NORTH MEMORIAL HEALTH CARE: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- NORTH MEMORIAL HEALTH CARE (EIN 41-0729979)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-08
- IRS object ID
- 201343129349301229
- 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 H
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-08T10:13:10-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390859910 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 S 6TH ST STE 2300 | AddressLine1 |
| City | MINNEAPOLIS | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410729979 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH MEMORIAL HEALTH CARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NORT | NameControl |
| Phone | 7635205200 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TODD OSTENDORF | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 7635205200 | Phone |
| Date Signed | 2013-11-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LAWRENCE H MOHR CPA | Name |
| PTIN | P00447603 | PTIN |
| Phone | 6128764500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LOREN TAYLOR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 721988510 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.NORTHMEMORIAL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1954 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | GENERAL ACUTE CARE HOSPITAL PROVIDING HIGHLY SPECIALIZED TRAUMA AND EMERGENCY SERVICES, CORONARY CARE OPEN HEART SURGERY, ONCOLOGY, HIGH RISK MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL-SURGICAL, OBSTETRICAL, PEDIATRIC REHABILITATIVE, AND BEHAVIORAL SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 5431 | TotalNbrEmployees |
| Total Nbr Volunteers | 613 | TotalNbrVolunteers |
| Total Gross UBI | 8608997 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -1990929 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1036554 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 760857 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 617110561 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 643415269 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 54576333 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9554787 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -2308164 | OtherRevenuePriorYear |
| Other Revenue Current Year | -2758020 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 670415284 | TotalRevenuePriorYear |
| Total Revenue Current Year | 650972893 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 372718647 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 392891408 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 252459977 | OtherExpensePriorYear |
| Other Expenses Current Year | 267259635 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 625178624 | TotalExpensesPriorYear |
| Total Expenses Current Year | 660151043 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 45236660 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -9178150 | RevenuesLessExpensesCY |
| Total Assets BOY | 557564309 | TotalAssetsBOY |
| Total Assets EOY | 574490605 | TotalAssetsEOY |
| Total Liabilities BOY | 241051561 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 250822311 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 316512748 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 323668294 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | INSPIRING EACH OTHER TO GIVE OUR PATIENTS AND THEIR FAMILIES COMPASSIONATE, REMARKABLE CARE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 569924373 | Expense |
| Revenue | 585325187 | Revenue |
| Description | NORTH MEMORIAL HEALTH CARE IS A GENERAL ACUTE CARE HOSPITAL PROVIDING HIGHLY SPECIALIZED TRAUMA AND EMERGENCY SERVICES, CORONARY CARE OPEN HEART SURGERY, ONCOLOGY, HIGH RISK MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL - SURGICAL, OBSTETRICAL, PEDIATRIC REHABILITATIVE, AND BEHAVIORAL SERVICES. IN ADDITION TO CHARITY AND UNCOMPENSATED CARE, NMHC ALSO PROVIDES NUMEROUS COMMUNITY BENEFITS (AT NO COST OR BELOW COST).IN FURTHERANCE OF ITS CHARITABLE PURPOSE, NORTH MEMORIAL PROVIDES A WIDE VARIETY OF BENEFITS TO THE COMMUNITY, INCLUDING OFFERING VARIOUS COMMUNITY BASED PROGRAMS, SUCH AS HEALTH SCREENINGS, SUPPORT COUNSELING FOR PARENTS AND FAMILIES, PASTORAL CARE, CRISIS INTERVENTION, TRANSPORTATION TO AND FROM THE HOSPITAL CAMPUSES, AND THE DONATION OF SPACE FOR USE BY COMMUNITY GROUPS. ADDITIONALLY A LARGE NUMBER OF HEALTH-RELATED EDUCATIONAL PROGRAMS ARE PROVIDED FOR THE BENEFIT OF THE COMMUNITY, INCLUDING HEALTH ENHANCEMENTS AND WELLNESS, CLASSES ON SPECIFIC CONDITIONS, UNREIMBURSED COSTS OF MEDICAL EDUCATION, TELEPHONE INFORMATION SERVICES, AND COST RELATED TO PROGRAMS DESIGNED TO IMPROVE THE GENERAL STANDARDS OF THE HEALTH OF THE COMMUNITY. NORTH MEMORIAL ALSO PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED COSTS TO RESIDENTS OF ITS COMMUNITY, PRIMARILY THROUGH: (A) THE DIFFERENCE BETWEEN PUBLIC PROGRAM PAYMENTS (PRIMARILY MEDICARE AND MEDICAID) AND THE RELATED COSTS OF PROVIDING SUCH SERVICES; AND (B) SERVICES PROVIDED TO PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT WHO ARE DETERMINED UNABLE TO PAY BECAUSE OF ECONOMIC FACTORS. IN ADDITION, NORTH MEMORIAL CONTRIBUTES TO FUNDING MEDICAL CARE FOR THE UNINSURED THROUGH PAYMENT OF PATIENT SERVICE TAXES, WHICH INCLUDE THE MEDICAID SURCHARGE AND THE MINNESOTA CARE TAX ON CERTAIN NET REVENUE. | Description |
| Total Program Service Expense | 569924373 | 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 | 1 | 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 | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| 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 | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | 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 | 586 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 5431 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 1 | ForeignFinancialAccount |
