2013-11-13T15:43:49-06:00 2012-12-31 990 2012-01-01 510190875 MAYO CLINIC HEALTH SYSTEM - RED CEDAR INC MAYO 5075381297 2321 STOUT ROAD MENOMONIE WI 54751 JEANIE LUBINSKY 5075381297 2013-11-13 2012 2016-02-25 16:41:14Z HENRY SIMPSON MD 2321 STOUT ROAD MENOMONIE WI 54751 95295222 0 X WWW.MAYOCLINICHEALTHSYSTEM.ORG X 1976 WI OPERATION OF A HOSPITAL & THREE CLINICS. 11 4 787 174 20342 0 641537 1155594 86288083 92323418 826448 1042887 630317 693785 88386385 95215684 8371 15530 0 0 48875160 51731508 0 0 90476 27811127 30702448 76694658 82449486 11691727 12766198 104260919 119390767 10221091 12252285 94039828 107138482 X 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. 0 0 73027969 92940952 PATIENT CARE (SEE SCHEDULE O):MAYO CLINIC HEALTH SYSTEM-RED CEDAR (MCHS-RED CEDAR) IS A MEMBER OF THE MAYO CLINIC HEALTH SYSTEM. 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.AS PART OF THE MAYO CLINC HEALTH SYSTEM, MCHS-RED CEDAR OPERATES A CLINIC AND A HOSPITAL IN MENOMONIE, WISCONSIN - ALONG WITH REGIONAL CLINICS IN GLENWOOD CITY AND ELMWOOD, WISCONSIN. MCHS-RED CEDAR'S CLINICS PROVIDE PRIMARY CARE, INCLUDING FAMILY PRACTICE, INTERNAL MEDICINE, OB/GYN, PEDIATRICS AND GENERAL SURGERY. IN ADDITION, SPECIALTY CARE IN OCCUPATIONAL MEDICINE, BEHAVIORAL HEALTH, ORTHOPEDICS, PODIATRY AND NUTRITIONAL EDUCATION ARE ALSO PROVIDED. DURING 2012, THERE WERE 101,447 CLINIC VISITS. MCHS-RED CEDAR'S HOSPITAL IS A 25-BED CRITICAL ACCESS HOSPITAL PROVIDING MEDICAL, SURGICAL, MATERNITY, EMERGENCY AND CRITICAL CARE SERVICES TO AREA RESIDENTS. IN 2012, 1,956 PATIENTS WERE ADMITTED, 2,847 SURGICAL PROCEDURES WERE PERFORMED AND 9,853 PATIENTS USED THE HOSPITAL'S EMERGENCY ROOM.IN CONJUNCTION WITH MAYO CLINIC AND ITS AFFILIATES, MCHS-RED CEDAR IS ABLE TO PROVIDE EMERGENCY MEDICAL HELICOPTER SERVICE THROUGHOUT THE REGION. THE HELICOPTER PROVIDES RAPID PATIENT TRANSPORT TO THE APPROPRIATE HEALTHCARE FACILITY ALONG WITH DELIVERING HIGH-LEVEL CRITICAL CARE.MCHS-RED CEDAR ALSO OPERATES LINK TO LIFE (AN EASY-TO-USE PERSONAL RESPONSE SERVICE) TO ENSURE THAT OLDER ADULTS LIVING AT HOME CAN GET QUICK ASSISTANCE WHENEVER IT MAY BE NEEDED - 24 HOURS A DAY, 365 DAYS A YEAR. WHEN THE PERSONAL HELP BUTTON IS PRESSED, A MCHS-RED CEDAR MONITOR RESPONDS, ASSESSES THE SITUATION AND SUMMONS APPROPRIATE HELP. THERE WERE 418 SUBSCRIBERS TO THE PROGRAM DURING 2012.MCHS-RED CEDAR PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. SERVICES ARE ALSO PROVIDED TO MEDICAID AND MEDICARE PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN 2012, MCHS-RED CEDAR PROVIDED APPROXIMATELY $1,186,625 IN FINANCIAL ASSISTANCE TO PATIENTS. THE UNREIMBURSED COST OF MEDICAID PATIENTS WAS APPROXIMATELY $3,335,303.MCHS-RED CEDAR ALSO LEASES SPACE AND PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE. 1260169 15530 9135 OTHER COMMUNITY PROGRAMS (SEE SCHEDULE O):IN 2012, MCHS-RED CEDAR PROVIDED VARIOUS COMMUNITY SERVICES AND EDUCATIONAL OFFERINGS TO AREA RESIDENTS. SOME OF THESE ACTIVITIES ARE DESCRIBED BELOW. A FREE CLINIC PROVIDING HEALTH CARE TO THE UNDERPRIVILEGED OF THE COMMUNITY IS HOUSED AT MCHS-RED CEDAR. OFFICE SPACE, STORAGE AND SERVICES ARE PROVIDED TO THE FREE CLINIC AT OR BELOW COST OR FREE OF CHARGE. MCHS-RED CEDAR ALSO CONDUCTED FOUR BLOOD DRIVES TO BENEFIT THE AMERICAN RED CROSS, DONATING STAFF TIME, FACILITIES AND SUPPORT. THE VALUE OF THE STAFF TIME, FACILITIES AND SUPPORT FOR THESE ACTIVITIES IS APPROXIMATELY $22,645. MCHS-RED CEDAR ALSO PROVIDED SPORTS PHYSICALS TO 261 STUDENTS AT DISCOUNTED RATES. MCHS-RED CEDAR DONATED $12,530 TO LOCAL CHARITES/COMMUNITY GROUPS AND PROVIDED $3,000 IN SCHOLARSHIPS TO GRADUATING HIGH SCHOOL SENIORS