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

View the entire original 990 at ProPublica ↗

Organization: MAYO CLINIC HEALTH SYSTEM-CANNON FALLS (EIN 20-4156428)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-09-30
IRS object ID: 201342739349300064
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-09-30T09:31:49-05:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	204156428	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MAYO CLINIC HEALTH SYSTEM-CANNON FALLS	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MAYO	NameControl
Phone	5075381297	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1116 WEST MILL STREET	AddressLine1
City	CANNON FALLS	City
State	MN	State
ZIP Code	55009	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	EDWARD TUSA	Name
Title	CFO	Title
Phone	5072634221	Phone
Date Signed	2013-09-27	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	THOMAS J WITT MD	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1116 WEST MILL STREET	AddressLine1
City	CANNON FALLS	City
State	MN	State
ZIP Code	55009	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	23263637	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.MAYOCLINICHEALTHSYSTEM.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	2006	YearFormation
State Legal Domicile	MN	StateLegalDomicile
Activity Or Mission Description	OPERATION OF HOSPITAL AND CLINIC.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	9	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	4	NbrIndependentVotingMembers
Total Nbr Employees	237	TotalNbrEmployees
Total Nbr Volunteers	24	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	376427	ContributionsGrantsPriorYear
Contributions Grants Current Year	1070973	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	18336170	ProgramServiceRevenuePriorYear
Program Service Revenue CY	22086437	ProgramServiceRevenueCY
Investment Income Prior Year	23293	InvestmentIncomePriorYear
Investment Income Current Year	-40059	InvestmentIncomeCurrentYear
Other Revenue Prior Year	35087	OtherRevenuePriorYear
Other Revenue Current Year	58405	OtherRevenueCurrentYear
Total Revenue Prior Year	18770977	TotalRevenuePriorYear
Total Revenue Current Year	23175756	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	3000	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	9624	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	10547652	SalariesEtcPriorYear
Salaries Etc Current Year	12514185	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	65000	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	65000	TotalFundrsngExpCurrentYear
Other Expense Prior Year	7909702	OtherExpensePriorYear
Other Expenses Current Year	8267858	OtherExpensesCurrentYear
Total Expenses Prior Year	18460354	TotalExpensesPriorYear
Total Expenses Current Year	20856667	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	310623	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	2319089	RevenuesLessExpensesCY
Total Assets BOY	15962247	TotalAssetsBOY
Total Assets EOY	18663160	TotalAssetsEOY
Total Liabilities BOY	2094047	TotalLiabilitiesBOY
Total Liabilities EOY	1632453	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	13868200	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	17030707	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	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.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	17275228	Expense
Revenue	22023915	Revenue
Description	PATIENT SERVICES (HOSPITAL & CLINIC) - SEE SCHEDULE OMAYO 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 900 PHYSICIANS AND 13,000 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, SEVEN 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.IN 2012, MAYO CLINIC HEALTH SYSTEM-CANNON FALLS (MCHS-CF) HAD 209 MEDICAL/SURGICAL ADMISSIONS AND 120 SWING BED ADMISSIONS WITH AN AVERAGE DAILY CENSUS OF 6.9. THERE WERE ALSO 2,351 EMERGENCY ROOM VISITS AND 195 OUTPATIENT SURGERIES. MCHS-CF PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THEIR CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. SERVICES ARE ALSO PROVIDED TO BOTH MEDICAID AND MEDICARE PATIENTS 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. IN 2012, MCHS-CF PROVIDED APPROXIMATELY $88,300 IN CHARITY CARE TO PATIENTS. THE UNCOMPENSATED COST OF MEDICAID PATIENTS WAS APPROXIMATELY $202,100; AND THE COST OF PATIENTS UNDER OTHER MEANS TESTED GOVERNMENT PROGRAMS WAS APPROXIMATELY $80,800.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	33682	Expense
Grants	9624	Grants
Revenue	15027	Revenue
