MAYO CLINIC HEALTH SYSTEM - NEW PRAGUE: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MAYO CLINIC HEALTH SYSTEM - NEW PRAGUE (EIN 41-0723639)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-11
- IRS object ID
- 201433159349303008
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-11T14:56:53-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410723639 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAYO CLINIC HEALTH SYSTEM - NEW PRAGUE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MAYO | BusinessNameControlTxt |
| Phone | 5075381297 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 SECOND STREET NORTHEAST | AddressLine1 |
| City | NEW PRAGUE | City |
| State | MN | State |
| ZIP Code | 56071 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES J TARASOVITCH | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5073856449 | PhoneNum |
| Signature | 2014-11-11 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GREGORY R KUTCHER MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 SECOND STREET NORTHEAST | AddressLine1 |
| City | NEW PRAGUE | City |
| State | MN | State |
| ZIP Code | 56071 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $37,009,750 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MAYOCLINICHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1951 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | HOSPITAL AND CLINIC | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 288 | TotalEmployeeCnt |
| Total Volunteers | 92 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $147,094 | PYContributionsGrantsAmt |
| CY Contributions Grants | $416,961 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $36,320,503 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $36,203,494 | CYProgramServiceRevenueAmt |
| PY Investment Income | $12,953 | PYInvestmentIncomeAmt |
| CY Investment Income | -$6,659 | CYInvestmentIncomeAmt |
| PY Other Revenue | $445,860 | PYOtherRevenueAmt |
| CY Other Revenue | $375,895 | CYOtherRevenueAmt |
| PY Total Revenue | $36,926,410 | PYTotalRevenueAmt |
| CY Total Revenue | $36,989,691 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,597 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $8,759 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,233,605 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,196,176 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,775,140 | PYOtherExpensesAmt |
| CY Other Expenses | $20,484,249 | CYOtherExpensesAmt |
| PY Total Expenses | $37,013,342 | PYTotalExpensesAmt |
| CY Total Expenses | $36,689,184 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$86,932 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $300,507 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $22,123,496 | TotalAssetsBOYAmt |
| Total Assets EOY | $23,047,830 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,560,558 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,184,385 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $16,562,938 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $16,863,445 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION, AND RESEARCH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $32,789,000 | ExpenseAmt |
| Grant | $4,282 | GrantAmt |
| Revenue | $36,111,733 | RevenueAmt |
| Desc | 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 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. AS OUR MISSION STATES, OUR ORGANIZATION AIMS 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. OUR VISION IS TO ACHIEVE THE HIGHEST STANDARDS FOR MEDICAL CARE AND HEALTH IMPROVEMENT IN THE COMMUNITIES IN WHICH WE LIVE AND WORK. OUR FIRST PRIORITY IS TO MEET PATIENT NEEDS GUIDED BY THE CORE VALUES OF INTEGRITY, CONTINUOUS IMPROVEMENT, SERVICE, TEAMWORK, INNOVATION, BALANCE AND FINANCIAL INTEGRITY.AS A MEMBER OF MAYO CLINIC HEALTH SYSTEM, MCHS - NEW PRAGUE PROVIDES QUALITY HEALTHCARE CLOSE TO HOME WITH DIRECT ACCESS TO HIGHLY SPECIALIZED CARE IF THE NEED ARISES.INPATIENT SERVICES: MCHS - NEW PRAGUE IS A 25 BED CRITICAL ACCESS HOSPITAL LOCATED IN NEW PRAGUE, MINNESOTA. MCHS - NEW PRAGUE HAD 760 ADMISSIONS AND HAD 147 BIRTHS IN 2013OUTPATIENT CLINIC SERVICES: A TOTAL OF 60,000 OUTPATIENT REGISTRATIONS WERE RECORDED, INCLUDING LAB, RADIOLOGY, SPECIALTY CLINIC VISITS, THERAPY, SLEEP STUDIES, AND AMBULATORY SURGERIES. THERE WERE 6,047 PATIENTS SEEN IN THE EMERGENCY DEPARTMENT.MEDICAL STAFF: MCHS - NEW PRAGUE HAS ACTIVE MEDICAL STAFF WHICH CONSISTS OF FAMILY PRACTICE, WOMEN'S HEALTH, INTERNAL MEDICINE, PEDIATRIC PHYSICIANS, ER PHYSICIANS AND A GENERAL SURGEON. CONSULTING SPECIALISTS INCLUDE ALLERGY, CARDIOLOGY, ORAL/MAXILLOFACIAL SURGERY, ENT GASTROENTEROLOGY, INFECTIOUS DISEASES, NEPHROLOGY, NEUROLOGY, ONCOLOGY, ORTHOPEDICS, OB/GYN, OPHTHALMOLOGY, PULMONOLOGY, RADIOLOGY/TELE-RADIOLOGY, GASTROENTEROLOGY, RHEUMATOLOGY, UROLOGY, DENTISTRY, AND PODIATRY.UNCOMPENSATED CARE: MCHS - NEW PRAGUE PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. MCHS - NEW PRAGUE IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND IS REIMBURSED BASED ON ITS COST OF PROVIDING SERVICES FOR HOSPITAL MEDICARE PATIENTS.CHARITY CARE IS ALSO PROVIDED FOR PATIENTS THAT ARE FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. THE COST OF CHARITY CARE PROVIDED IN 2013 WAS APPROXIMATELY $192,400.THE COST OF UNCOMPENSATED CARE IN 2013 PROVIDED TO OTHER GOVERNMENTAL AND LOW INCOME PATIENTS THROUGH MEDICAID WAS APPROXIMATELY $1,248,500. THIS AMOUNT INCLUDES THE MEDICAID SURCHARGE AND MINNESOTACARE TAX (A PROGRAM THAT PROVIDES HEALTH CARE FOR LOW INCOME POPULATIONS). THE AMOUNT OF THE MEDICAID SURCHARGE AND MINNESOTACARE TAX PAID IN 2013 WAS $229,463 AND $419,207, RESPECTIVELY.THE COST OF UNCOMPENSATED CARE PROVIDED THROUGH MEDICARE WAS APPROXIMATELY $1,580,200.MCHS - NEW PRAGUE ALSO PROVIDES DISCOUNTS TO UNINSURED PATIENTS. THE TOTAL DISCOUNTS GIVEN IN 2013 WERE $99,100.THE HOSPITAL AUXILIARY OPERATES UNDER MCHS-NEW PRAGUE'S TAX EXEMPT STATUS. THE AUXILIARY'S MAIN SOURCES OF INCOME ARE THE OPERATION OF A GIFT SHOP AND FUNDRAISING.THE AUXILIARY AND ITS VOLUNTEERS HAVE ENHANCED THE ENVIRONMENT AND SERVICES OFFERED TO PATIENTS, VISITORS & STAFF OF THE HOSPITAL. AUXILIARY MEMBERS CONTRIBUTE THOUSANDS OF HOURS OF SERVICE EACH YEAR. THE MAJOR SERVICES PROVIDED BY AUXILIARY MEMBER VOLUNTEERS IS THE GIFT SHOP, PATRONIZED BY PATIENTS, VISITORS MAKING PURCHASES FOR PATIENTS, AND EMPLOYEES CONTRIBUTES IMPORTANTLY TO OUR EXEMPT FUNCTION BY IMPROVING PHYSICAL COMFORT AND MENTAL WELL BEING OF ITS PATIENTS.DURING 2013, APPROXIMATELY 85 VOLUNTEERS DONATED APPROXIMATELY 7,262 HOURS OF VOLUNTEER SERVICE. THE VALUE OF THIS SERVICE BASED ON THE INDEPENDENT SECTOR'S VALUE OF VOLUNTEER TIME IS APPROXIMATELY $163,800. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $497,386 | ExpenseAmt |
