PARK NICOLLET HEALTH SERVICES: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
PARK NICOLLET HEALTH SERVICES (EIN 36-3465840)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-14
IRS object ID
201433189349303883
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

FieldValueIRS element (for citing)
Return2014-11-14T11:24:10-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135665207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14200 WELLS FARGO CENTER 90 S 7THAddressLine1
Address Line2STREETAddressLine2
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN363465840EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PARK NICOLLET HEALTH SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlPARKBusinessNameControlTxt
Phone9529933108PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BOULEVARDAddressLine1
CityST LOUIS PARKCity
StateMNState
ZIP Code55426ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCATHERINE LENAGHPersonNm
Person TitleCFOPersonTitleTxt
Phone9529933108PhoneNum
Signature2014-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANN LAMOUREUXPreparerPersonNm
PTINP00691316PTIN
Phone6123055000PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCATHERINE LENAGHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BLVDAddressLine1
CityST LOUIS PARKCity
StateMNState
ZIP Code55426ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$93,887,050GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PARKNICOLLET.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1986FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionIS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITYActivityOrMissionDesc
Voting Members Governing Body21VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee9577TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$88,826TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$94,377,481PYProgramServiceRevenueAmt
CY Program Service Revenue$93,779,238CYProgramServiceRevenueAmt
PY Investment Income-$1,061,647PYInvestmentIncomeAmt
CY Investment Income-$1,028CYInvestmentIncomeAmt
PY Other Revenue-$34,642PYOtherRevenueAmt
CY Other Revenue$23,583CYOtherRevenueAmt
PY Total Revenue$93,281,192PYTotalRevenueAmt
CY Total Revenue$93,801,793CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$18,450,743PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,786,933CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$71,769,304PYOtherExpensesAmt
CY Other Expenses$75,061,688CYOtherExpensesAmt
PY Total Expenses$90,220,047PYTotalExpensesAmt
CY Total Expenses$89,848,621CYTotalExpensesAmt
PY Revenues Less Expenses$3,061,145PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,953,172CYRevenuesLessExpensesAmt
Total Assets BOY$180,813,556TotalAssetsBOYAmt
Total Assets EOY$123,234,379TotalAssetsEOYAmt
Total Liabilities BOY$183,173,040TotalLiabilitiesBOYAmt
Total Liabilities EOY$123,194,564TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$2,359,484NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$39,815NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOUR MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$16,946,546ExpenseAmt
Revenue$18,009,578RevenueAmt
DescPARK NICOLLET HEALTH SERVICES, IN ADDITION TO BEING A SUBSIDIARY OF HEALTHPARTNERS, IS THE PARENT IN A SYSTEM OF RELATED HEALTHCARE ORGANIZATIONS INCLUDING, PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PARK NICOLLET HEALTH CARE PRODUCTS, PARK NICOLLET INSTITUTE, AND TRIA ORTHOPAEDIC CENTER. PARK NICOLLET HEALTH SERVICES IS EMPLOYING AND SOURCING SENIOR LEADERS TO ITS SUBSIDARIES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$60,691,492ExpenseAmt
Revenue$75,729,507RevenueAmt
DescTRIA ORTHOPAEDIC CENTER IS A LIMITED LIABILITY COMPANY THAT IS FULLY OWNED BY PARK NICOLLET HEALTH SERVICES, A NONPROFIT INTEGRATED CARE DELIVERY SYSTEM. TRIA ORTHOPAEDIC CENTER IS A LEADER IN ORTHOPAEDIC TREATMENT, PROVIDING COMPREHENSIVE CARE FROM DIAGNOSIS, TO TREATMENT, TO REHABILITATION, EVEN SURGERY AT ONE CONVENIENT LOCATION IN BLOOMINGTON, MINNESOTA. TRIA ORTHOPAEDIC CENTER HAS OVER 40 HIGHLY-TRAINED ORTHOPAEDIC DOCTORS WITH A VARIETY OF SUB-SPECIALTIES SUCH AS SPORTS MEDICINE, ACUTE INJURY, SHOULDER, KNEE, SPINE, HAND AND WRIST, FOOT AND ANKLE, HIP AND FRACTURES. FOR IMMEDIATE ORTHOPAEDIC NEEDS, TRIA OFFERS WALK-IN CARE SEVEN DAYS A WEEK THROUGH THE ACUTE INJURY CLINIC, WITH NO APPOINTMENT NEEDED. TRIA'S SPORTS MEDICINE SPECIALISTS HAVE SERVED AS OFFICIAL TEAM PHYSICIANS FOR MINNESOTA'S PRO SPORTS TEAMS FOR OVER 25 YEARS. TRIA ORTHOPAEDIC CENTER'S MISSION IS TO PROVIDE OUR PATIENTS AND COMMUNITY WITH EXCEPTIONAL ORTHOPAEDIC CARE AND SERVICES SUPPORTED BY INNOVATIVE EDUCATION AND RESEARCH. OUR VISION IS TO BECOME THE NATIONAL LEADER IN PROVIDING MUSCULOSKELETAL CARE, DRIVING INNOVATION IN IMPROVING HEALTH CARE.CORE VALUESPATIENTS:OUR PATIENTS COME FIRSTPEOPLE:OUR PEOPLE ARE OUR GREATEST ASSETORTHOPAEDICS:ORTHOPAEDICS IS OUR FOCUSRESEARCH:RESEARCH IS FUNDAMENTAL TO IMPROVING PATIENT CAREEDUCATION:EDUCATION ENHANCES OUR PROFESSION AND PATIENT CAREGROWTH:SUSTAINABLE GROWTH CREATES VALUECOMMUNITY:WE WILL BE A GOOD NEIGHBOR IN OUR COMMUNITYCOMMUNITY SERVICES SUMMARYANNUALLY, TRIA TRAINS THREE SPORTS MEDICINE FELLOWS. APPROXIMATELY 30 MEDICAL SCHOOL STUDENTS, AND 50 RESIDENTS ROTATE THROUGH TRIA EACH YEAR.TRIA CONTINUES TO LEAD THE WAY IN OUTCOMES MEASUREMENT. PATIENT COMPLETE EXTENSIVE PRE AND POST SURVEYS TO ASSESS FUNCTIONAL OUTCOMES ON EIGHT DIFFERENT PROCEDURE TYPES. SOME OF TRIA'S PATIENT REGISTRIES ARE NOW AMONGST THE MOST EXTENSIVE IN THE INDUSTRY. EVERY TUESDAY MORNING TRIA PROVIDES PROFESSIONAL EDUCATION SESSIONS FOR OUR STAFF, FELLOWS, CLINICAL STAFF IN THE AREA, AND NUMEROUS STUDENTS, AND RESIDENTS TRIA'S ANNUAL ORTHOPAEDIC & SPORTS MEDICINE CONFERENCE DREW OVER 200 PROFESSIONALS.THE TRIA INSTITUTE PROVIDES SEVERAL SESSIONS OF A "DAY IN THE LIFE OF AN ORTHOPAEDIC PROVIDER PROGRAM." THIS EDUCATIONAL PROGRAM IS FOR STUDENTS IN OUR COMMUNITY THAT WOULD LIKE TO LEARN MORE ABOUT THE HEALTHCARE PROFESSION, SPECIFICALLY ORTHOPAEDICS, AND INCLUDES THE SHADOWING OF TRIA CLINICIANS.OVER 175 FREE HIGH SCHOOL PHYSICALS WERE PROVIDED FOR AREA HIGH SCHOOL ATHLETES PRIOR TO THE FALL SEASON. ADDITIONAL PHYSICALS WERE SUBSIDIZED FOR THE STUDENT ATHLETES AT DAKOTA COUNTY TECHNICAL COLLEGE AND HOCKEY PLAYERS FOR THE MINNESOTA MAGICIANS