MAYO CLINIC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- MAYO CLINIC (EIN 41-1906820)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-10
- IRS object ID
- 201503149349302565
- Schema version
- 2014v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-10T13:12:59-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411906820 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAYO CLINIC HEALTH SYSTEM-LAKE CITY | BusinessNameLine1Txt |
| 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 | 500 WEST GRANT STREET | AddressLine1Txt |
| City | LAKE CITY | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55041 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES J TARASOVITCH | PersonNm |
| Person Title | REGION CFO | PersonTitleTxt |
| Phone | 5073852646 | PhoneNum |
| Signature | 2015-11-10 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DAVID C AGERTER MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 WEST GRANT STREET | AddressLine1Txt |
| City | LAKE CITY | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55041 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $47,275,038 | 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 | 1998 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | OPERATION OF A HOSPITAL, FOUR CLINICS AND A NURSING HOME. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 335 | TotalEmployeeCnt |
| Total Volunteers | 149 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $495,412 | PYContributionsGrantsAmt |
| CY Contributions Grants | $453,408 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $40,110,493 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $45,891,970 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$17,620 | PYInvestmentIncomeAmt |
| CY Investment Income | $90,723 | CYInvestmentIncomeAmt |
| PY Other Revenue | $143,056 | PYOtherRevenueAmt |
| CY Other Revenue | $141,166 | CYOtherRevenueAmt |
| PY Total Revenue | $40,731,341 | PYTotalRevenueAmt |
| CY Total Revenue | $46,577,267 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $7,601 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $9,718 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,433,220 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,424,644 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $39,139 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $22,910,592 | PYOtherExpensesAmt |
| CY Other Expenses | $24,773,339 | CYOtherExpensesAmt |
| PY Total Expenses | $41,351,413 | PYTotalExpensesAmt |
| CY Total Expenses | $42,207,701 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$620,072 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,369,566 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,971,969 | TotalAssetsBOYAmt |
| Total Assets EOY | $34,755,493 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,683,936 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,100,894 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,288,033 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $30,654,599 | 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 | $26,100,061 | ExpenseAmt |
| Revenue | $38,664,973 | RevenueAmt |
| Desc | PATIENT SERVICES (HOSPITAL & CLINICS) - SEE SCHEDULE O:MAYO CLINIC HEALTH SYSTEM - LAKE CITY (MCHS-LAKE CITY) IS A MEMBER 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 NEARLY 70 COMMUNITIES, MAYO CLINIC HEALTH SYSTEM INCLUDES 19 OWNED HOSPITALS, FIVE 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.MCHS-LAKE CITY OWNS AND OPERATES AN 18 BED CRITICAL ACCESS HOSPITAL SERVING LAKE CITY, MINNESOTA AND SURROUNDING COMMUNITIES. DURING THE YEAR ENDED DECEMBER 31, 2014, LAKE CITY HAD 213 MEDICAL/SURGICAL ADMISSIONS, 58 OBSTETRIC ADMISSIONS, 58 DELIVERIES AND 153 SWING BED ADMISSIONS WITH AN AVERAGE DAILY CENSUS OF 8.67. IN ADDITION, THERE WERE 2,728 EMERGENCY ROOM VISITS, 349 SAME DAY SURGERIES AND ANCILLARY SERVICES INCLUDING LABORATORY, CARDIAC REHABILITATION, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, AND RADIOLOGY SERVICES. RADIOLOGY SERVICES INCLUDED MAMMOGRAPHY, CT, MRI AND ULTRASOUND.MCHS-LAKE CITY ALSO OWNS AND OPERATES FOUR CLINICS LOCATED IN ALMA, WISCONSIN AND IN LAKE CITY, PLAINVIEW AND WABASHA, MINNESOTA. THESE CLINICS ARE STAFFED BY ELEVEN FAMILY MEDICINE PHYSICIANS, A GENERAL SURGEON, TWO PHYSICIAN ASSISTANTS, AND FIVE NURSE PRACTITIONERS, INCLUDING A CERTIFIED NURSE-MIDWIFE. ON AN ANNUAL BASIS, THERE ARE APPROXIMATELY 57,260 PATIENT VISITS AMONG THE FOUR CLINIC LOCATIONS.MCHS-LAKE CITY CONTINUES TO PROVIDE A VENTILATOR PROGRAM TO ENSURE CONTINUUM OF CARE AND THE MOST APPROPRIATE PLACEMENT AND LEVEL OF CARE FOR VENTILATED AND OTHER PATIENTS REQUIRING A HIGH LEVEL OF RESPIRATORY CARE. THE ULTIMATE GOAL IS TO WEAN THE PATIENTS FROM THE VENTILATOR. MCHS-LAKE CITY HAS COMMITTED ELEVEN BEDS IN THE FACILITY FOR CARING FOR THIS KIND OF PATIENT POPULATION, ALONG WITH PROVIDING CLASSROOM AND SKILLS TRAINING FOR NURSING STAFF AND PROVIDERS.MCHS-LAKE CITY ALSO OPERATES LIFELINE (AN EASY-TO-USE PERSONAL RESPONSE SERVICE) TO ENSURE THAT OLDER ADULTS LIVING AT HOME CAN GET QUICK ASSISTANCE WHENEVER IT MAY BE NEEDED - 24 HOURS A DAY, 365 DAYS A YEAR. WHEN THE PERSONAL HELP BUTTON IS PRESSED, A MCHS-LAKE CITY MONITOR RESPONDS, ASSESSES THE SITUATION AND SUMMONS APPROPRIATE HELP. THERE WERE APPROXIMATELY 90 SUBSCRIBERS TO THE PROGRAM DURING 2014.MCHS-LAKE CITY 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 BOTH MEDICAID AND MEDICARE PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN ADDITION, SERVICES ARE PROVIDED TO PATIENTS UNDER OTHER MEANS TESTED GOVERNMENT PROGRAMS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN 2014, MCHS-LAKE CITY PROVIDED APPROXIMATELY $839,000 IN FINANCIAL ASSISTANCE (AT COST) TO PATIENTS. THE UNREIMBURSED COST OF SERVICES TO PATIENTS UNDER OTHER MEANS TESTED GOVERNMENT PROGRAMS WAS APPROXIMATELY $531,000 WHICH INCLUDES MNCARE TAX OF $408,748.LAKE CITY HAS APPROXIMATELY 149 VOLUNTEERS INCLUDING INDIVIDUALS AND SERVICE GROUPS WHO PROVIDED APPROXIMATELY 5,338 HOURS OF VOLUNTEER SERVICES DURING 2014. THEY STAFF THE INFORMATION DESK DIRECTING PATIENTS AND VISITORS TO THEIR DESTINATION AND PERFORM CLERICAL DUTIES FOR VARIOUS DEPARTMENTS IN THE MEDICAL CENTER. BASED ON THE 2014 INDEPENDENT SECTOR STATISTICS, THE APPROXIMATE VALUE OF THESE SERVICES IS $123,148.MAYO CLINIC HEALTH SYSTEM-LAKE CITY PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE OF PROVIDING PATIENT CARE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,707,679 | ExpenseAmt |
| Revenue | $7,337,771 | RevenueAmt |
