2013-11-07T09:10:37-06:00 2012-12-31 990 2012-01-01 411236756 MAYO CLINIC HEALTH SYSTEM-MANKATO MAYO 5075381297 1025 MARSH STREET MANKATO MN 56002 JAMES TARASOVITCH 5073856449 2013-11-07 2012 2016-02-24 21:20:13Z GREGORY KUTCHER MD 1025 MARSH STREET MANKATO MN 56002 319530809 0 X WWW.MAYOCLINICHEALTHSYSTEM.ORG X 1968 MN HOSPITAL AND CLINICS 16 7 3257 248 13812 -1808 3643396 4515761 288695800 311650784 207005 563303 2164140 2067320 294710341 318797168 146629 126322 0 0 158029142 174374882 0 0 611804 118520347 127843721 276696118 302344925 18014223 16452243 231186118 248126557 41510343 41948311 189675775 206178246 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 257223262 297351890 PATIENT CARE (SCHEDULE O):PATIENT CARE: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, AND PERFORMANCE WITHIN 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.MAYO CLINIC HEALTH SYSTEM - MANKATO (MCHS-MANKATO) IS A MEMBER OF THE MAYO CLINIC HEALTH SYSTEM.IN 2012, MCHS-MANKATO ADMITTED MORE THAN 10,650 PATIENTS, SERVED OVER 250,000 OUTPATIENTS AND SERVED OVER 225,000 CLINIC PATIENT VISITS.PHYSICIAN CLINICS: MCHS-MANKATO OPERATES SEVERAL PRIMARY CARE AND MULTI-SPECIALTY CLINICS TO SERVE THE NEEDS OF THE AREA. THESE CLINICS INCLUDE APPROXIMATELY 150 PHYSICIAN AND MID-LEVEL PROVIDERS. THESE CLINICS ARE LOCATED IN MANKATO, NORTH MANKATO, LAKE CRYSTAL, ST. PETER, AND LE SUEUR.MCHS-MANKATO CONTRACTS WITH THE NEW ULM MEDICAL CENTER TO HOUSE A RENAL DIALYSIS UNIT, THE CONTRACT WAS ENTERED INTO FOR THE BENEFIT OF OUR PATIENTS TO RECEIVE HEMODIALYSIS SERVICES CLOSER TO HOME.MCHS-MANKATO EMPLOYS BOARD CERTIFIED EMERGENCY ROOM PHYSICIANS TO STAFF THE MCHS-MANKATO ER 24 HOURS A DAY, 7 DAYS A WEEK.MCHS-MANKATO CONTRACTS WITH MAYO CLINIC IN ROCHESTER FOR PHYSICIAN SERVICES IN CARDIOLOGY, MEDICAL ONCOLOGY, & RADIATION ONCOLOGY. WITHOUT THESE ARRANGEMENTS, MANKATO AREA PATIENTS WOULD HAVE TO TRAVEL GREATER DISTANCES FROM HOME TO RECEIVE THESE SPECIALTY SERVICES.MCHS-MANKATO PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS/RESIDENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. CHARITY CARE IS ALSO PROVIDED FOR PATIENTS THAT ARE FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED.THE COST OF CHARITY CARE PROVIDED IN 2012 WAS APPROXIMATELY $1,279,000.THE COST OF UNCOMPENSATED CARE PROVIDED TO LOW INCOME PATIENTS THROUGH MEDICAID WAS APPROXIMATELY $20,037,000. THIS AMOUNT INCLUDES A MEDICAID SURCHARGE OF $1,627,000 AND $3,447,000 PAID TO MINNESOTA CARE (A PROGRAM THAT PROVIDES HEALTH CARE FOR LOW INCOME POPULATIONS).THE COST OF UNCOMPENSATED CARE PROVIDED THROUGH MEDICARE WAS APPROXIMATELY $39,798,000.MCHS-MANKATO ALSO PROVIDES DISCOUNTS TO UNINSURED PATIENTS. THE TOTAL DISCOUNTS GIVEN IN 2012 WERE $828,000.HOSPITAL AUXILIARY:THE HOSPITAL AUXILIARY OPERATES UNDER MCHS-MANKATO'S TAX EXEMPT STATUS. THE AUXILIARY'S MAIN SOURCES OF INCOME ARE THE OPERATION OF A GIFT SHOP & FUNDRAISING. THE AUXILIARY AND ITS VOLUNTEERS HAVE ENHANCED THE HEALING ENVIRONMENT AND SERVICES OFFERED TO PATIENTS, VISITORS & STAFF OF THE HOSPITAL. AUXILIARY MEMBERSHIP TOTALED OVER 300 PEOPLE & THESE MEMBERS CONTRIBUTE THOUSANDS OF HOURS OF SERVICE EACH YEAR. THE MAJOR SERVICES PROVIDED BY AUXILIARY MEMBER VOLUNTEERS ARE AS FOLLOWS: THE GIFT SHOP, PATRONIZED BY PATIENTS, VISITORS MAKING PURCHASES FOR PATIENTS, AND EMPLOYEES CONTRIBUTES IMPORTANTLY TO OUR EXEMPT FUNCTION BY IMPROVING PHYSICAL COMFORT AND MENTAL WELL BEING OF ITS PATIENTS, THEREBY ENCOURAGING THEIR RECOVERY; AND ALSO KEEPING EMPLOYEES & MEDICAL STAFF ON THE HOSPITAL PREMISES, THEREBY INCREASING THE HOSPITAL'S EFFICIENCY.THE COORDINATION OF THE ANNUAL WOMEN'S SHOW. THE LARGEST EXPO OF ITS KIND IN SOUTHERN MINNESOTA, THIS EVENT TYPICALLY DRAWS SEVERAL THOUSAND PEOPLE FOR A DAY OF EDUCATION, INFORMATION, SEMINARS, HEALTH SCREENINGS, EXHIBIT BOOTHS AND FOOD.VOLUNTEERS HAVE ASSEMBLED LARGE NUMBERS OF MAILINGS FOR HOSPITAL DEPARTMENTS AS WELL AS BABY PACKETS FOR DISTRIBUTION TO NEW MOTHERS.DURING 2012, APPROXIMATELY 248 VOLUNTEERS DONATED APPROXIMATELY 17,315 HOURS OF VOLUNTEER SERVICE THESE SERVICES WERE VALUED AT APPROXIMATELY $383,354 BASED ON THE INDEPENDENT SECTOR. 