2015-11-04T11:22:02-06:00 2014-12-31 990 2014-01-01 411404075 MAYO CLINIC HEALTH SYSTEM-ALBERT LEA AND AUSTIN MAYO 5075381297 1000 FIRST DRIVE NW AUSTIN MN 55912 JAMES J TARASOVITCH REGION CFO 5073852646 2015-11-04 2014 2016-04-25 22:37:26Z DAVID C AGERTER MD 1000 FIRST DRIVE NW AUSTIN MN 55912 287172851 0 5983 X WWW.MAYOCLINICHEALTHSYSTEM.ORG X 1981 MN HOSPITALS AND CLINICS 12 5 2393 227 0 0 3261039 3974230 267168874 275612472 6558116 5888073 1343385 1348594 278331414 286823369 261061 251635 0 0 174853738 181428102 0 0 116218 95608039 95413359 270722838 277093096 7608576 9730273 332660841 350759424 28337642 33688706 304323199 317070718 X 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. 0 0 240687680 276732997 PATIENT CARE (SEE SCHEDULE O)PATIENT CARE: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 EFFORTSMAYO CLINIC HEALTH SYSTEM-ALBERT LEA AND AUSTIN (MCHS-AL/AU) IS A MINNESOTA NON-PROFIT CORPORATION, TAX EXEMPT AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. TO JUSTIFY THIS TAX EXEMPT STATUS, MCHS-AL/AU PROVIDES SCHOLARSHIPS, CHARITY CARE, INTERPRETING AND EDUCATIONAL SERVICES, AND VARIOUS OTHER COMMUNITY BENEFITS. MCHS-AL/AU PROVIDES PRIMARY CARE NEEDS, INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, OB/GYN, PEDIATRICS AND GENERAL SURGERY. IN ADDITION, MCHS-AL/AU ALSO PROVIDES SPECIALTY CARE IN CARDIOLOGY, DERMATOLOGY, NEUROLOGY, ONCOLOGY, OPHTHALMOLOGY, OPTOMETRY, OCCUPATIONAL HEALTH, PHYSICAL MEDICINE & REHAB, PSYCHIATRY, RHEUMATOLOGY, AUDIOLOGY, ALLERGY, ORTHOPEDICS, ENT, PSYCHOLOGY, PODIATRY, PHYSICAL THERAPY, WOUND CARE, UROLOGY, AND PLASTIC SURGERY. IN 2014, MCHS-AL/AU HAD 313,010 CLINIC VISITS. MCHS-AL/AU OPERATES REGIONAL CLINICS IN ADAMS, ALDEN, BLOOMING PRAIRIE, KIESTER, LEROY, NEW RICHLAND, AND WELLS, MINNESOTA AND LAKE MILLS, IOWA.DURING 2014, HOSPITAL INPATIENT DAYS TOTALED 16,374 WITH 1,633 ADDITIONAL DAYS FOR NEWBORN CARE. AS PART OF THE MAYO CLINIC HEALTH SYSTEM, MCHS-AL/AU ACCESSES EMERGENCY MEDICAL HELICOPTER SERVICE THROUGHOUT SOUTHERN MINNESOTA AND NORTHERN IOWA AND RECEIVES AMBULANCE SERVICES FROM GOLD CROSS. THE HELICOPTER PROVIDES RAPID PATIENT TRANSPORT TO THE APPROPRIATE HEALTH CARE FACILITY ALONG WITH DELIVERING HIGH-LEVEL CRITICAL CARE.FOUNTAIN CENTERS IS A MCHS-AL/AU PROGRAM FOR SUBSTANCE ABUSE AND ADDICTION; ITS MAIN CAMPUS IN ALBERT LEA OFFERS RESIDENTIAL AND OUTPATIENT TREATMENT, SUPPORT AND AFTERCARE PROGRAMS. CURRENTLY, FOUNTAIN CENTERS ALSO OFFERS OUTPATIENT PROGRAMS IN AUSTIN, FAIRMONT, FARIBAULT, MANKATO, OWATONNA, ROCHESTER AND WASECA AND REACHES FAR OUTSIDE OF MCHS-AL/AU SERVICE AREA TO MEET CHEMICAL DEPENDENCY TREATMENT NEEDS IN SOUTHERN MINNESOTA.MCHS-AL/AU OPERATES ON A NONDISCRIMINATORY BASIS REGARDLESS OF RACE, COLOR, SEX, RELIGION OR NATIONAL ORIGIN.MCHS-AL/AU PROVIDES A VARIETY OF FINANCIAL ASSISTANCE OPTIONS TO PATIENTS WHO MEET ESTABLISHED CRITERIA. ITS ALMCARE PROGRAM ALLOWS PATIENTS WHO MEET FINANCIAL GUIDELINES TO ENROLL ANNUALLY TO RECEIVE CARE DISCOUNTS FROM 10% TO 100%, WITH A $10 CO-PAY FOR PRESCRIPTIONS. SERVICES ARE ALSO PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. THE COST OF CHARITY CARE PROVIDED DURING 2014 WAS APPROXIMATELY $4,829,000. THE COST OF UNCOMPENSATED MEDICAID FOR 2014 WAS APPROXIMATELY $7,535,000. THIS AMOUNT INCLUDES THE MEDICAID SURCHARGE OF $995,472 AND $3,568,122 PAID TO MINNESOTA CARE (A PROGRAM THAT PROVIDES HEALTH CARE FOR LOW INCOME POPULATIONS). THE UNREIMBURSED COST OF MEDICARE WAS APPROXIMATELY $9,892,000.MCHS-AL/AU ALSO LEASES SPACE AND PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE OF PROVIDING PATIENT CARE. 538147 231140 89919 COMMUNITY SUPPORT (SEE SCHEDULE 0):COMMUNITY SUPPORT: MCHS-AL/AU IS AN ACTIVE MEMBER OF THE COMMUNITY, SUPPORTING SUCH COMMUNITY SERVICES AS SENIOR RESOURCES, FREEBORN COUNTY FAMILY SERVICES COLLABORATIVE, RIVERLAND COMMUNITY COLLEGE, UNITED WAY, YMCA, AREA FOOD SHELVES, NUMEROUS YOUTH ACTIVITIES, COMMUNITY DEVELOPMENT PROJECTS AND SEVERAL OTHER HEALTH-RELATED ORGANIZATIONS.IN 2014, MCHS-AL/AU PREPARED 27,372 MEALS FOR MEALS ON WHEELS, AN ORGANIZATION THAT DISTRIBUTES MEALS TO ELDERLY RESIDENTS IN THE COMMUNITIES OF ALBERT LEA AND AUSTIN. THERE ARE NUMEROUS HEALTH AND WELLNESS EDUCATION PROGRAMS, CLASSES AND SUPPORT GROUPS PROVIDED TO THE COMMUNITY THROUGHOUT THE YEAR. THESE CLASSES/SUPPORT GROUPS INCLUDE CHILDBIRTH EDUCATION, PRENATAL BREASTFEEDING EDUCATION CLASSES, BEREAVEMENT EDUCATION SUPPORT SERIES, CANCER SUPPORT GROUP, DIABETES SUPPORT GROUP, OSTOMY SUPPORT GROUP, CHEMICAL DEPENDENCY RELAPSE SUPPORT GROUP, TOBACCO CESSATION SERVICES, SPORTS SCREENINGS, INDIVIDUAL SPORTS CONDITIONING AND SPORTS INJURY EVALUATIONS, ALL AT NO CHARGE.MCHS-AL/AU'S PATIENT EDUCATION CENTER PROVIDES FREE BLOOD PRESSURE CHECKS AND HEALTH RESOURCES FOR THE COMMUNITY. 1,570 BLOOD PRESSURE CHECKS WERE PROVIDED IN 2014. LOCATED WITHIN THE FRONT CORRIDOR, THE CENTER'S LIBRARY AREA INCLUDES EASY ACCESS FOR COMMUNITY MEMBERS TO HEALTH EDUCATION AND WELLNESS INFORMATION VIA STAFF, BROCHURES, DVDS, AND USE OF FOUR PUBLIC COMPUTERS. IN 2014, 3,800 PEOPLE WERE ASSISTED WITH PATIENT EDUCATION SERVICES.ALSO LOCATED IN THE PATIENT EDUCATION CENTER IS MCHS-AL/AU'S PATIENT ADVOCATE. SHE IS A CERTIFIED SENIOR HEALTH INSURANCE PROGRAM VOLUNTEER WHO FACILITATES MEDICATION ASSISTANCE FOR THOSE UNABLE TO AFFORD MEDICATION PRESCRIBED. SHE ALSO ASSISTS MEDICARE PARTICIPANTS ENROLLING IN THE PART D PLAN. EXPLAINING INSURANCE AND CLARIFYING INSURANCE ISSUES ARE ALSO OFFERED THROUGH THE PATIENT ADVOCATE. WITH THE DEVELOPMENT OF ALMCARE, SHE WORKS CLOSELY WITH THE FINANCE DEPARTMENT IN EDUCATING AND FOLLOWING UP WITH UNINSURED OR UNDERINSURED PATIENTS THAT ARE ACCEPTED INTO THIS PROGRAM.FREE EDUCATION PROGRAMS INCLUDE: - 5 HEALTH EDUCATION PROGRAMS - 52 HEALTH TALK RADIO PROGRAMS - 3 HEALTH SYMPOSIUMS MCHS-AL/AU PROVIDES FREE HEALTH ASSESSMENTS AND SCREENINGS, COUNSELING SERVICES, FREE INTERPRETING SERVICES, AND SPACE FOR COMMUNITY MEETINGS AND SUPPORT GROUPS. MCHS-AL/AU HAS A HOME HEALTH PROGRAM IN WHICH PRIMARILY ELDERLY PATIENTS WITH CIRCULATORY, RESPIRATORY AND OTHER HEALTH PROBLEMS ARE PROVIDED ASSISTANCE WITH PERSONAL CARES AND ACTIVITIES OF DAILY LIVING. DURING 2014, THE HOME HEALTH PROGRAM SERVED 279 PATIENTS.MCHS-AL/AU ALSO PROVIDES A HOSPICE FOR THE FAMILIES OF TERMINAL PATIENTS. IN 2014, 401 FAMILIES WERE SERVICED BY THIS HOSPICE.DURING 2014, MCHS-AL/AU PROVIDED FREE SPORTS PHYSICALS TO 457 AREA STUDENT ATHLETES. MCHS-AL/AU ALSO BENEFITS FROM COMMUNITY VOLUNTEERS IN ITS AUXILIARY, HOSPICE AND CHEMICAL DEPENDENCY PROGRAMS, AND AS MOVERS AT THE FRONT INFORMATION DESK. DURING 2014, VOLUNTEERS DONATED APPROXIMATELY 28,346 HOURS TO THE MEDICAL CENTER. THE VALUE OF THIS DONATED TIME IS APPROXIMATELY $653,900 BASED ON THE INDEPENDENT SECTORS AVERAGE ESTIMATED VALUE OF SUCH SERVICES. THESE SERVICE HOURS WERE PRIMARILY SPENT ORGANIZING AND MANAGING ACTIVITIES FOR THE BENEFIT OF THE MEDICAL CENTER'S PATIENTS, PATIENTS' FAMILIES, VISITORS, AND STAFF.DURING 2014, MCHS-AL/AU MADE CASH AND EQUIPMENT DONATIONS TOTALING OVER $374,000 TO VARIOUS CHARITABLE AND COMMUNITY ORGANIZATIONS. ITS COMMUNITY INVOLVEMENT PROGRAM ALLOWS STAFF TO VOLUNTEER EIGHT HOURS ANNUALLY DURING WORK TIME. IN 2014, 70 MCHS-AL/AU VOLUNTEERS PROVIDED 389 HOURS OF SERVICES TO ENDORSED COMMUNITY PROGRAMS AND PROJECTS. THE VALUE OF THIS DONATED TIME IS APPROXIMATELY $18,433. 