2013-09-30T09:31:49-05:00 2012-12-31 990 2012-01-01 411862132 MAYO CLINIC HEALTH SYSTEM - OWATONNA MAYO 5075381297 2200 26TH STREET NW OWATONNA MN 55060 DAVID W BERG 5074554441 2013-09-27 2012 2016-02-25 16:41:14Z BRIAN E BUNKERS MD 2200 26TH STREET NW OWATONNA MN 55060 69549442 0 X WWW.MAYOCLINICHEALTHSYSTEM.ORG X 1997 MN OPERATION OF A MEDICAL CLINIC 9 3 504 3 -4506 -4506 84936 670830 64816791 68599452 100055 121115 338217 66825 65339999 69458222 98353 31301 0 0 40528945 40988356 0 0 0 20662594 25238095 61289892 66257752 4050107 3200470 48829418 58057684 6863652 8317637 41965766 49740047 X TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION, AND RESEARCH. 0 0 54913024 67308548 PATIENT CARE (SEE SCHEDULE O):MAYO CLINIC HEALTH SYSTEM - OWATONNA (MCHS-OWATONNA) IS A MEMBER OF THE MAYO CLINIC HEALTH SYSTEM. MAYO CLINIC HEALTH SYSTEM IS A FAMILY OF CLINICS, HOSPITALS AND HEALTH CARE FACILITIES SERVING COMMUNITIES IN MINNESOTA, IOWA AND WISCONSIN. AS PART OF MAYO CLINIC, MAYO CLINIC HEALTH SYSTEM OFFERS OUTSTANDING CARE CLOSE TO HOME. PHYSICIANS AND STAFF IN MAYO CLINIC HEALTH SYSTEM HAVE READY ACCESS TO THE KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC, YET CAN MEET PATIENTS' HEALTH CARE NEEDS LOCALLY. MAYO CLINIC HEALTH SYSTEM IS PART OF THE COMMUNITY, FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES IN WHICH WE LIVE AND WORK. MAYO CLINIC HEALTH SYSTEM TEAMS WITH MAYO CLINIC TO DELIVER UNPARALLELED HEALTH CARE TO COMMUNITIES THROUGH AN INTEGRATED NETWORK OF CLINICS AND HOSPITALS.IN 2012, MAYO CLINIC HEALTH SYSTEM SITES EMPLOYED APPROXIMATELY 1,000 PHYSICIANS AND 14,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT THE MAYO CLINIC HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN 72 COMMUNITIES, THE SYSTEM INCLUDES 18 OWNED HOSPITALS, SIX OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH TWO ADDITIONAL HOSPITALS, AND CONTRACT MANAGEMENT AGREEMENTS WITH AN ADDITIONAL HOSPITAL AND NURSING HOME. SINCE ITS INCEPTION IN 1992, MAYO CLINIC HEALTH SYSTEM HAS GROWN FROM A NEW IDEA TO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN AMERICA. MAYO CLINIC HEALTH SYSTEM COMPLETES MORE THAN TWO-MILLION PATIENT VISITS ANNUALLY. IT ALSO SERVES AS A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS BEING RECOGNIZED SIX TIMES BY THE AMERICAN MEDICAL GROUP ASSOCIATION'S ACCLAIM AWARD PROGRAM (2005 ACCLAIM AWARD RECIPIENT AND FIVE-TIME ACCLAIM AWARD HONOREE). THE ACCLAIM AWARDS HONOR PHYSICIAN-LED ORGANIZATIONS DELIVERING CARE ALIGNED WITH THE IDEAL DELIVERY MODEL WHERE PATIENTS EXPERIENCE SAFE, RELIABLE, RESPONSIVE, READILY AVAILABLE AND INTEGRATED CARE. IN ADDITION, THE MINNESOTA COUNCIL FOR QUALITY HAS RECOGNIZED MAYO CLINIC HEALTH SYSTEM THREE TIMES FOR ITS PERFORMANCE EXCELLENCE EFFORTS. INDIVIDUAL MAYO CLINIC HEALTH SYSTEM LOCATIONS HAVE ALSO BEEN HONORED FOR THEIR COMMITMENT TO QUALITY, SAFETY, SERVICE, PERFORMANCE AND THEIR COMMUNITIES.PEOPLE IN MINNESOTA, IOWA AND WISCONSIN CAN HAVE PEACE OF MIND KNOWING THAT MAYO CLINIC HEALTH SYSTEM AND MAYO CLINIC PARTNER TO ENSURE HEALTHIER LIVES IN THE REGION.AS PART OF THE MAYO CLINIC HEALTH SYSTEM, MCHS-OWATONNA IS ORGANIZED AND OPERATED AS A NONPROFIT MULTI-SPECIALTY CLINIC PROVIDING HEALTH CARE SERVICES AT ITS MAIN CLINIC FACILITY IN THE CITY OF OWATONNA, MINNESOTA AND OUTREACH AT OTHER CLINIC FACILITIES LOCATED IN THE AREA SURROUNDING OWATONNA. MCHS-OWATONNA STAFF INCLUDES PHYSICIANS IN A VARIETY OF SPECIALTY FIELDS INCLUDING: FAMILY MEDICINE, INTERNAL MEDICINE, GENERAL SURGERY, OBSTETRICIAN/GYNECOLOGY, DERMATOLOGY, OTOLARYNGOLOGY, OPHTHALMOLOGY, ORTHOPEDICS, PEDIATRICS, PLASTIC & RECONSTRUCTIVE SURGERY, UROLOGY, URGENT CARE AND EMERGENCY MEDICINE. MCHS-OWATONNA OFFERS COMPREHENSIVE LABORATORY, DIAGNOSTIC, PAIN MANAGEMENT AND INFUSION THERAPY SERVICES LIKE CHEMOTHERAPY FOR AREA CANCER PATIENTS. SPECIALTY PHYSICIANS IN GENERAL SURGERY, OBSTETRICS, OTOLARYNGOLOGY