Description	COMMUNITY OUTREACH - SEE SCHEDULE OMAYO CLINIC HEALTH SYSTEM-CANNON FALLS (MCHS-CF) PARTICIPATES IN COMMUNITY AND SENIOR WELLNESS EVENTS WHERE FREE OR NOMINAL FEE SCREENING TESTS ARE OFFERED AS WELL AS FREE PATIENT EDUCATION MATERIALS. NO-COST FLU SHOT CLINICS ARE PROVIDED ANNUALLY AT THE SENIOR HEALTH FAIR. FREE COMMUNITY SCREENING FOR DIABETES IS DONE THROUGH A PARTNERSHIP WITH THE LOCAL LIONS CLUB AT THE MEDICAL CENTER ON AN ANNUAL BASIS. MCHS-CF MEALS ON WHEELS PROGRAM PROVIDES FREE HOME DELIVERED NOON MEALS TO HOMEBOUND SENIORS OVER 60 WITH A MODERATE TO HIGH NUTRITIONAL RISK. THIS PROGRAM IS AVAILABLE ON AN ANNUAL BASIS, MONDAY THROUGH FRIDAY TO APPROXIMATELY 16-22 PARTICIPANTS. MCHS-CF AUXILIARY PROVIDES APPROXIMATELY 20 VOLUNTEERS TO GREET AND DIRECT PATIENTS DURING HIGH-VOLUME SURGERY WEEKDAYS AND OFFER CLERICAL SUPPORT TO STAFF. THE AUXILIARY VOLUNTEERS PROVIDED APPROXIMATELY 621 HOURS OF VOLUNTEER SERVICES. BASED ON THE 2012 INDEPENDENT SECTOR STATISTICS, THE APPROXIMATE VALUE OF THESE SERVICES IS $13,750. THE AUXILIARY ALSO SPONSORS A SCHOLARSHIP PROGRAM FOR LOCAL STUDENTS PURSUING A CAREER IN A HEALTH-CARE RELATED FIELD, IN 2012 $1,500 WAS GIVEN OUT IN SCHOLARSHIPS.	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Revenue	100200	Revenue
Description	MAYO CLINIC HEALTH SYSTEM-CANNON FALLS (MCHS-CF) LEASES SPACE AND PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Rev	100200	TotalOfOtherProgramServiceRev
Total Program Service Expense	17308910	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	1	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	1	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	237	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	9	NbrVotingGoverningBodyMembers
Number Independent Voting Members	4	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	1	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	1	LocalChapters
Policies Reference Chapters	1	PoliciesReferenceChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	0	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	MN	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	MAYO CORPORATE TAX UNIT	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	5075381297	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	200 FIRST STREET SW	AddressLine1
City	ROCHESTER	City
State	MN	State
ZIP Code	55905	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
ALTRICHTER MD PAUL M
VICE-CHAIR/DIRECTOR	1.00	40.00	X	X	0	223050	51748
BAILEY TED
DIRECTOR	1.00	0.00	X		0	0	0
BERNARD MD MATTHEW E
DIRECTOR	1.00	40.00	X		0	257663	47428
BREKKEN KATHLEEN A
DIRECTOR	1.00	0.00	X		0	0	0
BRIGGS KATHLEEN E
DIRECTOR	1.00	0.00	X		0	0	0
PARKS DOUGLAS A
DIRECTOR/REGION CAO	1.00	40.00	X	X	0	189781	44522
WHITED MD BRIAN L
DIRECTOR	1.00	40.00	X		0	351898	38626
WITT MD THOMAS J
CHAIR/CEO/DIRECTOR	1.00	40.00	X	X	0	452522	63616
WULF GREG
DIRECTOR	1.00	0.00	X		0	0	0
AGERTER MD DAVID C
REGION CEO	1.00	40.00		X	0	483600	35091
CHRISTIAN GLENN P
SECRETARY	40.00	1.00		X	176420	0	36914
KOCH MARK B
ASSISTANT SECRETARY	1.00	40.00		X	0	289086	16795
PILOT DAVID L
REGION CFO	1.00	40.00		X	0	196045	33934
PRIEST WILLIAM F
CAO	40.00	0.00		X	196211	0	44846
TUSA EDWARD A
CFO/TREASURER	40.00	0.00		X	143951	0	43038
NORDAHL MD THOMAS W
PHYSICIAN	40.00	0.00			398610	0	64622	X
TURNA MD TARLOCHAN S
FAMILY MEDICINE PHYSICIAN	40.00	0.00			442682	0	37382	X
CHESTNUT MD JANET S
ER PHYSICIAN/MEDICAL DIRECTOR	40.00	0.00			312693	0	65909		X
DALEY MD JOHN R
PHYSICIAN	40.00	0.00			121079	0	0		X
JOHNSTON-FLANDERS MD MEGAN S
FAMILY MEDICINE PHYSICIAN	40.00	0.00			210277	0	32671		X
STRICKER MD ALEXANDER W
FAMILY PRACTICE PHYSICIAN	40.00	0.00			209780	0	10284		X
WOLTER KIMBERLY D
NURSE MANAGER	40.00	0.00			127489	0	18155		X
ANGSTMAN MD GREGORY L
FORMER CEO/CHAIR	0.00	40.00			0	269734	34690			X
BIREN DAVID H
FORMER TREASURER	0.00	40.00			0	168420	17200			X
KRAMER CHERYL A
FORMER SECRETARY	0.00	40.00			0	160314	8285			X
LOHR MD ROBERT H
FORMER INTERIM CHAIR/CEO/DIRECTOR	0.00	40.00			0	238917	62645			X
TRANKEL SUSAN K
FORMER SECRETARY	0.00	40.00			0	169339	15597			X
KRAWCZYK MD NICOLAS W
FORMER HIGHEST PAID	0.00	40.00			0	189570	6516			X
SUCHOMEL-OLSON MD ALICE M
FORMER HIGHEST PAID	0.00	40.00			0	150879	27112			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2339192	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	3790818	TotalReportableCompFrmRltdOrgs
Total Other Compensation	857626	TotalOtherCompensation
Number Individuals GT100 K	13	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
MAYO CLINIC
200 FIRST STREET SW	ROCHESTER	MN	55905	MEDICAL & ADMIN SERVICES	877009
MAYO CLINIC HEALTH SYSTEM-RED WING
1407 W 4TH STREET	RED WING	MN	55066	ADMIN SERVICES	399269
TW WALTER ANESTHESIA SERVICES INC
17189 COUNTY 27 BLVD	PINE ISLAND	MN	55963	ANESTHESIA (CRNA)	273257
GRAPETREE MEDICAL STAFFING INC
703 16TH STREET	SPIRIT LAKE	IA	51360	AHS STAFFING	181370
MAYO CLINIC HEALTH SYSTEM-LAKE CITY
500 WEST GRANT ST	LAKE CITY	MN	55041	ADMIN SERVICES	163363

