2012-11-15T13:34:56-06:00 2011-12-31 420714325 MCGLADREY LLP 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990 2011-01-01 411865874 GRAND ITASCA CLINIC AND HOSPITAL GRAN 2183265000 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 SARAH GUSTAFSON 2183265000 2012-11-13 1 TODD A JACKSON P00092672 6123324300 2011 2016-02-24 21:20:13Z MICHAEL YOUSO 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 76061205 0 X WWW.GRANDITASCA.ORG X 1997 MN PATIENT-CENTERED EXCELLENCE 15 11 617 104 0 0 0 0 34947939 74433876 234662 768209 505120 859120 35687721 76061205 0 0 0 0 20574572 43564249 0 0 160096 13824543 30917887 34399115 74482136 1288606 1579069 88939608 91295839 52568398 52405270 36371210 38890569 X PROVIDE QUALITY, ACCESSIBLE, AND VALUABLE HEALTH CARE SERVICES VIA A HOSPITAL, HOME HEALTH AGENCY, AND CLINIC TO THE SURROUNDING RURAL COMMUNITY. 1 0 59298930 75292996 GRAND ITASCA CLINIC AND HOSPITAL IS AN INTEGRATED MULTI-SPECIALTY CLINIC AND ACUTE/SURGICAL HOSPITAL. THE FACILITY IS LICENSED FOR 64 BEDS WHICH ARE COMPRISED OF 14 ACUTE REHAB BEDS, 34 MEDICAL BEDS, 10 INTENSIVE CARE BEDS AND 6 OB BEDS. IN ADDITION TO PROVIDING TRADITIONAL HOSPITAL SERVICES, THE FACILITY HAS FOUR SURGERY SUITES, A 24-HOUR EMERGENCY DEPARTMENT, OUTPATIENT MENTAL HEALTH SERVICES, OUTPATIENT REHABILITATION SERVICES, AND OUTPATIENT CLINIC SERVICES. THE FACILITY EMPLOYS APPROXIMATELY 620 PEOPLE INCLUDING 45 HEALTHCARE PROVIDERS.THE FACILITY SERVED APPROXIMATELY 2,392 INPATIENTS AND APPROXIMATELY 147,000 OUTPATIENT ENCOUNTERS INCLUDING CLINIC, EMERGENCY ROOM, OUTPATIENT IMAGING AND OUTPATIENT SURGICAL PROCEDURE. GRAND ITASCA SERVES THE PATIENT REGARDLESS OF THE PERSON'S ABILITY TO PAY. DURING THE CALENDAR YEAR, THE FACILITY PROVIDED $301,482 OF CHARITY CARE, $1,039,001 DISCOUNT TO THE UNINSURED AND ABSORBED $1,297,961 OF UNPAID MEDICARE AND MEDICAID COSTS. GRAND ITASCA CLINIC AND HOSPITAL ALSO PROVIDES OTHER SUPPORT TO THE COMMUNITY THROUGH CASH AND IN-KIND DONATIONS THAT TOTALED $6,773 IN 2011 CALENDAR YEAR. IN ADDITION, GRAND ITASCA PROVIDED HEALTHCARE SUPPORT SERVICES OF $40,776 INCLUDING ASK-A-NURSE AND PATIENT TRANSPORTATION. GRAND ITASCA ALSO PAID $1,028,299 IN PAYMENTS FOR MINNESOTA CARE TAX AND MEDICAID SURCHARGES, WHICH WERE USED TO FUND CARE FOR THE INDIGENT AND UNDERINSURED. 59298930 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 49 0 1 617 1 0 0 0 0 0 0 0 0 0 0 X 15 11 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 MN X SARAH GUSTAFSON 2183265000 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 PETER MCDERMOTT 1.00 X X 0 0 0 MARVA JEAN HUTCHENS 1.00 X X 0 0 0 MARY KOSAK 1.00 X X 0 0 0 SHELLY STEERE 1.00 X X 0 0 0 MIKE IVES 1.00 X 0 0 0 RON IANNELLI 1.00 X 0 0 0 COLLEEN NARDONE 1.00 X 0 0 0 BARBARA MCDONALD 1.00 X 0 0 0 ELIZABETH MISKOVICH 1.00 X 0 0 0 BARB SANDERSON 1.00 X 0 0 0 CHARLES KAMPEN 1.00 X 0 0 0 JANICE M ROURK 40.00 X 148416 0 27430 JAMISON L HARKER 40.00 X 239843 0 34088 RICHARD J HELVIG 40.00 X 95056 0 817 NATHAN M NOZNESKY 40.00 X X 308611 0 30213 