| Desc | RESIDENT SERVICES (NURSING HOME) - SEE SCHEDULE OMAYO CLINIC HEALTH SYSTEM - LAKE CITY (MCHS-LAKE CITY) ALSO OWNS AND OPERATES A 90-BED NURSING HOME THAT SEEKS TO ENHANCE RESIDENT'S QUALITY OF LIFE BY HELPING INDIVIDUALS MAINTAIN THEIR HEALTH AND SELF-RELIANCE. RESIDENTS ARE PROVIDED WITH 24-HOUR NURSING CARE, A ROOM, NUTRITIONALLY WELL-BALANCED MEALS, SNACKS, HOUSEKEEPING AND LAUNDRY SERVICES, ACTIVITY PROGRAMS, AND SOCIAL SERVICES ASSISTANCE AS NEEDED OR REQUESTED. RESIDENTS ALSO HAVE ACCESS TO SPECIALIZED SERVICES SUCH AS REHABILITATION SERVICES, REGISTERED DIETICIAN SERVICES, BEAUTY AND BARBER SERVICES, TELEPHONE SERVICES AND TELEVISION/CABLE SERVICES FOR AN ADDITIONAL FEE. THE AVERAGE DAILY CENSUS FOR THE NURSING HOME IN 2014 WAS 85.52.THE NURSING HOME'S DIETARY DEPARTMENT PROVIDES MEALS ON A DAILY BASIS FOR THE LAKE CITY HOME DELIVERED MEALS PROGRAM. MEALS ARE DELIVERED BY LIONS CLUB VOLUNTEERS TO LAKE CITY RESIDENTS WHO HAVE BEEN REFERRED TO THE PROGRAM BY HEALTHCARE PROVIDERS. MCHS-LAKE CITY PROVIDES THE ADMINISTRATION FOR THE PROGRAM INCLUDING REGISTRATION, NUTRITION PLANNING, MEAL PREPARATION, AND BILLING. THIS SERVICE ALLOWS SENIOR CITIZENS AND OTHERS WITH MEDICAL NEEDS TO LIVE INDEPENDENTLY FOR LONGER THAN WOULD OTHERWISE BE POSSIBLE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $24,416 | ExpenseAmt |
| Grant | $9,718 | GrantAmt |
| Revenue | $650 | RevenueAmt |
| Desc | COMMUNITY BENEFIT - SEE SCHEDULE O:AS PART OF ITS ACTIVITIES, MAYO CLINIC HEALTH SYSTEM - LAKE CITY (MCHS-LAKE CITY) PROVIDES VARIOUS SUPPORT GROUPS AND PROGRAMS TO THE COMMUNITY AT NO CHARGE. THESE GROUPS AND CLASSES INCLUDE CARDIAC SUPPORT GROUPS INCLUDING 73 PARTICIPANTS IN CARDIAC REHAB PHASE 3 AND 125 PARTICIPANTS IN CARDIAC SUPPORT GROUP, DIABETIC EDUCATIONAL PROGRAMS, A BREAST CANCER SUPPORT GROUP, AND OUTREACH FOR CITIZENS WHERE OUTREACH NURSES CONDUCTED BLOOD PRESSURE AND BLOOD SUGAR SCREENING FOR 1,822 PERSONS, MENTORING PROGRAMS AND PRENATAL CLASSES FOR EXPECTANT PARENTS.MCHS-LAKE CITY OFFERED SPORTS PHYSICALS AT A REDUCED RATE FOR STUDENTS WHO ARE PARTICIPATING IN SPORTS THROUGH THE LOCAL SCHOOLS, A PREVENTATIVE INJURY TRAINING PROGRAM, CONCUSSION SCREENING FOR 25 STUDENTS, FREE SKIN SCREENINGS AT LOCAL WRESTLING MEETS, AND STAFF ATTENDANCE AT HOME HIGH SCHOOL FOOTBALL GAMES TO RESPOND TO EMERGENCIES. MCHS-LAKE CITY ALSO HAS A PROGRAM THAT ALLOWS LOCAL HIGH SCHOOL STUDENTS TO COME ON-SITE AND LEARN ABOUT HEALTHCARE-RELATED CAREERS AND PARTICIPATE IN JOB SHADOWING EXPERIENCES. 42 STUDENTS PARTICIPATED IN HEALTH CAREER CLASS PRESENTATIONS. ALSO DURING 2014, MCHS-LAKE CITY PROVIDED $1,000 FOR SCHOLARSHIPS TO STUDENTS PURSUING A FIELD IN HEALTH CARE AND $8,718 IN DONATIONS TO LOCAL CHARITIES OR COMMUNITY ORGANIZATIONS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $33,832,156 | 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 | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | 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 | Yes (1) | 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 | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 335 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | 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 | 0 | 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 | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| States Where Copy Of Return Is Fld | WI | 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 (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| GARTNER PHILLIP A | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| GRUBER JOHN | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KEENAN AARON | |||||||||
| DIRECTOR (1/1-9/16) | 1.00 | 40.00 | Yes (X) | $0 | $143,429 | $36,836 | |||
| MAHN DAVID | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SCHAAL MELISSA | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SOLBERG MD JEREMY J | |||||||||
| DIRECTOR | 40.00 | 0.00 | Yes (X) | $253,199 | $0 | $47,833 | |||
| SPANO MD DENNIS C | |||||||||
| VICE-CHAIR / DIRECTOR | 40.00 | 0.00 | Yes (X) | $515,463 | $0 | $57,273 | Yes (X) | ||
| WILKINSON MD JOHN M | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $244,088 | $18,065 | |||
| WITT MD THOMAS J | |||||||||
| CHAIR / CEO / DIRECTOR | 40.00 | 0.00 | Yes (X) | $456,792 | $0 | $66,580 | Yes (X) | ||
| AGERTER MD DAVID C | |||||||||
| REGION CEO | 1.00 | 40.00 | $0 | $555,112 | $18,208 | Yes (X) | |||
| GUDGELL STEPHEN F | |||||||||
| RIVER CORRIDOR CAO/TREAS(3/27-12/31) | 1.00 | 40.00 | $0 | $196,790 | $19,698 | Yes (X) | |||
| KOCH MARK B | |||||||||
| ASSISTANT SECRETARY | 1.00 | 40.00 | $0 | $395,727 | $18,025 | Yes (X) | |||
| PARKS DOUGLAS A | |||||||||
| REGION CAO | 1.00 | 40.00 | $0 | $232,013 | $50,759 | Yes (X) | |||
| STIENE SUSAN M | |||||||||
| SECRETARY | 40.00 | 0.00 | $160,222 | $0 | $46,392 | Yes (X) | |||
| TARASOVITCH JAMES J | |||||||||
| REGION CFO | 1.00 | 40.00 | $0 | $354,461 | $28,513 | Yes (X) | |||
| ADAMSON MD STEVEN C | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $334,708 | $0 | $54,094 | Yes (X) | |||
| ANDERSON DO TRENT D | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $271,211 | $0 | $31,710 | Yes (X) | |||
| JESKE MD ROBERT D | |||||||||
| PHYSICIAN | 1.00 | 40.00 | $103,017 | $163,175 | $41,502 | Yes (X) | |||
| RENELT MD JOHN A | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $393,907 | $0 | $60,466 | Yes (X) | |||
| SCHWEND DO PHILLIP P | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $263,007 | $0 | $65,913 | Yes (X) | |||
| BROWN MARK C | |||||||||
| FMR COO | 0.00 | 40.00 | $0 | $150,748 | $33,847 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,751,526 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,435,543 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $695,714 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 28 | 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 |
|---|---|---|---|---|---|
| MAYO CLINIC | |||||
| 200 1ST STREET SW | ROCHESTER | MN | 55905 | MEDICAL & SUPPORT SERVICES | $741,408 |
| CENTREX REHAB | |||||
| 1007 E 14TH ST | MINNEAPOLIS | MN | 55404 | PURCHASE SERVICES | $507,294 |
| SAINT ELIZABETH MEDICAL CENTER | |||||
| 1200 GRAND BLVD W | WABASHA | MN | 55981 | MEDICAL SERVICES | $301,608 |
| AMN HEALTHCARE INC | |||||
| FILE 56157 | LOS ANGELES | CA | 90074 | PURCHASE SERVICES | $179,340 |
| SODEXO OPERATIONS LLC | |||||
| 4880 PAYSPHERE CIRCLE | CHICAGO | IL | 60674 | MANAGEMENT FEES | $177,794 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $1,140 | MembershipDuesAmt |
| Related Organizations | $107,871 | RelatedOrganizationsAmt |
| Government Grants | $344,397 | GovernmentGrantsAmt |
