OKEFENOKEE HEALTH INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- OKEFENOKEE HEALTH INC (EIN 58-1667166)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-08
- IRS object ID
- 201613139349301756
- Schema version
- 2015v2.1
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-08T12:27:03-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581667166 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAYO CLINIC HEALTH SYSTEM IN | BusinessNameLine1Txt |
| Business Name Line2 | WAYCROSS INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MAYO | BusinessNameControlTxt |
| Phone | 5075381297 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 TEBEAU STREET | AddressLine1Txt |
| City | WAYCROSS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31501 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN M LOCKETT | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5075381297 | PhoneNum |
| Signature | 2016-11-08 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROGER FORGEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 TEBEAU STREET | AddressLine1Txt |
| City | WAYCROSS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $182,803,772 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 5983 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MAYOCLINICHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1985 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | OPERATION OF A HOSPITAL, CLINICS, NURSING HOMES, A REHAB UNIT AND A SENIOR BEHAVIORAL UNIT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 1496 | TotalEmployeeCnt |
| Total Volunteers | 73 | TotalVolunteersCnt |
| Total Gross UBI | $20,925 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,097,771 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,011,104 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $174,152,185 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $180,273,400 | CYProgramServiceRevenueAmt |
| PY Investment Income | $60,458 | PYInvestmentIncomeAmt |
| CY Investment Income | $56,420 | CYInvestmentIncomeAmt |
| PY Other Revenue | $923,721 | PYOtherRevenueAmt |
| CY Other Revenue | $824,133 | CYOtherRevenueAmt |
| PY Total Revenue | $177,234,135 | PYTotalRevenueAmt |
| CY Total Revenue | $182,165,057 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $164,853 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $27,342 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $85,302,483 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $96,084,701 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $106,111,809 | PYOtherExpensesAmt |
| CY Other Expenses | $107,230,521 | CYOtherExpensesAmt |
| PY Total Expenses | $191,579,145 | PYTotalExpensesAmt |
| CY Total Expenses | $203,342,564 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$14,345,010 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$21,177,507 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $114,554,521 | TotalAssetsBOYAmt |
| Total Assets EOY | $161,347,067 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $51,871,151 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $119,841,204 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $62,683,370 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $41,505,863 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION, AND RESEARCH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $184,933,601 | ExpenseAmt |
| Revenue | $180,736,545 | RevenueAmt |
| Desc | PATIENT CARE (SEE SCHEDULE O):MAYO CLINIC HEALTH SYSTEM IN WAYCROSS (MCHS-WAYCROSS) IS PART OF THE MAYO CLINIC HEALTH SYSTEM. MAYO CLINIC HEALTH SYSTEM IS A FAMILY OF CLINICS, HOSPITALS AND HEALTH CARE FACILITIES SERVING COMMUNITIES IN MINNESOTA, IOWA, WISCONSIN AND GEORGIA. AS PART OF MAYO CLINIC, THE HEALTH SYSTEM OFFERS CARE DESIGNED FOR THE WHOLE BODY CLOSE TO THE PATIENT'S HOME, WHEN THEY NEED IT. A MULTIDISCIPLINARY TEAM OF EXPERTS HAS READY ACCESS TO KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC AND COLLABORATES ON PROVIDING EXACTLY THE CARE THE PATIENT NEEDS. MAYO CLINIC HEALTH SYSTEM SITES EMPLOY APPROXIMATELY 1,000 PHYSICIANS AND 15,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN MORE THAN 60 COMMUNITIES, MAYO CLINIC HEALTH SYSTEM INCLUDES 19 OWNED HOSPITALS, TWO OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH ONE ADDITIONAL HOSPITAL, AND CONTRACT MANAGEMENT AGREEMENTS WITH TWO ADDITIONAL HOSPITALS AND ONE NURSING HOME. SINCE ITS INCEPTION IN 1992, MAYO CLINIC HEALTH SYSTEM HAS GROWN INTO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN THE UNITED STATES. MORE THAN 600,000 UNIQUE PATIENTS ACCOUNT FOR MORE THAN 2.6 MILLION VISITS ANNUALLY IN MAYO CLINIC HEALTH SYSTEM. IT IS ALSO A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS. AS PART OF THE MAYO CLINIC HEALTH SYSTEM, MCHS-WAYCROSS SERVES A NINE-COUNTY REGION IN SOUTHEAST GEORGIA. MCHS-WAYCROSS OPERATES A 231-BED HOSPITAL, A 96-BED SKILLED NURSING FACILITY, A REHAB UNIT AND A PSYCHIATRIC UNIT IN WAYCROSS, GEORGIA ALONG WITH AN ADDITIONAL 78-BED SKILLED NURSING FACILITY IN BLACKSHEAR, GEORGIA. MCHS-WAYCROSS PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. SERVICES ARE ALSO PROVIDED TO MEDICAID AND MEDICARE PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES.FINANCIAL ASSISTANCE (AT COST) PROVIDED TO PATIENTS IN 2015 WAS APPROXIMATELY $5,187,700. THE COST OF UNCOMPENSATED CARE PROVIDED TO LOW INCOME PATIENTS THROUGH MEDICAID WAS APPROXIMATELY $10,428,700. THE COST OF UNCOMPENSATED CARE PROVIDED TO PATIENTS THROUGH MEDICARE WAS APPROXIMATELY $16,906,800. SATILLA ADVOCACY SERVICES, A RAPE CRISIS AND CHILD ADVOCACY CENTER, OPERATES UNDER THE UMBRELLA OF MCHS-WAYCROSS AND SERVES VICTIMS OF SEXUAL ASSAULT AND OTHER VIOLENT CRIMES IN THE SIX COUNTIES THAT MAKE UP THE WARE JUDICIAL CIRCUIT. A FULL RANGE OF SERVICES IS OFFERED FROM THE TIME A VICTIM REPORTS AN INCIDENT, INCLUDING EMERGENCY DEPARTMENT SERVICES, FOLLOW UP AT THE RAPE CRISIS/CHILD ADVOCACY CENTER, THERAPY AND SUPPORT BY OUR LEGAL ADVOCACY PERSONNEL. IN 2015, SATILLA ADVOCACY SERVED 603 NEW VICTIMS AND PRESENTED PREVENTION EDUCATION TO 13,688 PEOPLE.ALL REVENUE AFTER EXPENSES IS REINVESTED TO CARE FOR THE CITIZENS OF THE COMMUNITY THROUGH CLINICAL CARE, HEALTH PROGRAMS, STATE-OF-THE-ART TECHNOLOGY AND FACILITIES, AND TEACHING AND TRAINING OF MEDICAL PROFESSIONALS.APPROXIMATELY 73 COMMUNITY VOLUNTEERS PROVIDED APPROXIMATELY 9,617 HOURS OF DONATED TIME TO THE HOSPITAL IN 2015. VOLUNTEERS PROVIDE HOSPITALITY SERVICES TO PATIENTS, FAMILIES AND VISITORS. THE DONATED SERVICES PROVIDED BY THE VOLUNTEERS IN 2015 WERE VALUED AT APPROXIMATELY $226,580 BASED ON STATISTICS FROM THE INDEPENDENT SECTOR. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,203,800 | ExpenseAmt |
| Grant | $27,342 | GrantAmt |
| Revenue | $195,317 | RevenueAmt |
| Desc | COMMUNITY PROGRAMS & HEALTH PROFESSIONS EDUCATION (SEE SCHEDULE O):CONSISTENT WITH ITS CHARITABLE MISSION, MCHS-WAYCROSS PROVIDES COMMUNITY BENEFIT TO THE COMMUNITY IT SERVES. FOR 2015, MCHS-WAYCROSS PROVIDED HEALTH EDUCATION AND HEALTH SUPPORT SERVICES. MANY OF THESE BENEFITS AND SERVICES ARE DESCRIBED BELOW.MCHS-WAYCROSS IS INVOLVED IN MANY ACTIVITIES AIMED AT EDUCATING THE COMMUNITY ABOUT HEALTH-RELATED TOPICS. EXAMPLES OF THESE ACTIVITIES INCLUDE A MONTHLY CALENDAR OF EVENTS AND CLASSES OFFERED AT THE HOSPITAL THAT IS DISTRIBUTED VIA EMAIL AND ADVERTISED IN LOCAL NEWSPAPERS. THE FOLLOWING ARE SOME OF THE CLASSES AND SEMINARS OFFERED DURING 2015. - SENIOR SAFETY DAY - PRENATAL CLASSES - DIABETES CLASSES - SMOKING CESSATION - WOMEN'S HEALTH BLITZ - CANCER SUPPORT GROUPTHE HOSPITAL STAFF PROVIDED BLOOD PRESSURE SCREENINGS, EDUCATIONAL PROGRAMS AND HEALTH SEMINARS TO RESIDENTS IN SCHOOLS, SENIOR CITIZENS CENTERS, SOCIAL CLUBS AND AT HEALTH FAIRS THROUGHOUT THE SERVICE AREA INCLUDING SENIOR SAFETY DAY, SWAMPFEST, AND PIERCE, BRANTLEY AND WARE COUNTY HIGH SCHOOL FOOTBALL GAMES. MCHS-WAYCROSS PROVIDED APPROXIMATELY $22,000 OF STAFF TIME AND SUPPLIES TO HELP PATIENTS ACCESS FREE MEDICATIONS THROUGH PHARMACEUTICAL COMPANIES' PRESCRIPTION ASSISTANCE PROGRAMS. MCHS-WAYCROSS OFFERED ENROLLMENT ASSISTANCE TO 339 PEOPLE IN THE COMMUNITY SO THEY WOULD BE ABLE TO ACCESS PUBLIC HEALTH PROGRAMS SUCH AS MEDICAID. IN 2015, MCHS-WAYCROSS WORKED WITH LOCAL COLLEGES AND TECHNICAL SCHOOLS TO OFFER CLINICAL ROTATIONS FOR A VARIETY OF HEALTHCARE PROFESSIONALS THAT INCLUDED PROVIDING A CLINICAL SETTING FOR STUDENTS THAT INCLUDED SIX HOURS PER STUDENT OF STAFF MENTORING. ORIENTATION, DRUG SCREENS, CRIMINAL BACKGROUND CHECKS AND SOCIAL SECURITY CHECKS WERE PROVIDED FOR ALL STUDENTS. IN ADDITION, RENT-FREE CLASSROOM SPACE WAS PROVIDED. MCHS-WAYCROSS PARTNERS WITH THE MEDICAL COLLEGE OF GEORGIA AT GEORGIA REGENTS UNIVERSITY TO SPONSOR