FAIRVIEW HEALTH SERVICES: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
FAIRVIEW HEALTH SERVICES (EIN 41-0991680)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201243189349300939
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-13T08:53:18-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line150 SOUTH SIXTH ST STE 2800AddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55402ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN410991680EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1FAIRVIEW HEALTH SERVICESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlFAIRNameControl
Phone6126724976Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12450 RIVERSIDE AVENUEAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55454ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCHARLES MOOTYName
TitleINTERIM CHIEF EXECUTIVE OFFICERTitle
Phone6126724976Phone
Date Signed2012-11-13DateSigned
Authorize Third Party0AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKristina RasmussenName
PTINP00143920PTIN
Phone6123974000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCHARLES MOOTYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12450 RIVERSIDE AVENUEAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55454ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3002366863GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.fairview.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1906YearFormation
State Legal DomicileMNStateLegalDomicile
Activity Or Mission DescriptionTo improve the health of the communities we serve. See Schedule O.We commit our skills and resources to the benefit of the whole person by providing the finest in healthcare, while addressing the physical, emotional and spiritual needs of individuals and their families. We further pledge to support the research and education efforts of our partner, the University of Minnesota, and its tradition of excellence.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees18271TotalNbrEmployees
Total Nbr Volunteers2228TotalNbrVolunteers
Total Gross UBI198437727TotalGrossUBI
Net Unrelated Business Txbl Income-9882850NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4346740ContributionsGrantsPriorYear
Contributions Grants Current Year3830761ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2736032009ProgramServiceRevenuePriorYear
Program Service Revenue CY2580257082ProgramServiceRevenueCY
Investment Income Prior Year-18138464InvestmentIncomePriorYear
Investment Income Current Year-16523702InvestmentIncomeCurrentYear
Other Revenue Prior Year5298917OtherRevenuePriorYear
Other Revenue Current Year7561086OtherRevenueCurrentYear
Total Revenue Prior Year2727539202TotalRevenuePriorYear
Total Revenue Current Year2575125227TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1750000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2112167GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1171068968SalariesEtcPriorYear
Salaries Etc Current Year1234045246SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1464137589OtherExpensePriorYear
Other Expenses Current Year1334452237OtherExpensesCurrentYear
Total Expenses Prior Year2636956557TotalExpensesPriorYear
Total Expenses Current Year2570609650TotalExpensesCurrentYear
Revenues Less Expenses Prior Year90582645RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4515577RevenuesLessExpensesCY
Total Assets BOY2564961247TotalAssetsBOY
Total Assets EOY2600633058TotalAssetsEOY
Total Liabilities BOY1431994180TotalLiabilitiesBOY
Total Liabilities EOY1487604088TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1132967067NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1113028970NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionFairview's mission is:To improve the health of the communities we serve. See Schedule O.We commit our skills and resources to the benefit of the whole person by providing the finest in healthcare, while addressing the physical, emotional and spiritual needs of individuals and their families. We further pledge to support the research and education efforts of our partner, the University of Minnesota, and its tradition of excellence. Fairview's Vision: To be the best health care delivery system for America, in partnership with the University of Minnesota.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense798565017Expense
Grants2112167Grants
Revenue2267255150Revenue
DescriptionProviding medical servicesFairview Health Services provides exceptional clinical care and patient experience within the full continuum of services in the system. Through its network of hospitals, clinics and ambulatory care programs, and its affiliation with the Academic Health Center of the University of Minnesota and University of Minnesota Physicians (the University faculty practice), Fairview provides the entire continuum of healthcare services in a coordinated and cost-effective manner to both urban and rural communities. See Schedule O.Fairview also has a full continuum of health care services, including primary and specialty care clinics, physical therapy/sports medicine, retail pharmacies, home care and hospice, long-term care and more. The healthcare services which Fairview provides to the community include but are not limited to: primary, specialty, tertiary and quatenary care, hospital and physician services, senior services, home care and hospice, pharmacy, children's health care, therapy, behavioral and other services. In addition to the 1,558,221 patient care encounters in 2011, Fairview personnel experienced over 800,000 encounters with the community at large, including low-income populations as well as education and media encounters for special needs groups and other community members. Fairview's mission is to improve the health of the communities it serves. Medical services which Fairview provides to the community include: arthritis services, assisted living, battered women support services, behavioral services, bone marrow transplants, cancer care, children's health care services, chronic care services, complementary medicine, diabetes services, education, emergency services, heart health services, home health care, hospice, infusion therapy, inpatient and outpatient mental health and chemical dependency services, maternal/child health, multiple sclerosis services, neurosciences, nutrition and weight management services, pharmacy services, radiology and imaging, rehabilitation services, respiratory care services, skilled nursing care, solid organ transplants, senior services, social work services, support groups and services for various health issues, surgical services, urgent care, volunteer opportunities, walking programs and wound care.Services are offered at the following locations: Fairview Southdale Hospital, located in Edina, Minnesota is a multi-specialty medical center rated by HealthGrades as the number one hospital in Minnesota for heart and stroke care in 2011. Southdale was also five-star rated in 2011 in 15 areas including Critical Care, Pulmonary Services, Joint Replacement, and Total Knee Replacement. University of Minnesota Amplatz Children's Hospital is located in Minneapolis, Minnesota on the campus of the University of Minnesota Medical Center. UMACH provides a broad spectrum of pediatric programs and services -- ranging from pediatric general surgery, imaging and neonatal and pediatric intensive care to cardiac and oncology services and blood and marrow and organ transplantation. The hospital is also home to Minnesota's only children's behavioral inpatient unit with programming exclusively devoted to children ages 12 and younger. The University of Minnesota Medical Center, Fairview in Minneapolis, is one of the most respected teaching institutions in the nation, balancing responsiveness to patient needs and wishes with access to innovative treatments and technology to deliver superior health outcomes. As the core teaching hospital of the University of Minnesota Medical School, the medical center focuses on patient care, which is congruent with the medical school's mission of research and education. Fairview serves as a training site for residents in various specialties and is the core teaching site for the University of Minnesota residents. Senior residents and fellows provide Fairview some degree of clinical service that we would otherwise not receive. University of Minnesota Medical Center includes outpatient and inpatient facilities. Comprehensive services range from primary care, emergency care and the delivery of thousands of babies each year, as well as care of patients with the most complex medical conditions. Areas of specialization include solid organ and blood and marrow transplantation, heart disease, cancer, neurosciences, pediatrics, and behavioral illnesses. In 2011, UMMC was ranked on the U.S. New & World Report's "America's Best Hospitals" list among the top 50 hospitals in the United States in six specialties. Range Regional Health Services located in Hibbing, Minnesota, a related entity, provides advanced, high technology, inpatient and outpatient care. Mesabi combines the area's finest medical services to provide the most comprehensive health care system on the Iron Range and northeast Minnesota. Fairview Lakes Medical Center, located in Wyoming, Minnesota, takes a patient-focused and team-oriented approach to health care. This medical center offers inpatient and outpatient care to the surrounding community. Fairview Northland Regional Medical Center, located in Princeton, Minnesota, provides health care to communities ranging from Elk River north to Milaca. Fairview Red Wing Medical Center, a related subsidiary, combines a clinic and hospital into one state-of-the-art facility. Opened in 2001, the medical center has a 50-bed inpatient hospital care unit that includes intensive care and a birthing center. Clinic services include: primary family services, specialty medical and specialty surgical services, urgent and emergency care and rehabilitation services. This medical center also offers the latest in diagnostic tools, i.e. CT scan, MRI and full lab services. Red Wing Medical Center is a complete health care facility for patients throughout Goodhue and Pierce counties.Fairview Ridges Hospital, located in Burnsville, Minnesota is a multi-specialty medical center dedicated to taking care of you and your family. With more than 40 locations across the Twin Cities and Minnesota,Fairview Clinics aim to make primary care seamless for its patients. In 2011, more than 99 percent of Fairview patients rated the care they received as excellent and were so satisfied that they would recommend a Fairview clinic to their family or friends. Patients reported that the electronic medical record system has enhanced doctor-patient relationships. Information transfers are fast and direct. Fairview MyChart offers online access to providers and medical records.Fairview, in partnership with University of Minnesota Physicians, provides exceptional specialty care at the more than 50 specialty care clinics at the University of Minnesota Medical Center. Fairview operates other continuum services including: Fairview Home Care and Hospice, Fairview Home Medical Equipment, Fairview Pharmacy, Institute for Athletic Medicine, Fairview Rehabilitation Services, Fairview MS Achievement Center, Fairview Partners, Fairview Counseling Services, Fairview Care Management and Coordination, and subsidized health services.Fairview is committed to the health needs of the communities it serves. Fairview subsidizes some of the essential services and programs that operate at a loss, including hospice, palliative services and mental health services.For more information, visit www.fairview.org.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense911545046Expense
Revenue265185412Revenue