481939 840 RESEARCH (SEE SCHEDULE O):RESEARCH:MCHS-AL/AU STAFF WORK WITH MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM PHYSICIAN INVESTIGATORS TO COORDINATE CLINICAL RESEARCH STUDIES WITH A CMS GRANT. IN 2014, MCHS-AL/AU PARTICIPATED IN A COMPASS GRANT TO PROVIDE CARE COORDINATION DESIGNED TO IMPROVE THE HEALTH AND WELL BEING OF PATIENTS DIAGNOSED WITH BOTH DEPRESSION AND A CHRONIC DISEASE IN COMMUNITIES THEY SERVE. 382040 20495 1200 HEALTH PROFESSIONS EDUCATION (SCHEDULE O):HEALTH PROFESSIONS EDUCATION:MCHS-AL/AU SPONSORS A SCHOLARSHIP PROGRAM FOR HIGH SCHOOL SENIORS AND NON-TRADITIONAL STUDENTS FROM THE MCHS-AL/AU SERVICE AREA WHO ARE ENTERING THE HEALTHCARE FIELD. IN THE YEAR ENDING DECEMBER 31, 2014, 25 SCHOLARSHIPS WERE AWARDED TOTALING $20,495. IN ADDITION, MCHS-AL/AU PROVIDES MEETING SPACE AND SPONSORS VARIOUS "ON-SITE" EDUCATION PROGRAMS INCLUDING SHADOWING, PRECEPTORSHIPS, AND INTERNSHIPS. THE ESTIMATED COST OF SUPERVISION AND SPACE FOR THESE PROGRAMS IS $365,500. 382040 20495 1200 242089806 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 110 0 1 2393 1 0 0 0 0 0 0 0 0 0 0 X 12 5 1 1 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 0 1 1 MN X CORPORATE TAX UNIT 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 CIOTA MD MARK R CEO/CHAIR/DIRECTOR 40.00 0.00 X X 758637 0 45304 CRANDALL DAVID TREASURER/DIRECTOR 1.00 0.00 X X 0 0 0 CRUZ-LARES LINDA A SECRETARY/DIRECTOR 1.00 0.00 X X 0 0 0 CUNNINGHAM MD PETER L DIRECTOR 40.00 0.00 X 96716 0 27428 FUNK MICHAEL S DIRECTOR 1.00 0.00 X 0 0 0 GABRIELSON SHARON R DIRECTOR 1.00 40.00 X 0 237017 46495 MILLER MD ROBERT C VICE CHAIR/DIRECTOR 1.00 40.00 X X 0 552626 59411 MONSON REV GLENN L DIRECTOR 1.00 0.00 X 0 0 0 PARKS DOUGLAS A REGION CAO/DIRECTOR 1.00 40.00 X X 0 232013 50759 POTACH BRENDA DIRECTOR 1.00 0.00 X 0 0 0 SCHULZ MD JOHN M DIRECTOR 40.00 0.00 X 538679 0 47215 YTTERBERG MD KAREN L DIRECTOR 1.00 40.00 X 0 203442 41093 AGERTER MD DAVID C REGION CEO 1.00 40.00 X 0 555112 18208 DANKERT SHERI S SITE CFO 40.00 0.00 X 161352 0 37872 KOCH MARK B ASSISTANT SECRETARY 1.00 40.00 X 0 395727 18025 TARASOVITCH JAMES J REGION CFO 1.00 40.00 X 0 354461 28513 WALDHOFF STEPHEN C CAO 1.00 40.00 X 0 283236 18786 ANGSTMAN MD GREGORY L PHYSICIAN 40.00 0.00 X 292588 0 37854 BARNES MD DARRYL E MEDICAL STAFF PRESIDENT/PHYSICIAN 40.00 0.00 X 404072 0 44220 COLLIER DPM ROBERT L MEDICAL STAFF VP/PHYSICIAN 40.00 0.00 X 331679 0 46259 COPPES MD JOHN B MEDICAL DIRECTOR/PHYSICIAN 40.00 0.00 X 468248 0 38134 ECKSTROM MD MICHAEL T CHAIR OF SURGERY/PHYSICIAN 40.00 0.00 X 1048270 0 45172 GOINS MD JENNIFER L PHYSICIAN 40.00 0.00 X 420843 0 50484 GRZYBOWSKI MD JOHN A CHAIR OF PRIMARY CARE/PHYSICIAN 40.00 0.00 X 367617 0 42993 KATTEL MD SHARMA B PHYSICIAN 40.00 0.00 X 348972 0 32913 KLEIS DO KEITH R PHYSICIAN 40.00 0.00 X 366953 0 45738 LARSON VIRGINIA OPERATIONS ADMINISTRATOR 40.00 0.00 X 171004 0 35971 LOMBARDI MD JOSEPH M PHYSICIAN 40.00 0.00 X 286676 0 28215 NORDENG RODNEY L OPERATIONS ADMINISTRATOR 40.00 0.00 X 163881 0 38072 SCHULZ MD JODI L PHYSICIAN 40.00 0.00 X 543743 0 43831 SMITH MD A DON PHYSICIAN 40.00 0.00 X 358380 0 43924 STOLTENBERG MD HEIDI G PHYSICIAN 40.00 0.00 X 296650 0 38373 ULRICH MD MICHAEL D PHYSICIAN 40.00 0.00 X 381404 0 48995 YOUNG DO NATHAN P CHAIR OF MED SPECIALTIES/PHYSICIAN 40.00 0.00 X 239582 61341 31407 BECKENBAUGH DO JEFFREY P PHYSICIAN 40.00 0.00 X 711050 0 47944 BOYCE MD CORY A PHYSICIAN 40.00 0.00 X 645654 0 35876 ENGMAN MD STEVEN J PHYSICIAN 40.00 0.00 X 655378 0 47174 SKORIN DO LEONID PHYSICIAN 40.00 0.00 X 917918 0 37148 WEAVER MD CHAD H PHYSICIAN 40.00 0.00 X 678307 0 20314 KRITZER TAMMY L FORMER KEY EMPLOYEE 40.00 0.00 X 149996 0 35980 11804249 2874975 1356100 203 1 1 0 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 PATIENT/LAB/ADMIN SERVICES 2847013 AMPHION MEDICAL SOLUTIONS 8301 EXCELSIOR DRIVE MADISON WI 53717 TRANSCRIPTION SERVICES 2340036 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 PROFESSIONAL SERVICES 896453 MEDICAL DOCTOR ASSOCIATES PO BOX 277185 ATLANTA GA 30384 PROFESSIONAL SERVICES 735050 MASON CITY CLINIC PC 250 SOUTH CRESENT DR MASON CITY IA 50401 PROFESSIONAL SERVICES 693211 23 47649 1920 9926 1032151 2853400 29184 3974230 NET PATIENT REVENUE 620000 256330271 256330271 SHARED SERVICES 561000 18967298 18967298 RENT FROM AFFILIATES 531120 222944 222944 MEALS ON WHEELS 624210 89919 89919 EDUCATION REVENUE 611600 1200 1200 840 840 275612472 5971646 5971646 18277 31061 -12784 -12784 -12784 120474 204047 -83573 -83573 -83573 7874 9926 19322 -11448 -11448 4229 800 3429 3429 125377 94252 31125 31125 CAFETERIA/VENDING 722210 1102818 1102818 MEDICAL RECORD/TRANSCR 541900 89278 89278 MISC CONSULTING 541610 81642 81642 64534 20388 44146 1338272 286823369 276824956 0 6024183 231140 231140 20495 20495 8890766 7800249 1090517 667797 400047 267750 132794815 116387685 16331934 75196 7849204 6980638 864171 4395 22456712 21474619 969852 12241 8768808 7689330 1074815 4663 187577 438 187139 1653 1653 2481 2481 24634318 15606238 9026520 1560 575836 23810 544041 7985 9835930 7433492 2396098 6340 2488125 1985598 502527 4648012 4362986 285026 1273333 841409 428272 3652 748957 709328 39629 102996 102996 10857320 10167867 689453 1514681 1514681 MEDICAL SUPPLIES 29803971 29803971 MN CARE TAX 3568122 3568122 BAD DEBT EXPENSE 3190228 3190228 MEDICAID SURCHARGE 995472 995472 984347 797314 186847 186 277093096 242089806 34887072 116218 5445 8787 8004 160 42389275 44245858 4435445 4723896 2593036 1180307 216825154 107852139 113023068 108973015 151681147 173459885 20000 0 18505421 18167516 332660841 350759424 18323227 22040656 69750 845397 13826 12959 9930839 10789694 28337642 33688706 X 301881312 314498645 2061283 2185256 380604 386817 304323199 317070718 332660841 350759424 X 9730273 3552100 -534854 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1653 1653 0 PART II-B, LINE 1: MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN (MCHS-AL/AU) PROVIDES INFORMATION OR EXPRESSES ITS CONCERN 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-AL/AU REPRESENTATIVES CONTACTED ELECTED OFFICIALS OF GOVERNMENT TO DISCUSS ISSUES RELATING TO HEALTH CARE AND HEALTH CARE REFORM. THE AMOUNT IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING. 380604 6213 386817 371157 9447 380604 301543 69614 371157 301543 301543 301543 301543 1.00000 0 1 1 5906413 5906413 143161497 60419900 82741597 66019500 47432239 18587261 1737744 1737744 108973015 MAYO POOLED INVESTMENTS 173459885 F 173459885 DUE FROM AFFILIATES 1424062 DEFERRED COMPENSATION 9385334 PARTNERSHIP INVESTMENT 61178 INTEREST IN NET ASSETS OF FDN 7296942 18167516 DUE TO AFFILIATES 64930 DEFERRED COMPENSATION LIABILITY 9441898 ASSET RETIREMENT OBLIGATION 1281866 OTHER LIABILITY 1000 10789694 X PART V, LINE 4: THE ENDOWMENT FUNDS PROVIDE A STABLE FUNDING SOURCE FOR RESEARCH AND EDUCATION PROGRAMS. 