JUNIOR HOCKEY TEAM.TRIA PROVIDED MEDICAL COVERAGE FOR NUMEROUS MAJOR SPORTING EVENTS IN THE COMMUNITY IN THE PAST YEAR INCLUDING THE U.S. POND HOCKEY CHAMPIONSHIPS AT LAKE NOKOMIS IN JANUARY AND THE NATURE VALLEY GRAND PRIX BICYCLE FESTIVAL IN ST. PAUL, MINNEAPOLIS, CANNON FALLS, MENOMONIE, WI AND STILLWATER IN JUNE.TRIA EMPLOYEES RAISE MONEY FOR THOSE IN NEED THROUGH THE JEANS FOR A CAUSE PROGRAM. EMPLOYEES WHO CONTRIBUTE $5 ARE ALLOWED TO WEAR JEANS ON FRIDAYS. THE WEARING OF JEANS FOR THE CAUSE BUTTONS SIGNIFIES THE FUND RAISING ASPECT OF THE PROGRAM TO PATIENTS. OVER $5000 WAS RAISED FOR COMMUNITY CHARITIES THROUGHOUT THE YEAR.TRIA TEAM MEMBERS PARTICIPATE IN VOLUNTEER ACTIVITIES INCLUDING PACKING FOOD FOR THE SECOND HARVEST FOOD SHELF. THEY ALSO ARE INVOLVED IN BOTH THE TOY AND SCHOOL SUPPLY DRIVES FOR VOLUNTEERS ENLISTED TO ASSIST PEOPLE (VEAP) WHICH IS A BLOOMINGTON-BASED NON-PROFIT ORGANIZATION SUPPORTING LOW INCOME RESIDENTS IN SURROUNDING COMMUNITIES.TRIA PROVIDED FREE SCREENING AND EDUCATIONAL SUPPORT FOR THE MEDICA LABORCARE HEALTH FAIR AT TARGET FIELD AND FOR HUNDREDS OF PEOPLE AT THE PREP 45 DAY EVENT AT THE MINNESOTA STATE FAIR.TRIA'S PHYSICIANS AND PROFESSIONAL STAFF, INCLUDING PHYSICAL THERAPISTS AND HAND THERAPISTS, FREQUENTLY SPEAK TO COMMUNITY GROUPS. THIS PAST YEAR 16 SUCH SESSIONS WERE PROVIDED.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$77,638,038TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document102IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee9577EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Excess Business Holdings0ExcessBusinessHoldingsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members21GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldNCStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CATHERINE LENAGHBusinessNameLine1
FieldValueIRS element (for citing)
Phone9529933108PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BOULEVARDAddressLine1
CityST LOUIS PARKCity
StateMNState
ZIP Code55426ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeInd
PARK NICOLLET GROUP RETURN -SEE SCH
DIRECTORS30.00Yes (X)$0$2,804,300$0
PARK NICOLLET GROUP RETURN -SEE SCH
OFFICERS55.00$10,096,469$1,832,196$409,715Yes (X)
PARK NICOLLET GROUP RETURN -SEE SCH
HIGHEST COMPENSATED EMPLOYEES1.00$0$4,056,896$055.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$10,096,469TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$8,693,392TotReportableCompRltdOrgAmt
Total Other Compensation$409,715TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K29IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICES621400$75,722,183$75,722,183
SERVICES TO AFFILIATES EXEMPT ORG561000$14,109,171$14,109,171
PREMIER PURCHASING900099$3,947,884$3,900,428$47,456
FieldValueIRS element (for citing)
Total Program Service Revenue$93,779,238TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,279TotalRevenueColumnAmt
Exclusion$11,279ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$18,849RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$43,960RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$25,111RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$25,111TotalRevenueColumnAmt
Exclusion-$25,111ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$28,990OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$41,297OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$12,307OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$12,307TotalRevenueColumnAmt
Exclusion-$12,307ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS SERVICESDesc
Business541900BusinessCd
Total Revenue Column$48,694TotalRevenueColumnAmt
Related Or Exempt Func Income$7,324RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$41,370UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$48,694OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$93,801,793TotalRevenueColumnAmt
Related Or Exempt Func Income$93,739,106RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$88,826UnrelatedBusinessRevenueAmt
Exclusion-$26,139ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$10,096,469TotalAmt
Management And General$10,096,469ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,622,451TotalAmt
Management And General$1,622,451ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$617,167TotalAmt
Management And General$617,167ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,618,751TotalAmt
Program Services$148,049ProgramServicesAmt
Management And General$1,470,702ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$832,095TotalAmt
Management And General$832,095ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$13,306TotalAmt
Management And General$13,306ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,650TotalAmt
Management And General$2,650ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$49,940,650TotalAmt
Program Services$40,069,467ProgramServicesAmt
Management And General$9,871,183ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$821,135TotalAmt
Program Services$13,155ProgramServicesAmt
Management And General$807,980ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,087,340TotalAmt
Program Services$732,967ProgramServicesAmt
Management And General$354,373ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$685,712TotalAmt
Program Services$338,928ProgramServicesAmt
Management And General$346,784ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$5,298,090TotalAmt
Program Services$3,913,753ProgramServicesAmt
Management And General$1,384,337ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$11,697TotalAmt
Program Services$4,890ProgramServicesAmt
Management And General$6,807ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$100,976TotalAmt
Program Services$3,670ProgramServicesAmt
Management And General$97,306ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,886TotalAmt
Management And General$2,886ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,116,350TotalAmt
Program Services$2,885,245ProgramServicesAmt
Management And General$231,105ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$710,739TotalAmt
Program Services$52,202ProgramServicesAmt
Management And General$658,537ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES AND EQ$8,297,652$8,281,834$15,818
BAD DEBT$2,892,188$2,892,188
MN CARE TAX$1,323,750$1,323,750
IND EXP ALL - SHARED EX$0$16,946,546-$16,946,546

