PARK NICOLLET HEALTH SERVICES: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- PARK NICOLLET HEALTH SERVICES (EIN 36-3465840)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-10
- IRS object ID
- 201133149349302538
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
- Affiliated Group Attachment
- Affiliated Group Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-10T14:18:09-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 South Sixth Street | AddressLine1 |
| City | Minneapolis | City |
| State | MN | State |
| ZIP Code | 55402 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363465840 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Health Services | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PARK | NameControl |
| Phone | 9529933108 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Sheila McMillan | Name |
| Title | CFO | Title |
| Phone | 9529936790 | Phone |
| Date Signed | 2011-10-31 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kristina Rasmussen | Name |
| Phone | 6123974000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Sheila McMillan | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 24769713 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | parknicollet.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1986 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | Cares for and supports the health, healing, and learning of those served. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 18 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 8894 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 62471 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 120000 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 149100 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 19684905 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 23530001 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 745254 | InvestmentIncomePriorYear |
| Investment Income Current Year | 879836 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 187167 | OtherRevenuePriorYear |
| Other Revenue Current Year | 180101 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 20737326 | TotalRevenuePriorYear |
| Total Revenue Current Year | 24739038 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 17230653 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 19078634 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 7024564 | OtherExpensePriorYear |
| Other Expenses Current Year | 6175340 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 24255217 | TotalExpensesPriorYear |
| Total Expenses Current Year | 25253974 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3517891 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -514936 | RevenuesLessExpensesCY |
| Total Assets BOY | 100021705 | TotalAssetsBOY |
| Total Assets EOY | 130926788 | TotalAssetsEOY |
| Total Liabilities BOY | 119150313 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 150282169 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -19128608 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -19355381 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | Park Nicollet Health Services has a mission to care for and support the health, healing, and learning of those served. The focus is on excellent care, delivered in a caring manner, with emphasis on disease prevention and wellness education. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 22614422 | Expense |
| Revenue | 23530251 | Revenue |
| Description | Park Nicollet Health Services ("PNHS") is the parent organization to an integrated care system that includes Park Nicollet Methodist Hospital, Park Nicollet Clinic, Park Nicollet Health Care Products, Park Nicollet Foundation and Park Nicollet Institute. PNHS and affiliates have more than 8,100 team members, including more than 1,000 physicians on staff. PNHS is a nonprofit, integrated care delivery system. It is staffed by nationally recognized hospital and clinic doctors, clinical professionals, nurses and other team members who help patients stay healthy and take care of them when they are sick.In 2010, PNHS and affiliates, a national health care improvement leader, continued to make dramatic patient care advances, win prominent awards, expand access to services and integrate efficiency into PNHS' operations. PNHS and affiliates also have enhanced community health, increased team member satisfaction and promoted research and education. In 2010, PNHS built on its already extraordinary reputation for excellent care, outstanding quality improvement and leadership in patient safety, teaching and research.PNHS uses five core values to accomplish its mission: care, service, stewardship, joy and learning. Highlights of 2010 that support PNHS' values include the following:Patient councils have been established to foster collaboration between patients, families and care teams. These councils focus on topics such as patient safety, facility design, clinician-patient communication, quality improvement, patient/family education, ethics and research. Park Nicollet Methodist Hospital received several 2010 HealthGrades recognitions including: Pulmonary Care Excellence Award, Cardiac Care Excellence Award, Cardiac Surgery Excellence Award and the Critical Care Excellence Award. These honors placed Park Nicollet Methodist Hospital in the top 5 percent of hospitals nationwide. Park Nicollet Methodist Hospital is certified as an Advanced Primary Stroke Center and received its eighth consecutive HealthGrades Stroke Care Excellence Award.Park Nicollet Methodist Hospital participates in the National Database for Nursing Quality Improvement (NDNQI) which is a composite of 17 measures related to patient safety and hospital-acquired infections. As part of these measures, the nursing staff improvement teams have reduced patient falls more than one third in 2010. The hospital went from 2.99 falls per 1,000 patient days in 2009 to 1.95 per 1,000 patient days in 2010. The average number of falls dropped from 18 per month in 2008-09 to 13 per month in 2010. There was a significant decline in reportable pressure ulcers, ventilator-associated pneumonias and central line infections.Park Nicollet Methodist Hospital nursing staff and volunteers have joined forces to prevent delirium and functional decline in patients age 70 and older. In 2010, we became the first Minnesota site for a program called HELP (Hospital Elder Life Program). Trained volunteers visit patients each day to provide intentional interventions around cognitive and physical functioning as a method to prevent delirium. This program has maintained