2013-11-14T15:29:24-06:00 2012-12-31 135665207 KPMG LLP 4200 WELLS FARGO CTR 90 S 7TH STREET MINNEAPOLIS MN 55402 990 2012-01-01 830379473 STILLWATER MEDICAL GROUP STIL 9528836584 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 DOUGLAS E JOHNSON 9528836584 2013-11-14 1 JASON DIVINE P01076050 6123055000 2012 2016-02-24 21:20:13Z DOUGLAS E JOHNSON 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 46243183 0 X WWW.STILLWATERMEDICALGROUP.COM X 2003 MN TO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEY. 8 1 495 1 0 0 1775103 2292510 32822761 43852723 1282 3898 107204 44762 34706350 46193893 0 0 0 0 27405095 39957104 0 0 0 11182017 12985199 38587112 52942303 -3880762 -6748410 38589916 31918395 6149354 6226243 32440562 25692152 X TO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEY. 0 0 47151637 0 43852723 SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS 47151637 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 495 1 0 0 0 0 0 0 0 0 0 0 X 8 1 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X X DOUG JOHNSON 6514304581 927 CHURCHILL STREET WEST STILLWATER MN 55082 X REX CATTANACH 0.10 X 0 0 0 ANDREW E DORWART MD 60.00 X 436085 0 30860 BRIAN H RANK MD 0.50 64.50 X 0 682622 182078 JEFFREY J ROBERTSON 13.30 32.70 X X 0 570018 58940 MARTHA SANFORD MD 57.00 X 183970 0 25576 STEPHEN M SCALLON MD 50.00 X 267554 0 18986 THOMAS J STORMONT MD 60.00 X 815202 0 39650 DON WESSELL MD 55.00 X 260558 0 22470 DOUGLAS E JOHNSON 16.00 39.00 X 0 297995 50874 MATHEW RICHIE 45.00 X 200055 0 22213 KEVIN J BJORK MD 50.00 X 459308 0 33381 CANDY COREY 50.00 X 436469 0 26644 LAURA A DEAN 70.00 X 383363 0 22314 BRUCE F DENNISON 40.00 X 337738 0 29346 BENJAMIN G WILLIAMS 50.00 X 463721 0 20634 4244023 1550635 583966 77 0 1 0 GREINER CONSTRUCTION INC 625 MARQUETTE AVE STE 840 MINNEAPOLIS MN 55402 CONSTRUCTION SERVICES 794825 ALLINA MEDICAL TRANSPORTATION PO BOX 9382 MINNEAPOLIS MN 554409382 TRANSPORTATION SERVICES 514394 THREE RIVERS PATHOLOGY PO BOX 1725 MINNETONKA MN 55345 PATHOLOGY PROFESSIONAL SERVICES 237671 INTEREM HEALTHCARE STAFFING SOLUTIONS 8170 33RD AVE S BLOOMINGTON MN 55425 TEMPORARY STAFFING 173623 ST PAUL RADIOLOGY 166 4TH ST E ST PAUL MN 551011421 RADIOLOGY PROFESSIONAL SERVICES 165638 10 1646500 468000 178010 2292510 NET PATIENT REVENUES 621400 41273026 41273026 PHYSICIAN COVERAGE 624410 2579697 2579697 43852723 3898 3898 78958 49290 29668 29668 29668 MISCELLANEOUS REVENUE 900099 15094 15094 15094 46193893 43852723 0 48660 1750099 1750099 32137989 29651329 2486660 1605266 1481609 123657 2413285 2227384 185901 2050465 1892513 157952 702316 1006649 -304333 75082 6112 68970 1047174 481253 565921 946276 90994 855282 1427094 647865 779229 22216 3002 19214 7844 887 6957 2335 2335 2731133 2647096 84037 591753 569821 21932 SUPPLIES - MEDICAL 3423068 3415499 7569 TAXES & ASSESSMENTS 641956 645165 -3209 RECRUITMENT, TRAINING & 525699 275449 250250 MAINTENANCE & REPAIR 470241 156831 313410 371012 202080 168932 52942303 47151637 5790666 0 5848702 846310 7117500 6077410 655021 798175 27330 17901 28645546 4466947 24941363 24178599 38589916 31918395 6125405 5212049 23949 14194 0 1000000 6149354 6226243 X 32440562 25692152 32440562 25692152 38589916 31918395 -6748410 0 X 0 1 X 1 0 X 4776111 5742558 3850607 1775103 1824510 17968889 39850338 40025219 21837212 32822761 43852723 178388253 