NORTH MEMORIAL HEALTH CARE: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- NORTH MEMORIAL HEALTH CARE (EIN 41-0729979)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-13
- IRS object ID
- 201443179349300344
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-13T10:03:45-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 S 6TH ST 2300 | AddressLine1 |
| 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 | 410729979 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH MEMORIAL HEALTH CARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 7635205200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TODD OSTENDORF | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 7635205200 | PhoneNum |
| Signature | 2014-10-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAWRENCE H MOHR CPA | PreparerPersonNm |
| PTIN | P00447603 | PTIN |
| Phone | 6128764500 | PhoneNum |
| Preparation | 2014-10-16 | PreparationDt |
| 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 | LOREN TAYLOR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $773,015,019 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NORTHMEMORIAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1954 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | GENERAL ACUTE CARE HOSPITAL PROVIDING HIGHLY SPECIALIZED TRAUMA AND EMERGENCY SERVICES, CORONARY CARE OPEN HEART SURGERY, ONCOLOGY, HIGH RISK MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL-SURGICAL, OBSTETRICAL, PEDIATRIC REHABILITATIVE, AND BEHAVIORAL SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 5213 | TotalEmployeeCnt |
| Total Volunteers | 670 | TotalVolunteersCnt |
| Total Gross UBI | $7,628,696 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$3,261,397 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $760,857 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,250,375 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $643,415,269 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $631,102,778 | CYProgramServiceRevenueAmt |
| PY Investment Income | $9,554,787 | PYInvestmentIncomeAmt |
| CY Investment Income | $14,778,356 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$2,758,020 | PYOtherRevenueAmt |
| CY Other Revenue | -$490,606 | CYOtherRevenueAmt |
| PY Total Revenue | $650,972,893 | PYTotalRevenueAmt |
| CY Total Revenue | $646,640,903 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $392,891,408 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $370,462,198 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $267,259,635 | PYOtherExpensesAmt |
| CY Other Expenses | $263,129,622 | CYOtherExpensesAmt |
| PY Total Expenses | $660,151,043 | PYTotalExpensesAmt |
| CY Total Expenses | $633,591,820 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$9,178,150 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $13,049,083 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $574,490,605 | TotalAssetsBOYAmt |
| Total Assets EOY | $581,188,207 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $250,822,311 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $220,859,367 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $323,668,294 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $360,328,840 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | INSPIRING EACH OTHER TO GIVE OUR PATIENTS AND THEIR FAMILIES COMPASSIONATE, REMARKABLE CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $554,105,958 | ExpenseAmt |
| Revenue | $573,896,075 | RevenueAmt |
| Desc | NORTH MEMORIAL HEALTH CARE (NMHC) IS A GENERAL ACUTE CARE HOSPITAL PROVIDING HIGHLY SPECIALIZED TRAUMA AND EMERGENCY SERVICES, CORONARY CARE, OPEN HEART SURGERY, ONCOLOGY, HIGH RISK MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL- SURGICAL, OBSTETRICAL, PEDIATRIC, REHABILITATION, BEHAVIORAL HEALTH, MEDICAL TRANSPORTATION AND HOME HEALTH AND HOSPICE SERVICES. IN ADDITION TO CHARITY AND UNCOMPENSATED CARE, NMHC ALSO PROVIDES NUMEROUS COMMUNITY BENEFITS (AT NO COST OR BELOW COST) IN FURTHERANCE OF ITS CHARITABLE PURPOSE. NORTH MEMORIAL PROVIDES A WIDE VARIETY OF BENEFITS TO THE COMMUNITY, INCLUDING OFFERING VARIOUS COMMUNITY BASED PROGRAMS, SUCH AS HEALTH SCREENINGS, SUPPORT COUNSELING FOR PARENTS AND FAMILIES, PASTORAL CARE, CRISIS INTERVENTION, TRANSPORTATION TO AND FROM THE HOSPITAL CAMPUSES, AND THE DONATION OF SPACE FOR USE BY COMMUNITY GROUPS. ADDITIONALLY A LARGE NUMBER OF HEALTH-RELATED EDUCATIONAL PROGRAMS ARE PROVIDED FOR THE BENEFIT OF THE COMMUNITY, INCLUDING HEALTH ENHANCEMENTS AND WELLNESS, CLASSES ON SPECIFIC CONDITIONS, UNREIMBURSED COSTS OF MEDICAL EDUCATION, TELEPHONE INFORMATION SERVICES, AND COST RELATED TO PROGRAMS DESIGNED TO IMPROVE THE GENERAL STANDARDS OF THE HEALTH OF THE COMMUNITY. NORTH MEMORIAL ALSO PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED COSTS TO RESIDENTS OF ITS COMMUNITY, PRIMARILY THROUGH (A) THE DIFFERENCE BETWEEN PUBLIC PROGRAM PAYMENTS (PRIMARILY MEDICARE AND MEDICAID) AND THE RELATED COSTS OF PROVIDING SUCH SERVICES, AND (B) SERVICES PROVIDED TO PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT WHO ARE DETERMINED UNABLE TO PAY BECAUSE OF ECONOMIC FACTORS. IN ADDITION, NORTH MEMORIAL CONTRIBUTES TO FUNDING MEDICAL CARE FOR THE UNINSURED THROUGH PAYMENT OF PATIENT SERVICE TAXES, WHICH INCLUDE THE MEDICAID SURCHARGE AND THE MINNESOTA CARE TAX ON CERTAIN NET REVENUE. | Desc |
| Total Program Service Expenses | $554,105,958 | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 459 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 5213 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | Yes (1) | ForeignFinancialAccountInd |
| Foreign Country | BD | ForeignCountryCd |
| 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 | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TODD OSTENDORF | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7635205200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| LOREN TAYLOR | |||||||||
