2012-09-11T10:58:02-05:00 2011-12-31 390758449 WIPFLI LLP 7601 FRANCE AVENUE SOUTH SUITE 400 MINNEAPOLIS MN 55435 990 2011-01-01 411518013 CRITICAL CARE SERVICES INC DBA LIFE LINK III CRIT 6126384900 3010 BROADWAY STREET NE MINNEAPOLIS MN 554131768 ROBERT SANNERUD 6126384900 2012-09-06 1 RICHARD RUVELSON P00234075 9525483400 2012-09-06 2011 2016-02-24 21:20:13Z EDWARD R EROE 3010 BROADWAY STREET NE MINNEAPOLIS MN 554131768 26104573 0 X WWW.LIFELINKIII.COM X 1985 MN TO PROVIDE EXCELLENT MEDICAL CARE AND TRANSPORTATION SERVICES FOR PATIENTS 15 0 231 15 -451 -451 0 0 31794384 25657655 244 272283 -20816 -1531 31773812 25928407 0 0 0 0 11245068 8360892 0 0 0 18788860 17640573 30033928 26001465 1739884 -73058 13461490 12095755 4844684 3552007 8616806 8543748 X THE MISSION OF LIFE LINK III IS TO PROVIDE COMFORT AND THE HIGHEST QUALITY OF LIFE-SAVING CARE TO THE ILL AND INJURED THROUGH SAFE, APPROPRIATE AND RAPID TRANSPORTATION. LIFE LINK III WILL BE THE AREA'S PREFERRED PROVIDER OF AIR AND GROUND MEDICAL TRANSPORTATION, AND WILL ACCOMPLISH THIS BY SETTING, HOLDING AND ENHANCING THE STANDARD FOR EXCELLENCE IN PATIENT CARE, TRANSPORTATION AND INDUSTRY LEADERSHIP. 0 1 16415743 19708454 ROTOR WING SERVICES - PROVIDES AIR TRANSPORTATION OF PATIENTS REQUIRING MEDICAL CARE IN HELICOPTERS CONFIGURED FOR MOBILE INTENSIVE CARE - 2,082 TRANSPORTS. SEE SCHEDULE O. 1745826 2230269 FIXED WING SERVICES - PROVIDES AIR TRANSPORTATION OF PATIENTS REQUIRING MEDICAL CARE IN AIRPLANES CONFIGURED FOR MOBILE INTENSIVE CARE - 238 TRANSPORTS. SEE SCHEDULE O. 3275709 3390520 GROUND SERVICES - PROVIDES GROUND TRANSPORTATION OF PATIENTS REQUIRING MEDICAL CARE IN VEHICLES CONFIGURED AS AMBULANCE 5,290 TRANSPORTS AND PROVIDES GROUND TRANSPORTATION FOR WHEELCHAIR BOUND PATIENTS - 1,892 TRANSPORTS. SEE SCHEDULE O. 31254 328412 IN ADDITION TO THE COMMUNITY AND HEALTHCARE-RELATED EVENTS, FOR 24 YEARS LIFE LINK III HAS PRESENTED THE TRAUMA TACTICS(SM) CONFERENCE. ANNUALLY, THIS CONFERENCE PROVIDES HIGH QUALITY CONTINUING EDUCATION WITH EXCEPTIONAL SPEAKERS AND SPECIAL GUESTS FOR 200+ EMERGENCY SERVICE AND FIRST RESPONDER PERSONNEL FROM MINNESOTA, WISCONSIN AND SURROUNDING STATES. TRAUMA TACTICS(SM) IS DESIGNED TO ENHANCE THE SKILLS OF PROVIDERS OF ALL LEVELS, FROM RESCUE AND PRE-HOSPITAL SITUATIONS TO TRANSPORT AND IN-HOSPITAL TREATMENT.MEMBERSHIP FEES ARE GENERALLY ASSESSED ONLY AS ORGANIZATIONS JOIN AS MEMBERS. 2011 MEMBERSHIP FEES REPRESENT THE THIRD OF THREE PAYMENTS FOR ST. LUKE'S HOSPITAL OF DULUTH. 