Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Doing Business As
HENNEPIN COUNTY MEDICAL CENTER
 
Number and street (or P.O. box if mail is not delivered to street address)
701 PARK AVENUE FINANCE P-1
 
Room/suite
City or town, state or country, and ZIP + 4
MINNEAPOLIS, MN55415
D Employer identification number

42-1707837
E Telephone number

G Gross receipts $ 658,217,560
F Name and address of principal officer:
LARRY A KRYZANIAK
701 PARK AVENUE FINANCE P-1
MINNEAPOLIS,MN55415
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.HCMED.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 2007
M State of legal domicile: MN
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: FORM 990, PART I, LINE1 AND FORM 990, PART III, LINE 1 HCMC IS A LEVEL ONE TRAUMA CENTER, ACUTE & TERTIARY CARE, PUBLIC TEACHING HOSPITAL. HCMC PROVIDES THE BEST POSSIBLE CARE TO EVERY PATIENT SERVED AND SEARCHES FOR NEW WAYS TO IMPROVE HEALTHCARE FOR TOMORROW. HCMC IS EDUCATING HEALTHCARE PROVIDERS FOR THE FUTURE AND ENSURING ACCESS TO HEALTHCARE FOR ALL. FORM 990, PART I LINE 1, SIGNIFICANT ACTVIVITES FOR 2010 AS A SAFETY NET HOSPITAL, HCMC RECEIVES SUPPLEMENTAL MEDICAID PAYMENTS, ALSO KNOWN AS UPPER PAYMENT LIMIT PAYMENTS (UPL), FOR INPATIENT AND OUTPATIENT SERVICES THROUGH INTERGOVERNMENTAL TRANSFERS IN ACCORDANCE WITH SPECIFIC STATE STATUES SUBJECT TO FEDERAL REGULATIONS AND APPROVAL. DURING 2009, MINNESOTA STATE LEGISLATION CREATED SEVERAL NEW SUPPLEMENTAL MEDICAID PAYMENT STATUTES. UPON FEDERAL APPROVAL IN 2010, THE MEDICAL CENTER RECEIVED NONRECURRING PAYMENTS OF APPROXIMATELY 17 MILLION UNDER THESE STATUTES RELATED TO THE 2009 FEDERAL FISCAL YEAR. HCMC ALSO RECEIVES AMOUNTS FR
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 10
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 5,164
6 Total number of volunteers (estimate if necessary) .... 6 384
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 1,084,330
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -74,062
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 210,560 55,618,122
9 Program service revenue (Part VIII, line 2g) ......... 591,747,048 597,152,250
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 493,320 593,837
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 5,392,444 4,385,210
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 597,843,372 657,749,419
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,006,600 1,008,754
14 Benefits paid to or for members (Part IX, column (A), line 4) ....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 330,354,097 323,356,779
16a Professional fundraising fees (Part IX, column (A), line 11e)....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 252,418,676 265,464,183
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 583,779,373 589,829,716
19 Revenue less expenses. Subtract line 18 from line 12...... 14,063,999 67,919,703
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 350,021,810 429,395,423
21 Total liabilities (Part X, line 26)............ 143,085,452 154,539,362
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 206,936,358 274,856,061
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: FORM 990, PART I, LINE1 AND FORM 990, PART III, LINE 1 HCMC IS A LEVEL ONE TRAUMA CENTER, ACUTE & TERTIARY CARE, PUBLIC TEACHING HOSPITAL. HCMC PROVIDES THE BEST POSSIBLE CARE TO EVERY PATIENT SERVED AND SEARCHES FOR NEW WAYS TO IMPROVE HEALTHCARE FOR TOMORROW. HCMC IS EDUCATING HEALTHCARE PROVIDERS FOR THE FUTURE AND ENSURING ACCESS TO HEALTHCARE FOR ALL. FORM 990, PART I LINE 1, SIGNIFICANT ACTVIVITES FOR 2010 AS A SAFETY NET HOSPITAL, HCMC RECEIVES SUPPLEMENTAL MEDICAID PAYMENTS, ALSO KNOWN AS UPPER PAYMENT LIMIT PAYMENTS (UPL), FOR INPATIENT AND OUTPATIENT SERVICES THROUGH INTERGOVERNMENTAL TRANSFERS IN ACCORDANCE WITH SPECIFIC STATE STATUES SUBJECT TO FEDERAL REGULATIONS AND APPROVAL. DURING 2009, MINNESOTA STATE LEGISLATION CREATED SEVERAL NEW SUPPLEMENTAL MEDICAID PAYMENT STATUTES. UPON FEDERAL APPROVAL IN 2010, THE MEDICAL CENTER RECEIVED NONRECURRING PAYMENTS OF APPROXIMATELY 17 MILLION UNDER THESE STATUTES RELATED TO THE 2009 FEDERAL FISCAL YEAR. HCMC ALSO RECEIVES AMOUNTS FR
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 517,550,863 including grants of $ 1,008,754 ) (Revenue $ 657,692,237 )
HHS, INC., CONSISTS OF A HOSPITAL IN MINNEAPOLIS, PRIMARY CARE CLINICS IN THE FOLLOWING COMMUNITIES AND SPECIALTY CARE CENTERS AS FOLLOWS. HOSPITAL HCMC OPERATES APPROXIMATELY 477 BEDS AS AN ACUTE CARE HOSPITAL AND COMPREHENSIVE ACADEMIC MEDICAL CENTER AND PUBLIC HOSPITAL LOCATED IN THE HEART OF THE TWIN CITIES OF MINNEAPOLIS AND ST. PAUL, MINNESOTA. HCMC IS MINNESOTA'S PREMIER LEVEL 1 TRAUMA CENTER WITH MANY NATIONALLY RECOGNIZED PROGRAMS AND SPECIALTIES. HCMC IS A TEACHING HOSPITAL FOR DOCTORS WHO GO ON TO PRACTICE THROUGHOUT THE STATE AND NATION. HCMC IS A SAFETY NET HOSPITAL PROVIDING CARE FOR LOW-INCOME, THE UNINSURED AND VULNERABLE POPULATIONS. ACUTE DIALYSIS (DAVITA) ACUTE DIALYSIS SERVICES' MAIN PURPOSE AND GOAL IS TO PROVIDE QUALITY CARE TO ALL OUR PATIENTS. WE ARE RESPONSIBLE FOR HEMODIALYSIS TREATMENTS AND OTHER NEPHROLOGY NURSING NEEDS OF THE ACUTE AND CHRONIC PATIENTS ADMITTED TO THE HOSPITAL. WE PROVIDE THE PATIENT WITH THE SERVICES OF AN EXPERIENCED TEAMMATE AND WORK IN CONJUNCTION WITH THE HOSPITAL TO ENSURE THAT EACH PATIENT REACHES THE HIGHES LEVEL OF HEALTH, SECURITY, AND INDEPENDENCE 24- HOURS A DAY, 7-DAYS A WEEK. ACUTE PSYCHIATRIC SERVICES (APS) APS IS A PSYCHIATRIC EMERGENCY DEPARTMENT OPEN 24 HOURS PER DAY, 7 DAYS PER WEEK, FOR ANYONE EXPERIENCING A MENTAL HEALTH OR EMOTIONAL CRISIS. WE PROVIDE ASSESSMENT, INTERVENTION, AND REFERRAL. AMBULATORY BURN CLINIC THE AMBULATORY BURN AND WOUND CLINIC WHICH SERVES ALL AGES, IS A SPECIALTY CLINIC PROVIDING COMPREHENSIVE TREATMENT AND MANAGEMENT OF PATIENTS WITH A VARIETY OF WOUNDS AND/OR PATIENTS NEEDING IV THERAPY. AMBULATORY CARE AMBULATORY CARE SERVICES AT HENNEPIN COUNTY MEDICAL CENTER (HCMC) ARE SUPPORTED BY MORE THAN 300 PHYSICIANS AND RELATED PROVIDERS FROM HENNEPIN FACULTY ASSOCIATES (HFA) AND HCMC. AMBULATORY CARE IS PROVIDED THROUGH BOTH MULTISPECIALTY AND PRIMARY CARE CLINICS. ANESTHESIA GENERAL, MONITORED ANESTHESIA CARE AND REGIONAL ANESTHESIA ARE PROVIDED BY ANESTHESIOLOGISTS AND CERTIFIED REGISTERED NURSE ANESTHETISTS. ANESTHESIA CARE IS PROVIDED FOR ELECTIVE, URGENT AND EMERGENT OPERATING ROOM CASES AND IN ANCILLARY AREAS INCLUDING CARDIAC CATHETER LAB, RADIOLOGY, VASCULAR ACCESS, GASTRO-INTESTIONAL LAB, LABOR AND DELIVERY AND PSYCHIATRY. AUDIOLOGY CLINIC THE AUDIOLOGY CLINIC PROVIDES HIGH QUALITY INPATIENT AND OUTPATIENT SERVICES TO INDIVIDUALS OF ALL AGES, FROM INFANCY TO GERIATRIC. OUR LICENSED AUDIOLOGISTS HAVE ADVANCED EXPERTISE IN EVALUATING AND TREATING A WIDE RANGE OF HEARING IMPAIRMENTS, AS WELL AS PRESCRIBING AND FITTING SOPHISTICATED HEARING INSTRUMENTS. BIOMEDICAL ETHICS COMMITTEE FOCUS ON ETHICAL ISSUES THAT ARISE IN PATIENT CARE. BONE AND MINERAL CLINIC SPECIALTY CLINIC FOR THE MANAGEMENT OF BONE AND MINERAL METABOLISM SUCH AS OSTEOPOROSIS AND KIDNEY STONE DISEASE. ALSO PERFORM BONE DENSITOMETRY WITH AN IDXA BONE DENSITOMETRY SCANNER, THE NEWEST AVAILABLE TECHNOLOGY FOR DETECTING BONE DENSITY. BURN CENTER THE BURN CENTER IS A 17 BED UNIT THAT HAS RECEIVED VERIFICATION AS A BURN CENTER FROM THE AMERICAN BURN ASSOCIATION. A MULTIDISCIPLINARY TEAM APPROACH IS USED BY THE BURN CENTER TO PROVIDE INTENSIVE, ACUTE, AND REHABILITATIVE CARE TO ALL AGE GROUPS THAT PRESENT WITH THERMAL INJURIES, COMPLEX WOUNDS, PLASTIC SURGERY, AND SKIN DISORDERS OF VARYING SEVERITY. CARDIAC SERVICES (HENNEPIN HEART CENTER) CARDIAC SERVICES INCLUDES THE FOLLOWING SERVICE AREAS: CARDIAC CATHETERIZATION LABORATORY; CARDIAC ECHOCARDIOGRAPHY LABORATORY; CARDIAC MEDICAL INTERMEDIATE CARE (CMIC); CARDIAC REHABILITATION; CARDIAC-RENAL; UNIT (CARE); CARDIAC RESEARCH CARDIOLOGY ADMINISTRATION; CARDIOLOGY CLINIC CARDIOTHORACIC SURGERY; ELECTROCARDIOGRAM (EKG); ELECTROPHYSIOLOGY LABORATORY AND R5 OBSERVATION UNIT. CENTRAL STERILE SUPPLY REPROCESSING OF REUSABLE MEDICAL / SURGICAL INSTRUMENTS AND SUPPLIES IN A MANNER THAT IS SAFE, EFFECTIVE, AND FOLLOWS RECOMMENDATIONS SET FORTH BY GOVERNING AGENCIES. CENTRAL STERILE SUPPLY SERVES ALL HCMC CLINICS, NURSING STATIONS, OPERATING ROOMS AND OTHER AFFILIATES. CHAPLAINCY (SPIRITUAL CARE) THE MISSION OF HENNEPIN COUNTY MEDICAL CENTER'S SPIRITUAL CARE DEPARTMENT IS TO PROVIDE SENSITIVE SUPPORT TO PATIENTS AND FAMILY MEMBERS AFFECTED BY CRISIS, ILLNESS OR LOSS-WHILE RESPECTING THEIR CULTURE, RELIGION, VALUE SYSTEMS, TRADITIONS AND FAITH COMMUNITIES. THE DEPARTMENT HAS A NUMBER OF ITEMS AVAILABLE UPON REQUEST TO SUPPORT THE DIVERSE NEEDS OF MANY FAITHS. CHILD/ADOLESCENT PSYCHIATRY CLINIC THE CHILD/ADOLESCENT PSYCHIATRY CLINIC OFFERS A VARIETY OF OUTPATIENT SERVICES TO HELP CHILDREN AND ADOLESCENTS WHO ARE HAVING BEHAVIORAL AND EMOTIONAL PROBLEMS. SERVICES INCLUDE PSYCHIATRIC AND PSYCHOLOGICAL EVALUATIONS, THERAPY, PARENTING SKILLS COUNSELING AND MEDICATION MANAGEMENT. COMPREHENSIVE CANCER CENTER THE COMPREHENSIVE CANCER CENTER IS COMMITTED TO PROVIDING THE FINEST IN CANCER-RELATED SERVICES THROUGH AN INTEGRATED SYSTEM OF HEALTH AND SOCIAL SERVICES. THE CONTINUUM OF CARE EXTENDS FROM PREVENTION, DIAGNOSIS, TREATMENT, SYMPTOM CONTROL, AND CURE, THROUGH ALL RELATED ASPECTS OF ADJUSTMENT TO RELAPSE, SURVIVORSHIP, AND BEREAVEMENT COUNSELING. CONTACT CENTER THE CONTACT CENTER IS A MAIN POINT OF PATIENT ENTRY INTO HENNEPIN COUNTY MEDICAL CENTER'S HOSPITAL AND MEDICAL CLINICS. WE PROVIDE PATIENTS WITH ONE-STOP ACCESS TO THE SERVICES PROVIDED BOTH ON AND OFF CAMPUS. PATIENTS ARE ABLE TO REGISTER, SCHEDULE, RESCHEDULE, OR CANCEL APPOINTMENTS, SIGN UP FOR MY CHART ACTIVATION, AND LEARN MORE ABOUT TOPICS DISCUSSED ON WCCO'S HEALTHY MATTER'S RADIO SHOW. IN ADDITION, THE CONTACT CENTER'S TRIAGE NURSES OFFER TRIAGE SUPPORT, SYMPTOM SUPPORT, LAB RESULTS, APPOINTMENT SCHEDULING, REFILL MANAGEMENT AND REQUESTS, AND WILL CONTACT PROVIDERS AS NEEDED. CONTINUING MEDICAL EDUCATION THE PURPOSE OF MEDICAL CENTER'S CME PROGRAM IS TO PROVIDE ORGANIZED, PLANNED EDUCATION ACTIVITIES TO HELP PHYSICIANS IMPROVE THEIR MEDICAL KNOWLEDGE, DELIVERY OF-HEALTHCARE, AND PROFESSIONAL NETWORKING. HCMC IS ACCREDITED BY THE MINNESOTA MEDICAL ASSOCIATION TO SPONSOR AMA PRA CATEGORY 1 CREDIT(S) FOR PHYSICIANS. COORDINATED CARE SYSTEM THE HENNEPIN COORDINATED CARE SYSTEM (HCCCS) PROVIDES CARE FOR PATIENTS WITH COMPLEX MEDICAL NEEDS AND "EXPRESS ACCESS" TO CLINICS POST DISCHARGE. EACH MONTH AN AVERAGE OF 1400 PATIENTS ARE SEEN. SERVICE IS PROVIDED TO OUTPATIENTS AND INPATIENTS. THE AGES OF THE PATIENT POPULATION RANGE FROM PEDIATRICS THROUGH GERIATRICS. THEY REPRESENT A LARGE VARIETY OF RACES AND ETHNIC GROUPS AND VARIOUS FINANCIAL BACKGROUNDS. THEY MAY BE INSURED, UNDERINSURED, OR UNINSURED. APPROXIMATELY THIRTY PERCENT OF PATIENTS ARE UNDER AGE 12, AND ABOUT TEN PERCENT ARE OVER AGE 65. DISABILITY EVALUATION CENTER (DEC) THE DISABILITY EVALUATION CENTER ASSISTS HENNEPIN COUNTY MEDICAL CENTER PATIENTS WITH APPLICATIONS TO THE STATE MEDICAL REVIEW TEAM (SMRT) FOR DISABILITY AS WELL AS SOCIAL SECURITY APPLICATIONS. WE WILL ASSIST THE PATIENT IN COMPLETING FORMS, SCHEDULING EXAMS THAT ARE REQUIRED BY THE STATE OR THE DEC AS WELL AS PROVIDE A RESOURCE FOR ALL HCMC USERS. ELECTROENCEPHALOGRAM LAB (EEG) THE EEG LAB OFFERS DIAGNOSTIC TESTING FOR ALL PATIENTS FROM NEWBORNS TO ADULTS UPON A RECOMMENDATION FROM A PHYSICIAN. ROUTINE EEG TESTING (RECORDING OF ELECTRICAL IMPULSES FROM THE BRAIN) IS PERFORMED IN BOTH AN INPATIENT AND OUTPATIENT SETTING. EEG TESTING IN THE OPERATING ROOM IS USED TO MONITOR NEUROLOGICAL FUNCTION DURING SURGERY. EMERGENCY MEDICINE (EMS) EMERGENCY MEDICAL SERVICES INCLUDES THE FOLLOWING SERVICE AREAS: - EMERGENCY DEPARTMENT AND EXPRESS CARE - EMERGENCY MEDICAL SERVICES, COMPRISED OF EMS FIELD OPERATIONS, EMS EMERGENCY COMMUNICATION CENTER, EMS EDUCATION ELECTROMYOGRAPHY LABORATORY DEPARTMENT (EMG) THE EMG LABORATORY PROVIDES NERVE CONDUCTION STUDIES (NCS), NEEDLE ELECTROMYOGRAPHY, AUTONOMIC NERVOUS SYSTEM TESTING, BOTULINIUM TOXIN AND PHENOL INJECTIONS ON ADULT AND PEDIATRIC INPATIENTS (AMBULATORY OR PORTABLE) AND OUTPATIENTS FROM ALL ETHNIC AND SOCIO-ECONOMIC GROUPS. EAR, NOSE AND THROAT CLINIC (ENT) THE ENT CLINIC IS A SPECIALTY CLINIC THAT PROVIDES A WIDE RANGE OF SURGICAL, DIAGNOSTIC AND POSTOPERATIVE MANAGEMENT OF PATIENTS WITH EAR, NOSE AND THROAT CONDITIONS. EXTENDED CARE DEPARTMENT EXTENDED CARE PROVIDES PRIMARY CARE TO HCMC PATIENTS LIVING IN NURSING FACILITIES. FAMILY MEDICINE DEPARTMENT THE VISION OF DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE IS TO USE HIGH QUALITY MEDICAL EDUCATION AND PATIENT CARE TO CREATE EXCELLENT FAMILY PHYSICIANS WHO ARE SKILLED IN CARING FOR PEOPLE OF DIVERSE CULTURES, COMMITTED TO SERVING THEIR COMMUNITY, AND COMPETENT TO PRACTICE IN MULTIPLE SETTINGS. GASTROINTESTINAL LAB (GI) THE GI LAB IS PART OF THE SURGICAL SERVICES AREA PROVIDING PRE-PROCEDURE, PROCEDURAL AND NURSING VISITS TO A DIVERSE POPULATION OF BOTH INPATIENTS AND OUTPATIENTS SERVING PRIMARILY ADULTS. G3 MEDICAL /SURGICAL / ORTHOPAEDICS G3 IS A 37-BED, ALL PRIVATE-ROOM UNIT THAT SERVES MEDICAL AND SURGICAL PATIENTS, WITH AN EMPHASIS ON ORTHOPAEDICS AND HOSPITALIST
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 517,550,863
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part IIIClick to see attachment........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. .....
20b
 
