LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC (EIN 41-0811697)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-11-14
IRS object ID: 201733189349308258
Schema version: 2016v3.0
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 C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-11-14T15:23:48-06:00	ReturnTs
Tax Period End	2016-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	135665207	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	4200 WELLS FARGO CTR 90 S 7TH	AddressLine1Txt
Address Line2	STREET	AddressLine2Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55402	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	410811697	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LAKEVIEW MEMORIAL HOSPITAL	BusinessNameLine1Txt
Business Name Line2	ASSOCIATION INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	LAKE	BusinessNameControlTxt
Phone	9528836584	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8170 33RD AVENUE SOUTH PO BOX 1309	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	554401309	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DOUGLAS E JOHNSON	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	9528836584	PhoneNum
Signature	2017-11-14	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MONROE JORDAN GIERL	PreparerPersonNm
PTIN	P01413237	PTIN
Phone	6123055000	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	198.174.110.146	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2017-11-14	IPDt
IP Tm	15:23:25	IPTm
IP Timezone	CS	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	1A39D2BAC3E977A191A219CBBAAA8778AA2E0A5D	AtSubmissionCreationDeviceId
At Submission Filing Device Id	282CC43464B9830A349574F670F0BA37F913502D	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2017-02-10 21:41:12Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DOUGLAS E JOHNSON	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8170 33RD AVENUE SOUTH PO BOX 1309	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	554401309	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$117,458,957	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.LAKEVIEW.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1880	FormationYr
Legal Domicile State	MN	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	1246	TotalEmployeeCnt
Total Volunteers	270	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$161,890	PYContributionsGrantsAmt
CY Contributions Grants	$650,454	CYContributionsGrantsAmt
PY Program Service Revenue	$102,438,860	PYProgramServiceRevenueAmt
CY Program Service Revenue	$116,751,882	CYProgramServiceRevenueAmt
PY Investment Income	$11,806	PYInvestmentIncomeAmt
CY Investment Income	$10,121	CYInvestmentIncomeAmt
PY Other Revenue	$21,241	PYOtherRevenueAmt
CY Other Revenue	$6,265	CYOtherRevenueAmt
PY Total Revenue	$102,633,797	PYTotalRevenueAmt
CY Total Revenue	$117,418,722	CYTotalRevenueAmt
PY Grants And Similar Paid	$164,340	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$165,967	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$50,555,039	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$53,645,203	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$41,941,176	PYOtherExpensesAmt
CY Other Expenses	$47,519,148	CYOtherExpensesAmt
PY Total Expenses	$92,660,555	PYTotalExpensesAmt
CY Total Expenses	$101,330,318	CYTotalExpensesAmt
PY Revenues Less Expenses	$9,973,242	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$16,088,404	CYRevenuesLessExpensesAmt
Total Assets BOY	$56,184,449	TotalAssetsBOYAmt
Total Assets EOY	$65,996,525	TotalAssetsEOYAmt
Total Liabilities BOY	$21,027,058	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$19,025,211	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$35,157,391	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$46,971,314	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TO MEET THE HEALTHCARE NEEDS OF INDIVIDUALS, FAMILIES & COMMUNITIES OF THE ST. CROIX VALLEY.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$87,674,616	ExpenseAmt
Grant	$165,967	GrantAmt
Revenue	$111,393,234	RevenueAmt
Desc	SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS	Desc
Total Program Service Expenses	$87,674,616	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	0	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	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	0	TaxExemptBondsInd
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	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1246	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
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
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	9	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	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	Yes (1)	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	DOUGLAS JOHNSON	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6514304581	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	927 CHURCHILL STREET WEST	AddressLine1Txt
City	STILLWATER	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55082	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ARBA-DELLA BECK
DIRECTOR	0.08	Yes (X)	$0	$0	$0
REBECCA BILLINGSLEY
DIRECTOR & VICE CHAIR	0.08	Yes (X)	$0	$0	$0
BRUCE BARTIE DO
DIRECTOR	0.08	Yes (X)	$0	$0	$0
ELIZABETH BRADSHAW
DIRECTOR	0.08	Yes (X)	$0	$0	$0
PHILLIP DONALDSON
DIRECTOR	0.08	Yes (X)	$0	$0	$0
DAVID REAMER
DIRECTOR	0.08	Yes (X)	$0	$0	$0
C ANDREW ROLLWAGEN
DIRECTOR	0.08	Yes (X)	$0	$0	$0
JIM SCHUG
DIRECTOR & CHAIR	0.08	Yes (X)	$0	$0	$0
JOHN S MISA MD
DIRECTOR	0.50	Yes (X)	$0	$557,263	$97,212	49.50
TED WEGLEITNER
CEO	40.00	Yes (X)	$0	$521,283	$106,696	15.00	Yes (X)
NICK MEYER
DIRECTOR	0.08	Yes (X)	$0	$0	$0
DENISE PONTRELLI
DIRECTOR	0.08	Yes (X)	$0	$0	$0
JULIE SCHMIDT
DIRECTOR	0.08	Yes (X)	$0	$0	$0
DOUGLAS E JOHNSON
CFO & TREASURER	24.70		$372,676	$0	$76,277	30.30	Yes (X)
PAUL L ERICKSON
EXEC. DIR. - DEVELOPMENT	51.00		$124,489	$0	$50,112	2.00	Yes (X)
THOMAS S ANDERSON
VP - MEDICAL AFFAIRS	55.00		$0	$364,280	$52,041		Yes (X)
CYNTHIA A APPLESETH
MANAGER - PHARMACY	45.00		$165,230	$0	$79,155			Yes (X)
JEFFREY W MAANUM
LEAD ULTRASOUND TECH.	40.00		$147,470	$0	$49,756			Yes (X)
ROBBI HAGELBERG
CNO	40.00		$203,524	$0	$24,205			Yes (X)
MICHELLE A KRAFT
DIRECTOR OF FINANCE	47.00		$149,557	$0	$19,937			Yes (X)
STEPHANIE NOE
NEONATAL NURSE PRACTIONER	40.00		$140,163	$0	$38,143			Yes (X)
JEFFREY J ROBERTSON
FORMER CEO	0.00		$574,771	$0	$28,812				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,877,880	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,442,826	TotReportableCompRltdOrgAmt
Total Other Compensation	$622,346	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	61	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	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
KRAUS-ANDERSON CONSTRUCTION CO
525 S 8TH ST	MINNEAPOLIS	MN	55404	CONSTRUCTION SERVICES	$7,106,671
REGIONS HOSPITAL
640 JACKSON ST	ST PAUL	MN	551012595	ANCILLARY TESTING SERVICES	$365,910
BWBR ARCHITECTS
380 ST PETER ST STE 600	ST PAUL	MN	55102	ARCHITECTURAL SERVICES	$340,425
QUEST DIAGNOSTICS
1355 MITTEL BLVD	WOODDALE	IL	60675	LAB SERVICES	$314,950
MOHAGEN HANSEN ARCHITECTURAL GROUP
1000 TWELVE OAKS CTR	WAYZATA	MN	55391	ARCHITECTURAL SERVICES	$302,396

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	25	CntrctRcvdGreaterThan100KCnt
Government Grants	$629,628	GovernmentGrantsAmt
All Other Contributions	$20,826	AllOtherContributionsAmt
Total Contributions	$650,454	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
NET PATIENT REVENUE	623990	$111,393,234	$111,393,234
OTHER REVENUE	900099	$4,945,168		$4,945,168
CAFETERIA	722210	$319,115		$319,115
GIFT SHOP	453220	$94,365		$94,365

Field	Value	IRS element (for citing)
Total Program Service Revenue	$116,751,882	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,121	TotalRevenueColumnAmt
Exclusion	$10,121	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$46,500	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$40,235	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$6,265	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,265	TotalRevenueColumnAmt
Exclusion	$6,265	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$117,418,722	TotalRevenueColumnAmt
Related Or Exempt Func Income	$111,393,234	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$5,375,034	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$165,967	TotalAmt
Program Services	$165,967	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$623,554	TotalAmt
Management And General	$623,554	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$43,977,535	TotalAmt
Program Services	$40,036,401	ProgramServicesAmt
Management And General	$3,941,134	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,965,845	TotalAmt
Program Services	$1,876,551	ProgramServicesAmt
Management And General	$89,294	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,077,623	TotalAmt
Program Services	$4,013,054	ProgramServicesAmt
Management And General	$64,569	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,000,646	TotalAmt
Program Services	$2,864,348	ProgramServicesAmt
Management And General	$136,298	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$22,664	TotalAmt
Program Services	$9,125	ProgramServicesAmt
Management And General	$13,539	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$7,500	TotalAmt
Management And General	$7,500	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,854,956	TotalAmt
Program Services	$878,504	ProgramServicesAmt
Management And General	$2,976,452	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$108,200	TotalAmt
Program Services	$99,319	ProgramServicesAmt
Management And General	$8,881	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,100,928	TotalAmt
Program Services	$944,998	ProgramServicesAmt
Management And General	$155,930	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$553,726	TotalAmt
Program Services	$174,689	ProgramServicesAmt
Management And General	$379,037	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,151,092	TotalAmt
Program Services	$1,412,836	ProgramServicesAmt
Management And General	$738,256	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$106,976	TotalAmt
Program Services	$99,337	ProgramServicesAmt
Management And General	$7,639	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$75,160	TotalAmt
Program Services	$39,524	ProgramServicesAmt
Management And General	$35,636	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$3,964,872	TotalAmt