a Confusion Assessment Method (CAM) positive conversion to only 2 percent, which is far below the 15 percent for patients who aren't visited by the program.Advanced Care Planning for end of life care is a significant system-wide initiative in 2010. The hospital and the Park Nicollet Foundation have partnered to develop focus areas within the community and at Park Nicollet Clinics to discuss advanced care planning and ensure advanced directives are available for care teams in the hospital.Park Nicollet Clinic helped open a new health resource center in the Brooklyn Center High School in 2010. It provides free and low-cost medical, mental health and dental care to children and youth in the community. This community resource is the fourth such school-affiliated clinic established, staffed and funded in partnership with Park Nicollet Foundation and Park Nicollet Methodist Hospital.In 2010, by partnering with the local non-profit Children's Dental Services, four community clinics for children began offering free and low-cost dental care to any child or adolescent in the communities served. In 2010, Park Nicollet Clinic received four of the eleven certifications by the state of Minnesota to be "health care homes". Health care homes, also known as "medical homes", offer a team approach to care. A care coordinator works with patients and their families to coordinate with a clinical team that may include physicians, nurses, clinicians, specialists and pharmacists. The program also coordinates with community resources such as schools and social service agencies to ensure continuity of care that will follow patients after they leave the clinic and into the communities where they live.Park Nicollet Clinic and its affiliates are dedicated to caring for, and supporting the health, healing and learning of patients, team members and the community. Park Nicollet Clinic and its affiliates accomplish this in many ways and are especially grateful to its volunteers. In 2010, PNHS and affiliates gave more than $3.1 million through 106 grants. PNHS and affiliates continued its joint sponsorship of the Successful Aging Initiative, which focuses on improving coordination of community and health care services for senior citizens. Park Nicollet Clinic and Park Nicollet Foundation partner with 21 school districts to assure that all students are up to date with their immunizations. PNHS and affiliates strive to assure help is there when needed during serious or life-threatening illnesses. We offer programs that are not fully funded or reimbursed under traditional health insurance, including Club CREATE, Stroke INSPIRE and Melrose Institute.PNHS provided more than 9,900 prescriptions for outpatient medications to low income individuals and families, assuring medical treatment for acute and chronic conditions such as asthma and diabetes.The Park Nicollet Frauenshuh Cancer Center Rehabilitation Program received a HealthPartners "Innovation Award" in 2010 for its excellent work in improving the lives of cancer survivors. The program helps cancer patients reduce pain, improve their function and strength, and find support from rehabilitation team members and fellow patients.Park Nicollet Methodist Hospital implemented Schwartz Center Rounds in 2010 to help clinicians, nurses and all care team members cope with the social and emotional challenges of working in modern health care. Participants can expect a facilitated, interactive forum where both presenters and attendees can share thoughts and feelings in a safe environment. Park Nicollet Methodist Hospital expanded and remodeled the Emergency Center. There are now 30 private examination rooms and a new 12-bed observation unit that will help decrease the length of stay for appropriate observation patients. In 2010, Park Nicollet Institute participated in 225 research studies. An additional 292 studies were active through Metro-MN Community Clinical Oncology Program. Key studies related to Park Nicollet quality measures include medical home evaluation, bariatric surgery outcomes, venous thrombo-embulism and diabetes steroid protocols.PNHS authors published 43 peer-reviewed articles, books and book chapters, including articles published in two high-impact journals: New England Journal of Medicine and the Lancet. PNHS became one of seven health groups that created a partnership to participate in Accelerating Changes and Transformation in Organizations and Networks (ACTION II) research network. This network was developed by the Agency for Healthcare Research and Quality (AHRQ) to promote and accelerate the development, implementation, dissemination and sustainability of evidence-based innovation in health care delivery and organization to measurably improve health care in the U.S. The Institute is coordinating PNHS's participation in this network.Park Nicollet Institute sponsored 85 professional education activities, reaching more than 9,100 participants. Our Office of Continuing Medical Education (CME) awarded 28,508 category 1 CME credits. Park Nicollet Institute's patient education department partnered with clinical teams to develop and implement patient education strategies and tools in 22 focus areas such as anticoagulation, asthma, delirium, falls prevention, pediatric weight management, depression and diabetes. We offered 225 health education classes, reaching 2,931 people. More than 2,700 people visited the Park Nicollet Health Library, and the library conducted 766 searches on behalf of patients.The patient education department is working with Primary Care and Park Nicollet Clinic-Minneapolis on Minnesota's Statewide Health Improvement Program (SHIP) to improve the health of Minnesotans. | Description |
| Total Program Service Expense | 22614422 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 1 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 1 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Number Forms Transmitted With1096 | 46 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 8894 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 1 | ForeignFinancialAccount |
| Name Of Foreign Country | CJ | NameOfForeignCountry |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 18 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 1 | LocalChapters |
| Policies Reference Chapters | 1 | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sheila McMillan | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9529936790 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Blvd | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (32 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| David Abelson MD | ||||||||
