2012-09-27T13:12:14-05:00 2011-12-31 990 2011-01-01 411862132 MAYO CLINIC HEALTH SYSTEM - OWATONNA MAYO 5075381297 2200 26TH STREET NW OWATONNA MN 55060 KRISTIN S JOHNSON 5075381297 2012-09-27 2011 2016-02-24 21:20:13Z X BRIAN E BUNKERS MD 2200 26TH STREET NW OWATONNA MN 55060 65534508 0 X WWW.MAYOCLINICHEALTHSYSTEM.ORG X 1997 MN OPERATION OF A MEDICAL CLINIC 9 3 516 3 11351 8388 84936 64816791 100055 338217 65339999 98353 0 40528945 0 0 20662594 61289892 4050107 42772664 48829418 4832769 6863652 37939895 41965766 X TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION, AND RESEARCH. 1 0 51443505 0 65088069 PATIENT CARE (SEE SCHEDULE O):MAYO CLINIC HEALTH SYSTEM - OWATONNA (MCHS-OWATONNA) IS A MEMBER OF THE MAYO CLINIC HEALTH SYSTEM. MAYO CLINIC HEALTH SYSTEM IS A FAMILY OF CLINICS, HOSPITALS AND HEALTH CARE FACILITIES SERVING COMMUNITIES IN MINNESOTA, IOWA AND WISCONSIN. AS PART OF MAYO CLINIC, MAYO CLINIC HEALTH SYSTEM OFFERS OUTSTANDING CARE CLOSE TO HOME. PHYSICIANS AND STAFF IN MAYO CLINIC HEALTH SYSTEM HAVE READY ACCESS TO THE KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC, YET CAN MEET PATIENTS HEALTH CARE NEEDS LOCALLY. MAYO CLINIC HEALTH SYSTEM IS PART OF THE COMMUNITY, FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES IN WHICH WE LIVE AND WORK. MAYO CLINIC HEALTH SYSTEM TEAMS WITH MAYO CLINIC TO DELIVER UNPARALLELED HEALTH CARE TO COMMUNITIES THROUGH AN INTEGRATED NETWORK OF CLINICS AND HOSPITALS.IN 2011, MAYO CLINIC HEALTH SYSTEM SITES EMPLOYED APPROXIMATELY 900 PHYSICIANS AND 13,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT THE MAYO CLINIC HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN 72 COMMUNITIES, THE SYSTEM INCLUDES 18 OWNED HOSPITALS, SEVEN OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH TWO ADDITIONAL HOSPITALS, AND CONTRACT MANAGEMENT AGREEMENTS WITH AN ADDITIONAL HOSPITAL AND NURSING HOME. SINCE ITS INCEPTION IN 1992, MAYO CLINIC HEALTH SYSTEM HAS GROWN FROM A NEW IDEA TO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN AMERICA. MAYO CLINIC HEALTH SYSTEM COMPLETES MORE THAN TWO-MILLION PATIENT VISITS ANNUALLY. IT ALSO SERVES AS A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS BEING RECOGNIZED SIX TIMES BY THE AMERICAN MEDICAL GROUP ASSOCIATION'S ACCLAIM AWARD PROGRAM (2005 ACCLAIM AWARD RECIPIENT AND FIVE-TIME ACCLAIM AWARD HONOREE). THE ACCLAIM AWARDS HONOR PHYSICIAN-LED ORGANIZATIONS DELIVERING CARE ALIGNED WITH THE IDEAL DELIVERY MODEL WHERE PATIENTS EXPERIENCE SAFE, RELIABLE, RESPONSIVE, READILY AVAILABLE AND INTEGRATED CARE. IN ADDITION, THE MINNESOTA COUNCIL FOR QUALITY HAS RECOGNIZED MAYO CLINIC HEALTH SYSTEM THREE TIMES FOR ITS PERFORMANCE EXCELLENCE EFFORTS. INDIVIDUAL MAYO CLINIC HEALTH SYSTEM LOCATIONS HAVE ALSO BEEN HONORED FOR THEIR COMMITMENT TO QUALITY, SAFETY, SERVICE, PERFORMANCE AND THEIR COMMUNITIES.PEOPLE IN MINNESOTA, IOWA AND WISCONSIN CAN HAVE PEACE OF MIND KNOWING THAT MAYO CLINIC HEALTH SYSTEM AND MAYO CLINIC PARTNER TO ENSURE HEALTHIER LIVES IN THE REGION.AS PART OF THE MAYO CLINIC HEALTH SYSTEM, MCHS-OWATONNA IS ORGANIZED AND OPERATED AS A NONPROFIT MULTI-SPECIALTY CLINIC PROVIDING HEALTH CARE SERVICES AT ITS MAIN CLINIC FACILITY IN THE CITY OF OWATONNA, MINNESOTA AND OUTREACH AT OTHER CLINIC FACILITIES LOCATED IN THE AREA SURROUNDING OWATONNA. MCHS-OWATONNA STAFF INCLUDES PHYSICIANS IN A VARIETY OF SPECIALTY FIELDS INCLUDING; FAMILY MEDICINE, INTERNAL MEDICINE, GENERAL SURGERY, OBSTETRICIAN/GYNECOLOGY, DERMATOLOGY, OTOLARYNGOLOGY, OPHTHALMOLOGY, ORTHOPEDICS, PEDIATRICS, PLASTIC & RECONSTRUCTIVE SURGERY, UROLOGY, URGENT CARE AND EMERGENCY MEDICINE. MCHS-OWATONNA OFFERS COMPREHENSIVE LABORATORY, DIAGNOSTIC, PAIN