AND ORTHOPEDIC SURGERY SEE PATIENTS AT OTHER AREA CLINICS AND HOSPITALS PROVIDING SPECIALTY CARE AND CRITICAL ON-CALL SUPPORT. THE HOSPITALS THAT BENEFIT FROM THIS CARE AND ON-CALL SUPPORT ARE EXEMPT UNDER SECTION 501(C)(3) OF THE CODE, AND MANY ARE RELATED HOSPITALS IN THE MAYO CLINIC HEALTH SYSTEM. WHILE PHYSICIANS AT MCHS-OWATONNA MEET THE VAST MAJORITY OF PATIENTS' HEALTHCARE NEEDS IN OWATONNA, A TEAM OF VISITING SPECIALISTS FROM MAYO CLINIC SEE PATIENTS LOCALLY, PROVIDING CONVENIENT CONSULTATION AND CARE IN CARDIOLOGY, ONCOLOGY, NEUROLOGY, NEPHROLOGY, AND DIALYSIS.MCHS-OWATONNA RECORDED 134,214 PRIMARY CARE VISITS AND 251,691 RADIOLOGY AND LAB TESTS FOR 2012. MCHS-OWATONNA PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. SERVICES ARE ALSO PROVIDED TO BOTH MEDICAID AND MEDICARE PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN 2012, MCHS-OWATONNA PROVIDED APPROXIMATELY $400,700 IN FINANCIAL ASSISTANCE (AT COST) TO PATIENTS. THE UNREIMBURSED COST OF SERVICES TO MEDICAID PATIENTS WAS APPROXIMATELY $6,133,400 AND THE UNREIMBURSED COST OF SERVICES TO MEDICARE PATIENTS WAS APPROXIMATELY $9,206,000. MCHS-OWATONNA ALSO PAID $1,074,526 OF MINNESOTACARE TAX, WHICH IS USED TO FUND A STATE PROGRAM FOR PROVIDING MEDICAL CARE TO THE LOW INCOME POPULATION. 309676 31301 591 COMMUNITY INVOLVEMENT & EDUCATION (SEE SCHEDULE O):MCHS-OWATONNA'S COMMUNITY INVOLVEMENT AND CHARITABLE CONTRIBUTIONS FOCUS ON:- IMPROVING QUALITY OF LIFE;- PROMOTING YOUTH POTENTIAL; - IMPROVING COMMUNITY HEALTH AND WELLNESS; AND- PARTNERING FOR COMMUNITY GROWTH AND DEVELOPMENT.IN 2012, MCHS-OWATONNA PROVIDED VARIOUS COMMUNITY SERVICES AND EDUCATIONAL OPPORTUNITIES TO AREA RESIDENTS. SOME OF THESE ACTIVITIES ARE DESCRIBED BELOW. OVER 180 WOMEN ATTENDED THE ANNUAL "WOMEN'S HEALTH DAY EDUCATIONAL EVENT". THE EVENT EXISTS TO EDUCATE THE WOMEN OF OWATONNA AND THE SURROUNDING AREA ON HEALTHCARE TOPICS RELATED TO WOMEN. NEARLY 500 LOCAL RESIDENTS ATTENDED THE ANNUAL "HAVE A SAFE SUMMER CHILDREN'S SAFETY FAIR". THE FAIR IS A COMMUNITY PROGRAM THAT IS DESIGNED TO EDUCATE YOUTH ABOUT HEALTH AND SAFETY. THE FAIR IS A PARTNERSHIP WITH THE MEDICAL PROFESSION, LAW ENFORCEMENT, SCHOOLS, PUBLIC SERVICE ORGANIZATIONS, THE CITY OF OWATONNA, STEELE COUNTY PUBLIC HEALTH, AND OTHER COMMUNITY ORGANIZATIONS THAT PROVIDE SAFETY TRAINING AND HEALTHY SUMMER ACTIVITIES FOR YOUTH. THE ANNUAL COMMUNITY WALKING PROGRAM IS DESIGNED TO INCREASE THE PHYSICAL ACTIVITY LEVEL OF STEELE COUNTY RESIDENTS MEASURED BY THE NUMBER OF STEPS THEY WALK IN A DAY. THE PROGRAM IS IN COLLABORATION WITH THE OWATONNA HOSPITAL AND THE CITY OF OWATONNA. OVER 500 PARTICIPATED IN THE 2012 WALKING PROGRAM.MCHS-OWATONNA HELD AN ANNUAL FLU SHOT CLINIC FOR THE COMMUNITY AND WENT ON-SITE TO LOCAL BUSINESSES TO ADMINISTER FLU SHOTS FOR EMPLOYEES. ALSO OFFERED WERE FREE DIABETES AND CANCER SUPPORT GROUP SESSIONS, FREE COLORECTAL SCREENINGS AND EDUCATIONAL SEMINARS.MCHS-OWATONNA PHYSICIANS PROVIDED MEDICAL COVERAGE AT VARIOUS LOCAL HIGH SCHOOL SPORTING EVENTS. IN ADDITION, SPORTS SCREENINGS WERE OFFERED TO LOCAL AND SURROUNDING AREA STUDENTS AT NO CHARGE. MCHS-OWATONNA SPONSORED HAND WASHING STATIONS AT THE STEELE COUNTY FREE FAIR AND STAFF VOLUNTEERED THEIR TIME TO REPRESENT THE CLINIC AT THE FAIR.MCHS-OWATONNA STAFF SPOKE AT SEVERAL EVENTS DURING THE YEAR AND SERVED ON THE BOARDS OF VARIOUS AGENCIES IN THE COMMUNITY.MCHS-OWATONNA DISTRIBUTES A QUARTERLY NEWSLETTER "HOMETOWN HEALTH" TO ALL MAILBOXES IN ITS SERVICE AREA TO KEEP EVERYONE INFORMED OF NEW SERVICES, NEW PROVIDERS, EDUCATION/PREVENTION AND PATIENT CARE RELATED INFORMATION. MCHS-OWATONNA PROVIDED CLINICAL EXPERIENCE FOR NURSING AND HEALTH RELATED CAREERS WHICH WERE OFFERED THROUGH A LOCAL COMMUNITY COLLEGE. DURING 2012, STUDENTS WERE PROVIDED THE OPPORTUNITY FOR JOB SHADOWING. MCHS-OWATONNA ALSO PROVIDED CLINICALS FOR RESIDENTS.IN ADDITION TO THE ABOVE ACTIVITIES, MCHS-OWATONNA GAVE $31,301 IN GRANTS TO CHARITIES AND COMMUNITY ORGANIZATIONS. 