MAYO CLINIC HEALTH SYSTEM-OAKRIDGEINC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MAYO CLINIC HEALTH SYSTEM-OAKRIDGEINC (EIN 39-1029430)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-07-26
IRS object ID
201302079349301010
Schema version
2012v2.1
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)
Timestamp2013-07-26T12:04:10-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391029430EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MAYO CLINIC HEALTH SYSTEM-OAKRIDGEINCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMAYONameControl
Phone5075381297Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 70 / 13025 EIGHTH STREETAddressLine1
CityOSSEOCity
StateWIState
ZIP Code547580070ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDEAN B EIDEName
TitleVICE PRESIDENTTitle
Phone7158387940Phone
Date Signed2013-07-26DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDEAN B EIDENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 70 / 13025 EIGHTH STREETAddressLine1
CityOSSEOCity
StateWIState
ZIP Code547580070ZIPCode
FieldValueIRS element (for citing)
Gross Receipts24612888GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MAYOCLINICHEALTHSYSTEM.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionHOSPITAL, NURSING HOME AND RESIDENTIAL CARE APARTMENT COMPLEXActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees277TotalNbrEmployees
Total Nbr Volunteers24TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3199871ContributionsGrantsPriorYear
Contributions Grants Current Year3250237ContributionsGrantsCurrentYear
Program Service Revenue Prior Year19650445ProgramServiceRevenuePriorYear
Program Service Revenue CY21310294ProgramServiceRevenueCY
Investment Income Prior Year-15090InvestmentIncomePriorYear
Investment Income Current Year-7InvestmentIncomeCurrentYear
Other Revenue Prior Year-11906OtherRevenuePriorYear
Other Revenue Current Year-18273OtherRevenueCurrentYear
Total Revenue Prior Year22823320TotalRevenuePriorYear
Total Revenue Current Year24542251TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year6325GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY6850GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year13455036SalariesEtcPriorYear
Salaries Etc Current Year14708209SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year6568TotalFundrsngExpCurrentYear
Other Expense Prior Year6132191OtherExpensePriorYear
Other Expenses Current Year9171239OtherExpensesCurrentYear
Total Expenses Prior Year19593552TotalExpensesPriorYear
Total Expenses Current Year23886298TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3229768RevenuesLessExpensesPriorYear
Revenues Less Expenses CY655953RevenuesLessExpensesCY
Total Assets BOY12857186TotalAssetsBOY
Total Assets EOY13927389TotalAssetsEOY
Total Liabilities BOY4012453TotalLiabilitiesBOY
Total Liabilities EOY4426703TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8844733NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY9500686NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION, AND RESEARCH.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense22175097Expense
Revenue21320288Revenue
DescriptionPATIENT CARE (SCHEDULE O)MAYO CLINIC HEALTH SYSTEM - OAKRIDGE (MCHS-OAKRIDGE) IS A MEMBER OF THE MAYO CLINIC HEALTH SYSTEM. IT IS A WISCONSIN NONPROFIT CORPORATION, TAX EXEMPT AS AN ORGANIZATION DESCRIBED IN SEC. 501(C)(3) OF THE INTERNAL REVENUE CODE. THE CORPORATION, WHICH INCLUDES A HOSPITAL, CLINIC, NURSING HOME AND RESIDENTIAL CARE APARTMENT COMPLEX, OPERATES PRIMARILY FOR THE RESIDENTS OF OSSEO AND SURROUNDING COMMUNITIES.MAYO CLINIC HEALTH SYSTEM IS A FAMILY OF CLINICS, HOSPITALS AND HEALTH CARE FACILITIES SERVING COMMUNITIES IN MINNESOTA, IOWA AND WISCONSIN. AS PART OF MAYO CLINIC, MAYO CLINIC HEALTH SYSTEM OFFERS OUTSTANDING CARE CLOSE TO HOME. PHYSICIANS AND STAFF IN MAYO CLINIC HEALTH SYSTEM HAVE READY ACCESS TO THE KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC, YET CAN MEET PATIENTS' HEALTH CARE NEEDS LOCALLY. MAYO CLINIC HEALTH SYSTEM IS PART OF THE COMMUNITY, FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES IN WHICH WE LIVE AND WORK. MAYO CLINIC HEALTH SYSTEM TEAMS WITH MAYO CLINIC TO DELIVER UNPARALLELED HEALTH CARE TO COMMUNITIES THROUGH AN INTEGRATED NETWORK OF CLINICS AND HOSPITALS.IN 2012, MAYO CLINIC HEALTH SYSTEM SITES EMPLOYED APPROXIMATELY 1,000 PHYSICIANS AND 14,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT THE MAYO CLINIC HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN 72 COMMUNITIES, THE SYSTEM INCLUDES 18 OWNED HOSPITALS, SIX OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH TWO ADDITIONAL HOSPITALS, AND CONTRACT MANAGEMENT AGREEMENTS WITH AN ADDITIONAL HOSPITAL AND NURSING HOME. SINCE ITS INCEPTION IN 1992, MAYO CLINIC HEALTH SYSTEM HAS GROWN FROM A NEW IDEA TO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN AMERICA. MAYO CLINIC HEALTH SYSTEM COMPLETES MORE THAN TWO-MILLION PATIENT VISITS ANNUALLY. IT ALSO SERVES AS A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS BEING RECOGNIZED SIX TIMES BY THE AMERICAN MEDICAL GROUP ASSOCIATION'S ACCLAIM AWARD PROGRAM (2005 ACCLAIM AWARD RECIPIENT AND FIVE-TIME ACCLAIM AWARD HONOREE). THE ACCLAIM AWARDS HONOR PHYSICIAN-LED ORGANIZATIONS DELIVERING CARE ALIGNED WITH THE IDEAL DELIVERY MODEL WHERE PATIENTS EXPERIENCE SAFE, RELIABLE, RESPONSIVE, READILY AVAILABLE AND INTEGRATED CARE. IN ADDITION, THE MINNESOTA COUNCIL FOR QUALITY HAS RECOGNIZED MAYO CLINIC HEALTH SYSTEM THREE TIMES FOR ITS PERFORMANCE EXCELLENCE EFFORTS. INDIVIDUAL MAYO CLINIC HEALTH SYSTEM LOCATIONS HAVE ALSO BEEN HONORED FOR THEIR COMMITMENT TO QUALITY, SAFETY, SERVICE, PERFORMANCE AND THEIR COMMUNITIES.PEOPLE IN MINNESOTA, IOWA AND WISCONSIN CAN HAVE PEACE OF MIND KNOWING THAT MAYO CLINIC HEALTH SYSTEM AND MAYO CLINIC PARTNER TO ENSURE HEALTHIER LIVES IN THE REGION.MCHS-OAKRIDGE'S MISSION STATEMENT STATES THAT THE ORGANIZATION'S AIM IS TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION AND RESEARCH. OUR VISION IS TO ACHIEVE THE HIGHEST STANDARDS FOR MEDICAL CARE AND HEALTH IMPROVEMENT IN THE COMMUNITIES IN WHICH WE LIVE AND WORK. OUR FIRST PRIORITY IS TO MEET PATIENT NEEDS GUIDED BY THE CORE VALUES OF INTEGRITY, CONTINUOUS IMPROVEMENT, SERVICE, TEAMWORK, INNOVATION, BALANCE AND FINANCIAL INTEGRITY. MCHS-OAKRIDGE OPERATES ON A NONDISCRIMINATORY BASIS, REGARDLESS OF RACE, COLOR, SEX, RELIGION OR NATIONAL ORIGIN.THE HOSPITAL IS LICENSED FOR 18 ACUTE CARE BEDS AND PLAYS A VITAL ROLE IN THE HEALTH AND WELL BEING OF THE COMMUNITY BY OFFERING SERVICES SUCH AS 24-HOUR EMERGENCY CARE, CLINIC APPOINTMENTS, URGENT CARE, PT/OT/SPEECH/RESPIRATORY THERAPY, CARDIAC AND PULMONARY REHABILITATIVE TREATMENTS, AND ADVANCED DIAGNOSTIC TECHNOLOGY. IN 2012, THE FACILITY ADDED AN ADDITIONAL AMBULANCE TO THE OSSEO SERVICE AREA AND RELOCATED THE SLEEP STUDY SERVICE FROM OUR MONDOVI LOCATION TO OUR OUTPATIENT CLINIC IN OSSEO. THE HOSPITAL HAD 370 ADMISSIONS IN 2012 INCLUDING ADULTS AND SWING BED ADMISSIONS. THERE WERE 1,780 EMERGENCY ROOM VISITS IN 2012, ALONG WITH 71,458 LABORATORY PROCEDURES, 17,920 THERAPY AND REHABILITATIVE SERVICES, AND 8,816 IMAGING PROCEDURES PERFORMED. IN 2012 THERE WERE 31,377 PROFESSIONAL ENCOUNTERS RECORDED. THE NURSING HOME HAS 21 LICENSED