PARK NICOLLET: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PARK NICOLLET (EIN 45-5023260)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201313189349302991
- Schema version
- 2012v2.1
- 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 F
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-14T11:19:58-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 South Sixth Street | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 455023260 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Group Return | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PARK | NameControl |
| Phone | 9529933108 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Boulevard | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Catherine Lenagh | Name |
| Title | CFO | Title |
| Phone | 9529933108 | Phone |
| Date Signed | 2013-11-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kristina Rasmussen | Name |
| PTIN | P00143920 | PTIN |
| Phone | 6123974000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CATHERINE LENAGH | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Boulevard | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1454732594 | GrossReceipts |
| Group Return For Affiliates | 1 | GroupReturnForAffiliates |
| All Affiliates Included | 1 | AllAffiliatesIncluded |
| Group Exemption Number | 5874 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.parknicollet.com | WebSite |
| Type Of Organization Other | X | TypeOfOrganizationOther |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | Cares for and supports the health, healing, and learning of those served. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 20 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 1047 | TotalNbrVolunteers |
| Total Gross UBI | 4999954 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -912886 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 14391919 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 17418737 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1141830201 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1194561165 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 17727333 | InvestmentIncomePriorYear |
| Investment Income Current Year | 12435208 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 6353193 | OtherRevenuePriorYear |
| Other Revenue Current Year | 6666342 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1180302646 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1231081452 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 186876 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 167496 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 611537104 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 727620366 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 288531 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 544022710 | OtherExpensePriorYear |
| Other Expenses Current Year | 452244235 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1155746690 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1180032097 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 24555956 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 51049355 | RevenuesLessExpensesCY |
| Total Assets BOY | 925315895 | TotalAssetsBOY |
| Total Assets EOY | 943062738 | TotalAssetsEOY |
| Total Liabilities BOY | 487581753 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 442730848 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 437734142 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 500331890 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Cares for and supports the health, healing, and learning of those served. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 931126516 | Expense |
| Grants | 167496 | Grants |
| Revenue | 1097253810 | Revenue |
| Description | In 2012, Park Nicollet Health Services and affiliates, a national healthcare improvement leader, continued to make dramatic patient care advances, win prominent awards, expand access to services and integrate efficiency into Park Nicollet Health Services' operations. Park Nicollet Health Services and affiliates also have enhanced community health, increased team member satisfaction and promoted research and education. Park Nicollet Health Services uses five core values to accomplish its mission: care, service, stewardship, joy and learning. Highlights of 2012 that support Park Nicollet Health Service's values include the following: - Park Nicollet Clinic - Rogers opened August 6. The clinic offers Family Medicine, Pediatrics and extended hours. - Melrose Institute opened the doors at its new Maple Grove location in June. Patients are seen for initial assessments and for individual appointments with treatment teams. - Five times the size of the old OB/GYN department at Park Nicollet Clinic - Maple Grove, the expansion at Maple Grove Hospital includes two new services: Perinatology and Urogynecology. - Park Nicollet began a partnership with Virtuwell, an online health pioneer. - Mammo-a-go-go Park Nicollet began offering mobile mammography throughout our service area. - Methodist Hospital qualified for $3.3 million dollars from the Federal Government for "Meaningful Use" of an Electronic Medical Record. Park Nicollet demonstrated with 33 specific measures how we use the Electronic Medical Record for quality. - Park Nicollet was named one of the Top Workplaces in Minnesota by a Star Tribune survey. It recognizes the most progressive companies based on employee opinions about company leadership, communication, career opportunities, workplace environment, managerial skills, pay and benefits. - The Human Rights Campaign recognized Park Nicollet as a Leader in LGBT Healthcare Equality in the Healthcare Equality Index 2012 report. Park Nicollet earned top marks for our commitment to equitable, inclusive care for LGBT patients and their families. Park Nicollet was one of 234 healthcare facilities nationwide to be named. - The U.S. Military awarded Park Nicollet the Patriot Award, which recognizes employers who contribute to national security and protect liberty and freedom by supporting participation in America's National Guard and Reserve Force. - The Leapfrog Group awarded Methodist Hospital an "A" rating in its Hospital Safety Scores. Areas graded include infections, medication mix-ups and acquired injuries (bedsores). - Methodist Hospital was one of only five hospitals in Minnesota chosen by HealthGrades to receive an Emergency Medicine Excellence Award. This placed us in the top five percent of hospitals judged on the 12 most common conditions leading to hospitalization for Medicare recipients. - Eleven Park Nicollet Clinic locations were named to Consumer Reports' Top Clinics list. Of the 522 practices surveyed, only 37 clinics achieved the very highest score. - Park Nicollet was selected for a Reader's Choice Award in several categories including Best Clinic, Best Urgent Care and Best Hospital. Twelve Park Nicollet physicians were also mentioned. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 61349504 | Expense |
| Revenue | 61902773 | Revenue |
| Description | Park Nicollet Health Care Products is part of Park Nicollet Health Services, a nonprofit integrated care delivery system, staffed by nationally recognized hospital and clinic doctors, clinical professionals, nurses, researchers and other staff at Park Nicollet Methodist Hospital and Park Nicollet Clinic who help patients stay healthy and take care of patients when they are sick. Park Nicollet Health Care Products is a supporting organization to Park Nicollet Methodist Hospital and Park Nicollet Clinic, providing durable medical equipment (DME)/supplies and pharmaceuticals supporting ongoing patient care. Park Nicollet Health Care Products focus on the health, healing and learning of patients by providing easy access to products and services that support successful self-management of a health condition at home. The products support both short term acute conditions and chronic lifelong conditions, such as eyewear, hearing aids, and many products that cross into almost every medical subspecialty. The Pharmacy @ Park Nicollet meets growing demand for self-care products and services. The Pharmacies are at these Park Nicollet Clinic locations: Bloomington, Brookdale, Burnsville, Carlson Parkway (Minnetonka), Chanhassen, Eagan, Maple Grove, Minneapolis, St. Louis Park, and Wayzata as well as the Heart and Vascular Center and Meadowbrook at the Park Nicollet Methodist Hospital.The patient care experience does not end at the hospital or clinic door. Patients have many self-care needs to manage both their acute and chronic health conditions, and Park Nicollet Health Care Products is expanding its capacity to better serve these growing needs. Major accomplishments for 2012 include: - Enhanced product and pharmaceutical assortments available for patients, especially patients living with chronic health conditions such as diabetes, cancer, and bone and joint disease. - New and robust point of sale system for better patient service and ease of obtaining their prescriptions. - Automated dispensing for greater accuracy and efficient drugs. - Educated physicians and care provider's about Pharmacy services and products to better link solutions for patient health care needs, including smoking cessation. - Developed standard work around provider referrals to Park Nicollet Pharmacies, assuring that patients have the products needed as they go home from clinic or hospital. - Continue to provide customer service and sales training to all store staff and management. - Expanded Pharmacy MTM (Medication Therapy Management) services directly into the care environment to assist both providers and patients alike. - Update e-commerce Web site for Pharmacy @ Park Nicollet to make it easier for providers and patients to locate and purchase health care products. - Worked with staff to ensure their job satisfaction and self worth so that they can, in turn, share their positive attitude with clinical team members and customers. - Enhanced the focus on customer satisfaction scores to reinforce best practices and provide superior service. - Enhanced tracking systems to measure and monitor customer success of sales strategies. - Ensured all Pharmacy staff attended learning events to achieve their continuing education requirements. - Attended major trade shows to keep current with pharmacy assortment and billing information. - Held meetings and educational sessions for Pharmacy staff to learn the complexities of billing 3rd party payers to ensure compliance and accuracy of claims submission.The Contact Lens and Optical Store @ Park Nicollet Health Care Products, which meet growing demand for self-care products and services, are at these Park Nicollet Clinic sites: Bloomington, Brookdale, Burnsville, Carlson Parkway (Minnetonka), Chanhassen, Maple Grove, Minneapolis, Shakopee, and St. Louis Park. The patient care experience does not end at the hospital or clinic door. Patients have many self-care needs to manage both their acute and chronic health conditions, and Park Nicollet Health Care Products is expanding its capacity to better serve these growing needs.Major accomplishments for 2012 include: - Enhanced optical product assortments available for patients, especially patients living with chronic health conditions affecting their vision. - Enhance and expand the optical benefit program offered to Park Nicollet employees to increase the affordability of eyewear.Park Nicollet Health Care Products, branded as The Stores @ Park Nicollet, is a group of departments within Park Nicollet Health Services providing durable medical equipment (DME)/supplies and pharmaceuticals, supporting ongoing patient care. Park Nicollet Health Care Products partners with your clinician to provide products and services to help you live more comfortably.The Health and Care Stores, which meet a growing demand for self-care products and services, located within Park Nicollet Clinics, include: Health & Care Store offering DME products at 4 locations, Hearing Center & Store with 3 locations, CPAP clinic/Store with 2 locations and Breastfeeding Center, (1 location within the Meadowbrook Health & Care store).The Health & Care Stores are at these Park Nicollet Clinic sites: Burnsville, St. Louis Park, as well as the Heart and Vascular Center and Meadowbrook at the Park Nicollet Methodist Hospital.The patient care experience does not end at the hospital or clinic door. Patients have many self-care needs to manage both their acute and chronic health conditions, and Park Nicollet Health Care Products is expanding its capacity to better serve these growing needs. Major accomplishments for 2012 include: - Enhanced and expanded product assortments available for patients, especially patients living with chronic health conditions. - Educated physicians and care provider's about Health Care Stores product offerings to better link patient health care needs to product solutions, including smoking cessation. - Developed standard work for provider referrals to Health Care stores, assuring that patients have the products needed as they go home from clinic or hospital. - Continued customer service and sales training to all store staff and management. - Expanded point of care operation and specialty stores to help bring more products directly into the care environment to assist both providers and patients alike. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 33759968 | Expense |
| Revenue | 35404582 | Revenue |
| Description | Park Nicollet Health Services affiliates incurs expenses on behalf of affiliated tax exempt organizations, Park Nicollet Methodist Hospital, Park Nicollet Clinic, PNMC Holdings, Park Nicollet Health Care Products, and Park Nicollet Institute, providing rental space and lab services to its affiliated organizations in order to assure the efficient and professional delivery of health care and other services to the community and aids in the provision of low cost medical service. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 1026235988 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 1 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 493 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 20 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Catherine Lenagh | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9529933108 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (34 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| David Abelson MD | |||||||||
