIGNATED BY THE AMERICAN HEART ASSOCIATION (AHA) AS A COMMUNITY TRAINING CENTER (CTC) FOR THE AHA WHICH HAS ESTABLISHED GOLD CROSS AS A PROVIDER OF EMERGENCY CARDIAC CARE TRAINING AT VARIOUS PROFESSIONAL LEVELS FOR THE AHA. GOLD CROSS PROVIDES CUSTOMIZED EDUCATIONAL AND TRAINING PROGRAMS TO THE PUBLIC, MAYO CLINIC, MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, OTHER ALLIED HEALTH CARE AGENCIES, AND PUBLIC SAFETY AGENCIES COVERING TOPICS SUCH AS BASIC EMERGENCY CARE, MEDICAL-LEGAL ISSUES, OSHA REQUIREMENTS, ENVIRONMENTAL EMERGENCIES AND OTHER COURSES SPECIFIC TO CUSTOMER NEEDS. THROUGHOUT 2014 OVER 10,000 PEOPLE WERE TRAINED THROUGH THE CTC OPERATED BY GOLD CROSS.GOLD CROSS DONATES TRAINING TIME TO A VARIETY OF CITIES, COUNTIES, FIRE DEPARTMENTS, EMERGENCY MEDICAL SERVICE AGENCIES, AS WELL AS THE GENERAL PUBLIC. GOLD CROSS HAS DEMONSTRATED THIS COMMITMENT BY SUPPORTING VARIOUS ASSOCIATIONS INCLUDING THE SOUTHEAST REGIONAL EMS PROGRAM BOARD, THE ARROWHEAD EMS ASSOCIATION, THE CENTRAL MINNESOTA EMS JOINT POWERS BOARD, THE SOUTH CENTRAL EMS BOARD, THE MN EMS REGULATORY BOARD, THE MN EMS REGULATORY BOARD DATA COLLECTION SUBCOMMITTEE, THE MN EMS REGULATORY BOARD PREHOSPITAL EDUCATION ADVISORY COMMITTEE, THE MN EMS REGULATORY BOARD MENTAL HEALTH TRANSFER TASK FORCE, THE ROCHESTER/OLMSTED COUNTY INTEGRATED EMERGENCY MANAGEMENT SYSTEM DISASTER EXERCISE SUBCOMMITTEE, THE LAKEHEAD (MINNESOTA) AND VACATIONLAND (WISCONSIN) MUTUAL AID ASSOCIATIONS, THE AMERICAN HEART ASSOCIATION, THE MINNESOTA AMBULANCE ASSOCIATION, AND THE SOUTHEAST REGIONAL EMS PREHOSPITAL ADVISORY COMMITTEE. APPROXIMATELY 8,300 HOURS OF EMPLOYEE TIME WAS PROVIDED FOR A VARIETY OF SAFETY-RELATED PROGRAMS TO VARIOUS COMMUNITIES, BUSINESSES, AND SCHOOLS. IN ADDITION, GOLD CROSS AMBULANCE SERVICE EMPLOYEES PARTICIPATED IN A LARGE NUMBER OF COMMUNITY EVENTS, SCHOOL CAREER FAIRS, STUDENT TOURS, BROWNIE TROOPS, CUB SCOUTS, BOY SCOUTS, STUDENT MENTORSHIP PROGRAMS, VARIOUS PARADES, HEAD START EVENTS AND HEALTH FAIRS, AMONG OTHERS. THE ESTIMATED DOLLAR VALUE OF THESE EFFORTS AND OTHER DONATED SERVICES EXCEEDED $414,000. IN ADDITION GOLD CROSS HAS ESTABLISHED A 2-YEAR PARAMEDIC TRAINING PROGRAM IN CONJUNCTION WITH A LOCAL COMMUNITY COLLEGE AND THE MAYO SCHOOL OF HEALTH SCIENCES. THE INVESTMENT MADE IN THE PROGRAM HELPS SECURE A WELL-TRAINED WORKFORCE FOR GOLD CROSS AND OTHER AMBULANCE PROVIDERS THAT DEPEND ON A CONTINUOUS FLOW OF NEW, WELL-QUALIFIED AND CAPABLE PARAMEDICS INTO THE WORKFORCE. MANY LOCAL COMMUNITIES CANNOT UPGRADE THEIR AMBULANCE SERVICE FROM BASIC (BLS) TO ADVANCED (ALS) BECAUSE VOLUNTEERS DO NOT HAVE ACCESSIBLE TRAINING. INSPIRED BY THIS FACT, GOLD CROSS HAS WORKED WITH A MULTITUDE OF COMMUNITY PARTNERS TO DEVELOP INNOVATIVE TRAINING SOLUTIONS. SIMILARLY, VOLUNTEER COMMUNITY GROUPS SPECIALIZING IN FIRST RESPONSE OR DISASTER RESPONSE OFTEN LACK FINANCES TO MAKE INITIAL PURCHASES OF EQUIPMENT OR TO UPGRADE EQUIPMENT. GOLD CROSS DONATES USED EQUIPMENT TO SUCH ORGANIZATIONS REGULARLY. THE TOTAL VALUE OF DONATED EQUIPMENT, INCLUDING VEHICLES IN 2014 WAS APPROXIMATELY $71,500. GOLD CROSS FURTHER SUPPORTS VARIOUS COMMUNITIES BY CONTRACTING WITH THEM TO PROVIDE MANAGEMENT SUPPORT SERVICES FOR THEIR SERVICES.OVER THE YEARS, GOLD CROSS HAS DEVELOPED COOPERATIVE APPROACHES IN MEETING MEDICAL CENTER STAFFING NEEDS AS WELL AS INCREASING TRAINING FOR GOLD CROSS PARAMEDICS. BY COLLABORATING WITH HOSPITALS IN VARIOUS CITIES IN WHICH WE PROVIDE SERVICE, GOLD CROSS PARAMEDICS PROVIDE ADVANCED LEVEL PATIENT CARE IN THE EMERGENCY ROOM ENVIRONMENT IN COMMUNITIES THAT BENEFIT FROM THAT STAFFING. THROUGH