| CEO NORTH MEMORIAL | 50.00 | 5.00 | Yes (X) | Yes (X) | $776,215 | $0 | $23,125 | ||
| ROBERT D POTTS | |||||||||
| CHAIR OF BOARD | 2.00 | 0.00 | Yes (X) | Yes (X) | $4,500 | $0 | $0 | ||
| TIMOTHY BAYLOR | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $4,500 | $0 | $0 | |||
| SCOTT COLSON | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $1,800 | $0 | $0 | |||
| DANA CARLSON MD | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $4,500 | $0 | $0 | |||
| WARREN MACK | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $4,500 | $0 | $0 | |||
| PAT MCHALE | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JON NIELSON MD | |||||||||
| BOARD MEMBER (PART-YEAR) | 2.00 | 0.00 | Yes (X) | $1,800 | $0 | $0 | |||
| ROBERT PRENTISS JR | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $5,400 | $0 | $0 | |||
| ROBERT DAHL | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $1,800 | $0 | $0 | |||
| MIKE STEINHAUSER | |||||||||
| BOARD MEMBER | 2.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MATTHIAS FELDKAMP MD | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $3,600 | $0 | $0 | |||
| JOHN GRAY MD | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVE BECK | |||||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KAREN RAUENHORST | |||||||||
| BOARD MEMBER (PART-YEAR) | 2.00 | 0.00 | Yes (X) | $1,800 | $0 | $0 | |||
| AMY KOLAR MD | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $471,224 | $0 | $24,790 | |||
| BILL TOBIN | |||||||||
| BOARD MEMBER | 2.00 | 0.00 | Yes (X) | $4,500 | $0 | $0 | |||
| TODD OSTENDORF | |||||||||
| VP FINANCE, CFO (PART-YEAR) | 50.00 | 2.00 | Yes (X) | $129,998 | $0 | $4,912 | |||
| PATRICK BORAN | |||||||||
| VP FINANCE, CFO (PART-YEAR) | 50.00 | 4.00 | Yes (X) | $619,221 | $0 | $10,370 | |||
| KEVIN CROSTON MD | |||||||||
| CHIEF MEDICAL OFFICER | 50.00 | 2.00 | $464,710 | $0 | $22,533 | Yes (X) | |||
| TIFFANY ZITZEWITZ | |||||||||
| VP BUSINESS DEVELOPMENT | 50.00 | 2.00 | $288,619 | $0 | $24,485 | Yes (X) | |||
| ANDREW COCHRANE | |||||||||
| CEO MAPLE GROVE HOSPITAL | 0.00 | 50.00 | $381,414 | $0 | $24,893 | Yes (X) | |||
| GAYLE MATTSON | |||||||||
| PRESIDENT OF NORTH MEMORIAL | 50.00 | 0.00 | $353,861 | $0 | $13,397 | Yes (X) | |||
| DAVID ABRAMS | |||||||||
| VP HUMAN RESOURCES | 50.00 | 0.00 | $266,404 | $0 | $59,332 | Yes (X) | |||
| JOSEPH BOSTON | |||||||||
| VP FOUNDATION | 0.00 | 50.00 | $408,031 | $0 | $15,408 | Yes (X) | |||
| MICHAEL PARRISH | |||||||||
| VP EMERGENCY & ENTERPRISE OPERATIONS | 50.00 | 0.00 | $318,480 | $0 | $22,857 | Yes (X) | |||
| PATRICK TAFFE | |||||||||
| CHIEF INFORMATION OFFICER | 50.00 | 0.00 | $301,110 | $0 | $22,587 | Yes (X) | |||
| ANDREW HOULTON | |||||||||
| MEDICAL DIRECTOR | 50.00 | 0.00 | $276,288 | $0 | $25,246 | Yes (X) | |||
| JEFF WICKLANDER | |||||||||
| VP OPERATIONS | 50.00 | 0.00 | $267,046 | $0 | $13,616 | Yes (X) | |||
| TRACY KIRBY | |||||||||
| VP INPATIENT CARE/CNO | 50.00 | 0.00 | $182,540 | $0 | $11,427 | Yes (X) | |||
| ROBERT KING | |||||||||
| CARDIAC SURGEON | 50.00 | 0.00 | $709,750 | $0 | $25,139 | Yes (X) | |||
| ALOK MAHESHWARI | |||||||||
| CARDIOLOGIST | 50.00 | 0.00 | $727,784 | $0 | $24,496 | Yes (X) | |||
| STEVEN ROH | |||||||||
| CARDIOLOGIST | 50.00 | 0.00 | $799,532 | $0 | $27,104 | Yes (X) | |||
| THOMAS ROSSINI | |||||||||
| STAFF EMERGENCY PHYSICIAN | 50.00 | 0.00 | $725,026 | $0 | $24,955 | Yes (X) | |||
| JOSEPH VAN CAMP | |||||||||
| CARDIAC SURGEON | 50.00 | 0.00 | $688,139 | $0 | $25,139 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $9,194,092 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $445,811 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 434 | 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 |
|---|---|---|---|---|---|
| NORTH CLINIC | |||||
| 3366 OAKDALE AVE N 601 | ROBBINSDALE | MN | 55422 | PHYSICIAN SERVICES | $6,391,992 |
| DJ KRANZ COMPANY INCORPORATED | |||||
| 725 HIGHWAY 169 NORTH | PLYMOUTH | MN | 554416403 | CONSTRUCTION | $4,545,773 |
| ARAMARK HEALTHCARE FOOD | |||||
| 25271 NETWORK PLACE | CHICAGO | IL | 60673 | MANAGEMENT SUPPORT FOR DIETARY | $2,965,276 |
| RESPIRATORY CONSULTANTS PA | |||||
| 3366 OAKDALE AVE N 605 | ROBBINSDALE | MN | 55422 | INTENSIVISTS STAFFING | $2,504,067 |
| UNIVERSITY OF MINNESOTA PHYSICIANS | |||||
| 720 WASHINGTON AVE SE STE 200 | MINNEAPOLIS | MN | 55414 | PHYSICIAN SERVICES | $2,488,964 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 35 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $517,335 | RelatedOrganizationsAmt |
| All Other Contributions | $733,040 | AllOtherContributionsAmt |
| Noncash Contributions | $72,256 | NoncashContributionsAmt |
| Total Contributions | $1,250,375 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| HOSPITAL PATIENT REVENUE | 621500 | $576,540,127 | $568,911,431 | $7,628,696 | |
| CONTRACT REVENUE | 900099 | $25,922,957 | $25,922,957 | ||
| EHR/MEDICARE & OTHER | 900099 | $13,969,484 | $13,969,484 | ||
| PHARMACY | 900099 | $5,590,548 | $5,590,548 | ||
| JOINT VENTURE REVENUE | 900099 | $5,475,250 | $5,475,250 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,604,412 | TotalRevenueColumnAmt |
| Exclusion | $3,604,412 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $631,102,778 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,776,114 | TotalRevenueColumnAmt |
| Exclusion | $4,776,114 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $64,099 | TotalRevenueColumnAmt |
| Exclusion | $64,099 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,311,838 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $11,802,444 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$490,606 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$490,606 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$490,606 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $124,479,190 | SecuritiesAmt |