A RESIDENCY PROGRAM. THIS PROGRAM SERVES AS A RESPONSE TO DECLINING NUMBERS OF PRIMARY CARE PHYSICIANS IN RURAL SOUTH GEORGIA COMMUNITIES AND THE REGION AND A DESIRE TO TRAIN PRIMARY CARE PHYSICIANS IN SETTINGS THAT WOULD FACILITATE THE CHOICE OF PRACTICE IN SMALL AND RURAL COMMUNITIES.IN 2015, CONTRIBUTIONS WERE MADE TO COMMUNITY PARTNERSHIP EVENTS SUCH AS THE AMERICAN CANCER SOCIETY, YMCA, OKEFENOKEE TECHNICAL COLLEGE FOUNDATION AND THE SOUTHEAST CANCER UNIT.AS A CORPORATE CITIZEN, MCHS-WAYCROSS TAKES A LEADERSHIP ROLE AND COLLABORATES WITH OTHER REGIONAL AGENCIES TO INSURE THE COMMUNITY IS PREPARED FOR DISASTER SHOULD IT STRIKE. IN 2015, MCHS-WAYCROSS PROVIDED OVER $83,000 OF SUPPORT TO REGIONAL EMERGENCY PREPAREDNESS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $186,137,401 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | 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 | Yes (1) | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | 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 | 0 | 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 | Yes (1) | 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 | 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 | 117 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1496 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | GA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CORPORATE TAX UNIT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5075381297 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 FIRST STREET SW | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55905 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CALAMIA MD KENNETH T | ||||||||||
| DIRECTOR/PRESIDENT/CEO | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $409,587 | $72,647 | |||
| CATCHINGS MD TIMOTHY T | ||||||||||
| DIRECTOR | 40.00 | 0.00 | Yes (X) | $879,449 | $0 | $67,023 | ||||
| DAWSON MD NANCY L | ||||||||||
| DIRECTOR/VICE PRESIDENT | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $294,890 | $68,177 | |||
| DYE MD JAMES W | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| HERRIN OWEN | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| HOFFMAN MARY J | ||||||||||
| DIRECTOR/SECRETARY/TREASURER/CAO | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $366,692 | $55,266 | |||
| MUSIC ZA | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| PRESUTTI DO RICHARD J | ||||||||||
| DIRECTOR/PRESIDENT/CEO | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $460,216 | $54,328 | |||
| SWEAT HOLLI H | ||||||||||
| DIRECTOR/ASSISTANT SECRETARY | 40.00 | 0.00 | Yes (X) | Yes (X) | $190,401 | $0 | $53,791 | |||
| WATERS MD DONALD | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| BEARD TERESA B | ||||||||||
| ASSISTANT SECRETARY | 1.00 | 40.00 | Yes (X) | $0 | $111,389 | $33,191 | ||||
| LOCKETT KEVIN M | ||||||||||
| INTERIM CFO | 1.00 | 40.00 | Yes (X) | $0 | $165,792 | $47,001 | ||||
| RATHBUN JON | ||||||||||
| CFO | 1.00 | 40.00 | Yes (X) | $0 | $172,561 | $18,240 | ||||
| COCHON MD ARISTOTLE P | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $408,314 | $0 | $52,335 | Yes (X) | ||||
| JHA MD ASIT K | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $760,450 | $0 | $55,932 | Yes (X) | ||||
| LOTT MD MCGREGOR N | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $676,694 | $0 | $56,240 | Yes (X) | ||||
| WYKSTRA MD DAVID J | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $591,241 | $0 | $53,897 | Yes (X) | ||||
| BORDERS MD YOLANDA M | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $690,898 | $0 | $48,674 | Yes (X) | ||||
| GRIFFIN MD HOWARD | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $672,537 | $0 | $8,734 | Yes (X) | ||||
| JOHNSON MD KENNETH A | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $639,878 | $0 | $68,191 | Yes (X) | ||||
| PILLAI MD DILIP P | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $720,837 | $0 | $67,659 | Yes (X) | ||||
| SINGLETON MD BRIAN A | ||||||||||
| PHYSICIAN | 40.00 | 0.00 | $648,885 | $0 | $51,705 | Yes (X) | ||||
| CROFT CHERYL R | ||||||||||
| FORMER OFFICER | 0.00 | 40.00 | $0 | $243,699 | $57,954 | Yes (X) | ||||
| LANGE MD STEPHEN M | ||||||||||
| FORMER OFFICER | 0.00 | 40.00 | $0 | $606,363 | $57,915 | Yes (X) | ||||
| SMITH JR WINDELL R | ||||||||||
| FORMER OFFICER | 0.00 | 40.00 | $0 | $198,104 | $54,380 | Yes (X) | ||||
| WALTERS ROBERT M | ||||||||||
| FORMER OFFICER | 0.00 | 40.00 | $0 | $321,723 | $73,101 | Yes (X) | ||||
| BAKER MD MICHAEL P | ||||||||||
| FORMER KEY EMPLOYEE | 40.00 | 0.00 | $265,602 | $0 | $66,604 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $7,145,186 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,351,016 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,242,985 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 79 | 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 |
|---|---|---|---|---|---|
| SODEXO INC | |||||
| 9801 WASHINGTON BLVD | GAITHERABURY | MD | 20878 | FOOD SERVICES | $4,687,413 |
| SOUTHEAST GEORGIA ANESTHESIA LLC | |||||
| 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | ANESTHESIA SERVICES | $2,140,586 |
| MAYO CLINIC | |||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | MEDICAL & SUPPORT SERVICES | $1,145,544 |
| DIAGNOSTIC PET LLC | |||||
| 1256 SHILOH ROAD | ELLAVILLE | GA | 31806 | PET SCANS | $1,101,842 |
| CERNER HEALTHCARE SOLUTIONS INC | |||||
| 2800 ROCKCREEK PKWY | NORTH KANSAS CITY | MO | 64117 | BILLING SERVICES | $1,062,406 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 32 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $2,656 | FederatedCampaignsAmt |
| Related Organizations | $89,973 | RelatedOrganizationsAmt |
| Government Grants | $848,385 | GovernmentGrantsAmt |
| All Other Contributions | $70,090 | AllOtherContributionsAmt |
| Total Contributions | $1,011,104 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REVENUE | 620000 | $180,078,083 | $180,057,158 | $20,925 |
| EDUCATION REVENUE | 611600 | $195,317 | $195,317 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $180,273,400 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $431,540 | TotalRevenueColumnAmt |
| Exclusion | $431,540 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $165,877 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $41,095 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $124,782 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $124,782 | TotalRevenueColumnAmt |
| Exclusion | $124,782 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $222,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $597,620 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$375,120 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$375,120 | TotalRevenueColumnAmt |
| Exclusion | -$375,120 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| VENDING/CAFETERIA | 722210 | $630,377 | $630,377 | |
| MISC. REVENUE | 900099 | $68,974 | $28,085 | $40,889 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $699,351 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $182,165,057 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $180,910,937 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $20,925 | UnrelatedBusinessRevenueAmt |
| Exclusion | $222,091 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,342 | TotalAmt |
| Program Services | $27,342 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,845,768 | TotalAmt |
| Program Services | $3,845,768 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,302,257 | TotalAmt |
| Program Services | $1,212,493 | ProgramServicesAmt |
| Management And General | $89,764 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,139,113 | TotalAmt |
| Program Services | $58,386,526 | ProgramServicesAmt |
| Management And General | $6,752,587 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,077,741 | TotalAmt |
| Program Services | $6,344,033 | ProgramServicesAmt |
| Management And General | $733,708 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,001,229 | TotalAmt |
| Program Services | $12,549,804 | ProgramServicesAmt |
| Management And General | $1,451,425 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,718,593 | TotalAmt |
| Program Services | $4,229,444 | ProgramServicesAmt |
| Management And General | $489,149 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $377,779 | TotalAmt |
| Management And General | $377,779 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,622 | TotalAmt |
| Program Services | $41,622 | ProgramServicesAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $686 | TotalAmt |
| Management And General | $686 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,881,737 | TotalAmt |
| Program Services | $24,144,000 | ProgramServicesAmt |