MANAGEMENT AND INFUSION THERAPY SERVICES LIKE CHEMOTHERAPY FOR AREA CANCER PATIENTS. SPECIALTY PHYSICIANS IN GENERAL SURGERY, OBSTETRICS, OTOLARYNGOLOGY AND ORTHOPEDIC SURGERY SEE PATIENTS AT OTHER AREA CLINICS AND HOSPITALS PROVIDING SPECIALTY CARE AND CRITICAL ON-CALL SUPPORT. THE HOSPITALS THAT BENEFIT FROM THIS CARE AND ON-CALL SUPPORT ARE EXEMPT UNDER SECTION 501(C)(3) OF THE CODE, AND MANY ARE RELATED HOSPITALS IN THE MAYO CLINIC HEALTH SYSTEM. WHILE PHYSICIANS AT MCHS-OWATONNA MEET THE VAST MAJORITY OF PATIENTS' HEALTHCARE NEEDS IN OWATONNA, A TEAM OF VISITING SPECIALISTS FROM MAYO CLINIC SEE PATIENTS LOCALLY, PROVIDING CONVENIENT CONSULTATION AND CARE IN CARDIOLOGY, ONCOLOGY, NEUROLOGY, NEPHROLOGY, AND DIALYSIS.MCHS-OWATONNA RECORDED 163,192 PRIMARY CARE VISITS AND 293,526 RADIOLOGY AND LAB TESTS FOR 2011. MCHS-OWATONNA PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. SERVICES ARE ALSO PROVIDED TO BOTH MEDICAID AND MEDICARE PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN 2011, MCHS-OWATONNA PROVIDED APPROXIMATELY $178,110 IN FINANCIAL ASSISTANCE (AT COST) TO PATIENTS. THE UNREIMBURSED COST OF SERVICES TO MEDICAID PATIENTS WAS APPROXIMATELY $5,619,742 AND THE UNREIMBURSED COST OF SERVICES TO MEDICARE PATIENTS WAS APPROXIMATELY $8,041,326.MCHS-OWATONNA ALSO PAID $1,047,443 OF MINNESOTACARE TAX, WHICH IS USED TO FUND A STATE PROGRAM FOR PROVIDING MEDICAL CARE TO THE LOW INCOME POPULATION. 368793 98353 14506 COMMUNITY INVOLVEMENT & EDUCATION (SEE SCHEDULE O):MCHS-OWATONNA'S COMMUNITY INVOLVEMENT AND CHARITABLE CONTRIBUTIONS FOCUS ON:- IMPROVING QUALITY OF LIFE;- PROMOTING YOUTH POTENTIAL; - IMPROVING COMMUNITY HEALTH AND WELLNESS; AND- PARTNERING FOR COMMUNITY GROWTH AND DEVELOPMENT.IN 2011, MCHS-OWATONNA PROVIDED VARIOUS COMMUNITY SERVICES AND EDUCATIONAL OPPORTUNITIES TO AREA RESIDENTS. SOME OF THESE ACTIVITIES ARE DESCRIBED BELOW. OVER 180 WOMEN ATTENDED THE ANNUAL "WOMEN'S HEALTH DAY EDUCATIONAL EVENT". THE EVENT EXISTS TO EDUCATE THE WOMEN OF OWATONNA AND THE SURROUNDING AREA ON HEALTHCARE TOPICS RELATED TO WOMEN. NEARLY 500 LOCAL RESIDENTS ATTENDED THE ANNUAL "HAVE A SAFE SUMMER CHILDREN'S SAFETY FAIR". THE FAIR IS A COMMUNITY PROGRAM THAT IS DESIGNED TO EDUCATE YOUTH ABOUT HEALTH AND SAFETY. THE FAIR IS A PARTNERSHIP WITH THE MEDICAL PROFESSION, LAW ENFORCEMENT, SCHOOLS, PUBLIC SERVICE ORGANIZATIONS, THE CITY OF OWATONNA, STEELE COUNTY PUBLIC HEALTH, AND OTHER COMMUNITY ORGANIZATIONS THAT PROVIDE SAFETY TRAINING AND HEALTHY SUMMER ACTIVITIES FOR YOUTH. THE ANNUAL COMMUNITY WALKING PROGRAM IS DESIGNED TO INCREASE THE PHYSICAL ACTIVITY LEVEL OF STEELE COUNTY RESIDENTS MEASURED BY THE NUMBER OF STEPS THEY WALK IN A DAY. THE PROGRAM IS IN COLLABORATION WITH THE OWATONNA HOSPITAL AND THE CITY OF OWATONNA. OVER 750 PARTICIPATED IN THE 2011 WALKING PROGRAM.MCHS-OWATONNA HELD AN ANNUAL FLU SHOT CLINIC FOR THE COMMUNITY AND WENT ON-SITE TO LOCAL BUSINESSES TO ADMINISTER FLU SHOTS FOR EMPLOYEES. ALSO OFFERED WERE FREE DIABETES AND CANCER SUPPORT GROUP SESSIONS, FREE COLORECTAL SCREENINGS AND EDUCATIONAL SEMINARS.MCHS-OWATONNA PHYSICIANS PROVIDED MEDICAL COVERAGE AT VARIOUS LOCAL HIGH SCHOOL SPORTING EVENTS. IN ADDITION, SPORTS SCREENINGS WERE OFFERED TO LOCAL AND SURROUNDING AREA STUDENTS AT NO CHARGE. MCHS-OWATONNA SPONSORED HAND WASHING STATIONS AT THE STEELE COUNTY FREE FAIR AND STAFF VOLUNTEERED THEIR TIME TO REPRESENT THE CLINIC AT THE FAIR.MCHS-OWATONNA STAFF SPOKE AT SEVERAL EVENTS DURING THE YEAR AND SERVED ON THE BOARDS OF VARIOUS AGENCIES IN THE COMMUNITY.MCHS-OWATONNA DISTRIBUTES A QUARTERLY NEWSLETTER "HOMETOWN HEALTH" TO ALL MAILBOXES IN ITS SERVICE AREA TO KEEP