2014-10-24T10:09:24-05:00 2013-12-31 990 2013-01-01 590714831 MAYO CLINIC FLORIDA MAYO 5075381297 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 MARY J HOFFMAN TREASURER 5075381297 2014-10-24 2013 2015-11-30 17:44:51Z WILLIAM C RUPP MD 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 456988382 0 5983 X WWW.MAYOCLINIC.ORG X 1982 FL OPERATION OF A HOSPITAL. 17 0 1770 167 0 0 2337645 2036596 414046145 450207583 8940 32310 4714477 4711893 421107207 456988382 152261 49928 0 0 94682088 99153627 0 0 0 280524965 281553475 375359314 380757030 45747893 76231352 449891848 540156654 225898976 239918579 223992872 300238075 X TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION, AND RESEARCH. 0 0 314752465 49928 450724768 PATIENT & COMMUNITY SERVICES (SEE SCHEDULE O)PATIENT & COMMUNITY SERVICES:MAYO CLINIC FLORIDA (MCF) IS AN ACUTE-CARE HOSPITAL LOCATED IN JACKSONVILLE, FLORIDA. MCF HAS 214 LICENSED BEDS AND PROVIDES ACUTE PATIENT CARE AND SERVICES IN MEDICAL AND SURGICAL SPECIALTIES. DURING 2013, MCF HAD OVER 1,700 EMPLOYEES AND STAFF WHO TREATED 9,500 UNIQUE INPATIENTS, PERFORMED 12,600 SURGERIES, TREATED 46,300 PEOPLE ON AN OUTPATIENT BASIS AND CARED FOR 27,100 PEOPLE IN THE EMERGENCY ROOM.MCF, IN AFFILIATION WITH MAYO CLINIC JACKSONVILLE (A RELATED MULTISPECIALTY OUTPATIENT CLINIC EXEMPT UNDER SECTION 501(C)(3) OF THE CODE), IS ONE OF THE MAIN PROVIDERS OF HEALTH CARE SERVICES IN NORTHEAST FLORIDA. MAYO CLINIC FLORIDA IS LOCATED ON THE CAMPUS OF MAYO CLINIC JACKSONVILLE (MCJ). THE AFFILIATED ORGANIZATIONS ARE OFTEN REFERRED TO AND VIEWED AS A SINGLE INTEGRATED INSTITUTION.MCF PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. FINANCIAL ASSISTANCE IS ALSO PROVIDED FOR PATIENTS THAT ARE FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. THE COST OF UNCOMPENSATED CARE PROVIDED TO LOW INCOME PATIENTS THROUGH MEDICAID WAS APPROXIMATELY $4,631,600. THE COST OF UNCOMPENSATED CARE PROVIDED TO PATIENTS THROUGH MEDICARE WAS APPROXIMATELY $9,409,500. FINANCIAL ASSISTANCE (AT COST) PROVIDED TO PATIENTS IN 2013 WAS APPROXIMATELY $4,078,100. OF THE FINANCIAL ASSISTANCE PROVIDED EACH YEAR, A PORTION OF IT GOES TO TRANSPLANT PATIENTS WHO WOULD OTHERWISE DIE WITHOUT A NEW, FUNCTIONING ORGAN.BEING CONNECTED AND INVOLVED PROVIDES AN OPPORTUNITY FOR MCJ AND MCF TO COLLABORATE WITH OTHER HEALTH SERVICE PROVIDERS TO ADDRESS THE COMMUNITY'S HEALTH CARE NEEDS AND PROVIDE ASSISTANCE TO THOSE WHO HAVE TROUBLE ACCESSING ADEQUATE MEDICAL CARE.MCF AND MCJ HAVE PARTNERED WITH OVER 30 ORGANIZATIONS TO IMPROVE THE QUALITY OF LIFE AND MAKE JACKSONVILLE AND NORTHEAST FLORIDA A HEALTHIER COMMUNITY. THESE PARTNERSHIPS HELP MCF AND MCJ DISCOVER UNMET NEEDS IN THE COMMUNITY AND DEVELOP PROGRAMS TO FULFILL THOSE NEEDS.MCF AND MCJ SUPPORT THE SULZBACHER CENTER WHICH PROVIDES COMPREHENSIVE SERVICES FOR THE HOMELESS. MCF AND MCJ PROVIDE MULTI-YEAR FINANCIAL SUPPORT AND PHYSICIAN SUPPORT TO THE SULZBACHER CENTER IN ORDER TO ASSIST THE CENTER IN PROVIDING AFTER-HOURS PRIMARY AND BEHAVIORAL HEALTH CARE TO UNINSURED PATIENTS WHO ARE HOMELESS. IN 2013, SUPPORT TOTALED $36,095, WHICH PROVIDED CARE TO 78 PATIENTS IN THE MEDICAL PROCEDURE CLINIC AND 47 PATIENTS SEEN BY MAYO PSYCHIATRISTS. ABOUT 68% OF THE SULZBACHER CENTER BEACHES CLINIC PATIENT POPULATION LIVES AT 100% OR BELOW THE FEDERAL POVERTY LEVEL.MCF AND MCJ WORK WITH THE BLOOD ALLIANCE TO OPERATE THE MAYO CLINIC BLOOD DONOR CENTER. THE CENTER IS STAFFED AND OPERATED BY THE BLOOD ALLIANCE. UNDERSTANDING THE NEED TO INCREASE BLOOD DONATION, THE MAYO SITES PROVIDE SPACE AND FURNISHINGS FOR A DONOR CENTER OPEN TO THE PUBLIC. IN 2013, THE DONOR CENTER COLLECTED 1,985 UNITS OF RED BLOOD CELLS AND 476 UNITS OF PLATELET PRODUCTS.MCF AND MCJ ARE DEDICATED TO FURTHERING MINORITY HEALTH AND WELLNESS EFFORTS AND REDUCING HEALTH DISPARITIES. THROUGH EDUCATION AND AWARENESS PROGRAMS, PERSONALIZED HEALTH CARE AND INNOVATIVE RESEARCH, MCF AND MCJ STRIVE TO ELIMINATE DISPARITIES WITHIN THE COMMUNITIES AND TO HELP PREVENT AND REDUCE ILLNESS AND DEATH IN MINORITY POPULATIONS. IN 2013, THE HEALTH DISPARITIES PROGRAM HELD SEVERAL MAJOR PROJECTS AND INITIATIVES TO BRING TOGETHER THE JACKSONVILLE COMMUNITY TO DISCUSS AND LEARN ABOUT SOLUTIONS TO SOME OF THE HEALTH DISPARITIES FACED BY THE LOCAL COMMUNITY.IN 2013, STAFF FROM MCF AND MCJ WORKED WITH LOCAL CHURCHES AND COMMUNITY ORGANIZATIONS TO BRING HEALTH EDUCATION AND SCREENINGS TO THE COMMUNITY IN 5 MAIN EVENTS THAT REACHED 300 PEOPLE. IN ADDITION, VITAMIN D EDUCATION AND FREE VITAMIN D TESTING WAS OFFERED AT VARIOUS EVENTS THROUGHOUT THE COMMUNITY. MCF AND MCJ PROVIDED ASSISTANCE FOR THE FEBRUARY 2013 GRAND OPENING OF THE CENTER FOR THE PREVENTION OF HEALTH DISPARITIES ON EDWARD WATERS COLLEGE CAMPUS, A HISTORICALLY BLACK COLLEGE. SEVERAL MAYO SPONSORED COMMUNITY EVENTS HAVE BEEN HELD AT THE CENTER. STAFF CONTINUES TO EDUCATE THE COMMUNITY ON THE IMPORTANCE OF RESEARCH PARTICIPATION AND THE IMPORTANCE OF WORKING TOGETHER TO REDUCE HEALTH DISPARITIES WITHIN THE COMMUNITY.IN 2013, MAYO CLINIC WAS THE LEAD SPONSOR FOR AN EXHIBIT ENTITLED "RACE: ARE WE SO DIFFERENT?". THE EXHIBIT WAS HELD AT THE JACKSONVILLE MUSEUM OF SCIENCE AND HISTORY (MOSH) FROM JANUARY 26 TO APRIL 28. MCF AND MCJ EMPLOYEES, VOLUNTEERS AND THEIR GUESTS WERE ENCOURAGED TO ATTEND THE EVENT AND MADE AVAILABLE FACILITATOR-LEAD GROUP DISCUSSIONS. SPECIAL EVENTS WERE HELD AT MOSH AND AT THE MCF/MCJ CAMPUSES TO ENCOURAGE PARTICIPATION. MORE THAN 1,900 MAYO EMPLOYEES AND THEIR GUESTS ATTENDED THE EXHIBIT. MOSH ALSO SCHEDULED SPECIAL