BEDS AND EACH RESIDENT RECEIVES PERSONALIZED MEDICAL, SOCIAL AND SPIRITUAL CARE. THE FOCUS IS ON PRESERVING THE LIFESTYLE OF EACH RESIDENT WITH 24-HOUR NURSING CARE, SOCIAL SERVICES, ACTIVITY THERAPY, DIETARY SERVICES, AND REHABILITATION THERAPY. THERE WERE 23 ADMISSIONS TO THE NURSING HOME DURING 2012, WITH 6,930 DAYS OF SERVICE.THE RESIDENTIAL CARE APARTMENT COMPLEX PROVIDES INDEPENDENT AND ASSISTED LIVING CONDITIONS WHILE STILL OFFERING IMPORTANT AMENITIES OF DAILY LIVING, SUCH AS DAILY NOON MEALS, PLANNED ACTIVITIES, WEEKLY HOUSEKEEPING SERVICES AND AN EMERGENCY CALL SYSTEM IN EACH APARTMENT. THERE WERE 4,607 DAYS OF SERVICE IN 2012 AND AN AVERAGE OCCUPANCY OF 92%. FINANCIAL ASSISTANCE IS AVAILABLE TO PATIENTS FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. THE COST OF FINANCIAL ASSISTANCE PROVIDED IN 2012 WAS APPROXIMATELY $755,000.MCHS-OAKRIDGE ALSO PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS/RESIDENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN ADDITION, SERVICES ARE PROVIDED TO PATIENTS UNDER OTHER MEANS TESTED GOVERNMENT PROGRAMS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. THE UNREIMBURSED COST OF MEDICAID WAS APPROXIMATELY $1,040,000.MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL, INC. AND MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC, INC. VOLUNTARILY ENTERED INTO AN AGREEMENT WITH THE WISCONSIN ATTORNEY GENERAL RELATING TO CHARITY CARE. THE TERMS OF THE AGREEMENT INCLUDE AN AUTOMATIC DISCOUNT FOR UNINSURED PATIENTS, A PAYMENT CAP FOR THOSE UNINSURED PATIENTS THAT MEET THE ORGANIZATION'S CHARITY CARE CRITERIA, AND A COMMITMENT TO MAKE INFORMATION AVAILABLE TO OUR PATIENTS REGARDING OUR CHARITY CARE PROGRAM. ADDITIONALLY, THE WISCONSIN ATTORNEY GENERAL REVIEWED AND APPROVED OUR BILLING AND COLLECTION POLICIES AND PRACTICES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense110700Expense
Grants1500Grants
Revenue140Revenue
DescriptionEDUCATION (SEE SCHEDULE O)DURING 2012, PHYSICIANS AND PHYSICIAN ASSISTANTS FROM MCHS-OAKRIDGE TAUGHT CLASSES IN THE LOCAL SCHOOL DISTRICTS ABOUT THE IMPORTANCE OF HEALTHY LIFESTYLES AND ADOLESCENCE.THE MCHS-OAKRIDGE FACILITY IN OSSEO ALSO PARTICIPATED IN A HEALTH AND SAFETY DAY BY PROVIDING STUDENTS WITH EDUCATIONAL INFORMATION ON HEALTH AND SAFETY, SUCH AS, BIKE HELMET SAFETY AND HAND WASHING TECHNIQUES. WE REACHED 500 STUDENTS AT THE LOCAL ELEMENTARY SCHOOL.AGAIN IN 2012, MCHS-OARKRIDGE OFFERED GIRL SCOUTS THE OPPORTUNITY TO EARN AN AWARENESS PATCH THROUGH OUR EDUCATION ON BREAST CANCER AND TEACHING HOW A MAMMOGRAM MAY DETECT ABNORMALITIES IN A FEMALE (OR MALE) BREAST.MCHS-OAKRIDGE ENTERED INTO AN AGREEMENT WITH UW-EAU CLAIRE TO ACCEPT A STUDENT INTERN FROM THE HEALTH CARE ADMINISTRATION PRACTICUM PROGRAM. THE INTERN, UNDER THE DIRECTION OF ADMINISTRATION, WORKS WITH EMPLOYEES IN OUR FACILITIES TO GAIN KNOWLEDGE AND EXPERIENCE IN HEALTHCARE ADMINISTRATION. IN 2012, WE PROVIDED TWO STUDENTS THE OPPORTUNITY TO LEARN HANDS ON ABOUT THE HEALTH CARE ENVIRONMENT.MCHS-OAKRIDGE ALSO OFFERED A FREE CPR COURSE IN 2012 REACHING 24 PEOPLE FROM THE COMMUNITY.FOR 2012, MCHS-OAKRIDGE AWARDED THREE POST SECONDARY SCHOLARSHIPS TO LOCAL HIGH SCHOOL STUDENTS PURSUING CAREERS IN A HEALTH-RELATED FIELD.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense60056Expense
Grants5350Grants
Revenue12474Revenue
DescriptionOTHER COMMUNITY BENEFITS (SEE SCHEDULE O)MCHS-OAKRIDGE IS INVOLVED IN SEVERAL COMMUNITY EVENTS.FREE BLOOD PRESSURE SCREENINGS ARE OFFERED AT THE OSSEO FACILITY EACH WEEK. THE MONDOVI FACIITY HAS A SELF-TEST BLOOD PRESSURE MACHINE AVAILABLE FOR PATIENT BLOOD PRESSURE MONITORING DURING BUSINESS HOURS. STAFF FROM MCHS-OAKRIDGE ALSO ATTEND LOCAL COMMUNITY EVENTS, PROVIDING BLOOD PRESSURE SCREENINGS.ANNUALLY, MCHS-OAKRIDGE ATTENDS THE BUFFALO COUNTY FAIR TO PROVIDE INFORMATION ON SUN SAFETY AND TO OFFER BLOOD PRESSURE SCREENINGS. IN 2012, FREE GLUCOSE SCREENINGS WERE ADDED AT THE EVENT.IN THE SUMMER OF 2012, MCHS-OAKRIDGE SUPPORTED A LOCAL 4H GROUP AT A 4H YOUTH FAIR, WHERE THE FOCUS WAS ON PUBLIC SAFETY SERVICES. THE STUDENTS ASSISTED OUR EMT CREW AS THEY PERFORMED HANDS-ON DEMONSTRATIONS WITH THE FAIR GOERS: VITAL SIGNS, CHEST COMPRESSIONS AND AED, BANDAGING AND SPLINTING, AMBULANCE TOURS, A SAFETY INFORMATION TABLE AND MAKING AN ITEM TO COMFORT AMBULANCE PASSENGERS.AGAIN IN 2012, MCHS-OAKRIDGE WAS A MAJOR SPONSOR FOR A LOCAL 5K EVENT TO HELP RAISE FUNDS FOR A BARRIER-FREE PLAYGROUND IN THE OSSEO COMMUNITY.DURING 2012, MCHS-OAKRIDGE SPONSORED THE AMERICAN CANCER SOCIETY RELAY FOR LIFE IN THE COMMUNITIES OF OSSEO AND MONDOVI. STAFF AT OUR SITES ORGANIZED TEAMS AND COORDINATED SEVERAL FUNDRAISERS THROUGHOUT THE YEAR TO HELP RAISE DOLLARS TO SUPPORT RESEARCH, EDUCATION, ADVOCACY AND SERVICES PROVIDED BY THE LOCAL AMERICAN CANCER SOCIETY ORGANIZATION. BETWEEN THE TWO COMMUNITIES, MORE THAN $6,000 WAS RAISED. DURING THE HOLIDAY SEASON, STAFF FROM MCHS-OAKRIDGE DONATED TO FAMILIES THROUGH THE ADOPT-A-FAMILY PROGRAM. IN ADDITION, MCHS-OAKRIDGE HAS A MITTEN TREE, IN WHICH STAFF AND COMMUNITIES PARTICIPATE BY PURCHASING AND DONATING MITTENS, SCARVES AND HATS FOR FAMILIES IN NEED.SINCE 2010, THROUGH THE OVERSEAS COUPON PROGRAM, MCHS-OAKRIDGE HAS RAISED CLOSE TO $50,000 IN FOOD COUPONS. THIS PROGRAM TAKES EXPIRED MANUFACTURER COUPONS AND SENDS THEM OVERSEAS TO MILITARY BASES SO THEY CAN BE USED BY FAMILIES OVERSEAS. THROUGH THIS PROGRAM, MCHS-OAKRIDGE PROVIDES SUPPORT FOR THE U.S. AIR FORCE BASE IN OKINAWA, JAPAN.MCHS-OAKRIDGE'S AMBULANCE SERVICE IS A HOSPITAL BASED SERVICE WITH 3 AMBULANCES AND PROVIDES EMERGENCY RESPONSE TO THE ENTIRE SURROUNDING COMMUNITY. THERE WERE 850 AMBULANCE CALLS IN 2012. EMTS ARE ON CALL 24 HOURS PER DAY, 7 DAYS PER WEEK.AN INSTYMEDS MACHINE IS PROVIDED BY MCHS-OARKRIDGE TO PROVIDE PATIENTS ACCESS TO EMERGENT MEDICATION PRESCRIPTIONS GENERATED FROM THE EMERGENCY DEPARTMENT IN OSSEO WHEN RETAIL PHARMACIES ARE CLOSED. THERE WERE 891 PRESCRIPTIONS FILLED THRU INSTYMEDS IN 2012.MCHS-OAKRIDGE HAS A VOLUNTEER PROGRAM WHICH PROVIDES SERVICE HOURS TO THE ACTIVITY DEPARTMENT. THE HOURS WERE SPENT ORGANIZING AND MANAGING ACTIVITIES FOR THE BENEFIT OF OUR PATIENTS, PATIENTS' FAMILIES, AND VISITORS. DURING 2012, APPROXIMATELY 24 VOLUNTEERS DONATED 534 HOURS OF VOLUNTEER SERVICE TO THE ORGANIZATION, VALUED AT APPROXIMATELY $11,823 BASED ON THE INDEPENDENT SECTORS AVERAGE ESTIMATED VALUE OF SUCH SERVICES.IN ADDITION, MCHS-OAKRIDGE DONATED $5,350 TO LOCAL CHARITIES AND COMMUNITY ORGANIZATIONS DURING 2012.Description
FieldValueIRS element (for citing)
Total Program Service Expense22345853TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling1CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees277NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CORPORATE TAX UNITBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5075381297TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 FIRST STREET SWAddressLine1
CityROCHESTERCity
StateMNState
ZIP Code55905ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
BILSKI THOMAS
TREASURER/DIRECTOR1.000.00XX000
BOEHNE DEAN
DIRECTOR1.000.00X000
DOWNEY MD WALTER G
SECRETARY/DIRECTOR1.0040.00XX026715861814
GULLICKSRUD CHERYL
VICE PRESIDENT/DIRECTOR1.000.00XX000
LARSON MD JOHN L