No
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
287
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
5,164
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
13
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
MN
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
DAVID ALBRIGHT
701PARK AVENUE FINANCE P-1
701 PARK AVENUE FINANCE P-1
MINNEAPOLIS,MN55415
(612) 873-9292
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) ARTHUR A GONZALEZ
CEO/SECRETAR
 55.00 X   X       525,104 0 40,046
(2) RANDALL JOHNSON
DIRECTOR
 2.00 X           0 97,143 15,125
(3) MICHAEL OPAT
DIRECTOR
 2.00 X           0 88,983 25,850
(4) ANITA PAMPUSCH PHD
DIRECTOR
 2.00 X           0 0 0
(5) CHRISTOPHER PUTO PHD
DIRECTOR/ TR
 2.00 X           0 0 0
(6) DAVID JONES
CHAIR-FINANC
 2.00 X           0 0 0
(7) DONALD JACOBS MD
DIRECTOR
 2.00 X           0 0 0
(8) JAN MALCOLM
DIRECTOR
 2.00 X           0 0 0
(9) JUDITH SHANK MD
DIRECTOR
 2.00 X           0 0 0
(10) MARK BERNHARDSON
CHAIRMAN
 2.00 X           0 0 0
(11) MARY AZZAHIR
CHAIR-GOVERN
 2.00 X           0 0 0
(12) RAYMOND WALDRON
DIRECTOR
 2.00 X           0 0 0
(13) SHARON SAYLES BELTON
VICE CHAIR
 2.00 X           0 0 0
(14) LARRY KRYZANIAK
CFO
 55.00     X       319,813 0 30,984
(15) JOANNE SUNQUIST
CIO
 55.00       X     236,765 0 31,539
(16) KATHY WILDE
CNO
 55.00       X     233,405 0 24,841
(17) TIMOTHY HARLIN
CHIEF OPERAT
 55.00       X     215,922 0 38,218
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) TERRY W HOWELL
CHIEF QUALIT
 55.00       X     213,246 0 23,747
(19) JEANETTE TAYLOR-JONES
VP SUPPORT S
 55.00       X     195,574 0 28,074
(20) MICHAEL HARRISTHAL
VP PUBLIC PO
 55.00       X     160,607 0 27,367
(21) SCOTT CHASTEK
ANESTHETIST
 55.00         X   172,961 0 22,526
(22) MICHAEL SINGH
ANESTHETIST
 55.00         X   169,021 0 19,786
(23) SAMUEL D FINE
PHARMACIST
 55.00         X   167,579 0 28,294
(24) DIONNE HART
PSYCHIATRIST
 55.00         X   156,454 0 0
(25) THOMAS J LUTTENEGGER
ANESTHETIST
 55.00         X   155,971 0 27,502










