2011-11-03T09:06:02-05:00 2010-12-31 990 2010-01-01 411906820 MAYO CLINIC HEALTH SYSTEM-LAKE CITY MAYO 5075381297 500 WEST GRANT STREET LAKE CITY MN 55041 cheri kramer 5075381297 2011-11-03 2010 2016-03-07 17:11:31Z FKA LAKE CITY MEDICAL CENTER CHERI KRAMER 500 WEST GRANT STREET LAKE CITY MN 55041 34926130 0 X WWW.LAKECITYMEDICALCENTER.ORG X 1998 MN OPERATION OF HOSPITAL AND CLINIC. 9 3 308 200 0 0 179973 322205 29641301 34347622 14549 4157 207753 182827 30043576 34856811 3500 9265 0 0 12849609 16663846 0 0 159290 15372758 17812553 28225867 34485664 1817709 371147 26097492 28276454 2847839 2805022 23249653 25471432 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. 1 0 24140886 28685065 PATIENT SERVICES (HOSPITAL & CLINICS) - SEE SCHEDULE O:LAKE CITY MEDICAL CENTER (LCMC) IS A MEMBER OF THE MAYO HEALTH SYSTEM. MAYO 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 HEALTH SYSTEM OFFERS OUTSTANDING CARE CLOSE TO HOME. PHYSICIANS AND STAFF IN MAYO HEALTH SYSTEM HAVE READY ACCESS TO THE KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC, YET CAN MEET PATIENTS' HEALTH CARE NEEDS LOCALLY. MAYO HEALTH SYSTEM IS PART OF THE COMMUNITY, FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES IN WHICH WE LIVE AND WORK. MAYO HEALTH SYSTEM TEAMS WITH MAYO CLINIC TO DELIVER UNPARALLELED HEALTH CARE TO COMMUNITIES THROUGH AN INTEGRATED NETWORK OF CLINICS AND HOSPITALS.MAYO HEALTH SYSTEM SITES EMPLOY APPROXIMATELY 800 PHYSICIANS AND 13,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT THE MAYO HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN 70 COMMUNITIES, THE SYSTEM INCLUDES 17 OWNED HOSPITALS, SEVEN OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH THREE ADDITIONAL HOSPITALS, AND CONTRACT MANAGEMENT AGREEMENTS WITH TWO ADDITIONAL HOSPITALS AND ONE NURSING HOME. SINCE ITS INCEPTION IN 1992, MAYO HEALTH SYSTEM HAS GROWN FROM A NEW IDEA TO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN AMERICA. MAYO 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 HEALTH SYSTEM THREE TIMES FOR ITS PERFORMANCE EXCELLENCE EFFORTS. INDIVIDUAL MAYO 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 HEALTH SYSTEM AND MAYO CLINIC PARTNER TO ENSURE HEALTHIER LIVES IN THE REGION. LCMC OWNS AND OPERATES AN 18 BED CRITICAL ACCESS HOSPITAL SERVING LAKE CITY, MINNESOTA AND SURROUNDING COMMUNITIES. DURING THE YEAR ENDED DECEMBER 31, 2010, LCMC HAD 271 MEDICAL/SURGICAL ADMISSIONS, 70 OBSTETRIC ADMISSIONS, 67 DELIVERIES, AND 126 SWING BED ADMISSIONS WITH AN AVERAGE DAILY CENSUS OF 7.37. IN ADDITION, THERE WERE 2,187 EMERGENCY ROOM VISITS, 507 SAME DAY SURGERIES, AND ANCILLARY SERVICES INCLUDING LABORATORY, CARDIAC REHABILITATION, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, POLYSOMNOGRAPHY STUDIES, AND RADIOLOGY SERVICES. RADIOLOGY SERVICES INCLUDED MAMMOGRAPHY, CT, MRI, AND ULTRASOUND.LCMC ALSO OWNS AND OPERATES FOUR CLINICS LOCATED IN ALMA, WISCONSIN AND IN LAKE CITY, PLAINVIEW AND WABASHA, MINNESOTA. THESE CLINICS ARE STAFFED BY FOURTEEN FAMILY MEDICINE PHYSICIANS, A GENERAL SURGEON, ONE PHYSICIAN ASSISTANT, AND SIX NURSE PRACTITIONERS, INCLUDING A CERTIFIED NURSE-MIDWIFE. ON AN ANNUAL BASIS, THERE ARE APPROXIMATELY 53,000 PATIENT VISITS AMONG THE FOUR CLINIC LOCATIONS.DURING 2009, LCMC STARTED A VENTILATOR PROGRAM WHICH CONTINUED IN 2010 TO ENSURE CONTINUUM OF CARE AND THE MOST APPROPRIATE PLACEMENT AND LEVEL OF CARE FOR VENTILATED AND OTHER PATIENTS REQUIRING A HIGH LEVEL OF RESPIRATORY CARE. THE ULTIMATE GOAL IS TO WEAN THE PATIENTS FROM THE VENTILATOR. LCMC HAS COMMITTED FIVE BEDS IN THE FACILITY FOR CARING FOR THIS KIND OF PATIENT POPULATION, ALONG WITH PROVIDING CLASSROOM AND SKILLS TRAINING FOR NURSING STAFF AND PROVIDERS. LCMC ALSO OPERATES LIFELINE (AN EASY-TO-USE PERSONAL RESPONSE SERVICE) TO ENSURE THAT OLDER ADULTS LIVING AT HOME CAN GET QUICK ASSISTANCE WHENEVER IT MAY BE NEEDED - 24 HOURS A DAY, 365 DAYS A YEAR. WHEN THE PERSONAL HELP BUTTON IS PRESSED, A LCMC MONITOR RESPONDS, ASSESSES THE SITUATION AND SUMMONS APPROPRIATE HELP. THERE WERE APPROXIMATELY 110 SUBSCRIBERS TO THE PROGRAM DURING 2010.LCMC 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 ADDITION, SERVICES ARE PROVIDED TO PATIENTS UNDER OTHER MEANS TESTED GOVERNMENT PROGRAMS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN 2010, LCMC PROVIDED APPROXIMATELY $109,606 IN FINANCIAL ASSISTANCE (AT COST) TO PATIENTS. THE UNREIMBURSED COST OF SERVICES TO MEDICAID PATIENTS FOR WAS APPROXIMATELY $309,139. THE UNREIMBURSED COST OF SERVICES TO PATIENTS UNDER OTHER MEANS TESTED GOVERNMENT PROGRAMS WAS APPROXIMATELY $415,337. THE UNREIMBURSED COST OF SERVICES TO MEDICARE PATIENTS WAS APPROXIMATELY $76,039.LCMC HAS APPROXIMATELY 200 VOLUNTEERS INCLUDING INDIVIDUALS AND SERVICE GROUPS WHO PROVIDED APPROXIMATELY 4,313 HOURS OF VOLUNTEER SERVICES DURING 2010. THEY MAN THE INFORMATION DESK DIRECTING PATIENTS AND VISITORS TO THEIR DESTINATION AND CLERICAL DUTIES FOR VARIOUS DEPARTMENTS IN THE MEDICAL CENTER. BASED ON THE 2010 INDEPENDENT SECTOR STATISTICS, THE APPROXIMATE VALUE OF THESE SERVICES IS $91,694. 