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. BIKES FOR BARKER 5746 3896 1850 366 1999 5 12054 6030 6024 16957 17800 9926 7874 366 18956 19322 -11448 1 1 X 1 X 1 X 1 1 1 0 0 4829024 4829024 0.01760 38899230 31363905 7535325 0.02750 4730520 4002986 727534 0.00270 48458774 35366891 13091883 0.04780 133750 133750 0.00050 382040 1200 380840 0.00140 6258466 4621557 1636909 0.00600 481939 94026 387913 0.00140 168577 168577 0.00060 7424772 4716783 2707989 0.00990 55883546 40083674 15799872 0.05770 11611 11611 0.00000 84696 84696 0.00030 26000 26000 0.00010 3949 3949 0.00000 15587 15587 0.00010 93977 93977 0.00030 235820 235820 0.00080 0 3190228 48212408 66613452 -18401044 X 1 1 2 1 MCHS IN ALBERT LEA 404 WEST FOUNTAIN STREET ALBERT LEA MN 56007 MAYOCLINICHEALTHSYSTEM.ORG 00920 X X X 2 MCHS IN AUSTIN 1000 FIRST DRIVE NW AUSTIN MN 55912 MAYOCLINICHEALTHSYSTEM.ORG 00920 X X X MCHS IN ALBERT LEA 1 0 0 1 X X X X X X X X 13 1 0 1 1 X MAYOCLINICHEALTHSYSTEM.ORG/ABOUT-US X 1 13 0 1 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X X X X X X X X X 1 X 0 X X X X X 1 X 0 0 MCHS IN AUSTIN 2 0 0 1 X X X X X X X X X 13 1 0 0 1 X MAYOCLINICHEALTHSYSTEM.ORG/ABOUT-US X 1 13 0 1 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X X X X X X X X X 1 X 0 X X X X X 1 X 0 0 MCHS IN ALBERT LEA PART V, SECTION B, LINE 5: A SURVEY WAS SENT OUT TO RANDOM RESIDENTS OF FREEBORN COUNTY AND KEY INFORMANT SESSIONS WERE HELD THAT INCLUDED, BUT WERE NOT LIMITED TO: THE DEAN OF STUDENTS FROM TWO AREA HIGH SCHOOLS, THE DIRECTOR OF FREEBORN COUNTY WORKFORCE DEVELOPMENT, THE DIRECTOR OF SEMCAC, A POLICE OFFICER OF THE ALBERT LEA POLICE DEPARTMENT, AND AN AREA CLERGYMAN. A CHNA ADVISORY GROUP WAS CONVENED IN THE PLANNING STAGES OF CONDUCTING THE CHNA AND AGAIN WHEN SURVEY AND KEY INFORMANT SESSION RESULTS WERE COMPLETED. THE CHNA ADVISORY GROUP INCLUDED: THE DIRECTOR OF FREEBORN COUNTY PUBLIC HEALTH, THE DIRECTOR OF ALBERT LEA FAMILY YMCA, THE DIRECTOR OF FREEBORN COUNTY CHILDREN'S CENTER, A REPRESENTATIVE OF FREEBORN COUNTY RESOURCES, THE DIRECTOR OF FREEBORN COUNTY UNITED WAY, THE DIRECTOR OF FREEBORN COUNTY FAMILY SERVICE COLLABORATIVE, THE EXECUTIVE DIRECTOR OF ALBERT LEA/FREEBORN COUNTY CHAMBER OF COMMERCE, AND THE DIRECTOR OF SOUTHEAST MINNESOTA COMMUNITY ACTION COMMITTEE. MCHS IN AUSTIN PART V, SECTION B, LINE 5: THE CHNA EFFORT DIRECTLY REACHED OUT TO CITIZENS WHO REPRESENT THE VARIETY OF AGES, INCOMES, EDUCATION LEVELS AND ETHNIC BACKGROUNDS IN MOWER COUNTY, AND INTENTIONALLY CONNECTED WITH GROUPS SUCH AS THE COMMUNITY HEALTH SERVICES ADMINISTRATOR OF MOWER COUNTY HEALTH AND HUMAN SERVICES THAT REPRESENT THE 15.3 PERCENT OF CITIZENS WHO LIVE BELOW THE POVERTY LEVEL AND GROWING POPULATION OF MINORITIES. IN ADDITION, FOCUS GROUPS AND A CITIZEN SURVEY WERE CONDUCTED AT WORKPLACES, HEALTH FAIRS, HIGH SCHOOLS, THE LOCAL COMMUNITY COLLEGE, AND ENGLISH LANGUAGE LEARNING CLASSROOMS AS WELL AS TAKING INFORMATION FROM SURVEYS CONDUCTED BY MOWER COUNTY HEALTH AND HUMAN SERVICES AND MOWER REFRESHED, WHICH REFLECT A WIDE SAMPLING OF THE COUNTY'S POPULATION BY ETHNICITY, AGE, AND GENDER. MCHS IN ALBERT LEA PART V, SECTION B, LINE 11: MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN IN ALBERT LEA (MCHS-ALBERT LEA) IN PARTNERSHIP WITH FREEBORN COUNTY PUBLIC HEALTH IDENTIFIED SIX SIGNIFICANT HEALTH NEEDS IN FREEBORN COUNTY. OF THOSE, MENTAL HEALTH, OBESITY AND CHRONIC DISEASE PREVENTION WERE CHOSEN AS THE TOP THREE HEALTH PRIORITIES THAT MCHS-ALBERT LEA HAD THE POTENTIAL TO POSITIVELY IMPACT.MENTAL HEALTH: IMPLEMENTATION STRATEGIES FOR MENTAL HEALTH INCLUDED (1) IDENTIFYING SPECIFIC COMMUNITY GAPS IN MENTAL HEALTH CARE, (2) INCREASING AWARENESS OF MENTAL HEALTH ISSUES AND ROLE OF PRIMARY-CARE PROVIDERS IN IDENTIFICATION, REFERRAL AND FOLLOW-UP AND (3) IDENTIFYING INNOVATIVE MENTAL HEALTH CARE OPTIONS. SPECIFIC ACTIONS TAKEN INCLUDED SURVEYING LOCAL MENTAL HEALTH PROVIDERS TO DETERMINE ACCESS AND PERCEPTION OF UNMET NEEDS, CONVENING A WORKGROUP OF MENTAL HEALTH PROVIDERS THROUGH THE FREEBORN COUNTY UNITED WAY AND CREATING A MENTAL HEALTH WORKGROUP OF THE ALBERT LEA/FREEBORN COUNTY CHAMBER WORKSITE WELLNESS COMMITTEE TO INCREASE USAGE OF CURRENT EMPLOYEE ASSISTANCE PROGRAMS (EAPS) WITHIN LOCAL BUSINESSES AND ENCOURAGE OTHERS TO IMPLEMENT EAPS. MCHS-ALBERT LEA ALSO COLLABORATED WITH BLUE ZONES/VITALITY PROJECT AND THE STATEWIDE HEALTH IMPROVEMENT PROGRAM (SHIP) TO DISCUSS WITH EMPLOYERS THE BENEFITS OF WORKPLACE MENTAL HEALTH OPTIONS. MCHS- ALBERT LEA HAS CONTRIBUTED STAFF RESOURCES TO CHAIR THE MENTAL HEALTH WORKGROUP OF THE CHAMBER WORKSITE WELLNESS COMMITTEE AND AS MCHS REPRESENTATIVES TO THE BLUE ZONES/VITALITY PROJECT LEADERSHIP GROUP AND SHIP CLINICAL COMMUNITY LINKAGES WORKGROUP. INCREASING AWARENESS AMONG PRIMARY-CARE PROVIDERS AND EXPANDING THEIR ROLE IN THE AREA OF MENTAL HEALTH REQUIRED A REGIONAL STRATEGY THROUGH THE MCHS SOUTHEAST MINNESOTA REGION CLINICAL PRACTICE COMMITTEE (CPC) FOR SUCCESS. BUILDING ON THE CMS COMPASS PROGRAM REFERRAL PROCESS ALREADY IN PLACE IN THE REGION WHERE PATIENTS WITH CHRONIC IDENTIFIED, SCREENED AND REFERRED FOR MENTAL HEALTH CARE WAS DETERMINED TO BE A VIABLE OPTION FOR ALL THREE COMMUNITY HEALTH NEED PRIORITIES. THE COMPASS PROGRAM IS ALSO EXPANDING TO INCLUDE NOT ONLY PATIENTS ON GOVERNMENT-FUNDED PROGRAMS, BUT POTENTIALLY ALL PATIENTS. THE CPC HAS ALSO ENDORSED PILOTING TELEMEDICINE FOR MENTAL HEALTH TREATMENT IN THE REGION AND CURRENTLY POLICIES AND PROCEDURES AROUND ITS USE ARE IN PROCESS.ANOTHER STRATEGY FOR IDENTIFYING REFERRING PATIENTS WITH MENTAL HEALTH ISSUES FOR APPROPRIATE TREATMENT IS ASKING PATIENTS TO COMPLETE A DEPRESSION INVENTORY AT EACH VISIT, THE RESULTS OF WHICH ARE REFERRED TO A NEWLY-HIRED BEHAVIORAL HEALTH NURSE PRACTITIONER RESPONSIBLE FOR DEVELOPING TREATMENT PLANS FOR PATIENTS WHOSE SCREENINGS INDICATE DEPRESSION. CREATING AN AWARENESS OF THIS NEW PROCESS AND THE ROLE OF THE PRIMARY CARE PROVIDER HAS BEGUN AND WILL LIKELY BE AN ONGOING PROCESS AS BENEFITS OF THE NURSE PRACTITIONER ROLE AND PATIENT SUCCESS THROUGH MENTAL HEALTH INTERVENTION IS SHARED.MENTAL HEALTH PRACTITIONERS AGREE THAT IMPROVING MENTAL HEALTH IS KEY AND A PRECURSOR TO DEALING WITH OBESITY AND CHRONIC HEALTH CONDITIONS, SO MENTAL HEALTH STRATEGIES HAVE BEEN MORE FOCUSED AND INTENSE TO ALLOW FOR SUCCESS WITH OBESITY AND OTHER CHRONIC HEALTH CONDITIONS. OBESITY:FIT FOREVER, ORGANIZED AND SUPPORTED BY THE COMMUNITY RELATIONS COMMITTEE OF MCHS- ALBERT LEA, IS A COLLABORATIVE CHILDREN'S ANTI-OBESITY EFFORT WITH THE ALBERT LEA FAMILY "Y" AND ALBERT LEA AREA SCHOOLS. IT WAS