| Grant | $4,477 | GrantAmt |
| Revenue | $214,945 | RevenueAmt |
| Desc | COMMUNITY BENEFIT (SEE SCHEDULE O)COMMUNITY BENEFIT:COMMUNITY EDUCATION: MCHS - NEW PRAGUE COMMUNITY EDUCATION PROVIDED CLASSES AND SUPPORT GROUPS ON THE TOPICS OF CHILDBIRTH, BREASTFEEDING, SIBLING ACCEPTANCE OF A NEWBORN, CPR, FIRST AID, SENIOR HEALTH, DIABETES, PREVENTING FALLS, FLU, COLON CANCER, STRESS MANAGEMENT, WOMEN'S HEART HEALTH, WEIGHT LOSS, PRE-DIABETES, OBESITY, NUTRITION, HIP AND KNEE REPLACEMENT OPTIONS, NURSING CARE IN CRISIS SITUATIONS, GRIEF SUPPORT, CANCER SUPPORT, AND HOSPITAL SERVICES. MCHS - NEW PRAGUE ALSO PROVIDED TOURS, HOSTED A JOB SHADOW EXPERIENCE FOR STUDENTS AND INTERNSHIPS. COMMUNITY EDUCATION PROVIDES MONTHLY PHYSICIAN EDUCATION AS WELL AS CLINICAL IN-SERVICES FOR HOSPITAL AND CLINIC STAFF AND OTHER COMMUNITY HEALTHCARE PROVIDERS.EMT EDUCATION: IN PARTNERSHIP WITH AREA VOLUNTEER POLICE, FIRE AND AMBULANCE, EMT'S ARE TRAINED ANNUALLY AT MCHS - NEW PRAGUE. THESE VOLUNTEERS PROVIDE EMERGENCY TRANSPORT SERVICES IN THE COMMUNITIES OF NEW PRAGUE, LECENTER, LESUEUR, MONTGOMERY, LONSDALE, NEW MARKET, ELKO, SHAKOPEE AND BELLE PLAINE."THE FITNESS CENTER" COMBINES OUTPATIENT REHABILITATION SERVICES WITH A COMMUNITY FITNESS CENTER. THE FITNESS CENTER HAD AN AVERAGE OF APPROXIMATLEY 1,200 FITNESS MEMBERSHIPS. A WEIGHT LOSS PROGRAM WAS SPONSORED BY THE CENTER. THE OUTPATIENT REHABILITATION DEPARTMENT IS ABLE TO PROVIDE MULTIDISCIPLINARY CARE INVOLVING PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. ATHLETIC TRAINERS PROVIDE SERVICES FOR STUDENT ATHLETES WITHIN AREA SCHOOL DISTRICTS. THE FITNESS CENTER PARTICIPATES IN SILVER SNEAKERS', THE NATION'S LEADING EXERCISE PROGRAM FOR MEDICARE ELIGIBLE BENEFICIARIES. STRENGTH, RANGE OF MOTION AND YOGA CLASSES ARE OFFERED. BECAUSE ONE-THIRD OF U.S. CHILDREN ARE OVERWEIGHT OR AT RISK OF BECOMING OVERWEIGHT, THE FITNESS CENTER SPONSORS THE FIT KIDS PROGRAM. THE FIT KIDS PROGRAM IS AN ACTIVE LIFESTYLE PROGRAM CONDUCTED IN ALL 4TH GRADE CLASSES IN THE DISTRICT. THIS ENCOMPASSES STUDENTS IN 13 CLASSROOMS BETWEEN 4 SCHOOLS. THIS PROGRAM IS DESIGNED TO IMPROVE CHILDREN'S AWARENESS ABOUT THE IMPORTANCE OF EATING HEALTHY, DECREASING SEDENTARY TIME AND INCREASING PHYSICAL ACTIVITY.MCHS - NEW PRAGUE PROVIDES IN KIND SUPPORT TO THE PEACE CENTER. THE PEACE CENTER IS A FOOD DISTRIBUTION CENTER SERVING INDIVIDUALS IN NEW PRAGUE AND THE SURROUNDING AREA. FOUNDED IN 1983 AND LOCATED ON THE CAMPUS OF MCHS - NEW PRAGUE, THE PEACE CENTER SERVES THE COMMUNITY BY HELPING NEARLY 5,000 INDIVIDUALS PER YEAR WITH THEIR EVERYDAY NEEDS. MCHS - NEW PRAGUE PROVIDES PERSONNEL, ADMINISTRATIVE, FINANCE, AND OTHER SUPPORT TO THE PEACE CENTER. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $173,451 | ExpenseAmt |
| Revenue | $144,057 | RevenueAmt |
| Desc | QUEEN'S COURT: QUEEN'S COURT IS A SENIOR HOUSING FACILITY LOCATED ADJACENT TO THE HOSPITAL IN NEW PRAGUE. CURRENTLY, THERE ARE 16 UNITS AVAILABLE FOR RENT AND A SECTION OF THE BUILDING IS USED FOR MAYO CLINIC HEALTH SYSTEM ADMINISTRATIVE SERVICES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $33,459,837 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 288 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CORPORATE TAX UNIT | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5075381297 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 FIRST STREET SW | AddressLine1 |
| City | ROCHESTER | City |
| State | MN | State |
| ZIP Code | 55905 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| BROD RENEE | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DEACONSON MD TIMOTHY F | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $716,596 | $33,542 | |||
| GRACE RICHARD W | |||||||||
| DIRECTOR/VP/REGION CAO | 1.00 | 40.00 | Yes (X) | $0 | $314,087 | $30,442 | Yes (X) | ||
| HERRMANN MD MARTIN J | |||||||||
| DIRECTOR/CHAIR | 1.00 | 40.00 | Yes (X) | $0 | $251,223 | $48,155 | Yes (X) | ||
| KUTCHER MD GREGORY R | |||||||||
| DIR/PRESIDENT/REGION CEO | 1.00 | 40.00 | Yes (X) | $0 | $455,895 | $35,280 | Yes (X) | ||
| MILLER JOSH | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MOGA MD C NIC | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $285,725 | $27,027 | |||
| SCHOENBAUER BRAD | |||||||||
| DIRECTOR/VICE CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| TARASOVITCH JAMES J | |||||||||
| DIR/SECY/TREAS/REGION CFO | 1.00 | 40.00 | Yes (X) | $0 | $266,706 | $27,577 | Yes (X) | ||
| WOLF BRUCE | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| WORNSON RICHARD | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KLIMP MARY J | |||||||||
| SITE ADMINISTRATOR | 40.00 | 0.00 | $210,893 | $0 | $22,532 | Yes (X) | |||
| KOCH MARK B | |||||||||
| ASSISTANT SECRETARY | 1.00 | 40.00 | $0 | $316,763 | $13,860 | Yes (X) | |||
| CHINNA LEKSHMI MERCY C | |||||||||
| CHARGE NURSE | 40.00 | 0.00 | $160,957 | $0 | $18,864 | Yes (X) | |||
| HOPKINS LAURA H | |||||||||
| NURSE ADMINISTRATOR | 40.00 | 0.00 | $158,665 | $0 | $12,920 | Yes (X) | |||
| JENSEN CHRISTOPHER T | |||||||||
| CRNA | 40.00 | 0.00 | $231,252 | $0 | $31,743 | Yes (X) | |||
| SIMON CAROL | |||||||||
| CHARGE NURSE | 40.00 | 0.00 | $170,532 | $0 | $30,190 | Yes (X) | |||
| STUPICA BRUCE | |||||||||
| CRNA | 40.00 | 0.00 | $253,912 | $0 | $9,056 | Yes (X) | |||
| CARDWELL MD BRET A | |||||||||
| FORMER HIGHEST PAID | 0.00 | 40.00 | $0 | $391,138 | $42,777 | Yes (X) | |||
| OVERGAARD SHAWN M | |||||||||
| FORMER HIGHEST PAID | 0.00 | 40.00 | $0 | $232,989 | $16,446 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,186,211 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,231,122 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $400,411 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MCHS - FAIRMONT | |||||
| 800 MEDICAL CENTER DRIVE PO BOX 80 | FAIRMONT | MN | 56031 | PHYSICIANS | $3,296,885 |