1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 2,922,422 186,126 383,899
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet207
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
HENNEPIN FACULTY ASSOCIATES
HENNEPIN FACULTY ASSOCIATES
914 SOUTH 8TH STREET 600
914 SOUTH 8TH STREET 600
MINNEAPOLIS,MN55404 		HEALTH SERVICES 46,682,311
MCGOUGH CONSTRUCTION INC
MCGOUGH CONSTRUCTION INC
2737 FAIRVIEW AVENUE N
2737 FAIRVIEW AVENUE N
SAINT PAUL,MN55113 		CONSTRUCTION 16,538,772
UNIVERSITY OF MINNESOTA
UNIVERSITY OF MINNESOTA
420 DELAWARE STREET
420 DELAWARE ST SE
MINNEAPOLIS,MN55455 		MEDICAL EDUCATI 6,586,978
SODEXO HEATLTHCARE SERVICES
DODEXO HEALTHCARE SERVICES
3023 RANDOLPH STREET NE
4880 PAYSPERE CIRCLE
CHICAGO,IL60674 		HEALTH SERVICES 4,959,460
EPIC SYSTEMS CORPORATION
EPIC SYSTEMS CORPORATION
BOX 88314
BOX 88314
MILWAUKEE,WI53288 		CONSULTING/MEDI 3,901,571
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet238
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 55,246,873
f All other contributions, gifts, grants, and
similar amounts not included above1f 		371,249
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 55,618,122
Program Service Revenue Business Code
2a MEDICARE/MEDICAID PAYMENTS 900,099 241,139,245 241,139,245    
b INPATIENT REVENUE-NON GOV'T 900,099 172,955,063 172,955,063    
c OUTPATIENT REVENUE-NON GOV'T 900,099 98,967,915 98,967,915    
d OTHER STATE/FEDERAL PROGRAMS 900,099 53,310,614 53,310,614    
e INPATIENT PHARMACY 446,110 26,959,568 26,959,568    
f All other program service revenue . 3,819,845 2,233,842   1,586,003
g Total. Add lines 2a–2f........MediumBullet 597,152,250
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 1,061,978     1,061,978
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 1,122,572  
b Less: rental expenses    
c Rental income or (loss) 1,122,572  
d Net rental income or (loss).......MediumBullet 1,122,572     1,122,572
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses   468,141
c Gain or (loss)   -468,141
d Net gain or (loss)..........MediumBullet -468,141     -468,141
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a CAFETERIA SALES 722,210 1,904,586     1,904,586
b UNRELATED PARKING LOT REVENUE 812,930 570,612   570,612  
c UNRELATED PHARMACY REVENUE 446,110 513,718   513,718  
d All other revenue .... 273,722 273,722    
e Total. Add lines 11a–11d ......MediumBullet 3,262,638
12 Total revenue. See Instructions....MediumBullet 657,749,419 595,839,969 1,084,330 5,206,998
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 1,008,754 1,008,754
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,887,190 316,104 1,571,086  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 241,835,314 201,327,899 40,507,415  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 16,682,701 13,888,349 2,794,352  
9 Other employee benefits ....... 46,428,373 38,651,621 7,776,752  
10 Payroll taxes ........... 16,523,201 13,755,565 2,767,636  
11 Fees for services (non-employees):        
a Management ......        
b Legal .........        
c Accounting ........... 170,029 102,017 68,012  
d Lobbying ........... 170,655   170,655  
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other ..........        
12 Advertising and promotion .... 1,093,431 910,281 183,150  
13 Office expenses .......        
14 Information technology ...... 913,567 760,545 153,022  
15 Royalties ..        
16 Occupancy ........... 9,067,623 7,548,796 1,518,827  
17 Travel ............ 352,995 293,868 59,127  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 257,913 214,713 43,200  
20 Interest ........... 610,486 508,230 102,256  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 33,577,625 27,953,373 5,624,252  
23 Insurance .............. 317,605 264,406 53,199  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a MEDICAL SUPPLIES & MEDIC 65,928,779 65,928,779    
b PURCH SRV-HFA 36,895,455 36,895,455    
c BAD DEBTS 33,771,517 33,771,517    
d FACILITY/GROUNDS MAINT 14,482,543 12,056,717 2,425,826  
e MN CARE TAX/SURCHARGE 10,923,714 10,923,714    
f All other expenses 56,930,246 50,470,160 6,460,086  
25 Total functional expenses. Add lines 1 through 24f 589,829,716 517,550,863 72,278,853 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 37,693,888 1 88,716,597
2 Savings and temporary cash investments .......   2  
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 102,079,046 4 118,822,733
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 3,617,615 8 3,278,587
9 Prepaid expenses and deferred charges ............ 2,141,933 9 3,937,867
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 519,118,830
b Less: accumulated depreciation. ..... 10b 307,700,890 203,292,824 10c 211,417,940
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ...... 901,368 12 858,986
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 295,136 15 2,362,713
16 Total assets. Add lines 1 through 15 (must equal line 34)... 350,021,810 16 429,395,423
Liabilities 17 Accounts payable and accrued expenses . 130,104,500 17 144,000,283
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 12,980,952 25 10,539,079
26 Total liabilities. Add lines 17 through 25..... 143,085,452 26 154,539,362
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .....   27  
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ..... 187,755,685 31 203,416,365
32 Retained earnings, endowment, accumulated income, or other funds 19,180,673 32 71,439,696
33 Total net assets or fund balances ..... 206,936,358 33 274,856,061
34 Total liabilities and net assets/fund balances ..... 350,021,810 34 429,395,423
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
657,749,419
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
589,829,716
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
67,919,703
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
206,936,358
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
 
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
274,856,061
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990: ENTERPRISE FUND
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
HENNEPIN HEALTHCARE SYSTEM INC
  		Employer identification number

42-1707837
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
HENNEPIN HEALTHCARE SYSTEM INC
  		Employer identification number

42-1707837
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
HENNEPIN HEALTHCARE SYSTEM INC
  		Employer identification number

42-1707837
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ...... 114,523  
b Total lobbying expenditures to influence a legislative body (direct lobbying) ....... 56,132  
c Total lobbying expenditures (add lines 1a and 1b) ................... 170,655  
d Other exempt purpose expenditures ........................ 589,659,061  
e Total exempt purpose expenditures (add lines 1c and 1d) ............... 589,829,716  
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000  
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) ................. 250,000  
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount     1,000,000 1,000,000 2,000,000
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		        3,000,000
             
c Total lobbying expenditures     213,175 170,655 383,830
             
d Grassroots non-taxable amount     250,000 250,000 500,000
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		         750,000
             
f Grassroots lobbying expenditures     160,810 114,523 275,333
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
 
No
 
j
Total. lines 1c through 1i ...................................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
No
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
No
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
No
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
No
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
  SCHEDULE C, PART I-A, LINE 1 HENNEPIN HEALTHCARE SYSTEM, INC AND HENNEPIN COUNTY MN ENTERED INTO A SERVICE AGREEMENT WITH HENNEPIN COUNTY INTERGOVERNMENTAL RELATIONS(IGR), TO FURNISH STATE AND FEDERAL LOBBYING SERVICES RELATED TO HHS, INC MISSION AND PURPOSE. TOTAL 100,000 HHS, INC PAYS ASSOCIATION DUES TO THE FOLLOWING ORGANIZATIONS OF WHICH A PORTION OF THE DUES ARE FOR LOBBYING EFFORTS. THE FOLLOWING AMOUNTS ARE THE PORTION THAT REPRESENTS LOBBYING. 1. MINNESOTA HOSPITAL ASSOCIATION 4,180 2. ASSOCIATION OF AMERICAN MEDICAL COLLEGES 678 3. SAFETY NET HOSPITALS FOR PHARMACEUTICAL ACCESS 165 4. NATIONAL ASSOCIATION FOR PUBLIC HOSPITALS 9,500 TOTAL 14,523 TOTAL GRASS ROOTS LOBBYING BY HHS FOR 2010 114,523 HHS, INC INCURRED 56,132 FOR DIRECT LOBBYING EXPENSE IN REACTION TO THE ELIMINATION OF APPROXIMATELY 46 MILLION IN STATE OF MINNESOTA FUNDING FOR GENERAL ASSISTANCE MEDICAL CARE (GAMC) THAT WAS LINE ITEM VETOED BY THE GOVERNOR IN 2009. GAMC PROVIDES CARE FOR THOSE WHO HAVE NO, OR CAN NOT AFFORD HEALTH INSURANCE IN THE STATE OF MINNESOTA. THE LOBBYIST IS REGISTERED WITH THE STATE OF MINNESOTA. HCMC DISCOUNTINUED THE USE OF A LOBBYIST IN FEB 2011.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
No
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   18,939,367 18,939,367
b Buildings ................   289,896,145 172,893,741 117,002,404
c Leasehold improvements ............   5,698,088 3,492,261 2,205,827
d Equipment ................   134,467,584 92,202,520 42,265,064
e Other .................   70,117,646 39,112,368 31,005,278
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 211,417,940
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
LEASE REFUNDING CERTIFICATES 10,539,079








Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 10,539,079
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 657,749,419
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 589,829,716
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 67,919,703
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 67,919,703
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 617,185,902
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3 617,185,902
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b 40,563,517
c Add lines 4a and 4b....................... 4c 40,563,517
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 657,749,419
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 549,266,199
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3 549,266,199
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b 40,563,517
c Add lines 4a and 4b....................... 4c 40,563,517
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 589,829,716
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
RECONCILIATION OF CHANGES - OTHER SCHEDULE D, PAGE 4, PART XI, LINE 8 BAD DEBT RECLASS -33,771,517 IGT2 RECLASS -6,792,000 BAD DEBT RECLASS 33,771,517 IGT2 RECLASS 6,792,000
REVENUE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 4B BAD DEBT RECLASS 33,771,517 IGT2 RECLASS 6,792,000
EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 4B BAD DEBT RECLASS 33,771,517 IGT2 RECLASS 6,792,000
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    31,956,000   31,956,000 5.420 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    209,587,000 189,534,000 20,053,000 3.400 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		    241,543,000 189,534,000 52,009,000 8.820 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		24 3,030,327 3,994,922 3,942,883 52,039 0.010 %
f Health professions education
(from Worksheet 5) .. 		5 1,320 64,347,214 41,954,569 22,392,645 3.800 %
g Subsidized health services
(from Worksheet 6) .. 		1 50,000 233,704 93,000 140,704 0.020 %
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		1 200 9,000   9,000  
jTotal Other Benefits ... 31 3,081,847 68,584,840 45,990,452 22,594,388 3.830 %
kTotal. Add lines 7d and 7j. .. 31 3,081,847 310,127,840 235,524,452 74,603,388 12.650 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support 1   13,511   13,511  
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building 1   23,988 1,700 22,288  
7 Community health improvement advocacy 1   11,200   11,200  
8 Workforce development            
9 Other            
10 Total 3   48,699 1,700 46,999 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
16,530,000
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
 