2920144 3000 1233005 EDUCATION (SCHEDULE O):EDUCATION: RURAL FAMILY PRACTICE RESIDENCY PROGRAM - THIS PROGRAM IS BASED ON THE CONCEPT THAT EFFECTIVE TRAINING IN RURAL MEDICINE IS BEST CARRIED OUT IN A RURAL AREA. THE PROGRAM IS BASED IN MANKATO AND BEGAN IN 1994. RESIDENTS PARTICIPATE IN A HEALTH CARE DELIVERY SYSTEM THAT LINKS AMBULATORY & INPATIENT SERVICES IN A RURAL COMMUNITY WITH TERTIARY & QUATERNARY CARE IN A MAJOR METROPOLITAN AREA. THE RESIDENCY PROVIDES A SUPPORTIVE ENVIRONMENT TO MAXIMIZE DIDACTIC LEARNING AND THE ACQUISITION OF PROCEDURAL AND PATIENT-PHYSICIAN COMMUNICATION SKILLS. CLINICAL REFERENCE LIBRARIES AND LIBRARY SEARCH SERVICES ARE AVAILABLE AT ALL SITES. DURING THEIR FIRST YEAR, RESIDENTS DEVELOP THEIR OWN PATIENT PANELS MUCH AS THEY WOULD IN A TYPICAL PRACTICE. THE FIRST YEAR OF TRAINING CONSISTS OF INTENSIVE EXPERIENCE IN THE BASIC DISCIPLINES OF INTERNAL MEDICINE, OBSTETRICS, PEDIATRICS, EMERGENCY MEDICINE, SURGERY, GYNECOLOGY AND NEUROLOGY. INTEGRATION INTO THE COMMUNITY IS AN IMPORTANT PART OF THE TRAINING. PRACTICE MANAGEMENT AND COMMUNITY MEDICINE ARE EMPHASIZED DURING THIS TIME. RESIDENTS ARE ENCOURAGED TO GET INVOLVED WITH COMMUNITY ORGANIZATIONS, CONDUCT EDUCATIONAL EVENTS IN SCHOOLS, AND OTHERWISE BE INVOLVED IN CIVIC ORGANIZATIONS.ROTATIONS IN ORTHOPEDICS, SURGERY, OBSTETRICS, INTERNAL MEDICINE, GYNECOLOGY, AND AMBULATORY PEDIATRICS OCCUR AT MCHS-MANKATO. IN THE THIRD YEAR, ROTATIONS IN OPHTHALMOLOGY, OTOLARYNGOLOGY, DERMATOLOGY, UROLOGY, AND SUBSPECIALTY MEDICINE ARE ALSO CARRIED OUT AT MCHS-MANKATO. BEHAVIORAL MEDICINE IS TAUGHT IN A LONGITUDINAL FASHION OVER ALL THREE YEARS WITH A ONE-MONTH CONCENTRATED EXPERIENCE IN THE SECOND OR THIRD YEAR.ALMOST TWO THIRDS OF THE PHYSICIANS THAT HAVE GRADUATED FROM THE PROGRAM HAVE BEGUN THEIR PRACTICE IN RURAL SETTINGS. 164704 10893 RESEARCH (SCHEDULE O)RESEARCH:CLINICAL RESEARCH IN MEDICAL ONCOLOGY IS PROVIDED FOR PHASE III AND IV STUDIES, EMPLOYED RESEARCH ASSOCIATES AND A PHYSICIAN PRINCIPAL INVESTIGATOR COORDINATING THE PROGRAM. CLINICAL RESEARCH ACCRUAL OCCURS THOUGH THE NORTH CENTRAL CANCER TREATMENT GROUP (NCCTG), CLINICAL TRIALS SUPPORT UNIT (CTSU), MAYO CLINIC CANCER RESEARCH CONSORTIUM (MCCRC), AND RADIATION THERAPY ONCOLOGY GROUP (RTOG) RESEARCH GROUPS. CLINICAL RESEARCH PROTOCOLS AND TRIALS ARE AVAILABLE IN MANY SPECIALTY AREAS WITH NEW STUDIES OPENING ON A REGULAR BASIS. CLINICAL RESEARCH ASSOCIATES WORK WITH THE PHYSICIAN INVESTIGATORS TO COORDINATE THE STUDIES. 123322 123322 14544328 COMMUNITY SUPPORT:DIABETES WELLNESS PROGRAM - THE DIABETES & WELLNESS PROGRAM IS A COMMUNITY PROGRAM SPONSORED BY MCHS-MANKATO WHICH IS DESIGNED TO HELP PEOPLE WITH DIABETES BETTER MANAGE THEIR HEALTH. A TEAM OF HEALTH EXPERTS PROVIDES INDIVIDUALIZED CARE TO ANYONE WITH DIABETES INTERESTED IN IMPROVING THEIR HEALTH. MEETINGS CONSIST OF A THREE-HOUR SESSION EVERY SIX MONTHS INCLUDING INDIVIDUAL SESSIONS WITH VARIOUS MEMBERS OF THE DIABETES WELLNESS TEAM AND A ONE-HOUR GROUP SESSION WITH OTHER CLIENTS & THEIR SPOUSES/SUPPORT PERSONS. THE DIABETES WELLNESS TEAM INCLUDES A DIABETES NURSE EDUCATOR, DIETITIAN, BEHAVIORAL COUNSELOR, SKIN/WOUND CARE SPECIALIST, EXERCISE