THIS COLLABORATIVE EFFORT, GOLD CROSS PARAMEDICS RECEIVE TRAINING AND EXPERIENCE TO FURTHER ENHANCE THEIR SKILLS AND THE HOSPITAL AND MEDICAL CENTER BENEFIT FROM THE AVAILABILITY OF PARAMEDICS TO ASSIST DURING PERIODS OF TIME WHEN THEY EXPERIENCE SHORTAGES IN STAFFING.GOLD CROSS IS A FOUNDING MEMBER OF THE NORTH CENTRAL EMS COOPERATIVE (NCEMSC). THE NCEMSC IS MADE UP OF MEMBERS FROM THROUGHOUT THE UNITED STATES AND PROVIDES GROUP PURCHASING OF AMBULANCES, MEDICAL SUPPLIES AND DEVICES AND OTHER SERVICES ESSENTIAL TO AMBULANCE OPERATIONS IN AN EFFORT TO REDUCE COSTS OF VARIOUS INFRASTRUCTURES FOR AMBULANCE SERVICES FACING FINANCIAL HARDSHIP. IN ADDITION, GOLD CROSS PARTICIPATES IN THE WORK OF THE NORTH CENTRAL EMS INSTITUTE (NCEMSI) FOR THE PURPOSES OF ADVANCING BENCHMARKING AND PUBLIC POLICY RESEARCH RELATED TO THE EMS INDUSTRY. SIMILAR INVESTMENTS OF STAFF TIME AND ADMINISTRATIVE RESOURCES ARE EXPENDED IN EFFORTS WITH THE AMERICAN AMBULANCE ASSOCIATION ON NATIONAL BENCHMARKING EFFORTS FOR THE PURPOSE OF IMPROVING THE SERVICES PROVIDED TO THE PATIENTS SERVED BY EMS NATION WIDE, AS WELL AS THE AMERICAN HEART ASSOCIATION ON RESEARCH FUNDING AND EXECUTION OF COMMUNITY AWARENESS. 6484432 5179195 SHARED SERVICES - SEE SCHEDULE O:SHARED SERVICES:PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE OF PROVIDING PATIENT CARE. 37367511 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 0 0 513 1 0 0 0 0 0 0 0 0 0 0 X 8 0 1 1 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 0 MN X CORPORATE TAX UNIT 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 COLLINS CRAIG C DIRECTOR 1.00 40.00 X 0 281893 64399 DRUCKER PAUL E DIRECTOR 1.00 40.00 X 0 135888 37698 RUSTAD CHRISTOPHER D DIRECTOR/SECRETARY (6/16-12/31/2014) 1.00 40.00 X X 0 146216 31473 SANTRACH MD PAULA J DIRECTOR / VICE CHAIR 1.00 40.00 X X 0 409577 61220 SCHNEIDER KENNETH J DIRECTOR 1.00 40.00 X 0 307744 17827 SEINOLA SCOTT A DIRECTOR / PRESIDENT / CEO 1.00 40.00 X X 0 282631 23246 SMOLDT CRAIG A DIRECTOR / CHAIR 1.00 40.00 X X 0 451699 9994 TRANKEL SUSAN K DIRECTOR / SECRETARY (1/1 -5/1) 1.00 40.00 X X 0 73039 7841 ZIETLOW MD SCOTT P DIRECTOR 1.00 40.00 X 0 497257 63778 ANDERSON PAUL D VICE PRESIDENT 40.00 1.00 X 159152 0 20819 GALINDEZ JR PETER ASST. SECRETARY 1.00 40.00 X 0 191426 48120 PEREZ ROBERT E TREASURER 1.00 40.00 X 0 135711 21911 HALLUM BRADLEY G DIRECTOR OF OPERATIONS 40.00 1.00 X 113617 0 30085 LEE STEVEN E PARAMEDIC/REGISTERED NURSE 40.00 1.00 X 69591 59337 14658 RINGHOFER KENNETH W PARAMEDIC 40.00 1.00 X 108014 0 27171 WILL MATTHEW D SUPPORT SERVICES DIRECTOR 40.00 1.00 X 119397 0 17565 WINGROVE GARY L GOV'T AFFAIRS SPECIALIST 40.00 1.00 X 111428 0 12153 681199 2972418 509958 7 0 1 0 MAYO FOUNDATION FOR MEDICAL EDUCATION AN 200 FIRST ST SW ROCHESTER MN 55905 ACCOUNTS PAYABLE PROCUREMENT AGENT 1793430 1 26463 26463 NET PATIENT REVENUE 621910 40335310 40335310 SHARED SERVICES REVENUE 561000 5179195 5179195 EDUCATION REVENUE 611600 546835 546835 46061340 1319 1319 9600 5957 7616 130 1984 5827 7811 7811 7497 24068 -16571 -16571 -16571 MISC CONSULTING SERVICES 541610 158442 158442 MEDICAL RECORD/TRANSCRIPTION FEES 541900 11876 11876 MISC. REVENUE 900099 757 757 156 156 171231 46251593 46073973 0 151157 X 5001040 5001040 179972 179972 17523040 15208765 2314275 525746 452203 73543 4624263 3806099 818164 1352688 1163471 189217 17449 17418 31 2619 2619 16250 16250 4636082 2364526 2271556 26781 2459 24322 1232539 734038 498501 165613 15735 149878 527522 517437 10085 993351 929855 63496 18995 8141 10854 1297546 1278012 19534 406997 90501 316496 BAD DEBT EXPENSE 4355995 4355995 