1290809 MCHS-OWATONNA LEASES SPACE AND PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE. 1290809 55222700 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 22 0 1 504 1 1 1 0 0 0 0 0 0 0 0 0 X 9 3 1 1 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 MN X MAYO CORPORATE TAX UNIT 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 AGERTER MD DAVID C 1.00 40.00 X X 0 483600 35091 BERG DAVID W 40.00 0.00 X X 203776 0 16878 BUNKERS MD BRIAN E 40.00 0.00 X X 347327 0 11421 CROCKETT ERIC D 1.00 40.00 X 0 132841 31469 GROFF STAN 1.00 0.00 X X 0 0 0 HERZOG JAMES 1.00 0.00 X 0 0 0 HOWELL MD THOMAS G 1.00 40.00 X 0 445497 59261 MCGRAW COLLEEN 1.00 0.00 X 0 0 0 PLATE MD REINOLD H 40.00 0.00 X X 321748 0 14377 JOHNSON KRISTIN S 40.00 0.00 X 161080 0 10844 KOCH MARK B 1.00 40.00 X 0 289086 16795 PARKS DOUGLAS A 1.00 40.00 X 0 189781 44522 PILOT DAVID L 1.00 40.00 X 0 196045 33934 BECKMAN MD JANET M 40.00 0.00 X 321176 0 8420 BEYER MD DEREK A 40.00 0.00 X 501448 0 15485 BLOMQUIST MD KARL L 40.00 0.00 X 286593 0 27921 GRIFFIN MD LORRAINE J 40.00 0.00 X 279534 0 5156 HUANG MD ALLEN T 40.00 0.00 X 502038 0 53614 IVANCE MD DAVID W 40.00 0.00 X 605526 0 9967 MULET MD MIGUEL E 40.00 0.00 X 568282 0 12598 OLSON MD KEITH J 40.00 0.00 X 277267 0 7666 SANDHOFER MD CHARLES R 40.00 0.00 X 288492 0 8376 SNEIDERS MD ALEX 40.00 0.00 X 463451 0 32732 WALLNER MD DIANE E 40.00 0.00 X 413618 0 16283 WRAY-RAABOLLE MD JASON T 40.00 0.00 X 335296 0 11942 JONES MD GREGORY C 40.00 0.00 X 504162 0 4814 PENN MD DAVID M 40.00 0.00 X 628074 0 27699 PINO MD WILBERT B 40.00 0.00 X 558126 0 6209 REIMER MD MARK B 40.00 0.00 X 571580 0 19095 STEINLE MD JASON W 40.00 0.00 X 630001 0 27358 PALEY MD KEITH H 40.00 0.00 X 473936 0 38154 PALEY MD DANIEL S 40.00 0.00 X 365474 0 28553 9608005 1736850 636634 72 1 1 0 MAYO CLINIC 200 1ST ST SW ROCHESTER MN 55905 MEDICAL AND SUPPORT SERVICES 1577098 SHARED HEALTH SERVICES LLC 134 SOUTHVIEW ST OWATONNA MN 55060 MEDICAL SERVICES 760175 TOP-NOTCH CLEANING 785 22ND ST SE OWATONNA MN 55060 JANITORIAL SERVICES 524602 MAYO CLINIC HEALTH SYSTEM-FARIBAULT 300 STATE AVE FARIBAULT MN 55021 MEDICAL SERVICES 467904 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 ROCHESTER MN 55905 LAB SERVICES 459076 14 670830 670830 NET PATIENT REVENUE 621110 67308548 67308548 SHARED SERVICES REVENUE 561000 1019098 1019098 RENTAL REVENUE FROM AFFILIATES 531120 271215 271215 EDUCATION REVENUE 611600 591 591 68599452 117805 117805 70835 74265 0 78771 70835 -4506 66329 -4506 70835 15759 12449 3310 3310 3310 MISC. REVENUE 900099 496 496 496 69458222 68599948 -4506 191950 X 31301 31301 6140336 5747757 392579 2126115 2126115 24149765 20352413 3797352 2533946 2281588 252358 4181488 3473968 707520 1856706 1642594 214112 106086 106086 56408 56408 7848507 5645048 2203459 183346 183346 1941608 643682 1297926 1145981 33206 1112775 1141640 1057560 84080 3943 3943 673557 449876 223681 1822795 1445060 377735 307091 303308 3783 MEDICAL SUPPLIES 6073897 6073897 BAD DEBT EXPENSE 2626857 2626857 MN CARE TAX 1074526 1074526 EMPLOYEE RELATED EXPENS 179349 164356 14993 52504 45645 6859 66257752 55222700 11035052 0 -11880 3659 4714 185455 8751596 11554095 99693 119103 434714 696912 937373 786114 39117975 16331878 20767635 22786097 135307 348820 16849367 19216932 731430 832124 129469 1528373 48829418 58057684 6590216 7555554 58335 71514 215101 690569 6863652 8317637 X 41965766 49740047 41965766 49740047 48829418 58057684 X 3200470 161572 4412239 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1562494 1562494 24196898 7751591 16445307 7283301 5172894 2110407 6075282 3407393 2667889 22786097 MAYO POOLED INVESTMENTS 19216932 F 19216932 DUE TO AFFILIATES 119776 DEFERRED COMPENSATION LIABILITY 348820 OTHER LIABILITIES RELATED TO FARIBAULT MERGER 221973 690569 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: AT DECEMBER 31, 2012 AND 2011, THE RESERVE FOR UNRECOGNIZED TAX BENEFITS WAS NOT SIGNIFICANT, AND AS A RESULT, THERE IS NO LONGER A RESERVE FOR UNRECOGNIZED TAX BENEFITS RECORDED FOR THE FILING ORGANIZATION. 