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
104,805,000
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
152,139,000
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-47,334,000
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 HENNEPIN HEALTHCARE SYSTEM INC
HENNEPIN COUNTY MEDICAL CENTER
701 PARK AVENUE
MINNEAPOLIS,MN55415 		X X X X   X X X LEVEL 1 TRAUMA HOSPITAL
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:HENNEPIN HEALTHCARE SYSTEM INC
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1 Yes  
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20 10
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3 Yes  
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4   No
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5 Yes  
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7 Yes  
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 200.0%
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.0%
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14 Yes  
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16 Yes  
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?7
Name and address Type of Facility (Describe)
1 HCMC- BROOKLYN CENTER CLINIC
6601 SHINGLE CREEK PARKWAY
MINNEAPOLIS,MN55430 		HOSPITAL BASED CLINIC
2 HCMC- BROOKLYN CENTER CLINIC
6601 SHINGLE CREEK PARKWAY
MINNEAPOLIS,MN55430 		HOSPITAL BASED CLINIC
3 HCMC- BROOKLYN CENTER CLINIC
6601 SHINGLE CREEK PARKWAY
MINNEAPOLIS,MN55430 		HOSPITAL BASED CLINIC
4 HCMC- BROOKLYN CENTER CLINIC
6601 SHINGLE CREEK PARKWAY
MINNEAPOLIS,MN55430 		HOSPITAL BASED CLINIC
5 HCMC- BROOKLYN CENTER CLINIC
6601 SHINGLE CREEK PARKWAY
MINNEAPOLIS,MN55430 		HOSPITAL BASED CLINIC
6 HCMC- BROOKLYN CENTER CLINIC
6601 SHINGLE CREEK PARKWAY
MINNEAPOLIS,MN55430 		HOSPITAL BASED CLINIC
7 HCMC- BROOKLYN CENTER CLINIC
6601 SHINGLE CREEK PARKWAY
MINNEAPOLIS,MN55430 		HOSPITAL BASED CLINIC
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
OTHER TESTING METHODS FOR FREE OR DISCOUNTED CARE PART I LINE 3C THIS LINE IS NOT APPLICABLE
SUBSIDIZED HEALTH SERVICES EXPLANATION PART I LINE 7G THE HOSPITAL PROVIDES SERVICES THAT WOULD NOT BE PROVIDED OR WOULD NEED TO BE PROVIDED BY THE GOVERNMENT OR OTHER NONPROFITS IF THE DECISION WAS BASED ON FINANCIAL TERMS RESPOND TO PUBLIC HEALTH NEEDS OR INVOLVE EDUCATION OR RESEARCH THAT FURTHERS COMMUNITY HEALTH THE HOSPITAL ALSO PROVIDES EMERGENCY AND TRAUMA BEHAVIORAL HEALTH SERVICES OTHER SERVICES PROVIDED AT A FINANCIAL LOSS BECAUSE THEY MEET COMMUNITY NEEDS INCLUDE EMERGENCY CLOTHING FOR ADULTS AND CHILDREN WHEN PATIENTS CANNOT AFFORD CLOTHING APPROPRIATE FOR THE WEATHER HAVE CLOTHING RUINED IN AN ACCIDENT OR CLOTHING THAT IS IN POOR SHAPE OR TOO WORN ADDRESSING HOMELESSNESS AND POVERTY SUPPORTING ECONOMIC DEVELOPMENT OR ENVIRONMENTAL PROTECTION EFFORTS OR IMPROVING PUBLIC SPACES THROUGH REVITALIZATION
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE PART I LINE 7 COLUMN F COMMUNITY BENEFIT AMOUNTS DO NOT INCLUDE BAD DEBTS IN THE AMOUNT OF 33772000 THIS IS COMPUTED FROM HHS INC EPIC AR SYSTEM AND FROM WRITE OFFS CHARGES FORGONE AND BAD DEBT POSTED OR RESERVED FOR IN THE GENERAL LEDGER FOR COMMUNITY BENEFIT REPORTING IN THE NOTES TO THE FINANCIAL STATEMENTS THE MINNESOTA HOSPITAL ASSOCIATION INCLUDES BAD DEBTS AS COMMUNITY BENEFIT AS ALL OTHER HOSPITALS REPORT THIS AMOUNT WHICH IS SEPARATELY LISTED ALONG WITH OTHER COMMUNITY BENEFITS WHICH ARE REPORTED TO THE MINNESOTA STATE LEGISLATURE
COSTING METHODOLOGY EXPLANATION PART I LINE 7 HENNEPIN HEALTHCARE SYSTEM INC AS A SAFETY NET HOSPITAL HAS A TREAT FIRST POLICY TO MEET THE HEALTHCARE NEEDS OF ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY CONSISTENT WITH A COMMITMENT TO CHARITABLE PURPOSES AND A DEDICATION TO SERVING THE HEALTHCARE NEEDS OF THE COMMUNITY NO INDIVIDUAL IS TURNED AWAY OR DENIED TREATMENT FOR COSTING PURPOSES HHS INC USES A COMBINATION OF STANDARD COSTING WHERE APPLICABLE AND FEDERAL POVERTY GUIDELINES PART I LINE 7A INCLUDED IN CHARITY CARE AT COST IS MN CARE TAX AND SURCHARGE TAXES IN THE AMOUNT OF 6046387 AND 4721100 RESPECTIVELY THESE TAXES ARE IMPOSED BY MINNESOTA STATUTE TO COVER COST OF PROVIDING HEALTHCARE COVERAGES FOR THOSE WHO CANNOT AFFORD INSURANCE
COMMUNITY BUILDING ACTIVITIES PART II THE HOSPITAL IS HEAVILY INVOLVED IN COMMUNITY SUPPORT PROGRAMS INCLUDING DOMESTIC FAMILY VIOLENCE PROGRAMS FOR THE SURROUNDING COUNTIES IN THE STATE OF MINNESOTA SUSPECTED CHILD ABUSE AND NEGLECTSCANT PROGRAMS AND CONFERENCES TO MEET THE NEEDS OF COMMUNITIES NATIVE AMERICAN ADVOCATE WHICH IS HEALTH IMPROVEMENT ADVOCACY FOR NATIVE AMERICANS ADDRESSING HOMELESSNESS AND POVERTY SUPPORTING ECONOMIC DEVELOPMENT AND ENVIRONMENTAL PROTECTION EFFORTS OR IMPROVING PUBLIC SPACE THROUGH REVITALIZATION EACH PROGRAM IS DONE ANNUALLY AND IS FREE OF CHARGE
BAD DEBT EXPENSE EXPLANATION PART III LINE 4 BAD DEBTS IN THE COST AMOUNT OF 16530000 AS REPORTED ON LINE 2 IS THE COST AS A PERCENTAGE OF ADJUSTED PATIENT CHARGES DIVIDED BY OPERATING EXPENSES TO ACHIEVE A COST TO CHARGE RATIO THIS AMOUNT IS THE PRODUCT OF THE RATIO OF COST TO CHARGES MULTIPLIED BY THE BAD DEBT EXPENSE PART III LINE 4 BAD DEBT EXPENSE EXPLANATION BAD DEBTS EXPENSE IN THE AMOUNT OF 33772000 WHICH IS NOT INCLUDED IN COMMUNITY BENEFITS IS THE AMOUNT RECORDED DURING 2010 WHICH IS WRITTEN OFF OR SENT TO COLLECTIONS NET OF RECOVERIES AND NET OF BOOK RESERVES FOR ADJUSTMENTS TO THE ONGOING BAD DEBT ALLOWANCE ON OPEN ACCOUNTS RECEIVABLE
MEDICARE EXPLANATION PART III LINE 8 THE SHORTFALL IN MEDICARE IS DETERMINED BY THE COST TO CHARGE RATIO THAT IS COMPUTED EVERY YEAR AND COMPARED FOR REASONABLENESS THE SHORTFALL IN MEDICARE PAYMENTS TO COMPUTED COSTS REPRESENTS THE NET COSTS THAT THE HOSPITAL INCURS FOR NONCOMMUNITY BENEFIT MEDICARE EXPENSES ABSORBED BY THE HOSPITAL
COLLECTION PRACTICES EXPLANATION PART III LINE 9B HHS INC USES A COMBINATION OF DISCOUNT AND COLLECTION POLICIES PATIENTS ARE SCREENED USING ESTABLISHED GUIDELINES AS SET BY THE HOSPITAL AND WHEREVER POSSIBLE THE PATIENT OR PATIENTS FAMILY CAN FILL OUT AN APPLICATION FOR FINANCIAL ASSISTANCE THOSE THAT DO NOT QUALIFY FOR MEDICAL ASSISTANCE CHARITY CARE OR HENNEPIN CARE OR WHO ARE UNINSURED WILL BE OFFERED AN UNINSURED DISCOUNT CARE PATIENTS WITH SELF PAY BALANCES WHO ARE CONSIDERED ABLE TO PAY BASED ON FINANCIAL SCREENING MAY BE TURNED OVER TO COLLECTIONS IF THE HOSPITAL DEEMS THAT THEY HAVE THE ABILITY TO COLLECT FOR SERVICES
NEEDS ASSESSMENT PART VI SCHEDULE H PART V COMMUNITY HEALTH NEEDS ASSESSMENT AS REQUIRED BY MINNESOTA LAW HHS INC IS REQUIRED TO PERFORM AN ANNUAL NEEDS ASSESMENT FOR THE SURROUNDING METRO TWIN CITIES AREA ENTITLED HEALTH SERVICES PLAN THE REPORT IS ANNUALLY APPPROVED BY HHS INC BOARD AND THE HENNEPIN COUNTY HEALTH HUMAN SERVICES COMMITTEE THE REPORT IS ALSO SUBMITTED TO THE MINNESOTA DEPARTMENT OF HEALTH HHS INC USES A VARIETY OF COMMUNITY NEEDS ASSESSMENTS EG SHAPE AND HEALTH SERVICE PLANNING DOCUMENTS TO DEVELOP A PROFILE OF THE HEALTH STATUS OF THE COMMUNITY CURRENTLY THERE ARE NO COMPREHENSIVE AND WIDELY ACCESSIBLE AND ACCEPTED DOCUMENTS THAT PROVIDE A DEFENSIVE BASELINE AS A MEANS FOR LONGITUDINAL ESTIMATE FOR IMPROVEMENT HHS INC USES STUDIES OR INITIATIVES BEING CONDUCTED BY PUBLIC HEALTH DEPARTMENTS HEALTH CARE SYSTEMS AND OTHER AGENCIES AND ENTITIES FOCUSED ON SPECIFIC CONDITIONS OR SPECIFIC GEOGRAPHIC REGIONS IMPROVEMENTS INCLUDE THE IDENTIFICATION OF DATASETS TO CREATE AND SYNDICATE BASELINE DATA AND ENGAGE IN COLLABORATIVE DISCUSSIONS AMONG AND BETWEEN PUBLIC HEALTH DEPARTMENTS AND HEALTH CARE SYSTEMS HCMC CONDUCTED EXPLORATORY DISCUSSION SESSIONS THAT INCLUDED ALL OF THE HENNEPIN COUNTY HEALTHCARE SYSTEMS OPEN COMMUNITY FORUM AND THE THREE LARGEST PUBLIC HEALTH DEPARTMENTS HCMC DATA SHOW THAT PROFOUND HEALTH DISPARITIES EXIST IN MINNESOTA AT HCMC 6065 OF SERVICES ARE PROVIDED TO PERSONS BELONGING TO RACIAL AND ETHNIC MINORITIES HCMCHHS ADMINISTERS PRESS GANEY PATIENT SATISFACTION SURVEYS IN FIVE LANGUAGES AND HAS BEGUN TO STRATIFY RESULTS BY RACE AND ETHNICITY THUS ALLOWING FOR GREATER AWARENESS AND THE OPPORTUNITY FOR FOCUSED INTERVENTION THE HEALTH SERVICES PLAN IS APPROVED ANNUALLY BY THE HENNEPIN HEALTHCARE SYSTEM INC BOARD OF DIRECTORS AND THE HENNEPIN COUNTY HEALTH HUMAN SERVICES COMMITTEE
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI PATIENTS ARE SCREENED USING ESTABLISHED GUIDELINES AS SET BY THE HOSPITAL AND WHEREVER POSSIBLE THE PATIENT OR PATIENTS FAMILY CAN FILL OUT AN APPLICATION FOR MEDICAL ASSISTANCE ANDOR HENNEPIN CARE REQUIRED TO SUBMIT THE REQUIRED VERIFICATIONS FOR THOSE THAT DO NOT QUALIFY FOR CHARITY CARE HENEPIN CARE MAY BE ELIGIBLE FOR AN UNINSURED DISCOUNT PATIENTS WHO HAVE A PAST DUE BILL BALANCE AND BASED UPON FINANCIAL ASSISTANCE SCREENING ARE CONSIDERED ABLE TO PAY MAY BE TURNED OVER TO COLLECTIONS IF THE HOSPITAL DEEMS THAT THEY HAVE TO THE ABILITY TO COLLECT FOR SERVICES
COMMUNITY INFORMATION PART VI HENNEPIN HEALTHCARE SYSTEM INC IS A PUBLIC CORPORATION SAFETY NET HOSPITAL ENGAGED IN THE DELIVERY OF HEALTHCARE AND RELATED SERVICES TO THE GENERAL PUBLIC IN THE STATE OF MN INCLUDING THE INDIGENT AS DEFINED BY STATE AND FEDERAL LAW AS DETERMINED BY THE HENNEPIN COUNTY BOARD OF COMMISSIONERS IT HAS A TREAT FIRST POLICY REGARDLESS OF A PATIENTS ABILITY TO PAY