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	8	NumberOfContractorsGT100K
Membership Dues	7	MembershipDues
Fundraising Events	3645	FundraisingEvents
Related Organizations	916393	RelatedOrganizations
Government Grants	145448	GovernmentGrants
All Other Contributions	5480	AllOtherContributions
Total Contributions	1070973	TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE	620000	16812249	16812249
LAB REVENUE	621510	5163887	5163887
RENTAL REVENUE FROM AFFILIATES	531120	95274	95274
MEALS ON WHEELS REVENUE	624210	15027	15027

Field	Value	IRS element (for citing)
Total Program Service Revenue	22086437	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	24301	TotalRevenueColumn
Exclusion	$24,301	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	21214	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	21214	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	0	Real

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	1235	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	65595	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	-64360	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-64360	TotalRevenueColumn
Exclusion	-$64,360	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	5210	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	3645	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	1072	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	4138	TotalRevenueColumn
Exclusion	$4,138	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA/VENDING REVENUE	722210	39256	39256
MEDICAL RECORD/TRANSCRIPTION FEES	541900	8523	8523
MISCELLANOUS REVENUE	900099	4926	4926

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1562	TotalRevenueColumn
Exclusion	$1,562	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	54267	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	23175756	TotalRevenueColumn
Related Or Exempt Function Income	22139142	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	-$34,359	ExclusionAmount