EVERYONE INFORMED OF NEW SERVICES, NEW PROVIDERS, EDUCATION/PREVENTION AND PATIENT CARE RELATED INFORMATION. MCHS-OWATONNA PROVIDED CLINICAL EXPERIENCE FOR NURSING AND HEALTH RELATED CAREERS WHICH WERE OFFERED THROUGH A LOCAL COMMUNITY COLLEGE. DURING 2011, STUDENTS WERE PROVIDED THE OPPORTUNITY FOR JOB SHADOWING. MCHS-OWATONNA ALSO PROVIDED CLINICALS FOR RESIDENTS.IN ADDITION TO THE ABOVE ACTIVITIES, MCHS-OWATONNA GAVE $98,353 IN GRANTS TO CHARITIES AND COMMUNITY ORGANIZATIONS. OF THIS AMOUNT, $66,222 WAS THE BOOK VALUE OF LAND DONATED FOR THE CONSTRUCTION OF A LONG-TERM CARE FACILITY. 51812298 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 21 0 1 516 1 1 1 0 0 0 0 0 0 0 0 0 X 9 3 1 1 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MN X MAYO CORPORATE TAX UNIT 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 X AGERTER MD DAVID C 1.00 X X 0 439287 46318 BERG DAVID W 40.00 X X 201363 0 15222 BUNKERS MD BRIAN E 40.00 X X 324931 0 4710 CROCKETT ERIC D 1.00 X 0 127209 25195 GROFF STAN 1.00 X 0 0 0 HERZOG JAMES 1.00 X 0 0 0 HOWELL MD THOMAS G 1.00 X 0 442312 47690 MCGRAW COLLEEN 1.00 X 0 0 0 PALEY MD KEITH H 40.00 X X 452756 0 17356 PLATE MD REINOLD H 40.00 X X 323750 0 8899 JOHNSON KRISTIN S 40.00 X 159793 0 10280 PARKS DOUGLAS A 1.00 X 0 174599 36434 PILOT DAVID L 1.00 X 0 187660 33075 ANDERSON-BECKMAN MD JANET M 40.00 X 240962 0 8179 BLOMQUIST MD KARL L 40.00 X 270699 0 27202 MULET MD MIGUEL E 40.00 X 523586 0 11007 PALEY MD DANIEL S 40.00 X 310560 0 11058 SANDHOFER MD CHARLES R 40.00 X 274135 0 6855 WRAY-RAABOLLE MD JASON T 40.00 X 317774 0 11848 BEYER MD DEREK A 40.00 X 510485 0 14802 IVANCE MD DAVID W 40.00 X 657409 0 11195 OLSEN MD KENNETH D 40.00 X 712721 0 12212 PENN MD DAVID M 40.00 X 656859 0 25852 STEINLE MD JASON W 40.00 X 673403 0 9186 6611186 1371067 394575 61 0 1 0 SHARED HEALTH SERVICES LLC 134 SOUTHVIEW OWATONNA MN 55060 MEDICAL SERVICES 1964546 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 MEDICAL & SUPPORT SERVICES 1842468 TOP-NOTCH CLEANING 785 22ND STREET SE OWATONNA MN 55060 JANITORIAL SERVICES 538121 MAYO CLINIC HEALTH SYSTEM - FARIBAULT 300 STATE AVENUE FARIBAULT MN 55021 MEDICAL SERVICES 473020 MAYO COLLABOTATIVE SERVICES INC 200 FIRST STREET SW ROCHESTER MN 55905 LAB SERVICES 348048 8 84936 84936 NET PATIENT REVENUE 620000 63398824 63398824 SHARED SERVICES 561000 1164119 1164119 RENT FROM AFFILIATES 531120 239342 239342 EDUCATION REVENUE 611600 14506 14506 64816791 95112 95112 98987 34873 91044 23522 7943 11351 19294 11351 7943 84886 79943 4943 4943 4943 MISC. CONSULTING 541610 270238 270238 MISC. REVENUE 900099 48685 15546 33139 318923 65339999 65102575 11351 141137 98353 98353 3532925 2798791 734134 235373 235373 28236547 24882404 3354143 2466467 2194409 272058 4314768 3657130 657638 1742865 1519255 223610 286800 286800 33245 33245 5768191 4527723 1240468 102235 575 101660 1027551 318905 708646 1093594 3642 1089952 1051786 983692 68094 7916 7916 406328 282523 123805 1674040 1306573 367467 391437 388154 3283 MEDICAL SUPPLIES 5118377 5115602 2775 BAD DEBT EXPENSE 2200657 2200657 MN CARE TAX 1047443 1047443 EMPLOYEE EXPENSES 239562 61622 177940 213432 181556 31876 61289892 51812298 9477594 0 16712 -11880 1350 4714 8955072 8751596 54845 99693 406227 434714 1182177 937373 32168871 11401236 21973232 20767635 135307 9334840 16849367 790393 731430 57816 129469 42772664 48829418 4721204 6590216 43471 58335 68094 215101 4832769 6863652 X 37939895 41965766 37939895 41965766 42772664 48829418 X 4050107 -24236 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1562494 1562494 23909624 6770513 17139111 6690528 4630723 2059805 6225 6225 20767635 MAYO POOLED INVESTMENTS 16849367 F 16849367 DUE TO AFFILIATES 79794 DEFERRED COMPENSATION LIABILITY 135307 215101 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: AT DECEMBER 31, 2011 AND 2010 THERE WAS NO SIGNIFICANT LIABILITY FOR UNRECOGNIZED TAX BENEFITS FOR THE FILING ORGANIZATION. 