DEVELOPED TO ENCOURAGE ACTIVITY AND GOOD NUTRITION WHICH WOULD NOT ONLY LEAD TO LOWER INCIDENCE OF OBESITY AMONG YOUTH, BUT ENCOURAGE PARENTS AND FAMILIES TO MAKE SUBTLE CHANGES AS YOUTH SHARE INFORMATION GAINED AT FIT FOREVER ACTIVITIES. PRE AND POST-TESTS HELP MEASURE AWARENESS, AS WELL AS HEALTH IMPROVEMENTS, FOR PARTICIPANTS. THE PROGRAM BEGAN WITH LOCAL 7TH GRADERS AND HAS NOW EXPANDED TO 6TH GRADERS. THIS MIDDLE SCHOOL GROUP IS ABLE TO WALK THE FEW BLOCKS TO THE "Y" AFTER SCHOOL. IN 2014, 7TH GRADE PARTICIPATION INCREASED TO 100 STUDENTS WHO WERE REWARDED WITH FREE "Y" MEMBERSHIPS WHICH ENABLES THEM TO CONTINUE TO MAKE POSITIVE ACTIVITY CHANGES AND DEVELOP LIFELONG GOOD HEALTH HABITS. MCHS-ALBERT LEA ALSO SUPPORTS THE PROGRAM WITH FUNDS FOR FIT FOREVER PROGRAM COSTS AND SOME "Y" MEMBERSHIPS FOR 6TH AND 7TH GRADERS AT A SET AMOUNT OF $10,000 ANNUALLY. CHRONIC HEALTH DISEASE PREVENTION:IN THE AREA OF DIABETES, A MEMO OF UNDERSTANDING HAS BEEN SIGNED TO COLLABORATE WITH THE Y-USA PRE-DIABETES PROGRAM TO PROMOTE THE PROGRAM TO PATIENTS AT RISK FOR DEVELOPING DIABETES AND TO PROVIDERS SO THEY MAY REFER TO THE PROGRAM AND RECEIVE ONGOING INFORMATION ABOUT PATIENT PROGRESS. MCHS-ALBERT LEA HAS ALSO PARTNERED WITH MAYO CLINIC AND THE STATEWIDE HEALTH IMPROVEMENT PROGRAM (SHIP) IN FREEBORN COUNTY TO SUPPORT THE EVIDENCE-BASED COMMUNITY PROGRAM "LIVING WELL WITH CHRONIC DISEASE" AND HAVE MET WITH THE PRIMARY CARE DIVISION TO EXPLORE THE BEST PROCESS FOR PATIENT REFERRAL AND PROGRAM FEEDBACK. WITH GENERAL CHRONIC DISEASE, THE EXPANSION OF THE COMPASS PROGRAM TO ALL PATIENTS WITH DUO DIAGNOSIS OF STRESS, ANXIETY, DEPRESSION AND CHRONIC DISEASE SHOULD GREATLY IMPACT OPPORTUNITIES FOR IMPROVING MENTAL AND PHYSICAL HEALTH. THE COMPASS PROGRAM SETS METRICS AND MEASURES OUTCOMES WITH A VERY SPECIFIC SET OF CRITERIA.PUBLIC EDUCATION OPPORTUNITIES ARE ALSO OFFERED FOR DIABETES AND HEALTHY EATING AND WOMEN'S HEART HEALTHY SYMPOSIUMS ARE HELD ANNUALLY WHERE OUR PHYSICIANS AND NUTRITIONISTS PROVIDE WOMEN WITH INFORMATION AND TOOLS TO MAKE POSITIVE LIFESTYLE CHANGES TO PREVENT HEART DISEASE. THE IMPACT OVER TIME OF SUPPORTING AND REFERRING TO COMMUNITY WELLNESS PROGRAMS, WHERE PEOPLE GAIN KNOWLEDGE AND PRACTICAL TIPS ABOUT HOW TO LIVE HEALTHIER THROUGH GOOD NUTRITION, ACTIVITY AND STRESS-REDUCTION TECHNIQUES, IS A DELIBERATE STRATEGY TO HELP THEM TAKE RESPONSIBILITY FOR THEIR HEALTH AND LOWER UTILIZATION OF CLINIC SERVICES AND ASSOCIATED COSTS. IN ADDITION, PARTICIPANTS IN THESE PROGRAMS FORM THEIR OWN SUPPORT NETWORKS WHERE THEY MAY CONTINUE TO MEET OR CHAT OR TOUCH BASE TO SHARE INFORMATION AND SUCCESS WHEN THE PROGRAM SERIES IS COMPLETE. STAFF FROM MCHS- ALBERT LEA, INCLUDING PUBLIC AFFAIRS, COMMUNITY ENGAGEMENT, NURSING AND NUTRITION, PARTICIPATE IN TEAMS CREATING AWARENESS OF THESE PROGRAMS, DEVELOPING COMMUNITY RESOURCES LISTS AND BUILDING A REFERRAL PROCESS WITH PROVIDERS.TOBACCO USE, DENTAL CARE AND BINGE DRINKING WERE ALSO IDENTIFIED AS HEALTH NEEDS BUT WERE NOT PURSUED AS EXPLAINED BELOW:TOBACCO USE:COMMUNITY SURVEY RESPONDENTS WHO USE TOBACCO INDICATED LITTLE IMPETUS TO QUIT ACCORDING TO THE COMMUNITY HEALTH NEEDS SURVEY IN 2013. OF THOSE WHO USE TOBACCO, 27.5% HAVE NEITHER TRIED TO QUIT NOR WANT TO QUIT. ANOTHER 40.4 % EITHER LIVE WITH A SMOKER OR INDICATE COST BARRIER FOR NICOTINE REPLACEMENT THERAPY TO QUIT TOBACCO USE, SO MCHS-ALBERT LEA AND ITS COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY GROUP DETERMINED THAT INCREASED EFFORTS TO ENCOURAGE/ACHIEVE CESSATION WOULD REQUIRE SUBSTANTIAL RESOURCES, BUT YIELD LITTLE IMPACT.MCHS-ALBERT LEA ALREADY PROVIDES FREE TOBACCO CESSATION PROGRAMS AND THE ALBERT LEA FREEBORN COUNTY CHAMBER, BLUE ZONES/VITALITY PROJECT AND SHIP HAVE UNDERTAKEN THE TASK OF INCREASING THE NUMBER OF SMOKE-FREE WORKPLACES AS BOTH A TACTIC AND AN INTERVENTION.DENTAL CARE:THE BIGGEST GAP WITH DENTAL CARE IS THAT NO LOCAL DENTISTS ACCEPT MEDICAL ASSISTANCE WHICH PREVENTS LOW-INCOME FAMILIES FROM ACCESSING DENTAL CARE. MCHS-ALBERT LEA EMPLOYS NO DENTISTS AND EFFORTS TO APPEAL TO THE COUNTY DENTAL GROUP TO PROVIDE LOW-COST SERVICES OR FREE SERVICES HAVE BEEN UNSUCCESSFUL.FREEBORN COUNTY PUBLIC HEALTH RECEIVED A SMALL GRANT TO HELP PROVIDE DENTAL HYGIENISTS FOR CHILDREN'S DENTAL CARE FOR PART OF 2013 AND PLANS TO PURSUE SIMILAR GRANTS TO COVER THE GAP IN DENTAL CARE. MCHS- ALBERT LEA SUPPLEMENTED GRANT FUNDS WITH A DONATION TO THE FREEBORN COUNTY PUBLIC HEALTH CHILDREN'S DENTAL CARE PROGRAM. IT WAS DETERMINED DENTAL CARE COULD NOT BE IMPACTED IN THIS AREA WITHOUT INTEREST AND COMMITMENT FROM LOCAL DENTISTS TO MEET DENTAL HEALTH NEEDS OF PEOPLE UNABLE TO PAY FOR THE CARE.BINGE DRINKING:COMMUNITY COALITIONS ARE ALREADY IN PLACE TO ADDRESS ALCOHOL AND YOUTH AND COULD BE EXPANDED TO INCLUDE BINGE DRINKING AWARENESS AND PREVENTION. MCHS-ALBERT LEA STAFF, IN ITS FOUNTAIN CENTERS CHEMICAL DEPENDENCY TREATMENT PROGRAM, PARTICIPATES IN ALL LOCAL ALCOHOL AWARENESS EFFORTS. THESE INCLUDE PARTNERS IN PREVENTION, ZERO ALCOHOL PROVIDERS, ALCOHOL, TOBACCO AND OTHER DRUGS (ATOD.) MCHS IN AUSTIN PART V, SECTION B, LINE 11: MCHS - ALBERT LEA AND AUSTIN IN AUSTIN (MCHS-AUSTIN) SEEKS TO IMPACT THE TOP THREE HEALTH CONCERNS IDENTIFIED BY THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) THROUGH MOWER REFRESHED, A COMMUNITY WELLNESS MODEL DEVELOPED BY MCHS-AUSTIN THAT ENGAGES, EQUIPS, AND EMPOWERS COMMUNITY MEMBERS OF ALL AGES TO MAKE HEALTHY LIVING EASIER IN MOWER COUNTY. MCHS-AUSTIN PROVIDES RESOURCES IN SUPPORT OF MOWER REFRESHED SUCH FUNDING A COMMUNITY ENGAGEMENT COORDINATOR FOR THE EFFORT AND ASSISTING IN THE PRACTICAL DEVELOPMENT OF THIS UNIQUE WELLNESS MOVEMENT. FOLLOWING ARE THE TOP THREE HEALTH CONCERNS IDENTIFIED BY THE 2013 CHNA ALONG WITH THE OBJECTIVES IN ADDRESSING THEM: - OBESITY: INCREASE ACTIVE LIVING AND NUTRITIONAL FOOD INTAKE - STRESS, ANXIETY, DEPRESSION: IMPROVING MENTAL FITNESS THROUGH PRACTICAL RESOURCES/SKILLS. - ACCESSING HEALTHCARE: WHEN, HOW, WHERE TO ACCESS THE APPROPRIATE LEVEL OF CARE.BULLYING WAS IDENTIFIED AS AN ISSUE BUT IS NOT BEING ADDRESSED WITH ADDITIONAL RESOURCES BECAUSE THERE IS AN ACTIVE GROUP, COMMUNITY AGAINST BULLYING, THAT IS DEALING WITH THIS ISSUE.STEPS TAKEN TOWARDS THE CURRENT IMPLEMENTATION STRATEGIES FROM EACH OF MOWER REFRESHED FOUR COMMUNITY ENGAGEMENT TEAMS ARE AS FOLLOWS:HEALTHIER CHOICES TEAM CURRENT INITIATIVES:- THE REFRESHED DINING PROJECT, AN EFFORT THAT ENCOURAGES AND PROMOTES HEALTHY OPTIONS IN MOWER COUNTY RESTAURANTS, CAFES, AND COFFEEHOUSES WAS LAUNCHED IN OCTOBER 2014 WITH FIVE CURRENT RESTAURANTS PARTICIPATING BY MEETING AT LEAST FIVE OF EIGHT ESTABLISHED CRITERIA AND THE INTENT TO ACHIEVE ALL EIGHT.