| Name Of Foreign Country | BD | NameOfForeignCountry |
| 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 | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| 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 | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| 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 | LOREN TAYLOR | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7635205200 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (35 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| ROBERT D POTTS | |||||||||
| CHAIRMAN OF BOARD | 2.00 | 0.00 | X | 2700 | 0 | 0 | |||
| TIMOTHY BAYLOR | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 2700 | 0 | 0 | |||
| BILL TOBIN | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 2700 | 0 | 0 | |||
| DANA CARLSON MD | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 1800 | 0 | 0 | |||
| WARREN MACK | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 2700 | 0 | 0 | |||
| PAT MCHALE | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| JON NIELSON MD | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 2700 | 0 | 0 | |||
| BETTY PAKSAD MD | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 2700 | 0 | 0 | |||
| ROBERT PRENTISS JR | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 2700 | 0 | 0 | |||
| KAREN RAUENHORST | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 2700 | 0 | 0 | |||
| MIKE STEINHAUSER | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| AMY KOLAR MD | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 2700 | 0 | 0 | |||
| JOHN GRAY MD | |||||||||
| DIRECTOR | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| STEVE BECK | |||||||||
| SECRETARY | 2.00 | 0.00 | X | 0 | 0 | 0 | |||
| LOREN TAYLOR | |||||||||
| CHEIF EXECUTIVE OFFICER | 50.00 | 0.00 | X | 922034 | 0 | 26638 | X | ||
| PATRICK BORAN | |||||||||
| CHIEF FINANCIAL OFFICER | 50.00 | 0.00 | 459510 | 0 | 22631 | X | |||
| PATRICK BORAN - SERP PAYMENT | |||||||||
| CHIEF FINANCIAL OFFICER | 50.00 | 0.00 | 1521420 | 0 | 0 | X | |||
| KEVIN CROSTON MD | |||||||||
| CHIEF MEDICAL OFFICER | 50.00 | 0.00 | 551607 | 0 | 21666 | X | |||
| TIFFANY ZITZEWITZ | |||||||||
| VP BUSINESS DEVELOPMENT | 50.00 | 0.00 | 332423 | 0 | 15694 | X | |||
| ANDREW COCHRANE | |||||||||
| CEO MAPLE GROVE HOSPITAL | 50.00 | 2.00 | 438133 | 0 | 24432 | X | |||
| GAYLE MATTSON | |||||||||
| PRESIDENT OF NORTH MEMORIAL | 50.00 | 0.00 | 179002 | 0 | 6193 | X | |||
| DAVID ABRAMS | |||||||||
| VP HUMAN RESOURCES | 50.00 | 0.00 | 309896 | 0 | 26258 | X | |||
| JOSEPH BOSTON | |||||||||
| VP FOUNDATION | 50.00 | 0.00 | 229583 | 0 | 20185 | X | |||
| MICHAEL PARRISH | |||||||||
| VP EMERGENCY & ENTERPRISE OPERATIONS | 50.00 | 0.00 | 354004 | 0 | 26292 | X | |||
| PATRICK TAFFE | |||||||||
| CHIEF INFORMATION OFFICER | 50.00 | 0.00 | 345091 | 0 | 26280 | X | |||
| TOM TIMMONS MD | |||||||||
| MEDICAL DIRECTOR, MEDICAL AFFAIRS | 50.00 | 0.00 | 446955 | 0 | 26334 | X | |||
| RYAN JOHNSON | |||||||||
| VP TREASURY | 50.00 | 0.00 | 210743 | 0 | 25262 | X | |||
| KELLY SPRATT | |||||||||
| DIRECTOR OF PRIMARY CARE | 50.00 | 0.00 | 208375 | 0 | 19071 | X | |||
| VIRGINIA MALONE | |||||||||
| CHIEF NURSING OFFICER | 50.00 | 0.00 | 631904 | 0 | 23993 | X | |||
| JOHN ALLEN | |||||||||
| VP - SERVICE LINE | 50.00 | 0.00 | 358210 | 0 | 4848 | X | |||
| JERROLD STEMPEL | |||||||||
| GASTROENTEROLOGIST | 50.00 | 0.00 | 821085 | 0 | 10622 | X | |||
| ALOK MAHESHWARI | |||||||||
| CARDIOLOGIST | 50.00 | 0.00 | 779626 | 0 | 23987 | X | |||
| STEVEN ROH | |||||||||
| CARDIOLOGIST | 50.00 | 0.00 | 735924 | 0 | 24644 | X | |||
| THOMAS ROSSINI | |||||||||
| ER STAFF PHYSICIAN | 50.00 | 0.00 | 733593 | 0 | 24526 | X | |||
| GEORGE TADROS | |||||||||
| CARDIOLOGIST | 50.00 | 0.00 | 702508 | 0 | 17500 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 11297726 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 417056 | TotalOtherCompensation |
| Number Individuals GT100 K | 428 | NumberIndividualsGT100K |
| Formers Listed | 0 | 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 |
|---|---|---|---|---|---|
| ACCRETIVE HEALTH | |||||
| 39918 TREASURY CENTER | CHICAGO | IL | 606949900 | REVENUE CYCLE SUPPORT | 10074454 |
| NORTH CLINIC | |||||
| 3366 OAKDALE AVE N 601 | ROBBINSDALE | MN | 55422 | PHYSICIAN SERVICES | 6525285 |
| ARAMARK HEALTHCARE FOOD | |||||
| 25271 NETWORK PLACE | CHICAGO | IL | 60673 | MANAGEMENT SUPPORT FOR DIETARY | 3376231 |
| RESPIRATORY CONSULTANTS PA | |||||
| 3366 OAKDALE AVE N 605 | ROBBINSDALE | MN | 55422 | INTENSIVISTS STAFFING | 2529688 |
| REVENUE CYCLE SOLUTIONS | |||||
| 4524 SOUTHLAKE PARKWAY 15 | HOOVER | AL | 35244 | A/R MANAGEMENT SERVICES | 1246940 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 40 | NumberOfContractorsGT100K |
| Related Organizations | 478215 | RelatedOrganizations |
| All Other Contributions | 282642 | AllOtherContributions |
| Noncash Contributions | 79238 | NoncashContributions |
| Total Contributions | 760857 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| HOSPITAL PATIENT REVENUE | 621500 | 589005944 | 580396947 | 8608997 | |
| CONTRACT REVENUE | 900099 | 26289249 | $26,289,249 | ||
| OTHER | 900099 | 9439937 | $9,439,937 | ||
| JOINT VENTURE REVENUE | 990099 | 7686260 | 7686260 | ||
| PHARMACY | 990099 | 4381696 | $4,381,696 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6612183 | TotalRevenueColumn |
| Exclusion | $6,612,183 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 643415269 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5576491 | TotalRevenueColumn |
| Exclusion | $5,576,491 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24315 | TotalRevenueColumn |
| Exclusion | $24,315 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 10955589 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 13713609 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -2758020 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -2758020 | TotalRevenueColumn |