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI HCMC PROVIDES MORE CARE TO MINNESOTA HEALTH CARE PROGRAM MHCP RECIPIENTS AND THE UNINSURED THAN DO OUR NONTEACHING HOSPITAL COUNTERPARTS NEARLY 50 OF HCMCHHS VOLUME IS PROVIDED TO LOWINCOME POPULATIONS HCMCHHS IS THE STATES LARGEST PROVIDER OF SERVICE TO THE POOR BY A SUBSTANTIAL MARGIN HCMC TREATS THE COUNTYS AND REGIONS MORE SEVERELY ILL PATIENTS SUCH AS THOSE REFERRED FROM OTHER HOSPITALS AND THOSE REQUIRING EXTENSIVE SUPPORT SERVICES PHYSICIANS AND ALUMNI ARE INTEGRAL TO THE REGIONS EMERGENCY PREPAREDNESS AND STANDBY CAPACITY AND PROVIDE MANY SPECIALIZED INPATIENT AND OUTPATIENT SERVICES SUCH AS ORGAN TRANSPLANTATION INTENSIVE NEONATAL CARE ONCOLOGY SERVICES AND SOPHISTICATED RECONSTRUCTIVE SURGERY TO THE REGIONS POPULATION HCMC FACILITATES THE TRANSITION OF NEW SERVICES AND TECHNOLOGIES INTO THE MAINSTREAM AND RAISE OUR REGIONAL STANDARDS
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILED PART VI MINNESOTA
ADDITIONAL INFORMATION PART VI PART I LINE 6A B THE COMMUNITY BENEFIT REPORT IS A FOOTNOTE DISCLOSURE AS PART OF HHS INC ANNUAL AUDITED FINANCIAL STATEMENT THAT IS AN ENTERPRISE FUND OF HENNEPIN COUNTY MINNESOTA AND IS SUCH FILED WITH THE COUNTY THE AUDITED STATEMENT IS AVAILABLE TO THE PUBLIC THE REPORT IS FILED WITH THE SECRETARY OF STATE MINNESOTA PART I LINE 7F HEALTH PROFESSIONAL EDUCATION PUBLIC HOSPITALS ARE SPECIAL PLACES THAT HELP THE UNDERSERVED AND PROVIDE COMPREHENSIVE AND UNIQUE SERVICES FOR THE GENERAL POPULATION HCMC IS A PREMIER TEACHING HOSPITAL AND CLINIC SYSTEM FROM THE TRAINING OF TOMORROWS DOCTORS TO ENSURING PHYSICIANS THROUGH OUT MINNESOTA REMAIN CURRENT ON THE LATEST MEDICAL ADVANCES HCMC HAS LONG BEEN AND CONTINUES TO BE A NATIONALLY RECOGNIZED PUBLIC HEALTH SYSTEM AND MEDICAL EDUCATION RESOURCE
HENNEPIN HEALTHCARE SYSTEM INC LINE NUMBER 1 PART V LINE 1J PART V LINE 1J HENNEPIN COUNTY MEDICAL CENTERHENNEPIN HEALTHCARE SYSTEM INC HCMCHHS PRODUCES AN ANNUAL HEALTH SERVICES PLAN FOR THE REVIEW AND APPROVAL BY THE HENNEPIN COUNTY BOARD OF COMMISSIONERSAS STATED IN THE BYLAWS THE HEALTH SERVICES PLAN WILL DRAW FROM A POPULATION NEEDS ASSESSMENT AND WILL DELINEATE THE CORPORATIONS ROLE IN THE COMMUNITY INCLUDING EDUCATION RESEARCH AND SERVICES TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY INCLUDING INDIGENT POPULATIONS THE PLAN MUST ALSO DESCRIBE CONTINUED COORDINATION WITH THE COUNTY THE PRINCIPLE HEALTH SERVICES TO BE PROVIDED SIGNIFICANT CHANGES IN THE PATTERNS OF THE COMMUNITY HEALTH NEEDS SIGNIFICANT PLANS FOR CHANGES IN THE DEPLOYMENT OF RESOURCES OR SITES THE PRIMARY THRUST OF WORKFORCE PLANS AND THE OPERATION AND EFFECT OF THE INDIGENT CARE FORMULA OUR OBJECTIVES ARE TO DESIGN AND FACILITATE ACTIONS THAT ARE CONTINUOUS OVER TIME MEASURABLE AND THAT BOTH LEVERAGE AND COMPLEMENT RELATIONSHIPS WITH PARTNERING ORGANIZATIONS THIS WORK INCLUDES ASSURANCE THAT INITIATIVES ARE DEEPLY EMBEDDED INTO DAYTODAY OPERATIONS
HENNEPIN HEALTHCARE SYSTEM INC LINE NUMBER 1 PART V LINE 3 PART V LINE 3 THE HEALTH SERVICES PLAN DRAWS FROM A POPULATION NEEDS ASSESSMENT AND WILL DELINEATE THE CORPORATIONS ROLE IN THE COMMUNITY INCLUDING EDUCATION RESEARCH AND SERVICES TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY INCLUDING INDIGENT POPULATIONS
HENNEPIN HEALTHCARE SYSTEM INC LINE NUMBER 1 PART V LINE 13G PART V LINE 13G HHSINC CREATED A WEB SITE BASED INFORMATION FOR PATIENTS FAMILY VISITORS THE SITE ALLOWS INDIVIDUALS ACCESS TO PATIENT RESOURCES AND A PORTAL IN THE PATIENT BILLING SITE THAT ASSISTS WITH PAYING FOR YOUR HEALTH SERVICES IN WHICH THE PATIENT CAN BE GUIDED THROUGH THE INPUT SCREENS WHETHER OR NOT THEY ARE INSURED
HENNEPIN HEALTHCARE SYSTEM INC LINE NUMBER 1 PART V LINE 15E PART V LINE 15E SEE EXPLANATION PART III LINE 9B
HENNEPIN HEALTHCARE SYSTEM INC LINE NUMBER 1 PART V LINE 16E PART V LINE 16E SEE EXPLANATION PART III LINE 9B
HENNEPIN HEALTHCARE SYSTEM INC LINE NUMBER 1 PART V LINE 17E PART V LINE 17E SEE EXPLANATION PART III LINE 9B
HENNEPIN HEALTHCARE SYSTEM INC LINE NUMBER 1 PART V LINE 19D PART V LINE 19D HCMC COLLECTIONSCUSTOMER SERVICE AREAS PROCESS DISCOUNT ADJUSTMENTS TO PATIENTS ACCOUNTS SUBJECT TO PROPER ADJUSTMENT APPROVALS AND GUIDELINES PATIENTS ARE ELIGIBLE FOR DISCOUNTS BASED ON PATIENT HOUSEHOLD SIZE AND INCOME IN RELATION TO FEDERAL POVERTY GUIDELINES PATIENTS WHO MAY BE ELIGIBLE FOR GOVERNMENT PROGRAMS ARE REQUIRED TO APPLY FOR THOSE PROGRAMS IF BENEFITS ARE DENIED THE APPLICABLE DISCOUNT SHALL APPLY FINANCIAL COUNSELORS COLLECT AND RECORD THE PATIENTS GROSSNET INCOME AND FAMILY SIZE TO DETERMINE APPROPRIATE DISCOUNT THE HOSPITAL USES FEDERAL GUIDELINES FOR DETERMINING DISCOUNTS AND FREE CARE
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number
42-1707837
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) ALLINA HOSPITAL - MERCY HOSPITAL
ALLINA HOSPITAL - MERCY HOSPITAL4050 COON RAPIDS BLVD
4050 COON RAPIDS BLVD
COON RAPIDS,MN55433 		36-3261413   47,612       EMERGENCY & PREPARD
(2) ALLINA HOSPITAL - UNITED HOSPITAL
ALLINA HOSPITAL - UNITED HOSPITAL333 SMITH AVENUE NORTH
333 SMITH AVENUE
SAINT PAUL,MN55102 		36-3261413   54,942       EMERGENCY & PREPARD
(3) ALLINA HOSPITAL - UNITY HOSPITAL
ALLINA HOSPITAL - UNITY HOSPITAL5500 OSBORNE ROAD
550 OSBORNE ROAD
FRIDLEY,MN55435 		36-3261413   46,211       EMERGENCY & PREPARD
(4) ALLINA HOSPITAL -ABBOTT NORTHWSTRN
ALLINA HOSPITAL-ABBOTT NORTHWESTER800 EAST 28TH STREET
800 EAST 28TH STREET
MINNEAPOLIS,MN55407 		36-3261413   92,826       EMERGENCY & PREPARD
(5) CHILDREN'S HOSPITAL- ST PAUL
CHILDREN'S HOSPITAL- ST PAUL345 N SMITH AVENUE
345 N SMITH AVENUE
SAINT PAUL,MN55102 		41-1754276   44,402       EMERGENCY & PREPARD
(6) CHILDREN'S HOSPITAL-MPLS
CHILDREN'S HOSPITAL-MPLS2525 CHICAGO AVENUE
2525 CHICAGO AVENUE
MINNEAPOLIS,MN55404 		41-1754276   46,616       EMERGENCY & PREPARD
(7) CLEARWTER TRUCK CENTER INC
CLEARWATER TRUCK CENTER INC925 SHORTY STREET
925 SHORTY STREET
CLEARWATER,MN55320 		41-1639302   26,385       EMERGENCY &PREPARD
(8) EARLE BROWN HERITAGE CENTER
EARLE BROWN HERITAGE CENTEREARLE BROWN DRIVE
EARLE BROWN DRIVE
BROOKLYN CENTER,MN55430 		41-6005011   38,995       EMERGENCY & PREPARD
(9) FAIRVIEW RIDGES HOSPITAL
FARIVIEW RIDGES HOSPITAL201 E NICOLLET BLVD
201 E NICOLLET BLVD
BURNSVILLE,MN55337 		41-0991680   67,850       EMERGENCY & PREPARD
(10) FAIRVIEW RIVERSIDE HOSPITAL
FAIRVIEW RIVERSIDE HOSPITAL2450 RIVERSIDE AVENUE
2450 RIVERSIDE AVENUE
MINNEAPOLIS,MN55454 		41-0991680   31,359       EMERGENCY & PREPARD
(11) FAIRVIEW SOUTHDALE HOSPITAL
FAIRVIEW SOUTHDALE HOSPITAL6401 FRANCE AVENUE SOUTH
6401 FRANCE AVENUE SOUTH
EDINA,MN55435 		41-0991680   32,088       EMERGENCY & PREPARD
(12) FAIRVIEW UNIVERSITY HOSPITAL
FAIRVIEW UNIVERSITY HOSPITAL500 HARVARD STREET
500 HARVARD STREET
MINNEAPOLIS,MN55455 		41-0991680   33,033       EMERGENCY & PREPARD
(13) GRAINGER
GRAINGER100 GRAINGER PARKWAY
100 GRAINGER PARKWAY
LAKE FOREST,IL60045 		36-1150280   35,898       EMERGENCY & PREPARD
(14) HEALTHEAST - SAINT JOHN'S HOSPITAL
HEALTHEAST - SAINT JOHN'S HOSPITAL1575 BEAM AVENUE
1575 BEAM AVENUE
MAPLEWOOD,MN55109 		41-1456897   45,960       EMERGENCY & PREPARD
(15) HEALTHEAST - SAINT JOSEPH HOSPITAL
HEALTHEAST - SAINT JOSEPH HOSPITAL45 WEST 10TH STREET
45 WEST 10TH STREET
SAINT PAUL,MN55102 		41-0693880   20,500       EMERGENCY & PREPARD
(16) HEALTHEAST - WOODWINDS HOSPITAL
HEALTHEAST - WOODWINDS HOSPITAL1690 UNIVERSITY AVENUE WEST
1690 UNIVERSITY AVENUE WEST
SAINT PAUL,MN55104 		41-1592761   38,822       EMERGENCY & PREPARD
(17) LAKEVIEW HOSPITAL
LAKEVIEW HOSPITAL927 CHURCHILL STREET WEST
927 CHURCHILL STREET WEST
STILLWATER,MN55082 		41-0811697   18,250       EMERGENCY & PREPARD
(18) MAPLE GROVE HOPITAL CORP
MAPLE GROVE HOSPITAL CORP9875 HOSPITAL DRIVE
9875 HOSPITAL DRIVE
MAPLE GROVE,MN55369 		20-8316475   18,250       EMERGEMCY & PREPARD
(19) NORTH MEMORIAL MEDICAL CENTER
NORTH MEMORIAL HOSPITAL3300 OAKDALE AVENUE N
3300 OAKDALE AVENUE N
ROBBINSDALE,MN55422 		41-0729979   71,909       EMERGENCY & PREPARD
(20) NORTHFIELD HOSPITAL
NORTHFIEL HOSPITAL2000 NORTH AVENUE
2000 NORTH AVENUE
NORTHFIELD,MN55057 		41-6007241   19,249       EMERGENCY & PREPARD
(21) PARK NICOLLET METHODIST HOSPITAL
PARK NICOLLET METHODIST HOSPITAL6500 EXCELSIOR BLVD
6500 EXCELSIOR BLVD
SAINT LOUIS PARK,MN55426 		41-0132080   54,456       EMERGENCY & PREPARD
(22) QUEEN OF PEACE HOSPITAL
QUEEN OF PEACE HOSPITAL301 2ND STREET NE
301 2ND STREET NE
NEW PRAGUE,MN56071 		41-0723639   18,250       EMERGENCY & PREPARD
(23) REGINA MEDICAL CENTER
REGINA MEDICAL CENTER1175 SINGER ROAD
1175 SINGER ROAD
HASTINGS,MN55033 		41-0740678   37,391       EMERGENCY & PREPARD
(24) REGIONS HOSPITAL
REGIONS HOSPITAL640 JACKSON STREET
640 JACKSON STREET
SAINT PAUL,MN55101 		41-0956618   31,000       EMERGENCY & PREPARD
(25) RIDGEVIEW MEDICAL CENTER
RIDGEVIEW MEDICAL CENTER500 SOUTH MAPLE STREET
500 SOUTH MAPLE STREET
WACONIA,MN55387 		31-1667875   18,250       EMERGENCY & PREPARD
(26) SAINT FRANCIS REGIONAL MEDICAL CTR
SAINT FRANCIS REGIONAL MEDICAL CTR1455 SAINT FRANCIS AVENUE
1455 SAINT FRANCIS AVENUE
SHAKOPEE,MN55379 		36-3261413   18,250       EMERGENCY & PREPARD
2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
24
3
Enter total number of other organizations ................................ . Bullet Image
14
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 HENNEPIN HEALTHCARE SYSTEMS, INC HAS A GRANT MANAGEMENT DEPARTMENT THAT WORKS IN COOPERATION WITH FINANCE, PROGRAM DIRECTORS AND HENNEPIN COUNTY, MN TO MONITOR GRANT RECEIPTS AND GRANT DISBURSEMENTS, (WHETHER FEDERAL, STATE, LOCAL OR INDIVIDUAL,) THAT THE ORGANIZATION HAS RECEIVED AND EXPENDED AND MONITORS COMPLIANCE ,(IF ANY) WITH SUCH GRANT REQUIREMENTS.
Schedule I (Form 990) 2010