5421737 5801981 RESIDENT SERVICES (NURSING HOME) - SEE SCHEDULE OLAKE CITY MEDICAL CENTER (LCMC) ALSO OWNS AND OPERATES A 90-BED NURSING HOME THAT SEEKS TO ENHANCE RESIDENT'S QUALITY OF LIFE BY HELPING INDIVIDUALS MAINTAIN THEIR HEALTH AND SELF-RELIANCE. RESIDENTS ARE PROVIDED WITH 24-HOUR NURSING CARE, A ROOM, NUTRITIONALLY WELL-BALANCED MEALS, SNACKS, HOUSEKEEPING AND LAUNDRY SERVICES, ACTIVITY PROGRAMS, AND SOCIAL SERVICES ASSISTANCE AS NEEDED OR REQUESTED. RESIDENTS ALSO HAVE ACCESS TO SPECIALIZED SERVICES SUCH AS REHABILITATION SERVICES; REGISTERED DIETICIAN SERVICES; BEAUTY AND BARBER SERVICES; TELEPHONE SERVICES; AND TELEVISION/CABLE SERVICES FOR AN ADDITIONAL FEE. THE AVERAGE DAILY CENSUS FOR THE NURSING HOME IN 2010 WAS 80.27.THE NURSING HOME'S DIETARY DEPARTMENT PROVIDES MEALS ON A DAILY BASIS FOR THE LAKE CITY HOME DELIVERED MEALS PROGRAM. MEALS ARE DELIVERED BY LIONS CLUB VOLUNTEERS TO LAKE CITY RESIDENTS WHO HAVE BEEN REFERRED TO THE PROGRAM BY HEALTHCARE PROVIDERS. PARTICIPANTS IN THE PROGRAM RECIEVE MEALS CONTAINING MEAT, POTATOES, VEGETABLES, SALAD, AND DESSERT AT A NOMINAL COST. DURING 2010, MORE THAN 3,725 MEALS WERE DELIVERED. LCMC PROVIDES THE ADMINISTRATION FOR THE PROGRAM INCLUDING REGISTRATION, DIETARY PLANNING, MEAL PREPARATION, AND BILLING. DIETARY PLANNING IS DONE TO ENSURE THAT EACH RECIPIENT'S NEEDS AND PREFERENCES ARE MET. THIS SERVICE ALLOWS SENIOR CITIZENS AND OTHERS WITH MEDICAL NEEDS TO LIVE INDEPENDENTLY FOR LONGER THAN WOULD OTHERWISE BE POSSIBLE. 111837 9265 8050 COMMUNITY BENEFIT - SEE SCHEDULE O:AS PART OF ITS ACTIVITIES, LAKE CITY MEDICAL CETNER (LCMC) PROVIDES VARIOUS SUPPORT GROUPS AND PROGRAMS TO THE COMMUNITY AT NO CHARGE. THESE GROUPS AND CLASSES INCLUDE CARDIAC SUPPORT GROUPS, DIABETIC EDUCATIONAL PROGRAMS, OUTREACH FOR SENIOR CITIZENS, MENTORING PROGRAMS AND PRENATAL CLASSES FOR EXPECTANT PARENTS. LCMC ALSO CONDUCTED FLU SHOT CLINICS AND OFFERED DISCOUNTED MAMMOGRAMS TO WOMEN WHO QUALIFIED DURING THE MONTHS OF MAY AND NOVEMBER.LCMC OFFERED SPORTS PHYSICALS AT A REDUCED RATE FOR STUDENTS WHO ARE PARTICIPATING IN SPORTS THROUGH THE LOCAL SCHOOLS, A PREVENTATIVE INJURY TRAINING PROGRAM, FREE SKIN SCREENINGS AT LOCAL WRESTLING MEETS, AND STAFF ATTENDANCE AT HOME HIGH SCHOOL FOOTBALL GAMES TO RESPOND TO EMERGENCIES. LCMC ALSO HAS A PROGRAM THAT ALLOWS LOCAL HIGH SCHOOL STUDENTS TO COME ON-SITE AND LEARN ABOUT HEALTHCARE RELATED CAREERS AND PARTICIPATE IN JOB SHADOWING EXPERIENCES. ALSO DURING 2010, LCMC PROVIDED $4,250 FOR SCHOLARSHIPS TO STUDENTS PURSUING A FIELD IN HEALTH CARE AND $5,015 IN DONATIONS TO LOCAL CHARITIES OR COMMUNITY ORGANIZATIONS. 29674460 1 1 0 0 0 0 0 1 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 23 0 1 308 1 0 0 0 0 0 1 1 0 0 0 0 X 9 3 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN WI X CHRISTIE LOHKAMP 5075381297 200 FIRST STREET SW ROCHESTER MN 55905 X DUNBAR JERRY 1.00 X 0 0 0 NYMAN MD MARK A 1.00 X 0 216705 51269 PETERSON TAMMY 1.00 X 0 0 0 SCHAAL MELISSA 1.00 X 0 0 0 SOLBERG MD JEREMY J 40.00 X 218286 0 15843 SPANO MD DENNIS C 40.00 X X 452588 0 87281 WALTMAN MARY LOU 1.00 X 0 0 0 WILKINSON MD JOHN M 1.00 X 0 217269 48990 WITT MD THOMAS J 40.00 X X 529729 0 79102 BIREN DAVID H 40.00 X 0 152896 17791 BROWN MARK C 40.00 X 73218 73270 26345 KRAMER CHERYL A 40.00 X 217881 0 7454 PILOT DAVID 1.00 X 0 184779 32142 MUNNS DO EARLE C 40.00 X 190119 0 20785 PFLAUM MD DOUGLAS D 40.00 X 264767 0 45741 SCHWEND DO PHILLIP P 40.00 X 358169 0 50274 TUOMINEN MD KORY 40.00 X 215323 0 14884 ZIEBARTH MD THOMAS M 40.00 X 185718 0 24630 ANGSTMAN MD GREGORY L X 0 278405 28649 2705798 1123324 551180 19 1 1 0 EBENEZER MANAGEMENT SERVICES 2722 PARK AVENUE SOUTH MINNEAPOLIS MN 55407 MANAGEMENT SERVICES 4617300 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 MEDICAL & SUPPORT SERVICES 1871664 FAIRVIEW RED WING HOSPITAL 1207 WEST 4TH STREET RED WING MN 55066 MEDICAL SERVICES 798565 MAYO COLLABORATIVE SERVICES INC 200 FIRST STREET SW ROCHESTER MN 55905 LAB SERVICES 383772 HIAWATHA VALLEY ANESTHESIA LLC 32715 