| Related Or Exempt Function Income | -2758020 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 60756564 | Securities |
| Other | 499425 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 57170211 | Securities |
| Other | 131797 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 3586353 | Securities |
| Other | 367628 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3953981 | TotalRevenueColumn |
| Exclusion | $3,953,981 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 650972893 | TotalRevenueColumn |
| Related Or Exempt Function Income | 585325187 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 8608997 | UnrelatedBusinessRevenue |
| Exclusion | $56,277,852 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6795712 | Total |
| Management And General | 6795712 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 301186599 | Total |
| Program Services | 263176850 | ProgramServices |
| Management And General | 38009749 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20960065 | Total |
| Program Services | 18314905 | ProgramServices |
| Management And General | 2645160 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43804074 | Total |
| Program Services | 38276000 | ProgramServices |
| Management And General | 5528074 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20144958 | Total |
| Program Services | 17602664 | ProgramServices |
| Management And General | 2542294 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1181483 | Total |
| Program Services | 1032380 | ProgramServices |
| Management And General | 149103 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 309173 | Total |
| Program Services | 270155 | ProgramServices |
| Management And General | 39018 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105017 | Total |
| Management And General | 105017 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5403694 | Total |
| Management And General | 5403694 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52338474 | Total |
| Program Services | 45733359 | ProgramServices |
| Management And General | 6605115 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1916141 | Total |
| Program Services | 1761704 | ProgramServices |
| Management And General | 154437 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6161383 | Total |
| Program Services | 5383816 | ProgramServices |
| Management And General | 777567 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9431391 | Total |
| Program Services | 8241149 | ProgramServices |
| Management And General | 1190242 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15274595 | Total |
| Program Services | 13346941 | ProgramServices |
| Management And General | 1927654 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4033288 | Total |
| Program Services | 3524287 | ProgramServices |
| Management And General | 509001 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33012900 | Total |
| Program Services | 28893067 | ProgramServices |
| Management And General | 4119833 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5159029 | Total |
| Program Services | 4507960 | ProgramServices |
| Management And General | 651069 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 83555864 | 73011114 | 10544750 |
| BAD DEBT EXP | 19779437 | 19779437 | |
| MAINTENANCE & REPAIR | 12814164 | 11197017 | 1617147 |
| GOVERNMENT TAXES | 9528063 | 9528063 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7255539 | Total |
| Program Services | 6343505 | ProgramServices |
| Management And General | 912034 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 660151043 | Total |
| Program Services | 569924373 | ProgramServices |
| Management And General | 90226670 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9381 | BOY |
| EOY | 19409 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15675164 | BOY |
| EOY | 9514694 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 345991 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 86029544 | BOY |
| EOY | 91286511 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5595194 | BOY |
| EOY | 5351746 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5825134 | BOY |
| EOY | 4999020 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 599039604 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 372770410 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 229626876 | BOY |
| EOY | 226269194 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 134867799 | BOY |
| EOY | 157932141 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49276441 | BOY |
| EOY | 51392579 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30312785 | BOY |
| EOY | 27725311 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 557564309 | BOY |
| EOY | 574490605 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64071117 | BOY |
| EOY | 69203465 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 443845 | BOY |
| EOY | 443845 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 124176381 | BOY |
| EOY | 148644676 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23513623 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28846595 | BOY |
| EOY | 32530325 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 241051561 | BOY |
| EOY | 250822311 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 316512748 | BOY |
| EOY | 323668294 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 316512748 | BOY |
| EOY | 323668294 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 557564309 | BOY |
| EOY | 574490605 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -9178150 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 16333696 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| 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 | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 1 | GrantsOtherOrganizations |
| Grants Other Organizations | $40,000 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $60,000 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 0 | OtherActivities |
