2013-11-14T11:19:58-06:00 2012-12-31 Deloitte Tax LLP 50 South Sixth Street Minneapolis MN 55402 990 2012-01-01 455023260 Park Nicollet Group Return PARK 9529933108 6500 Excelsior Boulevard St Louis Park MN 55426 Catherine Lenagh 9529933108 2013-11-13 1 Kristina Rasmussen P00143920 6123974000 2012 2016-02-24 21:20:13Z CATHERINE LENAGH 6500 Excelsior Boulevard St Louis Park MN 55426 1454732594 1 1 5874 X www.parknicollet.com X MN Cares for and supports the health, healing, and learning of those served. 20 12 0 1047 4999954 -912886 14391919 17418737 1141830201 1194561165 17727333 12435208 6353193 6666342 1180302646 1231081452 186876 167496 0 0 611537104 727620366 0 0 288531 544022710 452244235 1155746690 1180032097 24555956 51049355 925315895 943062738 487581753 442730848 437734142 500331890 X Cares for and supports the health, healing, and learning of those served. 0 0 931126516 167496 1097253810 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. 61349504 61902773 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. 33759968 35404582 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. 1026235988 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 X 493 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 X 20 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MN X Catherine Lenagh 9529933108 6500 Excelsior Blvd St Louis Park MN 55426 David Abelson MD 55.00 1.00 X X 0 1260661 256563 Steven Connelly MD 55.00 0.00 X X 0 640962 125270 Judith Corson 12.00 0.00 X X 0 0 0 Michael Kaupa 55.00 1.00 X X 0 826209 129063 Donald Lewis JD 12.00 0.00 X X 0 0 0 Sheila McMillan 55.00 1.00 X X 0 597712 92282 Ken Melrose 3.00 0.00 X X 0 0 0 Richard E Struthers 6.00 0.00 X X 0 0 0 Kenneth L Thome 12.00 0.00 X X 0 0 0 Leslie Baken MD 55.00 0.00 X 327814 0 49850 John Berg 1.00 0.00 X 0 0 0 Timothy Crimmins MD 3.00 0.00 X 0 0 0 Barbara Degnan 10.00 0.00 X 0 0 0 Paul Dominski 55.00 0.00 X 0 358861 67471 Bruce W Engelsma 3.00 0.00 X 0 0 0 Steve Frank 3.00 0.00 X 0 0 0 Roxanna Gapstur PhD 55.00 0.00 X 0 345604 73368 Christa Getchell 1.00 55.00 X 0 244070 32522 Tom Jones MD 55.00 0.00 X 746054 0 52052 Jeff Mendeloff MD 55.00 0.00 X 674305 0 59091 Ruth Mickelsen 3.00 0.00 X 0 0 0 Lee N Newcomer MD 8.00 0.00 X 0 0 0 William Richards MD 30.00 0.00 X 242262 0 36279 Janet Schaffer MD 55.00 0.00 X 306397 0 53479 Eric Schned MD 55.00 0.00 X 296909 0 48100 Dan Schumacher 3.00 0.00 X 0 0 0 Katherine Tarvestad 55.00 0.00 X 0 253246 48745 Mark Wilkowske MD 55.00 1.00 X 514143 0 56769 Theodore Wegleitner 55.00 0.00 X 0 373859 99515 Oliver Cass MD 55.00 0.00 X 816215 0 62270 Darin Epstein MD 55.00 0.00 X 840250 0 58498 Marni Feldmann MD 55.00 0.00 X 813564 0 61170 Robert Werling MD 55.00 0.00 X 902315 0 62397 Anton Willerscheidt MD 55.00 0.00 X 835324 0 61426 7315552 4901184 1586180 1130 0 1 0 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 117 2014078 4153279 11251380 17418737 Medical Services 621400 760575566 759609733 965833 Medicare/Medicaid 621400 336678244 336678244 Retail Sales 446110 61902773 56884676 4999954 18143 Services to Affiliates 561000 35404582 35404582 1194561165 6823521 6823521 191842 191842 1570 1570 2117213 1465317 651896 651896 651896 227053910 76367 221435983 274449 5617927 -198082 5419845 5419845 1249164 475393 773771 773771 Property Management 812930 2650959 2650959 Cafeteria 722210 2404291 2404291 Misc Services 722210 183855 183855 5239105 1231081452 1188577235 4999954 20085526 147496 147496 20000 20000 3463504 2998623 464881 592170808 521528806 70414764 227238 34376356 30275488 4087677 13191 61636140 54283362 7329126 23652 35973558 31682154 4277600 13804 1061986 1061986 406929 406929 457075 457075 48321664 36047960 12263058 10646 4052842 140139 3912703 15217502 10796159 4421343 24737809 14186544 10551265 38539147 35151584 3387563 1061087 808962 252125 802459 722648 79811 10402034 10402034 46940705 41384717 5555988 6128029 5967973 160056 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 24242876 22865855 1377021 1180032097 1026235988 153507578 288531 830871 374262 282705 344066 3414212 3812152 135003069 127500666 10046399 10143838 11936459 11094375 971123343 644100138 341170336 327023205 386672271 404678771 28139728 770643 7819845 57320760 925315895 943062738 82424257 60549128 11939650 6939535 379891311 370849064 1984777 1228803 1930180 0 9411578 3164318 487581753 442730848 X 436481051 499512581 976854 541533 276237 277776 437734142 500331890 925315895 943062738 X 51049355 12280679 -732286 X X 0 1 X 1 1 1 X 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 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 56865 56865 0 Explanation of Lobbying Activities: Part II-B, Line 1: Park Nicollet reimburses certain professional membership dues of employees. A portion of such membership dues are used by the professional associations for lobbying activities. 