1 STEELE COUNTY COMMUNITIES FOR A LIFETIME INC 1409 SOUTH CEDAR AVENUE OWATONNA MN 55060 270705237 501(C)(3) 66222 BOOK LAND LAND FOR THE CONSTRUCTION OF A LONG-TERM CARE FACILITY. 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY AND EQUALITY OF OPPORTUNITY. TRANSFERS OR GRANTS TO TAX-EXEMPT ORGANIZATIONS WILL BE USED PURSUANT TO THE POLICIES AND PROCEDURES OF THE GRANTEE ORGANIZATIONS AND TO FURTHER THE EXEMPT PURPOSES OF THE GRANTEE ORGANIZATIONS. BOTH THE FILING ORGANIZATION AND THE GRANTEE ORGANIZATION MAINTAIN ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED. X X 0 1 0 1 0 0 0 0 0 1 0 AGERTER MD DAVID C 0 341092 0 0 0 98195 0 32194 0 14124 0 485605 0 94907 BERG DAVID W 199665 0 530 0 1168 0 6241 0 8981 0 216585 0 0 0 BUNKERS MD BRIAN E 204710 0 0 0 120221 0 731 0 3979 0 329641 0 0 0 CROCKETT ERIC D 0 126842 0 0 0 367 0 6423 0 18772 0 152404 0 0 HOWELL MD THOMAS G 0 410064 0 0 0 32248 0 23154 0 24536 0 490002 0 26156 PALEY MD KEITH H 276734 0 0 0 176022 0 9203 0 8153 0 470112 0 0 0 PLATE MD REINOLD H 153214 0 0 0 170536 0 4296 0 4603 0 332649 0 0 0 JOHNSON KRISTIN S 159369 0 424 0 0 0 4930 0 5350 0 170073 0 0 0 PARKS DOUGLAS A 0 173183 0 0 0 1416 0 13141 0 23293 0 211033 0 0 PILOT DAVID L 0 187660 0 0 0 0 0 13374 0 19701 0 220735 0 0 ANDERSON-BECKMAN MD JANET M 214604 0 0 0 26358 0 7173 0 1006 0 249141 0 0 0 BLOMQUIST MD KARL L 199315 0 0 0 71384 0 4428 0 22774 0 297901 0 0 0 MULET MD MIGUEL E 276952 0 0 0 246634 0 5269 0 5738 0 534593 0 0 0 PALEY MD DANIEL S 295454 0 0 0 15106 0 5780 0 5278 0 321618 0 0 0 SANDHOFER MD CHARLES R 120646 0 0 0 153489 0 6209 0 646 0 280990 0 0 0 WRAY-RAABOLLE MD JASON T 260352 0 0 0 57422 0 7077 0 4771 0 329622 0 0 0 BEYER MD DEREK A 338550 0 0 0 171935 0 7350 0 7452 0 525287 0 0 0 IVANCE MD DAVID W 439979 0 0 0 217430 0 5082 0 6113 0 668604 0 0 0 OLSEN MD KENNETH D 465597 0 0 0 247124 0 7350 0 4862 0 724933 0 0 0 PENN MD DAVID M 545071 0 0 0 111788 0 17957 0 7895 0 682711 0 0 0 STEINLE MD JASON W 551228 0 0 0 122175 0 7350 0 1836 0 682589 0 0 0 PART I, LINE 1A DR. DANIEL PALEY WAS TRAVELING BETWEEN MEDICAL CONFERENCES ON A MULTI-DESTINATION TRIP. DURING THE TRIP, TWO OF THE FLIGHTS WERE FIRST CLASS. HE WAS ABLE TO PURCHASE THE FIRST CLASS TICKETS AT DISCOUNTED RATES FROM A TRAVEL WEBSITE. THE COST OF THE DISCOUNTED FIRST CLASS TICKETS WERE COMPAREABLE TO COACH CLASS TICKETS NORMALLY PURCHASED THROUGH THE AIRLINE OR TRAVEL AGENT. IN DECEMBER, CERTAIN EMPLOYEES OF THE FILING ORGANIZATION (ALLIED STAFF AND 1ST YEAR PHYSICIANS) RECEIVED A SMALL BONUS ($500 OR LESS DEPENDING ON THE LEVEL OF THE EMPLOYEE). THESE BONUSES WERE GROSSED-UP. DAVID BERG AND KRISTIN JOHNSON RECEIVED THESE GROSSED-UP BONUSES DURING 2011. PART I, LINE 1B THE FILING ORGANIZATION FOLLOWED AN UNWRITTEN POLICY THAT PROVIDED GROSS-UP ON THE ABOVE MENTIONED BONUSES PROVIDED TO EMPLOYEES. FOR FUTURE YEARS, THE ABOVE POLICY WILL BE EITHER DISCONTINUED OR BE WRITTEN AND STATE THE CONDITIONS, ELIGIBILITY AND TREATMENT OF ANY GROSS-UP PAYMENTS PROVIDED. PART I, LINE 4B THIS ENTITY OR ITS AFFILIATE HAS A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE MAYO PENSION PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(A)(17). STARTING JANUARY 1, 2011, ALL SRP BENEFITS ARE PAID AS AN ANNUAL TAXABLE CASH PAYMENT. THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). A PORTION OF THE AMOUNT MAY BE INCLUDED IN SCHEDULE J, PART II, COLUMN (F) IF DISCLOSED ON A PRIOR YEAR'S FORM 990. DAVID AGERTER, M.D. - $94,907 THOMAS HOWELL, M.D. - $26,156 PART I, LINE 7 IN DECEMBER, CERTAIN EMPLOYEES OF THE FILING ORGANIZATION (ALLIED STAFF AND 1ST YEAR PHYSICIANS) RECEIVED A SMALL BONUS ($500 OR LESS DEPENDING ON THE LEVEL OF THE EMPLOYEE). DAVID BERG AND KRISTIN JOHNSON RECEIVED THESE "NON-FIXED" PAYMENTS DURING 2011. SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: IN ADDITION TO THE PROCESS FOLLOWED BY THE FILING ORGANIZTION, THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990, PART VI, SECTION B, LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED. SUPPLEMENTAL INFORMATION PART III PART II: COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. MAYO CLINIC HEALTH SYSTEM - FARIBAULT BUSINESS RELATIONSHIP - BOARD OVERLAP 620176 SERVICES 0 KARI BUNKERS FAMILY MEMBER OF BRIAN BUNKERS, OFFICER 235373 EMPLOYMENT 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 PRIOR TO 2011, THE FILING ORGANIZATION WAS A TAXABLE CLINIC AND WAS GRANTED EXEMPTION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE EFFECTIVE JANUARY 1, 2011. THE PROGRAM SERVICES CONDUCTED BY THE FILING ARE NOT NEW. HOWEVER, THIS IS THE FIRST TIME BEING REPORTED ON FORM 990. FORM 990, PART VI, SECTION A, LINE 2 DUE TO EMPLOYMENT BY A RELATED ORGANIZATION, DAVID PILOT HAS A BUSINESS RELATIONSHIP WITH DAVID AGERTER, M.D. AND DOUGLAS PARKS. DUE TO BOARD MEMBERSHIP ON A RELATED TAXABLE ENTITY, BRIAN BUNKERS, M.D. AND THOMAS HOWELL HAVE A BUSINESS RELATIONSHIP. KEITH PALEY, M.D. AND DANIEL PALEY, M.D. HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 3 THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO-AFFILIATED ENTITIES ROUTINELY DELEGATED VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO RELATED ENTITIES. FORM 990, PART VI, SECTION A, LINE 4 THE FILING ORGANIZATION CHANGED ITS GOVERNING DOCUMENTS IN 2011 TO REFLECT A NAME CHANGE. THIS NAME CHANGE WAS PREVIOUSLY COMMUNICATED TO AND APPROVED BY THE IRS DURING THE TAX YEAR. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION IS MAYO CLINIC. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS ARE ELECTED OR REMOVED BY THE SOLE CORPORATE MEMBER, SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS. THE COMMUNITY DIRECTORS ARE NOMINATED BY A NOMINATING COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN TRANSACTIONS REQUIRE APPROVAL BY THE MEMBER BEFORE ACTION CAN BE TAKEN SUCH AS AMENDMENT TO THE ARTICLES AND BYLAWS, MERGER OR OTHER RESTRUCTURING, AND INCURRENCE OF DEBT. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 FOR THE FILING ORGANIZATION IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA U.S. MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. HIGHLIGHTS ARE PRESENTED TO BOARD MEMBERS, AND THE REVIEW IS DOCUMENTED IN MEETING MINUTES. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS AND ADMINISTRATIVE LEADERSHIP. IN ADDITION TO ANY REVIEW AND APPROVAL THAT MAY TAKE PLACE AT THE LOCAL ENTITY LEVEL, THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY IN THE FALL FOR THE NEXT YEAR'S COMPENSATION. THE SALARY OF THE CEO, CAO, AND BOARD VICE CHAIR WERE REVIEWED BY THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR MAYO CLINIC HEALTH SYSTEM PHYSICIAN AND ADMINISTRATIVE LEADERSHIP. THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION OF PHYSICIANS AND ADMINISTRATIVE LEADERSHIP FOR THE MAYO CLINIC HEALTH SYSTEM ENTITIES. THE COMMITTEE IS COMPRISED OF MAYO EMPLOYEES, BUT IS INDEPENDENT FOR INTERNAL REVENUE CODE 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED (WITH RECUSAL WHERE APPROPRIATE). FOR THOSE INDIVIDUALS FOR WHICH THIS COMMITTEE CAN NOT