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
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2011 and ending 12-31-2011
BCheck if applicable:
CName of organization
MAYO CLINIC JACKSONVILLE
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
4500 SAN PABLO ROAD
 
Room/suite
City or town, state or country, and ZIP + 4
JACKSONVILLE, FL32224
D Employer identification number

59-3337028
E Telephone number

G Gross receipts $ 622,982,959
F Name and address of principal officer:
DR WILLIAM RUPP
4500 SAN PABLO ROAD
JACKSONVILLE,FL32224
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.MAYOCLINIC.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: 1995
M State of legal domicile: FL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: OPERATION OF A MULTI-SPECIALTY OUTPATIENT CLINIC.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 17
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 0
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 3,228
6 Total number of volunteers (estimate if necessary) .... 6 788
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 5,840,482
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 823,923
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 68,605,514 103,302,964
9 Program service revenue (Part VIII, line 2g) ......... 500,742,104 513,290,018
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 5,007,850 3,013,562
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,456,175 1,560,609
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 575,811,643 621,167,153
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 35,011,614 42,414,206
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 316,099,336 309,176,981
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet31,537    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 243,341,325 263,130,323
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 594,452,275 614,721,510
19 Revenue less expenses. Subtract line 18 from line 12....... -18,640,632 6,445,643
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 592,107,945 599,685,540
21 Total liabilities (Part X, line 26)............. 264,941,134 267,126,566
22 Net assets or fund balances. Subtract line 21 from line 20..... 327,166,811 332,558,974
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
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Signature of officer Date
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Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
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Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
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: TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION, AND RESEARCH.
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 organization’s program service accomplishments for each of its three largest program services, as measured 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 $ 462,338,559 including grants of $ 40,782,159 ) (Revenue $ 511,861,791 )
PATIENT & COMMUNITY SERVICES (SEE SCHEDULE O)PATIENT & COMMUNITY SERVICES:MAYO CLINIC JACKSONVILLE (MCJ) IS A MULTISPECIALTY OUTPATIENT CLINIC WITH A TEAM APPROACH TO PATIENT CARE ALLOWING FOR COMPREHENSIVE EVALUATION AND ADVANCED TREATMENT OF COMPLEX DISEASES. MCJ HAS OVER 3,200 PHYSICIANS, SCIENTISTS, ALLIED HEALTH STAFF, STUDENTS AND ADMINSTRATIVE PERSONNEL. IN 2011, MORE THAN 97,000 PATIENTS WERE DIAGNOSED AND TREATED AT MCJ AND SURGEONS PERFORMED APPROXIMATELY 52,700 OUTPATIENT PROCEDURES.MCJ, IN AFFILIATION WITH MAYO CLINIC FLORIDA (A RELATED HOSPITAL EXEMPT UNDER SECTION 501(C)(3) OF THE CODE), IS ONE OF THE MAIN PROVIDERS OF HEALTH CARE SERVICES IN NORTHEAST FLORIDA. MAYO CLINIC FLORIDA (MCF) IS LOCATED ON THE CAMPUS OF MCJ. THE AFFILIATED ORGANIZATIONS ARE OFTEN REFERRED TO AND VIEWED AS A SINGLE INTEGRATED INSTITUTION.MCJ PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. FINANCIAL ASSISTANCE IS ALSO PROVIDED FOR PATIENTS THAT ARE FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. THE COST OF UNCOMPENSATED CARE PROVIDED TO LOW INCOME PATIENTS THROUGH MEDICAID WAS APPROXIMATELY $2,649,000. THE COST OF UNCOMPENSATED CARE PROVIDED TO PATIENTS THROUGH MEDICARE WAS APPROXIMATELY $175,956,000. FINANCIAL ASSISTANCE (AT COST) PROVIDED TO PATIENTS IN 2011 WAS APPROXIMATELY $6,445,000.OF THE FINANCIAL ASSISTANCE PROVIDED EACH YEAR, A PORTION OF IT GOES TO TRANSPLANT PATIENTS WHO WOULD OTHERWISE DIE WITHOUT A NEW, FUNCTIONING ORGAN.MCJ AND MCF REALIZE THAT NOT ALL RESIDENTS HAVE EASY ACCESS TO MEDICAL CARE WHEN THEY NEED IT. FOR SOME PEOPLE, LACK OF HEALTH INSURANCE PREVENTS THEM FROM GETTING TREATMENT WHILE OTHERS MAY NOT HAVE HEALTH PROFESSIONALS CLOSE AT HAND. REGARDLESS OF THE REASONS, MCJ AND MCF TRY TO DO THEIR PART FOR PEOPLE WHO ARE NOT GETTING ADEQUATE MEDICAL CARE BY FINDING CREATIVE WAYS TO PROVIDE IT. BEING CONNECTED AND INVOLVED PROVIDES AN OPPORTUNITY TO COLLABORATE WITH OTHER HEALTH SERVICE PROVIDERS TO ADDRESS THE COMMUNITY'S HEALTH CARE NEEDS.MCJ AND MCF HAVE PARTNERED WITH MANY ORGANIZATIONS TO IMPROVE THE QUALITY OF LIFE AND MAKE JACKSONVILLE AND NORTHEAST FLORIDA A HEALTHIER COMMUNITY. IN 2011, MCJ AND MCF WORKED WITH OVER 55 ORGANIZATIONS AND AGENCIES IN THE JACKSONVILLE AND NORTHEAST FLORIDA AREA. THESE PARTNERSHIPS HELP MCJ AND MCF DISCOVER UNMET NEEDS IN THE COMMUNITY AND DEVELOP PROGRAMS TO FULFILL THOSE NEEDS. MCJ AND MCF WORKED SUCCESSFULLY WITH THE BLOOD ALLIANCE TO OPEN THE MAYO CLINIC BLOOD DONOR CENTER IN 2008. THE CENTER, STAFFED AND OPERATED BY THE BLOOD ALLIANCE, IS OPEN FIVE DAYS A WEEK. UNDERSTANDING THE NEED TO INCREASE BLOOD DONATION, THE MAYO SITES WERE ABLE TO PROVIDE SPACE AND FURNISHINGS FOR A DONOR CENTER OPEN TO THE PUBLIC. MCJ, MCF AND THE BLOOD ALLIANCE COORDINATE TO CREATE INTERNAL MARKETING CAMPAIGNS AND EMPLOYEE CONTESTS TO STIMULATE WHOLE BLOOD AND PLATELET DONATIONS. IN 2011, THE CENTER COLLECTED 2,006 UNITS OF RED CELLS (96 PERCENT OF GOAL) AND 443 UNITS OF PLATELETS (120 PERCENT OF GOAL). MCJ AND MCF ARE DEDICATED TO FURTHERING MINORITY HEALTH AND WELLNESS EFFORTS AND REDUCING HEALTH DISPARITIES. THROUGH EDUCATION AND AWARENESS PROGRAMS, PERSONALIZED HEALTH CARE AND INNOVATIVE RESEARCH, MCJ AND MCF STRIVE TO ELIMINATE DISPARITIES WITHIN THE COMMUNITIES AND TO HELP PREVENT AND REDUCE ILLNESS AND DEATH IN MINORITY POPULATIONS. OVERALL, IN 2011 THE HEALTH DISPARITIES PROGRAM HELD SEVERAL MAJOR PROJECTS AND INITIATIVES TO BRING TOGETHER THE JACKSONVILLE COMMUNITY TO DISCUSS AND LEARN ABOUT SOLUTIONS TO SOME OF THE HEALTH DISPARITIES FACED BY THE LOCAL COMMUNITY.IN 2011, STAFF FROM MCJ AND MCF WORKED WITH LOCAL CHURCHES AND COMMUNITY ORGANIZATIONS TO BRING RESEARCH EDUCATION AND AWARENESS TO THE COMMUNITY. IN PARTNERSHIP WITH THE UNIVERTISY OF FLORIDA ACADEMIC HEALTH CENTER, A COMMUNITY FORUM WAS HELD TO DISCUSS THE IMPORTANCE OF CLINICAL RESEARCH AND TO DISPEL THE MYTHS THAT SURROUND CLINICAL RESEARCH. THE 55 COMMUNITY MEMBERS IN ATTENDANCE DISCUSSED WAYS THAT RESEARCH INSTITUTIONS CAN REACH OUT TO MINORITY COMMUNITIES TO INCLUDE THEM IN RESEARCH EFFORTS. IN 2010, MCJ AND MCF, ALONG WITH SEVERAL LOCAL AGENCIES (INCLUDING ELDERSOURCE, COMMUNITY HOSPICE AND THE CITY OF JACKSONVILLE) CONTRIBUTED TO THE FORMING OF THE CAREGIVER COALITION, WHICH PROVIDES WORKSHOPS THROUGHOUT NORTHEAST FLORIDA CENTERED AROUND CARING FOR THE CAREGIVER. THE FIRST CAREGIVER EXPO IN 2011 HELPED EDUCATE MORE THAN 600 FAMILY CAREGIVERS. AS A MEMBER OF THE CAREGIVER COALITION OF NORTHEAST FLORIDA, MCJ AND MCF PARTICIPATED AND SUPPORTED THE FIRST CAREGIVER EXPO WHICH WAS HELD AT THE HYATT ON APRIL 21ST. APPROXIMATELY 600 FAMILY CAREGIVERS ATTENDED THIS EVENT. MAYO'S MEMORY DISORDER CLINIC PARTICIPATED IN FIVE "CARING FOR THE CAREGIVER" COMMUNITY WORKSHOPS IN CONJUNCTION WITH THE CAREGIVER COALITION. THESE EFFORTS REACHED ABOUT 800 FAMILY CAREGIVERS THROUGHOUT NORTHEAST FLORIDA.THROUGH THE MEMORY DISORDER CLINIC, MCJ AND MCF PROVIDED MORE THAN 175 HOURS OF TRAINING TO MORE THAN 3,700 PEOPLE IN 2011. TRAINING INCLUDED TOPICS GEARED TOWARDS HEALTHY AGING, WHEN TO WORRY ABOUT MEMORY, RESEARCH UPDATES AND STRATEGIES FOR MANAGING DEMENTIAS. MEMORY DISORDER CLINIC STAFF ALSO PROVIDED FREE MONTHLY CLASSES ATTENDED BY 25 TO 30 FOR CAREGIVERS AND PARTNERED WITH THE CITY OF JACKSONVILLE TO PRESENT PROGRAMS ON MAINTAINING A HEALTHY LIFESTYLE.THE MEMORY DISORDER CLINIC IS THE CONTACT IN NORTHEAST FLORIDA FOR THE STATE-WIDE SILVER ALERT PROGRAM. STAFF WORK WITH LOCAL LAW ENFORCEMENT TO ASSURE THAT PERSONS RECEIVE INFORMATION ON DRIVING ALTERNATIVES, SAFE/RETURN IDENTIFICATION BRACELET AND RESOURCES.DURING 2011, MORE THAN 1,700 EMPLOYEES FROM BOTH MCJ AND MCF VOLUNTEERED THEIR TIME AND EXPERTISE FOR COMMUNITY PROJECTS. IN ADDITION, EMPLOYEES DONATED MORE THAN $227,000 TO THE UNITED WAY AND OTHER CHARITABLE CAUSES. EMPLOYEES OF MCJ AND MCF ARE MAJOR SUPPORTERS OF THE CHILDREN'S CHRISTMAS PARTY OF JACKSONVILLE, A PROJECT THEY HAVE BEEN INVOLVED WITH FOR 10 YEARS. IN 2011, THEY HELPED RAISE $14,000 ALONG WITH A CORPORATE DONATION OF $8,000 TO BUY OVER 500 BICYCLES AND HELMETS FOR THE MORE THAN 7,500 LOW-INCOME CHILDREN WHO ATTENDED THE PARTY. IN ADDITION, OVER 75 MAYO CLINIC EMPLOYEES VOLUNTEERED FOR THE SET-UP AND ACTUAL PARTY BEING SANTA'S HELPERS BY DISTRIBUTING TOYS AND GIVING BICYCLES TO THE CHILDREN.ACCESS TO CULTURAL EVENTS AND THE ARTS IS SOMETIMES AN OVERLOOKED MEASURE OF A COMMUNITY'S HEALTH AND QUALITY OF LIFE. MCJ AND MCF INTEGRATE THE ARTS INTO ITS MEDICAL ENVIRONMENT THOUGH ITS CENTER FOR HUMANITIES IN MEDICINE (HIM), WHICH PARTNERS WITH MORE THAN A DOZEN COMMUNITY MUSEUMS, SCHOOLS, MUSIC AND ART ORGANIZATIONS. WALKING THROUGH THE CAMPUS, PATIENTS AND VISITORS ARE LIKELY TO HEAR A PIANIST PLAYING A CLASSICAL MELODY. MANY PATIENTS' STAYS ARE BRIGHTENED BY LIVE MUSICAL PERFORMANCES OR WATCHING AN ARTIST BRING A CANVAS TO LIFE THOUGH HIM'S ART-AT-THE-BEDSIDE AND MUSIC-AT-THE-BEDSIDE PROGRAMS. VOLUNTEERS ESCORT THE FEATURED MUSICIANS AROUND THE CAMPUS IN SEARCH OF PATIENTS WHO WOULD APPRECIATE A BEDSIDE CONCERT. SIMILARLY, AN ART BY THE BEDSIDE PROGRAM BRINGS LOCAL VOLUNTEER ARTISTS IN TO WORK WITH PATIENTS ON PROJECTS SUCH AS NEEDLEPOINT, WATERCOLOR AND CREATING POSTCARDS. IN ADDITION, REGULAR MONTHLY CONCERTS, LECTURES AND WORKSHOPS ARE OPEN TO PATIENTS AND VISITORS. IN 2011, THE BEDSIDE AND OTHER PROGRAMS REACHED MORE THAN 3,800 PATIENTS AND VISITORS.EVERY YEAR, MCJ AND MCF FUND AND SPONSOR A VARIETY OF CULTURAL PROGRAMS OPEN TO ALL MEMBERS OF THE COMMUNITY, CREATING CONNECTIONS BETWEEN ART AND HEALING. AS MUSIC PROGRAMS IN PUBLIC SCHOOLS CONTINUE TO DECLINE, MCJ AND MCF ARE BRINGING CLASSICAL MUSICIANS AND DANCE TROUPES TO CLASSROOMS THROUGH ITS SPONSORSHIP OF THE BEACHES FINE ARTS SERIES.WITH SUPPORT FROM MCJ AND MCF, ALONG WITH OTHERS IN THE COMMUNITY, A SERIES OF FREE, WORLD-CLASS MUSIC AND DANCE PERFORMANCES ARE PROVIDED EIGHT TIMES A YEAR AT ST. PAUL'S BY THE SEA EPISCOPAL CHURCH IN JACKSONVILLE BEACH. FEATURED ARTISTS ALSO HOLD SPECIAL CONCERTS FOR STUDENTS AT VARIOUS DUVAL COUNTY SCHOOLS AND COMMUNITY ORGANIZATIONS. STUDENTS AT MORE THAN 50 LOCAL SCHOOLS HAVE HAD THE OPPORTUNITY TO ENJOY CLASSICAL MUSIC PERFORMANCES. THE PERFORMANCES ARE OPEN TO ALL SCHOOLS, WITH A SPECIAL EMPHASIS ON UNDERSERVED AND INNER-CITY YOUTH.IN 2011, MCJ AND MCF RECEIVED DONATED SERVICES FROM 788 COMMUNITY VOLUNTEERS, WHO PROVIDED APPROXIMATELY 92,921 HOURS, VALUED AT APPROXIMATELY $2,024,749 BASED ON THE INDEPENDENT SECTOR'S AVERAGE ESTIMATED HOURLY VALUE OF SUCH SERVICES FOR 2011.
