OLMSTED MEDICAL CENTER: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- OLMSTED MEDICAL CENTER (EIN 41-0855367)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-10-22
- IRS object ID
- 201912959349300311
- Schema version
- 2018v3.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-10-22T08:29:45-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 SOUTH SIXTH STREET SUITE 300 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410855367 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLMSTED MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OLMS | BusinessNameControlTxt |
| Phone | 5072883443 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 NINTH STREET SE | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55904 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIM WEIR | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 5072883443 | PhoneNum |
| Signature | 2019-10-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ROBERT E SCHILE | PreparerPersonNm |
| PTIN | P00369682 | PTIN |
| Phone | 6123764500 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-10-10 | IPDt |
| IP Tm | 09:26:43 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 971A8EAD25932F411DD256B5E237B6EBEA5F4AEB | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | E9B0F9A18C8000C04B4B0CC56389FCB9464530FE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KATHRYN LOMBARDO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 NINTH STREET SE | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55904 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $223,238,658 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OLMMED.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1949 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | THE DELIVERY OF EXCEPTIONAL PATIENT CARE FOCUSING ON CARING, QUALITY, SAFETY, AND SERVICE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 1497 | TotalEmployeeCnt |
| Total Volunteers | 90 | TotalVolunteersCnt |
| Total Gross UBI | $520,385 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$10,961 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $484,336 | PYContributionsGrantsAmt |
| CY Contributions Grants | $61,044 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $202,017,916 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $213,507,780 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,127,688 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,990,658 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,374,194 | PYOtherRevenueAmt |
| CY Other Revenue | $862,833 | CYOtherRevenueAmt |
| PY Total Revenue | $206,004,134 | PYTotalRevenueAmt |
| CY Total Revenue | $217,422,315 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $334,728 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $251,414 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $120,201,515 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $127,150,186 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $663,969 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $74,546,855 | PYOtherExpensesAmt |
| CY Other Expenses | $78,756,564 | CYOtherExpensesAmt |
| PY Total Expenses | $195,083,098 | PYTotalExpensesAmt |
| CY Total Expenses | $206,158,164 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $10,921,036 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,264,151 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $271,485,618 | TotalAssetsBOYAmt |
| Total Assets EOY | $278,992,681 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $73,118,011 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $72,518,565 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $198,367,607 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $206,474,116 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE DELIVERY OF EXCEPTIONAL PATIENT CARE FOCUSING ON CARING, QUALITY, SAFETY, AND SERVICE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $178,817,428 | ExpenseAmt |
| Grant | $251,414 | GrantAmt |
| Revenue | $213,510,193 | RevenueAmt |
