2012-11-14T09:58:14-06:00 2011-12-31 135665207 KPMG LLP 4200 WELLS FARGO CENTER 90 SOUTH 7T MINNEAPOLIS MN 55402 990 2011-01-01 391279567 HUDSON HOSPITAL FOUNDATION INC HUDS 7155316000 405 STAGELINE ROAD HUDSON WI 54016 KAREN K RAMBO 7155316000 2012-11-14 1 JASON DIVINE P01076050 6123055000 2011 2016-02-24 21:20:13Z DOUGLAS E JOHNSON 405 STAGELINE ROAD HUDSON WI 54016 206145 0 X WWW.HUDSONHOSPITAL.ORG X 1977 WI SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS 11 10 0 35 0 0 131573 141422 0 0 157511 -28985 58739 64934 347823 177371 14497 52962 0 0 0 0 0 0 19400 96892 104404 111389 157366 236434 20005 1577088 1942837 11376 196323 1565712 1746514 X TO SUPPORT, ACT FOR THE BENEFIT OF, AND CARRY OUT THE CHARITABLE PURPOSE OF HUDSON HOSPITAL, INC. BY SUPPORTING COMMUNITY HEALTH EDUCATION, PROVIDING HOME CARE ASSISTANCE, AND CONTRIBUTING TO OTHER HEALTH RELATED CHARITABLE ENDEAVORS. 0 0 66845 52962 27519 SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS 66845 1 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X X DOUGLAS E JOHNSON 6514304581 405 STAGELINE ROAD HUDSON WI 54016 X RYAN CARI 0.50 X 0 0 0 CRAIG J GIBSON 0.40 X 0 0 0 DAVE GRAMBOW 0.20 X 0 0 0 GENE HABERMAN 0.40 X 0 0 0 KIM HEINEMANN 0.20 X 0 0 0 ALAN KIECKER 0.30 X 0 0 0 MATT LAYMAN MD 0.20 X 0 0 0 MIKE LEVERTY 0.40 X 0 0 0 RICHARD O'CONNOR 1.20 X 0 0 0 LINDA ROBERTSON 0.10 X 0 0 0 STEPHEN SCHMITZ MD 0.20 X 0 0 0 LINDA ZEITS 0.60 X 0 0 0 MARIAN M FURLONG 51.00 X 0 287810 52714 KAREN K RAMBO 40.00 X 0 104701 11981 0 392511 64695 0 0 1 0 0 11315 130107 141422 -28985 -28985 30402 2883 27519 27519 27519 63306 11315 25891 37415 37415 177371 27519 0 8430 52962 52962 69641 1508 68133 20969 1569 19400 2471 1576 895 1484 1484 3359 3359 ADMINISTRATIVE EXPENSE 3400 3400 MISCELLANEOUS EXPENSE 3080 2471 609 157366 66845 71121 19400 118659 234974 6585 157457 128112 223741 128306 101685 2890 26621 1249362 1300044 71480 0 1577088 1942837 11376 196323 11376 196323 X 1285028 1378255 198994 286569 81690 81690 1565712 1746514 1577088 1942837 X 20005 160797 X 0 1 1 X 0 X 208830 87892 157800 118223 130107 702852 208830 87892 157800 118223 130107 702852 702852 85726 35358 164894 157511 -28995 414494 1117346 347810 0.62900 0.60800 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 15 70181 37941 286569 1 1 81690 81690 81690 81690 81690 81690 81690 81690 0.00000 1.00000 0.00000 0 0 128306 101685 26621 26621 177371 157366 20005 160797 160797 180802 206145 0 206145 -28774 -28774 177371 186140 28774 28774 157366 0 157366 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TO SUPPORT THE MISSION OF HUDSON HEALTH FOUNDATION, INC. PART XI, LINE 8 - OTHER ADJUSTMENTS: HUDSON HOSPITAL, INC. NET ASSET TRANSFER 160,797. PART XII, LINE 4B - OTHER ADJUSTMENTS: GOLF TOURNAMENT EXPENSE -24,418. WINE TASTING EVENT EXPENSE -1,473. LIFELINE UNIT EXPENSE -2,883. PART XIII, LINE 2D - OTHER ADJUSTMENTS: GOLF TOURNAMENT EXPENSE 24,418. WINE TASTING EVENT EXPENSE 1,473. LIFELINE UNIT EXPENSE 2,883. WI MN GOLF TOURNAMENT 53755 3960 49795 24418 WINE TASTING 20866 7355 13511 1473 74621 11315 63306 25891 25891 37415 1 HUDSON HOSPITAL INC 405 STAGELINE ROAD HUDSON WI 54016 390804125 501(C)(3) 46599 EQUIPMENT, PROGRAM SUPPORT & MEMORIALS 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: HUDSON HOSPITAL FOUNDATION, INC. (HHF) MANAGEMENT STAFF REVIEW THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH HHF'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO HHF'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE. X X 0 0 0 0 0 0 0 0 0 MARIAN M FURLONG 0 229067 0 58743 0 0 0 0 0 52714 0 340524 0 0 