4b (Code:   ) (Expenses $ 50,002,851 including grants of $ 1,630,492 ) (Revenue $ 699,138 )
RESEARCH ACTIVITIES (SEE SCHEDULE O)RESEARCH ACTIVITIES:MCJ CONDUCTS AN EXTENSIVE PROGRAM OF MEDICAL RESEARCH IN FACILITIES LOCATED ON ITS CAMPUS. RESEARCH FOCUSES ON NEUROSCIENCE, NEURODEGENERATIVE DISEASES, AND CANCER TREATMENT. TWO 75,000 SQUARE FOOT FACILITIES PROVIDE SPACE FOR ABOUT 320 SCIENTIFIC INVESTIGATORS AND SUPPORT STAFF INCLUDING PRE-DOCTORAL AND POST-DOCTORAL FELLOWS, VISITING SCIENTISTS, TECHNICIANS, AND OTHER SUPPORT PERSONNEL. SOME OF THE RESEARCH ACCOMPLISHMENTS FOR 2011 ARE LISTED BELOW.EXAMPLES ARE:- A STUDY BY RESEARCHERS AT MCJ AND WASHINGTON UNIVERSITY SCHOOL OF MEDICINE ADDED A NEW TWIST TO THE BODY OF EVIDENCE SUGGESTING HUMAN OBESITY IS DUE IN PART TO GENETIC FACTORS. WHILE STUDYING HORMONE RECEPTORS IN LABORATORY MICE, NEUROSCIENTISTS IDENTIFITED A NEW MOLECULAR PLAYER RESPONSIBLE FOR THE REGULATION OF APPETITE AND METABOLISM. THE SURPRISING FINDINGS SUGGEST THE POSSIBILITY OF A NOVEL TREATMENT FOR OBESITY. RESEARCHERS SAY IT MAY BE POSSIBLE TO DEVELOP A TREATMENT THAT INCREASES GENE EXPRESSION IN CERTAIN PROTEIN RECEPTORS, WHICH THEN INCREASES THE MESSAGES SENT TO THE BRAIN THAT DECREASE APPETITE. THE STUDY WAS PUBLISHED IN THE JANUARY 11 ONLINE ISSUE OF PLOS BIOLOGY.- A CANCER BIOLOGIST AND AN ONCOLOGIST FROM MCJ COLLABORATED TO DEVELOP A NOVEL METHOD TO IDENTIFY FUSION GENE MUTATIONS IN BREAST CANCER CELLS. THE TECHNOLOGY WILL ADVANCE THE CHARACTERIZATION OF GENOMIC ALTERATIONS THAT INDUCE THE TUMOR PHENOTYPE.- IN A MOUSE STUDY, SCIENTISTS AT MCJ HAVE DEMONSTRATED THE FEASIBILITY OF A PROMISING NEW STRATEGY FOR TREATING HUMAN TYPE 2 DIABETES, WHICH AFFECTS MORE THAN 200 MILLION PEOPLE WORLDWIDE. IN TYPE 2 DIABETES, THE BODY STOPS RESPONDING EFFICIENTLY TO INSULIN, A HORMONE THAT CONTROLS BLOOD SUGAR. TO COMPENSATE FOR THE INSENSITIVITY TO INSULIN, MANY DIABETES DRUGS WORK BY BOOSTING INSULIN LEVELS; FOR EXAMPLE, BY INJECTING MORE INSULIN OR BY INCREASING THE AMOUNT OF INSULIN SECRETED FROM THE PANCREAS. THE NEW STUDY, PUBLISHED IN THE JUNE 9 ISSUE OF PLOS ONE, SHOWED THAT A DIFFERENT APPROACH COULD ALSO BE EFFECTIVE FOR TREATING DIABETES BY BLOCKING THE BREAKDOWN OF INSULIN AFTER IT IS SECRETED FROM THE PANCREAS.- RESEARCHERS AT MCJ CONTINUED TO ADVANCE THE UNDERSTANDING OF PARKINSONS DISEASE, PUBLISHING SEVERAL GENE DISCOVERIES. RESEARCHERS DISCOVERED A NEW GENE MUTATION THEY SAY CAUSES PARKINSON'S DISEASE AND A GENETIC VARIATION THAT SEEMS TO PROTECT AGAINST THE DISEASE. THE MUTATION WAS IDENTIFIED IN A LARGE SWISS FAMILY WITH PARKINSON'S DISEASE, USING ADVANCED DNA SEQUENCING TECHNOLOGY. THE STUDY, PUBLISHED IN THE AMERICAN JOURNAL OF HUMAN GENETICS, WAS LED BY NEUROSCIENTISTS AT MCJ AND INCLUDED COLLABORATORS FROM THE UNITED STATES, CANADA, EUROPE, ASIA AND THE MIDDLE EAST. THE PROTECTIVE VARIANT CUT THE RISK OF DEVELOPING THE DISEASE BY NEARLY 20 PERCENT IN MANY POPULATIONS. THE STUDY, PUBLISHED IN THE ONLINE AUGUST 31 ISSUE OF LANCET NEUROLOGY, ALSO REPORTS THE DISCOVERY OF DIFFERENT VARIANTS OF THE SAME GENE, LRRK2 (THE MOST IMPORTANT PARKINSON'S RISK GENE FOUND TO DATE), THAT DOUBLE PARKINSON'S RISK IN CAUCASIANS AND ASIANS.- AN INTERNATIONAL RESEARCH TEAM, CO-LED BY SCIENTISTS AT MCJ, DISCOVERED THREE POTENTIAL SUSCEPTIBILITY GENES FOR DEVELOPMENT OF PROGRESSIVE SUPRANUCLEAR PALSY (PSP), A RARE NEURODEGENERATIVE DISEASE THAT CAUSES SYMPTOMS SIMILAR TO THOSE OF PARKINSON'S DISEASE BUT IS RESISTANT TO PARKINSON'S MEDICATIONS. THEIR REPORT WAS PUBLISHED IN THE ONLINE JUNE 19 ISSUE OF NATURE GENETICS. RESEARCHERS INDICATED THAT THE FINDINGS PROVIDED A "TESTABLE TRANSLATIONAL HYPOTHESIS" AS TO THE DEVELOPMENT AND PROGRESSION OF PSP AND MAY ALSO PROVIDE CLUES INTO OTHER MORE COMMON BRAIN DISORDERS BROUGHT ABOUT BY ACCUMULATION OF TAU PROTEIN IN THE BRAIN. THOSE "TAUOPATHIES" INCLUDE SOME FORMS OF PARKINSON'S DISEASE, FRONTOTEMPORAL DEMENTIA, ALZHEIMER'S DISEASE, AND OTHER DISORDERS. - THE DEPARTMENT OF NEUROSCIENCE AT MCJ CONTINUES TO MAINTAIN ITS REPUTATION AS A CENTER OF EXCELLENCE IN ALZHEIMER'S AND NEURODEGENERATIVE DISORDERS. DURING 2011, MEMBERS WERE RECOGNIZED FOR THEIR OUTSTANDING CONTRIBUTIONS TO THE FIELD AND DISCOVERY OF NEW GENES, BIOMARKERS AND THERAPEUTIC TARGETS. TO HELP CONTINUE MCJ'S INTERNATIONALLY RECOGNIZED WORK IN LEWY BODY DEMENTIA, THE HARRY T. MANGURIAN, JR. FOUNDATION AWARDED MCJ A $1 MILLION GIFT, PLEDGED OVER 4 YEARS. LEWY BODY DEMENTIA, WHICH COMBINES ASPECTS OF BOTH ALZHEIMER'S AND PARKINSON'S DISEASES, IS THE SECOND MOST COMMON FORM OF DEMENTIA IN THE UNITED STATES.- MCJ RESEARCHERS LED A GROUP OF NORTH AMERICAN INVESTIGATORS IN A STUDY THAT FOUND A GENETIC ABNORMALITY THEY SAY IS THE MOST COMMON CAUSE OF TWO DIFFERENT BUT RELATED FAMILIAL FORMS OF NEURODEGENERATIVE DISEASE - FRONTOTEMPORAL DEMENTIA (FTD) AND AMYOTROPHIC LATERAL SCLEROSIS (ALS), ALSO KNOWN AS LOU GEHRIG'S DISEASE. IN THE SEPTEMBER 21 ONLINE ISSUE OF NEURON, THEY SAY AN UNUSUAL MUTATION - A SHORT DNA SEQUENCE REPEATED HUNDREDS TO THOUSANDS OF TIMES - WAS FOUND IN ALMOST 12 PERCENT OF FAMILIAL FTD AND MORE THAN 22 PERCENT OF FAMILIAL ALS SAMPLES STUDIED. RESEARCHERS INDICATED THAT THE FINDINGS MAY LEAD TO SIGNIFICANT INSIGHTS INTO HOW THESE DISEASES DEVELOP AND MAY PROVIDE NEW WAYS IN TREATING THE DISEASES.- MCJ IS ALSO EXPLORING SCIENTIFIC PARTNERSHIPS WITH SEVERAL ACADEMIC INSTITUTIONS, INCLUDING ARIZONA STATE UNIVERSITY BIOINFORMATICS AND KAROLINSKA INSTITUTE. IN ADDITION, MCJ WILL CONTINUE TO DEVELOP SCIENTIFIC COLLABORATIONS WITH CANCER BIOLOGY AND A STATE-WIDE INITIATIVE WITH SCIENTISTS AT SCRIPPS FLORIDA AND THE UNIVERSITY OF FLORIDA.
4c (Code:   ) (Expenses $ 4,427,546 including grants of $   ) (Revenue $ 1,137,446 )
EDUCATION ACTIVITIES (SEE SCHEDULE O)EDUCATION ACTIVITIES:MCJ, IN CONJUNCTION WITH MCF, PROVIDES VARIOUS EDUCATIONAL PROGRAMS. IN 2011, 109 MEDICAL STUDENTS RECEIVED TRAINING AT THE MAYO SITES IN JACKSONVILLE. THROUGH 39 ACTIVE AND APPROVED MEDICAL PROGRAMS, A TOTAL OF 271 RESIDENTS AND FELLOWS ALSO RECEIVED TRAINING AT THE MAYO SITES IN JACKSONVILLE. PARTNERSHIPS WITH LOCAL EDUCATIONAL INSTITUTIONS PROVIDED 27 EDUCATIONAL PROGRAMS SERVING 300 ALLIED HEALTH STUDENTS THROUGH THE MAYO SCHOOL OF HEALTH SCIENCES. THE ABOVE MENTIONED STUDENTS, RESIDENTS AND FELLOWS RECEIVED ALL OR A PORTION OF THEIR TRAINING AT THE MCJ CAMPUS. IN 2011, PHYSICIANS AND RESEARCHERS AT MCJ AND MCF AUTHORED 556 ARTICLES PUBLISHED IN PEER-REVIEWED JOURNALS, PUBLISHED FOUR BOOKS, AS WELL AS 136 BOOK CHAPTERS. THE EDUCATIONAL MISSION OF MCJ AND MCF ALSO EXTENDS TO THE COMMUNITY. MCJ AND MCF BELIEVE THAT THEIR MEDICAL KNOWLEDGE MUST BE SHARED WITH THE COMMUNITY, PHYSICIANS AND HEALTH-CARE PROFESSIONALS. THROUGH THE MAYO CLINIC SCHOOL OF CONTINUOUS PROFESSIONAL DEVELOPMENT, HEALTH-CARE PROVIDERS RECEIVE EDUCATIONAL PROGRAMS TO UPDATE THEIR KNOWLEDGE. IN 2011, 6,500 PHYSICIANS AND HEALTH-CARE PROFESSIONALS PARTICIPATED IN THESE EDUCATIONAL PROGRAMS.MCJ AND MCF ESTABLISHED A HIGH SCHOOL BOOT CAMP TO INTRODUCE STUDENTS TO CAREER OPPORTUNITIES IN MEDICINE AND SCIENCE. THE BOOT CAMP OCCURS TWICE A YEAR AND SERVES APPROXIMATELY 50 STUDENTS PER SESSION. NINETY-TWO LOCAL HIGH SCHOOL STUDENTS PARTICIPATED IN 2011. MCJ AND MCF ALSO WORKED WITH THE PERRY INITIATIVE TO INVITE 31 HIGH SCHOOL GIRLS INTERESTED IN CAREERS IN ORTHOPEDIC SURGERY AND ENGINEERING TO VISIT MAYO CLINIC'S SIMULATION CENTER. IN ADDITION, MCJ AND MCF GRADUATE STUDENTS HAVE BEEN INVOLVED IN THE ANNUAL BRAIN AWARENESS WEEK, A NATIONAL EVENT THAT INTRODUCES SCIENCE CAREERS TO ELEMENTARY AND MIDDLE SCHOOL STUDENTS. MAYO GRADUATE STUDENTS REACHED OVER 300 STUDENTS IN NORTHEAST FLORIDA IN 2011 THROUGH THIS PROGRAM. MCJ AND MCF ALSO PROVIDE CLINICAL AND BASIC SCIENCE RESEARCH INTERNSHIPS FOR STUDENTS FROM ACROSS THE UNITED SATES. THERE WERE 42 STUDENTS ENROLLED IN THE CLINICAL RESEARCH INTERNSHIP STUDY PROGRAM AND 15 SUMMER UNDERGRADUATE RESEARCH FELLOWSHIP (SURF) STUDENTS PARTICIPATED IN A 10-WEEK BASIC SCIENCE RESEARCH PROGRAM. ADDITIONALLY, STAFF FROM MCJ AND MCF SUPPORT VARIOUS EDUCATIONAL PROGRAMS IN PUBLIC SCHOOLS. THESE STAFF MEMBERS ASSIST VARIOUS ELEMENTARY, HIGH SCHOOLS, COMMUNITY COLLEGES AND UNIVERSITIES IN THE COMMUNITY. THE STAFF MEMBERS SERVE ON ADVISORY BOARDS, BOARDS OF TRUSTEES AND PARTICIPATE AS RESOURCE PERSONS ON A REGULAR BASIS FOR SCHOOLS, COLLEGES AND UNIVERSITIES
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 516,768,956
Form 990 (2011)
Form 990 (2011)
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 for which 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
Yes
 