PRESIDENT/DIRECTOR1.0040.00XX037932752217
STOUGHTON MD RICK W
DIRECTOR1.0040.00X019231750780
WITTROCK EDWARD A
DIRECTOR1.0040.00X019541149149
BAMMEL PAUL M
REGIONAL CFO1.0040.00X030071161408
DICKEY JOHN M
REGIONAL CAO1.0040.00X036280364223
EIDE DEAN B
VP-OPERATIONS1.0040.00X01253373565
LINTON MD RANDALL L
REGIONAL CEO1.0040.00X057630064577
DAHL SANDY K
LEAD PHYSICIAN ASST.-ED40.000.00200605046561X
FREITAG BRANDT D
PHYSICIAN ASST-ER40.000.00173615048015X
JACOBSON RANEAU D
PHYSICIAN ASST-ER40.000.00146099040307X
JURY RITA B
NURSE ADMINISTRATOR40.000.00100556032133X
SCHIELD JESSICA L
PHYSICIAN ASST-ER40.000.00117395032983X
BANTLE DO CHARLES
FORMER SECRETARY0.0040.00019817957178X
FITZGERALD MD MICHAEL J
FORMER SITE CHAIR0.0040.00023542163998X
GARBER MD BRADLEY
FORMER VICE PRESIDENT0.0040.00021817143102X
FieldValueIRS element (for citing)
Total Reportable Comp From Org738270TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3051135TotalReportableCompFrmRltdOrgs
Total Other Compensation772010TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CL
PO BOX 1510EAU CLAIREWI54702PURCHASED SERVICES2127676
MAYO FOUNDATION FOR MEDICAL EDUCATION AN
200 FIRST STREET SWROCHESTERMN55905PURCHASING AGENT2103849
MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HO
1221 WHIPPLE STREETEAU CLAIREWI54702PURCHASED SERVICES698768
MAYO CLINIC HEALTH SYSTEM--PHARMACY & HO
1221 WHIPPLE STREETEAU CLAIREWI54702PURCHASED SERVICES256895
MAYO CLINIC
200 FIRST STREET SWROCHESTERMN55905PURCHASED SERVICES170833
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Fundraising Events6915FundraisingEvents
Related Organizations3030737RelatedOrganizations
Government Grants212585GovernmentGrants
Noncash Contributions3088NoncashContributions
Total Contributions3250237TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE6200002104465121044651
RESIDENT REVENUE623000260775260775
RENT FROM AFFILIATES53112047284728
EDUCATION REVENUE611600140140
FieldValueIRS element (for citing)
Total Program Service Revenue21310294TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2734TotalRevenueColumn
Exclusion$2,734ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real13800Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real61187Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-47387Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-47387TotalRevenueColumn
Exclusion-$47,387ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other1577Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other4318Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-2741Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-2741TotalRevenueColumn
Exclusion-$2,741ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events3560GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events6915CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses3894FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-334TotalRevenueColumn
Exclusion-$334ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming1167GrossIncomeGaming
Gaming Direct Expenses1238GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column-71TotalRevenueColumn
Exclusion-$71ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
CAFETERIA/VENDING7222102075520755
MEDICAL DIRECTOR FEES5419006500$6,500
MISCELLANEOUS90009922641853$411
FieldValueIRS element (for citing)
Total Other Revenue29519TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column24542251TotalRevenueColumn
Related Or Exempt Function Income21332902RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$40,888ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total5350Total
Program Services5350ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total1500Total
Program Services1500ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total10997886Total
Program Services10053894ProgramServices
Management And General943992ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total750940Total
Program Services686509ProgramServices
Management And General64431ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2212429Total
Program Services2022603ProgramServices
Management And General189826ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total746954Total
Program Services682865ProgramServices
Management And General64089ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total48097Total
Program Services27380ProgramServices
Management And General20717ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total7170Total
Program Services17ProgramServices
Management And General7153ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5043334Total
Program Services4977237ProgramServices
Management And General63938ManagementAndGeneral
Fundraising2159Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total43242Total
Management And General41290ManagementAndGeneral
Fundraising1952Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1225236Total
Program Services1186646ProgramServices
Management And General36481ManagementAndGeneral
Fundraising2109Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total75463Total
Program Services75463ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total470987Total
Program Services426356ProgramServices
Management And General44631ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total152197Total
Program Services130933ProgramServices
Management And General21264ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1620Total
Program Services653ProgramServices
Management And General619ManagementAndGeneral
Fundraising348Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total500804Total
Program Services490967ProgramServices
Management And General9837ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total61923Total
Program Services39905ProgramServices
Management And General22018ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE891117891117
MEDICAL SUPPLIES509828509828
MEDICAID SURCHARGE113169113169
DUES, LICENSES, ETC.22427213251102

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total4625Total
Program Services2136ProgramServices
Management And General2489ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total23886298Total
Program Services22345853ProgramServices
Management And General1533877ManagementAndGeneral
Fundraising6568Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1576BOY
EOY1577EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY111855BOY
EOY119203EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY5132EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3812434BOY
EOY3756100EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY60000EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY11554BOY
EOY12601EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY84127BOY
EOY68564EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis10682308LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6561114LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3910278BOY
EOY4121194EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4500237BOY
EOY5446855EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY425125BOY
EOY336163EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY12857186BOY
EOY13927389EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2766340BOY
EOY2949810EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY4826BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY6500BOY