| Management And General | $2,737,737 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $263,301 | TotalAmt |
| Program Services | $52,278 | ProgramServicesAmt |
| Management And General | $211,023 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,735,235 | TotalAmt |
| Program Services | $6,167,694 | ProgramServicesAmt |
| Management And General | $3,567,541 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,311 | TotalAmt |
| Program Services | $1,741 | ProgramServicesAmt |
| Management And General | $100,570 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,517,116 | TotalAmt |
| Program Services | $2,293,396 | ProgramServicesAmt |
| Management And General | $223,720 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $540,165 | TotalAmt |
| Program Services | $416,477 | ProgramServicesAmt |
| Management And General | $123,688 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,786 | TotalAmt |
| Management And General | $1,786 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,928,948 | TotalAmt |
| Program Services | $7,691,528 | ProgramServicesAmt |
| Management And General | $237,420 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,857 | TotalAmt |
| Program Services | $237,210 | ProgramServicesAmt |
| Management And General | $21,647 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| UNRELATED BUSINESS TAXE | $167 | $167 | |
| BAD DEBT EXPENSE | $28,585,438 | $28,585,438 | |
| MEDICAL SUPPLIES | $27,848,011 | $27,848,011 | |
| MEDICAID SURCHARGE | $1,661,407 | $1,661,407 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $485,955 | TotalAmt |
| Program Services | $401,189 | ProgramServicesAmt |
| Management And General | $84,766 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,342,564 | TotalAmt |
| Program Services | $186,137,401 | ProgramServicesAmt |
| Management And General | $17,205,163 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,818 | BOYAmt |
| EOY | $236,728 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $580,841 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,117,364 | BOYAmt |
| EOY | $33,870,024 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,084 | BOYAmt |
| EOY | $30,546 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $246,600 | BOYAmt |
| EOY | $126,216 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,057,772 | BOYAmt |
| EOY | $2,909,978 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,532 | BOYAmt |
| EOY | $188,922 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $147,647,610 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $84,153,989 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,179,799 | BOYAmt |
| EOY | $63,493,621 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $435,621 | BOYAmt |
| EOY | $44,746,960 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,362,664 | BOYAmt |
| EOY | $4,281,064 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,394,426 | BOYAmt |
| EOY | $11,463,008 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,554,521 | BOYAmt |
| EOY | $161,347,067 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,039,029 | BOYAmt |
| EOY | $28,719,615 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,964 | BOYAmt |
| EOY | $5,122 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $654,689 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,685 | BOYAmt |
| EOY | $44,253 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,145,784 | BOYAmt |
| EOY | $91,072,214 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,871,151 | BOYAmt |
| EOY | $119,841,204 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,605,118 | BOYAmt |
| EOY | $41,466,869 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,252 | BOYAmt |
| EOY | $38,994 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,683,370 | BOYAmt |
| EOY | $41,505,863 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,554,521 | BOYAmt |
| EOY | $161,347,067 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$21,177,507 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $30,265 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $19,122 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $49,387 | 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 | DURING 2015, MCHS-WAYCROSS OR ITS CONSULTANTS HAD CONTACT WITH STATE GOVERNMENT OFFICIALS AND/OR THEIR STAFF TO DISCUSS VARIOUS HEALTH CARE RELATED ISSUES. THE AMOUNT IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,263,459 | OtherCostOrOtherBasisAmt |
| Book Value | $1,263,459 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $41,095 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $83,580,436 | OtherCostOrOtherBasisAmt |
| Depreciation | $42,350,815 | DepreciationAmt |
| Book Value | $41,270,716 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,825,402 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,188,564 | DepreciationAmt |
| Book Value | $1,636,838 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $58,393,657 | OtherCostOrOtherBasisAmt |
| Depreciation | $40,614,610 | DepreciationAmt |
| Book Value | $17,779,047 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,543,561 | OtherCostOrOtherBasisAmt |
| Book Value | $1,543,561 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $63,493,621 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MAYO POOLED INVESTMENTS | Desc |
| Book Value | $44,746,960 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $44,746,960 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATES | $9,501,255 |
| DEFERRED COMPENSATION | $420,524 |
| OTHER LONG TERM ASSETS | $1,541,229 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $11,463,008 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $90,651,690 |
| DEFERRED COMPENSATION | $420,524 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $91,072,214 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | NURSING HOME RESIDENT TRUST ACCOUNT - RESIDENTS' FUNDS. |
| PART X, LINE 2: | AT DECEMBER 31, 2015 AND 2014, THE RESERVE FOR UNRECOGNIZED TAX BENEFITS WAS NOT SIGNIFICANT, AND AS A RESULT, THERE IS NO RESERVE FOR UNRECOGNIZED TAX BENEFITS RECORDED FOR THE FILING ORGANIZATION. |
| PART X, OTHER LIABILITIES (DUE TO AFFILIATES): | THE DUE TO AMOUNT IS CURRENTLY CONTESTED BY THE WAYCROSS COMMUNITY DIRECTORS. MAYO CLINIC HAS INDICATED A WILLINGNESS TO NEGOTIATE THE BALANCE DUE IN THE CONTEXT OF A NEW AFFILIATION AND EXIT TRANSACTION THAT POSITIONS WAYCROSS FOR FUTURE SUCCESS. |
| PART X, OTHER LIABILITIES (DUE TO AFFILIATES): | RECLASS OF NET RESERVES BETWEEN 2014 AND 2015. AT 12/31/14, $45,225,000 OF NET RESERVES WERE CARRIED AS AN OFFSET TO INTERCOMPANY LIABILITIES (INCLUDED ON FORM 990, PART X, LINE 25). IN 2015, THE NET RESERVES WERE SET UP IN AN INVESTMENT ACCOUNT (MAYO POOLED INVESTMENTS REFLECTED ON FORM 990, PART X, LINE 12) WITH A CORRESPONDING OFFSET TO INTERCOMPANY LIABILITIES (INCLUDED ON FORM 990, PART X, LINE 25). |
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 |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,187,711 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,187,711 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02970 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $33,423,690 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,995,038 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,428,652 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05970 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $38,611,401 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,995,038 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,616,363 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08940 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $255,247 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $255,247 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $759,209 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $145,976 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $613,233 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00350 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,685,985 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,878,961 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,807,024 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07330 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,716 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,716 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,719,157 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,024,937 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,694,220 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07840 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $58,330,558 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $29,019,975 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $29,310,583 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16780 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,430 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,430 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $67,986 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $67,986 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $92,126 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $92,126 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,630 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,630 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,456 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,456 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $170,628 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $170,628 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $28,585,438 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $40,451,911 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $40,397,476 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $54,435 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 TEBEAU STREET | AddressLine1Txt |
