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MAYO CLINIC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
MAYO CLINIC (EIN 41-0760836)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-12
IRS object ID
201413169349302016
Schema version
2013v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2014-11-12T10:33:57-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN410760836EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MAYO CLINIC HEALTH SYSTEM-FAIRMONTBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlMAYOBusinessNameControlTxt
Phone5075381297PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 MEDICAL CENTER DRIVEAddressLine1
CityFAIRMONTCity
StateMNState
ZIP Code56031ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAMES J TARASOVITCHPersonNm
Person TitleCFOPersonTitleTxt
Phone5073852646PhoneNum
Signature2014-11-12SignatureDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerGREGORY KUTCHER MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 MEDICAL CENTER DRIVEAddressLine1
CityFAIRMONTCity
StateMNState
ZIP Code56031ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$82,393,676GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption5983GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MAYOCLINICHEALTHSYSTEM.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1940FormationYr
Legal Domicile StateMNLegalDomicileStateCd
Activity Or MissionHOSPITAL, NURSING HOME, AND CLINICSActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee724TotalEmployeeCnt
Total Volunteers102TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,814,016PYContributionsGrantsAmt
CY Contributions Grants$1,254,737CYContributionsGrantsAmt
PY Program Service Revenue$80,396,932PYProgramServiceRevenueAmt
CY Program Service Revenue$80,454,397CYProgramServiceRevenueAmt
PY Investment Income-$7,722PYInvestmentIncomeAmt
CY Investment Income$248,442CYInvestmentIncomeAmt
PY Other Revenue$346,379PYOtherRevenueAmt
CY Other Revenue$340,517CYOtherRevenueAmt
PY Total Revenue$82,549,605PYTotalRevenueAmt
CY Total Revenue$82,298,093CYTotalRevenueAmt
PY Grants And Similar Paid$18,718PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$10,995CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$48,186,790PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$52,380,048CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$145,063CYTotalFundraisingExpenseAmt
PY Other Expenses$36,058,876PYOtherExpensesAmt
CY Other Expenses$33,413,293CYOtherExpensesAmt
PY Total Expenses$84,264,384PYTotalExpensesAmt
CY Total Expenses$85,804,336CYTotalExpensesAmt
PY Revenues Less Expenses-$1,714,779PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,506,243CYRevenuesLessExpensesAmt
Total Assets BOY$38,852,778TotalAssetsBOYAmt
Total Assets EOY$36,823,577TotalAssetsEOYAmt
Total Liabilities BOY$15,327,520TotalLiabilitiesBOYAmt
Total Liabilities EOY$16,804,562TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$23,525,258NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$20,019,015NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$74,771,378ExpenseAmt
Revenue$80,756,468RevenueAmt
DescPATIENT SERVICES (SEE SCHEDULE O)PATIENT SERVICES: 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 14,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN MORE THAN 70 COMMUNITIES, MAYO CLINIC HEALTH SYSTEM INCLUDES 18 OWNED HOSPITALS, SIX OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH TWO ADDITIONAL HOSPITALS, AND CONTRACT MANAGEMENT AGREEMENTS WITH AN ADDITIONAL HOSPITAL AND 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 2.5 MILLION VISITS ANNUALLY IN MAYO CLINIC HEALTH SYSTEM. IT IS ALSO A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS. MAYO CLINIC HEALTH SYSTEM - FAIRMONT IS A MEDICAL CENTER PROVIDING CARE TO PATIENTS IN THE CLINIC SETTING, THE EYE CLINIC, THE HOSPITAL, AND EMERGENCY ROOM. THE MEDICAL CENTER ALSO PROVIDES LONG-TERM CARE AND OTHER MEDICAL SERVICES TO THE COMMUNITY OF FAIRMONT, MINNESOTA, AND THE SURROUNDING SOUTH CENTRAL MINNESOTA AND NORTH CENTRAL IOWA SERVICE AREA. THE MEDICAL CENTER IS A "SOLE COMMUNITY HOSPITAL". THE MEDICAL CENTER'S OPERATIONS CONSIST OF A 57-BED ACUTE CARE HOSPITAL, AN ATTACHED 40-BED SKILLED CARE NURSING HOME, AN ATTACHED PROVIDER-BASED CLINIC WITH SATELLITE REGIONAL CLINICS LOCATED IN SHERBURN, MINNESOTA AND TRUMAN, MINNESOTA, CONVENIENT CARE CLINIC LOCATED IN THE WAL-MART STORE IN FAIRMONT, MINNESOTA, AND A SATELLITE CLINIC LOCATED IN ARMSTRONG, IOWA.THE MEDICAL CENTER'S MISSION, VISION AND VALUES STATEMENT IS LISTED BELOW: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.VISION: MAYO CLINIC WILL PROVIDE AN UNPARALLELED EXPERIENCE AS THE MOST TRUSTED PARTNER FOR HEALTH CARE.PRIMARY VALUE: THE NEEDS OF THE PATIENT COME FIRST.THE MEDICAL CENTER PROVIDES CHARITY CARE FOR PATIENTS FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. THE MEDICAL CENTER ALSO PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. THE TOTAL COST OF CHARITY CARE PROVIDED IN 2013 WAS APPROXIMATELY $488,300. THE TOTAL COST OF UNCOMPENSATED CARE PROVIDED TO LOW INCOME PATIENTS THROUGH MEDICAID AND MINNESOTACARE (A STATE PROGRAM FOR PROVIDING MEDICAL CARE TO THE LOW INCOME POPULATION) WAS APPROXIMATELY $2,548,800. INCLUDED IN THIS AMOUNT IS THE MEDICAID SURCHARGE OF $577,732 AND THE MINNESOTA CARE TAX OF $708,698.THE TOTAL UNREIMBURSED COST OF MEDICARE WAS APPROXIMATELY $12,642,000.MAYO CLINIC HEALTH SYSTEM - FAIRMONT OFFERS 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.MCHS-FAIRMONT ALSO LEASES SPACE AND PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE OF PROVIDING PATIENT CARE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$18,000ExpenseAmt
Grant$3,000GrantAmt
DescMEDICAL EDUCATON (SEE SCHEDULE O)MEDICAL EDUCATION:MAYO CLINIC HEALTH SYSTEM - FAIRMONT (MCHS-FAIRMONT) PROVIDES CLINICAL EXPERIENCE TO STUDENTS OF IOWA LAKES COMMUNITY COLLEGE, MINNESOTA WEST COMMUNITY COLLEGE, SOUTH CENTRAL COLLEGE, RIVERLAND COMMUNITY COLLEGE, AND PRESENTATION COLLEGE.MCHS - FAIRMONT PROVIDED $3,000 IN SCHOLARSHIPS TO LOCAL COMMUNITY STUDENTS PURSUING A HEALTH-RELATED CAREER.MCHS - FAIRMONT OFFERS NUMEROUS EDUCATIONAL SEMINARS, CLASSES AND OPPORTUNITIES FOR ITS PATIENTS, THEIR FAMILIES, EMPLOYEES, COMMUNITY MEMBERS, AND THE GENERAL PUBLIC. THE FOLLOWING IS A SAMPLING OF THE EVENTS THAT WERE OFFERED IN 2013: PARENTING CLASSES, FAMILY FUN FAIR, MARTIN COUNTY FAIR, CANCER SUPPORT GROUPS,"SPEAKING OF" HEALTH BROADCAST, ON CAMPUS PRESENTATIONS, AND HOMETOWN HEALTH NEWSLETTER MAILINGS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$15,327ExpenseAmt
Grant$7,995GrantAmt