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$756,567TotalAmt
Program Services$31,394ProgramServicesAmt
Management And General$725,173ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$89,848,621TotalAmt
Program Services$77,638,038ProgramServicesAmt
Management And General$12,210,583ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$33,563,214BOYAmt
EOY$2,446,785EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$95,823,095BOYAmt
EOY$72,938,150EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,619,700BOYAmt
EOY$10,986,590EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$461,160BOYAmt
EOY$457,258EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,523,592BOYAmt
EOY$1,291,836EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$61,400,152LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$34,307,663LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$29,954,223BOYAmt
EOY$27,092,489EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$4,633,879BOYAmt
EOY$5,239,411EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,234,693BOYAmt
EOY$2,781,860EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$180,813,556BOYAmt
EOY$123,234,379EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$90,687,138BOYAmt
EOY$89,826,433EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$92,485,902BOYAmt
EOY$33,368,131EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$183,173,040BOYAmt
EOY$123,194,564EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$2,359,484BOYAmt
EOY$39,815EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$2,359,484BOYAmt
EOY$39,815EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$180,813,556BOYAmt
EOY$123,234,379EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,953,172ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$12,752NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$3,114,044PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$1,547,419OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type3 Func IntYes (X)SupportingOrgType3FuncIntInd
CertificationYes (X)CertificationInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Supported Org Information SupportedOrgInformationGrp (3 entries)

EINEINOrganization TypeOrganizationTypeDescGoverning Document ListedGoverningDocumentListedIndSupported Org NotifiedSupportedOrgNotifiedIndUS OrganizedUSOrganizedIndSupportSupportAmt
PARK NICOLLET METHODIST HOSPITAL
4101320803Yes (1)Yes (1)Yes (1)$9,739,975
PARK NICOLLET CLINIC
4108349203Yes (1)Yes (1)Yes (1)$6,930,298
PARK NICOLLET INSTITUTE
4109618624Yes (1)Yes (1)Yes (1)$276,273
FieldValueIRS element (for citing)
Supported Organizations Total3SupportedOrganizationsTotalCnt
Support Sum$16,946,546SupportSumAmt

Schedule C IRS990ScheduleC

Total Direct Lobbying TotalDirectLobbyingGrp

FieldValueIRS element (for citing)
Filing Organizations Total$53,953FilingOrganizationsTotalAmt
Affiliated Group Total$53,953AffiliatedGroupTotalAmt

Total Lobbying Expend TotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$53,953FilingOrganizationsTotalAmt
Affiliated Group Total$53,953AffiliatedGroupTotalAmt

Other Exempt Purpose Expend OtherExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$89,797,273FilingOrganizationsTotalAmt
Affiliated Group Total$1,219,951,713AffiliatedGroupTotalAmt

Total Exempt Purpose Expend TotalExemptPurposeExpendGrp

FieldValueIRS element (for citing)
Filing Organizations Total$89,851,226FilingOrganizationsTotalAmt
Affiliated Group Total$1,220,005,666AffiliatedGroupTotalAmt

Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp

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

Grassroots Nontaxable GrassrootsNontaxableGrp

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

Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp

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

Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp

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

Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp

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

Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp

FieldValueIRS element (for citing)
Current Year Minus3$200,569CurrentYearMinus3Amt
Current Year Minus2$191,800CurrentYearMinus2Amt
Current Year Minus1$210,630CurrentYearMinus1Amt
Current Year$51,106CurrentYearAmt
Total$654,105TotalAmt

Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp

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

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$145,133BeginningYearBalanceAmt
Contributions$15,494ContributionsAmt
Grants Or Scholarships$120,000GrantsOrScholarshipsAmt
End Year Balance$40,627EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$124,503BeginningYearBalanceAmt
Contributions$20,630ContributionsAmt
End Year Balance$145,133EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,917,864OtherCostOrOtherBasisAmt
Book Value$1,917,864BookValueAmt

Buildings BuildingsGrp

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

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$38,940,034OtherCostOrOtherBasisAmt
Depreciation$19,086,496DepreciationAmt
Book Value$19,853,538BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,521,120OtherCostOrOtherBasisAmt
Depreciation$15,200,033DepreciationAmt
Book Value$5,321,087BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$27,092,489TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE AND FROM RELATED PARTIES$8,728,213
CONTINGENT MALPRACTICE LIABILITY$22,953,315
POST RETIREMENT OBLIGATION$1,686,603
FieldValueIRS element (for citing)
Total Liability$33,368,131TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE TERM ENDOWMENT FUNDS FOR USE WITHIN PARK NICOLLET HEALTH SERVICES ARE FOR THE CARING FOR COLLEAGUES PROGRAM.
PART X, LINE 2:PARK NICOLLET HEALTH SERVICES RECORDED NO LIABILITIES AT DECEMBER 31, 2013 OR JANUARY 1, 2013 FOR UNRECOGNIZED TAX BENEFITS.

