MAYO CLINIC HEALTH SYSTEM-SPRINGFIELD: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- MAYO CLINIC HEALTH SYSTEM-SPRINGFIELD (EIN 41-1893827)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-03
- IRS object ID
- 201123079349301127
- Schema version
- 2010v3.4
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-03T12:40:47-05:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411893827 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAYO CLINIC HEALTH SYSTEM-SPRINGFIELD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MAYO | NameControl |
| Phone | 5075381297 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 NORTH JACKSON AVENUE | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MN | State |
| ZIP Code | 56087 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES J TARASOVITCH | Name |
| Title | CFO | Title |
| Phone | 5073856449 | Phone |
| Date Signed | 2011-11-03 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | fka SPRINGFIELD MEDICAL CENTER - MAY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GREGORY KUTCHER MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 NORTH JACKSON AVENUE | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MN | State |
| ZIP Code | 56087 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 16714828 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MAYOHEALTHSYSTEM.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1997 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | MEDICAL CLINIC, HOSPITAL, EMERGENCY ROOM AND DENTAL CLINIC | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 4 | NbrIndependentVotingMembers |
| Total Nbr Employees | 111 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 115708 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 61692 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 14375969 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 16553062 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 95216 | InvestmentIncomePriorYear |
| Investment Income Current Year | 85657 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 21357 | OtherRevenuePriorYear |
| Other Revenue Current Year | 11151 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 14608250 | TotalRevenuePriorYear |
| Total Revenue Current Year | 16711562 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 17137 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 32305 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 8321295 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8510311 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4975471 | OtherExpensePriorYear |
| Other Expenses Current Year | 5732078 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 13313903 | TotalExpensesPriorYear |
| Total Expenses Current Year | 14274694 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1294347 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2436868 | RevenuesLessExpensesCY |
| Total Assets BOY | 20716599 | TotalAssetsBOY |
| Total Assets EOY | 22894107 | TotalAssetsEOY |
| Total Liabilities BOY | 1662073 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1402713 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 19054526 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 21491394 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION, AND RESEARCH. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 12781057 | Expense |
| Revenue | 16551055 | Revenue |
| Description | PATIENT CARE (SCHEDULE O)MAYO HEALTH SYSTEM IS A FAMILY OF CLINICS, HOSPITALS AND HEALTH CARE FACILITIES SERVING COMMUNITIES IN MINNESOTA, IOWA AND WISCONSIN. AS PART OF MAYO CLINIC, MAYO HEALTH SYSTEM OFFERS OUTSTANDING CARE CLOSE TO HOME. PHYSICIANS AND STAFF IN MAYO HEALTH SYSTEM HAVE READY ACCESS TO THE KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC, YET CAN MEET PATIENTS' HEALTH CARE NEEDS LOCALLY. MAYO HEALTH SYSTEM IS PART OF THE COMMUNITY, FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES IN WHICH WE LIVE AND WORK. MAYO HEALTH SYSTEM TEAMS WITH MAYO CLINIC TO DELIVER UNPARALLELED HEALTH CARE TO COMMUNITIES THROUGH AN INTEGRATED NETWORK OF CLINICS AND HOSPITALS.MAYO HEALTH SYSTEM SITES EMPLOY APPROXIMATELY 800 PHYSICIANS AND 13,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT THE MAYO HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN 70 COMMUNITIES, THE SYSTEM INCLUDES 17 OWNED HOSPITALS, SEVEN OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH THREE ADDITIONAL HOSPITALS, AND CONTRACT MANAGEMENT AGREEMENTS WITH TWO ADDITIONAL HOSPITALS AND ONE NURSING HOME. SINCE ITS INCEPTION IN 1992, MAYO HEALTH SYSTEM HAS GROWN FROM A NEW IDEA TO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN AMERICA. MAYO HEALTH SYSTEM COMPLETES MORE THAN TWO-MILLION PATIENT VISITS ANNUALLY. IT ALSO SERVES AS A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS BEING RECOGNIZED SIX TIMES BY THE AMERICAN MEDICAL GROUP ASSOCIATION'S ACCLAIM AWARD PROGRAM (2005 ACCLAIM AWARD RECIPIENT AND FIVE-TIME ACCLAIM AWARD HONOREE). THE ACCLAIM AWARDS HONOR PHYSICIAN-LED ORGANIZATIONS DELIVERING CARE ALIGNED WITH THE IDEAL DELIVERY MODEL WHERE PATIENTS EXPERIENCE SAFE, RELIABLE, RESPONSIVE, READILY AVAILABLE AND INTEGRATED CARE. IN ADDITION, THE MINNESOTA COUNCIL FOR QUALITY HAS RECOGNIZED MAYO HEALTH SYSTEM THREE TIMES FOR ITS PERFORMANCE EXCELLENCE EFFORTS. INDIVIDUAL MAYO HEALTH SYSTEM LOCATIONS HAVE ALSO BEEN HONORED FOR THEIR COMMITMENT TO QUALITY, SAFETY, SERVICE, PERFORMANCE AND THEIR COMMUNITIES.PEOPLE IN MINNESOTA, IOWA AND WISCONSIN CAN HAVE PEACE OF MIND KNOWING THAT MAYO HEALTH SYSTEM AND MAYO CLINIC PARTNER TO ENSURE HEALTHIER LIVES IN THE REGION.PATIENT CARE:SMC PROVIDES HEALTH, MEDICAL AND DENTAL SERVICES TO THE SPRINGFIELD, MINNESOTA, COMMUNITY AS WELL AS SURROUNDING COMMUNITIES. SERVICES ARE OFFERED THROUGH ITS HOSPITAL AND CLINICS IN SPRINGFIELD, MINNESOTA, AS WELL AS A SATELLITE MEDICAL CLINIC AT LAMBERTON, MINNESOTA. THERE WERE 1,783 PATIENTS TREATED IN THE EMERGENCY ROOM IN 2010, WHICH IS OPEN 24 HOURS A DAY. THERE WERE 593 ACUTE PATIENTS DISCHARGED FROM INPATIENT CARE DURING 2010, AND 16,715 PATIENT OFFICE VISITS TOOK PLACE AT THE MEDICAL CLINICS IN 2010. THE DENTAL CLINIC HAD 2,961 PATIENT VISITS IN 2010.THE CLINIC IN LAMBERTON SAW 1,325 PATIENTS IN 2010. THIS CLINIC PROVIDES A NEEDED HEALTH CARE ACCESS POINT TO A COMMUNITY OF 900, INCLUDING MANY WHO ARE ELDERLY.UNCOMPENSATED CARE:SMC PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. SMC IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND IS REIMBURSED BASED ON ITS COST OF PROVIDING SERVICES FOR HOSPITAL MEDICARE PATIENTS.CHARITY CARE IS ALSO PROVIDED FOR PATIENTS THAT ARE FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. THE COST OF CHARITY CARE PROVIDED IN 2010 WAS APPROXIMATELY $22,000. THE COST OF UNCOMPENSATED CARE IN 2010 PROVIDED TO OTHER GOVERNMENTAL AND LOW INCOME PATIENTS THROUGH MEDICAID WAS APPROXIMATELY $587,000. THIS AMOUNT INCLUDES THE MEDICAID SURCHARGE AND PAYMENT TO MINNESOTACARE (A PROGRAM THAT PROVIDES HEALTH CARE FOR LOW INCOME POPULATIONS). THE AMOUNT OF THE MEDICAID SURCHARGE AND MINNESOTACARE TAX PAID IN 2010 WAS APPROXIMATELY $250,000.SMC ALSO PROVIDES DISCOUNTS TO UNINSURED PATIENTS. THE TOTAL DISCOUNTS GIVEN IN 2010 WERE $43,000. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Revenue | 5815 | Revenue |