Revenue$4,000RevenueAmt
DescCOMMUNITY CONTRIBUTIONS (SEE SCHEDULE O)COMMUNITY CONTRIBUTIONS:MAYO CLINIC HEALTH SYSTEM - FAIRMONT (MCHS-FAIRMONT) OFFERED BLOOD PRESSURE SCREENINGS AND FLU IMMUNIZATIONS TO THE COMMUNITY.MCHS-FAIRMONT PROVIDED FINANCIAL SUPPORT TO THE FAIRMONT CHAMBER OF COMMERCE AND LAKEVIEW HEALTH SERVICES. TOTAL DONATIONS IN 2013 WERE APPROXIMATELY $7,995.IN 2013, MCHS-FAIRMONT RECEIVED DONATED SERVICES FROM 98 VOLUNTEERS, WHO PROVIDED 10,094 VOLUNTEER HOURS, VALUED AT APPROXIMATELY $227,721 BASED ON THE INDEPENDENT SECTOR'S AVERAGE ESTIMATED HOURLY VALUE OF SUCH SERVICE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$74,804,705TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee724EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CORPORATE TAX UNITBusinessNameLine1
FieldValueIRS element (for citing)
Phone5075381297PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 FIRST ST SWAddressLine1
CityROCHESTERCity
StateMNState
ZIP Code55905ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BROLSMA GREG
DIRECTOR1.000.00Yes (X)$0$0$0
GAALSWYK MARK
DIRECTOR1.000.00Yes (X)$0$0$0
GREEN MD JEFFREY P
DIRECTOR/VICE CHAIR40.000.00Yes (X)$236,962$0$43,113Yes (X)
KOWAL DO GERALD K
DIRECTOR (6/24-12/31)1.0040.00Yes (X)$0$316,556$41,714
KUTCHER MD GREGORY R
DIR/PRES/REGION CEO1.0040.00Yes (X)$0$455,895$35,280Yes (X)
LARDYTRACI
DIRECTOR (4/22-12/31)1.000.00Yes (X)$0$0$0
MORRIS MD MARIE E
DIRECTOR/CHAIR40.000.00Yes (X)$367,429$0$49,741Yes (X)
STRUCK ALLEN W
DIRECTOR/SECY/TREAS1.000.00Yes (X)$0$0$0Yes (X)
BARTINGALE ROBERT F
SITE ADMINISTRATOR40.000.00$215,286$0$50,540Yes (X)
GRACE RICHARD W
REGION CAO1.0040.00$0$314,087$30,442Yes (X)
KOCH MARK B
ASSISTANT SECRETARY1.0040.00$0$316,763$13,860Yes (X)
TARASOVITCH JAMES J
REGION CFO1.0040.00$0$266,706$27,577Yes (X)
FREDERICK RYANNON K
CHIEF NURSING OFFICER35.005.00$145,237$19,619$29,554Yes (X)
HANSEN GAYLE B
CHIEF INTEGRATION/EMP EXP OFFICER40.000.00$267,910$0$53,479Yes (X)
BERTHELSEN MD STEPHEN O
PHYSICIAN40.000.00$630,918$0$13,385Yes (X)
HODGES MD LEROY W
PHYSICIAN40.000.00$607,955$0$52,956Yes (X)
MASTERSON MD CLINTON J
PHYSICIAN40.000.00$627,727$0$0Yes (X)
RODRIGUEZ MD RUFUS R
PHYSICIAN/CHIEF OF STAFF40.000.00$741,291$0$63,729Yes (X)
SZUTZ MD TIMOTHY J
PHYSICIAN40.000.00$763,898$0$66,963Yes (X)
HAGEDORN MD STEVEN D
FORMER VICE CHAIR0.0040.00$0$227,445$59,594Yes (X)
SUTER BRIAN E
FORMER INTERIM CAO40.000.00$182,479$0$36,167Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,787,092TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,917,071TotReportableCompRltdOrgAmt
Total Other Compensation$668,094TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K69IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
COMPHEALTH INC- PHYSICIAN
PO BOX 972670DALLASTX75397LOCUM PHYSICIANS$905,870
NINELINE INC
815 J STREET STE 303SAN DIEGOCA92101LOCUM PHYSICIANS$727,623
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX75397LOCUM PHYSICIANS$515,374
MAYO CLINIC
200 FIRST STREET SWROCHESTERMN55905MEDICAL & ADMIN SERVICES$305,532
DELTA LOCUM TENENS
PO BOX 202940DALLASTX75320LOCUM PHYSICIANS$177,953
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K10CntrctRcvdGreaterThan100KCnt
Federated Campaigns$5,600FederatedCampaignsAmt
Fundraising$2,551FundraisingAmt
Related Organizations$202,587RelatedOrganizationsAmt
Government Grants$1,043,903GovernmentGrantsAmt
All Other Contributions$96AllOtherContributionsAmt
Total Contributions$1,254,737TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT REVENUE620000$74,543,258$74,543,258
SHARED SERVICES561000$5,798,805$5,798,805
RENT FROM AFFILIATES531120$108,334$108,334
LIFELINE621990$4,000$4,000
FieldValueIRS element (for citing)
Total Program Service Revenue$80,454,397TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$296,110TotalRevenueColumnAmt
Exclusion$296,110ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$14,155RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$14,155RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,155TotalRevenueColumnAmt
Exclusion$14,155ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$47,668OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$47,668OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$47,668TotalRevenueColumnAmt
Exclusion-$47,668ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$1,482FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$2,551ContriRptFundraisingEventAmt
Fundraising Direct Expenses$3,107FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,625TotalRevenueColumnAmt
Exclusion-$1,625ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$44,303GrossSalesOfInventoryAmt
Cost Of Goods Sold$44,808CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$505TotalRevenueColumnAmt
Exclusion-$505ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
CAFETERIA/VENDING722210$212,471$212,074$397
MED REC/TRANSCR FEES541900$57,986$57,986
MISC. REVENUE900099$38,702$36,011$2,691

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,333TotalRevenueColumnAmt
Exclusion$19,333ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$328,492OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$82,298,093TotalRevenueColumnAmt
Related Or Exempt Func Income$80,760,468RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$282,888ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$7,995TotalAmt
Program Services$7,995ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$3,000TotalAmt
Program Services$3,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,455,959TotalAmt
Program Services$868,744ProgramServicesAmt
Management And General$587,215ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$2,246,987TotalAmt
Program Services$2,028,341ProgramServicesAmt
Management And General$218,646ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$37,817,227TotalAmt
Program Services$33,896,876ProgramServicesAmt
Management And General$3,814,374ManagementAndGeneralAmt
Fundraising$105,977FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,795,014TotalAmt
Program Services$2,545,790ProgramServicesAmt
Management And General$241,518ManagementAndGeneralAmt
Fundraising$7,706FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,568,498TotalAmt
Program Services$4,983,604ProgramServicesAmt
Management And General$570,085ManagementAndGeneralAmt
Fundraising$14,809FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,496,363TotalAmt
Program Services$2,218,104ProgramServicesAmt
Management And General$271,829ManagementAndGeneralAmt
Fundraising$6,430FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$45,168TotalAmt
Program Services$45,168ProgramServicesAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$5,364TotalAmt