MEDICAL SUPPLIES 844567 844567 MN CARE TAX 387500 387500 EMPLOYEE RELATED EXPENS 187745 187745 70570 2004 68566 44394870 37367511 7027359 0 3109336 3754647 14511769 9877744 4730711 4634025 10148631 11713464 3711570 3939307 21700248 24041443 1700338 1779686 6253745 6658869 7954083 8438555 X 13746165 15602888 13746165 15602888 21700248 24041443 1856723 0 X 0 1 X 1 0 X 1 36934 28332 26463 91730 27665265 29881881 40654864 42828110 46073973 187104093 27665265 29881882 40691798 42856442 46100436 187195823 0 0 0 187195823 24831 17276 18939 15464 16876 93386 24831 17276 18939 15464 16876 93386 27450 29450 240556 160197 158598 616251 27717546 29928608 40951293 43032103 46275910 187905460 0.99620 0.99640 0.00050 0.00070 X SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME: MISC. REVENUE 2010 AMOUNT: $ 27,450. 2011 AMOUNT: $ 29,450. 2012 AMOUNT: $ 240,556. 2013 AMOUNT: $ 160,197. 2014 AMOUNT: $ 158,598. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 16250 0 0 16250 0 PART II-B, LINE 1: DURING 2014 GOLD CROSS AMBULANCE SERVICE (GCMN) OFFICIALS HAD SEVERAL MEETINGS AND CONTACTS WITH GOVERNMENT OFFICIALS, PRIMARILY FROM THE MINNESOTA STATE GOVERNMENT. THESE MEETINGS INCLUDED DISCUSSIONS OF VARIOUS STATE REGULATORY AGENCIES. THESE MEETINGS WERE PRIMARILY HELD IN ST. PAUL, MINNESOTA. GCMN ALSO HAD A MEMBERSHIP IN THE MINNESOTA AMBULANCE ASSOCIATION WHICH MAY ADVOCATE ON BEHALF OF ITS MEMBERS BEFORE THE MINNESOTA LEGISLATURE. GCMN HAS ON OCCASION CORRESPONDED WITH ELECTED REPRESENTATIVES AND GOVERNMENT OFFICIALS OUTLINING GCMN'S CONCERNS AND RECOMMENDATIONS ON VARIOUS HEALTH CARE INITIATIVES AND PROPOSALS. THE PRIMARY FOCUS OF ALL THESE CONTACTS WAS TO DISCUSS PRINCIPLES OF AMBULANCE RELATED HEALTH CARE LEGISLATION RATHER THAN TRY TO INFLUENCE SPECIFIC PROPOSED LEGISLATION. THE MAJORITY OF THESE ACTIVITIES WERE CONDUCTED BY REGISTERED LOBBYISTS. FEES PAID TO REGISTERED LOBBYISTS FOR THESE ACTIVITIES TOTALED $16,250. EMPLOYEES AND REPRESENTATIVES OF GCMN HAVE ALSO CORRESPONDED, HELD MEETINGS AND TESTIFIED BEFORE LEGISLATORS AND LEGISLATIVE COMMITTEES AT THE REQUEST OF LEGISLATORS WHEN PARTICULAR EXPERTISE IN CERTAIN AREAS WAS REQUIRED. GCMN ALSO OCCASIONALLY HOSTS VISITS TO OUR VARIOUS SITES FOR POLICY MAKERS AND ELECTED OFFICIALS WHEN CERTAIN PROCEDURES AND UNIQUE ASPECTS OF GCMN OPERATIONS MAY HAVE A USEFUL BEARING ON PUBLIC POLICY OR THE PROVISION OF PUBLIC SERVICES. GCMN MAY ALSO DEAL WITH MEMBERS OF GOVERNMENT ON A LESS REGULAR BASIS WHEN MAKING EFFORTS TO MEET CERTAIN REGULATORY REQUIREMENTS IMPOSED BY LOCAL, STATE AND FEDERAL LAW AND RULE. THESE AREAS MAY INCLUDE AMBULANCE-RELATED REGULATIONS, PERSONNEL CERTIFICATION, TAX STATUS, LICENSING OF REGULATED ACTIVITIES SUCH AS OUR CERTIFIED TRAINING INSTITUTIONS, REAL ESTATE AND GROWTH MANAGEMENT ISSUES, ZONING, PUBLIC WORKS AND OTHER ISSUES COMMON IN THE COURSE OF PROVIDING SERVICES TO OUR PATIENTS AND FULFILLING OUR EDUCATIONAL AND RESEARCH OBLIGATIONS. WE BELIEVE THAT THESE INFORMAL MEETINGS DO NOT CONSTITUTE ATTEMPTS TO INFLUENCE SPECIFIC LEGISLATION AS CONTEMPLATED BY THESE QUESTIONS. 761869 761869 3110726 2195587 915139 304178 286384 17794 10334996 7395773 2939223 4634025 MAYO POOLED INVESTMENTS 11713464 F 11713464 DUE FROM AFFILIATES 3939307 3939307 DUE TO AFFILIATES 6658869 6658869 X PART X, LINE 2: AT DECEMBER 31, 2014 AND 2013, THE RESERVE FOR UNRECOGNIZED TAX BENEFITS WAS NOT SIGNIFICANT, AND AS A RESULT, THERE IS NO LONGER A RESERVE FOR UNRECOGNIZED TAX BENEFITS RECORDED FOR THE FILING ORGANIZATION. 