| President and CEO | 55.00 | X | X | 789529 | 0 | 220188 | ||
| David J Cooke | ||||||||
| Sr VP & CFO (1/1-1/4) | 55.00 | X | X | 699941 | 0 | 93397 | ||
| Judith Corson | ||||||||
| Secretary | 3.00 | X | X | 0 | 0 | 0 | ||
| Steven Connelly MD | ||||||||
| Former Exec VP & CMO | 55.00 | X | X | 514388 | 0 | 48590 | ||
| Bruce W Engelsma | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Steven Frank | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| David Homans MD | ||||||||
| Chief of Specialty Serv | 55.00 | X | 476226 | 0 | 38872 | |||
| Jeffrey B Husband MD | ||||||||
| Director | 55.00 | X | 0 | 569522 | 49426 | |||
| Ann Rockler Jackson | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Michael Johnson | ||||||||
| Sr VP Community Advance | 55.00 | X | 355684 | 0 | 59876 | |||
| Kathryn D Kallas | ||||||||
| VP Inpatient Care & CNO | 55.00 | X | X | 344809 | 0 | 103609 | ||
| Michael Kaupa | ||||||||
| Executive VP and COO | 55.00 | X | X | 602417 | 0 | 137571 | ||
| Jodee Kozlak | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Donald Lewis | ||||||||
| Vice Chair | 3.00 | X | X | 0 | 0 | 0 | ||
| Charles McCoy MD | ||||||||
| Director | 55.00 | X | 0 | 188968 | 32901 | |||
| Ken Melrose | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Sheila McMillan | ||||||||
| Sr VP & CFO (8/30-12/31) | 55.00 | X | X | 147443 | 0 | 49507 | ||
| Ruth Mickelsen | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Lee N Newcomer MD | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| James O Pohlad | ||||||||
| Director | 3.00 | X | 0 | 0 | 0 | |||
| Janette Strathy MD | ||||||||
| Director | 55.00 | X | 0 | 304114 | 36101 | |||
| Richard E Struthers | ||||||||
| Treasurer | 3.00 | X | X | 0 | 0 | 0 | ||
| Kenneth L Thome | ||||||||
| Chair | 3.00 | X | X | 0 | 0 | 0 | ||
| Mark Wilkowske MD | ||||||||
| Chief of Oncology Serv | 55.00 | X | 0 | 609656 | 49964 | |||
| Susan Zwaschka | ||||||||
| VP Corp Compliance | 55.00 | X | 319851 | 0 | 94811 | |||
| Paul Dominski | ||||||||
| VP HR, Mrktg & Retail | 55.00 | 354068 | 0 | 113370 | X | |||
| Carol Greenland | ||||||||
| VP of Marketing | 55.00 | 419916 | 0 | 33497 | X | |||
| Mary Johnson | ||||||||
| COO of TRIA | 55.00 | 399144 | 0 | 113050 | X | |||
| John Misa MD | ||||||||
| Chief of Primary Care | 55.00 | 438894 | 0 | 86150 | X | |||
| Thomas Schmidt MD | ||||||||
| Chief of Patient Safety | 55.00 | 435403 | 0 | 111384 | X | |||
| Samuel Carlson MD | ||||||||
| Former Exec VP & CMO | 0 | 173093 | 79194 | X | ||||
| David K Wessner | ||||||||
| Former President & CEO | 1387855 | 0 | 101086 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 7685568 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1845353 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1652544 | TotalOtherCompensation |
| Number Individuals GT100 K | 29 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Dell Marketing LP | |||||
| Dept CH14102 | Palatine | IL | 600554012 | Computer Services | 2866807 |
| The Crimson Initiative | |||||
| PO Box 79461 | Baltimore | MD | 212790461 | Computer Services | 346079 |
| Meagher & Geer | |||||
| 4200 Multifooods Tower 33 S 6th St | Minneapolis | MN | 55402 | Legal Services | 236539 |
| Robins Kaplan Miller & Ciresi | |||||
| 2800 Lasalle Plaza | Minneapolis | MN | 55402 | Legal Services | 208333 |
| Emergency Physicians | |||||
| 5435 Feltl Road | Minnetonka | MN | 55343 | Medical Services | 166666 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 6 | NumberOfContractorsGT100K |
| Related Organizations | 149100 | RelatedOrganizations |
| Total Contributions | 149100 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| Services to Affiliates | 561000 | 22109620 | 22109420 | 200 |
| Income- Premier Purch | 900003 | 1420381 | 1358110 | 62271 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 23530001 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 879877 | TotalRevenueColumn |
| Exclusion | $879,877 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 210485 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 30634 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 179851 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 179851 | TotalRevenueColumn |
| Exclusion | $179,851 | ExclusionAmount |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 41 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -41 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -41 | TotalRevenueColumn |
| Exclusion | -$41 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Miscellaneous | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 250 | TotalRevenueColumn |
| Related Or Exempt Function Income | 250 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 250 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24739038 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23467780 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 62471 | UnrelatedBusinessRevenue |
| Exclusion | $1,059,687 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5658796 | Total |
| Management And General | 5658796 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7585308 | Total |
| Management And General | 7585308 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2729514 | Total |
| Management And General | 2729514 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2196665 | Total |
| Management And General | 2196665 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 908351 | Total |
| Management And General | 908351 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 226676 | Total |
| Management And General | 226676 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 265243 | Total |
| Management And General | 265243 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 120000 | Total |
| Management And General | 120000 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 152904 | Total |
| Management And General | 152904 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5862 | Total |
| Management And General | 5862 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 497275 | Total |
| Management And General | 497275 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4914 | Total |
| Management And General | 4914 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93543 | Total |
| Management And General | 93543 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58 | Total |
| Management And General | 58 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 762990 | Total |
| Management And General | 762990 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Bad Debt | 3661592 | 0 | 3661592 | 0 |