| President and CEO | 55.00 | 1.00 | X | X | 0 | 1260661 | 256563 | ||
| Steven Connelly MD | |||||||||
| Exec VP & CMO | 55.00 | 0.00 | X | X | 0 | 640962 | 125270 | ||
| Judith Corson | |||||||||
| Secretary | 12.00 | 0.00 | X | X | 0 | 0 | 0 | ||
| Michael Kaupa | |||||||||
| Executive VP and COO | 55.00 | 1.00 | X | X | 0 | 826209 | 129063 | ||
| Donald Lewis JD | |||||||||
| Vice Chair | 12.00 | 0.00 | X | X | 0 | 0 | 0 | ||
| Sheila McMillan | |||||||||
| CFO | 55.00 | 1.00 | X | X | 0 | 597712 | 92282 | ||
| Ken Melrose | |||||||||
| Director | 3.00 | 0.00 | X | X | 0 | 0 | 0 | ||
| Richard E Struthers | |||||||||
| Treasurer | 6.00 | 0.00 | X | X | 0 | 0 | 0 | ||
| Kenneth L Thome | |||||||||
| Chair | 12.00 | 0.00 | X | X | 0 | 0 | 0 | ||
| Leslie Baken MD | |||||||||
| Director | 55.00 | 0.00 | X | 327814 | 0 | 49850 | |||
| John Berg | |||||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | |||
| Timothy Crimmins MD | |||||||||
| Director | 3.00 | 0.00 | X | 0 | 0 | 0 | |||
| Barbara Degnan | |||||||||
| Director | 10.00 | 0.00 | X | 0 | 0 | 0 | |||
| Paul Dominski | |||||||||
| Director | 55.00 | 0.00 | X | 0 | 358861 | 67471 | |||
| Bruce W Engelsma | |||||||||
| Director | 3.00 | 0.00 | X | 0 | 0 | 0 | |||
| Steve Frank | |||||||||
| Director | 3.00 | 0.00 | X | 0 | 0 | 0 | |||
| Roxanna Gapstur PhD | |||||||||
| Director | 55.00 | 0.00 | X | 0 | 345604 | 73368 | |||
| Christa Getchell | |||||||||
| Director | 1.00 | 55.00 | X | 0 | 244070 | 32522 | |||
| Tom Jones MD | |||||||||
| Director | 55.00 | 0.00 | X | 746054 | 0 | 52052 | |||
| Jeff Mendeloff MD | |||||||||
| Director | 55.00 | 0.00 | X | 674305 | 0 | 59091 | |||
| Ruth Mickelsen | |||||||||
| Director | 3.00 | 0.00 | X | 0 | 0 | 0 | |||
| Lee N Newcomer MD | |||||||||
| Director | 8.00 | 0.00 | X | 0 | 0 | 0 | |||
| William Richards MD | |||||||||
| Director | 30.00 | 0.00 | X | 242262 | 0 | 36279 | |||
| Janet Schaffer MD | |||||||||
| Director | 55.00 | 0.00 | X | 306397 | 0 | 53479 | |||
| Eric Schned MD | |||||||||
| Director | 55.00 | 0.00 | X | 296909 | 0 | 48100 | |||
| Dan Schumacher | |||||||||
| Director | 3.00 | 0.00 | X | 0 | 0 | 0 | |||
| Katherine Tarvestad | |||||||||
| Director | 55.00 | 0.00 | X | 0 | 253246 | 48745 | |||
| Mark Wilkowske MD | |||||||||
| Chief of Oncology Serv | 55.00 | 1.00 | X | 514143 | 0 | 56769 | |||
| Theodore Wegleitner | |||||||||
| TRIA COO | 55.00 | 0.00 | 0 | 373859 | 99515 | X | |||
| Oliver Cass MD | |||||||||
| Medical Doctor | 55.00 | 0.00 | 816215 | 0 | 62270 | X | |||
| Darin Epstein MD | |||||||||
| Medical Doctor | 55.00 | 0.00 | 840250 | 0 | 58498 | X | |||
| Marni Feldmann MD | |||||||||
| Medical Doctor | 55.00 | 0.00 | 813564 | 0 | 61170 | X | |||
| Robert Werling MD | |||||||||
| Medical Doctor | 55.00 | 0.00 | 902315 | 0 | 62397 | X | |||
| Anton Willerscheidt MD | |||||||||
| Medical Doctor | 55.00 | 0.00 | 835324 | 0 | 61426 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 7315552 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4901184 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1586180 | TotalOtherCompensation |
| Number Individuals GT100 K | 1130 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| University of MN Physicians | |||||
| 720 Washington Avenue SE | Minneapolis | MN | 55414 | Medical Services | 10600689 |
| RJM Construction | |||||
| 5455 HWY 169 | Plymouth | MN | 55442 | Construction Services | 5325467 |
| Dell Financial Services | |||||
| 12519 Collections Center Drive | Chiciago | IL | 60693 | Computer Services | 4074071 |
| MModel Services | |||||
| PO Box 102467 | Atlanta | GA | 30368 | Medical Services | 3073001 |
| Memorial Blood Center of Minneapolis | |||||
| PO Box 1164 | Minneapolis | MN | 55480 | Medical Services | 2812162 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 117 | NumberOfContractorsGT100K |
| Related Organizations | 2014078 | RelatedOrganizations |
| Government Grants | 4153279 | GovernmentGrants |
| All Other Contributions | 11251380 | AllOtherContributions |
| Total Contributions | 17418737 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|---|
| Medical Services | 621400 | 760575566 | 759609733 | $965,833 | |
| Medicare/Medicaid | 621400 | 336678244 | 336678244 | ||
| Retail Sales | 446110 | 61902773 | 56884676 | $18,143 | 4999954 |
| Services to Affiliates | 561000 | 35404582 | 35404582 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1194561165 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6823521 | TotalRevenueColumn |
| Exclusion | $6,823,521 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 191842 | TotalRevenueColumn |
| Exclusion | $191,842 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1570 | TotalRevenueColumn |
| Exclusion | $1,570 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2117213 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1465317 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 651896 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 651896 | TotalRevenueColumn |
| Exclusion | $651,896 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 227053910 | Securities |
| Other | 76367 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 221435983 | Securities |
| Other | 274449 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 5617927 | Securities |
| Other | -198082 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5419845 | TotalRevenueColumn |
| Exclusion | $5,419,845 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 1249164 | GrossSalesOfInventory |
| Cost Of Goods Sold | 475393 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 773771 | TotalRevenueColumn |
| Exclusion | $773,771 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Property Management | 812930 | 2650959 | $2,650,959 |
| Cafeteria | 722210 | 2404291 | $2,404,291 |
| Misc Services | 722210 | 183855 | $183,855 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 5239105 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1231081452 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1188577235 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 4999954 | UnrelatedBusinessRevenue |
| Exclusion | $20,085,526 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 147496 | Total |
| Program Services | 147496 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20000 | Total |
| Program Services | 20000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3463504 | Total |
| Program Services | 2998623 | ProgramServices |
| Management And General | 464881 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 592170808 | Total |
| Program Services | 521528806 | ProgramServices |
| Management And General | 70414764 | ManagementAndGeneral |
| Fundraising | 227238 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34376356 | Total |
| Program Services | 30275488 | ProgramServices |
| Management And General | 4087677 | ManagementAndGeneral |
| Fundraising | 13191 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61636140 | Total |
| Program Services | 54283362 | ProgramServices |
| Management And General | 7329126 | ManagementAndGeneral |
| Fundraising | 23652 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35973558 | Total |
| Program Services | 31682154 | ProgramServices |
| Management And General | 4277600 | ManagementAndGeneral |
| Fundraising | 13804 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1061986 | Total |
| Management And General | 1061986 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 406929 | Total |
| Management And General | 406929 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 457075 | Total |
| Management And General | 457075 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48321664 | Total |
| Program Services | 36047960 | ProgramServices |
| Management And General | 12263058 | ManagementAndGeneral |
| Fundraising | 10646 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4052842 | Total |
| Program Services | 140139 | ProgramServices |
| Management And General | 3912703 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15217502 | Total |
| Program Services | 10796159 | ProgramServices |
| Management And General | 4421343 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24737809 | Total |
| Program Services | 14186544 | ProgramServices |
| Management And General | 10551265 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38539147 | Total |
| Program Services | 35151584 | ProgramServices |
| Management And General | 3387563 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1061087 | Total |
| Program Services | 808962 | ProgramServices |
| Management And General | 252125 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 802459 | Total |
| Program Services | 722648 | ProgramServices |
| Management And General | 79811 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10402034 | Total |
| Program Services | 10402034 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46940705 | Total |
| Program Services | 41384717 | ProgramServices |
| Management And General | 5555988 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6128029 | Total |
| Program Services | 5967973 | ProgramServices |
| Management And General | 160056 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Medical Supplies | 139207836 | 137683034 | 1524802 | 0 |
| Cost of Goods Sold | 40560745 | 40560745 | 0 | 0 |
| Bad Debt Expense | 28581705 | 28581705 | 0 | 0 |
| Management Fees | 21521805 | 21521805 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24242876 | Total |
| Program Services | 22865855 | ProgramServices |
| Management And General | 1377021 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1180032097 | Total |
| Program Services | 1026235988 | ProgramServices |
| Management And General | 153507578 | ManagementAndGeneral |
| Fundraising | 288531 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 830871 | BOY |
| EOY | 374262 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 282705 | BOY |
| EOY | 344066 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3414212 | BOY |
| EOY | 3812152 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135003069 | BOY |
| EOY | 127500666 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10046399 | BOY |
| EOY | 10143838 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11936459 | BOY |
| EOY | 11094375 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 971123343 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 644100138 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 341170336 | BOY |
| EOY | 327023205 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 386672271 | BOY |
| EOY | 404678771 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28139728 | BOY |
| EOY | 770643 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7819845 | BOY |
| EOY | 57320760 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 925315895 | BOY |
| EOY | 943062738 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 82424257 | BOY |
| EOY | 60549128 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11939650 | BOY |
| EOY | 6939535 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 379891311 | BOY |
| EOY | 370849064 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1984777 | BOY |
| EOY | 1228803 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1930180 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9411578 | BOY |
| EOY | 3164318 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 487581753 | BOY |
| EOY | 442730848 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 436481051 | BOY |
| EOY | 499512581 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 976854 | BOY |
| EOY | 541533 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 276237 | BOY |
| EOY | 277776 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 437734142 | BOY |
| EOY | 500331890 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 925315895 | BOY |
| EOY | 943062738 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 51049355 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 12280679 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -732286 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| General Explanation | Schedule A, Part IV, Supplemental Information: Park Nicollet Methodist Hospital Line 3; 170(b)(1)(a)(iii) Park Nicollet Clinic Line 3; 170(b)(1)(a)(iii) Park Nicollet Institute Line 4; 170(b)(1)(a)(iii) Park Nicollet Health Care Products Line 11 Type II; 509(a)(3) PNMC Holdings Line 11 Type I; 509(a)(3) Part I, Line 11: Supporting organizations detail: PNMC Holdings and Park Nicollet Healthcare Products provide support to following organizations: PNMC Holdings: Line 11, column (i) Park Nicollet Clinic, (ii) 41-0834920, (iii) 170(b)(1)(a)(iii), (iv), Yes, (v) Yes, (vi) Yes, (vii) $2,205,011 Park Nicollet Health Care Products: Line 11, column (i) Park Nicollet Methodist Hospital, (ii) 41-0132080, (iii) 170(b)(1)(a)(iii), (iv), Yes, (v) Yes, (vi) Yes, (vii) $5,622,927 Line 11, column (i) Park Nicollet Clinic, (ii) 41-0834920, (iii) 170(b)(1)(a)(iii), (iv), Yes, (v) Yes, (vi) Yes, (vii) $66,447,892 | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $56,865 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 56865 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | Park Nicollet reimburses certain professional membership dues of employees. A portion of such membership dues are used by the professional associations for lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 20854970 | BeginningOfYearBalance |
| Contributions | 2046767 | Contributions |