| Total Lobbying Expenditures IIB | 100000 | 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 | CONTACTS AND VISITS WERE MADE WITH STATE LEVEL LEGISLATORS TO PROMOTE HEALTH CARE RELATED ISSUES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2382667 | BeginningOfYearBalance |
| Contributions | 270795 | Contributions |
| Investment Earnings Or Losses | 92571 | InvestmentEarningsOrLosses |
| Other Expenditures | 62063 | OtherExpenditures |
| End Of Year Balance | 2683970 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2251229 | BeginningOfYearBalance |
| Contributions | 72500 | Contributions |
| Investment Earnings Or Losses | 71751 | InvestmentEarningsOrLosses |
| Other Expenditures | 12813 | OtherExpenditures |
| End Of Year Balance | 2382667 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1737891 | BeginningOfYearBalance |
| Contributions | 513452 | Contributions |
| Investment Earnings Or Losses | 25341 | InvestmentEarningsOrLosses |
| Other Expenditures | 24455 | OtherExpenditures |
| End Of Year Balance | 2252229 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1537773 | BeginningOfYearBalance |
| Contributions | 247046 | Contributions |
| Investment Earnings Or Losses | 17937 | InvestmentEarningsOrLosses |
| Other Expenditures | 64865 | OtherExpenditures |
| End Of Year Balance | 1737891 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1910328 | BeginningOfYearBalance |
| Contributions | -382648 | Contributions |
| Investment Earnings Or Losses | 19699 | InvestmentEarningsOrLosses |
| Other Expenditures | 9606 | OtherExpenditures |
| End Of Year Balance | 1537773 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.97540 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.02460 | TermEndowmentEOYBalance |
| 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 | 15594663 | OtherCostOrOtherBasis |
| Book Value | 15594663 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 224843016 | OtherCostOrOtherBasis |
| Depreciation | 106390240 | Depreciation |
| Book Value | 118452776 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 14112962 | OtherCostOrOtherBasis |
| Depreciation | 8915346 | Depreciation |
| Book Value | 5197616 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 334744724 | OtherCostOrOtherBasis |
| Depreciation | 251853175 | Depreciation |
| Book Value | 82891549 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9744239 | OtherCostOrOtherBasis |
| Depreciation | 5611649 | Depreciation |
| Book Value | 4132590 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 226269194 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (4 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| RREEF AMERICA REIT II | 19825560 | F |
| MELLON AGGREGATE BOND INDEX FUND | 26056183 | F |
| CASH ON DEPOSIT WITH BOND TRUSTEE | 5466048 | F |
| AGENCY ACCOUNT | 44788 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 51392579 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (7 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| EXECUTIVE PENSION PLAN | $4,027,668 |
| RESTORATION PENSION PLAN | $54,482 |
| PY PENSION LIABILITY | $19,572,930 |
| POST RETIREMENT HEALTH INSURANCE | $2,577,057 |
| SECURITIES LENDING | $6,130,328 |
| CAA DEPOSIT RESERVE | $128,175 |
| SETTLEMENTS AND CLAIMS PAYABLE | $39,685 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 32530325 | 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: | ALL ENDOWMENT FUNDS ARE HELD BY A RELATED ENTITY: NORTH MEMORIAL FOUNDATION. 1) RALPH ROSSEN ENDOWMENT: THIS ENDOWMENT WAS ESTABLISHED IN 1986 TO PROVIDE RECOGNITION TO NURSING STAFF THAT PROVIDE REMARKABLE SERVICE TO NORTH MEMORIAL PATIENTS AND THEIR FAMILIES. MEMBERS OF THE ROSSEN FAMILY SERVE ON A COMMITTEE ALONG WITH THE VP AND CHIEF NURSING OFFICER OF NORTH MEMORIAL TO SELECT THE RECIPIENTS. 2) HAROLD B. KAISER HONORARY LECTURESHIP ENDOWMENT: DR KAISER IS THE FOUNDER OF ALLERGY & ASTHMA SPECIALISTS, P.A. ESTABLISHED IN 1966. THE HAROLD B KAISER HONORARY LECTURESHIP ENDOWMENT PROVIDES FUNDING FOR A KEYNOTE SPEAKER FOR THE ANNUAL ALLERGY & ASTHMA CONFERENCE HELD IN THE MINNEAPOLIS AREA IN MARCH. 3) HAROLD ECKER ENDOWMENT: ESTABLISHED IN 1994 IN HONOR OF THE EXCELLENT CARE THAT MR. ECKER RECEIVED AS A PATIENT AT NORTH MEMORIAL, THE HAROLD ECKER ENDOWMENT PROVIDES A $500 AWARD TO THREE NORTH MEMORIAL EMPLOYEES RECOGNIZING THEIR OUTSTANDING PERFORMANCE AND PERSONAL ATTITUDE. THE AWARD IS OPENED TO ALL EMPLOYEES AND THE WINNERS ARE SELECTED BY A COMMITTEE OF NORTH MEMORIAL EMPLOYEES AND PRESENTED AT THE ANNUAL QUALITY AWARDS LUNCHEON IN NOVEMBER EACH YEAR. 4) RESIDENTIAL HOSPICE ENDOWMENT: THE RESIDENTIAL HOSPICE ENDOWMENT WAS ESTABLISHED BY DR. JOHN AND PATTY MANION TO PROVIDE ASSISTANCE TO THE RESIDENTIAL HOSPICE PROGRAM AT NORTH MEMORIAL. FUNDS ARE USED TO UPGRADE THE FACILITIES AND EQUIPMENT AT THE NORTH RESIDENTIAL HOSPICE FACILITY IN BROOKLYN CENTER, PROVIDE ADDITIONAL PROGRAM SUPPORT, STAFF TRAINING AND TO ASSIST THOSE FAMILIES THAT CANNOT AFFORD THIS SERVICE. 5) HELEN MURRAY MEMORIAL ENDOWMENT THIS ENDOWMENT WAS ESTABLISHED WITH AN IRREVOCABLE CHARITABLE REMAINDER TRUST BY JEANNE MITHUN TO RECOGNIZE THE OUTSTANDING SERVICE THAT NORTH RESIDENTIAL HOSPICE PROVIDED TO HER MOTHER (HELEN MURRAY) AND HER FAMILY. FUNDS ARE USED TO PROVDE CARE TO INDIVIDUALS UNABLE TO PAY FOR SERVICES AT THE FACILITY. 6) PAY IT FORWARD THE PAY IT FORWARD FUND WAS ESTABLISHED BY BREAST CANCER SURVIVOR MICHELLE MOREY AND HER HUSBAND SCOTT BISSEN. MICHELLE RECOGNIZED A NEED TO HELP WOMEN STRUGGLING FINANCIALLY WHILE GOING THROUGH CANCER TREATMENT. PATIENTS ELIGIBLE FOR ASSISTANCE ARE FROM NORTH MEMORIAL, UNITY AND MONTICELLO HOSPITALS. THE FUND IS ADMINISTERED AT NO FEE THROUGH THE NORTH MEMORIAL FOUNDATION. 7) MEDICAL STAFF ENDOWMENT THIS ENDOWMENT WAS ESTABLISHED IN 2010 BY THE NORTH MEMORIAL MEDICAL STAFF EXECUTIVE COMMITTEE. PROCEEDS FROM THE ENDOWMENT WILL FUND NORTH MEMORIAL PROGRAMS SUCH AS JUNIOR VOLUNTEER SCHOLARSHIP, SAFEJOURNEY, PASTORAL CARE, ETC. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | NORTH MEMORIAL EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2012 OR 2011. NORTH MEMORIAL IS NOT CURRENTLY UNDER EXAMINATION BY ANY TAX JURISDICTION. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| 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 | 10107837 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 10107837 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01530 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 81552760 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 55551399 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 26001361 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03940 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 91660597 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 55551399 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 36109198 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05470 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1803288 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1803288 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4818184 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1716975 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3101209 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00470 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 62331968 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 48084969 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 14246999 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02160 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 152111 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 156437 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -4326 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 533872 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 533872 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 69639423 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 49958381 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 19681042 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02980 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 161300020 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 105509780 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 55790240 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08450 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $7,035,344 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 135938805 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 183755655 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -47816850 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (9 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 MAPLE GROVE HOSPITAL | |||
| HOSPITAL | 0.75000 | 0.00000 | 0.00000 |
| 2 NM SURGERY CENTER MAPLE GROVE | |||
| OUTPATIENT SURG CTR | 0.50000 | 0.00000 | 0.50000 |
| 3 MN DIAGNOSTIC IMAGING PARTNERS | |||
| OUTPATIENT IMAGING CTR | 0.60000 | 0.00000 | 0.40000 |
| 4 PREFERRED ONE ADMINISTRATIVE SERVICES | |||
| CLAIMS ADMINISTRATOR | 0.25000 | 0.00000 | 0.25000 |
| 5 PREFERRED ONE COMMUNITY HEALTH PLAN | |||
| INSURANCE COMPANY | 0.50000 | 0.00000 | 0.00000 |
| 6 INSTITUTE OF ATHLETIC MEDICINE | |||
| CLINIC | 0.37000 | 0.00000 | 0.00000 |
| 7 MONTICELLO CANCER CENTER | |||
| OPTNT CANCER CLINIC | 0.40000 | 0.00000 | 0.00000 |
| 8 NORTH RADIATION ONCOLOGY | |||
| OPTNT RADIATION ONC CLNC | 0.50000 | 0.00000 | 0.00000 |
| 9 BLAINE URGENCY CENTER | |||
| URGENT CARE | 0.50000 | 0.00000 | 0.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | NORTH MEMORIAL MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH MEMORIAL MEDICAL CENTER | 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 | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | 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 |
| State Regulation | X | StateRegulation |
| 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 |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART III, LINE 4: NORTH MEMORIAL'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DESCRIPTION ABOUT BAD DEBT EXPENSE. THE COST TO CHARGE RATIO WAS USED TO DETERMINE THE AMOUNT ON PART III, SECTION A, LINE 2. WE DO NOT HAVE THE INFORMATION NECESSARY TO DETERMINE WHICH PORTION OF THE AMOUNT REPORTED ON LINE 2 IS COMMUNITY BENEFIT. | |
| PART III, LINE 8: THE SHORTFALL REPORTED REPRESENTS THE AMOUNT MEDICARE REIMBURSEMENT IS LESS THAN THE ESTIMATED COST OFPROVIDING SERVICES TO THOSE PATIENTS. THE METHOD USED TO ESTIMATE THOSE COSTS IS THE COST TO CHARGE RATIO APPROACH WHICH CALCULATES THE RATIO OF TOTAL HOSPITAL COSTS / TOTAL HOSPITAL GROSS REVENUE AND THEM APPLIES THAT RATIO TO TOTAL MEDICARE GROSS REVENUE. | |
| PART III, LINE 9B: NORTH MEMORIAL HAS POLICIES AND PROCEDURES IN PLACE FOR COLLECTION PRACTICES THAT INCLUDE IDENTIFICATION AND SCREENING FOR CHARITY CARE AND FINANCIAL ASSISTANCE. THE POLICIES ARE AVAILABLE ON THE ORGANIZATIONS INTRANET AND PERTAIN TO ALL ENTITIES UNDER THE NORTH MEMORIAL CORPORATE UMBRELLA. | |
| PART V, SECTION B, LINE 20D: THE MINNESOTA ATTORNEY GENERAL'S OFFICE REQUIRES HOSPITALS TO RENDER SERVICES TO THOSE PATIENTS WHO DO NOT HAVE INSURANCE AT A REDUCED RATE EQUAL TO THE DISCOUNT INCURRED FROM THE HIGHEST VOLUME MANAGE CARE PLAN. | NORTH MEMORIAL MEDICAL CENTER |
| PART V, SECTION B, LINE 22: PER THE MINNESOTA ATTORNEY GENERAL'S AGREEMENT, THIRD PARTY LIABILITY AND PROCEDURES THAT ARE NOT MEDICALLY NECESSARY ARE NOT COVERED UNDER THE MINNESOTA ATTORNEY GENERAL'S AGREEMENT AND THOSE PATIENTS CAN BE BILLED FULL CHARGES. | NORTH MEMORIAL MEDICAL CENTER |
| PART VI, LINE 2: NORTH MEMORIAL WORKS CLOSELY WITH COMMUNITY MEMBERS TO DETERMINE AREAS OF INTEREST AND NEED IN HEALTHCARE SERVICES. STARTING IN LATE 2012 AND INTO 2013 WE STARTED COMPLETING A FULL COMMUNITY NEEDS ASSESSMENT, INCLUDING COMMUNITY FOCUS GROUPS, TO BETTER UNDERSTAND THE COMMUNITY'S HEALTH NEEDS. | |