Program Services$5,364ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$11,390,635TotalAmt
Program Services$7,162,985ProgramServicesAmt
Management And General$4,227,650ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$53,086TotalAmt
Program Services$178ProgramServicesAmt
Management And General$52,908ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,086,023TotalAmt
Program Services$2,818,173ProgramServicesAmt
Management And General$262,600ManagementAndGeneralAmt
Fundraising$5,250FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,669,628TotalAmt
Program Services$1,663,955ProgramServicesAmt
Management And General$5,673ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$335,799TotalAmt
Program Services$225,895ProgramServicesAmt
Management And General$107,265ManagementAndGeneralAmt
Fundraising$2,639FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$208,834TotalAmt
Program Services$206,772ProgramServicesAmt
Management And General$2,062ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$362,164TotalAmt
Program Services$362,164ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,409,660TotalAmt
Program Services$2,196,423ProgramServicesAmt
Management And General$210,985ManagementAndGeneralAmt
Fundraising$2,252FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$541,102TotalAmt
Program Services$409,660ProgramServicesAmt
Management And General$131,442ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES$8,584,172$8,584,172
BAD DEBT EXPENSE$3,114,017$3,114,017
MN CARE TAX$708,698$708,698
MEDICAID SURCHARGE$577,732$577,732

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$321,211TotalAmt
Program Services$170,895ProgramServicesAmt
Management And General$150,316ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$85,804,336TotalAmt
Program Services$74,804,705ProgramServicesAmt
Management And General$10,854,568ManagementAndGeneralAmt
Fundraising$145,063FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$5,999BOYAmt
EOY$6,106EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$24,268BOYAmt
EOY$10,689EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$13,172,523BOYAmt
EOY$12,480,568EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,073,530BOYAmt
EOY$1,081,623EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,043,720BOYAmt
EOY$997,211EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$51,991,456LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$33,346,725LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$20,082,238BOYAmt
EOY$18,644,731EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,450,500BOYAmt
EOY$3,602,649EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$38,852,778BOYAmt
EOY$36,823,577EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,843,589BOYAmt
EOY$6,187,597EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$2,786BOYAmt
EOY$2,693EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,481,145BOYAmt
EOY$10,614,272EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,327,520BOYAmt
EOY$16,804,562EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$21,075,336BOYAmt
EOY$17,683,560EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,429,506BOYAmt
EOY$1,173,295EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,020,416BOYAmt
EOY$1,162,160EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$23,525,258BOYAmt
EOY$20,019,015EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$38,852,778BOYAmt
EOY$36,823,577EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$3,506,243ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$5,364OtherActivitiesAmt
Total Lobbying Expenditures$5,364TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationMAYO CLINIC HEALTH SYSTEM - MANKATO (MCHS-MANKATO), THE PARENT COMPANY OF THE FILING ORGANIZATION, PROVIDES SUPPORT SERVICES TO THE FILING ORGANIZATION THAT INCLUDES PROVIDING INFORMATION OR EXPRESSING 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 2013, MCHS - MANKATO REPRESENTATIVES HAD SEVERAL MEETINGS WITH MEMBERS OF THE LEGISLATIVE AND EXECUTIVE BRANCHES 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.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,449,921BeginningYearBalanceAmt
Contributions$198,621ContributionsAmt
Other Expenditures$313,088OtherExpendituresAmt
End Year Balance$2,335,454EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,965,688BeginningYearBalanceAmt
Contributions$484,234ContributionsAmt
Investment Earnings Or Losses$37,602InvestmentEarningsOrLossesAmt
Other Expenditures$37,603OtherExpendituresAmt
End Year Balance$2,449,921EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,103,153BeginningYearBalanceAmt
Contributions$468,387ContributionsAmt
Investment Earnings Or Losses-$570InvestmentEarningsOrLossesAmt
Other Expenditures$605,282OtherExpendituresAmt
End Year Balance$1,965,688EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,776,123BeginningYearBalanceAmt
Contributions$261,963ContributionsAmt
Investment Earnings Or Losses$229,353InvestmentEarningsOrLossesAmt
Other Expenditures$164,286OtherExpendituresAmt
End Year Balance$2,103,153EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,466,513BeginningYearBalanceAmt
Contributions$429,655ContributionsAmt
Investment Earnings Or Losses$54,803InvestmentEarningsOrLossesAmt
Other Expenditures$174,848OtherExpendituresAmt
End Year Balance$1,776,123EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.50000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.50000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$105,880OtherCostOrOtherBasisAmt
Book Value$105,880BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$38,155,079OtherCostOrOtherBasisAmt
Depreciation$23,090,555DepreciationAmt
Book Value$15,064,524BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,730,497OtherCostOrOtherBasisAmt
Depreciation$10,256,170DepreciationAmt
Book Value$3,474,327BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$18,644,731TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
CHARITABLE GIFT ANNUITY$66,031
DUE FROM AFFILIATES$288,832
DEFERRED COMPENSATION$1,408,568
INTEREST IN NET ASSETS OF FDN$1,839,218
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,602,649TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ASSET RETIREMENT OBLIGATION$45,120
DUE TO AFFILIATES$9,160,584
DEFERRED COMPENSATION LIABILITY$1,408,568
FieldValueIRS element (for citing)
Total Liability$10,614,272TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:MAYO CLINIC HEALTH SYSTEM - FAIRMONT MAINTAINS A "RESIDENT TRUST" ACCOUNT/BANK ACCOUNT FOR THE RESIDENTS OF A 40 BED SKILLED NURSING HOME.