SPECIALIST, SOCIAL WORKER, DIABETES CASE MANAGER, PHARMACIST, & OTHERS AS NEEDED. ANYONE 18 YEARS OR OLDER WITH DIABETES IS ENCOURAGED TO PARTICIPATE, ALONG WITH THE SPOUSE OR OTHER SUPPORT PERSON. THIS PROGRAM IS OFFERED AT NO COST TO THE PARTICIPANTS.STOP! NICOTINE DEPENDENCE PROGRAM - THIS PROGRAM FOCUSES ON COUNSELING, PHARMACOLOGIC THERAPY, & RELAPSE PREVENTION. PARTICIPANTS ARE ENCOURAGED TO BRING A SMOKE-FREE SUPPORT PERSON TO GROUPS. THE STAFF OF STOP! ARE TRAINED IN THE TREATMENT OF NICOTINE DEPENDENCE AND WORK IN COLLABORATION WITH THE PATIENT'S PRIMARY CARE PHYSICIAN.SEXUAL ASSAULT RESOURCE TEAM - SURVIVORS OF SEXUAL VIOLENCE OFTEN EXPERIENCE FEAR, SHOCK, NUMBNESS, DISBELIEF, SHAME, ANGER, AND FEELINGS OF A LOSS OF CONTROL OVER THEIR LIVES. THEY HAVE EXPERIENCED A MAJOR CRISIS IN THEIR LIFE. IT MAY BE DIFFICULT TO TRUST PEOPLE, AND TO CONTINUE ON WITH NORMAL ROUTINE MAY REQUIRE TREMENDOUS EFFORT. CRISES OF ANY KIND ARE EASIER TO COPE WITH WHEN THERE ARE SUPPORTIVE PEOPLE CLOSE BY, PEOPLE WHO ACCEPT AND UNDERSTAND YOUR FEELINGS, PEOPLE WHO CAN HELP YOU OBTAIN NEEDED INFORMATION, AND PEOPLE WHO CARE.THE PRIORITY FOR THE SEXUAL ASSAULT RESOURCE TEAM IS TO ATTEND TO THE PATIENT'S MEDICAL NEEDS IN A SAFE, NON-JUDGMENTAL SETTING. CARING AND SUPPORTIVE RESOURCE TEAM ADVOCATES ARE AVAILABLE TO LISTEN TO CONCERNS, ANSWER QUESTIONS AND PRESENT VARIOUS OPTIONS. WHILE IN THE EMERGENCY DEPARTMENT, CARE WILL BE PROVIDED BY A NURSE WHO HAS SPECIAL TRAINING IN HELPING VICTIMS OF SEXUAL ASSAULT. THE TEAM NURSE WILL EXPLAIN WHAT WILL HAPPEN WHILE IN THE EMERGENCY DEPARTMENT AND WILL ANSWER ANY QUESTIONS. SHE WILL ALSO OFFER EMOTIONAL SUPPORT & GUIDANCE, ALONG WITH PERFORMING THE SPECIAL EXAMS NEEDED.PREADMISSION EDUCATION PROGRAM - PREADMISSION EDUCATION IS PERSONAL TIME WITH A REGISTERED NURSE TO DISCUSS THE HOSPITAL STAY, PAIN MANAGEMENT, AND NURSING CARE. IT IS DESIGNED TO HELP THE PATIENT AND FAMILY PREPARE FOR THE HOSPITAL EXPERIENCE, TO HELP THEM UNDERSTAND WHAT TO EXPECT DURING THE STAY, AND TO HELP THEM PLAN FOR THE EVENTUAL RETURN HOME. A REGISTERED NURSE WILL PROVIDE ONE-ON-ONE INSTRUCTION FOR THE PATIENT AND FAMILY PRIOR TO ADMISSION TO THE HOSPITAL WHERE INFORMATION IS RECEIVED ON PREPARING FOR SURGERY AND THE HOSPITAL STAY. EACH PREADMISSION SESSION IS STRUCTURED SPECIFICALLY FOR THE INDIVIDUAL AND SUBJECTS ROUTINELY COVERED INCLUDE PRE-SURGERY INSTRUCTIONS, PAIN CONTROL, COUGHING, AND DEEP BREATHING TECHNIQUES. THIS PROGRAM IS OFFERED FREE OF CHARGE.YELLOW RIBBON SUICIDE SUPPORT - MCHS-MANKATO PROVIDES A 24-HOUR HOTLINE FOR SUICIDE AND OTHER CRISIS INTERVENTION SUPPORT. THIS SUPPORT ALSO INCLUDES PROVIDING STAFF FOR PROGRAMS CONDUCTED PRIMARILY IN PUBLIC SCHOOLS, COLLEGES AND IN COMMUNITY EVENTS THAT HIGHLIGHT SUICIDE PREVENTION. SUPPORT GROUPS - A NUMBER OF GROUPS ARE SUPPORTED AND COORDINATED BY MCHS-MANKATO TO ASSIST PATIENTS AND THEIR FRIENDS AND FAMILY IN DEALING WITH A VARIETY OF MEDICAL ISSUES INCLUDING: ALZHEIMER'S, AIDS, ARTHRITIS/FIBROMYALGIA, BEREAVEMENT, BREAST CANCER, BRAIN INJURY, CANCER, CROHN'S DISEASE, DIABETES, MENTAL ILLNESSES, MULTIPLE SCLEROSIS, OSTOMY, STROKE, AND SUICIDE.BICYCLE SAFETY RALLY - MCHS-MANKATO ANNUALLY SPONSORS A BIKE SAFETY RALLY. THE EVENT FEATURED BIKE HELMETS FOR SALE AT UP TO 85 PERCENT OFF RETAIL PRICE, A BIKE SAFETY CHECK, A BIKE SAFETY RODEO, CHILDREN'S ACTIVITIES, PRIZE GIVEAWAYS AND LIVE RADIO BROADCASTS. OVER 1,000 HELMETS ARE SOLD AT THE EVENT. MCHS-MANKATO STAFF AND VOLUNTEERS PROVIDE OVER 500 HOURS OF TIME TO THIS EVENT. THE RALLY IS ALSO SPONSORED IN PART BY AREA BUSINESSES.DONATIONS - ANNUALLY, MCHS-MANKATO CONTRIBUTES FINANCIALLY TO