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OLMSTED MEDICAL CENTER: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
OLMSTED MEDICAL CENTER (EIN 41-0855367)
Tax period
2023-01-01 to 2023-12-31
Filed
2024-09-30
IRS object ID
202402749349301335
Schema version
2023v5.1
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-09-30T15:35:45-05:00ReturnTs
Tax Period End2023-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110700 NORTHUP WAY SUITE 200AddressLine1Txt
CityBELLEVUECityNm
State AbbreviationWAStateAbbreviationCd
ZIP98004ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410855367EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1OLMSTED MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlOLMSBusinessNameControlTxt
Phone5072883443PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1210 NINTH STREET SEAddressLine1Txt
CityROCHESTERCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55904ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIM WEIRPersonNm
Person TitleCHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone5072883443PhoneNum
Signature2024-09-26SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKURT BENNION CPAPreparerPersonNm
PTINP01469618PTIN
Phone4252506100PhoneNum
Preparation2024-09-26PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2024-10-15 13:58:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJAMES HOFFMANNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1210 NINTH STREET SEAddressLine1Txt
CityROCHESTERCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55904ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$284,835,998GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.OLMMED.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1949FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionPARTNERING FOR BETTER HEALTH AND BETTER LIVES.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee1618TotalEmployeeCnt
Total Volunteers26TotalVolunteersCnt
Total Gross UBI$2,406,735TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$79,854PYContributionsGrantsAmt
CY Contributions Grants$456,867CYContributionsGrantsAmt
PY Program Service Revenue$255,962,007PYProgramServiceRevenueAmt
CY Program Service Revenue$273,983,346CYProgramServiceRevenueAmt
PY Investment Income$2,323,986PYInvestmentIncomeAmt
CY Investment Income$4,002,188CYInvestmentIncomeAmt
PY Other Revenue$357,509PYOtherRevenueAmt
CY Other Revenue$511,975CYOtherRevenueAmt
PY Total Revenue$258,723,356PYTotalRevenueAmt
CY Total Revenue$278,954,376CYTotalRevenueAmt
PY Grants And Similar Paid$183,694PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$258,481CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$150,056,988PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$163,830,549CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$97,703CYTotalFundraisingExpenseAmt
PY Other Expenses$104,559,476PYOtherExpensesAmt
CY Other Expenses$109,386,581CYOtherExpensesAmt
PY Total Expenses$254,800,158PYTotalExpensesAmt
CY Total Expenses$273,475,611CYTotalExpensesAmt
PY Revenues Less Expenses$3,923,198PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,478,765CYRevenuesLessExpensesAmt
Total Assets BOY$277,318,598TotalAssetsBOYAmt
Total Assets EOY$295,849,044TotalAssetsEOYAmt
Total Liabilities BOY$44,947,503TotalLiabilitiesBOYAmt
Total Liabilities EOY$55,026,006TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$232,371,095NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$240,823,038NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPARTNERING FOR BETTER HEALTH AND BETTER LIVES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$233,358,386ExpenseAmt
Grant$258,481GrantAmt
Revenue$271,576,611RevenueAmt
DescPERSONAL APPROACH TO CARE THROUGH MORE THAN 25 SPECIALTIES. ALL OF OUR SPECIALTY SERVICES COMPLIMENT PRIMARY CARE AND OFFER PATIENTS GREATER CONVENIENCE AND PEACE OF MIND. WE CONTINUE TO WORK TO POSITION OMC AS A PREFERRED HEALTHCARE PROVIDER FOR PRIMARY AND SECONDARY CARE AMONG SOUTHEASTERN MINNESOTA RESIDENTS. OMC'S 218 CLINICIANS AND 1,100+ HEALTHCARE PROFESSIONALS SERVE AT 27 LOCATIONS, INCLUDING PHYSICAL/OCCUPATIONAL THERAPY, TWO MULTI-SPECIALTY CLINICS, SPORTS MEDICINE FACILITIES, A LEVEL IV TRAUMA HOSPITAL WITH 24-HOUR EMERGENCY ROOM AND BIRTHCENTER, TWO WALK-IN FASTCARE RETAIL CLINICS, A SKYWAY CLINIC IN DOWNTOWN ROCHESTER, AND 11 COMMUNITY BRANCH CLINICS. IN 2023, OMC HAD 354,344 PATIENT VISITS SERVING 82,081 UNIQUE PATIENTS. (CONTINUED ON SCHEDULE O)THE HOSPITAL PROVIDED CARE FOR 2,657 PATIENT ADMISSIONS RESULTING IN 6,413 PATIENT DAYS INCLUDING 887 BIRTHS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$176,549ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescOMC WELCOMES ITS MANY OPPORTUNITIES TO BE AN ACTIVE, CONTRIBUTING PARTNER TO SOUTHEASTERN MINNESOTA'S HEALTH AND WELLNESS EFFORTS. AS A 501(C)(3) NON-PROFIT ORGANIZATION, OMC ACTIVELY SUPPORTS SOUTHEASTERN MINNESOTA'S HEALTH AND WELLNESS EFFORTS THROUGH THE CONTRIBUTION OF STAFF TIME/TALENT, IN-KIND RESOURCES, AND FINANCIAL ASSISTANCE. IN 2023, OUR COMMUNITY CONTRIBUTIONS MADE UP 29.93% OF OUR ANNUAL OPERATING EXPENSE - MORE THAN $79,786,000 IN SUPPORT OF OUR COMMITMENT TO BE AN ACTIVE, CONTRIBUTING PARTNER IN THE COMMUNITIES WE SERVE. ANOTHER WAY OMC ACTIVELY SUPPORTS COMMUNITY HEALTH IS THROUGH ITS PARTNERSHIP WITH MAYO CLINIC, OLMSTED COUNTY PUBLIC HEALTH, AND SEVERAL OTHER COMMUNITY-SERVICE ORGANIZATIONS AS TOGETHER WE IMPLEMENTED (CONTINUED ON SCHEDULE O)THE YEAR-THREE ACTION PLAN BASED ON OUR COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). OVER THE PAST YEAR, WE CONTINUED TO MAKE IT EASIER FOR COMMUNITY MEMBERS TO DONATE THEIR TIME AND TALENT TO OMC. IN ADDITION TO ADDING AN ONLINE VOLUNTEER APPLICATION FORM TO OUR WEBSITE, WE EXPANDED OUR VOLUNTEERS IN PATIENT CARE OPPORTUNITIES LIKE CANINE COMPANIONS AND ESCORT/GREETER ROLES TO HELP PATIENTS NAVIGATE OUR EXPANDING HOSPITAL CAMPUS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$233,534,935TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document142IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1618EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KEVIN HIGGINSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5072883443PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1210 NINTH STREET SEAddressLine1Txt
CityROCHESTERCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55904ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
MATTHEW KIRSCH MD
PHYSICIAN36.000.00Yes (X)$1,140,560$0$42,234
VIDHAN CHANDRA MD
PHYSICIAN36.000.00Yes (X)$1,065,088$0$14,969
SAMER ABDEL-AZIZ MD
PHYSICIAN40.000.00Yes (X)$1,030,524$0$42,473
MARK HERR MD
PHYSICIAN40.000.00Yes (X)$1,051,783$0$15,395
TIM WEIR FACHE
CHIEF EXECUTIVE OFFICER40.001.00$945,667$0$31,142Yes (X)
SRDAN BABOVIC MD