| Desc | PERSONAL 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 174 CLINICIANS AND 1,000 HEALTHCARE PROFESSIONALS SERVE AT 22 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 WALK-IN SKYWAY CLINIC IN DOWNTOWN ROCHESTER, AND 11 COMMUNITY BRANCH CLINICS. IN 2018, OMC HAD 325,311 PATIENT VISITS SERVING 80,910 UNIQUE PATIENTS. THE HOSPITAL PROVIDED CARE FOR 2,993 PATIENT ADMISSIONS RESULTING IN 6,504 PATIENT DAYS INCLUDING 982 BIRTHS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $45,659 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | COMMUNITY OUTREACH AND SUPPORT ACTIVITIES: OMC 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 2018, OUR COMMUNITY CONTRIBUTIONS MADE UP 25.61% OF OUR ANNUAL OPERATING EXPENSE - MORE THAN $50,658,000 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 THE YEAR-TWO ACTION PLAN BASED ON OUR COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). IN 2018, OMC CONTINUED ITS TRADITION OF WELCOMING HUNDREDS OF SCHOOL-AGED CHILDREN AND COLLEGE STUDENTS FOR ON-SITE SCIENCE, TECHNOLOGY, ENGINEERING, AND MATH (STEM) EDUCATION EXPERIENCES DESIGNED TO CULTIVATE THE NEXT GENERATION OF CAREGIVERS. OUR CAREGIVERS ALSO EXTENDED THEIR COMMUNITY OUTREACH DURING THE YEAR, REPRESENTING OMC AT MORE THAN 50 COMMUNITY HEALTH FAIR EVENTS IN SOUTHEASTERN MINNESOTA. 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $178,863,087 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 164 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1497 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEVIN HIGGINS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5072883443 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 NINTH STREET SE | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55904 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| KATHRYN LOMBARDO MD | |||||||||
| PRESIDENT | 40.00 | 1.00 | Yes (X) | Yes (X) | $597,884 | $0 | $27,068 | ||
| KEN BROWN | |||||||||
| BOARD CHAIR | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SRDAN BABOVIC MD | |||||||||
| CLINIC TRUSTEE (THROUGH JAN 2018) | 40.00 | 0.00 | Yes (X) | $708,882 | $0 | $28,338 | |||
| STEVE BORCHARDT | |||||||||
| PUBLIC TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DAN CHRISTIANSON | |||||||||
| PUBLIC TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ELAINE GARRY | |||||||||
| PUBLIC TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| HAL HENDERSON | |||||||||
| PUBLIC TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JAY HESLEY | |||||||||
| PUBLIC TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| GREG HOUSE | |||||||||
| PUBLIC TRUSTEE (THROUGH SEP 2018) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CAROLE NISTLER MD | |||||||||
| CLINIC TRUSTEE | 36.00 | 0.00 | Yes (X) | $294,009 | $0 | $37,879 | |||
| JACK PRIGGEN | |||||||||
| PUBLIC TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JOSEPH TRICARICO MD | |||||||||
| CLINIC TRUSTEE | 36.00 | 0.00 | Yes (X) | $437,978 | $0 | $49,498 | |||
| MARK WILBUR MD | |||||||||
| CLINIC TRUSTEE | 34.00 | 0.00 | Yes (X) | $325,035 | $0 | $25,809 | |||
| TIM WEIR | |||||||||
| CEO | 40.00 | 1.00 | Yes (X) | $723,505 | $0 | $47,920 | |||
| KEVIN HIGGINS | |||||||||
| CFO/TREASURER/SECRETARY | 40.00 | 1.00 | Yes (X) | $442,119 | $0 | $46,445 | |||
| RANDY HEMANN MD | |||||||||
| MEDICAL VICE PRESIDENT MED SERVICES | 40.00 | 0.00 | $425,125 | $0 | $40,179 | Yes (X) | |||
| JAMES HOFFMANN MD | |||||||||
| MEDICAL VICE PRESIDENT SURG SERVICES | 36.00 | 0.00 | $511,892 | $0 | $40,901 | Yes (X) | |||
| SAMER ABDEL-AZIZ MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $787,548 | $0 | $51,634 | Yes (X) | |||
| VIDHAN CHANDRA MD | |||||||||
| PHYSICIAN | 36.00 | 0.00 | $981,394 | $0 | $31,181 | Yes (X) | |||
| JACOB JUTA MD | |||||||||
| PHYSICIAN | 36.00 | 0.00 | $690,417 | $0 | $50,806 | Yes (X) | |||
| MATTHEW KIRSCH MD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $967,205 | $0 | $34,129 | Yes (X) | |||
| DAVID LOWE MD | |||||||||
| PHYSICIAN | 40.00 | 1.00 | $712,465 | $0 | $51,617 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $8,605,458 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $563,404 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 226 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EPIC SYSTEMS CORPORATION | |||||
| PO BOX 88314 | MILWAUKEE | WI | 53288 | COMPUTER SUPPORT | $5,961,606 |
| AMERICAN EXPRESS | |||||
| 2975 W CORPORATE LAKES BLVD | WESTON | FL | 33331 | ELECTRONIC VENDOR PAYMENT SYSTEM | $2,153,979 |
| HARRIS (HIMEC) | |||||
| 8251 SOLUTIONS CENTER | CHICAGO | IL | 60677 | MECHANICAL, ELECTRICAL, HEATING, CONSTRU | $1,601,698 |
| CERNER COPORATION | |||||
| PO BOX 959156 | ST LOUIS | MO | 63195 | COMPUTER SUPPORT | $1,175,939 |
| UNIVERSAL HOSPITAL SERVICES INC | |||||
| PO BOX 851313 | MINNEAPOLIS | MN | 55485 | MEDICAL EQUIPMENT MAINTENANCE | $1,123,631 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 135 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $30,442 | RelatedOrganizationsAmt |