| Total Contributions | $453,408 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 620000 | $38,459,753 | $38,459,753 |
| NURSING HOME REVENUE | 623110 | $7,337,771 | $7,337,771 |
| SHARED SERVICES REVENU | 561000 | $63,466 | $63,466 |
| LIFELINE | 621990 | $30,980 | $30,980 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $45,891,970 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,143 | TotalRevenueColumnAmt |
| Exclusion | $1,143 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $40,304 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $38,713 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,591 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,591 | TotalRevenueColumnAmt |
| Exclusion | $1,591 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $742,683 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $653,103 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $89,580 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $89,580 | TotalRevenueColumnAmt |
| Exclusion | $89,580 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $19,291 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $5,955 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,336 | TotalRevenueColumnAmt |
| Exclusion | $13,336 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| CAFETERIA/VENDING REVE | 722210 | $115,099 | $100,284 | $14,815 |
| MISC. REVENUE | 900099 | $9,815 | $9,815 | |
| MEDICAL RECORD/TRANSCR | 541900 | $1,325 | $1,325 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $126,239 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,577,267 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $46,003,394 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $120,465 | 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 | $8,718 | TotalAmt |
| Program Services | $8,718 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Program Services | $1,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,603,755 | TotalAmt |
| Program Services | $1,603,755 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,957 | TotalAmt |
| Program Services | $114,957 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,282,673 | TotalAmt |
| Program Services | $10,959,099 | ProgramServicesAmt |
| Management And General | $1,292,839 | ManagementAndGeneralAmt |
| Fundraising | $30,735 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,784 | TotalAmt |
| Program Services | $269,788 | ProgramServicesAmt |
| Management And General | $41,021 | ManagementAndGeneralAmt |
| Fundraising | $975 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,245,476 | TotalAmt |
| Program Services | $2,014,762 | ProgramServicesAmt |
| Management And General | $225,357 | ManagementAndGeneralAmt |
| Fundraising | $5,357 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $865,999 | TotalAmt |
| Program Services | $782,514 | ProgramServicesAmt |
| Management And General | $81,546 | ManagementAndGeneralAmt |
| Fundraising | $1,939 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,094,027 | TotalAmt |
| Program Services | $5,595,161 | ProgramServicesAmt |
| Management And General | $498,866 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,401 | TotalAmt |
| Management And General | $1,401 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203 | TotalAmt |
| Program Services | $203 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,370,280 | TotalAmt |
| Program Services | $5,087,641 | ProgramServicesAmt |
| Management And General | $5,282,639 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,240 | TotalAmt |
| Management And General | $7,240 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,899,697 | TotalAmt |
| Program Services | $1,732,539 | ProgramServicesAmt |
| Management And General | $167,025 | ManagementAndGeneralAmt |
| Fundraising | $133 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,168 | TotalAmt |
| Program Services | $110,168 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $906,143 | TotalAmt |
| Program Services | $586,295 | ProgramServicesAmt |
| Management And General | $319,848 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,381 | TotalAmt |
| Program Services | $121,115 | ProgramServicesAmt |
| Management And General | $62,266 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,857 | TotalAmt |
| Program Services | $31,857 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $806,528 | TotalAmt |
| Program Services | $791,557 | ProgramServicesAmt |
| Management And General | $14,971 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,489 | TotalAmt |
| Management And General | $191,489 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $2,511,006 | $2,511,006 |
| BAD DEBT EXPENSE | $549,286 | $549,286 |
| MEDICAID SURCHARGE | $540,621 | $540,621 |
| MN CARE TAX | $408,748 | $408,748 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,264 | TotalAmt |
| Program Services | $11,366 | ProgramServicesAmt |
| Management And General | $149,898 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,207,701 | TotalAmt |
| Program Services | $33,832,156 | ProgramServicesAmt |
| Management And General | $8,336,406 | ManagementAndGeneralAmt |
| Fundraising | $39,139 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,645 | BOYAmt |
| EOY | $99,343 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,435 | BOYAmt |
| EOY | $20,341 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,872 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,598,418 | BOYAmt |
| EOY | $7,074,944 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,167 | BOYAmt |
| EOY | $5,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $507,270 | BOYAmt |
| EOY | $543,455 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $387,178 | BOYAmt |
| EOY | $246,314 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $24,211,802 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,945,208 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,038,285 | BOYAmt |
| EOY | $11,266,594 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,974,879 | BOYAmt |
| EOY | $15,499,502 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $311,820 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,971,969 | BOYAmt |
| EOY | $34,755,493 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,928,295 | BOYAmt |
| EOY | $3,124,630 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,435 | BOYAmt |
| EOY | $20,338 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $731,206 | BOYAmt |
| EOY | $955,926 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,683,936 | BOYAmt |