PHYSICIAN40.000.00Yes (X)$951,501$0$14,588
JAMES HOFFMANN DO
PRESIDENT32.001.00$645,762$0$31,985Yes (X)Yes (X)
KEVIN HIGGINS
CHIEF FINANCIAL OFFICER40.001.00$578,825$0$50,782Yes (X)
TAMARA ALEXANDROV MD
CLINIC TRUSTEE37.200.00$493,641$0$12,402Yes (X)
KEITH KLEIS MD
CLINIC TRUSTEE40.000.00$403,115$0$42,234Yes (X)
MARAL KENDARIAN MD
CLINIC TRUSTEE34.000.00$391,807$0$14,623Yes (X)
MARK WILBUR MD CHIEF
MEDICAL OFFICER (STARTING JULY 2023)40.000.00$385,476$0$15,635Yes (X)
RANDY HEMANN MD CHIEF
MEDICAL OFFICER (THROUGH JUNE 2023)40.000.00$376,634$0$22,917Yes (X)
MIKE MALUGANI
PUBLIC TRUSTEE-CHAIR1.000.00$0$0$0Yes (X)Yes (X)
MICHAEL TUOHY
PUBLIC TRUSTEE-CHAIR ELECT1.000.00$0$0$0Yes (X)Yes (X)
CASSIE HARRINGTON
PUBLIC TRUSTEE1.001.00$0$0$0Yes (X)
CAROLE NISTLER MD
PUBLIC TRUSTEE1.000.00$0$0$0Yes (X)
WENDY SHANNON
PUBLIC TRUSTEE1.000.00$0$0$0Yes (X)
DON SUPALLA
PUBLIC TRUSTEE1.001.00$0$0$0Yes (X)
CORENIA WALZ
PUBLIC TRUSTEE1.001.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$9,460,383TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$351,379TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K272IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CONSTRUCTION COLLABORATIVE
1708 SECOND STREET SWROCHESTERMN55902BUILDING CONSTRUCTION SERVICES$5,000,925
EPIC HOSTING LLC
1979 MILKY WAYVERONAWI53593COMPUTER SOFTWARE SERVICES$1,783,119
EPIC SYSTEMS CORPORATION
PO BOX 88314MILWAUKEEWI53288COMPUTER SOFTWARE SERVICES$1,676,134
MAYO COLLABORATIVE SERVICES LLC
PO BOX 9146MINNEAPOLISMN55480LAB SERVICES$1,499,924
HAYES LOCUM LLC
PO BOX 88122CHICAGOIL606801122PHYSICIAN STAFFING COMPANY$1,474,027
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K143CntrctRcvdGreaterThan100KCnt
Related Organizations$54,757RelatedOrganizationsAmt
Government Grants$402,110GovernmentGrantsAmt
Total Contributions$456,867TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICES621110$267,599,841$267,599,841
PHARMACY456110$6,383,505$3,976,770$2,406,735
FieldValueIRS element (for citing)
Total Program Service Revenue$273,983,346TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,144,280TotalRevenueColumnAmt
Exclusion$4,144,280ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$73,410RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$73,410RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$73,410TotalRevenueColumnAmt
Exclusion$73,410ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$5,703,660SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$5,829,832SecuritiesAmt
Other$15,920OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$126,172SecuritiesAmt
Other-$15,920OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$142,092TotalRevenueColumnAmt
Exclusion-$142,092ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$52,235GrossSalesOfInventoryAmt
Cost Of Goods Sold$35,870CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,365TotalRevenueColumnAmt
Exclusion$16,365ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MISCELLANEOUS621990$218,324$218,324
CAFETERIA722514$203,876$203,876
FieldValueIRS element (for citing)
Other Revenue Total$422,200OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$278,954,376TotalRevenueColumnAmt
Related Or Exempt Func Income$271,576,611RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,406,735UnrelatedBusinessRevenueAmt
Exclusion$4,514,163ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$258,481TotalAmt
Program Services$258,481ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,424,144TotalAmt
Management And General$2,424,144ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$127,417,772TotalAmt
Program Services$111,835,608ProgramServicesAmt
Management And General$15,582,164ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$6,819,210TotalAmt
Program Services$5,409,117ProgramServicesAmt
Management And General$1,376,338ManagementAndGeneralAmt
Fundraising$33,755FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$19,123,474TotalAmt
Program Services$14,668,436ProgramServicesAmt
Management And General$4,445,156ManagementAndGeneralAmt
Fundraising$9,882FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$8,045,949TotalAmt
Program Services$6,854,557ProgramServicesAmt
Management And General$1,162,027ManagementAndGeneralAmt
Fundraising$29,365FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$731,685TotalAmt
Program Services$103,940ProgramServicesAmt
Management And General$627,745ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$349,466TotalAmt
Management And General$349,466ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$132,727TotalAmt
Management And General$132,727ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$21,298,274TotalAmt
Program Services$16,795,004ProgramServicesAmt
Management And General$4,503,270ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$819,085TotalAmt
Program Services$9,772ProgramServicesAmt
Management And General$809,313ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$417,927TotalAmt
Program Services$116,140ProgramServicesAmt
Management And General$301,787ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$644,934TotalAmt
Program Services$371,885ProgramServicesAmt
Management And General$273,049ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$7,921,985TotalAmt
Program Services$6,124,044ProgramServicesAmt
Management And General$1,797,941ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$486,068TotalAmt
Program Services$196,003ProgramServicesAmt
Management And General$290,065ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,064,333TotalAmt
Program Services$629,027ProgramServicesAmt
Management And General$435,306ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$385,116TotalAmt
Program Services$11,461ProgramServicesAmt
Management And General$373,655ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$10,954,649TotalAmt
Program Services$10,954,649ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,462,603TotalAmt
Program Services$531,319ProgramServicesAmt
Management And General$1,931,284ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL/GEN. SUPPLIES$38,633,744$38,416,379$217,365
EQUIP/SOFT. MAINTENANCE$10,873,874$8,057,183$2,791,990$24,701
BAD DEBT$7,891,210$7,891,210
MN CARE TAX$4,300,720$4,300,720

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$18,181TotalAmt
Management And General$18,181ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$273,475,611TotalAmt
Program Services$233,534,935ProgramServicesAmt
Management And General$39,842,973ManagementAndGeneralAmt
Fundraising$97,703FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$88,774,622BOYAmt
EOY$94,865,292EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$32,144,937BOYAmt
EOY$42,878,900EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,595,936BOYAmt