LAKEVIEW DRIVE LAKE CITY MN 55041 MEDICAL SERVICES 329928 10 13987 245426 62792 2225 322205 NET PATIENT REVENUE 620000 28365903 28365903 NURSING HOME REVENUE 623110 5801981 5801981 SHARED SERVICES 561000 111723 111723 LIFELINE 621990 39716 39716 RENT FROM AFFILIATES 531120 28299 28299 34347622 5338 5338 65209 63008 2201 2201 2201 1000 2181 -1181 -1181 -1181 5915 13987 2750 3165 3165 1730 1380 350 350 CAFETERIA/VENDING 722210 100299 100299 MISC. REVENUE 900099 47451 17814 29637 MEDICAL RECORDS 541900 17878 17878 11483 11483 177111 34856811 34495096 0 39510 5015 5015 4250 4250 1692670 1080160 612510 149927 149927 11431782 10077145 1250504 104133 271643 244234 23964 3445 2240776 1925408 296880 18488 877048 748736 121296 7016 4576613 4198447 378166 49317 49317 8005 8005 5069548 4500959 568049 540 29407 29407 4057638 3619730 423965 13943 589845 589845 707286 707286 102051 64845 35469 1737 80979 55729 25250 1046053 1046053 88282 88282 BAD DEBT EXPENSE 429333 429333 MEDICAID SURCHARGE 409988 409988 MN CARE TAX 302283 302283 DUES, LICENSES, ETC. 91443 330 91113 EMPLOYEE EXPENSES 85251 85251 89231 16320 62923 9988 34485664 29674460 4651914 159290 52729 833943 560769 34859 8000 4694898 6143175 347327 198260 216915 841976 23455128 10979071 11362143 12476057 8680085 7726122 182626 14062 26097492 28276454 2367952 2755022 479887 50000 2847839 2805022 X 23249653 25471432 23249653 25471432 26097492 28276454 X 371147 1850632 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 19427 37763 44410 12780 0 5670 5670 5670 5670 5670 5670 1.00000 0 0 191866 191866 15634080 5736993 9897087 7438975 5242078 2196897 190207 190207 12476057 MAYO POOLED INVESTMENTS 7726122 F 7726122 INTERCOMPANY PAYABLES 50000 50000 Part IV, Line 1b: NURSING HOME RESIDENT TRUST ACCOUNT - RESIDENTS' FUNDS Description of Intended Use of Endowment Funds: Part V, Line 4: TO PROVIDE FINANCIAL SUPPORT FOR PROGRAMS AND SERVICES AT LAKE CITY MEDICAL CENTER. Description of Uncertain Tax Positions Under FIN 48: Part X: AT DECEMBER 31, 2010 AND 2009 THERE WAS NO MATERIAL LIABILITY FOR UNRECOGNIZED TAX BENEFITS FOR THE FILING ORGANIZATION. GOLF TOURNAMENT 13002 8277 4725 1090 472 284 CIRCLE OF LIFE 5K / 10K RUN 6900 5710 1190 904 19902 13987 5915 1090 472 1188 2750 3165 1 1 1 X 1 X 1 1 0 1 1 109606 109606 0.00320 3408675 3099536 309139 0.00910 792358 377021 415337 0.01220 4310639 3476557 834082 0.02450 44707 8050 36657 0.00110 34741 34741 0.00100 9727208 6911424 2815784 0.08270 32389 32389 0.00100 9839045 6919474 2919571 0.08580 14149684 10396031 3753653 0.11030 0 274964 988346 836840 151506 X 1 1 1 1 LAKE CITY MEDICAL CENTER

500 WEST GRANT STREET LAKE CITY MN 55041

X X X X NOT REQUIRED 1 5 LAKE CITY NURSING HOME

500 WEST GRANT STREET LAKE CITY MN 55041

NURSING HOME LAKE CITY CLINIC

500 WEST GRANT STREET LAKE CITY MN 55041

CLINIC WABASHA CLINIC

1202 5TH GRANT BLVD WEST WABASHA MN 55981

CLINIC PLAINVIEW CLINIC

275 1ST STREET SW PLAINVEIW MN 55964

CLINIC ALMA CLINIC

204 SOUTH MAIN STREET ALMA WI 54610

CLINIC Part I, Line 6a: THE ANNUAL REPORT FOR THE FILING ORGANIZATION IS PART OF A CONSOLIDATED REPORT PREPARED BY MAYO CLINIC. Part I, Line 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO. Part I, Line 7g: THE FOLLOWING NET COMMUNITY BENEFIT COST ATTRIBUTED TO PHYSICIAN CLINICS THAT WERE INCLUDED IN SUBSIDIZED HEALTH SERVICES WERE $20,860. 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 $ 429333. Part III, Line 4: FOOTNOTE FROM MAYO CLINIC CONSOLIDATED AUDITED FINANCIAL STATEMENTS: ACCOUNTS RECEIVABLE FOR MEDICAL SERVICES ARE STATED AT NET REALIZABLE VALUE. THE CLINIC ESTIMATES THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED ON HISTORIC WRITE-OFFS AND THE AGING OF THE ACCOUNTS. ACCOUNTS ARE WRITTEN OFF WHEN COLLECTION EFFORTS HAVE BEEN EXHAUSTED.BAD DEBT EXPENSE AT COST IS DETERMINED USING THE SAME COST TO CHARGE RATIO THAT IS USED TO CALCULATE FINANCIAL ASSISTANCE AND MEDICAID SHORTFALL. DISCOUNTS AND ALLOWANCES ARE ACCOUNTED FOR SEPARATELY FROM BAD DEBT EXPENSE.THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP. Part III, Line 8: THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY). HOWEVER, USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY ACTUALLY RESULTS IN A MEDICARE SHORTFALL OF $76,039 AS REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS.THE MOST COMMON REASONS FOR A DIFFERENCE BETWEEN THE MEDICARE SURPLUS REPORTED ON SCHEDULE H AND THE MEDICARE SHORTFALL REPORTED ON THE CORE FORM, PART III INCLUDE: (1) INCLUSION OF MEDICARE ADVANTAGE REVENUE AND EXPENSES; (2) INCLUSION OF PART