EOY7000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1234787BOY
EOY1469893EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4012453BOY
EOY4426703EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY8836123BOY
EOY9464859EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY8610BOY
EOY35827EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8844733BOY
EOY9500686EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12857186BOY
EOY13927389EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses655953ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc1AgentTrusteeEtc
Beginning Balance1424BeginningBalance
Additions During Year4913AdditionsDuringYear
Distributions During Year5505DistributionsDuringYear
Ending Balance832EndingBalance
Included On FS1IncludedOnFS
Explanation In Part XIIIXExplanationInPartXIII

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis287719OtherCostOrOtherBasis
Book Value287719BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7265614OtherCostOrOtherBasis
Depreciation4335673Depreciation
Book Value2929941BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3000475OtherCostOrOtherBasis
Depreciation2225441Depreciation
Book Value775034BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis128500OtherCostOrOtherBasis
Book Value128500BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4121194TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionMAYO CLINIC INVESTMENT POOLDescription
Book Value5446855BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities5446855TotalOfBookValueSecurities

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATESDescription
Amount$1,469,893Amount
FieldValueIRS element (for citing)
Total Of Amounts1469893TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART IV, LINE 1B:NURSING HOME RESIDENT FUNDS
PART IV, LINE 2B:RCAC (RESIDENTIAL CARE APARTMENT COMPLEX) DEPOSITS
PART X, LINE 2:AT DECEMBER 31, 2012 AND 2011, THE RESERVE FOR UNRECOGNIZED TAX BENEFITS WAS NOT SIGNIFICANT, AND AS A RESULT, THERE IS NO LONGER A RESERVE FOR UNRECOGNIZED TAX BENEFITS RECORDED FOR THE FILING ORGANIZATION.DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense755071TotalCommunityBenefitExpense
Net Community Benefit Expense755071NetCommunityBenefitExpense
Percent Of Total Expense0.03280PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense3244503TotalCommunityBenefitExpense
Direct Offsetting Revenue2204526DirectOffsettingRevenue
Net Community Benefit Expense1039977NetCommunityBenefitExpense
Percent Of Total Expense0.04520PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense3999574TotalCommunityBenefitExpense
Direct Offsetting Revenue2204526DirectOffsettingRevenue
Net Community Benefit Expense1795048NetCommunityBenefitExpense
Percent Of Total Expense0.07800PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense54706TotalCommunityBenefitExpense
Direct Offsetting Revenue12474DirectOffsettingRevenue
Net Community Benefit Expense42232NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense110700TotalCommunityBenefitExpense
Net Community Benefit Expense110700NetCommunityBenefitExpense
Percent Of Total Expense0.00480PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense5682999TotalCommunityBenefitExpense
Direct Offsetting Revenue3360502DirectOffsettingRevenue
Net Community Benefit Expense2322497NetCommunityBenefitExpense
Percent Of Total Expense0.10100PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense4500TotalCommunityBenefitExpense
Net Community Benefit Expense4500NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5852905TotalCommunityBenefitExpense
Direct Offsetting Revenue3372976DirectOffsettingRevenue
Net Community Benefit Expense2479929NetCommunityBenefitExpense
Percent Of Total Expense0.10780PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense9852479TotalCommunityBenefitExpense
Direct Offsetting Revenue5577502DirectOffsettingRevenue
Net Community Benefit Expense4274977NetCommunityBenefitExpense
Percent Of Total Expense0.18580PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense2650TotalCommunityBuildingExpense
Net Community Building Expense2650NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense2650TotalCommunityBuildingExpense
Net Community Building Expense2650NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$891,117BadDebtExpenseAmount
Amount Reimbursed By Medicare7107694AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare6998552CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall109142MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MAYO CLINIC HEALTH SYSTEM-OAKRIDGE INCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line113024 8TH STAddressLine1
CityOSSEOCity
StateWIState
ZIP Code54758ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MAYO CLINIC HEALTH SYSTEM-OAKRIDGE INCBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Other Actions TakenXOtherActionsTaken
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
MCHS OAKRIDGE-OSSEO CAMPUS
13025 8TH STREETOSSEOWI54758NURSING HOME AND RCAC
MCHS OAKRIDGE-MONDOVI CLINIC
700 BUFFALO STMONDOVIWI54755PROVIDER BASED CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 6A: THE ANNUAL REPORT FOR THE FILING ORGANIZATION IS PART OF A CONSOLIDATED REPORT PREPARED BY MAYO CLINIC. THE FILING ORGANIZATION IS ALSO PART OF AN ANNUAL CONSOLIDATED REPORT FOR THE MAYO CLINIC HEALTH SYSTEM NORTHWEST WISCONSIN REGION.
PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO.
PART I, LINE 7G: THE FOLLOWING NET COMMUNITY BENEFIT COST ATTRIBUTED TO A PHYSICIAN CLINIC WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES: $112,160.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 891117.
PART II: THROUGH DONATIONS AND GRANTS TO PUBLIC, PRIVATE AND NONPROFIT ORGANIZATIONS, THE FILING ORGANIZATION ASSITS WITH SUSTAINING AND ENHANCING THE COMMUNITIES IT SERVES.
PART III, LINE 4: THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED IN THE ACCOUNTS RECEIVABLE FOOTNOTE OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS.FOOTNOTES RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS CAN BE FOUND ON PAGES 6, 8, AND 9 OF MAYO CLINIC'S 2012 CONSOLIDATED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8: THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY).REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.
PART III, LINE 9B: MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING REASONABLE ATTEMPTS TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN ADDITION, MAYO CLINIC AND ITS AFFILIATES ACCEPT REASONABLE PAYMENT PLANS FROM PATIENTS WHEN AN ACCOUNT IS THE PATIENT'S RESPONSIBILITY AND TRY TO IDENTIFY THOSE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS OFFERED TO ANY PATIENT IF THE FACTS AND CIRCUMSTANCES SUGGEST THAT THE PATIENT DOES NOT HAVE THE ABILITY TO PAY THEIR BILL IN WHOLE OR IN PART. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED; INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILTY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY BASED ON SUBMISSION OF REQUESTED INFORMATION. COLLECTION ACTIVITY WOULD ONLY RESUME IF MAYO WOULD TELL THE COLLECTION AGENCY TO PURSUE COLLECTIONS ON THE BALANCE OR PARTIAL BALANCE IF THERE WAS A CHARITY ADJUSTMENT.