31254 328412 21468532 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 57 0 231 1 1 1 0 0 0 0 0 0 0 0 0 X 15 0 0 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X ROBERT SANNERUD CFO 6126384900 3010 BROADWAY STREET NE MINNEAPOLIS MN 554131768 X DAVID DRIES MD 1.00 X 0 0 0 DAVID MILLER 1.00 X 0 322741 62864 DR ANDREA LAMPLAND 1.00 X 0 0 0 DR STEVEN EYER 1.00 X 0 0 0 GRETCHEN LEITERMAN 1.00 X 0 0 0 JAMES WUELLNER 1.00 X 0 315369 82655 JEFFREY PETERSON 1.00 X 0 981752 283012 JIM DAVIS 1.00 X 0 380588 31628 JIM LESTE 1.00 X 0 137525 29375 JO ANN HOAG 2.00 X X 0 271935 60031 JOHN DOHERTY 2.00 X X 0 394760 51957 JOHN FOLSTAD 2.00 X X 0 160427 31878 MICHAEL HARRISTHAL 2.00 X 0 194586 31027 MICHAEL MCAVOY 1.00 X 0 0 0 WILLIAM HEEGAARD MD 1.00 X 0 0 0 SHAWN DRYDEN 1.00 X 0 102536 17086 EDWARD R EROE 40.00 X 45422 0 1500 R CARTER MCCOMB 37.00 X 132677 0 0 RICK L RAMBO 40.00 X 360312 0 11752 ROBERT SANNERUD 40.00 X 141390 0 23847 STACEY BREWERS 36.00 X 132736 0 9220 WILLIAM SCHNEIDER 36.00 X 114003 0 13445 KRISTIN BRAND 40.00 X 104193 0 9163 THOMAS MAYO 36.00 X 101147 0 6962 1131880 3262219 757402 8 0 1 0 AIR METHODS CORPORATION 7211 SOUTH PEORIA ENGLEWOOD CO 80112 AIRCRAFT, PILOTS AND MECHANICS 8099385 CLUB JET 17957 BEARPATH TRAIL EDEN PRAIRIE MN 55347 AIRCRAFT, PILOTS AND MECHANICS 1505270 EMERGENCY APPARATUS MAINTENANCE 7512 4TH AVENUE LINO LAKES MN 55014 AMBULANCE REPAIR 187578 K&E CONSULTING INC 1541 OAKVIEW COURT LINO LAKES MN 55038 TECHNOLOGY SUPPORT AND MAINT 155230 FAEGRE & BENSON LLP 90 SOUTH SEVENTH STREET STE 2200 MINNEAPOLIS MN 55402 LEGAL SERVICES 146073 9 ROTOR WING SERVICE 621910 19708454 19708454 GROUND SERVICE (DISCON 621910 3390520 3390520 FIXED WING SERVICE 621910 2230269 2230269 MEMBERSHIP FEE 900099 293333 293333 EDUCATION SERVICES 541900 35079 35079 25657655 33105 33105 67776 69307 -1531 -1531 -451 -1080 346037 106859 239178 239178 239178 25928407 25657655 -451 271203 716900 716900 6321064 5157606 1163458 74554 65354 9200 693206 580896 112310 555168 406246 148922 201113 201113 63312 63312 1059058 9040 1050018 123427 123427 1193952 1018849 175103 9483 9483 10207061 10125420 81641 1037264 943115 94149 29531 2567 26964 32188 32188 603192 259012 344180 240499 135842 104657 BAD DEBT EXPENSE 2428714 2428714 MEDICAL SUPPLIES 317243 282545 34698 MISCELLANEOUS 54987 13777 41210 MINNESOTA CARE TAX 39549 39549 26001465 21468532 4532933 0 3149680 -185571 87777 4326556 4709855 2723989 45497 361268 138601 101170 408641 248317 7628850 4827749 3197294 2801101 1724145 1718925 13461490 12095755 2180873 2288893 7487 2628 490358 2120966 1260486 45000 0 4844684 3552007 X 8616806 8543748 8616806 8543748 13461490 12095755 -73058 0 X X 0 1 1 X 0 X X 0 0 0 ALLINA HEALTH SYSTEM 363261413 3 1 0 1 0 CHILDREN'S HEALTH CARE 411754276 3 1 0 1 0 HENNEPIN HEALTHCARE SYSTEM INC 421707837 3 1 0 1 0 REGIONS HOSPITAL 410956618 3 1 0 1 0 FAIRVIEW HEALTH SERVICES 410991680 3 1 0 1 0 CENTRA CARE HEALTH SYSTEM 411813221 3 1 0 1 0 SACRED HEART HOSP OF THE HOSPITAL SISTERS OF THE 3RD ORDER OF ST FRANCIS 390807060 3 1 0 1 0 ST LUKE'S HOSPITAL OF DULUTH 410714079 3 1 0 1 0 ST MARY'S MEDICAL CENTER 410695604 3 1 0 1 0 9 0 0 0 0 0 0 0 0 0 1 6503 6503 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: LOBBYING EXPENSES IDENTIFIED AS A PERCENTAGE OF MEMBERSHIP DUES FOR AMERICAN AMBULANCE ASSOCIATION, MINNESOTA AMBULANCE ASSOCIATION, MINNESOTA SAFETY COUNCIL, WISCONSIN EMS ASSOCIATION, AAMS, AND ASSOCIATION FOR CRITICAL CARE TRANSPORT. 