1 OWATONNA FOUNDATION PO BOX 642 OWATONNA MN 55060 416038547 501(C)(3) 5000 SUPPORT EXEMPT PURPOSE OWATONNA AREA CHAMBER FOUNDATION 320 HOFFMAN DRIVE OWATONNA MN 55060 363319497 501(C)(3) 5000 SUPPORT EXEMPT PURPOSE 2 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY AND EQUALITY OF OPPORTUNITY. TRANSFERS OR GRANTS TO TAX-EXEMPT ORGANIZATIONS WILL BE USED PURSUANT TO THE POLICIES AND PROCEDURES OF THE GRANTEE ORGANIZATIONS AND TO FURTHER THE EXEMPT PURPOSES OF THE GRANTEE ORGANIZATIONS. BOTH THE FILING ORGANIZATION AND THE GRANTEE ORGANIZATION MAINTAIN ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED. X 1 1 X X X 0 1 0 0 0 0 0 0 0 AGERTER MD DAVID C 0 449783 0 0 0 33817 0 19707 0 15384 0 518691 0 0 BERG DAVID W 202139 0 507 0 1130 0 6378 0 10500 0 220654 0 0 0 BUNKERS MD BRIAN E 346098 0 0 0 1229 0 7500 0 3921 0 358748 0 0 0 CROCKETT ERIC D 0 132414 0 0 0 427 0 9484 0 21985 0 164310 0 0 HOWELL MD THOMAS G 0 385179 0 0 0 60318 0 29725 0 29536 0 504758 0 0 PLATE MD REINOLD H 318780 0 0 0 2968 0 7463 0 6914 0 336125 0 0 0 JOHNSON KRISTIN S 160274 0 406 0 400 0 4983 0 5861 0 171924 0 0 0 KOCH MARK B 0 279804 0 0 0 9282 0 322 0 16473 0 305881 0 0 PARKS DOUGLAS A 0 188612 0 0 0 1169 0 20335 0 24187 0 234303 0 0 PILOT DAVID L 0 196045 0 0 0 0 0 13937 0 19997 0 229979 0 0 BECKMAN MD JANET M 319810 0 0 0 1366 0 7500 0 920 0 329596 0 0 0 BEYER MD DEREK A 470806 0 0 0 30642 0 7500 0 7985 0 516933 0 0 0 BLOMQUIST MD KARL L 280985 0 0 0 5608 0 5096 0 22825 0 314514 0 0 0 GRIFFIN MD LORRAINE J 267544 0 0 0 11990 0 4529 0 627 0 284690 0 0 0 HUANG MD ALLEN T 462205 0 0 0 39833 0 7500 0 46114 0 555652 0 0 0 IVANCE MD DAVID W 586089 0 0 0 19437 0 5223 0 4744 0 615493 0 0 0 MULET MD MIGUEL E 425967 0 0 0 142315 0 5723 0 6875 0 580880 0 0 0 OLSON MD KEITH J 233779 0 0 0 43488 0 6789 0 877 0 284933 0 0 0 SANDHOFER MD CHARLES R 265730 0 0 0 22762 0 7500 0 876 0 296868 0 0 0 SNEIDERS MD ALEX 447606 0 0 0 15845 0 7500 0 25232 0 496183 0 0 0 WALLNER MD DIANE E 315223 0 0 0 98395 0 3543 0 12740 0 429901 0 0 0 WRAY-RAABOLLE MD JASON T 310664 0 0 0 24632 0 7484 0 4458 0 347238 0 0 0 JONES MD GREGORY C 501909 0 0 0 2253 0 3178 0 1636 0 508976 0 0 0 PENN MD DAVID M 626805 0 0 0 1269 0 6070 0 21629 0 655773 0 0 0 PINO MD WILBERT B 557923 0 203 0 0 0 0 0 6209 0 564335 0 0 0 REIMER MD MARK B 558915 0 0 0 12665 0 7500 0 11595 0 590675 0 0 0 STEINLE MD JASON W 628642 0 0 0 1359 0 7500 0 19858 0 657359 0 0 0 PALEY MD KEITH H 347738 0 0 0 126198 0 7438 0 30716 0 512090 0 0 0 PALEY MD DANIEL S 362832 0 0 0 2642 0 7442 0 21111 0 394027 0 0 0 PART I, LINE 1A TWO OF THE LISTED PERSONS RECEIVED AN AWARD OR OTHER TANGIBLE RECOGNITION THAT WAS TREATED AS TAXABLE COMPENSATION. PURSUANT TO INSTITUTIONAL POLICIES, CERTAIN SUCH AWARDS HAVE A TAX GROSS-UP APPLIED IN ORDER NOT TO DIMINISH THE RECOGNITION AND CELEBRATORY NATURE OF THE AWARD. PART I, LINE 4B THIS ENTITY OR ITS AFFILIATE HAS A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE MAYO PENSION PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(A)(17). STARTING JANUARY 1, 2011, ALL SRP BENEFITS ARE PAID AS AN ANNUAL TAXABLE CASH PAYMENT. THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). DAVID C. AGERTER, M.D. - $27,454 THOMAS HOWELL, M.D. - $24,360 MARK B. KOCH - $8,013 SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: IN ADDITION TO COMPENSATION REVIEW PROCESSES ON A SITE LEVEL, THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990, PART VI, SECTION B, LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED. PART III: COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. MAYO CLINIC HEALTH SYSTEM - FARIBAULT