WHO ARE ENTERING COLLEGE OR A VOCATIONAL PROGRAM FOR A HEALTH-RELATED FIELD OF STUDY.IN ADDITION TO THE ABOVE, MCHS-RED CEDAR SPONSORS SEVERAL PROGRAMS FOR THE BENEFIT OF THE COMMUNITY. SOME OF THE PROGRAMS OFFERED DURING 2012 ARE LISTED BELOW:- 468 AQUACISE CLASSES- 5 DIABETES SUPPORT GROUP SESSIONS- 23 CAREGIVER SUPPORT GROUP SESSIONS- 6 HEART DISEASE SUPPORT GROUP SESSIONS- 73 CPR / FIRST AID PROGRAMS- 28 FAMILY / PARENTING / PRENATAL EDUCATION PROGRAMS- 2 COMMUNITY HOSTED HEALTH FAIRS- 1 SLEEP APNEA / DEPRIVATION PROGRAMS- 36 BLOOD PRESSURE / BLOOD SUGAR SCREENINGS- 2 WOMEN'S HEALTH EDUCATION PROGRAMS- 6 SENIOR EDUCATION & OUTREACH PROGRAMS- 6 CHOLESTEROL SCREENING EVENTS- 1 CHILDREN'S HEALTH & SAFETY EVENT- 93 WELLNESS ROCKS EVENTS- 8 MOTIVATION TO MOVE EVENTS- 23 TAI CHI CLASSES- 15 PRESENTATIONS- 7 COMMUNITY HOSTED FAIRS/EVENTS- 5 FITNESS CLASSES- 7 STEPPING ON CLASSES- 6 POWERFUL TOOLS FOR THE CAREGIVER CLASSES- 6 STRESS/MENTAL HEALTH EVENTS- 17 YOUTH/SCHOOL FACILITY TOURS- 16 OTHER COMMUNITY EVENTS MCHS-RED CEDAR ALSO RECEIVES DONATED SERVICES FROM VOLUNTEERS CONSISTING OF INDIVIDUALS AND ORGANIZATIONS THAT HELP ORGANIZE AND MANAGE ACTIVITIES FOR THE BENEFIT OF MCHS-RED CEDAR'S PATIENTS, PATIENT'S FAMILIES, VISITORS AND STAFF. THE VOLUNTEERS OPERATE A GIFT SHOP, ASSIST PATIENTS AND GREET VISITORS. DURING 2012, VOLUNTEERS DONATED APPROXIMATELY 14,474 HOURS OF SERVICE. BASED ON 2012 INDEPENDENT SECTOR STATISTICS, THE APPROXIMATE VALUE OF THESE SERVICES WERE $320,454. 74288138 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 1 81 0 1 787 1 1 1 0 0 0 0 0 0 0 0 0 X 11 4 1 1 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 WI MN X CORPORATE TAX UNIT 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 IMSANDE KRISTIN 1.00 0.00 X 0 0 0 JACOBSON ROSEMARY 1.00 0.00 X 0 0 0 KRYSHAK WILLIAM 1.00 0.00 X X 0 0 0 LINTON MD RANDALL L 1.00 40.00 X X 0 576300 64577 NELSON MD CARRIE J 40.00 0.00 X X 236149 0 32431 NESSE MD ROBERT E 1.00 40.00 X 0 688141 18683 O'NEILL JAN E 1.00 0.00 X 5544 0 166 QUILLING CINDY 1.00 0.00 X 0 0 0 RUSTAD CHRISTOPHER D 1.00 40.00 X X 0 150996 27056 SIMPSON MD HENRY J 40.00 0.00 X X 299001 0 45476 WITT MD THOMAS J 1.00 40.00 X 28729 423793 63616 BAMMEL PAUL M 1.00 40.00 X 0 300711 61408 DICKEY JOHN M 1.00 40.00 X 0 362803 64223 LINDBERG STEVEN J 40.00 0.00 X 216388 0 42784 LUBINSKY JEANENNE M 40.00 0.00 X 160012 0 15573 DEYO-SVENDSEN MD MARK E 40.00 0.00 X 274009 0 24306 HERRMANN MD THOMAS M 40.00 0.00 X 366950 0 57187 MCNALLY DO PAUL D 40.00 0.00 X 729099 0 57512 RICH MD NATHAN L 40.00 0.00 X 370964 0 44582 SYTH MD CARA N 40.00 0.00 X 331167 0 55995 THIRUMALAI MD SRIDHAR 40.00 0.00 X 700427 0 53262 3718439 2502744 728837 59 0 1 0 MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE H 1221 WHIPPLE STREET EAU CLAIRE WI 54702 MEDICAL SERVICES 5116982 MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE C 733 W CLAIREMONT AVE EAU CLAIRE WI 54701 MEDICAL SERVICES 2936830 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 MEDICAL SERVICES 1463070 WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 75397 MEDICAL SERVICES 822860 SHEFCHIK BUILDERS N3651 STATE ROAD 25 MENOMONIE WI 54751 CONSTRUCTION SERVICES 438462 9 960 351993 802641 37749 1155594 NET PATIENT REVENUE 620000 92165516 92165516 LIFELINE 621990 102572 102572 RENT FROM AFFILIATES 531120 55330 55330 92323418 1072891 1072891 37749 4778 37749 34782 0 -30004 -30004 -30004 17790 7007 10783 10783 CAFETERIA/VENDING 722210 299489 299489 CONSULTING SERVICES 541610 194725 174383 20342 MISC. REVENUE 900099 145248 109257 35991 43540 43540 683002 95215684 92950087 20342 1089661 X 12530 12530 3000 3000 1383529 710396 