300000 300000 2657945 1036369 1621576 4666669 3787144 879525 4236 4236 0 2801101 25928407 26001465 -73058 -73058 21625961 69307 69307 21556654 4371753 4371753 25928407 21992352 69307 69307 21923045 4078420 4078420 26001465 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, ASC TOPIC 740-10, INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. MANAGEMENT DOES NOT BELIEVE THE ORGANIZATION HAS ANY MATERIAL UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS. THE ORGANIZATION'S FEDERAL RETURNS FOR TAX YEARS 2008 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NET AGAINST RENTAL REVENUE 69,307. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROGRAM EXPENSES FROM DISCONTINUED OPERATIONS 4,078,420. MEMBERSHIP FEE 293,333. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NET AGAINST RENTAL REVENUE 69,307. PART XIII, LINE 4B - OTHER ADJUSTMENTS: PROGRAM EXPENSES FROM DISCONTINUED OPERATIONS 4,078,420. NORTH AMERICA - CANADA AND MEXICO, BUT 0 1 PROGRAM SERVICES MEDICAL AIR TRANSPORT. 53451 0 1 0 0 0 1 53451 0 53451 0 0 0 0 0 0 X X 1 0 0 0 0 0 0 0 0 DAVID MILLER 0 218219 0 67242 0 37280 0 56668 0 6196 0 385605 0 2166 JAMES WUELLNER 0 291990 0 0 0 23379 0 0 0 82655 0 398024 0 364197 JEFFREY PETERSON 0 563498 0 286599 0 131655 0 248995 0 34017 0 1264764 0 92326 JIM DAVIS 0 278990 0 52884 0 48714 0 15380 0 16248 0 412216 0 0 JIM LESTE 0 137525 0 0 0 0 0 4223 0 25152 0 166900 0 0 JO ANN HOAG 0 217016 0 0 0 54919 0 0 0 60031 0 331966 0 276576 JOHN DOHERTY 0 323460 0 71300 0 0 0 19116 0 32841 0 446717 0 0 JOHN FOLSTAD 0 160427 0 0 0 0 0 11068 0 20810 0 192305 0 0 MICHAEL HARRISTHAL 0 194586 0 0 0 0 0 14411 0 16616 0 225613 0 0 RICK L RAMBO 143967 0 0 0 216345 0 0 0 11752 0 372064 0 0 0 ROBERT SANNERUD 120971 0 20419 0 0 0 4186 0 19661 0 165237 0 0 0 PART I, LINE 4A RICK L. RAMBO, INTERIM CEO - $216,345 R CARTER MCCOMB CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION 132677 THEN INTERIM CEO, R. CARTER MCCOMB HAD AN OWNERSHIP INTEREST IN ADVANCES IN MEDICINE WHICH PROVIDED CONTRACTED MANAGEMENT SERVICES. 0 CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 IN 2011 CRITICAL CARE SERVICES, INC. PUBLISHED AN RFP FOR THE SALE OF ITS GROUND OPERATIONS IN MINNEAPOLIS, MN AND ST. CROIX FALLS, WI. THE RFP RESULTED IN THE SUCCESSFUL SALE (SEPTEMBER 6, 2011) OF THE ST. CROIX FALLS, WI EMERGENCY 911 AMBULANCE SERVICES TO A CONSORTIUM FORMED BY THE LOCAL HOSPITAL AND AN AREA AMBULANCE PROVIDER. THE RFP RESULTED IN THE CLOSURE OF THE MINNEAPOLIS-BASED INTERFACILITY GROUND AMBULANCE (JUNE 30, 2011) AND STS OPERATIONS (JULY 28, 2011) AS NO VIABLE OFFERS WERE RECEIVED FOR THOSE OPERATIONS. ADDITIONAL INFORMATION: FORM 990, PART III HELICOPTER TRANSPORTATION SERVICES LIFE LINK