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
PARK NICOLLET GROUP RETURN -SEE SCH
DIRECTORS$0$2,382,923$0$191,267$0$230,110$0$167,347$0$200,625$0$3,172,272$0$27,358
PARK NICOLLET GROUP RETURN -SEE SCH
OFFICERS$7,045,674$1,186,441$2,003,259$449,792$1,047,536$195,963$684,705$310,872$1,231,295$98,843$12,012,469$2,241,911$598,065$269,491
PARK NICOLLET GROUP RETURN -SEE SCH
HIGHEST COMPENSATED EMPLOYEES$0$3,698,993$0$110,811$0$247,092$0$0$0$291,424$0$4,348,320$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE PARK NICOLLET HEALTH SERVICES' BOARD OF DIRECTORS IS RESPONSIBLE FOR ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S CEO AND EXECUTIVE DIRECTORS.
PART I, LINES 4A-BTHE AMOUNT OF SEVERANCE COMPENSATION AND BENEFITS PROVIDED TO EACH OF THE INDIVIDUAL ON SEVERANCE DURING 2013 IS AS FOLLOWS: SHEILA MCMILLAN $101,077 SCHEDULE J, PART I, LINE 4B: SENIOR LEADERS OF PARK NICOLLET HEALTH SERVICES AND AFFILIATES ARE GIVEN THE OPPORTUNITY TO PARTICIPATE IN THE CAPITAL ACCUMULATION ACCOUNT PLAN. THE CAPITAL ACCUMULATION ACCOUNT PLAN (CAA PLAN) PARTICIPATION IS LIMITED TO SENIOR LEADERS AND ALL THE VICE PRESIDENTS. EACH PARTICIPANT RECEIVES AN ANNUAL ALLOWANCE EQUAL TO THE SUM OF (I) A STATED PERCENT OF SALARY, (II) VOLUNTARY SALARY DEFERRALS. THE ALLOWANCE IS CREDITED TO A BOOKKEEPING ACCOUNT. EARNINGS ARE CREDITED TO THE ACCOUNT BASED ON THE PERFORMANCE OF SIMULATED INVESTMENTS. BENEFITS VEST UPON THE EARLIEST OF REMAINING EMPLOYED TO AN ELECTIVE VESTING DATE (TWO YEARS TO AGE 68), INVOLUNTARY TERMINATION WITHOUT CAUSE, DISABILITY, DEATH, OR NOT COMPETING FOR 24 MONTHS FOLLOWING VOLUNTARY OR FOR-CAUSE TERMINATION. BENEFITS ARE PAID IN A SINGLE LUMP SUM UPON VESTING. PARTICIPANTS ARE GENERAL CREDITORS OF THE EMPLOYER FOR THE PAYMENT OF THE BENEFITS. THE FOLLOWING PARTICIPANTS RECEIVED PAYOUTS FROM A RELATED ORGANIZATION, PARK NICOLLET HEALTH SERVICES, RELATED TO CAA PLAN: LAST NAME FIRST NAME 2013 COMPENSATION CONNELLY STEVEN $ 52,281 DAMROW PAUL, MD $ 27,770 FLASCHENRIEM JULIE $ 29,208 FRAZIER LAURA $ 18,275 GAPSTUR ROXANNA $ 25,322 HOMANS DAVID $ 40,453 KAUPA MICHAEL $ 61,277 LARSON GARY $ 31,668 LENAGH CATHERINE $ 17,015 LONG BRETT $ 18,005 MCMILLAN SHEILA $ 12,129 MISA JOHN $ 97,612 SANDSTROM JOAN $ 35,286 SPIEGLE DUANE $ 26,810 WEGLEITNER THEODORE $ 34,820 OFFICERS AND DIRECTORS EMPLOYED BY HEALTHPARTNERS, INC HAVE DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II WHICH INCLUDE AMOUNTS FROM A NONQUALIFIED 457(F) PLAN, THE FOLLOWING PARTICIPANTS RECEIVED PAYOUTS: DAVID ABELSON, MD $ 113,160 BABETTE APLAND $ 9,023 MARY BRAINERD $ 130,379 BRIAN RANK, MD $ 30,313
PART I, LINE 7SCHEDULE J, PART I, LINE 7: ALL PHYSICIANS, EMPLOYED BY AND SEEING PATIENTS FOR PARK NICOLLET HEALTH SERVICES AND AFFILIATES, ARE ELIGIBLE FOR A 3% ACCESS INCENTIVE PAYOUT BASED ON THEIR DEPARTMENT REACHING CERTAIN GOALS INCLUDING ACCESS FOR PATIENTS AND QUALITY INITIATIVES. IN THEIR ROLES AS EXECUTIVES EMPLOYED BY PARK NICOLLET HEALTH SERVICES, THE EXECUTIVES ARE ELIGIBLE FOR INCENTIVE PAYOUTS. THE INCENTIVE AWARD WILL BE 30% FOR THE CFO, COO, CMO AND 25% FOR ALL OTHER EXECUTIVES WITH AN OPPORTUNITY FOR INCENTIVE CREDIT ABOVE THE TARGET LEVEL. THE ULTIMATE PAYOUT INCLUDES A REDUCTION/INCREASE MULTIPLIER DEPENDING ON WHETHER THE CONSOLIDATED PARK NICOLLET HEALTH SERVICES ORGANIZATION REACHED THAT YEAR'S OPERATING MARGIN GOAL AS SET BY THE BOARD OF DIRECTORS. EACH PARTICIPANT WILL BE RESPONSIBLE FOR TWO FINANCIAL GOALS, AND NOT LESS THAN THREE AND NOT MORE THAN FIVE INDIVIDUAL STRATEGIC OBJECTIVES. IN THEIR ROLES AS MANAGEMENT EMPLOYED BY PARK NICOLLET HEALTH SERVICES, CERTAIN MANAGERS ARE ELIGIBLE FOR INCENTIVE PAYOUTS. THE INCENTIVE AWARD WILL BE 15% OF THEIR ANNUAL BASE PAY COMPENSATION WITH AN OPPORTUNITY FOR INCENTIVE CREDIT ABOVE THE TARGET LEVEL. THE ULTIMATE PAYOUT INCLUDES A REDUCTION/INCREASE MULTIPLIER DEPENDING ON WHETHER THE CONSOLIDATED PARK NICOLLET HEALTH SERVICES ORGANIZATION REACHED THAT YEAR'S OPERATING MARGIN GOAL AS SET BY THE BOARD OF DIRECTORS. INCENTIVE PAYMENTS ARE A FUNCTION OF BOTH INDIVIDUAL AND ORGANIZATIONAL PERFORMANCE. THE PARTICIPANT MUST BE ASSIGNED AT LEAST THREE, AND NOT MORE THAN FOUR FOCUSED INCENTIVE OBJECTIVE, ONE OF WHICH MUST BE FINANCIAL IN NATURE.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

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

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$43,400,000$223,727,818$31,038,532$1,580,827$6,863,730$194,800,0002008Yes (1)0Yes (1)Yes (1)
B$182,727,701$23,996,922$1,861,956$18,543,816$144,049,1592009Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A0Yes (1)000000Yes (1)
B0Yes (1)000000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