673133 38396485 35637013 2741778 17694 3119562 2878647 238548 2367 6315786 5787625 510351 17810 2516146 2288307 226139 1700 197157 197157 16000 16000 5784 5784 10149385 7832837 2269253 47295 178243 9398 168845 3521725 3117385 402972 1368 354819 78577 276242 1448013 1448013 442484 385669 56303 512 30866 30866 2585529 2426030 158400 1099 584175 584175 MEDICAL SUPPLIES 7831430 7831430 BAD DEBT EXPENSE 2831478 2831478 MEDICAID SURCHARGE 212849 212849 DUES, LICENSES, ETC. 181995 149293 32071 631 130516 26836 103680 82449486 74288138 8070872 90476 4268 4152 401910 423926 135 129509 10754000 13705374 150500 198000 1592782 1211155 1360435 841958 55466568 25417134 27628438 30049434 0 0 61146309 71365138 1222142 1462121 104260919 119390767 8971408 10742527 108037 43266 1141646 1466492 10221091 12252285 X 94039693 107008973 135 129509 94039828 107138482 104260919 119390767 X 12766198 245125 87331 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5784 5784 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE AMOUNT IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING. 2501818 379108 33067 2847859 2419724 82094 2501818 2230745 304769 111659 4131 2419724 1730538 516013 15806 2230745 2748041 -863469 137402 16632 1730538 1.00000 0 1 1 2112197 2112197 36108919 14336682 21772237 14621838 11080452 3541386 2623614 2623614 30049434 MAYO CLINIC POOLED INVESTMENTS 71365138 F 71365138 INTERCOMPANY PAYABLES 91371 DEFERRED COMPENSATION LIABILITY 1375121 1466492 X DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TO SUPPORT MEDICAL PROGRAMS AND RELATED SERVICES THAT BENEFIT THE COMMUNITY SERVED BY THE FILING ORGANIZATION. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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. 1 1 X 1 X 1 X 1 1 1 0 1 1 1186625 1186625 0.01490 10984837 7649534 3335303 0.04190 12171462 7649534 4521928 0.05680 1140954 9135 1131819 0.01420 49062 49062 0.00060 10522715 7645403 2877312 0.03610 37570 37570 0.00050 11750301 7654538 4095763 0.05140 23921763 15304072 8617691 0.10820 8827 8827 0.00010 13584 13584 0.00020 3732 3732 0.00000 5686 5686 0.00010 940 940 0.00000 32769 32769 0.00040 0 2831478 13283862 12920746 363116 X 1 1 1 1 MAYO CLINIC HEALTH SYSTEM - RED CEDAR

2321 STOUT ROAD MENOMONIE WI 54751

X X X X MAYO CLINIC HEALTH SYSTEM - RED CEDAR 1 1 1 200.000000000000 1 400.000000000000 1 X X X X X X 1 1 X X X X X 1 0 X X X X X 1 X 0 0 5 MENOMONIE CLINIC

2321 STOUT ROAD MENOMONIE WI 54751

CLINIC GLENWOOD CITY CLINIC

219 EAST OAK AVENUE GLENWOOD CITY WI 54013

CLINIC ELMWOOD CLINIC

236 EAST SPRINGER AVENUE ELMWOOD WI 54740

CLINIC BEHAVIORAL HEALTH BUILDING

2411 STOUT ROAD MENOMONIE WI 54751

BEHAVIORAL HEALTH CENTER FOR PREVENTION & PHYSICAL REHABIL

2407 STOUT ROAD MENOMONIE WI 54751

PHYSICAL REHABILITATION PART I, LINE 6A: THE ANNUAL REPORT FOR THE FILING ORGANIZATION IS PART OF A CONSOLIDATED REPORT PREPARED BY MAYO CLINIC. 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: 780,587 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 $ 2831478. PART II: THROUGH DONATIONS AND GRANTS TO PUBLIC, PRIVATE AND NONPROFIT ORGANIZATIONS, THE FILING ORGANIZATION ASSISTS 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 REPORTED ON LINE 7, IF ANY, 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. MAYO CLINIC HEALTH SYSTEM - RED CEDAR 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 - RED CEDAR 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 MAYOCLINIC.ORG. MAYO CLINIC HEALTH SYSTEM - RED CEDAR PART V, SECTION B, LINE 20D: THE POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 10% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERICIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE. PART