III PROVIDES HELICOPTER AIR MEDICAL TRANSPORTATION INCLUDING ON-SCENE EMERGENCY RESPONSE AND INTER-FACILITY TRANSPORT, 24 HOURS A DAY, 365 DAYS A YEAR. WITH HELICOPTER BASES THROUGHOUT MINNESOTA AND WESTERN WISCONSIN, LIFE LINK III TRANSPORTS ALL TYPES OF CRITICALLY ILL OR INJURED PATIENTS. AIRPLANE TRANSPORTATION SERVICES LIFE LINK III PROVIDES AIRPLANE AMBULANCE TRANSPORTATION THROUGHOUT THE UNITED STATES, AND INTERNATIONALLY, 24 HOURS A DAY, 365 DAYS A YEAR. LIFE LINK III HAS A DEDICATED, MEDICALLY-CONFIGURED AIRPLANE READY AT ALL TIMES AND HAS ACCESS TO A FLEET OF OTHER AIRCRAFT FOR ADDITIONAL SUPPORT TO TRANSPORT ALL TYPES OF ILL OR INJURED PATIENTS. GROUND AMBULANCE TRANSPORTATION SERVICES THRU JUNE OF 2011, LIFE LINK III PROVIDED BASIC LIFE SUPPORT (BLS), ADVANCED LIFE SUPPORT (ALS) AND CRITICAL CARE TRANSPORTATION SERVICES VIA GROUND AMBULANCE, 24 HOURS A DAY. LIFE LINK III WORKS WITH TWIN CITIES AND OUTSTATE HOSPITALS TO PROVIDE CARE AND TRANSPORT FOR ALL TYPES OF ILL AND INJURED PATIENTS. EDUCATION AND SAFETY LIFE LINK III'S GROUND AMBULANCE, AIRPLANE AND HELICOPTER TRANSPORTATION SERVICES ARE ACCREDITED BY THE COMMISSION ON ACCREDITATION OF MEDICAL TRANSPORT SYSTEMS (CAMTS), WHICH REFLECTS THE ORGANIZATION'S COMMITMENT TO MEETING OR EXCEEDING THE HIGHEST STANDARDS IN PATIENT CARE, QUALITY AND SAFETY. THERE ARE OVER 140 CAMTS ACCREDITED SERVICES NATIONALLY AT THE END OF 2011. LIFE LINK III IS ONE (1) OF 26 MEDICAL TRANSPORTATION SERVICES NATIONALLY THAT ARE CAMTS ACCREDITED FOR ALL THREE MODES OF TRANSPORTATION. LIFE LINK III PROVIDES OUTREACH EDUCATION AND TRAINING TO PRE-HOSPITAL AND HOSPITAL HEALTHCARE PROVIDERS COVERING SUCH TOPICS AS HELICOPTER LANDING ZONE SET UP, SCENE SAFETY, PATIENT TRANSPORT PREPARATION AND OTHER PATIENT CARE TOPICS. LIFE LINK III ACTIVELY PARTICIPATES WITH THE COMMUNITIES IT SERVES, INCLUDING PUBLIC, INFORMATIONAL, SCHOOL, INJURY PREVENTION AND COMMUNITY EVENTS. IN 2011 THE ORGANIZATION DONATED APPROXIMATELY 1300 HOURS OF CLINICIAN TIME, 490 HOURS OF PILOT TIME AND 154 HOURS OF AIRCRAFT TIME FOR 242 SEPARATE COMMUNITY AND HEALTHCARE-RELATED EVENTS AND TRAININGS. THE 25 OUTREACH EDUCATION PROGRAMS TRAINED APPROXIMATELY 550 EMS AND COMMUNITY-BASED MEDICAL AND FIRST RESPONDERS. FINANCIAL ASSISTANCE LIFE LINK III MAINTAINS A PROGRAM THAT WE CALL COMMUNITY CARE. THAT PROGRAM PROVIDES CARE FOR THOSE WHO ARE UNINSURED OR UNABLE TO AFFORD THE COST OF SERVICES. WE MAINTAIN RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE WE PROVIDE UNDER THIS PROGRAM. APPLICANTS FOR OUR CHARITY CARE PROGRAM ARE REQUESTED TO PROVIDE CURRENT AND PRIOR YEAR INCOME INFORMATION. WE USE INCOME-BASED CRITERIA IN OUR DETERMINATION OF CHARITY CARE AND USE THE FEDERAL POVERTY GUIDELINES ESTABLISHED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES IN DETERMINATION OF ELIGIBILITY. IN 2011 THE COST OF PROVIDING CARE TO PATIENTS UNDER THIS