| EOY | $4,100,894 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,288,033 | BOYAmt |
| EOY | $30,654,599 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,288,033 | BOYAmt |
| EOY | $30,654,599 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,971,969 | BOYAmt |
| EOY | $34,755,493 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,369,566 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$3,000 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
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 | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $203 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $203 | 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 | THE AMOUNT IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING. MAYO CLINIC HEALTH SYSTEM-LAKE CITY PROVIDES INFORMATION OR EXPRESSES ITS CONCERNS TO LEGISLATIVE BODIES AND GOVERNMENT OFFICIALS ON MATTERS DIRECTLY RELATED TO HEALTH, THE DELIVERY OF HEALTH CARE AND MEDICAL EDUCATION AND/OR RESEARCH. IN 2014, MCHS-LAKE CITY REPRESENTATIVES HAD A MEETING WITH MEMBERS OF THE LEGISLATIVE AND EXECUTIVE BRANCHES OF GOVERNMENT TO DISCUSS ISSUES RELATING TO HEALTH CARE AND HEALTH CARE REFORM. | 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 | $101,866 | OtherCostOrOtherBasisAmt |
| Book Value | $101,866 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $17,192 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $17,143,106 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,483,393 | DepreciationAmt |
| Book Value | $9,676,905 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,807,064 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,461,815 | DepreciationAmt |
| Book Value | $1,345,249 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $142,574 | OtherCostOrOtherBasisAmt |
| Book Value | $142,574 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,266,594 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MAYO POOLED INVESTMENTS | Desc |
| Book Value | $15,499,502 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $15,499,502 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $955,926 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $955,926 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | NURSING HOME RESIDENT TRUST ACCOUNT - RESIDENTS' FUNDS. |
| PART X, LINE 2: | AT DECEMBER 31, 2014 AND 2013, THE RESERVE FOR UNRECOGNIZED TAX BENEFITS WAS NOT SIGNIFICANT, AND AS A RESULT, THERE IS NO LONGER A RESERVE FOR UNRECOGNIZED TAX BENEFITS RECORDED FOR THE FILING ORGANIZATION. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SILENT AUCTION | Event1Nm |
| Gross Receipts Event1 | $6,400 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $6,400 | GrossRevenueEvent1Amt |
| Gross Receipts Total | $6,400 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $6,400 | GrossRevenueTotalEventsAmt |
| Net Income Summary | $6,400 | NetIncomeSummaryAmt |
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 | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $839,246 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $839,246 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02010 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,603,157 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,399,323 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $203,834 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00490 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,117,318 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $586,095 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $531,223 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01280 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,559,721 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,985,418 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,574,303 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03780 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,416 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $650 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,944,814 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,080,464 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,864,350 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14080 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,288 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,288 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,972,518 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,081,114 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,891,404 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14140 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,532,239 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,066,532 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,465,707 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.17920 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,220 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,220 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,430 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,430 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,718 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,718 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,368 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,368 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $549,286 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $10,429,728 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,416,940 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $12,788 | 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 - LAKE CITY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 WEST GRANT STREET | AddressLine1Txt |
| City | LAKE CITY | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55041 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.MAYOCLINICHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| State License | 20693 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| 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 - LAKE CITY | 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 |
| 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 |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://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 |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| 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 (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MAYO CLINIC HEALTH SYSTEM - LAKE CITY | PART V, SECTION B, LINE 5: INPUT WAS PROVIDED BY THE HEALTHY COMMUNITIES SUPERVISOR AND COMMUNITY HEALTH SPECIALIST OF THE PUBLIC HEALTH DIVISION OF GOODHUE COUNTY HEALTH AND HUMAN SERVICES AND THE DIRECTOR OF WABASHA COUNTY PUBLIC HEALTH. IN ADDITION, INPUT WAS RECEIVED FROM KEY INFORMANT INTERVIEWS, COUNTY-WIDE MAIL SURVEYS, LOCAL FOCUS GROUPS, AND SURVEYS COMPLETED BY THE SCHOOL DISTRICTS, AND THE CHEMICAL HEALTH INITIATIVE. |