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 temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
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
Yes
 
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
Yes
 
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
Yes
 
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
 
No
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
Yes
 
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, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
Yes
 
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.. Click to see attachment
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.. Click to see attachment
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
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see attachment
20b
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization 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...... Click to see attachment
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................ Click to see attachment
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......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
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 ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
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.. Click to see attachment
28c
Yes
 
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
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, 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
35b
Yes
 
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
 
No
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 (2011)
Form 990 (2011)
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
0
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
3,228
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
 
 
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 (2011)
Form 990 (2011)
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
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
17
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
0
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
Yes
 
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
Yes
 
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
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
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
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
Yes
 
11a
Has the organization provided a complete 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
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did 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
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes," to line 15a or 15b, 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,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take 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
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 made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
CORPORATE TAX
200 FIRST STREET SW
ROCHESTER,MN55905
(507) 538-1297
Form 990 (2011)
Form 990 (2011)
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 (do not check more than one box, unless person is both an officer and a director/trustee) 		(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) BRIGHAM ROBERT F
SECRETARY & DIRECTOR
 20.00 X   X       444,651 0 21,448
(2) BROTT MD THOMAS G
DIRECTOR
 20.00 X           335,221 0 57,696
(3) BUSKIRK MD STEVEN J
DIRECTOR
 20.00 X           529,915 0 44,633
(4) DAWSON MD NANCY L
DIRECTOR
 20.00 X           256,282 0 50,060
(5) DEVAULT MD KENNETH R
DIRECTOR
 20.00 X           507,647 0 48,884
(6) GONWA MD THOMAS A
DIRECTOR
 20.00 X           322,886 0 68,899
(7) HARRISON DEBRA A
DIRECTOR
 20.00 X           188,898 0 13,838
(8) HOFFMAN MARY J
TREAS., ASST. SECY., CFO & DIRECTOR
 20.00 X   X       261,849 0 51,188
(9) JORGENSEN STEVEN C
ASST. SECRETARY & DIRECTOR
 20.00 X   X       282,766 0 44,794
(10) LANGE MD STEPHEN M
VICE CHAIR & DIRECTOR
 20.00 X   X       520,832 0 54,714
(11) LEVENTHAL MD JACK P
DIRECTOR
 20.00 X           414,346 0 14,004
(12) MATHEWS HILARY G
DIRECTOR
 20.00 X           241,398 0 20,088
(13) MURRAY MD PETER M
DIRECTOR
 20.00 X           562,628 0 40,948
(14) O'CONNOR MD MARY I
DIRECTOR
 20.00 X           602,096 0 56,683
(15) RUPP MD WILLIAM C
CHAIR, CEO & DIRECTOR
 20.00 X   X       740,718 0 8,205
(16) SMITH MD CD
DIRECTOR
 20.00 X           555,375 0 55,540
(17) TOMLINSON DANIEL L
DIRECTOR
 20.00 X           181,536 0 37,863
Form 990 (2011)
Form 990 (2011)
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 (do not check more than one box, unless person is both an officer and a director/trustee) 		(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) ACKERMAN FRANKLIN K
ASSOCIATE ADMINISTRATOR
 20.00       X     180,132 0 30,775
(19) FORD MARGARET J
ASSOCIATE ADMINISTRATOR
 20.00       X     183,197 0 41,685
(20) HUBER HAROLD D
CHAIR - SYSTEM SUPPORT
 20.00       X     204,567 0 14,728
(21) KHOOR MD ANDRAS
CHAIR - LABORATORY MEDICINE
 20.00       X     408,158 0 54,209
(22) PASCUAL MD JORGE M
PHYSICIAN
 20.00       X     323,275 0 47,002
(23) SCHEFFEL JEFFREY G
VICE CHAIR - RESEARCH ADMIN
 20.00       X     153,966 0 38,425
(24) SPACKMAN MD THOMAS N
CHAIR - ANESTHESIOLOGY
 20.00       X     423,512 0 59,520
(25) UITTI MD RYAN J
PHYSICIAN
 20.00       X     262,755 0 51,556
(26) WALTERS ROBERT M
CHAIR - REGIONAL PRACTICE
 20.00       X     163,012 126,195 56,416
(27) WHAREN MD ROBERT E
CHAIR - NEURO SURGERY
 20.00       X     1,029,569 0 56,155
(28) WILLIAMS MD HUGH J
CHAIR - RADIOLOGY
 20.00       X     716,656 0 48,384
(29) AGNEW MD RICHARD C
PHYSICIAN
 20.00         X   918,061 0 60,967
(30) DEEN MD HUGH G
PHYSICIAN
 20.00         X   994,340 0 52,854
(31) HANEL MD RICARDO A
PHYSICIAN
 20.00         X   976,646 0 33,478
(32) LANE MD GARY E
PHYSICIAN
 20.00         X   792,554 0 50,924
(33) REIMER MD RONALD
PHYSICIAN
 20.00         X   983,177 0 50,342
(34) BARTLEY MD GEORGE B
FORMER CHAIR & CEO
 0.00           X 0 554,514 46,878
(35) BOLLING DAVID B
FORMER KEY EMPLOYEE
 0.00           X 0 211,624 20,608
(36) CROFT CHERYL
FORMER KEY EMPLOYEE
 0.00           X 0 234,831 46,681
(37) PRESUTTI DO RICHARD J
FORMER KEY EMPLOYEE
 20.00           X 311,941 0 37,809
(38) WEBER JOAN A
FORMER KEY EMPLOYEE
 0.00           X 0 198,428 24,605
(39) ZORN CHRISTINA K
FORMER KEY EMPOYEE
 0.00           X 0 197,986 31,582
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 15,974,562 1,523,578 1,645,068
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet534
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
Yes
 
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. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
MAYO FOUNDATION FOR MEDICAL EDUCATION &
200 FIRST STREET SW
ROCHESTER,MN55905 		SUPPORT SERVICES 50,687,508
MAYO COLLABORATIVE SERVICES INC
200 FIRST STREET SW
ROCHESTER,MN55905 		LAB SERVICES 3,930,218
MMSI INC
200 FIRST STREET SW
ROCHESTER,MN55905 		BENEFIT SERVICES 1,747,852
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet3
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 78,369,120
e Government grants (contributions)1e 19,721,095
f All other contributions, gifts, grants, and
similar amounts not included above1f 		5,212,749
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 103,302,964
Program Service Revenue Business Code
2a NET PATIENT REVENUE 620,000 386,427,305 386,427,305    
b SHARED SERVICES 561,000 119,521,665 119,521,665    
c LAB REVENUE 621,500 5,654,096   5,654,096  
d EDUCATION REVENUE 611,600 1,137,446 1,137,446    
e RESEARCH REVENUE 541,700 549,506 549,506    
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 513,290,018
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 3,402,346     3,402,346
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet 164,603 162,182 2,421  
(i) Real (ii) Personal
6a Gross rents 324,483 2,024
b Less: rental expenses 120,012 1,323
c Rental income or (loss) 204,471 701
d Net rental income or (loss).......MediumBullet 205,172   701 204,471
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   870,076
b Less: cost or other basis and sales expenses   1,258,860
c Gain or (loss)   -388,784
d Net gain or (loss)..........MediumBullet -388,784     -388,784
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 697,605
b Less: cost of goods sold ..b 435,611
c Net income or (loss) from sales of inventory..MediumBullet 261,994     261,994
Miscellaneous Revenue Business Code
11a MISCELLANEOUS 900,099 459,959 241,548   218,411
b PARKING 812,930 280,990     280,990
c CONSULTING/MANAGEMENT 541,610 187,891 4,627 183,264  
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 928,840
12 Total revenue. See Instructions....MediumBullet 621,167,153 508,044,279 5,840,482 3,979,428
Form 990 (2011)
Form 990 (2011)
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).
Check if Schedule O contains a response to any question in this Part IX. .........
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 United States. See Part IV, line 21 42,412,651 42,412,651
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 1,555 1,555
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 12,161,926 9,500,523 2,629,866 31,537
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 1,987,778 1,987,778    
7 Other salaries and wages 227,632,823 225,104,302 2,528,521  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 21,732,709 21,383,102 349,607  
9 Other employee benefits ....... 32,054,535 31,541,353 513,182  
10 Payroll taxes ........... 13,607,210 13,340,509 266,701  
11 Fees for services (non-employees):        
a Management ...... 515,315 489,449 25,866  
b Legal ......... 1,847,240 428,924 1,418,316  
c Accounting ...........        
d Lobbying ........... 45,281 45,281    
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ...... 655,341   655,341  
g Other .......... 92,896,743 28,492,907 64,403,836  
12 Advertising and promotion .... 48,167 47,577 590  
13 Office expenses ....... 13,839,558 11,636,798 2,202,760  
14 Information technology ...... 17,202,430 311,863 16,890,567  
15 Royalties .. 56,975 54,475 2,500  
16 Occupancy ........... 18,542,204 14,374,309 4,167,895  
17 Travel ............ 4,469,076 4,250,191 218,885  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 547,959 499,849 48,110  
20 Interest ........... 5,649,632 5,649,632    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 23,077,031 23,052,807 24,224  
23 Insurance .............. 7,315,019 7,171,671 143,348  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a MEDICAL SUPPLIES 56,115,539 56,115,539    
b BAD DEBT EXPENSE 17,159,435 17,159,435    
c EMPLOYEE EXPENSES 1,604,904 987,401 617,503  
d DUES, LICENSES, ETC. 815,740 727,675 88,065  
e
f All other expenses 726,734 1,400 725,334  
25 Total functional expenses. Add lines 1 through 24f 614,721,510 516,768,956 97,921,017 31,537
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 14,843 1 5,176
2 Savings and temporary cash investments .......   2 47,578
3 Pledges and grants receivable, net ......... 22,583,688 3 26,081,936
4 Accounts receivable, net ......... 76,509,329 4 73,728,166
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 ............. 15,253 7 19,695
8 Inventories for sale or use .............. 3,129,774 8 1,985,849
9 Prepaid expenses and deferred charges ............ 1,206,956 9 190,883
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 519,474,212
b Less: accumulated depreciation. ..... 10b 242,132,205 268,435,219 10c 277,342,007
11 Investments—publicly traded securities .......... 24,850,742 11  
12 Investments—other securities. See Part IV, line 11 ...... 102,345,379 12 107,166,520
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 93,016,762 15 113,117,730
16 Total assets. Add lines 1 through 15 (must equal line 34)... 592,107,945 16 599,685,540
Liabilities 17 Accounts payable and accrued expenses . 29,692,720 17 25,680,562
18 Grants payable ..........   18  
19 Deferred revenue .......... 1,952,114 19 3,183,359
20 Tax-exempt bond liabilities .......... 100,000,000 20 0
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 (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 133,296,300 25 238,262,645
26 Total liabilities. Add lines 17 through 25..... 264,941,134 26 267,126,566
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 ..... 248,242,424 27 251,053,640
28 Temporarily restricted net assets ..... 43,413,294 28 44,278,376
29 Permanently restricted net assets ..... 35,511,093 29 37,226,958
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 .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 327,166,811 33 332,558,974
34 Total liabilities and net assets/fund balances ..... 592,107,945 34 599,685,540
Form 990 (2011)
Form 990 (2011)
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
621,167,153
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
614,721,510
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
6,445,643
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
327,166,811
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-1,053,480
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
332,558,974
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:  
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 (2011)
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
2011
Open to Public
Inspection
Name of the organization
MAYO CLINIC JACKSONVILLE
 
Employer identification number

59-3337028
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... 76,094,722 70,928,948 79,544,148 68,605,514 103,302,964 398,476,296
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.. 76,094,722 70,928,948 79,544,148 68,605,514 103,302,964 398,476,296
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.           398,476,296
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4.. 76,094,722 70,928,948 79,544,148 68,605,514 103,302,964 398,476,296
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 10,441,939 -3,541,530 4,014,800 5,360,010 3,726,829 20,002,048
9 Net income from unrelated business activities, whether or not the business is regularly carried on.. 52,896 53,867 661,148 1,200,259 823,923 2,792,093
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).           421,270,437
12
12
2,327,832,882
13
Section C. Computation of Public Support Percentage
14
14
94.590 %
15
15
93.630 %
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2011

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
2011
Name of organization
MAYO CLINIC JACKSONVILLE
 
Employer identification number

59-3337028
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 on line H of its
Form 990-EZ or on Part I, 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) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MAYO CLINIC JACKSONVILLE
  		Employer identification number

59-3337028
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total 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)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MAYO CLINIC JACKSONVILLE
  		Employer identification number

59-3337028
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(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) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
MAYO CLINIC JACKSONVILLE
  		Employer identification number

59-3337028
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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 $  
Use duplicate copies of Part III if additional space is needed
(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) (2011)

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
2011
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, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
MAYO CLINIC JACKSONVILLE
 
Employer identification number

59-3337028
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 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 function 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) 2011

Schedule C (Form 990 or 990-EZ) 2011
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 expenses, and share of excess lobbying expenditures).
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) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  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) .................    
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) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2011


Schedule C (Form 990 or 990-EZ) 2011
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)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(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? ..........................
Yes
 
45,281
j
Total. Add lines 1c through 1i ...............................
45,281
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? .......
 
