2013-10-30T11:12:20-05:00 2012-12-31 990 2012-01-01 411263419 RED WING SEMINARY HOME REDW 5075381297 PO BOX 95 - 701 HEWITT BOULEVARD RED WING MN 55066 THOMAS J WITT MD 5075381297 2013-10-29 2012 2016-03-07 17:11:31Z X X FKA FAIRVIEW SEMINARY HOME THOMAS J WITT MD PO BOX 95 - 701 HEWITT BOULEVARD RED WING MN 55066 2687995 0 X WWW.MAYOCLINICHEALTHSYSTEM.ORG X 1943 MN PROVIDE EXEMPLARY CARE TO THE WHOLE PERSON, ENCOMPASS BODY, MIND, AND SPIRIT AT EVERY LIFE STAGE. X 13 5 0 8 0 0 11030 4659 5629984 2642633 36192 -31033 10400 11765 5687606 2628024 0 2338047 0 0 74385 0 0 0 0 5573677 3095505 5648062 5433552 39544 -2805528 2700415 0 465403 0 2235012 0 X RED WING SEMINARY HOME'S MISSION IS TO PROVIDE EXEMPLARY CARE TO THE WHOLE PERSON; ENCOMPASSING BODY, MIND, AND SPIRIT, AT EVERY STAGE OF LIFE. 0 1 4996740 2338047 2648331 SEE SCHEDULE ORED WING SEMINARY HOME BECAME A MEMBER OF THE MAYO CLINIC HEALTH SYSTEM ON JULY 1, 2012, WITH BENEDICTINE HEALTH SYSTEM MANAGING THE HOME. PRIOR TO THAT THEY WERE PART OF THE FAIRVIEW HEALTH SYSTEM. MAYO CLINIC HEALTH SYSTEM IS A FAMILY OF CLINICS, HOSPITALS AND HEALTH CARE FACILITIES SERVING COMMUNITIES IN MINNESOTA, IOWA AND WISCONSIN. AS PART OF MAYO CLINIC, MAYO CLINIC HEALTH SYSTEM OFFERS OUTSTANDING CARE CLOSE TO HOME. PHYSICIANS AND STAFF IN MAYO CLINIC HEALTH SYSTEM HAVE READY ACCESS TO THE KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC, YET CAN MEET PATIENTS' HEALTH CARE NEEDS LOCALLY. MAYO CLINIC HEALTH SYSTEM IS PART OF THE COMMUNITY, FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES IN WHICH WE LIVE AND WORK. MAYO CLINIC HEALTH SYSTEM TEAMS WITH MAYO CLINIC TO DELIVER UNPARALLELED HEALTH CARE TO COMMUNITIES THROUGH AN INTEGRATED NETWORK OF CLINICS AND HOSPITALS.IN 2012, MAYO CLINIC HEALTH SYSTEM SITES EMPLOYED APPROXIMATELY 1,000 PHYSICIANS AND 14,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT THE MAYO CLINIC HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN 72 COMMUNITIES, THE 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 FROM A NEW IDEA TO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN AMERICA. MAYO CLINIC HEALTH SYSTEM COMPLETES MORE THAN TWO-MILLION PATIENT VISITS ANNUALLY. IT ALSO SERVES AS A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS BEING RECOGNIZED SIX TIMES BY THE AMERICAN MEDICAL GROUP ASSOCIATION'S ACCLAIM AWARD PROGRAM (2005 ACCLAIM AWARD RECIPIENT AND FIVE-TIME ACCLAIM AWARD HONOREE). THE ACCLAIM AWARDS HONOR PHYSICIAN-LED ORGANIZATIONS DELIVERING CARE ALIGNED WITH THE IDEAL DELIVERY MODEL WHERE PATIENTS EXPERIENCE SAFE, RELIABLE, RESPONSIVE, READILY AVAILABLE AND INTEGRATED CARE. IN ADDITION, THE MINNESOTA COUNCIL FOR QUALITY HAS RECOGNIZED MAYO CLINIC HEALTH SYSTEM THREE TIMES FOR ITS PERFORMANCE EXCELLENCE EFFORTS. INDIVIDUAL MAYO CLINIC HEALTH SYSTEM LOCATIONS HAVE ALSO BEEN HONORED FOR THEIR COMMITMENT TO QUALITY, SAFETY, SERVICE, PERFORMANCE AND THEIR COMMUNITIES.PEOPLE IN MINNESOTA, IOWA AND WISCONSIN CAN HAVE PEACE OF MIND KNOWING THAT MAYO CLINIC HEALTH SYSTEM AND MAYO CLINIC PARTNER TO ENSURE HEALTHIER LIVES IN THE REGION.RED WING SEMINARY HOME OPERATES A HOME FOR THE AGED TO SATISFY THEIR HEALTH CARE AND FINANCIAL SECURITY NEEDS. RED WING SEMINARY HOME PARTICIPATES IN THE MEDICARE AND MEDICAID PROGRAMS AND OPERATES TO PROVIDE QUALITY SERVICE AT THE LOWEST POSSIBLE COST. IN 2012, THE COMMUNITY BENEFIT RELATED TO THE MEDICARE AND MEDICAID PROGRAMS WAS APPROXIMATELY $319,000 AND $322,000, RESPECTIVELY. THE HOME FURNISHES CARE AND HOUSING TO AGED INDIVIDUALS WHO OTHERWISE WOULD BE UNABLE TO PROVIDE FOR