| MAYO CLINIC HEALTH SYSTEM - LAKE CITY | PART V, SECTION B, LINE 6A: MAYO CLINIC HEALTH SYSTEM-CANNON FALLS, MAYO CLINIC HEALTH SYSTEM-LAKE CITY AND MAYO CLINIC HEALTH SYSTEM-RED WING COLLABORATED ON THE CHNA WHICH ENCOMPASSES THE COUNTIES THAT THE THREE HOSPITALS SERVE. |
| MAYO CLINIC HEALTH SYSTEM - LAKE CITY | PART V, SECTION B, LINE 11: MAYO CLINIC IS A NOT-FOR-PROFIT ORGANIZATION WITH THE 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. AS PART OF MAYO CLINIC, MAYO CLINIC HEALTH SYSTEM OFFERS A VARIETY OF HEALTH CARE OPTIONS TO THE COMMUNITIES IT SERVES, RANGING FROM PRIMARY AND SPECIALTY CARE TO MORE COMPLEX CARE AT MAYO CLINIC. THE RESIDENTS OF CANNON FALLS, LAKE CITY AND RED WING ALSO BENEFIT FROM MAYO CLINIC EDUCATION AND RESEARCH EFFORTS SO BEST PRACTICES IDENTIFIED ARE IMPLEMENTED LOCALLY TO ASSURE THE HIGHEST STANDARDS OF CARE, QUALITY AND SAFETY. ONGOING PARTNERSHIPS WITH LOCAL PUBLIC HEALTH, SENIOR SERVICE PROGRAMS, NON PROFITS AND OTHER COMMUNITY ORGANIZATIONS ARE INTEGRAL TO IMPROVING THE HEALTH AND QUALITY OF LIFE FOR AREA RESIDENTS. WITH THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND SUBSEQUENT SURVEYS, COMMUNITY MEETINGS AND INTERVIEWS, OUR CONTINUING WORK WITH OUR COMMUNITY PARTNERS HAVE NEVER BEEN MORE IMPORTANT. WE APPRECIATE THE UNIQUE PERSPECTIVES AND INSIGHTS THAT ALL COMMUNITY GROUPS CONTRIBUTE AS WE COLLECTIVELY IDENTIFY HEALTH AND SOCIAL ISSUES AND WORK TOWARD IMPROVING THE HEALTH STATUS OF OUR COMMUNITY. MAYO CLINIC HEALTH SYSTEM IN CANNON FALLS, LAKE CITY, AND RED WING (MCHS-CANNON FALLS/LAKE CITY/RED WING) COLLABORATED ON A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, IDENTIFIED COMMON NEEDS, AND DEVELOPED THE FOLLOWING JOINT IMPLEMENTATION PLANS TO ADDRESS THE NEEDS IDENTIFIED IN THE ASSESSMENT.IDENTIFIED NEED: OBESITYGOAL: INCREASE AWARENESS OF INDIVIDUAL HEALTH AND OBESITY MANAGEMENT OPTIONS FOR YOUTH AND FAMILIES.IMPLEMENTATION PLAN UPDATE:SOCIAL MEDIA STRATEGY - MCHS- CANNON FALLS/LAKE CITY/RED WING UTILIZED SOCIAL MEDIA TO PROMOTE THE MAYO MESSAGES FOR HEALTHY ACTIVITY AND NUTRITION. PINS AND POSTS THAT FOLLOW TRENDS AND HEALTH EVENTS ARE UPDATED DAILY. THE TEAM CONTINUES TO WORK ON HOW TO QUANTIFY THE EFFECT THESE HEALTHY AND POSITIVE MESSAGES HAVE ON THE REGION. SOCIAL MEDIA ALLOWS VARIOUS DEMOGRAPHIC AUDIENCES THAT INCLUDE MALES AND FEMALES AGES 18-64 TO RECEIVE EDUCATION AND ENGAGE ONLINE WITH MAYO CLINIC HEALTH SYSTEM. MCHS SOCIAL MEDIA CHANNELS INCLUDE: FACEBOOK, TWITTER, YOUTUBE, PINTEREST AND GOOGLE PLUS. EXAMPLES OF STRATEGIC SOCIAL MEDIA CAMPAIGNS INCLUDE RUNNING TIPS, HEALTHY RECIPES, HEART HEALTH TIPS, EXERCISE, AND WELLNESS INFORMATION. WRITTEN CONTENT, PHOTOS AND VIDEOS ARE INCORPORATED AS APPLICABLE IN EACH SOCIAL MEDIA CHANNEL. 5210 STRATEGY - THE 5210 PROGRAM HAS BEEN PROMOTED IN PEDIATRICS AND FAMILY PRACTICE THROUGHOUT WABASHA COUNTY BY WORKING WITH THE HEALTH DEPARTMENT'S STATE HEALTH IMPROVEMENT PROGRAM. THE 5210 PROGRAM IS A SPECIFIC PROGRAM TO REDUCE SCREEN TIME (TV, COMPUTER, IPAD AND GAMES) AND INCREASE EXERCISE AND ACTIVITY OF ELEMENTARY STUDENTS FOR ONE MONTH. BIKES WERE GIVEN AS REWARDS FOR THOSE WHO SUCCESSFULLY ELIMINATED EXCESS SCREEN TIME FROM THEIR DAY. COMMUNITY EVENT SPONSORSHIP - MCHS CANNON FALLS/LAKE CITY/RED WING PARTNERED WITH LOCAL NONPROFITS TO ENCOURAGE YOUTH ACTIVITY SUCH AS THE LAKE CITY SCHOOLS BIKE PROGRAM, CANNON FALLS BIKE EVENT, "GET READY TO RAMBLE", THE CANNON VALLEY TRAIL, AND RED WING'S "OPEN YOUR DOOR" CAMPAIGN FOR MAPS AND TRAILS. NUTRITION AND COOKING EVENTS WERE HELD AT THE FARMERS MARKET WITH THE SUSTAINABILITY COMMISSION. FREE EDUCATION AND SCREENINGS WERE GIVEN BY THE OUTREACH NURSES WHO HAD INDIVIDUAL CONTACT WITH 1,822 PERSONS. IN ORDER TO ROLE MODEL ACTIVITY, MINI FRISBEES ARE DISTRIBUTED RATHER THAN TREATS AT YOUTH EVENTS, BIKE HELMETS ARE USED AS GIVE A WAYS, COOKBOOKS ARE DISTRIBUTED AND MCHS SPONSORS HEALTHY LIVING COMMUNITY EVENTS INCLUDING BIKE RALLYS AND RUN/WALKS.IMPROVE EMPLOYEE HEALTH STRATEGY - MCHS CANNON FALLS/LAKE CITY/RED WING EMPLOYEES MODEL HEALTH STRATEGIES AND ARE INFLUENCERS IN ALL THE COMMUNITIES MCHS SERVES. EMPLOYEE HEALTH AND WELLNESS CONDUCTED A "TAKE YOUR BREAK" EXERCISE PROGRAM WITH 60 EMPLOYEES ATTENDING AND CHANGING DAILY OFFICE HABITS. WALKING MEETING TRAINING WAS HELD AT A LEADERSHIP DEVELOPMENT INSTITUTE AND EMPLOYEES ARE ENCOURAGED TO CONDUCT WALKING MEETINGS. MCHS CANNON FALLS AND LAKE CITY HAVE PATHS MAPPED IN AND AROUND THEIR FACILITIES TO ENCOURAGE WALKING BREAKS FOR ALL STAFF. IDENTIFIED NEED: ACCESSGOAL: TO SUPPORT AND PROMOTE COMMUNITY HEALTH CARE ACCESS.IMPLEMENTATION PLAN UPDATE: MCHS CANNON FALLS/LAKE CITY/RED WING PARTNERS WITH LOCAL VOLUNTEERS, COUNTY SERVICES, THE CARE FREE CLINIC BOARD OF DIRECTORS AND CARE CLINIC STAFF TO MAINTAIN THE FREE CLINIC FOR OUR SERVICE AREA. MALPRACTICE INSURANCE IS PROVIDED FOR ALL MCHS EMPLOYEES WHO VOLUNTEER AT THE CLINIC. MCHS PROVIDES $15,000 IN LAB AND RADIOLOGY SERVICES BILLED AT A MEDICARE LEVEL FOR CARE PATIENTS SO THE CARE CLINIC CAN INCREASE THE SCOPE OF SERVICES THEY PROVIDE WITHOUT ADDITIONAL FEES TO THE PATIENTS. THE CARE CLINIC IS LOCATED IN THE MCHS BUILDING THAT WAS PREVIOUSLY THE RED WING HOSPITAL EMERGENCY ROOM. THE SPACE IS PROVIDED FREE OF CHARGE. TECHNOLOGY IS PROVIDED TO CONNECT THE VOLUNTEER PROVIDERS WITH THE PATIENT RECORDS AND TEST RESULTS WHILE MAINTAINING THE HIGHEST LEVEL OF PATIENT CONFIDENTIALITY. SPECIALTY SERVICES (DIABETES, OPHTHALMOLOGY) CLINICS ARE SUPPORTED WITH TIME AND EQUIPMENT. MCHS-CANNON FALLS INVITED NONPROFIT ORGANIZATIONS TO CHOOSE ITEMS THEY NEEDED FROM THE EQUIPMENT THAT WAS NOT MOVED TO THE NEW FACILITY. THE NURSE TRIAGE LINE PROMOTES ACCESS TO SERVICES FOR COMMUNITY MEMBERS WHETHER THEY ARE CURRENT OR NON-CURRENT PATIENTS. THE TRIAGE STAFF ARE ABLE TO DIRECT INDIVIDUALS WHO CALL ASKING FOR ADVICE TO APPROPRIATE LEVELS OF SERVICE AND MANY TIMES ARE ABLE TO SAVE THEM FROM AN APPOINTMENT BY PROVIDING OVER THE COUNTER OPTIONS. LIMITED PROTOCOLS CAN BE SHARED WITH NON PATIENTS INCREASING THEIR ACCESS TO CARE. THIS SERVICE IS STILL BEING ASSESSED AND WILL BE EVALUATED IN THE 2015 CHNA IMPLEMENTATION REVIEW.IDENTIFIED NEED: MENTAL HEALTHGOAL: EDUCATE AND PROVIDE RESOURCES FOR THE COMMUNITY BY UTILIZING SOCIAL MEDIA TO EDUCATE THE COMMUNITY.IMPLEMENTATION