MICHAEL J YOUSO 40.00 X 271485 0 34935 JACK V CARLISLE 40.00 X 252868 0 34743 BRUCE L LORENZ 40.00 X 104599 0 7489 TIMOTHY M GOLD 40.00 X 404909 0 35215 ROBERTA L ZIMMERMAN 40.00 X 353574 0 30036 JOHN A KOLE 40.00 X 331924 0 35071 DENNIS F SCHERER 40.00 X 330086 0 30027 DEBRA M NYQUIST 40.00 X 304993 0 35071 3146364 0 335135 61 0 1 0 MIDWEST MEDICAL INSURANCE CO PO BOX 86 MINNEAPOLIS MN 55486 INSURANCE COVERAGE 394246 INITIO INC 212 THIRD AVE N 3510 MINNEAPOLIS MN 55401 ADVERTISING AGENCY 374373 TRU SERVICES LLC 200 CUMMINGS CTR STE 272D BEVERLY MA 01915 INSURANCE COVERAGE 301842 ARAMARK UNIFORM SERVICES 1920 OAK STREET LACROSSE WI 54603 UNIFORM CLEANING 286788 MEMORIAL BLOOD CENTER MPLS INC PO BOX 1164 MINNEAPOLIS MN 55480 BLOOD REFERENCE LAB 210375 8 PATIENTS AND RESIDENT 621110 74433876 74433876 74433876 768209 768209 MISCELLANEOUS OPERATIN 621110 702417 702417 HEALTH RELATED ACTIVIT 621110 179548 179548 NET INCOME ATTRIBUTED 621110 -22845 -22845 859120 76061205 75292996 0 768209 1281983 1027051 254826 106 34395627 27555778 6836994 2855 2221051 1779377 441490 184 2763117 2213649 549239 229 2902471 2325291 576939 241 167467 134165 33288 14 99671 79851 19812 8 204914 164165 40732 17 999433 800688 198662 83 2272975 1820975 451811 189 127229 101928 25290 11 1988290 1592902 395223 165 154887 124086 30788 13 5359404 4293643 1065316 445 577596 462736 114812 48 SUPPLIES 9188480 7361276 1826441 763 BAD DEBT 3715798 2976882 738608 308 NON PHY FEES 2977668 2385535 591886 247 MISC EXPENSES 1963420 1201148 608195 154077 1120655 897804 222758 93 74482136 59298930 15023110 160096 5272997 12829047 25051 12520762 11313392 1016932 940927 1012960 1624635 75146992 30047562 48749713 45099430 20341193 19488408 88939608 91295839 6362600 6710496 36762521 35497521 9443277 10197253 52568398 52405270 X 36063199 38582558 308011 308011 36371210 38890569 88939608 91295839 X 1579069 940291 X 0 1 1 X 0 X 607331 607331 44509767 12109244 32400523 236722 67370 169352 29793172 17870948 11922224 45099430 DEFERRED FINANCING COSTS 1144275 ASSETS LIMITED TO USE 17658516 CHARITABLE REMAINDER TRUST 208011 OTHER ASSETS 477606 19488408 OTHER ACCURALS 933272 POST RETIREMENT BENEFIT 6865794 SELF INSURED WORKER'S COMP 504857 CAPITAL LEASE OBLIGATION 652198 CURRENT PORTION OF LONG TERM DEBT 1241132 10197253 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CORPORATION AND FOUNDATION HAVE REVIEWED THEIR TAX POSITIONS FOR ALL OPEN TAX YEARS AND HAVE CONCLUDED THAT NO MATERIAL LIABILITIES EXIST AS OF DECEMBER 31, 2011. GENERALLY, THE CORPORATION AND FOUNDATION ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS PRIOR TO THE FISCAL YEAR ENDED JUNE 20, 2007. 1 1 X 1 X 1 X 0 1 1 0 1 1 373203 373203 0.00530 16293494 14484279 1809215 0.02560 16666697 14484279 2182418 0.03090 40807 40807 0.00060 10500 10500 0.00010 7188 7188 0.00010 58495 58495 0.00080 16725192 14484279 2240913 0.03170 40826 40826 0.00060 7188 7188 0.00010 48014 48014 0.00070 1 3715798 928950 28368851 28547864 -179013 X 1 1 1 CDI GRAND RAPIDS LLC PROVIDE MRI, DIAGNOSTIC INJECTION AND PAIN MANAGEMENT SERVICES 0.55000 0.00000 0.00000 1 1 GRAND ITASCA CLINIC AND HOSPITAL