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	X	InfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	8100	Total
Program Services	8100	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	1524	Total
Program Services	1524	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	1584676	Total
Program Services	943296	ProgramServices
Management And General	641380	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	71018	Total
Program Services	71018	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	8466753	Total
Program Services	7670576	ProgramServices
Management And General	796177	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	474866	Total
Program Services	397221	ProgramServices
Management And General	77645	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1297732	Total
Program Services	1085541	ProgramServices
Management And General	212191	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	619140	Total
Program Services	517905	ProgramServices
Management And General	101235	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	11240	Total
Management And General	11240	ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	65000	Total
Fundraising	65000	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	3463997	Total
Program Services	2307186	ProgramServices
Management And General	1156811	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	30614	Total
Program Services	30614	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	994813	Total
Program Services	889625	ProgramServices
Management And General	105188	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	263244	Total
Management And General	263244	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	174572	Total
Program Services	173591	ProgramServices
Management And General	981	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	6803	Total
Program Services	5501	ProgramServices
Management And General	1302	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	164239	Total
Program Services	137921	ProgramServices
Management And General	26318	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	7477	Total
Program Services	7477	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	531533	Total
Program Services	531533	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	36287	Total
Program Services	17422	ProgramServices
Management And General	18865	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
MEDICAL SUPPLIES	1318364	1318364
BAD DEBT EXPENSE	725491	725491
MN CARE TAX	200089	200089
MEDICAID SURCHARGE	140118	140118

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	198977	Total
Program Services	128798	ProgramServices
Management And General	70179	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	20856667	Total
Program Services	17308910	ProgramServices
Management And General	3482756	ManagementAndGeneral
Fundraising	65000	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	751	BOY
EOY	953	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	951609	BOY
EOY	302567	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	379594	BOY
EOY	1608596	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	3321897	BOY
EOY	4587603	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	225070	BOY
EOY	201436	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	276047	BOY
EOY	213321	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	8533358	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	4361619	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	3819995	BOY
EOY	4171739	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	6861884	BOY
EOY	7576345	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	125400	BOY
EOY	600	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	15962247	BOY
EOY	18663160	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	1797879	BOY
EOY	1391356	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	296168	BOY
EOY	241097	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	2094047	BOY
EOY	1632453	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	10644638	BOY
EOY	12434744	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	3170982	BOY
EOY	4543383	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	52580	BOY
EOY	52580	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	13868200	BOY
EOY	17030707	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	15962247	BOY
EOY	18663160	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	2319089	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	4033	ReconciliationUnrealizedInvest
Reconcilation Other Changes	839385	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$1,106	OtherActivitiesAmount
Total Lobbying Expenditures IIB	1106	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	THE AMOUNT IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	52580	BeginningOfYearBalance
Investment Earnings Or Losses	1066	InvestmentEarningsOrLosses
Other Expenditures	1066	OtherExpenditures
End Of Year Balance	52580	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	52580	BeginningOfYearBalance
End Of Year Balance	52580	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	52580	BeginningOfYearBalance
End Of Year Balance	52580	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	52580	BeginningOfYearBalance
End Of Year Balance	52580	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	52580	BeginningOfYearBalance
End Of Year Balance	52580	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	907081	OtherCostOrOtherBasis
Book Value	907081	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3616045	OtherCostOrOtherBasis
Depreciation	2228193	Depreciation
Book Value	1387852	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3434269	OtherCostOrOtherBasis
Depreciation	2133426	Depreciation
Book Value	1300843	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	575963	OtherCostOrOtherBasis
Book Value	575963	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	4171739	TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
HOSPITAL DISTRICT INVESTMENT	2037828	F
MAYO POOLED INVESTMENTS	5538517	F

Field	Value	IRS element (for citing)
Total Of Book Value Securities	7576345	TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
ASSET RETIREMENT OBLIGATION	$158,373
DUE TO AFFILIATES	$82,724

Field	Value	IRS element (for citing)
Total Of Amounts	241097	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	THE ENDOWMENT FUNDS PROVIDE A STABLE FUNDING SOURCE TO SUPPORT THE MISSION OF THE ORGANIZATION.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X, LINE 2:	AT DECEMBER 31, 2012 AND 2011, 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.