| Miscellaneous expenses | 384283 | 0 | 384283 | 0 |
| Ind exp all- Shared Exp | 0 | 22614422 | -22614422 | 0 |
| 0 | 0 | 0 | 0 | |
| 0 | 0 | 0 | 0 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25253974 | Total |
| Program Services | 22614422 | ProgramServices |
| Management And General | 2639552 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -4404668 | BOY |
| EOY | -2051742 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83685114 | BOY |
| EOY | 115652826 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 776043 | BOY |
| EOY | 927200 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2012199 | BOY |
| EOY | 1898742 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1056952 | BOY |
| EOY | 2481532 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2772989 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 855019 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1918028 | BOY |
| EOY | 1917970 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10067514 | BOY |
| EOY | 8601769 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4910523 | BOY |
| EOY | 1498491 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100021705 | BOY |
| EOY | 130926788 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74049830 | BOY |
| EOY | 80904058 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45100483 | BOY |
| EOY | 69378111 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119150313 | BOY |
| EOY | 150282169 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -19128608 | BOY |
| EOY | -19355381 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -19128608 | BOY |
| EOY | -19355381 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100021705 | BOY |
| EOY | 130926788 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -514936 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 288163 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type3 Func Int | X | SupportingOrg509a3Type3FuncInt |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (3 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| Park Nicollet Methodist Hospital | |||||
| 410132080 | 3 | 1 | 1 | 1 | $9,757,320 |
| Park Nicollet Clinic | |||||
| 410834920 | 3 | 1 | 1 | 1 | $12,485,900 |
| Park Nicollet Institute | |||||
| 410961862 | 4 | 1 | 1 | 1 | $371,202 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 3 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 22614422 | SumOfAmounts |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Belongs To Affiliated Group | X | OrgBelongsToAffiliatedGroup |
Total Direct Lobbying TotalDirectLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 200569 | FilingOrganizationsTotals |
| Affiliated Group Totals | 200569 | AffiliatedGroupTotals |
Total Lobbying Expenditures TotalLobbyingExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 200569 | FilingOrganizationsTotals |
| Affiliated Group Totals | 200569 | AffiliatedGroupTotals |
Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 25053405 | FilingOrganizationsTotals |
| Affiliated Group Totals | 1028067413 | AffiliatedGroupTotals |
Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 25253974 | FilingOrganizationsTotals |
| Affiliated Group Totals | 1028267982 | AffiliatedGroupTotals |
Lobbying Nontaxable LobbyingNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 1000000 | FilingOrganizationsTotals |
| Affiliated Group Totals | 1000000 | AffiliatedGroupTotals |
Grassroots Nontaxable GrassrootsNontaxableAmount
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 250000 | FilingOrganizationsTotals |
| Affiliated Group Totals | 250000 | AffiliatedGroupTotals |
Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 0 | FilingOrganizationsTotals |
| Affiliated Group Totals | 0 | AffiliatedGroupTotals |
Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Totals | 0 | FilingOrganizationsTotals |
| Affiliated Group Totals | 0 | AffiliatedGroupTotals |
Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 1000000 | CurrentYearMinus3 |
| Current Year Minus2 | 1000000 | CurrentYearMinus2 |
| Current Year Minus1 | 1000000 | CurrentYearMinus1 |
| Current Year | 1000000 | CurrentYear |
| Total | 4000000 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $6,000,000 | LobbyingCeilingAmount |
Total Lobbying Expenditures2 TotalLobbyingExpenditures2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 110038 | CurrentYearMinus3 |
| Current Year Minus2 | 172394 | CurrentYearMinus2 |
| Current Year Minus1 | 108350 | CurrentYearMinus1 |
| Current Year | 200569 | CurrentYear |
| Total | 591351 | Total |
Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus3 | 250000 | CurrentYearMinus3 |
| Current Year Minus2 | 250000 | CurrentYearMinus2 |
| Current Year Minus1 | 250000 | CurrentYearMinus1 |
| Current Year | 250000 | CurrentYear |
| Total | 1000000 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $1,500,000 | GrassrootsCeilingAmount |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 145133 | BeginningOfYearBalance |
| Contributions | 15494 | Contributions |
| Grants Or Scholarships | 120000 | GrantsOrScholarships |
| End Of Year Balance | 40627 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 124503 | BeginningOfYearBalance |
| Contributions | 20630 | Contributions |
| End Of Year Balance | 145133 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 138463 | BeginningOfYearBalance |
| Contributions | 15140 | Contributions |
| Grants Or Scholarships | 29100 | GrantsOrScholarships |
| End Of Year Balance | 124503 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1917864 | OtherCostOrOtherBasis |
| Book Value | 1917864 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 21134 | OtherCostOrOtherBasis |
| Depreciation | 21134 | Depreciation |
| Book Value | 0 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9261 | OtherCostOrOtherBasis |
| Depreciation | 9261 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 824730 | OtherCostOrOtherBasis |
| Depreciation | 824624 | Depreciation |
| Book Value | 106 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1917970 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (4 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Investment in PN Assurance | 191200 | C |
| Investment in TRIA Orthopaedic Center, LLC | 2002000 | C |
| Investment In Premier Purchasing Partners, LP | 770806 | C |
| Investment in Tri-Care | 5637763 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 8601769 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due to and from Related Parties | $50,863,601 |
| Contingent Malpractice Liability | $16,156,860 |