PART V, SECTION B, LINE 14G: IN REGARDS TO THE POSTINGS WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.MAYO CLINIC HEALTH SYSTEM-OAKRIDGE INC
PART V, SECTION B, LINE 18E: FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE TO EVERY PATIENT VIA MAYO'S PUBLIC WEBSITE, FROM CUSTOMER SERVICE AND PATIENT ACCESS LOCATIONS, AND IS REFERENCED ON MAYO'S AUTHORIZATION FORMS AND STATEMENTS. IN ADDITION, BROCHURES ARE AVAILABLE IN THE ADMISSIONS AREA AND THE PROCESS OF HOW TO APPLY IS AVAILABLE ON THE MAYO CLINIC WEBSITE.UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, MAYO DISCUSSES ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE.MONTHLY STATEMENTS ARE SENT TO PATIENTS THAT OUTLINE CURRENT CHARGES AND ACTIONS WITH INSURANCE AND INCLUDES INFORMATION ABOUT MAYO'S CHARITY CARE POLICY. SOME MAYO SITES UTILIZE ADVOCATES TO CONTACT THE PATIENT UPON DISCHARGE TO HELP THEM SECURE GOVENMENTAL ASSISTANCE OR FINANCIAL ASSISTANCE.EACH CHARITY CARE REVIEW IS DOCUMENTED IN MAYO'S BILLING SYSTEM AND COMMUNICATED TO THE PATIENT. COMPLETED CHARITY CARE FORMS ARE MAINTAINED EITHER IN PAPER OR ELECTRONIC FORMAT. THE PATIENT IS INFORMED REGARDING THE OUTCOME OF THE REVIEW.MAYO OFTEN IDENTIFIES CHARITY CARE OPPORTUNITIES AFTER THE PATIENT HAS BEEN DISMISSED. IN MANY CASES, THIS IS DUE TO LIMITED INSURANCE COVERAGE OR INSURANCE DENIALS AFTER THE SERVICE WAS PERFORMED. IN THESE CASES, WHEN A PATIENT EXPRESSES AN INABILITY TO PAY FOR THEIR SERVICES, STAFF WILL INITIATE A CHARITY REVIEW AS INDICATED BY THE FINANCIAL ASSISTANCE POLICY, WHICH IS AVAILABLE FOR EVERY PATIENT AT MAYO CLINIC.ORG.MAYO CLINIC HEALTH SYSTEM-OAKRIDGE INC
PART V, SECTION B, LINE 20D: THE POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 50% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN USING THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERICIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE.MAYO CLINIC HEALTH SYSTEM-OAKRIDGE INC
PART VI, LINE 2: THE FILING ORGANIZATION'S ADMINISTRATION, ALONG WITH MEMBERS OF THE MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE FOUNDATION, INC., WORK CLOSELY WITH LOCAL EDUCATIONAL INSTITUTIONS, AREA FREE CLINICS, NEIGHBORHOOD ASSOCIATIONS, CHARITIES, AND HEALTH DEPARTMENTS TO ASSESS HEALTHCARE NEED. MONETARY DONATIONS, SERVICES, EDUCATION, VOLUNTEERS AND GOODS ARE SUPPLIED ONCE THOSE NEEDS ARE ASSESSED. REQUESTS FOR ASSISTANCE ARE TRIAGED THROUGH THE CORPORATE COMMUNICATION DEPARTMENTS, AND EVALUATED BASED ON ANNUAL STRATEGY. PART OF THAT STRATEGY INCLUDES INPUT FROM THE RESPONSIBLE VICE PRESIDENT AND ULTIMATELY REVIEWED BY THE MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE FOUNDATION, INC. ACCORDING TO THE DONATION REQUEST FLOWCHART. THE MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE FOUNDATION, INC. ANNUAL STRATEGY IS BASED ON COMMUNITY HEALTH NEED, STRATEGIC INITIATIVES AND COMMUNITY ASSESSMENTS.
PART VI, LINE 3: MEASURES TO PUBLICIZE FINANCIAL ASSISTANCE POLICY:MAYO CLINIC IS COMMITTED TO OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY FOR THEIR MEDICAL SERVICES IN WHOLE OR IN PART. IN ORDER TO ACCOMPLISH THIS CHARITABLE GOAL, MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM SITES WIDELY PUBLICIZE THIS POLICY IN THE COMMUNITIES THAT THE INDIVIDUAL MAYO CLINIC AFFILIATED SITES SERVE. MAYO CLINIC AFFILIATED SITES MAKE COPIES OF THIS POLICY AVAILABLE BY POSTING IT ON THEIR WEBPAGE INCLUDING THE ABILITY TO DOWNLOAD A COPY OF THE POLICY FREE OF CHARGE. INDIVIDUALS IN THE COMMUNITY SERVED WILL BE ABLE TO OBTAIN A COPY OF THE POLICY IN LOCATIONS THROUGHOUT EACH MAYO CLINIC AFFILIATED SITE OR UPON REQUEST. THE POLICY EXPLAINS THE FINANCIAL ASSISTANCE PROGRAM AND FACTORS AFFECTING ELIGIBILITY. WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.
PART VI, LINE 4: MAYO CLINIC HEALTH SYSTEM - OAKRIDGE (MCHS-OAKRIDGE) IS LOCATED IN OSSEO, WISCONSIN. ITS SERVICE AREA INCLUDES TREMPEALEAU COUNTY AND PORTIONS OF BUFFALO AND JACKSON COUNTIES IN SOUTH-WEST WISCONSIN. MCHS-OAKRIDGE IS A DESIGNATED CRITICAL ACCESS HOSPITAL FOR MEDICARE PURPOSES AND IS ONE OF THREE HOSPITALS IN TREMPEALEAU COUNTY. THE POPULATION OF TREMPEALEAU COUNTY (WHICH COMPRISES MOST OF THE MCHS-OAKRIDGE SERVICE AREA) IS APPROXIMATELY 28,816. ACCORDING TO 2010 CENSUS DATA, APPROXIMATELY 11 PERCENT OF TREMPEALEAU COUNTY INDIVIDUALS ARE LIVING BELOW POVERTY LEVEL. IN ADDITION, ACCORDING TO THE 2005-2007 WISCONSIN FAMILY HEALTH SURVEY, APPROXIMATELY 11 PERCENT OF THE TREMPEALEAU COUNTY POPULATION WAS UNINSURED FOR ALL OR PART OF THE PAST YEAR. ACCORDING TO COUNTY HEALTH RANKINGS "SNAPSHOT: 2012", TREMPEALEAU COUNTY RANKED 46 OF 72 COUNTIES IN HEALTH OUTCOMES AND 40 OF 72 IN HEALTH FACTORS.MCHS-OAKRIDGE ALSO HAS A LOCATION IN MONDOVI, WISCONSIN. THIS SERVICE AREA INCLUDES A CLINIC IN BUFFALO COUNTY. THERE IS ONE OTHER CLINIC IN THIS COUNTY IN ALMA [MAYO CLINIC HEALTH SYSTEM- LAKE CITY IN ALMA]. NEARBY IS DURAND IN PEPIN COUNTY, WHERE ANOTHER CLINIC GROUP IS LOCATED. THE POPULATION OF BUFFALO COUNTY IS APPROXIMATELY 13,587. ACCORDING TO 2010 CENSUS DATA, APPROXIMATELY 9.5 PERCENT OF BUFFALO COUNTY INDIVIDUALS ARE LIVING BELOW POVERTY LEVEL. IN ADDITION, ACCORDING TO THE BUFFALO COUNTY PUBLIC HEALTH SURVEY, APPROXIMATELY 15 PERCENT OF THE BUFFALO COUNTY POPULATION WAS UNINSURED FOR ALL OR PART OF THE PAST YEAR. ACCORDING TO COUNTY HEALTH RANKINGS "SNAPSHOT: 2012", BUFFALO COUNTY RANKED 26 OF 72 COUNTIES IN HEALTH OUTCOMES AND 16 OF 72 IN HEALTH FACTORS.
PART VI, LINE 5: THE FILING ORGANIZATION IS AN AFFILIATE OF THE MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION - EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO CLINIC HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY - IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.SURPLUS FUNDS - MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE.COMMUNITY REPRESENTATION ON GOVERNING BODY - THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, WHETHER IN HEALTH CARE POLICY, BUSINESS, GOVERNMENT OR ANOTHER FIELD. IN ADDITION TO THIS COMMUNITY REPRESENTATION AT THE PARENT ENTITY, THE FILING ORGANIZATION ALSO INVOLVES LOCAL COMMUNITY MEMBERS ON ITS GOVERNING BODY.OPEN VS. CLOSED STAFF MODEL - STAFF PRIVILEGES ARE GENERALLY EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.EMERGENCY ROOM - THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK, WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY.
PART VI, LINE 6: THIS FILING ORGANIZATION IS A PART OF MAYO CLINIC HEALTH SYSTEM (WHICH IS PART OF A LARGER GROUP OF ENTITIES AFFILIATED WITH MAYO CLINIC). THE MAYO CLINIC HEALTH SYSTEM IS DESCRIBED IN RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O). THAT STATEMENT ALSO DESCRIBES THE ROLES OF THE VARIOUS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.SPECIFICALLY, THE FILING ORGANIZATION PROVIDES HOSPITAL AND CLINIC SERVICES FOR OSSEO, WISCONSIN AND THE SURROUNDING AREA.FOR MORE SPECIFIC DESCRIPTION, SEE THE RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O).
