2012-11-08T15:29:44-06:00 2011-12-31 861065772 Deloitte Tax LLP 50 South Sixth Street Minneapolis MN 55402 990 2011-01-01 363465840 Park Nicollet Health Services PARK 9529933108 6500 Excelsior Blvd St Louis Park MN 55426 Sheila McMillan 9529933108 2012-11-01 1 Kristina Rasmussen P00143920 6123974000 2011 2016-02-24 21:20:13Z Sheila McMillan 6500 Excelsior Blvd St Louis Park MN 55426 90069617 0 X www.parknicollet.com X 1986 MN Cares for and supports the health, healing, and learning of those served. 24 11 9195 0 11669 0 149100 0 23530001 90023909 879836 11187 180101 -24930 24739038 90010166 0 5000 0 0 19078634 16832711 0 0 0 6175340 66510834 25253974 83348545 -514936 6661621 130926788 126439298 150282169 131489767 -19355381 -5050469 X Park Nicollet Health Services has a mission to care for and support the health, healing, and learning of those served. The focus is on excellent care, delivered in a caring manner, with emphasis on disease prevention and wellness education. 1 0 16673312 19623986 Park Nicollet Health Services is the parent organization to an integrated care system that includes Park Nicollet Methodist Hospital, Park Nicollet Clinic, Park Nicollet Health Care Products, Park Nicollet Institute and PNMC Holdings. Park Nicollet Health Services and affiliates have more than 8,100 team members and more than 1,000 physicians on the Park Nicollet Methodist Hospital Medical Staff, most of which are employed by Park Nicollet Clinic. Park Nicollet Health Services is a nonprofit system staffed by nationally recognized doctors, clinical professionals, nurses and other team members who help patients stay healthy and take care of them when they are sick.In 2011, Park Nicollet Health Services and affiliates, a national health care improvement leader, continued to make dramatic patient care advances, win prominent awards, expand access to services and integrate efficiency into Park Nicollet Health Services' operations. Park Nicollet Health Services and affiliates also have enhanced community health, increased team member satisfaction and promoted research and education. Park Nicollet Health Services mission is to care for and support the health, healing and learning of those served. Park Nicollet Health Services uses five core values to accomplish its mission: care, service, stewardship, joy and learning. Highlights of 2011 that support Park Nicollet Health Service's values include the following: - Park Nicollet opened Park Nicollet Clinic-Lakeville on Aug. 22 near the intersection of 185th Street and I-35W. The clinic opened with 25 team members, including four physicians. It offers family medicine, pediatrics and extended hours. - Park Nicollet Melrose Institute expanded its eating disorders care to Park Nicollet Clinic-Burnsville in October after the number of Melrose patient from Dakota County doubled over a three-year period. - Park Nicollet completed its electronic medical record (EMR) transition from Last Word to Epic in early July. This was the culmination of three years of planning and implementations. The EPIC Command Center received more than 13,000 calls between July 2 and 18, and 130 people were working in the center when Epic went live on July 5. As part of the transition to Epic, Park Nicollet launched My Chart service, so patients can access portions of their EMR at mychart.parknicollet.com. - For the third consecutive year, Park Nicollet achieved 100 percent of its quality goals as part of its participation in the Physicians Group Practice (PGP) Demonstration, Medicare's first physician pay-for-performance initiative at the group practice level. Park Nicollet's 2011 federal PGP bonus payment was nearly $5.7 million. - Park Nicollet is one of 32 health systems to receive Accountable Care Organization (ACO) status from the Centers for Medicare & Medicaid Services (CMS). Through the Pioneer ACO Model, Park Nicollet is working with CMS to test new payment models in order to provide Medicare beneficiaries with higher quality care while reducing growth in Medicare expenditures through enhanced care coordination. - Park Nicollet International Diabetes Center (IDC) began working with Mayo Clinic to develop a clinical diabetes training program for Chinese physicians after signing a $3.9 million contract with the China Ministry of Health. This is a five-year initiative to