THEMSELVES WITHOUT HARDSHIP. THE SERVICES RENDERED ARE NURSING CARE, SOCIAL SERVICES, AND IF DESIRED, SPIRITUAL SUPPORT.ON DECEMBER 31, 2012 THE RED WING SEMINARY HOME MERGED INTO THE MAYO CLINIC HEALTH SYSTEM-RED WING. 4996740 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 1 2 0 1 0 0 0 0 0 0 0 0 0 0 0 X 13 5 1 1 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X CORPORATE TAX 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 AGERTER MD DAVID C 1.00 40.00 X X 0 483600 35091 ALEXANDER MD JACK W 1.00 40.00 X 0 313346 38280 ANDERST DONNA 1.00 0.00 X 0 0 0 BECK JENNIFER 1.00 0.00 X 0 0 0 BODENSTEINER RICHARD 1.00 0.00 X 0 0 0 DEJONG MD AMY A 1.00 40.00 X 0 236073 35015 DOHERTY JOHN 1.00 40.00 X 0 310405 41762 FOOT III SILAS B 1.00 0.00 X X 0 0 0 HALEY BARBARA 1.00 0.00 X X 0 0 0 HANSON JOHN O 1.00 0.00 X 0 0 0 KETCHAM MD JEFFREY M 1.00 40.00 X X 0 618288 31879 KOCH MARK B 1.00 40.00 X 0 289086 16795 MURPHY DAVID D 1.00 0.00 X 0 0 0 PARKS DOUGLAS A 1.00 40.00 X X 0 189781 44522 PHILLIPPE PAULA 1.00 40.00 X 0 430949 63998 RIEGELMAN ROBERT 1.00 0.00 X X 0 0 0 SIMPSON MD HENRY J 1.00 40.00 X 0 299001 45476 WILLIAMS MD AMY W 1.00 40.00 X 0 242537 31959 WITT MD THOMAS J 1.00 40.00 X X 0 452522 63616 WORDELMAN SCOTT R 1.00 40.00 X X 0 413997 39152 LARSON MICHAEL J 1.00 40.00 X 0 247605 38437 PILOT DAVID L 1.00 40.00 X 0 196045 33934 DIMUNATION NANCY 0.00 40.00 X 0 209166 25139 EICH MD MATTHEW A 0.00 40.00 X 0 621666 29044 HUGHES MD EVERETT M 0.00 40.00 X 0 616027 36155 JOHNSON MD MICHAEL R 0.00 40.00 X 0 520271 35589 MCDEVITT MD CHRISTOPHER 0.00 40.00 X 0 425153 37879 SAWHNEY MD JASWIN S 0.00 40.00 X 0 392818 33986 0 7508336 757708 0 1 1 0 EBENEZER MANAGEMENT SERVICES 2722 PARK AVENUE MINEAPOLIS MN 55407 STAFFING SERVICES 2103111 AEGIS THERAPIES INC 1000 FIANNA WAY FORT SMITH AZ 72919 REHAB SERVICES 231577 2 4659 4659 PATIENT CARE 620000 2553131 2553131 RESIDENT REVENUE 623000 60810 60810 MEALS ON WHEELS 624210 28692 28692 2642633 26755 26755 8250 2183 6067 6067 6067 57788 -57788 -57788 -57788 MISCELLANEOUS REVENUE 900099 5698 5698 5698 2628024 2648331 0 -24966 X 2338047 2338047 74157 74157 2246110 1954228 291882 1079 1079 188538 169864 18674 113217 113217 18279 16945 1334 106460 106460 57943 23795 34148 MEDICAID SURCHARGE 118230 118230 MEDICAL SUPPLIES 108824 108824 BAD DEBT EXPENSE 45486 45486 DUES, LICENSES & SUBSCR 9805 9805 7377 1644 5733 5433552 4996740 436812 0 661474 0 0 0 676180 0 0 0 0 0 60249 0 0 769362 0 527090 0 0 0 0 6060 0 2700415 0 464703 0 700 465403 0 X 2232291 0 2721 0 2235012 0 2700415 0 X -2805528 -2015 572531 X 0 1 X 1 0 X 2287 4325 5431 11030 4659 27732 5020849 5505265 5712087 5629984 2648331 24516516 5023136 5509590 5717518 5641014 2652990 24544248 0 0 0 24544248 19686 1652 17135 36192 35005 109670 19686 1652 17135 36192 35005 109670 5042822 5511242 5734653 5677206 2687995 24653918 0.99560 0.99240 0.00440 0.00760 X 0 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: AT DECEMBER 31, 2012 AND 2011, 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. 1 MAYO CLINIC HEALTH SYSTEM - RED WING 701 HEWITT BLVD RED WING MN 55066 411713783 501(C)(3) 159495 2178552 BOOK MERGER OF NON-CASH ASSETS AND LIABILITIES SUPPORT MISSION 1 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY AND EQUALITY OF OPPORTUNITY. NO ADDITIONAL MONITORING IS PERFORMED. TRANSFERS OR GRANTS TO AFFILIATED TAX-EXEMPT ORGANIZATIONS WILL BE USED PURSUANT TO THE POLICIES AND PROCEDURES OF THE GRANTEE ORGANIZATIONS AND TO FURTHER THE EXEMPT PURPOSES OF THE GRANTEE ORGANIZATIONS. BOTH THE FILING ORGANIZATION AND THE