Additional Data


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Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) ARTHUR A GONZALEZ (i)
(ii)		 525,104
  		 
  		 
  		24,500
  		15,546
  		565,150
  		 
 
(2) LARRY KRYZANIAK (i)
(ii)		 319,813
  		 
  		 
  		17,150
  		13,834
  		350,797
  		 
 
(3) JOANNE SUNQUIST (i)
(ii)		 236,765
  		 
  		 
  		16,222
  		15,317
  		268,304
  		 
 
(4) KATHY WILDE (i)
(ii)		 233,405
  		 
  		 
  		16,422
  		8,419
  		258,246
  		 
 
(5) TIMOTHY HARLIN (i)
(ii)		 215,922
  		 
  		 
  		12,946
  		25,272
  		254,140
  		 
 
(6) TERRY W HOWELL (i)
(ii)		 213,246
  		 
  		 
  		12,680
  		11,067
  		236,993
  		 
 
(7) JEANETTE TAYLOR-JONES (i)
(ii)		 195,574
  		 
  		 
  		14,571
  		13,503
  		223,648
  		 
 
(8) MICHAEL HARRISTHAL (i)
(ii)		 160,607
  		 
  		 
  		11,130
  		16,237
  		187,974
  		 
 
(9) SCOTT CHASTEK (i)
(ii)		 172,961
  		 
  		 
  		10,575
  		11,951
  		195,487
  		 
 
(10) MICHAEL SINGH (i)
(ii)		 169,021
  		 
  		 
  		11,831
  		7,955
  		188,807
  		 
 
(11) SAMUEL D FINE (i)
(ii)		 167,579
  		 
  		 
  		11,626
  		16,668
  		195,873
  		 
 
(12) DIONNE HART (i)
(ii)		 156,454
  		 
  		 
  		 
  		 
  		156,454
  		 
 
(13) THOMAS J LUTTENEGGER (i)
(ii)		 155,971
  		 
  		 
  		10,820
  		16,682
  		183,473
  		 
 



Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
COMPENSATION CONTINGENT UPON NET EARNINGS OF ORGANIZATION SCHEDULE J, PAGE 1, PART I, LINE 6A HENNEPIN HEALTHCARE SYSTEM, INC., HAS TWO INCENTIVE PROGRAMS DESIGNED TO REWARD ELIGIBLE EMPLOYEES WITH A FINANCIAL PAYOUT IF ESTABLISHED ORGANIZATIONAL GOALS (FOCUSED ON CUSTOMER SERVICE AND PATIENT SAFETY) ARE MET. THE OBJECTIVES OF THE PLANS ARE TO ALIGN COMPENSATION PRACTICES WITH ORGANIZATIONAL GOALS AND OBJECTIVES AND REWARD INDIVIDUALS BASED ON PERFORMANCE-BASED CRITERIA. INDIVIDUALS ARE NOT ALLOWED TO PARTICIPATE IN BOTH PLANS AND BOTH ARE SUBJECT TO MODIFICATION BY THE BOARD OF DIRECTORS INCLUDING THE RIGHT TO NOT PAY ANY AMOUNT. FOR EXAMPLE, UNFORESEEN OR CATASTROPHIC CIRCUMSTANCES THAT WOULD MAKE IT DIFFICULT TO JUSTIFY PAYING IN A GIVEN YEAR. EACH PLAN HAS QUALIFICATIONS THAT MUST BE MET IN ORDER FOR THE DISCRETIONARY PAYMENT TO BE CONSIDERED. DURING 2010 THERE WERE PAYOUTS FOR CERTAIN PERSONS LISTED IN PART VII, SECTION A, LINE 1A. THESE INCENTIVE PAYMENTS WERE FOR THE 2009 PROGRAM YEAR, ACCRUED DURING 2009. THE SPECIFIC INCENTIVE PLAN FOR LEADERS WITHIN THE ORGANIZATION WAS NOT IN PLACE DURING 2010, THEREFORE, NO ACCRUALS WERE MADE DURING 2010 FOR THIS PROGRAM.
OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III FORM 990 SCHEDULE J PART 1, QUESTION 3 AS PART OF ITS ANNUAL BOARD APPROVAL ITEMS, A LINE ITEM MOTION IS DONE. FORM 990 SCHEDULE J PART II KEY EMPLOYEES - ADDITIONS INCLUDED AS HHS, INC KEY EMPLOYEES ARE THE FOLLOWING HENNEPIN FACULTY ASSOCIATES (HFA) EMPLOYEES. THEY ARE NOT COMPENSATED BY HHS, INC. OR ANY RELATED ORGANIZATION, BUT ARE PAID THROUGH A SHARED SERVICES AGREEMENT WITH HFA. THIS AGREEMENT IS INCLUDED AS PART OF FORM 990, PART VII, SECTION B, INDEPENDENT CONTRACTORS. DEFERRED NON-TAXABLE NAME/ TITLE COMPENSATION COMPENSATION BENEFITS MICHAEL B. BELZER M.D 323,796 31,152 26,794 CHIEF MEDICAL OFFICER GREGORY A. LUTZ 252,278 31,152 6,458 CHIEF CLINICAL OFFICER CONTINUE FROM PREVIOUS PAGE STEVEN P. STERNER M.D 291,867 31,152 24,894 CHIEF CLINICAL OFFICER
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Identifier Return Reference Explanation
ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION FORM 990, PART I, LINE1 AND FORM 990, PART III, LINE 1 HCMC IS A LEVEL ONE TRAUMA CENTER, ACUTE & TERTIARY CARE, PUBLIC TEACHING HOSPITAL. HCMC PROVIDES THE BEST POSSIBLE CARE TO EVERY PATIENT SERVED AND SEARCHES FOR NEW WAYS TO IMPROVE HEALTHCARE FOR TOMORROW. HCMC IS EDUCATING HEALTHCARE PROVIDERS FOR THE FUTURE AND ENSURING ACCESS TO HEALTHCARE FOR ALL. FORM 990, PART I LINE 1, SIGNIFICANT ACTVIVITES FOR 2010 AS A SAFETY NET HOSPITAL, HCMC RECEIVES SUPPLEMENTAL MEDICAID PAYMENTS, ALSO KNOWN AS UPPER PAYMENT LIMIT PAYMENTS (UPL), FOR INPATIENT AND OUTPATIENT SERVICES THROUGH INTERGOVERNMENTAL TRANSFERS IN ACCORDANCE WITH SPECIFIC STATE STATUES SUBJECT TO FEDERAL REGULATIONS AND APPROVAL. DURING 2009, MINNESOTA STATE LEGISLATION CREATED SEVERAL NEW SUPPLEMENTAL MEDICAID PAYMENT STATUTES. UPON FEDERAL APPROVAL IN 2010, THE MEDICAL CENTER RECEIVED NONRECURRING PAYMENTS OF APPROXIMATELY 17 MILLION UNDER THESE STATUTES RELATED TO THE 2009 FEDERAL FISCAL YEAR. HCMC ALSO RECEIVES AMOUNTS FROM HENNEPIN COUNTY FOR CAPITAL ASSET ADDITIONS. THESE CAPITAL CONTRIBUTIONS TOTALED APPROXIMATELY 22 MILLION AND 16 MILLION IN 2010 AND 2009, RESPECTIVELY. NET OF THESE AMOUNTS, PART 1, LINE 19 "REVENUE LESS EXPENSES" WOULD BE 28.5 MILLION AND (2.5) MILLION FOR 2010 AND 2009, RESPECTIVELY.
EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS FORM 990, PAGE 1, PART I, LINE 6 HENNEPIN COUNTY MEDICAL CENTER HAD 11,756 HOURS LOGGED IN 2010 BY VOLUNTEERS WHO HELP THROUGHOUT THE HOSPITAL, ANSWERING PHONES LINES AND SUPPORTING THE INFORMATION DESK AND ENHANCING THE PATIENT AND VISITOR EXPERIENCE AND PROVIDING COMPANIONSHIP TO PATIENTS.
FIRST ACHIEVEMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A POPULATIONS. ACUTE DIALYSIS (DAVITA) ACUTE DIALYSIS SERVICES' MAIN PURPOSE AND GOAL IS TO PROVIDE QUALITY CARE TO ALL OUR PATIENTS. WE ARE RESPONSIBLE FOR HEMODIALYSIS TREATMENTS AND OTHER NEPHROLOGY NURSING NEEDS OF THE ACUTE AND CHRONIC PATIENTS ADMITTED TO THE HOSPITAL. WE PROVIDE THE PATIENT WITH THE SERVICES OF AN EXPERIENCED TEAMMATE AND WORK IN CONJUNCTION WITH THE HOSPITAL TO ENSURE THAT EACH PATIENT REACHES THE HIGHES LEVEL OF HEALTH, SECURITY, AND INDEPENDENCE 24- HOURS A DAY, 7-DAYS A WEEK. ACUTE PSYCHIATRIC SERVICES (APS) APS IS A PSYCHIATRIC EMERGENCY DEPARTMENT OPEN 24 HOURS PER DAY, 7 DAYS PER WEEK, FOR ANYONE EXPERIENCING A MENTAL HEALTH OR EMOTIONAL CRISIS. WE PROVIDE ASSESSMENT, INTERVENTION, AND REFERRAL. AMBULATORY BURN CLINIC THE AMBULATORY BURN AND WOUND CLINIC WHICH SERVES ALL AGES, IS A SPECIALTY CLINIC PROVIDING COMPREHENSIVE TREATMENT AND MANAGEMENT OF PATIENTS WITH A VARIETY OF WOUNDS AND/OR PATIENTS NEEDING IV THERAPY. AMBULATORY CARE AMBULATORY CARE SERVICES AT HENNEPIN COUNTY MEDICAL CENTER (HCMC) ARE SUPPORTED BY MORE THAN 300 PHYSICIANS AND RELATED PROVIDERS FROM HENNEPIN FACULTY ASSOCIATES (HFA) AND HCMC. AMBULATORY CARE IS PROVIDED THROUGH BOTH MULTISPECIALTY AND PRIMARY CARE CLINICS. ANESTHESIA GENERAL, MONITORED ANESTHESIA CARE AND REGIONAL ANESTHESIA ARE PROVIDED BY ANESTHESIOLOGISTS AND CERTIFIED REGISTERED NURSE ANESTHETISTS. ANESTHESIA CARE IS PROVIDED FOR ELECTIVE, URGENT AND EMERGENT OPERATING ROOM CASES AND IN ANCILLARY AREAS INCLUDING CARDIAC CATHETER LAB, RADIOLOGY, VASCULAR ACCESS, GASTRO-INTESTIONAL LAB, LABOR AND DELIVERY AND PSYCHIATRY. AUDIOLOGY CLINIC THE AUDIOLOGY CLINIC PROVIDES HIGH QUALITY INPATIENT AND OUTPATIENT SERVICES TO INDIVIDUALS OF ALL AGES, FROM INFANCY TO GERIATRIC. OUR LICENSED AUDIOLOGISTS HAVE ADVANCED EXPERTISE IN EVALUATING AND TREATING A WIDE RANGE OF HEARING IMPAIRMENTS, AS WELL AS PRESCRIBING AND FITTING SOPHISTICATED HEARING INSTRUMENTS. BIOMEDICAL ETHICS COMMITTEE FOCUS ON ETHICAL ISSUES THAT ARISE IN PATIENT CARE. BONE AND MINERAL CLINIC SPECIALTY CLINIC FOR THE MANAGEMENT OF BONE AND MINERAL METABOLISM SUCH AS OSTEOPOROSIS AND KIDNEY STONE DISEASE. ALSO PERFORM BONE DENSITOMETRY WITH AN IDXA BONE DENSITOMETRY SCANNER, THE NEWEST AVAILABLE TECHNOLOGY FOR DETECTING BONE DENSITY. BURN CENTER THE BURN CENTER IS A 17 BED UNIT THAT HAS RECEIVED VERIFICATION AS A BURN CENTER FROM THE AMERICAN BURN ASSOCIATION. A MULTIDISCIPLINARY TEAM APPROACH IS USED BY THE BURN CENTER TO PROVIDE INTENSIVE, ACUTE, AND REHABILITATIVE CARE TO ALL AGE GROUPS THAT PRESENT WITH THERMAL INJURIES, COMPLEX WOUNDS, PLASTIC SURGERY, AND SKIN DISORDERS OF VARYING SEVERITY. CARDIAC SERVICES (HENNEPIN HEART CENTER) CARDIAC SERVICES INCLUDES THE FOLLOWING SERVICE AREAS: CARDIAC CATHETERIZATION LABORATORY; CARDIAC ECHOCARDIOGRAPHY LABORATORY; CARDIAC MEDICAL INTERMEDIATE CARE (CMIC); CARDIAC REHABILITATION; CARDIAC-RENAL; UNIT (CARE); CARDIAC RESEARCH CARDIOLOGY ADMINISTRATION; CARDIOLOGY CLINIC CARDIOTHORACIC SURGERY; ELECTROCARDIOGRAM (EKG); ELECTROPHYSIOLOGY LABORATORY AND R5 OBSERVATION UNIT. CENTRAL STERILE SUPPLY REPROCESSING OF REUSABLE MEDICAL / SURGICAL INSTRUMENTS AND SUPPLIES IN A MANNER THAT IS SAFE, EFFECTIVE, AND FOLLOWS RECOMMENDATIONS SET FORTH BY GOVERNING AGENCIES. CENTRAL STERILE SUPPLY SERVES ALL HCMC CLINICS, NURSING STATIONS, OPERATING ROOMS AND OTHER AFFILIATES. CHAPLAINCY (SPIRITUAL CARE) THE MISSION OF HENNEPIN COUNTY MEDICAL CENTER'S SPIRITUAL CARE DEPARTMENT IS TO PROVIDE SENSITIVE SUPPORT TO PATIENTS AND FAMILY MEMBERS AFFECTED BY CRISIS, ILLNESS OR LOSS-WHILE RESPECTING THEIR CULTURE, RELIGION, VALUE SYSTEMS, TRADITIONS AND FAITH COMMUNITIES. THE DEPARTMENT HAS A NUMBER OF ITEMS AVAILABLE UPON REQUEST TO SUPPORT THE DIVERSE NEEDS OF MANY FAITHS. CHILD/ADOLESCENT PSYCHIATRY CLINIC THE CHILD/ADOLESCENT PSYCHIATRY CLINIC OFFERS A VARIETY OF OUTPATIENT SERVICES TO HELP CHILDREN AND ADOLESCENTS WHO ARE HAVING BEHAVIORAL AND EMOTIONAL PROBLEMS. SERVICES INCLUDE PSYCHIATRIC AND PSYCHOLOGICAL EVALUATIONS, THERAPY, PARENTING SKILLS COUNSELING AND MEDICATION MANAGEMENT. COMPREHENSIVE CANCER CENTER THE COMPREHENSIVE CANCER CENTER IS COMMITTED TO PROVIDING THE FINEST IN CANCER-RELATED SERVICES THROUGH AN INTEGRATED SYSTEM OF HEALTH AND SOCIAL SERVICES. THE CONTINUUM OF CARE EXTENDS FROM PREVENTION, DIAGNOSIS, TREATMENT, SYMPTOM CONTROL, AND CURE, THROUGH ALL RELATED ASPECTS OF ADJUSTMENT TO RELAPSE, SURVIVORSHIP, AND BEREAVEMENT COUNSELING. CONTACT CENTER THE CONTACT CENTER IS A MAIN POINT OF PATIENT ENTRY INTO HENNEPIN COUNTY MEDICAL CENTER'S HOSPITAL AND MEDICAL CLINICS. WE PROVIDE PATIENTS WITH ONE-STOP ACCESS TO THE SERVICES PROVIDED BOTH ON AND OFF CAMPUS. PATIENTS ARE ABLE TO REGISTER, SCHEDULE, RESCHEDULE, OR CANCEL APPOINTMENTS, SIGN UP FOR MY CHART ACTIVATION, AND LEARN MORE ABOUT TOPICS DISCUSSED ON WCCO'S HEALTHY MATTER'S RADIO SHOW. IN ADDITION, THE CONTACT CENTER'S TRIAGE NURSES OFFER TRIAGE SUPPORT, SYMPTOM SUPPORT, LAB RESULTS, APPOINTMENT SCHEDULING, REFILL MANAGEMENT AND REQUESTS, AND WILL CONTACT PROVIDERS AS NEEDED. CONTINUING MEDICAL EDUCATION THE PURPOSE OF MEDICAL CENTER'S CME PROGRAM IS TO PROVIDE ORGANIZED, PLANNED EDUCATION ACTIVITIES TO HELP PHYSICIANS IMPROVE THEIR MEDICAL KNOWLEDGE, DELIVERY OF-HEALTHCARE, AND PROFESSIONAL NETWORKING. HCMC IS ACCREDITED BY THE MINNESOTA MEDICAL ASSOCIATION TO SPONSOR AMA PRA CATEGORY 1 CREDIT(S) FOR PHYSICIANS. COORDINATED CARE SYSTEM THE HENNEPIN COORDINATED CARE SYSTEM (HCCCS) PROVIDES CARE FOR PATIENTS WITH COMPLEX MEDICAL NEEDS AND "EXPRESS ACCESS" TO CLINICS POST DISCHARGE. EACH MONTH AN AVERAGE OF 1400 PATIENTS ARE SEEN. SERVICE IS PROVIDED TO OUTPATIENTS AND INPATIENTS. THE AGES OF THE PATIENT POPULATION RANGE FROM PEDIATRICS THROUGH GERIATRICS. THEY REPRESENT A LARGE VARIETY OF RACES AND ETHNIC GROUPS AND VARIOUS FINANCIAL BACKGROUNDS. THEY MAY BE INSURED, UNDERINSURED, OR UNINSURED. APPROXIMATELY THIRTY PERCENT OF PATIENTS ARE UNDER AGE 12, AND ABOUT TEN PERCENT ARE OVER AGE 65. DISABILITY EVALUATION CENTER (DEC) THE DISABILITY EVALUATION CENTER ASSISTS HENNEPIN COUNTY MEDICAL CENTER PATIENTS WITH APPLICATIONS TO THE STATE MEDICAL REVIEW TEAM (SMRT) FOR DISABILITY AS WELL AS SOCIAL SECURITY APPLICATIONS. WE WILL ASSIST THE PATIENT IN COMPLETING FORMS, SCHEDULING EXAMS THAT ARE REQUIRED BY THE STATE OR THE DEC AS WELL AS PROVIDE A RESOURCE FOR ALL HCMC USERS. ELECTROENCEPHALOGRAM LAB (EEG) THE EEG LAB OFFERS DIAGNOSTIC TESTING FOR ALL PATIENTS FROM NEWBORNS TO ADULTS UPON A RECOMMENDATION FROM A PHYSICIAN. ROUTINE EEG TESTING (RECORDING OF ELECTRICAL IMPULSES FROM THE BRAIN) IS PERFORMED IN BOTH AN INPATIENT AND OUTPATIENT SETTING. EEG TESTING IN THE OPERATING ROOM IS USED TO MONITOR NEUROLOGICAL FUNCTION DURING SURGERY. EMERGENCY MEDICINE (EMS) EMERGENCY MEDICAL SERVICES INCLUDES THE FOLLOWING SERVICE AREAS: - EMERGENCY DEPARTMENT AND EXPRESS CARE - EMERGENCY MEDICAL SERVICES, COMPRISED OF EMS FIELD OPERATIONS, EMS EMERGENCY COMMUNICATION CENTER, EMS EDUCATION ELECTROMYOGRAPHY LABORATORY DEPARTMENT (EMG) THE EMG LABORATORY PROVIDES NERVE CONDUCTION STUDIES (NCS), NEEDLE ELECTROMYOGRAPHY, AUTONOMIC NERVOUS SYSTEM TESTING, BOTULINIUM TOXIN AND PHENOL INJECTIONS ON ADULT AND PEDIATRIC INPATIENTS (AMBULATORY OR PORTABLE) AND OUTPATIENTS FROM ALL ETHNIC AND SOCIO-ECONOMIC GROUPS. EAR, NOSE AND THROAT CLINIC (ENT) THE ENT CLINIC IS A SPECIALTY CLINIC THAT PROVIDES A WIDE RANGE OF SURGICAL, DIAGNOSTIC AND POSTOPERATIVE MANAGEMENT OF PATIENTS WITH EAR, NOSE AND THROAT CONDITIONS. EXTENDED CARE DEPARTMENT EXTENDED CARE PROVIDES PRIMARY CARE TO HCMC PATIENTS LIVING IN NURSING FACILITIES. FAMILY MEDICINE DEPARTMENT THE VISION OF DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE IS TO USE HIGH QUALITY MEDICAL EDUCATION AND PATIENT CARE TO CREATE EXCELLENT FAMILY PHYSICIANS WHO ARE SKILLED IN CARING FOR PEOPLE OF DIVERSE CULTURES, COMMITTED TO SERVING THEIR COMMUNITY, AND COMPETENT TO PRACTICE IN MULTIPLE SETTINGS. GASTROINTESTINAL LAB (GI) THE GI LAB IS PART OF THE SURGICAL SERVICES AREA PROVIDING PRE-PROCEDURE, PROCEDURAL AND NURSING VISITS TO A DIVERSE POPULATION OF BOTH INPATIENTS AND OUTPATIENTS SERVING PRIMARILY ADULTS. G3 MEDICAL /SURGICAL / ORTHOPAEDICS G3 IS A 37-BED, ALL PRIVATE-ROOM UNIT THAT SERVES MEDICAL AND SURGICAL PATIENTS, WITH AN EMPHASIS ON ORTHOPAEDICS AND HOSPITALIST SERVICES. HENNEPIN BARIATRIC CENTER THE HENNEPIN COUNTY MEDICAL CENTER HAS ESTABLISHED A WORLD-CLASS TEAM OF HEALTH CARE PROVIDERS TO HELP PATIENTS ACHIEVE WEIGHT LOSS GOALS. THE CENTERS OFFERS A COMPREHENSIVE WEIGHT LOSS PROGRAM. HENNEPIN CENTER FOR DIABETES AND ENDOCRINOLOGY THE HENNEPIN CENTER FOR DIABETES AND ENDOCRINOLOGY (HCDE) PROVIDES COMPREHENSIVE SERVICES TO PEOPLE WITH HORMONAL DISORDERS SUCH AS DIABETES. TREATMENT INCLUDES CLINICAL CARE, EDUCATION, NUTRITION AND WEIGHT MANAGEMENT. PATIENT CARE FOCUSES ON PREVENTING COMPLICATIONS ASSOCIATED WITH DIABETES. HOME EQUIPMENT SERVICES HOME EQUIPMENT SERVICES (HES) PARTNERS WITH HCMC
REASON FORM 720 WAS NOT FILED FORM 990, PART V, LINE 14B HHS, INC DOES NOT PROVIDE ANY TANNING SERVICES.
CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 AS PER THE CORPORATE BYLAWS, THE ORGANIZATION SHALL HAVE ONE CLASS OF MEMBERS: A GOVERNING MEMBER. THE GOVERNING MEMBER OF THE ORGANIZATION IS THE COUNTY OF HENNEPIN MINNESOTA AND IS REPRESENTED BY THE HENNEPIN COUNTY BOARD OF COMMISSIONERS.
ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A HENNEPIN COUNTY, MN HAS RETAINED ALL THE RIGHTS , DUTIES AND PRIVILEGES AS TO ALL MATTERS SPECIFIED UNDER THE BYLAWS OF HHS, INC. HHS, INC. BOARD OF DIRECTORS IS EMPOWERED TO CARRY OUT RIGHTS, DUTIES AND PRIVILEGES OF THE ORGANIZATION TO THE EXTENT AS SPECIFIED IN HHS, INC. BYLAWS. HENNEPIN COUNTY, MN RETAINS ITS AUTHORITY TO APPOINT HHS, INC BOARD MEMBERS, APPROVE HHS, INC ANNUAL BUDGETS, APPROVE ANY ADDITIONAL INDEBTEDNESS, AND APPROVE THE ANNUAL HHS, INC HEALTH SERVICES PLAN WHICH IS REQUIRED BY STATE LAW.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B HENNEPIN COUNTY, MN AUTHORITY IS SET IN THE BYLAWS OF THE ORGANIZATION. THIS INCLUDES APPOINT HHS, INC BOARD MEMBERS, APPROVE HHS, INC ANNUAL BUDGETS, APPROVE ANY ADDITIONAL INDEBTEDNESS, APPROVAL OF THE FINANCE COMMITEE RECONMENDATIONS AND EXECUTIVE COMMITTEE AND APPROVE THE ANNUAL HHS, INC HEALTH SERVICES PLAN WHICH IS REQUIRED BY STATE LAW.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B THE 990 IS COMPLETED AND REVIEWED INTERNALLY FOR FINALIZATION AND IS THEN MAILED TO THE HHS, INC BOARD OF DIRECTORS FOR REVIEW. ANY QUESTIONS THAT THE BOARD HAS IS ANSWERED BY THE NEXT MEETING BEFORE APPROVAL. AT THE OCTOBER MONTHLY BOARD MEETING IT IS FORMALLY APPROVED VIA A LINE ITEM MOTION. IT IS THEN SIGNED AND MAILED BY THE DUE DATE.
ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C HHS, INC HAS A POLICY ON CONFLICT OF INTEREST AND CONFIDENTIALITY WHICH REQUIRES AN INTERESTED PERSON WHO IS A DIRECTOR, OFFICER OR MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS MUST DISLOSE IN WRITING WHEN POSSIBLE, OR ORALLY WHEN TIME DOES NOT ALLOW FOR WRITTEN DISCLOSURE. THE EXISTENCE AND NATURE OF HIS/HER RELATIONSHIP OR MATERIAL FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT AT OR PRIOR TO THE MEETING OF THE BOARD OR COMMITTEE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AN INTEREST PERSON SHALL NOT ATTEMPT TO EXERT HIS OR HER PERSONAL INFLUENCE WITH RESPECT TO THE MATTER EITHER AT OR OUTSIDE THE MEETING. COPIES OF DISCLOSURES ARE MAINTAINED BY CORPORATE LEGAL COUNSEL WHO ALSO DOES MONITORING. EVERY YEAR THE ORGANIZATION IS AUDITED SEPARATELY FROM HENNEPIN COUNTY, MN AND A SEPARATE AUDIT REPORT IS PREPARED AND PRESENTED TO THE BOARD OF DIRECTORS AND TO THE HENNEPIN COUNTY, MN BOARD OF DIRECTORS.
COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A HHS, INC BOARD OF DIRECTORS ENGAGES AN INDEPENDENT CONSULTING FIRM EXPERT, RSM MCGLADREY TO EVALUATE THE BASE AND TOTAL CASH COMPENSATION FOR THE CEO AND OTHER QUALIFIED EXECUTIVES. MCGLADREY GATHERED COMPARABILITY DATA ACCORDING TO THE ASSUMPTIONS OUTLINED IN HHS' COMPENSATION PHILOSOPHY, INCLUDING DATA RELEVANT TO OTHER ACADEMIC AND PUBLIC HOSPITALS. THE DATA TAKES INTO CONSIDERATION THE SCOPE OF THE COMPARISON GROUP, INCLUDING FACTORS SUCH AS REVENUE, EMPLOYEE SIZE AND GEOGRAPHIC REGION. MCGLADREY COMPILED THIS DATA FIRST FOR CONSIDERATION BY THE COMPENSATION SUBCOMMITTEE OF THE BOARD WHO THEN DISCUSSES AND SUBMITS FOR APPROVAL BY THE HHS, INC BOARD OF DIRECTORS. ARTHUR A. GONZALEZ, CHIEF EXECUTIVE OFFICER HAS AN EMPLOYMENT CONTRACT WITH THE HOSPITAL WHICH IS APPROVED BY THE HHS, INC BOARD.
COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B SEE ABOVE EXPLANATION IN LINE 15A.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 INFORMATION FROM THE ORGANIZATION ANNUAL FORM 990 TAX RETURN IS AVAILABLE ON THE OFFICE OF ATTORNEY GENERAL WEBSITE AT WWW.AG.STATE.MN.US/CHARITIES. AUDITED FINANCIAL STATEMENTS AND FORM 1023, FORM 990 & FORM 990-T TAX RETURN ARE AVAILABLE UPON REQUEST DURING NORMAL BUSINESS HOURS. ITEMS DESCRIBED WITHIN ARE AVAILABLE UPON REQUEST DURING NORMAL BUSINESS HOURS. HENNEPIN HEALTHCARE SYSTEM IS A COMPONENT UNIT OF HENNEPIN COUNTY, MINNESOTA A POLITICAL SUBDIVISION OF THE STATE OF MINNESOTA AND AS SUCH TNE ABOVE LISTED DOCUMENTS ARE AVAILABLE TO PUBLIC INSPECTION. THE TAX RETURN IS AVAILALBE FOR PUBLIC INSPECTION AT WWW.GUIDESTAR.ORG WEBSITE.
REASON FOR NOT UNDERGOING REQUIRED AUDIT FORM 990, PAGE 12, PART XII, LINE 3B HHS,INC DID UNDERGO THE REQUIRED AUDITS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