| All Other Contributions | $30,602 | AllOtherContributionsAmt |
| Total Contributions | $61,044 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICES | 621110 | $211,189,581 | $211,189,581 | |
| PHARMACY | 446110 | $2,318,199 | $1,797,814 | $520,385 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $213,507,780 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,531,201 | TotalRevenueColumnAmt |
| Exclusion | $2,531,201 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $78,415 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $78,415 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $78,415 | TotalRevenueColumnAmt |
| Exclusion | $78,415 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,265,289 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,805,056 | SecuritiesAmt |
| Other | $776 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $460,233 | SecuritiesAmt |
| Other | -$776 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $459,457 | TotalRevenueColumnAmt |
| Exclusion | $459,457 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $50,259 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $10,511 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,748 | TotalRevenueColumnAmt |
| Exclusion | $39,748 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| MISCELLANEOUS | 621990 | $432,536 | $432,536 | |
| CAFETERIA | 621990 | $309,721 | $309,721 | |
| EHR INCENTIVE | 621990 | $2,413 | $2,413 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $744,670 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $217,422,315 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $212,989,808 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $520,385 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,851,078 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $251,414 | TotalAmt |
| Program Services | $251,414 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,810,467 | TotalAmt |
| Program Services | $3,238,001 | ProgramServicesAmt |
| Management And General | $1,572,466 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,994,333 | TotalAmt |
| Program Services | $85,571,485 | ProgramServicesAmt |
| Management And General | $9,094,561 | ManagementAndGeneralAmt |
| Fundraising | $328,287 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,105,972 | TotalAmt |
| Program Services | $5,500,776 | ProgramServicesAmt |
| Management And General | $577,082 | ManagementAndGeneralAmt |
| Fundraising | $28,114 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,778,233 | TotalAmt |
| Program Services | $10,526,224 | ProgramServicesAmt |
| Management And General | $4,161,831 | ManagementAndGeneralAmt |
| Fundraising | $90,178 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,461,181 | TotalAmt |
| Program Services | $5,287,334 | ProgramServicesAmt |
| Management And General | $1,152,069 | ManagementAndGeneralAmt |
| Fundraising | $21,778 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $618,248 | TotalAmt |
| Program Services | $354,677 | ProgramServicesAmt |
| Management And General | $263,571 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,331 | TotalAmt |
| Management And General | $173,331 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,097 | TotalAmt |
| Management And General | $129,097 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,078 | TotalAmt |
| Management And General | $148,078 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,950,886 | TotalAmt |
| Program Services | $7,833,797 | ProgramServicesAmt |
| Management And General | $2,117,089 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $467,147 | TotalAmt |
| Program Services | $1,204 | ProgramServicesAmt |
| Management And General | $465,943 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,503,270 | TotalAmt |
| Program Services | $1,697,612 | ProgramServicesAmt |
| Management And General | $729,197 | ManagementAndGeneralAmt |
| Fundraising | $76,461 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $643,782 | TotalAmt |
| Program Services | $263,717 | ProgramServicesAmt |
| Management And General | $380,065 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,159,019 | TotalAmt |
| Program Services | $5,120,497 | ProgramServicesAmt |
| Management And General | $1,038,522 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,578 | TotalAmt |
| Program Services | $90,444 | ProgramServicesAmt |
| Management And General | $16,134 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $820,690 | TotalAmt |