DescriptionCost of participating in government programsFairview is committed to serving the health care needs of members of its community. To support full access to services, Fairview participates in the following public health care programs: Medicare, Medicaid, MinnesotaCare and General Assistance Medical Care. Reimbursement from these programs for services rendered, generally falls below the cost of providing the care. To compensate for the under funding by government programs, Fairview makes a significant financial investment to offset these losses. See Schedule O.In 2011, Fairview incurred $48,906,363 of taxes and surcharges costs in health care services that exceeded the reimbursement received by public programs, surcharges, taxes and fees related to these programs and not including Medicare. The following is a breakdown on costs related to the cost of participating in government programs: Costs exceed Medicaid ReimbursementFairview is serving thousands of low-income individuals covered by Medical Assistance, General Assistance Medical Care and MinnesotaCare. Reimbursement from these programs is less than Fairview's cost of providing care to these patients. Total Medicaid costs were $289,551,029. The cost of the Medicaid Surcharge Minnesota Care tax to the hospitals ws $46,103,837.MinnesotaCare taxThe state of Minnesota levies a 2 percent tax on certain healthcare provider revenues. Money generated from this tax helps to defray the costs incurred from MinnesotaCare and other programs/services for uninsured individuals. In 2011, Fairview paid $28,569,213 in MinnesotaCare taxes. Taxes and feesFairview does pay some property tax to local and state government. This helps to fund civil and educational services in the community. These costs totaled $4,373,103.Costs exceed Medicare Reimbursement:Fairview cares for thousands of individuals ages 65 and older who are covered by Medicare. Fairview incurred $51,791,566 of Medicare reimbursement shortfalls. Reimbursement from Medicare is less than Fairview's cost of providing care to the patient. The total cost of providing these benefits was $373,229,306.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense106631448Expense
Revenue13444359Revenue
DescriptionThe primary purpose of the educational and research programs is to educate health professionals in the broader community. The programs of medical, general clinical and patient care research are designed primarily to benefit the community. Through its affiliation with the University, Fairview increased its focus and support on research and education. The University of Minnesota Medical Center, Fairview, Fairview Southdale Hospital and Fairview Ridges Hospital are the primary teaching sites for the residency program at the University of Minnesota.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense88533780Expense
Revenue34372161Revenue
DescriptionContinuation of Schedule HUncompensated careIn 2011, Fairview experienced a dramatic increase in uncompensated care, due to higher unemployment, loss of personal income and other economic factors. Fairview tracks financial contributions of this type in three categories: charity care, uninsured discount program and bad debt.Charity careFairview treats all patients with dignity and respect, regardless of their ability to pay. Fairview's Community Care program supports the mission to provide quality medical care to everyone in the community. To qualify for 100 percent of hospital expense to be assumed by Fairview, individual or family income must be at or below 275 percent of the Federal Poverty Guidelines. Fairview also offers Community Care Programs for Fairview Clinics, Fairview Home Care and Hospice and Fairview Pharmacy. In 2011, Fairview incurred $25,343,743 in costs associated with providing charity care to some of its patients. Uninsured hospital discount programFairview provides an upfront discount to uninsured patients for hospital and hospital-based clinic services that are medically necessary. This discount is automatically applied to the patient's bill. To qualify for this discount, patients or the account guarantor, must be uninsured and a Minnesota resident. Patients who receive the uninsured discount may also apply for Fairview's Hospital Community Care Program. In 2011, Fairview provided $16,153,707 in subsidized discounts to uninsured individuals. Fairview participates in various community activities that address health problems. Fairview provides numerous in-kind donations to individuals and other not-for-profit organizations to support community needs.Bad DebtFairview provides medical care to all those in need. There are instances when patients are unable or unwilling to pay for care received. When patient account balances go unpaid, the amounts are tracked as bad debt. In 2011, bad debt exceeded $47,036,330.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp88533780TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev34372161TotalOfOtherProgramServiceRev
Total Program Service Expense1905275291TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office1ForeignOffice
Foreign Activities1ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096903NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees18271NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account1ForeignFinancialAccount
Name Of Foreign CountryBDNameOfForeignCountry
Name Of Foreign CountryCJNameOfForeignCountry
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Excess Business Holdings0ExcessBusinessHoldings
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledMNStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1TODD SHERRILLBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6126724986TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1400 STINSON BLVD NEAddressLine1
CityMINNEAPOLISCity
StateMNState
ZIP Code55413ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (48 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
John Bjorklund MD
Director5.00X000
Jon R Campbell
Chairman/Director10.00X000X
Bobbie Daniels MD
Director5.00X000
Doug Dirks
Director5.00X000
Joanell Dyrstad
Secretary5.00X000X
Michael Fay
Director5.00X000
Buck Foot III
Director5.00X000
Ann Hengel
Director5.00X000
Carol Ley MD
Director5.00X000
Charles Mooty
Vice Chair-Director5.00X000X
Christopher P Nelson Rev
Director5.00X000
Kevin Nelson MD
Director5.00X000
Mark Paller MD
Director5.00X000
Joanne Lofgren Ploetz
Director5.00X000
Aaron Friedman MD
Director5.00X000
David Murphy
Director5.00X000
Karen Grabow
Director5.00X000
Connie G Weinman
Director5.00X000
Betsy Wergin
Director5.00X000
Mark Eustis
President & CEO50.00X13587200118045X
James Fox
CFO40.00611934033802X
Bradley Beard
President of Southdale40.00474574056660X
Daniel K Anderson
Sr. Operating Officer40.00607046048514X
Robert Beacher
President, Fairview Pharma40.00549455037077X
Paula Phillippe
Chief of Human Resources40.00478288072123X
Scott Wordelman
President & CEO- Red Wing40.00378387022497X
Mark Thomas
President & CEO of Ebeneze40.00405172031002X
George Chresand
Sr. VP & General Counsel40.00427963043339X
Beth Krehbiel
President, Ridges Hospital40.00346637036335X
Allen Vickers
VP Chief Audit Exec & Comp40.00242206023616X
Mark Hansberry
VP Strategic Planning40.00391116046876X
John Doherty
Sr. Operating Exec.40.00394760051957X
Terry Carroll
CIO40.00521138042300X
Richard Howard
Sr. VP40.00276177019715X
Steven A Borgstrom
VP, Treasurer40.0027580204003X
Mark Dixon
Pres.of South Region40.00628937043951X
Daniel M Fromm
CFO40.00518597034381X
Terry Martinson
Officer40.00402200034548X
David Moen
President of FPA40.0027495525903840912X
Carolyn Wilson
President of UMMC & UMAH40.0016713302415X
Deborah Demarais MD
President of CPMG40.00356949027871X
Kathleen Taranto
Sr. VP Patient Care40.00483246020683X
Steven Hill
Officer40.00479340013301X
David M Lindgren MD
Orthopedic Surgeon40.00726643031263X
William Omlie MD
Surgeon40.00687276023836X
Daniel Yoon MD
Surgeon40.00582031012128X
Todd Lindquist MD
Surgeon40.00605419036059X
John Rogers MD
Surgeon40.00474069016863X
FieldValueIRS element (for citing)
Total Reportable Comp From Org14126170TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs259038TotalReportableCompFrmRltdOrgs
Total Other Compensation1026072TotalOtherCompensation
Number Individuals GT100 K2319NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
U OF M PHYSICIANS #200
420 DELAWARE ST NEMINNEAPOLISMN55455MEDICAL/PHYSICIAN147762303
ACCRETIVE HEALTH INC
401 NORTH MICHIGAN AVE STE 2700CHICAGOIL60611REVENUE CYCLE CONSULTATION/MANAGEMENT15902117
HEALTH SYSTEMS COOP LAUNDRY
725 Minnehaha Avenue EST PAULMN55106LAUNDRY4678081
SODEXO MARRIOTT SERVICES
9801 WASHINGTONIAN BLVDGaithersburgMD20878NUTRITION MANAGEMENT CONSULTING3828932
CAROL CORPORATION
NW 5936 PO Box 1450MINNEAPOLISMN55485TECHNOLOGY SERVICES3157611
FieldValueIRS element (for citing)
Number Of Contractors GT100 K215NumberOfContractorsGT100K
Related Organizations3571805RelatedOrganizations
Government Grants258956GovernmentGrants
Noncash Contributions409672NoncashContributions
Total Contributions3830761TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Patient Care62410010614266871061426687
Laboratory6215005806645265772695243395002
Medicare-Medicaid624100533132376533132376
Pharmacy446110361322132166746082194576050
Medical Services5419002075755020513260244290

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column22953811TotalRevenueColumn
Related Or Exempt Function Income22315519RelatedOrExemptFunctionIncome
Unrelated Business Revenue222385UnrelatedBusinessRevenue
Exclusion$415,907ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue2580257082TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column17926847TotalRevenueColumn
Exclusion$17,926,847ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real10501509Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real2940423Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real7561086Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column7561086TotalRevenueColumn
Exclusion$7,561,086ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities383819871Securities
Other6030793Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities418321774Securities
Other5979439Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-34501903Securities
Other51354Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-34450549TotalRevenueColumn
Exclusion-$34,450,549ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2575125227TotalRevenueColumn
Related Or Exempt Function Income2381403448RelatedOrExemptFunctionIncome
Unrelated Business Revenue198437727UnrelatedBusinessRevenue
Exclusion-$8,546,709ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2112167Total
Program Services2112167ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total15430117Total
Program Services3863044ProgramServices
Management And General11567073ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total972421934Total
Program Services824909540ProgramServices
Management And General147512394ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total53362447Total
Program Services45363452ProgramServices
Management And General7998995ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total128520852Total
Program Services109300385ProgramServices
Management And General19220467ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total64309896Total
Program Services52147652ProgramServices
Management And General12162244ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total127489452Total
Program Services78705824ProgramServices
Management And General48783628ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1384281Total
Program Services296277ProgramServices
Management And General1088004ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total657047Total
Management And General657047ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total649021Total
Management And General649021ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total228957Total
Program Services228957ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total416775049Total
Program Services96971588ProgramServices
Management And General319803461ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total2609536Total
Program Services20150ProgramServices
Management And General2589386ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total51705076Total
Program Services24251092ProgramServices
Management And General27453984ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total19480225Total
Program Services19480225ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total5960Total