20854970 2046767 877865 1798265 21981337 22048592 1489934 -341465 2342091 20854970 23127080 1474161 850097 3402746 22048592 40045623 3239794 538558 20696895 23127080 40780143 3726005 -162788 4297737 40045623 0.44000 0.56000 0 1 1 27661044 27661044 450941858 265962813 184979045 54239184 36490735 17748449 435145529 341646590 93498939 3135728 3135728 327023205 Due From Related Parties 54243700 LT Real Estate Deposits 35018 Bond Issue costs 3042042 57320760 Capital Lease Obligation 84392 Long-term Capital Lease Obligation 3079926 3164318 X 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. 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 0 0 0 0 0 0 68332 0 68332 0 0 0 0 0 0 1 1 X 1 X 275.000000000000 1 X 385.000000000000 1 0 1 1 9770007 83924 9686083 0.00840 110462687 65424712 45037975 0.03910 120232694 65508636 54724058 0.04750 28822 4467384 631135 3836249 0.00330 6031132 1443276 4587856 0.00400 7506770 6042957 1463813 0.00130 28822 18005286 8117368 9887918 0.00860 28822 138237980 73626004 64611976 0.05610 7281 7281 0.00000 7281 7281 1 18031554 0 126482048 125069455 1412593 X 1 1 1 1 Park Nicollet Methodist Hospital

6500 Excelsior Blvd St Louis Park MN 55426

X X X X Park Nicollet Methodist Hospital 1 1 X X X X X X X X X 12 1 0 1 X X X X 0 0 1 1 275.000000000000 1 385.000000000000 1 X X X 1 1 X 1 0 1 X 0 1 29 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 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. Part III, Line 2: 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. Park Nicollet Methodist Hospital 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. Part VI, Line 2: 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. 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. Part VI, Line 3: 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 4: 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 5: 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 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. Part VI, Line 6: 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 7: List of States Receiving Community Benefit Report: MN 1 Park Nicollet Foundation 6500 Excelsior Blvd St Louis Park MN 55426 237346465 501(c)(3) 123902 Grant Money to Other Organizations 1 0 Scholarships 15 20000 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: 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. 0 1 0 0 0 0 0 1 0 David Abelson MD 0 778762 0 328156 0 153743 0 180400 0 76163 0 1517224 0 132075 Steven Connelly MD 0 441588 0 187134 0 12240 0 53760 0 71510 0 766232 0 0 Michael Kaupa 0 467702 0 286948 0 71559 0 57600 0 71463 0 955272 0 56421 Sheila McMillan 0 412710 0 172632 0 12370 0 51000 0 41282 0 689994 0 0 Leslie Baken MD 279342 0 8454 0 40018 0 0 0 49850 0 377664 0 0 0 Paul Dominski 0 198130 0 114965 0 45766 0 14000 0 53471 0 426332 0 39136 Roxanna Gapstur PhD 0 239021 0 99154 0 7429 0 29400 0 43968 0 418972 0 0 Christa Getchell 0 180846 0 54489 0 8735 0 13725 0 18797 0 276592 0 0 Tom Jones MD 676185 0 29426 0 40443 0 0 0 52052 0 798106 0 0 0 Jeff Mendeloff MD 631734 0 23466 0 19105 0 0 0 59091 0 733396 0 0 0 William Richards MD 125051 0 6535 0 110676 0 0 0 36279 0 278541 0 0 0 Janet Schaffer MD 290172 0 0 0 16225 0 0 0 53479 0 359876 0 0 0 Eric Schned MD 250869 0 12594 0 33446 0 0 0 48100 0 345009 0 0 0 Katherine Tarvestad 0 244785 0 0 0 8461 0 30000 0 18745 0 301991 0 0 Mark Wilkowske MD 464615 0 38107 0 11421 0 0 0 56769 0 570912 0 0 0 Theodore Wegleitner 0 251213 0 87277 0 35369 0 30000 0 69515 0 473374 0 25191 Oliver Cass MD 778299 0 32545 0 5371 0 0 0 62270 0 878485 0 0 0 Darin Epstein MD 785318 0 51475 0 3457 0 0 0 58498 0 898748 0 0 0 Marni Feldmann MD 779086 0 33431 0 1047 0 0 0 61170 0 874734 0 0 0 Robert Werling MD 865289 0 33873 0 3153 0 0 0 62397 0 964712 0 0 0 Anton Willerscheidt MD 814283 0 16737 0 4304 0 0 0 61426 0 896750 0 0 0 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. Tom Jones MD Director Salary Draw in Excess X 1068 1068 0 0 0 Janet Schaffer MD Director Salary Draw in Excess X 7088 7088 0 0 0 Eric Schned MD Director Salary Draw in Excess X 5123 5123 0 0 0 Anton Willerscheidt MD Highest Compensated Employee Salary Draw in Excess X 6096 6096 0 0 0 19375 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 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. 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 Park Nicollet Health Services 1 TRIA Orthopaedic Center Research Institute 8100 Northland Drive Bloomington MN 55431 200033919 Health Care Research and Education MN 501(c)(3) 11 Type I Park Nicollet Health Services 1 Methodist Brain Lab Leasing LLC 6500 Excelsior Blvd St Louis Park MN 55426 208725994 Health Care MN Park Nicollet Methodist Hospital Related 182060 46493 0 1 0.60000 Park Nicollet Enterprises 6500 Excelsior Blvd St Louis Park MN 55426 411656735 Real Estate for Related Organization MN Park Nicollet Health Services C 0 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 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