2011-09-30T14:03:58-05:00 2010-12-31 990 2010-01-01 411405254 CHARTERHOUSE INC CHAR 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 MARK A ENQUIST 5075381297 2011-09-30 2010 2016-03-07 17:11:31Z MARK A ENQUIST 200 FIRST STREET SW ROCHESTER MN 55905 22533470 0 X WWW.CHARTERHOUSE-MAYO.ORG X 1981 MN RETIREMENT LIVING CENTER 9 0 442 60 0 0 32009 54971 18900063 21813741 357657 404117 86729 72422 19376458 22345251 10720 0 0 0 12272831 12063200 0 0 0 6432323 8933713 18715874 20996913 660584 1348338 43625279 46563347 38427019 39930212 5198260 6633135 X TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY RESIDENT SERVED BY PASSIONATE AND DEDICATED STAFF SO THAT CHARTER HOUSE IS A PREFERRED PLACE TO LIVE AND WORK. 0 0 19491060 21816709 PROGRAM SERVICE ACCOMPLISHMENTS (SEE SCH O)CHARTERHOUSE IS A RETIREMENT LIVING CENTER WHOSE PURPOSE IS TO MEET THE PHYSICAL, EMOTIONAL, RECREATIONAL, AND SIMILAR NEEDS OF ELDERLY PERSONS. CHARTERHOUSE RESIDENTS OCCUPIED 223 INDEPENDENT LIVING UNITS IN 2010. CHARTERHOUSE PROVIDES A CULTURAL ARTS ROOM, CRAFT ROOMS, A FITNESS CENTER, A GREENHOUSE, A CHAPEL, A LIBRARY, A MUSIC ROOM, AND OTHER FACILITIES TO ENHANCE THE WELL-BEING OF RESIDENTS. A SECURED, YEAR-ROUND SKYWAY-SUBWAY SYSTEM LINKS CHARTERHOUSE TO THE MAYO MEDICAL CENTER CAMPUS AND THE DOWNTOWN BUSINESS COMMUNITY.CHARTERHOUSE OPERATES ON A NONDISCRIMINATORY BASIS, REGARDLESS OF RACE, COLOR, SEX, RELIGION OR NATIONAL ORIGIN.CHARTERHOUSE PROVIDES A CONTINUUM OF SERVICES TO MEET THE HEALTHCARE NEEDS OF RESIDENTS, RANGING FROM A STATE LICENSED, MEDICARE CERTIFIED 32-BED SKILLED NURSING FACILITY, CALLED THE HEALTH CENTER, TO A LICENSED CERTIFIED HOME HEALTH CARE AGENCY. THE HEALTH CENTER ACCEPTS BOTH RESIDENTS AND NONRESIDENTS FOR ITS PROGRAM. IN 2010, THE SKILLED NURSING FACILITY ADMITTED 596 PATIENTS, WITH A TOTAL OF 9,335 PATIENT DAYS. THE HOME HEALTH AGENCY IS STAFFED BY REGISTERED NURSES AND EXPERIENCED HEALTHCARE AIDES AND IT PROVIDES SERVICES TO RESIDENTS THAT HELP THEM REMAIN IN THEIR INDEPENDENT LIVING ENVIRONMENT FOR AS LONG AS POSSIBLE. SERVICES PROVIDED BY THE HOME HEALTH AGENCY PERSONNEL RANGE FROM PERSONAL GROOMING TO MEAL PREPARATION. 28,062 HOME HEALTH VISITS WERE MADE IN 2010.CHARTERHOUSE HAS A 32-BED CARE FACILITY CALLED THE SUPPORTIVE CARE CENTER LICENSED BY THE MINNESOTA DEPARTMENT OF HEALTH. IN THIS SETTING, LICENSED NURSING STAFF PROVIDE RESIDENTS 24-HOUR A DAY ASSISTANCE WITH THEIR DAILY LIVING ACTIVITIES.CHARTERHOUSE ALSO HAS A 49 UNIT RESIDENTIAL SETTING CALLED THE ASSISTED LIVING CENTER. THIS CENTER SERVES RESIDENTS WHO ARE NOT ABLE TO LIVE INDEPENDENTLY IN AN APARTMENT, BUT DO NOT REQUIRE THE SKILLED NURSING CARE PROVIDED IN THE HEALTH CENTER. PERSONAL CARE SERVICES IN THIS FACILITY ARE PROVIDED BY THE HOME HEALTH AGENCY.CHARTERHOUSE MAINTAINS CONTINUING ARRANGEMENTS WITH OTHER ORGANIZATIONS, FACILITIES, AND HEALTH PERSONNEL TO PROVIDE ACCESS TO THE SERVICES OF PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPISTS, HEARING AID AND EYEGLASS SERVICES, A GERIATRIC CONTINUITY CLINIC AND A PODIATRY CLINIC, TO MEET THE HEALTHCARE NEEDS OF ITS