| Post Retirement Obligation | $2,357,650 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 69378111 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | The Term endowment funds for use within Park Nicollet Health Services are for the Caring for Colleagues program. |
| Description of Uncertain Tax Positions Under FIN 48: | Part X: | There were no unrecognized tax benefits of liabilities for the years ended December 31, 2010, 2009, and 2008. |
Schedule F IRS990ScheduleF
Accts Actvs Out US Table AcctsActvsOutUSTable (2 entries)
| RegionRegion | Number Of OfficesNumberOfOffices | Number Of EmployeesNumberOfEmployees | Type Of Activities ConductedTypeOfActivitiesConducted | Specific Services ProvidedSpecificServicesProvided | Total ExpendituresTotalExpenditures |
|---|---|---|---|---|---|
| Central America & the Caribbean | 0 | 0 | Program services | Insurance for related tax exempt organizations | 13988 |
| Central America & the Caribbean | 0 | 0 | Investments | 129099 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Number Of Employees | 0 | SubtotalNumberOfEmployees |
| Cont Number Of Employees | 0 | ContNumberOfEmployees |
| Total Number Of Employees | 0 | TotalNumberOfEmployees |
| Subtotal Amount Spent | 143087 | SubtotalAmountSpent |
| Cont Amount Spent | 0 | ContAmountSpent |
| Total Amount Spent | 143087 | TotalAmountSpent |
| Transfer To Foreign Corp | 0 | TransferToForeignCorp |
| Interest In Foreign Trust | 0 | InterestInForeignTrust |
| Own Foreign Corp | 1 | OwnForeignCorp |
| Passive Foreign Invest Co | 0 | PassiveForeignInvestCo |
| Foreign Partnership | 0 | ForeignPartnership |
| Boycott Countries | 0 | BoycottCountries |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (20 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| David Abelson MD | |||||||||||||
| 593117 | 0 | 171752 | 0 | 24660 | 0 | 132000 | 0 | 88188 | 0 | 1009717 | 0 | 0 | 0 |
| David J Cooke | |||||||||||||
| 35960 | 0 | 179487 | 0 | 484494 | 0 | 0 | 0 | 93397 | 0 | 793338 | 0 | 47333 | 0 |
| Steven Connelly MD | |||||||||||||
| 423861 | 0 | 80252 | 0 | 10275 | 0 | 0 | 0 | 48590 | 0 | 562978 | 0 | 0 | 0 |
| David Homans MD | |||||||||||||
| 466334 | 0 | 4303 | 0 | 5589 | 0 | 0 | 0 | 38872 | 0 | 515098 | 0 | 0 | 0 |
| Jeffrey B Husband MD | |||||||||||||
| 0 | 545937 | 0 | 14097 | 0 | 9488 | 0 | 0 | 0 | 49426 | 0 | 618948 | 0 | 0 |
| Michael Johnson | |||||||||||||
| 231294 | 0 | 81203 | 0 | 43187 | 0 | 0 | 0 | 59876 | 0 | 415560 | 0 | 25300 | 0 |
| Kathryn D Kallas | |||||||||||||
| 246209 | 0 | 86343 | 0 | 12257 | 0 | 38405 | 0 | 65204 | 0 | 448418 | 0 | 0 | 0 |
| Michael Kaupa | |||||||||||||
| 384510 | 0 | 202453 | 0 | 15454 | 0 | 56390 | 0 | 81181 | 0 | 739988 | 0 | 0 | 0 |
| Charles McCoy MD | |||||||||||||
| 0 | 180229 | 0 | 5099 | 0 | 3640 | 0 | 0 | 0 | 32901 | 0 | 221869 | 0 | 0 |
| Sheila McMillan | |||||||||||||
| 124202 | 0 | 0 | 0 | 23241 | 0 | 30400 | 0 | 19107 | 0 | 196950 | 0 | 0 | 0 |
| Janette Strathy MD | |||||||||||||
| 0 | 217314 | 0 | 6002 | 0 | 80798 | 0 | 0 | 0 | 36101 | 0 | 340215 | 0 | 0 |
| Mark Wilkowske MD | |||||||||||||
| 0 | 564495 | 0 | 41572 | 0 | 3589 | 0 | 0 | 0 | 49964 | 0 | 659620 | 0 | 0 |
| Susan Zwaschka | |||||||||||||
| 226426 | 0 | 77201 | 0 | 16224 | 0 | 28200 | 0 | 66611 | 0 | 414662 | 0 | 0 | 0 |
| Paul Dominski | |||||||||||||
| 293792 | 0 | 46834 | 0 | 13442 | 0 | 36000 | 0 | 77370 | 0 | 467438 | 0 | 0 | 0 |
| Carol Greenland | |||||||||||||
| 45497 | 0 | 88218 | 0 | 286201 | 0 | 0 | 0 | 33497 | 0 | 453413 | 0 | 28560 | 0 |
| Mary Johnson | |||||||||||||
| 268155 | 0 | 102969 | 0 | 28020 | 0 | 32400 | 0 | 80650 | 0 | 512194 | 0 | 0 | 0 |
| John Misa MD | |||||||||||||
| 318750 | 0 | 108173 | 0 | 11971 | 0 | 45250 | 0 | 40900 | 0 | 525044 | 0 | 0 | 0 |
| Thomas Schmidt MD | |||||||||||||
| 246616 | 0 | 87600 | 0 | 101187 | 0 | 30360 | 0 | 81024 | 0 | 546787 | 0 | 75673 | 0 |
| Samuel Carlson MD | |||||||||||||
| 0 | 411 | 0 | 0 | 0 | 172682 | 0 | 0 | 0 | 79194 | 0 | 252287 | 0 | 0 |
| David K Wessner | |||||||||||||
| 44990 | 0 | 367603 | 0 | 975262 | 0 | 0 | 0 | 101086 | 0 | 1488941 | 0 | 154681 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 1a | Park Nicollet Health Services pays social club dues to both the Interlachen and Minneapolis Clubs in the name of David Abelson, CEO, for use by all Park Nicollet Health Services officers and key employees. The facilities are used for a variety of business meetings held by key executives from Park Nicollet Health Services. Park Nicollet Health Services also pays for Rotary Club of Minneapolis dues for Michael J. Johnson, Park Nicollet Foundation President and Park Nicollet Health Services and Affiliates Director. Park Nicollet Health Services considers these expenses to be business expenses of the organization; therefore these amounts are not included in taxable income for the individuals. Part I, Line 3: The Park Nicollet Health Services' Board of Directors is responsible for establishing the compensation of the organization's CEO and Executive Directors. |
| Part I, Lines 4a-b | During 2010, Park Nicollet Health Services terminated without cause the employment of individuals in reportable positions. Severance payments were determined to be payable under the Park Nicollet Health Services Executive Management Group Severance Policy (the "Policy"). The policy provides that if Park Nicollet Health Services terminates a covered individual without cause, and if the individual releases all legal claims against Park Nicollet Health Services, then Park Nicollet Health Services will provide the terminated individual severance compensation for a period of one year including salary, health, life, dental and disability benefits, as well as deferred compensation, incentive compensation, and pension plan payments. Based on the foregoing, the amount of severance compensation and benefits provided to each of the individual on severance during 2010 is as follows: Samuel E. Carlson, MD $142,974 Carol A. Greenland, $238,000 David K. Wessner, $703,040 David J. Cooke, $400,000 Part I, Line 4B: Senior leaders of Park Nicollet Health Services are given the opportunity to participate in the Capital Accumulation Account Plan. The Capital Accumulation Account Plan (CAA Plan) participation is limited to senior leaders and all the vice presidents. Each participant receives an annual allowance equal to the sum of (i) a stated percent of salary, (ii) voluntary salary deferrals, and (iii) credits for exchanging up to five vacation days. The allowance is credited to a bookkeeping account. Earnings are credited to the account based on the performance of simulated investments. Benefits vest upon the earliest of remaining employed to an elective vesting date (two years to age 68), involuntary termination without cause, disability, death, or not competing for 24 months following voluntary or for-cause termination. Benefits are paid in a single lump sum upon vesting. Participants are general creditors of the employer for the payment of the benefits. The following participants received payouts from a related organization, Park Nicollet Health Services, related to CAA plan: David K. Wessner, $154,681 Carol A. Greenland, $28,560 David J. Cooke, $47,333 Thomas Schmidt, $75,673 Michael Johnson, $25,300 |