Program Services5960ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total52945827Total
Program Services40230367ProgramServices
Management And General12715460ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1958718Total
Program Services1352714ProgramServices
Management And General606004ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2720881Total
Program Services2395677ProgramServices
Management And General325204ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total37784988Total
Program Services35528239ProgramServices
Management And General2256749ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total96716278Total
Program Services76705006ProgramServices
Management And General20011272ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total13259975Total
Program Services4349508ProgramServices
Management And General8910467ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Supplies Non Medical3145430393072085507334489
Taxes62791916614107641381152
Medical Supplies5046654050466540
Bad Debt470363304701382222508

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total33243141Total
Program Services20957791ProgramServices
Management And General12285350ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total2570609650Total
Program Services1905275291ProgramServices
Management And General665334359ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5376889BOY
EOY3322470EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY60374536BOY
EOY44143882EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY38672373BOY
EOY45389230EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY257986181BOY
EOY355148658EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY41411969BOY
EOY49906981EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY18215784BOY
EOY11615013EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1626101385LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec792424070LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY775544811BOY
EOY833677315EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY646441376BOY
EOY668907521EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY43878592BOY
EOY42196156EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY539678648BOY
EOY443468119EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY137380088BOY
EOY102857713EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2564961247BOY
EOY2600633058EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY248871858BOY
EOY262990255EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY842909114BOY
EOY836086765EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY50660530BOY
EOY47813889EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY289552678BOY
EOY340713179EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1431994180BOY
EOY1487604088EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1080831229BOY
EOY1053870877EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY52135838BOY
EOY59158093EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1132967067BOY
EOY1113028970EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2564961247BOY
EOY2600633058EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4515577ReconcilationRevenueExpenses
Reconcilation Other Changes-24453674ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers1Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members1MailingsMembers
Mailings Members$9,300MailingsMembersAmount
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$639,721DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB649021TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierExplanation of Lobbying Activities:Identifier
Return ReferencePart II-B, Line 1:ReturnReference
ExplanationDuring 2011 Fairview Health Services (Fairview) officials had several meetings and contacts with both Federal and state government officials, congressional staff and representatives to discuss various health care reform and Medicare proposals and proposed legislation. Fairview also has representation on the healthcare leadership council which has advocated health care reform proposals. In addition, Fairview has corresponded with representatives, staff and government officials outlining our concerns and recommendations regarding health care reform. The primary focus of all these interactions was to discuss principles for health care reform rather than trying to influence the passage of any specific legislation. The majority of these activities were conducted by employees of Fairview and the expenditures for this activity totaled approximately $119,550. Additionally, Fairview paid approximately $529,471 to outside lobbyists in 2011. Fairview also provided information and/or expressed its concern to legislative bodies and government officials on matters directly related to health, the delivery of health care and medical education and/or research. Such activity is normally at the request of a legislative body, committee or member. In 2011, Fairview representatives had meetings with members of the legislative/executive branches of government to discuss issues relating to health care and health care reform. Fairview may also deal with members of government to discuss issues dealing with Fairview's tax exempt status and health care issues including sales tax exemption, state health care reform, real estate tax issues, physician licensing, Medicaid , etc. Fairview believes these informational meetings are essential to support our charitable purpose and do not constitute attempts to influence specific legislation as contemplated by these questions.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1273345BeginningOfYearBalance
Contributions48469Contributions
Investment Earnings Or Losses49974InvestmentEarningsOrLosses
Grants Or Scholarships55085GrantsOrScholarships
End Of Year Balance1316703EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1242544BeginningOfYearBalance
Contributions17356Contributions
Investment Earnings Or Losses23235InvestmentEarningsOrLosses
Grants Or Scholarships9790GrantsOrScholarships
End Of Year Balance1273345EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1203453BeginningOfYearBalance
Contributions15648Contributions
Investment Earnings Or Losses23443InvestmentEarningsOrLosses
End Of Year Balance1242544EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance930716BeginningOfYearBalance
Contributions299914Contributions
Investment Earnings Or Losses-27177InvestmentEarningsOrLosses
End Of Year Balance1203453EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.13000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.87000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis16449664OtherCostOrOtherBasis
Book Value16449664BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis972688920OtherCostOrOtherBasis
Depreciation408153547Depreciation
Book Value564535373BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis58487585OtherCostOrOtherBasis
Depreciation37499622Depreciation
Book Value20987963BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis507467203OtherCostOrOtherBasis
Depreciation340050878Depreciation
Book Value167416325BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis71008013OtherCostOrOtherBasis
Depreciation6720023Depreciation
Book Value64287990BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings833677315TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionInvestments in AffiliatesDescription
Book Value443468119BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related443468119TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
IBNR Claims Reserve Ins subs Claim Reserve$4,892,568
Work Comp Reserve$29,125,749
Other Liabilities$18,954,068
Related Org Liabilities$275,824,782
Current Portion of Work Comp$4,291,861
Current Portion of LT Debt$7,624,151
FieldValueIRS element (for citing)
Total Of Amounts340713179TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Intended Use of Endowment Funds:Part V, Line 4:Scholarships and awards given during 2011 amounted to $55,085 and are awarded through the Fairview Foundation. Clinical Pastoral Endowment Fund was established to provide a Clinical Pastoral Education Scholarship Award for ELCA pastors who are interested in becoming acquainted with the field for specialized ministry. The scholarship enables a recipient to attend one of the three-month CPE training courses offered by any of the Fairview hospitals. The applicant shall have finished the unit of training prior to receipt of the scholarship money. Scholarship money is paid from annual investment income. Service Award Endowment Fund was established to support a nurse volunteer working in a short-term mission assignment. The award is paid annually from investment revenues earned by the endowment. Pediatric Cardiology Fund purpose is to provide funding for pediatric cardiology in the areas of prevention, treatment, and research. Domestic Violence Fund earnings should be used to fund the training recognition and/or recruitment of volunteers for programs supporting victims of domestic violence.
Description of Uncertain Tax Positions Under FIN 48:Part X:During 2007, Fairview adopted FASB Interpretation No. 48, Accounting for Uncertainty in Income Taxes, an interpretation of FASB Statement No. 109, Accounting for Income Taxes (FIN 48), which clarifies the Accounting for Uncertainty in Income Taxes recognized in an entity's financial statements and prescribes a recognition threshold and measurement attributes for financial statement disclosure of tax positions taken or expected to be taken on a tax return. In accordance with FIN 48, a tax position is a proposition in a previously filed tax return or a position expected to be taken in a future tax filing that is reflected in measuring current or deferred income tax assets and liabilities. Tax positions shall be recognized only when it is more likely than not (likelihood of greater than 50%), based on technical merits, that the position will be sustained upon examination. Under FIN 48, the financial statement impact of an uncertain income tax position that was taken or is expected to be taken on the income tax return and that meets the more-likely-than-not threshold must be recognized and measured using a probability weighted approach at the largest amount that is more likely than not to be sustained upon audit by the relevant taxing authority. The adoption of FIN 48 did not have a material impact on Fairview's consolidated financial position, liability for unrecognized income tax benefits, (deficit) excess of revenue over expenses, or cash flows. There are no material changes in Fairview's unrecognized income tax position on December 31, 2011. Fairview does not expect that there will be a significant change in the total amount of unrecognized tax benefits within the next 12 months. At December 31, 2011, 2010, and 2009, Fairview has net operating loss carryforwards for federal income tax purposes. A valuation allowance has been recorded for the full amount of the deferred tax asset related to the net operating loss carryforwards due to the uncertainty regarding their use.

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable (2 entries)

RegionRegionNumber Of EmployeesNumberOfEmployeesType Of Activities ConductedTypeOfActivitiesConductedSpecific Services ProvidedSpecificServicesProvidedTotal ExpendituresTotalExpenditures
Central America and the Caribbean1Program ServicesSelf Insurance9602052
Central America and the CaribbeanInvestment97685765
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees1SubtotalNumberOfEmployees
Cont Number Of Offices0ContNumberOfOffices
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees1TotalNumberOfEmployees
Subtotal Amount Spent107287817SubtotalAmountSpent
Cont Amount Spent0ContAmountSpent
Total Amount Spent107287817TotalAmountSpent
Transfer To Foreign Corp0TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp1OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV (2 entries)

IdentifierIdentifierExplanationExplanation
Method Used to Acccount for Expenditures:Schedule F, Part I, Line 3: The method used to account for expenditures is based on the US dollar.
