PARK NICOLLET HEALTH SERVICES: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- PARK NICOLLET HEALTH SERVICES (EIN 41-0132080)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-10
- IRS object ID
- 201123149349302852
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-10T14:13:08-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 South Sixth Street Suite 2800 | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410132080 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Methodist Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PARK | NameControl |
| Phone | 9529933108 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SHEILA MCMILLAN | Name |
| Title | CFO | Title |
| Phone | 9529932036 | Phone |
| Date Signed | 2011-10-31 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kristina Rasmussen | Name |
| Phone | 6123974000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Sheila McMillan | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 622497441 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.parknicollet.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1893 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | Cares for and supports the health, healing, and learning of those served. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 873 | TotalNbrVolunteers |
| Total Gross UBI | 324729 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 10760966 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1517359 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 451665477 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 469698817 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 15591331 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4928553 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4648712 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4542399 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 482666486 | TotalRevenuePriorYear |
| Total Revenue Current Year | 480687128 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 5927406 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 5033519 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 219905421 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 220561017 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 535589 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 234193430 | OtherExpensePriorYear |
| Other Expenses Current Year | 246850933 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 460026257 | TotalExpensesPriorYear |
| Total Expenses Current Year | 472445469 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 22640229 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8241659 | RevenuesLessExpensesCY |
| Total Assets BOY | 637051838 | TotalAssetsBOY |
| Total Assets EOY | 659774758 | TotalAssetsEOY |
| Total Liabilities BOY | 363590533 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 367355363 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 273461305 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 292419395 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Park Nicollet Methodist Hospital has a mission to care for and support the health, healing, and learning of those served. The focus is on excellent care, delivered in a caring manner, with emphasis on disease prevention and wellness education. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 387212026 | Expense |
| Grants | 5033519 | Grants |
| Revenue | 452696464 | Revenue |
| Description | Park Nicollet Methodist Hospital is a 426-bed facility with more than 2,700 employees and more than 960 physicians on its medical staff. Located in St. Louis Park, Minnesota, it is recognized as an area leader in cancer care, cardiovascular services, maternity care and neuro-rehabilitation medicine. Park Nicollet Methodist Hospital is part of Park Nicollet Health Services, an integrated care system, staffed by nationally recognized hospital and clinic doctors, clinical professionals, nurses and other team members. Park Nicollet Methodist Hospital helps patients stay healthy and takes care of them when they are sick. Park Nicollet Methodist Hospital's mission is to care for and support the health, healing and learning of those served.Park Nicollet Methodist Hospital uses five core values to accomplish its mission - care, service, stewardship, joy and learning. Highlights of 2010 that support Park Nicollet Methodist Hospital's values include the following:Park Nicollet Methodist Hospital actively involves its patients, employees, board members and community partners in identifying patient and community needs. In 2010, Park Nicollet Methodist Hospital provided more than $4.8 million in patient services charity care, more than $15.7 million in unreimbursed medical care and provided more than $2.2 million to the community through other channels.Patient councils have been established to foster collaboration between patients, families, and care teams. These councils focus on topics such as patient safety, facility design, clinician-patient communication, quality improvement, patient/family education, ethics, and research. Park Nicollet Methodist Hospital received several 2010 HealthGrades recognitions including: Pulmonary Care Excellence Award, Cardiac Care Excellence Award, Cardiac Surgery Excellence Award and the Critical Care Excellence Award. These honors placed Park Nicollet Methodist Hospital in the top 5 percent of hospitals nationwide. Park Nicollet Methodist Hospital is certified as an Advanced Primary Stroke Center and received an eighth consecutive HealthGrades Stroke Care Excellence Award.Park Nicollet Methodist Hospital participates in the National Database for Nursing Quality Improvement (NDNQI) which is a composite of 17 measures related to patient safety and hospital-acquired infections. As part of these measures, the nursing staff improvement teams have reduced patient falls more than one third in 2010. The hospital went from 2.99 falls per 1,000 patient days in 2009 to 1.95 per 1,000 patient days in 2010. The average number of falls dropped from 18 per month in 2008-09 to 13 per month in 2010. There was a significant decline in reportable pressure ulcers, ventilator-associated pneumonias, and central line infections.Park Nicollet Methodist Hospital nursing staff and volunteers have joined forces to prevent delirium and functional decline in patients age 70 and older. In 2010 we became the first Minnesota site for a program called HELP (Hospital Elder Life Program). Trained volunteers visit patients each day to provide intentional interventions around cognitive and physical functioning as a method to prevent delirium. This program has maintained a Confusion Assessment Method (CAM) positive conversion to only 2%, which is far below the 15% for patients who aren't visited by the program.Advanced Care Planning for end of life care is a significant system-wide initiative in 2010. The hospital and the Park Nicollet Foundation have partnered to develop focus areas within the community and at Park Nicollet Clinics to discuss advanced care planning and ensure advanced directives are available for care teams in the hospital.Park Nicollet Methodist Hospital is affiliated with Park Nicollet Health Services, Park Nicollet Clinic, Park Nicollet Foundation, Park Nicollet Institute and Park Nicollet Health Care Products. Together with the affiliated organizations, Park Nicollet Methodist Hospital has accomplished the following in 2010:Park Nicollet Methodist Hospital and its affiliates are dedicated to caring for, and supporting the health, healing and learning of patients, employees and the community. Park Nicollet Methodist Hospital and its affiliates accomplish this in many ways and are especially grateful to its volunteers. In 2010, Park Nicollet Health Services and affiliates gave more than $3.1 million through 106 grants. Park Nicollet Health Services and affiliates continued its joint sponsorship of the Successful Aging Initiative, which focuses on improving coordination of community and health care services for senior citizens. Park Nicollet Methodist Hospital and Park Nicollet Foundation partner with 21 school districts to assure that all students are up to date with their immunizations. Park Nicollet Health Services and affiliates strive to assure help is there when needed during serious or life-threatening illnesses. We offer programs that are not fully funded or reimbursed under traditional health insurance, including Club CREATE, Stroke INSPIRE and Melrose Institute.A new health resource center in the Brooklyn Center High School opened in February 2010, providing free and low-cost medical, mental health and dental care to children and youth in the community. This community resource is the fourth such school-affiliated clinic established, staffed and funded in partnership with Park Nicollet Foundation and Park Nicollet Methodist Hospital.In 2010, by partnering with the local non-profit Children's Dental Services, four community clinics for children began offering free or reduced-cost dental care to any child or adolescent in the communities served. In 2010, Park Nicollet Methodist Hospital, along with Park Nicollet Clinic and other affiliates provided needed comprehensive care, including primary, specialty, hospital and pharmacy services, at no charge, 1,996 individuals enrolled in the St. Mary's program - and innovative model of providing continuity of care for the uninsured. Park Nicollet Health Services provided more than 9,900 prescriptions for outpatient medications to low income individuals and families, assuring medical treatment for