SERVE AS THE INDEPENDENT REVIEW, THEIR COMPENSATION AND BENEFITS ARE REVIEWED BY THE GOVERNANCE COMMITTEE (DESCRIBED BELOW). THE COMPENSATION AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. INFORMATION ON MAYO CLINIC HEALTH SYSTEM PHYSICIAN AND ADMINISTRATIVE LEADERSHIP COMPENSATION AND BENEFITS IS ALSO REVIEWED BY THE MAYO CLINIC COMMITTEE ON OFFICER SUCCESSION, COMPENSATION AND GOVERNANCE (GOVERNANCE COMMITTEE), WHICH IS COMPRISED OF SEVEN OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. IN ADDITION TO THE ABOVE COORDINATED REVIEW PROCESSES CONDUCTED BY MAYO CLINIC AND ITS AFFILIATES, THE FILING ORGANIZATION ALSO HAS ITS OWN COMPENSATION REVIEW PROCESS THAT INCLUDES REVIEW BY THE FILING ORGANIZATION'S COMPENSATION COMMITTEE, BENCHMARK/COMPARABILITY DATA AND APPROVAL BY BOARD OR COMPENSATION COMMITTEE. THE FILING ORGANIZATION'S REVIEW PROCESS COVERS BOTH A PHYSICIAN COMPENSATION PLAN AND AN ADMINISTRATOR COMPENSATION PLAN. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. FORM 990, PART VII, SECTION A, AVERAGE HOURS PER WEEK DEVOTED TO POSITION WITH RELATED ORGANIZATIONS: DAVID AGERTER, M.D. - 40 HOURS ERIC CROCKETT - 40 HOURS THOMAS HOWELL, M.D. - 40 HOURS DOUGLAS PARKS - 40 HOURS DAVID PILOT - 40 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -24,236. BLOOMER LAKEVIEW INC 2110 DUNCAN ROAD BLOOMER WI 54724 391450617 LOW INCOME HOUSING WI 501(C)(3) 7 MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC 1 CHARTERHOUSE INC 200 FIRST STREET SW ROCHESTER MN 55905 411405254 RETIREMENT LIVING CENTER MN 501(C)(3) 9 MAYO CLINIC 1 FOUNTAIN LAKE TREATMENT CENTER 404 WEST FOUNTAIN STREET ALBERT LEA MN 56007 411404076 CHEMICAL DEPENDENCY TREATMENT MN 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--ALBERT LEA 1 FRANCISCAN SKEMP FOUNDATION OF ARCADIA INC 464 SOUTH JOHNSON STREET ARCADIA WI 54612 391322480 FUNDRAISING FOUNDATION WI 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC 1 GCAS 200 FIRST STREET SW ROCHESTER MN 55905 411917517 AMBULANCE SERVICE MN 501(C)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 GOLD CROSS AMBULANCE SERVICE 200 FIRST STREET SW ROCHESTER MN 55905 411917516 AMBULANCE SERVICE MN 501(C)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 GOLD CROSS AMBULANCE INC 200 FIRST STREET SW ROCHESTER MN 55905 391942957 AMBULANCE SERVICE MN 501(C)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 LUTHER LAKESIDE APARTMENTS INC 714 SOUTH BARSTOW STREET EAU CLAIRE WI 54701 391409024 LOW INCOME HOUSING WI 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 416011702 PATIENT CARE - CLINIC MN 501(C)(3) 9 MAYO CLINIC 1 MAYO CLINIC -- METHODIST HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410739106 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC -- SAINT MARYS HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410944601 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC ARIZONA 13400 EAST SHEA BLVD SCOTTSDALE AZ 85259 860800150 HOSPITAL AND CLINIC AZ 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 590714831 HOSPITAL FL 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MAYO CLINIC HEALTH SYSTEM--ALBERT LEA 404 WEST FOUNTAIN STREET ALBERT LEA MN 56007 411404075 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--AUSTIN 1000 FIRST DRIVE NW AUSTIN MN 55912 410695606 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--AUSTIN FOUNDATION 1000 FIRST DRIVE NW AUSTIN MN 55912 300107471 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC HEALTH SYSTEM--AUSTIN 1 MAYO CLINIC HEALTH SYSTEM--CANNON FALLS 1116 WEST MILL STREET CANNON FALLS MN 55009 204156428 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC 1501 THOMPSON STREET