PART I, LINE 6 HUDSON HOSPITAL FOUNDATION, INC. (HHF) HAS NO EMPLOYEES. HHF'S PRESIDENT IS EMPLOYED BY HUDSON HOSPITAL, INC. (HOSPITAL), WHICH HAS AN INCENTIVE PROGRAM WHICH INCENTS AND REWARDS THE HOSPITAL'S EMPLOYEES WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC YEAR. HOW THE PROGRAM WORKS: THE HOSPITAL BOARD OF DIRECTORS HAVE AUTHORITY FOR THE PROGRAM AND APPROVE EACH LEVEL OF THE PROGRAM ON AN ANNUAL BASIS. THE HOSPITAL INCENTIVE PROGRAM REWARDS ARE BASED ON POSITION IN THE ORGANIZATION AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATIONS STRATEGIC PLAN. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, EMPLOYEE AND/OR LEADERSHIP DEVELOPMENT, CARE DELIVERY, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE, ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. INCENTIVE PROGRAM GOALS FOR EACH YEAR WILL TYPICALLY BE DETERMINED BY OCTOBER OF THE PREVIOUS YEAR. SPECIFIC MEASURES FOR THE SELECTED GOAL AREAS WILL BE OUTLINED EACH YEAR IN A SUPPLEMENTAL DOCUMENT AND WILL BE COMMUNICATED TO PARTICIPANTS DURING THE FIRST QUARTER OF THE EACH YEAR. THE ACTUAL ANNUAL PAYMENT IS DETERMINED BY THE LEVEL OF GOAL ATTAINMENT. STEWARDSHIP GOALS ARE TIED TO BUDGET. A NET MARGIN THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE HOSPITAL. ADDITIONALLY, THERE IS A CAP ON THE AMOUNT OF NET MARGIN USED UNDER THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. EXEMPT PURPOSE AND ACHIEVEMENTS FORM 990, PART III, LINE 4A THE PURPOSE OF THE HUDSON HOSPITAL FOUNDATION (HHF) IS TO RAISE PHILANTHROPIC FUNDS TO ADVANCE THE MISSION, VISION, AND VALUES OF HUDSON HOSPITAL, INC. (HOSPITAL). ESTABLISHED IN 1977, HHF RAISES FUNDS TO PROVIDE SIGNIFICANT FINANCIAL SUPPORT FOR PROGRAMS AND CAPITAL NEEDS THAT ASSIST THE HOSPITAL WITH PROVIDING EXCEPTIONAL CARE CLOSE TO HOME. I. ORGANIZATION AND GOVERNANCE HHF IS A WISCONSIN NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). HHF'S SOLE CORPORATE MEMBER IS THE HOSPITAL, WHICH IS ALSO A NON-PROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C) (3). HHF IS PART OF THE HEALTHPARTNERS FAMILY OF CARE. HEALTHPARTNERS, INC., A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) WHICH IS RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4), IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL AND REGIONS HOSPITAL'S SISTER ORGANIZATIONS, REGIONS HOSPITAL FOUNDATION, CAPITAL VIEW TRANSITIONAL CARE CENTER, STILLWATER HEALTH SYSTEM, AND RAMSEY INTEGRATED HEALTH SERVICES, ALL OF WHICH ARE MINNESOTA NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). HPI-RAMSEY IS ALSO THE SOLE CORPORATE MEMBER OF RH-WISCONSIN, INC., A WISCONSIN NON-STOCK CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). HEALTHPARTNERS, INC. IS ALSO THE SOLE CORPORATE MEMBER OF THE FOLLOWING ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C) (3): GROUP HEALTH PLAN, INC. (A STAFF MODEL HMO), WHICH IS ITSELF THE SOLE CORPORATE MEMBER OF HEALTHPARTNERS RESEARCH FOUNDATION, PHYSICIANS NECK & BACK CLINICS AND HEALTHPARTNERS CENTRAL MINNESOTA CLINICS, INC. (FORMERLY CENTRAL MINNESOTA GROUP HEALTH, INC.), HEALTHPARTNERS INSTITUTE FOR MEDICAL EDUCATION, AND RHSC, INC., ALL OF WHICH ARE EXEMPT UNDER SECTION 501(C) (3); RH-WISCONSIN, INC. AND GROUP HEALTH PLAN, INC. ARE CORPORATE MEMBERS OF THE HOSPITAL AND WESTFIELDS HOSPITAL, INC., BOTH OF WHICH ARE WISCONSIN NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN, INC. IS ALSO THE SOLE CORPORATE MEMBER OF WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY, AN AMBULANCE SERVICE WHICH IS A WISCONSIN NON-PROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). TOGETHER, ALL