acute and chronic conditions such as asthma and diabetes.Park Nicollet Methodist Hospital implemented Schwartz Center Rounds in 2010 to help clinicians, nurses and all care team members cope with the social and emotional challenges of working in modern health care. Participants can expect a facilitated, interactive forum where both presenters and attendees can share thoughts and feelings in a safe environment. Park Nicollet Methodist Hospital expanded and remodeled the Emergency Center. There are now 30 private examination rooms and a new 12-bed observation unit that will help decrease the length of stay for appropriate observation patients.In 2010, Park Nicollet Clinic received four of the eleven certifications by the state of Minnesota to be "health care homes". Health care homes, also known as "medical homes," offer a team approach to primary care. A care coordinator works with patients and their families to coordinate with a clinical team that may include physicians, nurses, clinicians, specialists and pharmacists. The program also coordinates with community resources such as schools and social service agencies to ensure continuity of care that will follow patients after they leave the clinic and into the communities where they live.The Park Nicollet Frauenshuh Cancer Center Rehabilitation Program received a HealthPartners "Innovation Award" in 2010 for its excellent work in improving the lives of cancer survivors. The program helps cancer patients reduce pain, improve their function and strength, and find support from rehabilitation team members and other cancer patients. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 14049055 | Expense |
| Revenue | 16464529 | Revenue |
| Description | Services to Affiliated Organizations:Park Nicollet Methodist Hospital incurs expenses on behalf of affiliated tax exempt organizations, Park Nicollet Health Services, Park Nicollet Clinic, Park Nicollet Health Care Products, and Park Nicollet Institute. Park Nicollet Methodist Hospital provides rental space and lab services to its affiliated organizations in order to assure the efficient and professional delivery of health care and other services to the community and aids in the provision of low cost medical service. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 742695 | Expense |
| Revenue | 556655 | Revenue |
| Description | Medical Services Education:Park Nicollet Methodist Hospital incurs expenses for the educational outreach programs and services offered throughout the five state regional areas, including a network of approximately 90 Parkinson's support groups, health professional conferences or in-services for those working with Parkinson's community in the region. Park Nicollet Methodist Hospital also offers onsite educational conferences for nurses, rehab therapists and social workers on an annual basis.See Schedule OFunds are also used for an annual support group facilitator training, and for Progress and Possibilities, the largest Parkinson's conference designed for patients and their family members in the service region. Park Nicollet Methodist Hospital also has an education center that offers childbirth preparation classes that are led by experienced health care professionals with advanced training and expertise in patient education and prenatal care. In 2010 Park Nicollet Methodist Hospital held 107 classes with 2,698 participants. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 402003776 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 0 | 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 | 0 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | 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 | 0 | 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 | 1 | 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 |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 230 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | 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 | 0 | LocalChapters |
| 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 | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| 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 | Sheila McMillan | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9529936790 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (32 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| David Abelson MD | ||||||||
| President and CEO | 55.00 | X | X | 0 | 789529 | 220188 | ||
| Steven Connelly MD | ||||||||
| Chief Medical Officer | 55.00 | X | X | 0 | 514388 | 48590 | ||
| David J Cooke | ||||||||
| Sr VP & CFO (1/1-1/4) | 55.00 | X | X | 0 | 699941 | 93397 | ||
| Judith Corson | ||||||||
| Secretary | 3.00 | X | X | 0 | 0 | 0 | ||
| Bruce W Engelsma | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Steven Frank | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| David Homans MD | ||||||||
| Chief of Specialty Serv | 55.00 | X | 0 | 476226 | 38872 | |||
| Jeffrey B Husband MD | ||||||||
| Director | 55.00 | X | 0 | 569522 | 49426 | |||
| Ann Rockler Jackson | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Michael Johnson | ||||||||
| Sr VP Community Advance | 55.00 | X | 0 | 355684 | 59876 | |||
| Kathryn D Kallas | ||||||||
| VP Inpatient Care & CNO | 55.00 | X | X | 0 | 344809 | 103609 | ||
| Michael Kaupa | ||||||||
| Executive VP and COO | 55.00 | X | X | 0 | 602417 | 137571 | ||
| Jodee Kozlak | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Donald Lewis | ||||||||
| Vice Chair | 3.00 | X | X | 0 | 0 | 0 | ||
| Charles McCoy MD | ||||||||
| Director | 55.00 | X | 0 | 188968 | 32901 | |||
| Sheila McMillan | ||||||||
| Sr VP & CFO (8/30-12/31) | 55.00 | X | X | 0 | 147443 | 49507 | ||
| Ken Melrose | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Ruth Mickelsen | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Lee N Newcomer MD | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| James O Pohlad | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Janette Strathy MD | ||||||||
| Director | 55.00 | X | 0 | 304114 | 36101 | |||
| Richard E Struthers | ||||||||
| Treasurer | 3.00 | X | X | 0 | 0 | 0 | ||
| Kenneth L Thome | ||||||||
| Chair | 3.00 | X | X | 0 | 0 | 0 | ||
| Mark Wilkowske MD | ||||||||
| Chief of Oncology Serv | 55.00 | X | 0 | 609656 | 49964 | |||
| Susan Zwaschka | ||||||||
| VP Corp Compliance | 55.00 | X | 0 | 319851 | 94811 | |||
| John Axelson MD | ||||||||
| Medical Doctor | 55.00 | 301959 | 0 | 45220 | X | |||
| Paula Deakins MD | ||||||||
| Medical Doctor | 55.00 | 216893 | 0 | 41379 | X | |||
| Joel Jahraus MD | ||||||||
| Medical Doctor | 55.00 | 351474 | 0 | 46591 | X | |||
| Julie Lesser MD | ||||||||
| Medical Doctor | 55.00 | 328297 | 0 | 49252 | X | |||
| Deborah Mangham MD | ||||||||
| Medical Doctor | 55.00 | 313655 | 0 | 44449 | X | |||
| Samuel Carlson MD | ||||||||
| Former Executive VP & CMO | 0 | 173093 | 79194 | X | ||||
| David K Wessner | ||||||||
| Former President & CEO | 0 | 1387855 | 101086 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1512278 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 7483496 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1421984 | TotalOtherCompensation |
| Number Individuals GT100 K | 268 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| RJM Construction LLC | |||||
| 5455 HWY 169 | Plymouth | MN | 55442 | Construction Services | 5920862 |
| Memorial Blood Center of Mpls | |||||
| PO Box 1164 | Minneapolis | MN | 55480 | Medical Services | 3290898 |
| ARUP Laboratories | |||||
| PO Box 27964 | Salt Lake City | UT | 84127 | Medical Services | 2488783 |
| Knutson Construction Services | |||||
| 5500 Wayzata Blvd | Minneapolis | MN | 55416 | Construction Services | 2219531 |
| West Suburan Pathologists | |||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55416 | Medical Services | 2022108 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 88 | NumberOfContractorsGT100K |
| Related Organizations | 1517359 | RelatedOrganizations |
| Total Contributions | 1517359 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| Medical Service Income | 621400 | 270818846 | 270309471 | $509,375 |
| Medicare/Medicaid | 621400 | 181858787 | 181858787 | |
| Services to Affiliates | 900003 | 16464529 | 16464529 | |
| Medical Service - Edu | 621400 | 556655 | 556655 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 469698817 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4384179 | TotalRevenueColumn |
| Exclusion | $4,384,179 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 536004 | TotalRevenueColumn |
| Exclusion | $536,004 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 468174 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 441162 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 27012 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 27012 | TotalRevenueColumn |
| Exclusion | $27,012 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 140916218 | Securities |
| Other | 142664 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 139854071 | Securities |
| Other | 1196441 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1062147 | Securities |
| Other | -1053777 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8370 | TotalRevenueColumn |
| Exclusion | $8,370 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 496897 | GrossSalesOfInventory |
| Cost Of Goods Sold | 318639 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 178258 | TotalRevenueColumn |
| Exclusion | $178,258 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Parking Revenue | 812930 | 1977560 | $1,977,560 | |
| Cafeteria/Vending/Serv | 722210 | 1844175 | $1,844,175 | |