RESIDENTS.CHARTERHOUSE ALSO OFFERS AN ARRAY OF SUPPORT SERVICES INCLUDING ASSISTANCE WITH GROCERY SHOPPING, MEAL PREPARATION, PERSONAL LAUNDRY AND LINEN, BATHING, DRESSING, PERSONAL CORRESPONDENCE, AND AN ESCORT SERVICE TO AND FROM COMMUNITY EVENTS AND APPOINTMENTS.CHARTERHOUSE MAINTAINS IN RESIDENCE OLDER PERSONS WHO BECOME UNABLE TO PAY REGULAR CHARGES. SUCH RESIDENTS ARE ENTITLED TO REMAIN IN THEIR APARTMENTS AND TO RECEIVE CHARTERHOUSE'S NORMAL AND ROUTINE SERVICES, AS LONG AS THEY HAVE NOT WILLFULLY DISSIPATED THEIR PERSONAL ASSETS. CHARTERHOUSE MAINTAINS A BENEVOLENT CARE FUND TO ASSIST NEEDY RESIDENTS IN MEETING THEIR FINANCIAL OBLIGATION TO CHARTERHOUSE.CHARTERHOUSE IS INVLOVED IN A RESEARCH PROJECT THAT COMPARES THE EFFICANCY OF TELE-MONITORING VERSUS STANDARD CLINICAL PRACTICE FOR 200 SENIORS (100 PER ARM OF THE RANDOMIZED STUDY). THE STUDY INVOLVES COLLECTING BIO-METRIC DATA FOR SELECTED PATIENTS 7 DAYS A WEEK BY MID-LEVEL PROVIDERS AND NURSES VIA PHONE AND COMPUTER MODALITIES. VOLUNTEER SERVICE - CHARTERHOUSE HAS A VOLUNTEER PROGRAM COMPRISED OF APPROXIMATELY 60 VOLUNTEERS. APPROXIMATELY 785 HOURS WERE DONATED IN 2010 (AT AN APPROXIMATE VALUE OF $16,768 BASED ON STATISTICS FROM THE INDEPENDENT SECTOR).IN ADDITION, THE RESIDENTS OF CHARTERHOUSE HAVE AN ANNUAL RUMMAGE SALE AND GIFT THE NET PROCEEDS TO LOCAL CHARITIES. 90852 UNCOMPENSATED CARE - CHARTERHOUSE PROVIDES A VARIETY OF FINANCIAL ASSISTANCE OPTIONS TO PATIENTS WHO MEET ESTABLISHED CRITERIA. THE MEDICARE SHORTFALL DURING 2010 WITHIN CHARTERHOUSE'S SKILLED NURSING FACILITY WAS APPROXIMATELY $1,923,810. IN ADDITION, CHARTERHOUSE PROVIDED $131,318 IN CHARITABLE ASSISTANCE TO RESIDENTS NO LONGER ABLE TO AFFORD THEIR UNITS. CHARTERHOUSE PAID $90,852 TO MNCARE - A PROGRAM THAT OFFERS HEALTHCARE ASSISTANCE TO LOW INCOME POPULATIONS. 19581912 1 1 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 442 1 0 0 0 0 0 0 0 0 0 0 X 9 0 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X CORPORATE TAX UNIT 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 X KEVIN WHITFORD MD 1.00 X 0 229558 43494 MARK A ENQUIST 40.00 X X 0 153765 40503 NAN B SAWYER 1.00 X 0 503199 63004 PAUL E ZAHASKY 1.00 X 0 169966 22191 TERRENCE L CASCINO MD 1.00 X X 0 827596 149352 JULIE S HANSEN 1.00 X 0 175202 38321 DENNIS GASTINEAU MD 1.00 X 0 654260 76407 KENNETH SCHNEIDER 1.00 X 0 291190 20080 BARBARA L FREDERICK 1.00 X X 0 207717 15099 CLAIRE E BENDER MD 0.00 X 0 3050283 131463 0 6262736 599914 0 1 1 0 MAYO FDN FOR MEDICAL EDUCATION AND RESEA 200 FIRST STREET SW ROCHESTER MN 55905 PURCHASING AGENT 3845333 FRANKLIN HEATING STATION 200 FIRST STREET SW ROCHESTER MN 55905 OCCUPANCY 760461 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 MEDICAL SERVICES 107743 3 54971 54971 NET PATIENT REVENUE 620000 10131536 10131536 RESIDENT REVENUE 623000 8963975 8963975 RENTAL REVENUE FROM AF 531120 2253500 2253500 NON-RESIDENT RENTALS 531120 264276 264276 FOOD SERVICE REVENUE 722210 154160 154160 46294 46294 21813741 404117 404117 257673 188219 69454 69454 MISC. REVENUE 900099 2968 2968 2968 22345251 21552433 0 737847 