NUMEROUS LOCAL AGENCIES AND INITIATIVES. DURING 2012, MCHS-MANKATO PROVIDED OVER $120,000 IN DONATIONS.MINNESOTA BREAST AND CERVICAL CANCER CONTROL - MCHS-MANKATO PARTICIPATES AS THE MANKATO FUNDING COORDINATOR FOR THE MINNESOTA BREAST AND CERVICAL CANCER CONTROL PROGRAM, WHICH IS SPONSORED BY THE STATE OF MINNESOTA. THE PROGRAM IS A PARTNERSHIP BETWEEN THE PUBLIC HEALTH AND PRIVATE HEALTH CARE SECTORS. THE GOAL IS TO PROVIDE QUALITY BREAST AND CERVICAL CANCER SCREENING, FREE OF CHARGE, TO LOW AND MODERATE INCOME MINNESOTA WOMEN, AGE 40 AND OVER, WHO ARE UNINSURED OR UNDERINSURED. THIS PROJECT INVOLVES PROVIDING SCREENING AND DIAGNOSTIC MAMMOGRAMS, CLINIC VISITS, COLPOSCOPY, PAP SMEARS AND FINE NEEDLE ASPIRATION OF A BREAST LUMP AT NO COST FOR QUALIFIED INDIVIDUALS. QUALIFICATIONS ARE BASED ON INCOME ELIGIBILITY DETERMINED BY FEDERAL POVERTY GUIDELINES. BORN LEARNING: BORN LEARNING IS A FREE PROGRAM THAT PROVIDES NEW PARENTS WITH USEFUL INFORMATION TO ACHIEVE A HEALTHY CHILD. IT INCLUDES A SERIES OF 18 MONTHLY NEWSLETTERS STARTING WITH BIRTH AND CONTINUING UNTIL AGE THREE. BORN LEARNING INCLUDES INFORMATION ON NUTRITION, DEVELOPMENT, AND HEALTH AND WELLNESS. IT IS SENT QUARTERLY WITH THE UNITED WAY'S POWER OF PARENTING NEWSLETTER. THIS SERVICE IS A JOINT ENDEAVOR WITH THE MANKATO AREA UNITED WAY.SUPPORTIVE PRAYER AND LISTENING: THIS IS OFFERED THROUGH PASTORAL CARE AS PART OF THE SPIRIT-CENTERED CARE INITIATIVE. STEPHEN MINISTRY: A STEPHEN MINISTER IS SOMEONE WHO HAS 50 HOURS OF TRAINING IN CONFIDENTIAL LISTENING. STEPHEN MINISTERS ARE AVAILABLE TO LISTEN TO A PATIENT'S STORY AFTER RETURNING HOME. WE REALIZE THAT THE PATIENT MAY BE IN THE MIDST OF A LIFE SITUATION THAT HAS BECOME OVERWHELMING AND HAS CONTRIBUTED TO THEIR HOSPITALIZATION. WE CARE ABOUT PATIENTS' SPIRITUAL AND PHYSICAL WELL-BEING AFTER THEY LEAVE THE HOSPITAL. A CHAPLAIN CAN DISCUSS THE POSSIBILITY OF CONNECTING WITH A STEPHEN MINISTER WHO WOULD TOUCH BASE REGULARLY.THE VARIOUS ASPECTS OF THE PARISH NURSING PROGRAM WERE FUNDED BY THE ORGANIZATION AND BY PARTICIPATION BY STAFF AND VOLUNTEERS TO CARRY OUT THE VARIOUS EFFORTS.SHARED SERVICES: MCHS-MANKATO LEASES SPACE AND PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE. 123322 123322 14544328 260431432 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 359 0 1 3257 1 1 1 0 0 0 0 0 0 0 0 0 X 16 7 1 1 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 0 MN X CORPORATE TAX UNIT 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 ALLEN SHERI 1.00 0.00 X 0 0 0 BROLSMA GREG 1.00 0.00 X 0 0 0 CRAGUN MD KEVIN T 1.00 40.00 X 0 578601 57531 GAALSWYK MARK 1.00 0.00 X 0 0 0 GRACE RICHARD W 40.00 0.00 X X 323282 563 29395 HAMMELL DO LUCAS J 1.00 40.00 X 0 152810 24765 HEBL MD JAMES R 1.00 40.00 X 0 446849 42999 HERRMANN MD MARTIN J 1.00 40.00 X 0 231061 35889 JOHNSON TOM 1.00 0.00 X 0 0 0 KUTCHER MD GREGORY R 40.00 0.00 X X 455629 0 43636 MILLER DENNIS 1.00 0.00 X X 0 0 0 MORRIS MD MARIE E 1.00 40.00 X 0 366288 43124 NESSE MD ROBERT E 1.00 40.00 X 0 688141 18683 PIESCHEL SHARON 1.00 0.00 X 0 0 0 SCHOENBAUER BRAD 1.00 0.00 X 0 0 0 SPINNER MD ROBERT J 1.00 40.00 X 0 774109 50139 YEAR PAMELA 1.00 0.00 X 0 0 0 FRATZKE MARK S 40.00 0.00 X 263808 0 34056 KOCH MARK B 1.00 40.00 X 0 289086 16795 TARASOVITCH JAMES J 40.00 0.00 X 265536 0 26828 CAMPBELL MD STEPHEN S 40.00 0.00 X 320346 0 37926 DEACONSON MD TIMOTHY F 40.00 0.00 X 582524 0 39436 KOWAL DO GERALD K 40.00 0.00 X 322154 0 40898 REEVES MD ANDREW L 40.00 0.00 X 388977 0 42438 CANNELLA MD DOMINIC M 40.00 0.00 X 672157 0 31938 CHYATTE MD DOUGLAS 40.00 0.00 X 706988 0 24710 LI MD SHILUN D 40.00 0.00 X 612031 0 36938 STANCHFIELD JR MD WARREN R 40.00 