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

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE KSCHEDULE K EXPLANATION OF REPORTING ON AN OBLIGATED GROUP BASIS: PURSUANT TO A LOAN AGREEMENT WITH THE CITY OF ST. LOUIS PARK, MINNESOTA, PARK NICOLLET HEALTH SERVICES IS NAMED AS A MEMBER OF THE "OBLIGATED GROUP" ALONG WITH PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PNMC HOLDINGS, PARK NICOLLET INSTITUTE, AND PARK NICOLLET HEALTH CARE PRODUCTS. EACH MEMBER OF THE OBLIGATED GROUP IS AN OBLIGOR UNDER THE LOAN AGREEMENT. PARK NICOLLET HEALTH SERVICES DID NOT USE BOND FUNDS; THEREFORE THERE ARE NO BONDS ON THE BALANCE SHEET. PARK NICOLLET HEALTH SERVICES IS THE PARENT OF THE OBLIGATED GROUP, AND HAS ELECTED TO REPORT ALL TAX-EXEMPT BOND ACTIVITY ON ITS RETURN.
PART I COLUMN C LINE A:THE CUSIP ON FORM 8038 IS 791740EE2, WHICH IS INCORRECT, THE CORRECT VALUE, 791748EE2 IS SHOWN HERE.
PART II LINE 4THE AMOUNT SHOWN IN COLUMN A CONSISTS OF $20,831,496 IN A DEBT SERVICE RESERVE FUND PLUS $10,207,035 IN A DEBT SERVICE FUND. THE AMOUNT SHOWN IN COLUMN B CONSISTS OF $18,610,258 IN A DEBT SERVICE RESERVE FUND PLUS $5,386,663 IN A DEBT SERVICE FUND.
PART II LINE 13:PARK NICOLLET HEALTH SERVICES DETERMINED THE YEAR OF SUBSTANTIAL COMPLETION FOR EACH ISSUE AS FOLLOWS: THE PURPOSE OF THE ISSUES IN COLUMN A WAS TO REFUND PRIOR ISSUES FOR WHICH THE ORIGINAL CAPITAL PROJECT WAS COMPLETE PRIOR TO REFUNDING. THEREFORE THE YEAR OF SUBSTANTIAL COMPLETION IS THE YEAR OF ISSUANCE. THE PURPOSE OF THE BOND ISSUE IN COLUMN B WAS TO REFUND THE 2008 A AND B BOND ISSUE SINCE THE RELATED CAPITAL PROJECT OF THE 2008 B ISSUE WAS NOT YET COMPLETE AS OF 12/31/2008. THE YEAR OF SUBSTANTIAL COMPLETION WAS 2009.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 4EFFECTIVE JANUARY 1, 2013, PARK NICOLLET HEALTH SERVICES AND ITS SUBSIDIARIES BECAME PART OF THE HEALTHPARTNERS ORGANIZATION OF RELATED HEALTH CARE DELIVERY AND FINANCING ENTITIES. PNHS' ARTICLES OF INCORPORATION AND BYLAWS WERE AMENDED TO IDENTIFY HEALTHPARTNERS, INC. AS THE SOLE MEMBER OF PNHS. PNHS' BYLAWS WERE FURTHER AMENDED TO ESTABLISH THAT THE PERSONS SERVING AS THE BOARD OF DIRECTORS OF THE SOLE MEMBER, ALSO SERVE AS THE BOARD OF DIRECTORS OF PNHS. IN THE EVENT THAT THE PNHS BOARD OF DIRECTORS WERE EVER COMPOSED OF PERSONS WHO ARE NOT ALSO CONTEMPORANEOUSLY SERVING AS THE DIRECTORS OF THE SOLE MEMBER, THEN THE SOLE MEMBER WOULD EXERCISE CUSTOMARY RESERVE POWERS WITH RESPECT TO THE PNHS BOARD OF DIRECTORS (E.G. APPROVAL OF BUDGETS, APPROVAL OF MERGER, APPROVAL OF APPOINTMENT OF THE CHIEF EXECUTIVE OFFICER, APPROVAL OF DISSOLUTION, ETC.). NO ADDITIONAL SIGNIFICANT CHANGES WERE MADE TO PNHS' ARTICLES AND BYLAWS OTHER THAN THOSE NECESSARY TO GIVE EFFECT TO THE RELATIONSHIP OF PNHS TO HEALTHPARTNERS, INC. DESCRIBED ABOVE.
FORM 990, PART VI, SECTION A, LINE 6HEALTHPARTNERS, INC IS THE SOLE MEMBER OF PARK NICOLLET HEALTH SERVICES.
FORM 990, PART VI, SECTION A, LINE 7ATHE PERSONS WHO SERVE AS THE BOARD OF DIRECTORS OF HEALTHPARTNERS, INC. ALSO SERVE AS THE BOARD OF DIRECTORS OF PNHS. HEALTHPARTNERS, INC. IS A MINNESOTA LICENSED HEALTH MAINTENANCE ORGANIZATION. THE BOARD OF HEALTHPARTNERS, INC. IS COMPRISED OF A MAJORITY OF DIRECTORS WHO ARE ELECTED BY HMO MEMBERS (PERSONS HOLDING HMO CONTRACTS), AND A MINORITY OF DIRECTORS WHO ARE EITHER HEALTH CARE PROFESSIONALS APPOINTED BY THE BOARD OR WHO ARE SERVING EX OFFICIO.
FORM 990, PART VI, SECTION A, LINE 7BPNHS' BYLAWS WERE FURTHER AMENDED TO ESTABLISH THAT THE PERSONS SERVING AS THE BOARD OF DIRECTORS OF THE SOLE MEMBER, ALSO SERVE AS THE BOARD OF DIRECTORS OF PNHS. IN THE EVENT THAT THE PNHS BOARD OF DIRECTORS WERE EVER COMPOSED OF PERSONS WHO ARE NOT ALSO CONTEMPORANEOUSLY SERVING AS THE DIRECTORS OF THE SOLE MEMBER, THEN THE SOLE MEMBER WOULD EXERCISE CUSTOMARY RESERVE POWERS WITH RESPECT TO THE PNHS BOARD OF DIRECTORS (E.G. APPROVAL OF BUDGETS, APPROVAL OF MERGER, APPROVAL OF APPOINTMENT OF THE CHIEF EXECUTIVE OFFICER, APPROVAL OF DISSOLUTION, ETC.). NO ADDITIONAL SIGNIFICANT CHANGES WERE MADE TO PNHS ARTICLES AND BYLAWS OTHER THAN THOSE NECESSARY TO GIVE EFFECT TO THE RELATIONSHIP OF PNHS TO HEALTHPARTNERS, INC. DESCRIBED ABOVE.
FORM 990, PART VI, SECTION B, LINE 11PARK NICOLLET HEALTH SERVICES PREPARES THE FORM 990 WITHIN THE FINANCE DEPARTMENT WITH ASSISTANCE FROM INDIVIDUALS IN HUMAN RESOURCES, MARKETING, AND OPERATIONS. UPON COMPLETION OF GATHERING THE NECESSARY INFORMATION FOR THE RETURN, THE FORM WAS COMPILED AND DRAFTS WERE REVIEWED BY THE ASSISTANT CONTROLLER - ACCOUNTING OPERATIONS, VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER, THE LAW DEPARTMENT, THE AUDIT AND COMPLIANCE COMMITTEE AND PARK NICOLLET'S ACCOUNTING FIRM. AFTER ALL REVIEWS WERE COMPLETE; THE FORM 990 WAS GIVEN TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR APPROVAL PRIOR TO FILING THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12CAT PARK NICOLLET HEALTH SERVICES ALL KEY EMPLOYEES, DIRECTORS, AND OFFICERS ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST DISCLOSURE STATEMENT EACH YEAR; HOWEVER THE OBLIGATION TO REPORT POTENTIAL CONFLICTS IS ONGOING. PARK NICOLLET HEALTH SERVICES BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES PURSUANT TO ITS CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS AND OFFICERS ANNUALLY ARE PROVIDED A COPY OF THE POLICY AND REQUIRED TO COMPLETE A QUESTIONNAIRE INDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNCEL REVIEWS THE COMPLETED QUESTIONNAIRES AND PROVIDES A REPORT TO THE GOVERNANCE COMMITTEE OF THE BOARD. THE REPORT IDENTIFIES ANY SIGNIFICANT POTENTIAL CONFLICTS DISCLOSED IN THE COMPLETED QUESTIONNAIRES. A WRITTEN REPORT IS PROVIDED TO THE CHAIR AND CHIEF EXECUTIVE OFFICER (CEO). BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE PARK NICOLLET HEALTH SERVICES' BOARD OF DIRECTORS IS RESPONSIBLE FOR THE IMPLEMENTATION AND OVERSIGHT OF EXECUTIVE COMPENSATION AND BENEFIT PLANS. PARK NICOLLET USES AN OUTSIDE CONSULTANT TO PROVIDE A YEARLY MARKET BASED INDEX OF SALARY ADJUSTMENTS FOR EXECUTIVES IN SIMILAR LEADERSHIP POSITIONS. THE BOARD OF DIRECTORS REVIEWS THE SALARY RANGES AND RECOMMENDS SALARY INCREASES FOR EACH EXECUTIVE, INCLUDING THE CEO, BASED UPON THE BOARD OF DIRECTORS' EVALUATION OF JOB PERFORMANCE AND EXPERIENCE LEVEL OF THE INDIVIDUAL WITHIN THE ORGANIZATION. THE AVERAGE SALARY INCREASES FOR ALL PARK NICOLLET EXECUTIVES CANNOT EXCEED THE AVERAGE MARKET SALARY INCREASE REPORTED FOR EXECUTIVES BY THE CONSULTANT. THE COMPENSATION COMMITTEE THEN REVIEWS AND APPROVES COMPENSATION ADJUSTMENTS BASED ON THE INFORMATION PROVIDED BY THE OUTSIDE CONSULTANTS AND THE BOARD OF DIRECTORS' RECOMMENDATIONS. FOR CERTAIN PHYSICIANS, THE MAJORITY OF PAY DISCLOSED IS FOR HIS/HER WORK AS A PHYSICIAN FOR PARK NICOLLET INSTITUTE OR PARK NICOLLET CLINIC. A SMALL STIPEND IS ADDED FOR SERVING ON THE BOARD OF DIRECTORS. THE FOLLOWING IS A DESCRIPTION OF HOW PAY FOR PHYSICIANS' PATIENT CARE WORK IS DETERMINED. THE PARK NICOLLET HEALTH SERVICES' BOARD OF DIRECTORS IS RESPONSIBLE FOR THE IMPLEMENTATION AND OVERSIGHT OF THE PHYSICIAN COMPENSATION AND BENEFIT PLANS. THE BOARD OF DIRECTORS DELEGATES THE DAY-TO-DAY ADMINISTRATION OF THE PHYSICIAN COMPENSATION PLAN TO THE CEO. THE CHIEF MEDICAL OFFICER, WHO REPORTS DIRECTLY TO THE CEO, ADMINISTERS THE COMPENSATION PROGRAM. A COMPENSATION AND BENEFITS COMMITTEE SERVES IN AN ADVISORY CAPACITY TO THE CMO IN ORDER TO ADMINISTER PHYSICIAN COMPENSATION WITHIN THE BUDGET TO ENSURE FAIRNESS AND ALIGNMENT WITH PARK NICOLLET HEALTH SERVICES' GOALS. THE RESPONSIBILITIES OF THE CMO: RECOMMENDING COMPENSATION POLICIES AND PLAN DESIGNS FOR PHYSICIANS TO THE CEO AND BOARD OF DIRECTORS; OVERSEEING COMPENSATION PLAN OPERATION AND PAYMENTS TO CLINICAL DEPARTMENTS; EVALUATING COMPENSATION PLAN FOR PERFORMANCE ON A PERIODIC BASIS; SERVING AS FINAL APPEAL PROCESS FOR ISSUES UNRESOLVED BY INDIVIDUALS, DEPARTMENT CHAIRS AND CHIEFS OF SERVICES. ANNUALLY, INFORMATION ON EACH PHYSICIAN'S PAY AND PRODUCTIVITY IS GRAPHED AGAINST THE SURVEY RESULTS FOR THE SAME YEAR. THIS INFORMATION IS PRESENTED TO THE COMPENSATION COMMITTEE OF THE PARK NICOLLET HEALTH SERVICES BOARD OF DIRECTORS FOR REVIEW. PARK NICOLLET HEALTH SERVICES' PHYSICIAN PAY PROGRAM IS DESIGNED TO ENSURE MARKET BASED PAY FOR MARKET BASED PRODUCTIVITY STANDARDS. THE MARKET IS DETERMINED BY THE AMERICAN MEDICAL GROUP ASSOCIATION (AMGA) NATIONAL PHYSICIAN COMPENSATION SURVEY DATA, WHICH PROVIDES MARKET DATA FOR BOTH COMPENSATION AND PRODUCTIVITY. WHEN APPROPRIATE, THE CMO MAY RECOMMEND ADJUSTMENTS TO THESE GUIDELINES WITH EVIDENCE OF LOCAL MARKET DATA.
FORM 990, PART VI, SECTION C, LINE 19PARK NICOLLET HEALTH SERVICES GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. PARK NICOLLET HEALTH SERVICES MAILS ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS TO FINANCIAL INSTITUTIONS, GOVERNMENTAL INSTITUTIONS, BOARD MEMBERS,MEDIA REPRESENTATIVES,VENDORS, AND THE MINNESTOA HOSPITAL ASSOCIATIONS(MHA) PARK NICOLLET HEALTH SERVICES DISCLOSES QUARTERLY FINANCIAL STATEMENTS TO BONDHOLDERS AND MHA. THE ANNUAL AUDITED AND QUARTERLY FINANCIAL STATEMENTS ARE ALSO POSTED AT EMMA.MSRB.ORG. THE FORMS 990 ARE AVAILABLE UPON REQUEST OR FROM THE STATE OF MINNESOTA OR AT GUIDESTAR.ORG.
FORM 990, PART IX, LINE 11GEMPLOYEES OF AFFILIATES: PROGRAM SERVICE EXPENSES 31,319,003. MANAGEMENT AND GENERAL EXPENSES 6,959,892. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,278,895. MANAGEMENT CONSULTANTS: PROGRAM SERVICE EXPENSES 2,977. MANAGEMENT AND GENERAL EXPENSES 2,348,930. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,351,907. OTHER PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 8,747,487. MANAGEMENT AND GENERAL EXPENSES 562,361. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,309,848.
FORM 990, PART XI, LINE 9:POST RETIREMENT OBLIGATION 1,547,419.
FORM 990, PART XII, LINE 2C:NEITHER THE OVERSIGHT PROCESS NOR THE SELECTION PROCESS FOR THE REVIEW OF THE AUDIT OF PARK NICOLLET HEALTH SERVICES AND AFFILIATES' FINANCIAL STATEMENTS HAVE CHANGED DURING THE TAX YEAR.
FORM 990PURSUANT TO TREASURY REG SECTION 1.6033-2(D)(5), PARK NICOLLET HEALTH SERVICES HAS ELECTED TO REPORT INFORMATION ABOUT CONTRIBUTIONS, GIFTS & GRANTS, CONPENSATION, AND OTHER INFORMATION ABOUT OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, FORMER EMPLOYEES, CERTAIN OTHER HIGHLY PAID EMPLOYEES, CERTAIN PROFESSIONAL CONTRACTORS, AND CERTAIN OTHER CONTRACTORS ON A CONSOLIDATED BASIS FOR ALL MEMBERS OF THE GROUP, INCLUDING THE PARENT ORGANIZATION, ON THE GROUP RETURN OF PARK NICOLLET GROUP RETURN (EIN 45-5023260).