| Investment Earnings Or Losses | 877865 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1798265 | GrantsOrScholarships |
| End Of Year Balance | 21981337 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 22048592 | BeginningOfYearBalance |
| Contributions | 1489934 | Contributions |
| Investment Earnings Or Losses | -341465 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 2342091 | GrantsOrScholarships |
| End Of Year Balance | 20854970 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 23127080 | BeginningOfYearBalance |
| Contributions | 1474161 | Contributions |
| Investment Earnings Or Losses | 850097 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 3402746 | GrantsOrScholarships |
| End Of Year Balance | 22048592 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 40045623 | BeginningOfYearBalance |
| Contributions | 3239794 | Contributions |
| Investment Earnings Or Losses | 538558 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 20696895 | GrantsOrScholarships |
| End Of Year Balance | 23127080 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 40780143 | BeginningOfYearBalance |
| Contributions | 3726005 | Contributions |
| Investment Earnings Or Losses | -162788 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 4297737 | GrantsOrScholarships |
| End Of Year Balance | 40045623 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.44000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.56000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 27661044 | OtherCostOrOtherBasis |
| Book Value | 27661044 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 450941858 | OtherCostOrOtherBasis |
| Depreciation | 265962813 | Depreciation |
| Book Value | 184979045 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 54239184 | OtherCostOrOtherBasis |
| Depreciation | 36490735 | Depreciation |
| Book Value | 17748449 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 435145529 | OtherCostOrOtherBasis |
| Depreciation | 341646590 | Depreciation |
| Book Value | 93498939 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3135728 | OtherCostOrOtherBasis |
| Book Value | 3135728 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 327023205 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Due From Related Parties | 54243700 |
| LT Real Estate Deposits | 35018 |
| Bond Issue costs | 3042042 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 57320760 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Capital Lease Obligation | $84,392 |
| Long-term Capital Lease Obligation | $3,079,926 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3164318 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | The term endowment funds for use within Park Nicollet Clinic, Park Nicollet Institute and Park Nicollet Methodist Hospital are for Grants related to Education, Research and Patient Care. |
| Description of Uncertain Tax Positions Under FIN 48: | Part X, Line 2: | Park Nicollet Health Services and affiliates adopted the provisions of FIN 48, Accounting for Uncertainty in Income Taxes - an interpretation of FASB Statement No. 109, on January 1, 2007. As a result of the implementation of FIN 48, Park Nicollet Health Services and affiliates were not required to recognize a liability for unrecognized tax benefits. There were no unrecognized tax benefits for the years ended December 31, 2011 and 2012. |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable (3 entries)
| RegionRegion | Number Of OfficesNumberOfOffices | Number Of EmployeesNumberOfEmployees | Type Of Activities ConductedTypeOfActivitiesConducted | Specific Services ProvidedSpecificServicesProvided | Total ExpendituresTotalExpenditures |
|---|---|---|---|---|---|
| East Asia and the Pacific | 0 | 0 | Program Services | Education | 27617 |
| Europe (including Iceland & Greenland) | 0 | 0 | Program Services | Education | 20716 |
| North America | 0 | 0 | Program Services | Education | 19999 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Offices | 0 | SubtotalNumberOfOffices |
| Subtotal Number Of Employees | 0 | SubtotalNumberOfEmployees |
| Cont Number Of Offices | 0 | ContNumberOfOffices |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Offices | 0 | TotalNumberOfOffices |
| Total Number Of Employees | 0 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 68332 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 68332 | TotalAmountSpent |
| Transfer To Foreign Corp | 0 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 0 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 275.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 385.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9770007 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 83924 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9686083 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00840 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 110462687 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 65424712 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 45037975 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03910 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 120232694 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 65508636 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 54724058 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04750 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 28822 | PersonsServed |
| Total Community Benefit Expense | 4467384 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 631135 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3836249 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00330 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6031132 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1443276 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4587856 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00400 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7506770 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6042957 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1463813 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 28822 | PersonsServed |
| Total Community Benefit Expense | 18005286 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8117368 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9887918 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00860 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 28822 | PersonsServed |
| Total Community Benefit Expense | 138237980 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 73626004 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 64611976 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05610 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 7281 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 7281 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 7281 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 7281 | NetCommunityBuildingExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $18,031,554 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 126482048 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 125069455 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1412593 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Methodist Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Methodist Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 0 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 275.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 385.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 29 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (29 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Struther's Parkinson Center | ||||
| 6701 Country Club Drive | Golden Valley | MN | 55427 | Research and Treatment of Parkinson's Disease |
| Park Nicollet Melrose Institute | ||||
| 3625 Monterey Drive | St Louis Park | MN | 55416 | Eating disorder clinic/General Medical |
| 3900 ClinicAmbulatory Surgical Ctr | ||||
| 3900 Park Nicollet Boulevard | St Louis Park | MN | 55416 | Ambulatory Surgical Center and General Medical and Retail |
| Meadowbrook Medical Building | ||||
| 3931 Louisiana Avenue South | St Louis Park | MN | 55426 | Physician offices, ancillary medical services and Medical Retail |
| Prairie Center | ||||
| 8455 Flying Cloud Drive | Eden Prairie | MN | 55344 | Physician offices, ancillary medical services and Medical Retail |
| Bloomington Clinic | ||||
| 5320 Hyland Greens Drive | Bloomington | MN | 55437 | Physician offices, ancillary medical services and Medical Retail |
| Brookdale Clinic | ||||
| 6000 Earle Brown Drive | Brooklyn Center | MN | 55430 | Physician offices, ancillary medical services and Medical Retail |
| Burnsville Clinic | ||||
| 1400 Fairview Drive | Burnsville Clinic | MN | 55337 | Physician offices, ancillary medical services and Medical Retail |
| Carlson Parkway Clinic | ||||
| 15111 Twelve Oaks Center Drive | Minnetonka | MN | 55305 | Physician offices, ancillary medical services and Medical Retail |
| Chanhassen Clinic | ||||
| 300 Lake Drive East | Chanhassen | MN | 55317 | Physician offices, ancillary medical services and Medical Retail |
| Creekside | ||||
| 6600 Excelsior Blvd | St Louis Park | MN | 55426 | Physician offices, ancillary medical services and Medical Retail |
| CT-MRI Center | ||||
| 4951 Excelsior Blvd | St Louis Park | MN | 55416 | Imaging Center/Optical Retail |
| Eagen Clniic | ||||
| 1885 Plaza Drive | Eagan | MN | 55122 | Physician offices, ancillary medical services and Medical Retail |
| Golden Valley Clinic | ||||
| 8240 Golden Valley Drive | Golden Valley | MN | 55427 | Physician offices, ancillary medical services and Medical Retail |
| Lakeville Clnic | ||||
| 18432 Kenrick Avenue | Lakeville | MN | 55044 | Physician offices, ancillary medical services and Medical Retail |
| Maple Grove Clnic | ||||
| 15800 95th Avenue North | Maple Grove | MN | 55369 | Physician offices, ancillary medical services and Medical Retail |
| Maple Grove OB | ||||
| 9855 Hospital Drive Suite 275 | Maple Grove | MN | 55369 | OB services |
| Maple Grove Rehab | ||||
| 9827 Maplge Grove Pkwy North | Maple Grove | MN | 55369 | Rehabiliation Services |
| Minneapolis Clinic | ||||
| 2001 Blaisdell Avenue South | Minneapolis | MN | 55404 | Physician offices, ancillary medical services and Medical Retail |
| Minnetonka - Shorewood Clinic | ||||
| 19685 Highway 7 | Shorewood | MN | 55331 | Physician offices, ancillary medical services and Medical Retail |
| Plymouth Clinic | ||||
| 3007 Harbor Lane North | Plymouth Clinic | MN | 55447 | Physician offices, ancillary medical services and Medical Retail |
| Prior Lake Clinic | ||||
| 4670 Park Nicollet Avenue SE | Prior Lake | MN | 55372 | Physician offices, ancillary medical services and Medical Retail |
| Shakopee Clinic | ||||
| 1415 St Francis Avenue | Shakopee Clinic | MN | 55379 | Physician offices, ancillary medical services and Medical Retail |
| Shakopee Clinic | ||||
| 1515 St Francis Avenue | Shakopee Clinic | MN | 55379 | Physician offices, ancillary medical services and Medical Retail |
| Shakopee Clinic | ||||
| 1601 St Francis Avenue | Shakopee Clinic | MN | 55379 | Physician offices, ancillary medical services and Medical Retail |
| St Louis Park Clinic | ||||
| 3800 Park Nicollet Blvd | St Louis Park | MN | 55416 | Physician offices, ancillary medical services and Medical Retail |
| St Louis Park Clinic | ||||
| 3850 Park Nicollet Blvd | St Louis Park | MN | 55416 | Physician offices, ancillary medical services and Medical Retail |
| Wayzata Medical Building | ||||
| 250 Central Avenue North | Wayzata | MN | 55391 | Physician offices, ancillary medical services and Medical Retail |
| Rogers Clinic | ||||
| 13688 Rogers Drive | Rogers | MN | 55374 | Physician offices, ancillary medical services and Medical Retail |
Form990 Schedule H Part VI Form990ScheduleHPartVI (22 entries)
| ExplanationExplanation | Return ReferenceReturnReference | IdentifierIdentifier |
|---|---|---|
| Part I, Line 6a: Park Nicollet Foundation a related organization of Park Nicollet Methodist Hospital completes an organization wide annual community benefit report that includes Park Nicollet Methodist Hospital and other affiliated entities. | ||
| Part I, Line 7: Park Nicollet Methodist Hospital uses the cost-to-charge ratio method when calculating the amounts reported on part I, line 7. The cost-to-ratio was derived using Worksheet 2, ratio of patient care-cost-to charge, from the schedule H instructions. | ||
| Part I, L7 Col(f): Bad Debt Expense of $28,581,705 was subtracted for purposes of calculating the percentage in Schedule H, Part I, Line 7, column (f).Part III, Line 3: Park Nicollet Methodist Hospital and its affiliates work with those qualifying for charity care along every step of the process including accepting applications for financial assistance after previous attempts to work with the patient fail. Every effort is made to work with the patient to provide financial assistance when appropriate. While there are people who do not cooperate with the hospital regarding payment plans, financial assistance or with those trying to help them get on government programs, it is impossible to know their reason for not cooperating and therefore know whether they may have qualified for charity care. Park Nicollet doesn't have predictive software which would make assumptions based on housing situation, credit reports, etc. and recommend assistance without a process for gathering income verification. In light of the foregoing facts, Park Nicollet is unable to reasonably determine whether any amount of bad debt could have been classified as charity care. | ||
| Part II: Park Nicollet Methodist Hospital partnered with first responders from the cities of St. Louis Park, Edina, Eden Prairie, Hopkins, Richfield, Minnetonka, Chanhassen and Bloomington to conduct training using Methodist Hospital 8th Floor. The drill helped firefighters develop skills for search, rescue and evacuations in a hospital setting. This event was planned in order to be prepared for a variety of disaster situations. Because Methodist's 8th Floor is scheduled for remodeling in the near future, this is a unique opportunity to use an empty hospital floor for this kind of training. | ||