1 MAYO CLINIC 200 FIRST ST SW ROCHESTER MN 55905 416011702 501(C)(3) 5000000 SUPPORT EXEMPT PURPOSE RICE FIRE DEPARTMENT PO BOX 179 RICE MN 56367 411252539 CITY OF RICE 8500 FMV 2006 FORD E-350 WHEELED COACH AMBULANCE SUPPORT OF COMMUNITY WITH DONATION OF USED EQUIPMENT ELROSA FIRE DEPARTMENT 207 STATE STREET ELROSA MN 56325 411848991 CITY OF ELROSA 8500 FMV 2006 FORD E-350 #401 WHEELED COACH AMBULANCE SUPPORT OF COMMUNITY WITH DONATION OF USED EQUIPMENT INTERNATIONAL FIRE RELIEF MISSION 30345 ELM STREET LINDSTROM MN 55045 300478928 501(C)(3) 8500 FMV 2006 FORD E-350 #402 WHEELED COACH AMBULANCE SUPPORT OF COMMUNITY WITH DONATION OF USED EQUIPMENT AUGUSTA BRIDGE CREEK FIRE DEPARTMENT INC 745 INDUSTRIAL DR AUGUSTA WI 54722 391840998 CITY OF AUGUSTA 8500 FMV 2004 FORD E-350 WHEELED COACH AMBULANCE SUPPORT OF COMMUNITY WITH DONATION OF USED EQUIPMENT INTERNATIONAL HEALTH SERVICES OF MN PO BOX 16436 ST PAUL MN 55116 411427077 501(C)(3) 7500 FMV 2005 FORD E-350 WHEELED COACH AMBULANCE SUPPORT OF COMMUNITY WITH DONATION OF USED EQUIPMENT WESTERN TECHNICAL COLLEGE 400 7TH STREET NORTH LA CROSSE WI 54601 396002842 STATE OF WISCONSIN 7500 FMV 2003 FORD E-350 WHEELED COACH AMBULANCE SUPPORT OF COMMUNITY WITH DONATION OF USED EQUIPMENT RIVERLAND TECHNICAL COLLEGE 1900 8TH AVENUE NW AUSTIN MN 55912 411286409 STATE OF MINNESOTA 7500 FMV 2005 FORD E-350 WHEELED COACH AMBULANCE SUPPORT OF COMMUNITY WITH DONATION OF USED EQUIPMENT MINNESOTA HIGHWAY SAFETY CENTER 720 4TH AVENUE SOUTH ST CLOUD MN 56301 411687554 STATE OF MINNESOTA 7500 FMV 2005 FORD E-350 WHEELED COACH AMBULANCE SUPPORT OF COMMUNITY WITH DONATION OF USED EQUIPMENT SOUTH CENTRAL COLLEGE 1920 LEE BLVD NORTH MANKATO MN 56003 411687554 STATE OF MINNESOTA 7500 FMV 2005 FORD E-350 WHEELED COACH AMBULANCE SUPPORT OF COMMUNITY WITH DONATION OF USED EQUIPMENT 10 PART I, LINE 2: THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY AND EQUALITY OF OPPORTUNITY. TRANSFERS OR GRANTS TO TAX-EXEMPT ORGANIZATIONS AND/OR AFFILIATED TAX-EXEMPT ORGANIZATIONS WILL BE USED PURSUANT TO THE POLICIES AND PROCEDURES OF THE GRANTEE ORGANIZATIONS AND TO FURTHER THE EXEMPT PURPOSES OF THE GRANTEE ORGANIZATIONS. BOTH THE FILING ORGANIZATION AND THE GRANTEE ORGANIZATION MAINTAIN ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED. 1 0 1 0 0 0 0 0 0 0 COLLINS CRAIG C DIRECTOR 0 280124 0 0 0 1769 0 35928 0 28471 0 346292 0 0 DRUCKER PAUL E DIRECTOR 0 131820 0 0 0 4068 0 11347 0 26351 0 173586 0 0 RUSTAD CHRISTOPHER D DIRECTOR/SECRETARY (6/16-12/31/2014) 0 145263 0 0 0 953 0 12997 0 18476 0 177689 0 0 SANTRACH MD PAULA J DIRECTOR / VICE CHAIR 0 374197 0 0 0 35380 0 46338 0 14882 0 470797 0 0 SCHNEIDER KENNETH J DIRECTOR 0 297458 0 0 0 10286 0 539 0 17288 0 325571 0 0 SEINOLA SCOTT A DIRECTOR / PRESIDENT / CEO 0 280867 0 0 0 1764 0 415 0 22831 0 305877 0 0 SMOLDT CRAIG A DIRECTOR / CHAIR 0 398066 0 0 0 53633 0 0 0 9994 0 461693 0 0 ZIETLOW MD SCOTT P DIRECTOR 0 442917 0 0 0 54340 0 37006 0 26772 0 561035 0 0 ANDERSON PAUL D VICE PRESIDENT 155747 0 0 0 3405 0 0 0 20819 0 179971 0 0 0 GALINDEZ JR PETER ASST. SECRETARY 0 190898 0 0 0 528 0 22537 0 25583 0 239546 0 0 PEREZ ROBERT E TREASURER 0 125690 0 0 0 10021 0 0 0 21911 0 157622 0 0 PART I, LINE 3 THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990 PART VI SECTION B LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED. PART I, LINE 4B THIS ENTITY OR ITS AFFILIATE HAS A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE MAYO PENSION PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(A)(17). STARTING JANUARY 1, 2011, ALL SRP BENEFITS ARE PAID AS AN ANNUAL TAXABLE CASH PAYMENT. THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). SANTRACH M.D., PAULA J. $32,289 SCHNEIDER, KENNETH J. $ 8,425 SMOLDT, CRAIG A. $35,328 ZIETLOW M.D., SCOTT P. $50,971 PART II: COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. KWIK TRIP INC OVERLAPPING BOARD 552540 FUEL PURCHASE - ALL TRANSACTIONS ARE CONDUCTED AT AN ARMS LENGTH BASIS. 