| Description | EDUCATION (SCHEDULE O)EDUCATION:AS AN IMPORTANT COMPONENT OF THE AREAS' INFRASTRUCTURE, SMC IS INVOLVED IN SEVERAL DIFFERENT WAYS IN PROVIDING AND/OR SUPPORTING HEALTH CARE RELATED EDUCATION IN SPRINGFIELD AND THE SURROUNDING AREA. SMC HAS A TUITION SCHOLARSHIP PROGRAM THAT PROVIDES FUNDING, UP TO A TOTAL OF $15,000 OVER THREE YEARS, IF A PERSON AGREES TO A SET AMOUNT OF YEARS OF EMPLOYMENT. 3 PEOPLE WERE PROVIDED A TOTAL OF $5,000 IN 2010 UNDER THIS PROGRAM WHICH IS ONE OF THE BEST IDENTIFIED WAYS TO HELP PROVIDE STAFFING FOR OUR RURAL MEDICAL CENTER. UNFORTUNATELY, THIS PARTICULAR BENEFIT ONLY "COUNTS" IF IT IS MADE TO A PERSON WHO IS NOT YET OUR EMPLOYEE, THUS THE $5,000 IS NOT INCLUDED IN OUR OFFICIAL TALLY OF COMMUNITY BENEFITS SINCE ALL THREE INDIVIDUALS ASSISTED WERE ALREADY SMC EMPLOYEES.SMC PROVIDES MANY DIFFERENT EDUCATIONAL SEMINARS REGARDING SPECIFIC TOPICS, INCLUDING DIABETES CLASSES, CHILDBIRTH CLASSES, AND SIBLING CLASSES. BEGINNING IN 2008, SMC PIONEERED A COMMUNITY INITIATIVE TO ADDRESS CHILDHOOD OBESITY AND PARTNERED WITH LOCAL SCHOOLS, PUBLIC HEALTH AND THE LOCAL GROCERY STORE. INCLUDED IN THIS INITIATIVE WAS TO PROVIDE NUTRITION AND PHYSICAL ACTIVITY TALKS TO STUDENTS IN K-6TH GRADE. THERE HAVE ALSO BEEN OTHER AWARENESS ACTIVITIES SPONSORED BY SMC, SUCH AS BREAST HEALTH AWARENESS AND OTHER TOPICS THAT HAVE BEEN SHARED IN SOME MANNER WITH THE COMMUNITY AT NO CHARGE. IT IS ESTIMATED THAT COSTS FOR STAFF TIME AND MATERIALS ASSOCIATED WITH THESE VARIOUS EDUCATIONAL EPISODES AMOUNTED TO APPROXIMATELY $13,000 IN 2010. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 37431 | Expense |
| Grants | 32305 | Grants |
| Description | COMMUNITY BUILDING/COMMUNITY HEALTH IMPROVEMENT SERVICES (SCHEDULE O)COMMUNITY BUILDING:SMC EMPLOYED 99 ALLIED HEALTH STAFF, 6 PHYSICIANS AND 1 DENTIST DURING 2010. IT IS IMPORTANT THAT EMPLOYEES OF SMC CONTRIBUTE TO THE COMMUNITY BY MEANS OF PROVIDING THEIR TIME TO WORTHWHILE CIVIC PROJECTS THAT IMPROVE THE OVERALL COMMUNITY PROFILE. MANY TIMES THIS ACTIVITY OCCURS DURING TYPICAL WORK TIME WHILE BEING COMPENSATED BY SMC, SUCH AS SERVING AS A MEMBER ON THE LOCAL AMBULANCE SERVICE. SOME OF THESE SETTINGS INCLUDE SMC EMPLOYEES WHO SERVE IN LEADERSHIP POSITIONS SUCH AS WITH THE SPRINGFIELD AREA CHAMBER OF COMMERCE OR THE SPRINGFIELD AREA CONVENTION & VISITORS BUREAU. SOME OF THE PROJECTS WORKED ON AS PART OF THESE ORGANIZATIONS ARE TO INCREASE TOURISM BY THE DEVELOPMENT OF A RECREATIONAL TRAIL SYSTEM AS WELL AS UTILIZING SMC MECHANICAL EQUIPMENT AND MAINTENANCE PERSONNEL TO CLEAN THE LOCAL TRAILS. SMC PARTICIPATES IN MANY WAYS AS A REGULAR BUSINESS MEMBER OF THE COMMUNITY. AS SUCH, THERE ARE OFTEN TIMES FINANCIAL CONTRIBUTIONS MADE, FOR EXAMPLE, TO HELP SPONSOR THE DISTRIBUTION OF HEALTH AND SAFETY BOOKS TO SCHOOL CHILDREN OR PERHAPS PARTICIPATION IN A BUSINESS EVENT SUCH AS THE ANNUAL HOME & GARDEN SHOW.SPRINGFIELD MEDICAL CENTER HAS INVESTED BOTH TIME AND RESOURCES ON EMERGENCY PREPAREDNESS FOR POSSIBLE BIO-TERRORISM IN CONJUNCTION WITH OTHER HOSPITALS AND PUBLIC HEALTH DEPARTMENTS WITHIN THE REGION. PART OF THIS TRAINING IS DONE WITH EMPLOYEES OF THE CITY OF SPRINGFIELD, INCLUDING REGULAR MEETINGS TO ORGANIZE DRILLS, HOLD DRILLS AND REVISE PLANS. COMMUNITY OUTREACH:SMC PROVIDES A NUMBER OF SERVICES AND PROGRAMS THROUGHOUT THE YEAR THAT HAVE THE GOAL OF IMPROVING COMMUNITY HEALTH STATUS. THE VAST MAJORITY OF THESE SERVICES AND PROGRAMS ARE PROVIDED FREE OR AT A NOMINAL CHARGE. SOME OF THESE PROGRAMS, SUCH AS THE ANNUAL FUN-RUN/WALK, ARE DONE IN AN ATTEMPT TO ENCOURAGE AREA RESIDENTS TO BEGIN A HABIT OF REGULAR PHYSICAL FITNESS. APPROXIMATELY 100 ATTENDEES PER YEAR PARTICIPATE IN THIS EVENT.SMC IS ALSO LOOKING TO PROMOTE SAFETY AS AN IMPORTANT COMPONENT OF PHYSICAL ACTIVITY. FOR MANY YEARS SMC HAS CONDUCTED AN ANNUAL BIKE HELMET SAFETY PROGRAM TO APPROPRIATELY SIZE AND SELL APPROXIMATELY 50 BIKE HELMETS AND PROVIDED THESE AT A NOMINAL CHARGE, APPROXIMATELY $8 PER HELMET, UP TO 75% OFF THE RETAIL PRICE. THIS PROGRAM IS WIDELY ADVERTISED PRIOR TO THE EVENT AND MANY SMC PERSONNEL PARTICIPATE DURING THE DISTRIBUTION EVENT. ROUTINELY ONE OF THE MOST VISIBLE EXAMPLES OF THIS COMMUNITY OUTREACH IS THE HEALTH FAIR THAT IS HELD EVERY OTHER YEAR DURING NATIONAL HOSPITAL WEEK. IT IS ESTIMATED THAT THE SUBTOTAL OF VARIOUS TYPES OF COMMUNITY OUTREACH ACTIVITIES AMOUNTED TO $6,000 OF EXPENSE DURING 2010.ALL TOTALED, CONSIDERING ACTUAL COSTS OF IN-KIND STAFF EXPENSES AND EXPENSES PAID BY SMC, THE COMBINED TOTAL FOR PATIENT CARE, EDUCATION, COMMUNITY BUILDING, AND COMMUNITY OUTREACH WAS AT LEAST $36,000 AND PROBABLY MUCH MORE. SMC CONTINUES TO GET BETTER AT TRACKING THIS TYPE OF INFORMATION THAT HISTORICALLY WAS NOT DOCUMENTED BECAUSE THE GOAL WAS TO PROVIDE ASSISTANCE AND SUPPORT WHERE IT WAS NEEDED AND NOT NECESSARILY TAKE CREDIT FOR BEING A GOOD CORPORATE CITIZEN. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 12818488 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 111 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 4 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CORPORATE TAX UNIT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5075381297 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 FIRST STREET SW | AddressLine1 |
| City | ROCHESTER | City |
| State | MN | State |
| ZIP Code | 55905 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| CARDAMONE-RAYNER MD MARK | ||||||||
| DIRECTOR | 1.00 | X | 0 | 407467 | 36824 | |||
| GRACE RICHARD | ||||||||
| CAO | 1.00 | X | 0 | 246470 | 15578 | X | ||
| LOOMIS TUCKER | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| OLSON KEITH | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| PIESCHEL SHARON | ||||||||
| DIRECTOR/SECY | 1.00 | X | 0 | 0 | 0 | X | ||
| ROSCOE MD BRANDON | ||||||||
| DIRECTOR/VICE CHAIR | 40.00 | X | 347352 | 0 | 26309 | X | ||
| SCHMIT-CLINE MD ANNETTE | ||||||||
| DIRECTOR/CHAIR | 40.00 | X | 294816 | 0 | 34603 | X | ||
| WELLER PHIL | ||||||||