B REVENUE AND EXPENSES; (3) INCLUSION OF OTHER FEE SCHEDULE REVENUE; AND (4) SOME TIMING ISSUES.REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. Part III, Line 9b: MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING EVERY REASONABLE ATTEMPT TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED, INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILTY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY. COLLECTION ACTIVITY WOULD ONLY RESUME IF MAYO WOULD TELL THE COLLECTION AGENCY TO PURSUE COLLECTIONS ON THE BALANCE OR PARTIAL BALANCE IF THERE WAS A CHARITY ADJUSTMENT. Part VI, Line 8: NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED ON THE MINNESOTA HOSPITAL ANNUAL REPORT OR TO THE WISCONSIN HOSPITAL ASSOCIATION. Part VI, Line 2: LAKE CITY MEDICAL CENTER (LCMC) EMPLOYEES THROUGHOUT THE ORGANIZATION ASSESS THE NEEDS OF LAKE CITY AND THE SURROUNDING COMMUNITIES THROUGH PERSONAL INTERACTION AND INVOLVEMENT WITH LOCAL SCHOOLS, CIVIC GROUPS AND HEALTH DEPARTMENTS, AS WELL AS THROUGH THE COLLECTION AND ANALYSIS OF FEEDBACK FROM PATIENTS AND COMMUNITY MEMBERS. LCMC EMPLOYEES MEET AND REMAIN IN CLOSE CONTACT WITH ADMINISTRATION AT LINCOLN HIGH SCHOOL IN LAKE CITY. AS A RESULT OF THIS CLOSE INTERACTION, LCMC PROVIDED SEVERAL SERVICES TO STUDENTS IN 2010 INCLUDING A PREVENTATIVE INJURY TRAINING PROGRAM FOR ATHLETES AND SEVERAL STAFF PRESENTATIONS ABOUT THEIR JOBS DURING HIGH SCHOOL CAREER CLASSES AT SCHOOL. LCMC EMPLOYEES ARE ALSO STRONGLY CONNECTED WITH LOCAL CIVIC GROUPS. MANY EMPLOYEES ARE ACTIVE MEMBERS OF VARIOUS LAKE CITY ORGANIZATIONS, WHILE OTHERS GIVE HEALTHCARE PRESENTATIONS TO THESE GROUPS. THIS PARTICIPATION NOT ONLY PROMOTES INVOLVEMENT IN THE COMMUNITY, BUT ALSO GIVES COMMUNITY MEMBERS A CHANCE TO ASK QUESTIONS, SHARE COMMENTS, CONCERNS OR OTHER SUGGESTIONS THEY MAY HAVE REGARDING THE MEDICAL CENTER.LCMC ALSO WORKS WITH THE WABASHA PUBLIC HEALTH ORGANIZATION TO DEVELOP RELATIONSHIPS AMONG HEALTH CARE PROVIDERS AND COMMUNITY LEADERS. THIS PARTNERSHIP PROMOTES THE ACTIVE REFERRAL OF PATIENTS TO LOCAL RESOURCES SUCH AS ACCESS TO HIGH QUALITY NUTRITIOUS FOODS, PHYSICAL ACTIVITY AND TOBACCO USE CESSATION PROGRAMS.LCMC STAFF ARE TRAINED TO IDENTIFY PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE PROGRAMS. LCMC HAS PROGRAMS IN PLACE (CHARITY CARE AND THE TONY HEBERT MEMORIAL FUND) TO HELP THOSE WHO ARE IN NEED OF HEALTHCARE, BUT HAVE NO INSURANCE OR ARE NOT ABLE TO RECEIVE OTHER FINANCIAL ASSISTANCE. LCMC ALSO PROVIDES FREE OR REDUCED COST SERVICES TO COMMUNITY MEMBERS THROUGH PREVENTATIVE HEALTH AND FOOT CLINICS. AS THESE EXAMPLES OF INVOLVEMENT DEMONSTRATE, LCMC IS CLOSELY CONNECTED WITH THE COMMUNITY. IN ADDITION TO THIS, LCMC ACTIVELY SEEKS FEEDBACK FROM PATIENTS AND COMMUNITY MEMBERS THROUGH ITS PATIENT ADVISORY COUNCIL (PAC) AND PRESS GANEY SURVEYS. THE PAC IS A GROUP OF TEN COMMUNITY MEMBERS WHO SERVE AS A LCMC FOCUS GROUP TO PROVIDE FEEDBACK PRIOR TO THE IMPLEMENTATION OF NEW PROGRAMS AND SERVICES, ASSIST IN THE IDENTIFICATION OF OPPORTUNITIES THAT WILL IMPROVE PATIENT AND FAMILY SATISFACTION, PROVIDE TIMELY AND DIRECT INPUT INTO LCMC SYSTEM AND PROCESS CHANGES, OFFER INPUT TO LEADERSHIP IN THE PLANNING AND EVALUATION OF SERVICES, AND SERVE AS A VITAL LINK BETWEEN LCMC AND THE COMMUNITY. THE SURVEY, WHICH IS ADMINISTERED BY PRESS GANEY, IS SENT TO A CROSS SECTION OF PATIENTS TO COMPILE USEFUL FEEDBACK ON WAYS LCMC CAN IMPROVE CUSTOMER SERVICES AND DETERMINE WHETHER OR NOT THERE IS A NEED FOR NEW OR EXPANDED SERVICES. THE DATA FROM THE PRESS GANEY SURVEY IS REVIEWED AND ANALYZED BY MEMBERS OF LCMC'S QUALITY AND ADMINISTRATION DEPARTMENTS, AS WELL AS LCMC'S ER/INPATIENT SATISFACTION TEAM, A TEAM DEDICATED TO IMPROVING PATIENT SATISFACTION IN THE ER AND HOSPITAL.THROUGH THESE VARIOUS AVENUES, LCMC STAFF MEMBERS ACROSS MANY DEPARTMENTS STAY CONNECTED WITH THE COMMUNITY TO ASSESS THE HEALTH CARE NEEDS OF LAKE CITY AND SURROUNDING AREAS. Part VI, Line 3: ELIGIBILITY: THE CHARITY CARE INFORMATION BROCHURE IS PROMINENTLY DISPLAYED IN REGISTRATION AND PATIENT-ACCOUNT WAITING AREAS. THE BROCHURE EXPLAINS THE CHARITY CARE PROGRAM AND FACTORS AFFECTING ELIGIBILITY. IDENTIFICATION: THERE ARE A NUMBER OF WAYS A PATIENT CAN BE IDENTIFIED AND EVALUATED FOR CHARITY CARE ASSISTANCE.1. PATIENTS MAY REQUEST FINANCIAL ASSISTANCE.2. STAFF MAY REFER PATIENTS TO A FINANCIAL COUNSELOR.3. COLLECTION AGENCIES MAY REFER PATIENTS.4. BUSINESS/PATIENT FINANCIAL SERVICES MAY REFER PATIENTS TO A FINANCIAL COUNSELOR.5. PHYSICIANS MAY REFER PATIENTS.6. LOCAL GOVERNMENT