| Program Services | $610,737 | ProgramServicesAmt |
| Management And General | $195,807 | ManagementAndGeneralAmt |
| Fundraising | $14,146 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,695,081 | TotalAmt |
| Program Services | $1,565,398 | ProgramServicesAmt |
| Management And General | $129,683 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,098,064 | TotalAmt |
| Program Services | $8,098,064 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,261,929 | TotalAmt |
| Program Services | $1,261,929 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $24,382,987 | $24,381,478 | $1,489 | $20 |
| BAD DEBT | $8,719,526 | $8,719,526 | ||
| EQUIP/SOFTWARE MAINT | $7,314,877 | $4,828,430 | $2,381,462 | $104,985 |
| MISCELLANEOUS | $5,563,974 | $3,660,343 | $1,903,631 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,158,164 | TotalAmt |
| Program Services | $178,863,087 | ProgramServicesAmt |
| Management And General | $26,631,108 | ManagementAndGeneralAmt |
| Fundraising | $663,969 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,471,599 | BOYAmt |
| EOY | $78,819,467 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,089,734 | BOYAmt |
| EOY | $36,811,197 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,955,845 | BOYAmt |
| EOY | $1,999,254 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,657,048 | BOYAmt |
| EOY | $1,596,646 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $182,672,234 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $79,104,029 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,358,957 | BOYAmt |
| EOY | $103,568,205 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,843,768 | BOYAmt |
| EOY | $56,197,912 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,667 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,485,618 | BOYAmt |
| EOY | $278,992,681 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,000,500 | BOYAmt |
| EOY | $32,318,500 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,257 | BOYAmt |
| EOY | $10,000 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,347,294 | BOYAmt |
| EOY | $30,011,080 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,196,344 | BOYAmt |
| EOY | $4,338,867 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,773,297 | BOYAmt |
| EOY | $5,547,922 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $793,319 | BOYAmt |
| EOY | $292,196 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,118,011 | BOYAmt |
| EOY | $72,518,565 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,367,607 | BOYAmt |
| EOY | $206,474,116 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,367,607 | BOYAmt |
| EOY | $206,474,116 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,485,618 | BOYAmt |
| EOY | $278,992,681 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $11,264,151 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$3,157,641 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,181,760 | OtherCostOrOtherBasisAmt |
| Book Value | $6,181,760 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $95,560,615 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,084,723 | DepreciationAmt |
| Book Value | $62,475,892 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $61,654,473 | OtherCostOrOtherBasisAmt |
| Depreciation | $46,019,306 | DepreciationAmt |
| Book Value | $15,635,167 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,275,386 | OtherCostOrOtherBasisAmt |
| Book Value | $19,275,386 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $103,568,205 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY PAYOR SETTLEMENTS | Desc |
| Amt | $292,196 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $292,196 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE MEDICAL CENTER AND THE FOUNDATION ARE EXEMPT FROM FEDERAL INCOME TAXES AS TAX EXEMPT ORGANIZATIONS 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, 2018 AND 2017. THE MEDICAL CENTER AND THE FOUNDATION ARE ALSO EXEMPT FROM STATE INCOME TAXES UNDER APPLICABLE MINNESOTA STATUTES. THE MEDICAL CENTER AND THE FOUNDATION FILE FEDERAL AND STATE INCOME TAX RETURNS. GENERALLY, THE MEDICAL CENTER AND THE FOUNDATION ARE NO LONGER SUBJECT TO STATE AND FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEAR ENDED DECEMBER 31, 2013, 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, 2018, THERE WERE NO UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,513,566 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,513,566 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00770 