| Management fees | 900003 | 324729 | 324729 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 190665 | TotalRevenueColumn |
| Related Or Exempt Function Income | 18831 | RelatedOrExemptFunctionIncome |
| Exclusion | $171,834 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4337129 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 480687128 | TotalRevenueColumn |
| Related Or Exempt Function Income | 469208273 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 324729 | UnrelatedBusinessRevenue |
| Exclusion | $9,636,767 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5018519 | Total |
| Program Services | 5018519 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15000 | Total |
| Program Services | 15000 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 174515982 | Total |
| Program Services | 162825232 | ProgramServices |
| Management And General | 11375273 | ManagementAndGeneral |
| Fundraising | 315477 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11923995 | Total |
| Program Services | 10978836 | ProgramServices |
| Management And General | 919654 | ManagementAndGeneral |
| Fundraising | 25505 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21433781 | Total |
| Program Services | 19489394 | ProgramServices |
| Management And General | 1891917 | ManagementAndGeneral |
| Fundraising | 52470 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12687259 | Total |
| Program Services | 11533417 | ProgramServices |
| Management And General | 1122705 | ManagementAndGeneral |
| Fundraising | 31137 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1183991 | Total |
| Management And General | 1183991 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 543250 | Total |
| Management And General | 543250 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 645426 | Total |
| Management And General | 645426 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17875352 | Total |
| Program Services | 15644959 | ProgramServices |
| Management And General | 2119393 | ManagementAndGeneral |
| Fundraising | 111000 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2861102 | Total |
| Program Services | 1341715 | ProgramServices |
| Management And General | 1519387 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6898028 | Total |
| Program Services | 4193926 | ProgramServices |
| Management And General | 2704102 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4601829 | Total |
| Program Services | 4471336 | ProgramServices |
| Management And General | 130493 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19206367 | Total |
| Program Services | 17744781 | ProgramServices |
| Management And General | 1461586 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 535662 | Total |
| Program Services | 495712 | ProgramServices |
| Management And General | 39950 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140873 | Total |
| Program Services | 137881 | ProgramServices |
| Management And General | 2992 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6774479 | Total |
| Program Services | 6774479 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22424994 | Total |
| Program Services | 20278482 | ProgramServices |
| Management And General | 2146512 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 728691 | Total |
| Management And General | 728691 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Medical Supplies | 79557649 | 79369213 | 188436 | 0 |
| MGMT Exps to Affiliate | 57631612 | 17278926 | 40352686 | 0 |
| Bad Debt Expense | 10796131 | 10796131 | 0 | 0 |
| MN Care Expense | 9670754 | 9670754 | 0 | 0 |
| Residency Training | 3359309 | 3359309 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1415434 | Total |
| Program Services | 585774 | ProgramServices |
| Management And General | 829660 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 472445469 | Total |
| Program Services | 402003776 | ProgramServices |
| Management And General | 69906104 | ManagementAndGeneral |
| Fundraising | 535589 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 666166 | BOY |
| EOY | 215451 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 215641 | BOY |
| EOY | 192677 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57867168 | BOY |
| EOY | 51425553 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3343406 | BOY |
| EOY | 4103428 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6547062 | BOY |
| EOY | 6606091 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 656515245 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 402273037 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 249818220 | BOY |
| EOY | 254242208 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 237342965 | BOY |
| EOY | 251127068 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1753175 | BOY |
| EOY | 1266926 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 79498035 | BOY |
| EOY | 90595356 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 637051838 | BOY |
| EOY | 659774758 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45153549 | BOY |
| EOY | 56736034 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 641398 | BOY |
| EOY | 681971 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 308236828 | BOY |
| EOY | 303106284 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3340847 | BOY |
| EOY | 2698222 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6217911 | BOY |
| EOY | 4132852 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 363590533 | BOY |
| EOY | 367355363 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 272823840 | BOY |
| EOY | 291658627 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 430452 | BOY |
| EOY | 553755 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 207013 | BOY |
| EOY | 207013 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 273461305 | BOY |
| EOY | 292419395 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 637051838 | BOY |
| EOY | 659774758 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 8241659 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 10716431 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $2,974 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 2974 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Other Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1i: | ReturnReference |
| Explanation | Park Nicollet Methodist Hospital reimburses certain professional membership dues of employees. A portion of such membership dues are used by the professional associations for lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 17079402 | BeginningOfYearBalance |
| Contributions | 930078 | Contributions |
| Investment Earnings Or Losses | 736414 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2301894 | GrantsOrScholarships |
| End Of Year Balance | 16444000 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 26956287 | BeginningOfYearBalance |
| Contributions | 1850987 | Contributions |
| Investment Earnings Or Losses | 760496 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 12488368 | GrantsOrScholarships |
| End Of Year Balance | 17079402 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 28219534 | BeginningOfYearBalance |
| Contributions | 2016228 | Contributions |
| Investment Earnings Or Losses | -1038915 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2240560 | GrantsOrScholarships |
| End Of Year Balance | 26956287 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.51000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.49000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5599978 | OtherCostOrOtherBasis |
| Book Value | 5599978 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 325795540 | OtherCostOrOtherBasis |
| Depreciation | 170581365 | Depreciation |
| Book Value | 155214175 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2886731 | OtherCostOrOtherBasis |
| Depreciation | 2602314 | Depreciation |
| Book Value | 284417 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 322232996 | OtherCostOrOtherBasis |
| Depreciation | 229089358 | Depreciation |
| Book Value | 93143638 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 254242208 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Investment in PNHS Investment Partnership | 209343502 | F |
| Treasury Market Funds | 41479098 | F |
| Money Market | 304468 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 251127068 | TotalOfBookValueSecurities |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Due To/From Affiliates | 87741842 |
| Bond Issue Costs | 2728127 |
| Interest Receivable | 74484 |
| Long Term Real Estate Deposits | 50903 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 90595356 | TotalBookValueOtherAssets |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | The term endowment funds for use within Park Nicollet Methodist Hospital are for Grants related to Education, Research and Patient Care. |