PROGRAMMING TO COMPLEMENT THE EXHIBIT. MORE THAN 45,000 PEOPLE, INCLUDING 8,528 STUDENTS AND 2,169 TEACHERS AND CHAPERONES, VISITED MOSH OR ATTENDED AN EVENT DURING THE EXHIBIT.IN 2010, MCF AND MCJ, ALONG WITH SEVERAL LOCAL AGENCIES, CONTRIBUTED TO THE FORMING OF THE CAREGIVER COALITION, WHICH PROVIDES WORKSHOPS THROUGHOUT NORTHEAST FLORIDA CENTERED ON CARING FOR THE CAREGIVER. THE THIRD CAREGIVER EXPO IN 2013 HELPED EDUCATE MORE THAN 300 FAMILY CAREGIVERS. MAYO'S MEMORY DISORDER CLINIC PARTICIPATED IN SIX "CARING FOR THE CAREGIVER" WORKSHOPS IN CONJUNCTION WITH THE CAREGIVER COALITION. THESE EFFORTS REACHED ABOUT 900 FAMILY CAREGIVERS THROUGHOUT NORTHEAST FLORIDA.THROUGH THE MEMORY DISORDER CLINIC, MCF AND MCJ PROVIDED MORE THAN 265 HOURS OF TRAINING TO MORE THAN 3,800 PEOPLE IN 2013. TRAINING INCLUDED TOPICS GEARED TOWARDS HEALTHY AGING, WHEN TO WORRY ABOUT MEMORY, RESEARCH UPDATES AND STRATEGIES FOR MANAGING DEMENTIAS. STAFF ALSO PROVIDED FREE MONTHLY CLASSES FOR CAREGIVERS AND PARTNERED WITH THE CITY OF JACKSONVILLE TO PRESENT PROGRAMS ON MAINTAINING A HEALTHY LIFESTYLE. THESE EVENTS WERE ATTENDED BY MORE THAN 400 PEOPLE IN 2013.THE MEMORY DISORDER CLINIC IS THE CONTACT IN NORTHEAST FLORIDA FOR THE STATE-WIDE SILVER ALERT PROGRAM. STAFF RESPONDED TO 17 SILVER ALERTS IN 2013 AND WORKED WITH LOCAL LAW ENFORCEMENT TO ASSURE THAT PERSONS RECEIVE INFORMATION ON DRIVING ALTERNATIVES, SAFE/RETURN IDENTIFICATION BRACELETS AND RESOURCES.DURING 2013, MORE THAN 2,000 EMPLOYEES FROM BOTH MCF AND MCJ PARTICIPATED IN COMMUNITY EVENTS OR VOLUNTEERED THEIR TIME AND EXPERTISE FOR COMMUNITY PROJECTS. IN ADDITION, EMPLOYEES DONATED MORE THAN $232,000 TO THE UNITED WAY AND OTHER CHARITABLE CAUSES.EMPLOYEES OF MCF AND MCJ ARE SUPPORTERS OF THE CHILDREN'S CHRISTMAS PARTY OF JACKSONVILLE, A PROJECT THEY HAVE BEEN INVOLVED WITH FOR 12 YEARS. IN 2013, THEY HELPED RAISE $8,500 ALONG WITH A CORPORATE DONATION OF $8,000 TO BUY BICYCLES AND HELMETS FOR MORE THAN 8,600 LOW-INCOME CHILDREN WHO ATTENDED THE PARTY. OVER 75 MAYO CLINIC EMPLOYEES VOLUNTEERED FOR THE SET-UP AND ACTUAL PARTY.CULTURAL EVENTS AND THE ARTS ARE A MEASURE OF A COMMUNITY'S HEALTH AND QUALITY OF LIFE. MCF AND MCJ INTEGRATE THE ARTS INTO THEIR MEDICAL ENVIRONMENT THROUGH ITS CENTER FOR HUMANITIES IN MEDICINE, WHICH PARTNERS WITH MORE THAN A DOZEN COMMUNITY MUSEUMS, SCHOOLS, MUSIC AND ART ORGANIZATIONS. MANY PATIENTS' STAYS ARE BRIGHTENED BY LIVE MUSICAL PERFORMANCES OR WATCHING AN ARTIST BRING A CANVAS TO LIFE THROUGH THE "ART-AT-THE-BEDSIDE" AND "MUSIC-AT-THE-BEDSIDE" PROGRAMS.THE CENTER FOR HUMANITIES IN MEDICINE HAS 12 PROGRAMS THAT ARE DESIGNED FOR PATIENTS, FAMILIES, CAREGIVERS, STAFF AND COMMUNITY TO PROMOTE THE COMPASSIONATE DELIVERY OF HEALTH CARE. RESEARCH DEMONSTRATES THE BENEFITS OF ARTS IN HEALTHCARE TO IMPROVE PATIENTS' OVERALL HEALTH OUTCOMES, COMPLIANCE WITH TREATMENT, AND ENHANCE THEIR QUALITY OF LIFE.SOME OF THE PROGRAMS TAKE PLACE AT HOSPITALIZED PATIENTS' BEDSIDES. OTHERS ARE OFFERED IN SUPPORT GROUP SETTINGS. MUSIC, DANCE AND THEATRICAL PERFORMANCES TAKE PLACE IN THE ATRIUM AND LECTURE HALLS, WHILE GALLERIES ON CAMPUS HOST VISUAL ART EXHIBITIONS. IN 2013, THE CENTER PROVIDED VISUAL ART AND MUSIC PROGRAMMING THROUGHOUT THE CLINIC AND HOSPITAL THAT SERVED THOUSANDS OF PATIENTS, VISTORS AND STAFF.SOME PROGRAMS TAKE PLACE OFF-CAMPUS. "CONNECT AT THE CUMMER: ART FOR ALZHEIMER'S" ENABLES PATIENTS WITH THIS ILLNESS AND THEIR CAREGIVERS TO CONTEMPLATE AND CONNECT OVER WORKS OF ART AT A FINE ART MUSEUM, THE CUMMER MUSEUM OF ART & GARDENS. THIS PROGRAM SERVED MORE THAN 120 PATIENTS AND CAREGIVERS IN 2013. MCF RECEIVED DONATED SERVICES FROM 167 COMMUNITY VOLUNTEERS, WHO PROVIDED 28,158 HOURS IN 2013, VALUED AT APPROXIMATELY $634,960 BASED ON THE INDEPENDENT SECTOR'S AVERAGE ESTIMATED HOURLY VALUE OF SUCH SERVICES FOR 2013. 20972933 4186723 EDUCATION ACTIVITIES (SEE SCHEDULE O)EDUCATION ACTIVITIES:MCF, IN CONJUNCTION WITH MCJ, PROVIDES VARIOUS EDUCATIONAL PROGRAMS. IN 2013, 78 MEDICAL STUDENTS RECEIVED TRAINING AT THE MAYO SITES IN JACKSONVILLE. THROUGH 44 ACTIVE AND APPROVED RESIDENCY AND FELLOWSHIP PROGRAMS, A TOTAL OF 289 LEARNERS ALSO RECEIVED TRAINING AT THE MAYO SITES IN JACKSONVILLE. PARTNERSHIPS WITH LOCAL EDUCATIONAL INSTITUTIONS PROVIDED 27 EDUCATIONAL PROGRAMS SERVING 267 ALLIED HEALTH STUDENTS THROUGH THE MAYO SCHOOL OF HEALTH SCIENCES. THE ABOVE MENTIONED STUDENTS, RESIDENTS AND FELLOWS RECEIVED ALL OR A PORTION OF THEIR TRAINING AT THE MCF CAMPUS.IN 2013, PHYSICIANS AND RESEARCHERS AT MCF AND MCJ AUTHORED 552 ARTICLES PUBLISHED IN PEER-REVIEWED JOURNALS, PUBLISHED 3 BOOKS, 129 ABSTRACTS, 36 EDITORIALS AND 33 BOOK CHAPTERS.THE EDUCATIONAL MISSION OF MCF AND MCJ ALSO EXTENDS TO THE COMMUNITY. MCF AND MCJ BELIEVE THAT THEIR MEDICAL KNOWLEDGE MUST BE SHARED WITH THE COMMUNITY, PHYSICIANS AND HEALTH-CARE PROFESSIONALS. THROUGH THE MAYO CLINIC SCHOOL OF CONTINUOUS PROFESSIONAL DEVELOPMENT, HEALTH-CARE PROVIDERS RECEIVE EDUCATIONAL PROGRAMS TO UPDATE THEIR KNOWLEDGE. IN 2013, OVER 9,000 PHYSICIANS AND HEALTH-CARE PROFESSIONALS PARTICIPATED IN THESE EDUCATIONAL PROGRAMS.MCF AND MCJ ESTABLISHED A HIGH SCHOOL BOOT CAMP TO INTRODUCE STUDENTS TO CAREER OPPORTUNITIES IN MEDICINE AND SCIENCE. THE BOOT CAMP OCCURS TWICE A YEAR AND SERVES APPROXIMATELY 50 STUDENTS PER SESSION. IN 2013, 94 LOCAL HIGH SCHOOL STUDENTS PARTICIPATED. MCF AND MCJ ALSO WORKED WITH THE PERRY INITIATIVE TO INVITE 36 HIGH SCHOOL GIRLS INTERESTED IN CAREERS IN ORTHOPEDIC SURGERY AND ENGINEERING TO VISIT THE SIMULATION CENTER