Program Services	$3,365,813	ProgramServicesAmt
Management And General	$599,059	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$333,331	TotalAmt
Program Services	$44,673	ProgramServicesAmt
Management And General	$288,658	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL & PHARMACY SUPP	$29,315,343	$29,244,882	$70,461
EQUIPMENT & MAINTENANCE	$2,691,751	$1,420,134	$1,271,617
TAXES & ASSESSMENTS	$1,962,678		$1,962,678
OTHER EXPENSE	$1,077,252	$798,007	$279,245

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$192,719	TotalAmt
Program Services	$186,454	ProgramServicesAmt
Management And General	$6,265	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$101,330,318	TotalAmt
Program Services	$87,674,616	ProgramServicesAmt
Management And General	$13,655,702	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$16,861,991	BOYAmt
EOY	$19,062,723	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$9,017,810	BOYAmt
EOY	$11,808,536	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,142,993	BOYAmt
EOY	$1,925,420	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$369,911	BOYAmt
EOY	$161,670	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$48,773,422	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$16,207,405	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$25,723,350	BOYAmt
EOY	$32,566,017	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$1,207,577	BOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$860,817	BOYAmt
EOY	$472,159	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$56,184,449	BOYAmt
EOY	$65,996,525	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$10,873,009	BOYAmt
EOY	$11,325,733	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$10,154,049	BOYAmt
EOY	$7,699,478	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$21,027,058	BOYAmt
EOY	$19,025,211	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$35,157,391	BOYAmt
EOY	$46,971,314	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$35,157,391	BOYAmt
EOY	$46,971,314	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$56,184,449	BOYAmt
EOY	$65,996,525	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$16,088,404	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$4,274,481	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 C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Total Lobbying Expenditures	$0	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION PAYS FOR CERTAIN CORPORATE AND EMPLOYEE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,951,767	OtherCostOrOtherBasisAmt
Book Value	$2,951,767	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$22,490,171	OtherCostOrOtherBasisAmt
Depreciation	$4,359,155	DepreciationAmt
Book Value	$18,131,016	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$326,621	OtherCostOrOtherBasisAmt
Depreciation	$124,703	DepreciationAmt
Book Value	$201,918	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$21,325,913	OtherCostOrOtherBasisAmt
Depreciation	$10,842,338	DepreciationAmt
Book Value	$10,483,575	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,678,950	OtherCostOrOtherBasisAmt
Depreciation	$881,209	DepreciationAmt
Book Value	$797,741	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$32,566,017	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	PENSION LIABILITIES	Desc
Amt	$7,699,478	Amt

Field	Value	IRS element (for citing)
Total Liability	$7,699,478	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	LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. HP'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2016 OR 2015 FOR UNRECOGNIZED TAX BENEFITS.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	275.000000000000	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
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	$1,534,841	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,534,841	NetCommunityBenefitExpnsAmt
Total Expense	0.01510	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,226,600	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$805,301	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,421,299	NetCommunityBenefitExpnsAmt
Total Expense	0.01400	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,665,145	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,951,368	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,713,777	NetCommunityBenefitExpnsAmt
Total Expense	0.01690	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,426,586	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,756,669	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,669,917	NetCommunityBenefitExpnsAmt
Total Expense	0.04600	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$444,790	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$25,080	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$419,710	NetCommunityBenefitExpnsAmt
Total Expense	0.00410	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$119,859	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$119,859	NetCommunityBenefitExpnsAmt
Total Expense	0.00120	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,036,876	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,952,759	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,084,117	NetCommunityBenefitExpnsAmt
Total Expense	0.04030	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$165,967	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$165,967	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,767,492	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,977,839	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,789,653	NetCommunityBenefitExpnsAmt
Total Expense	0.04720	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$19,194,078	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,734,508	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,459,570	NetCommunityBenefitExpnsAmt
Total Expense	0.09320	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,834,600	BadDebtExpenseAmt
Reimbursed By Medicare	$28,139,258	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$30,130,415	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,991,157	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	LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	927 CHURCHILL STREET W	AddressLine1Txt
City	STILLWATER	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55082	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.LAKEVIEWHEALTH.ORG/	WebsiteAddressTxt
State License	8029322	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	LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION	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	15	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA	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	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	275.000000000000	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
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
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	HTTP://WWW.LAKEVIEWHEALTH.ORG/POLICIES	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTP://WWW.LAKEVIEWHEALTH.ORG/CHARITY-CARE-APPLICATION	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTP://WWW.LAKEVIEWHEALTH.ORG/POLICIES	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
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	Yes (1)	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION,	PART V, SECTION B, LINE 5: AS PART OF THE DATA COLLECTION PROCESS FOR THE MOST RECENT CHNA THAT WAS CONDUCTED IN 2015, LAKEVIEW HOSPITAL CONDUCTED TWO COMMUNITY CONVERSATIONS DURING THE SUMMER OF 2015 TO GATHER INPUT FROM VARIOUS GROUPS IN THE COMMUNITY, INCLUDING REPRESENTATIVES OF UNDERSERVED POPULATIONS. THESE CONVERSATIONS INCLUDED INDIVIDUALS WITH SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH; FEDERAL, STATE OR LOCAL HEALTH DEPARTMENT OR AGENCIES WITH INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED, INCLUDING PUBLIC SCHOOL REPRESENTATION; AND LEADERS, REPRESENTATIVES OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS.
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION,	PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES INCLUDED IN THE 2015 CHNA INCLUDED REGIONS HOSPITAL, HUDSON HOSPITAL, WESTFIELDS HOSPITAL, AMERY REGIONAL MEDICAL CENTER, AND PARK NICOLLET METHODIST HOSPITAL.
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION,	PART V, SECTION B, LINE 11: THE 2015 HEALTHPARTNERS CHNA CONDUCTED RESULTED IN THE FOLLOWING PRIORITIES:PRIORITY 1: INCREASE ACCESS TO MENTAL HEALTHPRIORITY 2: PROMOTE POSITIVE BEHAVIORS TO REDUCE OBESITY (NUTRITION / PHYSICAL ACTIVITY)PRIORITY 3: INCREASE ACCESS TO PRIMARY AND PREVENTIVE CARE PRIORITY 4: IMPROVE SERVICE INTEGRATIONPRIORITY 5: PROMOTE CHANGE IN UNHEALTHY LIFESTYLES (TOBACCO / ALCOHOL / SUBSTANCE ABUSE)A FULL REPORT OF LAKEVIEW HOSPITAL'S 2015 CHNA AND ANNUAL IMPLEMENTATION PLAN UPDATE IS POSTED ON THEIR WEBPAGE AT HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA WHICH PROVIDES A DETAILED DESCRIPTION OF ALL THE ACTIVITIES.ACTIONS THE HOSPITAL IS DEDICATED TO IMPROVING THE HEALTH OF THE COMMUNITY AND HAS USED THE ABOVE FINDINGS AND HEALTH PRIORITIES TO CREATE A HOSPITAL SPECIFIC IMPLEMENTATION PLAN. THE HOSPITAL'S IMPLEMENTATION PLAN IDENTIFIES OBJECTIVES AND ACTION STEPS FOR EACH PRIORITY. EACH OBJECTIVE IDENTIFIES ONE WAY THAT THE HOSPITAL WILL POSITIVELY IMPACT THE HEALTH OF THE COMMUNITY. THE ACTION STEPS DEMONSTRATE STRATEGIES THAT THE HOSPITAL WILL TAKE TO CARRY OUT EACH OBJECTIVE.
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION,	PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS LISTED ON THE BACK OF THE PATIENT STATEMENT PER THE MINNESOTA ATTORNEY GENERAL (AG) AGREEMENT.
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION,	PART V, SECTION B, LINE 24: WHEN A PATIENT IS UNINSURED THERE HAVE BEEN INSTANCES WHERE A PORTION OF THE BALANCE IS COVERED BY THE UNINSURED DISCOUNT AND THE REMAINING BALANCE IS COVERED BY CHARITY CARE. EXAMPLE: AN UNINSURED PATIENT HAS $1,000 IN GROSS CHARGES FOR AN EMERGENCY ROOM VISIT. THE PATIENT QUALIFIES FOR CHARITY CARE AND ALSO IS ELIGIBLE FOR THE UNINSURED DISCOUNT. A PORTION OF THE GROSS CHARGES IS COVERED BY THE UNINSURED DISCOUNT AND THE REMAINDER BY CHARITY CARE, WHICH MAY TOTAL AN AMOUNT EQUAL TO THE GROSS CHARGE FOR THAT VISIT.

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 7:	ACTUAL COSTS WERE ESTIMATED USING A COST-TO-CHARGE RATIO AND EXCLUDING BAD DEBT.