EOY$3,717,462EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$3,626,108BOYAmt
EOY$3,595,657EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$202,103,907LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$105,186,445LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$94,558,692BOYAmt
EOY$96,917,462EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$46,626,913BOYAmt
EOY$46,094,945EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$7,991,390BOYAmt
EOY$7,779,326EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$277,318,598BOYAmt
EOY$295,849,044EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$31,917,798BOYAmt
EOY$41,881,668EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$69,063BOYAmt
EOY$69,063EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,789,108BOYAmt
EOY$4,140,756EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,171,534BOYAmt
EOY$8,934,519EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$44,947,503BOYAmt
EOY$55,026,006EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$232,371,095BOYAmt
EOY$240,823,038EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$232,371,095BOYAmt
EOY$240,823,038EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$277,318,598BOYAmt
EOY$295,849,044EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$5,478,765ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$3,926,453NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$953,276OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,676,710OtherCostOrOtherBasisAmt
Book Value$6,676,710BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$109,815,631OtherCostOrOtherBasisAmt
Depreciation$51,541,173DepreciationAmt
Book Value$58,274,458BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$84,172,039OtherCostOrOtherBasisAmt
Depreciation$53,645,272DepreciationAmt
Book Value$30,526,767BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,439,527OtherCostOrOtherBasisAmt
Book Value$1,439,527BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$96,917,462TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
THIRD PARTY PAYOR SETTLEMENTS$1,001,571
RIGHT-OF-USE LEASE LIABILITIES$7,932,948
FieldValueIRS element (for citing)
Total Liability$8,934,519TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE MEDICAL CENTER IS EXEMPT FROM FEDERAL INCOME TAXES AS A TAX EXEMPT ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT FOR INCOME ON CERTAIN UNRELATED BUSINESS INCOME. THERE IS NO MATERIAL UNRELATED BUSINESS INCOME FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022. THE MEDICAL CENTER IS ALSO EXEMPT FROM STATE INCOME TAXES UNDER APPLICABLE MINNESOTA STATUTES. THE MEDICAL CENTER FILES FEDERAL AND STATE INCOME TAX RETURNS. GENERALLY, THE MEDICAL CENTER IS NO LONGER SUBJECT TO STATE AND FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEAR ENDED DECEMBER 31, 2019, AND PRIOR. OMC RETAIL SERVICES, LLC IS A DISREGARDED LLC UNDER IRS REGULATIONS, AND IT ACHIEVES TAX-EXEMPT TREATMENT BASED ON THE EXEMPT STATUS OF ITS PARENT, OLMSTED MEDICAL CENTER. AT DECEMBER 31, 2023, THERE WERE NO UNCERTAIN TAX POSITIONS.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,003,307TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,003,307NetCommunityBenefitExpnsAmt
Total Expense0.00380TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$64,233,295TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$34,656,356DirectOffsettingRevenueAmt
Net Community Benefit Expns$29,576,939NetCommunityBenefitExpnsAmt
Total Expense0.11140TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,285,232TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,285,232NetCommunityBenefitExpnsAmt
Total Expense0.00480TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$66,521,834TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$34,656,356DirectOffsettingRevenueAmt
Net Community Benefit Expns$31,865,478NetCommunityBenefitExpnsAmt
Total Expense0.12000TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$25,181,158TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,341,495DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,839,663NetCommunityBenefitExpnsAmt
Total Expense0.03330TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$151,098TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$151,098NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$167,108TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$167,108NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$25,499,364TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,341,495DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,157,869NetCommunityBenefitExpnsAmt
Total Expense0.03450TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$92,021,198TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$50,997,851DirectOffsettingRevenueAmt
Net Community Benefit Expns$41,023,347NetCommunityBenefitExpnsAmt
Total Expense0.15450TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,441TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,441NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,441TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,441NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$7,891,210BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$15,773,812ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$27,356,124CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$11,582,312MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1OLMSTED MEDICAL CENTER - HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11650 4TH STREET SEAddressLine1Txt
CityROCHESTERCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55904ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTP://WWW.OLMMED.ORGWebsiteAddressTxt
State License376238StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1OLMSTED MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE LINE 7DOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE LINE 7DOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTP://WWW.OLMMED.ORG/ABOUT/COMMUNITY-INVOLVEMENT/StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://WWW.OLMMED.ORG/PATIENTS-VISITORS/ACCOUNTS/PAYMENT-ASSISTANCE/FAPAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://WWW.OLMMED.ORG/PATIENTS-VISITORS/ACCOUNTS/PAYMENT-ASSISTANCE/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
OLMSTED MEDICAL CENTERPART V, SECTION B, LINE 5: OLMSTED MEDICAL CENTER LAUNCHED A COLLABORATIVE EFFORT WITH OLMSTED COUNTY, MAYO CLINIC, MANY OF THE COMMUNITY BENEFIT NON-PROFIT ORGANIZATIONS, AND THE PUBLIC TO IDENTIFY THE COMMUNITY NEEDS.
OLMSTED MEDICAL CENTERPART V, SECTION B, LINE 6A: OLMSTED MEDICAL CENTER COLLABORATED WITH MAYO CLINIC.
OLMSTED MEDICAL CENTERPART V, SECTION B, LINE 6B: OLMSTED MEDICAL CENTER COLLABORATED WITH OLMSTED COUNTY HEALTH SERVICES TO PRODUCE THE COMMUNITY HEALTH NEEDS ASSESSMENT.