PART VI, LINE 7: NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO THE WISCONSIN HOSPITAL ASSOCIATION.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY AND EQUALITY OF OPPORTUNITY. FEDERAL AWARDS THAT ARE SUBCONTRACTED TO OTHER ORGANIZATIONS ARE MONITORED BY THE FILING ORGANIZATION AS PRESCRIBED IN OMB CIRCULAR A-133. NO ADDITIONAL MONITORING IS PERFORMED. TRANSFERS OR GRANTS TO TAX-EXEMPT ORGANIZATIONS WILL BE USED PURSUANT TO THE POLICIES AND PROCEDURES OF THE GRANTEE ORGANIZATIONS AND TO FURTHER THE EXEMPT PURPOSES OF THE GRANTEE ORGANIZATIONS. BOTH THE FILING ORGANIZATION AND THE GRANTEE ORGANIZATION MAINTAIN ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DOWNEY MD WALTER G
SECRETARY/DIRECTOR024127906951018928025710036104032897200
LARSON MD JOHN L
PRESIDENT/DIRECTOR0193262076780178387025710026507043154400
STOUGHTON MD RICK W
DIRECTOR01837970694101579019715031065024309700
WITTROCK EDWARD A
DIRECTOR017902801472301660030468018681024456000
BAMMEL PAUL M
REGIONAL CFO027192202133207457025710035698036211900
DICKEY JOHN M
REGIONAL CAO0325896025923010984025710038513042702600
LINTON MD RANDALL L
REGIONAL CEO0515316050000010984025710038867064087700
DAHL SANDY K
LEAD PHYSICIAN ASST.-ED20060500000208210257400247166000
FREITAG BRANDT D
PHYSICIAN ASST-ER1734650001500183240296910221630000
JACOBSON RANEAU D
PHYSICIAN ASST-ER1459480001510148910254160186406000
SCHIELD JESSICA L
PHYSICIAN ASST-ER1173950000050320279510150378000
BANTLE DO CHARLES
FORMER SECRETARY01839140718307082020252036926025535700
FITZGERALD MD MICHAEL J
FORMER SITE CHAIR020739406925021102024830039168029941900
GARBER MD BRADLEY
FORMER VICE PRESIDENT019404306734017394021668021434026127300

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUPPLEMENTAL INFORMATIONPART IIIPART I, LINE 3: THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990, PART VI, SECTION B, LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED.
SUPPLEMENTAL INFORMATIONPART IIIPART II: COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MAYO CLINIC HEALTH SYSTEM--PHARMACY & HOME MEDICAL INCBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipTAXABLE AFFILIATE WITH OVERLAP OF BOARD MEMBERSRelationship
Amount Of Transaction270695AmountOfTransaction
Description Of TransactionRENT AND PURCHASED SERVICESDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: BAMMEL, PAUL M. BANTLE D.O., CHARLES DICKEY, JOHN M. DOWNEY M.D., WALTER G. EIDE, DEAN B. FITZGERALD M.D., MICHAEL J. GARBER M.D., BRADLEY LARSON M.D., JOHN L. LINTON M.D., RANDALL L. STOUGHTON M.D., RICK W. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: BAMMEL, PAUL M. DICKEY, JOHN M. LINTON M.D., RANDALL L. THE FOLLOWING INDIVIDUAL IS EMPLOYED BY A RELATED ORGANIZATION: WITTROCK, EDWARD A. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: BAMMEL, PAUL M. DICKEY, JOHN M. LINTON M.D., RANDALL L. RANDALL L. LINTON M.D. AND EDWARD A. WITTROCK HAVE A BUSINESS RELATIONSHIP AS BOTH SERVE ON THE BOARD OF MAYO CLINIC HEALTH SYSTEM - PHARMACY & HOME MEDICAL, A RELATED TAXABLE ENTITY.
FORM 990, PART VI, SECTION A, LINE 3MAYO CLINIC, MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, AND OTHER RELATED COMPANIES PROVIDE MANAGEMENT SERVICES TO THE ENTIRE SYSTEM OF ENTITIES. MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE HOSPITAL AND MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC ALSO PROVIDE MANAGEMENT SERVICES ON A REGIONAL BASIS THAT INCLUDES THE FILING ORGANIZATION. SINCE THE ENTITIES ARE RELATED ORGANIZATIONS, COMPENSATION FOR THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES HAS BEEN DISCLOSED IN PART VII AND SCHEDULE J AS REQUIRED.
FORM 990, PART VI, SECTION A, LINE 6THE SOLE CORPORATE MEMBER IS MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF DIRECTORS SHALL BE ELECTED BY THE SOLE CORPORATE MEMBER
FORM 990, PART VI, SECTION A, LINE 7BTHE ARTICLES AND BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, BUDGET, AND DEBT, AMENDMENT OF THE ARTICLES AND BYLAWS, AND GENERAL OPERATION DECISIONS.
FORM 990, PART VI, SECTION A, LINE 8BTHE FILING ORGANIZATION HAS NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. THEREFORE, THERE IS NO DOCUMENTATION FOR PART VI SECTION A LINE 8B.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE ASSISTANT ADMINISTRATOR OF FINANCE, THE REGIONAL SITE VICE PRESIDENT, AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CTHE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF THE MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS.
THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS AND ADMINISTRATIVE LEADERSHIP. IN ADDITION TO ANY REVIEW AND APPROVAL THAT MAY TAKE PLACE AT THE LOCAL ENTITY LEVEL, THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY IN THE FALL FOR THE NEXT YEAR'S COMPENSATION. THE SALARY OF THE REGIONAL CEO, REGIONAL CAO AND PHYSICIAN LEADERS ON THE BOARD OF THE FILING ORGANIZATION WERE REVIEWED BY THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR MAYO CLINIC HEALTH SYSTEM PHYSICIANS AND ADMINISTRATIVE LEADERSHIP. THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION OF PHYSICIANS AND ADMINISTRATIVE LEADERSHIP FOR THE MAYO CLINIC HEALTH SYSTEM ENTITIES. THE COMMITTEE IS COMPRISED OF MAYO EMPLOYEES, BUT IS INDEPENDENT FOR INTERNAL REVENUE CODE 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED (WITH RECUSAL WHERE APPROPRIATE). THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE THEN REVIEWS AND APPROVES THE COMPENSATION. FOR THOSE INDIVIDUALS FOR WHICH THE MAYO CLINIC HEALTH SYSTEM COMMITTEE CAN NOT SERVE AS THE INDEPENDENT REVIEW, THEIR COMPENSATION AND BENEFITS ARE REVIEWED BY THE GOVERNANCE COMMITTEE (DESCRIBED BELOW). THE COMPENSATION AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. INFORMATION ON MAYO CLINIC HEALTH SYSTEM PHYSICIAN AND ADMINISTRATIVE LEADERSHIP COMPENSATION AND BENEFITS IS ALSO REVIEWED BY THE MAYO CLINIC COMMITTEE ON OFFICER SUCCESSION, COMPENSATION AND GOVERNANCE (GOVERNANCE COMMITTEE), WHICH IS COMPRISED OF SEVEN OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION C, LINE 19THE FILING ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. THE FILING ORGANIZATION IS A HOSPITAL AFFILIATED WITH MAYO CLINIC. AS SUCH, MAYO CLINIC'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FILING ORGANIZATION'S FORM 990 AND WOULD BE AVAILABLE UPON REQUEST OF THE FORM 990.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES FROM AFFILIATES: PROGRAM SERVICE EXPENSES 4,263,918. MANAGEMENT AND GENERAL EXPENSES 3,269. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,267,187. OTHER FEES: PROGRAM SERVICE EXPENSES 713,319. MANAGEMENT AND GENERAL EXPENSES 60,669. FUNDRAISING EXPENSES 2,159. TOTAL EXPENSES 776,147.OTHER FEES