| NORTH MEMORIAL MEDICAL CENTER | |||||
| 3300 OAKDALE NORTH | ROBBINSDALE | MN | 55422 | ED PHYSICIAN STAFFING | $1,461,962 |
| SHARED MEDICAL SERVICES | |||||
| PO BOX 330 | COTTAGE GROVE | WI | 53527 | MOBILE RADIOLOGY | $243,670 |
| ALLINA HOSPITAL AND CLINICS | |||||
| PO BOX 9383 | MINNEAPOLIS | MN | 55440 | CLINICAL SERVICES | $214,754 |
| SODEXO INC AND AFFILIATES | |||||
| 10 EARHART DRIVE | WILLIAMSBILL | NY | 14221 | DIETARY & ENVIRONMENTAL SERVICES | $177,495 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $560 | MembershipDuesAmt |
| Related Organizations | $283,014 | RelatedOrganizationsAmt |
| Government Grants | $123,572 | GovernmentGrantsAmt |
| All Other Contributions | $9,815 | AllOtherContributionsAmt |
| Total Contributions | $416,961 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 620000 | $36,059,437 | $36,059,437 |
| RESIDENT REVENUE | 623000 | $144,057 | $144,057 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $36,203,494 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,493 | TotalRevenueColumnAmt |
| Exclusion | $5,493 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $69,056 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $69,056 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $69,056 | TotalRevenueColumnAmt |
| Exclusion | $69,056 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $12,152 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$12,152 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$12,152 | TotalRevenueColumnAmt |
| Exclusion | -$12,152 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $1,063 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,063 | TotalRevenueColumnAmt |
| Exclusion | $1,063 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $7,954 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $7,907 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47 | TotalRevenueColumnAmt |
| Exclusion | $47 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| HEALTH CLUB FEES | 900099 | $214,945 | $214,945 | |
| CAFETERIA/VENDING | 722210 | $48,292 | $48,292 | |
| MISC CONSULTING | 541610 | $37,840 | $37,840 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,652 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,004 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $648 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $305,729 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,989,691 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $36,470,735 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $101,995 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,759 | TotalAmt |
| Program Services | $8,759 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $233,425 | TotalAmt |
| Management And General | $233,425 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $286,717 | TotalAmt |
| Program Services | $138,403 | ProgramServicesAmt |
| Management And General | $148,314 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,585,333 | TotalAmt |
| Program Services | $12,453,274 | ProgramServicesAmt |
| Management And General | $132,059 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $208,976 | TotalAmt |
| Program Services | $207,733 | ProgramServicesAmt |
| Management And General | $1,243 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,980,779 | TotalAmt |
| Program Services | $1,942,926 | ProgramServicesAmt |
| Management And General | $37,853 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $900,946 | TotalAmt |
| Program Services | $870,408 | ProgramServicesAmt |
| Management And General | $30,538 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,179 | TotalAmt |
| Program Services | $157,179 | ProgramServicesAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,793 | TotalAmt |
| Program Services | $2,793 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,354,692 | TotalAmt |
| Program Services | $7,900,859 | ProgramServicesAmt |
| Management And General | $2,453,833 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,101 | TotalAmt |
| Program Services | $9,757 | ProgramServicesAmt |
| Management And General | $2,344 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,427,237 | TotalAmt |
| Program Services | $1,410,034 | ProgramServicesAmt |
| Management And General | $17,203 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $995,977 | TotalAmt |
| Program Services | $994,999 | ProgramServicesAmt |
| Management And General | $978 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,910 | TotalAmt |
| Program Services | $62,118 | ProgramServicesAmt |
| Management And General | $13,792 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,037 | TotalAmt |
| Program Services | $101,287 | ProgramServicesAmt |
| Management And General | $750 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,001 | TotalAmt |
| Program Services | $83,001 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,277,954 | TotalAmt |
| Program Services | $1,254,976 | ProgramServicesAmt |
| Management And General | $22,978 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,822 | TotalAmt |
| Program Services | $120 | ProgramServicesAmt |
| Management And General | $97,702 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $3,867,104 | $3,867,104 |
| BAD DEBT EXPENSE | $1,112,121 | $1,112,121 |
| MNCARE TAX | $419,207 | $419,207 |
| MEDICAID SURCHARGE | $229,463 | $229,463 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $269,651 | TotalAmt |
| Program Services | $233,316 | ProgramServicesAmt |
| Management And General | $36,335 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,689,184 | TotalAmt |
| Program Services | $33,459,837 | ProgramServicesAmt |
| Management And General | $3,229,347 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $438 | BOYAmt |
| EOY | $639 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,755 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,628,474 | BOYAmt |
| EOY | $5,916,400 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $469,373 | BOYAmt |
| EOY | $525,863 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,680 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,756,959 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,487,094 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,541,209 | BOYAmt |