| DIRECTOR/TREASURER | 1.00 | X | 0 | 0 | 0 | X | ||
| WHITED MD BRIAN | ||||||||
| DIRECTOR | 1.00 | X | 0 | 293376 | 36159 | |||
| KUTCHER MD GREGORY | ||||||||
| CEO | 1.00 | 0 | 383913 | 36179 | X | |||
| OVIATT JD JONATHAN J | ||||||||
| ASST SECY | 1.00 | 0 | 737491 | 171708 | X | |||
| TARASOVITCH JIM | ||||||||
| CFO | 1.00 | 0 | 196637 | 15325 | X | |||
| THORESON SCOTT | ||||||||
| ADMINISTRATOR | 20.00 | 136580 | 0 | 32665 | X | |||
| BEERS DDS ADAM | ||||||||
| PHYSICIAN | 40.00 | 184792 | 0 | 29973 | X | |||
| DAVIS MD THOMAS | ||||||||
| PHYSICIAN | 40.00 | 298751 | 0 | 20498 | X | |||
| DHAMI MD RANDEEP | ||||||||
| PHYSICIAN | 40.00 | 309936 | 0 | 39473 | X | |||
| HOLMAN MD HERBERT | ||||||||
| PHYSICIAN | 40.00 | 209708 | 0 | 28305 | X | |||
| SCHMITZ DO MICHAEL | ||||||||
| PHYSICIAN | 40.00 | 273389 | 0 | 40544 | X | |||
| RUPP MD WILLIAM C | ||||||||
| FORMER PRESIDENT | 1.00 | 0 | 820006 | 49246 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2055324 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3085360 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 613389 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| HEYMANN CONSTRUCTION COMPANY | |||||
| 210 3RD SOUTH STREET | NEW ULM | MN | 560730606 | CONSTRUCTION GENERAL | 1526294 |
| IMMANUEL ST JOSEPH'S-MAYO HEALTH SYSTEM | |||||
| 1025 MARSH STREET | MANKATO | MN | 56001 | PURCHASED SERVICES | 977777 |
| ST JOHN LUTHERAN HOME | |||||
| 201 S COUNTY ROAD 5 | SPRINGFIELD | MN | 56087 | PURCHASED SERVICES | 186607 |
| MAYO CLINIC | |||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | PURCHASED SERVICES | 110347 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Related Organizations | 47804 | RelatedOrganizations |
| Government Grants | 8759 | GovernmentGrants |
| All Other Contributions | 5129 | AllOtherContributions |
| Total Contributions | 61692 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 620000 | 16538847 | 16538847 |
| RENT FROM AFFILIATES | 531120 | 8400 | 8400 |
| EDUCATION REVENUE | 611600 | 5815 | 5815 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 16553062 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 84577 | TotalRevenueColumn |
| Exclusion | $84,577 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1900 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1900 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1900 | TotalRevenueColumn |
| Exclusion | $1,900 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1080 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1080 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1080 | TotalRevenueColumn |
| Exclusion | $1,080 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 1289 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 3266 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1977 | TotalRevenueColumn |
| Exclusion | -$1,977 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| MEDICAL DIRECTOR FEES | 541900 | 6800 | $6,800 | |
| MISC. REVENUE | 900099 | 2203 | $620 | 1583 |
| MEDICAL RECORD/TRANSCR | 541900 | 1253 | 1253 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 972 | TotalRevenueColumn |
| Related Or Exempt Function Income | 972 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 11228 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16711562 | TotalRevenueColumn |
| Related Or Exempt Function Income | 16556870 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $93,000 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32305 | Total |
| Program Services | 32305 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 872325 | Total |
| Program Services | 703080 | ProgramServices |
| Management And General | 169245 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 551946 | Total |
| Program Services | 551946 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5431157 | Total |
| Program Services | 5116225 | ProgramServices |
| Management And General | 314932 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 186369 | Total |
| Program Services | 177948 | ProgramServices |
| Management And General | 8421 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1058465 | Total |
| Program Services | 1004617 | ProgramServices |
| Management And General | 53848 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 410049 | Total |
| Program Services | 382387 | ProgramServices |
| Management And General | 27662 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29694 | Total |
| Management And General | 29694 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 816074 | Total |
| Program Services | 651664 | ProgramServices |
| Management And General | 164410 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42115 | Total |
| Management And General | 42115 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1663695 | Total |
| Program Services | 1556750 | ProgramServices |
| Management And General | 106945 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 825610 | Total |
| Program Services | 386265 | ProgramServices |
| Management And General | 439345 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 340391 | Total |
| Program Services | 336523 | ProgramServices |
| Management And General | 3868 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80877 | Total |
| Program Services | 67175 | ProgramServices |
| Management And General | 13702 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53211 | Total |
| Program Services | 53211 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1103941 | Total |
| Program Services | 1094446 | ProgramServices |
| Management And General | 9495 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48097 | Total |
| Management And General | 48097 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 363786 | 363786 | |
| MN CARE TAX | 164728 | 164728 | |
| MEDICAID SURCHARGE | 84733 | 84733 | |
| EMPLOYEE RELATED EXPENS | 57020 | 56977 | 43 |
| DUES/LICENSES/SUBSCR | 51106 | 27624 | 23482 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7000 | Total |
| Program Services | 6098 | ProgramServices |
| Management And General | 902 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14274694 | Total |
| Program Services | 12818488 | ProgramServices |
| Management And General | 1456206 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 350 | BOY |
| EOY | 350 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 44907 | BOY |
| EOY | 38197 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115965 | BOY |
| EOY | 21641 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3071512 | BOY |
| EOY | 2322704 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 102744 | BOY |