8442379 7771915 670464 179323 165082 14241 2807166 2584231 222935 634332 583956 50376 5143 5143 2541757 2444644 97113 5665 5665 2781295 2537557 243738 34308 34308 1370134 1349746 20388 15974 10954 5020 146529 121481 25048 58458 58458 1509051 1499151 9900 13665 13665 BAD DEBT EXPENSE 319997 319997 MN CARE TAX 90852 90852 EMPLOYEE RELATED EXPENS 22832 22443 389 DUES, LICENSES & SUBSCR 18053 2115 15938 20996913 19581912 1415001 0 3108 3046 1780370 1840585 74274 81973 51968 48925 38781995 16110297 20975286 22671698 18153581 20251359 2586692 1665761 43625279 46563347 2100760 1907629 2150925 2632487 29809966 31559572 4365368 3830524 38427019 39930212 X 4456874 5784684 107372 195702 634014 652749 5198260 6633135 43625279 46563347 X 1348338 86537 X X 0 1 1 X 0 X 2022 11511 971 32009 54971 101484 18856244 18883839 17239906 18867375 21549465 95396829 296802 264276 561078 18858266 18895350 17240877 19196186 21868712 96059391 0 0 0 96059391 940971 935439 723950 378978 404117 3383455 940971 935439 723950 378978 404117 3383455 164 3774 71 2968 6977 19799401 19834563 17964827 19575235 22275797 99449823 0.96590 0.96200 0.03400 0.03790 X Schedule A, Part II, Line 12, Explanation of Other Income: MISCELLANEOUS INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 11394 10953 11877 10470 1 634014 18735 652749 632659 1355 634014 604833 27826 632659 1.00000 0 1 1 1000000 1000000 36641541 15268641 21372900 1140454 841656 298798 22671698 MAYO POOLED INVESTMENTS 19842231 F INVESTMENTS LIMITED TO USE, HELD BY TRUSTEE 409128 F 20251359 DUE TO AFFILIATES 3830524 3830524 22345251 20996913 1348338 86537 86537 1434875 22620006 86536 188219 274755 22345251 0 22345251 21185132 188219 188219 20996913 0 20996913 Part IV, Line 1b: RESIDENTS MAY HAVE A PERSONAL FUND ACCOUNT AT THE CHARTERHOUSE BUSINESS OFFICE, THE FUNDS ARE KEPT IN A FINANCIAL INSTITUTION. CHARTERHOUSE MAINTAINS LEDGER SHEETS FOR EACH RESIDENT AND ALLOCATES INTEREST INCOME AND BANK EXPENSES TO ALL ACCOUNT HOLDERS AND ALSO ISSUES QUARTERLY STATEMENTS FOR REVIEW TO THE RESIDENTS. Part IV, Line 2b: RESIDENT SECURITY DEPOSITS AND CUSTODIAL RESIDENT ACCOUNT FOR RUMMAGE SALE. Description of Intended Use of Endowment Funds: Part V, Line 4: THE ENDOWMENT FUNDS PROVIDE A STABLE FUNDING SOURCE FOR CHARTER HOUSE PROGRAMS. Description of Uncertain Tax Positions Under FIN 48: Part X: CHARTERHOUSE RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS. Part XII, Line 2d - Other Adjustments: SALE OF INVENTORY - COST OF GOODS SOLD 188,219. Part XIII, Line 2d - Other Adjustments: SALE OF INVENTORY - COST OF GOODS SOLD 188,219. 0 1 0 0 0 0 0 0 0 KEVIN WHITFORD MD 0 227711 0 0 0 1847 0 19616 0 23878 0 273052 0 0 MARK A ENQUIST 0 152315 0 0 0 1450 0 15335 0 25168 0 194268 0 0 NAN B SAWYER 0 318929 0 0 0 184270 0 54549 0 8455 0 566203 0 53929 PAUL E ZAHASKY 0 167885 0 0 0 2081 0 669 0 21522 0 192157 0 0 TERRENCE L CASCINO MD 0 375365 0 0 0 452231 0 128753 0 20599 0 976948 0 115118 JULIE S HANSEN 0 174546 0 0 0 656 0 14934 0 23387 0 213523 0 0 DENNIS GASTINEAU MD 0 332025 0 0 0 322235 0 55480 0 20927 0 730667 0 37291 KENNETH SCHNEIDER 0 