| PART VI, LINE 3: NORTH MEMORIAL HEALTH CARE HAS A VERY PROACTIVE PROGRAM TO ASSIST UNINSURED AND UNDERINSURED PATIENTS WITH THEIR MEDICAL BILLS. WE COMPLY WITH THE ATTORNEY GENERAL'S REQUIREMENT TO PROVIDE AN IMMEDIATE DISCOUNT TO UNINSURED MINNESOTA RESIDENTS. WE HAVE PATIENT FINANCIAL ADVOCATES AS WELL AS A CONTRACTED VENDOR THAT MEETS WITH ALL OF OUR UNINSURED INPATIENTS AND SPECIFIC OUTPATIENTS TO ASSIST THEM IN MEDICAL ASSISTANCE ELIGIBILITY AND APPLICATIONS. THIS COULD INCLUDE A VISIT TO THEIR RESIDENCE IF THEY NEED HELP IN COMPLETING ASSISTANCE APPLICATIONS. SHOULD THEY NOT QUALIFY FOR STATE OR FEDERAL ASSISTANCE PROGRAMS, WE OFFER AND ASSIST THEM IN APPLYING FOR THE HOSPITAL'S FINANCIAL ASSISTANCE (CHARITY CARE) PROGRAM.OUR CHARITY CARE PROGRAM IS PUBLISHED IN THE CORPORATE POLICIES AND PROCEDURES AND PROVIDES FOR 100% COVERAGE OF MEDICAL BILLS FOR ANYONE WHOSE INCOME IS LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES AND NEEDS ASSISTANCE IN RESOLVING THEIR FINANCIAL OBLIGATION TO THE HOSPITAL. THERE IS A GRADUAL REDUCTION IN THE CHARITY COVERAGE BETWEEN THE 201% AND 400% OF THE FEDERAL POVERTY GUIDELINES.IF WE ARE UNABLE TO MEET WITH THE PATIENT BEFORE DISCHARGE FROM NORTH MEMORIAL, THE PATIENT IS GIVEN A PAMPHLET THAT LISTS CONTACT NUMBERS TO OUR BUSINESS OFFICE CUSTOMER SERVICE AREA TO DISCUSS OPTIONS FOR ASSISTANCE WITH THEIR MEDICAL BILLS. THIS CONTACT INFORMATION IS ALSO PROVIDED ON EVERY STATEMENT THAT IS SENT TO OUR CUSTOMERS. IN ADDITION, OUR INTERNAL COLLECTIONS DEPARTMENT AND OUR COLLECTION AGENCIES ARE WELL VERSED IN OUR ASSISTANCE PROGRAMS AND WILL ASSESS DURING THEIR CONVERSATIONS WITH PATIENTS IF REFERRAL TO EITHER A STATE OR FEDERAL PROGRAM OR OUR CHARITY CARE PROGRAM WOULD BE APPROPRIATE. | |
| PART VI, LINE 4: NORTH MEMORIAL SERVES A GEOGRAPHIC AREA THAT INCLUDES 42 ZIP CODES IN THE NORTHWEST QUADRANT OF THE TWIN CITIES METRO. THIS SERVICE AREA INCLUDES BOTH URBAN, SUBURBAN, EX-URBAN, AND RURAL AREAS. THIS SERVICE AREA INCLUDES A DIVERSE POPULATION OF MORE THAN 900,000 PEOPLE LIVING IN HENNEPIN, WRIGHT, SHERBURNE AND RAMSEY COUNTIES. | |
| PART VI, LINE 5: NORTH MEMORIAL HEALTH CARE IS A GENERAL ACUTE CARE HOSPITAL PROVIDING SPECIALIZED TRAUMA AND EMERGENCY SERVICES, CARDIOVASULAR AND OPEN HEART SERVICES, ONCOLOGY, HIGH RISK MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL-SURGICAL, OBSTETRICAL, PEDIATRIC, REHABILITATIVE AND BEHAVIORAL SERVICES. NMHC ALSO PROVIDES AN ARRAY OF HEALTH CARE SERVICES TO OUR COMMUNITY INCLUDING PRIMARY CARE, AMBULANCE TRANSPORTATION AND HOME HEALTH AND HOSPICE SERVICES. NORTH MEMORIAL IS GOVERNED BY A BOARD OF 15 REPRESENTATIVES CONSISTING OF PHYSICIANS AND VARIOUS LEADERS FROM THROUGHOUT THE COMMUNITY. BOARD MEMBERS ARE ELECTED TO SERVE THREE-YEAR TERMS FOR A TOTAL OF FIVE TERMS. THE MEDICAL CENTER ALSO SUPPORTS AN OPEN MEDICAL STAFF ORGANIZATION INCLUDING APPROXIMATELY 900 BOARD CERTIFIED PHYSICIANS AND 300 ALLIED HEALTH PROFESSIONSALS. THE NORTH MEMORIAL BOARD OF TRUSTEES ESTABLISHES AN ANNUAL MARGIN TARGET FOR MANAGEMENT. PER BOARD POLICY 75% OF ANY EXCESS AVAILABLE CASH FLOW IS REINVESTED IN THE FORM OF CAPITAL IMPROVEMENTS TO THE CENTER. THE REMAINING 25% IS REINVESTED TO SUPPORT LONG TERM OPERATIONS. | |
| PART VI, LINE 6: NORTH MEMORIAL HEALTH SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. THROUGH TARGETED OUTREACH, EDUCATION AND PARTNERSHIPS, WE IMPROVE THE HEALTH OF OUR COMMUNITIES BY LISTENING TO THEIR NEEDS AND RESPONDING WITH APPROPRIATE PROGRAMS AND SERVICES.OUR PROGRAMS, MANY OF WHICH HAVE BEEN NATIONALLY RECOGNIZED, RANGE FROM HEALTH EDUCATION AND FREE SCREENINGS TO TRAINING HEALTH PROFESSIONALS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | 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 (21 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LOREN TAYLOR | ||||||||||||||
| CHEIF EXECUTIVE OFFICER | 606008 | 0 | 145819 | 0 | 170207 | 0 | 17500 | 0 | 9138 | 0 | 948672 | 0 | 151502 | 0 |
| PATRICK BORAN | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 340106 | 0 | 58456 | 0 | 60948 | 0 | 17500 | 0 | 5131 | 0 | 482141 | 0 | 0 | 0 |
| PATRICK BORAN - SERP PAYMENT | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 0 | 0 | 0 | 0 | 1521420 | 0 | 0 | 0 | 0 | 0 | 1521420 | 0 | 1375503 | 0 |
| KEVIN CROSTON MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | 404932 | 0 | 68760 | 0 | 77915 | 0 | 17500 | 0 | 4166 | 0 | 573273 | 0 | 0 | 0 |
| TIFFANY ZITZEWITZ | ||||||||||||||
| VP BUSINESS DEVELOPMENT | 248077 | 0 | 21488 | 0 | 62858 | 0 | 13750 | 0 | 1944 | 0 | 348117 | 0 | 0 | 0 |
| ANDREW COCHRANE | ||||||||||||||
| CEO MAPLE GROVE HOSPITAL | 330000 | 0 | 56719 | 0 | 51414 | 0 | 17500 | 0 | 6932 | 0 | 462565 | 0 | 0 | 0 |
| GAYLE MATTSON | ||||||||||||||
| PRESIDENT OF NORTH MEMORIAL | 136381 | 0 | 15000 | 0 | 27621 | 0 | 0 | 0 | 6193 | 0 | 185195 | 0 | 0 | 0 |
| DAVID ABRAMS | ||||||||||||||
| VP HUMAN RESOURCES | 225000 | 0 | 38672 | 0 | 46224 | 0 | 17500 | 0 | 8758 | 0 | 336154 | 0 | 38632 | 0 |
| JOSEPH BOSTON | ||||||||||||||
| VP FOUNDATION | 164580 | 0 | 25468 | 0 | 39535 | 0 | 14351 | 0 | 5834 | 0 | 249768 | 0 | 0 | 0 |
| MICHAEL PARRISH | ||||||||||||||
| VP EMERGENCY & ENTERPRISE OPERATIONS | 260000 | 0 | 44694 | 0 | 49310 | 0 | 17500 | 0 | 8792 | 0 | 380296 | 0 | 0 | 0 |
| PATRICK TAFFE | ||||||||||||||
| CHIEF INFORMATION OFFICER | 254232 | 0 | 44041 | 0 | 46818 | 0 | 17500 | 0 | 8780 | 0 | 371371 | 0 | 0 | 0 |
| TOM TIMMONS MD | ||||||||||||||
| MEDICAL DIRECTOR, MEDICAL AFFAIRS | 329930 | 0 | 56715 | 0 | 60310 | 0 | 17500 | 0 | 8834 | 0 | 473289 | 0 | 0 | 49498 |
| RYAN JOHNSON | ||||||||||||||
| VP TREASURY | 177058 | 0 | 11122 | 0 | 22563 | 0 | 13173 | 0 | 12089 | 0 | 236005 | 0 | 0 | 0 |
| KELLY SPRATT | ||||||||||||||
| DIRECTOR OF PRIMARY CARE | 172308 | 0 | 0 | 0 | 36067 | 0 | 7000 | 0 | 12071 | 0 | 227446 | 0 | 0 | 0 |
| VIRGINIA MALONE | ||||||||||||||