Fairview Health Services (FHS) is the sole owner of Associated Medical Assurance (AMA), a separate legal entity, domiciled in and organized under the laws of Bermuda. AMA is a captive insurance company which provides certain insurance liability coverage (including general and professional) to FHS and its subsidiaries under a reimbursement policy. Premiums paid under the policy are based on an independent actuarial study.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage275.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage275.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available0ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense23650817TotalCommunityBenefitExpense
Direct Offsetting Revenue1843288DirectOffsettingRevenue
Net Community Benefit Expense21807529NetCommunityBenefitExpense
Percent Of Total Expense0.00870PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense381101160TotalCommunityBenefitExpense
Direct Offsetting Revenue244257610DirectOffsettingRevenue
Net Community Benefit Expense136843550NetCommunityBenefitExpense
Percent Of Total Expense0.05420PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense404751977TotalCommunityBenefitExpense
Direct Offsetting Revenue246100898DirectOffsettingRevenue
Net Community Benefit Expense158651079NetCommunityBenefitExpense
Percent Of Total Expense0.06290PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1157630TotalCommunityBenefitExpense
Net Community Benefit Expense1157630NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense100657859TotalCommunityBenefitExpense
Direct Offsetting Revenue10304376DirectOffsettingRevenue
Net Community Benefit Expense90353483NetCommunityBenefitExpense
Percent Of Total Expense0.03580PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense18363890TotalCommunityBenefitExpense
Direct Offsetting Revenue16153707DirectOffsettingRevenue
Net Community Benefit Expense2210183NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense5973589TotalCommunityBenefitExpense
Direct Offsetting Revenue3139983DirectOffsettingRevenue
Net Community Benefit Expense2833606NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense608384TotalCommunityBenefitExpense
Net Community Benefit Expense608384NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense126761352TotalCommunityBenefitExpense
Direct Offsetting Revenue29598066DirectOffsettingRevenue
Net Community Benefit Expense97163286NetCommunityBenefitExpense
Percent Of Total Expense0.03850PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense531513329TotalCommunityBenefitExpense
Direct Offsetting Revenue275698964DirectOffsettingRevenue
Net Community Benefit Expense255814365NetCommunityBenefitExpense
Percent Of Total Expense0.10140PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense9282TotalCommunityBuildingExpense
Net Community Building Expense9282NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense39322TotalCommunityBuildingExpense
Net Community Building Expense39322NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense1504TotalCommunityBuildingExpense
Net Community Building Expense1504NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense1289TotalCommunityBuildingExpense
Net Community Building Expense1289NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense95TotalCommunityBuildingExpense
Net Community Building Expense95NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense51492TotalCommunityBuildingExpense
Net Community Building Expense51492NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$47,036,330BadDebtExpenseAmount
Amount Attributable To940727AmountAttributableTo
Amount Reimbursed By Medicare347479718AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare410186063CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-62706345MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities5NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (5 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursChildrens HospitalChildrensHospitalTeaching HospitalTeachingHospitalResearch FacilityResearchFacility
Fairview Lakes Regional Medical Center
15200 Fairview BlvdWyomingMN550928013XXX
Fairview Northland Regional Hospital
2911 Northland DrPrincetonMN553712172XXX
Fairview Ridges Hospital
3201 E Nicollet BlvdBurnsvilleMN553375714XXX
Fairview Southdale Hospital
46401 France Avenue SEdinaMN554352104XXX
University of Minnesota Medical Center
52450 Riverside Avenue SMinneapolisMN554541450XXXXXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (5 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareState RegulationStateRegulationExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresAvailable On RequestAvailableOnRequestOther PublicityOtherPublicityActions On NonpaymentActionsOnNonpaymentPermit Other ActionsPermitOtherActionsCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
Fairview Lakes Regional Medical Center
111275.0000000000001275.0000000000001XXXXXXX11XX1X01X00
Fairview Northland Regional Hospital
211275.0000000000001275.0000000000001XXXXXXX11XX1X01X00
Fairview Ridges Hospital
311275.0000000000001275.0000000000001XXXXXXX11XX1X01X00
Fairview Southdale Hospital
411275.0000000000001275.0000000000001XXXXXXX11XX1X01X00
University of Minnesota Medical Center
511275.0000000000001275.0000000000001XXXXXXX11XX1X01X00

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities71NumberOfOtherFacilities

Other Facilities OtherFacilities (71 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
CPMG CLINIC FRIDLEY
631 UNIVERSITY AVE NEFRIDLEYMN55432FREE STANDING CLINIC
FAIRVIEW WYOMING CLINIC
5200 FAIRVIEW BLVDWYOMINGMN550928013FREE STANDING CLINIC
CPMG CLINIC - ANDOVER UC
13819 HANSON BLVD NWANDOVERMN55304URGENT CARE CLINIC
CPMG CLINIC BROOKLYN PARK
1000 ZANE AVE NEBROOKLYN PARKMN55443FREE STANDING CLINIC
CVC SOUTHDALE
6405 FRANCE AVEEDINAMN55435FREE STANDING CLINIC
CPMG CLINIC BLAINE
10961 CLUB WEST PARKWAY NEBLAINEMN55449FREE STANDING CLINIC
WYOMING PRIMARY CARE CLINIC
5200 FAIRVIEW BLVDWYOMINGMN550928013FREE STANDING CLINIC
FAIRVIEW PRINCETON CLINIC
919 NORTHLAND DRPRINCETONMN553712172FREE STANDING CLINIC
CPMG CLINIC COLUMBIA PARK
4000 CENTRAL AVE NECOLUMBIA HEIGHTSMN55421FREE STANDING CLINIC
SCPA SOUTHDALE
6405 FRANCE AVEEDINAMN55435FREE STANDING CLINIC
CVC UNIVERSITY OF MINNESOTA MEDICAL CENT
424 HARVARD STREET SEMINNEAPOLISMN55455FREE STANDING CLINIC
FAIRVIEW ELK RIVER CLINIC
290 MAIN STREET NW STE 100ELK RIVERMN553301251FREE STANDING CLINIC
ONCOLOGY CLINIC UMMC
424 HARVARD STREET SEMINNEAPOLISMN55455FREE STANDING CLINIC
LAKES HOMECARING & HOSPICE
5200 FAIRVIEW BLVDWYOMINGMN550928013HOME HEALTH CARE & HOSPICE
FAIRVIEW ORTHOTIC FHME REMOTE SITES
2450 RIVERSIDE AVENUEMINNEAPOLISMN55454ORTHOTIC CLINIC & EQUIPMENT
LAKES CLINIC - LINO LAKES
7455 VILLAGE DRIVELINO LAKESMN550141181FREE STANDING CLINIC
SCPA RIDGES
201 E NICOLLET BLVDBURNSVILLEMN55337FREE STANDING CLINIC
FAIRVIEW CHISAGO LAKES CLINIC
11725 STINSON AVECHISAGO CITYMN550139542FREE STANDING CLINIC
CPMG CLINIC - ANDOVER
13820 HANSON BLVD NWANDOVERMN55304FREE STANDING CLINIC
CPMG CLINIC - BROOKLYN PARK UC
1001 ZANE AVE NEBROOKLYN PARKMN55443URGENT CARE CLINIC
NORTHLAND CLINCS - ZIMMERMAN
25945 GATEWAY DRZIMMERMANMN553985300FREE STANDING CLINIC
FAIRVIEW NORTH BRANCH CLINIC
6413 OAK STNORTH BRANCHMN550565129FREE STANDING CLINIC
HAND CENTER - ORTHOTIC
2450 RIVERSIDE AVEMINNEAPOLISMN55454ORTHOTIC CLINIC & EQUIPMENT
LAKES CLINIC - RUSH CITY
760 W 4TH STRUSH CITYMN550699063FREE STANDING CLINIC
NORTHLAND CLINICS - MILACA
150 10TH ST NWMILACAMN563531737FREE STANDING CLINIC
FAIRVIEW HUGO CLINIC
14663 MERCANTILE DR NHUGOMN550384559FREE STANDING CLINIC
CVC RIDGES
201 NICOLLET BLVDBURNSVILLEMN55337FREE STANDING CLINIC
SCPA VEIN SOLUTIONS
6405 FRANCE AVEEDINAMN55435SPECIALTY CLINICS
HOMECARE & SENIOR SERVICES
2450 RIVERSIDE AVEMINNEAPOLISMN55454HOME HEALTH CARE & SENIOR SERVICES
INSTITUTE FOR ATHLETIC MEDICINE - EDINA
6363 FRANCE AVE S 100EDINAMN55435PT CLINIC
CLINICS HOSPITAL
2450 RIVERSIDE AVEMINNEAPOLISMN55454FREE STANDING CLINIC
INSTITUTE ATHLETIC MEDICINE - EDEN PRAIR
775 PRAIRIE CENTER DRIVE 250EDEN PRAIRIEMN55344PT CLINIC
INSTITUTE ATHLETIC MEDICINE - BURNSVILLE
501 NICOLLET BLVD 100BURNSVILLEMN55337PT CLINIC
FAIRVIEW ORTHOTICS AND PROSTHETICS
501 NICOLLET BLVD 100BURNSVILLEMN55337SPECIALTY CLINICS
FAIRVIEW ORTHOTICS AND PROSTHETICS
2450 RIVERSIDE AVEMINNEAPOLISMN55454SPECIALTY CLINICS
INSTITUTE ATHLETIC MEDICINE - WEST HEALT
2805 CAMPUS DRIVE 115PLYMOUTHMN55441PT CLINIC
INSTITUTE ATHLETIC MEDICINE - EAGAN
1440 DUCKWOOD DRIVEEAGANMN55122PT CLINIC
FAIRVIEW ORTHOTICS AND PROSTHETICS
2200 UNIVERSITY AVE W STE 114ST PAULMN55114SPECIALTY CLINICS
INSTITUTE ATHLETIC MEDICINE - TRAINERS
4080 W BROADWAY 300ROBBINSDALEMN554222233PT CLINIC
INSTITUTE ATHLETIC MEDICINE - BLOOMINGTO
600 W 98TH ST 390BLOOMINGTONMN55420PT CLINIC
BLOOMINGTON LAKES XERXES CLINIC
7901 XERXES AVENUE SOUTHBLOOMINGTONMN55431FREE STANDING CLINIC
LAKES CLINIC - PINE CITY
510 2ND ST SEPINE CITYMN55063FREE STANDING CLINIC
INSTITUTE ATHLETIC MEDICINE - ARBOR LAKE
12000 ELM CREEK BLVD STE 120MAPLE GROVEMN55369PT CLINIC
INSTITUTE ATHLETIC MEDICINE - UNIV VILLA
2525 UNIVERSITY AVENUEN S EMINNEAPOLISMN55414PT CLINIC
INSTITUTE ATHLETIC MEDICINE - HIGHLAND P
2155 FORD PARKWAYST PAULMN55116PT CLINIC
INSTITUTE ATHLETIC MEDICINE - APPLE VALL
15650 CEDAR AVE 160APPLE VALLEYMN55124PT CLINIC
INSTITUTE ATHLETIC MEDICINE - ROBBINSDAL
4080 W BROADWAY 300ROBBINSDALEMN554222233PT CLINIC
FAIRVIEW BLAINE PHYSICAL THERAPT
10961 CLUB WEST PARKWAY NEBLAINEMN55449PT CLINIC
INSTITUTE ATHLETIC MEDICINE - PLYMOUTH
9750 ROCKFORD ROADPLYMOUTHMN55442PT CLINIC
INSTITUTE ATHLETIC MEDICINE - BLAINE
1750 105TH AVE NEBLAINEMN55449PT CLINIC
FAIRVIEW ORTHOTICS AND PROSTHETICS
6363 FRANCE AVE S 110EDINAMN55435SPECIALTY CLINICS
INSTITUTE ATHLETIC MEDICINE - BROOKLYN P
8559 EDINBROOK PARKWAY 104BROOKLYN PARKMN55443PT CLINIC
INSTITUTE ATHLETIC MEDICINE - ELK RIVER
800 FREEPORT AVE N 200ELK RIVERMN553301251PT CLINIC
INSTITUTE ATHLETIC MEDICINE - MAPLE GROV
14500 99TH AVE N STE 1-210MAPLE GROVEMN55369PT CLINIC
INSTITUTE ATHLETIC MEDICINE - UPTOWN
3033 EXCELSIOR BLVD 225MINNEAPOLISMN55416PT CLINIC
INSTITUTE ATHLETIC MEDICINE - ST ANTHONY
2600 39TH AVE NE 220ST ANTHONYMN55421PT CLINIC
INSTITUTE ATHLETIC MEDICINE - ROSEVILLE
1955 WEST COUNTY RD B2ROSEVILLEMN55113PT CLINIC
CHISAGO SLEEP LAB
11725 STINSON AVECHISAGO CITYMN550139542SPECIALTY CLINICS
FAIRVIEW RIDLEY PHYSICAL THERAPY
6341 UNIVERSITY AVE NEFRIDLEYMN55432PT CLINIC
HAND CENTER - BURNSVILLE
675 E NICOLLET BLVD 225BURNSVILLEMN55337SPECIALTY CLINICS
INSTITUTE ATHLETIC MEDICINE - LAKEVILLE
18592 JOPLIN AVELAKEVILLEMN55044PT CLINIC
INSTITUTE ATHLETIC MEDICINE - LINO LAKES
7455 VILLAGE DRIVELINO LAKESMN550141181PT CLINIC
BROOKLYN PARK SLEEP CENTER
10000 ZANE AVE NEBROOKLYN PARKMN55443SPECIALTY CLINICS
INSTITUTE ATHLETIC MEDICINE - FARMINGTON
15075 CIMARRON AVE 20ROSEMOUNTMN55068PT CLINIC
INSTITUTE ATHLETIC MEDICINE -MAPLEWOOD
1650 BEAM AVE LOWER LEVELMAPLEWOODMN55109PT CLINIC
HAND CENTER - EDINA
6363 FRANCE AVE S 100EDINAMN55435SPECIALTY CLINICS
BROOKLN PARK PHYSICAL THERAPY
10000 ZANE AVE NEBROOKLYN PARKMN55443PT CLINIC
INSTITUTE ATHLETIC MEDICINE - HUGO
14712 VICTOR HUGO BOULEVARDHUGOMN550384559PT CLINIC
IOR NORTHEAST CLINIC
650 TAFT ST NE 400MINNEAPOLISMN55413SPECIALTY CLINICS
INSTITUTE ATHLETIC MEDICINE -WOODBURY
7616 CURRELL AVE 270WOODBURYMN55125PT CLINIC
COLUMBIA PARK PHYSICAL THERAPY
4000 CENTRAL AVE NECOLUMBIA HEIGHTSMN55421PT CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (39 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 3c: Patients that are eligible for the Fairview Community Care Program or other Charity Care Plans may receive a reduction on amounts owed or up to 100% of total charges. Fairview informs patients about the Community Care Program prior to delivery of services if feasible and as appropriate and during the billing process. Uninsured patients with household incomes up to 275% of the federal poverty level qualify for a 100% discount of the total charges. Uninsured patients with household incomes greater than 275% of the federal poverty level and below $125,000 are charged a discount rate equal to the highest contracted rate Fairview has negotiated with private payers.