258140 0 0 0 33050 0 1457 0 18623 0 311270 0 5458 BARBARA L FREDERICK 0 204000 0 0 0 3717 0 331 0 14768 0 222816 0 0 CLAIRE E BENDER MD 0 534391 0 0 0 2515892 0 121303 0 10160 0 3181746 0 432006 Part I, Line 4b THIS ENTITY OR ITS AFFILIATE HAS A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE MAYO PENSION PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(a)(17). IN 2010, THE COMPONENT OF THIS SRP BENEFIT THAT WAS DEFERRED COMPENSATION SUBJECT TO SECTIONS 409A AND 457(f) OF THE INTERNAL REVENUE CODE WAS TERMINATED. THIS PLAN TERMINATION TRIGGERED THE IMMEDIATE TAXATION OF THE ENTIRE SRP BENEFIT THAT HAS BEEN ACCRUED AND DEFERRED OVER EACH PARTICIPANT'S CAREER AT MAYO. STARTING JANUARY 1, 2011, ALL FUTURE SRP BENEFIT WILL BE PAID AS AN ANNUAL TAXABLE CASH PAYMENT THAT HAS NO SUBSTANTIAL RISK OF FORFEITURE. THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN EITHER AS A RESULT OF THE NORMAL OPERATION OF PLAN TERMS OR BECAUSE OF THE TERMINATION OF THE PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). A PORTION OF THE AMOUNT MAY BE INCLUDED IN SCHEDULE J, PART II, COLUMN (F) IF DISCLOSED ON A PRIOR YEAR'S FORM 990. THESE AMOUNTS HAVE BEEN ACCRUED OVER THE SPAN OF THE INDIVIDUAL'S CAREER AT MAYO. CLAIRE E. BENDER, M.D. $2,505,636 TERRANCE L. CASCINO, M.D. $444,899 DENNIS A. GASTINEAU, M.D. $319,144 NAN B. SAWYER $180,734 KENNETH J. SCHNEIDER $31,633 Supplemental Information Part III THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE THE NARRATIVE IN SCHEDULE O, FOR THE CORE 990 PART VI SECTION B LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED. COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. Form 990, Part VI, Section A, line 2 DUE TO OVERLAP OF BOARD MEMBERSHIP AND EMPLOYMENT ON RELATED EXEMPT ENTITIES, THE FOLLOWING INDIVIDUAL: NAN B. SAWYER HAS A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS: CLAIRE E. BENDER, M.D. TERRANCE L. CASCINO, M.D. MARK A. ENQUIST DENNIS A. GASTINEAU, M.D. JULIE S. HANSEN KENNETH J. SCHNEIDER KEVIN J. WHITFORD, M.D. PAUL E. ZAHASKY DUE TO OVERLAP OF BOARD MEMBERSHIP AND EMPLOYMENT ON RELATED EXEMPT ENTITIES, THE FOLLOWING INDIVIDUALS: NAN B. SAWYER TERRANCE L. CASCINO, M.D. HAVE A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL: BARBARA L. FREDERICK Form 990, Part VI, Section A, line 3 MAYO-AFFILIATED ENTITIES ROUTINELY DELEGATED VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO RELATED ENTITIES. Form 990, Part VI, Section A, line 6 THE SOLE CORPORATE MEMBER IS MAYO CLINIC Form 990, Part VI, Section A, line 7a DIRECTORS OF THIS CORPORATION MAY BE ELECTED BY THE EXECUTIVE BOARD OF MAYO CLINIC, THE SOLE CORPORATE MEMBER. Form 990, Part VI, Section A, line 7b THE BYLAWS PROVIDE THE SOLE COPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS OPERATIONS, CAPITAL, BUDGET, AMENDMENT OF THE ARTICLES OR BYLAWS, AND DEBT DECISIONS. Form 990, Part VI, Section B, line 11 THE FORM 990 IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE TREASURER AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF CHARTERHOUSE'S GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. HIGHLIGHTS ARE PRESENTED TO BOARD MEMBERS, AND THE REVIEW IS DOCUMENTED IN MEETING MINUTES. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. Form 990, Part VI, Section B, line 12c MAYO CLINIC AND ITS AFFILIATES (INCLUDING CHARTERHOUSE, INC.) HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS. FORM 990, PART VI, SECT B, LINE 15: THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS AND ADMINISTRATIVE LEADERSHIP. IN ADDITION TO ANY REVIEW AND APPROVAL THAT MAY TAKE PLACE AT THE LOCAL ENTITY LEVEL, THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY. THE SALARY OF THE VICE CHAIR AND SEVERAL OF THE BOARD OF DIRECTOR MEMBERS WAS REVIEWED BY THE GOVERNANCE COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR CHARTERHOUSE, INC. THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION OF PHYSICIANS AND ADMINISTRATIVE LEADERSHIP FOR THE ARIZONA, FLORIDA, AND ROCHESTER, MINNESOTA CAMPUSES. THE COMMITTEE IS COMPRISED OF MAYO EMPLOYEES, BUT IS INDEPENDENT FOR INTERNAL REVENUE CODE 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED (WITH RECUSAL WHERE APPROPRIATE). FOR THOSE INDIVIDUALS FOR WHICH THIS COMMITTEE CAN NOT SERVE AS THE INDEPENDENT REVIEW, THEIR COMPENSATION AND BENEFITS ARE REVIEWED BY THE GOVERNANCE COMMITTEE (DESCRIBED BELOW). THE SALARY AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. THE MAYO CLINIC COMMITTEE ON OFFICER SUCCESSION, COMPENSATION, AND GOVERNANCE (GOVERNANCE COMMITTEE) IS COMPRISED OF SEVEN OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. THIS GROUP REVIEWS THE COMPENSATION AND BENEFITS FOR PHYSICIANS FROM ALL CAMPUSES, INCLUDING THE MAYO HEALTH SYSTEM LOCATIONS, AS WELL AS CERTAIN SENIOR ADMINISTRATIVE AND EXECUTIVE LEADERSHIP (INCLUDING ALL PERSONS BELIEVED TO BE DISQUALIFIED PERSONS). THIS PROCESS ESTABLISHES ACCEPTABLE RANGES FOR VARIOUS POSITIONS, LEVELS, AND SPECIALTIES. THE COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. IN ADDITION, THE GOVERNANCE COMMITTEE DIRECTLY RETAINS AN INDEPENDENT THIRD-PARTY COMPENSATION CONSULTANT TO PROVIDE RELEVANT, CONTEMPORANEOUS BENCHMARK INFORMATION FOR A SMALL GROUP OF SENIOR PHYSICIAN, ADMINISTRATIVE, AND EXECUTIVE LEADERSHIP POSITIONS FOR WHICH AN INDIVIDUALIZED REVIEW AND RECOMMENDATION IS MADE. Form 990, Part VI, Section C, line 18 FORM 990 IS AVAILABLE UPON REQUEST. Form 990, Part VI, Section C, line 19 THE FILING ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST TO CHARTERHOUSE RESIDENTS, THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST TO CHARTERHOUSE RESIDENTS AND FROM OLMSTED COUNTY, THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. FORM 990, PART VIII, SECTION A AVERAGE HOURS PER WEEK DEVOTED TO POSITION WITH RELATED ORGANIZATION CLAIRE E. BENDER, M.D. 40.0 KEVIN WHITFORD, M.D. 40.0 NAN B. SAWYER 40.0 PAUL E. ZAHASKY 40.0 TERRENCE L. CASCINO, M.D. 40.0 JULIE S. HANSEN 40.0 DENNIS GASTINEAU, M.D. 40.0 KENNETH SCHNEIDER 40.0 BARBARA L. FREDRICK 40.0 Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 86,537. FORM 990, PART XII, LINE 2C THERE WAS NO CHANGE IN THE PROCESS DURING THE YEAR. INDEPENDENT VOTING