LOCATED ON THE MCF AND MCJ CAMPUS. THE SIMULATION CENTER HOSTED 1,072 EVENTS REACHING 7,631 LEARNERS. MANY OF THE SIMULATION ACTIVITIES INVOLVED PARTNERSHIPS WITH ACADEMIC INSTITUTIONS, MILITARY AND OTHER MEMBERS OF THE COMMUNITY. FACULTY PUBLISHED SIMULATION RELATED RESEARCH IN 6 JOURNALS IN 2013. MCF AND MCJ ALSO HOSTED ITS ANNUAL MED SCHOOL 101 EVENT FOR STUDENTS AND PARENTS TO LEARN MORE ABOUT TIPS ON GETTING INTO MEDICAL SCHOOL. IN 2013, THE EVENT HOSTED 160 ATTENDEES. IN ADDITION, MCF AND MCJ GRADUATE STUDENTS IN CANCER AND NEUROSCIENCE PARTICIPATED IN BRAIN AWARENESS EVENTS AND SERVED AS SCIENCE FAIR JUDGES AT A LOCAL SCIENCE FAIR TO AN AUDIENCE OF HUNDREDS.MCF AND MCJ ALSO PROVIDE CLINICAL AND BASIC SCIENCE RESEARCH INTERNSHIPS FOR STUDENTS FROM ACROSS THE UNITED STATES. IN 2013, THERE WERE 55 STUDENTS ENROLLED IN THE CLINICAL RESEARCH INTERNSHIP STUDY PROGRAM (CRISP) AND 7 STUDENTS ENROLLED IN THE SUMMER UNDERGRADUATE RESEARCH FELLOWSHIP (SURF), A 10-WEEK BASIC SCIENCE RESEARCH PROGRAM.ADDITIONALLY, STAFF FROM MCF AND MCJ SUPPORT VARIOUS EDUCATIONAL PROGRAMS IN PUBLIC SCHOOLS. THESE STAFF MEMBERS ASSIST VARIOUS ELEMENTARY, HIGH SCHOOLS, COMMUNITY COLLEGES AND UNIVERSITIES IN THE COMMUNITY. THE STAFF MEMBERS SERVE ON ADVISORY BOARDS, BOARDS OF TRUSTEES AND PARTICIPATE AS RESOURCE PERSONS ON A REGULAR BASIS FOR SCHOOLS, COLLEGES AND UNIVERSITIES.ONE EXAMPLE IS THE "BEYOND SCHOOL WALLS MENTORING" PROGRAM, A PARTNERSHIP OF MCF, MCJ, DUVAL COUNTY PUBLIC SCHOOLS AND BIG BROTHERS AND BIG SISTERS. UNDER THIS INNOVATIVE PROGRAM, MENTEES FROM LOCAL SCHOOLS REGULARLY COME TO MCF AND MCJ FOR STRUCTURED PROGRAMS. THE PROGRAM PROVIDES AN OPPORTUNITY TO EXPOSE HIGH SCHOOL STUDENTS TO EMPLOYMENT AND VOLUNTEER OPPORTUNITIES IN MEDICAL PRACTICE, EDUCATION AND RESEARCH. THE PROGRAM ALSO PROVIDES AN OPPORTUNITY FOR MCF AND MCJ STAFF TO MENTOR STUDENTS AND POSITIVELY IMPACT HIGH SCHOOL GRADUATION RATES IN DUVAL COUNTY PUBLIC SCHOOLS. THE PROGRAM INVOLVES 25 ADMINISTRATORS FROM MCF AND MCJ TO SERVE AS MENTORS TO 25 FLETCHER HIGH SCHOOL STUDENTS. THE PROGRAM RUNS IN PARALLEL TO THE ACADEMIC SCHOOL YEAR AND REQUIRES A TWO-YEAR COMMITMENT FROM MENTORS AND MENTEES. STUDENTS TRAVEL TO MCF AND MCJ EVERY TWO WEEKS FOR ONE-ON-ONE MENTORING SESSIONS AND GROUP SESSIONS. PROGRAM EVALUATION CRITERIA INCLUDES: ABSENTEEISM FROM SCHOOL; GRADES; INCIDENCE OF BEHAVIORAL PROBLEMS OR ACTING OUT IN SCHOOL; AND GRADUATION RATES. IN 2013, MCJ AND MCF PARTNERED WITH BIG BROTHERS AND BIG SISTERS AND THE MEDICAL SCIENCES ACADEMY AT MANDARIN HIGH SCHOOL TO EXTEND THE BEYOND SCHOOL WALLS MENTORING MODEL TO 15-25 STUDENTS ENROLLED IN THE ACADEMY. STUDENTS ARE PAIRED WITH MCF AND MCJ STAFF FOR ONE-ON-ONE MENTORING, JOB SHADOWING, AND INDUSTRY-SPECIFIC GROUP TRAINING. 335725398 1 1 0 0 0 0 0 1 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1770 1 0 0 0 0 0 0 0 0 0 0 X 17 0 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 FL X CORPORATE TAX 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 BRIGHAM ROBERT F DIRECTOR/SECRETARY/CAO 1.00 40.00 X X 0 493698 25121 BROTT MD THOMAS G DIRECTOR/PHYSICIAN 1.00 40.00 X 0 323921 15871 BUSKIRK MD STEVEN J DIRECTOR/PHYSICIAN 1.00 40.00 X 0 579437 49284 CANGEMI MD JOHN R DIRECTOR/PHYSICIAN 1.00 40.00 X 0 494662 59445 CASLER MD JOHN D DIRECTOR/PHYSICIAN 1.00 40.00 X 0 464234 59377 DAWSON MD NANCY L DIRECTOR/PHYSICIAN 1.00 40.00 X 0 265047 54340 DEVAULT MD KENNETH R DIRECTOR/PHYSICIAN 1.00 40.00 X 0 547501 53414 GONWA MD THOMAS A DIRECTOR/PHYSICIAN 1.00 40.00 X 0 338932 69610 HARRISON DEBRA A DIRECTOR/CNO 1.00 40.00 X 0 206060 13370 HOFFMAN MARY J DIRECTOR/TREAS./ASST. SECY./CFO 1.00 40.00 X X 0 306542 58815 LANGE MD STEPHEN M DIRECTOR/VICE CHAIR/PHYSICIAN 1.00 40.00 X X 0 527773 61359 MATHEWS HILARY G DIRECTOR/ASST. SECRY./DIVISION CHAIR 1.00 40.00 X X 0 281667 64062 MURRAY MD PETER M DIRECTOR/PHYSICIAN 1.00 40.00 X 0 613648 45772 O'CONNOR MD MARY I DIRECTOR/PHYSICIAN 1.00 40.00 X 0 658535 58919 PASCUAL MD JORGE M DIRECTOR/PHYSICIAN 1.00 40.00 X 0 345052 58215 RUPP MD WILLIAM C DIRECTOR/CHAIR/CEO 1.00 40.00 X X 0 948585 14846 TOMLINSON DANIEL L DIRECTOR/DIVISION CHAIR 1.00 40.00 X 0 191757 42546 BESSER ROBERT A PHARMACIST 40.00 0.00 X 153582 0 33888 BROWN THOMAS E PERFUSIONIST 40.00 0.00 X 156655 0 17452 LOUGHLIN JOSEPH G PHARMACIST 40.00 0.00 X 153910 0 34698 METCALF SUZANNE PERFUSIONIST 40.00 0.00 X 150043 0 9073 VENTRESCA ELIZABETH C PHARMACIST 40.00 0.00 X 152821 0 19015 BARTLEY MD GEORGE B FORMER CHAIR / CEO 0.00 40.00 X 0 590839 48619 JORGENSEN STEVEN C FORMER ASSISTANT SECRETARY 0.00 40.00 X 0 318115 51789 LEVENTHAL MD JACK P FORMER VICE CHAIR 0.00 40.00 X 0 300453 14695 767011 8796458 1033595 53 1 1 0 MAYO FOUNDATION FOR MEDICAL EDUCATION AN 200 FIRST STREET SW ROCHESTER MN 55905 SUPPORT SERVICES 56674887 MAYO CLINIC JACKSONVILLE 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 SUPPORT/MEDICAL SERVICES 13231081 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 SUPPORT/MEDICAL SERVICES 1454379 3 210140 1826456 2036596 NET PATIENT REVENUE 620000 446020860 446020860 EDUCATION REVENUE 611600 4186723 4186723 450207583 6253 6253 26057 0 26057 26057 26057 CAFETERIA/VENDING 722210 4703044 4703044 MISC. REVENUE 900099 8849 864 7985 4711893 456988382 454911491 0 40295 X 49928 49928 70291545 70291545 4213589 4213589 18734679 18734679 5913814 5913814 2706 2706 21709 21709 127410013 82378680 45031333 1998 1998 6710610 6710610 92215 92215 8812661 8812661 162751 162751 7912 7912 5069464 5069464 18225521 18225521 309298 309298 UNRELATED