Part I, Line 7: Fairview uses the cost to charge ratio method for determining expenses. The Medicare cost reporting calculates services line by line where other expenses are calculated at the overall cost to charge ratio. One component of the costing method used is the Other Means tested government program. Minnesotas General Assistance Medical Care program (GAMC) meets this criteria. GAMC is a state funded program for low income adults, ages 21-64, who have no dependent children living with them and who do not qualify for federally funded health care programs. Eligible recipients must also meet income and asset tests. The ratio of cost to charges (RCC) is a percentage of adjusted total expense to gross patient revenue. The expense is calculated using GAMC Gross Revenue portion, based on our payer mix ratio, multiplied by a ration of cost to charges. The adjusted expense is the total expense less bad debt, taxes, directly assigned community benefit cost, and total other operating revenue less outreach Lab subaccounts.
Part I, Line 7g: Subsidized Health Services provided by Fairview includes addiction recovery and inpatient psychiatric units and ambulatory programs that serve low-income communities and home health programs. The following are areas of need which have been identified: Safety based on a recent upswing of violent crime, adolescent health based on assessment of diet, nutrition and exercise, as well as assets and risk behaviors such as substance use. These subsidized services are services offered by the hospitals.More recently realized is the need for more accurate diagnosis of Autism as it relates to Somali children. Current statistics suggest a disproportionate number of Somali children are being diagnosed with Autism. Fairview Health Services has been working with the Somali community since its high rate of autism was first identified. Clinicians of Fairview and the University of Minnesota that specialize in autism diagnosis and treatment have been working with the Somali community to determine next steps in the treatment. A program modeled after Fairviews has been implemented in the Somali community that helps with the management of autism within the community.
Part I, L7 Col(f): The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in healthcare coverage, and other collection indicators. The amount of bad debt expense included on form 990, Part IX, line 25, column (A) but subtracted for purposes of calculating the percentages in column (f) is $47,036,330.
Part II: Fairview is involved in a limited number of activities which are classified by definition as community building activities. While the majority of community activity addresses direct health needs, the community building activities are valuable for building tangible and intangible community infrastructure housing, safety, leadership skills and more. Across the Fairview system, 15 programs and partnerships are classified as community building activities. They range from a community housing initiative, economic development collaborative, leadership development and coalition building. In 2011 Fairview lead a Partnership-sponsored Scrubs Camp. The camp was a week-long residential experience for neighborhood and other city youth to get hands-on exploration of medical careers. Fairview makes investments each year in community health programming. A remarkable program called the Minnesota Immunization Network Initiative (MINI) is providing flu immunizations free of charge to low-income and uninsured individuals, largely from diverse minority groups. Each flu season, MIMI provides more than 6,000 immunizations to prevent influenza.
Part III, Line 4: The provision for bad debts is based on management's assessment of historical and expected net collections considering historical business and economic conditions, trends in healthcare coverage, and other collection indicators. Fairview uses the cost to charge ratio method for determining expenses.
Part III, Line 8: Fairview uses the cost to charge ratio method for determining expenses. The Medicare cost to charge ratio reporting is calculated service line by service line. Other expenses are calculated using the overall cost to charge ratio.Medicare Advantage patients and not cost report services, plus non-allowable costs allocated to Medicare patients also generate a shortfall of $22,794,809 not included in Part III, Sec. B Line 7 or reported elsewhere.
Part III, Line 9b: After our patients have received services, it is the policy of Fairview Health Services to bill patients and their applicable payors on a timely and accurate basis. During this billing and collection process, Fairview staff committed to providing quality customer service and timely follow up on all outstanding accounts. Billing: It is the goal of Fairview to bill all claims accurately and on a timely basis. Although dependent on information and communications from patients and payors, Fairview will provide sufficient follow up service to ensure that patients receive accurate account and billing information and have the oportunity to make payment and/or apply for community care. Fairview has agreed to certain billing and collection practices by an agreement with the Minnesota Attorney General's office.There are financial counselors at every entity Monday through Friday who interact with the patients in person and over the phone to tell them about programs that are available as well as help them apply for the programs. The information about needing help paying the bill is on signs in the hospitals and materials are distributed to self pay patients by registration staff. The statements sent out after the visit provide this information too. If a patient/family member calls the Central Business Office customer service staff to say they need assistance paying the bill they are informed about options at that time as well. Fairview provides a service that you call and this service interprets conversaton over the phone. This service can be used either as a three way phone call or the Financial Counselor, in a room with the patient or family can make the call together to the interpreter phone service. The interpreter services has close to 200 languages.The billing process will be assisted by the following guidelines:1) For all insured patients, Fairview will bill all third party payor information (as provided by or verified by the patient) on a timely and accurate basis.2) For all uninsured patients with Minnesota residency receiving hospital based services deemed medically necessary. Fairview will apply an uninsured discount equal to the discount provider to our largest contracted non-government payor, any remaining balance will be billed to the patient in a timely and manner.3) All billed patients have the opportunity to contact Fairview regarding financial assistance for their accounts. Financial assistance may include Community Care, payment arrangements, medical assistance or other applicable programs.4) If a patient contacts Fairview regarding Community Care before the account is referred to a collection agency or attorney, an application and required documentation is requested (income verification etc.), the account will then be processed based on the outcome of the Community Care determination.5) Fairview takes reasonable measures to not refer an account to collection unless there are no responses from the patient. If a patient contacts Fairview regarding Community Care after their account has been referred to a collection agency or attorney, Fairview will send an application to the patient provided the account meets the Community Care requirements. If the completed application with required documents (income verification, etc.) is submitted, all collection action will be suspended until the patient is notified of Fairview's determination.