DISCLOSURE STATEMENT RELATED TO FORMS 5713: FORM 5713 HAS BEEN FILED BY THE FOLLOWING MEMBERS OF THE CONTROLLED GROUP: MAYO CLINIC (EIN: 41-6011702) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH (EIN: 41-1506440) MAYO HOLDING COMPANY (EIN: 41-1578020) MAYO CLINIC ARIZONA (EIN: 86-0800150) MAYO CLINIC JACKSONVILLE (EIN: 59-3337028) DISCLOSURE STATEMENT RELATED TO FORMS 5471: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 4 AND 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED TAXPAYER NAME: MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-1506440 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED DISCLOSURE STATEMENT RELATED TO FORMS 8865: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 8865, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS, AS A CATEGORY 2 AND 3 FILER. THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 8865 FOR THESE PARTNERSHIPS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 8865 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILEDIN REGARDS TO FILING CERTAIN FOREIGN FORMS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (48 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNAAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
BLOOMER LAKEVIEW INC
2110 DUNCAN ROADBLOOMERWI54724391450617LOW INCOME HOUSINGWI501(C)(3)7MCHS--CHIPPEWA VALLEY INC1
CHARTERHOUSE INC
200 FIRST STREET SWROCHESTERMN55905411405254RETIREMENT LIVING CENTERMN501(C)(3)9MAYO CLINIC1
FRANCISCAN SKEMP FOUNDATION OF ARCADIA INC
464 SOUTH ST JOSEPH AVENUEARCADIAWI54612391322480FUNDRAISING FOUNDATIONWI501(C)(3)9MCHS--FRANCISCAN HEALTHCARE INC1
GOLD CROSS AMBULANCE SERVICE
200 FIRST STREET SWROCHESTERMN55905411917516AMBULANCE SERVICEMN501(C)(3)9MFMER1
LUTHER LAKESIDE APARTMENTS INC
PO BOX 1510EAU CLAIREWI54702391409024LOW INCOME HOUSING FOR ELDERLYWI501(C)(3)9MCHS--EAU CLAIRE HOSPITAL INC1
MAYO CLINIC
200 FIRST STREET SWROCHESTERMN55905416011702PATIENT CARE - CLINICMN501(C)(3)91N/A
MAYO CLINIC -- METHODIST HOSPITAL
200 FIRST STREET SWROCHESTERMN55905410739106HOSPITALMN501(C)(3)3MAYO CLINIC1
MAYO CLINIC -- SAINT MARYS HOSPITAL
200 FIRST STREET SWROCHESTERMN55905410944601HOSPITALMN501(C)(3)3MAYO CLINIC1
MAYO CLINIC ARIZONA
13400 EAST SHEA BOULEVARDSCOTTSDALEAZ85259860800150HOSPITAL AND CLINICAZ501(C)(3)3MAYO CLINIC1
MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION)
4500 SAN PABLO ROADJACKSONVILLEFL32224590714831HOSPITALFL501(C)(3)3MAYO CLINIC JACKSONVILLE1
MAYO CLINIC HEALTH SYSTEM IN WAYCROSS INC
1900 TEBEAU STREETWAYCROSSGA31501581667166HOSPITALGA501(C)(3)3MAYO CLINIC JACKSONVILLE1
MAYO CLINIC HEALTH SYSTEM--ALBERT LEA
1000 FIRST DRIVE NWAUSTINMN55912411404075HOSPITAL AND CLINICMN501(C)(3)3MAYO CLINIC1
MAYO CLINIC HEALTH SYSTEM--AUSTIN
1000 FIRST DRIVE NWAUSTINMN55912410695606HOSPITAL AND CLINICMN501(C)(3)3MAYO CLINIC1
MAYO CLINIC HEALTH SYSTEM--AUSTIN FOUNDATION
1000 FIRST DRIVE NWAUSTINMN55912300107471FUNDRAISING FOUNDATIONMN501(C)(3)7MCHS--AUSTIN1
MAYO CLINIC HEALTH SYSTEM--CANNON FALLS
1116 WEST MILL STREETCANNON FALLSMN55009204156428HOSPITAL AND CLINICMN501(C)(3)3MAYO CLINIC1
MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC
1501 THOMPSON STREETBLOOMERWI54724390980343HOSPITAL AND CLINICWI501(C)(3)3MCHS--EAU CLAIRE HOSPITAL INC1
MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC
733 W CLAIREMONT AVE PO BOX 1510EAU CLAIREWI54702391735831PATIENT CARE - CLINICWI501(C)(3)3MAYO CLINIC0
MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE FOUNDATION INC
733 W CLAIREMONT AVE PO BOX 1510EAU CLAIREWI54702391633407GRANTMAKING FOUNDATIONWI501(C)(3)11-IMCHS--EAU CLAIRE CLINIC INC0
MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC
1221 WHIPPLE STREETEAU CLAIREWI54703390813418HOSPITALWI501(C)(3)3MAYO CLINIC1
MAYO CLINIC HEALTH SYSTEM--FAIRMONT
800 MEDICAL CENTER DRIVE PO BOX 800FAIRMONTMN56031410760836HOSPITAL AND CLINICMN501(C)(3)3MCHS--MANKATO1
MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION INC
700 WEST AVE SOUTHLA CROSSEWI54601391186647FUNDRAISING FOUNDATIONWI501(C)(3)7MCHS--FRANCISCAN HEALTHCARE INC1
MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION-SPARTA INC
310 WEST MAIN STREETSPARTAWI54656391423234FUNDRAISING FOUNDATIONWI501(C)(3)9MCHS--FRANCISCAN HEALTHCARE INC1
MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC
700 WEST AVE SOUTHLA CROSSEWI54601391411999HEALTHCARE SYSTEM PARENTWI501(C)(3)11-IMAYO CLINIC1
MAYO CLINIC HEALTH SYSTEM--FRANCISCAN MEDICAL CENTER INC
700 WEST AVE SOUTHLA CROSSEWI54601390806374HOSPITAL AND CLINICWI501(C)(3)3MCHS--FRANCISCAN HEALTHCARE INC1
MAYO CLINIC HEALTH SYSTEM--HOME HEALTH & HOSPICE INC
PO BOX 2060EAU CLAIREWI54702391491516HOME HEALTH AND HOSPICE CAREWI501(C)(3)9MCHS--EAU CLAIRE HOSPITAL INC1
MAYO CLINIC HEALTH SYSTEM--LAKE CITY
500 WEST GRANT STREETLAKE CITYMN55041411906820HOSPITALMN501(C)(3)3MAYO CLINIC1
MAYO CLINIC HEALTH SYSTEM--MANKATO
1025 MARSH STREETMANKATOMN56002411236756HOSPITAL AND CLINICMN501(C)(3)3MAYO CLINIC1
MAYO CLINIC HEALTH SYSTEM--MANKATO HEALTH CARE FOUNDATION
1025 MARSH STREETMANKATOMN56002411663357FUNDRAISING FOUNDATIONMN501(C)(3)7MCHS--MANKATO1
MAYO CLINIC HEALTH SYSTEM--NEW PRAGUE
301 SECOND STREET NENEW PRAGUEMN56071410723639HOSPITAL AND CLINICMN501(C)(3)3MCHS--MANKATO1
MAYO CLINIC HEALTH SYSTEM--NORTHLAND INC
1222 EAST WOODLAND AVENUEBARRONWI54812390920634HOSPITAL AND CLINICWI501(C)(3)3MCHS--EAU CLAIRE HOSPITAL INC1
MAYO CLINIC HEALTH SYSTEM--OAKRIDGE INC
13025 EIGHTH STREET PO BOX 70OSSEOWI54758391029430HOSPITAL AND CLINICWI501(C)(3)3MCHS--EAU CLAIRE HOSPITAL INC1
MAYO CLINIC HEALTH SYSTEM--OWATONNA
134 SOUTHVIEW STOWATONNAMN55060411862132PATIENT CARE - CLINICMN501(C)(3)3MAYO CLINIC1
MAYO CLINIC HEALTH SYSTEM--RED CEDAR INC
2321 STOUT ROADMENOMONIEWI54751510190875HOSPITAL AND CLINICWI501(C)(3)3MAYO CLINIC1
MAYO CLINIC HEALTH SYSTEM--RED WING