| Other | $30,625 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $114,308,876 | SecuritiesAmt |
| Other | $262,796 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,170,314 | SecuritiesAmt |
| Other | -$232,171 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,938,143 | TotalRevenueColumnAmt |
| Exclusion | $9,938,143 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $646,640,903 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $573,896,075 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $7,628,696 | UnrelatedBusinessRevenueAmt |
| Exclusion | $63,865,757 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,108,824 | TotalAmt |
| Management And General | $6,108,824 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,968,847 | TotalAmt |
| Program Services | $257,891,864 | ProgramServicesAmt |
| Management And General | $36,076,983 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,449,043 | TotalAmt |
| Program Services | $8,289,420 | ProgramServicesAmt |
| Management And General | $1,159,623 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,768,249 | TotalAmt |
| Program Services | $35,765,013 | ProgramServicesAmt |
| Management And General | $5,003,236 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,167,235 | TotalAmt |
| Program Services | $17,692,235 | ProgramServicesAmt |
| Management And General | $2,475,000 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,106,193 | TotalAmt |
| Program Services | $970,437 | ProgramServicesAmt |
| Management And General | $135,756 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $302,387 | TotalAmt |
| Program Services | $265,277 | ProgramServicesAmt |
| Management And General | $37,110 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,017 | TotalAmt |
| Management And General | $105,017 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $748,801 | TotalAmt |
| Management And General | $748,801 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,156,507 | TotalAmt |
| Program Services | $42,246,556 | ProgramServicesAmt |
| Management And General | $5,909,951 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,455,374 | TotalAmt |
| Program Services | $2,241,769 | ProgramServicesAmt |
| Management And General | $213,605 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,469,135 | TotalAmt |
| Program Services | $4,797,942 | ProgramServicesAmt |
| Management And General | $671,193 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,851,733 | TotalAmt |
| Program Services | $7,765,414 | ProgramServicesAmt |
| Management And General | $1,086,319 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,862,273 | TotalAmt |
| Program Services | $13,915,594 | ProgramServicesAmt |
| Management And General | $1,946,679 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,959,715 | TotalAmt |
| Program Services | $3,473,764 | ProgramServicesAmt |
| Management And General | $485,951 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,286,737 | TotalAmt |
| Program Services | $28,295,892 | ProgramServicesAmt |
| Management And General | $3,990,845 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,394,743 | TotalAmt |
| Program Services | $4,732,679 | ProgramServicesAmt |
| Management And General | $662,064 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $83,751,147 | $73,472,885 | $10,278,262 |
| BAD DEBT EXPENSE | $24,225,425 | $24,225,425 | |
| MAINTENANCE & REPAIR | $12,972,740 | $11,380,676 | $1,592,064 |
| GOVERNMENT TAXES | $10,937,643 | $10,937,643 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,544,052 | TotalAmt |
| Program Services | $5,745,473 | ProgramServicesAmt |
| Management And General | $798,579 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $633,591,820 | TotalAmt |
| Program Services | $554,105,958 | ProgramServicesAmt |
| Management And General | $79,485,862 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,409 | BOYAmt |
| EOY | $18,424 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,514,694 | BOYAmt |
| EOY | $8,446,193 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,286,511 | BOYAmt |
| EOY | $83,422,384 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,351,746 | BOYAmt |
| EOY | $6,582,936 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,999,020 | BOYAmt |
| EOY | $3,962,207 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $599,339,798 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $386,732,231 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,269,194 | BOYAmt |
| EOY | $212,607,567 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $157,932,141 | BOYAmt |
| EOY | $205,615,544 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,392,579 | BOYAmt |
| EOY | $38,756,112 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,725,311 | BOYAmt |
| EOY | $21,776,840 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $574,490,605 | BOYAmt |
| EOY | $581,188,207 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,203,465 | BOYAmt |
| EOY | $62,622,331 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $443,845 | BOYAmt |
| EOY | $699,070 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $148,644,676 | BOYAmt |
| EOY | $138,985,212 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,530,325 | BOYAmt |
| EOY | $18,552,754 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250,822,311 | BOYAmt |
| EOY | $220,859,367 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $323,668,294 | BOYAmt |
| EOY | $360,328,840 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $323,668,294 | BOYAmt |
| EOY | $360,328,840 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $574,490,605 | BOYAmt |