| Part III, Line 4: Park Nicollet Methodist Hospital's audited financial statements include a footnote discussing bad debt expense, or allowance of doubtful accounts. The footnote is located on Note 7 on page 14 and 15 of the attached Audit Report. | ||
| Part III, Line 8: Park Nicollet Health Services believes that all of the Medicare loss should be classified as a community benefit. If these services were not provided to Medicare beneficiaries they would become the obligation of the federal government. Based on this, Medicare losses should be included as a community benefit because the losses are incurred while performing an important public service. The Medicare loss for Park Nicollet Methodist Hospital is based on the Medicare Cost Report as instructed per the 990 Schedule H instructions. The Medicare Cost Report only includes allowable costs for traditional Medicare products. Allowable costs are defined by the Centers for Medicare and Medicaid and do not include all of the costs that are incurred while providing services. If all costs where included in the calculation along with our Medicare advantage products our Medicare loss would be $9.0 million. In addition to the loss incurred at Park Nicollet Methodist Hospital, Park Nicollet Clinic incurred a Medicare loss of $63.0 million. This includes all Medicare products and all costs incurred by the clinic while providing services to Medicare beneficiaries.The losses from Medicare products for the group of entities included in this Group return total $72 million. | ||
| Part III, Line 9b: The collection policy incorporates the requirements as stated by the Minnesota Attorney general and views account resolution through the Park Nicollet financial assistance program as an option for account resolution. This option is shared with debtors via statements and as part of collection calls to debtors from Park Nicollet staff and collection agencies. Park Nicollet's financial assistance is also described in pamphlets and on our website. The website includes a simple interactive schedule to allow a debtor to see if they may qualify. If the Debtor qualifies for financial assistance, collection efforts cease and charges are cleared from their account. | ||
| Bad debt is accounted for on the financial statements by estimating patient liability net of any charity care and then calculating what portion of that will not be collected based historical uncollectable rates. When a patient meets our financial requirements it is classified as charity care; if they do not quality, their services will be written off as bad debt. Park Nicollet Methodist Hospital does not include any charity care in their bad debt expense calculation. | Part III, Line 2: | |
| Part V, Section B, Line 3: Over 1,100 community members representing area government, schools, churches, social service agencies, and healthcare providers were identified to participate in an online survey and focus Group. An online survey was conducted using Survey Monkey. The survey tool was designed to gain information from the respondents about their geographic location along with connections in the community. In addition to the online survey these community participants were also offered the opportunity to attend one of seven community-based focus groups using the World Cafe model of facilitation. These were offered in seven different locations and provided the opportunity for participants to engage in dialogue that would offer more in-depth about their communities and the identified needs. Team Members from Park Nicollet Health Services were present to take notes and summarize responses. The community needs assessment leadership team reviewed the input from both surveys and focus groups identified seven key themes that consistently emerged. An additional three areas of need were identified; although not consistently reported, they were felt to be important for inclusion in the report. To broaden the information received, meetings were held with groups of professionals for insight gathering and targeted to specific areas identified by Park Nicollet's community participants. Additional meetings with Somali Community Health Workers through Wellshare and retired physicians from Methodist Hospital were also held. Focus group participants included community members from the following organizations: Children First, IOCP, PNF Successful Aging Initiative, Crisis Connection, Pillsbury House, Mission, Inc., Minneapolis Crisis Nursery, Shalom Hospice, Teens Alone, Wellshare, Pathways, Saints Healthcare Foundation, Shakopee School District, City of Shakopee, Prior Lake/Savage School District, PNHS Stroke Inspire, St. Mary's Health Clinics, City of St. Louis Park, Depot Coffee House, STEP, Youth Care, Children's Dental Service, Bloomington School District, Alzheimer's Association, Lenox Center, Community In Collaboration Council, Greater Wayzata Area of Commerce, Community Education Advisory Council, Wayzata School District, St. David's Center for Child and Family Development, St. Louis Park School District, City of Chanhassen, Relate Counseling Center, Hopkins School District, ICA, Store to Door, City of Golden Valley, Greater Minneapolis Council of Churches. | Park Nicollet Methodist Hospital | |
| Part V, Section B, Line 5c: Park Nicollet Health Services Board of Director's approved the Implementation Strategy for Park Nicollet Methodist Hospital during 2012. A copy of the Community Health Needs Assessment and Implementation Strategy is posted to the Park Nicollet website at http://www.parknicollet.com/CommunityAndVolunteerism/Community%20Needs%20Health%20Assessment | Park Nicollet Methodist Hospital | |
| Part V, Section B, Line 7: Park Nicollet Methodist Hospital did not address the following needs identified in the Community Health Needs Assessment as these programs are adequately funded at the county level through federal, state, and county resources:Teen Pregnancy and Teen ParentingTeen and Young Adult Drug and Alcohol AbuseSmoking CessationPark Nicollet Methodist Hospital completed its Community Health Needs Assessment in December 2012 when it was approved by the Board of Directors. An implementation plan was also adopted by the Board, but execution of the implementation strategies did not begin until January 2013. | Park Nicollet Methodist Hospital | |
| Part V, Section B, Line 20d: Park Nicollet uses the discount rate associated with our "most preferred payer" which is defined as our largest commercial payer. | Park Nicollet Methodist Hospital | |
| Part V, Section B, Line 22: Park Nicollet charges its patients gross charges if the patient has elective surgery, which is not medically necessary. | Park Nicollet Methodist Hospital | |
| In late 2012, Park Nicollet Health Services Methodist Hospital completed its Community Health Needs Assessment. This assessment was the culmination of work that began in 2011 and was presented to and approved by the Park Nicollet Board of Directors in December 2012. This work resulted in the creation of the Park Nicollet Methodist Hospital 2013-2015 Implementation Strategy to meet community health needs identified through this process.To develop this needs assessment, Park Nicollet drew upon long-standing relationships with the broader community it serves and internal resources focusing on research and data analytics. For 22 years, Park Nicollet has convened populations of patients, government and service organizations in its service area in order to identify and act upon community needs. These convening activities became a valuable tool to survey and identify needs across the Park Nicollet Methodist Hospital and Park Nicollet Clinics' service areas.The Park Nicollet Foundation developed and integrated a successful "community connectivity model" in its planning process, developing priorities and goals across the entire organization. As a convener of communities across the service area, Park Nicollet engaged individuals within the community, social service agencies both public and private, established community organizations and community leaders in order to identify areas of unmet need within the community. Park Nicollet also brought to bear internal expertise, health data and administrative resources to partner with the community to identify needs. These resources include medical expertise, data analytics and research staff, financial and business services and other administrative services identified as important through the convening process. This convening activity has resulted in the creation of initiatives across the communities served by Park Nicollet Methodist Hospital and the Park Nicollet Clinics. These initiatives include: - Park Nicollet sponsored community clinics. - Growing through grief programs providing grief support and education to children who have experienced death of a loved one. - No Shots, No School Immunization initiatives providing enhanced access for children needing immunizations as part of the No Shots, No School program. - Healthy Community Collaborative groups to discuss issues and topics affecting residents in the community. This initiative currently supports the needs of residents in 8 different communities across our service area. - A Successful Aging Initiative in St. Louis Park providing support to senior citizens in the community to support their various medical and social needs.Community Health Needs Assessment (CHNA) Process:The convening role Park Nicollet plays is successful in identifying ongoing needs across the many communities we serve. In 2011 Park Nicollet began a more formal process to identify the greatest areas of unmet needs. The convening role we play is critical for identifying and creating connections to address needs of residents in the community. However, the CHNA process was more formalized and analytic in nature to pinpoint and prioritize the most prevalent needs in the community. Demographic Analysis/Data:A variety of data sources were used to collect and analyze the geographic, socio-economic and health data on the communities in the Park Nicollet Health Services' service area. These data sources provide a framework for reaching out to community members, local government and social service agencies and social support groups within the community. The following defines the sources used to undertake our Community Health Needs Assessment: - Thomson Reuters - Minnesota State Demographic Center - The Metropolitan Council - The U.S. Census Bureau - The Minnesota Department of Employment and Economic Development - The Minnesota Department of Health, Center for Health Statistics - The University of Wisconsin Population health Institute - The Centers for Disease Control (CDC) and Prevention's Behavioral Risk Factor Surveillance System (BRFSS) - CDC's National Center for Chronic Disease Preevention and Health Promotion - National Center for health Statistics - The Minnesota Hospital Association - Internal Park Nicollet DataPark Nicollet:The CHNA process is designed to reach broadly into the community to identify needs, gaps and barriers to health and health services. Deploying primary research, data analysis, validation and prioritization, the assessment process identified the following seven key themes of need: 1. Mental Health 2. Obesity 3. Seniors 4. Connecting Community Resources 5. Access and Affordability of care 6. Wellness 7. Culturally sensitive careThe process also identified the need for teen and young adult drug and alcohol abuse, teen pregnancy and parenting and smoking cessation; however, these needs did not elevate themselves to the level of the seven identified themes due to the availability of services already available in the community.Park Nicollet Methodist Hospital's CHNA was designed to provide broad community input from both primary research and analysis of existing community data. Park Nicollet was able to draw upon the above mentioned initiatives and processes to undertake this analysis of community need. The key elements of the CHNA process included the following teams and processes:1. A leadership team that was charged to conduct the 2011/2012 Needs Assessment:The responsibilities of this team included research and understanding of the requirements of a Community Health Needs Assessment, developing a strategic design for primary research and data analytics, validation and prioritization of the results and preparation of a final formal report that would be presented to the Park Nicollet Health Services Board of Directors. 2. A guidance group:The guidance group provides the skills and expertise of a diverse representation of: a. Park Nicollet Methodist Hospital b. Park Nicollet Foundation c. Area schools d. Local social service agencies e. Members of the community. f. County Government Health AgenciesThe guidance group met three times to review the proposed plan design for the CHNA, review preliminary results, assist with prioritization of the needs identified and provide input into potential responses to the identified needs. 3. Primary Research:Over 1100 community members representing churches, government, schools, social service agencies and health care providers were identified to participate in an online survey and focus group meetings across our service area. Park Nicollet leaders were also involved in this survey and focus group process. The survey was conducted using Survey Monkey. The survey tool was designed to obtain information from the respondents about their geographic location and their connections in the community. The survey asked the following questions of respondents: a. Which geographic region do you most affiliate with? Using state demographic data from the state Demographer, respondents were given seven geographic locations to choose from within the service area, with cities identified within each region. b. In your opinion, what are the major health care concerns in your community? c. Which health care concerns of those listed is the Most Important for the community to address? d. What role should Park Nicollet Clinics and Methodist Hospital play in responding to the most important concerns you identify? e. Are you aware of any services offered in your community to address concern you identified?4. Focus Groups:Using the World Cafe model of facilitation, community participants were also offered the opportunity to attend one of seven community - based focus group meetings. Each focus group was encouraged to discuss: a. What top needs most impact the health and wellness of individuals and families in your local community? b. What would it take to create the change needed to address these issues? c. What is the unique role of Park Nicollet Methodist Hospital in responding to those needs? d. Who in the community should be involved and why should they care?The results from the survey and the focus groups were tabulated. The leadership team then reviewed the summaries and identified seven key themes that consistently emerged in the data. 5. Additional Group Meetings:To broaden the information gathered, additional meetings were also held with small groups of professionals for insight gathering and targeted to specific areas identified by community participants. As a result meetings were also held with Somali Community Health Workers and retired physicians from Methodist Hospital. | Part VI, Line 2: | |