MEMBERS OF THE GOVERNING BODY FORM 990, PART VI, LINE 1 THE BOARD OF TRUSTEES OF MAYO CLINIC, THE PARENT ENTITY OF THE MAYO CLINIC AFILIATED ENTITIES, IS COMPRISED OF MORE THAN 50% PUBLIC TRUSTEES. ALBERT LEA MEDICAL CENTER -- MAYO HEALTH SYSTEM 404 WEST FOUNTAIN STREET ALBERT LEA MN 56007 411404075 HOSPITAL AND CLINIC MN 501(c)(3) 3 MAYO CLINIC 1 AUSTIN MEDICAL CENTER -- MAYO HEALTH SYSTEM 1000 FIRST DRIVE NW AUSTIN MN 55912 410695606 HOSPITAL AND CLINIC MN 501(c)(3) 3 MAYO CLINIC 1 AUSTIN MEDICAL CENTER FOUNDATION 1000 FIRST DRIVE NW AUSTIN MN 55912 300107471 FUNDRAISING FOUNDATION MN 501(c)(3) 7 AUSTIN MEDICAL CENTER -- MAYO HEALTH SYSTEM 1 BARRON MEMORIAL MEDICAL CENTER -- MAYO HEALTH SYSTEM 1222 EAST WOODLAND AVE BARRON WI 54812 390920634 HOSPITAL AND CLINIC WI 501(c)(3) 3 LUTHER HOSPITAL 1 BLOOMER LAKEVIEW INC 2110 DUNCAN ROAD BLOOMER WI 54724 391450617 LOW INCOME HOUSING WI 501(c)(3) 7 BLOOMER MEMORIAL MEDICAL CENTER INC -- MAYO HEALTH SYSTEM 1 BLOOMER MEMORIAL MEDICAL CENTER INC -- MAYO HEALTH SYSTEM 1501 THOMPSON STREET BLOOMER WI 54724 390980343 HOSPITAL AND CLINIC WI 501(c)(3) 3 LUTHER HOSPITAL 1 CANNON FALLS MEDICAL CENTER -- MAYO HEALTH SYSTEM 1116 WEST MILL STREET CANNON FALLS MN 55009 204156428 HOSPITAL AND CLINIC MN 501(c)(3) 3 MAYO CLINIC 1 CHARTERHOUSE INC 200 FIRST STREET SW ROCHESTER MN 55905 411405254 RETIREMENT LIVING CENTER MN 501(c)(3) 9 MAYO CLINIC 1 FAIRMONT MEDICAL CENTER -- MAYO HEALTH SYSTEM 800 MEDICAL CENTER DRIVE PO BOX 800 FAIRMONT MN 56031 410760836 HOSPITAL AND CLINIC MN 501(c)(3) 3 MAYO CLINIC 1 FOUNTAIN LAKE TREATMENT CENTER 404 WEST FOUNTAIN STREET ALBERT LEA MN 56007 411404076 CHEMICAL DEPENDENCY TREATMENT MN 501(c)(3) 3 ALBERT LEA MEDICAL CENTER -- MAYO HEALTH SYSTEM 1 FRANCISCAN SKEMP FOUNDATION OF ARCADIA INC 464 SOUTH JOHNSON STREET ARCADIA WI 54612 391322480 FUNDRAISING FOUNDATION WI 501(c)(3) 9 FRANCISCAN SKEMP HEALTHCARE INC 1 FRANCISCAN SKEMP FOUNDATION OF SPARTA INC 310 WEST MAIN STREET SPARTA WI 54656 391423234 FUNDRAISING FOUNDATION WI 501(c)(3) 9 FRANCISCAN SKEMP HEALTHCARE INC 1 FRANCISCAN SKEMP FOUNDATION INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391186647 FUNDRAISING FOUNDATION WI 501(c)(3) 11-II FRANCISCAN SKEMP HEALTHCARE INC 1 FRANCISCAN SKEMP HEALTHCARE INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391411999 HEALTHCARE SYSTEM PARENT WI 501(c)(3) 11-I MAYO CLINIC 1 FRANCISCAN SKEMP MEDICAL CENTER INC 700 WEST AVE SOUTH LA CROSSE WI 54601 390806374 HOSPITAL AND CLINIC WI 501(c)(3) 3 FRANCISCAN SKEMP HEALTHCARE INC 1 GCAS 200 FIRST STREET SW ROCHESTER MN 55905 411917517 AMBULANCE SERVICE MN 501(c)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 GOLD CROSS AMBULANCE SERVICE 200 FIRST STREET SW ROCHESTER MN 55905 411917516 AMBULANCE SERVICE MN 501(c)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 GOLD CROSS AMBULANCE INC 200 FIRST STREET SW ROCHESTER MN 55905 391942957 AMBULANCE SERVICE MN 501(c)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM 1025 MARSH STREET MANKATO MN 56002 411236756 HOSPITAL AND CLINIC MN 501(c)(3) 3 MAYO CLINIC 1 IMMANUEL-ST JOSEPH'S