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Special Fundraising Events	X	SpecialFundraisingEvents
Agreement Ref Fundraising	1	AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

Field	Value	IRS element (for citing)
Name Of Individual	DEAN J LINDEMAN	NameOfIndividual

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	30596 OXFORD MILL RD	AddressLine1
City	CANNON FALLS	City
State	MN	State
ZIP Code	55009	ZIPCode

Field	Value	IRS element (for citing)
Activity	FUNDRAISING	Activity
Fundraiser Control Of Funds	0	FundraiserControlOfFunds
Gross Receipts	0	GrossReceipts
Amount Retained By Contractor	0	AmountRetainedByContractor
Net To Organization	0	NetToOrganization

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent100	X	Pcent100
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	88299	TotalCommunityBenefitExpense
Net Community Benefit Expense	88299	NetCommunityBenefitExpense
Percent Of Total Expense	0.00440	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1693156	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1491089	DirectOffsettingRevenue
Net Community Benefit Expense	202067	NetCommunityBenefitExpense
Percent Of Total Expense	0.01000	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	114793	TotalCommunityBenefitExpense
Direct Offsetting Revenue	33999	DirectOffsettingRevenue
Net Community Benefit Expense	80794	NetCommunityBenefitExpense
Percent Of Total Expense	0.00400	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1896248	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1525088	DirectOffsettingRevenue
Net Community Benefit Expense	371160	NetCommunityBenefitExpense
Percent Of Total Expense	0.01840	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	40707	TotalCommunityBenefitExpense
Direct Offsetting Revenue	20615	DirectOffsettingRevenue
Net Community Benefit Expense	20092	NetCommunityBenefitExpense
Percent Of Total Expense	0.00100	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1500	TotalCommunityBenefitExpense
Net Community Benefit Expense	1500	NetCommunityBenefitExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4158559	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2127782	DirectOffsettingRevenue
Net Community Benefit Expense	2030777	NetCommunityBenefitExpense
Percent Of Total Expense	0.10090	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4200766	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2148397	DirectOffsettingRevenue
Net Community Benefit Expense	2052369	NetCommunityBenefitExpense
Percent Of Total Expense	0.10200	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6097014	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3673485	DirectOffsettingRevenue
Net Community Benefit Expense	2423529	NetCommunityBenefitExpense
Percent Of Total Expense	0.12040	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	950	TotalCommunityBuildingExpense
Net Community Building Expense	950	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	6450	TotalCommunityBuildingExpense
Net Community Building Expense	6450	NetCommunityBuildingExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	7400	TotalCommunityBuildingExpense
Net Community Building Expense	7400	NetCommunityBuildingExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$725,491	BadDebtExpenseAmount
Amount Reimbursed By Medicare	5533687	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	5475206	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	58481	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MAYO CLINIC HEALTH SYSTEM-CANNON FALLS	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1116 WEST MILL STREET	AddressLine1
City	CANNON FALLS	City
State	MN	State
ZIP Code	55009	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours
Other	HOSPITAL	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MAYO CLINIC HEALTH SYSTEM-CANNON FALLS	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	100.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	300.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Other Actions Taken	X	OtherActionsTaken
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	1	NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MAYO CLINIC HEALTH SYSTEM-CANNON FALLS	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1116 WEST MILL STREET	AddressLine1
City	CANNON FALLS	City
State	MN	State
ZIP Code	55009	ZIPCode