| EOY | $12,269,865 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,642,808 | BOYAmt |
| EOY | $3,256,699 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $708,759 | BOYAmt |
| EOY | $1,078,364 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,123,496 | BOYAmt |
| EOY | $23,047,830 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,722,238 | BOYAmt |
| EOY | $1,884,118 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,409,621 | BOYAmt |
| EOY | $62,077 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $428,699 | BOYAmt |
| EOY | $4,238,190 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,560,558 | BOYAmt |
| EOY | $6,184,385 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,854,179 | BOYAmt |
| EOY | $15,935,260 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $708,759 | BOYAmt |
| EOY | $910,055 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $18,130 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,562,938 | BOYAmt |
| EOY | $16,863,445 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,123,496 | BOYAmt |
| EOY | $23,047,830 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $300,507 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $2,793 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,793 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE AMOUNT IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING. MAYO CLINIC HEALTH SYSTEM - MANKATO (MCHS-MANKATO) - THE PARENT OF THE FILING ORGANIZATION - 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 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. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $0 | BeginningYearBalanceAmt |
| Contributions | $18,340 | ContributionsAmt |
| Investment Earnings Or Losses | $550 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $18,890 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.96000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.04000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,552,472 | OtherCostOrOtherBasisAmt |
| Book Value | $1,552,472 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,408,181 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,321,042 | DepreciationAmt |
| Book Value | $9,087,139 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,792,812 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,166,052 | DepreciationAmt |
| Book Value | $1,626,760 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,494 | OtherCostOrOtherBasisAmt |
| Book Value | $3,494 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,269,865 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MAYO POOLED INVESTMENTS | Desc |
| Book Value | $3,256,699 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $3,256,699 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $4,238,190 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,238,190 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENT FUNDS PROVIDE A STABLE FUNDING SOURCE FOR PASTORAL CARE, CARDIAC REHAB, AND NURSING EDUCATION. |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $192,418 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $192,418 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00540 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,339,304 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,090,848 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,248,456 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03510 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,531,722 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,090,848 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,440,874 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04050 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,732 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $13,732 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,732 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,732 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,563,454 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,090,848 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,472,606 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04140 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,477 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,477 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,477 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,477 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,112,121 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $10,824,169 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,843,003 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$18,834 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAYO CLINIC HEALTH SYSTEM - NEW PRAGUE | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 2ND ST NE | AddressLine1 |
| City | NEW PRAGUE | City |
| State | MN | State |
| ZIP Code | 56071 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | MAYOCLINICHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| State License | 00607 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MAYO CLINIC HEALTH SYSTEM - NEW PRAGUE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | MAYOCLINICHEALTHSYSTEM.ORG/ABOUT-US | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| Residency | Yes (X) | ResidencyInd |
| Other Factors | Yes (X) | OtherFactorsInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MAYO CLINIC HEALTH SYSTEM - NEW PRAGUE | PART V, SECTION B, LINE 3: MAYO CLINIC HEALTH SYSTEM IN NEW PRAGUE IDENTIFIED AND PRIORITIZED COMMUNITY HEALTH NEEDS THROUGH A COMPREHENSIVE PROCESS THAT INCLUDED INPUT FROM THE NEW PRAGUE CITY ADMINISTRATOR, THE PUBLIC HEALTH DIRECTORS OF SCOTT AND LE SUEUR COUNTIES, THE SUPERINTENDENTS OF MONTGOMERY AND BELLE PLAINE SCHOOL DISTRICTS, THE DIRECTOR OF THE NEW PRAGUE CHAMBER OF COMMERCE, AND OTHER COMMUNITY LEADERSHIP. |
| MAYO CLINIC HEALTH SYSTEM - NEW PRAGUE | PART 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 - NEW PRAGUE | PART 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 - NEW PRAGUE | PART 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 - NEW PRAGUE | PART 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| MCHS-NEW PRAGUE | ||||
| 212 COUNTY ROAD 37 | NEW PRAGUE | MN | 56071 | FAMILY PRACTICE |
| MCHS-MONTGOMERY | ||||