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SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) HENNEPIN HEALTH FOUNDATION
HENNEPIN HEALTH FOUNDATION
701 PARK AVENUE
ADMINISTRATION BUILDING
MINNEAPOLIS,MN55415
41-0845733 		PUB SUPPT MN 501C3 11A HHS INC
HENNEPIN HEALTHCARE SYSTEM INC
Yes
 












For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership












Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) HENNEPIN HEALTH FOUNDATION

 P 265,907 CASH
(2) HENNEPIN COUNTY

 C 55,246,873 CASH
(3) METROPOLITAN HEALTH PLAN

 K 25,196,000 CASH
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE R HHS INC IS RELATED TO THE FOLLOWING ORGANIZATIONS THROUGH COMMON BOARD MEMBER RELATIONSHIP WITH THE FOLLOWING ORGANIZATIONS AND ARE DISCLOSED IN HHS INC ANNUAL AUDIT FINANCIAL REPORT 1 HENNEPIN COUNTY MN 2 HENNEPIN HEALTH FOUNDATION 3 METROPOLITAN HEALTH PLAN
Additional Data


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TY 2010 AveragingAttachment
Name:
HENNEPIN HEALTHCARE SYSTEM INC
EIN: 42-1707837
Explanation:
FORM 5768 ELECTION EFFECTIVE FOR 2009 RETURN FILING.