STILLWATER MEDICAL GROUP: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- STILLWATER MEDICAL GROUP (EIN 83-0379473)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201423189349302662
- Schema version
- 2013v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T10:17:10-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135665207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 WELLS FARGO CTR 90 S 7TH | AddressLine1 |
| Address Line2 | STREET | AddressLine2 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 830379473 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STILLWATER MEDICAL GROUP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STIL | BusinessNameControlTxt |
| Phone | 9528836584 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVENUE SOUTH PO BOX 1309 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554401309 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DOUGLAS E JOHNSON | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9528836584 | PhoneNum |
| Signature | 2014-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANN LAMOUREUX | PreparerPersonNm |
| PTIN | P00691316 | PTIN |
| Phone | 6123055000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DOUGLAS E JOHNSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVENUE SOUTH PO BOX 1309 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 554401309 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $51,456,854 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STILLWATERMEDICALGROUP.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 505 | TotalEmployeeCnt |
| Total Volunteers | 1 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,292,510 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,566,795 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $43,852,723 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $49,802,312 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,898 | PYInvestmentIncomeAmt |
| CY Investment Income | -$1,278 | CYInvestmentIncomeAmt |
| PY Other Revenue | $44,762 | PYOtherRevenueAmt |
| CY Other Revenue | $23,305 | CYOtherRevenueAmt |
| PY Total Revenue | $46,193,893 | PYTotalRevenueAmt |
| CY Total Revenue | $51,391,134 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $3,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $39,957,104 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $45,256,062 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,985,199 | PYOtherExpensesAmt |
| CY Other Expenses | $13,912,951 | CYOtherExpensesAmt |
| PY Total Expenses | $52,942,303 | PYTotalExpensesAmt |
| CY Total Expenses | $59,172,013 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$6,748,410 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$7,780,879 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $31,918,395 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,541,401 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,226,243 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,491,392 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $25,692,152 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $24,050,009 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $54,185,909 | ExpenseAmt |
| Grant | $3,000 | GrantAmt |
| Revenue | $49,802,312 | RevenueAmt |
| Desc | SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS | Desc |
| Total Program Service Expenses | $54,185,909 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 505 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUG JOHNSON | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6514304581 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 927 CHURCHILL STREET WEST | AddressLine1 |
| City | STILLWATER | City |
| State | MN | State |
| ZIP Code | 55082 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| REX CATTANACH | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| ANDREW E DORWART MD | ||||||||
| CHAIR & DIRECTOR | 50.00 | Yes (X) | $459,143 | $0 | $44,230 | |||
| BRIAN H RANK MD | ||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $734,018 | $208,836 | 62.50 | ||
| JEFFREY J ROBERTSON | ||||||||
| DIRECTOR & CEO | 13.30 | Yes (X) | $0 | $548,354 | $68,616 | 36.70 | Yes (X) | |
| MARTHA SANFORD MD | ||||||||
| DIRECTOR | 52.50 | Yes (X) | $227,222 | $0 | $33,829 | 0.50 | ||
| STEPHEN M SCALLON MD | ||||||||
| DIRECTOR | 48.00 | Yes (X) | $288,516 | $0 | $21,277 | |||
| THOMAS J STORMONT MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $743,220 | $0 | $52,766 | |||
| DON WESSELL MD | ||||||||
| DIRECTOR | 50.00 | Yes (X) | $257,199 | $0 | $36,450 | |||
| DOUGLAS E JOHNSON | ||||||||