PART V, LINE 4:ENDOWMENTS ARE USED FOR CARDIAC REHAB, PASTORAL CARE, AND NURSING.
PART X, LINE 2:AT DECEMBER 31, 2013 AND 2012, 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 H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$488,212TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$488,212NetCommunityBenefitExpnsAmt
Total Expense0.00590TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,070,940TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,523,669DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,547,271NetCommunityBenefitExpnsAmt
Total Expense0.03080TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,559,152TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,523,669DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,035,483NetCommunityBenefitExpnsAmt
Total Expense0.03670TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,332TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$22,332NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,000NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,561,796TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$953,502DirectOffsettingRevenueAmt
Net Community Benefit Expns$608,294NetCommunityBenefitExpnsAmt
Total Expense0.00740TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,587,128TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$953,502DirectOffsettingRevenueAmt
Net Community Benefit Expns$633,626NetCommunityBenefitExpnsAmt
Total Expense0.00770TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,146,280TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,477,171DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,669,109NetCommunityBenefitExpnsAmt
Total Expense0.04440TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,995TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,995NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,995TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,995NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$3,114,017BadDebtExpenseAmt
Reimbursed By Medicare$16,129,428ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$20,055,077CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,925,649MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MAYO CLINIC HEALTH SYSTEM-FAIRMONTBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 MEDICAL CENTER DRIVEAddressLine1
CityFAIRMONTCity
StateMNState
ZIP Code56031ZIPCode
FieldValueIRS element (for citing)
Website AddressMAYOCLINICHEALTHSYSTEM.ORGWebsiteAddressTxt
State License00359StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherCLINIC, NURSING HOMEOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MAYO CLINIC HEALTH SYSTEM-FAIRMONTBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLMAYOCLINICHEALTHSYSTEM.ORG/ABOUT-USOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
All Needs AddressedYes (1)AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
Insurance StatusYes (X)InsuranceStatusInd
Uninsured DiscountYes (X)UninsuredDiscountInd
Medicaid MedicareYes (X)MedicaidMedicareInd
ResidencyYes (X)ResidencyInd
Other FactorsYes (X)OtherFactorsInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Available On RequestYes (X)AvailableOnRequestInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
MAYO CLINIC HEALTH SYSTEM-FAIRMONTPART V, SECTION B, LINE 3: MAYO CLINIC HEALTH SYSTEM IN FAIRMONT RECEIVED INPUT FROM LOCAL COMMUNITY AND ORGANIZATION LEADERS AND PUBLIC HEALTH OFFICIALS INCLUDING THE EXECUTIVE DIRECTOR AND SUPERVISOR OF HUMAN SERVICES OF FARIBAULT AND MARTIN COUNTIES.
MAYO CLINIC HEALTH SYSTEM-FAIRMONTPART V, SECTION B, LINE 12I: 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-FAIRMONTPART V, SECTION B, LINE 14G: 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.
MAYO CLINIC HEALTH SYSTEM-FAIRMONTPART V, SECTION B, LINE 18E: 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 GOVENMENTAL 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-FAIRMONTPART V, SECTION B, LINE 20D: 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.
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
MCHS-FAIRMONT IN ARMSTRONG
412 6TH STREETARMSTRONGIA50514CLINIC
MCHS-FAIRMONT IN SHERBURN
32 N MAIN STREETSHERBURNMN56171CLINIC
MCHS-FAIRMONT IN TRUMAN
401 N 4TH AVE ETRUMANMN56088CLINIC
MCHS-FAIRMONT IN BLUE EARTH
411 S GROVE ST SUITE 3BLUE EARTHMN56013PSYCHOLOGY SERVICES CLINIC
MCHS-FAIRMONT
1250 GOEMANN ROADFAIRMONTMN56013CLINIC

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 6A:THE ANNUAL REPORT FOR THE FILING ORGANIZATION IS PART OF A CONSOLIDATED REPORT PREPARED BY MAYO 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 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 $ 3,114,017.
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, 6, 8 AND 9 OF MAYO CLINIC'S 2013 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 APPROXIMATELY $12,642,000 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 MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILTY 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 MAYO WOULD TELL THE COLLECTION AGENCY TO PURSUE COLLECTIONS ON THE BALANCE OR PARTIAL BALANCE IF THERE WAS A CHARITY ADJUSTMENT.
PART VI, LINE 2:MAYO CLINIC HEALTH SYSTEM - FAIRMONT (MCHS-FAIRMONT) COLLABORATES WITH PUBLIC AND PRIVATE GROUPS IN ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. MCHS-FAIRMONT WORKS CLOSELY WITH THE HEALTH AND HUMAN SERVICES AGENCY THAT SERVES MARTIN AND FARIBAULT COUNTIES (MINNESOTA), WHICH IS MCHS-FAIRMONT'S MAIN SERVICE AREA, IN UNDERSTANDING THE NEEDS. DATA IS ALSO RESEARCHED, STUDIED, AND USED IN STRATEGIC PLANNING. DATA SOURCES INCLUDE COUNTY DATA, STATE DATA, AND MINNESOTA HOSPITAL ASSOCIATION DATA. IN ADDITION, MCHS-FAIRMONT PRESENTS PUBLIC EDUCATION EVENTS THROUGHOUT THE YEAR AND HAS LOCAL CABLE INFORMATIVE PROGRAMS.