PART I, LINE 7E: COMMUNITY HEALTH IMPROVEMENT SERVICES	LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (HOSPITAL) IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITY. THE HOSPITAL PROVIDED COMMUNITY ACTIVITIES AND PROGRAMS WHICH WERE SUBSIDIZED BY THE HOSPITAL IN ORDER TO IMPROVE COMMUNITY HEALTH. VARIOUS EVENTS INCLUDED, BUT WERE NOT LIMITED TO, THE FOLLOWING: DIABETES EDUCATION CLASSES, INCLUDING LIFE STEPS TO PREVENTION, STEP OUT DIABETES, AND HEALTHY WEIGHT FOR LIFE; POWERUP FOR KIDS WEEK, INCLUDING VEGETABLE GIVEAWAYS AND PRESCRIPTIONS TO USE AT GROCERY STORES TO PURCHASE VEGETABLES, TO PROMOTE BETTER EATING AND ACTIVE LIVES SO YOUTH CAN REACH THEIR FULL POTENTIAL; LADIES NIGHT OUT TO SUPPORT AND PROMOTE WOMEN'S HEALTH; HOPS FOR HEALTH TO SUPPORT MEN'S HEALTH; AND THE TEDDY BEAR CLINIC PROGRAM WHICH HELPS KINDERGARTNERS LEARN MORE ABOUT THE HEALTH CARE ENVIRONMENT, ALLEVIATING THE STRESS AND ANXIETY THAT IS SOMETIMES ASSOCIATED WITH COMING TO THE HOSPITAL. SUPPORT CLASSES INCLUDED: BREAST CANCER SUPPORT GROUP, MENOPAUSE SURVIVAL GUIDE, DIABETES SUPPORT GROUPS, FREEDOM FROM SMOKING, BREASTFEEDING CLASS, TAI CHI FOR ARTHRITIS, VEIN SCREENING, HAND AND WRIST ARTHRITIS, PELVIC HEALTH, AND VARIOUS OTHER EDUCATIONAL CLASSES FOR THE COMMUNITY. THE NET COST OF PROVIDING COMMUNITY HEALTH IMPROVEMENT AND OPERATIONS ASSOCIATED WITH OFFERING ALMOST 200 CLASSES IN 2016 WAS $398,360.
PART I, LINE 7F: HEALTH PROFESSIONS EDUCATION	THE HOSPITAL COORDINATES AND SUPPORTS WEEKLY CONTINUING MEDICAL EDUCATION (CME) PROGRAMS FOR STAFF AND COMMUNITY EDUCATION. TOTAL DIRECT COSTS FOR STIPENDS, PURCHASED SERVICES, SUPPLIES, ROOM RENTALS AND INDIRECT COSTS FOR THE YEAR WERE $99,400.
PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES	THE HOSPITAL IS COMMITTED TO PROVIDING NEEDED SERVICES, EVEN AT A FINANCIAL LOSS. IN 2016, LOSS ON SERVICES FOR INPATIENT AND OUTPATIENT HEALTH SERVICES INCLUDING CLINICAL NUTRITION, NEONATAL SERVICES, LABOR AND DELIVERY, AND HOMECARE AND HOSPICE SERVICES TOTALED $3,341,000.
PART I, LINE 7I: CONTRIBUTIONS FOR COMMUNITY BENEFIT	GRANTS TO SUPPORT HEALTH SERVICES FOR YOUTH AND ADULTS IN THE COMMUNITY INCLUDED: ABIJAH'S HOPE, AMERICAN DIABETES ASSOCIATION, CANVAS HEALTH, CENTURY COLLEGE, COMMUNITY THREAD, ESR, FAMILYMEANS, GRANITE HOUSE, OPERATION GRACE, OUR COMMUNITY KITCHEN, PROJECT LIFE, ST. ANDREW' RESOURCE CENTER, GRIEF AND CARE SUPPORT THROUGH ST. CROIX CHAPLAINCY, TREEHOUSE, VALLEY OUTREACH, YOUNGLIFE, YOUTH ADVANTAGE AND YOUTH SERVICE BUREAU.THE HOSPITAL'S CASH DONATIONS TO COMMUNITY-BASED TAX-EXEMPT ORGANIZATIONS IN THE FORM OF SPONSORSHIPS, GRANTS OR SUPPLIES FOR MEDICAL MISSION TRIPS TOTALED $166,000.
PART III, LINE 4:	THE "ACTUAL COST" OF BAD DEBT INCLUDED IN COMMUNITY BENEFIT IS ESTIMATED. BAD DEBT EXPENSE REPRESENTS THOSE ACCOUNTS RECEIVABLE WRITTEN OFF FROM PATIENTS THAT HAVE THE ABILITY TO PAY, AS DETERMINED FROM CHARITY CARE APPLICATIONS AND OTHER DOCUMENTATION, BUT CHOOSE NOT TO. THE BAD DEBT AMOUNT IS THE RECEIVABLE AFTER INSURANCE PAYMENT AND ADJUSTMENTS HAVE ALREADY BEEN MADE, INCLUDING ADJUSTMENTS FOR SELF-PAY IN ACCORDANCE WITH THE AGREEMENT WITH THE MINNESOTA ATTORNEY GENERAL'S OFFICE. SINCE REDUCTIONS HAVE ALREADY BEEN MADE FOR DISCOUNTS AND OTHER ALLOWANCES, THE ENTIRE BALANCE IS CONSIDERED BAD DEBT AND NO FURTHER REDUCTIONS ARE CONSIDERED.THE PROVISIONS FOR BAD DEBT FOOTNOTE IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS IS INCLUDED IN SECTION 1, PART (P), PAGES 11 AND 12.
PART III, LINE 8:	THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS:1) IT PROVIDES SERVICES TO A SIGNIFICANT PORTION OF OUR SERVICE POPULATION AT A NEGATIVE MARGIN; 2) THE HOSPITAL WOULD DISCONTINUE PROVIDING SERVICES TO MEDICARE PATIENTS IF THE DECISION WERE BASED STRICTLY ON A FINANCIAL BASIS; 3) THERE IS A COMMUNITY NEED TO PROVIDE THESE SERVICES LOCALLY; 4) IF THE HOSPITAL DID NOT PROVIDE THESE SERVICES; THEY WOULD BECOME THE OBLIGATION OF THE GOVERNMENT.
PART III, LINE 9B:	IN THE EVENT OF NONPAYMENT, THE HOSPITAL IS COMMITTED TO MAKING REASONABLE EFFORTS TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE BEFORE INITIATING COLLECTION ACTIONS. THE HOSPITAL'S BUSINESS OFFICE HAS THE AUTHORITY AND RESPONSIBILITY FOR DETERMINING WHETHER THE HOSPITAL HAS MADE REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE AND WHETHER THE HOSPITAL IS AUTHORIZED TO ENGAGE IN SPECIFIC COLLECTION ACTIONS WHICH ARE DESCRIBED IN THE HOSPITAL'S BILLING & COLLECTIONS POLICY FOUND ON THE PUBLIC WEBSITE, HTTP://WWW.LAKEVIEWHEALTH.ORG/CHARITY-CARE-APPLICATION.
PART III, SECTION A, LINE 2: BAD DEBT EXPENSE METHODOLOGY	SEE FINANCIAL STATEMENT FOOTNOTE PROVIDED IN RESPONSE TO PART III, SECTION A, LINE 4.
PART VI, LINE 2:	IN 2015, A COMPREHENSIVE, SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") COLLABORATION WAS CONDUCTED FOR HEALTHPARTNERS AND ITS HOSPITALS (REGIONS HOSPITAL, THE HOSPITAL, HUDSON HOSPITAL , WESTFIELDS HOSPITAL, AMERY REGIONAL MEDICAL CENTER, AND PARK NICOLLET METHODIST HOSPITAL) BY COMMUNITY HOSPITAL CONSULTING TO DETERMINE THE GREATEST HEALTH NEEDS IN THE COMMUNITIES THEY SERVE. THESE HOSPITALS SERVE SIMILAR COMMUNITIES AND HAVE OVERLAPPING STUDY AREAS. THE SYSTEM'S STUDY AREA IS DEFINED AS DAKOTA, HENNEPIN, RAMSEY, SCOTT, AND WASHINGTON COUNTIES IN MINNESOTA AND POLK AND ST. CROIX COUNTIES IN WISCONSIN. THE HOSPITAL'S SPECIFIC STUDY AREA IS DEFINED AS: - WASHINGTON COUNTY - ST. CROIX COUNTY - RAMSEY COUNTY DATA ELEMENTS REGARDING ALL SEVEN COUNTIES IN THE SYSTEM'S STUDY AREA ARE INCLUDED IN THIS REPORT FOR COMPARISON, AND ARE ALSO PROVIDED AS AN OPPORTUNITY FOR THE HOSPITALS TO WORK TOGETHER TO MEET THE NEEDS IDENTIFIED IN THE OVERLAPPING COUNTIES.- DEMOGRAPHICS: CHC CONSULTING ANALYZED THE MOST CURRENT DEMOGRAPHICS OF RESIDENTS IN WASHINGTON, ST. CROIX, AND RAMSEY COUNTIES INCLUDING: OVERALL POPULATION, POPULATION BY RACE AND ETHNICITY, MEDIAN AGE, MEDIAN HOUSEHOLD INCOME, POVERTY LEVELS, FOOD INSECURITY, AND EDUCATIONAL ATTAINMENT.- HEALTH DATA COLLECTION: CHC CONSULTING ANALYZED THE MOST CURRENT HEALTH DATA AVAILABLE PERTAINING TO RESIDENTS IN WASHINGTON, ST. CROIX, AND RAMSEY COUNTIES INCLUDING: MORTALITY RATES, CHRONIC CONDITIONS, HEALTH BEHAVIORS, MENTAL HEALTH, COMMUNICABLE DISEASES, PREVENTION AND FATALITY.- COMMUNITY INPUT: AS A PART OF COUNTY-WIDE ASSESSMENTS, SURVEYS AND LISTENING SESSIONS WERE CONDUCTED TO GATHER INPUT FROM COMMUNITY RESIDENTS. IN ADDITION, THE HOSPITAL CONDUCTED COMMUNITY CONVERSATIONS ON MAY 15, 2015 AND JULY 15, 2015 TO GAIN INSIGHT SURROUNDING SIGNIFICANT HEALTH NEEDS.- FINAL PRIORITIZED NEEDS - MENTAL AND BEHAVIORAL HEALTH - ACCESS AND AFFORDABILITY - CHRONIC DISEASE AND ILLNESS PREVENTION - EQUITABLE CAREA FULL REPORT OF THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN IS POSTED ON THEIR WEBPAGE AT HTTP://WWW.LAKEVIEWHEALTH.ORG/CHNA.