| City | WAYCROSS | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 148-416 | 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 | MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | 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 | WWW.MAYOCLINICHEALTHSYSTEM.ORG/ABOUT-US | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | 0 | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| 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 | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | MAYOCLINICHEALTHSYSTEM.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | MAYOCLINICHEALTHSYSTEM.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | MAYOCLINICHEALTHSYSTEM.ORG | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 5: PRIMARY DATA COLLECTION METHODS INCLUDED INTERVIEWS AND FOCUS GROUPS WITH KEY COMMUNITY REPRESENTATIVES. THE PURPOSE OF THE INTERVIEWS AND FOCUS GROUPS WAS TO GAIN DIRECT INPUT REGARDING HEALTH NEEDS, INCLUDING PRIMARY AND CHRONIC DISEASE NEEDS AND HEALTH ISSUES ASSOCIATED WITH UNINSURED PERSONS, LOW INCOME PERSONS AND MINORITY GROUPS.IN ADDITION, COMMUNITY INPUT WAS GARNERED FROM THE COMMUNITY ADVISORY COMMITTEE, WHICH INCLUDED REPRESENTATIVES FROM THE WARE COUNTY HEALTH DEPARTMENT, THE WARE COUNTY CHILDREN'S INITIATIVE AND OTHER COMMUNITY ORGANIZATIONS. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 11: TO ADDRESS THE NEEDS OF THE COMMUNITY'S TOBACCO USAGE AND OBESITY, MAYO CLINIC HEALTH SYSTEM IN WAYCROSS (MCHS-WAYCROSS) ALONG WITH WARE AND PIERCE COUNTY SCHOOL SYSTEMS HAVE PARTNERED TOGETHER TO HELP LOCAL COMMUNITY SCHOOLS. MCHS-WAYCROSS UTILIZED THE PARTNERSHIP WITH THE SCHOOLS (MEMORIAL DRIVE AND BLACKSHEAR ELEMENTARY), AS A COLLABORATIVE EFFORT, BY ENGAGING IN EDUCATION PROGRAMS ABOUT OBESITY AND TOBACCO AS PART OF A SOLUTION TO EDUCATE YOUTH ON THE IMPORTANCE OF HEALTHY EATING AND LIFESTYLES. MCHS-WAYCROSS' RESPIRATORY DEPARTMENT OFFERS EDUCATION ON SMOKING AND GENERAL TOBACCO USE AS AN ONGOING PUBLIC EDUCATION PROGRAM OFFERED TO ALL RESPIRATORY PATIENTS AND THEIR FAMILIES REGARDLESS OF A REPORTED INCIDENCE OF SMOKING. ALL PATIENTS ARE PRESENTED WITH A DISCHARGE PACKET REGARDING THE USE OF TOBACCO AND SMOKING. MCHS-WAYCROSS CONTINUES TO PARTNER WITH THE YMCA IN SUPPORT OF CAMP REVEILLE, A CAMP FOR UNDERSERVED CHILDREN, TO PROMOTE HEALTHY EATING AND EXERCISE.IN 2015, MCHS-WAYCROSS PARTNERED WITH SOUTHEAST GEORGIA PEDIATRICS AND AGSOUTH CREDIT UNION TO HOST A FARM-TO-LUNCH FOR THE STUDENTS AT MEMORIAL DRIVE ELEMENTARY. THIS WAS AN EFFORT TO JOIN THE NATION IN CELEBRATING FARM-TO-SCHOOL MONTH IN OCTOBER AND WAS USED TO EXPOSE THE CHILDREN TO LOCAL, FRESH REAL FOOD AND TO HELP SUPPORT LOCAL FARMERS. MCHS-WAYCROSS SPONSORED SCHOOL IN THE COMMUNITY, ON WEDNESDAY, OCTOBER 7TH, 2015. MCHS-WAYCROSS REPRESENTATIVES, DR. JOHN PRESUTTI AND TONI NELSON, ATTENDED THE LUNCH THAT DAY AND HAD PHOTOGRAPHS TAKEN WITH THE KIDS ENJOYING A LOCAL BURGER, LOCAL LETTUCE/SALAD AND SOME FRESH LOCAL BLUEBERRY JUICE.TO ADDRESS THE ADULT POPULATION, MCHS-WAYCROSS REACHED OUT TO COMMUNITY MEMBERS AND COMMUNITY ORGANIZATIONS THROUGH THE USE OF EDUCATIONAL TALKS, LECTURES, AND PRESENTATIONS ON HEALTH ISSUES CONDUCTED BY PHYSICIANS AND CLINICAL STAFF.PHYSICIAN PRESENTATIONS TO THE COMMUNITY: - WAYCROSS ROTARY - DR. LIBERTIN - KIWANIS CLUB - DR. PURI - WAYCROSS ROTARY CLUB - DR. CAMSARI - ST. PETER'S BAPTIST CHURCH - DR. CATCHINGS - GREEN THUMB GARDEN CLUB - DR. REESE - BLACKSHEAR ROTARY CLUB - DR. COCHON - WAYCROSS ROTARY -DR. COCHON - SENIOR WEIR CENTER, DOUGLAS- DR. CALAMIA - WAYCROSS EXCHANGE CLUB - DR. PURI - KIWANIS CLUB - ANGIE MOODY - BLACKSHEAR ROTARY - DR. HUFF - WAYCROSS ROTARY - DR. HUFF - WAYCROSS WOMEN'S CLUB - DR. PRESUTTI - WAYCROSS RETIRED TEACHERS ASSOCIATION - DR. REESE - TRINITY METHODIST KINGAGERS - DR. REESE - WAYCROSS KIWANIS CLUB - TERRY ANDERSONTO ADDRESS ACCESS TO HEALTH CARE, MCHS-WAYCROSS IS VERY LIMITED IN WHAT IT IS CAPABLE OF DOING. NEW PHYSICIANS AND PHYSICIAN ASSISTANTS HAVE BEEN RECRUITED. TRANSPORTATION FOR THE CITIZENS OF WARE AND PIERCE COUNTY IS PROVIDED BY A LOCAL BUSINESS GROUP. THESE SERVICES TAKE THE ELDERLY AND UNDERSERVED CITIZENS TO DOCTOR APPOINTMENTS AND OTHER FUNCTIONS AS NEEDED.HOW MCHS-WAYCROSS SERVES ITS COMMUNITY: - FINANCIAL ASSISTANCE - UNREIMBURSED COSTS OF GOVERNMENT PROGRAMS - COMMUNITY HEALTH IMPROVEMENT - HEALTH PROFESSIONS EDUCATION - SUBSIDIZED HEALTH CARE - CASH/IN-KIND SUPPORT - COMMUNITY BUILDINGTO HELP BETTER SERVE THE NEEDS IN THE COMMUNITY, MCHS-WAYCROSS PLANS TO INCREASE ITS FOCUS ON TOBACCO CESSATION. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 13B: IF A PATIENT BALANCE EXCEEDS 25% OF THE ANNUAL HOUSEHOLD INCOME, BUT THE PATIENT DOES NOT QUALIFY BASED ON FPG, CHARITY WILL BE ADJUSTED TO A MINIMUM OF THE AMOUNT GENERALLY BILLED (AGB). THE AGB IS DETERMINED USING THE LOOK-BACK METHOD AND CALCULATED USING ALL CLAIMS ALLOWED BY PRIVATE PAY INSURERS (INCLUDING MEDICARE ADVANTAGE) AND MEDICARE (TRADITIONAL) FOR INPATIENT AND OUTPATIENT SERVICES FOR THE YEAR. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 13H: THE REGIONAL PROXIMITY OF A PATIENT'S RESIDENCY IS A FACTOR FOR PRESCHEDULED SERVICES ONLY AND SECONDARY TO MEDICAL NEED. REGIONAL PROXIMITY IS NOT A FACTOR FOR EMERGENCY CARE PROVIDED. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 15E: REFER PATIENT TO APPLY FOR MEDICAL ASSISTANCE. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 16I: WITH REGARD TO THE POSTINGS WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE ARE DISCUSSED WITH THE PATIENT. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 20E: FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE TO EVERY PATIENT VIA MAYO'S PUBLIC WEBSITE, FROM CUSTOMER SERVICE AND PATIENT ACCESS LOCATIONS, AND IS REFERENCED ON MAYO'S AUTHORIZATION FORMS AND STATEMENTS. IN ADDITION, SIGNS ARE POSTED IN THE ADMISSIONS AREA AND THE PROCESS OF HOW TO APPLY IS AVAILABLE ON THE MAYO CLINIC WEBSITE.UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, MAYO DISCUSSES ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE.MONTHLY STATEMENTS ARE SENT TO PATIENTS THAT OUTLINE CURRENT CHARGES AND ACTIONS WITH INSURANCE AND INCLUDES INFORMATION ABOUT MAYO'S CHARITY CARE POLICY. SOME MAYO SITES UTILIZE ADVOCATES TO CONTACT THE PATIENT UPON DISCHARGE TO HELP THEM SECURE GOVERNMENTAL ASSISTANCE OR FINANCIAL ASSISTANCE.EACH CHARITY CARE REVIEW IS DOCUMENTED IN MAYO'S BILLING SYSTEM AND COMMUNICATED TO THE PATIENT. COMPLETED CHARITY CARE FORMS ARE MAINTAINED EITHER IN PAPER OR ELECTRONIC FORMAT. THE PATIENT IS INFORMED REGARDING THE OUTCOME OF THE REVIEW.MAYO OFTEN IDENTIFIES CHARITY CARE OPPORTUNITIES AFTER THE PATIENT HAS BEEN DISMISSED. IN MANY CASES, THIS IS DUE TO LIMITED INSURANCE COVERAGE OR INSURANCE DENIALS AFTER THE SERVICE WAS PERFORMED. IN THESE CASES, WHEN A PATIENT EXPRESSES AN INABILITY TO PAY FOR THEIR SERVICES, STAFF WILL INITIATE A CHARITY REVIEW AS INDICATED BY THE FINANCIAL ASSISTANCE POLICY, WHICH IS AVAILABLE FOR EVERY PATIENT AT MAYOCLINIC.ORG. |
| MAYO CLINIC HEALTH SYSTEM IN WAYCROSS | PART V, SECTION B, LINE 22D: THE POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 70% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN USING THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 23 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (23 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - SATILLA CARE CENTER | ||||
| 1600 RIVERSIDE AVENUE | WAYCROSS | GA | 31501 | SKILLED NURSING FACILITY |
| 2 - PIERCE COUNTY NURSING HOME | ||||