| EOY | 95471 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 79644 | BOY |
| EOY | 47933 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 17566753 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6875579 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9602296 | BOY |
| EOY | 10691174 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7344374 | BOY |
| EOY | 9310126 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 354807 | BOY |
| EOY | 366511 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20716599 | BOY |
| EOY | 22894107 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1424404 | BOY |
| EOY | 841268 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 237669 | BOY |
| EOY | 561445 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1662073 | BOY |
| EOY | 1402713 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19034540 | BOY |
| EOY | 21491394 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19986 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19054526 | BOY |
| EOY | 21491394 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20716599 | BOY |
| EOY | 22894107 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 2436868 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13284 | OtherCostOrOtherBasis |
| Book Value | 13284 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7703526 | OtherCostOrOtherBasis |
| Depreciation | 2807585 | Depreciation |
| Book Value | 4895941 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9849943 | OtherCostOrOtherBasis |
| Depreciation | 4067994 | Depreciation |
| Book Value | 5781949 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 10691174 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MAYO POOLED INVESTMENTS | Description |
| Book Value | 9310126 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 9310126 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO AFFILIATES | $450,116 |
| DEFERRED COMPENSATION LIABILITY | $111,329 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 561445 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of Uncertain Tax Positions Under FIN 48: | Identifier |
| Return Reference | Part X: | ReturnReference |
| Explanation | AT DECEMBER 31, 2010 AND 2009, THERE WAS NO MATERIAL LIABILITY FOR UNRECOGNIZED TAX BENEFITS FOR THE FILING ORGANIZATION. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 0 | FPGReferenceFreeCare |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 450.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22144 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 22144 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1522922 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 935639 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 587283 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04220 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1545066 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 935639 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 609427 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04380 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14064 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1096 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 12968 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17183 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 17183 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 31247 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1096 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 30151 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1576313 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 936735 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 639578 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04590 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6184 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6184 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6184 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6184 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $217,774 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 4980329 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4925668 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 54661 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SPRINGFIELD MEDICAL CENTER - MAYO HEALTH | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 NORTH JACKSON AVENUE | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MN | State |
| ZIP Code | 56087 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NOT REQUIRED | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| SPRINGFIELD DENTAL CLINIC | ||||
| 602 NORTH JACKSON AVENUE | SPRINGFIELD | MN | 56087 | DENTAL CLINIC |
| LAMBERTON CLINIC | ||||
| 310 SOUTH MAIN | LAMBERTON | MN | 56152 | CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| ExplanationExplanation |
|---|
| Part I, Line 3c: THE ORGANIZATION USES FEDERAL POVERTY GUIDELINES TO SET A MAXIMUM PAYMENT IN RELATION TO THE PATIENT'S INCOME. CONSIDERATION FOR 100% CHARITY CARE ADJUSTMENT (FREE CARE) IS GIVEN FOR CIRCUMSTANCES WHERE THE PATIENT IS UNEMPLOYED OR HAS NO SOURCE OF INCOME, DOES NOT HAVE A CURRENT PERMANENT RESIDENCE, OR HAS OTHER SIGNIFICANT FINANCIAL HARDSHIPS. |
| Part I, Line 6a: THE ANNUAL REPORT FOR THE FILING ORGANIZATION IS PART OF A CONSOLIDATED REPORT PREPARED BY MAYO CLINIC. |
| Part I, Line 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO. |
| Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 363786. |
| Part II: SMC PARTICIPATES IN MANY WAYS AS A REGULAR BUSINESS MEMBER OF THE COMMUNITY. AS SUCH, THERE ARE OFTEN TIMES FINANCIAL CONTRIBUTIONS MADE, FOR EXAMPLE, TO HELP SPONSOR THE DISTRIBUTION OF HEALTH AND SAFETY BOOKS TO SCHOOL CHILDREN OR PERHAPS PARTICIPATION IN A BUSINESS EVENT SUCH AS THE ANNUAL HOME & GARDEN SHOW. |
| Part III, Line 4: BAD DEBT EXPENSE AT COST IS DETERMINED USING THE SAME COST-TO-CHARGE RATIO THAT IS USED TO CALCULATE CHARITY CARE AND MEDICAID SHORTFALL. DISCOUNTS AND ALLOWANCES ARE ACCOUNTED FOR SEPARATELY FROM BAD DEBT EXPENSE.FROM CONSOLIDATED FINANCIAL STATEMENTS: ACCOUNTS RECEIVABLE FOR MEDICAL SERVICES - ACCOUNTS RECEIVABLE FOR MEDICAL SERVICES ARE STATED AT NET REALIZABLE VALUE. THE CLINIC ESTIMATES THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED ON HISTORIC WRITE-OFFS AND THE AGING OF THE ACCOUNTS. ACCOUNTS ARE WRITTEN OFF WHEN COLLECTION EFFORTS HAVE BEEN EXHAUSTED.SMC REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPALS (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP. |
| Part III, Line 8: THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY).REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE OTHER COMMUNITY BENEFIT NEEDS. |