BLOOMER WI 54724 390980343 HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC PO BOX 1510 EAU CLAIRE WI 54702 391735831 PATIENT CARE - CLINIC WI 501(C)(3) 3 MAYO CLINIC 0 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE FOUNDATION INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE WI 54702 391633407 GRANTMAKING FOUNDATION WI 501(C)(3) PF MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC 0 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 390813418 HOSPITAL WI 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--FAIRMONT 800 MEDICAL CENTER DRIVE PO BOX 800 FAIRMONT MN 56031 410760836 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391186647 FUNDRAISING FOUNDATION WI 501(C)(3) 11-II MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION-SPARTA INC 310 WEST MAIN STREET SPARTA WI 54656 391423234 FUNDRAISING FOUNDATION WI 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391411999 HEALTHCARE SYSTEM PARENT WI 501(C)(3) 11-I MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN MEDICAL CENTER INC 700 WEST AVE SOUTH LA CROSSE WI 54601 390806374 HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--HOME HEALTH & HOSPICE INC PO BOX 2060 EAU CLAIRE WI 54702 391491516 HOME HEALTH AND HOSPICE CARE WI 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--LAKE CITY 500 WEST GRANT STREET LAKE CITY MN 55041 411906820 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--MANKATO 1025 MARSH STREET MANKATO MN 56002 411236756 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--MANKATO HEALTH CARE FOUNDATION 1025 MARSH STREET MANKATO MN 56002 411663357 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC HEALTH SYSTEM--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--NEW PRAGUE 301 SECOND STREET NORTHEAST NEW PRAGUE MN 56071 410723639 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--NORTHLAND INC 1222 EAST WOODLAND AVE BARRON WI 54812 390920634 HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--OAKRIDGE INC PO BOX 70 / 13025 EIGHTH STREET OSSEO WI 54758 391029430 HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--OWATONNA 134 SOUTHVIEW OWATONNA MN 55060 411862132 PATIENT CARE - CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--RED CEDAR INC 2321 STOUT ROAD MENOMONIE WI 54751 510190875 HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--SPRINGFIELD 625 NORTH JACKSON AVENUE SPRINGFIELD MN 56087 411893827 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--ST JAMES 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 410797368 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--ST JAMES HEALTH CARE FOUNDATION 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 411444129 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC HEALTH SYSTEM--ST JAMES 1 MAYO CLINIC HEALTH SYSTEM--SUPPORTIVE HOMECARE INC PO BOX 2060 EAU CLAIRE WI 54702 391686673 HOME HEALTH CARE WI 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--WASECA 501 NORTH STATE STREET WASECA MN 56093 363606405 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--MANKATO 1 MAYO CLINIC JACKSONVILLE 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 593337028 PATIENT CARE - CLINIC FL 501(C)(3) 7 MAYO CLINIC 1 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 200 FIRST STREET SW ROCHESTER MN 55905 411506440 CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES MN 501(C)(3) 9 MAYO CLINIC 1 MAYO KLINIK STIFTUNG 60486 FRANKFURT AM MAIN FRANKFURT GM FUNDRAISING FOUNDATION GM MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES 200 FIRST STREET SW ROCHESTER MN 55905 412020392 SUPPORT RESEARCH, PRACTICE & EDUCATION MN 501(C)(3) 11-I MAYO CLINIC 1 POVERELLO FOUNDATION 200 