| Part I, Line 7 | All physicians employed by and seeing patients for Park Nicollet Clinic, are eligible for a 3% access incentive payout based on their department reaching certain goals including access for patients and quality initiatives. In their roles as executives employed by Park Nicollet Health Services, the executives are eligible for incentive payouts which are paid by Park Nicollet Health Services and Park Nicollet Clinic. The incentive award will be 35% of base pay compensation for the CEO, 30% for the CFO, COO, CMO and 25% for all other executives with an opportunity for incentive credit above the target level. The ultimate payout includes a reduction/increase multiplier depending on whether the consolidated Park Nicollet Health Services organization reached that year's operating margin goal as set by the Board of Directors. Each participant will be responsible for two financial goals, and not less than three and not more than five individual strategic objectives. In their roles as management employed by Park Nicollet Health Services, certain managers are eligible for incentive payouts. The incentive award will be 15% of their annual base pay compensation with an opportunity for incentive credit above the target level. The ultimate payout includes a reduction/increase multiplier depending on whether the consolidated Park Nicollet Health Services organization reached that year's operating margin goal as set by the Board of Directors. Incentive payments are a function of both individual and organizational performance. The participant must be assigned at least three, and not more than four focused incentive objective, one of which must be financial in nature. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| City of St Louis Park | |||||||
| 416005519 | 791740EE2 | 2008-08-14 | 223727818 | Refinance Series 2003 A Bonds Issued 11/13/03 | 0 | 0 | 0 |
| City of St Louis Park | |||||||
| 416005519 | 791748EG7 | 2009-12-31 | 182727701 | Refinance Series 2008 AB Bonds issued 8/14/08 | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Working Capital ExpendituresWorkingCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 16400000 | 233727818 | 30528212 | 1580827 | 6863730 | 194800000 | 2008 | 1 | 0 | 1 | 1 | |
| 182727701 | 23826295 | 1861956 | 18102000 | 144049159 | 2009 | 1 | 0 | 1 | 1 | 441816 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|
| 0 | 1 | 1 | 1 | 1 | 1 |
| 0 | 1 | 1 | 1 | 1 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part V Form990ScheduleKPartV (7 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Explanation of Reporting on an Obligated Group Basis | Pursuant to a loan agreement with the City of St. Louis Park, Minnesota, Park Nicollet Health Services is named as a member of the "Obligated Group" along with Park Nicollet Methodist Hospital, Park Nicollet Clinic, PNMC Holdings, Park Nicollet Institute, and Park Nicollet Health Care Products. Each member of the obligated group is an obligor under the loan agreement. Park Nicollet Health Services did not use bond funds; therefore there are no bonds on the balance sheet. |
| Part II, Line 4: | The amounts shown on line 4 include both reserve funds and debt service funds. For column A, $20,484,120 is in a reserve fund and $10,044,092 in a debt service fund. For column B, $18,439,632 is in a reserve fund, and $5,386,663 in a debt service fund. |
| Part II, Line 9, Column A: | $6,660,000 of the amount shown is a swap termination payment. |
| Part II, Line 9, Column B: | The amount shown is a swap termination payment. |
| Part II, Line 13 | Park Nicollet Health Services determined the year of substantial completion for each issue as follows: The purpose of the issue in column A was to refund a prior issue for which the original capital project was complete prior to refunding. Therefore the year of substantial completion is the year of issuance. The purpose of the bond issue in column B was to refund the 2008 A and B bond issue since the related capital project of the 2008 B issue was not yet complete until 2009 the year of substantial completion is 2009. |
| Part II, Line 17 | For issue B, the final allocation of proceeds has not been made, due to software limitations this question is being answered based on Park Nicollet Health Services intentions. |
| Part III | For issues A and B, Part III is not required, as those bonds refunded pre-2003 debt. However, due to software limitations, answers have been provided to certain Part III questions. |
Schedule L IRS990ScheduleL
Loan Table LoanTable (6 entries)
| Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|
| Samuel Carlson MD | |||||
| X | $485,974 | 485974 | 0 | 1 | 1 |
| David Cooke | |||||
| X | $403,235 | 403235 | 0 | 1 | 1 |
| Paul Dominiski | |||||
| X | $41,961 | 41961 | 0 | 1 | 1 |
| Carol Greenland | |||||
| X | $128,740 | 128740 | 0 | 1 | 1 |
| Michael J Johnson | |||||
| X | $248,182 | 248182 | 0 | 1 | 1 |
| David Wessner | |||||
| X | $590,650 | 590650 | 0 | 1 | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 1898742 | TotalBalanceDue |
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Marquette Real Estate Holdings | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | James O. Pohlad: Owner | Relationship |
| Amount Of Transaction | 4199956 | AmountOfTransaction |
| Description Of Transaction | Lease: Marquette Real Estate Holdings leases the TRIA Orthopaedic Center Building to an affiliate of Park Nicollet Health Services | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Park Nicollet Health Services and its related entities have a common board. The following officers, board members, and key employees are employees of and paid by Park Nicollet Health Services or its related organizations. These employees serve together on the common board which serves Park Nicollet Health Services and its related entities. David Abelson David J. Cooke Steven Connelly David Homans Jeffrey B. Husband Michael Johnson Kathryn D. Kallas Michael Kaupa Charles McCoy Sheila McMillan Janette Strathy Mark Wilkowske Susan Zwaschka | |