| TREASURER & CFO | 8.30 | $0 | $326,498 | $63,502 | 46.80 | Yes (X) | ||
| MATHEW RICHIE | ||||||||
| ADMINISTRATOR | 48.00 | $219,433 | $0 | $28,463 | Yes (X) | |||
| KEVIN J BJORK MD | ||||||||
| PHYSICIAN | 40.00 | $448,352 | $0 | $42,079 | Yes (X) | |||
| DAVID R HENLEY MD | ||||||||
| PHYSICIAN | 40.00 | $486,669 | $0 | $30,564 | Yes (X) | |||
| AMY C FOX MD | ||||||||
| PHYSICIAN | 40.00 | $467,366 | $0 | $27,696 | Yes (X) | |||
| ERIC J SATERBAK MD | ||||||||
| PHYSICIAN | 40.00 | $425,517 | $0 | $34,309 | Yes (X) | |||
| BENJAMIN G WILLIAMS MD | ||||||||
| PHYSICIAN | 40.00 | $473,577 | $0 | $29,347 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,496,214 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,608,870 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $721,964 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 83 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| I S S FACILITY SERVICES | |||||
| 4222 PARK GLEN RD | ST LOUIS PARK | MN | 55416 | FACILITY MAINTENANCE | $282,361 |
| MILLER EXCAVATING INC | |||||
| 3636 STAGECOACH TRAIL N | STILLWATER | MN | 55082 | CONSTRUCTION | $229,995 |
| ST PAUL RADIOLOGY | |||||
| 166 4TH ST E | ST PAUL | MN | 551011421 | RADIOLOGY PROFESSIONAL SERVICES | $156,440 |
| ENVENTIS TELECOM INC | |||||
| 2950 XENIUM LANE N STE 138 | PLYMOUTH | MN | 55441 | PROFESSIONAL NETWORK | $155,339 |
| APEX PRINT TECH | |||||
| 100 S OWASSO BLVD W | ST PAUL | MN | 55117 | STATEMENT PROCESSING | $106,136 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,421,000 | RelatedOrganizationsAmt |
| All Other Contributions | $145,795 | AllOtherContributionsAmt |
| Total Contributions | $1,566,795 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUES | 621400 | $46,497,632 | $46,497,632 |
| PHYSICIAN COVERAGE | 624410 | $3,304,680 | $3,304,680 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $49,802,312 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,278 | TotalRevenueColumnAmt |
| Exclusion | -$1,278 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $72,288 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $65,720 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,568 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,568 | TotalRevenueColumnAmt |
| Exclusion | $6,568 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $16,737 | TotalRevenueColumnAmt |
| Exclusion | $16,737 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $16,737 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $51,391,134 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $49,802,312 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $22,027 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,000 | TotalAmt |
| Program Services | $3,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,411,748 | TotalAmt |
| Program Services | $2,411,748 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,763,571 | TotalAmt |
| Program Services | $34,589,328 | ProgramServicesAmt |
| Management And General | $2,174,243 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,608,122 | TotalAmt |
| Program Services | $1,505,066 | ProgramServicesAmt |
| Management And General | $103,056 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,457,239 | TotalAmt |
| Program Services | $2,299,767 | ProgramServicesAmt |
| Management And General | $157,472 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,015,382 | TotalAmt |
| Program Services | $1,886,227 | ProgramServicesAmt |
| Management And General | $129,155 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $733,170 | TotalAmt |
| Program Services | $556,906 | ProgramServicesAmt |
| Management And General | $176,264 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,086 | TotalAmt |
| Program Services | $9,130 | ProgramServicesAmt |
| Management And General | $52,956 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,046,426 | TotalAmt |
| Program Services | $530,207 | ProgramServicesAmt |
| Management And General | $516,219 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $296,804 | TotalAmt |
| Program Services | $258,476 | ProgramServicesAmt |
| Management And General | $38,328 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,519,428 | TotalAmt |
| Program Services | $1,396,928 | ProgramServicesAmt |
| Management And General | $122,500 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,415 | TotalAmt |
| Program Services | $12,826 | ProgramServicesAmt |
| Management And General | $12,589 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,072 | TotalAmt |
| Program Services | $5,320 | ProgramServicesAmt |