| 501 4TH STREET NW | MONTGOMERY | MN | 56069 | FAMILY PRACTICE |
| MCHS-BELLE PLAINE | ||||
| 700 WEST PRARIE ST | BELLE PLAINE | MN | 56011 | FAMILY PRACTICE |
| MCHS-WOMEN'S HEALTH CENTER | ||||
| 301 2ND STREET NE | NEW PRAGUE | MN | 56071 | WOMEN'S HEALTH CENTER |
| CENTER FOR REHAB AND FITNESS | ||||
| 504 6TH AVE NW | NEW PRAGUE | MN | 56071 | REHAB AND FITNESS CENTER |
| MCHS-EXPRESS CARE NEW PRAGUE | ||||
| 200 ALTON AVE SE | NEW PRAGUE | MN | 56071 | EXPRESS CARE |
| MCHS-EXPRESS CARE BELLE PLAINE | ||||
| 1010 EAST ENTERPRISE DR | BELLE PLAINE | MN | 56011 | EXPRESS CARE |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 $ 1,112,121. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE MISSION OF MAYO CLINIC AND ITS AFFILIATES IS TO PUT THE NEEDS OF THE PATIENT FIRST. WE BELIEVE THAT MISSION IS BEST ACCOMPLISHED WITHIN HEALTHY, WELCOMING AND THRIVING COMMUNITIES. TO DELIVER ON THAT BELIEF, MCHS-NEW PRAGUE COLLABORATES WITH PUBLIC, PRIVATE AND NONPROFIT ORGANIZATIONS TO SUSTAIN AND ENHANCE THE COMMUNITIES IT SERVES. |
| PART III, LINE 2: | SCHEDULE H, PART III, SECTION A, LINE 1:THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.METHODOLOGY FOR SCHEDULE H, PART III, LINE 2:BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED IN THE ACCOUNTS RECEIVABLE FOOTNOTE OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 4: | FOOTNOTES RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS CAN BE FOUND ON PAGES 5, 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 $1,580,200 AS REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS. THE MOST COMMON REASONS FOR A DIFFERENCE BETWEEN THE MEDICARE SURPLUS REPORTED ON SCHEDULE H AND THE MEDICARE SHORTFALL REPORTED ON THE CORE FORM, PART III INCLUDE: (1) INCLUSION OF MEDICARE ADVANTAGE REVENUE AND EXPENSES; (2) INCLUSION OF PART B REVENUE AND EXPENSES; (3) INCLUSION OF OTHER FEE SCHEDULE REVENUE; AND (4) SOME TIMING ISSUES.REASONS WHY MEDICARE SHORTFALL REPORTED ON LINE 7, IF ANY, SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. |
| PART III, LINE 9B: | MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING REASONABLE ATTEMPTS TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN ADDITION, MAYO CLINIC AND ITS AFFILIATES ACCEPT REASONABLE PAYMENT PLANS FROM PATIENTS WHEN AN ACCOUNT IS THE PATIENT'S RESPONSIBILITY AND TRY TO IDENTIFY THOSE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS OFFERED TO ANY PATIENT IF THE FACTS AND CIRCUMSTANCES SUGGEST THAT THE PATIENT DOES NOT HAVE THE ABILITY TO PAY THEIR BILL IN WHOLE OR IN PART. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED; INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS 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 - NEW PRAGUE ADMINISTRATION AND ITS BOARD OF DIRECTORS ALONG WITH COMMUNITY STAKEHOLDERS, WORK CLOSELY WITH LOCAL EDUCATIONAL INSTITUTIONS, CHARITIES, AND HEALTH DEPARTMENTS TO ASSESS HEALTHCARE NEEDS. MCHS-NEW PRAGUE DEVELOPS A STRATEGIC PLAN TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY BASED ON THE INPUT RECEIVED. SERVICES, EDUCATION, VOLUNTEERS, IN KIND SUPPORT, MONETARY DONATIONS AND GOODS ARE SUPPLIED ONCE THOSE NEEDS ARE ASSESSED. REQUESTS FOR ASSISTANCE ARE TRIAGED THROUGH THE CORPORATE COMMUNICATION AND ADMINISTRATION DEPARTMENTS, AND EVALUATED BASED ON THE STRATEGIC PLAN. |
| 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. |
| PART VI, LINE 4: | MAYO CLINIC HEALTH SYSTEM- NEW PRAGUE IS LOCATED IN NEW PRAGUE, MN WHICH IS IN BOTH SCOTT AND LE SUEUR COUNTIES. SCOTT COUNTY IS A MIXED RURAL/SUBURBAN COUNTY. LE SUEUR COUNTY IS MAINLY RURAL.MAYO CLINIC HEALTH SYSTEM - NEW PRAGUE SERVES A PATIENT BASE OF ABOUT 60,000 IN SCOTT, LE SUEUR, RICE, AND SIBLEY COUNTIES. THERE ARE A TOTAL OF FOUR HOSPITALS NEARBY; ONE IN EACH COUNTY. IN LE SUEUR COUNTY THE MEDIAN HOUSEHOLD INCOME IS $57,477. 8.2% OF THE POPULATION IS BELOW THE POVERTY LEVEL. 14.4% OF THE POPULATION IS 65 YEARS AND OVER. IN SCOTT COUNTY, THE MEDIAN HOUSEHOLD INCOME IS $82,190. 4.7% OF THE POPULATION IS BELOW THE POVERTY LEVEL. 8.0% OF THE POPULATION IS 65 YEARS AND OVER. |
| PART VI, LINE 5: | THIS FILING ORGANIZATION IS AN AFFILIATE OF THE MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION- EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO 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 PHSYICIANS IN THE COMMUNITY.EMERGENCY ROOM - THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK, WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY. |
| PART VI, LINE 6: | THIS ORGANIZATION IS A PART OF MAYO CLINIC HEALTH SYSTEM (WHICH IS PART OF A LARGER GROUP OF ENTITIES AFFILIATED WITH MAYO CLINIC). THE MAYO CLINIC HEALTH SYSTEM IS DESCRIBED IN RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O). THAT STATEMENT ALSO DESCRIBES THE ROLES OF THE VARIOUS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. |
| PART VI LINE 7: | NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO A STATE HOSPITAL ASSOCIATION. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEACONSON MD TIMOTHY F | ||||||||||||||
| DIRECTOR | $0 | $716,596 | $0 | $0 | $0 | $0 | $0 | $12,750 | $0 | $20,792 | $0 | $750,138 | $0 | $0 |
| GRACE RICHARD W | ||||||||||||||
| DIRECTOR/VP/REGION CAO | $0 | $313,519 | $0 | $0 | $0 | $568 | $0 | $12,750 | $0 | $17,692 | $0 | $344,529 | $0 | $0 |
| HERRMANN MD MARTIN J | ||||||||||||||
| DIRECTOR/CHAIR | $0 | $248,575 | $0 | $0 | $0 | $2,648 | $0 | $23,183 | $0 | $24,972 | $0 | $299,378 | $0 | $0 |
| KUTCHER MD GREGORY R | ||||||||||||||
| DIR/PRESIDENT/REGION CEO | $0 | $455,895 | $0 | $0 | $0 | $0 | $0 | $12,750 | $0 | $22,530 | $0 | $491,175 | $0 | $0 |
| MOGA MD C NIC | ||||||||||||||
| DIRECTOR | $0 | $284,132 | $0 | $0 | $0 | $1,593 | $0 | $17,607 | $0 | $9,420 | $0 | $312,752 | $0 | $0 |
| TARASOVITCH JAMES J | ||||||||||||||
| DIR/SECY/TREAS/REGION CFO | $0 | $266,706 | $0 | $0 | $0 | $0 | $0 | $10,200 | $0 | $17,377 | $0 | $294,283 | $0 | $0 |
| KLIMP MARY J | ||||||||||||||
| SITE ADMINISTRATOR | $210,893 | $0 | $0 | $0 | $0 | $0 | $4,263 | $0 | $18,269 | $0 | $233,425 | $0 | $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 |
| CHINNA LEKSHMI MERCY C | ||||||||||||||
| CHARGE NURSE | $160,957 | $0 | $0 | $0 | $0 | $0 | $2,593 | $0 | $16,271 | $0 | $179,821 | $0 | $0 | $0 |
| HOPKINS LAURA H | ||||||||||||||