 
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
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible 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, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PERCENTAGE OF LOBBYING EXPENSES INCLUDED IN MEMBERSHIP DUES TO THE FLORIDA HOSPITAL ASSOCIATION, THE AMERICAN HOSPITAL ASSOCIATION, THE FLORIDA MEDICAL ASSOCIATION AND THE JACKSONVILLE CHAMBER OF COMMERCE.
Schedule C (Form 990 or 990EZ) 2011

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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MAYO CLINIC JACKSONVILLE
 
Employer identification number

59-3337028
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 can 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 through 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, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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 (ASC 958), 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 (ASC 958), 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 (ASC 958), 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) 2011

Schedule D (Form 990) 2011
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 .... 75,948,759 67,437,689 60,445,837 40,957,359
b Contributions ........ 3,362,234 5,883,716 4,437,091 24,902,621
c Net investment earnings, gains, and losses ... 2,241,784 7,086,954 4,491,671 -4,377,809
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		845,859 893,967 1,936,910 1,036,334
f Administrative expenses ....   3,565,633    
g End of year balance ...... 80,706,918 75,948,759 67,437,689 60,445,837
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet50.000 %
b
Permanent endowment SchDMd Bullet45.000 %
c
Temporarily restricted endowment SchDMd Bullet5.000 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
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)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   27,061,935 27,061,935
b Buildings ................   316,951,333 118,723,258 198,228,075
c Leasehold improvements ............        
d Equipment ................   166,839,460 123,380,917 43,458,543
e Other .................   8,621,484 28,030 8,593,454
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 277,342,007
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
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    
(3)Other
(A) MAYO POOLED INVESTMENTS 		107,166,520 F








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 107,166,520
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) must 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
(1) DUE FROM AFFILIATES 85,725,245
(2) DEFERRED COMPENSATION 27,392,485







Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 113,117,730
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes  
DUE TO AFFILIATES 210,870,160
DEFERRED COMPENSATION LIABILITY 27,392,485







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 238,262,645
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) 2011

Schedule D (Form 990) 2011
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  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
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 through 8 ......................... 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
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  
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  
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  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
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  
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  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
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
  PART III, LINE 1A: FOOTNOTE FROM MAYO CLINIC ("THE CLINIC") CONSOLIDATED AUDITED FINANCIAL STATEMENTS: THE CLINIC PERIODICALLY RECEIVES WORKS OF ART FROM VARIOUS BENEFACTORS. THESE ITEMS ARE UNIQUE IN NATURE AND ARE HELD ON DISPLAY FOR THE BENEFIT AND ENJOYMENT OF THE CLINIC'S PATIENTS. IT IS THE CLINIC'S POLICY TO NEITHER CAPITALIZE CONTRIBUTED WORKS OF ART NOR RECORD THE RELATED CONTRIBUTION REVENUE.
  PART III, LINE 4: WORKS OF ART DISPLAYED ACROSS THE FILING ORGANIZATION'S CAMPUS PROVIDE BEAUTY, PRESERVATION OF HERITAGE AND RESPECT FOR THE DIVERSITY OF PATIENTS, VISITORS AND STAFF.
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ENDOWMENT FUNDS PROVIDE A STABLE FUNDING SOURCE FOR RESEARCH AND EDUCATION PROGRAMS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: AT DECEMBER 31, 2011 AND 2010, THERE WAS NO SIGNIFICANT LIABILITY FOR UNRECOGNIZED TAX BENEFITS FOR THE FILING ORGANIZATION. FIN 48 FOOTNOTE FROM MAYO CLINIC ("THE CLINIC") CONSOLIDATED AUDITED FINANCIAL STATEMENTS: MOST OF THE INCOME RECEIVED BY THE CLINIC AND ITS SUBSIDIARIES IS EXEMPT FROM TAXATION UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. SOME OF ITS SUBSIDIARIES ARE TAXABLE ENTITIES, AND SOME OF THE INCOME RECEIVED BY OTHERWISE EXEMPT ENTITIES IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME (UBI). THE CLINIC OR ITS SUBSIDIARIES FILE INCOME TAX RETURNS IN THE U.S. FEDERAL, VARIOUS STATE, AND FOREIGN JURISDICTIONS. THE STATUTES OF LIMITATIONS FOR TAX YEARS 2008 THROUGH 2010 REMAINS OPEN IN THE MAJOR U.S. TAXING JURISDICTIONS IN WHICH THE CLINIC AND SUBSIDIARIES ARE SUBJECT TO TAXATION. IN ADDITION, FOR ALL TAX YEARS PRIOR TO 2008 GENERATING OR UTILIZING A NET OPERATING LOSS (NOL), TAX AUTHORITIES CAN ADJUST THE AMOUNT OF NOL CARRYFORWARD TO SUBSEQUENT YEARS. THE INTERNAL REVENUE SERVICE (IRS) PERFORMED AN EXAMINATION OF THE TAX AND INFORMATION RETURNS OF THE CLINIC AND TWO SUBSIDIARIES FOR 2005 AND 2006. AS A RESULT OF THE AUDIT BY THE IRS, ONE REMAINING ENTITY HAS EXTENDED THE STATUTES OF LIMITATIONS FOR 2005 THROUGH 2008 UNTIL DECEMBER 31, 2012. AS OF DECEMBER 31, 2011, ONE AUDIT REMAINS OPEN, AND THE IRS HAS PROPOSED ONE ADJUSTMENT THAT MANAGEMENT HAS TAKEN INTO CONSIDERATION DURING ITS DETERMINATION OF UNRECOGNIZED TAX BENEFITS SINCE THE PROPOSED ISSUE HAS NOT BEEN SETTLED. AT DECEMBER 31, 2011 AND 2010, THE RESERVE FOR UNRECOGNIZED TAX BENEFITS WAS NOT SIGNIFICANT. THE CLINIC'S PRACTICE IS TO RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE.
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MAYO CLINIC JACKSONVILLE
 
Employer identification number

59-3337028
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants
and other assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ..............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other
assistance outside the United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
CENTRAL AMERICA AND THE CARIBBEAN - 0 20 TRAVEL - INTERNATIONAL CONFERENCE   27,679
EAST ASIA AND THE PACIFIC - 0 39 TRAVEL - INTERNATIONAL CONFERENCE   71,403
EUROPE (INCLUDING ICELAND & GREENLAND) - 0 118 TRAVEL - INTERNATIONAL CONFERENCE   276,679
MIDDLE EAST AND NORTH AFRICA - 0 10 TRAVEL - INTERNATIONAL CONFERENCE   17,491
NORTH AMERICA - CANADA AND MEXICO, BUT 0 84 TRAVEL - INTERNATIONAL CONFERENCE   147,048
SOUTH AMERICA - ARGENTINA, BOLIVIA, 0 44 TRAVEL - INTERNATIONAL CONFERENCE   62,138
SOUTH ASIA - AFGHANISTAN, BANGLADESH, 0 13 TRAVEL - INTERNATIONAL CONFERENCE   26,028
SUB-SAHARAN AFRICA - ANGOLA, 0 2 TRAVEL - INTERNATIONAL CONFERENCE   2,909
RUSSIA & THE NEWLY INDEPENDENT STATES 0 3 TRAVEL - INTERNATIONAL CONFERENCE   9,374
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 330 631,375
b Total from continuation sheets to Part I ... 0 3 9,374
c Totals (add lines 3a and 3b) 0 333 640,749
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 5
Part V
Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
Identifier ReturnReference Explanation
PROCEDURE FOR MONITORING GRANTS OUTSIDE THE U.S.:   SCHEDULE F, PART I, LINE 2: FEDERAL AWARDS THAT ARE SUBCONTRACTED TO OTHER ORGANIZATIONS ARE MONITORED BY MAYO CLINIC AS PRESCRIBED IN OMB CIRCULAR A-133. SEE ALSO SCHEDULE I, PART IV FOR ADDITIONAL INFORMATION ON MAYO CLINIC'S PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS AS THE SAME PROCEDURES APPLY TO DOMESTIC AND FOREIGN GRANTS.
METHOD USED TO ACCCOUNT FOR EXPENDITURES:   SCHEDULE F, PART I, LINE 3: ACCRUAL METHOD
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2011
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
2011
Open to Public Inspection
Name of the organization
MAYO CLINIC JACKSONVILLE
 
Employer identification number

59-3337028
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did 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 used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
Yes
 
b
If "Yes," did 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
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
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 Financial Assistance at cost
(from Worksheet 1) .. 		    6,444,624   6,444,624 1.080 %
b Medicaid (from Worksheet 3, column a) .....     3,447,474 798,278 2,649,196 0.440 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .            
dTotal Financial Assistance and
Means-Tested Government Programs ..... 		    9,892,098 798,278 9,093,820 1.520 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		           
f Health professions education
(from Worksheet 5) .. 		    4,427,546 1,137,446 3,290,100 0.550 %
g Subsidized health services
(from Worksheet 6) .. 		    9,520,961 8,854,181 666,780 0.110 %
h Research (from Worksheet 7)     50,002,851 699,138 49,303,713 8.250 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....     393,043   393,043 0.070 %
jTotal Other Benefits ...     64,344,401 10,690,765 53,653,636 8.980 %
kTotal. Add lines 7d and 7j. ..     74,236,499 11,489,043 62,747,456 10.500 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(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     174,000   174,000 0.030 %
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total     174,000   174,000 0.030 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense........
2
17,159,435
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....
3
0
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
 