OLMSTED MEDICAL CENTERPART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ON OUR WEBSITE AT:HTTPS://WWW.OLMMED.ORG/ABOUT/COMMUNITY-INVOLVEMENT/AND ON THE COUNTY'S WEBSITE AT:HTTPS://WWW.OLMSTEDCOUNTY.GOV/GOVERNMENT/COUNTY-DEPARTMENTS/PUBLIC-HEALTH-SERVICES/HEALTH-ASSESSMENT-AND-PLANNING-PARTNERSHIP
OLMSTED MEDICAL CENTERPART V, SECTION B, LINE 11: A PRIORITIZATION PROCESS CONDUCTED BY OLMSTED COUNTY PUBLIC HEALTH ALLOWED MAYO CLINIC, OLMSTED MEDICAL CENTER, THE CHNA CORE GROUP, THE CHIP MEMBERS, AND OTHER COMMUNITY AGENCY GROUPS RESULTED IN THE LIST OF TOP FIVE COMMUNITY HEALTH NEEDS: OBESITY, MENTAL HEALTH, IMMUNIZATIONS, INJURY PREVENTION, AND HOMELESSNESS/FINANCIAL STRESS.OMC REMAINS COMMITTED TO WORKING WITH THE CHNA CORE GROUP AND ITS COLLABORATING PARTNERS TO DEVELOP AND IMPLEMENT A COMMUNITY HEALTH IMPROVEMENT PLAN. THE CHNA CORE GROUP WILL CONTINUE TO COORDINATE THE EFFORTS OF ALL OF THE INVOLVED HEALTH PROVIDERS AND AGENCIES IN THEIR WORK ON THE FIVE MAJOR COMMUNITY HEALTH PRIORITIES AS DETERMINED BY THE HEALTH NEEDS ASSESSMENT. A KEY GOAL WILL BE TO INTEGRATE MENTAL HEALTH, MEDICAL CARE, AND SOCIAL SERVICES FOR THOSE PARTICULARLY NEEDY INDIVIDUALS WHO HAVE MULTIPLE CHRONIC MEDICAL AND MENTAL HEALTH PROBLEMS AND WHO ARE FREQUENT AND HIGH-COST VISITORS TO EMERGENCY DEPARTMENTS, HOSPITALS, AND CLINICS.OMC'S COMMUNITY HEALTH NEEDS ASSESSMENT STEERING GROUP COMPRISED OF CLINICIANS, NURSES, DIETITIANS, AND ADMINISTRATORS HAS COMMITTED TO CONTINUING TO ENGAGE OUR STAFF IN THE VARIOUS COMMUNITY-LED EFFORTS THROUGH CHNA AND CHIP. IN ADDITION, THIS STEERING GROUP HAS DEVELOPED AN ACTION PLAN SPECIFIC TO OUR PATIENT BASE TO ADDRESS THESE SAME PRIORITIES. WHILE HOMELESSNESS AND FINANCIAL STRESS IS AN ISSUE BEYOND THE SCOPE OF OMC'S MISSION AND RESOURCES, OMC HAS ESTABLISHED SOME GOALS FOR THIS ISSUE AND INTENDS TO PARTICIPATE IN ANY COMMUNITY-WIDE EFFORTS TO ADDRESS THIS MOST DIFFICULT ISSUE. FOR ALL OF THE GOALS THAT FOLLOW, THE SPECIFIC NEEDS OF OMC PATIENTS, FEASIBILITY AND POTENTIAL IMPACT OF THE PLANS, FINANCIAL IMPLICATIONS, AND OPPORTUNITIES TO WORK WITH COMMUNITY ORGANIZATIONS WILL CONTINUE TO BE EVALUATED.
OLMSTED MEDICAL CENTERPART V, SECTION B, LINE 13H: OMC UTILIZES A THIRD PARTY TO CONDUCT AN ELECTRONIC REVIEW FOR PRESUMPTIVE ELIGIBILITY OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED THROUGH TRANSUNION / EBUREAU. ACCOUNTS THAT HAVE BEEN APPROVED UNDER THIS PROCESS WILL BE APPLIED TO THE FINANCIAL ASSISTANCE PROGRAM AND FURTHER COLLECTION ACTION WILL NOT TAKE PLACE.
OLMSTED MEDICAL CENTERPART V, SECTION B, LINE 20E: MEETING WITH PATIENTS UPON THEIR REQUEST.
FieldValueIRS element (for citing)
Facility26FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (26 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - OMC - MAIN CLINIC
210 9TH ST SEROCHESTERMN55904OUTPATIENT PHYSICIAN CLINIC
2 - OMC - BYRON CLINIC
846 HIGH POINT DR NEBYRONMN55920OUTPATIENT PHYSICIAN CLINIC
3 - OMC - CHATFIELD CLINIC
207 TWIFORD ST SWCHATFIELDMN55923OUTPATIENT PHYSICIAN CLINIC
4 - OMC - CANNON FALLS CLINIC
1705 HIGHWAY 200CANNON FALLSMN55009OUTPATIENT PHYSICIAN CLINIC
5 - OMC - PINE ISLAND CLINIC
111 COUNTY RD 11 NWPINE ISLANDMN55963OUTPATIENT PHYSICIAN CLINIC
6 - OMC - PLAINVIEW CLINIC
20 2ND AVE NEPLAINVIEWMN55964OUTPATIENT PHYSICIAN CLINIC
7 - OMC - PRESTON CLINIC
405 KANSAS ST NWPRESTONMN55965OUTPATIENT PHYSICIAN CLINIC
8 - OMC - ST CHARLES CLINIC
403 W FOURTH STST CHARLESMN55972OUTPATIENT PHYSICIAN CLINIC
9 - OMC - SPRING VALLEY CLINIC
802 MEMORIAL DRSPRING VALLEYMN55975OUTPATIENT PHYSICIAN CLINIC
10 - OMC - WANAMINGO CLINIC
217 MAIN ST SUITE BWANAMINGOMN55983OUTPATIENT PHYSICIAN CLINIC
11 - OMC - FASTCARE SOUTH CLINIC
90 14TH STREET SW SUITE 200ROCHESTERMN55902OUTPATIENT PHYSICIAN CLINIC
12 - OMC - NW CLINIC
5067 55TH ST NWROCHESTERMN55901OUTPATIENT PHYSICIAN CLINIC
13 - OMC - SKYWAY CLINIC
318 1ST AVE SW SUITE 203ROCHESTERMN55902OUTPATIENT PHYSICIAN CLINIC
14 - OMC - PHYSICAL THERAPY
102 ELTON HILLS DRROCHESTERMN55901PHYSICAL THERAPY
15 - OMC - SPORTS MED & ATHLETIC PERFORMANCE
5155 55TH ST NWROCHESTERMN55901PHYSICAL THERAPY/ATHLETIC PERFORMANCE
16 - OMC - STEWARTVILLE CLINIC
208 CENTERTOWN PLAZASTEWARTVILLEMN55976OUTPATIENT PHYSICIAN CLINIC
17 - OMC - NW RETAIL PHARMACY
5067 55TH ST NWROCHESTERMN55901RETAIL PHARMACY
18 - OMC - SE RETAIL PHARMACY
210 9TH ST SEROCHESTERMN55904RETAIL PHARMACY
19 - OMC - LAKE CITY CLINIC
507 W DOUGHTY STLAKE CITYMN55041OUTPATIENT PHYSICIAN CLINIC
20 - OMC - GREENVIEW
1544 GREENVIEW DR SWROCHESTERMN55902OUTPATIENT OPTICAL
21 - OMC- SLEEP MEDICINE
1650 FOURTH STREET SEROCHESTERMN55904SLEEP MEDICINE CLINIC
22 - OMC - MIRACLE MILE CLINIC
132 17TH AVENUE NWROCHESTERMN55901OUTPATIENT PHYSICIAN CLINIC
23 - OMC - CHATFIELD RETAIL PHARMACY
237 MAIN STREET NCHATFIELDMN55923RETAIL PHARMACY
24 - OMC - FASTCARE NORTH CLINIC
102 ELTON HILLS DRIVE SUITE 200ROCHESTERMN55901OUTPATIENT PHYSICIAN CLINIC
25 - OMC - PINE ISLAND RETAIL PHARMACY
111 COUNTY ROAD 11PINE ISLANDMN55963RETAIL PHARMACY
26 - OMC - SLEEP MEDICINE-HWY 52
4303 HWY 52 NORTHROCHESTERMN55901SLEEP MEDICINE CLINIC

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:ELIGIBILITY IS DETERMINED BY MEASURING INCOME, HOME EQUITY ASSETS BASED ON THE FEDERAL POVERTY GUIDELINES, AND PRESUMPTIVE DETERMINATION. BOTH INCOME AND ASSETS (SEPARATELY) HAVE TO FALL BELOW THE ANNUAL GROSS INCOME/ASSET MAXIMUM VALUES IN OMC'S FINANCIAL ASSISTANCE POLICY TO QUALIFY.