| NURSE ADMINISTRATOR | $158,665 | $0 | $0 | $0 | $0 | $0 | $3,141 | $0 | $9,779 | $0 | $171,585 | $0 | $0 | $0 |
| JENSEN CHRISTOPHER T | ||||||||||||||
| CRNA | $231,252 | $0 | $0 | $0 | $0 | $0 | $4,727 | $0 | $27,016 | $0 | $262,995 | $0 | $0 | $0 |
| SIMON CAROL | ||||||||||||||
| CHARGE NURSE | $170,532 | $0 | $0 | $0 | $0 | $0 | $3,532 | $0 | $26,658 | $0 | $200,722 | $0 | $0 | $0 |
| STUPICA BRUCE | ||||||||||||||
| CRNA | $253,912 | $0 | $0 | $0 | $0 | $0 | $4,084 | $0 | $4,972 | $0 | $262,968 | $0 | $0 | $0 |
| CARDWELL MD BRET A | ||||||||||||||
| FORMER HIGHEST PAID | $0 | $391,138 | $0 | $0 | $0 | $0 | $0 | $12,750 | $0 | $30,027 | $0 | $433,915 | $0 | $0 |
| OVERGAARD SHAWN M | ||||||||||||||
| FORMER HIGHEST PAID | $0 | $205,500 | $0 | $0 | $0 | $27,489 | $0 | $13,946 | $0 | $2,500 | $0 | $249,435 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, LINE 4B | 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). KOCH, MARK B. $8,890 MOGA M.D., C. NIC $ 770 |
| PART III | COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MARY NYTES | |||
| FAMILY MEMBER OF DIRECTOR RENEE BROD | $68,421 | EMPLOYMENT | 0 |
| ANNA HERRMANN | |||
| SPOUSE OF DIRECTOR MARTIN HERRMANN | $148,314 | EMPLOYMENT | 0 |
| PAIGE NYTES | |||
| FAMILY MEMBER OF DIRECTOR RENEE BROD | $67,674 | EMPLOYMENT | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: HERRMANN M.D., MARTIN J. MOGA M.D., C. NIC 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. KUTCHER M.D., GREGORY R. TARASOVITCH, JAMES J. KOCH, MARK B. THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: DEACONSON M.D., TIMOTHY F. GRACE, RICHARD W. 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: HERRMANN M.D., MARTIN J. DEACONSON M.D., TIMOTHY F. GRACE, RICHARD W. KUTCHER M.D., GREGORY R. TARASOVITCH, JAMES J. KOCH, MARK B. SCHOENBAUER, BRAD |
| 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. 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 6 | THE SOLE CORPORATE MEMBER IS MAYO CLINIC HEALTH SYSTEM-MANKATO |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE CORPORATE MEMBER APPOINTS THE FOUR MEMBER DIRECTORS AND DESIGNATES MEMBERS OF THE NOMINATING COMMITTEE FOR THE SEVEN COMMUNITY MEMBERS. ULTIMATE ELECTION IS BY THE BOARD OF DIRECTORS OF THE CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | CERTAIN TRANSACTIONS REQUIRE APPROVAL BY THE MEMBER BEFORE ACTION CAN BE TAKEN SUCH AS AMENDMENT TO THE ARTICLES AND BYLAWS, MERGER OR OTHER RESTRUCTURING, AND INCURRENCE OF DEBT. |
| 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 DIRECTOR OF FINANCE, THE CFO AND THE ADMINISTRATOR. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE 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 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 IN THE FALL FOR THE NEXT YEARS COMPENSATION. THE SALARIES OF THE CEO, CAO, AND SEVERAL BOARD MEMBERS WERE REVIEWED BY THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR MAYO CLINIC HEALTH SYSTEM - PHYSICIAN 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 COMPREHENSIVE REVIEW AND APPROVAL PROCESSES FOR THE REGION'S SENIOR LEADERSHIP AND PHYSICIANS (WHICH INCLUDE THE CEO AND CAO). THE PROCESSES INCLUDE REVIEW OF COMPARABILITY DATA FOR SIMILAR 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 19 | THE FILING ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. THE FILING ORGANIZATION IS A HOSPITAL AFFILIATED WITH MAYO CLINIC. AS SUCH, MAYO CLINIC'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FILING ORGANIZATION'S FORM 990 AND WOULD BE AVAILABLE UPON REQUEST OF THE FORM 990. |
| FORM 990, PART IX, LINE 11G | IC PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 5,643,133. MANAGEMENT AND GENERAL EXPENSES 2,375,052. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,018,185. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,257,726. MANAGEMENT AND GENERAL EXPENSES 78,781. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,336,507. |
| PART VI, SECTION B, LINES 10A THROUGH 16B | THE WRITTEN POLICIES AND PROCEDURES GOVERNING THE ACTIVITIES OF MCHS-NEW PRAGUE'S BRANCHES AND AFFILIATES ALONG WITH THE POLICIES DESCRIBED IN PART VI, SECTION B, LINES 10A THROUGH 16B THAT APPLY TO MCHS-NEW PRAGUE ALSO APLLIED TO QUEEN OF PEACE PROPERTIES, LLC, A DISREGARDED ENTITY OF MCHS-NEW PRAGUE THAT WAS DISSOLVED IN NOVEMBER 2013. |
| FILING OF CERTAIN FOREIGN FORMS | DISCLOSURE STATEMENT RELATED TO FORMS 5713: FORM 5713 HAS BEEN FILED BY THE FOLLOWING MEMBERS OF THE CONTROLLED GROUP: MAYO CLINIC (EIN: 41-6011702) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH (EIN: 41-1506440) MAYO CLINIC ARIZONA (EIN: 86-0800150) MAYO CLINIC JACKSONVILLE (EIN: 59-3337028) DISCLOSURE STATEMENT RELATED TO FORMS 5471: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 4 AND 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED TAXPAYER NAME: MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-1506440 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED DISCLOSURE STATEMENT RELATED TO FORMS 8865: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 8865, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS, AS A CATEGORY 2 AND 3 FILER. THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 8865 FOR THESE PARTNERSHIPS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 8865 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | QUEEN OF PEACE PROPERTIES LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 SECOND STREET NORTHEAST | AddressLine1 |
| City | NEW PRAGUE | City |
| State | MN | State |
| ZIP Code | 56071 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263202636 | EIN |
| Primary Activities | REAL ESTATE HOLDING | PrimaryActivitiesTxt |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Total Income | $0 | TotalIncomeAmt |
| End Of Year Assets | $0 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCHS-NEW PRAGUE | BusinessNameLine1 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (43 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd | Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | CountryForeignAddress/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLOOMER LAKEVIEW INC | |||||||||||||||
| 2110 DUNCAN ROAD | BLOOMER | WI | 54724 | 391450617 | LOW INCOME HOUSING | WI | 501(C)(3) | 7 | MCHS--CHIPPEWA VALLEY INC | Yes (1) | |||||