train 500 emerging expert physicians in China regarding advances in diabetes research, care and education. - Park Nicollet began conducting patient surveys at all locations as part of our effort to continually improve our Patient and Family Experience. Results will be tied to team member surveys. - Park Nicollet Frauenshuh Cancer Center (FCC) became the first program in Minnesota to be certified as a Quality Oncology Practice Initiative. - With a $1.5 million grant awarded by the Leona M. and Harry B. Helmsley Charitable Trust, IDC worked to further standardize glucose analysis to improve type 1 diabetes clinical outcomes. - Melrose Institute added a metabolic health and weight management program to its eating disorders treatment offerings. - In February, the 1,700 United Health Group employees who work at UHG's Minnetonka headquarters began using The Well, a new work-site clinic staffed by Park Nicollet clinicians and Optum Health wellness providers. - Launched Head + Heart, Together internal culture that combines intellect and the science of medicine with the compassion, spirit and humanity of Park Nicollet team members. The launch included team vision meetings, rollout of HHT competencies, a new appraisal system and HHT magazine for team members. - Gave more than $3.1 million to community organizations, with $1.26 million going to patient and family experience and enhancements, $1.1 million to community outreach and initiatives, and $744,000 to innovation and research. - Helped provide no-charge health care to 4,000 children at Park Nicollet's four community clinics. - Helped FCC provide music therapy, massage therapy, support groups, educational materials and research to improve cancer care and treatment options. - Helped pay for certified diabetes educators for IDC. - Helped Park Nicollet Struthers Parkinson's Center provide individualized treatment plans and support groups in more than 90 communities and fund research designed to improve care and treatment. - Helped Melrose Institute provide eating disorder classes, community educational events and research to improve care and treatment - Funded grief support and education for more than 450 students who had lost a loved one - Provided enhanced immunization access for children in 25 area school districts - Sponsored Project Better Gown, a 2011 design competition to design an improved exam gown. University of Minnesota students won the competition and were selected for the People's Choice Award at the park Nicollet Foundation's 2011 Gala. They shared a $25,000 Fellowship Grant for their sleek gown design, which features a pocket in the front and ties on the side and will be used to enhance patients' experience. - Launched new online giving and communication tools - Hosted the Tour de Clinic, which raised more than $55,000 for the Foundation's Annual Campaign. CEO David Abelson and team of cyclists biked nearly 200 miles and visited 21 Park Nicollet locations around the Twin Cities. - Collected more than $9,000 for American Cancer Society Daffodil Days - Held blood drives at multiple Park Nicollet locations through the year - Boxed food for needy people overseas for Feed My Starving Children - Served more than 250 lunches monthly for adults and children at Minneapolis Crisis Nursery from January through OctoberWe are gratified that many of our clinical and cost-saving achievements were recognized by respected third-party organizations. These honors and recognition included: - Park Nicollet received 2011 HealthGrades recognition that included: Distinguished Hospital Award for Patient Safety Cardiac Excellence Award Stroke Care Excellence Award Critical Care Excellence Award Pulmonary Care Excellence Award Gastrointestinal Medical Treatment Excellence Award Women's Health Excellence Award Innovation in Health Care Award - Park Nicollet's Leigh Myers-Higgins, RN, received the Good Catch for Patient Safety Award from the Minnesota Hospital Association. - Methodist Hospital's vascular laboratory was the only one in the Twin Cities to receive accreditation in four major testing areas from the Intersocietal Commission for the Accreditation of Vascular Labs. - Thomson Reuters named Methodist Hospital as one of its 50 Top Cardiovascular Hospitals. - Park Nicollet was named a Leader in Lesbian, Gay, Bi-sexual and Transgender (LGBT) Equality by the Human Rights Campaign Foundation, which publishes the annual Healthcare Equality Index report. The index focuses on policies and practices that help create a welcoming environment for LGBT patients and families. - 2011 Nurse of Excellence Award recipients were: Angel Larson, RN; Carrie Wickland, LPN; Kelly Albers, RN; Mary Jo Macklem, RN; Laura Nicklay, RN; Kris Smith, RN; and Vicki Norton, RN. - Joel Jahrus, MD, Medical Director of the Melrose Institute, received the Ellis Island Medal of Honor, which recognizes leadership dedicated to community service and a commitment to teaching and improving the health and well-being of others. Past recipients include former presidents Bill Clinton, George H. Bush and Gerald Ford. - FCC received the Commission on Cancer Outstanding Achievement Award. - IDC was selected as one of the top 25 medical organizations to participate in the Type 1 Diabetes Exchange. 49726203 70404725 TRIA Orthopaedic Center ("TRIA") is a leader in orthopaedic treatment, providing comprehensive care from diagnosis, to treatment, to rehabilitation, even surgery at one convenient location in Bloomington, Minnesota. TRIA has over 40 highly-trained orthopaedic doctors with a variety of sub-specialties such as sports medicine, acute injury, shoulder, knee, spine, hand and wrist, foot and ankle, hip and fractures. For immediate orthopaedic needs, TRIA offers walk-in care seven days a week through the Acute Injury Clinic, with no appointment needed. TRIA's sports medicine specialists have served as official team physicians for Minnesota's pro sports teams for over 25 years. TRIA is a Limited Liability Company that is fully owned by Park Nicollet Health Services, a nonprofit integrated care delivery system. TRIA's mission is to provide our patients and community with exceptional orthopaedic care and services supported by innovative education and research. TRIA's belief that the success of TRIA will be sustained through the talent of our people, the satisfaction of the patients we serve, the dedication we share to our profession and the core values/beliefs we will uphold. These values are:PATIENTS: Our patients come firstPEOPLE: Our people are our greatest assetORTHOPAEDICS: Orthopaedics is our focusRESEARCH: Research is fundamental to improving patient careEDUCATION: Education enhances our profession and patient careGROWTH: Sustainable growth creates valueCOMMUNITY: We will be a good neighbor in our communityProgram Service Accomplishments for TRIA include:- TRIA continues to grow to meet the musculoskeletal needs of the community. In 2011, the TRIA Clinic Services have grown by 7.8%, the Acute Injury Clinic by 18.6%, and Hand Therapy by 19.3%. Ancillary services have also grown to keep up with demand. X-ray has grown by 7.2% and MRI by 6.56%. - The Hilton Recovery program continues to grow. In the past year, total knee cases were added to the procedures that recover in the Hilton Hotel. Over 253 patients have now taken advantage of this lower-cost program with exceptional patient satisfaction feedback. In 2011, the Hilton Recovery program was awarded Medica's Innovation award.- TRIA continues to lead the way in outcomes measurement. Patients complete extensive pre and post surveys to assess functional outcomes on six different procedure types. Some of TRIA's patient registries are now amongst the most extensive in the industry. - TRIA provided over 140 free high school physicals for area high school athletes prior to the fall season. - TRIA provided medical coverage for the following major sporting events in the community in the past year: * U.S. Pond Hockey Championships at Lake Nokomis, * Nature Valley Grand Priz Bicycle Festival in St. Paul, Minneapolis, Cannon Falls, Menomonie, WI and Stillwater. - Annually, TRIA trains three sports medicine fellows and numerous medical school residents rotate through TRIA each year.- Every Tuesday morning TRIA provides professional education sessions for area medical students and clinical professionals. TRIA's annual spring sports medicine conference drew over 150 professionals.- TRIA employees raise money for those in need through the Jeans for a Cause program. Employees who contribute $5 are allowed to wear jeans on Fridays. The wearing of Jeans for the Cause buttons signifies the fund raising aspect of the program to patients.