Field	Value	IRS element (for citing)
Facility Type	CLINIC, SWING BED, DME	FacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
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 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 $ 725491.
PART II: THE COMMUNITY BUILDING EXPENSES IN 2012 RELATE TO FUNDS PROVIDED TO THE CANNON FALLS EDUCATION FOUNDATION, THE CANNON FALLS LIBRARY FOUNDATION, CANNON FALLS COMMUNITY CHURCH AND SEVERAL SMALLER CHARITIES. THESE EXPENDITURES PROMOTED EDUCATION, SPIRITUAL GROWTH AND YOUTH ACTIVITIES.
PART III, LINE 4: METHODOLOGY FOR SCHEDULE H, PART III, LINE 2: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.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.
PART III, LINE 8: THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. 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). HOWEVER, USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY ACTUALLY RESULTS IN A MEDICARE SHORTFALL OF $282,357 AS REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS.THE MOST COMMON REASONS FOR A DIFFERENCE BETWEEN THE MEDICARE SURPLUS REPORTED ON SCHEDULE H AND THE MEDICARE SHORTFALL REPORTED ON THE CORE FORM, PART III INCLUDE: (1) INCLUSION OF MEDICARE ADVANTAGE REVENUE AND EXPENSES; (2) INCLUSION OF PART B REVENUE AND EXPENSES; (3) INCLUSION OF OTHER FEE SCHEDULE REVENUE; AND (4) SOME TIMING ISSUES.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 CLINICS 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: WITH REGARD 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-CANNON FALLS
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-CANNON FALLS
PART V, SECTION B, LINE 20D: OUR POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 50% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN THE AVERAGE OF THE THREE BEST NEGOGIATED COMMERCIAL RATES OR THE BEST NEGOGIATED COMMERCIAL RATE.	MAYO CLINIC HEALTH SYSTEM-CANNON FALLS
PART VI, LINE 2: MAYO CLINIC HEALTH SYSTEM-CANNON FALLS (MCHS-CF) DETERMINES PATIENT NEEDS THROUGH A VARIETY OF MEANS: DIRECT FEEDBACK FROM PATIENTS TO EMPLOYEES AT POINT OF CARE AND AT OTHER OPPORTUNITIES, THROUGH COMMUNITY REPRESENTATION ON THE MEDICAL CENTER COMMUNITY ADVISORY COUNCIL AND THROUGH CONTINUAL, RANDOM, CONFIDENTIAL PATIENT SATISFACTION SURVEYS WHICH ARE PART OF THE DECISION-MAKING PROCESSES FOR IMPROVING PATIENT CARE AND CUSTOMER SERVICE.
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-CANNON FALLS (MCHS-CF) IS LOCATED IN CANNON FALLS, MINNESOTA. MCHS-CF SERVES CANNON FALLS AND THE SURROUNDING AREA WITHIN GOODHUE COUNTY. CANNON FALLS IS A RURAL COMMUNITY WITH A POPULATION OF 4,086 AS OF JULY 2011. THE SERVICE AREA POPULATION WAS 12,789 AS OF JULY 2011. THE POPULATION IS 48.3% MALE AND 51.7% IS FEMALE. THE MEDIAN RESIDENT AGE IS 40.0 YEARS OF AGE. THE ESTIMATED MEDIAN HOUSEHOLD INCOME IN CANNON FALLS FOR 2010 WAS $40,721. ACCORDING TO 2010 DATA, 5.6% OF RESIDENTS HAVE AN INCOME BELOW THE POVERTY LEVEL, WHILE 3.5% OF RESIDENTS HAVE AN INCOME BELOW 50% OF THE POVERTY LEVEL.
PART VI, LINE 5: THIS FILING ORGANIZATION IS AN AFFILIATE OF 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 ORGANIZATIONS ACTIVITIES.SURPLUS FUNDSMAYO 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 BODYTHE 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 CLINICS 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 V. 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 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.
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.		PART VI, LINE 7

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
CANNON FALLS LIBRARY FOUNDATION
306 MILL ST W	CANNON FALLS	MN	55009	411962864	501(C)(3)	5000	SUPPORT MISSION
(no name)
							SUPPORT MISSION