| 6. Validation Process:Once the key themes of need were identified and prioritized, meetings were scheduled with county health departments to discuss our findings and compare them with results from their own county needs assessments, and to identify any potential gaps that may exist from our own research. Prioritization of Community Health Needs:Once the responses through the survey and focus group process were collated, the results were presented to the CHNA Guidance Group, Park Nicollet Health Services Executive and Management Group and the Park Nicollet Foundation Board of Directors, for review, comment and prioritization. Participants were asked to rank each identified theme based on two criteria: importance or impact that the theme had on community health need; and, how strongly the theme correlated with Park Nicollet's strengths as a health care system. The results were then aggregated, summarized through averaging of rank values and plotted into a bubble graph. This process informed Park Nicollet on the major themes of need identified by the community and resulted in the development of a "Park Nicollet Methodist Hospital 2013-2015 Implementation Strategy" to meet Community Health Needs. Since the conclusion of this process, Park Nicollet hired staff to lead this process. | ||
| Park Nicollet Methodist Hospital participates in multiple unique financial assistance programs, including our own Financial Assistance (FA). We inform our patients in multiple ways about our FA program and other financial assistance options for services received at PNHS. Approximately 14 percent of hospital patients participate in state public programs and approximately 2 percent are uninsured.In addition to the written material, Customer Service, Collections and hospital Patient Access Liaisons (PALs) inform patients about assistance options, including government programs and FA. PALs are on-site in the hospital and can meet with patients in their rooms or prior to admission. Most customer service and collections work is done though phone calls, but our main clinic has an on-site location for personal conversations. Park Nicollet Methodist Hospital staff is trained in helping patients apply for Medical Assistance and has also contracted with outside services to assist patients in the application process for Medical Assistance in more complicated circumstances. | Part VI, Line 3: | |
| Park Nicollet Health Services is an integrated delivery system that includes Park Nicollet Methodist Hospital, 24 clinic locations and 10 specialty care centers, all of which are located in the west metropolitan area of the Twin Cities. The service area for the system defines the communities we serve and primarily includes the counties of: Hennepin, Carver, Dakota, and Scott. Park Nicollet Health Services also serves patients in Wright, Rice, Sibley and Le Seuer Counties. Park Nicollet Health Services draws patients from a larger 96 zip code service area. Park Nicollet Methodist Hospital's primary catchment area covers a smaller 28 zip code service area. Ninety percent of Park Nicollet's outpatient clinic visits and eighty-eight percent of Methodist Hospital admissions come from the 96 ZIP code service area. Fifty-four percent of the Methodist Hospital admissions come from the 28 ZIP code service area. The population density in the Park Nicollet Service Area consists of a mix of urban, suburban, ex-urban and rural communities. In order to fit our analysis to more specific communities within the broader service area, our assessment focused on the sub services areas defined in the following manner: - Core Service Area - Minneapolis Service Area - North East Service Area - North West Service Area - South East Service Area - South West Service Area - West Service AreaThis breakdown assures that needs are properly identified in accordance with the specific population of patients served by Service Area and reflects population density socio-economic factors. It also permits survey and focus group respondents to speak to needs based upon their own local community.Population Demographics:Based on 2010 estimates, 1.65 million people reside within the Park Nicollet 96 ZIP code service area. 535,000 people (one-third) reside within the smaller 28 ZIP code service area. Population density varies by the 7 service areas Park Nicollet serves and is described below. - Core Service Area (401,085) - Minneapolis Service Area (249,171) - North East Service Area (184,062) - North West Service Area (226,685) - South East Service Area (334,393) - South West Service Area (101,825) - West Service Area (157,176)Park Nicollet's service area (96 ZIP codes) is estimated to grow 3.2% in the next five years. The most significant growth in populations is projected to occur in the suburban and ex-urban service areas while the Core Service area, the Minneapolis Service Area, and the North East service area populations are expected to experience no growth. Over the next 20 years the population growth in the broader Park Nicollet service area is expected to grow by less than 1% per year, however, the biggest change during this 20 year period will be in the aging of the population served by Park Nicollet. Over the next 20 years the 65+ age group is estimated to more than double. The following section describes the demographic constituencies served by Park Nicollet Health Services:1. The Aging Population: The Core Service Area contains a more aged demographic than the other Service areas served by Park Nicollet. In the Core Service Area, 15% of the population is 65+ years old and 45% are 45+ years old. The North West and the South East Service Areas have a low distribution of population aged 65+. The first ring suburbs (Golden Valley, Richfield, St. Louis Park, New Hope and Edina) have large senior populations. There are also dense pockets of aged (65+) in Burnsville, Apple Valley, Minneapolis, Brooklyn Center, Brooklyn Park, Wayzata and Excelsior. 30% of seniors in the Park Nicollet Service area are currently in situations where they are living alone. 2. Minority Populations:Park Nicollet Health Services' service area contains a very diverse population of patients. There is wide variation in populations served across the 7 sub-service areas. The North East Service Area and the Minneapolis Service Area have the largest minority populations, 49% and 40% respectively. The West and the North West Service areas have low minority populations, 7% and 8% respectively. The most prevalent minority groups also vary by Service Area: * Hispanic population is the top minority group in 3 of 7 service areas (Minneapolis, South West and West). * Asian population is the top minority group in 3 of 7 service areas (Core, North West and South East) * Black population is the top minority group in 1 of the 7 service areas(North East).Minority population density is greater in areas in or near to the urban core of the Twin Cities.Over the next 5 years, the Park Nicollet service area population is estimated to grow by 3.8%. The minority populations are expected to account for 79% of that growth. Population growth in the Hispanic population is expected to see the largest increase over the next 5 years (22.3%). The largest portion of the increase in the Hispanic population is expected to occur in the Minneapolis Service Area. Nearly all service areas expect to see double digit increases in minority populations through 2015. Population Income and Access to Insurance:The diversity in income in the Park Nicollet service area is also very diverse. While the Park Nicollet Service Area contains 22 of the top 25 wealthiest zip codes (situated in the West/North West Service areas), the Eastern Service Area contains several low income zip codes (Core, Minneapolis, North East Service Areas). The West, North West, South East and South West service areas have the highest distribution of upper income households. Like income, the suburban/ex-urban service areas (North West, South East, South West and West) have a high percentage of the population that is commercially insured (80+%). The sub-service areas with the highest percent of Medicare patients include the Core (16%), Minneapolis (10.8%), North East (10.5%) and West (10.4%). The Minneapolis and the North East service areas have high Medicaid populations compared to the other service areas, with the Minneapolis Service Area having 16.7% and the North East Service Area having 14.3%. | Part VI, Line 4: | |
| Park Nicollet Health Services furthers its exempt purposes in multiple ways through its Methodist Hospital, Park Nicollet Clinics, its specialty programs and its commitment to research and education. Park Nicollet strives to meet its commitment to the Triple Aim of providing high quality health care at an affordable cost to the community by enhancing the patient experience. Park Nicollet's commitment to the patient and family experience is articulated through a focus on "Head + Heart, Together" (HHT)."Head" refers to our work around evidence-based medicine, our attention to clinical outcomes, the way we will use data to make decisions about the best care protocol to follow, and to the business of running a large healthcare system. "Heart" is all about providing compassionate care in the moment and keeping our patients at the center of everything we do and every decision we make. When we work across boundaries with our patients and families, we won't do things "to" or "for" patients we will do things with patients and their families."Together" means doing both head- and heart-centered activities in combination. It also means working as a team across departments and specialties, all of us united around caring together with our patients, their families in the communities we serve.Entities included in this return that further Park Nicollet Health Services exempt purpose , are Park Nicollet Methodist Hospital, a 426 bed hospital in St. Louis Park, Park Nicollet Clinic, with 19 primary care clinic locations in its 96 ZIP code service area, 30 lines of specialty services, and 8 specialty centers, Park Nicollet Institute, research and education, and Park Nicollet Health Care Products. Outside of the group, Park Nicollet Foundation serves as the convener of the communities we serve, involving Park Nicollet administrative and medical staff, to assess community need and facilitate a broad array of clinical and specialty services and the administrative support to meet unmet needs in the community. The Park Nicollet Foundation also provides financial assistance to community organizations and services that are consistent with needs identified by its Board of Directors. Park Nicollet's integrated system provides community benefit to underserved populations through convening of communities, education and support of patients and community members diagnosed with chronic disease, and research to improve quality of life. Health professionals within the integrated system assist patients in the community, in the state, in the nation, and around the world who need specialized programs and services for various conditions. Park Nicollet is also a recognized leader in process improvements to coordinate patient care and provide patients with social support systems to improve population health. This has been accomplished through its initiatives through the Physician Group Practice Demonstration Program sponsored by the Centers for Medicare and Medicaid Services. Park Nicollet also participates in the Pioneer ACO Demonstration that is sponsored by the Center for Medicare and Medicaid Innovation. In addition to innovating around care delivery design and patient support services, Park Nicollet participates in multiple learning initiatives through the demonstration program to share its knowledge and lessons learned with other organizations across the community and the country. Park Nicollet has been committed to these efforts in support of its commitment to the Triple Aim by providing communities with support systems assisting patients and families to improve their health. Park Nicollet Supports Community Sponsored Clinics:In 2012, in addition to funding programs and services to enhance the patient/family experience, the Park Nicollet Foundation granted nearly $850,000 directly to organizations that support the health and well-being of the communities we serve. We offer no-charge healthcare to children from infancy through high school at our community clinics in Brooklyn Center, Burnsville, St. Louis Park and Wayzata. No-charge and low-cost dental and mental health care is available by appointment at select