| Part X, Line 2: There were no unrecognized Tax Benefits or Liabilities for the years ended December 31, 2010, 2009 and 2008. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 275.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 275.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| 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 | 4851248 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 72247 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4779001 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01040 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 45912778 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 30128715 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15784063 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03420 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 50764026 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 30200962 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 20563064 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04460 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2907829 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 618250 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2289580 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5823653 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1566372 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4257281 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00920 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8731482 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2184622 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6546861 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01420 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 59495508 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 32385584 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 27109925 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05880 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $5,917,430 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 120790376 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 122847532 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -2057156 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| 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 | Park Nicollet Methodist Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| 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 | NA | 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 | 5 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (5 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Struther's Parkinson Center | ||||
| 6701 Country Club Drive | Golden Valley | MN | 55427 | Research and Treatment of Parkinson's Disease |
| Park Nicollet Melrose Institute | ||||
| 3625 Monterey Drive | St Louis Park | MN | 55416 | General Medical |
| Ambulatory Surgical Center | ||||
| 3900 Park Nicollet Boulevard | St Louis Park | MN | 55416 | Outpatient Surgery |
| Sleep Disorders | ||||
| 6940 Excelsior Blvd | St Louis Park | MN | 55426 | Medical Office Building |
| Meadowbrook Infusion Center Services | ||||
| 6490 Excelsior Blvd | St Louis Park | MN | 55426 | Cancer Center and Medical Office Building |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | Return ReferenceReturnReference |
|---|---|
| Part I, Line 6a: Park Nicollet Foundation, a related organization of Park Nicollet Methodist Hospital completes an organization wide annual community benefit report that includes Park Nicollet Methodist Hospital and other affiliated entities. | |
| Part I, Line 7: Park Nicollet Methodist Hospital uses the cost-to-charge ratio method when calculating the amounts reported on Part I, Line 7. The cost-to-charge ratio was derived using Worksheet 2, Ratio of Patient Care Cost-to-Charges, from the Schedule H instructions. | |
| Part I, L7 Col(f): Bad Debt Expense of $10,796,131 was subtracted for purposes of calculating the percentage in Schedule H, Part I, Line 7, column (f).Part III, Line 3: Park Nicollet Methodist Hospital works with those qualifying for charity care along every step of the process including accepting applications for financial assistance after previous attempts to work with the patient fail. Every effort is made to work with the patient to provide financial assistance when appropriate. While there are people who do not cooperate with the hospital regarding payment plans, financials assistance or with those trying to help them get on government programs, it is impossible to know their reason for not cooperating and therefore know whether they may have qualified for charity care. Park Nicollet Methodist Hospital does not have predictive software which would make assumptions based on housing situation, credit reports, etc. and recommend assistance without a process for gathering income verification. In light of the foregoing facts, the hospital is unable to reasonably determine whether any amount of bad debt could have been classified as charity care. | |
| Part III, Line 4: Park Nicollet Methodist Hospital's audited financial statements do not include a footnote discussing bad debt expense, or allowance of doubtful accounts. Bad debt is accounted for on the financial statements by estimating patient liability net of any charity care and then calculating what portion of that will not be collected based historical uncollectible rates. When a patient meets Park Nicollet Methodist Hospital's financial requirements it is classified as charity care; if they do not qualify, its services will be written off as bad debt. Park Nicollet Methodist Hospital does not include any charity care in its bad debt expense calculation. | |
| Part III, Line 8: Park Nicollet Methodist Hospital believes that all of the Medicare loss should be classified as a community benefit. The reason is that if these services were not provided by us they would become the obligation of the federal government. Based on this, Medicare losses should be included as a community benefit because the losses are incurred in performing an important public service. The allowable costs in Park Nicollet Methodist Hospital calculation came from the Medicare Cost Report as instructed per the Form 990, Schedule H instructions. | |
| Part III, Line 9b: The collection policy incorporates the requirements as stated by the Minnesota Attorney general and views account resolution through the Park Nicollet Methodist Hospital financial assistance program as an option for account resolution. This option is shared with debtors via statements and as part of collection calls to debtors from Park Nicollet Methodist Hospital staff and collection agencies. Park Nicollet Methodist Hospital's financial assistance is also described in pamphlets and on its website. The website includes a simple interactive schedule to allow a debtor to see if they may qualify. | |
| Part VI, Line 2: Integrated in our strategic planning process, Park Nicollet Methodist Hospital and its affiliates actively involves its patients, employees, board members and community partners in identifying patient and community needs. This process encourages awareness of changing patterns of need to improve the health of it's patients and community members. As part of current assessment of needs, the Park Nicollet Foundation convenes patients and community partners at monthly and quarterly meetings of several Healthy Communities Collaboratives and Advisory Groups located throughout Park Nicollet Foundation service area. A few examples of participating members include 1) Representatives from the school districts of St. Louis Park, Hopkins, Wayzata/Plymouth, Brooklyn Center, Osseo and Burnsville/Eagan/Savage, 2) Mental health providers such as The Family Partnership and North Psychology, 3) Groups working with underserved populations such as Northwest Hennepin Family Services Collaborative, Portico HealthNet, 360 Communities, Interfaith Outreach and providers who work with the developmental needs of young children such as St. David's Center. In 2010, Park Nicollet Health Services continued its joint sponsorship of the Successful Aging Initiative in St. Louis Park. This community based group meets monthly to identify and focus on the needs of senior citizens including improving coordination of community and health related services. Sixty to eighty participants regularly attend these sessions which include educational and networking opportunities for seniors and those working with seniors. In addition, patient advisory groups and councils have been established to foster collaboration between patients, families and care teams. These councils focus on topics such as patient safety, facility design, clinician-patient communication, quality improvement, patient/family education, ethics and research. Councils support work in the following areas, Methodist Hospital Patient Family Council, which focuses on quality and safety, Frauenshuh Cancer Center, Health Care Home quality teams, grown from four to seven "Health Care Home Patient Partner Councils", Melrose Institute,and Struthers Parkinson's Center.In 2010, Park Nicollet Methodist Hospital began planning for a formal Community Health Needs Assessment. This formal assessment will incorporate review of demographic and health information already collected and made available by government, schools and other public health education organizations. The Community Health Needs Assessment will assess the health and wellness needs of members of Park Nicollet Health Service's communities through an online survey and also convene a broad representation of knowledgeable community members and individuals representing underserved populations or those with special needs.Park Nicollet Institute participates in strategic planning and uses data gathered as part of this process to prioritize work in research and education. Data used to assess community benefit includes qualitative and clinical outcomes data gathered from numerous sources as described in Schedule H, Part VI, Question 6 below. | |