| 221 EAST CARTER AVENUE | BLACKSHEAR | GA | 31516 | SKILLED NURSING FACILITY |
| 3 - SATILLA REGIONAL REHAB INSTITUTE | ||||
| 2500 SATILLA PARKWAY | WAYCROSS | GA | 31501 | REHAB UNIT |
| 4 - SENIOR BEHAVIORAL UNIT | ||||
| 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | PSYCHIATRIC UNIT / BEHAVIORAL HEALTH |
| 5 - MCHSW - FAMILY PSYCHIATRY | ||||
| 1707 CITY BOULEVARD SQUARE | WAYCROSS | GA | 31501 | PSYCHIATRY CLINIC |
| 6 - MCHSW - NEUROLOGY | ||||
| 2101 TEBEAU STREET | WAYCROSS | GA | 31501 | NEUROLOGY CLINIC |
| 7 - MCHSW - PULMONOLOGY | ||||
| 2005 PIONEER STREET | WAYCROSS | GA | 31501 | PULMONOLOGY CLINIC |
| 8 - MCHSW - SURGICAL ASSOCIATES | ||||
| 1908 ALICE STREET | WAYCROSS | GA | 31501 | SURGICAL OFFICE |
| 9 - MCHSW - ORTHOPEDICS | ||||
| 305 PINEVIEW DRIVE | WAYCROSS | GA | 31501 | ORTHOPEDICS CLINIC |
| 10 - MCHSW - OPHTHALMOLOGY | ||||
| 413 LISTER STREET | WAYCROSS | GA | 31501 | OPTHALMOLOGY CLINIC |
| 11 - MCHSW - CARDIOLOGY | ||||
| 2004 PIONEER STREET | WAYCROSS | GA | 31501 | CARDIOLOGY CLINIC |
| 12 - MCHSW - INFECTIOUS DISEASES | ||||
| 411 LISTER STREET | WAYCROSS | GA | 31501 | INFECTIOUS DISEASES CLINIC |
| 13 - MCHSW - OBGYN | ||||
| 505 CITY BLVD | WAYCROSS | GA | 31501 | OB/GYN CLINIC |
| 14 - MCHSW - FAMILY MEDICINE | ||||
| 1921 ALICE STREET | WAYCROSS | GA | 31501 | FAMILY MEDICINE CLINIC |
| 15 - MCHSW - EXPRESS CARE | ||||
| 1921 ALICE STREET | WAYCROSS | GA | 31501 | CONVENIENT CARE CLINIC |
| 16 - MCHSW - HEMATOLOGYONCOLOGY | ||||
| 1706 ALICE STREET | WAYCROSS | GA | 31501 | HEMATOLOGY/ONCOLOGY CLINIC |
| 17 - MCHSW - RADIATION ONCOLOGY | ||||
| 1451 CHURCH STREET | WAYCROSS | GA | 31501 | RADIATION ONCOLOGY CLINIC |
| 18 - MCHSW - HEMATOLOGYONCOLOGY - DOUGLAS | ||||
| SHIRLEY AVENUE SUITES XXX-XX-XXXX | DOUGLAS | GA | 31535 | HEMATOLOGY/ONCOLOGY CLINIC |
| 19 - MCHSW - OUTREACH CLINIC | ||||
| 396 KINGSLAND DRIVE | FOLKSTON | GA | 31537 | OUTREACH CLINIC |
| 20 - MCSHW - FAMILY MEDICINE | ||||
| 808 BEACON STREET | WAYCROSS | GA | 31501 | PRIMARY CARE CLINIC |
| 21 - MCSHW - HEMATOLOGYONCOLOGY | ||||
| 1206 ALICE STREET | WAYCROSS | GA | 31501 | HEMATOLOGY/ONCOLOGY CLINIC |
| 22 - MCHSW - HEMATOLOGYONCOLOGY | ||||
| 101 SEYMOUR ST | DOUGLAS | GA | 31533 | HEMATOLOGY/ONCOLOGY CLINIC |
| 23 - MCHSW - OUTPATIENT IMAGING CENTER | ||||
| 410 ZACHARY STREET | WAYCROSS | GA | 31501 | RADIOLOGY/IMAGING |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | MEDICAL INDIGENCY MAY BE USED TO DETERMINE ELIGIBILITY. IF A PATIENT BALANCE EXCEEDS 25% OF THE ANNUAL HOUSEHOLD INCOME, BUT THE PATIENT DOES NOT QUALIFY BASED ON FPG, CHARITY WILL BE ADJUSTED TO A MINIMUM OF THE AMOUNT GENERALLY BILLED (AGB). THE AGB IS DETERMINED USING THE LOOK-BACK METHOD AND CALCULATED USING ALL CLAIMS ALLOWED BY PRIVATE PAY INSURERS (INCLUDING MEDICARE ADVANTAGE) AND MEDICARE (TRADITIONAL) FOR INPATIENT AND OUTPATIENT SERVICES FOR THE YEAR. |
| PART I, LINE 7: | A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO. |
| PART I, LINE 7G: | THE FOLLOWING NET COMMUNITY BENEFIT COST ATTRIBUTED TO A PHYSICIAN CLINIC WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES: $1,958,116. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 28,585,438. |
| SCHEDULE H, PART I, LINE 5 | THE FILING ORGANIZATION ESTIMATES CHARITY CARE FOR FINANCIAL PLANNING PURPOSES ONLY. THE ESTIMATED AMOUNT OF CHARITY CARE DOES NOT INFLUENCE OR HAVE ANY IMPACT ON THE AMOUNT OF CHARITY CARE PROVIDED. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THROUGH IN-KIND DONATIONS AND GRANTS TO PUBLIC, PRIVATE AND NONPROFIT ORGANIZATIONS, THE FILING ORGANIZATION ASSISTS WITH SUSTAINING AND ENHANCING THE COMMUNITIES IT SERVES BY ASSISTING IN COMMUNITY SUPPORT, ENVIRONMENTAL IMPROVEMENTS AND COMMUNITY IMPROVEMENT ADVOCACY. |
| PART III, LINE 2: | PART III, SECTION A, LINE 1:THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.METHODOLOGY FOR SCHEDULE H, PART III, LINE 2:BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED IN THE ACCOUNTS RECEIVABLE FOOTNOTE OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 4: | FOOTNOTES RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS CAN BE FOUND ON PAGES 5, 7, 8 AND 9 OF MAYO CLINIC'S 2015 CONSOLIDATED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY). HOWEVER, USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY ACTUALLY RESULTS IN A MEDICARE SHORTFALL OF $16,906,800 AS REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS.THE MOST COMMON REASONS FOR A DIFFERENCE BETWEEN THE MEDICARE SURPLUS REPORTED ON SCHEDULE H AND THE MEDICARE SHORTFALL REPORTED ON THE CORE FORM, PART III INCLUDE: (1) INCLUSION OF MEDICARE ADVANTAGE REVENUE AND EXPENSES; (2) INCLUSION OF PART B REVENUE AND EXPENSES; (3) INCLUSION OF OTHER FEE SCHEDULE REVENUE; AND (4) SOME TIMING ISSUES.REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. |
| PART III, LINE 9B: | MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING REASONABLE ATTEMPTS TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN ADDITION, MAYO CLINIC AND ITS AFFILIATES ACCEPT REASONABLE PAYMENT PLANS FROM PATIENTS WHEN AN ACCOUNT IS THE PATIENT'S RESPONSIBILITY AND TRY TO IDENTIFY THOSE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS OFFERED TO ANY PATIENT IF THE FACTS AND CIRCUMSTANCES SUGGEST THAT THE PATIENT DOES NOT HAVE THE ABILITY TO PAY THEIR BILL IN WHOLE OR IN PART. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED; INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS POTENTIALLY MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY BASED ON SUBMISSION OF REQUESTED INFORMATION. COLLECTION ACTIVITY WOULD ONLY RESUME IF THE PATIENT IS DETERMINED TO BE INELIGIBLE FOR FINANCIAL ASSISTANCE OR IS ELIGIBLE FOR ONLY PARTIAL FINANCIAL ASSISTANCE AND DOES NOT AGREE TO PAY THE REMAINING BALANCE. |
| PART VI, LINE 2: | CONSISTENT WITH ITS CHARITABLE MISSION, MAYO CLINIC HEALTH SYSTEM IN WAYCROSS (MCHS-WAYCROSS) PROVIDES COMMUNITY BENEFIT TO THE COMMUNITY IT SERVES. A COMMUNITY BENEFIT IS A PLANNED, MANAGED, ORGANIZED, AND MEASURED APPROACH TO MEETING IDENTIFIED COMMUNITY HEALTH NEEDS. IT INVOLVES THE PARTICIPATION OF THE HEALTHCARE ORGANIZATION WORKING WITH THE COMMUNITY TO BENEFIT ITS RESIDENTS THROUGH PROGRAMS AND SERVICES THAT IMPROVE THEIR HEALTH STATUS AND QUALITY OF LIFE. MCHS-WAYCROSS IMPROVES THE HEALTH AND WELL BEING OF THE NINE-COUNTY SERVICE AREA IN SOUTHEAST GEORGIA THAT IT SERVES THROUGH CLINICAL SERVICES, EDUCATION, AND PARTNERSHIPS THAT BUILD HEALTH CAPACITY IN THE COMMUNITY. COMMUNITY BENEFITS ARE PROVIDED FOR ALL CITIZENS AS WELL AS FOR THE MEDICALLY UNDERSERVED. THE ORGANIZATION PAYS CLOSE ATTENTION TO THE NEEDS OF LOW INCOME AND OTHER VULNERABLE PERSONS AND THE COMMUNITY AT LARGE. THE HOSPITAL WORKS WITH COMMUNITY GROUPS TO IDENTIFY NEEDS STRENGTHEN EXISTING COMMUNITY PROGRAMS AND PLAN NEWLY NEEDED SERVICES. IT PROVIDES A WIDE ARRAY OF COMMUNITY BENEFIT SERVICES DESIGNED TO IMPROVE COMMUNITY HEALTH AND THE HEALTH OF INDIVIDUALS. MCHS-WAYCROSS WORKS TO INCREASE ACCESS TO HEALTH CARE, IN ADDITION TO PROVIDING FREE AND DISCOUNTED SERVICES TO PEOPLE WHO ARE UNINSURED AND UNDERINSURED. THE ORGANIZATION'S COMMUNITY BENEFIT PROGRAMS ARE DESIGNED TO RESPOND TO ASSESSED NEEDS AND ARE FOCUSED ON PREVENTION AND EDUCATION. |
| PART VI, LINE 3: | MEASURES TO PUBLICIZE FINANCIAL ASSISTANCE POLICY:MAYO CLINIC IS COMMITTED TO OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY FOR THEIR MEDICAL SERVICES IN WHOLE OR IN PART. IN ORDER TO ACCOMPLISH THIS CHARITABLE GOAL, MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM SITES WIDELY PUBLICIZE THIS POLICY IN THE COMMUNITIES THAT THE INDIVIDUAL MAYO CLINIC AFFILIATED SITES SERVE. MAYO CLINIC AFFILIATED SITES MAKE COPIES OF THIS POLICY AND APPLICATIONS AVAILABLE BY POSTING IT ON THEIR WEBPAGE INCLUDING THE ABILITY TO DOWNLOAD A COPY OF THE POLICY AND APPLICATION FREE OF CHARGE. INDIVIDUALS IN THE COMMUNITY SERVED WILL BE ABLE TO OBTAIN A COPY OF THE POLICY IN LOCATIONS THROUGHOUT EACH MAYO CLINIC AFFILIATED SITE OR UPON REQUEST. THE POLICY EXPLAINS THE FINANCIAL ASSISTANCE PROGRAM AND FACTORS AFFECTING ELIGIBILITY. WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED. ADDITIONALLY, CHARITABLE CARE AND FINANCIAL ASSISTANCE IS REFERENCED ON PATIENT CORRESPONDENCE INCLUDING: THE MONTHLY STATEMENT OF ACCOUNT, ACCOUNT BALANCE LETTERS, AND LATE PAYMENT NOTIFICATIONS. ALL PATIENT CORRESPONDENCE REFERENCING CHARITABLE CARE AND FINANCIAL ASSISTANCE INCLUDE INTERNET, PHONE, AND MAILING ADDRESS CONTACT INFORMATION. |