- TRIA provides periodic free Smart Body Talks for the community. - TRIA physician's frequently speak and offer free assessments and injury prevention talks to area youth sport teams in the community. 66399515 1 0 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 106 0 1 9195 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 24 11 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 MN X Sheila McMillan 9529936790 6500 Excelsior Blvd St Louis Park MN 55426 Park Nicollet Group Return-See Sch 3.00 X 2058315 3243881 664969 Park Nicollet Group Return-See Sch 55.00 X 2811792 0 540286 Park Nicollet Group Return-See Sch 55.00 X 643958 0 75273 Park Nicollet Group Return-See Sch 55.00 X 0 4432551 289808 Park Nicollet Group Return-See Sch 0.00 X 481623 0 59060 5995688 7676432 1629396 46 1 1 0 0 Patient Care 621400 70404725 70404725 Services to Affiliates 561000 18021309 18021309 Income- Premier Purch 900099 1597875 1594775 3100 90023909 4587 4587 21150 59451 -38301 -38301 -38301 6600 0 6600 6600 6600 Miscellaneous 900099 13371 4802 8569 13371 90010166 90025611 11669 -27114 5000 5000 6107082 6107082 7051880 7051880 678169 678169 2108325 129342 1978983 887255 887255 357 357 45496770 34676039 10820731 882347 12837 869510 907088 260414 646674 422388 394513 27875 4175150 3620995 554155 12368 2561 9807 106284 7049 99235 4615 4615 2246585 280949 1965636 1121362 192 1121170 Medical Supplies 7248953 7170163 78790 0 Bad Debt 1919883 1919883 0 0 MN Care tax 1227539 1227539 0 0 Ind exp all- Shared Exp 0 16673312 -16673312 0 739145 18727 720418 83348545 66399515 16949030 0 -2051742 6037595 115652826 67584695 927200 14579272 1898742 0 0 519200 2481532 1166848 56202482 29164743 1917970 27037739 8601769 6413976 1498491 3099973 130926788 126439298 80904058 92087045 69378111 39402722 150282169 131489767 X -19355381 -5050469 0 0 0 0 -19355381 -5050469 130926788 126439298 X 6661621 7643291 X 0 1 1 X 0 X X X 0 0 0 Park Nicollet Methodist Hospital 410132080 3 1 1 1 7199880 Park Nicollet Clinic 410834920 3 1 1 1 9163645 Park Nicollet Institute 410961862 4 1 1 1 309787 3 16673312 X 0 0 191800 191800 191800 191800 82937464 1058716015 83129264 1058907815 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 172394 108350 200569 191800 673113 250000 250000 250000 250000 1000000 1500000 40627 11855 52482 145133 15494 120000 40627 124503 20630 145133 138463 15140 29100 124503 0.00000 0.00000 1.00000 0 1 1 1917864 1917864 21134 21134 0 36884419 12959603 23924816 17379065 16184006 1195059 27037739 Investment in Premier Purchasing Partners, LP 767124 C Investment in Tri-Care 5515963 C TRIA Building Capital Replacement Fund 130889 C 6413976 Due to and from Related Parties 19740142 Contingent Malpractice Liability 17017558 Post Retirement Obligation 2645022 39402722 Description of Intended Use of Endowment Funds: Part V, Line 4: The Term endowment funds for use within Park Nicollet Health Services are for the Caring for Colleagues program. Description of Uncertain Tax Positions Under FIN 48: Part X: There were no unrecognized tax benefits of liabilities for the years ended December 31, 2011, 2010 and 2009. Central America & the Caribbean 0 0 Program services Insurance for related tax exempt organizations 17813 0 0 0 0 0 0 17813 0 17813 0 0 1 0 0 0 X 1 1 X X X X X 1 1 0 0 0 0 0 1 0 Park Nicollet Group Return-See Sch 1365374 2881867 286881 135627 406060 226387 116552 0 249528 298889 2424395 3542770 0 0 Park Nicollet Group Return-See Sch 1900743 0 736791 0 174258 0 317644 0 222642 0 3352078 0 117083 0 Park Nicollet Group Return-See Sch 408394 0 165213 0 70351 0 4810 0 70463 0 719231 0 49169 0 Park Nicollet Group Return-See Sch 0 3828833 0 186075 0 417643 0 0 0 289808 0 4722359 0 0 Park Nicollet Group Return-See Sch 68383 0 125336 0 287904 0 29713 0 29347 0 540683 0 30600 0 Part I, Line 1a Park Nicollet Health Services pays social club dues to both the Interlachen and Minneapolis Clubs in the name of David Abelson, CEO, for use by all Park Nicollet Health Services officers and key employees. The facilities are used for a variety of business meetings held by key executives from Park Nicollet Health Services. Part I, Line 3: The Park Nicollet Health Services' Board of Directors is responsible for establishing the compensation of the organization's CEO and Executive Directors. Part I, Lines 4a-b