GRANTEE ORGANIZATION MAINTAIN ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED. 0 1 0 0 0 0 0 0 0 AGERTER MD DAVID C 0 449783 0 0 0 33817 0 19707 0 15384 0 518691 0 0 ALEXANDER MD JACK W 0 254104 0 58792 0 450 0 17500 0 20780 0 351626 0 0 DEJONG MD AMY A 0 227969 0 6585 0 1519 0 16992 0 18023 0 271088 0 0 DOHERTY JOHN 0 300485 0 9920 0 0 0 29076 0 12686 0 352167 0 0 KETCHAM MD JEFFREY M 0 606149 0 6851 0 5288 0 10000 0 21879 0 650167 0 0 KOCH MARK B 0 279804 0 0 0 9282 0 322 0 16473 0 305881 0 0 PARKS DOUGLAS A 0 188612 0 0 0 1169 0 20335 0 24187 0 234303 0 0 PHILLIPPE PAULA 0 417642 0 12320 0 987 0 34756 0 29242 0 494947 0 0 SIMPSON MD HENRY J 0 299001 0 0 0 0 0 22500 0 22976 0 344477 0 0 WILLIAMS MD AMY W 0 234905 0 0 0 7632 0 29895 0 2064 0 274496 0 0 WITT MD THOMAS J 0 410870 0 0 0 41652 0 42967 0 20649 0 516138 0 0 WORDELMAN SCOTT R 0 269926 0 69900 0 74171 0 26466 0 12686 0 453149 0 43393 LARSON MICHAEL J 0 203859 0 43246 0 500 0 17500 0 20937 0 286042 0 0 PILOT DAVID L 0 196045 0 0 0 0 0 13937 0 19997 0 229979 0 0 DIMUNATION NANCY 0 160824 0 47842 0 500 0 14743 0 10396 0 234305 0 0 EICH MD MATTHEW A 0 614581 0 6585 0 500 0 17500 0 11544 0 650710 0 0 HUGHES MD EVERETT M 0 587148 0 6585 0 22294 0 17500 0 18655 0 652182 0 0 JOHNSON MD MICHAEL R 0 490331 0 6585 0 23355 0 17500 0 18089 0 555860 0 0 MCDEVITT MD CHRISTOPHER 0 418447 0 6256 0 450 0 17500 0 20379 0 463032 0 0 SAWHNEY MD JASWIN S 0 377354 0 6616 0 8848 0 17500 0 16486 0 426804 0 0 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). DAVID C. AGERTER, M.D. $27,454 MARK B. KOCH $8,013 AMY W. WILLIAMS, M.D. $6,177 THOMAS J. WITT, M.D. $30,605 IN ADDITION, PRIOR TO AFFILIATION WITH MAYO CLINIC, SCOTT WORDELMAN PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN IN THE AMOUNT OF $43,393 THROUGH FAIRVIEW HEALTH SERVICES. SUPPLEMENTAL INFORMATION PART III 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. COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. ALL ASSETS, LIABILITIES AND NET ASSETS MERGED INTO PARENT 2012-12-31 2338047 BOOK VALUE AT END OF YEAR 411713783 MAYO CLINIC HEALTH SYSTEM-RED WING 701 HEWITT BLVD RED WING MN 55066 501(C)(3) 1 1 0 0 1 1 1 1 0 PART I, LINE 2E: THE BOARD OF DIRECTORS FOR RED WING SEMINARY HOME ARE THE SAME MEMBERS FOR MAYO CLINIC HEALTH SYSTEM-RED WING, WHICH IS THE SURVIVING ENTITY IN THE MERGER OF THE TWO ORGANIZATIONS. PART I, LINE 7C: THE REPORTING ORGANIZATION DID NOT HAVE ANY TAX EXEMPT BOND LIABILITIES. CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 RED WING SEMINARY HOME BECAME A MEMBER OF THE MAYO CLINIC HEALTH SYSTEM ON JULY 1, 2012, PRIOR TO THAT THEY WERE PART OF THE FAIRVIEW HEALTH SYSTEM. ON DECEMBER 31, 2012 RED WING SEMINARY HOME MERGED INTO THE MAYO CLINIC HEALTH SYSTEM-RED WING. FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: ALEXANDER M.D., JACK W. DEJONG M.D., AMY A. DIMUNATION, NANCY DOHERTY, JOHN EICH M.D., MATTHEW A. HUGHES M.D., EVERETT M. JOHNSON M.D., MICHAEL R. KETCHAM M.D., JEFFREY M. LARSON, MICHAEL J. MCDEVITT M.D., CHRISTOPHER PHILLIPPE, PAULA SAWHNEY M.D., JASWIN S. WORDELMAN, SCOTT R. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: AGERTER M.D., DAVID C. ALEXANDER M.D., JACK W. ANDERST, DONNA BECK, JENNIFER BODENSTEINER, RICHARD DEJONG M.D., AMY A. DIMUNATION, NANCY DOHERTY, JOHN EICH M.D., MATTHEW A. FOOT III., SILAS B. HALEY, BARBARA HANSON, JOHN O. HUGHES M.D., EVERETT M. JOHNSON M.D., MICHAEL R. KETCHAM M.D., JEFFREY M. KOCH, MARK B. LARSON, MICHAEL J. MCDEVITT M.D., CHRISTOPHER MURPHY, DAVID D. PARKS, DOUGLAS A. PHILLIPPE, PAULA PILOT, DAVID L. RIEGELMAN, ROBERT SIMPSON M.D., HENRY J. WILLIAMS M.D., AMY W. WITT M.D., THOMAS J. WORDELMAN, SCOTT R. THE FOLLOWING INDIVIDUAL IS EMPLOYED BY A RELATED ORGANIZATION: PILOT, DAVID L. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: AGERTER M.D., DAVID C. KOCH, MARK B. PARKS, DOUGLAS A. THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: SIMPSON M.D., HENRY J. WITT M.D., THOMAS J. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: SIMPSON M.D., HENRY J. WITT M.D., THOMAS J. THE FOLLOWING INDIVIDUAL IS EMPLOYED BY A RELATED ORGANIZATION: WITT M.D., THOMAS J. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: AGERTER M.D., DAVID C. KOCH, MARK B. PARKS, DOUGLAS A. PILOT, DAVID L. THE FOLLOWING INDIVIDUALS ARE EMPLOYED BY A RELATED ORGANIZATION: DOHERTY, JOHN PHILLIPPE, PAULA WORDELMAN, SCOTT R. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE. DOHERTY, JOHN FOOT III., SILAS B. PHILLIPPE, PAULA WORDELMAN, SCOTT R. MURPHY, DAVID D. 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-RED WING ALSO PROVIDES MANAGEMENT SERVICES ON A REGIONAL BASIS THAT INCLUDES THE FILING ORGANIZATION. PRIOR TO THE MAYO CLINIC HEALTH SYSTEM MERGER IN JULY 2012, EBENEZER MANAGEMENT SERVICES MANAGED THE FILING ORGANIZATION UNDER THE DIRECTION OF FAIRVIEW RED WING HEALTH SERVICES. 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 4 ON JULY 1, 2012 THE ORGANIZATION CHANGED ITS NAME TO RED WING SEMINARY HOME. ON DECEMBER 31, 2012 RED WING SEMINARY HOME MERGED INTO ITS PARENT ORGANIZATION MAYO CLINIC HEALTH SYSTEM-RED WING. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS MAYO CLINIC HEALTH SYSTEM-RED WING. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD SHALL CONSIST OF THOSE PERSONS WHO ARE CONTEMPORANEOUSLY MEMBERS OF THE BOARD OF DIRECTORS OF MCHS-RED WING AND THEREFORE ELECTED PURSUANT TO THE ARTICLES AND BYLAWS OF THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7B THE ARTICLES AND BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, BUDGET, DEBT, AMENDMENT OF THE ARTICLES AND BYLAWS, AND GENERAL OPERATION DECISIONS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. DUE TO THE MERGER AT THE END OF THE REPORTING YEAR, THE GOVERNING BODY THAT REVIEWED THE FILING ORGANIZATION'S 990 WAS MAYO CLINIC HEALTH SYSTEM-RED WING. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE FILING ORGANIZATION BECAME AN AFFILIATE OF MAYO CLINIC ON JULY 1, 2012. 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. PRE-AFFILIATION WITH MAYO CLINIC, MANAGERS, DIRECTORS, AND SENIOR MANAGEMENT OF THE REPORTING ORGANIZATION WERE REQUIRED TO ANNUALLY COMPLETE FAIRVIEW'S DUTY OF LOYALTY AND CONFLICT OF INTEREST STATEMENT IN COMPLIANCE WITH FAIRVIEW'S CONFLICT OF INTEREST POLICY. DISCLOSURES ARE REVIEWED BY THE COMPLIANCE DEPARTMENT. CONFLICTS OF INTEREST BY BOARD MEMBERS ARE BROUGHT TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD ALONG WITH ADDITIONAL DETAILED INFORMATION, FOR SPECIFIC REVIEW. IN ADDITION, THE COMPLIANCE OFFICER COMPILES A SCHEDULE SHOWING REPORTED CONFLICTS OF INTEREST BY MANAGERS, DIRECTORS, AND SENIOR MANAGEMENT WHICH IS ALSO PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD FOR REVIEW AND DISCUSSION. ANY PROBLEMATIC ISSUES ARISING FROM THESE DISCLOSURES ARE DISCUSSED AND RESOLVED BY THE COMMITTEE. BOARD MEMBERS AND MANAGEMENT EMPLOYEES ARE EXPECTED TO UPDATE THEIR CONLFICTS AS NECESSARY DURING THE YEAR. AS OF JULY 1, 2012, 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 MAYO-EMPLOYED 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 YEAR'S COMPENSATION. THE SALARY OF THE