AGENCIES MAY REFER PATIENTS.INDIGENT CARE: EMERGENCY ROOM PATIENTS WHO CANNOT PAY THEIR BILLS MAY BE CLASSIFIED AS "CHARITY" IF THEY DO NOT HAVE A JOB, MAILING ADDRESS, RESIDENCE, OR INSURANCE. CONSIDERATION MUST ALSO BE GIVEN TO CLASSIFYING EMERGENCY ROOM ONLY PATIENTS AS CHARITY IF THEY DO NOT PROVIDE ADEQUATE INFORMATION AS TO THEIR FINANCIAL STATUS. IN MANY INSTANCES, THESE PATIENTS ARE HOMELESS AND HAVE FEW RESOURCES TO COVER THE COST OF THEIR CARE.GOVERNMENTAL ASSISTANCE: IN DETERMINING WHETHER AN INDIVIDUAL QUALIFIES FOR CHARITY CARE, OTHER COUNTY OR GOVERNMENTAL ASSISTANCE PROGRAMS SHOULD ALSO BE CONSIDERED. MANY APPLICANTS ARE NOT AWARE THAT THEY MAY BE ELIGIBLE FOR PUBLIC HEALTH INSURANCE PROGRAMS.1. STAFF WILL HELP THE INDIVIDUAL DETERMINE ELIGIBILITY FOR GOVERNMENTAL OR OTHER ASSISTANCE, AS APPROPRIATE.2. PERSONS WHO ARE ELIGIBLE FOR PROGRAMS (SUCH AS STATE-SPONSORED MEDICAID) BUT WHO WERE NOT COVERED AT THE TIME THAT MEDICAL SERVICES WERE GRANTED MAY BE GRANTED CHARITY CARE, PROVIDED THAT THE PATIENT NOW APPLIES FOR GOVERNMENT ASSISTANCE. THIS MAY BE PRUDENT, ESPECIALLY IF THE PATIENT REQUIRES ONGOING SERVICES. Part VI, Line 4: LAKE CITY MEDICAL CENTER (LCMC) HAS LOCATIONS IN LAKE CITY, PLAINVIEW AND WABASHA, MINNESOTA, AS WELL AS IN ALMA, WISCONSIN. THE MAJORITY OF LCMC'S SERVICE AREAS INCLUDE GOODHUE AND WABASHA COUNTIES IN SOUTHEASTERN MINNESOTA AND BUFFALO COUNTY IN SOUTHWESTERN WISCONSIN. THE MAIN CAMPUS, LOCATED IN LAKE CITY, HOUSES AN 18-BED CRITICAL ACCESS HOSPITAL, A 90-BED NURSING HOME AND A HOSPITAL-BASED CLINIC WITH EIGHT PROVIDERS THAT SERVES LAKE CITY AND SURROUNDING COMMUNITIES. ACCORDING TO THE UNITED STATES CENSUS BUREAU, THE 2010 POPULATION FOR WABASHA COUNTY (WHICH COMPRISES MOST OF LCMC'S SERVICE AREA) IS 21,676. A 2009 ESTIMATE REPORTS THAT 23.3% OF THE POPULATION IS UNDER 18 YEARS OLD, AND 16.8% IS 65 YEARS OLD OR OLDER. THE MEDIAN HOUSEHOLD INCOME IS $49,517, AND AN ESTIMATED 8.3% OF INDIVIDUALS ARE LIVING BELOW POVERTY LEVEL. Part VI, Line 6: THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION - EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY - IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE. THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, WHETHER IN HEALTH CARE POLICY, BUSINESS, GOVERNMENT OR ANOTHER FIELD. IN ADDITION TO THIS COMMUNITY REPRESENTATION AT THE PARENT ENTITY, THE FILING ORGANIZATION ALSO INVOLVES LOCAL COMMUNITY MEMBERS ON ITS GOVERNING BODY. THE FILING ORGANIZATION'S STAFF PRIVILEGES ARE GENERALLY EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK, WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY. Part VI, Line 7: THE FILING ORGANIZATION IS A PART OF MAYO HEALTH SYSTEM (WHICH IS PART OF A LARGER GROUP OF ENTITIES AFFILIATED WITH MAYO CLINIC). THE MAYO HEALTH SYSTEM IS DESCRIBED IN RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O). THAT STATEMENT ALSO DESCRIBES THE ROLES OF THE VARIOUS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.SPECIFICALLY, THE FILING ORGANIZATION PROVIDES HOSPITAL AND CLINIC SERVICES FOR LAKE CITY, MINNESOTA AND THE SURROUNDING AREA.FOR MORE SPECIFIC DESCRIPTION, SEE THE RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O). 1 X 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. FEDERAL AWARDS THAT ARE SUBCONTRACTED TO OTHER ORGANIZATIONS ARE MONITORED BY THE FILING ORGANIZATION AS PRESCRIBED IN OMB CIRCULAR A-133. NO ADDITIONAL MONITORING IS PERFORMED. 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. THE FILING ORGANIZATION MAINTAINS ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED. X X 1 1 X X X 0 1 0 0 0 0 0 0 0 NYMAN MD MARK A 0 215442 0 0 0 1263 0 16924 0 34345 0 267974 0 0 SOLBERG MD JEREMY J 187166 0 0 0 31120 0 9918 0 5925 0 234129 0 0 0 SPANO MD DENNIS C 276083 0 0 0 176505 0 56289 0 30992 0 539869 0 42922 0 WILKINSON MD JOHN M 0 214662 0 0 0 2607 0 30570 0 18420 0 266259 0 0 WITT MD THOMAS J 331834 0 0 0 197895 0 68203 0 10899 0 608831 0 52480 0 BIREN DAVID H 0 150137 0 0 0 2759 0 493 0 17298 0 170687 0 0 BROWN MARK C 72398 67412 0 0 820 5858 2926 2926 8362 12131 84506 88327 0 0 KRAMER CHERYL A 211259 0 0 0 6622 0 814 0 6640 0 225335 0 0 0 PILOT DAVID 0 184779 0 0 0 0 0 13229 0 18913 0 216921 0 0 MUNNS DO EARLE C 183028 0 0 0 7091 0 8143 0 12642 0 210904 0 0 0 PFLAUM MD DOUGLAS D 78871 0 0 0 185896 0 27165 0 18576 0 310508 0 0 0 SCHWEND DO PHILLIP P 207396 0 0 0 150773 0 25482 0 24792 0 408443 0 33864 0 TUOMINEN MD KORY 79127 0 0 0 136196 0 10456 0 4428 0 230207 0 0 0 ZIEBARTH MD THOMAS M 140986 0 0 0 44732 0 15015 0 9615 