PART VI, LINE 3:	THE HOSPITAL DEFINES FINANCIAL ASSISTANCE AS THE COST OF CARE DELIVERED TO PATIENTS WHO HAVE A NEED FOR MEDICALLY NECESSARY TREATMENT BUT ARE UNABLE TO PAY FOR THE SERVICES THEY RECEIVE. THIS INCLUDES PATIENTS WHOSE CHARGES ARE FORGIVEN OR REDUCED BECAUSE OF INABILITY TO PAY, PATIENTS WHO ARE UNABLE TO PAY THE BALANCE LEFT BY ANY PAYER, AND PATIENTS FOR WHOM UNUSUAL CIRCUMSTANCES OR SPECIAL FINANCIAL HARDSHIP WARRANT SPECIAL CONSIDERATION. THE HOSPITAL IS COMPLIANT WITH THE 501R FEDERAL REGULATIONS, AND PROVIDES EASY ACCESS TO THE FINANCIAL ASSISTANCE PROGRAM INCLUDING THE FINANCIAL ASSISTANCE POLICY (FAP), APPLICATION, AND PLAIN LANGUAGE SUMMARY. THE FINANCIAL ASSISTANCE PROGRAM AND LISTS OF PROVIDERS COVERED BY THE PROGRAM IS ALSO WIDELY PUBLICIZED AND AVAILABLE ON THE HOSPITAL'S WEBSITE. TO INFORM AND EDUCATE PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAM, FINANCIAL ASSISTANCE POLICY, AND GOVERNMENT PROGRAMS, EACH PATIENT IS OFFERED AND PROVIDED WITH THE FINANCIAL ASSISTANCE PROGRAM POLICY AT REGISTRATION. THIS INFORMATION IS ALSO IS ALSO PROVIDED IN PUBLIC LOCATIONS, INCLUDING REGISTRATION, ON PATIENT STATEMENTS, AND LAKEVIEW'S PUBLIC WEBSITE, WWW.LAKEVIEWHEALTH.ORG.IN ADDITION TO FINANCIAL COUNSELING, THE HOSPITAL HAS STAFF SOCIAL WORKERS AND CASE MANAGERS TO HANDLE CRISIS INTERVENTIONS, EMERGENCY ROOM NEEDS, AND PATIENT AFTERCARE.TO INFORM AND EDUCATE PATIENTS ABOUT THEIR ELIGIBILITY FOR ASSISTANCE, EACH PATIENT BILLING STATEMENT AND COLLECTIONS LETTER PRODUCED BY THE HOSPITAL INCLUDE THE FOLLOWING NOTICE: "LAKEVIEW HOSPITAL OFFERS A FINANCIAL ASSISTANCE PROGRAM. FOR COPIES OF OUR APPLICATION, FINANCIAL ASSISTANCE POLICY, AND PLAIN LANGUAGE SUMMARY, WHICH INCLUDE INFORMATION ON ELIGIBILITY AND HOW WE CALCULATE FINANCIAL ASSISTANCE, PLEASE VISIT WWW.LAKEVIEWHEALTH.ORG. OUR PATIENT FINANCIAL SERVICES TEAM CAN HELP YOU ENROLL IN THIS PROGRAM. PLEASE CALL 651-430-4533."
PART VI, LINE 4:	THE HOSPITAL SERVES THE EASTERN TWIN CITIES' METRO AREA AND WESTERN WISCONSIN. THE HOSPITAL'S CORE SERVICE AREA INCLUDES STILLWATER, BAYPORT, LAKE ELMO, LAKELAND, AND MARINE ON ST. CROIX, MN ALONG WITH HOULTON AND SOMERSET, WI. PRIMARY SERVICE AREAS ARE HUDSON, NEW RICHMOND AND STAR PRAIRIE, WI, AND AFTON, MN. SECONDARY SERVICE AREAS ARE NEARBY CITIES IN EASTERN MINNESOTA AND WESTERN WISCONSIN.CENSUS FIGURES FOR 2013 SHOW THE FOLLOWING FOR WASHINGTON COUNTY:TOTAL POPULATION: 246,683- PERSONS UNDER 5 YEARS: 6.2%- PERSONS UNDER 18 YEARS: 25.4%- PERSONS 65 YEARS AND OVER: 12.3% IT IS ESTIMATED THAT THE 65 AND OLDER GROUP IN WASHINGTON COUNTY WILL GROW BY 350% BY 2030.- POPULATION CHANGE FROM 2010 TO 2013: +3.6%- FEMALES: 50.5%- WHITE PERSONS: 87.9%- PERSONS OF COLOR: 12.1%- LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME: 9.3%- HIGH SCHOOL GRADUATES: 95.9%- BACHELOR'S DEGREE OR HIGHER: 40.5%- PERSONS BELOW POVERTY LEVEL 2009 - 2013: 5.7%- MEDIAN HOUSEHOLD INCOME IN WASHINGTON COUNTY FROM 2009 - 2013 WAS $81,540.
PART VI, LINE 5:	THE HOSPITAL PROVIDED EDUCATION SCHOLARSHIPS TO PEOPLE WITH DIABETES THAT REQUIRED NUTRITION AND LIFE-STYLE EDUCATION; THE HOSPITAL ALSO PROVIDED FREE LAB AND PHARMACY SERVICES FOR PATIENTS OF THE ST. CROIX FAMILY MEDICAL CENTER, A LOCAL MEDICAL CLINIC THAT PROVIDES FREE AND DISCOUNTED SERVICES FOR INDIGENT AND LOW INCOME PATIENTS OF THE AREA. FOR ADDITIONAL DISCUSSION, SEE FORM 990, SCHEDULE O - "EXEMPT PURPOSE AND ACHIEVEMENTS".
PART VI, LINE 6:	AS A MEMBER OF STILLWATER HEALTH SYSTEM, THE HOSPITAL PARTICIPATES WITH THE MULTI-SPECIALTY CLINIC AND HEALTH SYSTEM LEADERSHIP WITHIN OUR OVERALL ORGANIZATION IN PROVIDING ACCESS TO CARE, SUPPORT GROUPS, EDUCATIONAL ACTIVITIES, AND FINANCIAL CONTRIBUTIONS TO THE MARKET AREA DESCRIBED ABOVE. THE MULTI-SPECIALTY CLINIC FURTHER PARTICIPATES IN MINNESOTA COMMUNITY MEASUREMENT, PRACTICES AND MEASURES PROVIDER, PERFORMANCE WITH SPECIFIC PREVENTIVE CARE METRICS AND SPECIFIC CHRONIC DISEASE MANAGEMENT METRICS. IN 2011, THE STILLWATER HEALTH SYSTEM AFFILIATED WITH HEALTHPARTNERS. THE MISSION OF HEALTHPARTNERS IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY.
PART VI, LINE 7, REPORTS FILED WITH STATES	MN
PART VI, LINE 7: STATES RECEIVING COMMUNITY BENEFIT REPORT	THE HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH MINNESOTA THROUGH THE MINNESOTA HOSPITAL ASSOCIATION (MHA).