Part V, Section B, Line 9: Uninsured patients with household incomes up to 275% of the federal poverty level qualify for a 100% discount of the total charges.Fairview Lakes Regional Medical Center
Part V, Section B, Line 9: Uninsured patients with household incomes up to 275% of the federal poverty level qualify for a 100% discount of the total charges.Fairview Northland Regional Hospital
Part V, Section B, Line 9: Uninsured patients with household incomes up to 275% of the federal poverty level qualify for a 100% discount of the total charges.Fairview Ridges Hospital
Part V, Section B, Line 9: Uninsured patients with household incomes up to 275% of the federal poverty level qualify for a 100% discount of the total charges.Fairview Southdale Hospital
Part V, Section B, Line 9: Uninsured patients with household incomes up to 275% of the federal poverty level qualify for a 100% discount of the total charges.University of Minnesota Medical Center
Part V, Section B, Line 10: Uninsured patients with household incomes greater than 275% of the federal poverty level and below $125,000 are charged a discount rate equal to the highest contracted rate Fairview has negotiated with private payers.Fairview Lakes Regional Medical Center
Part V, Section B, Line 10: Uninsured patients with household incomes greater than 275% of the federal poverty level and below $125,000 are charged a discount rate equal to the highest contracted rate Fairview has negotiated with private payers.Fairview Northland Regional Hospital
Part V, Section B, Line 10: Uninsured patients with household incomes greater than 275% of the federal poverty level and below $125,000 are charged a discount rate equal to the highest contracted rate Fairview has negotiated with private payers.Fairview Ridges Hospital
Part V, Section B, Line 10: Uninsured patients with household incomes greater than 275% of the federal poverty level and below $125,000 are charged a discount rate equal to the highest contracted rate Fairview has negotiated with private payers.Fairview Southdale Hospital
Part V, Section B, Line 10: Uninsured patients with household incomes greater than 275% of the federal poverty level and below $125,000 are charged a discount rate equal to the highest contracted rate Fairview has negotiated with private payers.University of Minnesota Medical Center
Part V, Section B, Line 13g: A summary of the Financial Assistance Policy is posted in various locations in the hospital.Fairview Lakes Regional Medical Center
Part V, Section B, Line 13g: A summary of the Financial Assistance Policy is posted in various locations in the hospital.Fairview Northland Regional Hospital
Part V, Section B, Line 13g: A summary of the Financial Assistance Policy is posted in various locations in the hospital.Fairview Ridges Hospital
Part V, Section B, Line 13g: A summary of the Financial Assistance Policy is posted in various locations in the hospital.Fairview Southdale Hospital
Part V, Section B, Line 13g: A summary of the Financial Assistance Policy is posted in various locations in the hospital.University of Minnesota Medical Center
Part V, Section B, Line 15e: It is the goal of Fairview to make reasonable efforts to provide information about the availability and eligibility of Fairviews Community Care program to patients before services are performed or immediately after emergency services are provided. In addition, Fairview will provide sufficient follow up services to ensure that patients receive accurate account and billing information and have the opportunity to make payment and or apply for Community Care after services are performed. If a patient feels he may be eligible to participate in Fairviews Community Care program once the billing process has begun, he can inform Fairview and collection processes will be suspended until a determination can be made regarding the patients eligibility.Fairview Lakes Regional Medical Center
Part V, Section B, Line 15e: It is the goal of Fairview to make reasonable efforts to provide information about the availability and eligibility of Fairviews Community Care program to patients before services are performed or immediately after emergency services are provided. In addition, Fairview will provide sufficient follow up services to ensure that patients receive accurate account and billing information and have the opportunity to make payment and or apply for Community Care after services are performed. If a patient feels he may be eligible to participate in Fairviews Community Care program once the billing process has begun, he can inform Fairview and collection processes will be suspended until a determination can be made regarding the patients eligibility.Fairview Northland Regional Hospital
Part V, Section B, Line 15e: It is the goal of Fairview to make reasonable efforts to provide information about the availability and eligibility of Fairviews Community Care program to patients before services are performed or immediately after emergency services are provided. In addition, Fairview will provide sufficient follow up services to ensure that patients receive accurate account and billing information and have the opportunity to make payment and or apply for Community Care after services are performed. If a patient feels he may be eligible to participate in Fairviews Community Care program once the billing process has begun, he can inform Fairview and collection processes will be suspended until a determination can be made regarding the patients eligibility.Fairview Ridges Hospital
Part V, Section B, Line 15e: It is the goal of Fairview to make reasonable efforts to provide information about the availability and eligibility of Fairviews Community Care program to patients before services are performed or immediately after emergency services are provided. In addition, Fairview will provide sufficient follow up services to ensure that patients receive accurate account and billing information and have the opportunity to make payment and or apply for Community Care after services are performed. If a patient feels he may be eligible to participate in Fairviews Community Care program once the billing process has begun, he can inform Fairview and collection processes will be suspended until a determination can be made regarding the patients eligibility.Fairview Southdale Hospital
Part V, Section B, Line 15e: It is the goal of Fairview to make reasonable efforts to provide information about the availability and eligibility of Fairviews Community Care program to patients before services are performed or immediately after emergency services are provided. In addition, Fairview will provide sufficient follow up services to ensure that patients receive accurate account and billing information and have the opportunity to make payment and or apply for Community Care after services are performed. If a patient feels he may be eligible to participate in Fairviews Community Care program once the billing process has begun, he can inform Fairview and collection processes will be suspended until a determination can be made regarding the patients eligibility.University of Minnesota Medical Center
Part V, Section B, Line 19d: Patients with incomes up to 275% of the federal poverty level qualify for a 100% discount on total charges. Therefore, no determination has to be made on the maximum amount that can be charged to FAP-eligible individuals for emergency or other medically necessary careFairview Lakes Regional Medical Center
Part V, Section B, Line 19d: Patients with incomes up to 275% of the federal poverty level qualify for a 100% discount on total charges. Therefore, no determination has to be made on the maximum amount that can be charged to FAP-eligible individuals for emergency or other medically necessary careFairview Northland Regional Hospital
Part V, Section B, Line 19d: Patients with incomes up to 275% of the federal poverty level qualify for a 100% discount on total charges. Therefore, no determination has to be made on the maximum amount that can be charged to FAP-eligible individuals for emergency or other medically necessary careFairview Ridges Hospital
Part V, Section B, Line 19d: Patients with incomes up to 275% of the federal poverty level qualify for a 100% discount on total charges. Therefore, no determination has to be made on the maximum amount that can be charged to FAP-eligible individuals for emergency or other medically necessary careFairview Southdale Hospital
Part V, Section B, Line 19d: Patients with incomes up to 275% of the federal poverty level qualify for a 100% discount on total charges. Therefore, no determination has to be made on the maximum amount that can be charged to FAP-eligible individuals for emergency or other medically necessary careUniversity of Minnesota Medical Center
Part VI, Line 2: Community needs assessments are conducted by Fairview corporate community health department staff every year on a rolling three year cycle for the primary service areas within Fairview Health Services. Year 1: Basic Demographic Assessments Year 2: Adolescent Assessments Year 3: Site or Issue Specific Assessments (e.g. analysis of charity care patients). Staff begin with existing community documents to build a baseline of information. This information may include patient data, existing recent social and cultural reports, education and business reports, new demographic information about income, housing, education and more. Next, staff conduct key interviews with community leaders from diverse sectors: social services, philanthrophy, government, health, education, business, minority groups, faith groups. Interviews allow assumptions to be validated and new information to be gathered. In addition, site community health staff partner with local public health departments and other community groups as part of their supplemental assessment of community need and/or to utilize the findings from their groups to better understand their communities. In Chisago and Washington counties, Fairview participates in the State Health Improvement Program (SHIP) community assessments. Identified needs include adolescent health based on the assessment of diet, nutrition and exercise. The mission of Healthy Communities Health Group of Maple Grove is: Attitude is Contagious - Healthy Community Healthy Youth of Maple Grove promotes positive development in youth and builds a sense of community.The goal of the Statewide Health Improvement Program is to increase Minnesotans longevity by living, better, healthier lives thereby reducing the burden of chronic disease. SHIP interventions are designed to reduce the percentage of Minnesotans who use or are exposed to tobacco and who are obese or overweight. Fairview Lakes CHO has an active role on the Leadership Team which oversees and provides guidance and oversight to the SHIP application and interventions.Provide low-income and other community members with bike helmets at cost or no cost while providing bike safety education and helmet fittings at community events other than Safety Camps.Planning Safe Bike to School Project to increase exercise. Includes bike donations to provide bikes to low income students so they can participate.Co-Coach Pioneering Healthy Communities Partnership with the YMCA and 10 other key sectors to implement policy and environmental changes that facilitates making healthierchoices where we live, work and play.Community Initiative works to prevent suicide through advocacy, education and support. Programming provides support for schools, staff and students and the community at large.The Chemical Health Initiative of Goodhue County was developed to enhance the quality of life of the Goodhue County families and citizens by promoting chemical health. The Initiative works on reducing drug, alcohol and tobacco use in the county by establishing community councils, and by providing awareness, education and prevention programming to communities.Coalition that is working to prevent underage drinking on the Iron Range. Providing education to community on social host laws and partnering with the courts to hold adult providers more accountable. Part of the ZAP grant.The Chemical Health Action Collaborative of Washington County works to prevent and reduce youth chemical use amoung youth through partnership, education, intervention, and change in social norms.The Chisago County Mental Wellness Task Force works to reduce the risk of suicide through education and collaboration with the larger Chisago community.The Mental Wellness Initiative includes the Teen Health Fund. Partners from five Washington County communities meet as individual communities and a larger group to network, develop and implement comprehensive depression awareness and suicide prevention programs in their school districts and communities. The local THF group is called the Forest Lake Area Depression Awareness and Suicide Prevention Collaborative.Beyond the formal needs assessments, Fairview leadership is engaged in their respective communities. Involvement includes participation on community boards, foundations, schools and more. Fairview also seeks community involvement through, community leaders serving on hospital boards and committees. Information gleaned through these connections are equally as important as the formal needs assessments. These connections can often identify emerging issues.
Part VI, Line 3: Fairview makes informaton about its charity care programs available on its Website (www.fairview.org). At the time of registration for services and through written materials in lobbies and waiting rooms. For patients identified as self-pay (whether that occurs before services are delivered or during the billing cycle), Fairview utilizes a standard process to assist patients learn about and access assistance from government programs or Fairview's Charity Care Program.For uninsured patients seen in a Fairview hospital, Fairview partners with an external vendor who meets with self-pay patients to assist them determine eligibility for government programs of Fairview's Charity Care Program. The vendor will also assist patients with completing the necessary paperwork to access these resources.Staff in Fairview's central business office have a self-pay team, which directs patients to the appropriate resources. There is also a community care coordinator who assists in getting patients connected to additional resources for which they may qualify.