BUSINESS INCO -2407 -2407 MEDICAL SUPPLIES 95221008 95221008 BAD DEBT EXPENSE 13041699 13041699 MEDICAID SURCHARGE 6289427 6289427 176890 176890 380757030 335725398 45031632 0 8995 67193 1141 12662 85947179 100883198 5916196 7448320 1207302 716148 370875419 120621151 207911432 250254268 433939 442688 148465664 180332177 449891848 540156654 19886949 24324858 126932937 126852118 79079090 88741603 225898976 239918579 X 223759913 300032890 101790 74016 131169 131169 223992872 300238075 449891848 540156654 76231352 13851 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 0 133254 22154 155408 116313 16941 133254 112496 3817 116313 131169 11366 5765 24274 112496 152107 5795 26733 131169 0.00000 0.84400 0.15600 0 1 1 35888 35888 252422482 64594051 187828431 88918453 56027100 32891353 29498596 29498596 250254268 DUE FROM AFFILIATES 180332177 180332177 DUE TO AFFILIATES 88741603 88741603 X PART III, LINE 1A: FOOTNOTE FROM MAYO CLINIC ("THE CLINIC") CONSOLIDATED AUDITED FINANCIAL STATEMENTS: THE CLINIC PERIODICALLY RECEIVES WORKS OF ART FROM VARIOUS BENEFACTORS. THESE ITEMS ARE UNIQUE IN NATURE AND ARE HELD ON DISPLAY FOR THE BENEFIT AND ENJOYMENT OF THE CLINIC'S PATIENTS. IT IS THE CLINIC'S POLICY TO NEITHER CAPITALIZE CONTRIBUTED WORKS OF ART NOR RECORD THE RELATED CONTRIBUTION REVENUE. PART III, LINE 4: WORKS OF ART DISPLAYED ACROSS THE FILING ORGANIZATION'S CAMPUS PROVIDE BEAUTY, PRESERVATION OF HERITAGE AND RESPECT FOR THE DIVERSITY OF PATIENTS, VISITORS AND STAFF. PART V, LINE 4: THE ENDOWMENT FUNDS PROVIDE A STABLE FUNDING SOURCE FOR RESEARCH AND EDUCATION PROGRAMS. PART X, LINE 2: AT DECEMBER 31, 2013 AND 2012, 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 1 X 1 X 1 X 1 1 0 1 1 4078063 4078063 0.01110 13615157 8983546 4631611 0.01260 17693220 8983546 8709674 0.02370 20972933 4186723 16786210 0.04570 33341431 19651128 13690303 0.03720 54314364 23837851 30476513 0.08290 72007584 32821397 39186187 0.10660 0 13041699 129081809 147268097 -18186288 X 1 1 1 1 MAYO CLINIC FLORIDA 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 WWW.MAYOCLINIC.ORG 4493 X X X X MAYO CLINIC FLORIDA 1 1 X X X X X X X X 13 1 1 1 X HTTP://WWW.MAYOCLINIC.ORG/ABOUT-MAYO-CLIN X X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X X X 1 1 X X X X X 1 0 X X X X X 1 X 0 0 MAYO CLINIC FLORIDA PART V, SECTION B, LINE 3: NINE HOSPITALS [SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC. (BAPTIST MEDICAL CENTER JACKSONVILLE, BAPTIST MEDICAL CENTER SOUTH, WOLFSON CHILDREN'S HOSPITAL), BAPTIST MEDICAL CENTER OF THE BEACHES, INC., BAPTIST MEDICAL CENTER OF NASSAU, INC., MAYO CLINIC FLORIDA, ST. VINCENT'S MEDICAL CENTER RIVERSIDE, ST. VINCENT'S MEDICAL CENTER SOUTH AND UF HEALTH)]. FOUR DEPARTMENTS OF HEALTH (FLORIDA DEPARTMENTS OF HEALTH FOR CLAY COUNTY, DUVAL COUNTY, ST. JOHN'S COUNTY AND NASSAU COUNTY) CONVENED WITH THE HEALTH PLANNING COUNCIL OF NORTHEAST FLORIDA TO FACILITATE THE CHNA. EACH HOSPITAL AGREED ON ITS RESPECTIVE TARGETED COMMUNITIES BASED ON INTERNAL HOSPITAL CENSUS, EXISTING COMMUNITY BENEFIT PROGRAMS, AS WELL AS SECONDARY DATA COLLECTION. A COMMUNITY HEALTH SURVEY WAS DEVELOPED AND ADMINISTERED TO A BROAD AND VARIED RANGE OF RESIDENTS LIVING IN THE TARGETED FIVE-COUNTY COMMUNITY. THE SURVEY CONTAINED QUESTIONS REGARDING PERCEIVED QUALITY OF LIFE AND HEALTH OF THE COMMUNITY, BARRIERS TO HEALTH CARE, USE OF HEALTH CARE NEEDS AND DEMOGRAPHIC INFORMATION. THE SURVEY INCLUDED PARTICIPANTS FROM CLAY, DUVAL, NASSAU AND ST. JOHNS COUNTIES. THE INTERNET PANEL METHOD WAS USED IN ORDER TO REACH THE LARGEST POSSIBLE NUMBER OF QUALIFIED RESPONDENTS. FOCUS GROUPS AND ROUND TABLE DISCUSSIONS WERE ANOTHER METHOD USED TO TAKE INTO ACCOUNT INPUT FROM THE PERSONS WHO REPRESENT THE BROAD INTEREST OF COMMUNITY SERVED. THE ROUNDTABLE DISCUSSIONS ALLOWED FOR THE IDENTIFICATION OF THE NEEDS AND PRIORITIES OF PARTICIPANTS WHO HAVE THE KNOWLEDGE AND EXPERTISE TO INFORM THE RESEARCH. REPRESENTATIVES FROM CLAY, DUVAL, NASSAU, PUTNAM AND ST. JOHNS COUNTIES GAVE THEIR INPUT ON MULTIPLE DIMENSIONS OF THEIR COMMUNITIES, INCLUDING THE BUILT ENVIRONMENT, LOCAL ECONOMY, BARRIERS TO ACCESS AND MOTIVATION FOR HEALTHY LIVING. FOR THE SECONDARY RESEARCH, PUBLIC HEALTH RELATED DATA WAS GATHERED FROM FIVE COUNTIES. EACH COUNTY HEALTH DEPARTMENT PROVIDED AN ASSESSMENT THAT DETERMINED PUBLIC HEALTH PRIORITIES FOR THE NEXT THREE TO FIVE YEARS. THE PARTNERSHIP'S CHNA REFLECTS THE PRIORITIES IDENTIFIED IN THE HEALTH DEPARTMENT ASSESSMENTS AND ITS CORRESPONDING HEALTH IMPROVEMENT PLAN. MAYO CLINIC FLORIDA PART V, SECTION B, LINE 4: THE CHNA WAS A COLLABORATIVE EFFORT THAT INCLUDED BAPTIST HEALTH, BROOKS REHABILITATION, SHANDS JACKSONVILLE MEDICAL CENTER, ST. VINCENT'S HEALTHCARE AND WOLFSON CHILDREN'S HOSPITAL. MAYO CLINIC FLORIDA PART V, SECTION B, LINE 5D: NORTHEAST FLORIDA COUNTS WEBSITE HTTP://ASSETS.THEHCN.NET/CONTENT/SITES/HPCNEF/2012_CHNA_REPORT_FINAL.PDF MAYO CLINIC FLORIDA PART V, SECTION B, LINE 7: ONE OF THE TOP PRIORITY RISK FACTORS IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT - BUILT ENVIRONMENT (PEDESTRIAN PATHS OR NEIGHBORHOOD GROCERY STORES) - WILL NOT BE ADDRESSED DIRECTLY BY MAYO CLINIC FLORIDA DUE TO THE INABILITY TO DIRECTLY IMPACT THE ISSUE. HOWEVER, RECOGNIZING THE CENTRALITY OF OBESITY TO EACH OF THE THREE MAJOR THEMES IDENTIFIED IN THE ASSESSMENT AND SPECIFIC TO ACUTE CARE OUTCOMES, MAYO CLINIC IN FLORIDA IDENTIFIED OBESITY AS THE ORGANIZATION'S PRIMARY NEED AND DESIGNED 10 INITIATIVES SPECIFIC TO THIS FOCUS AREA AND ASSOCIATED HEALTH OUTCOMES AS PART OF ITS STRATEGIC