OF THESE RELATED ORGANIZATIONS COMPRISE THE HEALTHPARTNERS FAMILY OF CARE(HEALTHPARTNERS), WHICH IS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT COMBINES THE PROVISION OF HEALTH CARE DELIVERY AND FINANCING OF HEALTH CARE SERVICES, FOR THE PURPOSE OF IMPROVING THE HEALTH OF ITS VARIOUS ENTITIES' MEMBERS, PATIENTS, AND THE BROADER COMMUNITY. HHF IS GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS COMPRISED OF 13 MEMBERS WHO INCLUDE COMMUNITY REPRESENTATIVES, MEDICAL STAFF AND THE PRESIDENT AND CEO OF THE HOSPITAL. II. ACTIVITIES COMMUNITY BENEFIT ACTIVITIES IN 2011 INCLUDED: - AL HEIN 30TH ANNIVERSARY GOLF CELEBRATION: THE FOUNDATION GOLF TOURNAMENT RAISED NEARLY $50,000 IN 2011, WITH 180 GOLFERS AND DINNER GUESTS. MONEY RAISED FROM THIS EVENT WENT INTO AN UNRESTRICTED FUND THAT WAS DISTRIBUTED TO BOTH THE HOSPITAL AND THE COMMUNITY. - AROUND THE WORLD WINE TASTING: HHF HELD THIS EVENT IN PARTNERSHIP WITH LOCAL BUSINESS KNOTTY VINES. THE EVENT RAISED OVER $19,000, WITH 300 ATTENDEES. MONEY RAISED FROM THIS EVENT WENT INTO AN UNRESTRICTED FUND THAT WAS DISTRIBUTED TO BOTH THE HOSPITAL AND THE COMMUNITY. - A RECORD NUMBER OF COMMUNITY PARTICIPANTS ATTENDED THE WOMEN'S HEART EVENT - CLOSE TO MY HEART TO LEARN ABOUT WOMEN'S HEART DISEASE. SEVERAL PHYSICIANS SHARED THEIR PASSION FOR WOMEN'S HEART HEALTH AND PROVIDED INSIGHTS INTO NUTRITION, EXERCISE AND SIMPLE STEPS TO HELP REDUCE THE RISK OF HEART DISEASE. - SHARING AT WORK EMPLOYEE GIVING CAMPAIGN IN APRIL RAISED MORE THAN $20,000. FOR THE SECOND YEAR IN A ROW, EACH EMPLOYEE GIFT WAS MATCHED DOLLAR FOR DOLLAR BY HEALTHPARTNERS. CHARITABLE GIFTS FUND EMPLOYEE EMERGENCY GRANTS, GOOD SAMARITAN GRANTS TO PATIENTS WHO CANNOT AFFORD CERTAIN MEDICAL EXPENSES AND THE HEALING ARTS PROGRAM. - HHF PARTNERS FROM THE HUDSON LADIES BRIDGE MARATHON'S COMMITTED ITS ANNUAL CONTRIBUTION TO THE HEALING ARTS PROGRAM TO PROVIDE A NEW EXTRAORDINARY STAINED GLASS ART PIECE TO THE HOSPITAL'S COLLECTION LOCATED ON THE HOSPITAL'S FRONT WINDOWS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF HHF IS THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO BYLAWS, HHF'S BOARD OF DIRECTORS IS COMPRISED OF NOT LESS THAN SEVEN (7) AND NOT MORE THAN FIFTEEN (15) PERSONS APPOINTED BY THE HOSPITAL AS THE SOLE CORPORATE MEMBER OF HHF. FORM 990, PART VI, SECTION A, LINE 7B HHF'S CORPORATE MEMBER, THE HOSPITAL, MUST APPROVE THE FOLLOWING ACTIONS OF HHF'S BOARD OF DIRECTORS OR INITIATE THESE ACTIONS DIRECTLY: - AMENDMENTS OF THE ARTICLES, BYLAWS OR OTHER GOVERNING DOCUMENTS - SALE, LEASE, MORTGAGE OR PLEDGE OF ANY REAL ESTATE OR INTEREST THEREIN, OR OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS - ADOPTION OF AMMENDMENT OF A STRATEGIC PLAN, AND CAPITAL AND OPERATING BUDGETS - APPROVAL OF UNBUDGETED CAPITAL EXPENDITURES - APPROVAL OF BORROWING OR LENDING OF FUNDS OF THE FOUNDATION - MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY AND TRANSFER OR CONTRIBUTION OF ASSETS AND FUNDS TO SEPERATE ENTITIES - ESTABLISHMNENT OR DIVESTITURE OF ENTITIES OF WHICH HHF HAS AN EQUITY OR MANAGEMENT INTEREST, OR ESTABLISHMENT OF ANY SIGNIFICANT AND CONTINUING RELATIONSHIP WITH ANY ENTITY - DISSOLUTION AND DISTRIBUTION OF ASSETS FORM 990, PART VI, SECTION B, LINE 11 HHF'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF HHF. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF HHF, GHI'S INTERNAL LEGAL DEPARTMENT AND HEALTHPARTNERS, INC.'