0 210348 0 0 0 ANGSTMAN MD GREGORY L 0 202999 0 0 0 75406 0 15341 0 13308 0 307054 0 23519 Part I, Line 1a SOME OFFICERS, DIRECTORS, KEY EMPLOYEES OR HIGHEST PAID EMPLOYEES LISTED ON THIS RETURN 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. MAYO CLINIC AND AFFILIATES HAVE A NON-QUALIFIED DEFERRED COMPENSATION PLAN (SEE SCHEDULE J, PART I, LINE 4b) THAT INCLUDES A PARTIAL TAX ADJUSTMENT FOR PAYMENTS FROM THE PLAN OTHER THAN THE CURRENT COMPENSATION COMPONENT. PERSONAL INCOME TAX PREPARATION SERVICES (I.E. PERSONAL SERVICES) ARE AVAILABLE TO SOME OF THE OFFICERS, DIRECTORS, KEY EMPLOYEES OR HIGHEST PAID EMPLOYEES LISTED ON THIS RETURN. THIS BENEFIT IS TREATED AS TAXABLE COMPENSATION TO THE INDIVIDUALS WHO MAY HAVE RECEIVED THIS SERVICE. THE SUBMISSION OF A RECEIPT IS NOT REQUIRED AS THE BENEFIT IS PAID DIRECTLY TO THE VENDOR. 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). IN 2010, THE COMPONENT OF THIS SRP BENEFIT THAT WAS DEFERRED COMPENSATION SUBJECT TO SECTIONS 409A AND 457(f) OF THE INTERNAL REVENUE CODE WAS TERMINATED. THIS PLAN TERMINATION TRIGGERED THE IMMEDIATE TAXATION OF THE ENTIRE SRP BENEFIT THAT HAS BEEN ACCRUED AND DEFERRED OVER EACH PARTICIPANT'S CAREER AT MAYO. STARTING JANUARY 1, 2011, ALL FUTURE SRP BENEFIT WILL BE PAID AS AN ANNUAL TAXABLE CASH PAYMENT THAT HAS NO SUBSTANTIAL RISK OF FORFEITURE. THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN EITHER AS A RESULT OF THE NORMAL OPERATION OF PLAN TERMS OR BECAUSE OF THE TERMINATION OF THE PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). A PORTION OF THE AMOUNT MAY BE INCLUDED IN SCHEDULE J, PART II, COLUMN (F) IF DISCLOSED ON A PRIOR YEAR'S FORM 990. THESE AMOUNTS HAVE BEEN ACCRUED OVER THE SPAN OF THE INDIVIDUAL'S CAREER AT MAYO. GREGORY ANGSTMAN, M.D. - $75,406 DOUGLAS PFLAUM, M.D. - $164,718 PHILLIP SCHWEND, D.O. - $123,467 DENNIS SPANO, M.D. - $68,890 KORY TUOMINEN, M.D. - $28,773 THOMAS WITT, M.D. - $167,417 THOMAS ZIEBARTH, M.D. - $37,823 Supplemental Information Part III Part I, Line 3: IN ADDITION TO THE PROCESS FOLLOWED BY THE FILING ORGANIZTION, 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. Supplemental Information Part III Part II: COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION. CHRISTINE FICK FAMILY MEMBER OF MARY LOU WALTMAN, BOARD MEMBER 45787 EMPLOYMENT 0 New Program Services Form 990, Part III, line 2 LAKE CITY CLINIC, AN AFFILIATED OUT-PATIENT CLINIC, MERGED INTO THE FILING ORGANIZATION ON 1/1/2010. Form 990, Part VI, Section A, line 2 DUE TO OVERLAP OF BOARD MEMBERSHIP AND EMPLOYMENT BY RELATED TAXABLE ENTITY, THE FOLLOWING INDIVIDUAL: DAVID PILOT HAS A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL: GREGORY L. ANGSTMAN M.D. Form 990, Part VI, Section A, line 3 THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO-AFFILIATED ENTITIES ROUTINELY DELEGATED VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO RELATED ENTITIES. Form 990, Part VI, Section A, line 6 THE SOLE CORPORATE MEMBER OF LAKE CITY MEDICAL CENTER IS MAYO CLINIC ROCHESTER. Form 990, Part VI, Section A, line 7a THE SOLE CORPORATE MEMBER ELECTS THE GOVERNING BODY. ONE MEMBER IS ELECTED FROM A SLATE OF NOMINEES PROVIDED BY THE CITY COUNCIL OF LAKE CITY. Form 990, Part VI, Section A, line 7b THE BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS DEBT, AMENDMENT OF THE BYLAWS, MERGERS, AND NEW SERVICES. Form 990, Part VI, Section B, line 11 THE FORM 990 FOR THE FILING ORGANIZATION 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. HIGHLIGHTS ARE PRESENTED TO BOARD MEMBERS, AND THE REVIEW IS DOCUMENTED IN MEETING MINUTES. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990. Form 990, Part VI, Section B, line 12c 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. THE SALARY OF THE CEO, CAO, AND BOARD VICE CHAIR WERE REVIEWED BY THE MAYO HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR MAYO HEALTH SYSTEM PHYSICIANS. THE MAYO HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION OF PHYSICIANS AND ADMINISTRATIVE LEADERSHIP FOR THE MAYO 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 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 AN INDEPENDENT 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 ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. THE FILING ORGANIZATION IS A HOSPITAL AFFILIATED WITH MAYO CLINIC. AS SUCH, MAYO CLINIC'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FILING ORGANIZATION'S FORM 990 AND WOULD BE AVAILABLE UPON REQUEST OF THE FORM 990. Form 990, Part VII, Section A, Average Hours Per Week Devoted to