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 AVAILABLE BY POSTING IT ON THEIR WEBPAGE INCLUDING THE ABILITY TO DOWNLOAD A COPY OF THE POLICY 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.
PART VI, LINE 4:MAYO CLINIC HEALTH SYSTEM - FAIRMONT IS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT SERVES THE RESIDENTS OF MARTIN, FARIBAULT, WATONWAN, AND JACKSON COUNTIES IN MINNESOTA AND KOSSUTH, EMMETT, AND PALO ALTO COUNTIES IN IOWA. THE MAIN CITY SERVED IS FAIRMONT, MINNESOTA WITH THE BALANCE OF THE SERVICE AREA BEING SMALL TOWNS OR RURAL AGRICULTURAL AREAS. THE AREA POPULATION IS TRENDING OLDER THAN THE STATEWIDE AVERAGE. THE MAIN INDUSTRY IN THE SERVICE AREA IS AGRICULTURAL BASED.
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. 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: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 7NEITHER 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 ON THE MINNESOTA HOSPITAL ANNUAL REPORT OR TO THE MINNESOTA HOSPITAL ASSOCIATION.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceYes (X)HousingAllowanceOrResidenceInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E Expnss0WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
GREEN MD JEFFREY P
DIRECTOR/VICE CHAIR$231,311$0$0$0$5,651$0$18,141$0$24,972$0$280,075$0$0$0
KOWAL DO GERALD K
DIRECTOR (6/24-12/31)$0$316,556$0$0$0$0$0$12,750$0$28,964$0$358,270$0$0
KUTCHER MD GREGORY R
DIR/PRES/REGION CEO$0$455,895$0$0$0$0$0$12,750$0$22,530$0$491,175$0$0
MORRIS MD MARIE E
DIRECTOR/CHAIR$339,893$0$0$0$27,536$0$30,488$0$19,253$0$417,170$0$0$0
BARTINGALE ROBERT F
SITE ADMINISTRATOR$209,551$0$0$0$5,735$0$37,154$0$13,386$0$265,826$0$0$0
GRACE RICHARD W
REGION CAO$0$313,519$0$0$0$568$0$12,750$0$17,692$0$344,529$0$0
KOCH MARK B
ASSISTANT SECRETARY$0$305,711$0$0$0$11,052$0$230$0$13,630$0$330,623$0$0
TARASOVITCH JAMES J
REGION CFO$0$266,706$0$0$0$0$0$10,200$0$17,377$0$294,283$0$0
FREDERICK RYANNON K
CHIEF NURSING OFFICER$144,095$19,563$0$0$1,142$56$5,369$0$20,892$3,293$171,498$22,912$0$0
HANSEN GAYLE B
CHIEF INTEGRATION/EMP EXP OFFICER$256,869$0$0$0$11,041$0$33,093$0$20,386$0$321,389$0$0$0
BERTHELSEN MD STEPHEN O
PHYSICIAN$495,267$0$0$0$135,651$0$0$0$13,385$0$644,303$0$0$0
HODGES MD LEROY W
PHYSICIAN$561,130$0$0$0$46,825$0$30,731$0$22,225$0$660,911$0$0$0
MASTERSON MD CLINTON J
PHYSICIAN$586,438$0$0$0$41,289$0$0$0$0$0$627,727$0$0$0
RODRIGUEZ MD RUFUS R
PHYSICIAN/CHIEF OF STAFF$617,487$0$0$0$123,804$0$36,757$0$26,972$0$805,020$0$0$0
SZUTZ MD TIMOTHY J
PHYSICIAN$611,109$0$0$0$152,789$0$39,491$0$27,472$0$830,861$0$0$0
HAGEDORN MD STEVEN D
FORMER VICE CHAIR$0$224,256$0$0$0$3,189$0$37,014$0$22,580$0$287,039$0$0
SUTER BRIAN E
FORMER INTERIM CAO$168,112$0$0$0$14,367$0$13,997$0$22,170$0$218,646$0$0$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AIN 2013, HEALTH CLUB DUES WERE PAID BY MAYO CLINIC HEALTH SYSTEM - FAIRMONT ON BEHALF OF PAID EMPLOYEES WHO MET THE ATTENDANCE REQUIRMENTS. CLINTON J. MASTERSON, M.D., A HIGHEST COMPENSATED EMPLOYEE, RECEIVED HOUSING THAT WAS TREATED AS TAXABLE INCOME.
PART I, LINE 1BTHE HOUSING PROVIDED FOR DR. MASTERSON WAS APPROVED BY ADMINISTRATION AND CONSIDERED AS NECESSARY IN ORDER TO MEET CRITICAL STAFFING NEEDS THAT WOULD OTHERWISE GO UNMET. ALL OTHER ACTIVITIES FOLLOWED A WRITTEN POLICY.