During 2011, Park Nicollet Health Services terminated without cause the employment of individuals in reportable positions. Severance payments were determined to be payable under the Park Nicollet Health Services Executive Management Group Severance Policy (the "Policy"). The policy provides that if Park Nicollet Health Services terminates a covered individual without cause, and if the individual releases all legal claims against Park Nicollet Health Services, then Park Nicollet Health Services will provide the terminated individual severance compensation for a period of one year including salary, health, life, dental and disability benefits, as well as deferred compensation, incentive compensation, and pension plan payments. Part I, Line 4B: Senior leaders of Park Nicollet Health Services and affiliates are given the opportunity to participate in the Capital Accumulation Account Plan. The Capital Accumulation Account Plan (CAA Plan) participation is limited to senior leaders and all the vice presidents. Each participant receives an annual allowance equal to the sum of (i) a stated percent of salary, and (ii) voluntary salary deferrals. The allowance is credited to a bookkeeping account. Earnings are credited to the account based on the performance of simulated investments. Benefits vest upon the earliest of remaining employed to an elective vesting date (two years to age 68), involuntary termination without cause, disability, death, or not competing for 24 months following voluntary or for-cause termination. Benefits are paid in a single lump sum upon vesting. Participants are general creditors of the employer for the payment of the benefits. Part I, Line 7 All physicians employed by and seeing patients for Park Nicollet Health Services and affiliates, are eligible for a 3% access incentive payout based on their department reaching certain goals including access for patients and quality initiatives. In their roles as executives employed by Park Nicollet Health Services, the executives are eligible for incentive payouts. The incentive award will be 35% of base pay compensation for the CEO, 30% for the CFO, COO, CMO and 25% for all other executives with an opportunity for incentive credit above the target level. The ultimate payout includes a reduction/increase multiplier depending on whether the consolidated Park Nicollet Health Services organization reached that year's operating margin goal as set by the Board of Directors. Each participant will be responsible for two financial goals, and not less than three and not more than five individual strategic objectives. In their roles as management employed by Park Nicollet Health Services, certain managers are eligible for incentive payouts. The incentive award will be 15% of their annual base pay compensation with an opportunity for incentive credit above the target level. The ultimate payout includes a reduction/increase multiplier depending on whether the consolidated Park Nicollet Health Services organization reached that year's operating margin goal as set by the Board of Directors. Incentive payments are a function of both individual and organizational performance. The participant must be assigned at least three, and not more than four focused incentive objective, one of which must be financial in nature. City of St Louis Park 416005519 791748EE2 2008-08-14 223727818 Refinance Series 2003 A Bonds issued 11/13/03 0 0 0 City of St Louis Park 416005519 791748EG7 2009-12-31 182727701 Refinance Series 2008A and 2008B's Bond issued 8/14/08 0 0 0 25075000 223727818 30447921 1580827 6863730 194800000 2008 1 0 1 1 182727701 23634540 1861956 18543816 144049159 2009 1 0 1 1 0 1 1 1 1 1 0.00000 0.00000 0.00000 1 0 1 1 1 1 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 1 0 0 0 0 0 1 Explanation of Reporting on an Obligated Group Basis: Pursuant to a loan agreement with the City of St. Louis Park, Minnesota, Park Nicollet Health Services is named as a member of the "Obligated Group" along with Park Nicollet Methodist Hospital, Park Nicollet Clinic, PNMC Holdings, Park Nicollet Institute, and Park Nicollet Health Care Products. Each member of the obligated group is an obligor under the loan agreement. Park Nicollet Health Services did not use bond funds; therefore there are no bonds on the balance sheet. Park Nicollet Health