VI, LINE 2: THE VISION STATEMENT FOR MAYO CLINIC HEALTH SYSTEM-RED CEDAR (MCHS-RED CEDAR) SPEAKS TO CREATING A HEALTHIER COMMUNITY BY PROVIDING EXCEPTIONAL CARE. WHILE MCHS-RED CEDAR'S PATIENT CARE EFFORTS FOCUS ON THOSE WHO UTILIZE ITS SERVICES, MCHS-RED CEDAR PROVIDES EDUCATION THAT EXTENDS TO THE COMMUNITY-BASED SETTING THAT IS OPEN TO THE ENTIRE POPULATION. IN ITS CURRENT STRATEGIC PLAN, MCHS-RED CEDAR IDENTIFIED UNMET COMMUNITY HEALTH NEEDS AS A STRATEGIC OBJECTIVE. AS PART OF THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) THAT IS FACILITATED EVERY FIVE YEARS, MCHS-RED CEDAR COLLABORATES WITH REPRESENTATIVES FROM THE DUNN COUNTY HEALTH DEPARTMENT, LOCAL SCHOOL DISTRICTS, AND LOCAL NONPROFIT ORGANIZATIONS TO IDENTIFY, EVALUATE, AND PRIORITIZE UNMET COMMUNITY HEALTH NEEDS. THE MCHS-RED CEDAR EDUCATION DEPARTMENT UTILIZES DATA FROM THE CHIP TO MAKE RECOMMENDATIONS TO MCHS-RED CEDAR'S OPERATIONS COMMITTEE AND BOARD OF DIRECTORS ABOUT INTERVENTIONS THAT MCHS-RED CEDAR SHOULD CONSIDER FOR COMMUNITY EDUCATION AND HEALTH PROMOTION OUTREACH. MCHS-RED CEDAR'S EDUCATION DEPARTMENT HAS STRATIFIED HEALTH CARE NEED WITHIN OUR GEOGRAPHIC REGION BASED ON MULTIPLE INPUTS INCLUDING: 2006 AND 2011 DUNN COUNTY COMMUNITY HEALTH ASSESSMENT, FOCUS GROUPS, SURVEYS, AND REVIEW OF PERTINENT LITERATURE. THESE IDENTIFIED NEEDS ARE THEN FILTERED AND PRIORITIZED BASED ON CONSISTENCY WITH MCHS-RED CEDAR'S VISION/MISSION/VALUES, ABILITY OF MCHS-RED CEDAR TO IMPACT NEED IDENTIFIED, AND PATIENT COMMUNITY/BENEFIT. MCHS-RED CEDAR'S EDUCATION DEPARTMENT DEVELOPED A PROCESS TO DELIVER EDUCATIONAL PROGRAMMING AND FREE OR LOW-COST HEALTH SCREENINGS TO THE COMMUNITY AT LARGE, WITH A SUBSET OF PROGRAMMING TARGETING CHILDREN AND FAMILIES WITHIN THE SERVICE AREA THROUGH THE WELLNESS ROCKS PROGRAM. COMMUNITY EDUCATION OFFERINGS HAVE EXPANDED ANNUALLY AND CONTINUE TO ENGAGE MORE COMMUNITY ORGANIZATIONS AND PARTNERSHIPS. 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-RED CEDAR (MCHS-RED CEDAR) IS LOCATED IN MENOMONIE, WISCONSIN. ITS SERVICE AREA INCLUDES PORTIONS OF DUNN, ST. CROIX, PEPIN AND PIERCE COUNTIES IN WESTERN WISCONSIN. MCHS-RED CEDAR HAS THE ONLY ACUTE CARE HOSPITAL IN MENOMONIE, WHICH IS A DESIGNATED CRITICAL ACCESS HOSPITAL FOR MEDICARE PURPOSES. IT ALSO HAS A CLINIC IN MENOMONIE, ELMWOOD AND GLENWOOD CITY.ACCORDING TO 2010 CENSUS DATA, THE POPULATION OF DUNN COUNTY, WHICH COMPRISES MOST OF MCHS-RED CEDAR'S SERVICE AREA, IS APPROXIMATELY 44,000. ACCORDING TO 2010 CENSUS DATA, APPROXIMATELY 15.3% OF DUNN COUNTY INDIVIDUALS ARE LIVING BELOW POVERTY LEVEL. IN ADDITION, ACCORDING TO THE 2010 WISCONSIN FAMILY HEALTH SURVEY, APPROXIMATELY 10% OF THE DUNN COUNTY POPULATION WAS UNINSURED FOR ALL OR PART OF 2007 - 2009. 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 MENOMONIE, 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 ON THE MINNESOTA HOSPITAL ANNUAL REPORT OR TO THE WISCONSIN HOSPITAL ASSOCIATION. X 1 1 X X X 0 1 0 0 0 0 0 0 0 LINTON MD RANDALL L 0 515316 0 50000 0 10984 0 25710 0 38867 0 640877 0 0 NELSON MD CARRIE J 235999 0 150 0 0 0 21380 0 11051 0 268580 0 0 0 NESSE MD ROBERT E 0 593641 0 0 0 94500 0 0 0 18683 0 706824 0 0 RUSTAD CHRISTOPHER D 0 136826 0 0 0 14170 0 11422 0 15634 0 178052 0 0 SIMPSON MD HENRY J 299001 0 0 0 0 0 22500 0 22976 0 344477 0 0 0 WITT MD THOMAS J 28729 382141 0 0 0 41652 2600 40367 361 20288 31690 484448 0 0 BAMMEL PAUL M 0 271922 0 21332 0 7457 0 25710 0 35698 0 362119 0 0 DICKEY JOHN M 0 325896 0 25923 0 10984 0 25710 0 38513 0 427026 0 0 LINDBERG STEVEN J 216388 0 0 0 0 0 19981 0 22803 0 259172 0 0 0 LUBINSKY