44626449 45767777 25687819 34597864 45677233 196357142 0 0 0 196357142 103694 99638 48457 1282 3898 256969 103694 99638 48457 1282 3898 256969 44730143 45867415 25736276 34599146 45681131 196614111 0.99870 0.99820 0.00130 0.00180 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 0 0 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: STILLWATER MEDICAL GROUP PAYS FOR CERTAIN CORPORATE AND EMPLOYEE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES. 571589 571589 22999341 2793332 20206009 72269 10966 61303 5002347 1662649 3339698 24178599 PAYABLE TO RELATED ORGANIZATION - LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION 1000000 1000000 46243183 0 46243183 -49290 -49290 46193893 52991593 49290 49290 52942303 0 52942303 PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSE PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE X X X X 0 1 0 0 0 1 1 0 0 ANDREW E DORWART MD 414363 0 15177 0 6545 0 9190 0 21670 0 466945 0 0 0 BRIAN H RANK MD 0 487550 0 146450 0 48622 0 141242 0 40836 0 864700 0 25410 JEFFREY J ROBERTSON 0 390617 0 179401 0 0 0 33007 0 25933 0 628958 0 0 MARTHA SANFORD MD 168912 0 14215 0 843 0 5747 0 19829 0 209546 0 0 0 STEPHEN M SCALLON MD 248370 0 18664 0 520 0 6404 0 12582 0 286540 0 0 0 THOMAS J STORMONT MD 732986 0 62150 0 20066 0 11482 0 28168 0 854852 0 0 0 DON WESSELL MD 238935 0 21623 0 0 0 2474 0 19996 0 283028 0 0 0 DOUGLAS E JOHNSON 0 227324 0 70671 0 0 0 28672 0 22202 0 348869 0 0 MATHEW RICHIE 200055 0 0 0 0 0 4103 0 18110 0 222268 0 0 0 KEVIN J BJORK MD 415639 0 43669 0 0 0 9373 0 24008 0 492689 0 0 0 CANDY COREY 419250 0 17219 0 0 0 9322 0 17322 0 463113 0 0 0 LAURA A DEAN 338599 0 44764 0 0 0 7537 0 14777 0 405677 0 0 0 BRUCE F DENNISON 306499 0 31239 0 0 0 7301 0 22045 0 367084 0 0 0 BENJAMIN G WILLIAMS 453388 0 0 0 10333 0 6388 0 14246 0 484355 0 0 0 PART I, LINE 4B DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II INCLUDES AMOUNTS FROM A NONQUALIFIED 457(F) PLAN FOR THE FOLLOWING DIRECTOR: BRIAN H. RANK $ 27,380 PART I, LINE 6 STILLWATER MEDICAL GROUP'S (THE MEDICAL GROUP) OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE EMPLOYED BY THE MEDICAL GROUP, LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. (THE HOSPITAL) OR BY GROUP HEALTH PLAN, INC. (GHI). THE HOSPITAL AND GHI ARE BOTH RELATED ORGANIZATIONS. COMPENSATION REPORTED IN FORM 990, PART VIII INCLUDES ANY COMPENSATION DERIVED FROM EITHER THE MEDICAL GROUP'S, THE HOSPITAL'S, OR GHI'S MANAGEMENT INCENTIVE PROGRAMS, WHICH INCENT AND REWARD BUSINESS LEADERS WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC FISCAL YEAR. THE PROGRAMS ARE A KEY ELEMENT OF THE PARTICIPANT'S TOTAL COMPENSATION PACKAGE. THE MANAGEMENT INCENTIVE PROGRAMS' REWARDS ARE BASED ON POSITION IN THE ORGANIZATION (E.G. VICE PRESIDENT, DIRECTOR, MANAGER, OTHER SPECIFICALLY IDENTIFIED LEADERS) AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATION'S STRATEGIC PLAN AND WILL BE BALANCED. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, EMPLOYEE AND/OR LEADERSHIP DEVELOPMENT, CARE DELIVERY, PATIENT EDUCATION, SIX AIMS, MARKET SHARE, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE (NET MARGIN), ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. A NET MARGIN THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. SUPPLEMENTAL INFORMATION PART III SCHEDULE J, PART II - PRIOR REPORTED COMPENSATION: PART II, COLUMN (F) INCLUDES AMOUNTS PAID TO PARTICIPANTS IN THE CURRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEARS' 990'S, AS RETIREMENT AND DEFERRED COMPENSATION. ANY ANALYSIS OF EARNINGS FOR THE CURRENT YEAR, OF ANY PARTICIPANT OF THE PLAN, SHOULD EXCLUDE THE AMOUNT IN COLUMN F AS PART OF THE ANALYSIS SINCE THOSE EARNINGS WERE ALREADY REPORTED IN COLUMN (C) OF PREVIOUS YEARS' 990'S. EXEMPT PURPOSE AND ACHIEVEMENTS FORM 990, PART III, LINE 4A STILLWATER MEDICAL GROUP (CLINIC), A MULTI-SPECIALTY CLINIC, IS A MINNESOTA NON-PROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). THE CLINIC IS A PART OF STILLWATER HEALTH SYSTEM, A MINNESOTA 501(C)(3) TAX EXEMPT ORGANIZATION, ALONG WITH THE LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, A MINNESOTA 501(C)(3) TAX EXEMPT ORGANIZATION (HOSPITAL), LAKEVIEW MEMORIAL HOSPITAL FOUNDATION, A MINNESOTA 501(C)(3) TAX EXEMPT ORGANIZATION AND ST. CROIX VALLEY HEALTHCARE AND RESEARCH FOUNDATION, A MINNESOTA 501(C)(3) TAX EXEMPT PRIVATE FOUNDATION WHICH DISSOLVED SEPTEMBER 2012. STILLWATER HEALTH SYSTEM IS THE SOLE MEMBER OF THE CLINIC. THROUGH THIS RELATIONSHIP, THE CLINIC IS PART OF THE HEALTHPARTNERS FAMILY OF ORGANIZATIONS (HEALTHPARTNERS). HEALTHPARTNERS, INC. (HPI), A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) WHICH IS RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4), IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL AND REGIONS HOSPITAL'S SISTER ORGANIZATIONS, REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, STILLWATER HEALTH SYSTEM (LAKEVIEW HEALTH) AND RAMSEY INTEGRATED HEALTH SERVICES, ALL OF WHICH ARE MINNESOTA NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). HPI-RAMSEY IS ALSO THE SOLE CORPORATE MEMBER OF RH-WISCONSIN, INC., A WISCONSIN NON-STOCK CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). HEALTHPARTNERS, INC. IS ALSO THE SOLE CORPORATE MEMBER OF THE FOLLOWING ORGANIZATIONS THAT ARE MINNESOTA NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C) (3): GROUP HEALTH PLAN, INC. (GHI) (A MINNESOTA LICENSED STAFF MODEL HMO) WHICH IS ALSO THE SOLE CORPORATE MEMBER OF PHYSICIANS NECK & BACK CLINICS, WHICH IS ALSO A MINNESOTA NON-PROFIT CORPORATION EXEMPT UNDER SECTION 501(C) (3); HEALTHPARTNERS RESEARCH & EDUCATION (D/B/A HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH (HPIER)), AND RHSC, INC.. RH-WISCONSIN, INC. AND GHI ARE CORPORATE MEMBERS OF HUDSON HOSPITAL, INC. AND WESTFIELDS HOSPITAL, INC., BOTH OF WHICH ARE WISCONSIN NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN, INC. IS ALSO THE SOLE CORPORATE MEMBER OF WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY, AN AMBULANCE SERVICE WHICH IS A WISCONSIN NON-PROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). TOGETHER, ALL OF THESE RELATED ORGANIZATIONS COMPRISE THE HEALTHPARTNERS FAMILY OF ORGANIZATIONS (HEALTHPARTNERS), WHICH IS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT COMBINES THE PROVISION AND FINANCING OF HEALTH CARE SERVICES, FOR THE PURPOSE OF IMPROVING THE HEALTH OF ITS VARIOUS ENTITIES' MEMBERS, PATIENTS, AND THE BROADER COMMUNITY. HEALTHPARTNERS AND THE CLINIC ALSO PARTNER WITH OTHER PLANS, CARE PROVIDERS AND NON-PROFIT ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION; TO INCREASE ACCESS, CREATE AND DISSEMINATE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY AND COLLABORATE ON SYSTEM IMPROVEMENTS. TOTAL CHARITY CARE PROVIDED (CALCULATED AT COST) WAS $68,891 DURING THIS REPORTING PERIOD. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS STILLWATER HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBER HAS THE POWER TO RATIFY APPROVE AND REMOVE ALL MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBER HAS RESERVED TO ITSELF THE FOLLOWING POWERS CONCERNING THE GOVERNANCE OF THE CORPORATION: 1. RATIFICATION, APPROVAL AND REMOVAL ALL MEMBERS OF THE BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE. 2. APPROVAL OF ANY MISSION OR VISION STATEMENT OR STATEMENT OF CORPORATE PURPOSE ADOPTED BY THE ORGANIZATION. 3. APPROVAL OF THE ORGANIZATION'S STRATEGIC PLANS, CAPITAL BUDGETS, OPERATING BUDGETS AND FINANCIAL POLICIES. 4. APPROVAL OF ANY PLANS OF MERGER OR CONSOLIDATION BY THE ORGANIZATION WITH ANY FOREIGN OR DOMESTIC ORGANIZATION VOLUNTARY DISSOLUTION OF THE ORGANIZATION, OR SALE, LEASE OR TRANSFER OF THE ORGANIZATION'S REAL ESTATE OR A SIGNIFICANT PORTION OF THE OPERATIONS OR ASSETS OF THE ORGANIZATION. 5. APPROVAL OF THE GRANT OF A SECURITY INTEREST IN ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS, OR THE INCURRENCE OF INDEBTEDNESS OR THE GUARANTEE OF ANY INDEBTEDNESS. 6. APPROVAL OF INDIVIDUAL CAPITAL EXPENDITURES BY THE ORGANIZATION, WHETHER BUDGETED OR UNBUDGETED, IN EXCESS OF $500,000. 7. RATIFICATION OF SELECTION AND EVALUATION, AND TERMINATION, OF THE PRESIDENT OF THE ORGANIZATION. 8. APPROVAL OF PHYSICIAN, EMPLOYEE AND EXECUTIVE COMPENSATION PLANS FOR THE ORGANIZATION, INCLUDING CRITERIA FOR INCENTIVE COMPENSATION ARRANGEMENTS. 9. APPROVAL OF ALL SUBSTANTIVE AFFILIATIONS BETWEEN THE ORGANIZATION AND A THIRD PARTY. 10. APPROVAL OF CONFLICTS OF INTEREST POLICIES FOR THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE CLINIC'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF THE CLINIC. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF THE CLINIC, GHI'S INTERNAL LEGAL DEPARTMENT AND THE CLINIC'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF THE CLINIC. THE CLINIC MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY WILL BE PROVIDED IN A MAILING TO THE BOARD MEMBERS PRIOR TO THE FILING OF THE 990. EACH BOARD MEMBER WILL HAVE AN OPPORTUNITY TO COMMENT OR ASK QUESTIONS ABOUT THE 990 BEFORE IT IS FILED. THIS PROCESS WILL BE NOTED AND DOCUMENTED IN A WRITTEN MEMO IN THE FILES OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES INTERESTED PERSON TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST. INTERESTED PERSONS ARE EXCLUDED FROM DELIBERATIONS AND VOTES PERTAINING TO THE TRANSACTION OR ARRANGEMENT. ALTERNATIVES TO THE TRANSACTION OR ARRANGEMENT ARE EXPLORED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE IDENTIFIED THAT DOES NOT GIVE RISE TO CONFLICT OF INTEREST, THE BOARD CONSIDERS THE TRANSACTION OR ARRANGEMENT BASED ON ITS BENEFIT TO THE CORPORATION. IF THE BOARD HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE POSSIBLE CONFLICTS OF INTEREST, IT INFORMS THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORDS THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS IS WARRANTED, THE BOARD DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT TAKES APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. THE BOARD OF DIRECTORS AND OFFICERS ARE COVERED UNDER THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. DETERMINATIONS OF CONFLICTS OF INTEREST ARE MADE AND REVIEWED AT THE CLINIC PROVIDER LEVEL AND AT THE CORPORATION EXECUTIVE AND BOARD LEVEL. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING OFFICERS' COMPENSATION INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION IN 2012. EACH YEAR, UNDER THE DIRECTION OF THE LAKEVIEW HEALTH SYSTEM'S COMPENSATION COMMITTEE, AN ANNUAL TOTAL COMPENSATION MARKET REVIEW IS COMPLETED TO PROVIDE A COMPREHENSIVE MARKET REVIEW FOR THE FOLLOWING EXECUTIVE POSITIONS WITHIN LAKEVIEW HEALTH SYSTEM CEO, SYSTEM CFO, CLINIC PRESIDENT, CLINIC ADMINISTRATOR, AND HOSPITAL PRESIDENT. IN 2011, THE COMPENSATION COMMITTEE RETAINED AN INDEPENDENT EXECUTIVE CONSULTING FIRM TO PROVIDE A REVIEW OF ALL COMPONENTS OF COMPENSATION INCLUDING BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. IN 2012, UNDER THE COMMITTEE'S DIRECTION, THE GHI HUMAN RESOURCES DEPARTMENT USED THE SAME RECOGNIZED THIRD PARTY SALARY SURVEYS TO DETERMINE MEDIAN SALARY STRUCTURE CHANGES. BASED ON THIS UPDATED DATA, THE COMMITTEE LEARNED THE COMPENSATION RATES THAT ARE CONSIDERED P50 TO P60 OF THE MARKET FOR COMPARABLE LAKEVIEW POSITIONS. OTHER CONSIDERATIONS OF THE COMMITTEE INCLUDE: ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES, INDIVIDUAL PERFORMANCE, EXPERIENCE, SUBJECTIVE EVALUATION BY BOARD MEMBERS, GENERAL ECONOMIC CONDITIONS, COSTS OF REPLACEMENT, PREVAILING COMMUNITY ATTITUDES AND BELIEFS REGARDING COMPENSATION. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND W2S. FORM 990, PART VI, SECTION C, LINE 19 THE CLINIC'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM THE CLINIC OR HEALTHPARTNERS, INC.. THE CLINIC'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE MINNESOTA SECRETARY OF STATE'S OFFICE. AVERAGE HOURS PER WEEK - RELATED ORGANIZATION FORM 990, PART VII, SECTION A, LINE 1A, COLUMN (B) THE COMPENSATED BOARD MEMBERS AND OFFICERS FREQUENTLY DEVOTE THEIR TIME TO MULTIPLE RELATED ORGANIZATIONS IN A PARTICULAR WEEK. EACH INDIVIDUAL WORKS AN AVERAGE OF APPROXIMATELY 55 HOURS PER WEEK FOR STILLWATER HEALTH SYSTEM AND ITS RELATED ORGANIZATIONS. HEALTHPARTNERS INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411693838 HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(4) N/A 1 HPI - RAMSEY 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411793333 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 1 GROUP HEALTH PLAN INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410797853 STAFF MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(3) 170(B)(1) (A)(III) HEALTHPARTNERS INC 1 HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411670163 HEALTHCARE RESEARCH MN 501(C)(3) 509(A)(3) TYPE I GROUP HEALTH PLAN INC 1 CAPITOL VIEW TRANSITIONAL CARE CENTER 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 412011453 POST HOSPITALIZATION PATIENT CARE MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 1 REGIONS HOSPITAL 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410956618 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 1 REGIONS HOSPITAL FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411888902 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 170(B)(1) (A)(VI) HPI - RAMSEY 1 RHSC INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411891928 