Services is the parent of the Obligated Group, and has elected to report all tax-exempt bond activity on its return. Part II, Line 4: The amount shown in column A consists of $20,484,120 in a debt service reserve fund and $9,963,801 in a debt service fund. The amount shown in column B consists of $18,247,877 in a debt service reserve fund, and $5,386,663 in a debt service fund. Part II, Line 13: Park Nicollet Health Services determined the year of substantial completion for each issue as follows: The purpose of the issue in column A was to refund prior issues for which the original capital project was complete prior to refunding. Therefore the year of substantial completion is the year of issuance. The purpose of the bond issue in column B was to refund the 2008 A and B bond issue since the related capital project of the 2008 B issue was not yet complete until 2009 the year of substantial completion is 2009. Part II, Line 9: $6,660,000 of the amount shown in column A is a swap termination payment. $18,102,000 of the amount shown in column B is a swap termination payment. Part I, column (c), Line A: The CUSIP shown on Form 8038 is 79174EE2, which is incorrect; the correct value, 791748EE2 , is shown here. Marquette Real Estate Holdings James O. Pohlad: Owner 4300073 Lease: Marquette Real Estate Holdings leases the TRIA Orthopaedic Center Building to a disregarded entity of Park Nicollet Health Services. 0 New Program Services Form 990, Part III, line 2 TRIA Orthopaedic Center, LLC became a disregarded entity of Park Nicollet Health Services during the tax year 2011 and has been reported with the activities of Park Nicollet Health Services on the Form 990. TRIA Orthopaedic Center, LLC activities are described in Part III, Line 4b. Form 990, Part VI, Section A, line 2 Park Nicollet Health Services and its related entities (Park Nicollet Clinic, Park Nicollet Health Care Products, Park Nicollet Methodist Hospital, Park Nicollet Institute and PNMC Holdings) have a common board. The following officers, board members, and key employees are employees of and paid by Park Nicollet Health Services or its related organizations. These employees serve together on the common board which serves Park Nicollet Health Services and its related entities. David Abelson, MD Steven Connelly, MD Paul Dominski Roxanna Gapstur Christa Getchell David Homans, MD Jeffrey B. Husband, MD Tom Jones, MD Michael Kaupa Charles McCoy, MD Sheila McMillan William Richards, MD Janet Schaffer, MD Eric Schned, MD Janette Strathy, MD Katherine Tarvestad Mark Wilkowske, MD Susan Zwaschka Form 990, Part VI, Section B, line 11 Park Nicollet Health Services prepares the Form 990 within the finance department with assistance from individuals in human resources, marketing, and operations. Upon completion of gathering the necessary information for the return, the form was compiled by Park Nicollet Health Services' accounting firm. Drafts of the form were reviewed by the Assistant Controller - Accounting Operations, Vice President of Finance, Chief Financial Officer, and the Audit and Compliance Committee. After all internal reviews were complete, the final version of the Form 990 was given to each member of the Board of Directors prior to filing return. Form 990, Part VI, Section B, line 12c At Park Nicollet Health Services all key employees, directors, and officers are asked to complete a conflict of interest disclosure statement each year; however the obligation to report conflicts is ongoing. The Governance Committee, which meets five times per year, reviews all potential conflict disclosures and discusses the impact on the organization. If a potential conflict arises during the year, it is disclosed and reviewed by the Governance Committee. The Governance Committee presents the disclosure information and makes recommendations to the Board of Directors regarding management of any conflicts identified. When a transaction involving a potential conflict of interest is identified, the Board of Directors may appoint a disinterested individual or committee to review that conflict and ensure discussions related to those transactions can occur separately from those individuals with potential conflicts. All significant transactions include an analysis of fair market value. Form 990, Part VI, Section B, line 15 The Park Nicollet Health