Position with Related Organizations: DAVID BIREN - 40 HOURS DAVID PILOT- 40 HOURS MARK NYMAN, M.D. - 40 HOURS JOHN WILKINSON, M.D. - 40 HOURS MARK BROWN - 40 HOURS Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: MERGER OF LAKE CITY CLINIC 1,850,632. LAKE CITY CLINIC WAS AN AFFILIATED OUT-PATIENT CLINIC THAT MERGED INTO THE FILING ORGANIZATION ON 1/1/2010. Total to Form 990, Part XI, Line 5: 1,850,632. Form 990, Part XII, Line 2c: THERE WAS NO CHANGE IN THE PROCESS DURING THE YEAR. ALBERT LEA MEDICAL CENTER -- MAYO HEALTH SYSTEM 404 WEST FOUNTAIN STREET ALBERT LEA MN 56007 411404075 HOSPITAL AND CLINIC MN 501(c)(3) 3 MAYO CLINIC 1 AUSTIN MEDICAL CENTER -- MAYO HEALTH SYSTEM 1000 FIRST DRIVE NW AUSTIN MN 55912 410695606 HOSPITAL AND CLINIC MN 501(c)(3) 3 MAYO CLINIC 1 AUSTIN MEDICAL CENTER FOUNDATION 1000 FIRST DRIVE NW AUSTIN MN 55912 300107471 FUNDRAISING FOUNDATION MN 501(c)(3) 7 AUSTIN MEDICAL CENTER -- MAYO HEALTH SYSTEM 1 BARRON MEMORIAL MEDICAL CENTER -- MAYO HEALTH SYSTEM 1222 EAST WOODLAND AVE BARRON WI 54812 390920634 HOSPITAL AND CLINIC WI 501(c)(3) 3 LUTHER HOSPITAL 1 BLOOMER LAKEVIEW INC 2110 DUNCAN ROAD BLOOMER WI 54724 391450617 LOW INCOME HOUSING WI 501(c)(3) 7 BLOOMER MEMORIAL MEDICAL CENTER INC -- MAYO HEALTH SYSTEM 1 BLOOMER MEMORIAL MEDICAL CENTER INC -- MAYO HEALTH SYSTEM 1501 THOMPSON STREET BLOOMER WI 54724 390980343 HOSPITAL AND CLINIC WI 501(c)(3) 3 LUTHER HOSPITAL 1 CANNON FALLS MEDICAL CENTER -- MAYO HEALTH SYSTEM 1116 WEST MILL STREET CANNON FALLS MN 55009 204156428 HOSPITAL AND CLINIC MN 501(c)(3) 3 MAYO CLINIC 1 CHARTERHOUSE INC 200 FIRST STREET SW ROCHESTER MN 55905 411405254 RETIREMENT LIVING CENTER MN 501(c)(3) 9 MAYO CLINIC 1 FAIRMONT MEDICAL CENTER -- MAYO HEALTH SYSTEM 800 MEDICAL CENTER DRIVE PO BOX 800 FAIRMONT MN 56031 410760836 HOSPITAL AND CLINIC MN 501(c)(3) 3 MAYO CLINIC 1 FOUNTAIN LAKE TREATMENT CENTER 404 WEST FOUNTAIN STREET ALBERT LEA MN 56007 411404076 CHEMICAL DEPENDENCY TREATMENT MN 501(c)(3) 3 ALBERT LEA MEDICAL CENTER -- MAYO HEALTH SYSTEM 1 FRANCISCAN SKEMP FOUNDATION OF ARCADIA INC 464 SOUTH JOHNSON STREET ARCADIA WI 54612 391322480 FUNDRAISING FOUNDATION WI 501(c)(3) 9 FRANCISCAN SKEMP HEALTHCARE INC 1 FRANCISCAN SKEMP FOUNDATION OF SPARTA INC 310 WEST MAIN STREET SPARTA WI 54656 391423234 FUNDRAISING FOUNDATION WI 501(c)(3) 9 FRANCISCAN SKEMP HEALTHCARE INC 1 FRANCISCAN SKEMP FOUNDATION INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391186647 FUNDRAISING FOUNDATION WI 501(c)(3) 11-II FRANCISCAN SKEMP HEALTHCARE INC 1 FRANCISCAN SKEMP HEALTHCARE INC 700 WEST AVE SOUTH LA CROSSE WI 54601 391411999 HEALTHCARE SYSTEM PARENT WI 501(c)(3) 11-I MAYO CLINIC 1 FRANCISCAN SKEMP MEDICAL CENTER INC 700 WEST AVE SOUTH LA CROSSE WI 54601 390806374 HOSPITAL AND CLINIC WI 501(c)(3) 3 FRANCISCAN SKEMP HEALTHCARE INC 1 GCAS 200 FIRST STREET SW ROCHESTER MN 55905 411917517 AMBULANCE SERVICE MN 501(c)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 GOLD CROSS AMBULANCE SERVICE 200 FIRST STREET SW ROCHESTER MN 55905 411917516 AMBULANCE SERVICE MN 501(c)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 GOLD CROSS AMBULANCE INC 200 FIRST STREET SW ROCHESTER MN 55905 391942957 AMBULANCE SERVICE MN 501(c)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM 1025 MARSH STREET MANKATO MN 56002 411236756 HOSPITAL AND CLINIC MN 501(c)(3) 3 MAYO CLINIC 1 IMMANUEL-ST JOSEPH'S FOUNDATION -- MAYO HEALTH SYSTEM 1025 MARSH STREET MANKATO MN 56002 411663357 FUNDRAISING FOUNDATION MN 501(c)(3) 7 IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM 1 LAKE CITY MEDICAL CENTER - MAYO HEALTH SYSTEM 500 WEST GRANT STREET LAKE CITY MN 55041 411906820 HOSPITAL MN 501(c)(3) 3 MAYO CLINIC 1 LUTHER HOSPITAL 1221 WHIPPLE STREET EAU CLAIRE WI 54703 390813418 HOSPITAL WI 501(c)(3) 3 MAYO CLINIC 1 LUTHER LAKESIDE APARTMENTS INC 714 SOUTH BARSTOW STREET EAU CLAIRE WI 54701 391409024 LOW INCOME HOUSING WI 501(c)(3) 9 LUTHER HOSPITAL 1 LUTHER MIDELFORT FOUNDATION INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE WI 54702 391633407 GRANTMAKING FOUNDATION WI 501(c)(3) PF MIDELFORT CLINIC LTD -- MAYO HEALTH SYSTEM 0 MAYO CLINIC ARIZONA 13400 EAST SHEA BLVD 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 JACKSONVILLE 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 593337028 PATIENT CARE - CLINIC FL 501(c)(3) 7 MAYO CLINIC 1 MAYO CLINIC -- METHODIST HOSPITAL 200 FIRST STREET SW ROCHESTER MN 55905 410739106 HOSPITAL MN 501(c)(3) 3 MAYO CLINIC 1 MAYO CLINIC 200 FIRST STREET SW ROCHESTER MN 55905 416011702 PATIENT CARE - CLINIC MN 501(c)(3) 