| Part III, Line 9b: MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING EVERY REASONABLE ATTEMPT TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED, INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILTY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY. COLLECTION ACTIVITY WOULD ONLY RESUME IF MAYO WOULD TELL THE COLLECTION AGENCY TO PURSUE COLLECTIONS ON THE BALANCE OR PARTIAL BALANCE IF THERE WAS A CHARITY ADJUSTMENT. |
| PART VI LINE 8: NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO THE MINNESOTA HOSPITAL ASSOCIATION. |
| Part VI, Line 2: ADMINISTRATION, ALONG WITH MEMBERS OF THE SPRINGFIELD BOARD OF DIRECTORS WORK WITH LOCAL BUSINESSES, COMMUNITY LEADERS, CHARITIES, AND HEALTH DEPARTMENTS TO ASSESS HEALTHCARE NEEDS. PROGRAMS AND SERVICES, MONETARY DONATIONS, EDUCATION, VOLUNTEERS AND GOODS ARE SUPPLIED ONCE THOSE NEEDS ARE ASSESSED. REQUESTS FOR ASSISTANCE ARE REVIEWED AND EVALUATED BY ADMINISTRATION AND THE SPRINGFIELD BOARD OF DIRECTORS. |
| Part VI, Line 3: ELIGIBILITY: THE CHARITY CARE INFORMATION BROCHURE IS PROMINENTLY DISPLAYED IN REGISTRATION AND PATIENT-ACCOUNT WAITING AREAS. THE BROCHURE EXPLAINS THE CHARITY CARE PROGRAM AND FACTORS AFFECTING ELIGIBILITY. IDENTIFICATION: THERE ARE A NUMBER OF WAYS A PATIENT CAN BE IDENTIFIED AND EVALUATED FOR CHARITY CARE ASSISTANCE.1. PATIENTS MAY REQUEST FINANCIAL ASSISTANCE.2. MAYO CLINIC EMPLOYEES MAY REFER PATIENTS TO A FINANCIAL COUNSELOR.3. COLLECTION AGENCIES MAY REFER PATIENTS.4. THE BUSINESS SERVICES/PATIENT FINANCIAL SERVICES DEPARTMENT MAY REFER PATIENTS TO A FINANCIAL COUNSELOR.5. REFERRING PHYSICIANS MAY REFER PATIENTS.6. MAYO PHYSICIANS MAY REFER PATIENTS.7. LOCAL GOVERNMENT AGENCIES MAY REFER PATIENTS.INDIGENT CARE: EMERGENCY ROOM PATIENTS WHO CANNOT PAY THEIR BILLS MAY BE CLASSIFIED AS "CHARITY" IF THEY DO NOT HAVE A JOB, MAILING ADDRESS, RESIDENCE, OR INSURANCE. CONSIDERATION MUST ALSO BE GIVEN TO CLASSIFYING EMERGENCY ROOM ONLY PATIENTS AS CHARITY IF THEY DO NOT PROVIDE ADEQUATE INFORMATION AS TO THEIR FINANCIAL STATUS. IN MANY INSTANCES, THESE PATIENTS ARE HOMELESS AND HAVE FEW RESOURCES TO COVER THE COST OF THEIR CARE.GOVERNMENTAL ASSISTANCE: IN DETERMINING WHETHER AN INDIVIDUAL QUALIFIES FOR CHARITY CARE, OTHER COUNTY OR GOVERNMENTAL ASSISTANCE PROGRAMS SHOULD ALSO BE CONSIDERED. MANY APPLICANTS ARE NOT AWARE THAT THEY MAY BE ELIGIBLE FOR PUBLIC HEALTH INSURANCE PROGRAMS.1. MAYO CLINIC STAFF WILL HELP THE INDIVIDUAL DETERMINE ELIGIBILITY FOR GOVERNMENTAL OR OTHER ASSISTANCE, AS APPROPRIATE.2. PERSONS WHO ARE ELIGIBLE FOR PROGRAMS (SUCH AS STATE-SPONSORED MEDICAID) BUT WHO WERE NOT COVERED AT THE TIME THAT MEDICAL SERVICES WERE GRANTED MAY BE GRANTED CHARITY CARE, PROVIDED THAT THE PATIENT NOW APPLIES FOR GOVERNMENT ASSISTANCE. THIS MAY BE PRUDENT, ESPECIALLY IF THE PATIENT REQUIRES ONGOING SERVICES. |
| Part VI, Line 4: SPRINGFIELD MEDICAL CENTER - MAYO HEALTH SYSTEM (SMC) IS LOCATED IN SPRINGFIELD, MINNESOTA. ITS SERVICE AREA INCLUDES BROWN COUNTY AND PORTIONS OF REDWOOD, WATONWAN, AND COTTONWOOD COUNTIES IN SOUTHWESTERN MINNESOTA. SMC IS A DESIGNATED CRITICAL ACCESS HOSPITAL FOR MEDICARE PURPOSES AND IS ONE OF THREE HOSPITALS IN BROWN COUNTY. THE POPULATION OF BROWN COUNTY (WHICH COMPRISES MOST OF SMC'S SERVICE AREA) IS APPROXIMATELY 26,000. ACCORDING TO 2008 CENSUS DATA, APPROXIMATELY 9% OF BROWN COUNTY INDIVIDUALS ARE LIVING BELOW THE POVERTY LEVEL. APPROXIMATELY 6% OF THE POPULATION IS UNINSURED. IN ADDITION, APPROXIMATELY 19% OF THE INDIVIDUALS LIVING IN BROWN COUNTY ARE OVER AGE 65. |
| Part VI, Line 6: THIS HOSPITAL IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION- EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY - IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.SURPLUS FUNDS - MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE. THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, WHETHER IN HEALTH CARE POLICY, BUSINESS, GOVERNMENT OR ANOTHER FIELD. IN ADDITION TO THIS COMMUNITY REPRESENTATION AT THE PARENT ENTITY, THE FILING ORGANIZATION ALSO INVOLVES LOCAL COMMUNITY MEMBERS ON ITS GOVERNING BODY.OPEN V. CLOSED STAFF MODEL - STAFF PRIVILEGES ARE GENERALLY EXTENDED TO ALL QUALIFIED PHSYICIANS IN THE COMMUNITY.EMERGENCY ROOM - THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK, WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY. |
| Part VI, Line 7: THIS ORGANIZATION IS A PART OF MAYO HEALTH SYSTEM (WHICH IS PART OF A LARGER GROUP OF ENTITIES AFFILIATED WITH MAYO CLINIC). THE MAYO HEALTH SYSTEM IS DESCRIBED IN RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O). THAT STATEMENT ALSO DESCRIBES THE ROLES OF THE VARIOUS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRIENDS OF BATAHOLA | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 15204 | AddressLine1 |
| City | BATON ROUGE | City |
| State | LA | State |
| ZIP Code | 708955204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 721513873 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Non Cash Assistance | 17183 | AmountOfNonCashAssistance |
| Method Of Valuation | BOOK VALUE | MethodOfValuation |
| Description Of Non Cash Assistance | MEDICAL SUPPLIES | DescriptionOfNonCashAssistance |
| Purpose Of Grant | MEDICAL SUPPLIES FOR CULTURAL CENTER | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY AND EQUALITY OF OPPORTUNITY. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARDAMONE-RAYNER MD MARK | |||||||||||||
| 0 | 407467 | 0 | 0 | 0 | 0 | 0 | 9800 | 0 | 27024 | 0 | 444291 | 0 | 0 |
| GRACE RICHARD | |||||||||||||
| 0 | 230365 | 0 | 0 | 0 | 16105 | 0 | 216 | 0 | 15362 | 0 | 262048 | 0 | 0 |
| ROSCOE MD BRANDON | |||||||||||||
| 337356 | 0 | 9996 | 0 | 0 | 0 | 3369 | 0 | 22940 | 0 | 373661 | 0 | 0 | 0 |
| SCHMIT-CLINE MD ANNETTE | |||||||||||||
| 289816 | 0 | 5000 | 0 | 0 | 0 | 12250 | 0 | 22353 | 0 | 329419 | 0 | 0 | 0 |
| WHITED MD BRIAN | |||||||||||||
| 0 | 293376 | 0 | 0 | 0 | 0 | 0 | 12250 | 0 | 23909 | 0 | 329535 | 0 | 0 |
| KUTCHER MD GREGORY | |||||||||||||
| 0 | 346309 | 0 | 37604 | 0 | 0 | 0 | 12250 | 0 | 23929 | 0 | 420092 | 0 | 0 |
| OVIATT JD JONATHAN J | |||||||||||||
| 0 | 448008 | 0 | 0 | 0 | 289483 | 0 | 144702 | 0 | 27006 | 0 | 909199 | 0 | 146270 |
| TARASOVITCH JIM | |||||||||||||
| 0 | 192924 | 0 | 0 | 0 | 3713 | 0 | 0 | 0 | 15325 | 0 | 211962 | 0 | 0 |
| THORESON SCOTT | |||||||||||||
| 136580 | 0 | 0 | 0 | 0 | 0 | 7225 | 0 | 25440 | 0 | 169245 | 0 | 0 | 0 |
| BEERS DDS ADAM | |||||||||||||
| 179792 | 0 | 5000 | 0 | 0 | 0 | 7604 | 0 | 22369 | 0 | 214765 | 0 | 0 | 0 |
| DAVIS MD THOMAS | |||||||||||||