Part VI, Line 4: Fairview Health Services is an integrated health system headquartered in Minneapolis, Minnesota. Fairview is comprised of seven hospitals or medical centers: 1) Fairview Lakes Medical Center in Wyoming, MN,2) Fairview Northland Medical Center in Princeton, MN,3) Fairview Ridges Hospital in Burnsville, MN,4) Fairview Southdale Hospital in Edina, MN,5) University of Minnesota Medical Center6) Fairview Maple Grove Medical Center in Maple Grove, MN, a related entity 7) Fair Red Wing Medical Center in Red Wing, MN,a related entity Fairview also has a full continuum of health care services. See Part III Page 2 , Lines 4a, 4b and 4c. In 2011, Fairview received national recognition when it was named to Thomson Reuter's top 10 U.S. health systems.As a system, 16.8 percent of patients served in 2011 were either uninsured or covered by Medicaid. Medicare covered 33.8 percent of all patients serviced by Fairview in 2011.Fairview Lakes Medical Center has a primary service area of 142,000 individuals residing in Anoka, Chisago, Isanti, Pine and Washington counties in Minnesota. Anoka and Washington are more urban as the Twin Cities metropolitan area continues to grow into these counties. Pine, Chisago and Isanti Counties are still relatively rural areas. In the next three years, 11 percent growth is projected in Fairview Lakes primary service area. Four of the counties within the primary service area have household incomes higher than the state average. In contrast, Pine County, the northern most county in the service area, has an average household income of $44,945, which is 21% below the state average. Pine County also has 13.6 percent of residents below the poverty line, higher than the 2010 state average at 11.6 percent.Fairview Lakes Medical Center is the only hospital in the primary services area. Within the secondary services areas, there are three other hospitas on the south edges of the service area. Fairview Lakes provides a full continuum of services, from primary care services at the clinic to home care services to long-term care. Of all the patients served by the medical center in 2010, 15.4 percent were uninsured or covered by Medicaid. In 2011, 36.9 percent of patients were covered by Medicare. Fairview Maple Grove Medical Center, a related entity, serves 360,000 individuals in a primary service area within Sherburne, Wright, Hennepin and Anoka counties in Minnesota. Median household income in these counties is above the state average. However, due to the size and diversity of Hennepin County, a higher than average percentage (11 percent) of county residents live below the federal poverty line. Sherburne, Wright and Anoka have large children populations; more than 100,000 children under the age of 18 live in the medical center primary service area. Fairview Maple Grove is an ambulatory medical center, working in partnership with University of Minnesota Physicians. Of all the patients served by the medical center in 2011, 7.9 percent were uninsured or covered by Medicaid. In 2011, 32.23 percent of patients were covered by Medicare.Fairview Northland Medical Center has a primary service area of 79,000 individuals residing in Sherburne, Benton, Kanabec, Mille Lac and Isanti counties in Minnesota. This largely rural area has projected a 17.5 percent increase by 2012, far exceeding the state average of 3.3 percent. Three of the five counties in the primary service area have median household incomes lower than the state average. Incomes in these counties (Benton, Mille Lac and Kanabec) range from $45,384 to 50,587, well below the state average of $57,318. The three counties also have a higher than average percentage of their residents living below the federal poverty line.Fairview Northland is the only hospital in the primary service area. Within the secondary service area, there are four other hospitals. Fairview Northland provides a full continuum of services, from primary care services to home care. Of all the patients served by the medical center in 2011, 19.0 percent were uninsured or covered by Medicaid. In 2011, 35.7 percent of patients were covered by Medicare.Fairview Red Wing Medical Center, a related entity, has a primary service area of 47,000 individuals who reside in Goodhue County in Minnesota and Pierce County in Wisconsin. This rural, agricultural community is relatively stable by population, ethnicity and language.Red Wing is located in Goodhue County. The average household income in Goodhue County was $54,967 in 2008, just below the state average of $57,000. In the county, 6.9 percent live below the poverty line, which is less than the state average of 9.6 percent.Fairview Red Wing Medical Center is the only hospital in the community. Fairview Red Wing provides a full continuum of services, from primary care services at the clinic to home care services to long-term care. Of all the patients served by the medical center in 2009, 17.4 percent were uninsured or covered by Medicaid. In 2009, 32.8 percent of patients served at Fairview Red Wing were covered by Medicare. In the future, that population is projected to surpass the state average.Fairview Ridges Hospital in Burnsville, MN has a primary service area of 336,000 individuals in Scott and Dakota counties. Over the last decade, Scott County has grown by 47 percent. Growth is projected to continue in Scott County, with an additional 19 percent growth by 2012.Located in the southern part of the greater Minneapolis-St. Paul metropolitan area, both counties have higher than average percentages of children under the age of 18. By income, individuals in Scott and Dakota counties have a higher household income than the state average. Fairview Ridges Hospital is a multi-specialty medical center and the only hospital serving the primary service area. Within Scott and Dakota counties, there are three other hospitals or medical centers. Of all the patients served by the medical center in 2011, 15.6 percent were uninsured or covered by Medicaid. In 2011, 32.3 percent of patients were covered by Medicare.Fairview Southdale Hospital in Edina, MN has a primary service area of 497,207 individuals residing in Hennepin and Carver counties. Carver County, a southwest suburb in the greater Minneapolis-St. Paul metropolitan area, is projecting a 13.9 percent increase in population by 2012. Individuals speaking a language other than English in the home in Carver County is significantly less than the state average, while it is significantly greater than the average in Hennepin County.Hennepin is large and diverse county, with 1.1 million residents. Eleven percent of Hennepin County residents live below the poverty line; yet the median household income is $62,275. Nearly 10 percent of the county is comprised of individuals born outside of this country. Twenty-five percent of the county residents are ethnic minorities.Fairview Southdale Hospital is one of two hospitals serving the primary service area. In the larger area of Hennepin and Carver counties, there are nine hospitals or medical centers serving the community. Fairview Southdale is a multi-specialty medical center rated by HealthGrades as the number one hospital in Minnesota for heart and stroke care in 2009. Southdale is also five-star rated in 2009 in 15 areas including Critical Care, Pulmonary Services, Joint Replacement, and Total Knee Replacement. Of all the patients served by the medical center in 2011, 44.9 percent were covered by Medicare. In 2011, 9.1 percent of patients were uninsured or covered by Medicaid. University of Minnesota Medical Center, Fairview (UMMC), located in Minneapolis, is a tertiary academic medical center drawing patients from across the Twin Cities region, the state and the country. UMMC is a partner with the University of Minnesota and University of Minnesota Physicians. The medical center is located in the Cedar-Riverside neighborhood of Minneapolis. Cedar-Riverside is a diverse community located just outside of downtown Minneapolis that is home to more than 7,500 individuals. Cedar-Riverside is home to a large group of recent immigrants from Somalia and other African countries. According to the most recent census data, forty one percent of residents are white, while 32 percent are black and 16 percent are Asian.Census data illustrates the economic challenges faced by the Cedar-Riverside neighborhood. More than half of Cedar-Riverside residents age 65 and above were living below the poverty guideline. For residents below age 65, 46 percent were below the poverty line. The University of Minnesota Medical Center, Fairview is the only medical center in the Cedar-Riverside neighborhood. Of all the patients served by the medical center in 2010, 22.5 percent were uninsured or covered by Medicaid. In 2011, 29.8 percent of patients were covered by Medicare.
Part VI, Line 5: Fairview Health Services is governed by an unpaid board of directors. The majority of the directors are community members who represent the various service areas and entities within the system. As a nonprofit health system, Fairview reinvests any excess revenues into the core operations of the organization. Research and education are at the very heart of the mission. In partnership with the University of Minnesota, Fairview invests millions of dollars each year into ground-breaking research and education of our next generation of healthcare workforce. Fairview also partners with a myriad of higher educational institutions to provide clinical hands-on training for future nurses, pharmacists, laboratory professionals and more. Fairview serves as a training site for residents in various specialities and is the core teaching site for the University of Minnesota residents. Senior residents and fellows provide Fairview some degree of clinical service that we would otherwise not receive.
Part VI, Line 6: Fairview Health Services, an integrated health care system headquartered in Minneapolis, MN. Based on the health care needs in that service area, community benefit activity is carried out by staff/leadership at that facility. The Fairview corporate community health department supports the local effort by sharing best practices, finding efficiencies among hospital community health leaders as appropriate, coordinating the community needs assessments and more.
MNReports Filed With StatesPart VI, Line 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Fairview FoundationBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12450 Riverside AvenueAddressLine1
CityMinneapolisCity
StateMNState
ZIP Code55454ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient411573810EINOfRecipient
IRC Section501(c)3IRCSection
Amount Of Cash Grant2112167AmountOfCashGrant
Purpose Of GrantSupport for the Compassion Capital Fund.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: The grants funds shall only be used for purposes that qualify as charitable, research and education purposes as defined in Section 501(c)(3) of the Internal Revenue Code of 1986.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Personal ServicesXPersonalServices
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception1InitialContractException
Rebuttable Presumption Procedure1RebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (29 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Mark Eustis
986991037172900010476301328201476765000
James Fox
2745609417304903050160970177050645736000
Bradley Beard
420414054160000188800377800531234000
Daniel K Anderson
504393099063035900284790200350655560000
Robert Beacher
387402016205300087010283760586532000
Paula Phillippe
375027067103036158000721230550411087640
Scott Wordelman
28428409158602517058860166110400884093170
Mark Thomas
285542011040109229074680235340436174000
George Chresand
353651074312000152310281080471302000
Beth Krehbiel
305427041210000126900236450382972000
Allen Vickers
20846103374500022820213340265822000
Mark Hansberry
322367068749000166190302570437992000
John Doherty
323460071300000191160328410446717000
Terry Carroll
428027093111000291520131480563438000
Richard Howard
24600103017600032650164500295892000
Steven A Borgstrom
20123902912304544000040030279805000
Mark Dixon
364358010165901629200332390107120672888000
Daniel M Fromm
4286810895260390048460295350552978000
Terry Martinson
2907810111419000180320165160436748000
David Moen
1846182590388953108060171500112291253330333427157100
Carolyn Wilson
1010070661260000024150169548000
Deborah Demarais MD
31270403999004255032790245920384820000
Kathleen Taranto
42432605892000037860168970503929000
Steven Hill
4217420575980003705095960492641000
David M Lindgren MD
662403036196028044080700231930757906000
William Omlie MD
602759052000032517053250185110711112000
Daniel Yoon MD
5394160782103479405864062640594159000
Todd Lindquist MD
55141107821046187073370287220641478000
John Rogers MD
426425015296032348040730127900490932000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1aSocial club dues are paid only on behalf of the CEO, primarily to provide offsite meeting spaces. If used for personal purposes, a rated portion of the dues is reported on the respective W2. Financial planning is provided for certain executives and reported on the respective W2.
Part I, Lines 4a-bThe Plan is open only to a select group of highly compensated employees. The Plan contributes the difference of what 403(b) employer contributions were missed for participants who earn more than the IRS limit on eligible compensation for qualified retirement plans (in 2011 that was $245,000). The contribution is unfunded. The Plan complies with section 457(f) of The Code. Those participating in a supplemental non-qualified retirement plan that is a 457(f)plan includes the following top level executives: Terry Carroll $23,488, Daniel Anderson $21,860, Bradley Beard $13,442, George Chresand $11,438, John Doherty $16,346, James Fox $16,097, Mark Hansberry $13,007, Beth Krehbiel $9,314, Mark Dixon $33,239, Mark Thomas $3,678, Terry Martinson $14,087, and Scott Wordelman $3,058. The plan for Mark Eustis, $96,166, is a dollar amount described in his employment agreement that is adjusted from time to time by the percentage increase in his base salary. As part of a separation agreement, James Fox received a severance payment in the amount of $386,679.