FIRST STREET SW ROCHESTER MN 55905 411494881 FUNDRAISING FOUNDATION MN 501(C)(3) 11-I MAYO CLINIC -- SAINT MARYS HOSPITAL 1 SOUTHERN METRO MEDICAL CLINICS INC 301 MAIN STREET NEW PRAGUE MN 56071 411623632 FAMILY PRACTICE CLINICS MN 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--NEW PRAGUE 1 FRANKLIN HEATING STATION 119 THIRD ST SW ROCHESTER MN 55902 410264830 UTILITY MN N/A MAYO CLINIC HEALTH SYSTEM--FARIBAULT 635 FIRST STREET SE FARIBAULT MN 55021 411817179 PATIENT CARE - CLINIC MN N/A C MAYO CLINIC HEALTH SYSTEM--DECORAH CLINIC PHYSICIANS 907 MONTGOMERY STREET DECORAH IA 52101 411711329 PATIENT CARE - CLINIC IA N/A C FIOS THERAPEUTICS INC 200 FIRST STREET SW ROCHESTER MN 55905 711029189 RESEARCH MN N/A C HEALTH TRADITION HEALTH PLAN 1808 EAST MAIN STREET ONALASKA WI 54650 391545987 MEDICAL SERVICES COMPANY WI N/A C LOBSS NETWORK SUPPORT 2002 INC 200 FIRST STREET SW ROCHESTER MN 55905 481276150 ADMINISTRATIVE SERVICES MN N/A C MAYO COLLABORATIVE SERVICES INC 200 FIRST STREET SW ROCHESTER MN 55905 411346366 REFERENCE LAB SERVICES MN N/A C MAYO HOLDING COMPANY 200 FIRST STREET SW ROCHESTER MN 55905 411578020 HOLDING COMPANY MN N/A C MAYO INSURANCE COMPANY LTD 200 FIRST STREET SW ROCHESTER MN 55905 SELF INSURANCE POOL CJ N/A C MAYO MEDICAL LABORATORIES NEW ENGLAND INC 265 BALLARDVALE STREET WILMINGTON MA 01887 043323713 LABORATORY SERVICES MA N/A C MAYO REGIONAL PRACTICES OF ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 061190278 THIRD PARTY ADMINISTRATION SERVICES AZ N/A C MHS SERVICES INC 200 FIRST STREET SW ROCHESTER MN 55905 411282517 EQUIPMENT & REAL ESTATE LEASING MN N/A C MMSI INC 21 FIRST STREET SW ROCHESTER MN 55905 411547003 THIRD PARTY ADMINISTRATION SERVICES MN N/A C MAYO CLINIC HEALTH SYSTEM--PHARMACY & HOME MEDICAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 391528920 PHARMACY SERVICES WI N/A C PHYSICIAN AND HOSPITAL PRACTICES INC 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 930926631 HEALTH SERVICES FL N/A C ROCHESTER AIRPORT COMPANY ROUTE 2 ROCHESTER MN 55902 410506870 AIRPORT MANAGEMENT MN N/A C SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION 13400 E SHEA BLVD SCOTTSDALE AZ 85259 860870505 COMMERCIAL PROPERTY OWNERS ASSOCIATION AZ N/A C THE STABILE BUILDING OWNERS' ASSOCIATION 200 FIRST STREET SW ROCHESTER MN 55905 208994499 COMMERCIAL PROPERTY OWNERS ASSOCIATION MN N/A C MAYO CLINIC GBS MAURITIUS 2ND FLOOR EBENE MEWS 57 EBENE CYBERCITY MP HEALTHCARE MANAGEMENT MP N/A C CHARITABLE LEAD TRUST (1) CHARITABLE TRUST CA N/A T PERPETUAL TRUST (1) CHARITABLE TRUST ND N/A T PERPETUAL TRUST (1) CHARITABLE TRUST LA N/A T PERPETUAL TRUST (2) CHARITABLE TRUST MA N/A T PERPETUAL TRUST (1) CHARITABLE TRUST MO N/A T PERPETUAL TRUST (1) CHARITABLE TRUST AZ N/A T CHARITABLE REMAINDER TRUST (1) CHARITABLE TRUST CO N/A T CHARITABLE REMAINDER TRUST (6) CHARITABLE TRUST FL N/A T CHARITABLE REMAINDER TRUST (1) CHARITABLE TRUST FL N/A T CHARITABLE REMAINDER TRUST (1) CHARITABLE TRUST IL N/A T CHARITABLE REMAINDER TRUST (1) CHARITABLE TRUST LA N/A T CHARITABLE REMAINDER TRUST (1) CHARITABLE TRUST MI N/A T CHARITABLE REMAINDER TRUST (66) CHARITABLE TRUST MN N/A T CHARITABLE REMAINDER TRUST (82) CHARITABLE TRUST MN N/A T CHARITABLE REMAINDER TRUST (1) CHARITABLE TRUST NC N/A T CHARITABLE REMAINDER TRUST (2) CHARITABLE TRUST TX N/A T 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 1 1 MAYO COLLABORATIVE SERVICES INC L 348048 GAAP MMSI INC Q 4526660 GAAP MAYO CLINIC HEALTH SYSTEM - FARIBAULT L 473020 GAAP MAYO CLINIC - METHODIST HOSPITAL A 52500 GAAP MMSI INC R 1924583 GAAP MAYO CLINIC HEALTH SYSTEM - FAIRBAULT K 146067 GAAP MAYO CLINIC HEALTH SYSTEM - AUSTIN N 119630 GAAP