BUSINESS RELATIONSHIP - BOARD OVERLAP 665972 SERVICES 0 KARI BUNKERS FAMILY MEMBER OF BRIAN BUNKERS, OFFICER 240003 EMPLOYMENT 0 RICHARD GRIFFIN FAMILY MEMBER OF LORRAINE GRIFFIN, OFFICER 370107 EMPLOYMENT 0 ANN SNEIDERS FAMILY MEMBER OF ALEX SNEIDERS, KEY EMPLOYEE 167914 EMPLOYMENT 0 MICHAEL SCHOENEMAN FAMILY MEMBER OF DIANE WALLNER, KEY EMPLOYEE 168418 EMPLOYMENT 0 LINDA WALLNER FAMILY MEMBER OF DIANE WALLNER, KEY EMPLOYEE 273556 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUAL IS EMPLOYED BY A RELATED ORGANIZATION: PILOT, DAVID L. RESULTING IN A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFICER, DIRECTOR, OR TRUSTEE: AGERTER M.D., DAVID C. KOCH, MARK B. PARKS, DOUGLAS A. BRIAN E. BUNKERS, M.D., THOMAS G. HOWELL, M.D., AND MARK B. KOCH HAVE A BUSINESS RELATIONSHIP AS THEY SERVE AS AN OFFICER, DIRECTOR, OR TRUSTEE OF MAYO CLINIC HEALTH SYSTEM-FARIBAULT, A RELATED TAXABLE ENTITY. FORM 990, PART VI, SECTION A, LINE 3 MAYO CLINIC, MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, AND OTHER RELATED COMPANIES PROVIDE MANAGEMENT SERVICES TO THE ENTIRE SYSTEM OF ENTITIES. SINCE THE ENTITIES ARE RELATED ORGANIZATIONS, COMPENSATION FOR THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES HAS BEEN DISCLOSED IN PART VII AND SCHEDULE J AS REQUIRED. FORM 990, PART VI, SECTION A, LINE 4 ARTICLES OF MERGER BETWEEN THE FILING ORGANIZATION AND MAYO CLINIC HEALTH SYSTEM-FARIBAULT WERE APPROVED AND SIGNED IN 2012 WITH AN EFFECTIVE DATE OF JANUARY 1, 2013. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION IS MAYO CLINIC. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS ARE ELECTED OR REMOVED BY THE SOLE CORPORATE MEMBER, SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS. THE COMMUNITY DIRECTORS ARE NOMINATED BY A NOMINATING COMMITTEE. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN TRANSACTIONS REQUIRE APPROVAL BY THE MEMBER BEFORE ACTION CAN BE TAKEN SUCH AS AMENDMENT TO THE ARTICLES AND BYLAWS, MERGER OR OTHER RESTRUCTURING, AND INCURRENCE OF DEBT. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA U.S. MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS AND ADMINISTRATIVE LEADERSHIP. IN ADDITION TO ANY REVIEW AND APPROVAL THAT MAY TAKE PLACE AT THE LOCAL ENTITY LEVEL, THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY IN THE FALL FOR THE NEXT YEAR'S COMPENSATION. THE SALARY OF THE CEO, CAO, AND BOARD VICE CHAIR WERE REVIEWED BY THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR MAYO CLINIC HEALTH SYSTEM PHYSICIAN AND ADMINISTRATIVE LEADERSHIP. THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION OF PHYSICIANS AND ADMINISTRATIVE LEADERSHIP FOR THE MAYO CLINIC HEALTH SYSTEM ENTITIES. THE COMMITTEE IS COMPRISED OF MAYO EMPLOYEES, BUT IS INDEPENDENT FOR INTERNAL REVENUE CODE 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED (WITH RECUSAL WHERE APPROPRIATE). FOR THOSE INDIVIDUALS FOR WHICH THIS COMMITTEE CAN NOT SERVE AS THE INDEPENDENT REVIEW, THEIR COMPENSATION AND BENEFITS ARE REVIEWED BY THE GOVERNANCE COMMITTEE (DESCRIBED BELOW). THE COMPENSATION AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. INFORMATION ON MAYO CLINIC HEALTH SYSTEM PHYSICIAN AND ADMINISTRATIVE LEADERSHIP COMPENSATION AND BENEFITS IS ALSO REVIEWED BY THE MAYO CLINIC COMMITTEE ON OFFICER SUCCESSION, COMPENSATION AND GOVERNANCE (GOVERNANCE COMMITTEE), WHICH IS COMPRISED OF SEVEN OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. IN ADDITION TO THE ABOVE COORDINATED REVIEW PROCESSES CONDUCTED BY MAYO CLINIC AND ITS AFFILIATES, THE FILING ORGANIZATION ALSO HAS ITS OWN COMPENSATION REVIEW PROCESS THAT INCLUDES REVIEW BY THE FILING ORGANIZATION'S COMPENSATION COMMITTEE, BENCHMARK/COMPARABILITY DATA AND APPROVAL BY BOARD OR COMPENSATION COMMITTEE. THE FILING ORGANIZATION'S REVIEW PROCESS COVERS BOTH A PHYSICIAN COMPENSATION PLAN AND AN ADMINISTRATOR COMPENSATION PLAN. FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. OTHER FEES FORM 990, PART IX, LINE 11G OTHER FEES : PROGRAM SERVICE EXPENSES 1,873,010. MANAGEMENT AND GENERAL EXPENSES 2,203,459. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,076,469. RADIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 2,397,663. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,397,663. LAB FEES: PROGRAM SERVICE EXPENSES 850,084. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 850,084. CLEANING SERVICES: PROGRAM SERVICE EXPENSES 524,291. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 524,291. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: FARIBAULT MERGER 4,412,239. IN REGARDS TO FILING CERTAIN FOREIGN FORMS SCHEDULE F, PART IV, LINES 3, 5, & 6 DISCLOSURE STATEMENT RELATED TO FORMS 5713: FORM 5713 HAS BEEN FILED BY THE FOLLOWING MEMBERS OF THE CONTROLLED GROUP: MAYO CLINIC (EIN: 41-6011702) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH (EIN: 41-1506440) MAYO HOLDING COMPANY (EIN: 41-1578020) MAYO CLINIC ARIZONA (EIN: 86-0800150) MAYO CLINIC JACKSONVILLE (EIN: 59-3337028) DISCLOSURE STATEMENT RELATED TO FORMS 5471: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 4 AND 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED TAXPAYER NAME: MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-1506440 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED DISCLOSURE STATEMENT RELATED TO FORMS 8865: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 8865, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS, AS A CATEGORY 2 AND 3 FILER. THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 8865 FOR THESE PARTNERSHIPS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 8865 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED BLOOMER LAKEVIEW INC 2110 DUNCAN ROAD BLOOMER WI 54724 391450617 LOW INCOME HOUSING WI 501(C)(3) 7 MCHS--CHIPPEWA VALLEY INC 1 CHARTERHOUSE INC 200 FIRST STREET SW ROCHESTER MN 55905 411405254 RETIREMENT LIVING CENTER MN 501(C)(3) 9 MAYO CLINIC 1 FRANCISCAN SKEMP FOUNDATION OF ARCADIA INC 464 SOUTH ST JOSEPH AVENUE ARCADIA WI 54612 391322480 FUNDRAISING FOUNDATION WI 501(C)(3) 9 MCHS--FRANCISCAN HEALTHCARE INC 1 GOLD CROSS AMBULANCE SERVICE 200 FIRST STREET SW ROCHESTER MN 55905 411917516 AMBULANCE SERVICE MN 501(C)(3) 9 MFMER 1 LUTHER LAKESIDE APARTMENTS INC PO BOX 1510 EAU CLAIRE WI 54702 391409024 LOW INCOME HOUSING FOR ELDERLY WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 416011702 PATIENT CARE - CLINIC MN 501(C)(3) 9 N/A 1 MAYO CLINIC -- METHODIST HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410739106 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC -- SAINT MARYS HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410944601 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 860800150 HOSPITAL AND CLINIC AZ 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 590714831 HOSPITAL FL 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MAYO CLINIC HEALTH SYSTEM IN WAYCROSS INC 1900 TEBEAU STREET WAYCROSS GA 31501 581667166 HOSPITAL GA 501(C)(3) 3 MAYO CLINIC JACKSONVILLE 1 MAYO CLINIC HEALTH SYSTEM--ALBERT LEA 1000 FIRST DRIVE NW AUSTIN MN 55912 411404075 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--AUSTIN 1000 FIRST DRIVE NW AUSTIN MN 55912 410695606 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--AUSTIN FOUNDATION 1000 FIRST DRIVE NW AUSTIN MN 55912 300107471 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--AUSTIN 1 MAYO CLINIC HEALTH SYSTEM--CANNON FALLS 1116 WEST MILL STREET CANNON FALLS MN 55009 204156428 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC 1501 THOMPSON STREET BLOOMER WI 54724 390980343 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE WI 54702 391735831 PATIENT CARE - CLINIC WI 501(C)(3) 3 MAYO CLINIC 0 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE FOUNDATION INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE WI 54702 391633407 GRANTMAKING FOUNDATION WI 501(C)(3) 11-I MCHS--EAU CLAIRE CLINIC INC 0 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 390813418 HOSPITAL WI 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--FAIRMONT 800 MEDICAL CENTER DRIVE PO BOX 800 FAIRMONT MN 56031 410760836 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391186647 FUNDRAISING FOUNDATION WI 501(C)(3) 7 MCHS--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION-SPARTA INC 310 WEST MAIN STREET SPARTA WI 54656 391423234 FUNDRAISING FOUNDATION WI 501(C)(3) 9 MCHS--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391411999 HEALTHCARE SYSTEM PARENT WI 501(C)(3) 11-I MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN MEDICAL CENTER INC 700 WEST AVE SOUTH LA CROSSE WI 54601 390806374 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--FRANCISCAN HEALTHCARE INC 1 MAYO CLINIC HEALTH SYSTEM--HOME HEALTH & HOSPICE INC PO BOX 2060 EAU CLAIRE WI 54702 391491516 HOME HEALTH AND HOSPICE CARE WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--LAKE CITY 500 WEST GRANT STREET LAKE CITY MN 55041 411906820 HOSPITAL MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--MANKATO 1025 MARSH STREET MANKATO MN 56002 411236756 HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--MANKATO HEALTH CARE FOUNDATION 1025 MARSH STREET MANKATO MN 56002 411663357 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--NEW PRAGUE 301 SECOND STREET NE NEW PRAGUE MN 56071 410723639 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--NORTHLAND INC 1222 EAST WOODLAND AVENUE BARRON WI 54812 390920634 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--OAKRIDGE INC 13025 EIGHTH STREET PO BOX 70 OSSEO WI 54758 391029430 HOSPITAL AND CLINIC WI 501(C)(3) 3 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--OWATONNA 134 SOUTHVIEW ST OWATONNA MN 55060 411862132 PATIENT CARE - CLINIC MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--RED CEDAR INC 2321 STOUT ROAD MENOMONIE WI 54751 510190875 HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--RED WING 701 HEWITT BOULEVARD RED WING MN 55066 411713783 PATIENT CARE SERVICES MN 501(C)(3) 3 MAYO CLINIC 1 MAYO CLINIC HEALTH SYSTEM--RED WING HOME HEALTH & HOSPICE 701 HEWITT BOULEVARD RED WING MN 55066 411539756 HOME HEALTHCARE SERVICES MN 501(C)(3) 7 MCHS--RED WING 1 MAYO CLINIC HEALTH SYSTEM--SPRINGFIELD 625 NORTH JACKSON AVENUE SPRINGFIELD MN 56087 411893827 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--ST JAMES 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 410797368 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC HEALTH SYSTEM--ST JAMES HEALTH CARE FOUNDATION 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 411444129 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MCHS--ST JAMES 1 MAYO CLINIC HEALTH SYSTEM--SUPPORTIVE HOMECARE INC PO BOX 2060 EAU CLAIRE WI 54702 391686673 HOME HEALTH CARE WI 501(C)(3) 9 MCHS--EAU CLAIRE HOSPITAL INC 1 MAYO CLINIC HEALTH SYSTEM--WASECA 501 NORTH STATE STREET WASECA MN 56093 363606405 HOSPITAL AND CLINIC MN 501(C)(3) 3 MCHS--MANKATO 1 MAYO CLINIC JACKSONVILLE 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 593337028 PATIENT CARE - CLINIC FL 501(C)(3) 7 MAYO CLINIC 1 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 200 FIRST STREET SW ROCHESTER MN 55905 411506440 CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES MN 501(C)(3) 9 MAYO CLINIC 1 MAYO KLINIK STIFTUNG 60486 FRANKFURT AM MAIN FRANKFURT GM FUNDRAISING FOUNDATION GM MFMER 1 MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES 200 FIRST STREET SW ROCHESTER MN 55905 412020392 SUPPORT RESEARCH, PRACTICE & EDUCATION MN 501(C)(3) 11-I MAYO CLINIC 1 POVERELLO FOUNDATION 200 FIRST STREET SW ROCHESTER MN 55905 411494881 FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC -- SAINT MARYS HOSPITAL 1 RED WING SEMINARY HOME 701 HEWITT BOULEVARD