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $44,979,725 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,556,630 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,423,095 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11360 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $46,493,291 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,556,630 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,936,661 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12130 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $45,659 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $45,659 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,610,138 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,424,507 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,185,631 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00600 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $106,710 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $106,710 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $119,096 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $119,096 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,881,603 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,424,507 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,457,096 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00730 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $50,374,894 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,981,137 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,393,757 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12860 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $8,719,526 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $22,848,621 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $26,935,485 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$4,086,864 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLMSTED MEDICAL CENTER - HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1650 4TH ST SE | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55904 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://WWW.OLMMED.ORG | WebsiteAddressTxt |
| State License | 376238 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLMSTED MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE LINE 7D | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE LINE 7D | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.OLMMED.ORG/ABOUT/COMMUNITY-INVOLVEMENT/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.OLMMED.ORG/APP/FILES/PUBLIC/1222/INFORMATION-SHEET---FINANCIAL- | FAPAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.OLMMED.ORG/PATIENTS-VISITORS/ACCOUNTS/PAYMENT-ASSISTANCE/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| OLMSTED MEDICAL CENTER | PART 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 CENTER | PART V, SECTION B, LINE 6A: OLMSTED MEDICAL CENTER COLLABORATED WITH MAYO CLINIC. |
| OLMSTED MEDICAL CENTER | PART V, SECTION B, LINE 6B: OLMSTED MEDICAL CENTER COLLABORATED WITH OLMSTED COUNTY HEALTH SERVICES TO PRODUCE THE COMMUNITY HEALTH NEEDS ASSESSMENT. |
| OLMSTED MEDICAL CENTER | PART 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.CO.OLMSTED.MN.US/OCPHS/REPORTS/NEEDS%20ASSESSMENT/PAGES/2016- COMMUNITY-HEALTH-NEEDS-ASSESSMENT-PLAN.ASPX. |
| OLMSTED MEDICAL CENTER | PART 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 CENTER | PART 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 CENTER | PART V, SECTION B, LINE 20E: MEETING WITH PATIENTS UPON THEIR REQUEST. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 21 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (21 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - OMC - MAIN CLINIC | ||||
| 210 9TH ST SE | ROCHESTER | MN | 55904 | OUTPATIENT PHYSICIAN CLINIC |
| 2 - OMC - BYRON CLINIC | ||||
| 846 HIGH POINT DR NE | BYRON | MN | 55920 | OUTPATIENT PHYSICIAN CLINIC |
| 3 - OMC - CHATFIELD CLINIC | ||||
| 207 TWIFORD ST SW | CHATFIELD | MN | 55923 | OUTPATIENT PHYSICIAN CLINIC |
| 4 - OMC - CANNON FALLS CLINIC | ||||
| 1705 HIGHWAY 200 | CANNON FALLS | MN | 55009 | OUTPATIENT PHYSICIAN CLINIC |
| 5 - OMC - PINE ISLAND CLINIC | ||||
| 111 COUNTY RD 11 NW | PINE ISLAND | MN | 55963 | OUTPATIENT PHYSICIAN CLINIC |
| 6 - OMC - PLAINVIEW CLINIC | ||||
| 20 2ND AVE NE | PLAINVIEW | MN | 55964 | OUTPATIENT PHYSICIAN CLINIC |
| 7 - OMC - PRESTON CLINIC | ||||
| 405 KANSAS ST NW | PRESTON | MN | 55965 | OUTPATIENT PHYSICIAN CLINIC |
| 8 - OMC - ST CHARLES CLINIC | ||||