1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744

X X X GRAND ITASCA CLINIC AND HOSPITAL 1 1 1 300.000000000000 1 300.000000000000 1 X X X X 1 0 1 X 1 X X X X X 1 X 0 0 2 NEW SPIRIT WOMEN'S CLINIC

409 SE 13TH STREET GRAND RAPIDS MN 55744

CLINIC GRAND ITASCA PROFESSIONAL BUILDING

111 SE 3RD STREET GRAND RAPIDS MN 55744

VARIOUS OUTPATIENT & BUSINESS SERVICES PART I, LINE 7: THE COSTING METHOD USED IS TO UTILIZE THE COST REPORT TO CAPTURE THE COST TO CHARGE RATIO. WE THEN COST OUT TOTAL BAD DEBT REPORTED AS CHARGES TO THE COST OF PROVIDING THOSE SERVICES. FROM REVIEW OF THE NUMBER OF APPLICATIONS DENIED FOR INSUFFICIENT INFORMATION WE ESTIMATE 25% OF BAD DEBT IS RELATED TO INDIVIDUALS WHO WOULD QUALIFY FOR CHARITY CARE. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3715798. PART II: GRAND ITASCA'S COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES BY PROVIDING INNOVATIVE AND ADVANCED MEDICAL SERVICES, WITH HIGH-QUALITY, SEAMLESS PATIENT CARE IN MIND. GRAND ITASCA'S INTERPRETATION AND ED PATIENT TAXI CAB SERVICES ALLOW FOR THE CARE OF EACH AND EVERY PATIENT, NO MATTER THE INITIAL BARRIERS OR HARDSHIPS THAT MAY EXIST. THE NURSE ON-LINE PROGRAM, BY PROVIDING A 24-HOUR MEDICAL ADVICE HOTLINE, EMPOWERS PATIENTS TO MAKE EDUCATED DECISIONS ABOUT THEIR MEDICAL TREATMENT. TRIAGE CAN BE COMPLETED PRIOR TO A PATIENT'S ARRIVAL, ALLOWING MEDICAL RESOURCES TO BE ALLOCATED MORE EFFICIENTLY AND EFFECTIVELY. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE, WHERE A THIRD-PARTY PAYOR IS RESPONSIBLE FOR PAYING THE AMOUNT, ARE CARRIED AT A NET AMOUNT DETERMINED BY THE ORIGINAL CHARGE FOR THE SERVICES PROVIDED, ADJUSTED BY AN ESTIMATE MADE FOR CONTRACTUAL ADJUSTMENTS OR DISCOUNTS PROVIDED TO THIRD-PARTY PAYORS.PATIENT ACCOUNTS RECEIVABLE DUE DIRECTLY FROM THE PATIENT ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICES PROVIDED LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF OUTSTANDING AMOUNTS ON A MONTHLY BASIS. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS, BY USING HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS, AND BY CONSIDERING THE PATIENT'S FINANCIAL HISTORY AND CREDIT HISTORY AND CURRENT ECONOMIC CONDITIONS. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. PART III, LINE 8: THE SHORTFALL IS THE COST OF SERVICES PROVIDED TO THE MEDICARE POPULATION IN THE COMMUNITY FOR WHICH WE DO NOT RECOUP ANY PAYMENTS FROM THE PATIENTS. THE COSTING METHODOLOGY IS TO UTLIZE THE COST TO CHARGE RATIO AS DETERMINED BY THE COST REPORT FOR THAT PERIOD. PART III, LINE 9B: ACCORDING TO ITS FINANCIAL POLICY, GRAND ITASCA CLINIC & HOSPITAL HOLDS RESPONSIBILITY FOR INFORMING ALL PATIENTS OF THEIR FINANCIAL OBLIGATIONS FOR SERVICES RECEIVED AND RESERVES THE RIGHT TO HOLD THE PATIENT OR HIS LEGAL REPRESENTATIVE ULTIMATELY RESPONSIBLE FOR ALL CHARGES INCURRED ONCE ANY COMMUNITY CARE DISCOUNT HAS BEEN ESTABLISHED BY THE ORGANIZATION. PATIENTS