REGIONAL CEO AND CAO, SITE CEO AND CAO, ALONG WITH PHYSICIAN LEADERS ON THE BOARD OF THE FILING ORGANIZATION WERE REVIEWED BY THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR MAYO CLINIC HEALTH SYSTEM PHYSICIANS AND ADMINISTRATIVE LEADERSHIP. THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION OF PHYSICIANS AND ADMINISTRATIVE LEADERSHIP FOR THE MAYO CLINIC HEALTH SYSTEM ENTITIES. THE COMMITTEE IS COMPRISED OF MAYO EMPLOYEES, BUT IS INDEPENDENT FOR INTERNAL REVENUE CODE 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED (WITH RECUSAL WHERE APPROPRIATE). THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE THEN REVIEWS AND APPROVES THE COMPENSATION. FOR THOSE INDIVIDUALS FOR WHICH THE MAYO CLINIC HEALTH SYSTEM COMMITTEE CAN NOT SERVE AS THE INDEPENDENT REVIEW, THEIR COMPENSATION AND BENEFITS ARE REVIEWED BY THE GOVERNANCE COMMITTEE (DESCRIBED BELOW). THE COMPENSATION AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. INFORMATION ON MAYO CLINIC HEALTH SYSTEM PHYSICIAN AND ADMINISTRATIVE LEADERSHIP COMPENSATION AND BENEFITS IS ALSO REVIEWED BY THE MAYO CLINIC COMMITTEE ON OFFICER SUCCESSION, COMPENSATION AND GOVERNANCE (GOVERNANCE COMMITTEE), WHICH IS COMPRISED OF SEVEN OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. PRE-AFFILIATION WITH MAYO CLINIC THE DETERMINATION OF EXECUTIVE COMPENSATION OF THE ORGANIZATION WAS PROCESSED BY THE FAIRVIEW HEALTH SERVICES HUMAN RESOURCES EXECUTIVE COMMITTEE AND INCLUDES A REVIEW OF COMPARABILITY DATA, REVIEW BY INDEPENDENT EXPERTS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. OTHER FEES FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 65,142. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 65,142. STAFFING SERVICES: PROGRAM SERVICE EXPENSES 1,700,110. MANAGEMENT AND GENERAL EXPENSES 201,232. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,901,342. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 14,439. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,439. CONTRACTED NUTRITION SERVICES: PROGRAM SERVICE EXPENSES 10,398. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,398. FAIRVIEW FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 25,508. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 25,508. THERAPY AND X-RAYS: PROGRAM SERVICE EXPENSES 229,281. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 229,281. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: MARKET ADJUSTMENT RELATED TO MERGER VALUATION 572,531. IN REGARDS TO FILING CERTAIN FOREIGN FORMS SCHEDULE F, PART IV, LINES 3, 5, & 6 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 HOLDING COMPANY (EIN: 41-1578020) MAYO CLINIC ARIZONA (EIN: 86-0800150) MAYO CLINIC JACKSONVILLE (EIN: 59-3337028) DISCLOSURE STATEMENT RELATED TO FORMS 5471: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 4 AND 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED TAXPAYER NAME: MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-1506440 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED DISCLOSURE STATEMENT RELATED TO FORMS 8865: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 8865, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS, AS A CATEGORY 2 AND 3 FILER. THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 8865 FOR THESE PARTNERSHIPS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 8865 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED BLOOMER LAKEVIEW INC 2110 DUNCAN ROAD BLOOMER WI 54724 391450617 LOW INCOME HOUSING WI 501(C)(3) 7 MCHS--CHIPPEWA VALLEY INC 1 CHARTERHOUSE INC 200 FIRST STREET SW ROCHESTER MN 55905 