| PART VI, LINE 4: | MCHS-WAYCROSS SERVES A NINE-COUNTY REGION IN SOUTHEAST GEORGIA. THE MAIN CAMPUS IS LOCATED IN WAYCROSS, GEORGIA (WARE COUNTY) AND INCLUDES A HOSPITAL, A SKILLED NURSING FACILITY, A REHAB UNIT AND A PSYCHIATRIC UNIT. AN ADDITIONAL SKILLED NURSING FACILITY IS LOCATED IN BLACKSHEAR, GEORGIA (PIERCE COUNTY).ACCORDING TO THE UNITED STATES CENSUS BUREAU, THE 2015 POPULATION ESTIMATE FOR WARE COUNTY (WHICH COMPRISES MOST OF WAYCROSS'S SERVICE AREA) IS 35,370. THE CENSUS BUREAU REPORTS THAT 23.9% OF THE POPULATION IS UNDER 18 YEARS OLD AND 16.5% IS 65 YEARS OLD OR OLDER. AN ESTIMATED 28.8% OF INDIVIDUALS ARE LIVING BELOW THE POVERTY LEVEL. |
| PART VI, LINE 5: | THE FILING ORGANIZATION IS AN AFFILIATE OF THE MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION - EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY - IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.SURPLUS FUNDS - MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE. COMMUNITY REPRESENTATION ON GOVERNING BODY - THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, WHETHER IN HEALTH CARE POLICY, BUSINESS, GOVERNMENT OR ANOTHER FIELD. IN ADDITION TO THIS COMMUNITY REPRESENTATION AT THE PARENT ENTITY, THE FILING ORGANIZATION ALSO INVOLVES LOCAL COMMUNITY MEMBERS ON ITS GOVERNING BODY. OPEN VS. CLOSED STAFF MODEL - THE FILING ORGANIZATION'S STAFF PRIVILEGES ARE GENERALLY EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.EMERGENCY ROOM - 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. |
| PART VI, LINE 6: | THIS ORGANIZATION IS A PART OF MAYO CLINIC HEALTH SYSTEM (WHICH IS PART OF A LARGER GROUP OF ENTITIES AFFILIATED WITH MAYO CLINIC). THE MAYO CLINIC HEALTH SYSTEM IS DESCRIBED IN RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O). THAT STATEMENT ALSO DESCRIBES THE ROLES OF THE VARIOUS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. |
| PART VI, LINE 7 | NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO A STATE HOSPITAL ASSOCIATION. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| 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 (22 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CALAMIA MD KENNETH T | ||||||||||||||
| DIRECTOR/PRESIDENT/CEO | $0 | $370,831 | $0 | $0 | $0 | $38,756 | $0 | $56,562 | $0 | $16,085 | $0 | $482,234 | $0 | $0 |
| CATCHINGS MD TIMOTHY T | ||||||||||||||
| DIRECTOR | $830,450 | $0 | $0 | $0 | $48,999 | $0 | $55,646 | $0 | $11,377 | $0 | $946,472 | $0 | $0 | $0 |
| DAWSON MD NANCY L | ||||||||||||||
| DIRECTOR/VICE PRESIDENT | $0 | $285,989 | $0 | $0 | $0 | $8,901 | $0 | $53,360 | $0 | $14,817 | $0 | $363,067 | $0 | $0 |
| HOFFMAN MARY J | ||||||||||||||
| DIRECTOR/SECRETARY/TREASURER/CAO | $0 | $345,161 | $0 | $0 | $0 | $21,531 | $0 | $34,373 | $0 | $20,893 | $0 | $421,958 | $0 | $0 |
| PRESUTTI DO RICHARD J | ||||||||||||||
| DIRECTOR/PRESIDENT/CEO | $0 | $415,681 | $0 | $0 | $0 | $44,535 | $0 | $32,848 | $0 | $21,480 | $0 | $514,544 | $0 | $0 |
| SWEAT HOLLI H | ||||||||||||||
| DIRECTOR/ASSISTANT SECRETARY | $190,114 | $0 | $0 | $0 | $287 | $0 | $31,846 | $0 | $21,945 | $0 | $244,192 | $0 | $0 | $0 |
| LOCKETT KEVIN M | ||||||||||||||
| INTERIM CFO | $0 | $165,129 | $0 | $0 | $0 | $663 | $0 | $20,360 | $0 | $26,641 | $0 | $212,793 | $0 | $0 |
| RATHBUN JON | ||||||||||||||
| CFO | $0 | $95,980 | $0 | $0 | $0 | $76,581 | $0 | $8,612 | $0 | $9,628 | $0 | $190,801 | $0 | $0 |
| COCHON MD ARISTOTLE P | ||||||||||||||
| PHYSICIAN | $401,990 | $0 | $0 | $0 | $6,324 | $0 | $27,065 | $0 | $25,270 | $0 | $460,649 | $0 | $0 | $0 |
| JHA MD ASIT K | ||||||||||||||
| PHYSICIAN | $736,463 | $0 | $0 | $0 | $23,987 | $0 | $35,220 | $0 | $20,712 | $0 | $816,382 | $0 | $0 | $0 |
| LOTT MD MCGREGOR N | ||||||||||||||
| PHYSICIAN | $658,177 | $0 | $0 | $0 | $18,517 | $0 | $30,964 | $0 | $25,276 | $0 | $732,934 | $0 | $0 | $0 |
| WYKSTRA MD DAVID J | ||||||||||||||
| PHYSICIAN | $573,644 | $0 | $0 | $0 | $17,597 | $0 | $30,964 | $0 | $22,933 | $0 | $645,138 | $0 | $0 | $0 |
| BORDERS MD YOLANDA M | ||||||||||||||
| PHYSICIAN | $650,494 | $0 | $0 | $0 | $40,404 | $0 | $27,251 | $0 | $21,423 | $0 | $739,572 | $0 | $0 | $0 |
| GRIFFIN MD HOWARD | ||||||||||||||
| PHYSICIAN | $646,526 | $0 | $0 | $0 | $26,011 | $0 | $5,300 | $0 | $3,434 | $0 | $681,271 | $0 | $0 | $0 |
| JOHNSON MD KENNETH A | ||||||||||||||
| PHYSICIAN | $637,847 | $0 | $0 | $0 | $2,031 | $0 | $48,567 | $0 | $19,624 | $0 | $708,069 | $0 | $0 | $0 |
| PILLAI MD DILIP P | ||||||||||||||
| PHYSICIAN | $682,616 | $0 | $0 | $0 | $38,221 | $0 | $44,802 | $0 | $22,857 | $0 | $788,496 | $0 | $0 | $0 |
| SINGLETON MD BRIAN A | ||||||||||||||
| PHYSICIAN | $644,300 | $0 | $0 | $0 | $4,585 | $0 | $33,455 | $0 | $18,250 | $0 | $700,590 | $0 | $0 | $0 |
| CROFT CHERYL R | ||||||||||||||
| FORMER OFFICER | $0 | $242,163 | $0 | $0 | $0 | $1,536 | $0 | $41,303 | $0 | $16,651 | $0 | $301,653 | $0 | $0 |
| LANGE MD STEPHEN M | ||||||||||||||
| FORMER OFFICER | $0 | $518,151 | $0 | $0 | $0 | $88,212 | $0 | $33,930 | $0 | $23,985 | $0 | $664,278 | $0 | $0 |
| SMITH JR WINDELL R | ||||||||||||||
| FORMER OFFICER | $0 | $197,200 | $0 | $0 | $0 | $904 | $0 | $29,158 | $0 | $25,222 | $0 | $252,484 | $0 | $0 |
| WALTERS ROBERT M | ||||||||||||||
| FORMER OFFICER | $0 | $305,907 | $0 | $0 | $0 | $15,816 | $0 | $56,223 | $0 | $16,878 | $0 | $394,824 | $0 | $0 |
| BAKER MD MICHAEL P | ||||||||||||||
| FORMER KEY EMPLOYEE | $236,278 | $0 | $0 | $0 | $29,324 | $0 | $46,890 | $0 | $19,714 | $0 | $332,206 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | MICHAEL P. BAKER, M.D. RECEIVED LOAN FORGIVENESS WHICH WAS TREATED AS TAXABLE INCOME AND WAS GROSSED UP. HOUSING ALLOWANCES ARE PROVIDED WHEN JUSTIFIED BY BUSINESS NEED SUCH AS RELOCATION OR WORK ASSIGNMENT. IN 2015, DILIP P. PILLAI, M.D. RECEIVED A HOUSING ALLOWANCE THAT WAS TREATED AS TAXABLE INCOME AND WAS GROSSED UP. BRIAN A. SINGLETON, M.D. RECEIVED A HOUSING ALLOWANCE THAT WAS TREATED AS TAXABLE INCOME. |
| PART I, LINE 3 | THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990 PART VI SECTION B LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED. |
| PART I, LINES 4A-B | PURSUANT TO A SEPARATION AGREEMENT, JON RATHBUN, FORMER CHIEF FINANCIAL OFFICER OF MAYO CLINIC FLORIDA / MAYO CLINIC JACKSONVILLE, RECEIVED THE FOLLOWING BENEFITS: PURCHASE OF HIS HOME AT APPRAISED FAIR MARKET VALUE, CASH COMPENSATION OF $65,757 (AN AMOUNT EQUAL TO 3 MONTHS' SALARY AND COBRA BENEFITS), AND AN AGREEMENT TO FORGO COLLECTION OF ANY RELOCATION OR MOVING EXPENSES THAT WERE SUBJECT TO POTENTIAL REPAYMENT ABSENT RETENTION. THIS ENTITY OR ITS AFFILIATE HAS A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE MAYO PENSION PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(A)(17). STARTING JANUARY 1, 2011, ALL SRP BENEFITS ARE PAID AS AN ANNUAL TAXABLE CASH PAYMENT. THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). CALAMIA M.D., KENNETH T. $30,734 DAWSON M.D., NANCY L. $ 2,918 HOFFMAN, MARY J. $18,685 LANGE M.D., STEPHEN M. $70,388 PRESUTTI D.O., RICHARD J. $ 9,125 WALTERS, ROBERT M. $11,890 THIS ENTITY HAS A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE ENTITY'S 403(B) PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(A)(17). THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). BORDERS M.D., YOLANDA M. $20,100 CATCHINGS M.D., TIMOTHY T. $43,948 COCHON M.D., ARISTOTLE P. $6,163 GRIFFIN M.D., HOWARD $11,361 JHA M.D., ASIT K. $23,521 LOTT M.D., MCGREGOR N. $18,212 PILLAI M.D., DILIP P. $18,185 WYKSTRA M.D., DAVID J. $17,362 |
| PART II: | COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL P BAKER MD | PersonNm |
| Relationship With Org | FORMER KEY EMPLOYEE | RelationshipWithOrgTxt |
| Loan Purpose | SIGN-ON BONUS SET-UP AS A FORGIVABLE LOAN | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $205,000 | OriginalPrincipalAmt |
| Balance Due | $30,546 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | 0 | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $30,546 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE FOLLOWING INDIVIDUAL(S) IS/ARE EMPLOYED BY A RELATED ORGANIZATION: LOCKETT, KEVIN M. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL(S) WHO IS/ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: RATHBUN, JON, THE FOLLOWING INDIVIDUAL(S) IS/ARE EMPLOYED BY A RELATED ORGANIZATION: CALAMIA M.D., KENNETH T., BEARD, TERESA B., PRESUTTI D.O., RICHARD J., HOFFMAN, MARY J., DAWSON M.D., NANCY L., RATHBUN, JON RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL(S) WHO IS/ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: PRESUTTI D.O., RICHARD J., HOFFMAN, MARY J., DAWSON M.D., NANCY L., RATHBUN, JON, LOCKETT, KEVIN M. |