0 FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: ZIETLOW M.D., SCOTT P. TRANKEL, SUSAN K. SMOLDT, CRAIG A. SEINOLA, SCOTT A. SCHNEIDER, KENNETH J. SANTRACH M.D., PAULA J. RUSTAD, CHRISTOPHER D. DRUCKER, PAUL E. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: COLLINS, CRAIG C. SANTRACH M.D., PAULA J. THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: GALINDEZ JR, PETER SEINOLA, SCOTT A. PEREZ, ROBERT E. COLLINS, CRAIG C. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: SEINOLA, SCOTT A. COLLINS, CRAIG C. SEINOLA, SCOTT A. COLLINS, CRAIG C. HAVE A BUSINESS RELATIONSHIP AS THEY SERVE AS AN OFFICER, DIRECTOR, OR TRUSTEE OF MMSI, INC, A RELATED TAXABLE ENTITY. FORM 990, PART VI, SECTION A, LINE 3 MAYO CLINIC, MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, AND OTHER RELATED COMPANIES PROVIDE MANAGEMENT SERVICES TO THE ENTIRE SYSTEM OF ENTITIES. SINCE THE ENTITIES ARE RELATED ORGANIZATIONS, COMPENSATION FOR THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES HAS BEEN DISCLOSED IN PART VII AND SCHEDULE J AS REQUIRED. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER IS MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE CORPORATE MEMBER ELECTS AND/OR REMOVES THE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER MUST APPROVE CERTAIN ACTIONS OF THE BOARD SUCH AS INCURRENCE OF DEBT, CHANGES INVOLVING THE CORPORATION OR ITS STRATEGIC PLAN AND/OR MISSION, THE ALTERATION OF NAMES USED BY FACILITIES OPERATED BY THE CORPORATION, AND DISTRIBUTION OF ASSETS UPON DISSOLUTION. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE SITE FINANCE STAFF AND THE TREASURER. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C MAYO CLINIC AND ITS AFFILIATES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS, EXECUTIVE AND SENIOR ADMINISTRATIVE LEADERSHIP, ALONG WITH ALLIED HEALTH STAFF. IN ADDITION TO ANY REVIEW AND APPROVAL THAT MAY TAKE PLACE AT THE LOCAL ENTITY OR REGIONAL LEVEL, THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY PRIOR TO IMPLEMENTATION OF THE RESPECTIVE COMPENSATION INCREASE. THE SALARIES AND BENEFIT PROGRAMS OF THE DIRECTOR/PRESIDENT/CEO AND THE DIRECTOR/VICE CHAIR WERE REVIEWED AND APPROVED BY THE PROCESS DESCRIBED BELOW FOR SENIOR ADMINISTRATIVE LEADERSHIP. THE COMPENSATION AND BENEFIT PROGRAMS FOR SENIOR ADMINISTRATIVE LEADERSHIP FOR ALL CAMPUSES, INCLUDING THE MAYO CLINIC HEALTH SYSTEM LOCATIONS, ARE REVIEWED AND APPROVED BY THE MAYO CLINIC BOARD OF TRUSTEES GOVERNANCE AND NOMINATING COMMITTEE. THE MAYO CLINIC BOARD OF TRUSTEES GOVERNANCE AND NOMINATING COMMITTEE IS COMPRISED OF NINE OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. THIS GROUP REVIEWS AND APPROVES THE COMPENSATION AND BENEFIT PROGRAMS FOR PHYSICIANS FROM ALL CAMPUSES, AS WELL AS CERTAIN SENIOR ADMINISTRATIVE AND EXECUTIVE LEADERSHIP (INCLUDING ALL PERSONS BELIEVED TO BE DISQUALIFIED PERSONS). THIS PROCESS ESTABLISHES ACCEPTABLE RANGES FOR VARIOUS POSITIONS, LEVELS, AND SPECIALTIES. THE COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. FORM 990, PART IX, LINE 11G IC PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,108,424. MANAGEMENT AND GENERAL EXPENSES 1,938,754. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,047,178. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 93,954. MANAGEMENT AND GENERAL EXPENSES 332,802. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 426,756. VEHICLE REPAIRS/MAINTENANCE: PROGRAM SERVICE EXPENSES 1,162,148. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,162,148. FILING OF CERTAIN FOREIGN FORMS DISCLOSURE STATEMENT RELATED TO FORMS 5713: FORM 5713 HAS BEEN FILED BY THE FOLLOWING MEMBERS OF THE CONTROLLED GROUP: MAYO CLINIC (EIN: 41-6011702) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH (EIN: 41-1506440) MAYO CLINIC ARIZONA (EIN: 86-0800150) MAYO CLINIC JACKSONVILLE (EIN: 59-3337028) DISCLOSURE STATEMENT RELATED TO FORMS 5471: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 4 AND 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED TAXPAYER NAME: MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-1506440 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED DISCLOSURE STATEMENT RELATED TO FORMS 8865: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 8865, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS, AS A CATEGORY 2 AND 3 FILER. THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 8865 FOR THESE PARTNERSHIPS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 8865 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED BLOOMER LAKEVIEW INC 2110 DUNCAN ROAD BLOOMER WI 54724 391450617 LOW INCOME HOUSING WI 501(C)(3) 7 MCHS--CHIPPEWA VALLEY INC 1 CHARTERHOUSE INC 200 FIRST STREET SW ROCHESTER MN 55905 411405254 RETIREMENT LIVING CENTER MN 501(C)(3) 9 MAYO CLINIC 1 DESTINATION MEDICAL CENTER EDA 50 SOUTH SIXTH STREET SUITE 1500 MINNEAPOLIS MN 554021498 464893585 ECONOMIC DEVELOPMENT MN 501(C)(3) 11-I MAYO CLINIC 1 GOLD CROSS AMBULANCE SERVICE 200 FIRST STREET SW ROCHESTER MN 55905 411917516 AMBULANCE SERVICE MN 501(C)(3) 9 MFMER 1 LUTHER LAKESIDE APARTMENTS INC PO BOX 1510 EAU CLAIRE WI 54702 391409024 LOW INCOME HOUSING FOR ELDERLY WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 416011702 PATIENT CARE - CLINIC MN 501(C)(3) 9 N/A 1 MAYO CLINIC ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 860800150 HOSPITAL AND CLINIC AZ 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 590714831 HOSPITAL FL 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MAYO CLINIC HOSPITAL -- ROCHESTER 200 FIRST STREET SW ROCHESTER MN 55905 410944601 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC JACKSONVILLE 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 593337028 PATIENT CARE - CLINIC FL 501(C)(3) 7 MAYO CLINIC 1 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 200 FIRST STREET SW ROCHESTER MN 55905 411506440 CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES MN 501(C)(3) 9 MAYO CLINIC 1 MAYO KLINIK STIFTUNG 60486 FRANKFURT AM MAIN FRANKFURT GM FUNDRAISING FOUNDATION GM MFMER 1 MCHS IN WAYCROSS INC 1900 TEBEAU STREET WAYCROSS GA 31501 581667166 HOSPITAL GA 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MCHS--ALBERT LEA AND AUSTIN 1000 FIRST DRIVE NW AUSTIN MN 55912 411404075 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--AUSTIN FOUNDATION 1000 FIRST DRIVE NW AUSTIN MN 55912 300107471 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--ALBERT LEA AND AUSTIN 1 MCHS--CANNON FALLS 32021 COUNTY ROAD 24 BLVD CANNON FALLS MN 55009 204156428 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--CHIPPEWA VALLEY INC 1501 THOMPSON STREET BLOOMER WI 54724 390980343 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MCHS--EAU CLAIRE CLINIC INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE WI 54702 391735831 PATIENT CARE - CLINIC WI 501(C)(3) 3 MAYO CLINIC 0 MCHS--EAU CLAIRE FOUNDATION INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE WI 