| Management And General | $10,752 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,165 | TotalAmt |
| Management And General | $1,165 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,217,949 | TotalAmt |
| Program Services | $3,168,274 | ProgramServicesAmt |
| Management And General | $49,675 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $600,442 | TotalAmt |
| Program Services | $582,238 | ProgramServicesAmt |
| Management And General | $18,204 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES - MEDICAL | $4,060,797 | $4,052,895 | $7,902 |
| TAXES & ASSESSMENTS | $1,003,001 | $508 | $1,002,493 |
| MAINTENANCE & REPAIR | $561,440 | $440,175 | $121,265 |
| RECRUITMENT, TRAINING & | $428,814 | $276,866 | $151,948 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $339,942 | TotalAmt |
| Program Services | $200,024 | ProgramServicesAmt |
| Management And General | $139,918 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,172,013 | TotalAmt |
| Program Services | $54,185,909 | ProgramServicesAmt |
| Management And General | $4,986,104 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $846,310 | BOYAmt |
| EOY | $361,684 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,077,410 | BOYAmt |
| EOY | $6,069,198 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $798,175 | BOYAmt |
| EOY | $773,148 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,901 | BOYAmt |
| EOY | $26,330 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $29,503,520 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,192,479 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,178,599 | BOYAmt |
| EOY | $22,311,041 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,918,395 | BOYAmt |
| EOY | $29,541,401 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,212,049 | BOYAmt |
| EOY | $5,485,413 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,194 | BOYAmt |
| EOY | $5,979 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,226,243 | BOYAmt |
| EOY | $5,491,392 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,692,152 | BOYAmt |
| EOY | $24,050,009 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,692,152 | BOYAmt |
| EOY | $24,050,009 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,918,395 | BOYAmt |
| EOY | $29,541,401 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$7,780,879 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $6,138,736 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,742,558 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,850,607 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,775,103 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,824,510 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,566,795 | CurrentTaxYearAmt |
| Total | $14,759,573 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $40,025,219 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,837,212 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $32,822,761 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $43,852,723 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $49,802,312 | CurrentTaxYearAmt |
| Total | $188,340,227 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $45,767,777 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $25,687,819 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $34,597,864 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $45,677,233 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $51,369,107 | CurrentTaxYearAmt |
| Total | $203,099,800 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $907,322 | CurrentTaxYearAmt |
| Total | $907,322 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $907,322 | CurrentTaxYearAmt |
| Total | $907,322 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $202,192,478 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $99,638 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,457 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,282 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,898 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | -$1,278 | CurrentTaxYearAmt |
| Total | $151,997 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $99,638 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,457 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,282 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,898 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | -$1,278 | CurrentTaxYearAmt |
| Total | $151,997 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $45,867,415 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $25,736,276 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $34,599,146 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $45,681,131 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $51,367,829 | CurrentTaxYearAmt |