411405254 RETIREMENT LIVING CENTER MN 501(C)(3) 9 MAYO CLINIC 1 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 1 GOLD CROSS AMBULANCE SERVICE 200 FIRST STREET SW ROCHESTER MN 55905 411917516 AMBULANCE SERVICE MN 501(C)(3) 9 MFMER 1 LUTHER LAKESIDE APARTMENTS INC PO BOX 1510 EAU CLAIRE WI 54702 391409024 LOW INCOME HOUSING FOR ELDERLY WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 416011702 PATIENT CARE - CLINIC MN 501(C)(3) 9 N/A 1 MAYO CLINIC -- METHODIST HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410739106 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC -- SAINT MARYS HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410944601 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 860800150 HOSPITAL AND CLINIC AZ 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 590714831 HOSPITAL FL 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MAYO CLINIC HEALTH SYSTEM IN WAYCROSS INC 1900 TEBEAU STREET WAYCROSS GA 31501 581667166 HOSPITAL GA 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MAYO CLINIC HEALTH SYSTEM--ALBERT LEA 1000 FIRST DRIVE NW AUSTIN MN 55912 411404075 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--AUSTIN 1000 FIRST DRIVE NW AUSTIN MN 55912 410695606 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--AUSTIN FOUNDATION 1000 FIRST DRIVE NW AUSTIN MN 55912 300107471 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--AUSTIN 1 MAYO CLINIC HEALTH SYSTEM--CANNON FALLS 1116 WEST MILL STREET CANNON FALLS MN 55009 204156428 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC 1501 THOMPSON STREET BLOOMER WI 54724 390980343 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--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 MAYO CLINIC HEALTH SYSTEM--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 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 390813418 HOSPITAL WI 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--FAIRMONT 800 MEDICAL CENTER DRIVE PO BOX 800 FAIRMONT MN 56031 410760836 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391186647 FUNDRAISING FOUNDATION WI 501(C)(3) 7 MCHS--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION-SPARTA INC 310 WEST MAIN STREET SPARTA WI 54656 391423234 FUNDRAISING FOUNDATION WI 501(C)(3) 9 MCHS--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391411999 HEALTHCARE SYSTEM PARENT WI 501(C)(3) 11-I MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN MEDICAL CENTER INC 700 WEST AVE SOUTH LA CROSSE WI 54601 390806374 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--HOME HEALTH & HOSPICE INC PO BOX 2060 EAU CLAIRE WI 54702 391491516 HOME HEALTH AND HOSPICE CARE WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--LAKE CITY 500 WEST GRANT STREET LAKE CITY MN 55041 411906820 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--MANKATO 1025 MARSH STREET MANKATO MN 56002 411236756 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--MANKATO HEALTH CARE FOUNDATION 1025 MARSH STREET MANKATO MN 56002 411663357 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--NEW PRAGUE 301 SECOND STREET NE NEW PRAGUE MN 56071 410723639 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--NORTHLAND INC 1222 EAST WOODLAND AVENUE BARRON WI 54812 390920634 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--OAKRIDGE INC 13025 EIGHTH STREET PO BOX 70 OSSEO WI 54758 391029430 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--OWATONNA 134 SOUTHVIEW ST OWATONNA MN 55060 411862132 PATIENT CARE - CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--RED CEDAR INC 2321 STOUT ROAD