| FORM 990, PART VI, SECTION A, LINE 3 | MAYO CLINIC, MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, AND OTHER RELATED COMPANIES PROVIDE MANAGEMENT SERVICES TO THE ENTIRE SYSTEM OF ENTITIES. SINCE THE ENTITIES ARE RELATED ORGANIZATIONS, COMPENSATION FOR THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES HAS BEEN DISCLOSED IN PART VII AND SCHEDULE J AS REQUIRED. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THIS CORPORATION SHALL BE MAYO CLINIC JACKSONVILLE (A NONPROFIT CORPORATION). |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE CORPORATE MEMBER APPOINTS MEMBERS TO THE BOARD OF DIRECTORS THROUGH MULTIPLE PROCESSES AS SPECIFIED IN THE BYLAWS. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ARTICLES AND BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, BUDGET, DEBT, AMENDMENT OF THE ARTICLES AND BYLAWS AND GENERAL OPERATION DECISIONS. THE COMMUNITY DIRECTORS HAVE THE AUTHORITY TO ENFORCE CERTAIN PROVISIONS OF THE INTEGRATION AGREEMENT. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE CHIEF ADMINISTRATIVE OFFICER AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | MAYO CLINIC AND ITS AFFILIATES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS, EXECUTIVE AND SENIOR ADMINISTRATIVE LEADERSHIP, ALONG WITH ALLIED HEALTH STAFF. IN ADDITION TO ANY REVIEW AND APPROVAL THAT MAY TAKE PLACE AT THE LOCAL ENTITY OR REGIONAL LEVEL, THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY PRIOR TO IMPLEMENTATION OF THE RESPECTIVE COMPENSATION INCREASE. THE COMPENSATION AND BENEFIT PROGRAM OF THE CHIEF EXECUTIVE OFFICER (CEO) WAS REVIEWED AND APPROVED BY THE PROCESS DESCRIBED BELOW FOR PHYSICIANS OF THE ARIZONA, FLORIDA, AND ROCHESTER, MINNESOTA CAMPUSES. THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION AND BENEFIT PROGRAMS FOR PHYSICIANS OF THE ARIZONA, FLORIDA, AND ROCHESTER, MINNESOTA CAMPUSES. THE COMMITTEE IS COMPRISED OF MAYO EMPLOYEES, BUT IS INDEPENDENT FOR INTERNAL REVENUE CODE 4958 FOR THE INDIVIDUALS WHOSE SALARIES ARE REVIEWED (WITH RECUSAL WHERE APPROPRIATE). THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. FOLLOWING REVIEW BY THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE, THE COMPENSATION AND BENEFIT PROGRAMS FOR PHYSICIANS OF THE ARIZONA, FLORIDA, AND ROCHESTER, MINNESOTA CAMPUSES ARE REVIEWED AND APPROVED BY THE MAYO CLINIC BOARD OF TRUSTEES GOVERNANCE AND NOMINATING COMMITTEE. THE MAYO CLINIC BOARD OF TRUSTEES GOVERNANCE AND NOMINATING COMMITTEE IS COMPRISED OF NINE OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. THIS GROUP REVIEWS AND APPROVES THE COMPENSATION AND BENEFIT PROGRAMS FOR PHYSICIANS FROM ALL CAMPUSES, AS WELL AS CERTAIN SENIOR ADMINISTRATIVE AND EXECUTIVE LEADERSHIP (INCLUDING ALL PERSONS BELIEVED TO BE DISQUALIFIED PERSONS). THIS PROCESS ESTABLISHES ACCEPTABLE RANGES FOR VARIOUS POSITIONS, LEVELS, AND SPECIALTIES. THE COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. THE SALARY AND BENEFIT PROGRAM OF THE CHIEF ADMINISTRATIVE OFFICER (CAO) WAS REVIEWED AND APPROVED BY THE PROCESS DESCRIBED BELOW FOR SENIOR ADMINISTRATIVE LEADERSHIP. THE COMPENSATION AND BENEFIT PROGRAMS FOR SENIOR ADMINISTRATIVE LEADERSHIP FOR ALL CAMPUSES, INCLUDING THE MAYO CLINIC HEALTH SYSTEM LOCATIONS, ARE REVIEWED AND APPROVED BY THE MAYO CLINIC BOARD OF TRUSTEES GOVERNANCE AND NOMINATING COMMITTEE. THE MAYO CLINIC BOARD OF TRUSTEES GOVERNANCE AND NOMINATING COMMITTEE IS COMPRISED OF NINE OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. THIS GROUP REVIEWS AND APPROVES THE COMPENSATION AND BENEFIT PROGRAMS FOR PHYSICIANS FROM ALL CAMPUSES, AS WELL AS CERTAIN SENIOR ADMINISTRATIVE AND EXECUTIVE LEADERSHIP (INCLUDING ALL PERSONS BELIEVED TO BE DISQUALIFIED PERSONS). THIS PROCESS ESTABLISHES ACCEPTABLE RANGES FOR VARIOUS POSITIONS, LEVELS, AND SPECIALTIES. THE COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FILING ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. THE FILING ORGANIZATION IS A HOSPITAL AFFILIATED WITH MAYO CLINIC. AS SUCH, MAYO CLINIC'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FILING ORGANIZATION'S FORM 990 AND WOULD BE AVAILABLE UPON REQUEST OF THE FORM 990. |
| FORM 990, PART IX, LINE 11G | I/C PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,105,838. MANAGEMENT AND GENERAL EXPENSES 107,589. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,213,427. OTHER PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 22,038,162. MANAGEMENT AND GENERAL EXPENSES 2,630,148. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 24,668,310. |
| FORM 990, PART XII, LINE 2B: | INDIVIDUAL AUDIT STATEMENTS ARE BEING PREPARED FOR THE FILING ORGANIZATION BUT WERE NOT FINALIZED AS OF THE FILING OF THIS RETURN. |
| FILING OF CERTAIN FOREIGN FORMS | DISCLOSURE STATEMENT RELATED TO FORMS 5713: FORM 5713 HAS BEEN FILED BY THE FOLLOWING MEMBERS OF THE CONTROLLED GROUP: MAYO CLINIC (EIN: 41-6011702) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH (EIN: 41-1506440) DISCLOSURE STATEMENT RELATED TO FORMS 5471: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 4 AND 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED TAXPAYER NAME: MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-1506440 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED DISCLOSURE STATEMENT RELATED TO FORMS 8865: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 8865, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS, AS A CATEGORY 2 AND 3 FILER. THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 8865 FOR THESE PARTNERSHIPS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 8865 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (39 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHARTERHOUSE INC | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411405254 | RETIREMENT LIVING CENTER | MN | 501(C)(3) | 9 | MAYO CLINIC | Yes (1) | |||||
| DESTINATION MEDICAL CENTER EDA | |||||||||||||||
| 50 SOUTH SIXTH STREET SUITE 1500 | MINNEAPOLIS | MN | 554021498 | 464893585 | ECONOMIC DEVELOPMENT | MN | 501(C)(3) | 11-I | MAYO CLINIC | Yes (1) | |||||
| GOLD CROSS AMBULANCE SERVICE | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411917516 | AMBULANCE SERVICE | MN | 501(C)(3) | 9 | MFMER | Yes (1) | |||||
| LUTHER LAKESIDE APARTMENTS INC | |||||||||||||||
| PO BOX 1510 | EAU CLAIRE | WI | 54702 | 391409024 | LOW INCOME HOUSING FOR ELDERLY | WI | 501(C)(3) | 9 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MAYO CLINIC | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 416011702 | PATIENT CARE - CLINIC | MN | 501(C)(3) | 9 | Yes (1) | N/A | |||||
| MAYO CLINIC ARIZONA | |||||||||||||||
| 13400 EAST SHEA BOULEVARD | SCOTTSDALE | AZ | 85259 | 860800150 | HOSPITAL AND CLINIC | AZ | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) | |||||||||||||||
| 4500 SAN PABLO ROAD | JACKSONVILLE | FL | 32224 | 590714831 | HOSPITAL | FL | 501(C)(3) | 3 | MAYO CLINIC JACKSONVILLE | Yes (1) | |||||
| MAYO CLINIC HOSPITAL -- ROCHESTER | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 410944601 | HOSPITAL | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MAYO CLINIC JACKSONVILLE | |||||||||||||||
| 4500 SAN PABLO ROAD | JACKSONVILLE | FL | 32224 | 593337028 | PATIENT CARE - CLINIC | FL | 501(C)(3) | 7 | MAYO CLINIC | Yes (1) | |||||
| MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411506440 | CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES | MN | 501(C)(3) | 9 | MAYO CLINIC | Yes (1) | |||||
| MAYO CLINIC STIFTUNG | |||||||||||||||
| FUNDRAISING FOUNDATION | MFMER | Yes (1) | 60486 FRANKFURT AM MAIN | FRANKFURT | GM | GM | |||||||||
| MCHS IN WAYCROSS INC | |||||||||||||||
| 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | 581667166 | HOSPITAL | GA | 501(C)(3) | 3 | MAYO CLINIC JACKSONVILLE | Yes (1) | |||||
| MCHS--ALBERT LEA AND AUSTIN | |||||||||||||||
| 1000 FIRST DRIVE NW | AUSTIN | MN | 55912 | 411404075 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--AUSTIN FOUNDATION | |||||||||||||||
| 1000 FIRST DRIVE NW | AUSTIN | MN | 55912 | 300107471 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MCHS--ALBERT LEA AND AUSTIN | Yes (1) | |||||
| MCHS--CANNON FALLS | |||||||||||||||
| 32021 COUNTY ROAD 24 BLVD | CANNON FALLS | MN | 55009 | 204156428 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--CHIPPEWA VALLEY INC | |||||||||||||||
| 1501 THOMPSON STREET | BLOOMER | WI | 54724 | 390980343 | HOSPITAL AND CLINIC | WI | 501(C)(3) | 3 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MCHS--EAU CLAIRE CLINIC INC | |||||||||||||||
| 733 W CLAIREMONT AVE PO BOX 1510 | EAU CLAIRE | WI | 54702 | 391735831 | PATIENT CARE - CLINIC | WI | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--EAU CLAIRE FOUNDATION INC | |||||||||||||||
| 733 W CLAIREMONT AVE PO BOX 1510 | EAU CLAIRE | WI | 54702 | 391633407 | GRANTMAKING FOUNDATION | WI | 501(C)(3) | 11-I | MCHS--EAU CLAIRE CLINIC INC | Yes (1) | |||||
| MCHS--EAU CLAIRE HOSPITAL INC | |||||||||||||||
| 1221 WHIPPLE STREET | EAU CLAIRE | WI | 54703 | 390813418 | HOSPITAL | WI | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--FAIRMONT | |||||||||||||||