clinics. Participating families include those who are unable to afford healthcare, are new to the area or have sensitive healthcare needs. Walk-in visitors are welcome at all locations. All clinics are operated in partnership with local school districts and funded by Park Nicollet Foundation. In 2012, there were 4336 visits to these clinics. The Brooklyn Center clinic alone had 1800 visits.Participating Park Nicollet Clinic locations: - Brookdale - Chanhassen - Creekside - Eagan - Golden Valley - Maple Grove - Minnetonka (Shorewood) - Plymouth - St. Louis Park - WayzataNo Shots No School Initiative:Minnesota law requires immunizations, or written proof of exemption, for school-age children to attend school. Park Nicollet Foundation collaborates with school districts to have all children immunized. Park Nicollet offers enhanced access for children needing immunizations as part of the No Shots, No School program, which is available May, August and the first two weeks of September. Participating school districts encourage parents to schedule appointments with a primary care doctor early to ensure required immunizations are given and documented well in advance of starting school. It takes at least four months to complete the Hepatitis B series.Park Nicollet provides immunization-only visits on a same-day appointment basis; immunizes children without a doctor visit or preventive care exam at the time of immunization; immunizes children not previously established as patients with the clinic; and provides immunizations to children with no direct charge to families.Park Nicollet Sponsored Community Collaboratives:Park Nicollet Foundation regularly convenes collaborative groups to discuss issues and topics affecting residents in the community. These meetings are held at different locations throughout Park Nicollet's service area. The following are some examples of this work: - Children First - Dakota County Healthy Community Collaborative - Meadowbrook Collaborative - NorthWest Hennepin Collaborative. - St. Louis Park Successful Aging Initiative - Scott County Healthy Community Collaborative The following are examples of specific activities that are supported by the Park Nicollet Foundation and Park Nicollet Health Services and demonstrate the organization's commitment to the community and meeting unmet community needs. 1. Growing Through Grief Program:Growing Through Grief is a school support program that provides 1:1 counseling and groups for children and teens who have experienced the death of someone important in their life. Over 450 students are served by the program on a weekly basis. 54 groups and 56 1:1 counseling sessions occur weekly. The children and teens age range served is 5 years of age to 18 year olds. All socio-economic groups are served. Students served are in the school districts of Osseo-Maple Grove, Wayzata, Hopkins, Mound-WestTonka, Minnetonka, St. Louis Park, Chanhassen/Chaska, Burnsville, Edina, Minneapolis; Eastview and Rosemount High Schools. Counselors serve on the emergency response team for schools. Counselors are certified traumatologists. This program is supported by Park Nicollet Foundation. Total expenses for 2012 were $212,692.2. Research and Education Activities:Research:Research is embedded in departments and strategies across Park Nicollet to support quality initiatives and the patient experience. Research encompasses investigator-initiated studies, clinical trials, practice-based research, outcomes and quality improvement projects, data analytics, statistics, survey development and focus groups. At Park Nicollet and Metro Minnesota Community Clinical Oncology Program, up to 500 research studies are active each year. Park Nicollet authors published 46 peer-reviewed papers, books and book chapters in 2012, sharing their findings with the medical community. Park Nicollet Institute provides the infrastructure and resources to support research and clinical quality goals of the organization, which includes the following: - Needs assessment and feasibility - Mentoring and training - Scientific and humans subjects review - Regulatory compliance and reporting - Grant management, including application preparation and submisson, contract and agreement negotiation, finance, budget development, identification of funding sources - Protocol development and research design - Manuscript and poster/presentation preparation - Database development, data cleaning, statistics and analytics, survey review and design, focus group facilitation - Study operations support including recruitment, consenting, enrolling, data collection/entry | Part VI, Line 5: | |
| Park Nicollet Institute's Patient Education department provides educational tools to support patients in preventing and managing illness and improving health. We provide programs, classes, videos, web content and decision support tools to help patients take an active role in their health. These resources help patients prevent and manage common health problems, live well with chronic conditions, prepare for procedures and improve overall health and well-being. In 2012, we held 118 patient education classes for 2,200 attendees. We conducted more than 6,757 diabetes education visits. We published 403 new or revised patient education materials. Our Park Nicollet Health Library provides resources and services for patients, family and the community. This includes literature searches and document delivery, as well as access to print, online and Internet resources. In 2012, the Library received 1,899 visitors and conducted 433 information searches for patients and their families. Funds library spends to make available.The Institute's Professional Education department provides learning activities to enhance physician knowledge, competence and performance. Continuing medical education (CME) staff partners with Park Nicollet physicians and departments to manage a comprehensive educational program through activities designed to meet individual and department needs. Our Office of Continuing Medical Education granted 30,464 CME credits through 69 professional education activities in 2012, reaching 8,422 participants.3. Advanced Care Planning and Hospice Education:Advance Care Planning: The program goal is to improve the quality of patient care by creating and implementing a blueprint of ideal management/progression of care planning and goals discussion over the course of adult life. We aim to: 1) define the best practice of progression of conversations and care planning, 2) improve the delivery of time appropriate utilization of existing advance care planning interventions, 3) develop or adopt new tools and processes where gaps exist, and 4) improve communication of goals and treatment preferences across care settings.In 2012, thirty-two community presentations were held and 827 individuals attended. Ten individual support sessions were held in St. Louis Park as part of the Successful Aging Initiative. Parish Nursing: Park Nicollet has five parish nurse programs and financially provides the benefits allocation for all of the nurses. The Foundation provided partial financial support for one program during 2012 and has provided seed funding to assist new programs to start up and operate. Additional benefits are provided through the system. The goals of the program are to provide education regarding wellness and healthy lifestyle, assessment of congregants and community members and referral to appropriate resources, and program development in the areas of health and wellness. Services provided include: blood pressure monitoring and referral for follow-up as needed, 1:1 visits to clients in their homes for assessment of health issues and referral to community resources, counseling regarding health issues, individual and group education on health related issues (advance care planning, exercise, diet, aging, lifestyle factors, etc.). The congregations we work with have an increasing number of elderly members and the nurses often assist in coordinating with other health care professionals.Community Presentations about Hospice: The hospice program provides community education about hospice and end of life issues at no charge to the participants. In 2012 eleven educational programs were held. A total of 120 people attended the community education events. Each one of these events lasted 1.5 hours in duration. Two hospice staff members presented at each session. 4. Providing Patient Financial Assistance:Park Nicollet Methodist Hospital participates in multiple unique financial assistance programs, including our own financial assistance (FA). We inform our patients in multiple ways about our FA program and other financial assistance options for services received at PNHS. A list of communications for patient relating to financial assistance follows: - Hospital booklets given to emergency center patients and inpatients - Website has FA information under Patient Accounts & Services - A financial assistance calculator is available to allow quick and easy estimation of eligibility under the program - A list of frequently asked questions to answer commonly asked questions related to the program - FA application can be printed for submission - All balance forward patient statements with a balance of $200 or greater include an FA application and instruction to complete the application along with answers to frequently asked questions about the FA program.In addition to the written materials, Customer Service, Collections, Financial Counselors and Account Specialists inform patients about assistance options, including government programs and FA. Most customer service and collection work is done over the phone, though many of our clinics and the hospital have staff on site to assist in applying for FA. Park Nicollet Methodist Hospital and clinic staff have also been trained to assist patients in applying for government programs. We also contract with an outside service to assist patients in the government program application process in more complicated circumstances.5. AdvoCare Program:AdvoCare is a free confidential service provided to Park Nicollet patients, employees, and community members who are living with domestic abuse. AdvoCare offers on-call coverage 24 hours a day, 365 days a year. AdvoCare provide face-to-face and/or phone advocacy for patients at Methodist Hospital, Park Nicollet Clinics and Urgent Cares, Melrose Institute, and offer office appointments. AdvoCare also provide phone advocacy for community calls.AdvoCare provides the following to patients and employees who are living with domestic abuse: - Crisis counseling - Advocacy - Safety planning - Information and Education - Emergency Housing Resources (for victims of domestic abuse) - Legal Resources - Information about support groups - On-going supportAdvoCare's Impact 2007-2012: - AdvoCare provided services to 4811 abuse victims. - 3682 of these clients were seen on Park Nicollet grounds while the client was receiving some sort of medical care. - 748 of these clients were community members who received services over the phone. - 381 of these clients were Park Nicollet employees.6. Chaplaincy Programs:Park Nicollet's Chaplaincy programs are supported by the Park Nicollet Foundation through funding from the Foundation. Jewish Chaplaincy Coverage: Funding for which helps support our Jewish Chaplain and his work. Funds are used to pay for expenses for the daily ministry that is provided by this chaplain for our Jewish patients and family members. It also covers expenses related to his weekly Jewish prayer services in our chapel and for chapel supplies.Clinical Pastoral Education: Funding is also made available for our hospice chaplain resident. This resident provides spiritual care and grief support to home and in-patient hospice patients and family member, and participates in our Clinical Pastoral Education program, an intensive graduate level experience that promotes personal and professional growth and more effective ministry. | ||