PROGRAM TOTALED APPROXIMATELY $243,000. PATIENT RECEIVABLES AND CREDIT POLICY PATIENT ACCOUNTS RECEIVABLE ARE UNCOLLATERALIZED PATIENT OBLIGATIONS THAT ARE STATED AT THE AMOUNT MANAGEMENT EXPECTS TO COLLECT FROM OUTSTANDING BALANCES. THESE OBLIGATIONS ARE PRIMARILY FROM LOCAL RESIDENTS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYER AGREEMENTS. THE ORGANIZATION BILLS THIRD-PARTY PAYERS ON THE PATIENTS' BEHALF, OR IF A PATIENT IS UNINSURED, THE PATIENT IS BILLED DIRECTLY. ONCE CLAIMS ARE SETTLED WITH THE PRIMARY PAYER, ANY SECONDARY INSURANCE IS BILLED, AND PATIENTS ARE BILLED FOR COPAY AND DEDUCTIBLE AMOUNTS THAT ARE THE PATIENTS' RESPONSIBILITY. PAYMENTS ON PATIENT ACCOUNTS RECEIVABLE ARE APPLIED TO THE SPECIFIC CLAIM IDENTIFIED ON THE REMITTANCE ADVICE OR STATEMENT. LIFE LINK III DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS. THE CARRYING AMOUNTS OF PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES THAT REFLECT MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT PROVIDES FOR CONTRACTUAL ADJUSTMENTS UNDER TERMS OF THIRD-PARTY REIMBURSEMENT AGREEMENTS THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNT RECEIVABLES. IN ADDITION, MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IT IS UNKNOWN HOW MUCH BAD DEBT EXPENSE, IF ANY, REASONABLY COULD BE ATTRIBUTABLE TO PERSONS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER OUR COMMUNITY CARE PROGRAM. FORM 990, PART VI, SECTION A, LINE 3 THROUGH JUNE 23, 2011, THE CEO POSITION WAS CONTRACTED OUT TO AN OUTSIDE INDIVIDUAL. FORM 990, PART VI, SECTION A, LINE 6 THERE IS ONE CLASS OF MEMBER. LIFE LINK III OPERATES AS A NON-PROFIT CONSORTIUM WITH NINE MEMBERS, INCLUDING: ALLINA HEALTH SYSTEM, CHILDREN'S HEALTH CARE, HENNEPIN HEALTHCARE SYSTEM INC, REGIONS HOSPITAL, FAIRVIEW HEALTH SERVICES, CENTRACARE HEALTH SYSTEM, SACRED HEART HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS, ST. LUKE'S HOSPITAL OF DULUTH, INC., ESSENTIA - ST. MARY'S MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A ALL MEMBERS ARE ENTITLED TO APPOINT TWO PERSONS TO THE BOARD OF DIRECTORS AND UPON DISSOLUTION OF THE ORGANIZATION, SHARE EQUALLY IN ANY SURPLUS PROPERTY. FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS REVIEWED IN DETAIL BY THE CHIEF FINANCIAL OFFICER (CFO). THE CFO PROVIDES A DRAFT OF THE FORM TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW. THE BOARD OF DIRECTORS THEN RECEIVES A DRAFT AND APPROVES PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO ANNUALLY COMPLETE AND SIGN THE CONFLICT OF INTEREST STATEMENT. THE SIGNED STATEMENTS REMAIN ON FILE WITH THE ORGANIZATION'S CEO FOR THE FISCAL (CALENDAR) YEAR. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION FOR THE CEO WAS ESTABLISHED AS PART OF A NATIONAL SEARCH FOR A NEW CEO. THE SEARCH COMMITTEE OF THE BOARD RELIED ON AN OUTSIDE NATIONAL RECRUITMENT FIRM TO GATHER RELEVANT MARKET DATA TO ESTABLISH COMPENSATION COMPARISONS, DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT, THE 2010 HHRAM EXECUTIVE COMPENSATION SURVEY (MOST RECENT AVAILABLE), AND IN CONSIDERATION OF THE NEEDS OF THE ORGANIZATION CONSISTENT WITH THE DIRECTION OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 15B: FOR ALL OTHER OFFICERS AND KEY EMPLOYEES, THE DIRECTOR OF HUMAN RESOURCES IDENTIFIES AND OBTAINS COMPENSATION SURVEYS, INDUSTRY AND MARKET DATA, AND OTHER EXTERNAL COMPETITIVE INFORMATION SOURCES FOR EVALUATION. THIS INFORMATION IS EVALUATED AND CONSIDERED IN THE CONTEXT OF THE JOB DESCRIPTION AND POSITION SKILLS AND EXPERIENCE REQUIREMENTS BY THE DIRECTOR OF HUMAN RESOURCES AND THE CEO TO DEVELOP A COMPENSATION RANGE TO BE USED IN THE HIRING PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE IN THE CARE OF THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER AND ARE AVAILABLE FOR INSPECTION UPON REQUEST AT THE ORGANIZATION'S OFFICE. FORM 990, PART VII, SECTION A: R. CARTER MCCOMB WAS HIRED AS A CONTRACTED INTERIM CEO. R. CARTER MCCOMB NO LONGER SERVES AS THE CEO. FORM 990, PART VII, SECTION A, COLUMN B: BOARD MEMBERS RECEIVING COMPENSATION FROM RELATED SUPPORTED ORGANIZATIONS ARE EMPLOYEES OF THOSE ENTITIES AND/OR THEIR AFFILIATES. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE AND BOARD OF DIRECTORS HAVE OVERSIGHT OF THE FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. CENTRA CARE HEALTH SYSTEM 1406 SIXTH AVENUE NORTH ST CLOUD MN 563031901 411813221 HOSPITAL MN 501(C)(3) LINE 3 0 ALLINA HEALTH SYSTEM PO BOX 43 MR 10890 MINNEAPOLIS MN 554400043 363261413 HOSPITAL MN 501(C)(3) LINE 3 0 CHILDREN'S HEALTH CARE 2525 CHICAGO AVENUE SOUTH MINNEAPOLIS MN 554041844 411754276 HOSPITAL MN 501(C)(3) LINE 3 0 HENNEPIN HEALTHCARE SYSTEM INC 701 PARK AVENUE MINNEAPOLIS MN 55415 421707837 HOSPITAL MN 501(C)(3) LINE 3 0 REGIONS HOSPITAL 640 JACKSON STREET ST PAUL MN 55101 410956618 HOSPITAL MN 501(C)(3) LINE 3 0 FAIRVIEW HEALTH SERVICES 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 410991680 HOSPITAL MN 501(C)(3) LINE 3 0 SACRED HEART HOSP OF THE HOSPITAL SISTERS OF THE 3RD ORDER OF ST FRANCIS 1110 OAK RIDGE DRIVE EAU CLAIRE WI 547016133 390807060 HOSPITAL MN 501(C)(3) LINE 3 0 ST LUKE'S HOSPITAL OF DULUTH 915 EAST FIRST STREET DULUTH MN 55805 410714079 HOSPITAL MN 501(C)(3) LINE 3 0 ST MARY'S MEDICAL CENTER 407 EAST THIRD STREET DULUTH MN 55805 410695604 HOSPITAL MN 501(C)(3) LINE 3 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 ALLINA HEALTH SYSTEM K 229629 COST FAIRVIEW HEALTH SERVICES K 215687 COST ALLINA HEALTH SYSTEM L 121539 COST CHILDRENS HEALTH CARE L 112881 COST FAIRVIEW HEALTH SERVICES L 155081 COST HENNEPIN HEALTHCARE SYSTEM INC L 124772 COST REGIONS HOSPITAL L 159004 COST CENTRACARE HEALTH SYSTEM L 110610 COST ST MARY'S MEDICAL CENTER L 200000 COST ST LUKE'S HOSPITAL OF DULUTH C 293333 COST CHILDRENS HEALTH CARE K 56676 COST