| Part VI, Line 3: Park Nicollet Methodist Hospital participates in multiple unique financial assistance programs, including our own Financial Assistance (FA). Park Nicollet Methodist Hospital informs its patients in multiple ways about its FA program and other financial assistance options for services received at Park Nicollet Health Services and affiliates. Approximately 14 percent of hospital patients participate in state public programs and approximately 2 percent are uninsured. A list of communications for patients relating to financial assistance follows:Hospital booklets given to inpatients,Web site, FA information found in billing and insurance section,FAQ on FA,FA calculator - online calculator allows quick and easy estimation of eligibility under the program,FA application - application may be printed for submission,Information on Medical Assistance, including eligibility and application process,Patient statements,All balance forward statements, regardless of balance, include a financial assistance applications and responses to frequently asked questions regarding FA.In addition to the written material, Customer Service, Collections and hospital Patient Access Liaisons (PALs) inform patients about assistance options, including government programs and FA. PALs are on-site in the hospital and can meet with patients in their rooms or prior to admission. Most customer service and collections work is done though phone calls, but our main clinic has an on-site location for personal conversations. Park Nicollet Methodist Hospital staff is trained in helping patients apply for Medical Assistance and has also contracted with outside services to assist patients in the application process for Medical Assistance in more complicated circumstances. | |
| Part VI, Line 4: Park Nicollet Health Services, through its 18 Twin Cities primary care clinics, other care locations and Methodist Hospital and specialty facilities, provides health care access to more than 1.6 million people, primarily in the western Twin Cities area. The majority (75.5 percent) of this population, spread over 96 ZIP codes, is white, 7.1 percent is black, 4.2 percent is Asian, 2.5 percent is Latino with those defining themselves as "multiracial" or "other" making up the rest of patients served. Park Nicollet Health Services' are strategically located in communities to provide access to care, regardless of economic status or means of transportation. The Socio-Economics of its population served varies both between and within each community. Park Nicollet Health Services' clinic locations span the entire west metro from Maple Grove and Brooklyn Center in the northwest to Minnetonka and St Louis Park in the central west to Shakopee and Prior Lake in the southwest and to Burnsville and Eagan in the south. A new clinic in the southern community of Lakeville is planned for 2011. These clinics serve communities (and individuals) across the Socio-Economic spectrum. True to their metropolitan nature, each community served enjoys diversity within its own borders. For example, in Brooklyn Center, in addition to Park Nicollet Clinic-Brookdale, Park Nicollet has set up a health clinic for school district students. This clinic is located in the high school and is available to all students regardless of their ability to pay. Minorities make up half of the Brooklyn Center population, and 72 percent of district students are from low-income families. And in St. Louis Park, home to many of the state's 12,500 Russian immigrants, we offer services, including translation, for those whose primary language is not English. | |
| Part VI, Line 6: | |
| Part VI, Line 6: Park Nicollet Methodist Hospital is a 426-bed facility recognized as an area leader in cancer care, cardiovascular services, maternity care and neuro-rehabiliation medicine, located in St. Louis Park, Minnesota. Medical staff privileges at the hospital are extended to all qualified physicians in the community. Park Nicollet Methodist Hospital's Board of Directors is a community board with all of its independent members living in the area served by the organization. Park Nicollet Methodist Hospital owns a facility in Golden Valley, Minnesota that houses the Struthers Parkinson's Center, which is dedicated to providing comprehensive assessment, treatment, support, education and research to improve the quality of life of people touched by this disease. Health professionals help patients from around the world receive specialized programs and services for Parkinson's disease at Struthers. A national leader in the treatment of eating disorders, Park Nicollet Methodist Hospital owns and operates the Park Nicollet Melrose Institute for eating disorders, located in St. Louis Park, Minnesota. This facility, was specially constructed for treating those with eating disorders. The Melrose Institute treatment model revolutionizes care, taking individualized treatment to a whole new level. The care teams work with patients to determine appropriate placement in inpatient, residential or one of four levels of outpatient care, including unique specialty areas not currently found elsewhere. The ongoing process for assessing community health needs as described in Schedule H, Part VI, Question 2 has enabled the entire PNHS organization to focus attention to the needs described below in addition to other health needs.Park Nicollet Foundation's community connectivity model of convening on need, building relationships and raising support has brought responses in these priority areas: Healthy kids are better learnersPark Nicollet Methodist Hospital, Park Nicollet Foundation and Park Nicollet Clinic partner with 21 school districts to assure that all students are up to date with their immunizations on the first day of school each year. A new health resource center in the Brooklyn Center High School opened in February 2010, providing no cost or low cost medical, mental health and dental care to children and youth in the community. This community resource is the fourth such school-affiliated clinic built, staffed and funded in partnership with Park Nicollet Foundation and Park Nicollet Methodist Hospital.In 2010, by partnering with Childrens Dental Services, a local non-profit, all 4 community clinics for kids began offering "no or reduced cost" dental care to any child or adolescent in the communities served. Students referred by school nurses, whose families are unable to afford medications, receive needed medications at no charge through Park Nicollet Pharmacies.Increasing access to care for the uninsuredIn 2010, Park Nicollet Methodist Hospital, along with Park Nicollet Clinic and other affiliates provided needed comprehensive care, including primary, specialty, hospital and pharmacy services, at no charge to 1,996 individuals enrolled in the St. Mary's program, an innovative model of providing continuity of care for the uninsured.Provided more than 9,900 prescriptions for outpatient medications to low income individuals and families, assuring medical treatment for acute and chronic conditions such as asthma and diabetes.Traditional financial assistance provided to individuals and families in need who are not enrolled in the St. Mary's program. Focus on seniorsSuccessful Aging Initiative responds to the needs of senior citizens in St. Louis Park, utilizing multidisciplinary work groups specifically focused on helping seniors stay safe in their homes by reducing the risk of falls and other injuries, increasing opportunities for fitness and exercise, improving transportation options, providing education to improve one's self-management of chronic illnesses, and encouraging completion of health care directives.Creating the health care homeGrowing economic and ethnic diversity in our communities has widened the gap of health disparities. Increased rates of obesity and diabetes, a growth in early childhood mental health issues, increased numbers of new immigrants unfamiliar with accessing United States' model of health care delivery and still struggling with issues of war and civil strife from their countries of origin and seniors isolated in their homes are just a few of the challenges that threaten the health of members of Park Nicollet Health Services' communities.Park Nicollet Clinics are leading the way in developing "health care homes" that not only provide needed medical care, but do so in a comprehensive model of support for patients and families to assure that they have timely access, effective coordination of care, a personal relationship with their physician and clinical care team, and a connection to other community resources.Sticking with patients when they need us mostOften the services needed to maintain one's health and wellbeing during a serious or life-threatening illness are not fully funded or reimbursed under traditional health insurance. Park Nicollet Methodist Hospital and Park Nicollet Foundation strive to assure the help is there when needed.Club CREATE, a therapeutic adult day program at Struthers Parkinson's Center, offers activities that enrich patients physically, mentally, spiritually and socially. The program utilizes a variety of artistic and creative outlets, relaxation and meditative programs, and movement and exercise opportunities.Park Nicollet Methodist Hospital's INSPIRE program is a unique service offering stroke survivors and their family support and education through seminars and support groups.Park Nicollet Methodist Hospital's Melrose Institute offers comprehensive care, education and support through innovative curriculum-based programs for those struggling with eating disorders. Reducing the number of "sleepless nights" while waiting for a diagnosis, helping patients conserve their energy by bringing services to them during treatments, offering spiritual care, social services and