FOUNDATION -- MAYO HEALTH SYSTEM 1025 MARSH STREET MANKATO MN 56002 411663357 FUNDRAISING FOUNDATION MN 501(c)(3) 7 IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM 1 LAKE CITY MEDICAL CENTER - MAYO HEALTH SYSTEM 500 WEST GRANT STREET LAKE CITY MN 55041 411906820 HOSPITAL MN 501(c)(3) 3 MAYO CLINIC 1 LUTHER HOSPITAL 1221 WHIPPLE STREET EAU CLAIRE WI 54703 390813418 HOSPITAL WI 501(c)(3) 3 MAYO CLINIC 1 LUTHER LAKESIDE APARTMENTS INC 714 SOUTH BARSTOW STREET EAU CLAIRE WI 54701 391409024 LOW INCOME HOUSING WI 501(c)(3) 9 LUTHER HOSPITAL 1 LUTHER MIDELFORT FOUNDATION INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE WI 54702 391633407 GRANTMAKING FOUNDATION WI 501(c)(3) PF MIDELFORT CLINIC LTD -- MAYO HEALTH SYSTEM 0 MAYO CLINIC ARIZONA 13400 EAST SHEA BLVD SCOTTSDALE AZ 85259 860800150 HOSPITAL AND CLINIC AZ 501(c)(3) 3 MAYO CLINIC 1 MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 590714831 HOSPITAL FL 501(c)(3) 3 MAYO CLINIC JACKSONVILLE 1 MAYO CLINIC JACKSONVILLE 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 593337028 PATIENT CARE - CLINIC FL 501(c)(3) 7 MAYO CLINIC 1 MAYO CLINIC -- METHODIST HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410739106 HOSPITAL MN 501(c)(3) 3 MAYO CLINIC 1 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 416011702 PATIENT CARE - CLINIC MN 501(c)(3) 9 MAYO CLINIC 1 MAYO CLINIC -- SAINT MARYS HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410944601 HOSPITAL MN 501(c)(3) 3 MAYO CLINIC 1 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 200 FIRST STREET SW ROCHESTER MN 55905 411506440 CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES MN 501(c)(3) 9 MAYO CLINIC 1 MIDELFORT CLINIC LTD -- MAYO HEALTH SYSTEM PO BOX 1510 EAU CLAIRE WI 54702 391735831 PATIENT CARE - CLINIC WI 501(c)(3) 3 MAYO CLINIC 0 MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES 200 FIRST STREET SW ROCHESTER MN 55905 412020392 SUPPORT RESEARCH, PRACTICE & EDUCATION MN 501(c)(3) 11-I MAYO CLINIC 1 NORTHWEST WISCONSIN HOMECARE INC PO BOX 2060 EAU CLAIRE WI 54702 391491516 HOME HEALTH AND HOSPICE CARE WI 501(c)(3) 9 LUTHER HOSPITAL 1 NORTHWEST WISCONSIN SUPPORTIVE HOMECARE INC PO BOX 2060 EAU CLAIRE WI 54702 391686673 HOME HEALTH CARE WI 501(c)(3) 9 LUTHER HOSPITAL 1 OSSEO MEDICAL CENTER INC -- MAYO HEALTH SYSTEM PO BOX 70 / 13025 EIGHTH STREET OSSEO WI 54758 391029430 HOSPITAL AND CLINIC WI 501(c)(3) 3 LUTHER HOSPITAL 1 POVERELLO FOUNDATION 200 FIRST STREET SW ROCHESTER MN 55905 411494881 FUNDRAISING FOUNDATION MN 501(c)(3) 11-I MAYO CLINIC -- SAINT MARYS HOSPITAL 1 RED CEDAR MEDICAL CENTER INC -- MAYO HEALTH SYSTEM 2321 STOUT ROAD MENOMONIE WI 54751 510190875 HOSPITAL AND CLINIC WI 501(c)(3) 3 MAYO CLINIC 1 SPRINGFIELD MEDICAL CENTER -- MAYO HEALTH SYSTEM 625 NORTH JACKSON AVENUE SPRINGFIELD MN 56087 411893827 HOSPITAL AND CLINIC MN 501(c)(3) 3 IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM 1 ST JAMES MEDICAL CENTER -- MAYO HEALTH SYSTEM 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 410797368 HOSPITAL AND CLINIC MN 501(c)(3) 3 IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM 1 ST JAMES MEDICAL CENTER FOUNDATION INC 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 411444129 FUNDRAISING FOUNDATION MN 501(c)(3) 7 ST JAMES MEDICAL CENTER -- MAYO HEALTH SYSTEM 1 WASECA MEDICAL CENTER -- MAYO HEALTH SYSTEM 501 NORTH STATE STREET WASECA MN 56093 363606405 HOSPITAL AND CLINIC MN 501(c)(3) 3 IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM 1 MAYO KLINIK STIFTUNG 60486 FRANKFURT AM MAIN FRANKFURT GM FUNDRAISING FOUNDATION GM MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 FRANKLIN HEATING STATION 119 THIRD ST SW ROCHESTER MN 55902 410264830 UTILITY MN N/A CANNON VALLEY CLINIC -- MAYO HEALTH SYSTEM 635 FIRST STREET SE FARIBAULT MN 55021 411817179 PATIENT CARE - CLINIC MN N/A C DECORAH CLINIC -- MAYO HEALTH SYSTEM 907 MONTGOMERY STREET DECORAH IA 52101 411711329 PATIENT CARE - CLINIC IA N/A C FIOS THERAPEUTICS INC 200 FIRST STREET SW ROCHESTER MN 55905 711029189 RESEARCH MN N/A C HEALTH TRADITION HEALTH PLAN 1808 EAST MAIN STREET ONALASKA WI 54650 391545987 MEDICAL SERVICES COMPANY WI N/A C LOBSS NETWORK SUPPORT 2002 INC 200 FIRST STREET SW ROCHESTER MN 55905 481276150 ADMINISTRATIVE SERVICES MN N/A C MAYO COLLABORATIVE SERVICES INC 200 FIRST STREET SW ROCHESTER MN 55905 411346366 REFERENCE LAB SERVICES MN N/A C MAYO HOLDING COMPANY 200 FIRST STREET SW ROCHESTER MN 55905 411578020 HOLDING COMPANY MN N/A C MAYO INSURANCE COMPANY LTD 200 FIRST STREET SW ROCHESTER MN 55905 SELF INSURANCE POOL CJ N/A C MAYO MEDICAL LABORATORIES NEW ENGLAND INC 265 BALLARDVALE STREET WILMINGTON MA 01887 043323713 LABORATORY SERVICES MA N/A C MAYO REGIONAL PRACTICES OF ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 061190278 THIRD PARTY ADMINISTRATION SERVICES AZ N/A C MHS SERVICES INC 200 FIRST STREET SW ROCHESTER MN 55905 411282517 EQUIPMENT & REAL ESTATE LEASING MN N/A C MMSI INC 21 FIRST STREET SW ROCHESTER MN 55905 411547003 THIRD PARTY ADMINISTRATION SERVICES MN N/A C NORTHWEST HEALTH VENTURES INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 391528920 PHARMACY SERVICES WI N/A C OWATONNA CLINIC -- MAYO HEALTH SYSTEM 134 SOUTHVIEW OWATONNA MN 55060 411862132 PATIENT CARE - CLINIC MN N/A C PHYSICIAN AND HOSPITAL PRACTICES INC 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 930926631 HEALTH SERVICES FL N/A C ROCHESTER AIRPORT COMPANY ROUTE 2 ROCHESTER MN 55902 410506870 AIRPORT MANAGEMENT MN N/A C SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION 13400 E SHEA BLVD SCOTTSDALE AZ 85259 860870505 COMMERCIAL PROPERTY OWNERS ASSOCIATION AZ N/A C THE STABILE BUILDING OWNERS' ASSOCIATION 200 FIRST STREET SW ROCHESTER MN 55905 208994499 COMMERCIAL PROPERTY OWNERS ASSOCIATION MN N/A C 1 0 1 0 0 0 1 0 1 1 0 1 0 1 0 0 0 1 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH G 9460516 GAAP MAYO CLINIC L 107743 GAAP MAYO CLINIC J 79078 GAAP MAYO CLINIC R 3652614 GAAP FRANKLIN HEATING STATION J 760461 GAAP MAYO CLINIC A 58458 GAAP MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH N 8171522 GAAP MAYO CLINIC C 44306 GAAP MAYO CLINIC I 59125 GAAP MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH R 639561 GAAP