0.00 X 615188 0 19454 WOLF MD MICHAEL J 40.00 0.00 X 573364 0 36938 CREST JEROME A 40.00 0.00 X 153445 0 28365 RUPP MD WILLIAM C 0.00 40.00 X 0 915355 11605 BOROWSKI THOMAS J 40.00 0.00 X 232586 0 34586 WHITED MD BRIAN L 40.00 0.00 X 351898 0 38626 6839913 4442863 847698 197 1 1 0 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 MANAGEMENT & OTHER SERVICES 20193573 BOLDT COMPANY 2525 N ROEMER ROAD PO BOX 419 APPLETON WI 54912 CONSTRUCTION 3629176 LCM PATHOLOGISTS PC 304 BELLE AVENUE MANKATO MN 56001 PATHOLOGY & LAB SERVICES 2027057 UNIVERSITY OF MN REGENTS 516 DELAWARE ST SE MINNEAPOLIS MN 55455 PHYSICIANS & RESIDENTS 1808405 MAYO COLLABORATIVE SERVICE INC 200 FIRST STREET SW ROCHESTER MN 55905 MEDICAL SERVICES 1256282 52 1510 2940 578327 3932984 4515761 PATIENT CARE REVENUE 620000 295862558 295862558 SHARED SERVICES 561000 14308915 14308915 EDUCATION REVENUE 611600 1233005 1233005 RENT FROM AFFILIATES 531120 235413 235413 RESEARCH REVENUE 541700 10893 10893 311650784 711450 711450 943763 386430 557333 557333 557333 32162 180309 -148147 -148147 -148147 11972 2940 12102 -130 -130 161773 154800 6973 6973 CAFETERIA & VENDING 722210 1111881 1111881 MEDICAL RECORDS 541900 220741 220741 MISC. REVENUE 900099 151129 151129 19393 5581 13812 1503144 318797168 313140116 13812 1127479 X 123322 123322 3000 3000 3216869 1774699 1442170 672616 405444 267172 140732445 128704416 11673536 354493 4175016 3778439 386343 10234 16626726 15047384 1538587 40755 8951210 8100951 828318 21941 296443 296443 272638 272638 7530 7530 36756309 23249856 13466309 40144 424014 27327 365547 31140 13774413 10023861 3668340 82212 4859820 4859820 5388189 5146762 240062 1365 1105695 805189 273544 26962 914265 911604 2661 119257 119257 12128016 11396799 730076 1141 1800855 1095407 705190 258 MEDICAL SUPPLIES 32949702 32949702 BAD DEBT EXPENSE 10682257 10682257 MN CARE TAX 3447439 3447439 MEDICAID SURCHARGE 1626726 1626726 1290153 715148 573846 1159 302344925 260431432 41301689 611804 5217 5451 70086 88041 35512613 40420647 4221595 3841081 4207015 3270974 204771987 101281954 108668801 103490033 71550615 88667321 6950176 8343009 231186118 248126557 33942165 33192950 582167 534599 2576213 2388288 4409798 5832474 41510343 41948311 X 189675775 206178246 189675775 206178246 231186118 248126557 16452243 50228 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 0 1 7530 7530 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE AMOUNT IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING. MAYO CLINIC HEALTH SYSTEM - MANKATO (MCHS-MANKATO) PROVIDES INFORMATION OR EXPRESSES ITS CONCERN TO LEGISLATIVE BODIES AND GOVERNMENT OFFICIALS ON MATTERS DIRECTLY RELATED TO HEALTH, THE DELIVERY OF HEALTH CARE AND MEDICAL EDUCATION AND/OR RESEARCH. IN 2012, MCHS-MANKATO REPRESENTATIVES HAD SEVERAL MEETINGS WITH MEMBERS OF THE LEGISLATIVE AND EXECUTIVE BRANCHES OF GOVERNMENT TO DISCUSS ISSUES RELATING TO HEALTH CARE AND HEALTH CARE REFORM. 7758995 7758995 84456021 36888453 47567568 112556971 64393501 48163470 103490033 MAYO POOLED INVESTMENTS 88028071 F ASSETS HELD BY TRUSTEES 639250 F 88667321 DEFERRED COMPENSATION RESERVE 5832474 5832474 X 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 0 1 1 1279061 1279061 0.00440 38899879 18863139 20036740 0.06870 40178940 18863139 21315801 0.07310 75000 15000 60000 0.00020 2917144 1233005 1684139 0.00580 2570560 1927594 642966 0.00220 164704 10893 153811 0.00050 20400 20400 0.00010 5747808 3186492 2561316 0.00880 45926748 22049631 23877117 0.08190 19975 19975 0.00010 5000 5000 0.00000 77947 77947 0.00030 102922 102922 0.00040 0 10682257 62536550 71956205 -9419655 X 1 1 1 1 MAYO CLINIC HEALTH SYSTEM - MANKATO