| CHIEF NURSING OFFICER | 226385 | 0 | 46413 | 0 | 359106 | 0 | 17500 | 0 | 6493 | 0 | 655897 | 0 | 0 | 0 |
| JOHN ALLEN | ||||||||||||||
| VP - SERVICE LINE | 17308 | 0 | 0 | 0 | 340902 | 0 | 2397 | 0 | 2451 | 0 | 363058 | 0 | 42188 | 0 |
| JERROLD STEMPEL | ||||||||||||||
| GASTROENTEROLOGIST | 420000 | 0 | 384644 | 0 | 16441 | 0 | 7500 | 0 | 3122 | 0 | 831707 | 0 | 0 | 0 |
| ALOK MAHESHWARI | ||||||||||||||
| CARDIOLOGIST | 736221 | 0 | 33000 | 0 | 10405 | 0 | 17500 | 0 | 6487 | 0 | 803613 | 0 | 0 | 0 |
| STEVEN ROH | ||||||||||||||
| CARDIOLOGIST | 679208 | 0 | 38000 | 0 | 18716 | 0 | 17500 | 0 | 7144 | 0 | 760568 | 0 | 0 | 0 |
| THOMAS ROSSINI | ||||||||||||||
| ER STAFF PHYSICIAN | 718940 | 0 | 0 | 0 | 14653 | 0 | 17500 | 0 | 7026 | 0 | 758119 | 0 | 0 | 0 |
| GEORGE TADROS | ||||||||||||||
| CARDIOLOGIST | 692300 | 0 | 0 | 0 | 10208 | 0 | 17500 | 0 | 0 | 0 | 720008 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUPPLEMENTAL INFORMATION | PART III | PART I, LINE 1A: THE ORGANIZATION REIMBURSES ONE OF THE EXECUTIVE MEMBERS FOR THE MONTHLY SOCIAL DUES AT THE GOLDEN VALLEY COUNTRY CLUB. THE DUES FOR 2012 WERE $90 PER MONTH OR 1,080 PER YEAR. THE NORTH MEMORIAL COMMUNITY FOUNDATION UTILIZES THE COUNTRY CLUB TO HOST VARIOUS FUND RAISING EVENTS THROUGH-OUT THE YEAR THAT SUPPORT VARIOUS ACTIVITIES FOR NORTH MEMORIAL. |
| SUPPLEMENTAL INFORMATION | PART III | PART I, LINE 2: ALL EXPENSES ARE REVIEWED PRIOR TO REIMBURSEMENT AND SIGNED OFF BY THE CEO. NORTH MEMORIAL REPORTS EXECUTIVE EXPENSE REIMBURSEMENT DATA TO THE BOARD OF TRUSTEES ON A PERIODIC BASIS. |
| SUPPLEMENTAL INFORMATION | PART III | PART I, LINE 4A: THE AMOUNTS REPORTED IN "OTHER REPORTABLE COMPENSATION" REFLECT PAYMENTS MADE IN 2012 PURSUANT TO SEVERANCE AGREEMENTS WITH 2 EMPLOYEES AS FOLLOWS: VIRGINIA MALONE - $270,000 JOHN ALLEN - $281,000 |
| SUPPLEMENTAL INFORMATION | PART III | PART I, LINE 4B: MR. PATRICK BORAN - SERP PAYMENT MR. BORAN HAS BEEN EMPLOYED BY NORTH MEMORIAL HEALTH CARE FOR TWENTY-NINE YEARS, THE MOST RECENT EIGHTEEN YEARS AS THE CHIEF FINANCIAL OFFICER OF THE ORGANIZATION. THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS ESTABLISHED TO COMPENSATE KEY EMPLOYEES FOR QUALIFIED RETIREMENT PLAN LIMITS. ANNUAL AMOUNTS RELATED TO THIS RETIREMENT BENEFIT WERE ACCRUED AND REPORTED ON THE FORM 990 AS DEFERRED COMPENSATION IN PRIOR YEARS. THE DETERMINATION OF PATRICK BORAN'S TOTAL COMPENSATION (ANNUAL SALARY, DEFERRED COMPENSATION AND EMPLOYEE BENEFITS) IS BASED ON ADVICE FROM A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT REGARDING THE MARKET VALUE OF THE SERVICES MR. BORAN PROVIDES. PATRICK BORAN'S TOTAL COMPENSATION IS APPROVED ANNUALLY BY THE BOARD OF TRUSTEES OF NORTH MEMORIAL HEALTH CARE. IN 2012, A SERP PAYMENT WAS MADE TO PATRICK BORAN IN THE AMOUNT OF $1,521,420. THIS PAYMENT WAS MADE UPON THE ELECTION OF THE PLAN PARTICIPANT (PATRICK BORAN) AS HE MET THE REQUIREMENTS OF AGE PLUS YEARS-OF-SERVICE REQUIRED FOR A PLAN DISTRIBUTION. THIS IS A ONE-TIME PAYMENT AS REQUIRED BY THE AGREEMENT. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|
| CITY OF MAPLE GROVE | ||||||||
| A | 410873250 | 56516TAD7 | 2005-09-22 | 55000000 | CONSTRUCTION OF OUTPATIENT CENTER | 0 | 1 | 0 |
| CITY OF ROBBINSDALE | ||||||||
| B | 716005496 | 2011-06-07 | 60000000 | REFUND SERIES 2008 BONDS | 0 | 1 | 0 | |
| CITY OF ROBBINSDALE | ||||||||
| C | 716005496 | 2011-06-07 | 15000000 | REFUND SERIES 2008 BONDS | 0 | 1 | 0 | |
Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount RetiredAmountRetired |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 54851782 | 4767980 | 1083801 | 49000001 | 2007 | 0 | 0 | 1 | 1 | |
| B | 60000000 | 749350 | 58710650 | 2011 | 1 | 0 | 1 | 1 | 4458365 | |
| C | 15000000 | 15000000 | 2011 | 1 | 0 | 1 | 1 | 667500 |
Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs |
|---|---|---|---|---|---|---|---|
| A | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
| C | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| C | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | 1 |
| B | 1 |
| C | 1 |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE K PART IV, ARBITRAGE, LINE 2C | Identifier |
| Return Reference | DATE REBATE COMPUTATION PERFORMED | ReturnReference |
| Explanation | ISSUER NAME: CITY OF MAPLE GROVE DATE THE REBATE COMPUTATION WAS PERFORMED: 08/31/2010 | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| ROBIN DRUG AND MERWIN PHARMACIES | |||
| BOARD MEMBER IS THE OWNER OF ROBIN DRUG AND MERWIN PHARMACIES | 875820 | MICHAEL STEINHAUSER, A BOARD MEMBER, IS THE OWNER OF ROBIN DRUG AND MERWIN PHARMACIES, WHICH SUPPLIES DRUGS AND PHARMACEUTICALS TO NORTH MEMORIAL HEALTH CARE. | 0 |
| OAKDALE OBGYN | |||
| BOARD MEMBER IS AN OWNER OF OAKDALE OBGYN | 609290 | JON NIELSEN, A BOARD MEMBER, IS AN OWNER OF OAKDALE OBSTETRICS & GYNECOLOGY (A.K.A. OAKDALE OBGYN) WHICH PROVIDES GYNECOLOGICAL SERVICES TO NORTH MEMORIAL HEALTH CARE. | 0 |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable (4 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | MEDICAL EQUIPMENT | 1 | 27572 | COST |
| X | NURSE CALL SYSTEM | 1 | 17570 | COST |
| X | VIDEO CONFERENCING EQUIPMENT | 1 | 15616 | COST |
| X | SOFTWARE | 1 | 18480 | COST |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Form990 Schedule M Part II Form990ScheduleMPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: | Identifier |
| Return Reference | PART I, COLUMN (B): | ReturnReference |