HEALTHCARE STAFFING MN 501(C)(3) 509(A)(3) TYPE II HEALTHPARTNERS INC 1 WESTFIELDS HOSPITAL INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 390808442 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN 1 WESTFIELDS HOSPITAL FOUNDATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 391770913 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT WI 501(C)(3) 509(A)(3) TYPE I WESTFIELDS HOSPITAL INC 1 RH-WISCONSIN 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 202287016 CORPORATE PLANNING AND OVERSIGHT WI 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY 1 PHYSICIANS NECK AND BACK CLINICS 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 270684883 SPECIALTY PATIENT CARE MN 501(C)(3) 509(A)(3) TYPE II GROUP HEALTH PLAN INC 1 HUDSON HOSPITAL INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 390804125 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN 1 HUDSON HOSPITAL FOUNDATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 391279567 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT WI 501(C)(3) 170(B)(1) (A)(VI) HUDSON HOSPITAL INC 1 WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 263616590 PROVIDE MEDICAL TRANSPORT SERVICES WI 501(C)(3) 509(A)(3) TYPE II RH-WISCONSIN 1 LAKEVIEW MEMORIAL HOSPITAL FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411386635 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 509(A)(3) TYPE II STILLWATER HEALTH SYSTEM 1 LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410811697 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) STILLWATER HEALTH SYSTEM 1 ST CROIX VALLEY HEALTHCARE & RESEARCH FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411923524 FOUNDATION MN 501(C)(3) PF STILLWATER HEALTH SYSTEM 1 STILLWATER HEALTH SYSTEM 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 300221189 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY 1 RAMSEY INTEGRATED HEALTH SERVICES 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411503090 IN-HOME PATIENT CARE MN 501(C)(3) 509(A)(2) HPI - RAMSEY 1 HEALTHPARTNERS ADMINISTRATORS INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411629390 THIRD PARTY ADMINISTRATOR MN HEALTHPARTNERS INC C 1 HEALTHPARTNERS ASSOCIATES INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 522365151 MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT MN HEALTHPARTNERS ADMINISTRATORS INC C 1 HEALTHPARTNERS SERVICES INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411683568 MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT MN HEALTHPARTNERS ADMINISTRATORS INC C 1 HEALTHPARTNERS VENTURES INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411838197 DEVELOP HEALTHCARE BUSINESS OPPORTUNITIES MN HEALTHPARTNERS INC C 1 HEALTHPARTNERS INSURANCE COMPANY 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411683523 MEDICAL AND DENTAL INSURANCE MN HEALTHPARTNERS ADMINISTRATORS INC C 1 DENTAL SPECIALTIES INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 451297583 DENTAL CLINIC STAFFING MN HEALTHPARTNERS ADMINISTRATORS INC C 1 HEALTHPARTNERS CENTRAL MINNESOTA CLINICS 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411236798 MEDICAL CLINIC STAFFING AND MANAGEMENT MN HEALTHPARTNERS ADMINISTRATORS INC C 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 HEALTHPARTNERS INC - CLAIMSHEALTHCARE SERVICES L 1709225