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Valuation Method UsedValuationMethodUsedDesc	Purpose Of GrantPurposeOfGrantTxt
PORTICO HEALTHNET
1690 UNIVERSITY AVE W STE 250	ST PAUL	MN	55104	411814659	501 (C)(3)	$14,688	CASH AMOUNT	PROGRAM SUPPORT
FAMILY MEANS
1875 NORTHWESTERN AVENUE	STILLWATER	MN	55082	416045574	501 (C)(3)	$30,000	CASH AMOUNT	PROGRAM SUPPORT
CANVAS HEALTH
7066 STILLWATER BLVD N	OAKDALE	MN	55128	410955577	501 (C)(3)	$10,500	CASH AMOUNT	PROGRAM SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	16	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC. (THE HOSPITAL) MANAGEMENT STAFF REVIEW THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH THE HOSPITAL'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO THE HOSPITAL'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	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 (11 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
JOHN S MISA MD
DIRECTOR	$0	$434,975	$0	$103,547	$0	$18,741	$0	$71,637	$0	$25,575	$0	$654,475	$0	$47,843
TED WEGLEITNER
CEO	$0	$380,178	$0	$130,432	$0	$10,673	$0	$74,602	$0	$32,094	$0	$627,979	$0	$6,196
DOUGLAS E JOHNSON
CFO & TREASURER	$272,057	$0	$74,284	$0	$26,335	$0	$42,843	$0	$33,434	$0	$448,953	$0	$0	$0
PAUL L ERICKSON
EXEC. DIR. - DEVELOPMENT	$115,067	$0	$7,908	$0	$1,514	$0	$20,750	$0	$29,362	$0	$174,601	$0	$0	$0
THOMAS S ANDERSON
VP - MEDICAL AFFAIRS	$0	$193,471	$0	$16,389	$0	$154,420	$0	$22,885	$0	$29,156	$0	$416,321	$0	$0
CYNTHIA A APPLESETH
MANAGER - PHARMACY	$155,009	$0	$9,971	$0	$250	$0	$51,249	$0	$27,906	$0	$244,385	$0	$0	$0
JEFFREY W MAANUM
LEAD ULTRASOUND TECH.	$147,470	$0	$0	$0	$0	$0	$19,772	$0	$29,984	$0	$197,226	$0	$0	$0
ROBBI HAGELBERG
CNO	$189,278	$0	$14,227	$0	$19	$0	$6,299	$0	$17,906	$0	$227,729	$0	$0	$0
MICHELLE A KRAFT
DIRECTOR OF FINANCE	$134,125	$0	$15,432	$0	$0	$0	$8,418	$0	$11,519	$0	$169,494	$0	$0	$0
STEPHANIE NOE
NEONATAL NURSE PRACTIONER	$140,126	$0	$0	$0	$37	$0	$8,049	$0	$30,094	$0	$178,306	$0	$0	$0
JEFFREY J ROBERTSON
FORMER CEO	$0	$0	$137,136	$0	$437,635	$0	$0	$0	$28,812	$0	$603,583	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART I, LINES 4A-B

SCHEDULE J PART I, LINE 4A THE AMOUNT OF SEVERANCE COMPENSATION PROVIDED TO EACH OF THE INDIVIDUALS ON SEVERANCE DURING 2016 IS AS FOLLOWS: JEFFREY ROBERTSON $437,635 SCHEDULE J PARK I , LINE 4B DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II INCLUDES AMOUNTS FROM A NONQUALIFIED 457(F) PLAN FOR THE FOLLOWING DIRECTORS AND OFFICERS: JOHN S. MISA, MD $ 46,794 TED WEGLITNER $ 36,015

990, SCHEDULE J, PART II, COLUMN F: PRIOR REPORTED COMPENSATION

COLUMN (F) INCLUDES AMOUNTS PAID TO PARTICIPANTS IN THE CURRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEARS' 990'S, AS RETIREMENT AND DEFERRED COMPENSATION, FOR THE FOLLOWING DIRECTOR: JOHN S. MISA, MD $ 47,843 TED WEGLEITNER 6,196 ANY ANALYSIS OF EARNINGS FOR THE CURRENT YEAR, FOR THESE PARTICIPANTS OF THE PLAN, SHOULD EXCLUDE THE AMOUNT IN COLUMN F AS PART OF THE ANALYSIS SINCE THOSE EARNINGS WERE ALREADY REPORTED IN COLUMN (C) OF PREVIOUS YEARS' 990'S.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
990, PART III, LINE 4A: EXEMPT PURPOSE AND ACHIEVEMENTS	CORPORATE STRUCTURE, PURPOSE, GOVERNANCE LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (THE HOSPITAL) IS A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND IS PART OF THE FAMILY OF HEALTHPARTNERS ORGANIZATIONS "HEALTHPARTNERS". FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED SYSTEM OF HEALTH CARE DELIVERY AND HEALTH CARE FINANCING ORGANIZATIONS, AND IS ONE OF THE LARGEST CONSUMER-GOVERNED ORGANIZATIONS IN THE COUNTRY. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTHCARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY. HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS WITH HEALTH CARE ACTIVITIES PRIMARILY OPERATING IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS PROVIDES A FULL-RANGE OF HEALTH CARE DELIVERY AND HEALTH PLAN SERVICES INCLUDING INSURANCE, PATIENT CARE, ADMINISTRATION AND HEALTH AND WELL-BEING PROGRAMS. HEALTHPARTNERS HEALTH PLAN'S SERVE MORE THAN 1.6 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,700 PHYSICIANS AND DENTISTS, SIX OWNED HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, OVER 100 OWNED AND LEASED PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES AND 24 DENTAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS ALSO CONTRACTS WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS LOCATED PRIMARILY IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUND RAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN THE HEALTHPARTNERS FAMILY, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. HEALTHPARTNERS IS DRIVING CHANGE THAT HELPS OUR MEMBERS AND PATIENTS LIVE HEALTHIER LIVES. HEALTHPARTNERS COLLABORATE WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES CONTINUING IN 2016 ARE TOTAL COST OF CARE MEASUREMENTS (DEVELOPMENT OF A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL, REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, STILLWATER HEALTH SYSTEM (SHS), RAMSEY INTEGRATED HEALTH SERVICES AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). SHS IS THE SOLE CORPORATE MEMBER OF THE HOSPITAL. THE HOSPITAL AND SHS ARE PART OF THE LAKEVIEW HEALTH SYSTEM (LAKEVIEW HEALTH) ALONG WITH THE LAKEVIEW MEMORIAL HOSPITAL FOUNDATION, A MINNESOTA 501(C) (3) TAX EXEMPT ORGANIZATION (THE FOUNDATION) AND STILLWATER MEDICAL GROUP (SMG), A MINNESOTA 501(C) (3) TAX EXEMPT ORGANIZATION. SHS IS ALSO THE SOLE CORPORATE MEMBER OF THE FOUNDATION AND SMG. HEALTHPARTNERS AND THE HOSPITAL ALSO PARTNER WITH OTHER PLANS, CARE PROVIDERS AND NON-PROFIT ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION; TO INCREASE ACCESS, CREATE AND DISSEMINATE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY AND COLLABORATE ON SYSTEM IMPROVEMENTS. THE HOSPITAL CONTINUES TO BE AN INTEGRAL PART OF THE STILLWATER COMMUNITY AND SURROUNDING AREA - A VITAL AND NECESSARY COMMUNITY RESOURCE SINCE 1880, THE FIFTH OLDEST HOSPITAL, AND SECOND OLDEST CONTINUALLY OPERATING HOSPITAL IN MINNESOTA. THE HOSPITAL IS DESIGNATED A LEVEL 3 TRAUMA HOSPITAL AND HAS MEDICAL STAFF IN A VARIETY OF SPECIALTIES, INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, OB/GYN, GENERAL SURGERY, ORTHOPEDICS, OTOLARYNGOLOGY, OCCUPATIONAL HEALTH, EMERGENCY MEDICINE, HOSPITALISTS, NEUROLOGY, ONCOLOGY, UROLOGY, CARDIOLOGY, SPORTS MEDICINE,, GASTROENTEROLOGY, RADIOLOGY, PATHOLOGY AND ANESTHESIOLOGY. COURTESY AND CONSULTING STAFF PROVIDE ADDITIONAL SERVICES, INCLUDING PAIN MANAGEMENT, AND INFECTIOUS DISEASE, PULMONARY/SLEEP MEDICINE AND ORAL SURGERY. CHARITY CARE: CHARITY CARE IS DEFINED AS THE COST OF CARE DELIVERED TO PATIENTS WHO ARE WILLING, BUT UNABLE TO PAY FOR THE SERVICES THEY RECEIVE. THIS INCLUDES: PATIENTS WHOSE CHARGES ARE FORGIVEN OR REDUCED BECAUSE OF INABILITY TO PAY; PATIENTS WHO ARE UNABLE TO PAY THE BALANCE LEFT BY ANY PAYER; AND PATIENTS FOR WHOM UNUSUAL CIRCUMSTANCES, OR SPECIAL FINANCIAL HARDSHIP, WARRANT SPECIAL CONSIDERATION. THE HOSPITAL PROVIDED $1,174,646 IN FREE OR DISCOUNTED CARE TO LOW-INCOME AND UNINSURED PATIENTS. GOVERNMENT-SPONSORED MEANS-TESTED HEALTH CARE: THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT CARE, INCLUDING EMERGENCY DEPARTMENT SERVICES TO MEDICAID PATIENTS. PAYMENTS RECEIVED FOR THESE SERVICES ARE BELOW THE COST OF CARE PROVIDED. THE HOSPITAL'S EXPENSE TO COVER UNREIMBURSED MEDICAID COSTS FOR PATIENTS TOTALED $1,422,143. BENEFIT TO THE COMMUNITY: THE HOSPITAL WORKS IN COLLABORATIVE PARTNERSHIP WITH THE COMMUNITY TO IMPROVE HEALTH AND WELL-BEING. THE LAKEVIEW HEALTH ORGANIZATIONS, THE COMMUNITY AND THE HOSPITAL ACCOMPLISHED A GREAT DEAL IN 2016. OUR PARTNERSHIP WAS ADVANCED ON APRIL 1, 2011, WITH A FORMAL AFFILIATION WITH HEALTHPARTNERS AND ITS FAMILY OF HEALTH CARE ORGANIZATIONS. ADVANCEMENTS WERE MADE TO ENSURE BETTER HEALTH FOR ALL, IMPROVED PATIENT EXPERIENCE AND AFFORDABLE HEALTH CARE. THE HOSPITAL CONTINUES TO GROW ITS REPUTATION FOR EXCELLENT CLINICAL OUTCOMES AND SERVICE. 1. COMMUNITY HEALTH SERVICES: THE HOSPITAL PARTICIPATED IN COMMUNITY-BASED COLLABORATIVE EFFORTS TO IMPROVE ACCESS TO COMMUNITY AND MENTAL HEALTH SERVICES: -THE COMMUNITY HEALTH ACTION TEAM (CHAT) FOCUSED DISCUSSION ON MENTAL HEALTH ACCESS AND STIGMA REDUCTION. THE HOSPITAL AND COMMUNITY PARTNERS SUPPORTED TRAINING FOR THE MAKE IT OK (MIO) ANTI-STIGMA CAMPAIGN. MIO AMBASSADORS' TRAINING WAS HELD FOR 25 COMMUNITY MEMBERS IN MARCH 2016. -THE HOSPITAL PROVIDES REPRESENTATION AT CONNECT COMMUNITY COLLABORATIVE FOR MENTAL AND CHEMICAL HEALTH. -BEHAVIORAL HEALTH SUMMIT GROUP: THE HOSPITAL IS AN ACTIVE PARTICIPANT IN THE WASHINGTON COUNTY SUMMIT WHICH EXPLORES PRIORITY NEEDS IN THE AREA OF BEHAVIORAL/MENTAL HEALTH AND SUBSTANCE ABUSE. -POWERUP IS A COMMUNITY-BASED INITIATIVE FOCUSED ON CHILDHOOD OBESITY PREVENTION. WORKING WITH SCHOOLS, BUSINESSES, THE FAITH COMMUNITY AND LOCAL ORGANIZATIONS AND LEADERS, POWERUP MAKES IT FUN AND POPULAR FOR KIDS AND FAMILIES TO EAT BETTER AND MOVE MORE. KEY PROGRAMS INCLUDE: POWERUP SCHOOL CHALLENGE INSPIRED MORE THAN 10,000 CHILDREN PLUS SCHOOL STAFF IN MORE THAN 30 SCHOOLS TO EAT MORE FRUITS AND VEGETABLES. MORE THAN 40,000 FAMILIES AND CHILDREN WERE REACHED THROUGH EVENTS, CLASSES, OUTREACH, PROGRAMS AND RESOURCES TO PROMOTE BETTER EATING, FAMILY MEALS, PHYSICAL ACTIVITY, REDUCED SCREEN TIME AND FEWER SUGARY DRINKS. OPEN GYMS, IN PARTNERSHIP WITH LOCAL SCHOOLS, HAVE EXPANDED TO INCLUDE MULTI-SITE OFFERINGS ON A WEEKLY BASIS. BETTER SHELF FOR BETTER HEALTH PROJECTS CONTINUES TO TRANSFORM FOOD SHELVES AND INCREASE ACCESS TO HEALTHY CHOICES FOR LOW INCOME COMMUNITY MEMBERS. -THE HOSPITAL HELD TWO AMERICAN RED CROSS BLOOD DRIVES IN 2016, ON THE HOSPITAL CAMPUS, WITH 50 STAFF AND COMMUNITY MEMBERS VOLUNTEERING FOR THIS CAUSE. -CONTINUED FACILITATION OF THE LOCAL CANCER SUPPORT GROUP, IN COLLABORATION WITH THE CANCER CENTER OF WESTERN WISCONSIN.