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
 
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
 
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
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures
(see instructions)
(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) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size 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 MAYO CLINIC JACKSONVILLE
4500 SAN PABLO ROAD
JACKSONVILLE,FL32224 		          X      
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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)
MAYO CLINIC JACKSONVILLE
Name of Hospital Facility:  
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 2011)
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    
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 the community health 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 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  
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    
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    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
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 Participation in the development of a community-wide community benefit plan
d Participation in the execution of a 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 Needs Assessment
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 and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained 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?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.000000000000%
If "No," explain in Part VI the criteria the hospital facility used.
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 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 (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 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 patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
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 why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
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)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
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 FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?3
Name and address Type of Facility (describe)
1 ST AUGUSTINE CLINIC
110 SOUTHWOOD LAKE DRIVE
ST AUGUSTINE,FL32086 		CLINIC
2 BEACHES PRIMARY CARE CENTER
742 MARSHLANDING PARKWAY
JACKSONVILLE BEACH,FL32250 		CLINIC
3 ROGER MAIN BUILDING
4203 BELFORT ROAD
JACKSONVILLE,FL32216 		OUTPATIENT DIALYSIS
4
5
6
7
8
9
10
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions 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, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any 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
    PART I, LINE 6A: THE ANNUAL REPORT FOR THE FILING ORGANIZATION IS PART OF A CONSOLIDATED REPORT PREPARED BY MAYO CLINIC.
    PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO.
    PART I, LINE 7G: THE FOLLOWING NET COMMUNITY BENEFIT COST ATTRIBUTED TO A PHYSICIAN CLINIC WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES: $492,985.
    PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 17159435.
    PART II: MAYO CLINIC JACKSONVILLE (MCJ) CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT FOR NEW AND ONGOING PROGRAMS WITHIN ALL AREAS SUPPORTING BASIC HUMAN SERVICES, EDUCATION AND WORKFORCE DEVELOPMENT, YOUTH AND ELDERLY ENRICHMENT OPPORTUNITIES, THE ARTS AND CULTURAL ENRICHMENT, DIVERSITY AND OTHERS. CAPITAL CAMPAIGNS AND MULTI-YEAR GRANTS ARE CONSIDERED AS MCJ'S FINANCIAL RESOURCES ALLOW. PRIORITY IS GIVEN TO PROJECTS THAT DEMONSTRATE ONE OR MORE OF THE FOLLOWING:- ADDRESS SIGNIFICANT AND EMERGENT NEEDS WITHIN OUR COMMUNITY- ENHANCE MAYO'S CAPACITY TO MEET ITS MISSION- IMPROVE HEALTH OF INDIVIDUALS IN COMMUNITIES- ENABLE LONG-TERM CAPACITY BUILDING AND SUSTAINABILITY- DEMONSTRATE PARTNERSHIP BUILDING AND COLLABORATION
    PART III, LINE 4: THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.FOOTNOTE FROM MAYO CLINIC ("THE CLINIC") 2011 CONSOLIDATED AUDITED FINANCIAL STATEMENTS: ACCOUNTS RECEIVABLE FOR MEDICAL SERVICES ARE STATED AT NET REALIZABLE VALUE. THE CLINIC ESTIMATES THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED ON HISTORIC WRITE-OFFS AND THE AGING OF THE ACCOUNTS. ACCOUNTS ARE WRITTEN OFF WHEN COLLECTION EFFORTS HAVE BEEN EXHAUSTED.BAD DEBT EXPENSE AT COST IS DETERMINED USING THE SAME COST TO CHARGE RATIO THAT IS USED TO CALCULATE FINANCIAL ASSISTANCE AND MEDICAID SHORTFALL. DISCOUNTS AND ALLOWANCES ARE ACCOUNTED FOR SEPARATELY FROM BAD DEBT EXPENSE.
    PART III, LINE 8: MAYO CLINIC JACKSONVILLE (MCJ) IS NOT REQUIRED TO FILE THE SAME MEDICARE COST REPORT THAT IS REQUIRED OF HOSPITALS AND REFERRED TO IN THE INSTRUCTIONS FOR CALCULATING THE AMOUNT TO REPORT IN PART III, SECTION B, LINE 6; HOWEVER, USING A COST-TO-CHARGE RATIO, MCJ DID HAVE A MEDICARE SHORTFALL OF $176,904,684 BASED ON MEDICARE REIMBURSEMENT OF $102,991,222 AND COSTS OF $279,895,906. BOTH REVENUE AND EXPENSE HAVE BEEN ADJUSTED TO ACCOUNT FOR MEDICARE REVENUE AND EXPENSES THAT ARE INCLUDED IN EDUCATION EXPENSES AND SUBSIDIZED HEALTH SERVICES. THE MEDICARE SHORTFALL REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS, REPORTS THE TOTAL MEDICARE SHORTFALL RELATED TO PATIENT CARE AND IS THEREFORE NOT ADJUSTED FOR EDUCATION EXPENSE AND SUBSIDIZED HEALTH SERVICES. REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS.
    PART III, LINE 9B: MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING EVERY REASONABLE ATTEMPT TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN ADDITION, MAYO CLINIC AND ITS AFFILIATES ACCEPT REASONABLE PAYMENT PLANS FROM PATIENTS WHEN AN ACCOUNT IS THE PATIENT'S RESPONSIBILITY AND TRY TO IDENTIFY THOSE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED; INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILTY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY BASED ON SUBMISSION OF REQUESTED INFORMATION. COLLECTION ACTIVITY WOULD ONLY RESUME IF MAYO WOULD TELL THE COLLECTION AGENCY TO PURSUE COLLECTIONS ON THE BALANCE OR PARTIAL BALANCE IF THERE WAS A CHARITY ADJUSTMENT.
MAYO CLINIC JACKSONVILLE   PART V, SECTION B, LINE 13G: WITH REGARD TO THE POSTINGS WITHIN THE FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHTOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.
MAYO CLINIC JACKSONVILLE   PART V, SECTION B, LINE 19D: THE POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 50% TO ELIGIBLE INDIVIDUALS WHICH RESULT IN AN AMOUNT LESS THAN THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERICIAL RATE.
    PART VI, LINE 2: MAYO CLINIC JACKSONVILLE (MCJ) AND MAYO CLINIC FLORIDA (MCF) WORK COLLABORATIVELY IN THEIR INPATIENT AND OUTPATIENT PRACTICES TO MEET THE HEALTH CARE NEEDS OF THE LOCAL DUVAL COUNTY AND ST. JOHNS COUNTY COMMUNITIES OF ABOUT 1 MILLION RESIDENTS. IN ADDITION, MCJ AND MCF ARE PART OF A MULTI-ENTITY, INTEGRATED HEALTHCARE ORGANIZATION THAT WORKS TOGETHER TO MEET THE HEALTH CARE NEEDS OF BROADER REGIONAL, NATIONAL AND INTERNATIONAL COMMUNITIES. THESE ENTITIES ARE COLLECTIVELY REFERRED TO AS "MAYO CLINIC" FOR PURPOSES OF THIS DESCRIPTION. MAYO CLINIC'S EFFORTS TO ASSESS THE HEALTH CARE NEEDS OF THE LOCAL NORTHEAST FLORIDA COMMUNITY REST ON FOUR GUIDING PRINCIPLES DEVELOPED IN CONJUNCTION WITH COMMUNITY PARTNERS AND AFFIRMED BY MAYO CLINIC LEADERSHIP:1. HEALTH IS VALUED BY BOTH THE COMMUNITY AND MAYO CLINIC.2. "HEALTH" IS DETERMINED BY BOTH MEDICAL AND NON-MEDICAL (E.G., SOCIAL AND BEHAVIORAL) FACTORS AND BOTH CATEGORIES OF FACTORS MUST BE ADDRESSED.3. MAYO CLINIC IS COMMITTED TO PRODUCING MEASURABLE IMPROVEMENTS IN THE HEALTH OF ALL DUVAL COUNTY AND ST. JOHNS COUNTY RESIDENTS, AND BEYOND.4. STRATEGIES TO IMPROVE COMMUNITY HEALTH ARE BEST DETERMINED AND IMPLEMENTED THROUGH PARTNERSHIPS BETWEEN HEALTH CARE PROVIDERS AND COMMUNITY MEMBERS.WITH THESE PRINCIPLES AS THE BASIS OF ITS DECISION MAKING, AND CONSISTENT WITH ITS PRIMARY VALUE OF "THE NEEDS OF THE PATIENT COME FIRST," MAYO CLINIC'S APPROACH TO ASSESS THE NEEDS OF THE COMMUNITY IS ORGANIZED INTO TWO MAIN FUNCTIONS: 1) MECHANISMS TO ENGAGE AND UTILIZE INPUT FROM THE COMMUNITY AND 2) MECHANISMS TO SUPPORT AND COORDINATE INITIATIVES WITHIN MAYO CLINIC.TO ENGAGE AND UTILIZE INPUT FROM THE COMMUNITY, MAYO CLINIC IN CONJUNCTION WITH EIGHT AREA HOSPITALS AND THE HEALTH PLANNING COUNCIL OF NORTHEAST FLORIDA BEGAN CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2011 BY REVIEWING AND COLLECTING QUALITATIVE, QUANTITATIVE AND SECONDARY DATA TO IDENTIFY GAPS IN PROVIDING ACCESS TO SAFE AND AFFORDABLE HEALTH CARE TO AREA RESIDENTS. IN PARTNERSHIP WITH AREA PROVIDERS PLANS WERE UNDERWAY IN 2011 TO CAPITALIZE ON AND LEVERAGE THE STRENGTHS AND RESOURCES OF INDIVIDUAL PROVIDERS TO ADDRESS IDENTIFIED GAPS IN THE HEALTH CARE NEEDS OF THE COMMUNITY. THE COMMUNITY HEALTH NEEDS ASSESSMENT PRESENTS A UNIQUE OPPORTUNITY TO ADVANCE MAYO CLINIC'S RESPONSE TO THE HEALTH CARE NEEDS OF THE COMMUNITY. WITHIN MAYO CLINIC, COORDINATION OF COMMUNITY ENGAGEMENT INITIATIVES IS ACCOMPLISHED THROUGH A COMMUNITY GIVING COMMITTEE, WHICH EVALUATES FUNDING AND SPONSORSHIP REQUESTS FROM COMMUNITY AGENCIES AND GUIDES INSTITUTIONAL SUPPORT FOR VARIOUS COMMUNITY INITIATIVES. THIS GROUP ENSURES THE GUIDING PRINCIPLES ARE FOLLOWED AND FACILITATES COMMUNITY OUTREACH INITIATIVES. THE JACKSONVILLE HEALTH DISPARITIES OVERSIGHT COMMITTEE WAS FORMED IN SEPTEMBER 2006 TO ADDRESS HEALTH DISPARITIES ISSUES. THE COMMITTEE WORKS CLOSELY WITH THE COMMUNITY RESEARCH ADVISORY BOARD (CRAB), WHICH CONSISTS OF MEMBERS FROM THE JACKSONVILLE COMMUNITY OF MULTICULTURAL BACKGROUNDS AND VARIOUS PROFESSIONS, WHO ARE RESPONSIBLE FOR 2 MAIN FUNCTIONS:- REVIEW RESEARCH PROTOCOLS AND PROVIDE IMPORTANT FEEDBACK BASED ON DIVERSE PERSPECTIVES TO INVESTIGATORS ABOUT THEIR PROPOSED STUDY DESIGN.- ADVISE ON STRATEGIES FOR THE RECRUITMENT OF DIVERSE POPULATIONS TO MCJ RESEARCH PROTOCOLS.MAYO CLINIC ALSO ATTRACTS PATIENTS FROM AREAS FAR BEYOND ITS IMMEDIATE COMMUNITIES. PATIENTS COME TO MAYO CLINIC FROM EVERY STATE AND MANY FOREIGN COUNTRIES. BESIDES ITS PRINCIPAL CLINICAL AND HOSPITAL FACILITIES IN ROCHESTER, MINNESOTA, MAYO CLINIC HAS A NETWORK OF COMMUNITY BASED HEALTH CARE PROVIDERS IN OVER 70 COMMUNITIES THROUGHOUT SOUTHERN MINNESOTA, NORTHERN IOWA AND WEST CENTRAL WISCONSIN. IN ADDITION, MAYO CLINIC HAS FACILITIES IN SCOTTSDALE AND PHOENIX, ARIZONA AS WELL AS JACKSONVILLE, FLORIDA. MAYO CLINIC SUPPORTS AND COORDINATES EFFORTS TO IMPROVE THE HEALTH AND WELL BEING WITHIN EACH OF THE COMMUNITIES IT SERVES AS WELL AS CONDUCTING MEDICAL EDUCATION AND RESEARCH ACTIVITIES TO ADVANCE THE SCIENCE OF MEDICINE TO BENEFIT A BROAD RANGE OF REGIONAL, NATIONAL AND INTERNATIONAL COMMUNITIES.
    PART VI, LINE 3: MEASURES TO PUBLICIZE FINANCIAL ASSISTANCE POLICY:MAYO CLINIC IS COMMITTED TO OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY FOR THEIR MEDICAL SERVICES IN WHOLE OR IN PART. IN ORDER TO ACCOMPLISH THIS CHARITABLE GOAL, MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM SITES WILL WIDELY PUBLICIZE THIS POLICY IN THE COMMUNITIES THAT THE INDIVIDUAL MAYO CLINIC AFFILIATED SITES SERVE. MAYO CLINIC AFFILIATED SITES WILL MAKE A COPY OF THIS POLICY AVAILABLE BY POSTING IT ON THEIR WEBPAGE INCLUDING THE ABILITY TO DOWNLOAD A COPY OF THE POLICY FREE OF CHARGE. INDIVIDUALS IN THE COMMUNITY SERVED WILL BE ABLE TO OBTAIN A COPY OF THE POLICY IN LOCATIONS THROUGHOUT EACH MAYO CLINIC AFFILIATED SITE OR UPON REQUEST. THE POLICY EXPLAINS THE FINANCIAL ASSISTANCE PROGRAM AND FACTORS AFFECTING ELIGIBILITY. WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.
    PART VI, LINE 4: MAYO CLINIC JACKSONVILLE (MCJ) AND MAYO CLINIC FLORIDA (MCF) ARE LOCATED IN EASTERN JACKSONVILLE, DUVAL COUNTY, FLORIDA AND TOGETHER SERVE POPULATIONS FROM JACKSONVILLE, AS WELL AS PATIENTS FROM ACROSS THE SOUTHEASTERN UNITED STATES AND INTERNATIONALLY. APPROXIMATELY 47% OF THE PATIENT POPULATION RESIDES OUTSIDE THE JACKSONVILLE METROPOLITAN AREA, AND 39% ARE COVERED BY MEDICARE. THE FILING ORGANIZATIONS EMPHASIZE COMPLEX AND DIFFICULT SPECIALTY AND TERTIARY CARE, INCLUDING ORGAN TRANSPLANTATION, NEUROLOGY, ONCOLOGY AND ORTHOPEDICS. THE ORGANIZATION DOES NOT HAVE PEDIATRIC OR OBSTETRIC PRACTICES, AND THIS LIMITS ACCESS TO MEDICAID PATIENTS SINCE FLORIDA'S MEDICAID BENEFITS ARE GENERALLY RESTRICTED TO CHILDREN AND PREGNANT WOMEN; HOWEVER, THE ORGANIZATION DOES HAVE AGREEMENTS WITH THE STATE OF FLORIDA TO PROVIDE A CERTAIN PERCENTAGE OF ORGAN TRANSPLANTS TO MEDICAID OR CHARITY PATIENTS (THE AMOUNT VARIES WITH EACH ORGAN TYPE).
    PART VI, LINE 5: THIS FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION - EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO CLINIC HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY - IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE. THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, EXPERIENCE, AND OTHER CRITERIA ESTABLISHED BY THE INDEPENDENT NOMINATING COMMITTEE OF THE BOARD OF TRUSTEES. AREAS OF EXPERTISE AND EXPERIENCE INCLUDE SUCH AREAS AS HEALTH CARE POLICY, RESEARCH, EDUCATION, BUSINESS, AND GOVERNMENT. THE FILING ORGANIZATION, WHICH IS CONTROLLED BY MAYO CLINIC, RELIES ON THE COMMUNITY REPRESENTATION OF THE MAYO CLINIC BOARD OF TRUSTEES TO FULFILL THIS REQUIREMENT. SEVERAL OF MAYO CLINIC'S HOSPITAL ENTITIES HAVE OBTAINED LETTER RULINGS APPROVING A STAFF MODEL IN WHICH ONLY MAYO CLINIC EMPLOYED PHYSICIANS ARE GIVEN STAFF PRIVILEGES IN ORDER TO MAINTAIN STANDARD METHODS OF PRACTICE AND PROTOCOLS. FOR THOSE ENTITIES, THE PHYSICIANS ARE SALARIED EMPLOYEES AND THUS THE ISSUE OF PRIVATE INUREMENT AND PRIVATE BENEFIT ADDRESSED BY THE OPEN STAFF REQUIREMENT ARE OTHERWISE ADDRESSED. THE FILING ORGANIZATION IS ONE OF THE ENTITIES WHICH OPERATES BASED ON THE CLOSED STAFF MODEL. THE PATIENTS OF THE FILING ORGANIZATION HAVE ACCESS TO AN EMERGENCY ROOM OPERATED BY A RELATED ENTITY ADJACENT TO OR IN CLOSE PROXIMITY TO THE FILING ORGANIZATION.
    PART VI, LINE 6: THE FILING ORGANIZATION IS PART OF A GROUP OF HEALTHCARE ENTITIES AFFILIATED WITH MAYO CLINIC. MAYO CLINIC IS THE FIRST AND LARGEST INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICE IN THE WORLD. DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." MORE THAN 3,300 PHYSICIANS, SCIENTISTS AND RESEARCHERS AND 46,000 ALLIED HEALTH STAFF WORK AT MAYO CLINIC, WHICH HAS SITES IN ROCHESTER, MINNESOTA, JACKSONVILLE, FLORIDA, AND SCOTTSDALE/PHOENIX, ARIZONA, AS WELL AS A REGIONAL NETWORK OF HOSPITALS AND CLINICS IN MINNESOTA, WISCONSIN, AND IOWA. COLLECTIVELY, MORE THAN HALF A MILLION PEOPLE ARE TREATED EACH YEAR.SPECIFICALLY, THE FILING ORGANIZATION PROVIDES MEDICAL EDUCATION, RESEARCH, AND CLINIC SERVICES AT THE FLORIDA LOCATION. FOR MORE SPECIFIC DESCRIPTION, SEE THE RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O).
    PART VI, LINE 7: NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED ON THE MINNESOTA HOSPITAL ANNUAL REPORT OR TO THE WISCONSIN HOSPITAL ASSOCIATION.
Schedule H (Form 990) 2011
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
2011
Open to Public
Inspection
Name of the organization
MAYO CLINIC JACKSONVILLE
 