- THE 1ST ANNUAL HARVEST 5K WAS HELD IN NOVEMBER OF 2014 TO CONNECT THE COMMUNITY TO FOOD SHELVES COUNTY WIDE AND TO RAISE FUNDS AND AWARENESS OF THE NEED TO RETHINK WHAT TO DONATE TO LOCAL FOOD SHELVES SEEKING TO MAKE THE HEALTHY CHOICE THE EASY CHOICE FOR ALL COMMUNITY MEMBERS. OVER 30 RUNNERS PARTICIPATED IN THE 5K AND APPROXIMATELY 15 VOLUNTEERS HELPED WITH THE EVENT. - REFRESHED KIDS SCHOOL ASSEMBLY PILOT PROGRAM IS A COORDINATION OF MONTHLY COMMUNITY GUESTS ENGAGING WITH 5TH AND 6TH GRADERS ON WELLNESS TOPICS WHILE TEACHERS HAVE TEAM BUILDING OPPORTUNITIES. THE PILOT SCHOOL, LOCATED IN THE CITY OF AUSTIN, HAS COMMITTED TO CONTINUE THE PROGRAM IN THE 2015-16 SCHOOL YEAR AND THE HEALTHIER CHOICES TEAM IS LOOKING TO PILOT THE PROGRAM AT THE ELEMENTARY LEVEL IN THE 2015-16 SCHOOL YEAR AT A SCHOOL IN MOWER COUNTY THAT IS OUTSIDE THE CITY OF AUSTIN.MENTAL FITNESS TEAM CURRENT INITIATIVES:- TAKE 5 IS AN EFFORT TO CREATE COMMON LANGUAGE ON BUILDING RESILIENCE TO STRESS AND ANXIETY THROUGH VARIOUS COMMUNITY EVENTS. THE 3RD ANNUAL TAKE 5 EVENT WAS HELD IN JUNE 2014. THIS IS A RETREAT MODEL THAT FOCUSES ON BUILDING RESILIENCE AND SKILLS TO COPE WITH STRESS, ANXIETY AND DEPRESSION. THE AVERAGE ATTENDANCE AT THIS EVENT IS 80 PARTICIPANTS WITH A TARGET POPULATION OF SCHOOL STAFF, SOCIAL SERVICES, FAITH COMMUNITIES AND LAW ENFORCEMENT. THE NEXT RETREAT IS SCHEDULED FOR EARLY SUMMER OF 2016.- BUILDING A RESILIENT WORKFORCE AS A BUSINESS STRATEGY IS A FIRST TIME EVENT THAT IS CURRENTLY BEING PLANNED FOR THE FALL OF 2015. THIS EVENT WILL TARGET LOCAL BUSINESSES (MANAGERS, SUPERVISORS, ADMINISTRATION, ETC.).- GROWING RESILIENT COMMUNITIES VIDEO PROJECT IS NEAR COMPLETION. THIS PROJECT WILL PRODUCE A VIDEO THAT CAN BE USED TO FOSTER CONVERSATION/GROUPS ON THE TOPIC OF RESILIENCY BY OFFERING SIMPLE WAYS TO CREATE RESILIENT ENVIRONMENTS WHERE WE LIVE, WORK, PLAY, LEARN, AND WORSHIP. - MCHS YOGA PILOT - AUSTIN CAMPUS: WEEKLY FREE YOGA CLASSES WERE OFFERED ON TUESDAYS FOR PATIENTS AND ON THURSDAYS FOR STAFF. THIS PROGRAM HAD AN OVERWHELMING RESPONSE. IN TWO DAYS 50 STAFF EXPRESSED INTEREST IN SIGNING UP FOR 15 SPOTS. FUNDING IS BEING SECURED THROUGH GRANTS TO PILOT THIS PROGRAM AT THE ALBERT LEA CAMPUS AND EXPAND OFFERINGS AT BOTH CAMPUSES FOR OTHER CLASSES THAT IMPROVE PHYSICAL AND MENTAL FITNESS.- COOPERATIVE HEALTH ACTION TRIAD (CHAT) IS A PROACTIVE APPROACH OF EDUCATORS FROM AUSTIN PUBLIC SCHOOLS AND HEALTH OFFICIALS TO ADDRESS MENTAL HEALTH. THE TRIAD INCLUDES: STUDENTS, STAFF, AND COMMUNITY. THIS EFFORT IS EXPLORING HOW TO CREATE A CULTURE THAT IS BASED ON OVERALL WELLNESS, GROWING MORE OF WHAT IS EFFECTIVE, AND STRENGTH-BASED STRATEGIES RATHER THAN PROBLEM FOCUSED STRATEGIES. WORKFORCE WELLNESS TEAM CURRENT INITIATIVES:- REFRESHED LUNCH & LEARN IS A MONTHLY LUNCH EVENT FOCUSED ON IMPROVING THE HEALTH OF THE LOCAL WORKFORCE FOR AREA PROFESSIONALS. LUNCH AND LEARNS ARE ABOUT DEVELOPING NETWORKS AND STRATEGIES THAT MAKE SENSE TO NOT ONLY PROMOTE WELLNESS PROGRAMMING BUT TO SHIFT THE WORKSITE ENVIRONMENTS TO FOSTER A WELLNESS CULTURE THAT NATURALLY ENGAGES EMPLOYERS AND EMPLOYEES IN WELL-LIVING. THIS MONTHLY EVENT AVERAGES 25-30 PARTICIPANTS. - THE WORKFORCE WELLNESS GROUP RECOGNIZES BUSINESSES IN MOWER COUNTY THAT ARE FINDING INNOVATIVE WAYS TO MAKE HEALTHIER CHOICES EASIER AND MORE ACCESSIBLE TO THEIR EMPLOYEES BY SPONSORING THE REFRESHED BUSINESS OF THE YEAR. TWO AREA EMPLOYERS, ONE WITH OVER 100 EMPLOYEES AND ONE WITH FEWER THAN 100 EMPLOYEES, RECEIVE THIS AWARD EACH YEAR AT THE AUSTIN AREA CHAMBER OF COMMERCE ANNUAL BANQUET - HEALTHCARE ACCESS GUIDE TOOL (BOOKLET & WEBPAGE): A BILINGUAL GUIDE TO IMPROVE UNDERSTANDING ON WHEN, WHERE, AND HOW TO ACCESS HEALTHCARE IN MOWER COUNTY AS WELL AS COST DIFFERENCE BETWEEN THE NURSE LINE ON THROUGH TO THE EMERGENCY ROOM. EXTENSIVE FOCUS GROUPS/INTERVIEWING TO RATE EFFECTIVENESS OF FINAL DRAFT BEGAN IN 2014 AND WILL CONTINUE INTO 2015 WITH THE HOPE TO DISTRIBUTE THE BOOKLET IN EARLY FALL 2015.LATINOS SALUDABLES TEAM CURRENT INITIATIVES: - LATINOS SALUDABLES COMMUNITY CONVERSATIONS: TWO CONVERSATIONS ON WELLNESS TOPICS WITH THE LATINO COMMUNITY WERE FACILITATED IN SPANISH BY COMMUNITY TEAM LEADERS DURING A COMMUNITY MEAL THAT WAS HELD AFTER A CHURCH SERVICE. A THIRD COMMUNITY CONVERSATION WAS HELD IN THE SPRING OF 2015 AND WITH AN INCREASE IN ATTENDANCE AT EACH EVENT, PLANS ARE FOR THIS TO BE A QUARTERLY EVENT. MCHS IN ALBERT LEA 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. MCHS IN AUSTIN 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. MCHS IN ALBERT LEA 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. MCHS IN AUSTIN 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. MCHS IN ALBERT LEA 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. MCHS IN AUSTIN 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. MCHS IN ALBERT LEA 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. MCHS IN AUSTIN 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 MCHS IN ALBERT LEA PART V, SECTION B, LINE 16A WEBSITE: SEE PART VI MCHS IN ALBERT LEA PART V, SECTION B, LINE 16B WEBSITE: SEE PART VI MCHS IN ALBERT LEA PART V, SECTION B, LINE 16C WEBSITE: SEE PART VI MCHS IN AUSTIN PART V, SECTION B, LINE 16A WEBSITE: SEE PART VI MCHS IN AUSTIN PART V, SECTION B, LINE 16B WEBSITE: SEE PART VI MCHS IN AUSTIN PART V, SECTION B, LINE 16C WEBSITE: SEE PART VI 20 MCHS - ALBERT LEA HEALTH REACH 1705 SE BROADWAY ALBERT LEA MN 56007 OUTPATIENT PHYSICAL THERAPY MCHS - ALBERT LEA IN LAKE MILLS 309 S 10TH AVE LAKE MILLS IA 50450 CLINIC MCHS - ALBERT LEA IN NEW RICHLAND 318 FIRST ST SW NEW RICHLAND MN 56072 CLINIC MCHS - ALBERT LEA IN ALDEN 192 WASHINGTON AVE ALDEN MN 56009 CLINIC MCHS - ALBERT LEA IN WELLS 301 S BROADWAY WELLS MN 56097 CLINIC MCHS - ALBERT LEA IN KIESTER 120 N MAIN ST KIESTER MN 56051 CLINIC MCHS - EXPRESS CARE IN ALBERT LEA 2708 BRIDGE AVE ALBERT LEA MN 56007 EXPRESS CARE CLINIC MCHS - AUSTIN IN ADAMS 908 WEST MAIN ST ADAMS MN 55909 CLINIC FOUNTAIN CENTERS IN AUSTIN 101 14TH ST NW AUSTIN MN 55912 CHEMICAL DEPENDENCY FOUNTAIN CENTERS IN ALBERT LEA 408 WEST FOUNTAIN STREET ALBERT LEA MN 56007 CHEMICAL DEPENDENCY FOUNTAIN CENTERS IN FAIRMONT 828 N NORTH AVENUE FAIRMONT MN 56031 CHEMICAL DEPENDENCY FOUNTAIN CENTERS IN FARIBAULT 2301 NW 4TH STREET FARIBAULT MN 55021 CHEMICAL DEPENDENCY FOUNTAIN CENTERS IN MANKATO 1400 MADISON AVE SUITE 326 MANKATO MN 56001 CHEMICAL DEPENDENCY FOUNTAIN CENTERS IN OWATONNA 134 SOUTHVIEW OWATONNA MN 55060 CHEMICAL DEPENDENCY FOUNTAIN CENTERS IN ROCHESTER CEDARWOOD MALL 4122 18TH AVE NW ROCHESTER MN 55901 CHEMICAL DEPENDENCY FOUNTAIN CENTERS IN WASECA 505 S STATE STREET SUITE 6 WASECA MN 56093 CHEMICAL DEPENDENCY FOUNTAIN CENTERS IN JACKSON 308 W ASHLEY ST JACKSON MN 56143 CHEMICAL DEPENDENCY MCHS - AUSTIN HOSPICE 101 14TH ST NW AUSTIN MN 55912 HOSPICE OFFICES MCHS - AUSTIN IN LEROY 671 EAST MAIN LEROY MN 55951 CLINIC MCHS - AUSTIN IN BLOOMING PRAIRIE 405 EAST MAIN BLOOMING PRAIRIE MN 55917 CLINIC PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO. PART I, LINE 7G: THE FOLLOWING NET COMMUNITY BENEFIT COST ATTRIBUTED TO A PHYSICIAN CLINIC WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES: $1,636,908. 