| EOY | $581,188,207 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $13,049,083 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $23,611,463 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $40,000 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $60,000 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $100,000 | 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 | CONTACTS AND VISITS WERE MADE WITH STATE LEVEL LEGISLATORS TO PROMOTE HEALTH CARE RELATED ISSUES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,683,970 | BeginningYearBalanceAmt |
| Contributions | $710,628 | ContributionsAmt |
| Investment Earnings Or Losses | $85,294 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $33,800 | OtherExpendituresAmt |
| End Year Balance | $3,446,092 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,382,667 | BeginningYearBalanceAmt |
| Contributions | $270,795 | ContributionsAmt |
| Investment Earnings Or Losses | $92,571 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $62,063 | OtherExpendituresAmt |
| End Year Balance | $2,683,970 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,251,229 | BeginningYearBalanceAmt |
| Contributions | $72,500 | ContributionsAmt |
| Investment Earnings Or Losses | $71,751 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $12,813 | OtherExpendituresAmt |
| End Year Balance | $2,382,667 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,737,891 | BeginningYearBalanceAmt |
| Contributions | $513,452 | ContributionsAmt |
| Investment Earnings Or Losses | $25,341 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $25,455 | OtherExpendituresAmt |
| End Year Balance | $2,251,229 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,537,773 | BeginningYearBalanceAmt |
| Contributions | $247,046 | ContributionsAmt |
| Investment Earnings Or Losses | $17,937 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $64,865 | OtherExpendituresAmt |
| End Year Balance | $1,737,891 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.96590 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.03410 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,594,663 | OtherCostOrOtherBasisAmt |
| Book Value | $15,594,663 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $232,409,363 | OtherCostOrOtherBasisAmt |
| Depreciation | $116,556,726 | DepreciationAmt |
| Book Value | $115,852,637 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,779,642 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,641,553 | DepreciationAmt |
| Book Value | $4,138,089 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $327,811,891 | OtherCostOrOtherBasisAmt |
| Depreciation | $254,555,955 | DepreciationAmt |
| Book Value | $73,255,936 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,744,239 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,977,997 | DepreciationAmt |
| Book Value | $3,766,242 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $212,607,567 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (5 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| RREEF AMERICA REIT II | $21,525,495 | F |
| MELLON AGGREGATE BOND INDEX FUND | $10,557,706 | F |
| CASH ON DEPOSIT WITH BOND TRUSTEE | $5,525,336 | F |
| AGENCY ACCOUNT | $15,575 | F |
| CASUALTY INSURANCE SECURITY | $1,132,000 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $38,756,112 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| EXECUTIVE PENSION PLAN | $3,660,101 |
| RESTORATION PENSION PLAN | $55,031 |
| PY PENSION LIABILITY | $9,153,907 |
| POST RETIREMENT HEALTH INSURANCE | $1,137,856 |
| SECURITIES LENDING | $4,044,544 |
| CAA DEPOSIT RESERVE | $138,387 |
| SETTLEMENTS AND CLAIMS PAYABLE | $362,928 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $18,552,754 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | ALL ENDOWMENT FUNDS ARE HELD BY A RELATED ENTITY: NORTH MEMORIAL FOUNDATION. 1) RALPH ROSSEN ENDOWMENT: THIS ENDOWMENT WAS ESTABLISHED IN 1986 TO PROVIDE RECOGNITION TO NURSING STAFF THAT PROVIDE REMARKABLE SERVICE TO NORTH MEMORIAL PATIENTS AND THEIR FAMILIES. MEMBERS OF THE ROSSEN FAMILY SERVE ON A COMMITTEE ALONG WITH THE VP AND CHIEF NURSING OFFICER OF NORTH MEMORIAL TO SELECT THE RECIPIENTS. 2) HAROLD B. KAISER HONORARY LECTURESHIP ENDOWMENT: DR KAISER IS THE FOUNDER OF ALLERGY & ASTHMA SPECIALISTS, P.A. ESTABLISHED IN 1966. THE HAROLD B KAISER HONORARY LECTURESHIP ENDOWMENT PROVIDES FUNDING FOR A KEYNOTE SPEAKER FOR THE ANNUAL ALLERGY & ASTHMA CONFERENCE HELD IN THE MINNEAPOLIS AREA IN MARCH. 3) HAROLD ECKER ENDOWMENT: ESTABLISHED IN 1994 IN HONOR OF THE EXCELLENT CARE THAT MR. ECKER RECEIVED AS A PATIENT AT NORTH MEMORIAL, THE HAROLD ECKER ENDOWMENT PROVIDES A $500 AWARD TO THREE NORTH MEMORIAL EMPLOYEES RECOGNIZING THEIR OUTSTANDING PERFORMANCE AND PERSONAL ATTITUDE. THE AWARD IS OPENED TO ALL EMPLOYEES AND THE WINNERS ARE SELECTED BY A COMMITTEE OF NORTH MEMORIAL EMPLOYEES AND PRESENTED AT THE ANNUAL QUALITY AWARDS LUNCHEON IN NOVEMBER EACH YEAR. 4) RESIDENTIAL HOSPICE ENDOWMENT: THE RESIDENTIAL HOSPICE ENDOWMENT WAS ESTABLISHED BY DR. JOHN AND PATTY MANION TO PROVIDE ASSISTANCE TO THE RESIDENTIAL HOSPICE PROGRAM AT NORTH MEMORIAL. FUNDS ARE USED TO UPGRADE THE FACILITIES AND EQUIPMENT AT THE NORTH RESIDENTIAL HOSPICE FACILITY IN BROOKLYN CENTER, PROVIDE ADDITIONAL PROGRAM SUPPORT, STAFF TRAINING AND TO ASSIST THOSE FAMILIES THAT CANNOT AFFORD THIS SERVICE. 5) HELEN MURRAY MEMORIAL ENDOWMENT THIS ENDOWMENT WAS ESTABLISHED WITH AN IRREVOCABLE CHARITABLE REMAINDER TRUST BY JEANNE MITHUN TO RECOGNIZE THE OUTSTANDING SERVICE THAT NORTH RESIDENTIAL HOSPICE PROVIDED TO HER MOTHER (HELEN MURRAY) AND HER FAMILY. FUNDS ARE USED TO PROVDE CARE TO INDIVIDUALS UNABLE TO PAY FOR SERVICES AT THE FACILITY. 6) PAY IT FORWARD THE PAY IT FORWARD FUND WAS ESTABLISHED BY BREAST CANCER SURVIVOR MICHELLE MOREY AND HER HUSBAND SCOTT BISSEN. MICHELLE RECOGNIZED A NEED TO HELP WOMEN STRUGGLING FINANCIALLY WHILE GOING THROUGH CANCER TREATMENT. PATIENTS ELIGIBLE FOR ASSISTANCE ARE FROM NORTH MEMORIAL, UNITY AND MONTICELLO HOSPITALS. THE FUND IS ADMINISTERED AT NO FEE THROUGH THE NORTH MEMORIAL FOUNDATION. 7) MEDICAL STAFF ENDOWMENT THIS ENDOWMENT WAS ESTABLISHED IN 2010 BY THE NORTH MEMORIAL MEDICAL STAFF EXECUTIVE COMMITTEE. PROCEEDS FROM THE ENDOWMENT WILL FUND NORTH MEMORIAL PROGRAMS SUCH AS JUNIOR VOLUNTEER SCHOLARSHIP, SAFEJOURNEY, PASTORAL CARE, ETC. 8) MAPLE GROVE MEDICAL STAFF ENDOWMENT WAS ESTABLISHED IN 2013 BY THE MAPLE GROVE MEDICAL STAFF EXECUTIVE COMMITTEE. PROCEEDS FROM THE ENDOWMENT WILL FUND MAPLE GROVE PROGRAMS. |