| 403 W FOURTH ST | ST CHARLES | MN | 55972 | OUTPATIENT PHYSICIAN CLINIC |
| 9 - OMC - SPRING VALLEY CLINIC | ||||
| 802 MEMORIAL DR | SPRING VALLEY | MN | 55975 | OUTPATIENT PHYSICIAN CLINIC |
| 10 - OMC - WANAMINGO CLINIC | ||||
| 217 MAIN ST SUITE B | WANAMINGO | MN | 55983 | OUTPATIENT PHYSICIAN CLINIC |
| 11 - OMC - FASTCARE NORTH CLINIC | ||||
| 3708 HIGHWAY 63 N | ROCHESTER | MN | 55906 | OUTPATIENT PHYSICIAN CLINIC |
| 12 - OMC - FASTCARE SOUTH CLINIC | ||||
| 2820 S BROADWAY | ROCHESTER | MN | 55904 | OUTPATIENT PHYSICIAN CLINIC |
| 13 - OMC - NW CLINIC | ||||
| 5067 55TH ST NW | ROCHESTER | MN | 55901 | OUTPATIENT PHYSICIAN CLINIC |
| 14 - OMC - SKYWAY CLINIC | ||||
| 318 1ST AVE SW SUITE 203 | ROCHESTER | MN | 55902 | OUTPATIENT PHYSICIAN CLINIC |
| 15 - OMC - PHYSICAL THERAPY | ||||
| 102 ELTON HILLS DR | ROCHESTER | MN | 55901 | PHYSICAL THERAPY |
| 16 - OMC - SLEEP MEDICINE | ||||
| 4303 HIGHWAY 52 | ROCHESTER | MN | 55901 | SLEEP MEDICINE |
| 17 - OMC - SPORTS MED & ATHLETIC PERFORMANCE | ||||
| 5155 55TH ST NW | ROCHESTER | MN | 55901 | PHYSICAL THERAPY/ATHLETIC PERFORMANCE |
| 18 - OMC - STEWARTVILLE CLINIC | ||||
| 208 CENTERTOWN PLAZA | STEWARTVILLE | MN | 55976 | OUTPATIENT PHYSICIAN CLINIC |
| 20 - OMC - NW RETAIL PHARMACY | ||||
| 5067 55TH ST NW | ROCHESTER | MN | 55901 | RETAIL PHARMACY |
| 21 - OMC - SE RETAIL PHARMACY | ||||
| 210 9TH ST SE | ROCHESTER | MN | 55904 | RETAIL PHARMACY |
| 22 - OMC - LAKE CITY CLINIC | ||||
| 507 W DOUGHTY ST | LAKE CITY | MN | 55041 | OUTPATIENT PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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): | $8,719,526 OF BAD DEBT EXPENSE WAS EXCLUDED IN CALCULATING THE PERCENTAGES REPORTED IN PART I, LINE 7, COLUMN F. |
| PART III, LINE 2: | PATIENT ACCOUNTS RECEIVABLE DUE DIRECTLY FROM THE PATIENTS ARE CARRIEDAT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED, LESS AMOUNTS COVEREDBY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFULRECEIVABLES. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTSBY IDENTIFYING TROUBLED ACCOUNTS AND BY HISTORICAL EXPERIENCE APPLIEDTO AN AGING OF ACCOUNTS. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF PATIENT ACCOUNTS RECEIVABLEPREVIOUSLY 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 NOTE ON PAGE 10 OF THE ATTACHED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE ORGANIZATION DERIVED ITS COSTING METHODOLOGY USED TO DETERMINE THEMEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COSTREPORT BY USING COST REPORT WORKSHEETS. MEDICARE COSTS ARE DETERMINEDTHROUGH THE MEDICARE COST FINDING PROCESS WHICH ALLOCATES GENERAL SERVICECENTER COSTS TO REVENUE DEPARTMENTS. THE METHODOLOGY DESCRIBED IN THEINSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTOACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THETOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA.THE REASONS MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFITARE: ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALSWOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENTPROGRAMS; BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THEBURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS;THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION INREIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESEINDIVIDUALS; AND THE AMOUNT SPENT TO COVER MEDICARE SHORTFALL IS MONEY NOTAVAILABLE 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 $16,289,647. |
| PART III, LINE 9B: | PATIENT FINANCIAL HARDSHIP POLICY: TO SUPPORT THE ORGANIZATION'S MISSIONAND PHILOSOPHY IN THAT THE PATIENT COMES FIRST AND PROVIDE A GUIDELINE INIDENTIFYING PATIENTS WHO HAVE AN EXCEPTIONAL PERSONAL FINANCIAL HARDSHIPAND REQUIRED NEEDED AND NECESSARY MEDICAL CARE AND THERE IS REMOTE ORNEGLIBLE CHANCE THAT THE INDIVIDUAL WILL BE ABLE TO REPAY.PROCEDURE: FACTORS THAT MAY CONTRIBUTE TO EXCEPTIONAL FINANCIAL HARDSHIPINCLUDE:1) UNEMPLOYMENT OR UNDEREMPLOYMENT THROUGH NO FAULT OF THE PATIENT AND/ORFAMILY; 2) THREATENED LOSS OF SHELTER THROUGH FORECLOSURE, ETC; 3) LOSS OFINCOME FROM FEDERAL, STATE OR OTHER GOVERNMENT BENEFITS INCLUDING, BUT NOTLIMITED TO SOCIAL SECURITY, SUPPLEMENTAL SECURITY INCOME, PUBLICASSISTANCE, ETC; 4) LOSS OF INCOME DUE TO DEATH OR DISABILITY; 5)EXCEPTIONAL EXPENSES INCURRED BECAUSE OF UNINSURED PROPERTY DAMAGE ORCOSTLY REPAIRS TO PRINCIPAL RESIDENCE; 6) EXCEPTIONAL EXPENSES DUE TOTEMPORARY OR CHRONIC ILLNESS; 7) EXCEPTIONAL EXPENSES DUE TO INCREASE INLIVING EXPENSES BECAUSE OF A DIVORCE, ABANDONMENT OR SEPARATION FROMSPOUSE OR