financial assistance for medications, groceries and other expenses while patients recover from their illness are commitments Frauenshuh Cancer Center at Park Nicollet Methodist Hospital makes to its patients.ResearchResearch is embedded in departments and strategies across Park Nicollet Health Services to support quality initiatives and the patient experience. Research encompasses investigator-initiated studies, clinical trials, practice-based research, outcomes and quality improvement projects, data analytics, statistics, survey development and focus groups. At Park Nicollet Health Services and its affiliates, more than 500 research studies are active each year. Park Nicollet Institute provides the infrastructure and resources to support research and clinical quality goals of the organization, which includes the following:Needs assessment and feasibilityMentoring and trainingScientific and humans subjects reviewRegulatory compliance and reportingGrant management, including application preparation and submission, contract and agreement negotiation, finance, budget development, identification of funding sourcesProtocol development and research designManuscript and poster/presentation preparationDatabase development data cleaning, statistics and analytics, survey review and design, focus group facilitationStudy operations support including recruitment, consenting, enrolling, data collection/entryPatient EducationPark Nicollet Methodist Hospital and Park Nicollet Institute's Patient Education department provides educational tools to support patients in preventing and managing illness and improving health. Park Nicollet Hospital and affiliates work closely with clinicians to create programs, classes, videos, web content and decision support tools to help patients take an active role in their health. These resources help patients prevent and manage common health problems, live well with chronic conditions, prepare for procedures and improve overall health and well-being. The key to assessing the needs for patient education involves including patients in the assessment process. Steps in the needs assessment process include defining the community or population, followed by determining what type of data is needed to complete the assessment and then collecting the data from a variety of sources which include, but are not limited to, patient and clinician surveys, local and national statistics related to the problem that is being addressed, evidenced-based care guidelines, quality and safety outcome reports, proprietary data sources as appropriate and published literature. | |
| Part VI, Line 7: | |
| Park Nicollet Methodist Hospital is part of Park Nicollet Health Services, an integrated health system. Other affiliates include 1) Park Nicollet Clinics in 18 locations, and other care locations, 2) Park Nicollet Foundation, the philanthropic arm of Park Nicollet Health Services helping to bring resources to needs in its communities, and 3) Park Nicollet Institute, focused on education and research for Park Nicollet Health Services and its community.All affiliates are under a common Board of Directors. Park Nicollet Foundation and Park Nicollet Institute have separate boards which are overseen by the Park Nicollet Health Services Board. The communities' health needs are shared among the affiliates and decisions regarding the effective use of resources to respond to those needs are coordinated. One specific example of this coordination was the development of a pediatric weight management program for Park Nicollet patients and other community members. The Park Nicollet Foundation, through its convening on need, identified pediatric obesity as a crucial problem within its school age population. In coordination with the Pediatric Endocrinology Department at Park Nicollet Clinic, a multidisciplinary program of group sessions for elementary and middle school aged children and parents was developed. This program, with both educational and experiential components, was developed and piloted in collaboration with the health education department of the Park Nicollet Institute. Funding was provided by a grant from Park Nicollet Foundation and in-kind contributions from the Park Nicollet Clinics. | Part VI, Line 6: |
| Professional EducationThe Institute's Professional Education department provides learning activities to enhance physician knowledge, competence and performance. Continuing medical education (CME) staff partners with Park Nicollet physicians and departments to manage a comprehensive educational program through activities designed to meet individual and department needs.Understanding the gaps in clinical practice and the educational needs of physicians is critical to the success of the overall CME program and its planned activities. As part of the semi-annual review process, the Medical Education Committee (MEC) and the CME administrative group identify data sources and methods to review data for CME program planning. We identify our learners' professional practice gaps and needs by reviewing one or more of the following: organizational planning survey of target audience, e-surveys, structured interviews and biannual staff surveys, patient care audit and quality assurance reports,morbidity and mortality statistics,peer-reviewed abstracts,faculty input,individual clinician behavior and prescribing data,community measures quality data,clinician registries,quality outcomes reports,dashboards,desirable patient care improvements identified from measurement of clinical practice guidelines,literature review of recent trends in biomedical science research,evaluation data from preceding CME activities,input from regional and national medical education and research communities provided by the MEC committee, CME faculty and Park Nicollet leadership,HEDIS' data,Institute for Clinical Systems Improvement guidelines,focused patient and staff surveys,feedback from planning committees and focus groups representative of the target audience,patient surveys regarding quality of care and interaction with providers (Press Ganey reports),topic-specific patient surveys,annual Park Nicollet quality reports,safety tracking database-quality tracking,physician competencies,Park Nicollet planning,maintenance of certification requirements. | Part VI, Line 5: |
| MN | Part VI, Line 7. List of States Receiving Community Benefit Report. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| Park Nicollet Foundation | |||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55416 | 237346465 | 501(c)(3) | 24785 | Grants to commmunity members |
| Park Nicollet Institute | |||||||
| 3800 Park Nicollet Blvd | St Louis Park | MN | 55426 | 410961862 | 501(c)(3) | 4993734 | Research and Education |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | Scholarships | TypeOfGrant |
| Number Of Recipients | 15 | NumberOfRecipients |
| Amount Of Cash Grant | 15000 | AmountOfCashGrant |
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 Park Nicollet Methodist Hospital Service League has a student volunteer program to give financial support to student volunteers who have provided exceptional volunteer service and are interested in furthering their education. Applicants must be an active student volunteer, a senior in high school and who has applied to a post-high school education program and must be dedicated volunteer at Park Nicollet Methodist Hospital. Occasionally Park Nicollet Methodist Hospital grants monies to other tax-exempt organizations conducting programs and/or research that will ultimately benefit those served by Park Nicollet Health Services and affiliates. During calendar year 2010, grants were made to Park Nicollet Foundation and Park Nicollet Institute for improvements to medical services and medical research. These grants were made to parties related to Park Nicollet Methodist Hospital, so employees of Park Nicollet Methodist Hospital were able to verify the use of the monies contributed. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 1 | 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 (20 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| David Abelson MD | |||||||||||||
| 0 | 593117 | 0 | 171752 | 0 | 24660 | 0 | 132000 | 0 | 88188 | 0 | 1009717 | 0 | 0 |
| Steven Connelly MD | |||||||||||||
| 0 | 423861 | 0 | 80252 | 0 | 10275 | 0 | 0 | 0 | 48590 | 0 | 562978 | 0 | 0 |
| David J Cooke | |||||||||||||
| 0 | 35960 | 0 | 179487 | 0 | 484494 | 0 | 0 | 0 | 93397 | 0 | 793338 | 0 | 47333 |
| David Homans MD | |||||||||||||
| 0 | 466334 | 0 | 4303 | 0 | 5589 | 0 | 0 | 0 | 38872 | 0 | 515098 | 0 | 0 |
| Jeffrey B Husband MD | |||||||||||||
| 0 | 545937 | 0 | 14097 | 0 | 9488 | 0 | 0 | 0 | 49426 | 0 | 618948 | 0 | 0 |
| Michael Johnson | |||||||||||||
| 0 | 231294 | 0 | 81203 | 0 | 43187 | 0 | 0 | 0 | 59876 | 0 | 415560 | 0 | 25300 |
| Kathryn D Kallas | |||||||||||||
| 0 | 246209 | 0 | 86343 | 0 | 12257 | 0 | 38405 | 0 | 65204 | 0 | 448418 | 0 | 0 |
| Michael Kaupa | |||||||||||||
| 0 | 384510 | 0 | 202453 | 0 | 15454 | 0 | 56390 | 0 | 81181 | 0 | 739988 | 0 | 0 |
| Charles McCoy MD | |||||||||||||
| 0 | 180229 | 0 | 5099 | 0 | 3640 | 0 | 0 | 0 | 32901 | 0 | 221869 | 0 | 0 |
| Sheila McMillan | |||||||||||||
| 0 | 124202 | 0 | 0 | 0 | 23241 | 0 | 30400 | 0 | 19107 | 0 | 196950 | 0 | 0 |
| Janette Strathy MD | |||||||||||||
| 0 | 217314 | 0 | 6002 | 0 | 80798 | 0 | 0 | 0 | 36101 | 0 | 340215 | 0 | 0 |
| Mark Wilkowske MD | |||||||||||||
| 0 | 564495 | 0 | 41572 | 0 | 3589 | 0 | 0 | 0 | 49964 | 0 | 659620 | 0 | 0 |
| Susan Zwaschka | |||||||||||||
| 0 | 226426 | 0 | 77201 | 0 | 16224 | 0 | 28200 | 0 | 66611 | 0 | 414662 | 0 | 0 |