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF HHF. ONCE THAT REVIEW PROCESS HAS BEEN COMPLETED, IT IS THE POLICY OF HHF TO MAKE AVAILABLE TO THE FINANCE AND AUDIT COMMITTEE OF IT'S BOARD OF DIRECTORS, AND TO IT'S BOARD OF DIRECTORS, A COPY OF THE 990 PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY WILL BE PROVIDED IN A MAILING TO THE FINANCE AND AUDIT COMMITTEE MEMBERS AND TO THE BOARD OF DIRECTORS MEMBERS PRIOR TO THE FILING OF THE 990. EACH MEMBER WILL HAVE AN OPPORTUNITY TO COMMENT OR ASK QUESTIONS ABOUT THE 990 BEFORE IT IS FILED. THIS PROCESS WILL BE NOTED AND DOCUMENTED IN A WRITTEN MEMO IN THE FILES OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C AS REQUIRED BY THE BYLAWS OF HHF, THE BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS AND KEY EMPLOYEES ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND REQUESTED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNSEL WILL SUMMARIZE THE FINDINGS FOLLOWING REVIEW OF THE QUESTIONNAIRE AND SUBMIT A REPORT TO THE CHAIR, THE HOSPITAL PRESIDENT AND HHF'S PRESIDENT. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY. FORM 990, PART VI, SECTION B, LINE 15 HHF HAS NO EMPLOYEES. HHF'S PRESIDENT IS EMPLOYED BY THE HOSPITAL, A RELATED ORGANIZATION. HOSPITAL COMPENSATION PROGRAM: KEY POINTS: - SALARY RANGES ARE DETERMINED BY UTILIZING PUBLISHED SALARY SURVEY DATA AND LOCAL JOB MARKET INFORMATION (TYPICALLY HRRAM'S ANNUAL SURVEY). - RANGES ARE UPDATED ANNUALLY DURING MAY BY THE HOSPITAL'S HR DEPARTMENT. - RANGES ARE POSITION SPECIFIC AND ARE 95-100% OF THE TWIN CITY MARKET OR 100% OF THE WISCONSIN DATA (THE HIGHER OF THE TWO). - THE HOSPITAL COMPENSATION DEPARTMENT IS REFERENCED FOR NON-MATCHING POSITIONS WITH HRRAM DATA. - WISCONSIN HOSPITAL ASSOCIATION SALARY SURVEY IS ALSO REFERENCED FOR SENIOR LEADERS AND EXECUTIVE POSITIONS. - PLACEMENT IN THE RANGE IS DETERMINED BY JOB DESCRIPTION REQUIREMENTS, INCLUDING EDUCATION, TRAINING, EXPERIENCE, LENGTH OF TIME IN THE POSITION, AND PERFORMANCE IN THE POSITION. FORM 990, PART VI, SECTION C, LINE 19 HHF'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM HHF. HHF'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE WISCONSIN SECRETARY OF STATE'S OFFICE. HHF'S CONFLICT OF INTEREST POLICY THROUGH IT'S RELATED ORGANIZATION, THE HOSPITAL, CAN BE VIEWED THROUGH THE HUDSONHOSPITAL.ORG WEBSITE. AVERAGE HOURS - RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A, LINE 1A, COLUMN (B) DIRECTORS AND OFFICERS OF HHF ARE EMPLOYED AND COMPENSATED BY REGIONS HOSPITAL OR THE HOSPITAL. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: HUDSON HOSPITAL, INC. NET ASSET TRANSFER 160,797. TOTAL TO FORM 990, PART XI, LINE 5: 160,797. HUDSON HOSPITAL INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 390804125 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN 0 RH WISCONSIN 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 202287016 CORPORATE PLANNING AND OVERSIGHT WI 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY 0 HPI RAMSEY 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 411793333 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 GROUP HEALTH PLAN INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 410797853 STAFF MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(3) 170(B)(1) (A)(III) HEALTHPARTNERS INC 0 HEALTHPARTNERS INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 411693838 HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(4) N/A 0 HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411236798 PRIMARY AND SPECIALTY PATIENT CARE MN 501(C)(3) 170(B)(1) (A)(III) GROUP HEALTH PLAN INC 0 HEALTHPARTNERS INSTITUTE FOR MEDICAL EDUCATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411835843 MEDICAL EDUCATION MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 HEALTHPARTNERS RESEARCH FOUNDATION 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 411670163 HEALTHCARE RESEARCH MN 501(C)(3) 509(A)(3) TYPE I GROUP HEALTH PLAN INC 0 CAPITAL VIEW TRANSITIONAL CARE CENTER 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 412011453 POST HOSPITALIZATION PATIENT CARE MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 0 RAMSEY INTEGRATED HEALTH SERVICES 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 411503090 IN-HOME PATIENT CARE MN 501(C)(3) 509(A)(2) HPI - RAMSEY 0 REGIONS HOSPITAL 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 410956618 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 0 REGIONS HOSPITAL FOUNDATION 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 411888902 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 170(B)(1) (A)(VI) HPI - RAMSEY 0 RHSC INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 411891928 HEALTHCARE STAFFING MN 501(C)(3) 509(A)(3) TYPE II HEALTHPARTNERS INC 0 WESTFIELDS HOSPITAL INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 390808442 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN 0 WESTFIELDS HOSPITAL FOUNDATION INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 391770913 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT WI 501(C)(3) 509(A)(3) TYPE I WESTFIELDS HOSPITAL INC 0 PHYSICIANS NECK AND BACK CLINICS 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 270684883 SPECIALTY PATIENT CARE MN 501(C)(3) 509(A)(3) TYPE II GROUP HEALTH PLAN INC 0 WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 263616590 PROVIDE MEDICAL TRANSPORT SERVICES WI 501(C)(3) 509(A)(3) TYPE II RH-WISCONSIN 0 LAKEVIEW MEMORIAL HOSPITAL FOUNDATION 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 411386635 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 509(A)(3) TYPE II STILLWATER HEALTH SYSTEM 0 LADEVIEW MEMORIAL HOSPITAL ASSOCIATION INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 410811697 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) STILLWATER HEALTH SYSTEM 0 ST CROIX VALLEY HEALTHCARE & RESEARCH FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411923524 FOUNDATION MN 501(C)(3) PF STILLWATER HEALTH SYSTEM 0 STILLWATER MEDICAL GROUP 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 830379473 PHYSICIANS GROUP MN 501(C)(3) 509(A)(2) STILLWATER HEALTH SYSTEM 0 STILLWATER HEALTH SYSTEM 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 300221189 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY 0 HEALTHPARTNERS ADMINISTRATORS INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 411629390 THIRD PARTY ADMINISTRATOR MN HEALTHPARTNERS INC C HEALTHPARTNERS ASSOCIATES INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 522365151 MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT MN HEALTHPARTNERS ADMINISTRATORS INC C HEALTHPARTNERS SERVICES INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 411683568 MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT MN HEALTHPARTNERS ADMINISTRATORS INC C HEALTHPARTNERS VENTURES INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 411838197 DEVELOP HEALTHCARE BUSINESS OPPORTUNITIES MN HEALTHPARTNERS INC C HEALTHPARTNERS INSURANCE COMPANY 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 411683523 MEDICAL AND DENTAL INSURANCE MN HEALTHPARTNERS ADMINISTRATORS INC C DENTAL SPECIALTIES INC 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 451297583 SPECIALTY DENTAL CARE MN HEALTHPARTNERS ADMINISTRATORS INC C 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0