FORM 990, PART III, LINE 4A	-THE HOSPITAL SPONSORED AND COORDINATED ALMOST 200 COMMUNITY BENEFIT CLASSES, EVENTS AND SUPPORT GROUPS DURING THE YEAR AT A NET COST OF APPROXIMATELY $398,300. 2. HEALTH PROFESSIONAL EDUCATION: THE HOSPITAL COORDINATES AND SUPPORTS WEEKLY CONTINUING MEDICAL EDUCATION (CME) PROGRAMS FOR STAFF AND COMMUNITY EDUCATION. TOTAL DIRECT COSTS FOR STIPENDS, PURCHASED SERVICES, SUPPLIES, ROOM RENTALS AND INDIRECT COSTS FOR THE YEAR WERE $99,400. 3. SUBSIDIZED HEALTH SERVICES: THE HOSPITAL IS COMMITTED TO PROVIDING NEEDED SERVICES, EVEN AT A FINANCIAL LOSS. IN 2016, LOSS ON SERVICES FOR INPATIENT AND OUTPATIENT HEALTH SERVICES, INCLUDING HOSPITAL OUTPATIENT SERVICES (CLINICAL DIABETES AND NUTRITION), NEONATAL SERVICES, AND HOMECARE AND HOSPICE SERVICES, TOTALED $3,341,000. STILLWATER AREA SCHOOLS WELLNESS PROGRAM AND CENTER OPERATES AT THE LARGEST HIGH SCHOOL IN THE SERVICE AREA. THE WELLNESS CENTER IS A PHYSICAL SPACE IN THE HIGH SCHOOL IN COLLABORATION WITH FAMILYMEANS, YOUTH SERVICE BUREAU, THE HOSPITAL'S POWERUP INITIATIVE, LAKEVIEW HEALTH AND INDEPENDENT SCHOOL DISTRICT 834. THIS COLLABORATION PROVIDES SERVICES TO YOUTH AT LOW TO NO-COST FOR MENTAL HEALTH, CHEMICAL HEALTH AND NUTRITION ISSUES. THE WELLNESS CENTER PROGRAM EXPERIENCED 4,485 CONTACTS FOR CHEMICAL AND MENTAL HEALTH ISSUES (2,460 STUDENTS, 1,350 STAFF AND 675 PARENT CONTACTS) IN 2016. 4. FINANCIAL CONTRIBUTIONS: TO ADDRESS HEALTH CARE ACCESS FOR UNINSURED AND UNDER-INSURED PATIENTS, THE HOSPITAL PROVIDES FUNDING TO PORTICO HEALTHNET (PORTICO). PORTICO IS A NONPROFIT ORGANIZATION THAT HELPED 213 PEOPLE IN 2016 ENROLL IN FREE OR LOW-COST HEALTH COVERAGE PROGRAMS. GRANTS TO SUPPORT HEALTH SERVICES FOR YOUTH AND ADULTS IN THE COMMUNITY INCLUDED: ABIJAH'S HOPE, AMERICAN DIABETES ASSOCIATION, CANVAS HEALTH, CENTURY COLLEGE, COMMUNITY THREAD, ESR, FAMILYMEANS, GRANITE HOUSE, OPERATION GRACE, OUR COMMUNITY KITCHEN, PROJECT LIFE, ST. ANDREW' RESOURCE CENTER, GRIEF AND CARE SUPPORT THROUGH ST. CROIX CHAPLAINCY, TREEHOUSE, VALLEY OUTREACH, YOUNGLIFE, YOUTH ADVANTAGE AND YOUTH SERVICE BUREAU. IN ADDITION, THE FOLLOWING ORGANIZATIONS AND PROGRAMS WERE SUPPORTED FOR OVERALL COMMUNITY BENEFIT: AMERICAN CANCER SOCIETY, AMERICAN DIABETES ASSOCIATION, AMERY REGIONAL MEDICAL CENTER FOUNDATION, BREAST CANCER AWARENESS, CAMP ODAYIN, CANVAS HEALTH, CHURCH OF ST. MARY, ESR, FAMILYMEANS, GLOBAL HEALTH MINISTRIES, GOOD SAMARITAN SOCIETY STILLWATER, HOPE HOUSE, MAHTOMEDI AREA EDUCATION FOUNDATION, MINNESOTA ORGANIZATION FOR FETAL ALCOHOL SYNDROME, MINNESOTA HOSPITAL ASSOCIATION, NORTHERN STAR COUNCIL BSA, PARTNERSHIP PLAN, RED CROSS, REGIONS HOSPITAL FOUNDATION, STILLWATER SUNRISE ROTARY, ST. ANNE CATHOLIC SCHOOL, STILLWATER HIGH SCHOOL, ST. CROIX COUNTY HEALTHIER TOGETHER, SISTER KENNEY FOUNDATION - COURAGE CENTER; UNITED WAY WASHINGTON COUNTY EAST, VALLEY CHAMBER CHORALE, AND YOUNGLIFE . THE HOSPITAL'S CASH DONATIONS TO COMMUNITY-BASED TAX-EXEMPT ORGANIZATIONS IN THE FORM OF SPONSORSHIPS, GRANTS OR SUPPLIES FOR MEDICAL MISSION TRIPS TOTALED $166,000. 5. COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL PROVIDES LEADERSHIP AND PARTICIPATES IN A NUMBER OF STRATEGIC COMMUNITY COLLABORATIONS AND INITIATIVES, INCLUDING: CHAT (COMMUNITY HEALTH ACTION TEAM): CONVENES NONPROFIT AND COMMUNITY LEADERS ON A MONTHLY BASIS TO COLLABORATE ON ADDRESSING PRIORITY COMMUNITY HEALTH NEEDS. CONNECT: COLLABORATIVE MISSION IS TO PREVENT AND REDUCE YOUTH ALCOHOL, TOBACCO AND OTHER DRUG USE THROUGH PARTNERSHIP, EDUCATION, INTERVENTION AND COMMUNITY CHANGE. WASHINGTON COUNTY COMMUNITY LEADERSHIP TEAM (CLT): THE HOSPITAL COLLABORATES ON BOTH TOBACCO CESSATION AND OBESITY INITIATIVES. HEALTHIER TOGETHER: FOCUSED ON A NUMBER OF HEALTH PRIORITIES, INCLUDING ALCOHOL AND SUBSTANCE ABUSE, IN ST. CROIX COUNTY, WI. THE HOSPITAL PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES THAT SUPPORTED ECONOMIC DEVELOPMENT, EMERGENCY PREPAREDNESS, LEADERSHIP DEVELOPMENT, COALITION BUILDING, HEALTH IMPROVEMENT ADVOCACY AND WORKFORCE DEVELOPMENT. THE HOSPITAL COLLECTED 51.4 TONS OF RECYCLING FOR A COST SAVINGS OF $3,440. THE HOSPITAL PARTICIPATES IN A PROGRAM WHERE FOOD WASTE FROM THE CAFETERIA IS SAVED IN BARRELS AND PICKED UP BY AN AREA FARMER WHO FEEDS THE SCRAPS TO PIG LIVESTOCK. THIS HELPS THE ENVIRONMENT BY REDUCING WASTE, AND ALSO REDUCES THE TAXES THE HOSPITAL PAYS ON GARBAGE BASED ON WEIGHT. IN 2016, 36,800 POUNDS OF FOOD WASTE WAS DIVERTED FROM THE LANDFILL. THE COMMUNITY PHARMACY GATHERED 83 POUNDS OF MEDICATIONS FOR DISPOSAL IN 2016. THE HOSPITAL INPATIENT/OUTPATIENT PHARMACY COLLECTED 25 POUNDS OF MEDICATIONS FOR DISPOSAL IN 2016. CONTINUED SUPPORT FOR THE ST. CROIX VALLEY FAITH COMMUNITY NURSE PROGRAM, WHICH IS A HEALTH CARE MINISTRY PROVIDING PHYSICAL, EMOTIONAL AND SPIRITUAL CARE FOR INDIVIDUALS, FAMILIES AND COMMUNITIES SERVED BY LOCAL CONGREGATIONS. THE PARISH NURSE PROMOTES A GREATER UNDERSTANDING OF HEALTH-RELATED ISSUES AND ADDRESSES THESE CONCERNS THROUGH INFORMATION AND EDUCATION. SUPPORTED THE PRESCRIPTION ASSISTANCE PROGRAM. A STAFF MEMBER AT THE HOSPITAL, FUNDED BY THE FOUNDATION, ASSISTS PATIENTS WHO HAVE DIFFICULTY AFFORDING THEIR MEDICATIONS. 