1025 MARSH ST MANKATO MN 56002

X X X X MAYO CLINIC HEALTH SYSTEM - MANKATO 1 1 1 100.000000000000 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 8 MCHS-MANKATO-EASTRIDGE

101 MARTIN LUTHER KING JR DRIVE MANKATO MN 56001

CLINIC MCHS-MANKATO-NORTHRIDGE

1695 LOR RAY DRIVE NORTH MANKATO MN 56003

CLINIC MCHS-MANKATO-ST PETER

1900 NORTH SUNRISE DRIVE ST PETER MN 56082

CLINIC MAYO CLINIC HEALTH SYSTEM-MANKATO

1400 MADISON AVENUE MANKATO MN 56001

DME AND PT MCHS-MANKATO-LE SUEUR

625 SOUTH 4TH STREET LE SUEUR MN 56058

CLINIC MCHS-MANKATO-NEW ULM

1324 5TH NORTH NEW ULM MN 56073

DIALYSIS MCHS-MANKATO-LAKE CRYSTAL

200 EAST PRINCE STREET LAKE CRYSTAL MN 56055

CLINIC MCHS-MANKATO

1400 MADISON AVENUE MANKATO MN 56001

HOSPICE 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: $364,734. 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 $ 10682257. PART II: THE MISSION OF MAYO CLINIC AND ITS AFFILIATES IS TO PUT THE NEEDS OF THE PATIENT FIRST. WE BELIEVE THAT MISSION IS BEST ACCOMPLISHED WITHIN HEALTHY, WELCOMING AND THRIVING COMMUNITIES. TO DELIVER ON THAT BELIEF, MCHS-MANKATO COLLABORATES WITH PUBLIC, PRIVATE AND NONPROFIT ORGANIZATIONS TO SUSTAIN AND ENHANCE THE COMMUNITIES IT SERVES. 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.PART III, SECTION A, LINE 1: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 SHORTFALL 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 $39,798,000 AS REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS.THE MOST COMMON REASONS FOR A DIFFERENCE BETWEEN THE MEDICARE SHORTFALL 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 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 - MANKATO 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 - MANKATO 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 GOVERNMENTAL 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 - MANKATO PART V, SECTION B, LINE 20D: OUR 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 COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE. PART VI, LINE 2: MAYO CLINIC HEALTH SYSTEM - MANKATO (MCHS-MANKATO) ADMINISTRATION AND ITS BOARD OF DIRECTORS ALONG WITH COMMUNITY STAKEHOLDERS, WORK CLOSELY WITH LOCAL EDUCATIONAL INSTITUTIONS, OPEN DOOR HEALTH CENTER, CHARITIES, AND HEALTH DEPARTMENTS TO ASSESS HEALTHCARE NEEDS. MCHS-MANKATO DEVELOPS A STRATEGIC PLAN TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY BASED ON THE INPUT RECEIVED. SERVICES, EDUCATION, VOLUNTEERS, IN KIND SUPPORT, MONETARY DONATIONS AND GOODS ARE SUPPLIED ONCE THOSE NEEDS ARE ASSESSED. REQUESTS FOR ASSISTANCE ARE TRIAGED THROUGH THE PUBLIC RELATIONS AND ADMINISTRATION DEPARTMENTS, AND EVALUATED BASED ON THE STRATEGIC PLAN. 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: MCHS-MANKATO IS LOCATED IN MANKATO, MINNESOTA. ITS SERVICE AREA INCLUDES BLUE EARTH, NICOLLET AND OTHER SURROUNDING COUNTIES IN SOUTHERN MINNESOTA. MCHS-MANKATO IS DESIGNATED AS A SOLE COMMUNITY HOSPITAL AND A RURAL REFERRAL CENTER FOR MEDICARE PURPOSES. MCHS-MANKATO IS THE ONLY HOSPITAL IN BLUE EARTH COUNTY. THE POPULATION OF BLUE EARTH AND NICOLLET COUNTY (WHICH COMPRISES A LARGE PORTION OF MCHS-MANKATO'S SERVICE AREA) IS APPROXIMATELY 100,000. ACCORDING TO THE U.S. CENSUS BUREAU, APPROXIMATELY 15% OF INDIVIDUALS IN THE TWO COUNTIES ARE LIVING BELOW POVERTY LEVEL. APPROXIMATELY 12% OF INDIVIDUALS IN THE TWO COUNTIES ARE ABOVE AGE 65 AND APPROXIMATELY 10% OF THE POPULATION WAS UNINSURED. 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 ORGANIZATION'S 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 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 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. PART VI LINE 7: NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO THE MINNESOTA HOSPITAL ASSOCIATION. 