PART I, LINE 3THE 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, LINE 4BTHIS 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). STEPHEN O. BERTHELSEN, M.D. $ 68,221 LEROY W. HODGES, M.D. $ 37,466 MARK B. KOCH $ 8,890 MARIE E. MORRIS, M.D. $ 20,849 RUFUS R. RODRIGUEZ, M.D. $109,159 TIMOTHY J. SZUTZ, M.D. $138,159
PART IIICOMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: GRACE, RICHARD W. KOWAL D.O., GERALD K. KUTCHER M.D., GREGORY R. TARASOVITCH, JAMES J. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: GRACE, RICHARD W. KOWAL D.O., GERALD K. KUTCHER M.D., GREGORY R. TARASOVITCH, JAMES J. KOCH, MARK B. BROLSMA, GREG GAALSWYK, MARK
FORM 990, PART VI, SECTION A, LINE 3MAYO CLINIC, MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, AND OTHER RELATED COMPANIES PROVIDE MANAGEMENT SERVICES TO THE ENTIRE SYSTEM OF ENTITIES. MAYO CLINIC HEALTH SYSTEM - MANKATO ALSO PROVIDES MANAGEMENT SERVICES ON A REGIONAL BASIS THAT INCLUDES THE FILING ORGANIZATION. 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 6THE SOLE CORPORATE MEMBER IS MAYO CLINIC HEALTH SYSTEM - MANKATO.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE CORPORATE MEMBER SHALL APPOINT/REPLACE THREE MEMBERS OF THE BOARD. THE REMAINING MEMBERS OF THE BOARD ARE NOMINATED THROUGH VARIOUS PROCESSES WITH APPROVAL BY THE BOARD OF DIRECTORS AND THE SOLE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7BTHE BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, BUDGET, DEBT DECISIONS AND AMENDMENT OF ARTICLES AND BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11THE 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 DIRECTOR OF FINANCE AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CMAYO 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 15THE 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 AND ADMINISTRATIVE LEADERSHIP. IN ADDITION TO ANY REVIEW AND APPROVAL THAT MAY TAKE PLACE AT THE LOCAL ENTITY LEVEL, THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY. THE SALARY OF THE CEO AND CAO WERE REVIEWED BY THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR MAYO CLINIC HEALTH SYSTEM PHYSICIANS AND ADMINISTRATIVE LEADERSHIP. THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION OF PHYSICIANS AND ADMINISTRATIVE LEADERSHIP FOR THE MAYO CLINIC HEALTH SYSTEM ENTITIES. THE COMMITTEE IS COMPRISED OF MAYO EMPLOYEES, BUT IS INDEPENDENT FOR INTERNAL REVENUE CODE 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED (WITH RECUSAL WHERE APPROPRIATE). THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE THEN REVIEWS AND APPROVES THE COMPENSATION. FOR THOSE INDIVIDUALS FOR WHICH THE MAYO CLINIC HEALTH SYSTEM COMMITTEE CAN NOT SERVE AS THE INDEPENDENT REVIEW, THEIR COMPENSATION AND BENEFITS ARE REVIEWED BY THE GOVERNANCE COMMITTEE (DESCRIBED BELOW). THE COMPENSATION AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. INFORMATION ON MAYO CLINIC HEALTH SYSTEM PHYSICIAN AND ADMINISTRATIVE LEADERSHIP COMPENSATION AND BENEFITS IS ALSO REVIEWED BY THE MAYO CLINIC COMMITTEE ON OFFICER SUCCESSION, COMPENSATION AND GOVERNANCE (GOVERNANCE COMMITTEE), WHICH IS COMPRISED OF SEVEN OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. IN ADDITION TO THE ABOVE COORDINATED REVIEW PROCESS CONDUCTED BY THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE AND/OR THE MAYO CLINIC GOVERNANCE COMMITTEE, THE SOUTHWEST MINNESOTA REGION OF THE MAYO CLINIC HEALTH SYSTEM (WHICH INCLUDES THE FILING ORGANIZATION) ALSO HAS ITS OWN COMPENSATION REVIEW AND APPROVAL PROCESSES FOR THE REGION'S SENIOR LEADERSHIP AND PHYSICIANS (WHICH INCLUDES THE CEO AND CAO). THE PROCESSES INCLUDE REVIEW OF COMPARABILITY DATA FOR SIMILIAR SIZED ORGANIZATIONS BY AN INDEPENDENT COMMITTEE CONSISTING OF PUBLIC BOARD MEMBERS ONLY. SALARY RANGES FOR THE PAST YEAR AND RANGES FOR THE NEXT YEAR ARE REVIEWED FOR REASONABLENESS. CONTEMPORANEOUS MEETING MINUTES OF THE COMPENSATION COMMITTEE ARE KEPT ON FILE.
FORM 990, PART VI, SECTION C, LINE 19THE 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 11GI/C PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,129,951. MANAGEMENT AND GENERAL EXPENSES 4,056,029. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,185,980. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,033,034. MANAGEMENT AND GENERAL EXPENSES 171,621. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,204,655.
FILING OF CERTAIN FOREIGN FORMSDISCLOSURE 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 (43 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACdAddress Line1ForeignAddress/AddressLine1CityForeignAddress/CityCountryForeignAddress/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