Services' Board of Directors is responsible for the implementation and oversight of executive compensation and benefit plans. Park Nicollet Health Services uses an outside consultant to provide yearly market based indexes of salary adjustments for executives in similar leadership positions. The Board of Directors reviews the salary ranges and recommends salary increases for each executive, including the CEO, based upon the Board of Directors' evaluation of job performance and experience level of the individual within the organization. The average salary increases for all Park Nicollet Health Services executives cannot exceed the average market salary increase reported for executives by the consultant. The compensation committee then reviews and approves compensation adjustments based on the information provided by the outside consultants and the Board of Directors' recommendations. For certain physicians, the majority of pay disclosed is for his/her work as a physician. A small stipend is added for serving on the Board of Directors. The following is a description of how pay for physicians' patient care work is determined. The Park Nicollet Health Services' Board of Directors is responsible for the implementation and oversight of the physician compensation and benefit plans. The Board of Directors delegates the day-to-day administration of the physician compensation plan to the Clinical Board of Governors and the Physician Compensation and Benefits Subcommittee. The purpose of the Physician Compensation and Benefits Subcommittee is to oversee physician and other clinician compensation and benefits plans and administration within the budget to ensure fairness and alignment with Park Nicollet Health Services' goals. The responsibilities of this committee include: Recommending of compensation policies and plan designs for physicians to the clinical board and Board of Directors; Overseeing compensation plan operation and payments to clinical departments; Evaluating compensation plan for performance on a periodic basis; Serving as final appeal process for issues unresolved by individuals, department chairs and chiefs of services. Annually, information on each physician's pay and productivity is graphed against the survey results for the same year. This information is presented to the compensation committee of the Park Nicollet Health Services Board of Directors for review. Park Nicollet Health Services' physician pay program is designed to ensure market based pay for market based productivity standards. The market is determined by the American Medical Group Association (AMGA) national physician compensation survey data, which provides market data for both compensation and productivity. When appropriate, the Clinic Compensation and Benefit Subcommittee grants adjustments to these guidelines with evidence of local market data. Form 990, Part VI, Section C, line 19 Park Nicollet Health Services governing documents, conflict of interest policy and financial statements are available to the public upon request. Park Nicollet Health Services mails its consolidated audited financial statements to financial institutions, governmental institutions, board members, media representatives, vendors, and the Minnesota Hospital Association (MHA). Park Nicollet Health Services discloses quarterly financial statements to bondholders. The annual audited and quarterly financial statements are also posted at emma.msrb.org. The forms 990 are available upon request or from the state of Minnesota or at Guidestar.org. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized losses on investments: -592. Post Retirement Obligation -277,059. Prior Period Adjustments - TRIA Orthopaedic Center LLC -42,592,215. Fund Balance Transfer of PN Assurance -81,570. Tria Capital Contribution 50,594,727. Total to Form 990, Part XI, Line 5: 7,643,291. Election: Pursuant to Treasury Reg Section 1.6033-2(d)(5), Park Nicollet Health Services has elected to report information about contributions, gifts & grants, compensation, and other information about officers, directors, trustees, key employees, former employees, certain other highly paid employees, certain professional contractors, and certain other contractors on a consolidated basis for all members of the group, including the parent organization, on the group return