JEANENNE M 160012 0 0 0 0 0 14401 0 1172 0 175585 0 0 0 DEYO-SVENDSEN MD MARK E 273759 0 250 0 0 0 22500 0 1806 0 298315 0 0 0 HERRMANN MD THOMAS M 366950 0 0 0 0 0 22500 0 34687 0 424137 0 0 0 MCNALLY DO PAUL D 729099 0 0 0 0 0 22500 0 35012 0 786611 0 0 0 RICH MD NATHAN L 370714 0 250 0 0 0 9660 0 34922 0 415546 0 0 0 SYTH MD CARA N 302430 0 28737 0 0 0 22500 0 33495 0 387162 0 0 0 THIRUMALAI MD SRIDHAR 700427 0 0 0 0 0 22500 0 30762 0 753689 0 0 0 PART I, LINE 1A GROUP TERM LIFE INSURANCE GROSSED UP FOR PHYSICIANS AND ADMINISTRATOR. PART I, LINE 4B THIS ENTITY OR ITS AFFILIATE HAS A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE MAYO PENSION PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(A)(17). STARTING JANUARY 1, 2011, ALL SRP BENEFITS ARE PAID AS AN ANNUAL TAXABLE CASH PAYMENT. THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). ROBERT NESSE, M.D. - $85,127 THOMAS WITT, M.D. - $30,605 SUPPLEMENTAL INFORMATION PART III PART 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 INFORMATION PART III PART II: COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. MMSI INC BOARD OVERLAP 9705308 HEALTH INSURANCE PAYMENTS AND PREMIUMS. 0 X 1 37749 FAIR MARKET VALUE 0 1 1 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): 774 SHARES OF MERCK & CO. STOCK. THIRD PARTY USE: PART I, LINE 32B: OUTSIDE FIRMS OR MAYO CLINIC DEVELOPMENT MAY BE USED TO PROCESS OR SELL NON-CASH DONATIONS. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: BAMMEL, PAUL M. DICKEY, JOHN M. LINTON M.D., RANDALL L. 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: RUSTAD, CHRISTOPHER D. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL WHO IS ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: NESSE M.D., ROBERT E. FORM 990, PART VI, SECTION A, LINE 3 MAYO 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 6 THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION IS MAYO CLINIC. FORM 990, PART VI, SECTION A, LINE 7A MAYO CLINIC, THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION SHALL ELECT THE COMMUNITY DIRECTORS, THE MAYO DIRECTORS, AND THE VOTING PHYSICIAN DIRECTORS. COMMUNITY MEMBERS ARE ELECTED FROM A SLATE OF NOMINEES RECOMMENDED BY A NOMINATING COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7B THE ARTICLES AND BYLAWS OF THE FILING ORGANIZATION PROVIDE THE SOLE CORPORATE MEMBER, MAYO CLINIC, CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, BUDGET, DEBT, AMENDMENT OF ARTICLES AND BYLAWS, AND GENERAL OPERATION DECISIONS. FORM 990, PART VI, SECTION B, LINE 11 THE 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 CHIEF FINANCIAL OFFICER AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA U.S. 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 12C THE FILING ORGANIZATION IS AFFILIATED WITH 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. FORM 990, PART VI, SECTION B, LINE 15 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 CEO, CAO, AND BOARD VICE CHAIR WERE REVIEWED BY THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR MAYO CLINIC HEALTH SYSTEM PHYSICIAN 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). FOR THOSE INDIVIDUALS FOR WHICH THIS 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. IN ADDITION TO THE ABOVE COORDINATED REVIEW PROCESSES CONDUCTED BY MAYO CLINIC AND ITS AFFILIATES, THE INTERNAL PROCESS USED AT THE LOCAL LEVEL FOR DETERMINING COMPENSATION FOR THE FILING ORGANIZATION'S CEO AND OTHER TOP MANAGEMENT OFFICIALS INCLUDED REVIEW OF COMPARABILITY DATA FOR SIMILAR SIZED ORGANIZATIONS BY AN INDEPENDENT COMMITTEE OF THE BOARD (PUBLIC MEMBERS ONLY). SALARIES FOR THE PAST YEAR AND RANGES FOR THE NEXT YEAR WERE REVEIWED FOR REASONABLENESS. CONTEMPORANEOUS MEETING MINUTES OF THE COMPENSATION COMMITTEE ARE KEPT ON FILE. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. 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. OTHER FEES FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 6,489,872. MANAGEMENT AND GENERAL EXPENSES 552,934. FUNDRAISING EXPENSES 47,295. TOTAL EXPENSES 7,090,101. I/C PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,342,965. MANAGEMENT AND GENERAL EXPENSES 1,716,319. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,059,284. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: PRIOR PERIOD ADJUSTMENT 87,331. IN REGARDS TO FILING CERTAIN FOREIGN FORMS 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-FILED BLOOMER LAKEVIEW INC 2110 DUNCAN ROAD BLOOMER WI 54724 391450617 LOW INCOME HOUSING WI 501(C)(3) 7 MCHS--CHIPPEWA VALLEY INC 1 CHARTERHOUSE INC 200 FIRST STREET SW ROCHESTER MN 55905 411405254 RETIREMENT LIVING CENTER MN 501(C)(3) 9 MAYO CLINIC 1 FRANCISCAN SKEMP FOUNDATION OF ARCADIA INC 464 SOUTH ST JOSEPH AVENUE ARCADIA WI 54612 391322480 FUNDRAISING FOUNDATION WI 501(C)(3) 9 MCHS--FRANCISCAN HEALTHCARE INC 1 GOLD CROSS AMBULANCE SERVICE 200 FIRST STREET SW ROCHESTER MN 55905 411917516 AMBULANCE SERVICE MN 501(C)(3) 9 MFMER 1 LUTHER LAKESIDE APARTMENTS INC PO BOX 1510 EAU CLAIRE WI 54702 391409024 LOW INCOME HOUSING FOR ELDERLY WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 416011702 PATIENT CARE - CLINIC MN 501(C)(3) 9 N/A 1 MAYO CLINIC -- METHODIST HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410739106 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC -- SAINT MARYS HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410944601 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 860800150 HOSPITAL AND CLINIC AZ 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 590714831 HOSPITAL FL 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MAYO CLINIC HEALTH SYSTEM IN WAYCROSS INC 1900 TEBEAU STREET WAYCROSS GA 31501 581667166 HOSPITAL GA 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MAYO CLINIC HEALTH SYSTEM--ALBERT LEA 1000 FIRST DRIVE NW AUSTIN MN 55912 411404075 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--AUSTIN 1000 FIRST DRIVE NW AUSTIN MN 55912 410695606 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--AUSTIN FOUNDATION 1000 FIRST DRIVE NW AUSTIN MN 55912 300107471 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--AUSTIN 1 MAYO CLINIC HEALTH SYSTEM--CANNON FALLS 1116 WEST MILL STREET CANNON FALLS MN 55009 204156428 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC 1501 THOMPSON STREET BLOOMER WI 54724 390980343 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE WI 54702 391735831 PATIENT CARE - CLINIC WI 501(C)(3) 3 MAYO CLINIC 0 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE FOUNDATION INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE WI 54702 391633407 GRANTMAKING FOUNDATION WI 501(C)(3) 11-I MCHS--EAU CLAIRE CLINIC INC 0 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 390813418 HOSPITAL WI 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--FAIRMONT 800 MEDICAL CENTER DRIVE PO BOX 800 FAIRMONT MN 56031 410760836 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391186647 FUNDRAISING FOUNDATION WI 501(C)(3) 7 MCHS--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION-SPARTA INC 310 WEST MAIN STREET SPARTA WI 54656 391423234 FUNDRAISING FOUNDATION WI 501(C)(3) 9 MCHS--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391411999 HEALTHCARE SYSTEM PARENT WI 501(C)(3) 11-I MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN MEDICAL CENTER INC 700 WEST AVE