BLOOMER LAKEVIEW INC
2110 DUNCAN ROADBLOOMERWI54724391450617LOW INCOME HOUSINGWI501(C)(3)7MCHS--CHIPPEWA VALLEY INCYes (1)
CHARTERHOUSE INC
200 FIRST STREET SWROCHESTERMN55905411405254RETIREMENT LIVING CENTERMN501(C)(3)9MAYO CLINICYes (1)
FRANCISCAN SKEMP FOUNDATION OF ARCADIA INC
464 SOUTH ST JOSEPH AVENUEARCADIAWI54612391322480FUNDRAISING FOUNDATIONWI501(C)(3)9MCHS--FRANCISCAN HEALTHCARE INCYes (1)
GOLD CROSS AMBULANCE SERVICE
200 FIRST STREET SWROCHESTERMN55905411917516AMBULANCE SERVICEMN501(C)(3)9MFMERYes (1)
LUTHER LAKESIDE APARTMENTS INC
PO BOX 1510EAU CLAIREWI54702391409024LOW INCOME HOUSING FOR ELDERLYWI501(C)(3)9MCHS--EAU CLAIRE HOSPITAL INCYes (1)
MAYO CLINIC
200 FIRST STREET SWROCHESTERMN55905416011702PATIENT CARE - CLINICMN501(C)(3)9Yes (1)N/A
MAYO CLINIC -- METHODIST HOSPITAL
200 FIRST STREET SWROCHESTERMN55905410739106HOSPITALMN501(C)(3)3MAYO CLINICYes (1)
MAYO CLINIC HOSPITAL-- ROCHESTER
200 FIRST STREET SWROCHESTERMN55905410944601HOSPITALMN501(C)(3)3MAYO CLINICYes (1)
MAYO CLINIC ARIZONA
13400 EAST SHEA BOULEVARDSCOTTSDALEAZ85259860800150HOSPITAL AND CLINICAZ501(C)(3)3MAYO CLINICYes (1)
MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION)
4500 SAN PABLO ROADJACKSONVILLEFL32224590714831HOSPITALFL501(C)(3)3MAYO CLINIC JACKSONVILLEYes (1)
MCHS IN WAYCROSS INC
1900 TEBEAU STREETWAYCROSSGA31501581667166HOSPITALGA501(C)(3)3MAYO CLINIC JACKSONVILLEYes (1)
MCHS--ALBERT LEA AND AUSTIN
1000 FIRST DRIVE NWAUSTINMN55912411404075HOSPITAL AND CLINICMN501(C)(3)3MAYO CLINICYes (1)
MCHS--AUSTIN FOUNDATION
1000 FIRST DRIVE NWAUSTINMN55912300107471FUNDRAISING FOUNDATIONMN501(C)(3)7MCHS--ALBERT LEA AND AUSTINYes (1)
MCHS--CANNON FALLS
1116 WEST MILL STREETCANNON FALLSMN55009204156428HOSPITAL AND CLINICMN501(C)(3)3MAYO CLINICYes (1)
MCHS--CHIPPEWA VALLEY INC
1501 THOMPSON STREETBLOOMERWI54724390980343HOSPITAL AND CLINICWI501(C)(3)3MCHS--EAU CLAIRE HOSPITAL INCYes (1)
MCHS--EAU CLAIRE CLINIC INC
733 W CLAIREMONT AVE PO BOX 1510EAU CLAIREWI54702391735831PATIENT CARE - CLINICWI501(C)(3)3MAYO CLINIC0
MCHS--EAU CLAIRE FOUNDATION INC
733 W CLAIREMONT AVE PO BOX 1510EAU CLAIREWI54702391633407GRANTMAKING FOUNDATIONWI501(C)(3)11-IMCHS--EAU CLAIRE CLINIC INC0
MCHS--EAU CLAIRE HOSPITAL INC
1221 WHIPPLE STREETEAU CLAIREWI54703390813418HOSPITALWI501(C)(3)3MAYO CLINICYes (1)
MCHS--FAIRMONT
800 MEDICAL CENTER DRIVE PO BOX 800FAIRMONTMN56031410760836HOSPITAL AND CLINICMN501(C)(3)3MCHS--MANKATOYes (1)
MCHS--FRANCISCAN HEALTHCARE FOUNDATION INC
700 WEST AVE SOUTHLA CROSSEWI54601391186647FUNDRAISING FOUNDATIONWI501(C)(3)7MCHS--FRANCISCAN HEALTHCARE INCYes (1)
MCHS--FRANCISCAN HEALTHCARE FOUNDATION-SPARTA INC
310 WEST MAIN STREETSPARTAWI54656391423234FUNDRAISING FOUNDATIONWI501(C)(3)9MCHS--FRANCISCAN HEALTHCARE INCYes (1)
MCHS--FRANCISCAN HEALTHCARE INC
700 WEST AVE SOUTHLA CROSSEWI54601391411999HEALTHCARE SYSTEM PARENTWI501(C)(3)11-IMAYO CLINICYes (1)
MCHS--FRANCISCAN MEDICAL CENTER INC
700 WEST AVE SOUTHLA CROSSEWI54601390806374HOSPITAL AND CLINICWI501(C)(3)3MCHS--FRANCISCAN HEALTHCARE INCYes (1)
MCHS--HOME HEALTH & HOSPICE INC
PO BOX 2060EAU CLAIREWI54702391491516HOME HEALTH AND HOSPICE CAREWI501(C)(3)9MCHS--EAU CLAIRE HOSPITAL INCYes (1)
MCHS--LAKE CITY
500 WEST GRANT STREETLAKE CITYMN55041411906820HOSPITALMN501(C)(3)3MAYO CLINICYes (1)
MCHS--MANKATO
1025 MARSH STREETMANKATOMN56002411236756HOSPITAL AND CLINICMN501(C)(3)3MAYO CLINICYes (1)
MCHS--MANKATO HEALTH CARE FOUNDATION
1025 MARSH STREETMANKATOMN56002411663357FUNDRAISING FOUNDATIONMN501(C)(3)7MCHS--MANKATOYes (1)
MCHS--NEW PRAGUE
301 SECOND STREET NENEW PRAGUEMN56071410723639HOSPITAL AND CLINICMN501(C)(3)3MCHS--MANKATOYes (1)
MCHS--NORTHLAND INC
1222 EAST WOODLAND AVENUEBARRONWI54812390920634HOSPITAL AND CLINICWI501(C)(3)3MCHS--EAU CLAIRE HOSPITAL INCYes (1)
MCHS--OAKRIDGE INC
13025 EIGHTH STREET PO BOX 70OSSEOWI54758391029430HOSPITAL AND CLINICWI501(C)(3)3MCHS--EAU CLAIRE HOSPITAL INCYes (1)
MCHS--OWATONNA
134 SOUTHVIEW STOWATONNAMN55060411862132PATIENT CARE - CLINICMN501(C)(3)3MAYO CLINICYes (1)
MCHS--RED CEDAR INC
2321 STOUT ROADMENOMONIEWI54751510190875HOSPITAL AND CLINICWI501(C)(3)3MAYO CLINICYes (1)
MCHS--RED WING
701 HEWITT BOULEVARDRED WINGMN55066411713783PATIENT CARE SERVICESMN501(C)(3)3MAYO CLINICYes (1)
MCHS--SPRINGFIELD
625 NORTH JACKSON AVENUESPRINGFIELDMN56087411893827HOSPITAL AND CLINICMN501(C)(3)3MCHS--MANKATOYes (1)
MCHS--ST JAMES
1101 MOULTON PARSONS DR PO BOX 460ST JAMESMN56081410797368HOSPITAL AND CLINICMN501(C)(3)3MCHS--MANKATOYes (1)
MCHS--ST JAMES HEALTH CARE FOUNDATION
1101 MOULTON PARSONS DR PO BOX 460ST JAMESMN56081411444129FUNDRAISING FOUNDATIONMN501(C)(3)7MCHS--ST JAMESYes (1)
MCHS--SUPPORTIVE HOMECARE INC