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (4 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Direct Controlling NADirectControllingNACd
DEFERRED COMPENSATION TRUST
6500 EXCELSIOR BLVDST LOUIS PARKMN55426411809020INVESTMENTSMN$1,771,604PARK NICOLLET HEALTH SERVICES
TRIA ORTHOPEDIC CENTER LLC
8100 NORTHLAND DRIVEBLOOMINGTONMN55431200034003HEALTH CAREMNPARK NICOLLET HEALTH SERVICES
HEALTHPARTNERS EAST SIDE HOLDING LLC
8170 33RD AVENUE SOUTH PO BOX 1309MINNEAPOLISMN554401309201282428REAL ESTATE HOLDING COMPANYDEN/A
HEALTHPARTNERS PROPERTY DEVELOPMENT COMPANY LLC
8170 33RD AVE S PO BOX 1309MPLSMN554401309455122853PROPERTY DEVELOPMENTMNN/A

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (27 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BLVDST LOUIS PARKMN55426410132080HEALTH CAREMN501(C)(3)LINE 3PARK NICOLLET HEALTH SERVICESYes (1)
PARK NICOLLET FOUNDATION
6500 EXCELSIOR BLVDST LOUIS PARKMN55426237346465GRANTS TO SERVE THE COMMUNITYMN501(C)(3)LINE 7PARK NICOLLET HEALTH SERVICESYes (1)
PARK NICOLLET CLINIC
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416410834920HEALTH CAREMN501(C)(3)LINE 3PARK NICOLLET HEALTH SERVICESYes (1)
PARK NICOLLET INSTITUTE
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416410961862HEALTH CARE RESEARCHMN501(C)(3)LINE 4PARK NICOLLET HEALTH SERVICESYes (1)
PARK NICOLLET HEALTH CARE PRODUCTS
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416010638901HEALTH CARE PRODUCTSMN501(C)(3)LINE 11B, IIPARK NICOLLET HEALTH SERVICESYes (1)
PNMC HOLDINGS
3800 PARK NICOLLET BLVDST LOUIS PARKMN55416101741792HEALTH CARE REAL ESTATEMN501(C)(3)LINE 11A, IPARK NICOLLET HEALTH SERVICESYes (1)
TRIA ORTHOPEADIC CENTER RESEARCH INSTITUTE
8100 NOIRTHLAND DRIVEBLOOMINGTONMN55431200033919HEALTH CARE RESEARCH AND EDUCATIONMN501(C)(3)LINE 11A, IPARK NICOLLET HEALTH SERVICESYes (1)
HEALTHPARTNERS INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411693838HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATIONMN501(C)(4)509(A)(3) TYPE IYes (1)N/A
HPI - RAMSEY
8170 33RD AVE S PO BOX 1309MPLSMN554401309411793333CORPORATE PLANNING AND OVERSIGHTMN501(C)(3)509(A)(3) TYPE IHEALTHPARTNERS INCYes (1)
GROUP HEALTH PLAN INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309410797853STAFF MODEL HEALTH MAINTENANCE ORGANIZATIONMN501(C)(3)170(B)(1) (A)(III)HEALTHPARTNERS INCYes (1)
HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH
8170 33RD AVE S PO BOX 1309MPLSMN554401309411670163HEALTHCARE EDUCATION & RESEARCHMN501(C)(3)509(A)(3) TYPE IGROUP HEALTH PLAN INCYes (1)
CAPITOL VIEW TRANSITIONAL CARE CENTER
8170 33RD AVE S PO BOX 1309MPLSMN554401309412011453POST HOSPITALIZATION PATIENT CAREMN501(C)(3)170(B)(1) (A)(III)HPI - RAMSEYYes (1)
REGIONS HOSPITAL
8170 33RD AVE S PO BOX 1309MPLSMN554401309410956618HOSPITALMN501(C)(3)170(B)(1) (A)(III)HPI - RAMSEYYes (1)
REGIONS HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309411888902PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTMN501(C)(3)170(B)(1) (A)(VI)HPI - RAMSEYYes (1)
RHSC INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411891928HEALTHCARE STAFFINGMN501(C)(3)509(A)(3) TYPE IIHEALTHPARTNERS INCYes (1)
RH-WISCONSIN
8170 33RD AVE S PO BOX 1309MPLSMN554401309202287016CORPORATE PLANNING AND OVERSIGHTWI501(C)(3)509(A)(3) TYPE IIHPI - RAMSEYYes (1)
PHYSICIANS NECK AND BACK CLINICS
8170 33RD AVE S PO BOX 1309MPLSMN554401309270684883SPECIALTY PATIENT CAREMN501(C)(3)509(A)(3) TYPE IIGROUP HEALTH PLAN INCYes (1)
HUDSON HOSPITAL INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309390804125HOSPITALWI501(C)(3)170(B)(1) (A)(III)RH-WISCONSINYes (1)
HUDSON HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391279567PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTWI501(C)(3)170(B)(1) (A)(VI)HUDSON HOSPITAL INCYes (1)
WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY
8170 33RD AVE S PO BOX 1309MPLSMN554401309263616590PROVIDE MEDICAL TRANSPORT SERVICESWI501(C)(3)509(A)(3) TYPE IIRH-WISCONSINYes (1)
LAKEVIEW MEMORIAL HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309MPLSMN554401309411386635PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTMN501(C)(3)509(A)(3) TYPE IISTILLWATER HEALTH SYSTEMYes (1)
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309410811697HOSPITALMN501(C)(3)170(B)(1) (A)(III)STILLWATER HEALTH SYSTEMYes (1)
STILLWATER MEDICAL GROUP
8170 33RD AVE S PO BOX 1309MPLSMN554401309830379473PHYSICIANS GROUPMN501(C)(3)509(A)(2)STILLWATER HEALTH SYSTEMYes (1)
STILLWATER HEALTH SYSTEM
8170 33RD AVE S PO BOX 1309MPLSMN554401309300221189CORPORATE PLANNING AND OVERSIGHTMN501(C)(3)509(A)(3) TYPE IIHPI - RAMSEYYes (1)
WESTFIELDS HOSPITAL INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309390808442HOSPITALWI501(C)(3)170(B)(1) (A)(III)RH-WISCONSINYes (1)
WESTFIELDS HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309391770913PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORTWI501(C)(3)509(A)(3) TYPE IWESTFIELDS HOSPITAL INCYes (1)
RAMSEY INTEGRATED HEALTH SERVICES
8170 33RD AVE S PO BOX 1309MPLSMN554401309411503090IN-HOME PATIENT CAREMN501(C)(3)509(A)(2)HPI - RAMSEYYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1METHODIST BRAIN LAB LEASING LLCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line16500 EXCELSIOR BLVDAddressLine1
CityST LOUIS PARKCity
StateMNState
ZIP Code55426ZIPCode
FieldValueIRS element (for citing)
EIN208725994EIN
Primary ActivitiesHEALTH CAREPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PARK NICOLLET METHODIST HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Entity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
PARK NICOLLET ENTERPRISES
6500 EXCELSIOR BLVDST LOUIS PARKMN55426411656735REAL ESTATE FOR RELATED ORGANICATIONMNPARK NICOLLET HEATLH SERVICESC$4,640,133$16,369,8581.000000
HEALTHPARTNERS ADMINISTRATORS INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411629390THIRD PARTY ADMINISTRATORMNHEALTHPARTNERS INCC0
HEALTHPARTNERS ASSOCIATES INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309522365151MEDICAL CLINIC STAFFING AND ASSET MANAGEMENTMNHEALTHPARTNERS ADMINISTRATORS INCC0
HEALTHPARTNERS SERVICES INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411683568MEDICAL CLINIC STAFFING AND ASSET MANAGEMENTMNHEALTHPARTNERS ADMINISTRATORS INCC0
HEALTHPARTNERS VENTURES INC
8170 33RD AVE S PO BOX 1309MPLSMN554401309411838197DEVELOP HEALTHCARE BUSINESS OPPORTUNITIESMNHEALTHPARTNERS INCC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (26 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
PARK NICOLLET HEALTH CARE PRODUCTS
S$45,234,316COST
PARK NICOLLET HEALTH CARE PRODUCTS
L$843,780COST
PARK NICOLLET HEALTH CARE PRODUCTS
Q$122,383,744COST
PARK NICOLLET ENTERPRISES
Q$4,573,272COST
PARK NICOLLET METHODIST HOSPITAL
Q$575,489,327COST
PARK NICOLLET METHODIST HOSPITAL
K$1,115,122COST
PARK NICOLLET METHODIST HOSPITAL
L$5,362,573COST
PARK NICOLLET METHODIST HOSPITAL
S$469,496,380COST
PARK NICOLLET INSTITUTE
Q$11,761,160COST
PARK NICOLLET INSTITUTE
L$214,000COST
PARK NICOLLET INSTITUTE
S$11,013,070COST
PARK NICOLLET CLINIC
Q$499,292,353COST
PARK NICOLLET CLINIC
L$7,442,023COST
PARK NICOLLET CLINIC
S$622,564,750COST
PARK NICOLLET CLINIC
K$4,116,523COST
PNMC HOLDINGS
Q$2,787,733COST
PARK NICOLLET METHODIST HOSPITAL (TRIA)
P$542,498COST
PARK NICOLLET METHODIST HOSPITAL (TRIA)
M$1,622,463COST
PARK NICOLLET HEALTH CARE PRODUCTS (TRIA)
P$1,191,213COST
PARK NICOLLET CLINIC (TRIA)
P$11,603,909COST
PARK NICOLLET CLINIC (TRIA)
M$157,746COST
PARK NICOLLET CLINIC (TRIA)
R$64,846COST
PARK NICOLLET ENTERPRISESTRIA)
P$2,562,956COST
PARK NICOLLET ENTERPRISESTRIA)
K$2,077,177COST
TRIA ORTHOPAEDIC CENTER RESEARCH INSTITUTE (TRIA)
J$208,298COST
TRIA ORTHOPAEDIC CENTER RESEARCH INSTITUTE (TRIA)
R$101,033COST

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