| Form 990, Part VI, Section A, line 4 | Bylaws were amended to change the membership of the Board of Directors by increasing the number of physician members from five to seven, and increasing the number of community members from 12 to 14. The bylaws were also changed to reflect changes in the structure and composition of committees of the board. | |
| Form 990, Part VI, Section B, line 11 | Park Nicollet Health Services prepares the Form 990 within the finance department with assistance from individuals in human resources, marketing, and operations. Upon completion of gathering the necessary information for the return, the form was compiled by Park Nicollet Health Services'accounting firm. Drafts of the form were reviewed by the Assistant Controller - Accounting Operations, Vice President of Finance, Chief Financial Officer, and the Audit and Compliance Committee. After all internal reviews were complete, the final version of the Form 990 was given to each member of the Board of Directors prior to filing return. | |
| At Park Nicollet Health Services all key employees, directors, and officers are required to fill out a conflict of interest statement each year; however the obligation to report conflicts is ongoing. The conflict of interest statements are reviewed by the Chief Compliance Officer and reported to the Park Nicollet Health Service's board's governance committee. The board ensures that any potential conflicts reported have been mitigated in an appropriate manner. When a transaction involving a potential conflict of interest is noted, the board of directors assigns a committee to review that conflict and ensure discussions related to those transactions can occur separately from those individuals with potential conflicts. All significant transactions include an analysis of fair market value. | Form 990, Part VI, Section B, line 12c | |
| The Park Nicollet Health Services' Board of Directors is responsible for the implementation and oversight of executive compensation and benefit plans. Park Nicollet Health Services uses an outside consultant to provide yearly market based indexes of salary adjustments for executives in similar leadership positions. The Board of Directors reviews the salary ranges and recommends salary increases for each executive, including the CEO, based upon the Board of Directors' evaluation of job performance and experience level of the individual within the organization. The average salary increases for all Park Nicollet Health Services executives cannot exceed the average market salary increase reported for executives by the consultant. The compensation committee then reviews and approves compensation adjustments based on the information provided by the outside consultants and the Board of Directors' recommendations. For certain physicians, the majority of pay disclosed is for his/her work as a physician. A small stipend is added for serving on the Board of Directors. The following is a description of how pay for physicians' patient care work is determined. The Park Nicollet Health Services' Board of Directors is responsible for the implementation and oversight of the physician compensation and benefit plans. The Board of Directors delegates the day-to-day administration of the physician compensation plan to the Clinical Board of Governors and the Physician Compensation and Benefits Subcommittee. The purpose of the Physician Compensation and Benefits Subcommittee is to oversee physician and other clinician compensation and benefits plans and administration within the budget to ensure fairness and alignment with Park Nicollet Health Services' goals. The responsibilities of this committee include: Recommending of compensation policies and plan designs for physicians to the clinical board and Board of Directors; Overseeing compensation plan operation and payments to clinical departments; Evaluating compensation plan for performance on a periodic basis; Serving as final appeal process for issues unresolved by individuals, department chairs and chiefs of services. Annually, information on each physician's pay and productivity is graphed against the survey results for the same year. This information is presented to the compensation committee of the Park Nicollet Health Services Board of Directors for review. Park Nicollet Health Services' physician pay program is designed to ensure market based pay for market based productivity standards. The market is determined by the American Medical Group Association (AMGA) national physician compensation survey data, which provides market data for both compensation and productivity. When appropriate, the Clinic Compensation and Benefit Subcommittee grants adjustments to these guidelines with evidence of local market data. | Form 990, Part VI, Section B, line 15 | |
| Park Nicollet Health Services governing documents, conflict of interest policy and financial statements are available to the public upon request. Park Nicollet Health Services mails its consolidated audited financial statements to financial institutions, governmental institutions, board members, media representatives, vendors, and the Minnesota Hospital Association (MHA). Park Nicollet Health Services discloses quarterly financial statements to bondholders. The annual audited and quarterly financial statements are also posted at emma.msrb.org. The forms 990 are available upon request or from the state of Minnesota or at Guidestar.org. Form 990, Part VII: Certain board members for Park Nicollet Health Services also provide services as employees to Park Nicollet Health Services and its subsidiaries. Hours worked are an estimate and are not tracked on an entity by entity basis. Therefore, these officers, directors, and key employees hours reported on Form 990, Part VII represent aggregate hours worked per week for all Park Nicollet Health Services entities. Community board members hours reported on Form 990, Part VII are an estimate and are not tracked on an entity by entity basis. Therefore, these directors hours reported on Form 990, Part VII represent aggregate hours of service provided per week for all Park Nicollet Health Services entities. | Form 990, Part VI, Section C, line 19 | |
| Changes in Net Assets or Fund Balances: | Post retirement Obligation -226,773. Expenses for grants paid directly by Park Nicollet Foundation -149,100. K-1 Gain/loss from Tria and Premier Purchasing LLC 664,036. Total to Form 990, Part XI, Line 5: 288,163. | Form 990, Part XI, line 5: |