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	1	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	PART I, LINE 2:	SCHEDULE 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.
SCHEDULE I, PART III, COLUMN (B)		THE FILING ORGANIZATION ESTIMATED THE NUMBER OF RECIPIENTS FOR EACH TYPE OF GRANT OR ASSISTANCE BASED UPON THE ACTUAL BOOKS AND RECORDS OF THE ORGANIZATION.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (23 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ALTRICHTER MD PAUL M
VICE-CHAIR/DIRECTOR	0	222520	0	0	0	530	0	24511	0	27237	0	274798	0	0
BERNARD MD MATTHEW E
DIRECTOR	0	254728	0	0	0	2935	0	27258	0	20170	0	305091	0	0
PARKS DOUGLAS A
DIRECTOR/REGION CAO	0	188612	0	0	0	1169	0	20335	0	24187	0	234303	0	0
WHITED MD BRIAN L
DIRECTOR	0	351898	0	0	0	0	0	12500	0	26126	0	390524	0	0
WITT MD THOMAS J
CHAIR/CEO/DIRECTOR	0	410870	0	0	0	41652	0	42967	0	20649	0	516138	0	0
AGERTER MD DAVID C
REGION CEO	0	449783	0	0	0	33817	0	19707	0	15384	0	518691	0	0
CHRISTIAN GLENN P
SECRETARY	176420	0	0	0	0	0	23244	0	13670	0	213334	0	0	0
KOCH MARK B
ASSISTANT SECRETARY	0	279804	0	0	0	9282	0	322	0	16473	0	305881	0	0
PILOT DAVID L
REGION CFO	0	196045	0	0	0	0	0	13937	0	19997	0	229979	0	0
PRIEST WILLIAM F
CAO	196211	0	0	0	0	0	23036	0	21810	0	241057	0	0	0
TUSA EDWARD A
CFO/TREASURER	143951	0	0	0	0	0	16957	0	26081	0	186989	0	0	0
NORDAHL MD THOMAS W
PHYSICIAN	398610	0	0	0	0	0	39040	0	25582	0	463232	0	0	0
TURNA MD TARLOCHAN S
FAMILY MEDICINE PHYSICIAN	442682	0	0	0	0	0	22947	0	14435	0	480064	0	0	0
CHESTNUT MD JANET S
ER PHYSICIAN/MEDICAL DIRECTOR	312693	0	0	0	0	0	46944	0	18965	0	378602	0	0	0
JOHNSTON-FLANDERS MD MEGAN S
FAMILY MEDICINE PHYSICIAN	190277	0	20000	0	0	0	9335	0	23336	0	242948	0	0	0
STRICKER MD ALEXANDER W
FAMILY PRACTICE PHYSICIAN	209780	0	0	0	0	0	10284	0	0	0	220064	0	0	0
ANGSTMAN MD GREGORY L
FORMER CEO/CHAIR	0	263190	0	6544	0	0	0	19472	0	15218	0	304424	0	0
BIREN DAVID H
FORMER TREASURER	0	166322	0	0	0	2098	0	32	0	17168	0	185620	0	0
KRAMER CHERYL A
FORMER SECRETARY	0	150408	0	0	0	9906	0	86	0	8199	0	168599	0	0
LOHR MD ROBERT H
FORMER INTERIM CHAIR/CEO/DIRECTOR	0	236020	0	0	0	2897	0	41981	0	20664	0	301562	0	0
TRANKEL SUSAN K
FORMER SECRETARY	0	166694	0	0	0	2645	0	25	0	15572	0	184936	0	0
KRAWCZYK MD NICOLAS W
FORMER HIGHEST PAID	0	163479	0	0	0	26091	0	0	0	6516	0	196086	0	0
SUCHOMEL-OLSON MD ALICE M
FORMER HIGHEST PAID	0	149029	0	0	0	1850	0	17665	0	9447	0	177991	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
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). A PORTION OF THE AMOUNT MAY BE INCLUDED IN SCHEDULE J, PART II, COLUMN (F) IF DISCLOSED ON A PRIOR YEAR'S FORM 990. DAVID C. AGERTER, M.D. $27,454 MATTHEW BERNARD, M.D. $1,852 MARK B. KOCH $8,013 THOMAS J. WITT M.D. $30,605
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. COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION.	SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	RYAN SCHRAMN	NamePerson