1 MANKATO FAMILY YMCA 1401 S RIVERFRONT DRIVE MANKATO MN 56001 410739108 501(C)(3) 5000 SUPPORT THEIR EXEMPT PURPOSE GREATER MANKATO AREA UNITED WAY INC 101 NORTH 2ND STREET 100 MANKATO MN 56001 416008819 501(C)(3) 10400 SUPPORT THEIR EXEMPT PURPOSE GREATER MANKATO GROWTH 1961 PREMIER DRIVE SUITE 100 MANKATO MN 56001 411446548 501(C)(6) 14040 SUPPORT COMMUNITY FUNCTIONS GREATER MANKATO EARLY LEARNING INITIATIVE ISD 77 10 CIVIC CENTER PLAZE MANKATO MN 560020166 263025866 501(C)(3) 9975 SUPPORT THEIR EXEMPT PURPOSE GREATER MANKATO DIVERSITY COUNCIL PO BOX 166 MANKATO MN 560020166 204627525 501(C)(3) 5000 SUPPORT THEIR EXEMPT PURPOSE AMERICAN NATIONAL RED CROSS 2025 E STREET NW WASHINGTON DC 20006 530196605 501(C)(3) 5000 SUPPORT THEIR EXEMPT PURPOSE OPEN DOOR HEALTH CENTER 309 HOLLY LANE MANKATO MN 56001 411461726 501(C)(3) 10000 FMV IN-KIND IT AND ADMIN SUPPORT SUPPORT THEIR EXEMPT PURPOSE MAYO CLINIC HEALTH SYSTEM - ST JAMES 1101 MOULTON PARSONS ST JAMES MN 56081 410797368 501(C)(3) 9599 SUPPORT THEIR EXEMPT PURPOSE 7 1 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. TRANSFERS OR GRANTS TO TAX-EXEMPT ORGANIZATIONS WILL BE USED PURSUANT TO THE POLICIES AND PROCEDURES OF THE GRANTEE ORGANIZATIONS AND TO FURTHER THE EXEMPT PURPOSES OF THE GRANTEE ORGANIZATIONS. BOTH THE FILING ORGANIZATION AND THE GRANTEE ORGANIZATION MAINTAIN ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED. 0 1 0 0 0 0 0 0 0 CRAGUN MD KEVIN T 0 507339 0 0 0 71262 0 27599 0 29932 0 636132 0 0 GRACE RICHARD W 323282 563 0 0 0 0 12500 0 16895 0 352677 563 0 0 HAMMELL DO LUCAS J 0 152810 0 0 0 0 0 3079 0 21686 0 177575 0 0 HEBL MD JAMES R 0 421940 0 0 0 24909 0 21273 0 21726 0 489848 0 0 HERRMANN MD MARTIN J 0 229116 0 0 0 1945 0 27797 0 8092 0 266950 0 0 KUTCHER MD GREGORY R 455629 0 0 0 0 0 12500 0 31136 0 499265 0 0 0 MORRIS MD MARIE E 0 333893 0 0 0 32395 0 34723 0 8401 0 409412 0 0 NESSE MD ROBERT E 0 593641 0 0 0 94500 0 0 0 18683 0 706824 0 0 SPINNER MD ROBERT J 0 683135 0 0 0 90974 0 29042 0 21097 0 824248 0 0 FRATZKE MARK S 263808 0 0 0 0 0 10000 0 24056 0 297864 0 0 0 KOCH MARK B 0 279804 0 0 0 9282 0 322 0 16473 0 305881 0 0 TARASOVITCH JAMES J 265536 0 0 0 0 0 10000 0 16828 0 292364 0 0 0 CAMPBELL MD STEPHEN S 320346 0 0 0 0 0 12500 0 25426 0 358272 0 0 0 DEACONSON MD TIMOTHY F 582524 0 0 0 0 0 12499 0 26937 0 621960 0 0 0 KOWAL DO GERALD K 322154 0 0 0 0 0 12500 0 28398 0 363052 0 0 0 REEVES MD ANDREW L 388977 0 0 0 0 0 12500 0 29938 0 431415 0 0 0 CANNELLA MD DOMINIC M 672157 0 0 0 0 0 5000 0 26938 0 704095 0 0 0 CHYATTE MD DOUGLAS 706988 0 0 0 0 0 5000 0 19710 0 731698 0 0 0 LI MD SHILUN D 612031 0 0 0 0 0 10000 0 26938 0 648969 0 0 0 STANCHFIELD JR MD WARREN R 615188 0 0 0 0 0 10000 0 9454 0 634642 0 0 0 WOLF MD MICHAEL J 573364 0 0 0 0 0 10000 0 26938 0 610302 0 0 0 CREST JEROME A 153445 0 0 0 0 0 7698 0 20667 0 181810 0 0 0 RUPP MD WILLIAM C 0 765942 0 0 0 149413 0 154 0 11451 0 926960 0 0 BOROWSKI THOMAS J 232586 0 0 0 0 0 10584 0 24002 0 267172 0 0 0 WHITED MD BRIAN L 351898 0 0 0 0 0 12500 0 26126 0 390524 0 0 0 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). KEVIN T. CRAGUN, M.D. $ 57,091 JAMES R. HEBL, M.D. $ 23,668 MARK B. KOCH $ 8,013 MARIE E. MORRIS, M.D. $ 21,090 ROBERT E. NESSE, M.D. $ 85,127 WILLIAM C. RUPP, M.D. $133,241 ROBERT J. SPINNER, M.D. $ 87,877 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. COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. MMSI INC BOARD OVERLAP 12936134 PURCHASED SERVICES & PATIENT CARE SERVICES 0 RACHEL R GRACE FAMILY RELATIONSHIP WITH BOARD OFFICER, RICHARD W. GRACE 11974 EMPLOYMENT 0 MAYO CLINIC HEALTH SYSTEM - FARIBAULT BOARD OVERLAP 215991 MEDICAL SERVICES 0 NEW ULM TELECOM BOARD OVERLAP 19617 TELECOMMUNICATION SERVICES 0 FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: CRAGUN M.D., KEVIN T. GRACE, RICHARD W. HEBL M.D., JAMES R. KOCH, MARK B. NESSE M.D., ROBERT E. SPINNER M.D., ROBERT J. 