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 $ 3,190,228. PART II, COMMUNITY BUILDING ACTIVITIES: THROUGH DONATIONS, GRANTS, AND VOLUNTEER HOURS 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 METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SHORTFALL REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY). HOWEVER, USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY ACTUALLY RESULTS IN A MEDICARE SHORTFALL OF $8,523,000 AS REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS.THE MOST COMMON REASONS FOR A DIFFERENCE BETWEEN THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H AND THE MEDICARE SHORTFALL REPORTED ON THE CORE FORM, PART III INCLUDE: (1) INCLUSION OF MEDICARE ADVANTAGE REVENUE AND EXPENSES; (2) INCLUSION OF PART B REVENUE AND EXPENSES; (3) INCLUSION OF OTHER FEE SCHEDULE REVENUE; AND (4) SOME TIMING ISSUES.REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. PART III, LINE 9B: MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING REASONABLE ATTEMPTS TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN ADDITION, MAYO CLINIC AND ITS AFFILIATES ACCEPT REASONABLE PAYMENT PLANS FROM PATIENTS WHEN AN ACCOUNT IS THE PATIENT'S RESPONSIBILITY AND TRY TO IDENTIFY THOSE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS OFFERED TO ANY PATIENT IF THE FACTS AND CIRCUMSTANCES SUGGEST THAT THE PATIENT DOES NOT HAVE THE ABILITY TO PAY THEIR BILL IN WHOLE OR IN PART. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED; INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS POTENTIALLY MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY BASED ON SUBMISSION OF REQUESTED INFORMATION. COLLECTION ACTIVITY WOULD ONLY RESUME IF THE PATIENT IS DETERMINED TO BE INELIGIBLE FOR FINANCIAL ASSISTANCE OR IS ELIGIBLE FOR ONLY PARTIAL FINANCIAL ASSISTANCE AND DOES NOT AGREE TO PAY THE REMAINING BALANCE. PART VI, LINE 2: FOR WELL OVER 100 YEARS IT HAS BEEN THE PRACTICE FOR MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN TO REACH OUT TO THE COMMUNITY FOR FEEDBACK, TO IDENTIFY NEEDS AND TO BUILD PARTNERSHIPS TO MEET THOSE NEEDS. ALBERT LEA/FREEBORN COUNTY:WORKING IN CONJUNCTION WITH FREEBORN COUNTY PUBLIC HEALTH AND THE MINNESOTA DEPARTMENT OF HEALTH, MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN IN ALBERT LEA (MCHS-ALBERT LEA) CONDUCTED A MULTI-FACETED APPROACH TO GATHERING INFORMATION AND IDENTIFYING LOCAL HEALTH NEEDS.THE PRIMARY TOOL WAS A COMMUNITY SURVEY DEVELOPED TO DETERMINE INDIVIDUAL HEALTH HABITS AND HEALTH CONCERNS THAT WOULD PROVIDE A GLIMPSE INTO THE HEALTH STATUS OF THE COMMUNITY THAT COULD BE COMPARED AGAINST OTHER COUNTY AND STATE DATA TO DETERMINE OUTLIERS.THE SURVEY WAS SUPPORTED BY KEY INFORMANT SURVEYS AND FACE-TO-FACE MEETINGS WITH COMMUNITY REPRESENTATIVES WHO PROVIDED VALUABLE FEEDBACK AND ANECDOTAL INFORMATION TO CLARIFY ISSUES AND GAPS IN COMMUNITY CARE AND SERVICES AND THROUGH REVIEW OF OTHER LOCAL ORGANIZATIONS' SURVEYS TO THEIR CONSTITUENTS. A COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY GROUP, COMPRISED OF LOCAL STAKEHOLDERS AND COMMUNITY ORGANIZATIONS AND PROGRAMS, WAS CREATED TO HELP IDENTIFY AND PRIORITIZE NEEDS AND DETERMINE WHICH COULD BE REALISTICALLY IMPACTED BY WORKING COLLABORATIVELY WITHIN THE COMMUNITY. NEEDS ASSESSMENT OUTCOMES REVEALED GAPS IN MENTAL HEALTH ACCESS AND CARE AND A HIGH PERCENTAGE OF OBESITY AND CHRONIC DISEASE WITHIN THE FREEBORN COUNTY POPULATION THAT HAVE POTENTIAL FOR IMPROVEMENT AS COMMUNITY GROUPS EXPAND CURRENT WORK OR IDENTIFY NEW PROGRAMS OR PROCESSES TO IMPACT HIGH PRIORITY NEEDS. AUSTIN/MOWER COUNTY:MOWER COUNTY HEALTH & HUMAN SERVICES AND MOWER REFRESHED (A CITIZEN DRIVEN WELLNESS MOVEMENT) COLLECTIVELY CONDUCTED A COMMUNITY SURVEY THAT REFLECTED A WIDE SAMPLING OF THE MOWER COUNTY POPULATION BY ETHNICITY, AGE AND GENDER.THE STRATEGY INVOLVED REACHING OUT DIRECTLY TO CITIZENS WHO REPRESENT THE VARIETY OF AGES, INCOMES, EDUCATION LEVELS, AND ETHNIC BACKGROUNDS IN MOWER COUNTY. AS SUCH AN INTENTIONAL EFFORT WAS MADE TO CONNECT WITH GROUPS THAT REPRESENTED THE 15.3% OF CITIZENS WHO LIVE BELOW THE POVERTY LEVEL AND OUR GROWING POPULATION OF MINORITIES TO ENGAGE THEM IN IDENTIFYING COMMUNITY NEEDS.IN THE PROCESS OF INTERVIEWING AND CONDUCTING SURVEYS, CITIZENS NOT ONLY RESPONDED WITH DATA, THE PROCESS ALSO RESULTED IN POTENTIAL SOLUTIONS AND THE DESIRE TO BECOME ENGAGED IN THE DEVELOPMENT OF THOSE SOLUTIONS. THIS WILL BE VALUABLE IN FUTURE NEEDS ASSESSMENTS, BUT MORE IMPORTANTLY IN EDUCATING AND EQUIPPING COMMUNITY MEMBERS TO TAKE RESPONSIBILITY FOR THEIR HEALTH AND THE WELLNESS OF THEIR FAMILIES.THIS SIGNIFICANT SAMPLING OF CITIZENS OFFERED BOTH MAYO CLINIC HEALTH SYSTEM, AUSTIN CAMPUS AND MOWER COUNTY PUBLIC HEALTH INSIGHT TO CONFIRM AND REFOCUS EFFORTS THROUGH PARTNERSHIPS TO ADDRESS THE BOTH IDENTIFIED HEALTH CONCERNS OF COMMUNITY MEMBERS AND POTENTIAL SOLUTIONS. 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: MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN IS AN INTEGRATED ORGANIZATION, WITH MAIN SITES IN ALBERT LEA AND AUSTIN AND NINE REGIONAL CLINIC LOCATIONS WITHIN 20 MILES OF EACH SITE. THE POPULATION OF THE PRIMARY SERVICE AREA FOR EACH IS ABOUT 35,000, CONCENTRATED IN FREEBORN AND MOWER COUNTIES, RESPECTIVELY. MAYO CLINIC HEALTH SYSTEM - ALBERT LEA AND AUSTIN OFFERS A BROAD RANGE OF INPATIENT, OUTPATIENT AND SPECIALTY SERVICES IN SOUTHERN MINNESOTA AND NORTHERN IOWA, INCLUDING A CONVENIENCE CARE CLINIC, CANCER CENTER, PHYSICAL MEDICINE AND REHABILITATION CENTER AND INPATIENT AND OUTPATIENT DRUG AND ALCOHOL TREATMENT FACILITIES. 2012 POPULATION ESTIMATES:ALBERT LEA/FREEBORN COUNTY 30,948AUSTIN/MOWER COUNTY 39,371PERSONS UNDER 5 YEARSALBERT LEA/FREEBORN COUNTY 5.8%AUSTIN/MOWER COUNTY 7.2%PERSONS UNDER 18 YEARSALBERT LEA/FREEBORN COUNTY 21.8%AUSTIN/MOWER COUNTY 25.3% PERSONS 65 AND OVER ALBERT LEA/FREEBORN COUNTY 20.7%AUSTIN/MOWER COUNTY 17.3%TOTAL FEMALE ALBERT LEA/FREEBORN COUNTY 50.3%AUSTIN/MOWER COUNTY 50.2%ETHNICITY/RACE WHITE ALONE ALBERT LEA/FREEBORN COUNTY 96.4%AUSTIN/MOWER COUNTY 93.2%BLACK ALONE ALBERT LEA/FREEBORN COUNTY 1.0%AUSTIN/MOWER COUNTY 3.0%AMERICAN INDIAN/ALASKA NATIVE ALONE ALBERT LEA/FREEBORN COUNTY 0.4%AUSTIN/MOWER COUNTY 0.4%ASIAN ALONE ALBERT LEA/FREEBORN COUNTY 1.0%AUSTIN/MOWER COUNTY 1.9%NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER ALBERT LEA/FREEBORN COUNTY 0.1%AUSTIN/MOWER COUNTY 0.2%HISPANIC OR LATINO ORIGIN ALBERT LEA/FREEBORN COUNTY 9.1%AUSTIN/MOWER COUNTY 11.1%WHITE, NON-HISPANIC ALBERT LEA/FREEBORN COUNTY 87.9%AUSTIN/MOWER COUNTY 82.7%SOURCE: US CENSUS BUREAU PART VI, LINE 5: THIS 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. 