| Total | $203,251,797 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99480 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99870 | PublicSupportPY509Pct |
| Investment Income CY | 0.00070 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00130 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $0 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | STILLWATER MEDICAL GROUP PAYS FOR CERTAIN CORPORATE AND EMPLOYEE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $725,904 | OtherCostOrOtherBasisAmt |
| Book Value | $725,904 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,046,765 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,476,514 | DepreciationAmt |
| Book Value | $18,570,251 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $72,269 | OtherCostOrOtherBasisAmt |
| Depreciation | $17,232 | DepreciationAmt |
| Book Value | $55,037 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,658,582 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,698,733 | DepreciationAmt |
| Book Value | $2,959,849 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $22,311,041 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $51,456,854 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $51,456,854 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$65,720 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$65,720 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $51,391,134 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $59,237,733 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $65,720 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $65,720 | ExpensesNotReportedAmt |
| Expenses Subtotal | $59,172,013 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $59,172,013 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSE -65,720. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSE 65,720. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | Yes (1) | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANDREW E DORWART MD | ||||||||||||||
| CHAIR & DIRECTOR | $409,258 | $0 | $49,885 | $0 | $0 | $0 | $13,923 | $0 | $30,307 | $0 | $503,373 | $0 | $0 | $0 |
| BRIAN H RANK MD | ||||||||||||||
| DIRECTOR | $0 | $538,408 | $0 | $144,639 | $0 | $50,971 | $0 | $167,347 | $0 | $41,489 | $0 | $942,854 | $0 | $27,358 |
| JEFFREY J ROBERTSON | ||||||||||||||
| DIRECTOR & CEO | $0 | $404,065 | $0 | $144,289 | $0 | $0 | $0 | $36,722 | $0 | $31,894 | $0 | $616,970 | $0 | $0 |
| MARTHA SANFORD MD | ||||||||||||||
| DIRECTOR | $215,837 | $0 | $11,385 | $0 | $0 | $0 | $8,182 | $0 | $25,647 | $0 | $261,051 | $0 | $0 | $0 |
| STEPHEN M SCALLON MD | ||||||||||||||
| DIRECTOR | $260,807 | $0 | $25,556 | $0 | $2,153 | $0 | $9,293 | $0 | $11,984 | $0 | $309,793 | $0 | $0 | $0 |
| THOMAS J STORMONT MD | ||||||||||||||
| DIRECTOR | $700,661 | $0 | $42,559 | $0 | $0 | $0 | $18,340 | $0 | $34,426 | $0 | $795,986 | $0 | $0 | $0 |
| DON WESSELL MD | ||||||||||||||
| DIRECTOR | $242,237 | $0 | $14,962 | $0 | $0 | $0 | $10,431 | $0 | $26,019 | $0 | $293,649 | $0 | $0 | $0 |
| DOUGLAS E JOHNSON | ||||||||||||||
| TREASURER & CFO | $0 | $266,918 | $0 | $59,580 | $0 | $0 | $0 | $32,438 | $0 | $31,064 | $0 | $390,000 | $0 | $0 |
| MATHEW RICHIE | ||||||||||||||
| ADMINISTRATOR | $187,433 | $0 | $32,000 | $0 | $0 | $0 | $4,341 | $0 | $24,122 | $0 | $247,896 | $0 | $0 | $0 |
| KEVIN J BJORK MD | ||||||||||||||
| PHYSICIAN | $405,822 | $0 | $35,494 | $0 | $7,036 | $0 | $14,428 | $0 | $27,651 | $0 | $490,431 | $0 | $0 | $0 |
| DAVID R HENLEY MD | ||||||||||||||
| PHYSICIAN | $473,193 | $0 | $0 | $0 | $13,476 | $0 | $2,358 | $0 | $28,206 | $0 | $517,233 | $0 | $0 | $0 |
| AMY C FOX MD | ||||||||||||||
| PHYSICIAN | $241,010 | $0 | $0 | $0 | $226,356 | $0 | $1,008 | $0 | $26,688 | $0 | $495,062 | $0 | $0 | $0 |
| ERIC J SATERBAK MD | ||||||||||||||
| PHYSICIAN | $413,497 | $0 | $0 | $0 | $12,020 | $0 | $7,217 | $0 | $27,092 | $0 | $459,826 | $0 | $0 | $0 |
| BENJAMIN G WILLIAMS MD | ||||||||||||||
| PHYSICIAN | $463,297 | $0 | $0 | $0 | $10,280 | $0 | $14,207 | $0 | $15,140 | $0 | $502,924 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II INCLUDES AMOUNTS FROM A NONQUALIFIED 457(F) PLAN FOR THE FOLLOWING DIRECTOR: BRIAN H. RANK $ 30,313 |