PLAN UPDATE: DR. SOOD'S "GUIDE TO STRESS FREE LIVING" BOOK HAS HAD MULTIPLE FACEBOOK POSTS TO PROMOTE MENTAL HEALTH AND PERSONAL STRESS MANAGEMENT. A COMMUNITY COLLABORATION LED BY MCHS CANNON FALLS/LAKE CITY/RED WING AND THE RED WING SHOE FOUNDATION SUCCEEDED IN MEETING THEIR THREE ESTABLISHED GOALS - 1) COUNTY WIDE RESOURCE LISTS WERE DEVELOPED AND SHARED, 2) NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) CHAPTER WAS REINSTATED IN GOODHUE COUNTY, AND 3) THE "MAKE IT OK" ANTI STIGMA PROGRAM WAS PROMOTED TO 1,263 PERSONS THROUGH EMPLOYERS AND IN TWELVE COMMUNITY SESSIONS. MENTAL HEALTH FIRST AID TRAINING WAS HELD IN TWO LOCATIONS IN GOODHUE COUNTY AND ADDITIONAL PARTICIPANTS ATTENDED TRAINING IN A NEIGHBORING COUNTY. IN TOTAL 42 COMMUNITY MEMBERS COMPLETED THE 8 HOUR TRAINING. THE GOAL OF "EVERY HAND JOINED" IS TO HELP YOUNG PEOPLE REACH THEIR FULL POTENTIAL FROM CRADLE TO CAREER. THE PROGRAM GIVES THEM THE KNOWLEDGE AND STRENGTHS NEEDED TO SUCCEED IN THE 21ST CENTURY. "EVERY HAND JOINED" FOCUSES ON THREE AREAS WHERE EXTRA SUPPORT WILL MAKE A LONG-TERM IMPACT ON SUCCESS. IT CURRENTLY INCLUDES: KINDERGARTEN READINESS, 3RD GRADE READING SKILLS, AND MATH SCORES. IMPROVE EMPLOYEE MENTAL HEALTH: UNDER THE EMPLOYEE ASSISTANCE (EAP) PROGRAM, NEWSLETTERS AND EDUCATIONAL FLYERS ARE DISTRIBUTED TO EMPLOYEES. THE EAP STAFF ATTEND AN ANNUAL EMPLOYEE HEALTH FAIR, IN ADDITION TO, ANTI STIGMA TRAINING AND BEHAVIORAL HEALTH PROMOTIONS INCLUDING CHAIR MASSAGES AND YOGA PROGRAMS.IDENTIFIED NEED: HIGHWAY SAFETYIMPLEMENTATION PLAN UPDATE: THE CITY OF CANNON FALLS SPECIFICALLY ASSESSED THE NEED TO INCREASE SAFETY ON HIGHWAY 52. AFTER THE ASSESSMENT WAS COMPLETE, THE STATE REVEALED PLANS TO ELIMINATE ALL CROSSOVER TRAFFIC IN CANNON FALLS. THESE CHANGES WERE IMPLEMENTED AS PART OF THE HIGHWAY 52 RECONSTRUCTION DURING 2014. A COMMUNITY GROUP HAS BEEN FORMED TO LEAD DISCUSSIONS ON REOPENING ONE OF THE HIGHWAY 52 CROSSINGS. IF THIS HAPPENS, THIS SAFETY NEED WILL NEED TO BE ADDRESSED AT THAT TIME. NEEDS NOT BEING ADDRESSED WITH ADDITIONAL RESOURCES: CHEMICAL HEALTH: THIS NEED IS BEING ADDRESSED IN THE COUNTY. MCHS-CANNON FALLS AND MCHS-RED WING ARE PARTNERS WITH THE GOODHUE COUNTY CHEMICAL HEALTH INITIATIVE AND THEY ARE IN THE FINAL YEAR OF A TEN YEAR GRANT PROCESS. THIS NEED MAY RESURFACE IN THE NEXT ASSESSMENT AND WILL BE EVALUATED AT THAT TIME.TOBACCO: PROGRAMS ARE SUPPORTED IN THE COUNTY THROUGH HEALTH AND HUMAN SERVICES. MCHS-RED WING DOES HAVE A CESSATION PROGRAM AND WORKS WITH OTHER STATE AND LOCAL REDUCTION EDUCATION PROGRAMS. |
| MAYO CLINIC HEALTH SYSTEM - LAKE CITY | 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 - LAKE CITY | 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 - LAKE CITY | 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, BROCHURES ARE AVAILABLE 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 - LAKE CITY | PART V, SECTION B, LINE 22D: OUR POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 10% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE. |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| MAYO CLINIC HEALTH SYSTEM - LAKE CITY PART V, SECTION B, LINE 16A WEBSITE: | SEE PART VI |
| MAYO CLINIC HEALTH SYSTEM - LAKE CITY PART V, SECTION B, LINE 16B WEBSITE: | SEE PART VI |
| MAYO CLINIC HEALTH SYSTEM - LAKE CITY PART V, SECTION B, LINE 16C WEBSITE: | SEE PART VI |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| MCHS - LAKE CITY (CARE CENTER) | ||||
| 500 WEST GRANT STREET | LAKE CITY | MN | 55041 | NURSING HOME |
| MCHS - LAKE CITY (LAKE CITY CLINIC) | ||||
| 500 WEST GRANT STREET | LAKE CITY | MN | 55041 | CLINIC |
| MCHS - LAKE CITY (WABASHA CLINIC) | ||||
| 1202 5TH GRANT BLVD WEST | WABASHA | MN | 55981 | CLINIC |
| MCHS - LAKE CITY (PLAINVIEW CLINIC) | ||||
| 275 1ST STREET SW | PLAINVEIW | MN | 55964 | CLINIC |
| MCHS - LAKE CITY (ALMA CLINIC) | ||||
| 204 SOUTH MAIN STREET | ALMA | WI | 54610 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 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 $ 549,286. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THROUGH DONATIONS AND GRANTS TO PUBLIC, PRIVATE AND NONPROFIT ORGANIZATIONS, THE FILING ORGANIZATION ASSISTS WITH SUSTAINING AND ENHANCING THE COMMUNITIES IT SERVES. |
| PART III, LINE 2: | 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 2014 CONSOLIDATED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | 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).REASONS WHY MEDICARE SHORTFALL REPORTED ON LINE 7, IF ANY, 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: | MAYO CLINIC HEALTH SYSTEM - LAKE CITY (MCHS-LAKE CITY) EMPLOYEES THROUGHOUT THE ORGANIZATION ASSESS THE NEEDS OF LAKE CITY AND THE SURROUNDING COMMUNITIES THROUGH PERSONAL INTERACTION AND INVOLVEMENT WITH LOCAL SCHOOLS, CIVIC GROUPS AND HEALTH DEPARTMENTS, AS WELL AS THROUGH THE COLLECTION AND ANALYSIS OF FEEDBACK FROM PATIENTS AND COMMUNITY MEMBERS.MCHS-LAKE CITY EMPLOYEES ARE ALSO STRONGLY CONNECTED WITH LOCAL CIVIC GROUPS. MANY EMPLOYEES ARE ACTIVE MEMBERS OF VARIOUS LAKE CITY ORGANIZATIONS, WHILE OTHERS GIVE HEALTHCARE PRESENTATIONS TO THESE GROUPS. THIS PARTICIPATION NOT ONLY PROMOTES INVOLVEMENT IN THE COMMUNITY, BUT ALSO GIVES COMMUNITY MEMBERS A CHANCE TO ASK QUESTIONS, SHARE COMMENTS, CONCERNS OR OTHER SUGGESTIONS THEY MAY HAVE REGARDING THE MEDICAL CENTER. MCHS-LAKE CITY PROVIDES PREVENTIVE HEALTH SCREENINGS THROUGHOUT THE COMMUNITY. MCHS-LAKE CITY ALSO WORKS WITH THE WABASHA PUBLIC HEALTH ORGANIZATION TO DEVELOP RELATIONSHIPS AMONG HEALTH CARE PROVIDERS AND COMMUNITY LEADERS. THIS PARTNERSHIP PROMOTES THE ACTIVE REFERRAL OF PATIENTS TO LOCAL RESOURCES SUCH AS ACCESS TO HIGH QUALITY NUTRITIOUS FOODS, PHYSICAL ACTIVITY AND TOBACCO USE CESSATION PROGRAMS. MCHS-LAKE CITY ACTIVELY SEEKS FEEDBACK FROM PATIENTS AND COMMUNITY MEMBERS THROUGH ITS PATIENT ADVISORY COUNCIL (PAC) AND PATIENT SATISFACTION SURVEYS. THE PAC IS A GROUP OF TEN COMMUNITY MEMBERS WHO SERVE AS A MCHS-CANNON FALLS/LAKE CITY /RED WING FOCUS GROUP TO PROVIDE FEEDBACK PRIOR TO THE IMPLEMENTATION OF NEW PROGRAMS AND SERVICES, ASSIST IN THE IDENTIFICATION OF OPPORTUNITIES THAT WILL IMPROVE PATIENT AND FAMILY SATISFACTION, PROVIDE TIMELY AND DIRECT INPUT INTO MCHS-LAKE CITY SYSTEM AND PROCESS CHANGES, OFFER INPUT TO LEADERSHIP IN THE PLANNING AND EVALUATION OF SERVICES, AND SERVE AS A VITAL LINK BETWEEN MCHS-LAKE CITY AND THE COMMUNITY.MCHS-LAKE CITY STAFF IS TRAINED TO IDENTIFY PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE PROGRAMS. THE ORGANIZATION HAS PROGRAMS IN PLACE FOR FINANCIAL ASSISTANCE TO HELP THOSE WHO ARE IN NEED OF HEALTH CARE BUT HAVE NO INSURANCE OR ARE NOT ABLE TO RECEIVE OTHER FINANCIAL ASSISTANCE. AS THESE EXAMPLES OF INVOLVEMENT DEMONSTRATE, MCHS-LAKE CITY IS CLOSELY CONNECTED WITH THE COMMUNITY. IN ADDITION TO THIS, MCHS- LAKE CITY ACTIVELY SEEKS FEEDBACK FROM PATIENTS AND COMMUNITY MEMBERS THROUGH AVATAR SURVEYS. THE SURVEY IS SENT TO A CROSS SECTION OF PATIENTS TO COMPILE USEFUL FEEDBACK ON WAYS MCHS-LAKE CITY CAN IMPROVE CUSTOMER SERVICES AND DETERMINE WHETHER OR NOT THERE IS A NEED FOR NEW OR EXPANDED SERVICES. THE DATA FROM THE SURVEY IS REVIEWED AND ANALYZED BY MEMBERS OF QUALITY AND ADMINISTRATION DEPARTMENTS AS WELL AS MCHS-LAKE CITY EMERGENCY ROOM (ER)/INPATIENT SATISFACTION TEAM, A TEAM DEDICATED TO IMPROVING PATIENT SATISFACTION IN THE ER AND HOSPITAL.THROUGH THESE VARIOUS AVENUES, MCHS-LAKE CITY STAFF MEMBERS ACROSS MANY DEPARTMENTS STAY CONNECTED WITH THE COMMUNITY TO ASSESS THE HEALTHCARE NEEDS OF LAKE CITY AND SURROUNDING AREAS. |