| CHARTERHOUSE INC | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411405254 | RETIREMENT LIVING CENTER | MN | 501(C)(3) | 9 | MAYO CLINIC | Yes (1) | |||||
| FRANCISCAN SKEMP FOUNDATION OF ARCADIA INC | |||||||||||||||
| 464 SOUTH ST JOSEPH AVENUE | ARCADIA | WI | 54612 | 391322480 | FUNDRAISING FOUNDATION | WI | 501(C)(3) | 9 | MCHS--FRANCISCAN HEALTHCARE INC | Yes (1) | |||||
| GOLD CROSS AMBULANCE SERVICE | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411917516 | AMBULANCE SERVICE | MN | 501(C)(3) | 9 | MFMER | Yes (1) | |||||
| LUTHER LAKESIDE APARTMENTS INC | |||||||||||||||
| PO BOX 1510 | EAU CLAIRE | WI | 54702 | 391409024 | LOW INCOME HOUSING FOR ELDERLY | WI | 501(C)(3) | 9 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MAYO CLINIC | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 416011702 | PATIENT CARE - CLINIC | MN | 501(C)(3) | 9 | Yes (1) | N/A | |||||
| MAYO CLINIC -- METHODIST HOSPITAL | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 410739106 | HOSPITAL | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MAYO CLINIC HOSPITAL-- ROCHESTER | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 410944601 | HOSPITAL | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MAYO CLINIC ARIZONA | |||||||||||||||
| 13400 EAST SHEA BOULEVARD | SCOTTSDALE | AZ | 85259 | 860800150 | HOSPITAL AND CLINIC | AZ | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) | |||||||||||||||
| 4500 SAN PABLO ROAD | JACKSONVILLE | FL | 32224 | 590714831 | HOSPITAL | FL | 501(C)(3) | 3 | MAYO CLINIC JACKSONVILLE | Yes (1) | |||||
| MCHS IN WAYCROSS INC | |||||||||||||||
| 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | 581667166 | HOSPITAL | GA | 501(C)(3) | 3 | MAYO CLINIC JACKSONVILLE | Yes (1) | |||||
| MCHS--ALBERT LEA AND AUSTIN | |||||||||||||||
| 1000 FIRST DRIVE NW | AUSTIN | MN | 55912 | 411404075 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--AUSTIN FOUNDATION | |||||||||||||||
| 1000 FIRST DRIVE NW | AUSTIN | MN | 55912 | 300107471 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MCHS--ALBERT LEA AND AUSTIN | Yes (1) | |||||
| MCHS--CANNON FALLS | |||||||||||||||
| 1116 WEST MILL STREET | CANNON FALLS | MN | 55009 | 204156428 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--CHIPPEWA VALLEY INC | |||||||||||||||
| 1501 THOMPSON STREET | BLOOMER | WI | 54724 | 390980343 | HOSPITAL AND CLINIC | WI | 501(C)(3) | 3 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MCHS--EAU CLAIRE CLINIC INC | |||||||||||||||
| 733 W CLAIREMONT AVE PO BOX 1510 | EAU CLAIRE | WI | 54702 | 391735831 | PATIENT CARE - CLINIC | WI | 501(C)(3) | 3 | MAYO CLINIC | 0 | |||||
| MCHS--EAU CLAIRE FOUNDATION INC | |||||||||||||||
| 733 W CLAIREMONT AVE PO BOX 1510 | EAU CLAIRE | WI | 54702 | 391633407 | GRANTMAKING FOUNDATION | WI | 501(C)(3) | 11-I | MCHS--EAU CLAIRE CLINIC INC | 0 | |||||
| MCHS--EAU CLAIRE HOSPITAL INC | |||||||||||||||
| 1221 WHIPPLE STREET | EAU CLAIRE | WI | 54703 | 390813418 | HOSPITAL | WI | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--FAIRMONT | |||||||||||||||
| 800 MEDICAL CENTER DRIVE PO BOX 800 | FAIRMONT | MN | 56031 | 410760836 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (1) | |||||
| MCHS--FRANCISCAN HEALTHCARE FOUNDATION INC | |||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 391186647 | FUNDRAISING FOUNDATION | WI | 501(C)(3) | 7 | MCHS--FRANCISCAN HEALTHCARE INC | Yes (1) | |||||
| MCHS--FRANCISCAN HEALTHCARE FOUNDATION-SPARTA INC | |||||||||||||||
| 310 WEST MAIN STREET | SPARTA | WI | 54656 | 391423234 | FUNDRAISING FOUNDATION | WI | 501(C)(3) | 9 | MCHS--FRANCISCAN HEALTHCARE INC | Yes (1) | |||||
| MCHS--FRANCISCAN HEALTHCARE INC | |||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 391411999 | HEALTHCARE SYSTEM PARENT | WI | 501(C)(3) | 11-I | MAYO CLINIC | Yes (1) | |||||
| MCHS--FRANCISCAN MEDICAL CENTER INC | |||||||||||||||
| 700 WEST AVE SOUTH | LA CROSSE | WI | 54601 | 390806374 | HOSPITAL AND CLINIC | WI | 501(C)(3) | 3 | MCHS--FRANCISCAN HEALTHCARE INC | Yes (1) | |||||
| MCHS--HOME HEALTH & HOSPICE INC | |||||||||||||||
| PO BOX 2060 | EAU CLAIRE | WI | 54702 | 391491516 | HOME HEALTH AND HOSPICE CARE | WI | 501(C)(3) | 9 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MCHS--LAKE CITY | |||||||||||||||
| 500 WEST GRANT STREET | LAKE CITY | MN | 55041 | 411906820 | HOSPITAL | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--MANKATO | |||||||||||||||
| 1025 MARSH STREET | MANKATO | MN | 56002 | 411236756 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--MANKATO HEALTH CARE FOUNDATION | |||||||||||||||
| 1025 MARSH STREET | MANKATO | MN | 56002 | 411663357 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MCHS--MANKATO | Yes (1) | |||||
| MCHS--NEW PRAGUE | |||||||||||||||
| 301 SECOND STREET NE | NEW PRAGUE | MN | 56071 | 410723639 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (1) | |||||
| MCHS--NORTHLAND INC | |||||||||||||||
| 1222 EAST WOODLAND AVENUE | BARRON | WI | 54812 | 390920634 | HOSPITAL AND CLINIC | WI | 501(C)(3) | 3 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MCHS--OAKRIDGE INC | |||||||||||||||
| 13025 EIGHTH STREET PO BOX 70 | OSSEO | WI | 54758 | 391029430 | HOSPITAL AND CLINIC | WI | 501(C)(3) | 3 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MCHS--OWATONNA | |||||||||||||||
| 134 SOUTHVIEW ST | OWATONNA | MN | 55060 | 411862132 | PATIENT CARE - CLINIC | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--RED CEDAR INC | |||||||||||||||
| 2321 STOUT ROAD | MENOMONIE | WI | 54751 | 510190875 | HOSPITAL AND CLINIC | WI | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--RED WING | |||||||||||||||
| 701 HEWITT BOULEVARD | RED WING | MN | 55066 | 411713783 | PATIENT CARE SERVICES | MN | 501(C)(3) | 3 | MAYO CLINIC | Yes (1) | |||||
| MCHS--SPRINGFIELD | |||||||||||||||
| 625 NORTH JACKSON AVENUE | SPRINGFIELD | MN | 56087 | 411893827 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (1) | |||||
| MCHS--ST JAMES | |||||||||||||||
| 1101 MOULTON PARSONS DR PO BOX 460 | ST JAMES | MN | 56081 | 410797368 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (1) | |||||
| MCHS--ST JAMES HEALTH CARE FOUNDATION | |||||||||||||||
| 1101 MOULTON PARSONS DR PO BOX 460 | ST JAMES | MN | 56081 | 411444129 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MCHS--ST JAMES | Yes (1) | |||||
| MCHS--SUPPORTIVE HOMECARE INC | |||||||||||||||