PART I, LINE 6A:THE OLMSTED MEDICAL CENTER ANNUAL REPORT IS MADE WIDELY AVAILABLE AND IS AVAILABLE ON THE WEBSITE.
PART I, LINE 7:THE AMOUNTS REPORTED ON PART I, LINES 7A-C ARE DERIVED USING THE COST-TO-CHARGE RATIO CALCULATION BASED ON WORKSHEET 2 OF THE IRS INSTRUCTIONS. THE AMOUNTS REPORTED ON PART I, LINES 7E-7I ARE DERIVED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM.
PART I, LINE 7G:SUBSIDIZED HEALTH SERVICES INCLUDED IN PART I, LINE 7G INCLUDE ACTIVITIES FROM THREE OF OMC'S CLINIC LOCATIONS.
PART I, LN 7 COL(F):$7,891,210 OF BAD DEBT EXPENSE WAS EXCLUDED IN CALCULATING THE PERCENTAGES REPORTED IN PART I, LINE 7, COLUMN F.
PART II, COMMUNITY BUILDING ACTIVITIES:OMC, OLMSTED COUNTY, THE CITY OF ROCHESTER AND MAYO CLINIC ARE ALL ACTIVELY INVOLVED IN DISASTER PREPAREDNESS PLANNING AND TRAINING ON A REGULAR BASIS.
PART III, LINE 2:PATIENT ACCOUNTS RECEIVABLE DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED, LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS AND BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF PATIENT ACCOUNTS RECEIVABLE PREVIOUSLY WRITTEN OFF ARE RECORDED WHEN RECEIVED.
PART III, LINE 3:THE ORGANIZATION HAS NOT IDENTIFIED A METHODOLOGY UNDER WHICH IT CAN REASONABLY ESTIMATE THE PORTION OF BAD DEBT EXPENSE ATTRIBUTABLE TO INDIVIDUALS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT FAILED TO COMPLETE AN APPLICATION.
PART III, LINE 1:THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HFMA STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.
PART III, LINE 4:SEE THE "PATIENT ACCOUNTS RECEIVABLE AND ALLOWANCE FOR CREDIT LOSSES NOTE ON PAGE 10 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:THE ORGANIZATION DERIVED ITS COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT BY USING COST REPORT WORKSHEETS. MEDICARE COSTS ARE DETERMINED THROUGH THE MEDICARE COST FINDING PROCESS WHICH ALLOCATES GENERAL SERVICE CENTER COSTS TO REVENUE DEPARTMENTS. THE METHODOLOGY DESCRIBED IN THEINSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA.THE REASONS MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT ARE: ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND THE AMOUNT SPENT TO COVER MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. AS REPORTED ON THE AUDITED FINANCIAL STATEMENTS, THE COMMUNITY BENEFIT OF COSTS IN EXCESS OF MEDICARE PAYMENTS WAS $38,450,522.
PART III, LINE 9B:PATIENT FINANCIAL HARDSHIP POLICY: TO SUPPORT THE ORGANIZATION'S MISSION AND PHILOSOPHY IN THAT THE PATIENT COMES FIRST AND PROVIDE A GUIDELINE IN IDENTIFYING PATIENTS WHO HAVE AN EXCEPTIONAL PERSONAL FINANCIAL HARDSHIP AND REQUIRED NEEDED AND NECESSARY MEDICAL CARE AND THERE IS REMOTE OR NEGLIBLE CHANCE THAT THE INDIVIDUAL WILL BE ABLE TO REPAY.PROCEDURE: FACTORS THAT MAY CONTRIBUTE TO EXCEPTIONAL FINANCIAL HARDSHIP INCLUDE:1) UNEMPLOYMENT OR UNDEREMPLOYMENT THROUGH NO FAULT OF THE PATIENT AND/OR FAMILY; 2) THREATENED LOSS OF SHELTER THROUGH FORECLOSURE, ETC; 3) LOSS OF INCOME FROM FEDERAL, STATE OR OTHER GOVERNMENT BENEFITS INCLUDING, BUT NOT LIMITED TO SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLIC ASSISTANCE, ETC; 4) LOSS OF INCOME DUE TO DEATH OR DISABILITY; 5) EXCEPTIONAL EXPENSES INCURRED BECAUSE OF UNINSURED PROPERTY DAMAGE OR COSTLY REPAIRS TO PRINCIPAL RESIDENCE; 6) EXCEPTIONAL EXPENSES DUE TO TEMPORARY OR CHRONIC ILLNESS; 7) EXCEPTIONAL EXPENSES DUE TO INCREASE IN LIVING EXPENSES BECAUSE OF A DIVORCE, ABANDONMENT OR SEPARATION FROMSPOUSE OR INCOME EARNER; 8) LOSS OF INCOME DUE TO DECLARATION OF INCOMPETENCE OR IN PROCESS OF BEING DECLARED INCOMPETENT; 9) PATIENT OR FAMILY MEMBER IS CONFINED TO A CONVALESCENT HOME OR OTHER RESIDENCE OTHER THAN THEIR PRINCIPAL RESIDENCE; 10) NATURAL DISASTERS SUCH AS FLOODS,FIRES, HURRICANES AND EARTHQUAKES; 11) EVICTION, HOMELESSNESS, LOSS OF OWNED RESIDENCE, ARSON, THEFT, ETC; 12) DISCONTINUANCE OF UTILITIES OR HEAT, OR UNSAFE OR UNHEALTHY LIVING CONDITIONS; 13) ANY OTHER CONDITION CONSIDERED LIFE THREATENING DUE TO EXCEPTIONAL FINANCIAL HARDSHIP.APPLICATION PROCESS: THE FINANCIAL HARDSHIP APPLICATION, UTILIZING OMC'S FINANCIAL ASSISTANCE APPLICATION, CONTAINS THE NECESSARY INFORMATION TO DETERMINE ELIGIBILITY FOR THE OMC FINANCIAL HARDSHIP PROGRAM. NO SEPARATE APPLICATION IS NECESSARY. SUPPORTING DOCUMENTATION REQUIRED TO MAKE AN ELIGIBILITY DETERMINATION ARE: 1) MOST RECENT TAX RETURNS; 2) CURRENT FAMILY PAYROLL STUB SHOWING YEAR-TO-DATE INCOME; 3) CURRENT TRANSUNION CREDIT REPORT AND OTHER FINANCIAL HARDSHIP DOCUMENTATION TO SUPPORT HARDSHIP; AND 4) EXPLANATION OF HARDSHIP SITUATION/NECESSITY AND RARE COMPLICATIONS.ELIGIBILITY DETERMINATION: BASED UPON PATIENT'S/FAMILY'S INCOME AND ASSETS AND COMPLETED FINANCIAL ASSISTANCE APPLICATION. BASED UPON TAKING INTO CONSIDERATION ALL PERSONAL FACTORS IN DETERMINING EXCEPTIONAL FINANCIAL HARDSHIP. THE BUSINESS SERVICES DEPARTMENT EVALUATES THEAPPLICATIONS MEETING THE CRITERIA AND PRESENTS TO ADMINISTRATION FOR APPROVAL. OMC RESERVES THE RIGHT TO MAKE ADJUSTMENT DETERMINATIONS ON A CASE-BY-CASE BASIS.