MAY BE REQUIRED TO MAKE PRE-ADMISSION DEPOSITS, PAY PRIOR OUTSTANDING ACCOUNTS IN FULL BEFORE RECEIVING ADDITIONAL SERVICES, OR ENTER INTO A PAYMENT ARRANGEMENT WITH GRAND ITASCA. IF DEEMED APPROPRIATE, GRAND ITASCA MAY REFER ACCOUNTS UNABLE TO BE COLLECTED IN-HOUSE TO A COLLECTION AGENCY, MAGISTRATE, OR ATTORNEY FOR FURTHER ACTION; OR TAKE LEGAL ACTION TO COLLECT ANY UNPAID BALANCES. GRAND ITASCA CLINIC AND HOSPITAL PART V, SECTION B, LINE 11H: CHARITY CARE IS BASED UPON THE INCOME AND ASSET LEVELS OF THE PATIENT APPLYING FOR ASSISTANCE. THE PATIENT IS REQUIRED TO SUBMIT AN APPLICATION FOR MEDICAL ASSISTANCE AS PART OF THE PROCESS. GRAND ITASCA CLINIC AND HOSPITAL PART V, SECTION B, LINE 15E: PRE-ADMISSION DEPOSIT, VERIFICATION OF INFORMATION, PAYMENT ARRANGEMENTS GRAND ITASCA CLINIC AND HOSPITAL PART V, SECTION B, LINE 17E: PATIENT RECEIVES A SERIES OF LETTERS INDICATING ACTIONS TO BE TAKEN IF PAYMENT ARRANGEMENTS ARE NOT MADE WITH THE FACILITY. PART VI, LINE 2: GRAND ITASCA REVIEWS APPLICABLE STATE AND COUNTY SURVEYS PERFORMED BY OTHER AGENCIES TO ASSESS THE NEEDS OF THE COMMUNITY. GRAND ITASCA WORKS WITH THESE AGENCIES TO PROVIDE THESE SERVICES WITHIN THE SCOPE OF THE MEDICAL FACILITY. PART VI, LINE 3: GRAND ITASCA HAS FINANCIAL ADVOCATES WORKING WITH UNINSURED PATIENTS TO ASSIST THEM IN COMPLETING APPLICATIONS FOR VARIOUS PROGRAMS THAT MAY PROVIDE THEM COVERAGE FOR MEDICAL SERVICES. PART VI, LINE 4: GRAND ITASCA SERVES THE PEOPLE OF GRAND RAPIDS AND THE SURROUNDING COMMUNITIES THROUGHOUT ITASCA COUNTY. THESE COMMUNITIES CONSIST PRIMARILY OF CAUCASIAN RACE, WITH GROWING POPULATIONS OF AMERICAN INDIAN, HISPANIC, AND AFRICAN AMERICAN CITIZENS PART VI, LINE 5: GRAND ITASCA PROMOTES HEALTH IN THE COMMUNITY BY SUPPORTING THE LOCAL FREE CLINIC, THROUGH THE PROVISION OF MEDICAL SUPPLIES, BASIC LAB TESTS AND BASIC X-RAYS TO THE PATIENTS OF THIS CLINIC AT NO CHARGE. GRAND ITASCA ALSO WORKS WITH A COMMUNITY COALITION TO DETERMINE THE HEALTH NEEDS OF THE COMMUNITY SERVICED BY GRAND ITASCA CLINIC & HOSPITAL. REPORTS FILED WITH STATES PART VI, LINE 7 MN X X X 0 0 0 0 0 0 0 0 0 JANICE M ROURK 148416 0 0 0 0 0 10103 0 17327 0 175846 0 0 0 JAMISON L HARKER 239843 0 0 0 0 0 16200 0 17888 0 273931 0 0 0 NATHAN M NOZNESKY 308611 0 0 0 0 0 16900 0 13313 0 338824 0 0 0 MICHAEL J YOUSO 271485 0 0 0 0 0 16900 0 18035 0 306420 0 0 0 JACK V CARLISLE 252868 0 0 0 0 0 16900 0 17843 0 287611 0 0 0 TIMOTHY M GOLD 404909 0 0 0 0 0 16900 0 18315 0 440124 0 0 0 ROBERTA L ZIMMERMAN 353574 0 0 0 0 0 16900 0 13136 0 383610 0 0 0 JOHN A KOLE 331924 0 0 0 0 0 16900 0 18171 0 366995 0 0 0 DENNIS F SCHERER 330086 0 0 0 0 0 16900 0 13127 0 360113 0 0 0 DEBRA M NYQUIST 304993 0 0 0 0 0 16900 0 18171 0 340064 0 0 0 GRAND RAPIDS STATE BANK SHELLY STEERE, TREASURER, IS VP OF THE BANK, WHICH IS GICH'S PRIMARY BANK. 229725 INTEREST PAID FROM CD'S AND CHECKING/SAVINGS ACCOUNTS AT GRAND RAPIDS STATE BANK 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 IN 2011 GRAND ITASCA CLINIC & HOSPITAL ENTERED INTO