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 - 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:MAYOCLINICHEALTHSYSTEM.ORG/LOCATIONS/ALBERT-LEA/BILLING ORMAYOCLINICHEALTHSYSTEM.ORG/LOCATIONS/AUSTIN/BILLING 1 AUSTIN COMMUNITY CHARITABLE FUND (VISION 2020) 329 NORTH MAIN STREET SUITE 106L AUSTIN MN 55912 363487772 501(C)(3) 26000 SUPPORT EXEMPT PURPOSE UNITED WAY OF FREEBORN COUNTY INC 341 SOUTH BROADWAY ALBERT LEA MN 56007 410956396 501(C)(3) 23500 SUPPORT EXEMPT PURPOSE UNITED WAY OF MOWER CO PO BOX 605 AUSTIN MN 55912 410831896 501(C)(3) 21041 SUPPORT EXEMPT PURPOSE FAMILY Y OF ALBERT LEA MINNESOTA INC 2021 WEST MAIN STREET ALBERT LEA MN 56007 411000679 501(C)(3) 13587 SUPPORT EXEMPT PURPOSE AUSTIN AREA COMMISSION FOR THE ARTS 300 N MAIN STREET AUSTIN MN 55912 411650727 501(C)(3) 12500 SUPPORT EXEMPT PURPOSE DEVELOPMENT CORPORATION OF AUSTIN 329 NORTH MAIN STREET SUITE 1061 AUSTIN MN 55912 237276266 501(C)(6) 11111 SUPPORT EXEMPT PURPOSE HORMEL FOUNDATION 329 NORTH MAIN STREET SUITE 102L AUSTIN MN 55912 410694716 501(C)(3) 10000 SUPPORT EXEMPT PURPOSE AMERICAN CANCER SOCIETY INC (RELAY FOR LIFE) 250 WILLILAMS STREET NW SUITE 400 ATLANTA GA 30303 131788491 501(C)(3) 8500 SUPPORT EXEMPT PURPOSE ALBERT LEA - FREEBORN COUNTY CHAMBER FOUNDATION 2580 BRIDGE AVE ALBERT LEA MN 56007 411651705 501(C)(3) 6550 SUPPORT EXEMPT PURPOSE ALBERT LEA ART CENTER 226 W CLARK STREET ALBERT LEA MN 56007 416038618 501(C)(3) 5500 SUPPORT EXEMPT PURPOSE CITY OF ALBERT LEA 221 E CLARK STREET ALBERT LEA MN 56007 416004922 CITY OF ALBERT LEA 5247 SUPPORT EXEMPT PURPOSE 10 1 SCHOLARSHIPS 25 20495 PART I, LINE 2: THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY AND EQUALITY OF OPPORTUNITY. TRANSFERS OR GRANTS TO TAX-EXEMPT ORGANIZATIONS AND/OR AFFILIATED TAX-EXEMPT ORGANIZATIONS WILL BE USED PURSUANT TO THE POLICIES AND PROCEDURES OF THE GRANTEE ORGANIZATIONS AND TO FURTHER THE EXEMPT PURPOSES OF THE GRANTEE ORGANIZATIONS. BOTH THE FILING ORGANIZATION AND THE GRANTEE ORGANIZATION MAINTAIN ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED. SCHOLARSHIPS ARE AWARDED TO INDIVIDUALS PURSUING A DEGREE IN A HEALTHCARE FIELD. THESE SCHOLARSHIPS ARE PAID DIRECTLY TO THE COLLEGE OR UNIVERSITY. 0 1 1 0 0 0 0 0 0 CIOTA MD MARK R CEO/CHAIR/DIRECTOR 758637 0 0 0 0 0 18200 0 27104 0 803941 0 0 0 GABRIELSON SHARON R DIRECTOR 0 236134 0 0 0 883 0 28406 0 18089 0 283512 0 0 MILLER MD ROBERT C VICE CHAIR/DIRECTOR 0 496482 0 0 0 56144 0 31739 0 27672 0 612037 0 0 PARKS DOUGLAS A REGION CAO/DIRECTOR 0 230653 0 0 0 1360 0 24478 0 26281 0 282772 0 0 SCHULZ MD JOHN M DIRECTOR 538679 0 0 0 0 0 18200 0 29015 0 585894 0 0 0 YTTERBERG MD KAREN L DIRECTOR 0 200990 0 0 0 2452 0 37331 0 3762 0 244535 0 0 AGERTER MD DAVID C REGION CEO 0 499015 0 0 0 56097 0 675 0 17533 0 573320 0 0 DANKERT SHERI S SITE CFO 161352 0 0 0 0 0 12914 0 24958 0 199224 0 0 0 KOCH MARK B ASSISTANT SECRETARY 0 378314 0 0 0 17413 0 533 0 17492 0 413752 0 0 TARASOVITCH JAMES J REGION CFO 0 293754 0 0 0 60707 0 10400 0 18113 0 382974 0 0 WALDHOFF STEPHEN C CAO 0 276292 0 0 0 6944 0 0 0 18786 0 302022 0 0 ANGSTMAN MD GREGORY L PHYSICIAN 292588 0 0 0 0 0 20272 0 17582 0 330442 0 0 0 BARNES MD DARRYL E MEDICAL STAFF PRESIDENT/PHYSICIAN 404072 0 0 0 0 0 20800 0 23420 0 448292 0 0 0 COLLIER DPM ROBERT L MEDICAL STAFF VP/PHYSICIAN 331679 0 0 0 0 0 20800 0 25459 0 377938 0 0 0 COPPES MD JOHN B MEDICAL DIRECTOR/PHYSICIAN 468248 0 0 0 0 0 20800 0 17334 0 506382 0 0 0 ECKSTROM MD MICHAEL T CHAIR OF SURGERY/PHYSICIAN 1048270 0 0 0 0 0 18200 0 26972 0 1093442 0 0 0 GOINS MD JENNIFER L PHYSICIAN 415843 0 5000 0 0 0 20800 0 29684 0 471327 0 0 0 GRZYBOWSKI MD JOHN A CHAIR OF PRIMARY CARE/PHYSICIAN 367617 0 0 0 0 0 18200 0 24793 0 410610 0 0 0 KATTEL MD SHARMA B PHYSICIAN 348972 0 0 0 0 0 18200 0 14713 0 381885 0 0 0 KLEIS DO KEITH R PHYSICIAN 366953 0 0 0 0 0 20800 0 24938 0 412691 0 0 0 LARSON VIRGINIA OPERATIONS ADMINISTRATOR 171004 0 0 0 0 0 12155 0 23816 0 206975 0 0 0 LOMBARDI MD JOSEPH M PHYSICIAN 286676 0 0 0 0 0 18200 0 10015 0 314891 0 0 0 NORDENG RODNEY L OPERATIONS ADMINISTRATOR 163881 0 0 0 0 0 13078 0 24994 0 201953 0 0 0 SCHULZ MD JODI L PHYSICIAN 543743 0 0 0 0 0 18200 0 25631 0 587574 0 0 0 SMITH MD A DON PHYSICIAN 358380 0 0 0 0 0 20800 0 23124 0 402304 0 0 0 STOLTENBERG MD HEIDI G PHYSICIAN 296650 0 0 0 0 0 18200 0 20173 0 335023 0 0 0 ULRICH MD MICHAEL D PHYSICIAN 381404 0 0 0 0 0 18200 0 30795 0 430399 0 0 0 YOUNG DO NATHAN P CHAIR OF MED SPECIALTIES/PHYSICIAN 239582 61261 0 0 0 80 19076 0 6781 5550 265439 66891 0 0 BECKENBAUGH DO JEFFREY P PHYSICIAN 711050 0 0 0 0 0 20800 0 27144 0 758994 0 0 0 BOYCE MD CORY A PHYSICIAN 645654 0 0 0 0 0 18200 0 17676 0 681530 0 0 0 ENGMAN MD STEVEN J PHYSICIAN 655378 0 0 0 0 0 20800 0 26374 0 702552 0 0 0 SKORIN DO LEONID PHYSICIAN 917918 0 0 0 0 0 18200 0 18948 0 955066 0 0 0 WEAVER MD CHAD H PHYSICIAN 678307 0 0 0 0 0 18200 0 2114 0 698621 0 0 0 KRITZER TAMMY L FORMER KEY EMPLOYEE 149996 0 0 0 0 0 11951 0 24029 0 185976 0 0 0 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). AGERTER M.D., DAVID C. $49,966 KOCH, MARK B. $14,770 MILLER M.D., ROBERT C. $48,823 WALDHOFF, STEPHEN C. $ 1,477 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. BEVERLY A LOMBARDI MD SPOUSE OF KEY EMPLOYEE, JOSEPH M. LOMBARDI M.D. 91579 EMPLOYMENT 0 PHILLIP R HANSON SPOUSE OF KEY EMPLOYEE, HEIDI G. STOLTENBERG M.D. 81773 EMPLOYMENT 0 STEVEN SCHULZ SPOUSE OF KEY EMPLOYEE, JODI L SCHULZ, M.D., 158666 EMPLOYMENT 0 MARY J SMITH SPOUSE OF KEY EMPLOYEE, A. DON SMITH, M.D. 70898 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 2 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. 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 TRUSTEES TO THE BOARD. FORM 990, PART VI, SECTION A, LINE 7B AMENDMENT OF ARTICLES OR BYLAWS REQUIRE APPROVAL BY BOTH THE GOVERNING BODY AND THE SOLE CORPORATE MEMBER. THE BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, BUDGET, AND DEBT DECISIONS. FORM 990, PART VI, SECTION A, LINE 8B THE FILING ORGANIZATION HAS NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. 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 IS 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 XI, LINE 9: LOSSES ON UNCOLLECTIBLE PLEDGES -8,754. CHANGE IN NET ASSETS OF FOUNDATION -526,100. 