54702 391633407 GRANTMAKING FOUNDATION WI 501(C)(3) 11-I MCHS--EAU CLAIRE CLINIC INC 0 MCHS--EAU CLAIRE HOSPITAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 390813418 HOSPITAL WI 501(C)(3) 3 MAYO CLINIC 1 MCHS--FAIRMONT 800 MEDICAL CENTER DRIVE PO BOX 800 FAIRMONT MN 56031 410760836 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MCHS--FRANCISCAN HEALTHCARE FOUNDATION INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391186647 FUNDRAISING FOUNDATION WI 501(C)(3) 7 MCHS--FRANCISCAN HEALTHCARE INC 1 MCHS--FRANCISCAN HEALTHCARE FOUNDATION-SPARTA INC 310 WEST MAIN STREET SPARTA WI 54656 391423234 FUNDRAISING FOUNDATION WI 501(C)(3) 9 MCHS--FRANCISCAN HEALTHCARE INC 1 MCHS--FRANCISCAN HEALTHCARE INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391411999 HEALTHCARE SYSTEM PARENT WI 501(C)(3) 11-I MAYO CLINIC 1 MCHS--FRANCISCAN MEDICAL CENTER INC 700 WEST AVE SOUTH LA CROSSE WI 54601 390806374 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--FRANCISCAN HEALTHCARE INC 1 MCHS--HOME HEALTH & HOSPICE INC PO BOX 2060 EAU CLAIRE WI 54702 391491516 HOME HEALTH AND HOSPICE CARE WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MCHS--LAKE CITY 500 WEST GRANT STREET LAKE CITY MN 55041 411906820 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--MANKATO 1025 MARSH STREET MANKATO MN 56002 411236756 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--MANKATO HEALTH CARE FOUNDATION 1025 MARSH STREET MANKATO MN 56002 411663357 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--MANKATO 1 MCHS--NEW PRAGUE 301 SECOND STREET NE NEW PRAGUE MN 56071 410723639 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MCHS--NORTHLAND INC 1222 EAST WOODLAND AVENUE BARRON WI 54812 390920634 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MCHS--OAKRIDGE INC 13025 EIGHTH STREET PO BOX 70 OSSEO WI 54758 391029430 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MCHS--OWATONNA 134 SOUTHVIEW ST OWATONNA MN 55060 411862132 PATIENT CARE - CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--RED CEDAR INC 2321 STOUT ROAD MENOMONIE WI 54751 510190875 HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC 1 MCHS--RED WING 701 HEWITT BOULEVARD RED WING MN 55066 411713783 PATIENT CARE SERVICES MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--SPRINGFIELD 625 NORTH JACKSON AVENUE SPRINGFIELD MN 56087 411893827 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MCHS--ST JAMES 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 410797368 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MCHS--ST JAMES HEALTH CARE FOUNDATION 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 411444129 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--ST JAMES 1 MCHS--SUPPORTIVE HOMECARE INC PO BOX 2060 EAU CLAIRE WI 54702 391686673 HOME HEALTH CARE WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MCHS--WASECA 501 NORTH STATE STREET WASECA MN 56093 363606405 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES 200 FIRST STREET SW ROCHESTER MN 55905 412020392 SUPPORT RESEARCH, PRACTICE & EDUCATION MN 501(C)(3) 11-I MAYO CLINIC 1 POVERELLO FOUNDATION 200 FIRST STREET SW ROCHESTER MN 55905 411494881 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC HOSPITAL - ROCHESTER 1 FRANKLIN HEATING STATION 119 THIRD ST SW ROCHESTER MN 55902 410264830 UTILITY MN N/A LATIGO PETROLEUM LLC PO BOX 14230 ODESSA TX 79768 364767494 OIL & GAS EXPLORATION DE N/A PHYSICIAN SOFTWARE SYSTEMS LLC 3333 WARRENVILLE ROAD SUITE 200 LISLE IL 60532 453414836 HEALTHCARE RELATED SOFTWARE IL N/A WATERSHED CAP INSTL PRTNRS III LP ONE MARITIME PLAZA SUITE 1525 SAN