INCOME EARNER; 8) LOSS OF INCOME DUE TO DECLARATION OFINCOMPETENCE OR IN PROCESS OF BEING DECLARED INCOMPETENT; 9) PATIENT ORFAMILY MEMBER IS CONFINED TO A CONVALESCENT HOME OR OTHER RESIDENCE OTHERTHAN THEIR PRINCIPAL RESIDENCE; 10) NATURAL DISASTERS SUCH AS FLOODS,FIRES, HURRICANES AND EARTHQUAKES; 11) EVICTION, HOMELESSNESS, LOSS OFOWNED RESIDENCE, ARSON, THEFT, ETC; 12) DISCONTINUANCE OF UTILITIES ORHEAT, OR UNSAFE OR UNHEALTHY LIVING CONDITIONS; 13) ANY OTHER CONDITIONCONSIDERED LIFE THREATENING DUE TO EXCEPTIONAL FINANCIAL HARDSHIP.APPLICATION PROCESS: THE FINANCIAL HARDSHIP APPLICATION, UTILIZING OMC'S FINANCIAL ASSISTANCE APPLICATION, CONTAINS THE NECESSARY INFORMATION TODETERMINE ELIGIBILITY FOR THE OMC FINANCIAL HARDSHIP PROGRAM. NO SEPARATEAPPLICATION IS NECESSARY. SUPPORTING DOCUMENTATION REQUIRED TO MAKE ANELIGIBILITY DETERMINATION ARE: 1) MOST RECENT TAX RETURNS; 2) CURRENTFAMILY PAYROLL STUB SHOWING YEAR-TO-DATE INCOME; 3) CURRENT TRANSUNIONCREDIT REPORT AND OTHER FINANCIAL HARDSHIP DOCUMENTATION TO SUPPORTHARDSHIP; AND 4) EXPLANATION OF HARDSHIP SITUATION/NECESSITY AND RARECOMPLICATIONS.ELIGIBILITY DETERMINATION: BASED UPON PATIENT'S/FAMILY'S INCOME ANDASSETS AND COMPLETED FINANCIAL ASSISTANCE APPLICATION. BASED UPON TAKINGINTO CONSIDERATION ALL PERSONAL FACTORS IN DETERMINING EXCEPTIONALFINANCIAL HARDSHIP. THE BUSINESS SERVICES DEPARTMENT EVALUATES THEAPPLICATIONS MEETING THE CRITERIA AND PRESENTS TO ADMINISTRATION FORAPPROVAL. OMC RESERVES THE RIGHT TO MAKE ADJUSTMENT DETERMINATIONS ON ACASE-BY-CASE BASIS. |
| PART VI, LINE 2: | OMC ACTIVELY WORKS WITH LOCAL GOVERNMENT IN ASSESSING AND ADDRESSINGCOMMUNITY NEEDS THROUGH MEETINGS, WORKSHOPS, AND COMMUNITY INPUT. INADDITION, OMC IS ACTIVELY INVOLVED WITH LOCAL GOVERNMENTS IN EMERGENCYPREPAREDNESS 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OMC REGIONAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 9TH STREET SE | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55904 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 260022777 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $251,414 | CashGrantAmt |
| Purpose Of Grant | PROVIDE FUNDING TO OMC REGIONAL FOUNDATION FOR HEALTHCARE EDUCATION AND COMMUNITY PURPOSES. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MOST OF 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 ORGANZATION 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KATHRYN LOMBARDO MD | ||||||||||||||
| PRESIDENT | $546,366 | $0 | $50,518 | $0 | $1,000 | $0 | $22,000 | $0 | $5,068 | $0 | $624,952 | $0 | $0 | $0 |
| SRDAN BABOVIC MD | ||||||||||||||
| CLINIC TRUSTEE (THROUGH JAN 2018) | $708,182 | $0 | $0 | $0 | $700 | $0 | $22,000 | $0 | $6,338 | $0 | $737,220 | $0 | $0 | $0 |
| CAROLE NISTLER MD | ||||||||||||||
| CLINIC TRUSTEE | $284,785 | $0 | $9,124 | $0 | $100 | $0 | $22,000 | $0 | $15,879 | $0 | $331,888 | $0 | $0 | $0 |
| JOSEPH TRICARICO MD | ||||||||||||||
| CLINIC TRUSTEE | $437,528 | $0 | $0 | $0 | $450 | $0 | $22,000 | $0 | $27,498 | $0 | $487,476 | $0 | $0 | $0 |
| MARK WILBUR MD | ||||||||||||||
| CLINIC TRUSTEE | $312,127 | $0 | $12,708 | $0 | $200 | $0 | $22,000 | $0 | $3,809 | $0 | $350,844 | $0 | $0 | $0 |
| TIM WEIR | ||||||||||||||
| CEO | $622,469 | $0 | $101,036 | $0 | $0 | $0 | $22,000 | $0 | $25,920 | $0 | $771,425 | $0 | $0 | $0 |
| KEVIN HIGGINS | ||||||||||||||
| CFO/TREASURER/SECRETARY | $379,685 | $0 | $48,886 | $0 | $13,548 | $0 | $22,000 | $0 | $24,445 | $0 | $488,564 | $0 | $0 | $0 |
| RANDY HEMANN MD | ||||||||||||||
| MEDICAL VICE PRESIDENT MED SERVICES | $391,627 | $0 | $32,498 | $0 | $1,000 | $0 | $22,000 | $0 | $18,179 | $0 | $465,304 | $0 | $0 | $0 |
| JAMES HOFFMANN MD | ||||||||||||||
| MEDICAL VICE PRESIDENT SURG SERVICES | $479,200 | $0 | $31,692 | $0 | $1,000 | $0 | $22,000 | $0 | $18,901 | $0 | $552,793 | $0 | $0 | $0 |
| SAMER ABDEL-AZIZ MD | ||||||||||||||
| PHYSICIAN | $787,548 | $0 | $0 | $0 | $0 | $0 | $22,000 | $0 | $29,634 | $0 | $839,182 | $0 | $0 | $0 |
| VIDHAN CHANDRA MD | ||||||||||||||
| PHYSICIAN | $977,961 | $0 | $3,333 | $0 | $100 | $0 | $22,000 | $0 | $9,181 | $0 | $1,012,575 | $0 | $0 | $0 |
| JACOB JUTA MD | ||||||||||||||
| PHYSICIAN | $690,417 | $0 | $0 | $0 | $0 | $0 | $22,000 | $0 | $28,806 | $0 | $741,223 | $0 | $0 | $0 |
| MATTHEW KIRSCH MD | ||||||||||||||
| PHYSICIAN | $960,136 | $0 | $7,069 | $0 | $0 | $0 | $22,000 | $0 | $12,129 | $0 | $1,001,334 | $0 | $0 | $0 |
| DAVID LOWE MD | ||||||||||||||