PO BOX 2060EAU CLAIREWI54702391686673HOME HEALTH CAREWI501(C)(3)9MCHS--EAU CLAIRE HOSPITAL INCYes (1)
MCHS--WASECA
501 NORTH STATE STREETWASECAMN56093363606405HOSPITAL AND CLINICMN501(C)(3)3MCHS--MANKATOYes (1)
MAYO CLINIC JACKSONVILLE
4500 SAN PABLO ROADJACKSONVILLEFL32224593337028PATIENT CARE - CLINICFL501(C)(3)7MAYO CLINICYes (1)
MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH
200 FIRST STREET SWROCHESTERMN55905411506440CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIESMN501(C)(3)9MAYO CLINICYes (1)
MAYO KLINIK STIFTUNG
FUNDRAISING FOUNDATIONMFMERYes (1)60486 FRANKFURT AM MAINFRANKFURTGMGM
MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES
200 FIRST STREET SWROCHESTERMN55905412020392SUPPORT RESEARCH, PRACTICE & EDUCATIONMN501(C)(3)11-IMAYO CLINICYes (1)
POVERELLO FOUNDATION
200 FIRST STREET SWROCHESTERMN55905411494881FUNDRAISING FOUNDATIONMN501(C)(3)7MAYO CLINIC HOSPITAL - ROCHESTERYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACd
FRANKLIN HEATING STATION
119 THIRD ST SWROCHESTERMN55902410264830UTILITYMNN/A
PHYSICIAN SOFTWARE SYSTEMS LLC
3333 WARRENVILLE ROAD SUITE 200LISLEIL60532453414836HEALTHCARE RELATED SOFTWAREILN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (37 entries)

Address Line1ForeignAddress/AddressLine1CityForeignAddress/CityCountryForeignAddress/CountryPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINLegal Domicile StateLegalDomicileStateCdEntity TypeEntityTypeTxt
GMO GLOBAL BOND INVESTMENT FUND
78 SIR JOHN ROGERSONS QUAYDUBLIN 2EIOTHER FINANCIAL INVESTMENT ACTIVITIESEIN/A0
HEALTH TRADITION HEALTH PLAN
MEDICAL SERVICES COMPANYN/A01808 EAST MAIN STREETONALASKAWI54650391545987WIC
LOBSS NETWORK SUPPORT 2002 INC
ADMINISTRATIVE SERVICESN/A0200 FIRST STREET SWROCHESTERMN55905481276150MNC
MAYO CLINIC GBS MAURITIUS
2ND FLOOR EBENE MEWS 57EBENE CYBERCITYMPHEALTHCARE MANAGEMENTMPN/A0C
MCHS--DECORAH CLINIC PHYSICIANS
PATIENT CARE - CLINICN/A0907 MONTGOMERY STREETDECORAHIA52101411711329IAC
MCHS--PHARMACY & HOME MEDICAL INC
PHARMACY SERVICESN/A01221 WHIPPLE STREETEAU CLAIREWI54703391528920WIC
MCHS PHYSICIANS IN WAYCROSS INC
PHYSICIAN OFFICESN/A01900 TEBEAU STREETWAYCROSSGA31501204363143GAC
MAYO HOLDING COMPANY
HOLDING COMPANYN/A0200 FIRST STREET SWROCHESTERMN55905411578020MNC
MAYO INSURANCE COMPANY LTD
SELF INSURANCE POOLCJN/A0200 FIRST STREET SWROCHESTERMN55905C
MMSI INC
THIRD PARTY ADMINISTRATION SERVICESN/A021 FIRST STREET SWROCHESTERMN55905411547003MNC
RESOUNDANT INC
MANUFACTURING MEDICAL DEVICE COMPONENTN/A0221 1ST AVE SWROCHESTERMN55902461661978MNC
ROCHESTER AIRPORT COMPANY
AIRPORT MANAGEMENTN/A0ROUTE 2ROCHESTERMN55902410506870MNC
SATILLA HEALTHNET INC
HEALTH SERVICESN/A01900 TEBEAU STREETWAYCROSSGA31501582151076GAC
SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION
COMMERCIAL PROPERTY OWNERS ASSOCIATIONN/A013400 E SHEA BLVDSCOTTSDALEAZ85259860870505AZC
THE STABILE BUILDING OWNERS' ASSOCIATION
COMMERCIAL PROPERTY OWNERS ASSOCIATIONN/A0200 FIRST STREET SWROCHESTERMN55905208994499MNC
DESTINATION MEDICAL CENTER ECONOMIC DEVELOPMENT AGENCY
ECONOMIC DEVELOPMENTN/A050 SOUTH SIXTH STREET SUITE 1500MINNEAPOLISMN554021498464893585MNC
CAVALRY CLO III LTD
PO BOX 1093 GT QUEENSGATE HOUSE SGRAND CAYMANCJINVESTMENT ACTIVITIESCJN/A0C
CHARITABLE LEAD TRUST (2)
CHARITABLE TRUSTN/A0CAT
CHARITABLE LEAD TRUST
CHARITABLE TRUSTN/A0MNT
CHARITABLE LEAD TRUST
CHARITABLE TRUSTN/A0ILT
PERPETUAL TRUST
CHARITABLE TRUSTN/A0NDT
PERPETUAL TRUST
CHARITABLE TRUSTN/A0AZT
PERPETUAL TRUST
CHARITABLE TRUSTN/A0LAT
PERPETUAL TRUST (2)
CHARITABLE TRUSTN/A0MAT
PERPETUAL TRUST
CHARITABLE TRUSTN/A0MNT
PERPETUAL TRUST
CHARITABLE TRUSTN/A0MOT
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTN/A0AZT
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTN/A0COT
CHARITABLE REMAINDER TRUST (7)
CHARITABLE TRUSTN/A0FLT
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTN/A0LAT
CHARITABLE REMAINDER TRUST (76)
CHARITABLE TRUSTN/A0MNT
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTN/A0NCT
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTN/A0TXT
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTN/A0COT
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTN/A0ILT
CHARITABLE REMAINDER TRUST
CHARITABLE TRUSTN/A0MIT
CHARITABLE REMAINDER TRUST (72)
CHARITABLE TRUSTN/A0MNT
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
MAYO CLINIC - METHODIST HOSPITAL
A$108,334GAAP
MAYO CLINIC HEALTH SYSTEM--NEW PRAGUE
L$3,296,885GAAP
MAYO CLINIC HEALTH SYSTEM--SPRINGFIELD
L$135,484GAAP
MAYO CLINIC HEALTH SYSTEM--ST JAMES
L$386,643GAAP
MAYO CLINIC HEALTH SYSTEM--WASECA
L$183,688GAAP
MAYO FOUNDATION FOR MEDICAL EDUCATION & RESEARCH
P$40,527,236GAAP
MMSI INC
R$6,126,385GAAP
MMSI INC
S$3,247,523GAAP