of Park Nicollet Group Return (EIN 45-5023260). TRIA Orthopaedic Center LLC 8100 Northland Drive Bloomington MN 55431 200034003 Health Care MN 6661622 39768298 Park Nicollet Health Services Deferred Compensation Trust 6500 Excelsior Blvd St Louis Park MN 55426 411809020 Investments MN 0 1715361 Park Nicollet Health Services Park Nicollet Methodist Hospital 6500 Excelsior Blvd St Louis Park MN 55426 410132080 Health Care MN 501(c)(3) 3 Park Nicollet Health Services 1 Park Nicollet Foundation 6500 Excelsior Blvd St Louis Park MN 55426 237346465 Grants to serve the community MN 501(c)(3) 7 Park Nicollet Health Services 1 Park Nicollet Clinic 3800 Park Nicollet Blvd St Louis Park MN 55416 410834920 Health Care MN 501(c)(3) 3 Park Nicollet Health Services 1 Park Nicollet Institute 3800 Park Nicollet Blvd St Louis Park MN 55416 410961862 Health Care Research MN 501(c)(3) 4 Park Nicollet Health Services 1 Park Nicollet Health Care Products 3800 Park Nicollet Blvd St Louis Park MN 55416 010638901 Health Care Products MN 501(c)(3) 11 Type II Park Nicollet Health Services 1 PNMC Holdings 3800 Park Nicollet Blvd St Louis Park MN 55416 411741792 Health Care Real Estate MN 501(c)(3) 11 Type I Park Nicollet Clinic 1 TRIA Orthopaedic Center Research Institute 8100 Northland Drive Bloomington MN 55431 200033919 Health Care Research and Education MN 501(c)(3) 11 Type I Park Nicollet Health Services 1 Methodist Brain Lab Leasing LLC 6500 Excelsior Blvd St Louis Park MN 55426 208725994 Health Care MN Park Nicollet Methodist Hospital N/A 0 0 Park Nicollet Health Services Investment Partnership 6500 Excelsior Blvd St Louis Park MN 55426 411675033 Investments MN Park Nicollet Methodist Hospital N/A 0 0 Park Nicollet Enterprises 6500 Excelsior Blvd St Louis Park MN 55426 411656735 Real Estate for Related Organization MN Park Nicollet Health Services C 4344896 18297451 1.00000 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 Park Nicollet Health Care Products R 43388766 Cost Park Nicollet Health Care Products K 1109180 Cost Park Nicollet Health Care Products P 106533418 Cost Park Nicollet Enterprises P 4277151 Cost Park Nicollet Methodist Hospital R 458171394 Cost Park Nicollet Methodist Hospital P 555218625 Cost Park Nicollet Methodist Hospital O 64765 Cost Park Nicollet Methodist Hospital J 987612 Cost Park Nicollet Methodist Hospital K 7199880 Cost Park Nicollet Institute P 9915232 Cost Park Nicollet Institute K 1624090 Cost Park Nicollet Institute R 7462752 Cost Park Nicollet Clinic P 441713363 Cost Park Nicollet Clinic K 9163645 Cost Park Nicollet Clinic R 562654767 Cost Park Nicollet Clinic J 3157600 Cost Park Nicollet Methodist Hospital (TRIA) O 237953 Cost Park Nicollet Methodist Hospital (TRIA) L 1916325 Cost Park Nicollet Methodist Hospital (TRIA) Q 835630 Cost Park Nicollet Health Care Products (TRIA) O 862784 Cost Park Nicollet Health Care Products (TRIA) Q 415449 Cost Park Nicollet Clinic (TRIA) Q 21874512 Cost Park Nicollet Clinic (TRIA) O 19657848 Cost Park Nicollet Enterprises (TRIA) O 2260921 Cost Park Nicollet Enterprises (TRIA) J 2078148 Cost Park Nicollet Enterprises (TRIA) R 2155886 Cost TRIA Orthopaedic Center Research Institute (TRIA) I 214203 Cost TRIA Orthopaedic Center Research Institute (TRIA) Q 69000 Cost Park Nicollet Health Services incurs lobbying expenses on behalf of Park Nicollet Methodist Hospital, Park Nicollet Institute, Park Nicollet Health Care Products and Park Nicollet Clinic. Other exempt expenses relate to the management expenses incurred by Park Nicollet Health Services on behalf of each entity. Park Nicollet Health Services 6500 Excelsior Boulevard St Louis Park MN 55416 363465840 X 0 191800 191800 107819 299619 59924 14981 0 131876 0 Park Nicollet Methodist Hospital 6500 Excelsior Boulevard St Louis Park MN 55416 410132080 0 0 0 33697492 33697492 1000000 250000 0 0 0 Park Nicollet Clinic 3800 Park Nicollet Boulevard St Louis Park MN 55416 410834920 0 0 0 43202125 43202125 1000000 250000 0 0 0 Park Nicollet Health Care Products 3800 Park Nicollet Boulevard St Louis Park MN 55416 010638901 0 0 0 1235768 1235768 198577 49644 0 0 0 Park Nicollet Institute 3800 Park Nicollet Boulevard St Louis Park MN 55416 410961862 0 0 0 4694260 4694260 384713 96178 0 0 0 PNMC Holdings 3800 Park Nicollet Boulevard St Louis Park MN 55416 411741792 0 0 0 0 0 0 0 0 0 0