| John Axelson MD | |||||||||||||
| 298962 | 0 | 0 | 0 | 2997 | 0 | 0 | 0 | 45220 | 0 | 347179 | 0 | 0 | 0 |
| Paula Deakins MD | |||||||||||||
| 208741 | 0 | 5583 | 0 | 2569 | 0 | 0 | 0 | 41379 | 0 | 258272 | 0 | 0 | 0 |
| Joel Jahraus MD | |||||||||||||
| 302904 | 0 | 43961 | 0 | 4609 | 0 | 0 | 0 | 46591 | 0 | 398065 | 0 | 0 | 0 |
| Julie Lesser MD | |||||||||||||
| 298814 | 0 | 9347 | 0 | 20136 | 0 | 0 | 0 | 49252 | 0 | 377549 | 0 | 0 | 0 |
| Deborah Mangham MD | |||||||||||||
| 298815 | 0 | 8066 | 0 | 6774 | 0 | 0 | 0 | 44449 | 0 | 358104 | 0 | 0 | 0 |
| Samuel Carlson MD | |||||||||||||
| 0 | 411 | 0 | 0 | 0 | 172682 | 0 | 0 | 0 | 79194 | 0 | 252287 | 0 | 0 |
| David K Wessner | |||||||||||||
| 0 | 44990 | 0 | 367603 | 0 | 975262 | 0 | 0 | 0 | 101086 | 0 | 1488941 | 0 | 154681 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1a | Park Nicollet Health Services pays social club dues to both the Interlachen and Minneapolis Clubs in the name of David Abelson, CEO, for use by all Park Nicollet Health Services officers and key employees. The facilities are used for a variety of business meetings held by key executives from Park Nicollet Health Services. Park Nicollet Health Services also pays for Rotary Club of Minneapolis dues for Michael J. Johnson, Park Nicollet Foundation President and Park Nicollet Health Services and affiliates Director. Park Nicollet Health Services considers these expenses to be business expenses of the organization; therefore these amounts are not included in taxable income for the individuals. Part I, Line 3: The Park Nicollet Health Services' Board of Directors is responsible for establishing the compensation of the organization's CEO and Executive Directors for Park Nicollet Methodist Hospital. |
| Part I, Lines 4a-b | During 2010, Park Nicollet Health Services, a related entity, terminated without cause the employment of individuals in reportable positions. Severance payments were determined to be payable under the Park Nicollet Health Services Executive Management Group Severance Policy (the "Policy"). The policy provides that if Park Nicollet Health Services terminates a covered individual without cause, and if the individual releases all legal claims against Park Nicollet Health Services, then Park Nicollet Health Services will provide the terminated individual severance compensation for a period of one year including salary, health, life, dental and disability benefits, as well as deferred compensation, incentive compensation, and pension plan payments. Based on the foregoing, the amount of severance compensation and benefits provided to each of the individual on severance during 2010 is as follows: Samuel E. Carlson, MD $142,974 David K. Wessner, $703,040 David J. Cooke, $400,000 Schedule J, Part I Line 4B: Senior leaders of Park Nicollet Methodist Hospital are given the opportunity to participate in the Capital Accumulation Account Plan. The Capital Accumulation Account Plan (CAA Plan) participation is limited to senior leaders and all the vice presidents. Each participant receives an annual allowance equal to the sum of (i) a stated percent of salary, (ii) voluntary salary deferrals, and (iii) credits for exchanging up to five vacation days. The allowance is credited to a bookkeeping account. Earnings are credited to the account based on the performance of simulated investments. Benefits vest upon the earliest of remaining employed to an elective vesting date (two years to age 68), involuntary termination without cause, disability, death, or not competing for 24 months following voluntary or for-cause termination. Benefits are paid in a single lump sum upon vesting. Participants are general creditors of the employer for the payment of the benefits. The following participants received payouts from a related organization, Park Nicollet Health Services, related to CAA plan: David K. Wessner, $154,681 David J. Cooke, $47,333 Michael Johnson $25,300 |
| Part I, Line 7 | All physicians employed by and seeing patients for Park Nicollet Clinic, are eligible for a 3% access incentive payout based on their department reaching certain goals including access for patients and quality initiatives. In their roles as executives employed by Park Nicollet Health Services, the executives are eligible for incentive payouts which are paid by Park Nicollet Health Services and Park Nicollet Clinic. The incentive award will be 35% of base pay compensation for the CEO, 30% for the CFO, COO, CMO and 25% for all other executives with an opportunity for incentive credit above the target level. The ultimate payout includes a reduction/increase multiplier depending on whether the consolidated Park Nicollet Health Services organization reached that year's operating margin goal as set by the Board of Directors. Each participant will be responsible for two financial goals, and not less than three and not more than five individual strategic objectives. In their roles as management employed by Park Nicollet Health Services, certain managers are eligible for incentive payouts. The incentive award will be 15% of their annual base pay compensation with an opportunity for incentive credit above the target level. The ultimate payout includes a reduction/increase multiplier depending on whether the consolidated Park Nicollet Health Services organization reached that year's operating margin goal as set by the Board of Directors. Incentive payments are a function of both individual and organizational performance. The participant must be assigned at least three, and not more than four focused incentive objective, one of which must be financial in nature. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Kraus-Anderson | |||
| Bruce Engelsma: CEO of Kraus-Anderson | 175497 | Construction: Kraus-Anderson provided construction services for Park Nicollet Methodist Hospital. | 0 |
| Marquette Real Estate Holdings | |||
| James Pohlad: Owner of Marquette Real Estate Holdings (MREH) | 4199956 | Development: Marquette Real Estate Holdings is the lead developer on building the Melrose Institute facilities owned by Park Nicollet Methodist Hospital. | 0 |
| RJM Construction | |||
| James Pohlad: Owner of MREH, Parent of RJM Construction | 5920862 | Construction: RJM Construction performed construction services for Park Nicollet Methodist Hospital. | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part IV, Line 24A | Park Nicollet Methodist Hospital, along with related organizations, is jointly liable for the tax exempt bonds held by Park Nicollet Health Services under a master trust agreement. The other members of the jointly liable group, which is collectively referred to as the "Obligated Group", include Park Nicollet Clinic, PNMC Holdings, Park Nicollet Institute, and Park Nicollet Health Care Products. In accordance with reporting requirements for Schedule K, all outstanding tax exempt bonds are reported solely on the Schedule K of Park Nicollet Health Services. | |
| Park Nicollet Health Services and its related entities have a common board. The following officers, board members, and key employees are employees of and paid by Park Nicollet Health Services or its related organizations. These employees serve together on the common board which serves Park Nicollet Health Services and its related entities. David Abelson David J. Cooke Steven Connelly David Homans Jeffrey B. Husband Michael Johnson Kathryn D. Kallas Michael Kaupa Charles McCoy Janette Strathy Sheila McMillan Mark Wilkowske Susan Zwaschka | Form 990, Part VI, Section A, line 2 | |
| Bylaws were amended to clarify the composition of the Board of Directors to be the same as the members of the Board of Directors of Park Nicollet Health Services, the sole member of the corporation. The bylaws were also amended to reserve certain powers to Park Nicollet Health Services, such as the power to approve major corporate actions, including amendments to governing documents, mergers and dissolution. The Articles of Incorporation were amended to provide that, upon dissolution, the assets remaining after payment of debts will be transferred to Park Nicollet Health Services, as long as Park Nicollet Health Services continues to be exempt from federal income tax under Section 501(c)(3). | Form 990, Part VI, Section A, line 4 | |
| Park Nicollet Health Services is the sole member of Park Nicollet Methodist Hospital. | Form 990, Part VI, Section A, line 6 | |
| The Board of Directors of Park Nicollet Methodist Hospital are those individuals who are contemporaneously members of the Board of Directors of Park Nicollet Health Services. | Form 990, Part VI, Section A, line 7a | |
| All decisions, including dissolution of the organization, made by the governing body of Park Nicollet Methodist Hospital are subject to the approval of the Board of Directors of Park Nicollet Health Services. | Form 990, Part VI, Section A, line 7b | |
| Park Nicollet Methodist Hospital prepares the Form 990 within the finance department with assistance from individuals in human resources, marketing, and operations. Upon completion of gathering the necessary information for the return, the form was compiled by the Park Nicollet Methodist Hospital's accounting firm. Drafts of the form were reviewed by the Assistant Controller - Accounting Operations, Vice President of Finance, Chief Financial Officer, and the Audit and Compliance Committee. After all internal reviews were complete, the final version of the Form 990 was given to each member of the Board of Directors prior to filing the return. | Form 990, Part VI, Section B, line 11 | |