9 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 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 MIDELFORT CLINIC LTD -- MAYO HEALTH SYSTEM PO BOX 1510 EAU CLAIRE WI 54702 391735831 PATIENT CARE - CLINIC WI 501(c)(3) 3 MAYO CLINIC 0 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 NORTHWEST WISCONSIN HOMECARE INC PO BOX 2060 EAU CLAIRE WI 54702 391491516 HOME HEALTH AND HOSPICE CARE WI 501(c)(3) 9 LUTHER HOSPITAL 1 NORTHWEST WISCONSIN SUPPORTIVE HOMECARE INC PO BOX 2060 EAU CLAIRE WI 54702 391686673 HOME HEALTH CARE WI 501(c)(3) 9 LUTHER HOSPITAL 1 OSSEO MEDICAL CENTER INC -- MAYO HEALTH SYSTEM PO BOX 70 / 13025 EIGHTH STREET OSSEO WI 54758 391029430 HOSPITAL AND CLINIC WI 501(c)(3) 3 LUTHER HOSPITAL 1 POVERELLO FOUNDATION 200 FIRST STREET SW ROCHESTER MN 55905 411494881 FUNDRAISING FOUNDATION MN 501(c)(3) 11-I MAYO CLINIC -- SAINT MARYS HOSPITAL 1 RED CEDAR MEDICAL CENTER INC -- MAYO HEALTH SYSTEM 2321 STOUT ROAD MENOMONIE WI 54751 510190875 HOSPITAL AND CLINIC WI 501(c)(3) 3 MAYO CLINIC 1 SPRINGFIELD MEDICAL CENTER -- MAYO HEALTH SYSTEM 625 NORTH JACKSON AVENUE SPRINGFIELD MN 56087 411893827 HOSPITAL AND CLINIC MN 501(c)(3) 3 IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM 1 ST JAMES MEDICAL CENTER -- MAYO HEALTH SYSTEM 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 410797368 HOSPITAL AND CLINIC MN 501(c)(3) 3 IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM 1 ST JAMES MEDICAL CENTER FOUNDATION INC 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES MN 56081 411444129 FUNDRAISING FOUNDATION MN 501(c)(3) 7 ST JAMES MEDICAL CENTER -- MAYO HEALTH SYSTEM 1 WASECA MEDICAL CENTER -- MAYO HEALTH SYSTEM 501 NORTH STATE STREET WASECA MN 56093 363606405 HOSPITAL AND CLINIC MN 501(c)(3) 3 IMMANUEL-ST JOSEPH'S -- MAYO HEALTH SYSTEM 1 MAYO KLINIK STIFTUNG 60486 FRANKFURT AM MAIN FRANKFURT GM FUNDRAISING FOUNDATION GM MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 1 FRANKLIN HEATING STATION 119 THIRD ST SW ROCHESTER MN 55902 410264830 UTILITY MN N/A CANNON VALLEY CLINIC -- MAYO HEALTH SYSTEM 635 FIRST STREET SE FARIBAULT MN 55021 411817179 PATIENT CARE - CLINIC MN N/A C DECORAH CLINIC -- MAYO HEALTH SYSTEM 907 MONTGOMERY STREET DECORAH IA 52101 411711329 PATIENT CARE - CLINIC IA N/A C FIOS THERAPEUTICS INC 200 FIRST STREET SW ROCHESTER MN 55905 711029189 RESEARCH MN N/A C HEALTH TRADITION HEALTH PLAN 1808 EAST MAIN STREET ONALASKA WI 54650 391545987 MEDICAL SERVICES COMPANY WI N/A C LOBSS NETWORK SUPPORT 2002 INC 200 FIRST STREET SW ROCHESTER MN 55905 481276150 ADMINISTRATIVE SERVICES MN N/A C MAYO COLLABORATIVE SERVICES INC 200 FIRST STREET SW ROCHESTER MN 55905 411346366 REFERENCE LAB SERVICES MN N/A C MAYO HOLDING COMPANY 200 FIRST STREET SW ROCHESTER MN 55905 411578020 HOLDING COMPANY MN N/A C MAYO INSURANCE COMPANY LTD 200 FIRST STREET SW ROCHESTER MN 55905 SELF INSURANCE POOL CJ N/A C MAYO MEDICAL LABORATORIES NEW ENGLAND INC 265 BALLARDVALE STREET WILMINGTON MA 01887 043323713 LABORATORY SERVICES MA N/A C MAYO REGIONAL PRACTICES OF ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE AZ 85259 061190278 THIRD PARTY ADMINISTRATION SERVICES AZ N/A C MHS SERVICES INC 200 FIRST STREET SW ROCHESTER MN 55905 411282517 EQUIPMENT & REAL ESTATE LEASING MN N/A C MMSI INC 21 FIRST STREET SW ROCHESTER MN 55905 411547003 THIRD PARTY ADMINISTRATION SERVICES MN N/A C NORTHWEST HEALTH VENTURES INC 1221 WHIPPLE STREET EAU CLAIRE WI 54703 391528920 PHARMACY SERVICES WI N/A C OWATONNA CLINIC -- MAYO HEALTH SYSTEM 134 SOUTHVIEW OWATONNA MN 55060 411862132 PATIENT CARE - CLINIC MN N/A C PHYSICIAN AND HOSPITAL PRACTICES INC 4500 SAN PABLO ROAD JACKSONVILLE FL 32224 930926631 HEALTH SERVICES FL N/A C ROCHESTER AIRPORT COMPANY ROUTE 2 ROCHESTER MN 55902 410506870 AIRPORT MANAGEMENT MN N/A C SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION 13400 E SHEA BLVD SCOTTSDALE AZ 85259 860870505 COMMERCIAL PROPERTY OWNERS ASSOCIATION AZ N/A C THE STABILE BUILDING OWNERS' ASSOCIATION 200 FIRST STREET SW ROCHESTER MN 55905 208994499 COMMERCIAL PROPERTY OWNERS ASSOCIATION MN N/A C 0 0 1 0 0 0 1 0 1 0 1 1 0 1 0 0 1 0 MMSI INC Q 2224290 GAAP MAYO COLLABORATIVE SERVICES INC L 383772 GAAP MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH G 2392 GAAP MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH N 12557889 GAAP MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH L 282846 GAAP MAYO CLINIC L 1871664 GAAP MAYO CLINIC C 252420 GAAP MAYO CLINIC K 78271 GAAP MAYO CLINIC I 28299 GAAP MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH C 54033 GAAP