SOUTH LA CROSSE WI 54601 390806374 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--HOME HEALTH & HOSPICE INC PO BOX 2060 EAU CLAIRE WI 54702 391491516 HOME HEALTH AND HOSPICE CARE WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--LAKE CITY 500 WEST GRANT STREET LAKE CITY MN 55041 411906820 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--MANKATO 1025 MARSH STREET MANKATO MN 56002 411236756 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--MANKATO HEALTH CARE FOUNDATION 1025 MARSH STREET MANKATO MN 56002 411663357 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--NEW PRAGUE 301 SECOND STREET NE NEW PRAGUE MN 56071 410723639 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--NORTHLAND INC 1222 EAST WOODLAND AVENUE BARRON WI 54812 390920634 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--OAKRIDGE INC 13025 EIGHTH STREET PO BOX 70 OSSEO WI 54758 391029430 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--OWATONNA 134 SOUTHVIEW ST OWATONNA MN 55060 411862132 PATIENT CARE - CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--RED CEDAR INC 2321 STOUT ROAD MENOMONIE WI 54751 510190875 HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--RED WING 701 HEWITT BOULEVARD RED WING MN 55066 411713783 PATIENT CARE SERVICES MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--RED WING HOME HEALTH & HOSPICE 701 HEWITT BOULEVARD RED WING MN 55066 411539756 HOME HEALTHCARE SERVICES MN 501(C)(3) 7 MCHS--RED WING 1 MAYO CLINIC HEALTH SYSTEM--SPRINGFIELD 625 NORTH JACKSON AVENUE SPRINGFIELD MN 56087 411893827 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--ST JAMES 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 410797368 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--ST JAMES HEALTH CARE FOUNDATION 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 411444129 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--ST JAMES 1 MAYO CLINIC HEALTH SYSTEM--SUPPORTIVE HOMECARE INC PO BOX 2060 EAU CLAIRE WI 54702 391686673 HOME HEALTH CARE WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--WASECA 501 NORTH STATE STREET WASECA MN 56093 363606405 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC JACKSONVILLE 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 593337028 PATIENT CARE - CLINIC FL 501(C)(3) 7 MAYO CLINIC 1 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 200 FIRST STREET SW ROCHESTER MN 55905 411506440 CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES MN 501(C)(3) 9 MAYO CLINIC 1 MAYO KLINIK STIFTUNG 60486 FRANKFURT AM MAIN FRANKFURT GM FUNDRAISING FOUNDATION GM MFMER 1 MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES 200 FIRST STREET SW ROCHESTER MN 55905 412020392 SUPPORT RESEARCH, PRACTICE & EDUCATION MN 501(C)(3) 11-I MAYO CLINIC 1 POVERELLO FOUNDATION 200 FIRST STREET SW ROCHESTER MN 55905 411494881 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC -- SAINT MARYS HOSPITAL 1 RED WING SEMINARY HOME 701 HEWITT BOULEVARD RED WING MN 55066 411263419 RESIDENT CARE AND HOUSING MN 501(C)(3) 9 MCHS--RED WING 1 SATILLA HEALTH MANAGEMENT INC 1900 TEBEAU STREET WAYCROSS GA 31501 581717889 HEALTHCARE SERVICES GA 501(C)(3) 3 MCHS IN WAYCROSS INC 1 THE DOWNTOWN PLAZA 701 HEWITT BOULEVARD RED WING MN 55066 411532554 ELDERLY HOUSING MN 501(C)(3) 9 MCHS--RED WING 1 FRANKLIN HEATING STATION 119 THIRD ST SW ROCHESTER MN 55902 410264830 UTILITY MN N/A PHYSICIAN SOFTWARE SYSTEMS LLC 3333 WARRENVILLE ROAD SUITE 200 LISLE IL 60532 453414836 HEALTHCARE RELATED SOFTWARE IL N/A HEALTH TRADITION HEALTH PLAN 1808 EAST MAIN STREET ONALASKA WI 54650 391545987 MEDICAL SERVICES COMPANY WI N/A C 1 LOBSS NETWORK SUPPORT 2002 INC 200 