| 298751 | 0 | 0 | 0 | 0 | 0 | 9800 | 0 | 10698 | 0 | 319249 | 0 | 0 | 0 |
| DHAMI MD RANDEEP | |||||||||||||
| 302736 | 0 | 7200 | 0 | 0 | 0 | 12250 | 0 | 27223 | 0 | 349409 | 0 | 0 | 0 |
| HOLMAN MD HERBERT | |||||||||||||
| 209708 | 0 | 0 | 0 | 0 | 0 | 10469 | 0 | 17836 | 0 | 238013 | 0 | 0 | 0 |
| SCHMITZ DO MICHAEL | |||||||||||||
| 266389 | 0 | 7000 | 0 | 0 | 0 | 12250 | 0 | 28294 | 0 | 313933 | 0 | 0 | 0 |
| RUPP MD WILLIAM C | |||||||||||||
| 0 | 694131 | 0 | 0 | 0 | 125875 | 0 | 40938 | 0 | 8308 | 0 | 869252 | 0 | 118772 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 4b | THIS ENTITY OR ITS AFFILIATE HAS A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE MAYO PENSION PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(a)(17). IN 2010, THE COMPONENT OF THIS SRP BENEFIT THAT WAS DEFERRED COMPENSATION SUBJECT TO SECTIONS 409A AND 457(f) OF THE INTERNAL REVENUE CODE WAS TERMINATED. THIS PLAN TERMINATION TRIGGERED THE IMMEDIATE TAXATION OF THE ENTIRE SRP BENEFIT THAT HAS BEEN ACCRUED AND DEFERRED OVER EACH PARTICIPANT'S CAREER AT MAYO. STARTING JANUARY 1, 2011, ALL FUTURE SRP BENEFIT WILL BE PAID AS AN ANNUAL TAXABLE CASH PAYMENT THAT HAS NO SUBSTANTIAL RISK OF FORFEITURE. THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN EITHER AS A RESULT OF THE NORMAL OPERATION OF PLAN TERMS OR BECAUSE OF THE TERMINATION OF THE PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). A PORTION OF THE AMOUNT MAY BE INCLUDED IN SCHEDULE J, PART II, COLUMN (F) IF DISCLOSED ON A PRIOR YEAR'S FORM 990. THESE AMOUNTS HAVE BEEN ACCRUED OVER THE SPAN OF THE INDIVIDUAL'S CAREER AT MAYO. JONATHAN OVIATT $284,303 WILLIAM RUPP, M.D. $111,567 | |
| Part III | COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990 PART VI SECTION B LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED. | Supplemental Information |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | BRANDON ROSCOE MD | NamePerson |
| Purpose Of Loan | RECRUITMENT | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $30,000 | OriginalPrincipalAmount |
| Balance Due | 16672 | BalanceDue |
| Default | 0 | Default |
| Approved By Board | 1 | ApprovedByBoard |
| Written Agreement | 1 | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 16672 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | DUE TO OVERLAP OF BOARD MEMBERSHIP AND EMPLOYMENT ON RELATED EXEMPT ENTITIES: RICHARD GRACE GREGORY KUTCHER M.D. SHARON PIESCHEL JAMES TARASOVITCH HAVE A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS: MARK CARDAMONE-RAYNER, M.D. GREGORY KUTCHER, M.D. JAMES TARASOVITCH BRIAN WHITED, M.D. DUE TO OVERLAP OF BOARD MEMBERSHIP AND EMPLOYMENT ON RELATED EXEMPT ENTITIES: JONATHAN OVIATT HAS A BUSINESS RELATIONSHIP WITH RICHARD GRACE. BOARD MEMBERS TUCKER LOOMIS AND SHARON PIESCHEL HAVE A BUSINESS RELATIONSHIP. | |
| Form 990, Part VI, Section A, line 3 | MAYO-AFFILIATED ENTITIES ROUTINELY DELEGATED VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO RELATED ENTITIES. | |
| Form 990, Part VI, Section A, line 6 | THE SOLE CORPORATE MEMBER IS IMMANUEL-ST. JOSEPH'S--MAYO HEALTH SYSTEM. | |
| Form 990, Part VI, Section A, line 7a | THE MEMBER ELECTS THE MEMBER DIRECTORS. THE OTHER DIRECTORS ARE ELECTED BY THE MEMBER FROM NOMINEES APPROVED BY THE BOARD OF DIRECTORS. | |
| Form 990, Part VI, Section A, line 7b | THE ARTICLES AND BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, BUDGET, AND DEBT, AMENDMENT OF THE ARTICLES AND BYLAWS, AND GENERAL OPERATION DECISIONS. | |
| Form 990, Part VI, Section B, line 11 | THE FORM 990 IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE VICE PRESIDENT OF FINANCE, THE CFO AND THE ADMINISTRATOR. THE VICE PRESIDENT OF FINANCE, CFO AND/OR ADMINISTRATOR PRESENT HIGHLIGHTS OF THE 990 TO THE REGIONAL FINANCE COMMITTEE AND SITE BOARD PRIOR TO THE FILING OF THE RETURNS. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. HIGHLIGHTS ARE PRESENTED TO BOARD MEMBERS, AND THE REVIEW IS DOCUMENTED IN MEETING MINUTES. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. | |
| MAYO CLINIC AND ITS AFFILIATES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS. | Form 990, Part VI, Section B, line 12c | |
| THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS AND ADMINISTRATIVE LEADERSHIP. IN ADDITION TO ANY REVIEW AND APPROVAL THAT MAY TAKE PLACE AT THE LOCAL ENTITY LEVEL, THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY. THE SALARY OF THE CEO AND CAO WERE REVIEWED BY THE MAYO HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR MAYO HEALTH SYSTEM PHYSICIANS. THE MAYO HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION OF PHYSICIANS AND ADMINISTRATIVE LEADERSHIP FOR THE MAYO HEALTH SYSTEM ENTITIES. THE COMMITTEE IS COMPRISED OF MAYO EMPLOYEES, BUT IS INDEPENDENT FOR INTERNAL REVENUE CODE 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED (WITH RECUSAL WHERE APPROPRIATE). FOR THOSE INDIVIDUALS FOR WHICH THIS COMMITTEE CAN NOT SERVE AS THE INDEPENDENT REVIEW, THEIR COMPENSATION AND BENEFITS ARE REVIEWED BY THE GOVERNANCE COMMITTEE (DESCRIBED BELOW). THE COMPENSATION AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. INFORMATION ON MAYO HEALTH SYSTEM PHYSICIAN AND ADMINISTRATIVE LEADERSHIP COMPENSATION AND BENEFITS IS ALSO REVIEWED BY THE MAYO CLINIC COMMITTEE ON OFFICER SUCCESSION, COMPENSATION AND GOVERNANCE (GOVERNANCE COMMITTEE), WHICH IS COMPRISED OF FIVE OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. THE COMPENSATION COMMITTEE IS CHARGED WITH THE RESPONSIBILITY TO RECOMMEND TO THE SOUTHWEST MINNESOTA REGION BOARD OF DIRECTORS ON AN ANNUAL BASIS THE APPROPRIATE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER AND CHIEF ADMINISTRATIVE OFFICER AND TOTAL COMPENSATION STRATEGY FOR THE ORGANIZATION. THE COMPENSATION COMMITTEE IS CREATED BY A BOARD RESOLUTION. CORE PURPOSE: a. REVIEW AND RECOMMEND TO THE BOARD THE TOTAL COMPENSATION STRATEGY OF THE SOUTHWEST MINNESOTA REGION, CONSISTENT WITH THE ORGANIZATION'S MISSION AND VALUES. b. REVIEW AND RECOMMEND TO THE BOARD THE TOTAL COMPENSATION PROPOSALS TO ENSURE SUPPORT OF ORGANIZATIONAL STRATEGY. c. REVIEW COMPENSATION AND BENEFITS DATA IN CONJUNCTION WITH MAYO CLINIC SHARED SERVICES GOALS IN MAKING RECOMMENDATIONS TO THE BOARD FOR TOTAL COMPENSATION PLANS. d. REVIEW AND RECOMMEND TO THE BOARD FOR APPROVAL EXECUTIVE COMPENSATION INCLUDING INCENTIVE PLANS FOR THE CHIEF EXECUTIVE OFFICER AND CHIEF ADMINISTRATIVE OFFICER. e. REVIEW AND RECOMMEND TO THE BOARD ORGANIZATIONAL SEVERANCE GUIDELINES. f. MANAGEMENT MEMBERS OF THE COMMITTEE MAY NOT VOTE ON ACTIONS RELATED DIRECTLY TO MANAGEMENT COMPENSATION. g. ANNUALLY REVIEW THE PHYSICIAN COMPENSATION STRATEGY AND ITS EFFECTIVENESS. RECOMMEND TO THE BOARD THE STRATEGIES AND GUIDELINES FOR MERIT PAY, INCENTIVES, SEVERANCE PAY, CONTRACTUAL RELATIONSHIPS AND OTHER UNUSUAL COMPENSATION ARRANGEMENTS THAT MAY ARISE. h. PERFORM ANY OTHER DUTIES AND RESPONSIBILITIES AS THE BOARD MAY DEEM NECESSARY, ADVISABLE OR APPROPRIATE FOR THE COMMITTEE TO PERFORM. i. ANNUALLY REVIEW THE COMPENSATION COMMITTEE CHARTER AND RECOMMEND CHANGES TO THE BOARD. | Form 990, Part VI, Section B, line 15b | |