6. COMMUNITY BENEFIT OPERATIONS: THE HOSPITAL STAFF TIME TO COLLECT, ANALYZE AND REPORT COMMUNITY BENEFITS FOR 2016 WAS APPROXIMATELY 70 HOURS. COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA); PLEASE REFER TO THE SCHEDULE H NARRATIVE IN THIS 990 REPORT. THE NET 2016 COMMUNITY BENEFIT CONTRIBUTION EQUALED $9,459,600 OR 9.3% OF TOTAL EXPENSES. THIS FIGURE IS REPORTED AT COST PER THE CATHOLIC HEALTH ASSOCIATION (CHA) COMMUNITY BENEFIT REPORTING GUIDELINES. 7. ORGANIZATION AWARDS AND ACHIEVEMENTS: PATIENT SATISFACTION SCORES - THE HOSPITAL CONTINUES TO PERFORM IN THE TOP DECILE FOR PATIENT EXPERIENCE. (SOURCE - NRC PICKER) RECIPIENT OF A 2016 GREENHEALTH PARTNER FOR CHANGE AWARD BY PRACTICE GREENHEALTH FOR SIGNIFICANT ACHIEVEMENT IN SUSTAINABILITY THE HOSPITAL WAS DESIGNATED BY THE MINNESOTA DEPARTMENT OF HEALTH AS A STROKE READY HOSPITAL THE HOSPITAL ACHIEVED LEADER IN LGBT HEALTHCARE EQUALITY STATUS BY THE NATIONAL LGBT HEALTHCARE EQUALITY INDEX, HUMAN RIGHTS CAMPAIGN FOUNDATION IN 2016. THE JOINT COMMISSION RECOGNITION OF THE HOSPITAL AS A TOP PERFORMER ON KEY QUALITY MEASURES (PNEUMONIA, SURGICAL CARE, VTE) THE HOSPITAL RECEIVED THE HEALTHGRADES OUTSTANDING PATIENT EXPERIENCE AWARD THE HOSPITAL RECEIVED THE "PATRIOTIC EMPLOYER" AWARD AND HONOR ON NOVEMBER 9, 2016 FROM THE OFFICE OF SECRETARY OF DEFENSE IN RECOGNITION OF OUR SUPPORT OF EMPLOYEE PARTICIPATION IN NATIONAL GUARD AND RESERVE FORCE THE HOSPITAL WAS NAMED A FIVE-STAR HOSPITAL BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) (2016). ONLY 250 HOSPITALS OUT OF THE 3500 MEDICARE-CERTIFIED ACUTE READY HOSPITALS IN THE U.S. WERE AWARDED THIS DESIGNATION. THE HOSPITAL WAS RECOGNIZED BY THE MINNESOTA HOSPITAL ASSOCIATION FOR OUTSTANDING DEDICATION AND COMMITMENT TO IMPROVING PATIENT SAFETY THROUGH PARTICIPATION IN THE PARTNERSHIP FOR PATIENTS MHA HOSPITAL ENGAGEMENT NETWORK 2.0. (2016) COMPARION MEDICAL ANALYTICS RANKED SURGICAL CARE AT THE HOSPITAL IN THE TOP 90TH PERCENTILE IN THE NATION, WITH HIGH SCORES IN PATIENT SAFETY AND SATISFACTION (2016). THE HOSPITAL WAS ACKNOWLEDGED AS A COMMUNITY VALUE FIVE-STAR HOSPITAL BY CLEVERLEY + ASSOCIATES, A RANKING EARNED BY THE TOP 20 PERCENT OF HOSPITALS IN THE NATION. THE COMMUNITY VALUE INDEX DEMONSTRATES THAT THE HOSPITAL PROVIDES VALUE TO THE COMMUNITY, REINVESTS IN THE FACILITY, MAINTAINS A LOW COST STRUCTURE, HAS REASONABLE CHARGES, AND PROVIDES HIGH QUALITY CARE TO PATIENTS. (2016) THREE PHYSICIANS FROM SMG AND THE HOSPITAL WERE SELECTED AS MPLS. ST. PAUL MAGAZINE'S 2016 TOP DOCTORS. KEVIN BJORK, MD, GENERAL SURGERY; CANDY COREY, MD, ONCOLOGY; AND LAURA DEAN, MD, OB/GYN, WERE SELECTED BY THEIR PEERS FOR THIS HONOR BASED ON THE EXCEPTIONAL CARE THEY PROVIDE. CMS AWARDED LAKEVIEW HOMECARE 5 (OF 5) STAR RATING FOR THE AGENCY PERFORMING BETTER IN 9 MEASURED CARE PRACTICES AND OUTCOMES THAN OTHER HOMECARE AGENCIES THE HOSPITAL BIRTH CENTER HAS BEEN NAMED TO THE WOMEN'S CHOICE AWARD LIST AS ONE OF THE BEST PLACES IN THE COUNTRY TO HAVE A BABY (2016)
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER IS SHS.
FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE MEMBER RATIFIES THE PERSONS ELECTED TO THE HOSPITAL BOARD, AT LEAST 75% OF WHOM MUST BE COMMUNITY LEADERS. THE CHIEF EXECUTIVE OFFICER OF THE SOLE MEMBER SERVES AS AN EX OFFICIO NON-VOTING HOSPITAL BOARD MEMBER. ADDITIONALLY, HEALTHPARTNERS AS THE SOLE MEMBER OF SHS APPOINTS ONE PERSON TO THE HOSPITAL BOARD.
FORM 990, PART VI, SECTION A, LINE 7B	THE SOLE MEMBER HAS CUSTOMARY POWERS INCLUDING APPROVAL OF HIGHLY SIGNIFICANT ACTIONS OF THE HOSPITAL'S BOARD OF DIRECTORS. THESE INCLUDE AMENDMENT OF THE GOVERNING DOCUMENTS; APPROVAL OF STRATEGIC PLANS AND ANNUAL BUDGETS; MERGER, CONSOLIDATION OR SUBSTANTIAL AFFILIATION WITH ANOTHER ENTITY; APPOINTMENT OF THE PRESIDENT OF THE HOSPITAL; AND INCURRENCE OF DEBT.
FORM 990, PART VI, SECTION B, LINE 11B	THE HOSPITAL'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF THE HOSPITAL. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF THE HOSPITAL, GHI'S INTERNAL LEGAL DEPARTMENT AND THE HOSPITAL'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF THE HOSPITAL. THE HOSPITAL MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THE HOSPITAL MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY IS PROVIDED T THE FULL BOARD OF DIRECTORS IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT THE MEETING. THIS PROCESS IS DOCUMENTED IN THE WRITTEN MEETING MINUTES.
FORM 990, PART VI, SECTION B, LINE 12C	THE HOSPITAL BOARD OF DIRECTORS MONITORS POTENTIAL CONFLICTS OF INTEREST OF ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES, BY MAINTAINING A CONFLICT OF INTEREST POLICY. ANNUALLY, UNDER THE POLICY, ALL BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS AND KEY EMPLOYEES ARE PROVIDED WITH A COPY OF THE POLICY AND REQUESTED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTERESTS. A REPORT OF THESE POTENTIAL CONFLICTS IS SHARED WITH THE GOVERNANCE COMMITTEE, THE CHAIR AND THE CEO. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE DOCUMENTED IN RELATION TO THIS POLICY.