| PART I, LINE 6 | STILLWATER MEDICAL GROUP'S (THE MEDICAL GROUP) OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE EMPLOYED BY THE MEDICAL GROUP, LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. (THE HOSPITAL) OR BY GROUP HEALTH PLAN, INC. (GHI). THE HOSPITAL AND GHI ARE BOTH RELATED ORGANIZATIONS. COMPENSATION REPORTED IN FORM 990, PART VIII INCLUDES ANY COMPENSATION DERIVED FROM EITHER THE MEDICAL GROUP'S, THE HOSPITAL'S, OR GHI'S MANAGEMENT INCENTIVE PROGRAMS, WHICH INCENT AND REWARD BUSINESS LEADERS WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC FISCAL YEAR. THE PROGRAMS ARE A KEY ELEMENT OF THE PARTICIPANT'S TOTAL COMPENSATION PACKAGE. THE MANAGEMENT INCENTIVE PROGRAMS' REWARDS ARE BASED ON POSITION IN THE ORGANIZATION (E.G. VICE PRESIDENT, DIRECTOR, MANAGER, OTHER SPECIFICALLY IDENTIFIED LEADERS) AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATION'S STRATEGIC PLAN AND WILL BE BALANCED. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, EMPLOYEE AND/OR LEADERSHIP DEVELOPMENT, CARE DELIVERY, PATIENT EDUCATION, SIX AIMS, MARKET SHARE, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE (NET MARGIN), ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. A NET MARGIN THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. |
| 990, SCHEDULE J, PART II: PRIOR REPORTED COMPENSATION | COLUMN (F) INCLUDES AMOUNTS PAID TO PARTICIPANTS IN THE CURRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEARS' 990'S, AS RETIREMENT AND DEFERRED COMPENSATION, FOR THE FOLLOWING DIRECTOR: BRIAN H. RANK, MD $ 27,358 ANY ANALYSIS OF EARNINGS FOR THE CURRENT YEAR, FOR THIS PARTICIPANT OF THE PLAN, SHOULD EXCLUDE THE AMOUNT IN COLUMN F AS PART OF THE ANALYSIS SINCE THOSE EARNINGS WERE ALREADY REPORTED IN COLUMN (C) OF PREVIOUS YEARS' 990'S. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 990, PART III, LINE 4A: EXEMPT PURPOSE AND ACHIEVEMENTS | STILLWATER MEDICAL GROUP (SMG), A MULTI-SPECIALTY CLINIC, IS A MINNESOTA NON-PROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) AND IS PART OF THE FAMILY OF HEALTHPARTNERS ORGANIZATIONS (HEALTHPARTNERS), AN INTEGRATED SYSTEM OF HEALTH FINANCING, CARE DELIVERY, AND SUPPORT SERVICES PROVIDING HEALTH PLAN SERVICES TO OVER 1,165,000 MEMBERS AND DELIVERING CARE TO OVER 4,500,000 PATIENT ENCOUNTERS, PRIMARILY IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTHCARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND IMPROVING AFFORDABILITY - ALL AT THE SAME TIME. HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ENTITIES - INCLUDING FIVE HOSPITALS AND THEIR RELATED FOUNDATIONS, TWO HEALTH MAINTENANCE ORGANIZATIONS, FOUR NON-PROFIT PHYSICIAN GROUPS, HOME CARE, TRANSITIONAL CARE, MEDICAL EQUIPMENT, A THIRD PARTY ADMINISTRATOR THAT SERVES SELF INSURED EMPLOYERS, AND MANY MORE. A COMPLETE LISTING OF ALL HEALTHPARTNERS ORGANIZATIONS, FOR WHICH HPI IS THE PARENT ORGANIZATION AND THE REPORTING RELATIONSHIP BETWEEN EACH OF THOSE ORGANIZATIONS, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS ALONG WITH REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, STILLWATER HEALTH SYSTEM (LAKEVIEW HEALTH), RAMSEY INTEGRATED HEALTH SERVICES AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). STILLWATER HEALTH SYSTEM (SHS) IS THE SOLE CORPORATE MEMBER OF SMG. SHS IS A MINNESOTA NON-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C) (3). SMG AND SHS ARE PART OF THE LAKEVIEW HEALTH SYSTEM ALONG WITH THE LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. (THE HOSPITAL), A MINNESOTA NON-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C) (3), AND LAKEVIEW MEMORIAL HOSPITAL FOUNDATION (THE FOUNDATION), A MINNESOTA NON-PROFIT CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C) (3). HEALTHPARTNERS AND SMG ALSO PARTNER WITH OTHER PLANS, CARE PROVIDERS AND NON-PROFIT ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION; TO INCREASE ACCESS, CREATE AND DISSEMINATE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY AND COLLABORATE ON SYSTEM IMPROVEMENTS. TOTAL CHARITY CARE PROVIDED (CALCULATED AT COST) WAS $399,586 DURING THIS REPORTING PERIOD. SMG CONTINUES TO WORK IN PARTNERSHIP WITH OTHER HEALTHPARTNERS ORGANIZATIONS AND THE COMMUNITY TO PROMOTE COMMUNITY HEALTH THROUGH CLINICAL INITIATIVES, EDUCATION AND OUTREACH, AND COMMUNITY HEALTH IMPROVEMENT EFFORTS SUCH AS THE POWER-UP PROGRAM. SMG CONTINUES TO BE AN INTEGRAL PART OF THE STILLWATER COMMUNITY AND SURROUNDING AREA. SMG OFFERS PRIMARY AND SPECIALTY SERVICES WITH MEDICAL CLINICS LOCATED IN STILLWATER, OAK PARK HEIGHTS AND MAHTOMEDI, MN AND SOMERSET, WI. IN ADDITION, SMG PROVIDES OUTREACH SPECIALTY SERVICES TO WHITE BEAR LAKE, MN AND HUDSON, NEW RICHMOND AND OSCEOLA, WI. SMG OFFERS URGENT CARE, FAMILY PRACTICE, EMERGENCY MEDICINE, HOSPITALIST, INTERNAL MEDICINE, NEUROLOGY, PEDIATRICS, OB/GYN, GENERAL SURGERY, PODIATRY, DERMATOLOGY, ENT, AUDIOLOGY, OCCUPATIONAL