| THE FILING ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. THE FILING ORGANIZATION IS A HOSPITAL AFFILIATED WITH MAYO CLINIC. AS SUCH, MAYO CLINIC'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FILING ORGANIZATION'S FORM 990 AND WOULD BE AVAILABLE UPON REQUEST OF THE FORM 990. | Form 990, Part VI, Section C, line 19 | |
| AVERAGE HOURS PER WEEK DEVOTED TO POSITION WITH RELATED ORGANIZATION | MARK CARDAMONE-RAYNER, M.D. 40 HOURS RICHARD GRACE 40 HOURS GREGORY KUTCHER, M.D. 40 HOURS JONATHAN OVIATT 40 HOURS WILLIAM RUPP, M.D. 40 HOURS JAMES TARASOVITCH 40 HOURS BRIAN WHITED, M.D. 40 HOURS SCOTT THORESON 20 HOURS | PART VII SECTION A |
| THERE WAS NO CHANGE IN THE PROCESS DURING THE YEAR. | PART XI LINE 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (43 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALBERT LEA MEDICAL CENTER -- MAYO HEALTH SYSTEM | ||||||||||||||
| 404 WEST FOUNTAIN STREET | ALBERT LEA | MN | 56007 | 411404075 | HOSPITAL AND CLINIC | MN | 501(c)(3) | 3 | MAYO CLINIC | 1 | ||||
| AUSTIN MEDICAL CENTER -- MAYO HEALTH SYSTEM | ||||||||||||||
| 1000 FIRST DRIVE NW | AUSTIN | MN | 55912 | 410695606 | HOSPITAL AND CLINIC | MN | 501(c)(3) | 3 | MAYO CLINIC | 1 | ||||
| AUSTIN MEDICAL CENTER FOUNDATION | ||||||||||||||
| 1000 FIRST DRIVE NW | AUSTIN | MN | 55912 | 300107471 | FUNDRAISING FOUNDATION | MN | 501(c)(3) | 7 | AUSTIN MEDICAL CENTER -- MAYO HEALTH SYSTEM | 1 | ||||
| BARRON MEMORIAL MEDICAL CENTER -- MAYO HEALTH SYSTEM | ||||||||||||||
| 1222 EAST WOODLAND AVE | BARRON | WI | 54812 | 390920634 | HOSPITAL AND CLINIC | WI | 501(c)(3) | 3 | LUTHER HOSPITAL | 1 | ||||
| BLOOMER LAKEVIEW INC | ||||||||||||||
| 2110 DUNCAN ROAD | BLOOMER | WI | 54724 | 391450617 | LOW INCOME HOUSING | WI | 501(c)(3) | 7 | BLOOMER MEMORIAL MEDICAL CENTER INC -- MAYO HEALTH SYSTEM | 1 | ||||
| BLOOMER MEMORIAL MEDICAL CENTER INC -- MAYO HEALTH SYSTEM | ||||||||||||||
| 1501 THOMPSON STREET | BLOOMER | WI | 54724 | 390980343 | HOSPITAL AND CLINIC | WI | 501(c)(3) | 3 | LUTHER HOSPITAL | 1 | ||||
| CANNON FALLS MEDICAL CENTER -- MAYO HEALTH SYSTEM | ||||||||||||||
| 1116 WEST MILL STREET | CANNON FALLS | MN | 55009 | 204156428 | HOSPITAL AND CLINIC | MN | 501(c)(3) | 3 | MAYO CLINIC | 1 | ||||
| CHARTERHOUSE INC | ||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411405254 | RETIREMENT LIVING CENTER | MN | 501(c)(3) | 9 | MAYO CLINIC | 1 | ||||
| FAIRMONT MEDICAL CENTER -- MAYO HEALTH SYSTEM | ||||||||||||||
| 800 MEDICAL CENTER DRIVE PO BOX 800 | FAIRMONT | MN | 56031 | 410760836 | HOSPITAL AND CLINIC | MN | 501(c)(3) | 3 | MAYO CLINIC | 1 | ||||
| FOUNTAIN LAKE TREATMENT CENTER | ||||||||||||||
| 404 WEST FOUNTAIN STREET | ALBERT LEA | MN | 56007 | 411404076 | CHEMICAL DEPENDENCY TREATMENT | MN | 501(c)(3) | 3 | ALBERT LEA MEDICAL CENTER -- MAYO HEALTH SYSTEM | 1 | ||||
| FRANCISCAN SKEMP FOUNDATION OF ARCADIA INC | ||||||||||||||
| 464 SOUTH JOHNSON STREET | ARCADIA | WI | 54612 | 391322480 | FUNDRAISING FOUNDATION | WI | 501(c)(3) | 9 | FRANCISCAN SKEMP HEALTHCARE INC | 1 | ||||
| FRANCISCAN SKEMP FOUNDATION OF SPARTA INC | ||||||||||||||
| 310 WEST MAIN STREET | SPARTA | WI | 54656 | 391423234 | FUNDRAISING FOUNDATION | WI | 501(c)(3) | 9 | FRANCISCAN SKEMP HEALTHCARE INC | 1 | ||||
| FRANCISCAN SKEMP FOUNDATION INC | ||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 391186647 | FUNDRAISING FOUNDATION | WI | 501(c)(3) | 11-II | FRANCISCAN SKEMP HEALTHCARE INC | 1 | ||||
| FRANCISCAN SKEMP HEALTHCARE INC | ||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 391411999 | HEALTHCARE SYSTEM PARENT | WI | 501(c)(3) | 11-I | MAYO CLINIC | 1 | ||||
| FRANCISCAN SKEMP MEDICAL CENTER INC | ||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 390806374 | HOSPITAL AND CLINIC | WI | 501(c)(3) | 3 | FRANCISCAN SKEMP HEALTHCARE INC | 1 | ||||
| GCAS | ||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411917517 | AMBULANCE SERVICE | MN | 501(c)(3) | 9 | MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH | 1 | ||||
| GOLD CROSS AMBULANCE SERVICE | ||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411917516 | AMBULANCE SERVICE | MN | 501(c)(3) | 9 | MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH | 1 | ||||
| GOLD CROSS AMBULANCE INC | ||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 391942957 | AMBULANCE SERVICE | MN | 501(c)(3) | 9 | MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH | 1 | ||||
| IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM | ||||||||||||||
| 1025 MARSH STREET | MANKATO | MN | 56002 | 411236756 | HOSPITAL AND CLINIC | MN | 501(c)(3) | 3 | MAYO CLINIC | 1 | ||||
| IMMANUEL-ST JOSEPH'S FOUNDATION -- MAYO HEALTH SYSTEM | ||||||||||||||
| 1025 MARSH STREET | MANKATO | MN | 56002 | 411663357 | FUNDRAISING FOUNDATION | MN | 501(c)(3) | 7 | IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM | 1 | ||||
| LAKE CITY MEDICAL CENTER - MAYO HEALTH SYSTEM | ||||||||||||||
| 500 WEST GRANT STREET | LAKE CITY | MN | 55041 | 411906820 | HOSPITAL | MN | 501(c)(3) | 3 | MAYO CLINIC | 1 | ||||
| LUTHER HOSPITAL | ||||||||||||||
| 1221 WHIPPLE STREET | EAU CLAIRE | WI | 54703 | 390813418 | HOSPITAL | WI | 501(c)(3) | 3 | MAYO CLINIC | 1 | ||||
| LUTHER LAKESIDE APARTMENTS INC | ||||||||||||||
| 714 SOUTH BARSTOW STREET | EAU CLAIRE | WI | 54701 | 391409024 | LOW INCOME HOUSING | WI | 501(c)(3) | 9 | LUTHER HOSPITAL | 1 | ||||
| LUTHER MIDELFORT FOUNDATION INC | ||||||||||||||
| 733 W CLAIREMONT AVE PO BOX 1510 | EAU CLAIRE | WI | 54702 | 391633407 | GRANTMAKING FOUNDATION | WI | 501(c)(3) | PF | MIDELFORT CLINIC LTD -- MAYO HEALTH SYSTEM | 0 | ||||
| MAYO CLINIC ARIZONA | ||||||||||||||
| 13400 EAST SHEA BLVD | SCOTTSDALE | AZ | 85259 | 860800150 | HOSPITAL AND CLINIC | AZ | 501(c)(3) | 3 | MAYO CLINIC | 1 | ||||
| MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) | ||||||||||||||
| 4500 SAN PABLO ROAD | JACKSONVILLE | FL | 32224 | 590714831 | HOSPITAL | FL | 501(c)(3) | 3 | MAYO CLINIC JACKSONVILLE | 1 | ||||
| MAYO CLINIC JACKSONVILLE | ||||||||||||||
| 4500 SAN PABLO ROAD | JACKSONVILLE | FL | 32224 | 593337028 | PATIENT CARE - CLINIC | FL | 501(c)(3) | 7 | MAYO CLINIC | 1 | ||||
| MAYO CLINIC -- METHODIST HOSPITAL | ||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 410739106 | HOSPITAL | MN | 501(c)(3) | 3 | MAYO CLINIC | 1 | ||||