PART VI, LINE 2:OMC ACTIVELY WORKS WITH LOCAL GOVERNMENT IN ASSESSING AND ADDRESSING COMMUNITY NEEDS THROUGH MEETINGS, WORKSHOPS, AND COMMUNITY INPUT. IN ADDITION, OMC IS ACTIVELY INVOLVED WITH LOCAL GOVERNMENTS IN EMERGENCY PREPAREDNESS AND DISEASE MANAGEMENT.
PART VI, LINE 3:OMC INFORMS PATIENTS OF THE FINANCIAL ASSISTANCE PROGRAMS AVAILABLE ANDASSISTS PATIENTS WHO INDICATE AN INABILITY TO PAY. OMC INFORMS PATIENTSOF THE FINANCIAL ASSISTANCE PROGRAMS BY PROVIDING THE FINANCIAL ASSISTANCEPOLICY ON BROCHURES IN THE NEW PATIENT PACKET AND AT THE FRONT DESK FORALL PATIENTS. THE POLICY IS ALSO PROVIDED ON THE BACK OF THE HOSPITALBILL STATEMENTS, ON THE HOSPITAL WEBSITE AND ON THE HOSPITAL'S ONLINEBILL-PAY SYSTEM.OMC PATIENT FINANCIAL COUNSELORS PROVIDE INFORMATION TO PATIENTS REGARDINGAVAILABLE HEALTHCARE FINANCIAL COVERAGE OPTIONS, SUCH AS: 1) MEDICALASSISTANCE, 2) MINNESOTA CARE, 3) OTHER FINANCIAL SERVICES AVAILABLE FORLOW INCOME FAMILIES IN THE COMMUNITY, 4) OMC'S FINANCIAL ASSISTANCEPROGRAM.THE PATIENT FINANCIAL COUNSELORS ASSIST OMC PATIENTS IN THE APPLICATION PROCESS. ALL APPLICATIONS ARE PROCESSED IN A TIMELY MANNER. PATIENT APPLICATIONS ARE CONSIDERED FOR CURRENT PATIENT RESPONSIBLE BALANCES, AS WELL AS NEAR FUTURE SCHEDULED MEDICAL SERVICES. PATIENTS MAY QUALIFY FOR FULL OR PARTIAL FINANCIAL ASSISTANCE. PATIENT FINANCIAL COUNSELORS NOTE PATIENT'S ACCOUNT VIA ON-LINE NOTES REGARDING APPLICATIONS SENT, APPLICATIONS IN PROCESS, AND WHETHER APPLICATIONS HAVE BEEN APPROVED, DENIED, OR ADDITIONAL INFORMATION IS REQUIRED. THE PATIENT FINANCIAL COUNSELORS INFORM THE PATIENT VIA A LETTER REGARDING THE DETERMINATION (APPROVED, DENIED, OR PARTIAL COVERAGE APPROVED) OF THE RECEIVED AND COMPLETED APPLICATION. PRIOR TO TURNING ACCOUNTS OVER THE THIRD PARTY COLLECTION, THE ACCOUNT WILL BE REVIEWED FOR POSSIBLE FINANCIAL ASSISTANCE PROGRAM QUALIFICATION THROUGH THE E-BUREAU PROCESS.
PART VI, LINE 4:OMC IS A REGIONAL HEALTH CARE FACILITY SERVING PATIENTS WITHIN A SIXTYMILE RADIUS OF ROCHESTER, MN.
PART VI, LINE 5:THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY. MEDICAL STAFF PRIVILEGES ARE OPEN TO ALL QUALIFIED PHYSICIANS IN THE AREA. THE ORGANIZATION UTILIZES ITS SURPLUS FUNDS TO INCREASE THE SERVICES OFFERED TO ITS PATIENTS.