| 7. Eating Disorders Support and Education Services:Park Nicollet Melrose Institute has helped treat and heal patients and families with all types of eating disorders for more than 25 years. Our facilities, located in St. Louis Park and Maple Grove offer varying levels and intensity of treatment including inpatient (sub-acute), residential, and three levels of outpatient care to meet the needs of patients. We use a multidisciplinary approach that includes medical, nutritional, psychological and behavioral care. Our innovative care includes treating males and females of all ages, eating disorders and diabetes, eating disorders and chemical dependency, eating disorders and athletes and recently has expanded to include a metabolic health and weight management program. Melrose aims to provide the best and most comprehensive care to individuals who may be struggling with eating issues. We have contracts with most major insurance companies in the state of Minnesota. We also have financial counselors on staff to help define the in's and out's of insurance plans to patients and their families. In those instances when we are not able to provide the needed services we are able to direct individuals to community resources that might better fit their needs.Our Community Relations Team keeps a pulse on our community's needs and responds to those needs by educating and raising awareness of eating disorders. The team spends hundreds of hours presenting and exhibiting to middle schools, high schools, church youth staff, corporations, physician groups, community professionals, employee assistance programs, and professional conferences to raise awareness of not only eating disorders but the importance of a positive body image. 8. Successful Aging Initiative (Senior Support Services):The mission of the Park Nicollet Successful Aging Initiative is to convene on need and learn from the St. Louis Park Community in order to build a vital aging community where seniors and their care partners will feel supported and have access to health care, services, work and volunteer opportunities. Work committees within the initiative have included Senior Stay Safe At Home, Advance Care Planning, Get Up and Get Active, ACT on Alzheimer's, and transportation. 9. Center for Population Health:Park Nicollet continued efforts this year to advance population health, patient experience and affordability. Under our partnership with CMS we agreed to take financial risk for quality and affordability for our attributed Medicare fee-for-service patients. As a result of this commitment we worked with patients and care teams to identify opportunities for improving health outside of scheduled office visits, urgent care, emergency care or inpatient stays - in pursuit of a continuous healing relationship. And, through the use of high-touch care coordination and case management we helped patients access the care they needed when they needed it and avoid unnecessarily expensive or invasive services. In partnership with physicians, nurses, pharmacists and other members of the medical home we implemented efforts to improve medication therapy, ease transitions of care, follow up with patients after hospitalization and address patients in our community with complex medical and social needs.In addition to the initiatives sited above the Foundation provides financial and other support to assist community non-profit partners. In 2012 that support included:a. Pharmacy for Healthy Youth and Community Clinics:This grant supports the provision of outpatient medications to the uninsured and under-insured youth through the four Park Nicollet Foundation Community Clinics, a mental health program for Hopkins and youth and Healthy Youth Facilitated Access programs.b. Children First:This grant from the Foundation helps the Children First organization spread the asset-building philosophy of the Search Institute throughout the community of St. Louis Park. It supports efforts to encourage all facets of the community to focus on making life better for its youth. c. Meadowbrook Collaborative:This grant supports program implementation in the areas of health, education and safety for the residents of the Meadowbrook neighborhood, a local community in need that is situated next door to Park Nicollet Methodist Hospital. d. Stroke Inspire Program:Stroke Inspire provides support, education, resources, and therapist-guided groups to stroke and brain injury survivors, their families and caregivers, Park Nicollet staff, and the surrounding community. e. West Suburban Teen Clinic (MyHealth):The West Suburban Teen Clinic offers access to adolescent-focused mental health services in two locations. This grant supported five additional hours per week of mental health care and allowed for an increase in the variety of care delivery methods, including offering dialectical behavior therapy (DBT) groups. Staff members have close relationships with teachers, administrators, and school counselors in over 20 school districts, where staff conduct presentations and host youth development groups on-site. In addition the clinic maintains referral relationships with hundreds of other middle schools, junior highs, high schools, alternative schools, and community colleges in the area. f. Intercongregational Communities Association:This grant supports the health of the community (primarily needy seniors) by supporting a refrigerated truck to delivery groceries, including purchasing gas and paying the salary of a driver/coordinator. In collaboration with the local school district, youth learn about hunger through food drive collections in their schools. g. St. Louis Park Emergency Program (STEP):STEP provides rent assistance to keep residents in their homes, transportation to medical appointments, and other social services for the elderly. The Park Nicollet Foundation grant partially funded a part-time transportation coordinator to work with senior citizens to address their need for services.h. ResourceWest:This grant allowed for the provision of in-depth mental health therapy to uninsured individuals, couples and families in the Hopkins and Minnetonka school districts. It also provided resources to reduce transportation barriers that can make it difficult for those served by ResourceWest to follow through on referrals to offsite providers.i. Teens Alone:Park Nicollet support helps Teens Alone provide year-round, free and confidential counseling and crisis services to youth and parents in the western suburbs of Minneapolis. The organization addresses issues of drug/alcohol abuse; emotional, sexual and physical abuse; racial issues; pregnancy; sexual orientation; family breakups; and teen homelessness. j. Interfaith Community Outreach and Community Partners (IOCP):The CONECT (Community Organizations Networking Compassionately Together) program of the IOCP serves more than 800 families living in eight low-income, multi-unit apartment neighborhoods in Plymouth, Minnesota. It offers onsite family and children support services and strong links with community resources. It also engages residents in building healthy neighborhoods. k. YMCA Ridgedale Branch:This grant supported the expansion of YMCA services in Minnetonka heights, a very low income community within the territory served by Park Nicollet Health Services. The grant provides for direct program implementation costs, including supplies, food, staffing, resident assistance, transportation, childcare assistance, class fees, sport team/community education fees and emerging needs. l. Family Partnership; West African Immigrant Outreach:This initiative addresses the mental health concerns of the large West African immigrant population of Brooklyn Park and Brooklyn Center, Minnesota a population that has experienced significant trauma. It works to expand the understanding of mental health among the target population, with the goal of reducing stigma and the reluctance to seek treatment.m. One Heartland:One Heartland offers a week-long family camp for those affected by or at-risk for type 2 diabetes. It focuses on educating children and their parents on ways to improve their health and manage their diabetes with Park Nicollet clinicians acting as content experts.n. Youth Determined to Succeed:Youth Determined to Succeed offers a youth-focused, comprehensive health, fitness and wellness program addressing obesity and weight management challenges. In partnership with their physicians, the program targets youth in Brooklyn Center and North Minneapolis to prevent and manage acute health concerns such as diabetes, cardio-vascular disease and asthma. | ||
| Park Nicollet Health Services, an integrated health system includes the members of the Group: 1) Park Nicollet Clinic, with 19 primary care clinic locations, and other care locations, 2) Park Nicollet Methodist Hospital, a 426 bed facility. 3) Park Nicollet Institute, focused on education and research for Park Nicollet Health Services and its community, 4) Park Nicollet Health Care Products, providing retail pharmacy and health related products through existing Park Nicollet locations. Outside of the group, entities include Park Nicollet Foundation, the philanthropic arm of Park Nicollet Health Services helping to bring resources to needs in its communities, and Tria Orthopaedic Center, a leader in orthopaedic treatment, providing comprehensive care from diagnosis, to treatment, to rehabilitation, even surgery in one facility.All affiliates are under a common Board of Directors. Park Nicollet Foundation has a separate board which is overseen by the Park Nicollet Health Services Board. The communities' health needs are shared among the affiliates and decisions regarding the effective use of resources to respond to these needs are coordinated.A specific example of this coordination of services to respond to community need is with the four school-affiliated community clinics. Initial development, funding and ongoing facilitation is provided by the Park Nicolet Foundation, staffing through the Park Nicollet Clinics, laboratory and other diagnostic services through Park Nicollet Methodist Hospital, and outpatient medications, eye glasses, and DME supplies through Park Nicollet Health Care Products. | Part VI, Line 6: | |
| MN | Part VI, Line 7: List of States Receiving Community Benefit Report: |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Foundation | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 237346465 | EINOfRecipient |
| IRC Section | 501(c)(3) | IRCSection |
| Amount Of Cash Grant | 123902 | AmountOfCashGrant |
| Purpose Of Grant | Grant Money to Other Organizations | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | Scholarships | TypeOfGrant |
| Number Of Recipients | 15 | NumberOfRecipients |
| Amount Of Cash Grant | 20000 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: The Park Nicollet Service League has a student volunteer scholarship program to give financial support to student volunteers who have provided exceptional volunteer service and are interested in furthering their education. Applicants must be an active student volunteer, a senior in high school and who has applied to a post-high school education program and must be dedicated volunteer at Park Nicollet Methodist Hospital. Occasionally Park Nicollet Hospital grants monies to other tax-exempt organizations conducting programs and/or research that will ultimately benefit those served by Park Nicollet Health Services and affiliates. During calendar year 2012, grants were made to Park Nicollet Foundation for improvements to medical services and medical research. These grants were made to parties related to Park Nicollet Methodist Hospital, so employees of Park Nicollet Methodist Hospital were able to verify the use of the monies contributed. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (21 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| David Abelson MD | ||||||||||||||
| President and CEO | 0 | 778762 | 0 | 328156 | 0 | 153743 | 0 | 180400 | 0 | 76163 | 0 | 1517224 | 0 | 132075 |
| Steven Connelly MD | ||||||||||||||
| Exec VP & CMO | 0 | 441588 | 0 | 187134 | 0 | 12240 | 0 | 53760 | 0 | 71510 | 0 | 766232 | 0 | 0 |
| Michael Kaupa | ||||||||||||||
| Executive VP and COO | 0 | 467702 | 0 | 286948 | 0 | 71559 | 0 | 57600 | 0 | 71463 | 0 | 955272 | 0 | 56421 |
| Sheila McMillan | ||||||||||||||
| CFO | 0 | 412710 | 0 | 172632 | 0 | 12370 | 0 | 51000 | 0 | 41282 | 0 | 689994 | 0 | 0 |
| Leslie Baken MD | ||||||||||||||
| Director | 279342 | 0 | 8454 | 0 | 40018 | 0 | 0 | 0 | 49850 | 0 | 377664 | 0 | 0 | 0 |
| Paul Dominski | ||||||||||||||
| Director | 0 | 198130 | 0 | 114965 | 0 | 45766 | 0 | 14000 | 0 | 53471 | 0 | 426332 | 0 | 39136 |
| Roxanna Gapstur PhD | ||||||||||||||
| Director | 0 | 239021 | 0 | 99154 | 0 | 7429 | 0 | 29400 | 0 | 43968 | 0 | 418972 | 0 | 0 |
| Christa Getchell | ||||||||||||||
| Director | 0 | 180846 | 0 | 54489 | 0 | 8735 | 0 | 13725 | 0 | 18797 | 0 | 276592 | 0 | 0 |
| Tom Jones MD | ||||||||||||||
| Director | 676185 | 0 | 29426 | 0 | 40443 | 0 | 0 | 0 | 52052 | 0 | 798106 | 0 | 0 | 0 |
| Jeff Mendeloff MD | ||||||||||||||
| Director | 631734 | 0 | 23466 | 0 | 19105 | 0 | 0 | 0 | 59091 | 0 | 733396 | 0 | 0 | 0 |
| William Richards MD | ||||||||||||||
| Director | 125051 | 0 | 6535 | 0 | 110676 | 0 | 0 | 0 | 36279 | 0 | 278541 | 0 | 0 | 0 |
| Janet Schaffer MD | ||||||||||||||
| Director | 290172 | 0 | 0 | 0 | 16225 | 0 | 0 | 0 | 53479 | 0 | 359876 | 0 | 0 | 0 |
| Eric Schned MD | ||||||||||||||
| Director | 250869 | 0 | 12594 | 0 | 33446 | 0 | 0 | 0 | 48100 | 0 | 345009 | 0 | 0 | 0 |
| Katherine Tarvestad | ||||||||||||||
| Director | 0 | 244785 | 0 | 0 | 0 | 8461 | 0 | 30000 | 0 | 18745 | 0 | 301991 | 0 | 0 |
| Mark Wilkowske MD | ||||||||||||||
| Chief of Oncology Serv | 464615 | 0 | 38107 | 0 | 11421 | 0 | 0 | 0 | 56769 | 0 | 570912 | 0 | 0 | 0 |
| Theodore Wegleitner | ||||||||||||||
| TRIA COO | 0 | 251213 | 0 | 87277 | 0 | 35369 | 0 | 30000 | 0 | 69515 | 0 | 473374 | 0 | 25191 |
| Oliver Cass MD | ||||||||||||||
| Medical Doctor | 778299 | 0 | 32545 | 0 | 5371 | 0 | 0 | 0 | 62270 | 0 | 878485 | 0 | 0 | 0 |
| Darin Epstein MD | ||||||||||||||
| Medical Doctor | 785318 | 0 | 51475 | 0 | 3457 | 0 | 0 | 0 | 58498 | 0 | 898748 | 0 | 0 | 0 |
| Marni Feldmann MD | ||||||||||||||
| Medical Doctor | 779086 | 0 | 33431 | 0 | 1047 | 0 | 0 | 0 | 61170 | 0 | 874734 | 0 | 0 | 0 |
| Robert Werling MD | ||||||||||||||
| Medical Doctor | 865289 | 0 | 33873 | 0 | 3153 | 0 | 0 | 0 | 62397 | 0 | 964712 | 0 | 0 | 0 |
| Anton Willerscheidt MD | ||||||||||||||
| Medical Doctor | 814283 | 0 | 16737 | 0 | 4304 | 0 | 0 | 0 | 61426 | 0 | 896750 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 4b | Senior leaders of Park Nicollet Health Services and affiliates are given the opportunity to participate in the Capital Accumulation Account Plan. The Capital Accumulation Account Plan (CAA Plan) participation is limited to senior leaders and all the vice presidents. Each participant receives an annual allowance equal to the sum of (i) a stated percent of salary, (ii) voluntary salary deferrals. The allowance is credited to a bookkeeping account. Earnings are credited to the account based on the performance of simulated investments. Benefits vest upon the earliest of remaining employed to an elective vesting date (two years to age 68), involuntary termination without cause, disability, death, or not competing for 24 months following voluntary or for-cause termination. Benefits are paid in a single lump sum upon vesting. Participants are general creditors of the employer for the payment of the benefits. The following participants received payouts from a related organization, Park Nicollet Health Services, related to CAA plan: - David Abelson, $132,075 - Paul Dominski, $39,136 - Michael Kaupa, $56,421 - Theodore Wegleitner, $25,191 |