| Explanation | LISTS THE NUMBER OF ITEMS CONTRIBUTED. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | LOREN TAYLOR AND BOB POTTS - BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE ORGANIZATION'S FINANCE AND AUDIT COMMITTEE REVIEWS THE FORM 990 BEFORE IT IS FILED. REPRESENTATIVES FROM THE HOSPITAL'S INDEPENDENT ACCOUNTING FIRM REVIEW THE FORM 990 WITH THE FINANCE AND AUDIT COMMITTEE IN DETAIL AND NOTES FOR THE COMMITTEE ANY CHANGES IN THE FORM 990 FROM PRIOR YEARS. AFTER THOROUGH DISCUSSION, THE FINANCE AND AUDIT COMMITTEE APPROVES THE FORM 990 AND FORWARDS IT TO THE FULL BOARD FOR ITS REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL MEMBERS OF THE BOARD OF DIRECTORS AND ALL EMPLOYEES RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY EACH YEAR. EACH BOARD MEMBER AND STAFF MEMBER FILLS OUT A CONFLICT OF INTEREST QUESTIONNAIRE IN WHICH THEY ARE ASKED TO IDENTIFY ANY RELATIONSHIP THAT WOULD CREATE A CONFLICT OF INTEREST. THE RESULTS ARE SUMMARIZED AND REVIEWED TO DETERMINE ANY ACTUAL OR POTENTIAL CONFLICT AND ARE REPORTED TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR KEY POSITIONS ARE REVIEWED BY THE EXECUTIVE COMMITTEE WORKING IN CONJUNCTION WITH AN OUTSIDE CONSULTANT. THE EXECUTIVE COMMITTEE INSURES THAT THE SALARY AND BENEFIT ADMINISTRATION REVIEW PROCESS IS BEING FOLLOWED, WHICH INCLUDES SALARY AND BENEFIT SURVEYS AND COMPARISONS OF ALL POSITIONS. THE CEO'S COMPENSATION IS SENT TO THE FULL BOARD FOR APPROVAL. THE COMPENSATION OF ALL OTHER KEY POSITIONS IS APPROVED BY THE CEO. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FINANCIAL STATEMENTS ARE AVAILABLE ONLINE THROUGH THE OFFICE OF THE ATTORNEY GENERAL VIA THE CHARITY REPORT FILED WITH THE STATE OF MINNESOTA. |
| FORM 990, PART VII, SECTION B: INDEPENDENT CONTRACTORS | NORTH MEMORIAL HEALTH CARE PAID ACCRETIVE HEALTH $10,074,454 FOR LABOR AND OTHER COSTS INCURRED DURING THE TAX YEAR. REBATES TOTALING $9,629,771 WERE SUBSEQUENTLY RETURNED TO NORTH MEMORIAL. THE AMOUNT REPORTED IN PART VII, SECTION B, COMPENSATION PAID TO INDEPENDENT CONTRACTORS, REFLECTS THE GROSS AMOUNT PAID TO ACCRETIVE HEALTH DURING 2012. |
| FORM 990, PART XII, LINE 2C: | NEITHER THE OVERSIGHT OF THE AUDIT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT WERE CHANGED DURING THE TAX YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OAKDALE MEDICAL CENTER | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OALDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320022819 | EIN |
| Primary Activities | LEASE MEDICAL OFFICE SPACE | PrimaryActivities |
| Legal Domicile State | MN | LegalDomicileState |
| Total Income | 704640 | TotalIncome |
| EOY Assets | 17560716 | EOYAssets |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTH MEMORIAL | BusinessNameLine1 |
Form990 Schedule R Part II Form990ScheduleRPartII (3 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 | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTH MEMORIAL FOUNDATION | |||||||||||
| 3300 OAKDALE AVENUE NORTH | ROBBINSDALE | MN | 55422 | 411777966 | FUNDRAISING | MN | 501(C)(3) | 7 | NORTH MEMORIAL | 0 | |
| ASSOCIATED HEALTH ASSURANCE | |||||||||||
| 3300 OAKDALE AVENUE NORTH | ROBBINSDALE | MN | 55422 | 980343815 | INSURANCE | 501(C)(3) | 11A | NORTH MEMORIAL | 1 | BD | |
| MAPLE GROVE HOSPITAL CORPORATION | |||||||||||
| 9875 HOSPITAL DRIVE | MAPLE GROVE | MN | 55369 | 208316475 | ACUTE CARE | MN | 501(C)(3) | 3 | NORTH MEMORIAL | 1 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE | ||||||||||||
| 9855 HOSPITAL DRIVE3300 OAKDALE AVE | MAPLE GROVE | MN | 55369 | 260393039 | OUTPATIENT SURGERY | MN | RELATED | 803982 | 2760962 | 0 | 1 | 0.50000 |
| MONTICELLO CANCER CENTER | ||||||||||||
| 1013 HART BLVD | MONTICELLO | MN | 55362 | 261909519 | CANCER CENTER | MN | RELATED | 2180027 | 2221713 | 0 | 1 | 0.40000 |
| MINNESOTA DIAGNOSTIC IMAGING PARTNERS LLC | ||||||||||||
| 2955 XENIUM LANE SUITE 40 | PLYMOUTH | MN | 55441 | 352162215 | RADIOLOGY | MN | RELATED | 1221755 | 2623211 | 0 | 1 | 0.60000 |
| NORTH RADIATION THERAPY CENTER LLC | ||||||||||||
| 6950 FRANCE AVE S SUITE 200 | EDINA | MN | 55435 | 743069974 | RADIOLOGY | MN | RELATED | 1559926 | 2042411 | 0 | 1 | 0.50000 |
| BLAINE URGENCY CENTER | ||||||||||||
| 480 OSBORNE RD NE | FRIDLEY | MN | 55432 | 461630126 | URGENT CARE | MN | RELATED | 0 | 1 | 0.50000 | ||
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OAKDALE HEALTH ENTERPRISES INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3300 OAKDALE AVENUE NORTH | AddressLine1 |
| City | ROBBINSDALE | City |
| State | MN | State |
| ZIP Code | 55422 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411546422 | EIN |
| Primary Activity | AMBULANCE | PrimaryActivity |
| Legal Domicile State | MN | LegalDomicileState |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 714111 | ShareOfTotalIncome |
| Share Of EOY Assets | 1501739 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | 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 | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (18 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| NORTH MEMORIAL FOUNDATION (CONTRIBUTIONS) | ||
| C | 478215 | FMV |
| NORTH MEMORIAL FOUNDATION (LEASE PMTS)(ENDED IN AUG 2012) | ||
| J | 65905 | FMV |
| MAPLE GROVE HOSPITAL CORPORATION (RETURN OF CAPITAL) | ||
| C | 9225000 | FMV |
| MAPLE GROVE HOSPITAL CORPORATION (DEBT GUARANTEE) | ||
| D | 107703750 | FMV |
| MAPLE GROVE HOSPITAL CORPORATION (LEASE PMTS) | ||
| J | 458957 | FMV |
| MAPLE GROVE HOSPITAL CORPORATION (MGMT FEE) | ||
| S | 7732114 | FMV |
| MAPLE GROVE HOSPITAL CORPORATION (SALARY REIMBURSMENT) | ||
| Q | 6351567 | FMV |
| ASSOCIATED HEALTH ASSURANCE (PREMUIMS) | ||
| M | 2378152 | FMV |
| OAKDALE HEALTH ENTERPRISES (PAYROLL) | ||
| P | 347994 | FMV |
| OAKDALE HEALTH ENTERPRISES (MGMT FEES) | ||
| S | 726215 | FMV |
| OAKDALE HEALTH ENTERPRISES (INTEREST ON LOAN) | ||
| S | 0 | FMV |
| OAKDALE MEDICAL OFFICE BUILDING (LEASE PAYMENTS) | ||
| J | 676356 | FMV |
| OAKDALE MEDICAL OFFICE BUILDING (EXPENSE REIMBURSMENTS) | ||
| Q | 410493 | FMV |
| MINNEAPOLIS RADIATION ONCOLOGY (LOAN GUARANTEE) | ||
| D | 143987 | FMV |
| NORTH MEMORIAL AMBULATORY SURGERY CENTER (LEASE PMTS) | ||
| J | 1637628 | FMV |
| MAPLE GROVE DIAGNOSTIC IMAGING (LEASE PMTS) | ||
| J | 763451 | FMV |
| MINNEAPOLIS RADIATION ONCOLOGY (LEASE PMTS) | ||
| J | 227852 | FMV |
| MINNEAPOLIS RADIATION ONCOLOGY (DIVIDEND) | ||
| R | 1315000 | FMV |
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