| Form 990, Part VI, Section B, line 12c | At Park Nicollet Methodist Hospital all key employees, directors, and officers are required to fill out a conflict of interest statement each year; however the obligation to report conflicts is ongoing. The conflict of interest statments are reviewed by the Chief Compliance Officer and reported to the Park Nicollet Health service's board's governance committee. The board ensures that any potential conflicts reported have been mitigated in an appropriate manner. When a transaction involving a potential conflict of interest is noted, the board of directors assigns a committee to review that conflict and ensure discussions related to those transactions can occur separately from those individuals with potential conflicts. All significant transactions include an analysis of fair market value. | |
| Form 990, Part VI, Section B, line 15 | The Board of Directors of Park Nicollet Methodist Hospital are those individuals who are contemporaneously members of the Board of Directors of Park Nicollet Health Services. The Park Nicollet Health Services' Board of Directors is responsible for the implementation and oversight of executive compensation and benefit plans for Park Nicollet Methodist Hospital. Park Nicollet Clinic uses an outside consultant to provide yearly market based indexes of salary adjustments for executives in similar leadership positions. The Board of Directors reviews the salary ranges and recommends salary increases for each executive, including the CEO, based upon the Board of Directors' evaluation of job performance and experience level of the individual within the organization. The average salary increases for all Park Nicollet Methodist Hospital executives cannot exceed the average market salary increase reported for executives by the consultant. The compensation committee then reviews and approves compensation adjustments based on the information provided by the outside consultants and the Board of Directors' recommendations. For certain physicians, the majority of pay disclosed is for his/her work as a physician for Park Nicollet Methodist Hospital. A small stipend is added for serving on the Board of Directors. The following is a description of how pay for physicians' patient care work is determined. The Park Nicollet Health Services' Board of Directors is responsible for the implementation and oversight of the physician compensation and benefit plans for Park Nicollet Methodist Hospital. The Board of Directors delegates the day-to-day administration of the physician compensation plan to the Clinical Board of Governors and the Physician Compensation and Benefits Subcommittee. The purpose of the Physician Compensation and Benefits Subcommittee is to oversee physician and other clinician compensation and benefits plans and administration within the budget to ensure fairness and alignment with Park Nicollet Health Services' goals. The responsibilities of this committee include: Recommending of compensation policies and plan designs for physicians to the clinical board and Board of Directors; Overseeing compensation plan operation and payments to clinical departments; Evaluating compensation plan for performance on a periodic basis; Serving as final appeal process for issues unresolved by individuals, department chairs and chiefs of services. Annually, information on each physician's pay and productivity is graphed against the survey results for the same year. This information is presented to the compensation committee of the Park Nicollet Health Services Board of Directors for review. Park Nicollet Health Services' physician pay program is designed to ensure market based pay for market based productivity standards. The market is determined by the American Medical Group Association (AMGA) national physician compensation survey data, which provides market data for both compensation and productivity. When appropriate, the Clinic Compensation and Benefit Subcommittee grants adjustments to these guidelines with evidence of local market data. | |
| Form 990, Part VI, Section C, line 19 | Park Nicollet Methodist Hospital's governing documents, conflict of interest policy and financial statements are available to the public upon request. Park Nicollet Health Services, as the parent organization of Park Nicollet Methodist Hospital, mails its consolidated audited financial statements to financial institutions, governmental institutions, board members, media representatives, vendors, and the Minnesota Hospital Association (MHA). Park Nicollet Health Services discloses quarterly financial statements to bondholders. The annual audited and quarterly financial statements are also posted at emma.msrb.org. The Forms 990 are available upon request or from the state of Minnesota or at Guidestar.org. Form 990, Part VII: Certain board members for Park Nicollet Methodist Hospital also provide services as employees to Park Nicollet Health Services and its subsidiaries. Hours worked are an estimate and are not tracked on an entity by entity basis. Therefore, these officers, directors, and key employees hours reported on Form 990, Part VII represent aggregate hours worked per week for all Park Nicollet Health Services entities. Community board members hours reported on Form 990, Part VII are an estimate and are not tracked on an entity by entity basis. Therefore, these directors hours reported on Form 990, Part VII represent aggregate hours of service provided per week for all Park Nicollet Health Services entities. | |
| Form 990, Part XI, line 5: | Net unrealized gains on investments: 11,210,998. Net assets released from Restrictions -17,710. Expenses for Grants Paid by Park Nicollet Foundation -476,857. Total to Form 990, Part XI, Line 5: 10,716,431. | Changes in Net Assets or Fund Balances: |
| Form 990, Part XII, Line 2C: | Neither the oversight process for the audit nor the auditor selection process for Park Nicollet Health Services and affiliates' financial statements have changed during the tax year. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| Park Nicollet Health Services | ||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | 363465840 | Health Care Adminstration | MN | 501(c)(3) | 11 Type III | 0 | |
| Park Nicollet Foundation | ||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | 237346465 | Grants to serve the community | MN | 501(c)(3) | 7 | 1 | Park Nicollet Health Services |
| Park Nicollet Clinic | ||||||||||
| 3800 Park Nicollet Blvd | St Louis Park | MN | 55416 | 410834920 | Health Care | MN | 501(c)(3) | 3 | 1 | Park Nicollet Health Services |
| Park Nicollet Institute | ||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | 410961862 | Health Care Research | MN | 501(c)(3) | 4 | 1 | Park Nicollet Health Services |
| Park Nicollet Health Care Products | ||||||||||
| 3800 Park Nicollet Blvd | St Louis Park | MN | 55416 | 010638901 | Health Care Products | MN | 501(c)(3) | 11 Type II | 1 | Park Nicollet Health Services |
| PNMC Holdings | ||||||||||
| 3800 Park Nicollet Blvd | St Louis Park | MN | 55416 | 411741792 | Health Care Real Estate | MN | 501(c)(3) | 11 Type I | 1 | Park Nicollet Clinic |
Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Methodist Brain Lab Leasing LLC | |||||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | 208725994 | Health Care | MN | Park Nicollet Methodist Hospital | Related | 329396 | 388175 | 0 | 1 | 0.60000 |
| Park Nicollet Health Services Investment Partnership | |||||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | 411675033 | Investment | MN | Park Nicollet Methodist Hospital | Investment | 5290456 | 180784260 | 0 | 1 | 0.61280 |
| TRIA Orthopaedic Center LLC | |||||||||||||
| 8100 Northland Drive | Bloomington | MN | 55431 | 200034003 | Health Care | MN | Park Nicollet Health Services | N/A | 0 | 0 | 0.00000 | ||
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Enterprises | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411656735 | EIN |
| Primary Activity | Real Estate for Related Organization | PrimaryActivity |
| Legal Domicile State | MN | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Health Services | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | 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 | 1 | 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 | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (19 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Park Nicollet Health Care Products | ||
| I | 869063 | Fair Market Value |
| Park Nicollet Health Care Products | ||
| K | 7160159 | Cost |
| Park Nicollet Health Care Products | ||
| R | 773807 | Cost |
| Park Nicollet Health Care Products | ||
| P | 279370 | Cost |
| Park Nicollet Enterprises | ||
| K | 149497 | Cost |
| TRIA Orthopaedic Center LLC | ||
| K | 319394 | Cost |
| TRIA Orthopaedic Center LLC | ||
| P | 338878 | Cost |
| TRIA Orthopaedic Center LLC | ||
| R | 381228 | Cost |
| Methodist Brain Lab Leasing LLC | ||
| J | 811577 | Fair Market Value |
| Methodist Brain Lab Leasing LLC | ||
| R | 486619 | Cost |
| Park Nicollet Institute | ||
| K | 1827539 | Cost |
| Park Nicollet Institute | ||
| P | 188966 | Cost |
| Park Nicollet Institute | ||
| B | 4993734 | Cost |
| Park Nicollet Institute | ||
| L | 77949 | Cost |
| Park Nicollet Foundation | ||
| C | 1517359 | Cost |
| Park Nicollet Clinic | ||
| P | 20775342 | Cost |
| Park Nicollet Clinic | ||
| I | 1348294 | Fair Market Value |
| Park Nicollet Clinic | ||
| K | 61298913 | Cost |
| Park Nicollet Institute | ||
| Q | 3348000 | Cost |
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