| Part I, Line 7 | All physicians, employed by and seeing patients for Park Nicollet Health Services and affiliates, are eligible for a 3% access incentive payout based on their department reaching certain goals including access for patients and quality initiatives. In their roles as executives employed by Park Nicollet Health Services, the executives are eligible for incentive payouts. The incentive award will be 35% of base pay compensation for the CEO, 30% for the CFO, COO, CMO and 25% for all other executives with an opportunity for incentive credit above the target level. The ultimate payout includes a reduction/increase multiplier depending on whether the consolidated Park Nicollet Health Services organization reached that year's operating margin goal as set by the Board of Directors. Each participant will be responsible for two financial goals, and not less than three and not more than five individual strategic objectives. In their roles as management employed by Park Nicollet Health Services, certain managers are eligible for incentive payouts. The incentive award will be 15% of their annual base pay compensation with an opportunity for incentive credit above the target level. The ultimate payout includes a reduction/increase multiplier depending on whether the consolidated Park Nicollet Health Services organization reached that year's operating margin goal as set by the Board of Directors. Incentive payments are a function of both individual and organizational performance. The participant must be assigned at least three, and not more than four focused incentive objective, one of which must be financial in nature. |
Schedule L IRS990ScheduleL
Loan Table LoanTable (4 entries)
| Relationship With OrganizationRelationshipWithOrganization | Purpose Of LoanPurposeOfLoan | Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|---|---|
| Tom Jones MD | |||||||
| Director | Salary Draw in Excess | X | $1,068 | 1068 | 0 | 0 | 0 |
| Janet Schaffer MD | |||||||
| Director | Salary Draw in Excess | X | $7,088 | 7088 | 0 | 0 | 0 |
| Eric Schned MD | |||||||
| Director | Salary Draw in Excess | X | $5,123 | 5123 | 0 | 0 | 0 |
| Anton Willerscheidt MD | |||||||
| Highest Compensated Employee | Salary Draw in Excess | X | $6,096 | 6096 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 19375 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Shannon Neale MD | |||
| William Richards, MD Family Member | 182748 | Employment: Shannon Neale is a Medical Doctor employed by Park Nicollet Clinic. | 1 |
| Randi Norby | |||
| Roxanna Gapstur, PhD; Family Member | 58090 | Employment: Randi Norby is a Clinical Nurse Specialist employed by Park Nicollet Clinic. | 1 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| List of Subordinate Organizations: Names, Addresses and EINs | Page 1, Line H(a): | Park Nicollet Methodist Hospital 41-0132080 6500 Excelsior Blvd, St. Louis Park, MN 55426 Park Nicollet Institute 41-0961862 3800 Park Nicollet Blvd St. Louis Park, MN 55416 Park Nicollet Health Care Products 01-0638901 3800 Park Nicollet Blvd St. Louis Park, MN 55416 Park Nicollet Clinic 41-0834920 3800 Park Nicollet Blvd St. Louis Park, MN 55416 PNMC Holdings 41-1741792 3800 Park Nicollet Blvd St. Louis Park, MN 55416 |
| Form 990, Part IV, Line 24A: | Park Nicollet Health Services, along with related organizations, is jointly liable for the tax exempt bonds held by Park Nicollet Health Services under a master trust agreement. The members of the jointly liable group, which is collectively referred to as the "Obligated Group", include Park Nicollet Clinic, Park Nicollet Methodist Hospital, PNMC Holdings, Park Nicollet Institute, and Park Nicollet Health Care Products. In accordance with reporting requirements for Schedule K, all outstanding tax exempt bonds are reported solely on the Schedule K of Park Nicollet Health Services. Part V, Line 3a: Park Nicollet Health Care Products has unrelated business gross income over $1,000. | |
| Form 990, Part VI, Section A, line 2 | Park Nicollet Health Services and its related entities have a common board. The following officers, Board Members and key employees are employees of and paid by Park Nicollet Health Services or its related organizations. These employees serve together on the common board which serves Park Nicollet Health Services and its related entities. David Abelson, MD Steven Connelly, MD Paul Dominski Roxanna Gapstur, PhD Christa Getchell Tom Jones, MD Michael Kaupa Sheila McMillan William Richards, MD Janet Schaffer, MD Katherine Tarvestad Mark Wilkowske, MD | |
| Form 990, Part VI, Section A, line 6 | Park Nicollet Health Services is the sole member of Park Nicollet Methodist Hospital, Park Nicollet Clinic, Park Nicollet Institute and Park Nicollet Health Care Products. Park Nicollet Clinic is the sole member of PNMC Holdings. | |
| Form 990, Part VI, Section A, line 7a | The Board of Directors of Park Nicollet Methodist Hospital, Park Nicollet Clinic, Park Nicollet Institute, PNMC Holdings and Park Nicollet Health Care Products are those individuals who are contemporaneously members of the Board of Directors of Park Nicollet Health Services. | |
| Form 990, Part VI, Section A, line 7b | All decisions, including dissolution of the organization, made by the governing body of Park Nicollet Methodist Hospital, Park Nicollet Clinic, Park Nicollet Institute, PNMC Holdings and Park Nicollet Health Care Products are subject to the approval of the Board of Directors of Park Nicollet Health Services. However, the Board of Directors of Park Nicollet Methodist Hospital, Park Nicollet Clinic, Park Nicollet Institute, PNMC Holdings and Park Nicollet Health Care Products are those individuals who are contemporaneously members of the Board of Directors of Park Nicollet Health Services. | |
| Form 990, Part VI, Section B, line 11 | The Form 990 filed on behalf of the subordinate organizations (Park Nicollet Methodist Hospital, Park Nicollet Clinic, Park Nicollet Institute, PNMC Holdings and Park Nicollet Health Care Products) is prepared within the finance department at Park Nicollet Health Services with assistance from individuals in human resources, marketing, and operations. Upon completion of gathering the necessary information for the return, the form was compiled by the Park Nicollet accounting firm. Drafts of the form were reviewed by the Assistant Controller - Accounting Operations, Vice President of Finance, Chief Financial Officer, and the Audit and Compliance Committee. After all internal reviews were complete; the final version of the Form 990 was given to each member of the Board of Directors for approval prior to filing the return. | |
| Form 990, Part VI, Section B, line 12c | At Park Nicollet Health Services all key employees, directors, and officers are asked to complete a conflict of interest disclosure statement each year; however the obligation to report conflicts is ongoing. The Governance Committee, which meets five times per year, reviews all potential conflict disclosures and discusses the impact on the organization. If a potential conflict arises during the year, it is disclosed and reviewed by the Governance Committee. The Governance Committee presents the disclosure information and makes recommendations to the Board of Directors regarding management of any conflicts identified. When a transaction involving a potential conflict of interest is identified, the Board of Directors may appoint a disinterested individual or committee to review that conflict and ensure discussions related to those transactions can occur separately from those individuals with potential conflicts. All significant transactions include an analysis of fair market value. | |
| Form 990, Part VI, Section B, line 15 | The Board of Directors of Park Nicollet Methodist Hospital, Park Nicollet Clinic, Park Nicollet Institute, PNMC Holdings and Park Nicollet Health Care Products are those individuals who are contemporaneously members of the Board of Directors of Park Nicollet Health Services. The Park Nicollet Health Services' Board of Directors is responsible for the implementation and oversight of executive compensation and benefit plans for Park Nicollet. Park Nicollet uses an outside consultant to provide yearly market based indexes of salary adjustments for executives in similar leadership positions. The Board of Directors reviews the salary ranges and recommends salary increases for each executive, including the CEO, based upon the Board of Directors' evaluation of job performance and experience level of the individual within the organization. The average salary increases for all Park Nicollet executives cannot exceed the average market salary increase reported for executives by the consultant. The compensation committee then reviews and approves compensation adjustments based on the information provided by the outside consultants and the Board of Directors' recommendations. For certain physicians, the majority of pay disclosed is for his/her work as a physician for Park Nicollet. A small stipend is added for serving on the Board of Directors. The following is a description of how pay for physicians' patient care work is determined. The Park Nicollet Health Services' Board of Directors is responsible for the implementation and oversight of the physician compensation and benefit plans for Park Nicollet. The Board of Directors delegates the day-to-day administration of the physician compensation plan to the Clinical Board of Governors and the Physician Compensation and Benefits Subcommittee. The purpose of the Physician Compensation and Benefits Subcommittee is to oversee physician and other clinician compensation and benefits plans and administration within the budget to ensure fairness and alignment with Park Nicollet Health Services' goals. The responsibilities of this committee include: Recommending of compensation policies and plan designs for physicians to the clinical board and Board of Directors; Overseeing compensation plan operation and payments to clinical departments; Evaluating compensation plan for performance on a periodic basis; Serving as final appeal process for issues unresolved by individuals, department chairs and chiefs of services. Annually, information on each physician's pay and productivity is graphed against the survey results for the same year. This information is presented to the compensation committee of the Park Nicollet Health Services Board of Directors for review. Park Nicollet Health Services' physician pay program is designed to ensure market based pay for market based productivity standards. The market is determined by the American Medical Group Association (AMGA) national physician compensation survey data, which provides market data for both compensation and productivity. When appropriate, the Clinic Compensation and Benefit Subcommittee grants adjustments to these guidelines with evidence of local market data. | |
| Form 990, Part VI, Section C, line 19 | Park Nicollet Group members' governing documents, conflict of interest policy and financial statements are available to the public upon request. Park Nicollet Health Services, as the parent organization of the Park Nicollet Methodist Hospital, Park Nicollet Clinic, Park Nicollet Institute, PNMC Holdings and Park Nicollet Health Care Products, mails its consolidated audited financial statements to financial institutions, governmental institutions, board members, media representatives, vendors, and the Minnesota Hospital Association (MHA). Park Nicollet Health Services discloses quarterly consolidated financial statements to bondholders and MHA. The annual consolidated audited and quarterly financial statements are also posted at emma.msrb.org. The Forms 990 are available upon request or from the state of Minnesota or at Guidestar.org. | |
| Changes in Net Assets or Fund Balances: | Form 990, Part XI, line 9: | Net Assets Released from Restrictions -732,286. |
| Form 990, Part XII, Line 2C: | Neither the oversight process for the audit nor the auditor selection process for Park Nicollet Health Services and affiliates' financial statements have changed during the tax year. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|
| Park Nicollet Health Services | ||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | 363465840 | Health Care Adminstration | MN | 501(c)(3) | 11 Type III | 0 | |
| Park Nicollet Foundation | ||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | 237346465 | Grants to serve the community | MN | 501(c)(3) | 7 | 1 | Park Nicollet Health Services |
| TRIA Orthopaedic Center Research Institute | ||||||||||
| 8100 Northland Drive | Bloomington | MN | 55431 | 200033919 | Health Care Research and Education | MN | 501(c)(3) | 11 Type I | 1 | Park Nicollet Health Services |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Methodist Brain Lab Leasing LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208725994 | EIN |
| Primary Activity | Health Care | PrimaryActivity |
| Legal Domicile State | MN | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Methodist Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | Related | PredominantIncomeType |
| Share Of Total Income | 182060 | ShareOfTotalIncome |
| Share Of EOY Assets | 46493 | ShareOfEOYAssets |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 1 | GeneralOrManagingPartner |
| Percentage Ownership | 0.60000 | PercentageOwnership |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Enterprises | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411656735 | EIN |
| Primary Activity | Real Estate for Related Organization | PrimaryActivity |
| Legal Domicile State | MN | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Health Services | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Park Nicollet Enterprises | ||
| L | 157459 | Cost |
| Park Nicollet Health Services | ||
| L | 1693708 | Cost |
| Park Nicollet Health Services | ||
| P | 240906 | Cost |
| Park Nicollet Health Services | ||
| S | 91657 | Cost |
| Methodist Brain Lab Leasing LLC | ||
| K | 444903 | Cost |
| Methodist Brain Lab Leasing LLC | ||
| S | 266601 | Cost |
| Park Nicollet Foundation | ||
| C | 2014078 | Cost |
| Park Nicollet Foundation | ||
| B | 123902 | Cost |
| Park Nicollet Health Services | ||
| Q | 13960975 | Cost |