IMPLEMENTATION PLAN. MAYO CLINIC FLORIDA PART V, SECTION B, LINE 12I: THE REGIONAL PROXIMITY OF A PATIENT'S RESIDENCY IS A FACTOR FOR PRESCHEDULED SERVICES ONLY AND SECONDARY TO MEDICAL NEED AND UNIQUENESS OF CARE. REGIONAL PROXIMITY IS NOT A FACTOR FOR EMERGENCY CARE PROVIDED. MAYO CLINIC FLORIDA PART V, SECTION B, LINE 14G: WITH REGARD TO THE POSTINGS WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED. MAYO CLINIC FLORIDA PART V, SECTION B, LINE 18E: FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE TO EVERY PATIENT VIA MAYO'S PUBLIC WEBSITE, FROM CUSTOMER SERVICE AND PATIENT ACCESS LOCATIONS, AND IS REFERENCED ON MAYO'S AUTHORIZATION FORMS AND STATEMENTS. IN ADDITION, BROCHURES ARE AVAILABLE IN THE ADMISSIONS AREA AND THE PROCESS OF HOW TO APPLY IS AVAILABLE ON THE MAYO CLINIC WEBSITE.UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, MAYO DISCUSSES ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE.MONTHLY STATEMENTS ARE SENT TO PATIENTS THAT OUTLINE CURRENT CHARGES AND ACTIONS WITH INSURANCE AND INCLUDES INFORMATION ABOUT MAYO'S CHARITY CARE POLICY. SOME MAYO SITES UTILIZE ADVOCATES TO CONTACT THE PATIENT UPON DISCHARGE TO HELP THEM SECURE GOVERNMENTAL ASSISTANCE OR FINANCIAL ASSISTANCE.EACH CHARITY CARE REVIEW IS DOCUMENTED IN MAYO'S BILLING SYSTEM AND COMMUNICATED TO THE PATIENT. COMPLETED CHARITY CARE FORMS ARE MAINTAINED EITHER IN PAPER OR ELECTRONIC FORMAT. THE PATIENT IS INFORMED REGARDING THE OUTCOME OF THE REVIEW.MAYO OFTEN IDENTIFIES CHARITY CARE OPPORTUNITIES AFTER THE PATIENT HAS BEEN DISMISSED. IN MANY CASES, THIS IS DUE TO LIMITED INSURANCE COVERAGE OR INSURANCE DENIALS AFTER THE SERVICE WAS PERFORMED. IN THESE CASES, WHEN A PATIENT EXPRESSES AN INABILITY TO PAY FOR THEIR SERVICES, STAFF WILL INITIATE A CHARITY REVIEW AS INDICATED BY THE FINANCIAL ASSISTANCE POLICY, WHICH IS AVAILABLE FOR EVERY PATIENT AT MAYOCLINIC.ORG. MAYO CLINIC FLORIDA PART V, SECTION B, LINE 20D: THE POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 50% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE. PART I, LINE 6A: THE ANNUAL REPORT FOR THE FILING ORGANIZATION IS PART OF A CONSOLIDATED REPORT PREPARED BY MAYO CLINIC. PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 13,041,699. PART III, LINE 2: THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.METHODOLOGY FOR SCHEDULE H, PART III, LINE 2:BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED IN THE ACCOUNTS RECEIVABLE FOOTNOTE OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. PART III, LINE 4: FOOTNOTES RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS CAN BE FOUND ON PAGES 5, 6, 8 AND 9 OF MAYO CLINIC'S 2013 CONSOLIDATED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SHORTFALL REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY). HOWEVER, USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY RESULTS IN A MEDICARE SHORTFALL OF APPROXIMATELY $9,409,500 AS REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS.THE MOST COMMON REASONS FOR A DIFFERENCE BETWEEN THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H AND THE MEDICARE SHORTFALL REPORTED ON THE CORE FORM, PART III INCLUDE: (1) INCLUSION OF MEDICARE ADVANTAGE REVENUE AND EXPENSES; (2) INCLUSION OF PART B REVENUE AND EXPENSES; (3) INCLUSION OF OTHER FEE SCHEDULE REVENUE; AND (4) SOME TIMING ISSUES. REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING EVERY REASONABLE ATTEMPT TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN ADDITION, MAYO CLINIC AND ITS AFFILIATES ACCEPT REASONABLE PAYMENT PLANS FROM PATIENTS WHEN AN ACCOUNT IS THE PATIENT'S RESPONSIBILITY AND TRY TO IDENTIFY THOSE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS OFFERED TO ANY PATIENT IF THE FACTS AND CIRCUMSTANCES SUGGEST THAT THE PATIENT DOES NOT HAVE THE ABILITY TO PAY THEIR BILL IN WHOLE OR IN PART. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED; INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILTY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY BASED ON SUBMISSION OF REQUESTED INFORMATION. COLLECTION ACTIVITY WOULD ONLY RESUME IF MAYO WOULD TELL THE COLLECTION AGENCY TO PURSUE COLLECTIONS ON THE BALANCE OR PARTIAL BALANCE IF THERE WAS A CHARITY ADJUSTMENT. PART VI, LINE 2: MAYO CLINIC FLORIDA (MCF) AND MAYO CLINIC JACKSONVILLE (MCJ) WORK COLLABORATIVELY IN THEIR INPATIENT AND OUTPATIENT PRACTICES TO MEET THE HEALTH CARE NEEDS OF THE LOCAL DUVAL COUNTY AND ST. JOHNS COUNTY COMMUNITIES OF ABOUT 1 MILLION RESIDENTS. IN ADDITION, MCF AND MCJ ARE PART OF A MULTI-ENTITY, INTEGRATED HEALTHCARE ORGANIZATION THAT WORKS TOGETHER TO MEET THE HEALTH CARE NEEDS OF BROADER REGIONAL, NATIONAL AND INTERNATIONAL COMMUNITIES. THESE ENTITIES ARE COLLECTIVELY REFERRED TO AS "MAYO CLINIC" FOR PURPOSES OF THIS DESCRIPTION. MAYO CLINIC'S EFFORTS TO ASSESS THE HEALTH CARE NEEDS OF THE LOCAL NORTHEAST FLORIDA COMMUNITY REST ON FOUR GUIDING PRINCIPLES DEVELOPED IN CONJUNCTION WITH COMMUNITY PARTNERS AND AFFIRMED BY MAYO CLINIC LEADERSHIP:1. HEALTH IS VALUED BY BOTH THE COMMUNITY AND MAYO CLINIC.2. "HEALTH" IS DETERMINED BY BOTH MEDICAL AND NON-MEDICAL (E.G., SOCIAL AND BEHAVIORAL) FACTORS AND BOTH CATEGORIES OF FACTORS MUST BE ADDRESSED.3. MAYO CLINIC IS COMMITTED TO PRODUCING MEASURABLE IMPROVEMENTS IN THE HEALTH OF ALL DUVAL COUNTY AND ST. JOHNS COUNTY RESIDENTS, AND BEYOND.4. STRATEGIES TO IMPROVE COMMUNITY HEALTH ARE BEST DETERMINED AND IMPLEMENTED THROUGH PARTNERSHIPS BETWEEN HEALTH CARE PROVIDERS AND COMMUNITY MEMBERS.WITH THESE PRINCIPLES AS THE BASIS OF ITS DECISION MAKING, AND