A JOINT VENTURE, CDI GRAND RAPIDS, LLC, TO OFFER MRI AND DTI SERVICES. FORM 990, PART VI, SECTION A, LINE 4 THE GOVERNANCE COMMITTEE PRESENTED THE FINAL PROPOSED CHANGES TO THE BOARD BYLAWS AS FOLLOWS: SECTION 4.1: ADD: "A PROVIDER IS DEFINED AS A CREDENTIALED PHYSICIAN OR ALLIED HEALTH PROFESSIONAL." CHANGE: "SHALL" TO "MAY" IN THE DECLARATION THAT "OF THE PROVIDER DIRECTORS, FOUR SHALL BE PROVIDERS EMPLOYED BY THE CORPORATION AND ONE SHALL BE A LOCAL PROVIDER NOT EMPLOYED BY THE CORPORATION. ADD: "THE PROVIDER NOT EMPLOYED BY THE CORPORATION SHOULD BE A LICENSED PHYSICIAN IN ACTIVE PRACTICE." SECTION 8.6: ADD: THE GOVERNANCE COMMITTEE "SHALL ANNUALLY REVIEW THE REPORT FROM THE GRAND ITASCA COMPLIANCE OFFICER REGARDING POLICIES AND PROCEDURES OF GRAND ITASCA TO ASSURE COMPLIANCE WITH ALL REQUIREMENTS OF THE IRS, ESPECIALLY AS IT RELATES TO FILING THE IRS 990 FORM "- OIG, CPG (OFFICE OF INSPECTOR GENERAL, COMPLIANCE PROGRAM GUIDANCE FOR HOSPITALS)." DELETE: THE GOVERNANCE COMMITTEE WILL ASSURE THAT A COPY OF THE IRS FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO ITS FILING. DELETE: THE GOVERNANCE COMMITTEE WILL ASSURE THAT A COPY OF THE ORGANIZATIONS "CONFLICT OF INTEREST POLICY" IS ALIGNED WITH IRS REQUIREMENTS AND THAT ALL BOARD MEMBERS HAVE NOTICES OF COMPLIANCE ON FILE. MOTION WAS MADE AND SECONDED TO APPROVE THE PROPOSED CHANGES TO THE GRAND ITASCA BOARD BYLAWS AS PRESENTED. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE DIRECTOR OF FINANCE AND A COPY IS PRESENTED TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR APPROVAL PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS SIGN THE CONFLICT OF INTEREST POLICY ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED BY ASSESSING THE MARKET THROUGH THE USE OF SURVEYS AND STUDIES AND DETERMINING PAY RATES AND RANGES FROM THE RESULTS OF THE ASSESSMENT. THE CEO COMPENSATION PACKAGE IS SUMMARIZED IN AN EMPLOYMENT AGREEMENT THAT IS APPROVED BY THE BOARD. THE COMPENSATION PACKAGE IS BASED UPON MARKET FOR THE POSITION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. AN ANNUAL REPORT IS ALSO ISSUED AND MAILED TO PATIENTS IN THE COMMUNITY. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CHANGE IN INTEREST IN HEALTH RELATED ACTIVITIES 903,698. FOUNDATION CHANGE IN NET ASSETS 14,440. UNCONSOLIDATING ADJUSTMENT 22,153. TOTAL TO FORM 990, PART XI, LINE 5: 940,291. JOINT VENTURE WITH A TAXABLE ENTITY FORM 990, PART VI, SECTION B, LINE 16A GRAND ITASCA THOROUGHLY EVALUATED THE PARTICIPATION IN THE CDI JOINT VENTURE. THIS EVALUATION INCLUDED REVIEW BY ATTORNEYS AND OTHER THIRD PARTY CONSULTANTS. GRAND ITASCA FOUNDATION 1601 GOLF COURSE ROAD GRAND RAPIDS MN 55744 411560554 FINANCIAL SUPPORT OF GRAND ITASCA CLINIC & HOSPITAL MN 501(C)(3) 11(F) GRAND ITASCA CLINIC & HOSPITAL 1 CDI GRAND RAPIDS LLC 1601 GOLF COURSE RD GRAND RAPIDS MN 55744 453783014 PROVIDE IN-HOUSE MRI AND DTI SERVICES MN GRAND ITASCA CLINIC & HOSPITAL RELATED 22382 844248 1 1 0.55000 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0