| 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-LAKE CITY HAS LOCATIONS IN LAKE CITY, PLAINVIEW AND WABASHA, MINNESOTA, AS WELL AS IN ALMA, WISCONSIN. THE MAJORITY OF MCHS-LAKE CITY'S SERVICE AREAS INCLUDE GOODHUE AND WABASHA COUNTIES IN SOUTHEASTERN MINNESOTA AND BUFFALO COUNTY IN SOUTHWESTERN WISCONSIN. THE MAIN CAMPUS, LOCATED IN LAKE CITY, HOUSES AN 18-BED CRITICAL ACCESS HOSPITAL, A 90-BED NURSING HOME AND A HOSPITAL-BASED CLINIC WITH 37 PROVIDERS THAT SERVE LAKE CITY AND SURROUNDING COMMUNITIES. ACCORDING TO THE UNITED STATES CENSUS BUREAU, AND MINNESOTA COMPASS THE 2011 POPULATION FOR WABASHA COUNTY (WHICH COMPRISES MOST OF LAKE CITY'S SERVICE AREA) IS 21,443. A 2012 ESTIMATE REPORTS THAT THE POPULATION OF LAKE CITY IS 5,047, 20.7% OF THE POPULATION IS UNDER 18 YEARS OLD, AND 23.2% IS 65 YEARS OLD OR OLDER. THE MEDIAN HOUSEHOLD INCOME IS $47,145, AND AN ESTIMATED 5.6% OF INDIVIDUALS ARE LIVING BELOW POVERTY LEVEL. |
| PART VI, LINE 5: | THE FILING ORGANIZATION IS AN AFFILIATE OF 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 CLINIC 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 V. 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. |
| PART V, SECTION B, LINES 16A, 16B, & 16C | URL OF THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY (BROCHURE):MAYOCLINICHEALTHSYSTEM.ORG/LOCATIONS/LAKE-CITY/BILLING |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal Services | Yes (X) | PersonalServicesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | Yes (1) | 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 (17 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEENAN AARON | ||||||||||||||
| DIRECTOR (1/1-9/16) | $0 | $142,929 | $0 | $0 | $0 | $500 | $0 | $15,820 | $0 | $21,016 | $0 | $180,265 | $0 | $0 |
| SOLBERG MD JEREMY J | ||||||||||||||
| DIRECTOR | $239,301 | $0 | $0 | $0 | $13,898 | $0 | $20,482 | $0 | $27,351 | $0 | $301,032 | $0 | $0 | $0 |
| SPANO MD DENNIS C | ||||||||||||||
| VICE-CHAIR / DIRECTOR | $311,858 | $0 | $0 | $0 | $203,605 | $0 | $27,533 | $0 | $29,740 | $0 | $572,736 | $0 | $0 | $0 |
| WILKINSON MD JOHN M | ||||||||||||||
| DIRECTOR | $0 | $229,428 | $0 | $0 | $0 | $14,660 | $0 | $223 | $0 | $17,842 | $0 | $262,153 | $0 | $0 |
| WITT MD THOMAS J | ||||||||||||||
| CHAIR / CEO / DIRECTOR | $408,368 | $0 | $0 | $0 | $48,424 | $0 | $44,943 | $0 | $21,637 | $0 | $523,372 | $0 | $0 | $0 |
| AGERTER MD DAVID C | ||||||||||||||
| REGION CEO | $0 | $499,015 | $0 | $0 | $0 | $56,097 | $0 | $675 | $0 | $17,533 | $0 | $573,320 | $0 | $0 |
| GUDGELL STEPHEN F | ||||||||||||||
| RIVER CORRIDOR CAO/TREAS(3/27-12/31) | $0 | $195,549 | $0 | $0 | $0 | $1,241 | $0 | $311 | $0 | $19,387 | $0 | $216,488 | $0 | $0 |
| KOCH MARK B | ||||||||||||||
| ASSISTANT SECRETARY | $0 | $378,314 | $0 | $0 | $0 | $17,413 | $0 | $533 | $0 | $17,492 | $0 | $413,752 | $0 | $0 |
| PARKS DOUGLAS A | ||||||||||||||
| REGION CAO | $0 | $230,653 | $0 | $0 | $0 | $1,360 | $0 | $24,478 | $0 | $26,281 | $0 | $282,772 | $0 | $0 |
| STIENE SUSAN M | ||||||||||||||
| SECRETARY | $156,724 | $0 | $0 | $0 | $3,498 | $0 | $27,074 | $0 | $19,318 | $0 | $206,614 | $0 | $0 | $0 |
| TARASOVITCH JAMES J | ||||||||||||||
| REGION CFO | $0 | $293,754 | $0 | $0 | $0 | $60,707 | $0 | $10,400 | $0 | $18,113 | $0 | $382,974 | $0 | $0 |
| ADAMSON MD STEVEN C | ||||||||||||||
| PHYSICIAN | $268,298 | $0 | $0 | $0 | $66,410 | $0 | $33,637 | $0 | $20,457 | $0 | $388,802 | $0 | $0 | $0 |
| ANDERSON DO TRENT D | ||||||||||||||
| PHYSICIAN | $244,884 | $0 | $25,000 | $0 | $1,327 | $0 | $3,440 | $0 | $28,270 | $0 | $302,921 | $0 | $0 | $0 |
| JESKE MD ROBERT D | ||||||||||||||
| PHYSICIAN | $102,733 | $118,830 | $0 | $44,000 | $284 | $345 | $0 | $11,797 | $12,276 | $17,429 | $115,293 | $192,401 | $0 | $0 |
| RENELT MD JOHN A | ||||||||||||||
| PHYSICIAN | $238,681 | $0 | $0 | $0 | $155,226 | $0 | $28,511 | $0 | $31,955 | $0 | $454,373 | $0 | $0 | $0 |
| SCHWEND DO PHILLIP P | ||||||||||||||
| PHYSICIAN | $228,014 | $0 | $0 | $0 | $34,993 | $0 | $39,236 | $0 | $26,677 | $0 | $328,920 | $0 | $0 | $0 |
| BROWN MARK C | ||||||||||||||
| FMR COO | $0 | $150,723 | $0 | $0 | $0 | $25 | $0 | $4,734 | $0 | $29,113 | $0 | $184,595 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | THE PERSONAL SERVICES THAT WERE PROVIDED ARE INCOME TAX PREPARATION SERVICES THAT, IN ACCORDANCE WITH MAYO POLICY, ARE AVAILABLE TO MAYO CLINIC VOTING/CONSULTING STAFF. SEVERAL OF THE CURRENT AND FORMER OFFICERS, DIRECTORS, AND KEY EMPLOYEES LISTED ON THIS RETURN RECEIVED THIS SERVICE, WHICH WAS TREATED AS TAXABLE COMPENSATION TO THE INDIVIDUALS. |
| 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 4B-C | 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). ADAMSON M.D., STEVEN C. $11,647 AGERTER M.D., DAVID C. $49,966 KOCH, MARK B. $14,770 RENELT M.D., JOHN A. $ 5,237 SPANO M.D., DENNIS C. $42,555 WITT M.D., THOMAS J. $38,983 UNDER MAYO CLINIC'S ROYALTY SHARING POLICY, INVENTORS, INCLUDING LISTED PERSONS, ARE ENTITLED TO SHARE IN A PORTION OF ROYALTIES RECEIVED BY MAYO INCLUDING INSTANCES WHERE SUCH ROYALTIES ARE IN THE FORM OF EQUITY-BASED INSTRUMENTS SUCH AS STOCK, WARRANTS, OR PARTNERSHIP INTERESTS. |
| 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 | RENELT MD JOHN A | PersonNm |
| Relationship With Org | EMPLOYEE | RelationshipWithOrgTxt |
| Loan Purpose | SIGNING BONUS | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $50,000 | OriginalPrincipalAmt |
| Balance Due | $5,000 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $5,000 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| LAURA S MARQUARDT | |||