PART VI, LINE 6:N/A

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1OMC REGIONAL FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1210 9TH STREET SEAddressLine1Txt
CityROCHESTERCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55904ZIPCd
FieldValueIRS element (for citing)
Recipient EIN260022777RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$258,481CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Valuation Method UsedN/AValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc
Purpose Of GrantPROVIDE FUNDING TO OMC REGIONAL FOUNDATION FOR HEALTHCARE EDUCATION AND COMMUNITY PURPOSES.PurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationMOST OF THE GRANT EXPENDITURES ARE PROVIDED TO OMC REGIONAL FOUNDATION, A RELATED ORGANIZATION. OMC PROVIDES FUNDS TO THE FOUNDATION FOR HEALTHCARE EDUCATION AND COMMUNITY PURPOSES AS NEEDED. THERE ARE NUMEROUS WAYS TO MONITOR THE USE OF THE GRANT FUNDS. MANY OF THE EVENTS ARE OPEN TO THE PUBLIC AND EASILY VERIFIABLE. STAFF OFTEN ASSIST AS VOLUNTEERS. THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE ITS MISSION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS COMMUNITY NEEDS IN THE HEALTH CARE AREA. NO ADDITIONAL MONITORING IS PERFORMED.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MATTHEW KIRSCH MD
PHYSICIAN$1,140,560$0$0$0$0$0$12,200$0$30,034$0$1,182,794$0$0$0
VIDHAN CHANDRA MD
PHYSICIAN$1,064,538$0$0$0$550$0$12,200$0$2,769$0$1,080,057$0$0$0
SAMER ABDEL-AZIZ MD
PHYSICIAN$1,030,524$0$0$0$0$0$12,200$0$30,273$0$1,072,997$0$0$0
MARK HERR MD
PHYSICIAN$1,051,783$0$0$0$0$0$12,200$0$3,195$0$1,067,178$0$0$0
TIM WEIR FACHE
CHIEF EXECUTIVE OFFICER$726,809$0$218,858$0$0$0$12,200$0$18,942$0$976,809$0$0$0
SRDAN BABOVIC MD
PHYSICIAN$951,001$0$0$0$500$0$12,200$0$2,388$0$966,089$0$0$0
JAMES HOFFMANN DO
PRESIDENT$535,333$0$109,429$0$1,000$0$12,200$0$19,785$0$677,747$0$0$0
KEVIN HIGGINS
CHIEF FINANCIAL OFFICER$454,823$0$107,271$0$16,731$0$12,200$0$38,582$0$629,607$0$0$0
TAMARA ALEXANDROV MD
CLINIC TRUSTEE$493,441$0$0$0$200$0$12,200$0$202$0$506,043$0$0$0
KEITH KLEIS MD
CLINIC TRUSTEE$403,115$0$0$0$0$0$12,200$0$30,034$0$445,349$0$0$0
MARAL KENDARIAN MD
CLINIC TRUSTEE$391,807$0$0$0$0$0$12,200$0$2,423$0$406,430$0$0$0
MARK WILBUR MD CHIEF
MEDICAL OFFICER (STARTING JULY 2023)$368,354$0$16,572$0$550$0$12,200$0$3,435$0$401,111$0$0$0
RANDY HEMANN MD CHIEF
MEDICAL OFFICER (THROUGH JUNE 2023)$281,186$0$94,448$0$1,000$0$12,200$0$10,717$0$399,551$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4BFormAndLineReferenceDesc
ExplanationOLMSTED MEDICAL CENTER HAS A 457 (F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN FOR CERTAIN INDIVIDUALS IN LEADERSHIP POSITIONS. DURING 2023, THE EMPLOYEES EARNED A N0N-VESTED CONTRIBUTION. SAID CONTRIBUTION WILL VEST WHEN THE PARTICIPANTS HAVE MET THE VESTING QUALIFICATIONS, AT WHICH TIME THE AMOUNT WILL BECOME TAXABLE TO THE EMPLOYEE. THE AMOUNT, NET OF TAXES, WILL RESIDE IN THE EMPLOYEE'S VESTED ACCOUNT UNTIL THE EMPLOYEE'S RETIREMENT OR DEPARTURE FROM THE ORGANIZATION. THE FOLLOWING AMOUNTS WERE EARNED IN 2023. THE VESTING YEAR IS SHOWN BELOW. TIM WEIR - $92,300 (2027) KEVIN HIGGINS - $41,499 (2027) DR. JAMES HOFFMANN - $46,150 (2024) DR. MARK WILBUR - $7,327 (2027)ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1ATHE EXECUTIVE COMMITTEE SHALL CONSIST OF FOUR (4) VOTING MEMBERS CONSISTING OF THE BOARD CHAIR, CHAIR OF THE FINANCE COMMITTEE, PRESIDENT AND CHIEF EXECUTIVE OFFICER, WHO WILL BE EX OFFICIO MEMBERS. EXCEPT AS PROVIDED BY THE BOARD OF TRUSTEES, THE EXECUTIVE COMMITTEE WILL HAVE THE AUTHORITY OF THE BOARD OF TRUSTEES IN THE MANAGEMENT OF THE BUSINESS OF THE CORPORATION TO ACT IN THE INTERVALS BETWEEN MEETINGS OF THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS PREPARED BY AN EXTERNAL ACCOUNTANT. A DRAFT OF THE FORM 990 WAS REVIEWED IN DETAIL BY THE FINANCIAL SERVICES MANAGER, CONTROLLER AND CFO. ANY NECESSARY CORRECTIONS AND ADJUSTMENTS WERE MADE. THE FORM 990 WAS REVIEWED BY THE CEO AND CFO AND PRESENTED TO THE COMPENSATION COMMITTEE. THE FINAL FORM 990 WAS MADE AVAILABLE TO THE BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CEACH CLINIC AND PUBLIC TRUSTEE AND PRINCIPAL OFFICER ("COVERED MEMBERS") OF THE CORPORATION ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS THAT EACH PERSON HAS RECEIVED AND UNDERSTANDS THE CONFLICTS OF INTEREST POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. UNLESS A PREVIOUSLY DISCLOSED AND DOCUMENTED CONFLICT OF INTEREST IS KNOWN TO THE BOARD, ALL CONFLICTS OF INTEREST ARE DISCLOSED TO THE BOARD BY THE COVERED MEMBER WITH THE CONFLICT(S) AND DOCUMENTED IN THE BOARD MEETING MINUTES. A COVERED MEMBER HAS DISCLOSED A CONFLICT IF HE OR SHE PROMPTLY PROVIDES A DESCRIPTION OF THE MATERIAL FACTS COMPRISING THE CONFLICT OF INTEREST TO THE BOARD. IF A COVERED MEMBER HAS A CONFLICT OF INTEREST ON ANY MATTER CONSIDERED BY THE BOARD, SUCH MATTER IS APPROVED BY THE BOARD IN A MANNER THAT COMPLIES WITH THE REQUIREMENTS OF THE SEVENTH RESTATED BYLAWS OF OLMSTED MEDICAL CENTER AND MINNESOTA STATUE SECTION 317A.255. SUCH LAW CURRENTLY STATES THAT A MATTER INVOLVING A CONFLICT OF INTEREST WILL NOT BE VOID OR VOIDABLE IF APPROVED BY ONE OF THE FOLLOWING PROCEDURES: THE CONTRACT OR TRANSACTION WAS, AND THE PERSON ASSERTING THE VALIDITY OF THE CONTRACT OR TRANSACTION HAS THE BURDEN OF ESTABLISHING THAT THE CONTRACT OR TRANSACTION WAS, FAIR AND REASONABLE AS TO THE CORPORATION WHEN IT WAS AUTHORIZED, APPROVED, OR RATIFIED. THE MATERIAL FACTS AS TO THE CONTRACT OR TRANSACTION AND AS TO THE TRUSTEE'S INTEREST ARE FULLY DISCLOSED OR KNOWN TO THE MEMBERS AND THE CONTRACT OR TRANSACTION IS APPROVED IN GOOD FAITH BY TWO-THIRDS OF THE MEMBERS ENTITLED TO VOTE, NOT COUNTING ANY VOTE THAT THE INTERESTED TRUSTEE MIGHT OTHERWISE HAVE, OR THE UNANIMOUS AFFIRMATIVE VOTE OF ALL MEMBERS, WHETHER OR NOT ENTITLED TO VOTE; OR THE MATERIAL FACTS AS TO THE CONTRACT OR TRANSACTION AND AS TO THE TRUSTEE'S INTEREST ARE FULLY DISCLOSED OR KNOWN TO THE BOARD OR A COMMITTEE, AND THE BOARD OR COMMITTEE AUTHORIZES, APPROVES, OR RATIFIES THE CONTRACT OR TRANSACTION IN GOOD FAITH BY A MAJORITY OF THE BOARD OR COMMITTEE, NOT COUNTING ANY VOTE THAT THE INTERESTED TRUSTEE MIGHT OTHERWISE HAVE, AND NOT COUNTING THE TRUSTEE IN DETERMINING THE PRESENCE OF A QUORUM.