| PART X, LINE 2: | NORTH MEMORIAL EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2013 OR 2012. NORTH MEMORIAL IS NOT CURRENTLY UNDER EXAMINATION BY ANY TAX JURISDICTION, HOWEVER, WE HAVE BEEN INFORMED BY THE STATE OF MINNESOTA THAT THEY WILL CONDUCT A SALES TAX AUDIT FOR THE PERIOD OF SEPTEMBER 2010 THROUGH DECEMBER 2013. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,409,217 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,409,217 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01800 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $78,706,288 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $52,068,619 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,637,669 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04200 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $90,115,505 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $52,068,619 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $38,046,886 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06000 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,735,387 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,735,387 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,704,908 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,749,040 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,955,868 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00620 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $54,974,826 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $41,354,749 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,620,077 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02150 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $155,983 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,267 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $134,716 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $768,102 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $768,102 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $63,339,206 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $43,125,056 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,214,150 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03180 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $153,454,711 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $95,193,675 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $58,261,036 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09180 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $8,592,642 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $134,554,544 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $183,550,210 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$48,995,666 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (10 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct | Ofcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPct | Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct |
|---|---|---|---|
| 1 MAPLE GROVE HOSPITAL | |||
| HOSPITAL | 0.75000 | 0.00000 | 0.00000 |
| 2 NM SURGERY CENTER MAPLE GROVE | |||
| OUTPATIENT SURG CTR | 0.50000 | 0.00000 | 0.50000 |
| 3 MN DIAGNOSTIC IMAGING PARTNERS | |||
| OUTPATIENT IMAGING CTR | 0.60000 | 0.00000 | 0.40000 |
| 4 PREFERRED ONE ADMINISTRATIVE SERVICES | |||
| CLAIMS ADMINISTRATOR | 0.25000 | 0.00000 | 0.25000 |
| 5 PREFERRED ONE COMMUNITY HEALTH PLAN | |||
| INSURANCE COMPANY | 0.50000 | 0.00000 | 0.00000 |
| 6 INSTITUTE OF ATHLETIC MEDICINE | |||
| CLINIC | 0.37000 | 0.00000 | 0.00000 |
| 7 MONTICELLO CANCER CENTER | |||
| OPTNT CANCER CLINIC | 0.40000 | 0.00000 | 0.00000 |
| 8 NORTH RADIATION ONCOLOGY | |||
| OPTNT RADIATION ONC CLNC | 0.50000 | 0.00000 | 0.00000 |
| 9 BLAINE URGENCY CENTER | |||
| URGENT CARE | 0.50000 | 0.00000 | 0.00000 |
| 10 PLYMOUTH CITY CENTER MEDICAL BUILDING | |||
| MEDICAL OFFICE BUILDING | 0.50000 | 0.00000 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH MEMORIAL MEDICAL CENTER | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH MEMORIAL MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.NORTHMEMORIAL.COM | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| NORTH MEMORIAL MEDICAL CENTER | PART V, SECTION B, LINE 3: ONE OF THE KEY OBJECTIVES IN CONDUCTING THE 2013 CHNA WAS TO IDENTIFY HEALTH ISSUES MOST IMPORTANT TO OUR COMMUNITY MEMBERS. THIS WAS ACCOMPLISHED IN SEVERAL WAYS. NORTH MEMORIAL HEALTH CARE CONVENED 4 FOCUS GROUPS FROM TARGET POPULATIONS FROM THROUGHOUT THE COMMUNITY. WE FURTHER INTERVIEWED COMMUNITY LEADERS REPRESENTING LOCAL GOVERNMENT, LAW ENFORCEMENT, EDUCATION, RELIGIOUS ORGANIZATION, PUBLIC HEALTH AND COMMUNITY-BASED ORGANIZATIONS. LASTLY, WE CONDUCTED AN ONLINE SURVEY FOR COMMUNITY MEMBERS AND NORTH MEMORIAL EMPLOYEES. WE RETAINED AN OUTSIDE CONSULTING FIRM TO LEAD THE FOCUS GROUPS. |
| NORTH MEMORIAL MEDICAL CENTER | PART V, SECTION B, LINE 20D: THE MINNESOTA ATTORNEY GENERAL'S OFFICE REQUIRES HOSPITALS TO RENDER SERVICES TO THOSE PATIENTS WHO DO NOT HAVE INSURANCE AT A REDUCED RATE EQUAL TO THE DISCOUNT INCURRED FROM THE HIGHEST VOLUME MANAGED CARE PLAN. |
| NORTH MEMORIAL MEDICAL CENTER | PART V, SECTION B, LINE 22: PER THE MINNESOTA ATTORNEY GENERAL'S AGREEMENT, THIRD PARTY LIABILITY AND PROCEDURES THAT ARE NOT MEDICALLY NECESSARY ARE NOT COVERED UNDER THE MINNESOTA ATTORNEY GENERAL'S AGREEMENT AND THOSE PATIENTS CAN BE BILLED FULL CHARGES. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MINNESOTA DIAGNOSTIC IMAGING PARTNERS LL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2955 XENIUM LANE SUITE 40 | AddressLine1 |