701 HEWITT BOULEVARDRED WINGMN55066411713783PATIENT CARE SERVICESMN501(C)(3)3MAYO CLINIC1
MAYO CLINIC HEALTH SYSTEM--RED WING HOME HEALTH & HOSPICE
701 HEWITT BOULEVARDRED WINGMN55066411539756HOME HEALTHCARE SERVICESMN501(C)(3)7MCHS--RED WING1
MAYO CLINIC HEALTH SYSTEM--SPRINGFIELD
625 NORTH JACKSON AVENUESPRINGFIELDMN56087411893827HOSPITAL AND CLINICMN501(C)(3)3MCHS--MANKATO1
MAYO CLINIC HEALTH SYSTEM--ST JAMES
1101 MOULTON PARSONS DR PO BOX 460ST JAMESMN56081410797368HOSPITAL AND CLINICMN501(C)(3)3MCHS--MANKATO1
MAYO CLINIC HEALTH SYSTEM--ST JAMES HEALTH CARE FOUNDATION
1101 MOULTON PARSONS DR PO BOX 460ST JAMESMN56081411444129FUNDRAISING FOUNDATIONMN501(C)(3)7MCHS--ST JAMES1
MAYO CLINIC HEALTH SYSTEM--SUPPORTIVE HOMECARE INC
PO BOX 2060EAU CLAIREWI54702391686673HOME HEALTH CAREWI501(C)(3)9MCHS--EAU CLAIRE HOSPITAL INC1
MAYO CLINIC HEALTH SYSTEM--WASECA
501 NORTH STATE STREETWASECAMN56093363606405HOSPITAL AND CLINICMN501(C)(3)3MCHS--MANKATO1
MAYO CLINIC JACKSONVILLE
4500 SAN PABLO ROADJACKSONVILLEFL32224593337028PATIENT CARE - CLINICFL501(C)(3)7MAYO CLINIC1
MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH
200 FIRST STREET SWROCHESTERMN55905411506440CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIESMN501(C)(3)9MAYO CLINIC1
MAYO KLINIK STIFTUNG
FUNDRAISING FOUNDATIONMFMER160486 FRANKFURT AM MAINFRANKFURTGMGM
MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES
200 FIRST STREET SWROCHESTERMN55905412020392SUPPORT RESEARCH, PRACTICE & EDUCATIONMN501(C)(3)11-IMAYO CLINIC1
POVERELLO FOUNDATION
200 FIRST STREET SWROCHESTERMN55905411494881FUNDRAISING FOUNDATIONMN501(C)(3)7MAYO CLINIC -- SAINT MARYS HOSPITAL1
RED WING SEMINARY HOME
701 HEWITT BOULEVARDRED WINGMN55066411263419RESIDENT CARE AND HOUSINGMN501(C)(3)9MCHS--RED WING1
SATILLA HEALTH MANAGEMENT INC
1900 TEBEAU STREETWAYCROSSGA31501581717889HEALTHCARE SERVICESGA501(C)(3)3MCHS IN WAYCROSS INC1
THE DOWNTOWN PLAZA
701 HEWITT BOULEVARDRED WINGMN55066411532554ELDERLY HOUSINGMN501(C)(3)9MCHS--RED WING1

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
FRANKLIN HEATING STATION
119 THIRD ST SWROCHESTERMN55902410264830UTILITYMNN/A
PHYSICIAN SOFTWARE SYSTEMS LLC
3333 WARRENVILLE ROAD SUITE 200LISLEIL60532453414836HEALTHCARE RELATED SOFTWAREILN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (36 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountryPostal CodeAddressForeign/PostalCode
HEALTH TRADITION HEALTH PLAN
1808 EAST MAIN STREETONALASKAWI54650391545987MEDICAL SERVICES COMPANYWIN/AC1
LOBSS NETWORK SUPPORT 2002 INC
200 FIRST STREET SWROCHESTERMN55905481276150ADMINISTRATIVE SERVICESMNN/AC1
MAYO CLINIC GBS MAURITIUS
HEALTHCARE MANAGEMENTN/AC12ND FLOOR EBENE MEWS 57EBENE CYBERCITYMPMP
MAYO CLINIC HEALTH SYSTEM--DECORAH CLINIC PHYSICIANS
907 MONTGOMERY STREETDECORAHIA52101411711329PATIENT CARE - CLINICIAN/AC1
MAYO CLINIC HEALTH SYSTEM--FARIBAULT
635 FIRST STREET SEFARIBAULTMN55021411817179PATIENT CARE - CLINICMNN/AC1
MAYO CLINIC HEALTH SYSTEM--PHARMACY & HOME MEDICAL INC
1221 WHIPPLE STREETEAU CLAIREWI54703391528920PHARMACY SERVICESWIN/AC1
MAYO COLLABORATIVE SERVICES INC
200 FIRST STREET SWROCHESTERMN55905411346366REFERENCE LAB SERVICESMNN/AC1
MAYO HOLDING COMPANY
200 FIRST STREET SWROCHESTERMN55905411578020HOLDING COMPANYMNN/AC1
MAYO INSURANCE COMPANY LTD
200 FIRST STREET SWROCHESTERMN55905SELF INSURANCE POOLN/AC1CJ
MAYO MEDICAL LABORATORIES NEW ENGLAND INC
265 BALLARDVALE STREETWILMINGTONMA01887043323713LABORATORY SERVICESMAN/AC1
MAYO REGIONAL PRACTICES OF ARIZONA
13400 EAST SHEA BOULEVARDSCOTTSDALEAZ85259061190278THIRD PARTY ADMINISTRATION SERVICESAZN/AC1
MMSI INC
21 FIRST STREET SWROCHESTERMN55905411547003THIRD PARTY ADMINISTRATION SERVICESMNN/AC1
RESOUNDANT INC
221 1ST AVE SWROCHESTERMN55902461661978MANUFACTURING MEDICAL DEVICE COMPONENTMNN/AC1
ROCHESTER AIRPORT COMPANY
ROUTE 2ROCHESTERMN55902410506870AIRPORT MANAGEMENTMNN/AC1
SATILLA HEALTH ENTERPRISES INC
1900 TEBEAU STREETWAYCROSSGA31501581717222HEALTHCAREGAN/AC1
SATILLA HEALTHNET INC
1900 TEBEAU STREETWAYCROSSGA31501582151076HEALTH SERVICESGAN/AC1
SATILLA REGIONAL SPECIALTY PHYSICIANS INC
1900 TEBEAU STREETWAYCROSSGA31501204363143PHYSICIAN OFFICESGAN/AC1
SIT ALPHA II BOND FUND LTD
980648163INVESTMENT MANAGEMENTN/AC1CLIFTON HOUSE 75 FORTH STGRAND CAYMANCJCJKY1-1108
SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION
13400 E SHEA BLVDSCOTTSDALEAZ85259860870505COMMERCIAL PROPERTY OWNERS ASSOCIATIONAZN/AC1
THE STABILE BUILDING OWNERS' ASSOCIATION
200 FIRST STREET SWROCHESTERMN55905208994499COMMERCIAL PROPERTY OWNERS ASSOCIATIONMNN/AC1
CHARITABLE LEAD TRUST
CHARITABLE TRUSTCAN/AT1
PERPETUAL TRUST
CHARITABLE TRUSTNDN/AT1
PERPETUAL TRUST
CHARITABLE TRUSTLAN/AT1
PERPETUAL TRUST (2)
CHARITABLE TRUSTMAN/AT1
PERPETUAL TRUST
CHARITABLE TRUSTMON/AT1
PERPETUAL TRUST
CHARITABLE TRUSTAZN/AT1
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTCON/AT1
CHARITABLE REMAINDER TRUST (6)
CHARITABLE TRUSTFLN/AT1
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTFLN/AT1
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTILN/AT1
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTLAN/AT1
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTMIN/AT1
CHARITABLE REMAINDER TRUST (68)
CHARITABLE TRUSTMNN/AT1
CHARITABLE REMAINDER TRUST (77)
CHARITABLE TRUSTMNN/AT1
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTNCN/AT1
CHARITABLE REMAINDER TRUST (2)
CHARITABLE TRUSTTXN/AT1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org1PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (12 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC
O133318GAAP
MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC
M457763GAAP
MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC
O1724305GAAP
MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC
P2065149GAAP
MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC
R99681GAAP
MAYO CLINIC HEALTH SYSTEM--HOME HEALTH & HOSPICE INC
A4728GAAP
MAYO CLINIC HEALTH SYSTEM--NORTHLAND INC
O69832GAAP
MAYO CLINIC HEALTH SYSTEM--PHARMACY & HOME MEDICAL INC
A13800GAAP
MAYO CLINIC HEALTH SYSTEM--PHARMACY & HOME MEDICAL INC
M256522GAAP
MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH
H6422491GAAP
MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH
P209468GAAP
MMSI INC
S725175GAAP

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