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. THE FOLLOWING INDIVIDUAL IS EMPLOYED BY A RELATED ORGANIZATION: HAMMELL D.O., LUCAS J. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: GRACE, RICHARD W. KOCH, MARK B. KUTCHER M.D., GREGORY R. TARASOVITCH, JAMES J. THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: HERRMANN M.D., MARTIN J. MORRIS M.D., MARIE E. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: BROLSMA, GREG GAALSWYK, MARK GRACE, RICHARD W. KOCH, MARK B. KUTCHER M.D., GREGORY R. MORRIS M.D., MARIE E. TARASOVITCH, JAMES J. 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 SOLE MEMBER ELECTS THE MEMBER DIRECTORS. THE SOLE MEMBER ELECTS THE COMMUNITY DIRECTORS THAT HAVE BEEN APPROVED BY THE BOARD OF DIRECTORS AND NOMINATED BY VARIOUS NOMINATING GROUPS. FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS DEBT, AMENDMENT OF THE BYLAWS, MERGERS, AND NEW SERVICES. 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 VICE PRESIDENT OF FINANCE, THE CFO AND THE ADMINISTRATOR. 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. 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 SALARIES OF THE CEO, CAO, AND PHYSICIAN LEADERSHIP 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). THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE THEN REVIEWS AND APPROVES THE COMPENSATION. FOR THOSE INDIVIDUALS FOR WHICH THE MAYO CLINIC HEALTH SYSTEM COMMITTEE CAN NOT SERVE AS THE INDEPENDENT REVIEW, THEIR COMPENSATION AND BENEFITS ARE REVIEWED BY THE GOVERNANCE COMMITTEE (DESCRIBED BELOW). THE COMPENSATION AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. INFORMATION ON MAYO CLINIC HEALTH SYSTEM PHYSICIAN AND ADMINISTRATIVE LEADERSHIP COMPENSATION AND BENEFITS IS ALSO REVIEWED BY THE MAYO CLINIC COMMITTEE ON OFFICER SUCCESSION, COMPENSATION AND GOVERNANCE (GOVERNANCE COMMITTEE), WHICH IS COMPRISED OF SEVEN OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 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 IC PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 8,395,641. MANAGEMENT AND GENERAL EXPENSES 12,956,898. FUNDRAISING EXPENSES 11,854. TOTAL EXPENSES 21,364,393. OTHER PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 3,887,297. MANAGEMENT AND GENERAL EXPENSES 497,706. FUNDRAISING EXPENSES 28,290. TOTAL EXPENSES 4,413,293. PROF. FEES & LABOR COSTS : PROGRAM SERVICE EXPENSES 8,884,235. MANAGEMENT AND GENERAL EXPENSES 11,705. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,895,940. LAB & COLLECTION FEES : PROGRAM SERVICE EXPENSES 1,057,343. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,057,343. TRANSCRIPTION SERVICES : PROGRAM SERVICE EXPENSES 1,025,340. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,025,340. IN REGARDS TO FILING CERTAIN FOREIGN FORMS 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) 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 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 GOLD CROSS AMBULANCE SERVICE M 110405 GAAP MAYO CLINIC - METHODIST HOSPITAL M 71341 GAAP MAYO CLINIC - SAINT MARYS HOSPITAL M 291393 GAAP MAYO CLINIC HEALTH SYSTEM--FAIRMONT Q 2916592 GAAP MAYO CLINIC HEALTH SYSTEM--FARIBAULT L 211352 GAAP MAYO CLINIC HEALTH SYSTEM--MANKATO HEALTH CARE FOUNDATION C 543175 GAAP MAYO CLINIC HEALTH SYSTEM--NEW PRAGUE L 916896 GAAP MAYO CLINIC HEALTH SYSTEM--NEW PRAGUE O 149273 GAAP MAYO CLINIC HEALTH SYSTEM--SPRINGFIELD L 679104 GAAP MAYO CLINIC HEALTH SYSTEM--SPRINGFIELD O 2176474 GAAP MAYO CLINIC HEALTH SYSTEM--ST JAMES L 594396 GAAP MAYO CLINIC HEALTH SYSTEM--ST JAMES O 2373371 GAAP MAYO CLINIC HEALTH SYSTEM--WASECA L 808092 GAAP MAYO CLINIC HEALTH SYSTEM--WASECA O 3307184 GAAP MAYO COLLABORATIVE SERVICES INC M 1256282 GAAP MAYO FOUNDATION FOR MEDICAL EDUCATION & RESEARCH M 97539 GAAP MMSI INC M 437842 GAAP MMSI INC S 12498292 GAAP