2011-11-10T14:18:09-06:00 2010-12-31 Deloitte Tax LLP 50 South Sixth Street Minneapolis MN 55402 990 2010-01-01 363465840 Park Nicollet Health Services PARK 9529933108 6500 Excelsior Blvd St Louis Park MN 55426 Sheila McMillan 9529936790 2011-10-31 1 Kristina Rasmussen 6123974000 2010 2016-03-07 17:11:31Z Sheila McMillan 6500 Excelsior Blvd St Louis Park MN 55426 24769713 0 X parknicollet.com X 1986 MN Cares for and supports the health, healing, and learning of those served. 18 9 8894 0 62471 0 120000 149100 19684905 23530001 745254 879836 187167 180101 20737326 24739038 0 0 0 0 17230653 19078634 0 0 0 7024564 6175340 24255217 25253974 -3517891 -514936 100021705 130926788 119150313 150282169 -19128608 -19355381 X 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. 0 0 22614422 23530251 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. 22614422 1 1 0 1 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 X 46 0 1 8894 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 X 18 9 1 0 1 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 MN X Sheila McMillan 9529936790 6500 Excelsior Blvd St Louis Park MN 55426 X David Abelson MD 55.00 X X 789529 0 220188 David J Cooke 55.00 X X 699941 0 93397 Judith Corson 3.00 X X 0 0 0 Steven Connelly MD 55.00 X X 514388 0 48590 Bruce W Engelsma 3.00 X 0 0 0 Steven Frank 3.00 X 0 0 0 David Homans MD 55.00 X 476226 0 38872 Jeffrey B Husband MD 55.00 X 0 569522 49426 Ann Rockler Jackson 3.00 X 0 0 0 Michael Johnson 55.00 X 355684 0 59876 Kathryn D Kallas 55.00 X X 344809 0 103609 Michael Kaupa 55.00 X X 602417 0 137571 Jodee Kozlak 3.00 X 0 0 0 Donald Lewis 3.00 X X 0 0 0 Charles McCoy MD 55.00 X 0 188968 32901 Ken Melrose 3.00 X 0 0 0 Sheila McMillan 55.00 X X 147443 0 49507 Ruth Mickelsen 3.00 X 0 0 0 Lee N Newcomer MD 3.00 X 0 0 0 James O Pohlad 3.00 X 0 0 0 Janette Strathy MD 55.00 X 0 304114 36101 Richard E Struthers 3.00 X X 0 0 0 Kenneth L Thome 3.00 X X 0 0 0 Mark Wilkowske MD 55.00 X 0 609656 49964 Susan Zwaschka 55.00 X 319851 0 94811 Paul Dominski 55.00 X 354068 0 113370 Carol Greenland 55.00 X 419916 0 33497 Mary Johnson 55.00 X 399144 0 113050 John Misa MD 55.00 X 438894 0 86150 Thomas Schmidt MD 55.00 X 435403 0 111384 Samuel Carlson MD X 0 173093 79194 David K Wessner X 1387855 0 101086 7685568 1845353 1652544 29 1 1 0 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 6 149100 149100 Services to Affiliates 561000 22109620 22109420 200 Income- Premier Purch 900003 1420381 1358110 62271 23530001 879877 879877 210485 30634 179851 179851 179851 41 -41 -41 -41 Miscellaneous 900099 250 250 250 24739038 23467780 62471 1059687 5658796 5658796 7585308 7585308 2729514 2729514 2196665 2196665 908351 908351 226676 226676 265243 265243 120000 120000 152904 152904 5862 5862 497275 497275 4914 4914 93543 93543 58 58 762990 762990 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 25253974 22614422 2639552 0 -4404668 -2051742 83685114 115652826 776043 927200 2012199 1898742 1056952 2481532 2772989 855019 1918028 1917970 10067514 8601769 4910523 1498491 100021705 130926788 74049830 80904058 45100483 69378111 119150313 150282169 X -19128608 -19355381 -19128608 -19355381 100021705 130926788 X -514936 288163 X X 0 1 1 X 0 X X X 0 0 0 Park Nicollet Methodist Hospital 410132080 3 1 1 1 9757320 Park Nicollet Clinic 410834920 3 1 1 1 12485900 Park Nicollet Institute 410961862 4 1 1 1 371202 3 22614422 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 200569 200569 200569 200569 25053405 1028067413 25253974 1028267982 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 110038 172394 108350 200569 591351 250000 250000 250000 250000 1000000 1500000 145133 15494 120000 40627 124503 20630 145133 138463 15140 29100 124503 1.00000 0 1 1 1917864 1917864 21134 21134 0 9261 9261 0 824730 824624 106 1917970 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 8601769 Due to and from Related Parties 50863601 Contingent Malpractice Liability 16156860 Post Retirement Obligation 2357650 69378111 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. Central America & the Caribbean 0 0 Program services Insurance for related tax exempt organizations 13988 Central America & the Caribbean 0 0 Investments 129099 0 0 0 143087 0 143087 0 0 1 0 0 0 X 1 1 X X X X X 1 1 0 0 0 0 0 1 0 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 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. 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 16400000 233727818 30528212 1580827 6863730 194800000 2008 1 0 1 1 182727701 23826295 1861956 18102000 144049159 441816 2009 1 0 1 1 0 1 1 1 1 1 0 1 1 1 1 1 0 0 0 0 0 1 0 0 0 0 0 1 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. Samuel Carlson MD X 485974 485974 0 1 1 David Cooke X 403235 403235 0 1 1 Paul Dominiski X 41961 41961 0 1 1 Carol Greenland X 128740 128740 0 1 1 Michael J Johnson X 248182 248182 0 1 1 David Wessner X 590650 590650 0 1 1 1898742 Marquette Real Estate Holdings James O. Pohlad: Owner 4199956 Lease: Marquette Real Estate Holdings leases the TRIA Orthopaedic Center Building to an affiliate of Park Nicollet Health Services 0 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. Form 990, Part VI, Section B, line 12c 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 15 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 C, line 19 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. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: 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 2C 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. 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 411809020 Investments MN 0 1270074 Park Nicollet Health Services 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 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 Park Nicollet Enterprises 6500 Excelsior Boulevard St Louis Park MN 55426 411656735 Real Estate for Related Organization MN Park Nicollet Health Services C 4752895 19194149 1.00000 1 0 1 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 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 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. Park Nicollet Health Services 6500 Excelsior Boulevard St Louis Park MN 55416 363465840 X 0 200569 200569 32569 233138 46628 11657 0 153941 0 Park Nicollet Methodist Hospital 6500 Excelsior Boulevard St Louis Park MN 55416 410132080 0 0 0 10141618 10141618 657081 164270 0 0 0 Park Nicollet Clinic 3800 Park Nicollet Boulevard St Louis Park MN 55416 410834920 0 0 0 12977665 12977665 798883 199721 0 0 0 Park Nicollet Health Care Products 3800 Park Nicollet Boulevard St Louis Park MN 55416 010638901 0 0 0 1518236 1518236 225912 56478 0 0 0 Park Nicollet Institute 3800 Park Nicollet Boulevard St Louis Park MN 55416 410961862 0 0 0 383317 383317 76663 19166 0 0 0