Field	Value	IRS element (for citing)
Relationship	SON-IN-LAW OF BOARD OFFICER, GLENN CHRISTIAN	Relationship
Amount Of Transaction	71018	AmountOfTransaction
Description Of Transaction	EMPLOYMENT	DescriptionOfTransaction
Sharing Of Revenues	0	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: CIOTA M.D., MARK R. PILOT, DAVID L. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: AGERTER M.D., DAVID C. CIOTA M.D., MARK R. KOCH, MARK B. PARKS, DOUGLAS A. PILOT, DAVID L. THE FOLLOWING INDIVIDUAL IS EMPLOYED BY A RELATED ORGANIZATION: WITT M.D., THOMAS J. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: AGERTER M.D., DAVID C. CIOTA M.D., MARK R. KOCH, MARK B. PARKS, DOUGLAS A. PILOT, DAVID L. WITT M.D., THOMAS J. THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: WHITED M.D., BRIAN L RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL WHO IS ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: KOCH, MARK B.
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. 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 MEMBER OF THE CORPORATION IS MAYO CLINIC.
FORM 990, PART VI, SECTION A, LINE 7A	THE GOVERNING BODY OF THE FILING ORGANIZATION CONSISTS OF NINE PERSONS ELECTED AS FOLLOWS: (A) FOUR COMMUNITY TRUSTEES ELECTED BY THE CANNON FALLS HOSPITAL DISTRICT; (B) CHAIR/CEO AND VICE CHAIR ELECTED BY THE BOARD OF TRUSTEES AND APPROVED BY THE SOLE MEMBER; AND (C) THREE MEMBER TRUSTEES ELECTED BY THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B	MAYO CLINIC, THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION, MUST APPROVE THE PERSON ELECTED AS THE VICE CHAIR. THE FILING ORGANIZATION'S BYLAWS ALSO PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, BUDGET, AMENDMENT OF ARTICLES OR BYLAWS AND DEBT 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 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 12C	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 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 15B	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 (THOMAS WITT, M.D.) AND CAO (BILL PRIEST) 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 CLINIC 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. IN ADDITION TO THE ABOVE COORDINATED REVIEW PROCESS CONDUCTED AT MAYO CLINIC AND ITS AFFILIATES, THE FILING ORGANIZATION ALSO HAS ITS OWN COMPENSATION REVIEW PROCESS FOR THE CEO AND OTHER TOP MANAGEMENT OFFICIALS. THE PROCESS INCLUDES REVIEW OF COMPARABILITY DATA FOR SIMILAR SIZED ORGANIZATIONS BY AN INDEPENDENT COMMITTEE OF THE BOARD (PUBLIC MEMBERS ONLY). SALARY RANGES FOR THE PAST YEAR AND RANGES FOR THE NEXT YEAR ARE REVIEWED 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 AND FINANCIAL STATEMENTS 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.
FORM 990, PART IX, LINE 11G	PHYSICIAN SERVICES : PROGRAM SERVICE EXPENSES 895,770. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 895,770. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 320,279. MANAGEMENT AND GENERAL EXPENSES 102,075. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 422,354. RADIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 309,952. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 309,952. LAB SERVICES: PROGRAM SERVICE EXPENSES 199,800. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 199,800. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 222,919. MANAGEMENT AND GENERAL EXPENSES 522,061. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 744,980. SHARED SERVICES W/ AFFILIATES: PROGRAM SERVICE EXPENSES 317,078. MANAGEMENT AND GENERAL EXPENSES 502,589. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 819,667. OTHER FEES: PROGRAM SERVICE EXPENSES 41,388. MANAGEMENT AND GENERAL EXPENSES 30,086. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 71,474.	OTHER FEES
FORM 990, PART XI, LINE 9:	PLEDGE RECEIVABLE ADJUSTMENT 839,385.	CHANGES IN NET ASSETS OR FUND BALANCES:
SCHEDULE F, PART IV, LINES 3,5,& 6	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)	IN REGARDS TO FILING CERTAIN FOREIGN FORMS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (48 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA	Address Line1AddressForeign/AddressLine1	CityAddressForeign/City	CountryAddressForeign/Country	Legal Domicile Foreign CountryLegalDomicileForeignCountry
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		1	N/A
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
					FUNDRAISING FOUNDATION				MFMER	1		60486 FRANKFURT AM MAIN	FRANKFURT	GM	GM
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

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA
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

Form990 Schedule R Part IV Form990ScheduleRPartIV (36 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Type Of EntityTypeOfEntity	Controlled OrgControlledOrg	Address Line1AddressForeign/AddressLine1	CityAddressForeign/City	CountryAddressForeign/Country	Legal Domicile Foreign CountryLegalDomicileForeignCountry	Postal CodeAddressForeign/PostalCode
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
					HEALTHCARE MANAGEMENT		N/A	C	1	2ND FLOOR EBENE MEWS 57	EBENE CYBERCITY	MP	MP
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		N/A	C	1				CJ
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
				980648163	INVESTMENT MANAGEMENT		N/A	C	1	CLIFTON HOUSE 75 FORTH ST	GRAND CAYMAN	CJ	CJ	KY1-1108
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

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	1	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
MAYO CLINIC HEALTH SYSTEM--AUSTIN
P	132098	GAAP
MAYO CLINIC HEALTH SYSTEM--LAKE CITY
M	163363	GAAP
MAYO CLINIC HEALTH SYSTEM--OWATONNA
M	104110	GAAP
MAYO CLINIC HEALTH SYSTEM--RED WING
M	399269	GAAP
MAYO COLLABORATIVE SERVICES INC
M	152656	GAAP
MMSI INC
R	1253073	GAAP
MMSI INC
S	988545	GAAP