FORM 990, PART VI, SECTION B, LINE 15AIN ORDER TO ENSURE THAT ALL OLMSTED MEDICAL CENTER (OMC) EXECUTIVE COMPENSATION DECISIONS ARE COMPETITIVE, EQUITABLE, UNIFORMLY ADMINISTERED, AND CONSISTENT WITH MARKET PRACTICES, OMC FOLLOWS RECOMMENDED BEST PRACTICES. THE GOALS OF EXECUTIVE COMPENSATION ARE TO ATTRACT AND RETAIN HIGHLY QUALIFIED PERSONNEL, TO MAINTAIN COMPENSATION LEVELS COMMENSURATE WITH THE SCOPE OF RESPONSIBILITIES FOR EACH POSITION, AND TO REWARD OUTSTANDING PERFORMANCE. OMC WILL SEEK MANAGEMENT TALENT BY CONDUCTING NATIONAL SEARCHES FOR QUALIFIED APPLICANTS FOR ANY VACANCIES AT THE CHIEF MEDICAL OFFICER, AND CHIEF EXECUTIVE OFFICER POSITIONS IN ADDITION TO VICE PRESIDENT POSITIONS AS NECESSARY. THE SAME PHILOSOPHY IS APPLICABLE TO THE POSITION OF OMC PRESIDENT. OMC ENGAGES AN EXTERNAL CONSULTANT WHO ANNUALLY COMPILES A PEER GROUP COMPENSATION ANALYSIS AND ON A TWO YEAR BASIS COMPILES A PEER GROUP COMPENSATION AND BENEFITS ANALYSIS. PEER GROUPS FOR EXECUTIVE COMPENSATION, WHICH INCLUDES BASE SALARIES, WILL BE PROVIDED FOR HEALTH DELIVERY SYSTEMS WITH A MINIMUM OF A HOSPITAL AND AN EMPLOYED PHYSICIAN NETWORK AND NET REVENUES ROUGHLY SIMILAR TO THE REVENUES OF OLMSTED MEDICAL CENTER. MOST RECENTLY A COMPENSATION AND BENEFITS PEER REVIEW STUDY WAS COMPLETED FOR THE CHIEF EXECUTIVE OFFICER, PRESIDENT, CHIEF MEDICAL OFFICER, AND VICE PRESIDENTS AND PRESENTED TO THE BOARD EXECUTIVE COMPENSATION COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE RECEIVES A SUMMARY OF EVERYONE'S COMPENSATION TO ENSURE IT IS IN ALIGNMENT WITH THE SAME COMPENSATION METHODOLOGY AND AGREED UPON METHODOLOGY OF THE EXECUTIVE COMPENSATION SYSTEM OF OMC. THESE POSITIONS INCLUDE THE CHIEF MEDICAL OFFICER,AND VICE PRESIDENTS OF OMC. THE EXECUTIVE COMPENSATION COMMITTEE WILL SET THE COMPENSATION OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER AND MINUTES ARE KEPT OF THESE DISCUSSIONS. THE BOARD OF TRUSTEES, ACTING THROUGH THE BOARD OF TRUSTEES COMPENSATION COMMITTEE, MUST APPROVE THE EXECUTIVE COMPENSATION POLICY AND PROCESS OF DETERMINING EXECUTIVE COMPENSATION AND BENEFITS. IN ADDITION, THE PHYSICIAN SALARIES ARE CALCULATED ANNUALLY, USING REGIONAL PHYSICIAN SALARY COMPARISON GUIDES FACTORING IN PRODUCTIVITY AND QUALITY MEASURES, AND REVIEWED ON AN ANNUAL BASIS FOR MARKET REASONABLENESS BY AN INDEPENDANT CONSULTING FIRM. THE PHYSICIANS RECEIVE NO COMPENSATION AS ATTENDING BOARD MEMBERS. THESE DISCUSSIONS ARE NOTED IN THE MINUTES OF THE BOARD OF TRUSTEES COMPENSATION COMMITTEE ANNUAL MEETING.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. THE ANNUAL FORM 990 & ATTACHED AUDITED FINANCIAL STATEMENT REPORT IS AVAILABLE IN ACCORDANCE WITH THE PUBLIC INSPECTION OF THE RETURN REQUIREMENTS.
FORM 990, PART XI, LINE 9:FOUNDATION EXPENSES -953,276.
FORM 990, PART XII, LINE 2C:THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1OMC RETAIL SERVICES LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1210 9TH STREET SEAddressLine1Txt
CityROCHESTERCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55904ZIPCd
FieldValueIRS element (for citing)
EIN460960716EIN
Primary ActivitiesPHARMACYPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd
Total Income$10,977,590TotalIncomeAmt
End Of Year Assets$1,110,085EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1OLMSTED MEDICAL CENTERBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1OMC REGIONAL FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1210 9TH STREET SEAddressLine1Txt
CityROCHESTERCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55904ZIPCd
FieldValueIRS element (for citing)
EIN260022777EIN
Primary ActivitiesHEALTHCARE EDUCATION AND COMMUNITY PURPOSESPrimaryActivitiesTxt
Legal Domicile StateMNLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12A, IPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1OLMSTED MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
OMC REGIONAL FOUNDATION
B$258,481FMV
OMC REGIONAL FOUNDATION
C$56,757FMV
OMC REGIONAL FOUNDATION
O$538,379FMV