| City | PLYMOUTH | City |
| State | MN | State |
| ZIP Code | 55441 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | OUTPATIENT RADIOLOGY | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 2: | AMOUNT REPRESENTS THE HOSPITAL'S BAD DEBT PROVISION REDUCED BY THE HOSPITAL'S COST TO CHARGE RATIO WHICH REPRESENTS THE BEST ESTIMATE OF COST FOR THE BAD DEBT PROVISION. |
| PART III, LINE 4: | NORTH MEMORIAL'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DESCRIPTION ABOUT BAD DEBT EXPENSE. THE COST TO CHARGE RATIO WAS USED TO DETERMINE THE AMOUNT ON PART III, SECTION A, LINE 2. WE DO NOT HAVE THE INFORMATION NECESSARY TO DETERMINE WHICH PORTION OF THE AMOUNT REPORTED ON LINE 2 IS COMMUNITY BENEFIT. |
| PART III, LINE 8: | THE SHORTFALL REPORTED REPRESENTS THE AMOUNT MEDICARE REIMBURSEMENT IS LESS THAN THE ESTIMATED COST OF PROVIDING SERVICES TO THOSE PATIENTS. THE METHOD USED TO ESTIMATE THOSE COSTS IS THE COST TO CHARGE RATIO APPROACH WHICH CALCULATES THE RATIO OF TOTAL HOSPITAL COSTS / TOTAL HOSPITAL GROSS REVENUE AND THEM APPLIES THAT RATIO TO TOTAL MEDICARE GROSS REVENUE. |
| PART III, LINE 9B: | NORTH MEMORIAL HAS POLICIES AND PROCEDURES IN PLACE FOR COLLECTION PRACTICES THAT INCLUDE IDENTIFICATION AND SCREENING FOR CHARITY CARE AND FINANCIAL ASSISTANCE. THE POLICIES ARE AVAILABLE ON THE ORGANIZATIONS INTRANET AND PERTAIN TO ALL ENTITIES UNDER THE NORTH MEMORIAL CORPORATE UMBRELLA. |
| PART VI, LINE 2: | NORTH MEMORIAL WORKS CLOSELY WITH COMMUNITY MEMBERS TO DETERMINE AREAS OF INTEREST AND NEED IN HEALTHCARE SERVICES. IN 2013 WE COMPLETED A FULL COMMUNITY NEEDS ASSESSMENT, INCLUDING COMMUNITY FOCUS GROUPS, TO BETTER UNDERSTAND THE COMMUNITY'S HEALTH NEEDS. |
| PART VI, LINE 3: | NORTH MEMORIAL HEALTH CARE HAS A VERY PROACTIVE PROGRAM TO ASSIST UNINSURED AND UNDERINSURED PATIENTS WITH THEIR MEDICAL BILLS. WE COMPLY WITH THE ATTORNEY GENERAL'S REQUIREMENT TO PROVIDE AN IMMEDIATE DISCOUNT TO UNINSURED MINNESOTA RESIDENTS. WE HAVE PATIENT FINANCIAL ADVOCATES AS WELL AS A CONTRACTED VENDOR THAT MEETS WITH ALL OF OUR UNINSURED INPATIENTS AND SPECIFIC OUTPATIENTS TO ASSIST THEM IN MEDICAL ASSISTANCE ELIGIBILITY AND APPLICATIONS. THIS COULD INCLUDE A VISIT TO THEIR RESIDENCE IF THEY NEED HELP IN COMPLETING ASSISTANCE APPLICATIONS. SHOULD THEY NOT QUALIFY FOR STATE OR FEDERAL ASSISTANCE PROGRAMS, WE OFFER AND ASSIST THEM IN APPLYING FOR THE HOSPITAL'S FINANCIAL ASSISTANCE (CHARITY CARE) PROGRAM.OUR CHARITY CARE PROGRAM IS PUBLISHED IN THE CORPORATE POLICIES AND PROCEDURES AND PROVIDES FOR 100% COVERAGE OF MEDICAL BILLS FOR ANYONE WHOSE INCOME IS LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES AND NEEDS ASSISTANCE IN RESOLVING THEIR FINANCIAL OBLIGATION TO THE HOSPITAL. THERE IS A GRADUAL REDUCTION IN THE CHARITY COVERAGE BETWEEN THE 201% AND 400% OF THE FEDERAL POVERTY GUIDELINES.IF WE ARE UNABLE TO MEET WITH THE PATIENT BEFORE DISCHARGE FROM NORTH MEMORIAL, THE PATIENT IS GIVEN A PAMPHLET THAT LISTS CONTACT NUMBERS TO OUR BUSINESS OFFICE CUSTOMER SERVICE AREA TO DISCUSS OPTIONS FOR ASSISTANCE WITH THEIR MEDICAL BILLS. THIS CONTACT INFORMATION IS ALSO PROVIDED ON EVERY STATEMENT THAT IS SENT TO OUR CUSTOMERS. IN ADDITION, OUR INTERNAL COLLECTIONS DEPARTMENT AND OUR COLLECTION AGENCIES ARE WELL VERSED IN OUR ASSISTANCE PROGRAMS AND WILL ASSESS DURING THEIR CONVERSATIONS WITH PATIENTS IF REFERRAL TO EITHER A STATE OR FEDERAL PROGRAM OR OUR CHARITY CARE PROGRAM WOULD BE APPROPRIATE. |
| PART VI, LINE 4: | NORTH MEMORIAL SERVES A GEOGRAPHIC AREA THAT INCLUDES 42 ZIP CODES IN THE NORTHWEST QUADRANT OF THE TWIN CITIES METRO. THIS SERVICE AREA INCLUDES BOTH URBAN, SUBURBAN, EX-URBAN, AND RURAL AREAS. THIS SERVICE AREA INCLUDES A DIVERSE POPULATION OF MORE THAN 900,000 PEOPLE LIVING IN HENNEPIN, WRIGHT, SHERBURNE AND RAMSEY COUNTIES. |
| PART VI, LINE 5: | NORTH MEMORIAL HEALTH CARE IS A GENERAL ACUTE CARE HOSPITAL PROVIDING SPECIALIZED TRAUMA AND EMERGENCY SERVICES, CARDIOVASULAR AND OPEN HEART SERVICES, ONCOLOGY, HIGH RISK MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL-SURGICAL, OBSTETRICAL, PEDIATRIC, REHABILITATIVE AND BEHAVIORAL SERVICES. NMHC ALSO PROVIDES AN ARRAY OF HEALTH CARE SERVICES TO OUR COMMUNITY INCLUDING PRIMARY CARE, AMBULANCE TRANSPORTATION AND HOME HEALTH AND HOSPICE SERVICES. NORTH MEMORIAL IS GOVERNED BY A BOARD OF 15 REPRESENTATIVES CONSISTING OF PHYSICIANS AND VARIOUS LEADERS FROM THROUGHOUT THE COMMUNITY. BOARD MEMBERS ARE ELECTED TO SERVE THREE-YEAR TERMS FOR A TOTAL OF FIVE TERMS. THE MEDICAL CENTER ALSO SUPPORTS AN OPEN MEDICAL STAFF ORGANIZATION INCLUDING APPROXIMATELY 900 BOARD CERTIFIED PHYSICIANS AND 300 ALLIED HEALTH PROFESSIONSALS. THE NORTH MEMORIAL BOARD OF TRUSTEES ESTABLISHES AN ANNUAL MARGIN TARGET FOR MANAGEMENT. PER BOARD POLICY 75% OF ANY EXCESS AVAILABLE CASH FLOW IS REINVESTED IN THE FORM OF CAPITAL IMPROVEMENTS TO THE CENTER. THE REMAINING 25% IS REINVESTED TO SUPPORT LONG TERM OPERATIONS. |
| PART VI, LINE 6: | NORTH MEMORIAL HEALTH SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. THROUGH TARGETED OUTREACH, EDUCATION AND PARTNERSHIPS, WE IMPROVE THE HEALTH OF OUR COMMUNITIES BY LISTENING TO THEIR NEEDS AND RESPONDING WITH APPROPRIATE PROGRAMS AND SERVICES.OUR PROGRAMS, MANY OF WHICH HAVE BEEN NATIONALLY RECOGNIZED, RANGE FROM HEALTH EDUCATION AND FREE SCREENINGS TO TRAINING HEALTH PROFESSIONALS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LOREN TAYLOR | ||||||||||||||
| CEO NORTH MEMORIAL | $606,008 | $0 | $0 | $0 | $170,207 | $0 | $17,850 | $0 | $5,275 | $0 | $799,340 | $0 | $0 | $0 |
| AMY KOLAR MD | ||||||||||||||