| PHYSICIAN | $708,632 | $0 | $3,333 | $0 | $500 | $0 | $22,000 | $0 | $29,617 | $0 | $764,082 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | JOSEPH TRICARICO, $6, GROSS UP ON EMPLOYEE RECOGNITION DAVID LOWE, MD, $6, GROSS UP ON EMPLOYEE RECOGNITION |
| PART I, LINE 4B | THE ORGANIZATION HAS A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR CERTAIN INDIVIDUALS IN LEADERSHIP POSITIONS. DURING 2018, TIM WEIR BECAME ELIGIBLE FOR A $75,626 PAYMENT IN 2023, KEVIN HIGGINS BECAME ELIGIBLE FOR A $25,900 PAYMENT IN 2023 AND RANDY HEMANN BECAME ELIGIBLE FOR A $5,850 PAYMENT IN 2023. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| CITY OF ROCHESTER MN | ||||||||
| A | 416005494 | 771902FY4 | 2010-07-07 | $20,202,546 | NW CLINIC CONSTRUCTION | 0 | 0 | 0 |
| CITY OF ROCHESTER MN | ||||||||
| B | 416005494 | 771902GK3 | 2013-04-24 | $19,290,018 | WOMEN'S HEALTH PAVILLION CONSTRUCTION | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $5,835,000 | $20,202,546 | $1,736,608 | $1,341,608 | $407,200 | $17,968,405 | $275,180 | 2011 | 0 | 0 | Yes (1) | Yes (1) |
| B | $2,465,000 | $19,290,018 | $490,226 | $286,285 | $18,513,507 | 2014 | 0 | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | DATE REBATE COMPUTATION PERFORMED | FormAndLineReferenceDesc |
| Explanation | ISSUER NAME: CITY OF ROCHESTER, MN DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2015 ISSUER NAME: CITY OF ROCHESTER, MN DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2017 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE 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 A, LINE 4 | THE ORGANIZATION'S BYLAWS WERE AMENDED IN JULY 2018 TO CHANGE THE CRITERIA TO QUALIFY AS A CLINIC TRUSTEE ON THE BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN EXTERNAL ACCOUNTANT. A DRAFT OF THE FORM 990 IS REVIEWED IN DETAIL BY THE FINANCIAL SERVICES MANAGER, CONTROLLER AND CFO. ANY NECESSARY CORRECTIONS AND ADJUSTMENTS ARE MADE. THE FORM 990 IS REVIEWED BY THE CEO AND CFO AND PRESENTED TO THE COMPENSATION COMMITTEE. THE FINAL FORM 990 IS MADE AVAILABLE TO THE BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH 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). 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 15A | IN 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, CHIEF CLINICAL CARE OFFICER AND CEO 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, INCENTIVE AND BENEFITS, 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 PEER REVIEW STUDY WAS COMPLETED FOR THE CEO, PRESIDENT, CHIEF MEDICAL OFFICER, CHIEF CLINICAL CARE 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, CHIEF CLINICAL CARE OFFICER AND VICE PRESIDENTS OF OMC. THE EXECUTIVE COMPENSATION COMMITTEE WILL SET THE COMPENSATION OF THE PRESIDENT, AND CEO, 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. THE BOARD OF TRUSTEES COMPENSATION COMMITTEE REPORTS TO THE FULL BOARD OF TRUSTEES ON AN ANNUAL BASIS THE COMPLETION OF SUCH DUTIES AND ARE ALSO NOTED IN THE MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE 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. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OMC RETAIL SERVICES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 9TH STREET SE | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55904 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460960716 | EIN |
| Primary Activities | PHARMACY | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Total Income | $2,333,847 | TotalIncomeAmt |
| End Of Year Assets | $1,126,564 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLMSTED MEDICAL CENTER | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OMC REGIONAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 9TH STREET SE | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55904 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 260022777 | EIN |
| Primary Activities | HEALTHCARE EDUCATION AND COMMUNITY PURPOSES | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLMSTED MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OLMSTED MEDICAL CENTER LASIK LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5715 W OLD SHAKOPEE ROAD STE 150 | AddressLine1Txt |
| City | BLOOMINGTON | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55437 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 822006285 | EIN |
| Primary Activities | EYE CARE | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $865 | ShareOfTotalIncomeAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| OMC REGIONAL FOUNDATION | ||
| B | $251,414 | GAAP |
| OMC REGIONAL FOUNDATION | ||
| O | $411,796 | GAAP |