Employer identification number
59-3337028
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) ST JOHN'S COUNTY CHAMBER OF COMMERCE1 RIBERIA STREET
ST AUGUSTINE,FL32084 		59-0432275 501(C)(6) 5,000       COMMUNITY DEVELOPMENT
(2) UNIVERSITY OF NORTH FLORIDA FOUNDATION1 UNF DRIVE
JACKSONVILLE,FL32224 		23-7167701 501(C)(3) 30,000       EDUCATION
(3) NORTH FLORIDA CARDIOVASCULAR EDUCATION FOUNDATION501 RIVERSIDE AVENUE SUITE 800
JACKSONVILLE,FL32202 		20-1773470 501(C)(3) 5,000       EDUCATION
(4) AMERICAN HEART ASSOCIATION5851 ST AUGUSTINE ROAD
JACKSONVILLE,FL32207 		13-5613797 501(C)(3) 142,500       HEALTHCARE
(5) AMERICAN DIABETES ASSOCIATION8384 BAYMEADOWS ROAD SUITE 10
JACKSONVILLE,FL32256 		13-1623888 501(C)(3) 12,500       HEALTHCARE
(6) ST ANDREW'S LIGHTHOUSE1797 BEACH BOULEVARD
JACKSONVILLE,FL32250 		31-1489868 501(C)(3) 35,000       HEATLHCARE
(7) MUSCULAR DYSTROPHY ASSOCIATION10245 CENTURION PARKWAY SUITE 315
JACKSONVILLE,FL32256 		13-1665552 501(C)(3) 5,000       HEALTHCARE
(8) JACKSONVILLE SYMPHONY ASSOCIATION300 WEST WATER STREET SUITE 200
JACKSONVILLE,FL32202 		59-6002520 501(C)(3) 75,000       COMMUNITY DEVELOPMENT
(9) AMERICAN CANCER SOCIETY1430 PRUDENTIAL DRIVE
JACKSONVILLE,FL32207 		59-0657320 501(C)(3) 50,000       HEALTHCARE
(10) BEACHES FINE ART SERIESPO BOX 51171
JACKSONVILLE BEACH,FL32240 		59-2989136 501(C)(3) 10,000       COMMUNITY DEVELOPMENT
(11) THE CHILDREN'S CHRISTMAS PARTY OF JACKSONVILLEPO BOX 5338
JACKSONVILLE,FL32247 		59-3611757 501(C)(3) 8,000       EQUALITY OF OPPORTUNITY
(12) LEUKEMIA & LYMPHOMA SOCIETY7077 BONNEVAL ROAD
JACKSONVILLE,FL32216 		86-0282117 501(C)(3) 5,000       HEALTHCARE
(13) KATIE CAPLES FOUNDATION98 SOUTH FLECHER AVENUE
AMELAI ISLAND,FL32034 		59-3580838 501(C)(3) 20,000       HEALTHCARE
(14) AMERICAN LUNG ASSOCIATION6852 BELFORT OAKS PLACE
JACKSONVILLE,FL32216 		59-0662271 501(C)(3) 10,000       HEALTHCARE
(15) DEEN DEVELOPMENT CORPORATION5290-4 NORWOOD AVENUE
JACKSONVILLE,FL32209 		30-0500543 501(C)(3) 13,090       HEALTHCARE
(16) LEADERSHIP JACKSONVILLE INC4040 WOODCOCK DRIVE SUITE 155
JACKSONVILLE,FL32207 		59-1718154 501(C)(3) 5,000       COMMUNITY DEVELOPMENT
(17) UNITED WAY OF NORTHEAST FLORIDAPO BOX 41428
JACKSONVILLE,FL32203 		59-0637825 501(C)(3) 25,000       EQUALITY OF OPPORTUNITY
(18) MISSION HOUSE INC800 SHETTER AVENUE
JACKSONVILLE,FL32250 		59-3376704 501(C)(3) 5,000       EQUALITY OF OPPORTUNITY
(19) JACKSONVILLE URBAN LEAGUE903 WEST UNION STREET
JACKSONVILLE,FL32204 		59-0637865 501(C)(3) 10,000       COMMUNITY DEVELOPMENT
(20) EDWARD WATERS COLLEGE1658 KINGS ROAD
JACKSONVILLE,FL32209 		59-1146751 501(C)(3) 5,000       EDUCATION
(21) WJCT100 FESTIVAL PARK AVENUE
JACKSONVILLE,FL32202 		59-0711482 501(C)(3) 15,000       COMMUNITY DEVELOPMENT
(22) DUVAL COUNTY PUBLIC SCHOOLS1701 PRUDENTIAL DRIVE
JACKSONVILLE,FL32207 		59-6000589 DUVAL COUNTY, FL 6,000       EDUCATION
(23) SISTERS NETWORK11691 CHERRY BARK DRIVE WEST
JACKSONVILLE,FL32218 		59-3488199 501(C)(3) 12,000       HEATHCARE
(24) WOMEN'S CENTER OF JACKSONVILLE5644 COLCORD AVENUE
JACKSONVILLE,FL32211 		23-7437216 501(C)(3) 5,000       EQUALITY OF OPPORTUNITY
(25) CORIELL INSTITUTE FOR MEDICAL RESEARCH43 HADDON AVENUE
CAMDEN,NJ08103 		21-0672684 501(C)(3) 32,485       RESEARCH
(26) PALO ALTO INSTITUTE FOR RESEARCH AND EDUCATION3801 MIRANDA AVENUE
PALO ALTO,CA94304 		77-0207331 501(C)(3) 18,184       RESEARCH
(27) COLUMBIA UNIVERSITY630 WEST 168TH STREET
NEW YORK,NY10032 		13-5598093 501(C)(3) 52,531       RESEARCH
(28) WASHINGTON UNIVERSITY700 ROSEDALE AVENUE BOX 1034
SAINT LOUIS,MO63111 		43-0653611 501(C)(3) 118,783       RESEARCH
(29) EMORY UNIVERSITY1599 CLIFTON ROAD 3RD FLOOR
ATLANTA,GA30322 		58-0566256 501(C)(3) 40,000       RESEARCH
(30) ALACHUA COUNTY HEALTH DEPARTMENT224 24TH STREET SE
GAINESVILLE,FL32641 		59-6000501 ALACHUA COUNTY, FL 88,191       RESEARCH
(31) UNIVERSITY OF VIRGINIA1001 NORTH EMMET STREET
CHARLOTTESVILLE,VA22904 		54-6001796 STATE OF VIRGINIA 217,069       RESEARCH
(32) UNIVERSITY OF TENNESSEE800 ANDY HOLT TOWER
KNOXVILLE,TN37996 		62-6001636 STATE OF TENNESSEE 14,093       RESEARCH
(33) UNIVERSITY OF FLORIDA2500 SOUTHWEST 2ND AVENUE
GAINESVILLE,FL32607 		59-6002052 STATE OF FLORIDA 23,903       RESEARCH
(34) UNIVERSITY OF MICHIGAN4260 PLYMOUTH ROAD
ANN ARBOR,MI48109 		38-6006309 STATE OF MICHIGAN 64,442       RESEARCH
(35) H LEE MOFFIT CANCER CENTER AND RESEARCH INSTITUTE12902 MAGNOLIA DRIVE
TAMPA,FL33612 		59-2451713 501(C)(3) 45,956       RESEARCH
(36) H LEE MOFFIT CANCER CENTER AND RESEARCH INSTITUTE HOSPITAL12902 MAGNOLIA DRIVE
TAMPA,FL33612 		59-3238634 501(C)(3) 52,945       RESEARCH
(37) MAYO CLINIC ARIZONA13400 EAST SHEA BOULEVARD
SCOTTSDALE,AZ85259 		86-0800150 501(C)(3) 38,125       RESEARCH
(38) MAYO CLINIC200 FIRST STREET SW
ROCHESTER,MN55905 		41-6011702 501(C)(3) 40,922,193       CONTRIBUTIONS & RESEARCH
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
37
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
1
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
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
PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY AND EQUALITY OF OPPORTUNITY. FEDERAL AWARDS THAT ARE SUBCONTRACTED TO OTHER ORGANIZATIONS ARE MONITORED BY THE FILING ORGANIZATION AS PRESCRIBED IN OMB CIRCULAR A-133. NO ADDITIONAL MONITORING IS PERFORMED. TRANSFERS OR GRANTS TO TAX-EXEMPT ORGANIZATIONS WILL BE USED PURSUANT TO THE POLICIES AND PROCEDURES OF THE GRANTEE ORGANIZATIONS AND TO FURTHER THE EXEMPT PURPOSES OF THE GRANTEE ORGANIZATIONS. BOTH THE FILING ORGANIZATION AND THE GRANTEE ORGANIZATION MAINTAIN ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED. TRANSFERS OR GRANTS TO AFFILIATED TAX-EXEMPT ORGANIZATIONS WILL BE USED PURSUANT TO THE POLICIES AND PROCEDURES OF THE GRANTEE ORGANIZATIONS AND TO FURTHER THE EXEMPT PURPOSES OF THE GRANTEE ORGANIZATIONS. BOTH THE FILING ORGANIZATION AND THE GRANTEE ORGANIZATION MAINTAIN ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED.
Schedule I (Form 990) 2011


Additional Data


Software ID:  
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
2011
Open to Public Inspection
Name of the organization
MAYO CLINIC JACKSONVILLE
 
Employer identification number

59-3337028
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 or provision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
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
Yes
 
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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
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
Yes
 
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
 
No
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 Regulations 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) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(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 as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) BRIGHAM ROBERT F (i)
(ii)		 439,640
0 		0
0 		5,011
0 		226
0 		21,222
0 		466,099
0 		0
0
(2) BROTT MD THOMAS G (i)
(ii)		 291,871
0 		0
0 		43,350
0 		43,692
0 		14,004
0 		392,917
0 		36,188
0
(3) BUSKIRK MD STEVEN J (i)
(ii)		 498,166
0 		0
0 		31,749
0 		30,629
0 		14,004
0 		574,548
0 		26,561
0
(4) DAWSON MD NANCY L (i)
(ii)		 253,929
0 		0
0 		2,353
0 		36,056
0 		14,004
0 		306,342
0 		0
0
(5) DEVAULT MD KENNETH R (i)
(ii)		 448,570
0 		0
0 		59,077
0 		22,640
0 		26,244
0 		556,531
0 		55,957
0
(6) GONWA MD THOMAS A (i)
(ii)		 299,320
0 		0
0 		23,566
0 		40,931
0 		27,968
0 		391,785
0 		17,422
0
(7) HARRISON DEBRA A (i)
(ii)		 186,524
0 		0
0 		2,374
0 		59
0 		13,779
0 		202,736
0 		0
0
(8) HOFFMAN MARY J (i)
(ii)		 260,080
0 		0
0 		1,769
0 		25,980
0 		25,208
0 		313,037
0 		0
0
(9) JORGENSEN STEVEN C (i)
(ii)		 264,251
0 		0
0 		18,515
0 		24,706
0 		20,088
0 		327,560
0 		16,933
0
(10) LANGE MD STEPHEN M (i)
(ii)		 440,328
0 		0
0 		80,504
0 		34,686
0 		20,028
0 		575,546
0 		74,282
0
(11) LEVENTHAL MD JACK P (i)
(ii)		 349,301
0 		0
0 		65,045
0 		0
0 		14,004
0 		428,350
0 		55,850
0
(12) MATHEWS HILARY G (i)
(ii)		 239,166
0 		0
0 		2,232
0 		0
0 		20,088
0 		261,486
0 		0
0
(13) MURRAY MD PETER M (i)
(ii)		 513,775
0 		0
0 		48,853
0 		26,194
0 		14,754
0 		603,576
0 		44,640
0
(14) O'CONNOR MD MARY I (i)
(ii)		 524,493
0 		0
0 		77,603
0 		29,715
0 		26,968
0 		658,779
0 		49,712
0
(15) RUPP MD WILLIAM C (i)
(ii)		 720,745
0 		0
0 		19,973
0 		117
0 		8,088
0 		748,923
0 		0
0
(16) SMITH MD CD (i)
(ii)		 472,820
0 		34,250
0 		48,305
0 		30,392
0 		25,148
0 		610,915
0 		44,866
0
(17) TOMLINSON DANIEL L (i)
(ii)		 180,617
0 		0
0 		919
0 		15,819
0 		22,044
0 		219,399
0 		0
0
(18) ACKERMAN FRANKLIN K (i)
(ii)		 179,498
0 		0
0 		634
0 		11,791
0 		18,984
0 		210,907
0 		0
0
(19) FORD MARGARET J (i)
(ii)		 181,486
0 		0
0 		1,711
0 		25,857
0 		15,828
0 		224,882
0 		0
0
(20) HUBER HAROLD D (i)
(ii)		 200,886
0 		0
0 		3,681
0 		24
0 		14,704
0 		219,295
0 		0
0
(21) KHOOR MD ANDRAS (i)
(ii)		 379,647
0 		0
0 		28,511
0 		29,241
0 		24,968
0 		462,367
0 		24,346
0
(22) PASCUAL MD JORGE M (i)
(ii)		 303,762
0 		0
0 		19,513
0 		25,914
0 		21,088
0 		370,277
0 		17,837
0
(23) SCHEFFEL JEFFREY G (i)
(ii)		 152,523
0 		0
0 		1,443
0 		17,027
0 		21,398
0 		192,391
0 		0
0
(24) SPACKMAN MD THOMAS N (i)
(ii)		 415,978
0 		0
0 		7,534
0 		40,476
0 		19,044
0 		483,032
0 		0
0
(25) UITTI MD RYAN J (i)
(ii)		 261,317
0 		0
0 		1,438
0 		24,274
0 		27,282
0 		314,311
0 		0
0
(26) WALTERS ROBERT M (i)
(ii)		 161,441
117,958 		0
0 		1,571
8,237 		19,631
15,197 		12,533
9,055 		195,176
150,447 		3,917
3,032
(27) WHAREN MD ROBERT E (i)
(ii)		 728,287
0 		0
0 		301,282
0 		34,687
0 		21,468
0 		1,085,724
0 		293,954
0
(28) WILLIAMS MD HUGH J (i)
(ii)		 588,986
0 		0
0 		127,670
0 		34,320
0 		14,064
0 		765,040
0 		121,642
0
(29) AGNEW MD RICHARD C (i)
(ii)		 624,724
0 		0
0 		293,337
0 		40,999
0 		19,968
0 		979,028
0 		282,009
0
(30) DEEN MD HUGH G (i)
(ii)		 716,998
0 		0
0 		277,342
0 		32,886
0 		19,968
0 		1,047,194
0 		269,837
0
(31) HANEL MD RICARDO A (i)
(ii)		 903,210
0 		0
0 		73,436
0 		13,510
0 		19,968
0 		1,010,124
0 		71,836
0
(32) LANE MD GARY E (i)
(ii)		 570,602
0 		0
0 		221,952
0 		36,920
0 		14,004
0 		843,478
0 		211,033
0
(33) REIMER MD RONALD (i)
(ii)		 712,075
0 		0
0 		271,102
0 		27,914
0 		22,428
0 		1,033,519
0 		263,912
0
(34) BARTLEY MD GEORGE B (i)
(ii)		 0
502,328 		0
0 		0
52,186 		0
27,761 		0
19,117 		0
601,392 		0
46,941
(35) BOLLING DAVID B (i)
(ii)		 0
209,601 		0
0 		0
2,023 		0
0 		0
20,608 		0
232,232 		0
0
(36) CROFT CHERYL (i)
(ii)		 0
233,478 		0
0 		0
1,353 		0
26,713 		0
19,968 		0
281,512 		0
0
(37) PRESUTTI DO RICHARD J (i)
(ii)		 309,921
0 		0
0 		2,020
0 		18,265
0 		19,544
0 		349,750
0 		0
0
(38) WEBER JOAN A (i)
(ii)		 0
196,691 		0
0 		0
1,737 		0
16,457 		0
8,148 		0
223,033 		0
0
(39) ZORN CHRISTINA K (i)
(ii)		 0
197,632 		0
0 		0
354 		0
11,494 		0
20,088 		0
229,568 		0
0
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 1A DR. RUPP AND DR. LEVENTHAL SERVED ON THE BOARD OF TRUSTEES FOR MAYO CLINIC (THE PARENT COMPANY OF THE FILING ORGANIZATION) AND WERE PROVIDED TRAVEL FOR COMPANIONS SO THEIR SPOUSES COULD ACCOMPANY THEM TO THE SITE OF THE MAYO CLINIC BOARD OF TRUSTEE MEETINGS. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION AND IS ORDINARILY GROSSED-UP. MAYO EMPLOYEES RESIDING IN FLORIDA DO NOT HAVE FLORIDA INCOME TAX AND INCUR REDUCTIONS IN THIER NET PAY AS A RESULT OF WORKING OUTSIDE OF FLORIDA DUE TO WITHHOLDING REQUIREMENTS OF OTHER STATES. FLORIDA EMPLOYEES PERFORMING WORK OUTSIDE OF FLORIDA RECEIVE A SUPPLEMENTAL PAYMENT TO HELP OFFSET THE COST OF THE STATE INCOME TAXES INCURRED AS A RESULT OF HAVING TO WORK OUTSIDE OF FLORIDA. SEVERAL CURRENT & FORMER TRUSTEES, KEY EMPLOYEES AND HIGHEST PAID EMPLOYEES LISTED ON THIS RETURN RECEIVED THIS SUPPLEMENTAL PAYMENT. DR. STEPHEN LANGE AND ROBERT BRIGHAM RECEIVED AN AWARD OR OTHER TANGIBLE RECOGNITION THAT WAS TREATED AS TAXABLE COMPENSATION. PURSUANT TO INSTITUTIONAL POLICIES, CERTAIN SUCH AWARDS HAVE A TAX GROSS-UP APPLIED IN ORDER NOT TO DIMINISH THE RECOGNITION AND CELEBRATORY NATURE OF THE AWARD. PERSONAL INCOME TAX PREPARATION SERVICES (I.E. PERSONAL SERVICES) ARE AVAILABLE TO ALL VOTING STAFF OF MAYO CLINIC. SEVERAL CURRENT & FORMER TRUSTEES, KEY EMPLOYEES AND HIGHEST PAID EMPLOYEES LISTED ON THIS RETURN RECEIVED THIS SERVICE, WHICH WAS TREATED AS TAXABLE COMPENSATION TO THE INDIVIDUALS. THE SUBMISSION OF A RECEIPT IS NOT REQUIRED AS THE BENEFIT IS PAID DIRECTLY TO THE VENDOR.
  PART I, LINE 4B THIS ENTITY OR ITS AFFILIATE HAS A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE MAYO PENSION PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(A)(17). STARTING JANUARY 1, 2011, ALL SRP BENEFITS ARE PAID AS AN ANNUAL TAXABLE CASH PAYMENT. THE FOLLOWING INDIVIDUALS RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). A PORTION OF THE AMOUNT MAY BE INCLUDED IN SCHEDULE J, PART II, COLUMN (F) IF DISCLOSED ON A PRIOR YEAR'S FORM 990. RICHARD AGNEW, M.D. - $282,009 THOMAS BROTT, M.D. - $36,188 STEVEN BUSKIRK, M.D. - $26,561 HUGH DEEN, M.D. - $269,837 KENNETH DEVAULT, M.D. - $55,957 THOMAS GONWA, M.D. - $17,422 RICARDO HANEL, M.D. - $71,836 STEVEN JORGENSEN - $16,933 ANDRAS KHOOR, M.D. - $24,346 GARY LANE, M.D. - $211,033 STEPHEN LANGE, M.D. - $74,282 JACK LEVENTHAL, M.D. - $55,850 PETER MURRAY, M.D. - $44,640 MARY O'CONNOR, M.D. - $49,712 JORGE PASCUAL, M.D. - $17,837 RONALD REIMER, M.D. - $263,912 C.D. SMITH, M.D. - $44,866 ROBERT WALTERS - $6,949 ROBERT WHAREN, M.D. - $293,954 HUGH WILLIAMS, M.D. - $121,642 GEORGE BARTLEY, M.D. - $46,941
SUPPLEMENTAL INFORMATION PART III COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION.
SUPPLEMENTAL INFORMATION PART III PART I, LINE 3: THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990 PART VI SECTION B LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED.
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
MAYO CLINIC JACKSONVILLE
 