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 BLOOMER LAKEVIEW INC 2110 DUNCAN ROAD BLOOMER WI 54724 391450617 LOW INCOME HOUSING WI 501(C)(3) 7 MCHS--CHIPPEWA VALLEY INC 1 CHARTERHOUSE INC 200 FIRST STREET SW ROCHESTER MN 55905 411405254 RETIREMENT LIVING CENTER MN 501(C)(3) 9 MAYO CLINIC 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 1 GOLD CROSS AMBULANCE SERVICE 200 FIRST STREET SW ROCHESTER MN 55905 411917516 AMBULANCE SERVICE MN 501(C)(3) 9 MFMER 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 1 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 416011702 PATIENT CARE - CLINIC MN 501(C)(3) 9 N/A 1 MAYO CLINIC ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 860800150 HOSPITAL AND CLINIC AZ 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 590714831 HOSPITAL FL 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MAYO CLINIC HOSPITAL -- ROCHESTER 200 FIRST STREET SW ROCHESTER MN 55905 410944601 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC JACKSONVILLE 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 593337028 PATIENT CARE - CLINIC FL 501(C)(3) 7 MAYO CLINIC 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 1 MAYO KLINIK STIFTUNG 60486 FRANKFURT AM MAIN FRANKFURT GM FUNDRAISING FOUNDATION GM MFMER 1 MCHS IN WAYCROSS INC 1900 TEBEAU STREET WAYCROSS GA 31501 581667166 HOSPITAL GA 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MCHS--ALBERT LEA AND AUSTIN 1000 FIRST DRIVE NW AUSTIN MN 55912 411404075 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--AUSTIN FOUNDATION 1000 FIRST DRIVE NW AUSTIN MN 55912 300107471 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--ALBERT LEA AND AUSTIN 1 MCHS--CANNON FALLS 32021 COUNTY ROAD 24 BLVD CANNON FALLS MN 55009 204156428 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 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 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 1 MCHS--FAIRMONT 800 MEDICAL CENTER DRIVE PO BOX 800 FAIRMONT MN 56031 410760836 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 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 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 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 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 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 1 MCHS--LAKE CITY 500 WEST GRANT STREET LAKE CITY MN 55041 411906820 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--MANKATO 1025 MARSH STREET MANKATO MN 56002 411236756 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--MANKATO HEALTH CARE FOUNDATION 1025 MARSH STREET MANKATO MN 56002 411663357 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--MANKATO 1 MCHS--NEW PRAGUE 301 SECOND STREET NE NEW PRAGUE MN 56071 410723639 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 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 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 1 MCHS--OWATONNA 134 SOUTHVIEW ST OWATONNA MN 55060 411862132 PATIENT CARE - CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--RED CEDAR INC 2321 STOUT ROAD MENOMONIE WI 54751 510190875 HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC 1 MCHS--RED WING 701 HEWITT BOULEVARD RED WING MN 55066 411713783 PATIENT CARE SERVICES MN 501(C)(3) 3 MAYO CLINIC 1 MCHS--SPRINGFIELD 625 NORTH JACKSON AVENUE SPRINGFIELD MN 56087 411893827 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 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 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 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 1 MCHS--WASECA 501 NORTH STATE STREET WASECA MN 56093 363606405 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 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 1 POVERELLO FOUNDATION 200 FIRST STREET SW ROCHESTER MN 55905 411494881 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC HOSPITAL - ROCHESTER 1 THE HIRSH FAMILY FOUNDATION 108 NORTH MAIN STREET AUSTIN MN 55912 411749842 FUNDRAISING FOUNDATION MN 501(C)(3) 11-I N/A 0 HORMEL FOUNDATION 329 N MAIN ST SUITE 102L AUSTIN MN 55912 410694716 FUNDRAISING FOUNDATION MN 501(C)(3) 11-I N/A 0 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 BWL HOLDINGS INC 1209 ORANGE STREET WILMINGTON DE 19801 472413749 OIL & GAS EXPLORATION DE N/A C 1 AMBIENT CLINICAL ANALYTICS INC 221 1ST AVE SW SUITE 202 ROCHESTER MN 55902 800928405 SOFTWARE DE N/A C 1 CAVALRY CLO III LTD PO BOX 1093 GT QUEENSGATE HOUSE S GRAND CAYMAN CJ INVESTMENT ACTIVITIES CJ N/A C 1 CAVALRY CLO IV LTD PO BOX 1093 GT QUEENSGATE HOUSE S GRAND CAYMAN CJ INVESTMENT ACTIVITIES CJ N/A C 1 GMO GLOBAL BOND INVESTMENT FUND 78 SIR JOHN ROGERSONS QUAY DUBLIN 2 EI OTHER FINANCIAL INVESTMENT ACTIVITIES EI N/A 1 HEALTH TRADITION HEALTH PLAN 1808 EAST MAIN STREET ONALASKA WI 54650 391545987 MEDICAL SERVICES COMPANY WI N/A C 1 LOBSS NETWORK SUPPORT 2002 INC 200 FIRST STREET SW ROCHESTER MN 55905 481276150 ADMINISTRATIVE SERVICES MN N/A C 1 MAYO CLINIC GBS MAURITIUS 2ND FLOOR EBENE MEWS 57 EBENE CYBERCITY MP HEALTHCARE MANAGEMENT MP N/A C 1 MAYO CLINIC SUPPORT SERVICES TEXAS 200 FIRST STREET SW ROCHESTER MN 55905 471751102 HEALTH SERVICES TX N/A C 1 MAYO HOLDING COMPANY 200 FIRST STREET SW ROCHESTER MN 55905 411578020 HOLDING COMPANY MN N/A C 1 MAYO INSURANCE COMPANY LTD 200 FIRST STREET SW ROCHESTER MN 55905 SELF INSURANCE POOL CJ N/A C 1 MCHS--DECORAH CLINIC PHYSICIANS 907 MONTGOMERY STREET DECORAH IA 52101 411711329 PATIENT CARE - CLINIC IA N/A C 1 MCHS--PHARMACY & HOME MEDICAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 391528920 PHARMACY SERVICES WI N/A C 1 MMSI INC 21 FIRST STREET SW ROCHESTER MN 55905 411547003 THIRD PARTY ADMINISTRATION SERVICES MN N/A C 1 RESOUNDANT INC 221 1ST AVE SW ROCHESTER MN 55902 461661978 MANUFACTURING MEDICAL DEVICE COMPONENT MN N/A C 1 ROCHESTER AIRPORT COMPANY ROUTE 2 ROCHESTER MN 55902 410506870 AIRPORT MANAGEMENT MN N/A C 1 SATILLA HEALTHNET INC 1900 TEBEAU STREET WAYCROSS GA 31501 582151076 HEALTH SERVICES GA N/A C 1 SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION 13400 E SHEA BLVD SCOTTSDALE AZ 85259 860870505 COMMERCIAL PROPERTY OWNERS ASSOCIATION AZ N/A C 1 THE STABILE BUILDING OWNERS' ASSOCIATION 200 FIRST STREET SW ROCHESTER MN 55905 208994499 COMMERCIAL PROPERTY OWNERS ASSOCIATION MN N/A C 1 CHARITABLE LEAD TRUST CHARITABLE TRUST CA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST ND N/A T 1 PERPETUAL TRUST CHARITABLE TRUST AZ N/A T 1 PERPETUAL TRUST CHARITABLE TRUST LA N/A T 1 PERPETUAL TRUST (2) CHARITABLE TRUST MA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST MO N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST AZ N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST CO N/A T 1 CHARITABLE REMAINDER TRUST (9) CHARITABLE TRUST FL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST LA N/A T 1 CHARITABLE REMAINDER TRUST (73) CHARITABLE TRUST MN N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST NC N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST NM N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST NV N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST NY N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST TX N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST WI N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST CO N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST IL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST MI N/A T 1 CHARITABLE REMAINDER TRUST (70) CHARITABLE TRUST MN N/A T 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 GOLD CROSS AMBULANCE SERVICE M 208360 GAAP MAYO CLINIC HOSPITAL - ROCHESTER A 116532 GAAP MAYO CLINIC HOSPITAL - ROCHESTER L 518670 GAAP MCHS-AUSTIN FOUNDATION C 649753 GAAP MCHS-CANNON FALLS Q 3876661 GAAP MCHS-LAKE CITY Q 1688451 GAAP MCHS-MANKATO M 332560 GAAP MCHS-WASECA L 58960 GAAP MMSI INC M 269136 GAAP MMSI INC R 11369124 GAAP MMSI INC S 15716617 GAAP