| BOARD MEMBER | $184,066 | $0 | $40,000 | $0 | $247,158 | $0 | $17,850 | $0 | $6,940 | $0 | $496,014 | $0 | $0 | $0 |
| PATRICK BORAN | ||||||||||||||
| VP FINANCE, CFO (PART-YEAR) | $115,113 | $0 | $0 | $0 | $504,108 | $0 | $8,581 | $0 | $1,789 | $0 | $629,591 | $0 | $0 | $0 |
| KEVIN CROSTON MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $400,446 | $0 | $0 | $0 | $64,264 | $0 | $17,850 | $0 | $4,683 | $0 | $487,243 | $0 | $0 | $0 |
| TIFFANY ZITZEWITZ | ||||||||||||||
| VP BUSINESS DEVELOPMENT | $250,000 | $0 | $0 | $0 | $38,619 | $0 | $17,500 | $0 | $6,985 | $0 | $313,104 | $0 | $0 | $0 |
| ANDREW COCHRANE | ||||||||||||||
| CEO MAPLE GROVE HOSPITAL | $330,000 | $0 | $0 | $0 | $51,414 | $0 | $17,850 | $0 | $7,043 | $0 | $406,307 | $0 | $0 | $0 |
| GAYLE MATTSON | ||||||||||||||
| PRESIDENT OF NORTH MEMORIAL | $304,990 | $0 | $0 | $0 | $48,871 | $0 | $13,138 | $0 | $259 | $0 | $367,258 | $0 | $0 | $0 |
| DAVID ABRAMS | ||||||||||||||
| VP HUMAN RESOURCES | $225,000 | $0 | $0 | $0 | $41,404 | $0 | $53,165 | $0 | $6,167 | $0 | $325,736 | $0 | $37,675 | $0 |
| JOSEPH BOSTON | ||||||||||||||
| VP FOUNDATION | $146,771 | $0 | $0 | $0 | $261,260 | $0 | $10,274 | $0 | $5,134 | $0 | $423,439 | $0 | $0 | $0 |
| MICHAEL PARRISH | ||||||||||||||
| VP EMERGENCY & ENTERPRISE OPERATIONS | $272,463 | $0 | $0 | $0 | $46,017 | $0 | $17,850 | $0 | $5,007 | $0 | $341,337 | $0 | $0 | $0 |
| PATRICK TAFFE | ||||||||||||||
| CHIEF INFORMATION OFFICER | $256,203 | $0 | $0 | $0 | $44,907 | $0 | $17,591 | $0 | $4,996 | $0 | $323,697 | $0 | $0 | $0 |
| ANDREW HOULTON | ||||||||||||||
| MEDICAL DIRECTOR | $272,308 | $0 | $0 | $0 | $3,980 | $0 | $18,196 | $0 | $7,050 | $0 | $301,534 | $0 | $0 | $0 |
| JEFF WICKLANDER | ||||||||||||||
| VP OPERATIONS | $216,731 | $0 | $15,000 | $0 | $35,315 | $0 | $7,431 | $0 | $6,185 | $0 | $280,662 | $0 | $0 | $0 |
| TRACY KIRBY | ||||||||||||||
| VP INPATIENT CARE/CNO | $157,154 | $0 | $0 | $0 | $25,386 | $0 | $5,261 | $0 | $6,166 | $0 | $193,967 | $0 | $0 | $0 |
| ROBERT KING | ||||||||||||||
| CARDIAC SURGEON | $675,880 | $0 | $25,000 | $0 | $8,870 | $0 | $17,850 | $0 | $7,289 | $0 | $734,889 | $0 | $0 | $0 |
| ALOK MAHESHWARI | ||||||||||||||
| CARDIOLOGIST | $716,650 | $0 | $7,500 | $0 | $3,634 | $0 | $17,850 | $0 | $6,646 | $0 | $752,280 | $0 | $0 | $0 |
| STEVEN ROH | ||||||||||||||
| CARDIOLOGIST | $721,650 | $0 | $74,000 | $0 | $3,882 | $0 | $19,849 | $0 | $7,255 | $0 | $826,636 | $0 | $0 | $0 |
| THOMAS ROSSINI | ||||||||||||||
| STAFF EMERGENCY PHYSICIAN | $581,837 | $0 | $140,269 | $0 | $2,920 | $0 | $17,850 | $0 | $7,105 | $0 | $749,981 | $0 | $0 | $0 |
| JOSEPH VAN CAMP | ||||||||||||||
| CARDIAC SURGEON | $684,900 | $0 | $0 | $0 | $3,239 | $0 | $17,850 | $0 | $7,289 | $0 | $713,278 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | THE ORGANIZATION REIMBURSES ONE OF THE EXECUTIVE MEMBERS FOR THE MONTHLY SOCIAL DUES AT THE GOLDEN VALLEY COUNTRY CLUB. THE DUES FOR 2013 WERE $90 PER MONTH OR $1,080 PER YEAR. THE NORTH MEMORIAL COMMUNITY FOUNDATION UTILIZES THE COUNTRY CLUB TO HOST VARIOUS FUNDRAISING EVENTS THROUGH-OUT THE YEAR THAT SUPPORT VARIOUS ACTIVITIES FOR NORTH MEMORIAL. |
| PART I, LINE 4A | A PORTION OF THE AMOUNTS REPORTED IN "OTHER REPORTABLE COMPENSATION" REFLECTS PAYMENTS MADE IN 2013 PURSUANT TO SEVERANCE AGREEMENTS WITH 2 EMPLOYEES AS FOLLOWS: PAT BORAN- $425,133 JOE BOSTON- $231,556 |
| PART I, LINE 6 | NORTH MEMORIAL HEALTH CARE'S ANNUAL INCENTIVE PLAN REQUIRES ACHIEVEMENT OF STATED PERFORMANCE METRICS, WHICH INCLUDE OPERATING CASH FLOW MARGIN. |
| PART III, LINE 2: | ALL EXPENSES ARE REVIEWED PRIOR TO REIMBURSEMENT AND SIGNED OFF BY THE CEO. NORTH MEMORIAL REPORTS EXECUTIVE EXPENSE REIMBURSEMENT DATA TO THE BOARD OF TRUSTEES ON A PERIODIC BASIS. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| CITY OF MAPLE GROVE | ||||||||
| A | 410873250 | 56516TAD7 | 2005-09-22 | $55,000,000 | CONSTRUCTION OF OUTPATIENT CENTER | 0 | Yes (1) | 0 |
| CITY OF ROBBINSDALE | ||||||||
| B | 716005496 | 2011-06-07 | $60,000,000 | REFUND SERIES 2008 BONDS | 0 | Yes (1) | 0 | |
| CITY OF ROBBINSDALE | ||||||||
| C | 716005496 | 2011-06-07 | $15,000,000 | REFUND SERIES 2008 BONDS | 0 | Yes (1) | 0 | |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | RetiredRetiredAmt |
|---|---|---|---|---|---|---|---|---|---|---|
| A | $54,851,782 | $4,767,980 | $1,083,801 | $49,000,001 | 2007 | 0 | 0 | Yes (1) | Yes (1) | |
| B | $60,000,000 | $749,350 | $58,710,650 | 2011 | Yes (1) | 0 | Yes (1) | Yes (1) | $7,564,220 | |
| C | $15,000,000 | $15,000,000 | 2011 | Yes (1) | 0 | Yes (1) | Yes (1) | $1,372,500 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 |
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| C | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | DATE REBATE COMPUTATION PERFORMED | FormAndLineReferenceDesc |
| Explanation | ISSUER NAME: CITY OF MAPLE GROVE DATE THE REBATE COMPUTATION WAS PERFORMED: 08/31/2010 | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| ROBIN DRUG AND MERWIN PHARMACIES | |||
| BOARD MEMBER IS THE OWNER OF ROBIN DRUG AND MERWIN PHARMACIES | $514,548 | MICHAEL STEINHAUSER, A BOARD MEMBER, IS THE OWNER OF ROBIN DRUG AND MERWIN PHARMACIES, WHICH SUPPLIES DRUGS AND PHARMACEUTICALS TO NORTH MEMORIAL HEALTH CARE. | 0 |
| OAKDALE OBGYN | |||
| BOARD MEMBER IS AN OWNER OF OAKDALE OBGYN | $448,956 | JON NIELSEN, A BOARD MEMBER, IS AN OWNER OF OAKDALE OBSTETRICS & GYNECOLOGY (A.K.A. OAKDALE OBGYN) WHICH PROVIDES GYNECOLOGICAL SERVICES TO NORTH MEMORIAL HEALTH CARE. | 0 |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp (4 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | FURNITURE | 1 | $48,077 | COST |
| Yes (X) | PIANO PLAYER | 1 | $8,545 | COST |
| Yes (X) | FURNITURE REU | 1 | $8,158 | COST |