| Neither the Oversight Process nor the Selection Process for the review of the audit of Park Nicollet Health Services and affiliates' financial statements have changed during the tax year. | Form 990, Part XI, Line 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Primary ActivitiesPrimaryActivities | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Total IncomeTotalIncome | EOY AssetsEOYAssets | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | EINEIN | Legal Domicile StateLegalDomicileState |
|---|---|---|---|---|---|---|---|---|---|---|
| PN Assurance Limited | ||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | Insurance | CJ | -13988 | 129099 | Park Nicollet Health Services | ||
| Deferred Compensation Trust | ||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | Investments | 0 | 1270074 | Park Nicollet Health Services | 411809020 | MN | |
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Park Nicollet Methodist Hospital | ||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | 410132080 | Health Care | MN | 501 (C) (3) | 3 | Park Nicollet Health Services | 1 |
| Park Nicollet Foundation | ||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | 237346465 | Grants to Serve the Community | MN | 501 (C) (3) | 7 | Park Nicollet Health Services | 1 |
| Park Nicollet Clinic | ||||||||||
| 3800 Park Nicollet Blvd | St Louis Park | MN | 55416 | 410834920 | Health Care | MN | 501 (C) (3) | 3 | Park Nicollet Health Services | 1 |
| Park Nicollet Institute | ||||||||||
| 3800 Park Nicollet Blvd | St Louis Park | MN | 55416 | 410961862 | Health Care Research | MN | 501 (C) (3) | 4 | Park Nicollet Health Services | 1 |
| Park Nicollet Health Care Products | ||||||||||
| 3800 Park Nicollet Blvd | St Louis Park | MN | 55416 | 010638901 | Health Care Products | MN | 501 (C) (3) | 11 Type II | Park Nicollet Health Services | 1 |
| PNMC Holdings | ||||||||||
| 3800 Park Nicollet Blvd | St Louis Park | MN | 55416 | 411741792 | Health Care Real Estate | MN | 501 (C) (3) | 11 Type I | Park Nicollet Clinic | 1 |
Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|---|---|
| TRIA Orthopaedic Center LLC | |||||||||||
| 8100 Northland Drive | Bloomington | MN | 55431 | 200034003 | Health Care | MN | Park Nicollet Health Services | Related | -1992444 | 0 | 1 |
| Park Nicollet Health Services Investment Partnership | |||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | 411675033 | Investments | MN | Park Nicollet Methodist Hospital | N/A | 0 | 0 | |
| Methodist Brain Lab Leasing LLC | |||||||||||
| 6500 Excelsior Blvd | St Louis Park | MN | 55426 | 208725994 | Health Care | MN | Park Nicollet Methodist Hospital | N/A | 0 | 0 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Enterprises | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6500 Excelsior Boulevard | AddressLine1 |
| City | St Louis Park | City |
| State | MN | State |
| ZIP Code | 55426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411656735 | EIN |
| Primary Activity | Real Estate for Related Organization | PrimaryActivity |
| Legal Domicile State | MN | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Park Nicollet Health Services | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 4752895 | ShareOfTotalIncome |
| Share Of EOY Assets | 19194149 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (21 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Park Nicollet Health Care Products | ||
| R | 27756658 | Cost |
| Park Nicollet Health Care Products | ||
| K | 1468107 | Cost |
| Park Nicollet Health Care Products | ||
| P | 103237173 | Cost |
| Park Nicollet Enterprises | ||
| P | 4160222 | Cost |
| TRIA Orthopaedic Center LLC | ||
| P | 15133850 | Cost |
| TRIA Orthopaedic Center LLC | ||
| R | 12730226 | Cost |
| TRIA Orthopaedic Center LLC | ||
| A | 826966 | Cost |
| Park Nicollet Methodist Hospital | ||
| R | 467427169 | Cost |
| Park Nicollet Methodist Hospital | ||
| P | 513426846 | Cost |
| Park Nicollet Methodist Hospital | ||
| O | 60439 | Cost |
| Park Nicollet Methodist Hospital | ||
| J | 1172420 | Fair Market Value |
| Park Nicollet Methodist Hospital | ||
| K | 9739719 | Cost |
| Park Nicollet Institute | ||
| P | 10982034 | Cost |
| Park Nicollet Institute | ||
| K | 367645 | Cost |
| Park Nicollet Institute | ||
| R | 11906077 | Cost |
| Park Nicollet Clinic | ||
| P | 440980567 | Cost |
| Park Nicollet Clinic | ||
| K | 12492019 | Cost |
| Park Nicollet Clinic | ||
| R | 591838456 | Cost |
| Park Nicollet Clinic | ||
| J | 2500606 | Fair Market Value |
| PNMC Holdings | ||
| P | 152313 | Cost |
| Park Nicollet Foundation | ||
| C | 149100 | Cost |
Affiliated Group Attachment AffiliatedGroupAttachment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Park Nicollet Health Services incurs lobbying expenses on behalf of Park Nicollet Methodist Hospital, Park Nicollet Institute, Park Nicollet Health Care Products and Park Nicollet Clinic. Other exempt expenses relate to the management expenses incurred by Park Nicollet Health Services on behalf of each entity. | Explanation |
Affiliated Group Schedule AffiliatedGroupSchedule
Affiliated Schedule AffiliatedSchedule (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Electing OrgElectingOrg | Total Grassroots LobbyingTotalGrassrootsLobbying | Total Direct LobbyingTotalDirectLobbying | Total Lobbying ExpendituresTotalLobbyingExpenditures | Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures | Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures | Lobbying NontaxableLobbyingNontaxableAmount | Grassroots NontaxableGrassrootsNontaxableAmount | Tot Lobbying Grassroot Minus NontxTotLobbyingGrassrootMinusNontx | Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx | Share Of Excess Lobbying ExpendtrsShareOfExcessLobbyingExpendtrs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Park Nicollet Health Services | |||||||||||||||
| 6500 Excelsior Boulevard | St Louis Park | MN | 55416 | 363465840 | X | 0 | 200569 | 200569 | 32569 | 233138 | $46,628 | $11,657 | 0 | 153941 | 0 |
| Park Nicollet Methodist Hospital | |||||||||||||||
| 6500 Excelsior Boulevard | St Louis Park | MN | 55416 | 410132080 | 0 | 0 | 0 | 10141618 | 10141618 | $657,081 | $164,270 | 0 | 0 | 0 | |
| Park Nicollet Clinic | |||||||||||||||
| 3800 Park Nicollet Boulevard | St Louis Park | MN | 55416 | 410834920 | 0 | 0 | 0 | 12977665 | 12977665 | $798,883 | $199,721 | 0 | 0 | 0 | |
| Park Nicollet Health Care Products | |||||||||||||||
| 3800 Park Nicollet Boulevard | St Louis Park | MN | 55416 | 010638901 | 0 | 0 | 0 | 1518236 | 1518236 | $225,912 | $56,478 | 0 | 0 | 0 | |
| Park Nicollet Institute | |||||||||||||||
| 3800 Park Nicollet Boulevard | St Louis Park | MN | 55416 | 410961862 | 0 | 0 | 0 | 383317 | 383317 | $76,663 | $19,166 | 0 | 0 | 0 | |