Employer identification number

59-3337028
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2011
Schedule L (Form 990 or 990-EZ) 2011
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) MMSI INC
  		BOARD OVERLAP 28,328,838 BENEFITS AND SERVICES   No
(2) JANICE CLARKE MD SPOUSE OF OFFICER / DIRECTOR 275,440 EMPLOYMENT   No
(3) KRISTIN SCHUMANN DAUGHTER OF OFFICER / DIRECTOR 40,399 EMPLOYMENT   No
(4) CAITLIN SCHEFFEL DAUGHTER OF KEY EMPLOYEE 17,858 EMPLOYMENT   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2011

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
2011
Open to Public
Inspection
Name of the organization
MAYO CLINIC JACKSONVILLE
 
Employer identification number

59-3337028
Identifier Return Reference Explanation
  FORM 990, PART VI, SECTION A, LINE 2 THE FOLLOWING INDIVIDUAL IS EMPLOYED BY A RELATED ORGANIZATION: ROBERT WALTERS RESULTING IN A BUSINESS REALTIONSHIP WITH THE FOLLOWING INDIVIDUALS WHO ARE ASSOCIATED WITH THE RELATED ORGANIZATION AS AN OFFIICER, DIRECTOR, OR TRUSTEE: ROBERT BRIGHAM MARY HOFFMAN DUE TO OVERLAP OF BOARD MEMERSHIP ON A RELATED TAXABLE ENTITY, THE FOLLOWING INDIVIDUALS: ROBERT BRIGHAM MARY HOFFMAN WILLIAM RUPP, M.D. HAVE A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS: ROBERT BRIGHAM MARY HOFFMAN WILLIAM RUPP, M.D.
  FORM 990, PART VI, SECTION A, LINE 3 MAYO CLINIC JACKSONVILLE IS AFFILIATED WITH MAYO CLINC. MAYO AFFILIATED ENTITIES ROUTINELY DELEGATED VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO RELATED ENTITIES.
  FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF MAYO CLINIC JACKSONVILLE IS MAYO CLINIC.
  FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE MAYO CLINIC JACKSONVILLE EXECUTIVE OPERATIONS TEAM SHALL BE ELECTED UPON THE NOMINATION OF THE VICE PRESIDENT/CEO AND ELECTION BY THE MAYO CLINIC BOARD OF GOVERNORS.
  FORM 990, PART VI, SECTION A, LINE 7B MAYO CLINIC JACKSONVILLE'S ARTICLES PROVIDE THE SOLE CORPORATE MEMBER POWER IN AREAS SUCH AS COMPENSATION, CAPTIAL, BUDGET, DEBT AND APPROVAL OF AMENDMENTS TO THE ARTICLES AND BYLAWS.
  FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATIONS GOVERNING BODY VIA U.S. MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. HIGHLIGHTS ARE PRESENTED TO BOARD MEMBERS, AND THE REVIEW IS DOCUMENTED IN MEETING MINUTES. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990.
  FORM 990, PART VI, SECTION B, LINE 12C MAYO CLINIC AND ITS AFFILIATES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS.
    FORM 990, PART VI, SECTION B, LINE 15: THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS AND ADMINISTRATIVE LEADERSHIP. THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY IN THE FALL FOR THE NEXT YEAR'S COMPENSATION. THE SALARIES OF THE CEO, CAO, CFO AND THE VICE CHAIR WERE REVIEWED BY THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE AND/OR THE MAYO CLINIC GOVERNANCE COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR PHYSICIAN AND ADMINISTRATIVE LEADERSHIP. THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION OF PHYSICIANS AND ADMINISTRATIVE LEADERSHIP FOR THE ARIZONA, FLORIDA, AND ROCHESTER, MINNESOTA CAMPUSES. THE COMMITTEE IS COMPRISED OF MAYO EMPLOYEES, BUT IS INDEPENDENT FOR INTERNAL REVENUE CODE 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED (WITH RECUSAL WHERE APPROPRIATE). FOR THOSE INDIVIDUALS FOR WHICH THIS COMMITTEE CAN NOT SERVE AS THE INDEPENDENT REVIEW, THEIR COMPENSATION AND BENEFITS ARE REVIEWED BY THE GOVERNANCE COMMITTEE (DESCRIBED BELOW). THE SALARY AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. THE MAYO CLINIC COMMITTEE ON OFFICER SUCCESSION, COMPENSATION, AND GOVERNANCE (GOVERNANCE COMMITTEE) IS COMPRISED OF SEVEN OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. THIS GROUP REVIEWS THE COMPENSATION AND BENEFITS FOR PHYSICIANS FROM ALL CAMPUSES, INCLUDING THE MAYO CLINC HEALTH SYSTEM LOCATIONS, AS WELL AS CERTAIN SENIOR ADMINISTRATIVE AND EXECUTIVE LEADERSHIP (INCLUDING ALL PERSONS BELIEVED TO BE DISQUALIFIED PERSONS). THIS PROCESS ESTABLISHES ACCEPTABLE RANGES FOR VARIOUS POSITIONS, LEVELS, AND SPECIALTIES. THE COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. IN ADDITION, THE GOVERNANCE COMMITTEE DIRECTLY RETAINS AN INDEPENDENT THIRD-PARTY COMPENSATION CONSULTANT TO PROVIDE RELEVANT, CONTEMPORANEOUS BENCHMARK INFORMATION FOR A SMALL GROUP OF SENIOR PHYSICIAN, ADMINISTRATIVE, AND EXECUTIVE LEADERSHIP POSITIONS FOR WHICH AN INDIVIDUALIZED REVIEW AND RECOMMENDATION IS MADE.
  FORM 990, PART VI, SECTION C, LINE 19 THE FILING ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. THE FILING ORGANIZATION IS A HOSPITAL AFFILIATED WITH MAYO CLINIC. AS SUCH, MAYO CLINIC'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FILING ORGANIZATION'S FORM 990 AND WOULD BE AVAILABLE UPON REQUEST OF THE FORM 990.
    FORM 990, PART VII, SECTION A, AVERAGE HOURS PER WEEK DEVOTED TO POSITION WITH RELATED ORGANIZATIONS: GEORGE BARTLEY, M.D. - 40 HOURS DAVID BOLLING - 40 HOURS CHERYL CROFT - 40 HOURS JOAN WEBER - 40 HOURS CHRISTINA ZORN - 40 HOURS ROBERT BRIGHAM - 20 HOURS THOMAS BROTT, M.D. - 20 HOURS STEVEN BUSKIRK, M.D. - 20 HOURS NANCY DAWSON, M.D. - 20 HOURS KENNETH DEVAULT, M.D. - 20 HOURS THOMAS GONWA, M.D. - 20 HOURS DEBRA HARRISON - 20 HOURS MARY HOFFMAN - 20 HOURS STEVEN JORGENSEN - 20 HOURS STEPHEN LANGE, M.D. - 20 HOURS JACK LEVENTHAL, M.D. - 20 HOURS HILARY MATHEWS - 20 HOURS PETER MURRAY, M.D. - 20 HOURS MARY O'CONNOR, M.D. - 20 HOURS WILLIAM RUPP, M.D. - 20 HOURS C.D. SMITH, M.D. - 20 HOURS DANIEL TOMLINSON - 20 HOURS FRANKLIN ACKERMAN - 20 HOURS MARGARET FORD - 20 HOURS HAROLD HUBER - 20 HOURS ANDRAS KHOOR, M.D. - 20 HOURS JORGE PASCUAL, M.D. - 20 HOURS JEFFREY SCHEFFEL - 20 HOURS THOMAS SPACKMAN, M.D. - 20 HOURS RYAN UITTI, M.D. - 20 HOURS ROBERT WALTERS - 20 HOURS ROBERT WHAREN, M.D. - 20 HOURS HUGH WILLIAMS, M.D. - 20 HOURS RICHARD AGNEW, M.D. - 20 HOURS HUGH DEEN, M.D. - 20 HOURS RICARDO HANEL, M.D. - 20 HOURS GRAY LANE, M.D. - 20 HOURS RONALD REIMER, M.D. - 20 HOURS RICHARD PRESUTTI, D.O. - 20 HOURS
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -1,053,480.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
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
2011
Open to Public Inspection
Name of the organization
MAYO CLINIC JACKSONVILLE
 
Employer identification number

59-3337028
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) BLOOMER LAKEVIEW INC

2110 DUNCAN ROAD

BLOOMER,WI54724
39-1450617 		LOW INCOME HOUSING WI 501(C)(3) 7 MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC
 
Yes
 
(2) CHARTERHOUSE INC

200 FIRST STREET SW

ROCHESTER,MN55905
41-1405254 		RETIREMENT LIVING CENTER MN 501(C)(3) 9 MAYO CLINIC
 
Yes
 
(3) FOUNTAIN LAKE TREATMENT CENTER

404 WEST FOUNTAIN STREET

ALBERT LEA,MN56007
41-1404076 		CHEMICAL DEPENDENCY TREATMENT MN 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--ALBERT LEA
 
Yes
 
(4) FRANCISCAN SKEMP FOUNDATION OF ARCADIA INC

464 SOUTH JOHNSON STREET

ARCADIA,WI54612
39-1322480 		FUNDRAISING FOUNDATION WI 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC
 
Yes
 
(5) GCAS

200 FIRST STREET SW

ROCHESTER,MN55905
41-1917517 		AMBULANCE SERVICE MN 501(C)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH
 
Yes
 
(6) GOLD CROSS AMBULANCE SERVICE

200 FIRST STREET SW

ROCHESTER,MN55905
41-1917516 		AMBULANCE SERVICE MN 501(C)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH
 
Yes
 
(7) GOLD CROSS AMBULANCE INC

200 FIRST STREET SW

ROCHESTER,MN55905
39-1942957 		AMBULANCE SERVICE MN 501(C)(3) 9 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH
 
Yes
 
(8) LUTHER LAKESIDE APARTMENTS INC

714 SOUTH BARSTOW STREET

EAU CLAIRE,WI54701
39-1409024 		LOW INCOME HOUSING WI 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC
 
Yes
 
(9) MAYO CLINIC

200 FIRST STREET SW

ROCHESTER,MN55905
41-6011702 		PATIENT CARE - CLINIC MN 501(C)(3) 9 MAYO CLINIC
 
Yes
 
(10) MAYO CLINIC -- METHODIST HOSPITAL

200 FIRST STREET SW

ROCHESTER,MN55905
41-0739106 		HOSPITAL MN 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(11) MAYO CLINIC -- SAINT MARYS HOSPITAL