FORM 990, PART VI, SECTION B, LINE 15	LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (HOSPITAL) PRESIDENT AND ITS OFFICERS ARE EMPLOYED BY GROUP HEALTH PLAN, INC. (GHI), OR BY STILLWATER HEALTH SYSTEM (SHS), BOTH OF WHICH ARE RELATED ORGANIZATIONS OR BY THE HOSPITAL. GHI, SHS AND THE HOSPITAL HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF THE HOSPITAL'S PRESIDENT AND OTHER OFFICERS. EVERY THREE YEARS, THE INDEPENDENT COMPENSATION COMMITTEE OF THE GHI BOARD OF DIRECTORS (THE "COMMITTEE"), RETAINS AN EXTERNAL COMPENSATION EXPERT TO CONDUCT AN EXTENSIVE MARKET COMPARABILITY REVIEW FOR ALL OFFICERS OF THE ORGANIZATION. THE REVIEW INCLUDES ALL COMPONENTS OF TOTAL COMPENSATION: BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE APPROPRIATE COMMITTEE. BASED ON THIS DATA, EITHER THE COMPENSATION COMMITTEE OF THE SHS OR THE COMPENSATION COMMITTEE OF GHI (THE "COMMITTEES") DETERMINE MINIMUM AND MAXIMUM TOTAL COMPENSATION RANGES ARE DETERMINED FOR EACH EMPLOYED OFFICER. IN INTERIM YEARS, GHI'S HUMAN RESOURCES STAFF, UNDER THE COMMITTEES' DIRECTION, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION CONSULTANT FOR THE COMMITTEE. FOR CERTAIN POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED TO SET SALARY RANGES BASED ON THE COMPETITIVE MARKET DATA SPECIFIC TO THOSE POSITIONS. THE COMMITTEES REVIEW AND APPROVE EACH YEAR'S COMPENSATION RESULTS. IN ALL CASES, THE COMMITTEES' MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMMITTEES MEMBERS' INDEPENDENCE AND THIS IS UPDATED AT ANY MEETING AT WHICH DECISIONS ARE BEING MADE. STAFF (OTHER THAN THE SECRETARY TO THE BOARD) IS NOT IN THE ROOM DURING DELIBERATIONS OR VOTE INCLUDING EXECUTIVE SESSIONS, AND CONTEMPORANEOUS MINUTES ARE KEPT. WITH THE HOSPITAL'S BOARD OF DIRECTORS INPUT, THE GHI EVP AND CHIEF ADMINISTRATIVE OFFICER CONDUCTS THE ANNUAL PERFORMANCE REVIEW AND, WITH THE COMPENSATION COMMITTEE OF THE SHS'S APPROVAL, DETERMINES THE COMPENSATION OF THE HOSPITAL PRESIDENT. THE HOSPITAL BOARD HAS DELEGATED TO THE PRESIDENT THE ACCOUNTABILITY TO CONDUCT ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL HOSPITAL-EMPLOYED OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMMITTEE. ANY EXCEPTIONS TO COMPENSATION IN EXCESS OF THE APPROVED RANGES ARE APPROVED BY THE COMPENSATION COMMITTEE OF THE SHS. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND ON THE EMPLOYEE'S W-2.
FORM 990, PART VI, SECTION C, LINE 19	THE HOSPITAL'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM THE HOSPITAL OR HEALTHPARTNERS. THE HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE MINNESOTA SECRETARY OF STATE'S OFFICE.
990, PART VII, SECT A, LN 1A, COL B: AVERAGE HOURS - RELATED ORGANIZATION	AVERAGE WEEKLY HOURS: THE COMPENSATED BOARD MEMBERS AND OFFICERS OF THE HOSPITAL ARE EMPLOYED AND COMPENSATED BY THE HOSPITAL, GHI OR PARK NICOLLET. THE COMPENSATED BOARD MEMBERS AND OFFICERS DEVOTE THEIR TIME TO MULTIPLE RELATED ORGANIZATIONS. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS.
FORM 990, PART XI, LINE 9:	TRANSFER TO AFFILIATE -4,436,156. CHANGE IN PENSION LIABILITY VALUATION 161,675.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
HEALTHPARTNERS INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411693838	HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION	MN	501(C)(4)	N/A	0
HPI - RAMSEY
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411793333	CORPORATE PLANNING AND OVERSIGHT	MN	501(C)(3)		0	509(A)(3) TYPE I	HEALTHPARTNERS INC
GROUP HEALTH PLAN INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	410797853	STAFF MODEL HEALTH MAINTENANCE ORGANIZATION	MN	501(C)(3)		0	170(B)(1) (A)(III)	HEALTHPARTNERS INC
HEALTHPARTNERS INSTITUTE
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411670163	HEALTHCARE EDUCATION & RESEARCH	MN	501(C)(3)		0	509(A)(3) TYPE I	HEALTHPARTNERS INC
CAPITOL VIEW TRANSITIONAL CARE CENTER
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	412011453	POST HOSPITALIZATION PATIENT CARE	MN	501(C)(3)		0	170(B)(1) (A)(III)	HPI - RAMSEY
REGIONS HOSPITAL
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	410956618	HOSPITAL	MN	501(C)(3)		0	170(B)(1) (A)(III)	HPI - RAMSEY
REGIONS HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411888902	PROVIDE SUPPORT TO HOSPITAL AND TO IMPROVE COMMUNITY HEALTH	MN	501(C)(3)		0	170(B)(1) (A)(VI)	HPI - RAMSEY
RHSC INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411891928	HEALTHCARE STAFFING	MN	501(C)(3)		0	509(A)(3) TYPE II	HEALTHPARTNERS INC
RH-WISCONSIN
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	202287016	CORPORATE PLANNING AND OVERSIGHT	WI	501(C)(3)		0	509(A)(3) TYPE I1	HPI - RAMSEY
PHYSICIANS NECK AND BACK CLINICS
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	270684883	SPECIALTY PATIENT CARE	MN	501(C)(3)		0	509(A)(3) TYPE II	GROUP HEALTH PLAN INC
HUDSON HOSPITAL INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	390804125	HOSPITAL	WI	501(C)(3)		0	170(B)(1) (A)(III)	RH-WISCONSIN
HUDSON HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	391279567	PROVIDE SUPPORT TO HOSPITAL AND TO IMPROVE COMMUNITY HEALTH	WI	501(C)(3)		0	170(B)(1) (A)(VI)	HUDSON HOSPITAL INC
LAKEVIEW MEMORIAL HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411386635	PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT	MN	501(C)(3)		0	509(A)(3) TYPE II	STILLWATER HEALTH SYSTEM
STILLWATER MEDICAL GROUP
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	830379473	PHYSICIANS GROUP	MN	501(C)(3)		0	509(A)(3 TYPE III)	STILLWATER HEALTH SYSTEM
STILLWATER HEALTH SYSTEM
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	300221189	CORPORATE PLANNING AND OVERSIGHT	MN	501(C)(3)		0	509(A)(3) TYPE II	HPI - RAMSEY
WESTFIELDS HOSPITAL INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	390808442	HOSPITAL	WI	501(C)(3)		0	170(B)(1) (A)(III)	RH-WISCONSIN
WESTFIELDS HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	391770913	PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT	WI	501(C)(3)		0	509(A)(3) TYPE I	WESTFIELDS HOSPITAL INC
RAMSEY INTEGRATED HEALTH SERVICES
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411503090	IN-HOME PATIENT CARE	MN	501(C)(3)		0	509(A)(2)	HPI - RAMSEY
PARK NICOLLET HEALTH SERVICES
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	363465840	CORPORATE PLANNING AND OVERSIGHT	MN	501(C)(3)		0	509(A)(2)	HEALTHPARTNERS INC
PARK NICOLLET FOUNDATION
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	237346465	GRANTS TO SERVE THE COMMUNITY	MN	501(C)(3)		0	170(B)(1) (A)(VI)	PARK NICOLLET HEALTH SERVICES
PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	410132080	HOSPITAL	MN	501(C)(3)		0	170(B)(1) (A)(III)	PARK NICOLLET HEALTH SERVICES
PARK NICOLLET HEALTH CARE PRODUCTS
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	010638901	HEALTHCARE PRODUCTS	MN	501(C)(3)		0	509(A)(3) TYPE I	PARK NICOLLET HEALTH SERVICES
PARK NICOLLET CLINIC
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	410834920	HEALTHCARE	MN	501(C)(3)		0	170(B)(1) (A)(III)	PARK NICOLLET HEALTH SERVICES
PNMC HOLDINGS
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	411741792	HEALTHCARE REAL ESTATE	MN	501(C)(3)		0	509(A)(3) TYPE I	PARK NICOLLET CLINIC
AMERY REGIONAL MEDICAL CENTER INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	390908320	HOSPITAL	WI	501(C)(3)		0	170(B)(1) (A)(III)	RH-WISCONSIN
AMERY REGIONAL MEDICAL CENTER FOUNDATION INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	391726539	PROVIDE SUPPORT TO HOSPITAL AND TO IMPROVE COMMUNITY HEALTH	WI	501(C)(3)		0	170(B)(1) (A)(VI)	AMERY REGIONAL MEDICAL CENTER INC

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
HEALTHPARTNERS ADMINISTRATORS INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411629390	THIRD PARTY ADMINISTRATOR	MN	HEALTHPARTNERS INC	C	0
HEALTHPARTNERS ASSOCIATES INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	522365151	MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT	MN	HEALTHPARTNERS ADMINISTRATORS INC	C	0
HEALTHPARTNERS SERVICES INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411683568	MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT	MN	HEALTHPARTNERS ADMINISTRATORS INC	C	0
HEALTHPARTNERS INSURANCE COMPANY
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411683523	MEDICAL AND DENTAL INSURANCE	MN	HEALTHPARTNERS ADMINISTRATORS INC	C	0
DENTAL SPECIALTIES INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	451297583	PROFESSIONAL DENTAL SERVICES	MN	HEALTHPARTNERS ADMINISTRATORS INC	C	0
HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411236798	MEDICAL CLINIC STAFFING	MN	HEALTHPARTNERS ADMINISTRATORS INC	C	0
PARK NICOLLET ENTERPRISES
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	411656735	REAL ESTATE FOR RELATED ORGANIZATIONS	MN	PARK NICOLLET HEALTH SERVICES	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (1)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (1)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	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	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	HEALTHPARTNERS INC - CLAIMSHEALTHCARE SERVICES	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	L	TransactionTypeTxt
Involved	$4,295,561	InvolvedAmt
Method Of Amount Determination	CASH AMOUNT	MethodOfAmountDeterminationTxt