RED WING MN 55066 411263419 RESIDENT CARE AND HOUSING MN 501(C)(3) 9 MCHS--RED WING 1 SATILLA HEALTH MANAGEMENT INC 1900 TEBEAU STREET WAYCROSS GA 31501 581717889 HEALTHCARE SERVICES GA 501(C)(3) 3 MCHS IN WAYCROSS INC 1 THE DOWNTOWN PLAZA 701 HEWITT BOULEVARD RED WING MN 55066 411532554 ELDERLY HOUSING MN 501(C)(3) 9 MCHS--RED WING 1 FRANKLIN HEATING STATION 119 THIRD ST SW ROCHESTER MN 55902 410264830 UTILITY MN N/A PHYSICIAN SOFTWARE SYSTEMS LLC 3333 WARRENVILLE ROAD SUITE 200 LISLE IL 60532 453414836 HEALTHCARE RELATED SOFTWARE IL N/A HEALTH TRADITION HEALTH PLAN 1808 EAST MAIN STREET ONALASKA WI 54650 391545987 MEDICAL SERVICES COMPANY WI N/A C 1 LOBSS NETWORK SUPPORT 2002 INC 200 FIRST STREET SW ROCHESTER MN 55905 481276150 ADMINISTRATIVE SERVICES MN N/A C 1 MAYO CLINIC GBS MAURITIUS 2ND FLOOR EBENE MEWS 57 EBENE CYBERCITY MP HEALTHCARE MANAGEMENT MP N/A C 1 MAYO CLINIC HEALTH SYSTEM--DECORAH CLINIC PHYSICIANS 907 MONTGOMERY STREET DECORAH IA 52101 411711329 PATIENT CARE - CLINIC IA N/A C 1 MAYO CLINIC HEALTH SYSTEM--FARIBAULT 635 FIRST STREET SE FARIBAULT MN 55021 411817179 PATIENT CARE - CLINIC MN N/A C 1 MAYO CLINIC HEALTH SYSTEM--PHARMACY & HOME MEDICAL INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 391528920 PHARMACY SERVICES WI N/A C 1 MAYO COLLABORATIVE SERVICES INC 200 FIRST STREET SW ROCHESTER MN 55905 411346366 REFERENCE LAB SERVICES MN N/A C 1 MAYO HOLDING COMPANY 200 FIRST STREET SW ROCHESTER MN 55905 411578020 HOLDING COMPANY MN N/A C 1 MAYO INSURANCE COMPANY LTD 200 FIRST STREET SW ROCHESTER MN 55905 SELF INSURANCE POOL CJ N/A C 1 MAYO MEDICAL LABORATORIES NEW ENGLAND INC 265 BALLARDVALE STREET WILMINGTON MA 01887 043323713 LABORATORY SERVICES MA N/A C 1 MAYO REGIONAL PRACTICES OF ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 061190278 THIRD PARTY ADMINISTRATION SERVICES AZ N/A C 1 MMSI INC 21 FIRST STREET SW ROCHESTER MN 55905 411547003 THIRD PARTY ADMINISTRATION SERVICES MN N/A C 1 RESOUNDANT INC 221 1ST AVE SW ROCHESTER MN 55902 461661978 MANUFACTURING MEDICAL DEVICE COMPONENT MN N/A C 1 ROCHESTER AIRPORT COMPANY ROUTE 2 ROCHESTER MN 55902 410506870 AIRPORT MANAGEMENT MN N/A C 1 SATILLA HEALTH ENTERPRISES INC 1900 TEBEAU STREET WAYCROSS GA 31501 581717222 HEALTHCARE GA N/A C 1 SATILLA HEALTHNET INC 1900 TEBEAU STREET WAYCROSS GA 31501 582151076 HEALTH SERVICES GA N/A C 1 SATILLA REGIONAL SPECIALTY PHYSICIANS INC 1900 TEBEAU STREET WAYCROSS GA 31501 204363143 PHYSICIAN OFFICES GA N/A C 1 SIT ALPHA II BOND FUND LTD CLIFTON HOUSE 75 FORTH ST GRAND CAYMAN CJ KY1-1108 980648163 INVESTMENT MANAGEMENT CJ N/A C 1 SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION 13400 E SHEA BLVD SCOTTSDALE AZ 85259 860870505 COMMERCIAL PROPERTY OWNERS ASSOCIATION AZ N/A C 1 THE STABILE BUILDING OWNERS' ASSOCIATION 200 FIRST STREET SW ROCHESTER MN 55905 208994499 COMMERCIAL PROPERTY OWNERS ASSOCIATION MN N/A C 1 CHARITABLE LEAD TRUST CHARITABLE TRUST CA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST ND N/A T 1 PERPETUAL TRUST CHARITABLE TRUST LA N/A T 1 PERPETUAL TRUST (2) CHARITABLE TRUST MA N/A T 1 PERPETUAL TRUST CHARITABLE TRUST MO N/A T 1 PERPETUAL TRUST CHARITABLE TRUST AZ N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST CO N/A T 1 CHARITABLE REMAINDER TRUST (6) CHARITABLE TRUST FL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST FL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST IL N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST LA N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST MI N/A T 1 CHARITABLE REMAINDER TRUST (68) CHARITABLE TRUST MN N/A T 1 CHARITABLE REMAINDER TRUST (77) CHARITABLE TRUST MN N/A T 1 CHARITABLE REMAINDER TRUST CHARITABLE TRUST NC N/A T 1 CHARITABLE REMAINDER TRUST (2) CHARITABLE TRUST TX N/A T 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 1 1 1 1 1 MAYO CLINIC - 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