200 FIRST STREET SW

ROCHESTER,MN55905
41-0944601 		HOSPITAL MN 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(12) MAYO CLINIC ARIZONA

13400 EAST SHEA BLVD

SCOTTSDALE,AZ85259
86-0800150 		HOSPITAL AND CLINIC AZ 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(13) MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION)

4500 SAN PABLO ROAD

JACKSONVILLE,FL32224
59-0714831 		HOSPITAL FL 501(C)(3) 3 MAYO CLINIC JACKSONVILLE
 
Yes
 
(14) MAYO CLINIC HEALTH SYSTEM--ALBERT LEA

404 WEST FOUNTAIN STREET

ALBERT LEA,MN56007
41-1404075 		HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(15) MAYO CLINIC HEALTH SYSTEM--AUSTIN

1000 FIRST DRIVE NW

AUSTIN,MN55912
41-0695606 		HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(16) MAYO CLINIC HEALTH SYSTEM--AUSTIN FOUNDATION

1000 FIRST DRIVE NW

AUSTIN,MN55912
30-0107471 		FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC HEALTH SYSTEM--AUSTIN
 
Yes
 
(17) MAYO CLINIC HEALTH SYSTEM--CANNON FALLS

1116 WEST MILL STREET

CANNON FALLS,MN55009
20-4156428 		HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(18) MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC

1501 THOMPSON STREET

BLOOMER,WI54724
39-0980343 		HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC
 
Yes
 
(19) MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC

PO BOX 1510

EAU CLAIRE,WI54702
39-1735831 		PATIENT CARE - CLINIC WI 501(C)(3) 3 MAYO CLINIC
 
 
No
(20) MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE FOUNDATION INC

733 W CLAIREMONT AVE PO BOX 1510

EAU CLAIRE,WI54702
39-1633407 		GRANTMAKING FOUNDATION WI 501(C)(3) PF MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC
 
 
No
(21) MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC

1221 WHIPPLE STREET

EAU CLAIRE,WI54703
39-0813418 		HOSPITAL WI 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(22) MAYO CLINIC HEALTH SYSTEM--FAIRMONT

800 MEDICAL CENTER DRIVE PO BOX 800

FAIRMONT,MN56031
41-0760836 		HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(23) MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION INC

700 WEST AVE SOUTH

LA CROSSE,WI54601
39-1186647 		FUNDRAISING FOUNDATION WI 501(C)(3) 11-II MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC
 
Yes
 
(24) MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE FOUNDATION-SPARTA INC

310 WEST MAIN STREET

SPARTA,WI54656
39-1423234 		FUNDRAISING FOUNDATION WI 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC
 
Yes
 
(25) MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC

700 WEST AVE SOUTH

LA CROSSE,WI54601
39-1411999 		HEALTHCARE SYSTEM PARENT WI 501(C)(3) 11-I MAYO CLINIC
 
Yes
 
(26) MAYO CLINIC HEALTH SYSTEM--FRANCISCAN MEDICAL CENTER INC

700 WEST AVE SOUTH

LA CROSSE,WI54601
39-0806374 		HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--FRANCISCAN HEALTHCARE INC
 
Yes
 
(27) MAYO CLINIC HEALTH SYSTEM--HOME HEALTH & HOSPICE INC

PO BOX 2060

EAU CLAIRE,WI54702
39-1491516 		HOME HEALTH AND HOSPICE CARE WI 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC
 
Yes
 
(28) MAYO CLINIC HEALTH SYSTEM--LAKE CITY

500 WEST GRANT STREET

LAKE CITY,MN55041
41-1906820 		HOSPITAL MN 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(29) MAYO CLINIC HEALTH SYSTEM--MANKATO

1025 MARSH STREET

MANKATO,MN56002
41-1236756 		HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(30) MAYO CLINIC HEALTH SYSTEM--MANKATO HEALTH CARE FOUNDATION

1025 MARSH STREET

MANKATO,MN56002
41-1663357 		FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC HEALTH SYSTEM--MANKATO
 
Yes
 
(31) MAYO CLINIC HEALTH SYSTEM--NEW PRAGUE

301 SECOND STREET NORTHEAST

NEW PRAGUE,MN56071
41-0723639 		HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(32) MAYO CLINIC HEALTH SYSTEM--NORTHLAND INC

1222 EAST WOODLAND AVE

BARRON,WI54812
39-0920634 		HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC
 
Yes
 
(33) MAYO CLINIC HEALTH SYSTEM--OAKRIDGE INC

PO BOX 70 / 13025 EIGHTH STREET

OSSEO,WI54758
39-1029430 		HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC
 
Yes
 
(34) MAYO CLINIC HEALTH SYSTEM--OWATONNA

134 SOUTHVIEW

OWATONNA,MN55060
41-1862132 		PATIENT CARE - CLINIC MN 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(35) MAYO CLINIC HEALTH SYSTEM--RED CEDAR INC

2321 STOUT ROAD

MENOMONIE,WI54751
51-0190875 		HOSPITAL AND CLINIC WI 501(C)(3) 3 MAYO CLINIC
 
Yes
 
(36) MAYO CLINIC HEALTH SYSTEM--SPRINGFIELD

625 NORTH JACKSON AVENUE

SPRINGFIELD,MN56087
41-1893827 		HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--MANKATO
 
Yes
 
(37) MAYO CLINIC HEALTH SYSTEM--ST JAMES

1101 MOULTON PARSONS DR PO BOX 460

ST JAMES,MN56081
41-0797368 		HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--MANKATO
 
Yes
 
(38) MAYO CLINIC HEALTH SYSTEM--ST JAMES HEALTH CARE FOUNDATION

1101 MOULTON PARSONS DR PO BOX 460

ST JAMES,MN56081
41-1444129 		FUNDRAISING FOUNDATION MN 501(C)(3) 7 MAYO CLINIC HEALTH SYSTEM--ST JAMES
 
Yes
 
(39) MAYO CLINIC HEALTH SYSTEM--SUPPORTIVE HOMECARE INC

PO BOX 2060

EAU CLAIRE,WI54702
39-1686673 		HOME HEALTH CARE WI 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE HOSPITAL INC
 
Yes
 
(40) MAYO CLINIC HEALTH SYSTEM--WASECA

501 NORTH STATE STREET

WASECA,MN56093
36-3606405 		HOSPITAL AND CLINIC MN 501(C)(3) 3 MAYO CLINIC HEALTH SYSTEM--MANKATO
 
Yes
 
(41) MAYO CLINIC JACKSONVILLE

4500 SAN PABLO ROAD

JACKSONVILLE,FL32224
59-3337028 		PATIENT CARE - CLINIC FL 501(C)(3) 7 MAYO CLINIC
 
Yes
 
(42) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH

200 FIRST STREET SW

ROCHESTER,MN55905
41-1506440 		CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES MN 501(C)(3) 9 MAYO CLINIC
 
Yes
 
(43) MAYO KLINIK STIFTUNG

60486 FRANKFURT AM MAIN
FRANKFURT    
GM
FUNDRAISING FOUNDATION GM     MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH
 
Yes
 
(44) MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES

200 FIRST STREET SW

ROCHESTER,MN55905
41-2020392 		SUPPORT RESEARCH, PRACTICE & EDUCATION MN 501(C)(3) 11-I MAYO CLINIC
 
Yes
 
(45) POVERELLO FOUNDATION

200 FIRST STREET SW

ROCHESTER,MN55905
41-1494881 		FUNDRAISING FOUNDATION MN 501(C)(3) 11-I MAYO CLINIC -- SAINT MARYS HOSPITAL
 
Yes
 
(46) SOUTHERN METRO MEDICAL CLINICS INC

301 MAIN STREET

NEW PRAGUE,MN56071
41-1623632 		FAMILY PRACTICE CLINICS MN 501(C)(3) 9 MAYO CLINIC HEALTH SYSTEM--NEW PRAGUE
 
Yes
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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
(1) FRANKLIN HEATING STATION

119 THIRD ST SW
ROCHESTER,MN55902
41-0264830 		UTILITY MN N/A
                  












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
(1) MAYO CLINIC HEALTH SYSTEM--FARIBAULT
635 FIRST STREET SE
FARIBAULT,MN55021
41-1817179 		PATIENT CARE - CLINIC MN N/A
 C      
(2) MAYO CLINIC HEALTH SYSTEM--DECORAH CLINIC PHYSICIANS
907 MONTGOMERY STREET
DECORAH,IA52101
41-1711329 		PATIENT CARE - CLINIC IA N/A
 C      
(3) FIOS THERAPEUTICS INC
200 FIRST STREET SW
ROCHESTER,MN55905
71-1029189 		RESEARCH MN N/A
 C      
(4) HEALTH TRADITION HEALTH PLAN
1808 EAST MAIN STREET
ONALASKA,WI54650
39-1545987 		MEDICAL SERVICES COMPANY WI N/A
 C      
(5) LOBSS NETWORK SUPPORT 2002 INC
200 FIRST STREET SW
ROCHESTER,MN55905
48-1276150 		ADMINISTRATIVE SERVICES MN N/A
 C      
(6) MAYO COLLABORATIVE SERVICES INC
200 FIRST STREET SW
ROCHESTER,MN55905
41-1346366 		REFERENCE LAB SERVICES MN N/A
 C      
(7) MAYO HOLDING COMPANY
200 FIRST STREET SW
ROCHESTER,MN55905
41-1578020 		HOLDING COMPANY MN N/A
 C      
(8) MAYO INSURANCE COMPANY LTD
200 FIRST STREET SW
ROCHESTER,MN55905
 SELF INSURANCE POOL CJ N/A
 C      
(9) MAYO MEDICAL LABORATORIES NEW ENGLAND INC
265 BALLARDVALE STREET
WILMINGTON,MA01887
04-3323713 		LABORATORY SERVICES MA N/A
 C      
(10) MAYO REGIONAL PRACTICES OF ARIZONA
13400 EAST SHEA BOULEVARD
SCOTTSDALE,AZ85259
06-1190278 		THIRD PARTY ADMINISTRATION SERVICES AZ N/A
 C      
(11) MHS SERVICES INC
200 FIRST STREET SW
ROCHESTER,MN55905
41-1282517 		EQUIPMENT & REAL ESTATE LEASING MN N/A
 C      
(12) MMSI INC
21 FIRST STREET SW
ROCHESTER,MN55905
41-1547003 		THIRD PARTY ADMINISTRATION SERVICES MN N/A
 C      
(13) MAYO CLINIC HEALTH SYSTEM--PHARMACY & HOME MEDICAL INC
1221 WHIPPLE STREET
EAU CLAIRE,WI54703
39-1528920 		PHARMACY SERVICES WI N/A
 C      
(14) PHYSICIAN AND HOSPITAL PRACTICES INC
4500 SAN PABLO ROAD
JACKSONVILLE,FL32224
93-0926631 		HEALTH SERVICES FL N/A
 C      
(15) ROCHESTER AIRPORT COMPANY
ROUTE 2
ROCHESTER,MN55902
41-0506870 		AIRPORT MANAGEMENT MN N/A
 C      
(16) SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION
13400 E SHEA BLVD
SCOTTSDALE,AZ85259
86-0870505 		COMMERCIAL PROPERTY OWNERS ASSOCIATION AZ N/A
 C      
(17) THE STABILE BUILDING OWNERS' ASSOCIATION
200 FIRST STREET SW
ROCHESTER,MN55905
20-8994499 		COMMERCIAL PROPERTY OWNERS ASSOCIATION MN N/A
 C      
(18) MAYO CLINIC GBS MAURITIUS
2ND FLOOR EBENE MEWS 57
EBENE CYBERCITY    
MP
HEALTHCARE MANAGEMENT MP N/A
 C      
(19) CHARITABLE LEAD TRUST (1)
 
 
CHARITABLE TRUST CA N/A
 T      
(20) PERPETUAL TRUST (1)
 
 
CHARITABLE TRUST ND N/A
 T      
(21) PERPETUAL TRUST (1)
 
 
CHARITABLE TRUST LA N/A
 T      
(22) PERPETUAL TRUST (2)
 
 
CHARITABLE TRUST MA N/A
 T      
(23) PERPETUAL TRUST (1)
 
 
CHARITABLE TRUST MO N/A
 T      
(24) PERPETUAL TRUST (1)
 
 
CHARITABLE TRUST AZ N/A
 T      
(25) CHARITABLE REMAINDER TRUST (1)
 
 
CHARITABLE TRUST CO N/A
 T      
(26) CHARITABLE REMAINDER TRUST (6)
 
 
CHARITABLE TRUST FL N/A
 T      
(27) CHARITABLE REMAINDER TRUST (1)
 
 
CHARITABLE TRUST FL N/A
 T      
(28) CHARITABLE REMAINDER TRUST (1)
 
 
CHARITABLE TRUST IL N/A
 T      
(29) CHARITABLE REMAINDER TRUST (1)
 
 
CHARITABLE TRUST LA N/A
 T      
(30) CHARITABLE REMAINDER TRUST (1)
 
 
CHARITABLE TRUST MI N/A
 T      
(31) CHARITABLE REMAINDER TRUST (66)
 
 
CHARITABLE TRUST MN N/A
 T      
(32) CHARITABLE REMAINDER TRUST (82)
 
 
CHARITABLE TRUST MN N/A
 T      
(33) CHARITABLE REMAINDER TRUST (1)
 
 
CHARITABLE TRUST NC N/A
 T      
(34) CHARITABLE REMAINDER TRUST (2)
 
 
CHARITABLE TRUST TX N/A
 T      
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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 related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
Yes
 
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
Yes
 
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
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) MAYO CLINIC FLORIDA

 R 20,105,749 GAAP
(2) MAYO CLINIC FLORIDA

 K 549,584 GAAP
(3) MAYO CLINIC FLORIDA

 P 52,199,320 GAAP
(4) MAYO CLINIC FLORIDA

 I 8,372,399 GAAP
(5) MAYO CLINIC FLORIDA

 C 40,000,000 GAAP
(6) MAYO COLLABORATIVE SERVICES INC

 K 5,461,151 GAAP
(7) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH

 P 938,129 GAAP
(8) MMSI INC

 R 26,580,986 GAAP
(9) MAYO CLINIC FLORIDA

 O 1,135,180 GAAP
(10) MAYO COLLABORATIVE SERVICES INC

 L 3,930,218 GAAP
(11) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH

 Q 17,031,624 GAAP
(12) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH

 O 130,157 GAAP
(13) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH

 N 250,246,203 GAAP
(14) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH

 G 150,589,837 GAAP
(15) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH

 L 488,973 GAAP
(16) MMSI INC

 L 1,747,852 GAAP
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations? 		(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 Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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 Data


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