| MAYO CLINIC | ||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 416011702 | PATIENT CARE - CLINIC | MN | 501(c)(3) | 9 | MAYO CLINIC | 1 | ||||
| MAYO CLINIC -- SAINT MARYS HOSPITAL | ||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 410944601 | HOSPITAL | MN | 501(c)(3) | 3 | MAYO CLINIC | 1 | ||||
| MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH | ||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411506440 | CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES | MN | 501(c)(3) | 9 | MAYO CLINIC | 1 | ||||
| MIDELFORT CLINIC LTD -- MAYO HEALTH SYSTEM | ||||||||||||||
| PO BOX 1510 | EAU CLAIRE | WI | 54702 | 391735831 | PATIENT CARE - CLINIC | WI | 501(c)(3) | 3 | MAYO CLINIC | 0 | ||||
| MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES | ||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 412020392 | SUPPORT RESEARCH, PRACTICE & EDUCATION | MN | 501(c)(3) | 11-I | MAYO CLINIC | 1 | ||||
| NORTHWEST WISCONSIN HOMECARE INC | ||||||||||||||
| PO BOX 2060 | EAU CLAIRE | WI | 54702 | 391491516 | HOME HEALTH AND HOSPICE CARE | WI | 501(c)(3) | 9 | LUTHER HOSPITAL | 1 | ||||
| NORTHWEST WISCONSIN SUPPORTIVE HOMECARE INC | ||||||||||||||
| PO BOX 2060 | EAU CLAIRE | WI | 54702 | 391686673 | HOME HEALTH CARE | WI | 501(c)(3) | 9 | LUTHER HOSPITAL | 1 | ||||
| OSSEO MEDICAL CENTER INC -- MAYO HEALTH SYSTEM | ||||||||||||||
| PO BOX 70 / 13025 EIGHTH STREET | OSSEO | WI | 54758 | 391029430 | HOSPITAL AND CLINIC | WI | 501(c)(3) | 3 | LUTHER HOSPITAL | 1 | ||||
| POVERELLO FOUNDATION | ||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411494881 | FUNDRAISING FOUNDATION | MN | 501(c)(3) | 11-I | MAYO CLINIC -- SAINT MARYS HOSPITAL | 1 | ||||
| RED CEDAR MEDICAL CENTER INC -- MAYO HEALTH SYSTEM | ||||||||||||||
| 2321 STOUT ROAD | MENOMONIE | WI | 54751 | 510190875 | HOSPITAL AND CLINIC | WI | 501(c)(3) | 3 | MAYO CLINIC | 1 | ||||
| SPRINGFIELD MEDICAL CENTER -- MAYO HEALTH SYSTEM | ||||||||||||||
| 625 NORTH JACKSON AVENUE | SPRINGFIELD | MN | 56087 | 411893827 | HOSPITAL AND CLINIC | MN | 501(c)(3) | 3 | IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM | 1 | ||||
| ST JAMES MEDICAL CENTER -- MAYO HEALTH SYSTEM | ||||||||||||||
| 1101 MOULTON PARSONS DR PO BOX 460 | ST JAMES | MN | 56081 | 410797368 | HOSPITAL AND CLINIC | MN | 501(c)(3) | 3 | IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM | 1 | ||||
| ST JAMES MEDICAL CENTER FOUNDATION INC | ||||||||||||||
| 1101 MOULTON PARSONS DR PO BOX 460 | ST JAMES | MN | 56081 | 411444129 | FUNDRAISING FOUNDATION | MN | 501(c)(3) | 7 | ST JAMES MEDICAL CENTER -- MAYO HEALTH SYSTEM | 1 | ||||
| WASECA MEDICAL CENTER -- MAYO HEALTH SYSTEM | ||||||||||||||
| 501 NORTH STATE STREET | WASECA | MN | 56093 | 363606405 | HOSPITAL AND CLINIC | MN | 501(c)(3) | 3 | IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM | 1 | ||||
| MAYO KLINIK STIFTUNG | ||||||||||||||
| FUNDRAISING FOUNDATION | MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH | 1 | 60486 FRANKFURT AM MAIN | FRANKFURT | GM | GM | ||||||||
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRANKLIN HEATING STATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 119 THIRD ST SW | AddressLine1 |
| City | ROCHESTER | City |
| State | MN | State |
| ZIP Code | 55902 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410264830 | EIN |
| Primary Activity | UTILITY | PrimaryActivity |
| Legal Domicile State | MN | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
Form990 Schedule R Part IV Form990ScheduleRPartIV (18 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Type Of EntityTypeOfEntity | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|
| CANNON VALLEY CLINIC -- MAYO HEALTH SYSTEM | |||||||||
| 635 FIRST STREET SE | FARIBAULT | MN | 55021 | 411817179 | PATIENT CARE - CLINIC | MN | N/A | C | |
| DECORAH CLINIC -- MAYO HEALTH SYSTEM | |||||||||
| 907 MONTGOMERY STREET | DECORAH | IA | 52101 | 411711329 | PATIENT CARE - CLINIC | IA | N/A | C | |
| FIOS THERAPEUTICS INC | |||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 711029189 | RESEARCH | MN | N/A | C | |
| HEALTH TRADITION HEALTH PLAN | |||||||||
| 1808 EAST MAIN STREET | ONALASKA | WI | 54650 | 391545987 | MEDICAL SERVICES COMPANY | WI | N/A | C | |
| LOBSS NETWORK SUPPORT 2002 INC | |||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 481276150 | ADMINISTRATIVE SERVICES | MN | N/A | C | |
| MAYO COLLABORATIVE SERVICES INC | |||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411346366 | REFERENCE LAB SERVICES | MN | N/A | C | |
| MAYO HOLDING COMPANY | |||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411578020 | HOLDING COMPANY | MN | N/A | C | |
| MAYO INSURANCE COMPANY LTD | |||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | SELF INSURANCE POOL | N/A | C | CJ | ||
| MAYO MEDICAL LABORATORIES NEW ENGLAND INC | |||||||||
| 265 BALLARDVALE STREET | WILMINGTON | MA | 01887 | 043323713 | LABORATORY SERVICES | MA | N/A | C | |
| MAYO REGIONAL PRACTICES OF ARIZONA | |||||||||
| 13400 EAST SHEA BOULEVARD | SCOTTSDALE | AZ | 85259 | 061190278 | THIRD PARTY ADMINISTRATION SERVICES | AZ | N/A | C | |
| MHS SERVICES INC | |||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411282517 | EQUIPMENT & REAL ESTATE LEASING | MN | N/A | C | |
| MMSI INC | |||||||||
| 21 FIRST STREET SW | ROCHESTER | MN | 55905 | 411547003 | THIRD PARTY ADMINISTRATION SERVICES | MN | N/A | C | |
| NORTHWEST HEALTH VENTURES INC | |||||||||
| 1221 WHIPPLE STREET | EAU CLAIRE | WI | 54703 | 391528920 | PHARMACY SERVICES | WI | N/A | C | |
| OWATONNA CLINIC -- MAYO HEALTH SYSTEM | |||||||||
| 134 SOUTHVIEW | OWATONNA | MN | 55060 | 411862132 | PATIENT CARE - CLINIC | MN | N/A | C | |
| PHYSICIAN AND HOSPITAL PRACTICES INC | |||||||||
| 4500 SAN PABLO ROAD | JACKSONVILLE | FL | 32224 | 930926631 | HEALTH SERVICES | FL | N/A | C | |
| ROCHESTER AIRPORT COMPANY | |||||||||
| ROUTE 2 | ROCHESTER | MN | 55902 | 410506870 | AIRPORT MANAGEMENT | MN | N/A | C | |
| SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION | |||||||||
| 13400 E SHEA BLVD | SCOTTSDALE | AZ | 85259 | 860870505 | COMMERCIAL PROPERTY OWNERS ASSOCIATION | AZ | N/A | C | |
| THE STABILE BUILDING OWNERS' ASSOCIATION | |||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 208994499 | COMMERCIAL PROPERTY OWNERS ASSOCIATION | MN | N/A | C | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| MMSI INC | ||
| K | 747911 | GAAP |
| IMMANUEL ST JOSEPH'S - MAYO HEALTH SYSTEM | ||
| L | 977777 | GAAP |
| MAYO CLINIC | ||
| L | 110346 | GAAP |
| MAYO CLINIC | ||
| R | 83394 | GAAP |
Comments