CONSISTENT WITH ITS PRIMARY VALUE OF "THE NEEDS OF THE PATIENT COME FIRST," MAYO CLINIC'S APPROACH TO ASSESS THE NEEDS OF THE COMMUNITY IS ORGANIZED INTO TWO MAIN FUNCTIONS: 1) MECHANISMS TO ENGAGE AND UTILIZE INPUT FROM THE COMMUNITY AND 2) MECHANISMS TO SUPPORT AND COORDINATE INITIATIVES WITHIN MAYO CLINIC.WITHIN MAYO CLINIC, COORDINATION OF COMMUNITY ENGAGEMENT INITIATIVES IS ACCOMPLISHED THROUGH A COMMUNITY GIVING COMMITTEE, WHICH EVALUATES FUNDING AND SPONSORSHIP REQUESTS FROM COMMUNITY AGENCIES AND GUIDES INSTITUTIONAL SUPPORT FOR VARIOUS COMMUNITY INITIATIVES. THIS GROUP ENSURES THE GUIDING PRINCIPLES ARE FOLLOWED AND FACILITATES COMMUNITY OUTREACH INITIATIVES. MAYO CLINIC ALSO ATTRACTS PATIENTS FROM AREAS FAR BEYOND ITS IMMEDIATE COMMUNITIES. PATIENTS COME TO MAYO CLINIC FROM EVERY STATE AND MANY FOREIGN COUNTRIES. BESIDES ITS PRINCIPAL CLINICAL AND HOSPITAL FACILITIES IN ROCHESTER, MINNESOTA, MAYO CLINIC HAS A NETWORK OF COMMUNITY BASED HEALTH CARE PROVIDERS IN OVER 70 COMMUNITIES THROUGHOUT SOUTHERN MINNESOTA, NORTHERN IOWA, WEST CENTRAL WISCONSIN AND SOUTHEASTERN GEORGIA. IN ADDITION, MAYO CLINIC HAS FACILITIES IN SCOTTSDALE AND PHOENIX, ARIZONA AS WELL AS JACKSONVILLE, FLORIDA. MAYO CLINIC SUPPORTS AND COORDINATES EFFORTS TO IMPROVE THE HEALTH AND WELL BEING WITHIN EACH OF THE COMMUNITIES IT SERVES AS WELL AS CONDUCTING MEDICAL EDUCATION AND RESEARCH ACTIVITIES TO ADVANCE THE SCIENCE OF MEDICINE TO BENEFIT A BROAD RANGE OF REGIONAL, NATIONAL AND INTERNATIONAL COMMUNITIES. PART VI, LINE 3: MEASURES TO PUBLICIZE FINANCIAL ASSISTANCE POLICY:MAYO CLINIC IS COMMITTED TO OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY FOR THEIR MEDICAL SERVICES IN WHOLE OR IN PART. IN ORDER TO ACCOMPLISH THIS CHARITABLE GOAL, MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM SITES WIDELY PUBLICIZE THIS POLICY IN THE COMMUNITIES THAT THE INDIVIDUAL MAYO CLINIC AFFILIATED SITES SERVE. MAYO CLINIC AFFILIATED SITES MAKE COPIES OF THIS POLICY AND APPLICATIONS AVAILABLE BY POSTING IT ON THEIR WEBPAGE INCLUDING THE ABILITY TO DOWNLOAD A COPY OF THE POLICY AND APPLICATION FREE OF CHARGE. INDIVIDUALS IN THE COMMUNITY SERVED WILL BE ABLE TO OBTAIN A COPY OF THE POLICY IN LOCATIONS THROUGHOUT EACH MAYO CLINIC AFFILIATED SITE OR UPON REQUEST. THE POLICY EXPLAINS THE FINANCIAL ASSISTANCE PROGRAM AND FACTORS AFFECTING ELIGIBILITY. WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED. PART VI, LINE 4: MAYO CLINIC FLORIDA (MCF) AND MAYO CLINIC JACKSONVILLE (MCJ) ARE LOCATED IN EASTERN JACKSONVILLE, DUVAL COUNTY, FLORIDA AND TOGETHER SERVE POPULATIONS FROM JACKSONVILLE, AS WELL AS PATIENTS FROM ACROSS THE SOUTHEASTERN UNITED STATES AND INTERNATIONALLY. APPROXIMATELY 47% OF THE PATIENT POPULATION RESIDES OUTSIDE THE JACKSONVILLE METROPOLITAN AREA, AND 39% OF PATIENTS ARE COVERED BY MEDICARE. THE FILING ORGANIZATIONS EMPHASIZE COMPLEX AND DIFFICULT SPECIALTY AND TERTIARY CARE, INCLUDING ORGAN TRANSPLANTATION, NEUROLOGY, ONCOLOGY AND ORTHOPEDICS. THE ORGANIZATION DOES NOT HAVE PEDIATRIC OR OBSTETRIC PRACTICES, AND THIS LIMITS ACCESS TO MEDICAID PATIENTS SINCE FLORIDA'S MEDICAID BENEFITS ARE GENERALLY RESTRICTED TO CHILDREN AND PREGNANT WOMEN; HOWEVER, THE ORGANIZATION DOES HAVE AGREEMENTS WITH THE STATE OF FLORIDA TO PROVIDE A CERTAIN PERCENTAGE OF ORGAN TRANSPLANTS TO MEDICAID OR CHARITY PATIENTS (THE AMOUNT VARIES WITH EACH ORGAN). PART VI, LINE 5: THIS FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION - EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO CLINIC HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY - IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.SURPLUS FUNDS - MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE. COMMUNITY REPRESENTATION ON GOVERNING BODY - THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, EXPERIENCE, AND OTHER CRITERIA ESTABLISHED BY THE INDEPENDENT NOMINATING COMMITTEE OF THE BOARD OF TRUSTEES. AREAS OF EXPERTISE AND EXPERIENCE INCLUDE SUCH AREAS AS HEALTH CARE POLICY, RESEARCH, EDUCATION, BUSINESS, AND GOVERNMENT. THE FILING ORGANIZATION, WHICH IS CONTROLLED BY MAYO CLINIC, RELIES ON THE COMMUNITY REPRESENTATION OF THE MAYO CLINIC BOARD OF TRUSTEES TO FULFILL THIS REQUIREMENT. OPEN V. CLOSED STAFF MODEL - SEVERAL OF MAYO CLINIC'S HOSPITAL ENTITIES HAVE OBTAINED LETTER RULINGS APPROVING A STAFF MODEL IN WHICH ONLY MAYO CLINIC EMPLOYED PHYSICIANS ARE GIVEN STAFF PRIVILEGES IN ORDER TO MAINTAIN STANDARD METHODS OF PRACTICE AND PROTOCOLS. FOR THOSE ENTITIES, THE PHYSICIANS ARE SALARIED EMPLOYEES AND THUS THE ISSUE OF PRIVATE INUREMENT AND PRIVATE BENEFIT ADDRESSED BY THE OPEN STAFF REQUIREMENT ARE OTHERWISE ADDRESSED. THE FILING ORGANIZATION IS ONE OF THE ENTITIES WHICH OPERATES BASED ON THE CLOSED STAFF MODEL. EMERGENCY ROOM - THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK, WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY. PART VI, LINE 6: THIS ORGANIZATION IS PART OF A GROUP OF HEALTHCARE ENTITIES AFFILIATED WITH MAYO CLINIC. MAYO CLINIC IS THE FIRST AND LARGEST INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICE IN THE WORLD. DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." MORE THAN 4,000 STAFF PHYSICIANS AND SCIENTISTS, 3,400 RESIDENTS, FELLOWS, AND STUDENTS, AND 53,000 ALLIED HEALTH STAFF WORK AT MAYO CLINIC, WHICH HAS SITES IN ROCHESTER, MINNESOTA, JACKSONVILLE, FLORIDA, AND SCOTTSDALE/PHOENIX, ARIZONA, AS WELL AS A REGIONAL NETWORK OF HOSPITALS AND CLINICS IN MINNESOTA, WISCONSIN, GEORGIA AND IOWA. COLLECTIVELY, MORE THAN HALF A MILLION PEOPLE ARE TREATED EACH YEAR.SPECIFICALLY, THE FILING ORGANIZATION PROVIDES HOSPITAL SERVICES AND MEDICAL EDUCATION AT THE FLORIDA LOCATION. FOR MORE SPECIFIC DESCRIPTION, SEE THE RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O). PART VI, LINE 7 NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO A STATE HOSPITAL ASSOCIATION. 