HEALTH, RETAIL MEDICINE, SPORTS MEDICINE, ENDOCRINOLOGY, UROLOGY, ONCOLOGY AND CARDIOLOGY MEDICAL SERVICES. IN ADDITION TO PROFESSIONAL SERVICES, SMG ALSO OFFERS LAB, IMAGING, HEARING AIDS, RETAIL PHARMACY AND PHYSICAL THERAPY ANCILLARY SERVICES. SMG CONTINUES ITS OPTIMIZATION OR EPIC ELECTRONIC MEDICAL RECORD (EHR) SYSTEM TO IMPROVE HEALTHPARTNERS' REGIONAL NETWORK AND ADVANCE QUALITY AND EXPERIENCE FOR PATIENTS, CLINICIANS AND MEDICAL STAFF, AND REDUCE HEALTH CARE COSTS. SMG HOSTS AND SPONSORS THE FOLLOWING COMMUNITY EVENTS: 1) COMMUNITY VEGGIE GIVEAWAY, FRESH VEGETABLES GROWN FROM LOCAL PRODUCERS ARE GIVEN TO COMMUNITY MEMBERS AT ALL CLINIC CAMPUSES. APPROXIMATE COSTS FOR VEGETABLES GIVEN AWAY - 2011 - $2,800 - 2012 - $2,900 - 2013 - $5,337 - 2014 - $3,000 (NOTE: LEFTOVER PRODUCE FROM GIVEAWAYS GO TO LOCAL COMMUNITY FOOD SHELVES). 2) HOPS FOR HEALTH IS AN ANNUAL MEN'S HEALTH BENEFIT TO COMMUNITY MEMBERS INCLUDING FREE BLOOD PRESSURE AND BLOOD SUGAR CHECKS AND THE OPPORTUNITY TO TALK WITH PROVIDERS ABOUT MEN'S HEALTH ISSUES 3) PARTICIPATION IN POWER UP CANDY TRADE IN WHEN COMMUNITY MEMBERS CAN TRADE IN CANDY FOR HEALTHY PRIZES. 4) PARTICIPATION IN RED CROSS BLOOD DRIVES TWO TIMES PER YEAR HOSTED AT THE MAIN CLINIC FOR STAFF AND COMMUNITY DONATIONS 5) LADIES NIGHT OUT IS AN ANNUAL WOMEN'S HEALTH BENEFIT TO COMMUNITY MEMBERS INCLUDING FREE BLOOD PRESSURE AND BLOOD SUGAR CHECKS, SCHEDULE MAMMOGRAMS AND THE OPPORTUNITY TO TALK WITH PROVIDERS ABOUT WOMEN'S HEALTH ISSUES 6) COMMUNITY APPRECIATION EVENT IS AN ANNUAL COMMUNITY HEALTH BENEFIT TO COMMUNITY MEMBERS INCLUDING FREE BLOOD PRESSURE AND BLOOD SUGAR CHECKS, HEARING AND VEIN SCREENINGS AND THE OPPORTUNITY TO TALK WITH PROVIDERS, DIETICIANS AND PHARMACISTS. 7) PARTNERSHIP WITH POWER UP FOR CHILDREN ACTIVITIES AND HEALTHY FOOD CHOICES. 8) HOUSE PRESCRIPTION ASSISTANCE PROGRAM 9) COMMUNITY CLASSES: - LIVING WITH HEARING LOSS: STRATEGIES AND TECHNOLOGY - MELANOMA SKIN CANCER - BLADDER TREATMENTS - TAI CHI FOR ARTHRITIS - VARICOSE VEIN SCREENINGS - ADVANCED DIRECTIVES - MENOPAUSE - HEART DISEASE: WHAT EVERY WOMAN SHOULD KNOW - PROSTATE HEALTH - DIABETES SUPPORT GROUP - SPORTS MEDICINE FOR PERFORMING ARTISTS - UNDERSTANDING YOUR THYROID - WINTER BLUES BUSTERS - KIDNEY STONES - 10 THINGS TO KNOW - DOES YOUR MAN HAVE A PROSTATE ISSUE? - POST-PARTUM SUPPORT GROUP - MANAGING DEPRESSION - LIVING WITH HEARING LOSS - THAT RINGING IN YOUR EARSMANAGING TINNITUS - COMMON FOOT PROBLEMS - MIND, BODY SILLS FOR CANCER PATIENTS - THE HEALTHY AGING BRAIN - TAKE A BITE OUT OF LYME DISEASE |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER IS STILLWATER HEALTH SYSTEM. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBER HAS THE POWER TO RATIFY APPROVE AND REMOVE ALL MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE MEMBER HAS RESERVED TO ITSELF THE FOLLOWING POWERS CONCERNING THE GOVERNANCE OF THE CORPORATION: 1. RATIFICATION, APPROVAL AND REMOVAL ALL MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE. 2. APPROVAL OF ANY MISSION OR VISION STATEMENT OR STATEMENT OF CORPORATE PURPOSE ADOPTED BY THE ORGANIZATION. 3. APPROVAL OF THE ORGANIZATION'S STRATEGIC PLANS, CAPITAL BUDGETS, OPERATING BUDGETS AND FINANCIAL POLICIES. 4. APPROVAL OF ANY PLANS OF MERGER OR CONSOLIDATION BY THE ORGANIZATION WITH ANY FOREIGN OR DOMESTIC ORGANIZATION VOLUNTARY DISSOLUTION OF THE ORGANIZATION, OR SALE, LEASE OR TRANSFER OF THE ORGANIZATION'S REAL ESTATE OR A SIGNIFICANT PORTION OF THE OPERATIONS OR ASSETS OF THE ORGANIZATION. 5. APPROVAL OF THE GRANT OF A SECURITY INTEREST IN ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS, OR THE INCURRENCE OF INDEBTEDNESS OR THE GUARANTEE OF ANY INDEBTEDNESS. 6. APPROVAL OF INDIVIDUAL CAPITAL EXPENDITURES BY THE ORGANIZATION, WHETHER BUDGETED OR UNBUDGETED, IN EXCESS OF $500,000. 7. RATIFICATION OF SELECTION AND EVALUATION, AND TERMINATION, OF THE PRESIDENT OF THE ORGANIZATION. 8. APPROVAL OF PHYSICIAN, EMPLOYEE AND EXECUTIVE COMPENSATION PLANS FOR THE ORGANIZATION, INCLUDING CRITERIA FOR INCENTIVE COMPENSATION ARRANGEMENTS. 9. APPROVAL OF ALL SUBSTANTIVE AFFILIATIONS BETWEEN THE ORGANIZATION AND A THIRD PARTY. 10. APPROVAL OF CONFLICTS OF INTEREST POLICIES FOR THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11 | SMG'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF SMG. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF SMG, GHI'S INTERNAL LEGAL DEPARTMENT AND SMG'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF SMG. SMG MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY WILL BE PROVIDED IN A MAILING TO THE BOARD MEMBERS PRIOR TO THE FILING OF THE 990. EACH BOARD MEMBER WILL HAVE AN OPPORTUNITY TO COMMENT OR ASK QUESTIONS ABOUT THE 990 BEFORE IT IS FILED. THIS PROCESS WILL BE NOTED AND DOCUMENTED IN A WRITTEN MEMO IN THE FILES OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | SMG'S BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES PURSUANT TO IT'S CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS AND OFFICERS ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND REQUIRED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNSEL REVIEWS THE COMPLETED QUESTIONNAIRES AND PROVIDES A REPORT TO THE GOVERNANCE COMMITTEE OF THE BOARD. THE REPORT IDENTIFIES ANY SIGNIFICANT POTENTIAL CONFLICTS DISCLOSED IN THE COMPLETED QUESTIONNAIRES. A WRITTEN REPORT IS PROVIDED TO THE CHAIR AND CHIEF EXECUTIVE OFFICER (CEO). BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMINING OFFICERS' COMPENSATION INCLUDES A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION. EACH YEAR, UNDER THE DIRECTION OF THE LAKEVIEW HEALTH SYSTEM'S COMPENSATION COMMITTEE, AN ANNUAL TOTAL COMPENSATION MARKET REVIEW IS COMPLETED TO PROVIDE A COMPREHENSIVE MARKET REVIEW FOR THE FOLLOWING EXECUTIVE POSITIONS WITHIN LAKEVIEW HEALTH SYSTEM CEO, SYSTEM CFO, CLINIC PRESIDENT, CLINIC ADMINISTRATOR, AND HOSPITAL PRESIDENT. THE COMPENSATION COMMITTEE RETAINS AN INDEPENDENT EXECUTIVE CONSULTING FIRM TO PROVIDE A REVIEW OF ALL COMPONENTS OF COMPENSATION INCLUDING BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. UNDER THE COMMITTEE'S DIRECTION, THE GHI HUMAN RESOURCES DEPARTMENT USED THE SAME RECOGNIZED THIRD PARTY SALARY SURVEYS TO DETERMINE MEDIAN SALARY STRUCTURE CHANGES. BASED ON THIS UPDATED DATA, THE COMMITTEE LEARNED THE COMPENSATION RATES THAT ARE CONSIDERED P50 TO P60 OF THE MARKET FOR COMPARABLE LAKEVIEW POSITIONS. OTHER CONSIDERATIONS OF THE COMMITTEE INCLUDE: ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES, INDIVIDUAL PERFORMANCE, EXPERIENCE, SUBJECTIVE EVALUATION BY BOARD MEMBERS, GENERAL ECONOMIC CONDITIONS, COSTS OF REPLACEMENT, PREVAILING COMMUNITY ATTITUDES AND BELIEFS REGARDING COMPENSATION. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND W2 STATEMENTS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CLINIC'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM THE CLINIC OR HEALTHPARTNERS, INC.. THE CLINIC'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE MINNESOTA SECRETARY OF STATE'S OFFICE. |
| 990, PART VII, SEC A, LINE 1A, COL B: AVERAGE HOURS - RELATED ORGANIZATIONS | THE COMPENSATED BOARD MEMBERS AND OFFICERS FREQUENTLY DEVOTE THEIR TIME TO MULTIPLE RELATED ORGANIZATIONS IN A PARTICULAR WEEK. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. |
| FORM 990, PART XI, LINE 9: | NET ASSET TRANSFER FROM LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. 6,100,000. NET ASSET TRANSFER LAKEVIEW MEMORIAL HOSPITAL FOUNDATION 38,738. REPORT ROUNDING -2. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411693838 | HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(4) | N/A | Yes (1) | ||
| HPI - RAMSEY | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411793333 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | Yes (1) | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| GROUP HEALTH PLAN INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410797853 | STAFF MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(3) | Yes (1) | 170(B)(1) (A)(III) | HEALTHPARTNERS INC | |
| HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411670163 | HEALTHCARE RESEARCH | MN | 501(C)(3) | Yes (1) | 509(A)(3) TYPE I | GROUP HEALTH PLAN INC | |
| CAPITOL VIEW TRANSITIONAL CARE CENTER | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 412011453 | POST HOSPITALIZATION PATIENT CARE | MN | 501(C)(3) | Yes (1) | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410956618 | HOSPITAL | MN | 501(C)(3) | Yes (1) | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411888902 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | MN | 501(C)(3) | Yes (1) | 170(B)(1) (A)(VI) | HPI - RAMSEY | |
| RHSC INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411891928 | HEALTHCARE STAFFING | MN | 501(C)(3) | Yes (1) | 509(A)(3) TYPE II | HEALTHPARTNERS INC | |
| RH-WISCONSIN | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 202287016 | CORPORATE PLANNING AND OVERSIGHT | WI | 501(C)(3) | Yes (1) | 509(A)(3) TYPE II | HPI - RAMSEY | |
| PHYSICIANS NECK AND BACK CLINICS | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 270684883 | SPECIALTY PATIENT CARE | MN | 501(C)(3) | Yes (1) | 509(A)(3) TYPE II | GROUP HEALTH PLAN INC | |