FRANCISCO CA 94111 462982848 INVESTMENT ACTIVITIES DE N/A BWL HOLDINGS INC 1209 ORANGE STREET WILMINGTON DE 19801 472413749 OIL & GAS EXPLORATION DE N/A C 1 AMBIENT CLINICAL ANALYTICS INC 221 1ST AVE SW SUITE 202 ROCHESTER MN 55902 800928405 SOFTWARE DE N/A C 1 CAVALRY CLO III LTD PO BOX 1093 GT QUEENSGATE HOUSE S GRAND CAYMAN CJ INVESTMENT ACTIVITIES CJ N/A C 1 CAVALRY CLO IV LTD PO BOX 1093 GT QUEENSGATE HOUSE S GRAND CAYMAN CJ INVESTMENT ACTIVITIES CJ N/A C 1 GMO GLOBAL BOND INVESTMENT FUND 78 SIR JOHN ROGERSONS QUAY DUBLIN 2 EI OTHER FINANCIAL INVESTMENT ACTIVITIES EI N/A 1 HEALTH TRADITION HEALTH PLAN 1808 EAST MAIN STREET ONALASKA WI 54650 391545987 MEDICAL SERVICES COMPANY WI N/A C 1 LOBSS NETWORK SUPPORT 2002 INC 200 FIRST STREET SW ROCHESTER MN 55905 481276150 ADMINISTRATIVE SERVICES MN N/A C 1 MAYO CLINIC GBS MAURITIUS 2ND FLOOR EBENE MEWS 57 EBENE CYBERCITY MP HEALTHCARE MANAGEMENT MP N/A C 1 MAYO CLINIC SUPPORT SERVICES TEXAS 200 FIRST STREET SW ROCHESTER MN 55905 471751102 HEALTH SERVICES TX N/A C 1 MAYO HOLDING COMPANY 200 FIRST STREET SW ROCHESTER MN 55905 411578020 HOLDING COMPANY MN N/A C 1 MAYO INSURANCE COMPANY LTD 200 FIRST STREET SW ROCHESTER MN 55905 SELF INSURANCE POOL CJ N/A C 1 MCHS--DECORAH CLINIC PHYSICIANS 907 MONTGOMERY STREET DECORAH IA 52101 411711329 PATIENT CARE - CLINIC IA N/A C 1 MCHS--PHARMACY & HOME MEDICAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 391528920 PHARMACY SERVICES WI N/A C 1 MMSI INC 21 FIRST STREET SW ROCHESTER MN 55905 411547003 THIRD PARTY ADMINISTRATION SERVICES MN N/A C 1 RESOUNDANT INC 221 1ST AVE SW ROCHESTER MN 55902 461661978 MANUFACTURING MEDICAL DEVICE COMPONENT MN N/A C 1 ROCHESTER AIRPORT COMPANY ROUTE 2 ROCHESTER MN 55902 410506870 AIRPORT MANAGEMENT MN N/A C 1 SATILLA HEALTHNET INC 1900 TEBEAU STREET WAYCROSS GA 31501 582151076 HEALTH SERVICES GA N/A C 1 SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION 13400 E SHEA BLVD SCOTTSDALE AZ 85259 860870505 COMMERCIAL PROPERTY OWNERS ASSOCIATION AZ N/A C 1 THE STABILE BUILDING OWNERS' ASSOCIATION 200 FIRST STREET SW ROCHESTER MN 55905 208994499 COMMERCIAL PROPERTY OWNERS ASSOCIATION MN N/A C 1 CHARITABLE LEAD TRUST CHARITABLE TRUST CA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST ND N/A T 1 PERPETUAL TRUST CHARITABLE TRUST AZ N/A T 1 PERPETUAL TRUST CHARITABLE TRUST LA N/A T 1 PERPETUAL TRUST (2) CHARITABLE TRUST MA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST MO N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST AZ N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST CO N/A T 1 CHARITABLE REMAINDER TRUST (9) CHARITABLE TRUST FL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST LA N/A T 1 CHARITABLE REMAINDER TRUST (73) CHARITABLE TRUST MN N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST NC N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST NM N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST NV N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST NY N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST TX N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST WI N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST CO N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST IL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST MI N/A T 1 CHARITABLE REMAINDER TRUST (70) CHARITABLE TRUST MN N/A T 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 1 MAYO CLINIC HOSPITAL - ROCHESTER Q 2633327 GAAP MCHS-ALBERT LEA AND AUSTIN L 208360 GAAP MCHS-EAU CLAIRE HOSPITAL INC L 100000 GAAP MCHS-MANKATO L 216113 GAAP MMSI INC R 3774640 GAAP MMSI INC S 1266141 GAAP