1 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 416011702 501(C)(3) 49928 CAPITAL TRANSFER 1 0 PART I, LINE 2: 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. X X 1 1 0 1 0 0 0 0 0 0 0 BRIGHAM ROBERT F DIRECTOR/SECRETARY/CAO 0 431123 0 0 0 62575 0 177 0 24944 0 518819 0 0 BROTT MD THOMAS G DIRECTOR/PHYSICIAN 0 301086 0 0 0 22835 0 141 0 15730 0 339792 0 0 BUSKIRK MD STEVEN J DIRECTOR/PHYSICIAN 0 505069 0 0 0 74368 0 34540 0 14744 0 628721 0 0 CANGEMI MD JOHN R DIRECTOR/PHYSICIAN 0 442948 0 0 0 51714 0 36601 0 22844 0 554107 0 0 CASLER MD JOHN D DIRECTOR/PHYSICIAN 0 427256 0 0 0 36978 0 33144 0 26233 0 523611 0 0 DAWSON MD NANCY L DIRECTOR/PHYSICIAN 0 261207 0 0 0 3840 0 39772 0 14568 0 319387 0 0 DEVAULT MD KENNETH R DIRECTOR/PHYSICIAN 0 483313 0 0 0 64188 0 25190 0 28224 0 600915 0 0 GONWA MD THOMAS A DIRECTOR/PHYSICIAN 0 316942 0 0 0 21990 0 42666 0 26944 0 408542 0 0 HARRISON DEBRA A DIRECTOR/CNO 0 203984 0 0 0 2076 0 50 0 13320 0 219430 0 0 HOFFMAN MARY J DIRECTOR/TREAS./ASST. SECY./CFO 0 290753 0 0 0 15789 0 28855 0 29960 0 365357 0 0 LANGE MD STEPHEN M DIRECTOR/VICE CHAIR/PHYSICIAN 0 454097 0 0 0 73676 0 36190 0 25169 0 589132 0 0 MATHEWS HILARY G DIRECTOR/ASST. SECRY./DIVISION CHAIR 0 279309 0 0 0 2358 0 36684 0 27378 0 345729 0 0 MURRAY MD PETER M DIRECTOR/PHYSICIAN 0 549965 0 0 0 63683 0 28932 0 16840 0 659420 0 0 O'CONNOR MD MARY I DIRECTOR/PHYSICIAN 0 562361 0 0 0 96174 0 32575 0 26344 0 717454 0 0 PASCUAL MD JORGE M DIRECTOR/PHYSICIAN 0 325805 0 0 0 19247 0 28724 0 29491 0 403267 0 0 RUPP MD WILLIAM C DIRECTOR/CHAIR/CEO 0 788533 0 0 0 160052 0 118 0 14728 0 963431 0 0 TOMLINSON DANIEL L DIRECTOR/DIVISION CHAIR 0 191041 0 0 0 716 0 17656 0 24890 0 234303 0 0 BESSER ROBERT A PHARMACIST 142549 0 0 0 11033 0 20384 0 13504 0 187470 0 0 0 BROWN THOMAS E PERFUSIONIST 155543 0 0 0 1112 0 11055 0 6397 0 174107 0 0 0 LOUGHLIN JOSEPH G PHARMACIST 134799 0 0 0 19111 0 21463 0 13235 0 188608 0 0 0 METCALF SUZANNE PERFUSIONIST 149488 0 0 0 555 0 7850 0 1223 0 159116 0 0 0 VENTRESCA ELIZABETH C PHARMACIST 139154 0 0 0 13667 0 11231 0 7784 0 171836 0 0 0 BARTLEY MD GEORGE B FORMER CHAIR / CEO 0 515129 0 0 0 75710 0 32256 0 16363 0 639458 0 0 JORGENSEN STEVEN C FORMER ASSISTANT SECRETARY 0 299236 0 0 0 18879 0 27451 0 24338 0 369904 0 0 LEVENTHAL MD JACK P FORMER VICE CHAIR 0 253109 0 0 0 47344 0 127 0 14568 0 315148 0 0 PART I, LINE 1A THOMAS BROWN WAS PROVIDED FIRST-CLASS TRAVEL WHICH WAS JUSTIFED BY A BUSINESS NEED (FLIGHT FOR A BUSINESS TRIP WAS CANCELED WHICH REQUIRED HIM TO RE-BOOK THE ONLY FLIGHT AVAILABLE WHICH WAS A FIRST-CLASS SEAT). THE TRAVEL WAS NOT TREATED AS TAXABLE INCOME AS THE FLIGHT WAS BUSINESS RELATED. FIRST-CLASS TRAVEL IS AVAILABLE BASED ON DEMONSTRATED BUSINESS NEED AND NOT BASED ON POSITION OR TO ANY SPECIFIC INDIVIDUALS. IN ADDITION TO ALL REGULAR TRAVEL AND DOCUMENTATION PROCESSES, FIRST-CLASS TRAVEL REQUIRES SEPARATE DOCUMENTATION OF BUSINESS NEED, APPROVAL OF SENIOR OFFICER AND OVERSIGHT REVIEW BY TRIP AND TRAVEL COMMITTEE. AS A BENEFIT TO ITS EMPLOYEES, THE FILING ORGANIZATION SUBSIDIZED EMPLOYEE MEMBERSHIPS TO THE YMCA AND SIMILIAR HEALTH/FITNESS FACILITIES. SUCH SUBSIDIES ARE AVAILABLE TO ALL EMPLOYEES AND ARE TREATED AS TAXABLE INCOME. FOR 2013, THOMAS BROWN AND SUZANNE METCALF RECEIVED THIS BENEFIT. 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). BARTLEY M.D., GEORGE B. $ 71,654 BRIGHAM, ROBERT F. $ 58,360 BROTT M.D., THOMAS G. $ 13,575 BUSKIRK M.D., STEVEN J. $ 69,952 CANGEMI M.D., JOHN R. $ 47,649 CASLER M.D., JOHN D. $ 33,717 DAWSON M.D., NANCY L. $ 2,209 DEVAULT M.D., KENNETH R. $ 61,692 GONWA M.D., THOMAS A. $ 17,839 HOFFMAN, MARY J. $ 7,646 JORGENSEN, STEVEN C. $ 8,667 LANGE M.D., STEPHEN M. $ 56,555 LEVENTHAL M.D., JACK P. $ 30,251 MATHEWS, HILARY G. $ 555 MURRAY M.D., PETER M. $ 60,246 O'CONNOR M.D., MARY I. $ 84,528 PASCUAL M.D., JORGE M. $ 16,493 RUPP M.D., WILLIAM C. $ 143,425 PART I, LINE 3 THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE THE CORE PART OF THE FORM 990, PART VI, SECTION B, LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED. PART II COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. A JACKSONVILLE ECONOMIC DEVELOPMENT COMMISSION 596000344 46936FAK4 2006-05-11 127465000 CONSTRUCTION OF HEALTH CARE FACILITIES 0 0 0 A 130491058 6330449 664147 123496462 2007 0 0 1 1 A 0 0 1 0 1 0 0.00190 0.00130 0.00320 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: JACKSONVILLE ECONOMIC DEVELOPMENT COMMISSION DATE THE REBATE COMPUTATION WAS PERFORMED: 01/04/2011 SCHEDULE K, PART II, PROCEEDS, LINE 3: FOR BOND ISSUE (A) - THE DIFFERENCE BETWEEN ISSUE PRICE IN PART I AND TOTAL PROCEEDS OF ISSUE IN PART II IS INVESTMENT EARNINGS. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: - BRIGHAM, ROBERT F. - BROTT M.D., THOMAS G. - BUSKIRK M.D., STEVEN J. - CANGEMI M.D., JOHN R. - CASLER M.D., JOHN D. - DAWSON M.D., NANCY L. - DEVAULT M.D., KENNETH R. - GONWA M.D., THOMAS A. - HARRISON, DEBRA A. - HOFFMAN, MARY J. - LANGE M.D., STEPHEN M. - MATHEWS, HILARY G. - MURRAY M.D., PETER M. - O'CONNOR M.D., MARY I. - PASCUAL M.D., JORGE M. - RUPP M.D., WILLIAM C. - TOMLINSON, DANIEL L. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: - BRIGHAM, ROBERT F. - BROTT M.D., THOMAS G. - BUSKIRK M.D., STEVEN J. - CANGEMI M.D., JOHN R. - CASLER M.D., JOHN D. - DAWSON M.D., NANCY L. - DEVAULT M.D., KENNETH R. - GONWA M.D., THOMAS A. - HARRISON, DEBRA A. - HOFFMAN, MARY J. - LANGE M.D., STEPHEN M. - MATHEWS, HILARY G. - MURRAY M.D., PETER M. - O'CONNOR M.D., MARY I. - PASCUAL M.D., JORGE M. - RUPP M.D., WILLIAM C. - TOMLINSON, DANIEL L. 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. MAYO CLINIC JACKSONVILLE ALSO PROVIDES MANAGEMENT SERVICES ON A REGIONAL BASIS THAT INCLUDES THE FILING ORGANIZATION. SINCE THE ENTITIES ARE RELATED ORGANIZATIONS, COMPENSATION FOR THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES HAS BEEN DISCLOSED IN PART VII AND SCHEDULE J AS REQUIRED. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS MAYO CLINIC JACKSONVILLE. FORM 990, PART VI, SECTION A, LINE 7A THE ELECTION OF THE MEMBERS OF THE GOVERNING BODY IS SUBJECT TO THE APPROVAL OF THE MAYO CLINIC BOARD OF GOVERNORS. FORM 990, PART VI, SECTION A, LINE 7B THE ARTICLES PROVIDE THE SOLE CORPORATE MEMBER POWER IN AREAS SUCH AS COMPENSATION, CAPITAL, BUDGET, DEBT, AND APPROVAL OF AMENDMENTS TO THE ARTICLES AND BYLAWS. 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 FILING ORGANIZATION'S TREASURER AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C MAYO CLINIC AND ITS AFFILIATES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS AND ADMINISTRATIVE LEADERSHIP. THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY IN THE FALL FOR THE NEXT YEAR'S COMPENSATION. THE SALARIES OF THE CEO, CAO, CFO AND THE VICE CHAIR WERE REVIEWED BY THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE AND/OR THE MAYO CLINIC GOVERNANCE COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR PHYSICIAN AND ADMINISTRATIVE LEADERSHIP. THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION OF PHYSICIANS AND ADMINISTRATIVE LEADERSHIP FOR THE ARIZONA, FLORIDA, AND ROCHESTER, MINNESOTA CAMPUSES. THE COMMITTEE IS COMPRISED OF MAYO EMPLOYEES, BUT IS INDEPENDENT FOR INTERNAL REVENUE CODE 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED (WITH RECUSAL WHERE APPROPRIATE). FOR THOSE INDIVIDUALS FOR WHICH THIS COMMITTEE CAN NOT SERVE AS THE INDEPENDENT REVIEW, THEIR COMPENSATION AND BENEFITS ARE REVIEWED BY THE GOVERNANCE COMMITTEE (DESCRIBED BELOW). THE SALARY AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. THE MAYO CLINIC COMMITTEE ON OFFICER SUCCESSION, COMPENSATION, AND GOVERNANCE (GOVERNANCE COMMITTEE) IS COMPRISED OF SEVEN OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. THIS GROUP REVIEWS THE COMPENSATION AND BENEFITS FOR PHYSICIANS FROM ALL CAMPUSES, INCLUDING THE MAYO CLINC HEALTH SYSTEM LOCATIONS, 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. IN ADDITION, THE GOVERNANCE COMMITTEE DIRECTLY RETAINS AN INDEPENDENT THIRD-PARTY COMPENSATION CONSULTANT TO PROVIDE RELEVANT, CONTEMPORANEOUS BENCHMARK INFORMATION FOR A SMALL GROUP OF SENIOR PHYSICIAN, ADMINISTRATIVE, AND EXECUTIVE LEADERSHIP POSITIONS FOR WHICH AN INDIVIDUALIZED REVIEW AND RECOMMENDATION IS MADE. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. THE FILING ORGANIZATION IS A HOSPITAL AFFILIATED WITH MAYO CLINIC. AS SUCH, MAYO CLINIC'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FILING ORGANIZATION'S FORM 990 AND WOULD BE AVAILABLE UPON REQUEST OF THE FORM 990. FORM 990, PART IX, LINE 11G I/C PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 71,817,556. MANAGEMENT AND GENERAL EXPENSES 45,031,333. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 116,848,889. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 10,561,123. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,561,123. 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 FRANCISCAN SKEMP FOUNDATION OF ARCADIA INC 464 SOUTH ST JOSEPH AVENUE ARCADIA WI 54612 391322480 FUNDRAISING FOUNDATION WI 501(C)(3) 9 MCHS--FRANCISCAN HEALTHCARE INC 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 -- METHODIST HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410739106 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HOSPITAL-- ROCHESTER 200 FIRST STREET SW ROCHESTER MN 55905 410944601 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 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 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 1116 WEST MILL STREET 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 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 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 WILLIAM B DREW CHARITABLE FOUNDATION TRUST PO BOX 2578 JACKSONVILLE FL 322032578 596669745 CHARITABLE TRUST FL 501(C)(3) 11-I N/A 0 DREW FOUNDATION 1234 KING STREET JACKSONVILLE FL 32204 596669745 CHARITABLE TRUST FL 501(C)(3) LINE 11A, I N/A 0 FRANKLIN HEATING STATION 119 THIRD ST SW ROCHESTER MN 55902 410264830 UTILITY MN N/A PHYSICIAN SOFTWARE SYSTEMS LLC 3333 WARRENVILLE ROAD SUITE 200 LISLE IL 60532 453414836 HEALTHCARE RELATED SOFTWARE IL N/A GMO GLOBAL BOND INVESTMENT FUND 78 SIR JOHN ROGERSONS QUAY DUBLIN 2 EI OTHER FINANCIAL INVESTMENT ACTIVITIES EI N/A 0 HEALTH TRADITION HEALTH PLAN 1808 EAST MAIN STREET ONALASKA WI 54650 391545987 MEDICAL SERVICES COMPANY WI N/A C 0 LOBSS NETWORK SUPPORT 2002 INC 200 FIRST STREET SW ROCHESTER MN 55905 481276150 ADMINISTRATIVE SERVICES MN N/A C 0 MAYO CLINIC GBS MAURITIUS 2ND FLOOR EBENE MEWS 57 EBENE CYBERCITY MP HEALTHCARE MANAGEMENT MP N/A C 0 MCHS--DECORAH CLINIC PHYSICIANS 907 MONTGOMERY STREET DECORAH IA 52101 411711329 PATIENT CARE - 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