| EMPLOYMENT | $64,309 | COMPENSATION PAID TO DAUGHTER OF BOARD OFFICER, SUSAN M. STIENE | 0 |
| LISA J GRUBER | |||
| EMPLOYMENT | $38,793 | COMPENSATION PAID TO SPOUSE OF BOARD MEMBER, JOHN GRUBER | 0 |
| MAUREEN T SULLIVAN-SPANO | |||
| EMPLOYMENT | $11,856 | COMPENSATION PAID TO SPOUSE OF BOARD OFFICER/MEMBER, DENNIS C. SPANO, M.D. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE FOLLOWING INDIVIDUAL IS EMPLOYED BY A RELATED ORGANIZATION: JESKE M.D., ROBERT D. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: KOCH, MARK B. TARASOVITCH, JAMES J. THE FOLLOWING INDIVIDUAL IS EMPLOYED BY A RELATED ORGANIZATION: TARASOVITCH, JAMES J. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL WHO IS ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: KOCH, MARK B. THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: KEENAN, AARON. WILKINSON M.D., JOHN M. PARKS, DOUGLAS A. GUDGELL, STEPHEN F. AGERTER M.D., DAVID C. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL WHO IS ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: KOCH, MARK B. |
| 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 CORPORATE MEMBER IS MAYO CLINIC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE CORPORATE MEMBER ELECTS THE GOVERNING BODY. ONE MEMBER IS ELECTED FROM A SLATE OF NOMINEES PROVIDED BY THE CITY COUNCIL OF LAKE CITY. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS DEBT, AMENDMENT OF THE BYLAWS, MERGERS, AND NEW SERVICES. AMENDMENTS OF THE ARTICLES OF INCORPORATION OR BYLAWS MUST BE APPROVED BY THE SOLE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 8B | THE FILING ORGANIZATION HAS A PHYSICIAN COMPENSATION COMMITTEE, A DELEGATED COMMITTEE OF THE BOARD, THAT MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS. THE COMMITTEE HAS NO AUTHORITY TO ACT ON BEHALF OF THE BOARD, THEREFORE, THERE IS NO DOCUMENTATION FOR PART VI, SECTION A, LINE 8B. |
| 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 REGION CHIEF FINANCIAL OFFICER AND FINANCE DIRECTOR, ALONG WITH SITE 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 SALARIES AND BENEFIT PROGRAMS OF THE CHIEF EXECUTIVE OFFICER (CEO) AND THE CHIEF ADMINISTRATIVE OFFICER (CAO) WERE 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 2,605,138. MANAGEMENT AND GENERAL EXPENSES 5,282,639. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,887,777. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,482,503. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,482,503. |
| FORM 990, PART XI, LINE 9: | RELIEVE CURRENT AND LONG TERM OUTSTANDING PLEDGE RECEIVABLES -3,000. |
| 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) MAYO CLINIC ARIZONA (EIN: 86-0800150) MAYO CLINIC JACKSONVILLE (EIN: 59-3337028) 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 (42 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLOOMER LAKEVIEW INC | |||||||||||||||
| 2110 DUNCAN ROAD | BLOOMER | WI | 54724 | 391450617 | LOW INCOME HOUSING | WI | 501(C)(3) | 7 | MCHS--CHIPPEWA VALLEY INC | Yes (1) | |||||
| 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 KLINIK 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 | 0 | |||||
| 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 | 0 | |||||
| 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 FOUNDATION-SPARTA INC | |||||||||||||||
| 310 WEST MAIN STREET | SPARTA | WI | 54656 | 391423234 | FUNDRAISING FOUNDATION | WI | 501(C)(3) | 9 | 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--HOME HEALTH & HOSPICE INC | |||||||||||||||
| PO BOX 2060 | EAU CLAIRE | WI | 54702 | 391491516 | HOME HEALTH AND HOSPICE CARE | WI | 501(C)(3) | 9 | MCHS--EAU CLAIRE HOSPITAL 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 | MAYO CLINIC | 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--ST JAMES HEALTH CARE FOUNDATION | |||||||||||||||
| 1101 MOULTON PARSONS DR PO BOX 460 | ST JAMES | MN | 56081 | 411444129 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MCHS--ST JAMES | Yes (1) | |||||
| MCHS--SUPPORTIVE HOMECARE INC | |||||||||||||||
| PO BOX 2060 | EAU CLAIRE | WI | 54702 | 391686673 | HOME HEALTH CARE | WI | 501(C)(3) | 9 | MCHS--EAU CLAIRE HOSPITAL INC | 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) | |||||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 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 |
| PHYSICIAN SOFTWARE SYSTEMS LLC | |||||||
| 3333 WARRENVILLE ROAD SUITE 200 | LISLE | IL | 60532 | 453414836 | HEALTHCARE RELATED SOFTWARE | IL | 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 (40 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BWL HOLDINGS INC | |||||||||||||
| 1209 ORANGE STREET | WILMINGTON | DE | 19801 | 472413749 | OIL & GAS EXPLORATION | DE | N/A | C | Yes (1) | ||||
| AMBIENT CLINICAL ANALYTICS INC | |||||||||||||
| 221 1ST AVE SW SUITE 202 | ROCHESTER | MN | 55902 | 800928405 | SOFTWARE | 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 | |||||||||||||
| 21 FIRST STREET SW | ROCHESTER | MN | 55905 | 411547003 | THIRD PARTY ADMINISTRATION SERVICES | MN | N/A | C | Yes (1) | ||||
| RESOUNDANT INC | |||||||||||||
| 221 1ST AVE SW | ROCHESTER | MN | 55902 | 461661978 | MANUFACTURING MEDICAL DEVICE COMPONENT | MN | N/A | C | Yes (1) | ||||
| ROCHESTER AIRPORT COMPANY | |||||||||||||
| ROUTE 2 | ROCHESTER | MN | 55902 | 410506870 | AIRPORT MANAGEMENT | MN | N/A | C | Yes (1) | ||||
| SATILLA HEALTHNET INC | |||||||||||||
| 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | 582151076 | HEALTH SERVICES | GA | 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 (9) | |||||||||||||
| CHARITABLE TRUST | FL | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | LA | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST (73) | |||||||||||||
| CHARITABLE TRUST | MN | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | NC | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | NM | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | NV | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | NY | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | TX | N/A | T | Yes (1) | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | WI | 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 (70) | |||||||||||||
| 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 | Yes (1) | 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 | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH | ||
| P | $16,462,192 | GAAP |
| MCHS-ALBERT LEA AND AUSTIN | ||
| P | $1,688,451 | GAAP |
| MCHS-CANNON FALLS | ||
| S | $276,635 | GAAP |
| MCHS-RED WING | ||
| R | $1,056,847 | GAAP |
| MMSI INC | ||
| R | $2,982,435 | GAAP |
| MMSI INC | ||
| S | $2,324,276 | GAAP |