Part I, Line 8Mark Eustis signed an initial employment agreement on August 1, 2007. The full Board approves executive compensation.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
CITY OF MINNEAPOLIS
41600537560374VCE12005-05-1075567679HOSPITAL EXPANSION OF PRINCETON HOSPITAL & RIDGES HOSPITAL000
CITY OF MINNEAPOLIS
41600537560374VCH42008-10-29728392490REFUND 2004A 5-13-2004, 2005A 5-10-2005, B&C CHILDREN'S HOSPITAL & EXPAN.000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount RetiredAmountRetiredAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestWorking Capital ExpendituresWorkingCapitalExpendituresOther Spent ProceedsOtherSpentProceeds
7867934347535520702997613368920070011
7296029998640253395763920940841920111001880000304477121469747215341000447110504

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrsEngage Bond Counsel ResearchEngageBondCounselResearch
011101
0011111

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000000
010001

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
ExplanationDifferences between the issue price (Part I) and total proceeds (Part II, line 3) of Schedule K are due to investment earnings.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Wells Fargo
1 entity officer: Jon Campbell is a board member1915565Various banking services0
University of Minnesota Physicians
1 entity officer: Bobbi Daniels is a board member32935969Supplies physician services.0

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionMedical EquipmentDescription
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990409672NoncashContribsRptdF990
Method Of Determining Revenuesreplacement costMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 6The members of the corporation are the individuals who constitute the Directors of this corporation.
Form 990, Part VI, Section A, line 7aThe Board has three categories of directors: 1) 3 ex officio who are Fairview's CEO and the University's Senior Vice President for Health Sciences and the Medical School Dean; 2) 10 elected directors who are 1 director elected by the Regents of the University of Minnesota and 9 elected by the Board after nomination from certain components of the Fairview system; and 3) between 3 to 8 at-large directors elected by the Board.
Form 990, Part VI, Section A, line 7bThe Regents of the University of Minnesota have the right to approve proposed amendments to the Articles of Incorporation and Bylaws of the corporation if the amendment would adversely affect their rights and certain sales of substantially all of Fairview's assets. The Fairview Association has the right to approve certain Bylaw amendments.
Form 990, Part VI, Section B, line 11The Tax Department conducts a detailed review of the completed return. The return is also reviewed by Fairview's General Counsel and Controller and then by an independent tax consultant. The Form 990 is presented to the Finance Committee for review of content. The Form 990 is subsequently provided to the members of the Board of Directors prior to filing. Upon approval from the Board of Directors, the Form 990 is filed.
Form 990, Part VI, Section B, line 12cManagers, directors and senior management of Fairview are required to annually complete Fairview's Duty of Loyalty and Conflict of Interest Statement in compliance with Fairview's Conflict of Interest policy. Disclosures are reviewed by the compliance department. Conflicts of interests by Board members are brought to the Audit and Compliance Committee of the Board, along with additional detailed information, for specific review. In addition, the Compliance Officer compiles a schedule showing reported conflicts of interest by managers, directors and senior management which is also presented to the Audit and Compliance Committee of the Board for review and discussion. Any problematic issues arising from these disclosures are discussed and resolved by the committee. Board members and management employees are expected to update their conficts, as necessary, during the year.
Form 990, Part VI, Section B, line 15The determination of executive compensation of the organization is processed by the Board's Human Resources Committee and includes a review of comparability data, review by independent experts and contemporaneous substantiation of the deliberation and decision process. The full Board approves executive compensation.
Form 990, Part VI, Section C, line 19Fairview Health Services makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. Inspection of the documents is available at the corporate finance department.
Form 990, Part XI, line 5:Net unrealized losses on investments: -20,453,080. Change in Beneficial Interest in Related Organization -4,410,266. Received Donated Capital Equipment Not Recognized for Book Income 409,672. Total to Form 990, Part XI, Line 5: -24,453,674.Changes in Net Assets or Fund Balances:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsDirect Controlling Entity NADirectControllingEntityNALegal Domicile Foreign CountryLegalDomicileForeignCountry
FAIRVIEW PHARMACY SERVICES LLC
711 KASOTA AVEMINNEAPOLISMN55414721586863Pharmacy salesMN52123432531376N/A
Fairview Maple Grove Surgery Center
2450 Riverside AvenueMINNEAPOLISMN55454208335586Medical Surgery ServicesMN36132213246063512N/A
Associated Medical Assurance
2450 Riverside AvenueMINNEAPOLISMN55454Self-Insurance960205253369257N/ABD

Form990 Schedule R Part II Form990ScheduleRPartII (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Fairview Foundation
2450 RIVERSIDE AVENUEMINNEAPOLISMN55454411573810FUNDRAISING TO SUPPORT FAIRVIEW'S MISSIONMN501(c)(3)7N/A1
Fairview Home Care and Hospice
2450 26TH AVENUE SMINNEAPOLISMN55406411434246HOME HEALTH CAREMN501(c)(3)9N/A1
RMC Properties Inc
2450 RIVERSIDE AVENUEMINNEAPOLISMN55454411482417LAND LEASE HOLDMN501(c)(3)9N/A1
Fairview Physician Associates Network
3400 WEST 66TH STREETMINNEAPOLISMN55435411753325CLINICAL INTEGRATIONMN501(c)(3)9N/A1
Fairview Red Wing Health Services & Subs
701 FAIRVIEW BLVDRED WINGMN55066411713783PATIENT HEALTH CARE SERVICESMN501(c)(3)3N/A1
Range Regional Health Services & Subs
750 EAST 34TH STREETHIBBINGMN55746411293970PATIENT HEALTH CARE SERVICESMN501(c)(3)3N/A1
Ebenezer Social Ministries & subs
2722 PARK AVENUE SOUTHMINNEAPOLISMN55407411883845NURSING HOME MANAGEMENTMN501(c)(3)9N/A1
Ebenezer Society
2722 PARK AVENUE SOUTHMINNEAPOLISMN55407410706141NURSING AND RESIDENTIAL CAREMN501(c)(3)9N/A1
Fairview Auxiliary
6401 FRANCE AVENUE SOUTHMINNEAPOLISMN55435411414831SUPPORT HOSPITAL SERVICESMN501(c)(3)13N/A1

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Fairview Clinics
2450 Riverside AvenueMinneapolisMN55454411761760PHYSICIAN SERVICESMNN/AC108568069210521761.00000
Fairview Physician and Clinic Services Inc
2450 Riverside AvenueMinneapolisMN55454411544996PHYSICIAN SERVICESMNN/AC1.00000
Fairview Development Company
2450 Riverside AvenueMinneapolisMN55454411568579LEASEHOLD MANAGEMENTMNN/AC176644966107001.00000
Ebenezer Management Services & Subsidiary
2722 Park Avenue SouthMinneapolisMN55407411567046NURSING & RESIDENTIAL CARE PROPERTY MANAGERSMNN/AC2673446954874121.00000
Fairview Subsidiary III (Express Care)
2450 Riverside AvenueMinneapolisMN55454205996177PHYSICIAN SERVICESMNN/AC8691261.00000
Behavioral Healthcare Providers
2450 Riverside AvenueMinneapolisMN55454411805759MENTAL HEALTH PRACTITIONERSMNN/AC686357018107601.00000
Surgical Consultants PA
2450 Riverside AvenueMinneapolisMN55454410877307MEDICAL SERVICESMNN/AC42631.00000
Minnesota Heart Inc
2450 Riverside AvenueMinneapolisMN55454411598660MEDICAL SERVICESMNN/AC2586534263771.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (36 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
FAIRVIEW FOUNDATION
I20000Fair Market Value
FAIRVIEW CLINICS
L56068Fair Market Value
FAIRVIEW CLINICS
I2691203Fair Market Value
BEHAVIORAL HEALTHCARE PROVIDERS
K96518Fair Market Value
RANGE REGIONAL HEALTH SERVICES
L128334fair Market Value
FAIRVIEW CLINICS
Q360093Fair Market Value
RANGE REGIONAL HEALTH SERVICES
Q133618Fair Market Value
FAIRVIEW PHYSICIAN ASSOCIATES NETWORK
R87316Fair Market Value
FAIRVIEW HOME CARE & HOSPICE
O520069Fair Market Value
FAIRVIEW HOME CARE & HOSPICE
Q1728469Fair Market Value
BEHAVIORAL HEALTHCARE PROVIDERS
R702982Fair Market Value
FAIRVIEW SUBSIDIARY III (EXPRESS CARE)
R706438Fair Market Value
SURGICAL CONSULTANTS
Q16014Fair Market Value
MINNESOTA HEART
R12524Fair Market Value
FAIRVIEW DEVELOPMENT COMPANY
Q170649Fair Market Value
EBENEZER SOCIETY
R1065793Fair Market Value
FAIRVIEW FOUNDATION
Q510932Fair Market Value
FAIRVIEW CLINICS
O4801643Fair Market Value
FAIRVIEW RED WING HEALTH SERVICES
K87677Fair Market Value
EBENEZER SOCIETY
K443873Fair Market Value
FAIRVIEW HOME CARE & HOSPICE
I60977Fair Market Value
FAIRVIEW PHYSICIAN ASSOCIATES NETWORK
P536Fair Market Value
FAIRVIEW FOUNDATION
C3981477Fair Market Value
FAIRVIEW FOUNDATION
B2112167Fair Market Value
FAIRVIEW FOUNDATION
P69Fair Market Value
RED WING HEALTH SERVICES
R190833Fair Market Value
FAIRVIEW FOUNDATION
K634Fair Market Value
FAIRVIEW HOME CARE & HOSPICE
K104988Fair Market Value
FAIRVIEW SUBSIDIARY III (EXPRESS CARE)
K711280Fair Market Value
FAIRVIEW RED WING HEALTH SERVICES
O19386Fair Market Value
FAIRVIEW PHYSICIAN ASSOCIATES NETWORK
L40473Fair Market Value
FAIRVIEW DEVELOPMENT COMPANY
K9865Fair Market Value
FAIRVIEW FOUNDATION
L5285Fair Market Value
FAIRVIEW CLINICS
K977607Fair Market Value
FAIRVIEW CLINICS
R5083772Fair Market Value
EBENEZER SOCIETY
O128893Fair Market Value

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