| HUDSON HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390804125 | HOSPITAL | WI | 501(C)(3) | Yes (1) | 170(B)(1) (A)(III) | RH-WISCONSIN & GROUP HEALTH PLAN INC | |
| HUDSON HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391279567 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | WI | 501(C)(3) | Yes (1) | 170(B)(1) (A)(VI) | HUDSON HOSPITAL INC | |
| WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 263616590 | PROVIDE MEDICAL TRANSPORT SERVICES | WI | 501(C)(3) | Yes (1) | 509(A)(3) TYPE II | RH-WISCONSIN | |
| LAKEVIEW MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411386635 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | MN | 501(C)(3) | Yes (1) | 509(A)(3) TYPE II | STILLWATER HEALTH SYSTEM | |
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410811697 | HOSPITAL | MN | 501(C)(3) | Yes (1) | 170(B)(1) (A)(III) | STILLWATER HEALTH SYSTEM | |
| STILLWATER HEALTH SYSTEM | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 300221189 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | Yes (1) | 509(A)(3) TYPE II | HPI - RAMSEY | |
| WESTFIELDS HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390808442 | HOSPITAL | WI | 501(C)(3) | Yes (1) | 170(B)(1) (A)(III) | RH-WISCONSIN & GROUP HEALTH PLAN INC | |
| WESTFIELDS HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391770913 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | WI | 501(C)(3) | Yes (1) | 509(A)(3) TYPE I | WESTFIELDS HOSPITAL INC | |
| RAMSEY INTEGRATED HEALTH SERVICES | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411503090 | IN-HOME PATIENT CARE | MN | 501(C)(3) | Yes (1) | 509(A)(2) | HPI - RAMSEY | |
| PARK NICOLLET HEALTH SERVICES | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 363465840 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | Yes (1) | 509(A)(2) TYPE III | HEALTHPARTNERS INC | |
| PARK NICOLLET FOUNDATION | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 237346465 | GRANTS TO SERVE THE COMMUNITY | MN | 501(C)(3) | Yes (1) | 170(B)(1) (A)(VI) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET METHODIST HOSPITAL | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410132080 | HOSPITAL | MN | 501(C)(3) | Yes (1) | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET INSTITUTE | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410961862 | HEALTHCARE RESEARCH | MN | 501(C)(3) | Yes (1) | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET HEALTH CARE PRODUCTS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 010638901 | HEALTHCARE PRODUCTS | MN | 501(C)(3) | Yes (1) | 509(A)(3) TYPE II | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET CLINIC | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410834920 | HEALTHCARE | MN | 501(C)(3) | Yes (1) | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PNMC HOLDINGS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 411741792 | HEALTHCARE REAL ESTATE | MN | 501(C)(3) | Yes (1) | 509(A)(3) TYPE I | PARK NICOLLET CLINIC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS ADMINISTRATORS INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411629390 | THIRD PARTY ADMINISTRATOR | MN | HEALTHPARTNERS INC | C | Yes (1) |
| HEALTHPARTNERS ASSOCIATES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 522365151 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | Yes (1) |
| HEALTHPARTNERS SERVICES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683568 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | Yes (1) |
| HEALTHPARTNERS VENTURES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411838197 | DEVELOP HEALTHCARE BUSINESS OPPORTUNITIES | MN | HEALTHPARTNERS INC | C | Yes (1) |
| HEALTHPARTNERS INSURANCE COMPANY | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683523 | MEDICAL AND DENTAL INSURANCE | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | Yes (1) |
| DENTAL SPECIALTIES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 451297583 | DENTAL CLINIC STAFFING | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | Yes (1) |
| HEALTHPARTNERS CENTRAL MINNESOTA CLINICS | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411236798 | MEDICAL CLINIC STAFFING AND MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | Yes (1) |
| PARK NICOLLET ENTERPRISES | |||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 411656735 | REAL ESTATE FOR RELATED ORGANIZATIONS | MN | PARK NICOLLET HEALTH SERVICES | C | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHPARTNERS INC - CLAIMSHEALTHCARE SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | L | TransactionTypeTxt |
| Involved | $1,720,854 | InvolvedAmt |
Comments