FIRST STREET SW ROCHESTER MN 55905 481276150 ADMINISTRATIVE SERVICES MN N/A C 1 MAYO CLINIC GBS MAURITIUS 2ND FLOOR EBENE MEWS 57 EBENE CYBERCITY MP HEALTHCARE MANAGEMENT MP N/A C 1 MAYO CLINIC HEALTH SYSTEM--DECORAH CLINIC PHYSICIANS 907 MONTGOMERY STREET DECORAH IA 52101 411711329 PATIENT CARE - CLINIC IA N/A C 1 MAYO CLINIC HEALTH SYSTEM--FARIBAULT 635 FIRST STREET SE FARIBAULT MN 55021 411817179 PATIENT CARE - CLINIC MN N/A C 1 MAYO CLINIC HEALTH SYSTEM--PHARMACY & HOME MEDICAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 391528920 PHARMACY SERVICES WI N/A C 1 MAYO COLLABORATIVE SERVICES INC 200 FIRST STREET SW ROCHESTER MN 55905 411346366 REFERENCE LAB SERVICES MN N/A C 1 MAYO HOLDING COMPANY 200 FIRST STREET SW ROCHESTER MN 55905 411578020 HOLDING COMPANY MN N/A C 1 MAYO INSURANCE COMPANY LTD 200 FIRST STREET SW ROCHESTER MN 55905 SELF INSURANCE POOL CJ N/A C 1 MAYO MEDICAL LABORATORIES NEW ENGLAND INC 265 BALLARDVALE STREET WILMINGTON MA 01887 043323713 LABORATORY SERVICES MA N/A C 1 MAYO REGIONAL PRACTICES OF ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 061190278 THIRD PARTY ADMINISTRATION SERVICES AZ N/A C 1 MMSI INC 21 FIRST STREET SW ROCHESTER MN 55905 411547003 THIRD PARTY ADMINISTRATION SERVICES MN N/A C 1 RESOUNDANT INC 221 1ST AVE SW ROCHESTER MN 55902 461661978 MANUFACTURING MEDICAL DEVICE COMPONENT MN N/A C 1 ROCHESTER AIRPORT COMPANY ROUTE 2 ROCHESTER MN 55902 410506870 AIRPORT MANAGEMENT MN N/A C 1 SATILLA HEALTH ENTERPRISES INC 1900 TEBEAU STREET WAYCROSS GA 31501 581717222 HEALTHCARE GA N/A C 1 SATILLA HEALTHNET INC 1900 TEBEAU STREET WAYCROSS GA 31501 582151076 HEALTH SERVICES GA N/A C 1 SATILLA REGIONAL SPECIALTY PHYSICIANS INC 1900 TEBEAU STREET WAYCROSS GA 31501 204363143 PHYSICIAN OFFICES GA N/A C 1 SIT ALPHA II BOND FUND LTD CLIFTON HOUSE 75 FORTH ST GRAND CAYMAN CJ KY1-1108 980648163 INVESTMENT MANAGEMENT CJ N/A C 1 SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION 13400 E SHEA BLVD SCOTTSDALE AZ 85259 860870505 COMMERCIAL PROPERTY OWNERS ASSOCIATION AZ N/A C 1 THE STABILE BUILDING OWNERS' ASSOCIATION 200 FIRST STREET SW ROCHESTER MN 55905 208994499 COMMERCIAL PROPERTY OWNERS ASSOCIATION MN N/A C 1 CHARITABLE LEAD TRUST CHARITABLE TRUST CA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST ND N/A T 1 PERPETUAL TRUST CHARITABLE TRUST LA N/A T 1 PERPETUAL TRUST (2) CHARITABLE TRUST MA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST MO N/A T 1 PERPETUAL TRUST CHARITABLE TRUST AZ N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST CO N/A T 1 CHARITABLE REMAINDER TRUST (6) CHARITABLE TRUST FL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST FL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST IL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST LA N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST MI N/A T 1 CHARITABLE REMAINDER TRUST (68) CHARITABLE TRUST MN N/A T 1 CHARITABLE REMAINDER TRUST (77) CHARITABLE TRUST MN N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST NC N/A T 1 CHARITABLE REMAINDER TRUST (2) CHARITABLE TRUST TX N/A T 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC A 37140 GAAP MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC M 4128550 GAAP MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC A 19495 GAAP MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC M 4805911 GAAP MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC O 311071 GAAP MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC P 79963 GAAP MAYO CLINIC HEALTH SYSTEM--FRANCISCAN MEDICAL CENTER INC M 58332 GAAP MAYO COLLABORATIVE SERVICES INC M 183866 GAAP MMSI INC R 6567682 GAAP MMSI INC S 3137626 GAAP