| Yes (X) | WHITEBOARDS | 1 | $7,476 | COST |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | LISTS THE NUMBER OF CONTRIBUTORS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | LOREN TAYLOR AND BOB POTTS - BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ORGANIZATION'S FINANCE AND AUDIT COMMITTEE REVIEWS THE FORM 990 BEFORE IT IS FILED. REPRESENTATIVES FROM THE HOSPITAL'S INDEPENDENT ACCOUNTING FIRM REVIEW THE FORM 990 WITH THE FINANCE AND AUDIT COMMITTEE IN DETAIL AND NOTES FOR THE COMMITTEE ANY CHANGES IN THE FORM 990 FROM PRIOR YEARS. AFTER THOROUGH DISCUSSION, THE FINANCE AND AUDIT COMMITTEE APPROVES THE FORM 990 AND FORWARDS IT TO THE FULL BOARD FOR ITS REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL MEMBERS OF THE BOARD OF DIRECTORS AND ALL EMPLOYEES RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY EACH YEAR. EACH BOARD MEMBER AND STAFF MEMBER FILLS OUT A CONFLICT OF INTEREST QUESTIONNAIRE IN WHICH THEY ARE ASKED TO IDENTIFY ANY RELATIONSHIP THAT WOULD CREATE A CONFLICT OF INTEREST. THE RESULTS ARE SUMMARIZED AND REVIEWED TO DETERMINE ANY ACTUAL OR POTENTIAL CONFLICT AND ARE REPORTED TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR KEY POSITIONS IS REVIEWED BY THE EXECUTIVE COMMITTEE WORKING IN CONJUNCTION WITH AN OUTSIDE CONSULTANT. THE EXECUTIVE COMMITTEE INSURES THAT THE SALARY AND BENEFIT ADMINISTRATION REVIEW PROCESS IS BEING FOLLOWED, WHICH INCLUDES SALARY AND BENEFIT SURVEYS AND COMPARISONS OF ALL POSITIONS. THE CEO'S COMPENSATION IS SENT TO THE FULL BOARD FOR APPROVAL. THE COMPENSATION OF ALL OTHER KEY POSITIONS IS APPROVED BY THE CEO. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FINANCIAL STATEMENTS ARE AVAILABLE ONLINE THROUGH THE OFFICE OF THE ATTORNEY GENERAL VIA THE CHARITY REPORT FILED WITH THE STATE OF MINNESOTA. |
| FORM 990, PART XII, LINE 2C: | NEITHER THE OVERSIGHT OF THE AUDIT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT WERE CHANGED DURING THE TAX YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OAKDALE MEDICAL CENTER | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320022819 | EIN |
| Primary Activities | LEASE MEDICAL OFFICE SPACE | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Total Income | $820,561 | TotalIncomeAmt |
| End Of Year Assets | $16,241,841 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH MEMORIAL | BusinessNameLine1 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTH MEMORIAL FOUNDATION | |||||||||||
| 3300 OAKDALE AVENUE NORTH | ROBBINSDALE | MN | 55422 | 411777966 | FUNDRAISING | MN | 501(C)(3) | 7 | NORTH MEMORIAL | 0 | |
| ASSOCIATED HEALTH ASSURANCE | |||||||||||
| 3300 OAKDALE AVENUE NORTH | ROBBINSDALE | MN | 55422 | 980343815 | INSURANCE | 501(C)(3) | LINE 11A, I | NORTH MEMORIAL | Yes (1) | BD | |
| MAPLE GROVE HOSPITAL CORPORATION | |||||||||||
| 9875 HOSPITAL DRIVE | MAPLE GROVE | MN | 55369 | 208316475 | ACUTE CARE | MN | 501(C)(3) | 3 | NORTH MEMORIAL | Yes (1) | |
| NORTH COLLABORATIVE CARE | |||||||||||
| 3300 OAKDALE AVE N | ROBBINSDALE | MN | 55422 | 461680666 | PRIMARY CARE | MN | 501(C)(3) | 7 | 0 | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE | ||||||||||||
| 9855 HOSPITAL DRIVE | MAPLE GROVE | MN | 55369 | 260393039 | OUTPATIENT SURGERY | MN | RELATED | $1,736,890 | $2,944,836 | 0 | Yes (1) | 0.50000 |
| MINNESOTA DIAGNOSTIC IMAGING PARTNERS LLC | ||||||||||||
| 2955 XENIUM LANE SUITE 40 | PLYMOUTH | MN | 55441 | 352162215 | RADIOLOGY | MN | RELATED | $1,082,434 | $2,374,047 | 0 | Yes (1) | 0.60000 |
| NORTH RADIATION THERAPY CENTER LLC | ||||||||||||
| 6950 FRANCE AVE S SUITE 200 | EDINA | MN | 55435 | 743069974 | RADIOLOGY | MN | RELATED | $1,419,770 | $2,131,734 | 0 | Yes (1) | 0.50000 |
| BLAINE URGENCY CENTER | ||||||||||||
| 480 OSBORNE RD NE | FRIDLEY | MN | 55432 | 461630126 | URGENT CARE | MN | RELATED | -$7,610 | $880,502 | 0 | Yes (1) | 0.50000 |
| PLYMOUTH CITY CENTER MEDICAL BUILDING | ||||||||||||
| 5700 SMETANA DRIVE SUITE 120 | MINNETONKA | MN | 55343 | 463883617 | MEDICAL OFFICE BUILDING | MN | RELATED | $2,780,145 | 0 | 0 | 0.50000 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OAKDALE HEALTH ENTERPRISES INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411546422 | EIN |
| Primary Activities | AMBULANCE | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH MEMORIAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $627,846 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $1,315,397 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (19 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NORTH MEMORIAL FOUNDATION (CONTRIBUTIONS) | ||
| C | $670,812 | FMV |
| MAPLE GROVE HOSPITAL CORPORATION (RETURN OF CAPITAL) | ||
| C | $7,373,860 | FMV |
| MAPLE GROVE HOSPITAL CORPORATION (DEBT GUARANTEE) | ||
| D | $105,443,016 | FMV |
| MAPLE GROVE HOSPITAL CORPORATION (LEASE PMTS) | ||
| J | $458,957 | FMV |
| MAPLE GROVE HOSPITAL CORPORATION (MGMT FEE) | ||
| S | $8,682,665 | FMV |
| MAPLE GROVE HOSPITAL CORPORATION (SALARY REIMBURSMENT) | ||
| Q | $7,479,153 | FMV |
| ASSOCIATED HEALTH ASSURANCE (PREMUIMS) | ||
| M | $2,631,250 | FMV |
| OAKDALE HEALTH ENTERPRISES (PAYROLL) | ||
| P | $1,593,140 | FMV |
| OAKDALE HEALTH ENTERPRISES (MGMT FEES) | ||
| S | $244,743 | FMV |
| OAKDALE HEALTH ENTERPRISES (INTEREST ON LOAN) | ||
| S | $10,768 | FMV |
| OAKDALE MEDICAL OFFICE BUILDING (LEASE PAYMENTS) | ||
| J | $676,356 | FMV |
| OAKDALE MEDICAL OFFICE BUILDING (EXPENSE REIMBURSMENTS) | ||
| Q | $426,528 | FMV |
| MINNEAPOLIS RADIATION ONCOLOGY (LEASE PMTS) | ||
| J | $227,191 | FMV |
| NORTH MEMORIAL AMBULATORY SURGERY CENTER (LEASE PMTS) | ||
| J | $1,615,853 | FMV |
| MINNEAPOLIS RADIATION ONCOLOGY (DIVIDEND) | ||
| J | $805,827 | FMV |
| MINNEAPOLIS RADIATION ONCOLOGY (DIVIDEND) | ||
| R | $1,225,000 | FMV |
| NORTH MEMORIAL FOUNDATION (STAFF SUPPORT) | ||
| O | $581,245 | FMV |
| BLAINE URGENCY CENTER (LINE OF CREDIT) | ||
| D | $935,766 | FMV |
| PLYMOUTH CITY CENTER MEDICAL BUILDING (CAPITAL CONTRIBUTION) | ||
| B | $2,780,145 | FMV |
Comments