MENOMONIE WI 54751 510190875 HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--RED WING 701 HEWITT BOULEVARD RED WING MN 55066 411713783 PATIENT CARE SERVICES MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--RED WING HOME HEALTH & HOSPICE 701 HEWITT BOULEVARD RED WING MN 55066 411539756 HOME HEALTHCARE SERVICES MN 501(C)(3) 7 MCHS--RED WING 1 MAYO CLINIC HEALTH SYSTEM--SPRINGFIELD 625 NORTH JACKSON AVENUE SPRINGFIELD MN 56087 411893827 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--ST JAMES 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 410797368 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--ST JAMES HEALTH CARE FOUNDATION 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 411444129 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--ST JAMES 1 MAYO CLINIC HEALTH SYSTEM--SUPPORTIVE HOMECARE INC PO BOX 2060 EAU CLAIRE WI 54702 391686673 HOME HEALTH CARE WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--WASECA 501 NORTH STATE STREET WASECA MN 56093 363606405 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC JACKSONVILLE 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 593337028 PATIENT CARE - CLINIC FL 501(C)(3) 7 MAYO CLINIC 1 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 200 FIRST STREET SW ROCHESTER MN 55905 411506440 CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES MN 501(C)(3) 9 MAYO CLINIC 1 MAYO KLINIK STIFTUNG 60486 FRANKFURT AM MAIN FRANKFURT GM FUNDRAISING FOUNDATION GM MFMER 1 MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES 200 FIRST STREET SW ROCHESTER MN 55905 412020392 SUPPORT RESEARCH, PRACTICE & EDUCATION MN 501(C)(3) 11-I MAYO CLINIC 1 POVERELLO FOUNDATION 200 FIRST STREET SW ROCHESTER MN 55905 411494881 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC -- SAINT MARYS HOSPITAL 1 RED WING SEMINARY HOME 701 HEWITT BOULEVARD RED WING MN 55066 411263419 RESIDENT CARE AND HOUSING MN 501(C)(3) 9 MCHS--RED WING 1 SATILLA HEALTH MANAGEMENT INC 1900 TEBEAU STREET WAYCROSS GA 31501 581717889 HEALTHCARE SERVICES GA 501(C)(3) 3 MCHS IN WAYCROSS INC 1 THE DOWNTOWN PLAZA 701 HEWITT BOULEVARD RED WING MN 55066 411532554 ELDERLY HOUSING MN 501(C)(3) 9 MCHS--RED WING 1 FAIRVIEW FOUNDATION 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 411573810 FUNDRAISING TO SUPPORT FAIRVIEWS MISSION MN 501(C)(3) 7 FAIRVIEW HEALTH SERVICES 1 FAIRVIEW HEALTH SERVICES 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 410991680 HOSPITAL PATIENT SERVICES MN 501(C)(3) 3 FAIRVIEW HEALTH SERVICES 1 FAIRVIEW HOME CARE AND HOSPICE 2450 26TH AVE SOUTH MINNEAPOLIS MN 55406 411434246 HOME HEALTH CARE MN 501(C)(3) 9 FAIRVIEW HEALTH SERVICES 1 FAIRVIEW PHYSICIAN ASSOCIATES NETWORK 3400 WEST 66TH STREET MINNEAPOLIS MN 55435 411753325 CLINICAL INTEGRATION MN 501(C)(3) 9 FAIRVIEW HEALTH SERVICES 1 RANGE REGIONAL HEALTH SERVICES 750 EAST 34TH STREET HIBBING MN 55746 411293970 HOSPITAL PATIENT SERVICES MN 501(C)(3) 3 FAIRVIEW HEALTH SERVICES 1 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 HEALTH TRADITION HEALTH PLAN 1808 EAST MAIN STREET ONALASKA WI 54650 391545987 MEDICAL SERVICES COMPANY WI N/A C 1 LOBSS NETWORK SUPPORT 2002 INC 200 FIRST STREET SW ROCHESTER MN 55905 481276150 ADMINISTRATIVE SERVICES MN N/A C 1 MAYO CLINIC GBS MAURITIUS 2ND FLOOR EBENE MEWS 57 EBENE CYBERCITY MP HEALTHCARE MANAGEMENT MP N/A C 1 MAYO CLINIC HEALTH SYSTEM--DECORAH CLINIC PHYSICIANS 907 MONTGOMERY STREET DECORAH IA 52101 411711329 PATIENT CARE - CLINIC IA N/A C 1 MAYO CLINIC HEALTH SYSTEM--FARIBAULT 635 FIRST STREET SE FARIBAULT MN 55021 411817179 PATIENT CARE - CLINIC MN N/A C 1 MAYO CLINIC HEALTH SYSTEM--PHARMACY & HOME MEDICAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 391528920 PHARMACY SERVICES WI N/A C 1 MAYO COLLABORATIVE SERVICES INC 200 FIRST STREET SW ROCHESTER MN 55905 411346366 REFERENCE LAB SERVICES MN N/A C 1 MAYO HOLDING COMPANY 200 FIRST STREET SW ROCHESTER MN 55905 411578020 HOLDING COMPANY MN N/A C 1 MAYO INSURANCE COMPANY LTD 200 FIRST STREET SW ROCHESTER MN 55905 SELF INSURANCE POOL CJ N/A C 1 MAYO MEDICAL LABORATORIES NEW ENGLAND INC 265 BALLARDVALE STREET WILMINGTON MA 01887 043323713 LABORATORY SERVICES MA N/A C 1 MAYO REGIONAL PRACTICES OF ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 061190278 THIRD PARTY ADMINISTRATION SERVICES AZ N/A C 1 MMSI INC 21 FIRST STREET SW ROCHESTER MN 55905 411547003 THIRD PARTY ADMINISTRATION SERVICES MN N/A C 1 RESOUNDANT INC 221 1ST AVE SW ROCHESTER MN 55902 461661978 MANUFACTURING MEDICAL DEVICE COMPONENT MN N/A C 1 ROCHESTER AIRPORT COMPANY ROUTE 2 ROCHESTER MN 55902 410506870 AIRPORT MANAGEMENT MN N/A C 1 SATILLA HEALTH ENTERPRISES INC 1900 TEBEAU STREET WAYCROSS GA 31501 581717222 HEALTHCARE GA N/A C 1 SATILLA HEALTHNET INC 1900 TEBEAU STREET WAYCROSS GA 31501 582151076 HEALTH SERVICES GA N/A C 1 SATILLA REGIONAL SPECIALTY PHYSICIANS INC 1900 TEBEAU STREET WAYCROSS GA 31501 204363143 PHYSICIAN OFFICES GA N/A C 1 SIT ALPHA II BOND FUND LTD CLIFTON HOUSE 75 FORTH ST GRAND CAYMAN CJ KY1-1108 980648163 INVESTMENT MANAGEMENT CJ N/A C 1 SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION 13400 E SHEA BLVD SCOTTSDALE AZ 85259 860870505 COMMERCIAL PROPERTY OWNERS ASSOCIATION AZ N/A C 1 THE STABILE BUILDING OWNERS' ASSOCIATION 200 FIRST STREET SW ROCHESTER MN 55905 208994499 COMMERCIAL PROPERTY OWNERS ASSOCIATION MN N/A C 1 BEHAVIORAL HEALTHCARE PROVIDERS 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 411805759 MENTAL HEALTH PRACTITIONERS MN N/A C 1 FAIRVIEW CLINICS 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 411761760 PHYSICIAN SERVICES MN N/A C 1 FAIRVIEW PHYSICIAN AND CLINIC SERVICES 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 411544996 PHYSICIAN SERVICES MN N/A C 1 FAIRVIEW SUBSIDIARY III (EXPRESS CARE) 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 205996177 PHYSICIAN SERVICES MN N/A C 1 MINNESOTA HEART 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 411598660 MEDICAL SERVICES MN N/A C 1 RIDGES DEVELOPMENT CO & SUBSIDIARY 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 411568579 LEASEHOLD MANAGEMENT MN N/A C 1 SURGICAL CONSULTANTS 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 410877307 MEDICAL SERVICES MN N/A C 1 CHARITABLE LEAD TRUST CHARITABLE TRUST CA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST ND N/A T 1 PERPETUAL TRUST CHARITABLE TRUST LA N/A T 1 PERPETUAL TRUST (2) CHARITABLE TRUST MA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST MO N/A T 1 PERPETUAL TRUST CHARITABLE TRUST AZ N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST CO N/A T 1 CHARITABLE REMAINDER TRUST (6) CHARITABLE TRUST FL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST FL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST IL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST LA N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST MI N/A T 1 CHARITABLE REMAINDER TRUST (68) CHARITABLE TRUST MN N/A T 1 CHARITABLE REMAINDER TRUST (77) CHARITABLE TRUST MN N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST NC N/A T 1 CHARITABLE REMAINDER TRUST (2) CHARITABLE TRUST TX N/A T 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0