| 800 MEDICAL CENTER DRIVE PO BOX 800 | FAIRMONT | MN | 56031 | 410760836 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (1) | |||||
| MCHS--FRANCISCAN HEALTHCARE FOUNDATION INC | |||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 391186647 | FUNDRAISING FOUNDATION | WI | 501(C)(3) | 7 | MCHS--FRANCISCAN HEALTHCARE INC | Yes (1) | |||||
| MCHS--FRANCISCAN HEALTHCARE INC | |||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 391411999 | HEALTHCARE SYSTEM PARENT | WI | 501(C)(3) | 11-I | MAYO CLINIC | Yes (1) | |||||
| MCHS--FRANCISCAN MEDICAL CENTER INC | |||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 390806374 | HOSPITAL AND CLINIC | WI | 501(C)(3) | 3 | MCHS--FRANCISCAN HEALTHCARE INC | Yes (1) | |||||
| MCHS--LAKE CITY | |||||||||||||||
| 500 WEST GRANT STREET | LAKE CITY | MN | 55041 | 411906820 | HOSPITAL | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--MANKATO | |||||||||||||||
| 1025 MARSH STREET | MANKATO | MN | 56002 | 411236756 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--MANKATO HEALTH CARE FOUNDATION | |||||||||||||||
| 1025 MARSH STREET | MANKATO | MN | 56002 | 411663357 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MCHS--MANKATO | Yes (1) | |||||
| MCHS--NEW PRAGUE | |||||||||||||||
| 301 SECOND STREET NE | NEW PRAGUE | MN | 56071 | 410723639 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (1) | |||||
| MCHS--NORTHLAND INC | |||||||||||||||
| 1222 EAST WOODLAND AVENUE | BARRON | WI | 54812 | 390920634 | HOSPITAL AND CLINIC | WI | 501(C)(3) | 3 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MCHS--OAKRIDGE INC | |||||||||||||||
| 13025 EIGHTH STREET PO BOX 70 | OSSEO | WI | 54758 | 391029430 | HOSPITAL AND CLINIC | WI | 501(C)(3) | 3 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MCHS--OWATONNA | |||||||||||||||
| 134 SOUTHVIEW ST | OWATONNA | MN | 55060 | 411862132 | PATIENT CARE - CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--RED CEDAR INC | |||||||||||||||
| 2321 STOUT ROAD | MENOMONIE | WI | 54751 | 510190875 | HOSPITAL AND CLINIC | WI | 501(C)(3) | 3 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MCHS--RED WING | |||||||||||||||
| 701 HEWITT BOULEVARD | RED WING | MN | 55066 | 411713783 | PATIENT CARE SERVICES | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--SPRINGFIELD | |||||||||||||||
| 625 NORTH JACKSON AVENUE | SPRINGFIELD | MN | 56087 | 411893827 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (1) | |||||
| MCHS--ST JAMES | |||||||||||||||
| 1101 MOULTON PARSONS DR PO BOX 460 | ST JAMES | MN | 56081 | 410797368 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (1) | |||||
| MCHS--WASECA | |||||||||||||||
| 501 NORTH STATE STREET | WASECA | MN | 56093 | 363606405 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (1) | |||||
| MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 412020392 | SUPPORT RESEARCH, PRACTICE & EDUCATION | MN | 501(C)(3) | 11-I | MAYO CLINIC | Yes (1) | |||||
| POVERELLO FOUNDATION | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411494881 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MAYO CLINIC HOSPITAL - ROCHESTER | Yes (1) | |||||
| SATILLA HEALTH FOUNDATION INC | |||||||||||||||
| 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | 582008998 | FUNDRAISING FOUNDATION | GA | 501(C)(3) | 11-III-FI | 0 | N/A | |||||
| SATILLA REGIONAL MEDICAL CENTER AUXILIARY | |||||||||||||||
| 410 DARLING AVENUE | WAYCROSS | GA | 31501 | 586066381 | PROMOTE AND COMPLEMENT HEALTH CARE | GA | 501(C)(3) | 11-I | 0 | N/A | |||||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| FRANKLIN HEATING STATION | |||||||
| 119 THIRD ST SW | ROCHESTER | MN | 55902 | 410264830 | UTILITY | MN | N/A |
| LATIGO PETROLEUM LLC | |||||||
| PO BOX 14230 | ODESSA | TX | 79768 | 364767494 | OIL & GAS EXPLORATION | DE | N/A |
| WATERSHED CAP INSTL PRTNRS III LP | |||||||
| ONE MARITIME PLAZA SUITE 1525 | SAN FRANCISCO | CA | 94111 | 462982848 | INVESTMENT ACTIVITIES | DE | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (37 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMBIENT CLINICAL ANALYTICS INC | |||||||||||||
| 221 1ST AVE SW SUITE 202 | ROCHESTER | MN | 55902 | 800928405 | SOFTWARE | DE | N/A | C | Yes (1) | ||||
| BWL HOLDINGS INC | |||||||||||||
| 1209 ORANGE STREET | WILMINGTON | DE | 19801 | 472413749 | OIL & GAS EXPLORATION | DE | N/A | C | Yes (1) | ||||
| CAVALRY CLO III LTD | |||||||||||||
| INVESTMENT ACTIVITIES | N/A | C | Yes (1) | PO BOX 1093 GT QUEENSGATE HOUSE S | GRAND CAYMAN | CJ | CJ | ||||||
| CAVALRY CLO IV LTD | |||||||||||||
| INVESTMENT ACTIVITIES | N/A | C | Yes (1) | PO BOX 1093 GT QUEENSGATE HOUSE S | GRAND CAYMAN | CJ | CJ | ||||||
| GMO GLOBAL BOND INVESTMENT FUND | |||||||||||||
| OTHER FINANCIAL INVESTMENT ACTIVITIES | N/A | Yes (1) | 78 SIR JOHN ROGERSONS QUAY | DUBLIN 2 | EI | EI | |||||||
| HEALTH TRADITION HEALTH PLAN | |||||||||||||
| 1808 EAST MAIN STREET | ONALASKA | WI | 54650 | 391545987 | MEDICAL SERVICES COMPANY | WI | N/A | C | Yes (1) | ||||
| LOBSS NETWORK SUPPORT 2002 INC | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 481276150 | ADMINISTRATIVE SERVICES | MN | N/A | C | Yes (1) | ||||
| MAYO CLINIC GBS MAURITIUS | |||||||||||||
| HEALTHCARE MANAGEMENT | N/A | C | Yes (1) | 2ND FLOOR EBENE MEWS 57 | EBENE CYBERCITY | MP | MP | ||||||
| MAYO CLINIC SUPPORT SERVICES TEXAS | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 471751102 | HEALTH SERVICES | TX | N/A | C | Yes (1) | ||||
| MAYO HOLDING COMPANY | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411578020 | HOLDING COMPANY | MN | N/A | C | Yes (1) | ||||
| MAYO INSURANCE COMPANY LTD | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | SELF INSURANCE POOL | N/A | C | Yes (1) | CJ | |||||
| MCHS--DECORAH CLINIC PHYSICIANS | |||||||||||||
| 907 MONTGOMERY STREET | DECORAH | IA | 52101 | 411711329 | PATIENT CARE - CLINIC | IA | N/A | C | Yes (1) | ||||
| MCHS--PHARMACY & HOME MEDICAL INC | |||||||||||||
| 1221 WHIPPLE STREET | EAU CLAIRE | WI | 54703 | 391528920 | PHARMACY SERVICES | WI | N/A | C | Yes (1) | ||||
| MMSI INC | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411547003 | THIRD PARTY ADMINISTRATION SERVICES | MN | N/A | C | Yes (1) | ||||
| RESOUNDANT INC | |||||||||||||
| 221 1ST AVE SW SUITE 202 | ROCHESTER | MN | 55902 | 461661978 | MANUFACTURING MEDICAL DEVICE COMPONENT | MN | N/A | C | Yes (1) | ||||
| ROCHESTER AIRPORT COMPANY | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 410506870 | AIRPORT MANAGEMENT | MN | N/A | C | Yes (1) | ||||
| SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION | |||||||||||||
| 13400 E SHEA BLVD | SCOTTSDALE | AZ | 85259 | 860870505 | COMMERCIAL PROPERTY OWNERS ASSOCIATION | AZ | N/A | C | Yes (1) | ||||
| THE STABILE BUILDING OWNERS' ASSOCIATION | |||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 208994499 | COMMERCIAL PROPERTY OWNERS ASSOCIATION | MN | N/A | C | Yes (1) | ||||
| CHARITABLE LEAD TRUST | |||||||||||||
| CHARITABLE TRUST | CA | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | ND | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | AZ | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | LA | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST (2) | |||||||||||||
| CHARITABLE TRUST | MA | N/A | T | Yes (1) | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | MO | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | AZ | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | CO | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (8) | |||||||||||||
| CHARITABLE TRUST | FL | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | LA | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | MA | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (77) | |||||||||||||
| CHARITABLE TRUST | MN | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (2) | |||||||||||||
| CHARITABLE TRUST | NC | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | TX | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | CO | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | IL | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | MI | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (64) | |||||||||||||
| CHARITABLE TRUST | MN | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (7) | |||||||||||||
| CHARITABLE TRUST | MN | N/A | T | Yes (1) | |||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | 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 | 0 | 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 | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | 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 | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH | ||
| S | $663,885 | GAAP |
| MMSI | ||
| S | $6,245,845 | GAAP |