| PO BOX 2060 | EAU CLAIRE | WI | 54702 | 391686673 | HOME HEALTH CARE | WI | 501(C)(3) | 9 | MCHS--EAU CLAIRE HOSPITAL INC | Yes (1) | |||||
| MCHS--WASECA | |||||||||||||||
| 501 NORTH STATE STREET | WASECA | MN | 56093 | 363606405 | HOSPITAL AND CLINIC | MN | 501(C)(3) | 3 | MCHS--MANKATO | Yes (1) | |||||
| MAYO CLINIC JACKSONVILLE | |||||||||||||||
| 4500 SAN PABLO ROAD | JACKSONVILLE | FL | 32224 | 593337028 | PATIENT CARE - CLINIC | FL | 501(C)(3) | 7 | MAYO CLINIC | Yes (1) | |||||
| MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411506440 | CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES | MN | 501(C)(3) | 9 | MAYO CLINIC | Yes (1) | |||||
| MAYO KLINIK STIFTUNG | |||||||||||||||
| FUNDRAISING FOUNDATION | MFMER | Yes (1) | 60486 FRANKFURT AM MAIN | FRANKFURT | GM | GM | |||||||||
| MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 412020392 | SUPPORT RESEARCH, PRACTICE & EDUCATION | MN | 501(C)(3) | 11-I | MAYO CLINIC | Yes (1) | |||||
| POVERELLO FOUNDATION | |||||||||||||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411494881 | FUNDRAISING FOUNDATION | MN | 501(C)(3) | 7 | MAYO CLINIC HOSPITAL - ROCHESTER | Yes (1) | |||||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| FRANKLIN HEATING STATION | |||||||
| 119 THIRD ST SW | ROCHESTER | MN | 55902 | 410264830 | UTILITY | MN | N/A |
| PHYSICIAN SOFTWARE SYSTEMS LLC | |||||||
| 3333 WARRENVILLE ROAD SUITE 200 | LISLE | IL | 60532 | 453414836 | HEALTHCARE RELATED SOFTWARE | IL | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (37 entries)
| Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | CountryForeignAddress/Country | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Legal Domicile StateLegalDomicileStateCd | Entity TypeEntityTypeTxt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GMO GLOBAL BOND INVESTMENT FUND | |||||||||||||
| 78 SIR JOHN ROGERSONS QUAY | DUBLIN 2 | EI | OTHER FINANCIAL INVESTMENT ACTIVITIES | EI | N/A | 0 | |||||||
| HEALTH TRADITION HEALTH PLAN | |||||||||||||
| MEDICAL SERVICES COMPANY | N/A | 0 | 1808 EAST MAIN STREET | ONALASKA | WI | 54650 | 391545987 | WI | C | ||||
| LOBSS NETWORK SUPPORT 2002 INC | |||||||||||||
| ADMINISTRATIVE SERVICES | N/A | 0 | 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 481276150 | MN | C | ||||
| MAYO CLINIC GBS MAURITIUS | |||||||||||||
| 2ND FLOOR EBENE MEWS 57 | EBENE CYBERCITY | MP | HEALTHCARE MANAGEMENT | MP | N/A | 0 | C | ||||||
| MCHS--DECORAH CLINIC PHYSICIANS | |||||||||||||
| PATIENT CARE - CLINIC | N/A | 0 | 907 MONTGOMERY STREET | DECORAH | IA | 52101 | 411711329 | IA | C | ||||
| MCHS--PHARMACY & HOME MEDICAL INC | |||||||||||||
| PHARMACY SERVICES | N/A | 0 | 1221 WHIPPLE STREET | EAU CLAIRE | WI | 54703 | 391528920 | WI | C | ||||
| MCHS PHYSICIANS IN WAYCROSS INC | |||||||||||||
| PHYSICIAN OFFICES | N/A | 0 | 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | 204363143 | GA | C | ||||
| MAYO HOLDING COMPANY | |||||||||||||
| HOLDING COMPANY | N/A | 0 | 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 411578020 | MN | C | ||||
| MAYO INSURANCE COMPANY LTD | |||||||||||||
| SELF INSURANCE POOL | CJ | N/A | 0 | 200 FIRST STREET SW | ROCHESTER | MN | 55905 | C | |||||
| MMSI INC | |||||||||||||
| THIRD PARTY ADMINISTRATION SERVICES | N/A | 0 | 21 FIRST STREET SW | ROCHESTER | MN | 55905 | 411547003 | MN | C | ||||
| RESOUNDANT INC | |||||||||||||
| MANUFACTURING MEDICAL DEVICE COMPONENT | N/A | 0 | 221 1ST AVE SW | ROCHESTER | MN | 55902 | 461661978 | MN | C | ||||
| ROCHESTER AIRPORT COMPANY | |||||||||||||
| AIRPORT MANAGEMENT | N/A | 0 | ROUTE 2 | ROCHESTER | MN | 55902 | 410506870 | MN | C | ||||
| SATILLA HEALTHNET INC | |||||||||||||
| HEALTH SERVICES | N/A | 0 | 1900 TEBEAU STREET | WAYCROSS | GA | 31501 | 582151076 | GA | C | ||||
| SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION | |||||||||||||
| COMMERCIAL PROPERTY OWNERS ASSOCIATION | N/A | 0 | 13400 E SHEA BLVD | SCOTTSDALE | AZ | 85259 | 860870505 | AZ | C | ||||
| THE STABILE BUILDING OWNERS' ASSOCIATION | |||||||||||||
| COMMERCIAL PROPERTY OWNERS ASSOCIATION | N/A | 0 | 200 FIRST STREET SW | ROCHESTER | MN | 55905 | 208994499 | MN | C | ||||
| DESTINATION MEDICAL CENTER ECONOMIC DEVELOPMENT AGENCY | |||||||||||||
| ECONOMIC DEVELOPMENT | N/A | 0 | 50 SOUTH SIXTH STREET SUITE 1500 | MINNEAPOLIS | MN | 554021498 | 464893585 | MN | C | ||||
| CAVALRY CLO III LTD | |||||||||||||
| PO BOX 1093 GT QUEENSGATE HOUSE S | GRAND CAYMAN | CJ | INVESTMENT ACTIVITIES | CJ | N/A | 0 | C | ||||||
| CHARITABLE LEAD TRUST (2) | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | CA | T | |||||||||
| CHARITABLE LEAD TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | MN | T | |||||||||
| CHARITABLE LEAD TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | IL | T | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | ND | T | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | AZ | T | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | LA | T | |||||||||
| PERPETUAL TRUST (2) | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | MA | T | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | MN | T | |||||||||
| PERPETUAL TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | MO | T | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | AZ | T | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | CO | T | |||||||||
| CHARITABLE REMAINDER TRUST (7) | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | FL | T | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | LA | T | |||||||||
| CHARITABLE REMAINDER TRUST (76) | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | MN | T | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | NC | T | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | TX | T | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | CO | T | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | IL | T | |||||||||
| CHARITABLE REMAINDER TRUST | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | MI | T | |||||||||
| CHARITABLE REMAINDER TRUST (72) | |||||||||||||
| CHARITABLE TRUST | N/A | 0 | MN | T | |||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| MAYO CLINIC HEALTH SYSTEM--FAIRMONT | ||
| M | $3,296,885 | GAAP |
| MMSI INC | ||
| R | $2,690,386 | GAAP |
| MMSI INC | ||
| S | $629,352 | GAAP |