TY 2011 Form 990

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) AGERTER MD DAVID C DIRECTOR	1.00	X			0	439,287	46,318
(2) CIOTA MD MARK R CHAIR / CEO / DIRECTOR	40.00	X	X		861,046	0	44,353
(3) CRUZ-LARES LINDA DIRECTOR	1.00	X			0	0	0
(4) FUNK MICHAEL S DIRECTOR	1.00	X			0	0	0
(5) GABRIELSON SHARON R DIRECTOR	1.00	X			0	166,660	36,971
(6) HEINZ MD DIETER VICE CHAIR / DIRECTOR	40.00	X	X		351,109	0	43,573
(7) KEPPLE-JOHNSON JANE K DIRECTOR	1.00	X			0	0	0
(8) MILLER MD ROBERT C TREASURER / DIRECTOR	1.00	X	X		0	489,366	42,689
(9) RIZZO MD MARCO DIRECTOR	1.00	X			0	529,139	38,256
(10) ROUTH LORI J DIRECTOR	40.00	X			134,972	0	11,866
(11) SAVELKOUL DONALD DIRECTOR	1.00	X			0	0	0
(12) VERDOORN JUDY D SECRETARY / DIRECTOR	1.00	X	X		0	0	0
(13) PARKS DOUGLAS A REGION CAO	4.00		X		0	174,599	36,434
(14) PILOT DAVID L CFO	16.00		X		187,660	0	33,075
(15) WALDHOFF STEPHEN C SITE CAO	40.00		X		0	249,049	54,308
(16) BUCKMASTER DPM ROY W PHYSICIAN	40.00			X	259,694	0	35,478
(17) ECKSTROM MD MICHAEL T PHYSICIAN	40.00			X	867,368	0	42,930

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(F) Estimated amount of other compensation from the organization and related organizations
(18) GRZYBOWSKI MD JOHN A PHYSICIAN / EX-OFFICIO	40.00	X			317,418	41,072
(19) LARSON VIRGINIA CLINIC ADMINISTRATOR	40.00	X			156,852	34,288
(20) LOMBARDI MD JOSEPH M PHYSICIAN	40.00	X			334,140	40,908
(21) STOLTENBERG MD HEIDI G PHYSICIAN	40.00	X			193,285	33,912
(22) ULRICH MD MICHAEL D PHYSICIAN	40.00	X			337,537	43,958
(23) UNDERDAHL STEVE L ADMINISTRATOR	40.00	X			163,150	13,886
(24) WAGGONER MD JULIAN R PHYSICIAN	40.00	X			517,999	50,052
(25) BOYCE MD CORY A PHYSICIAN	40.00		X		646,445	41,828
(26) GUJRAL MD SAROJ K PHYSICIAN	40.00		X		574,508	36,717
(27) LOTTS MD JEFFREY P PHYSICIAN	40.00		X		577,024	47,798
(28) SKORIN JR DO LEONID PHYSICIAN	40.00		X		750,460	35,549
(29) THORN MD STEPHEN PHYSICIAN	40.00		X		559,160	14,720
(30) SHELHAMER MD LEONARD E FORMER VICE CHAIR	40.00			X	236,575	33,500

(A) Name and business address	(B) Description of services	(C) Compensation
MAYO CLINIC 200 FIRST STREET SW ROCHESTER,MN55905	PATIENT/ADMIN SERVICES	4,721,527
MAYO COLLABORATIVE SERVICES INC 200 FIRST STREET SW ROCHESTER,MN55905	LAB SERVICES	780,887
WEATHERBY LOCUMS INC PO BOX 972633 DALLAS,TX75397	PHYSICIAN SERVICES	636,057
SERVICE 1ST BANK OF NEVADA 8363 W SUNSET RD STE 350 LAS VEGAS,NV89113	LOAN COLLECTION	463,183
MASON CITY CLINIC 250 S CRESCENT DR MASON CITY,IA50401	MEDICAL SERVICES	438,552
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 21

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	541,476	541,476
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	7,000	7,000
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 ....	5,151,582	4,321,249	830,333
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	1,899,108	180,272	1,718,836
7	Other salaries and wages	54,802,429	49,045,695	5,756,734
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,863,811	3,452,333	411,478
9	Other employee benefits .......	10,492,655	9,375,391	1,117,264
10	Payroll taxes ...........	3,843,661	3,434,329	409,332
11	Fees for services (non-employees):
a	Management ......	739,675		739,675
b	Legal .........
c	Accounting ...........	94,349		94,349
d	Lobbying ...........
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......	5,571		5,571
g	Other ..........	9,410,285	7,271,106	2,139,179
12	Advertising and promotion ....	165,006	11,098	153,908
13	Office expenses .......	5,649,797	4,216,607	1,433,190
14	Information technology ......	3,022,941		3,022,941
15	Royalties ..
16	Occupancy ...........	2,557,515	2,428,112	129,403
17	Travel ............	558,441	452,632	105,809
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	247,303	245,340	1,963
20	Interest ...........	45,712	45,712
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	5,315,779	5,145,787	169,992
23	Insurance ..............	1,268,155	1,268,155
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	16,242,330	16,242,330
b	BAD DEBT EXPENSE	2,173,056	2,173,056
c	MN CARE TAX	1,521,358	1,521,358
d	MEDICAID SURCHARGE	467,429	467,429
e
f	All other expenses	862,364	729,213	133,151
25	Total functional expenses. Add lines 1 through 24f	130,948,788	112,575,680	18,373,108	0
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 if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	535,539	1	237,343
2	Savings and temporary cash investments .......	0	2	0
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	20,655,239	4	25,537,157
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	2,506,561	8	2,531,108
9	Prepaid expenses and deferred charges ............	3,080,860	9	2,657,360
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	100,451,658
b	Less: accumulated depreciation. .....	10b	44,393,589	58,242,191	10c	56,058,069
11	Investments—publicly traded securities ..........		11
12	Investments—other securities. See Part IV, line 11 ......	59,836,100	12	61,405,884
13	Investments—program-related. See Part IV, line 11 ..		13
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	8,143,763	15	7,450,020
16	Total assets. Add lines 1 through 15 (must equal line 34)...	153,000,253	16	155,876,941
	17	Accounts payable and accrued expenses .	9,307,871	17	6,705,759
18	Grants payable ..........		18
19	Deferred revenue ..........		19
20	Tax-exempt bond liabilities ..........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
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.....	2,861,312	25	2,988,390
26	Total liabilities. Add lines 17 through 25.....	12,169,183	26	9,694,149
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	139,494,445	27	145,194,739
28	Temporarily restricted net assets .....	1,035,082	28	686,510
29	Permanently restricted net assets .....	301,543	29	301,543
	Organizations that do not follow SFAS 117, check here 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 .....	140,831,070	33	146,182,792
34	Total liabilities and net assets/fund balances .....	153,000,253	34	155,876,941

- TIN:

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.

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 HEALTH SYSTEM-ALBERT LEA

Employer identification number

41-1404075

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.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

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)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(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?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

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.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) 2011	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2011. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2010. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2011. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

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.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2010 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2010 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2011. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2010. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

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:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2011

Name of organization

MAYO CLINIC HEALTH SYSTEM-ALBERT LEA

Employer identification number

41-1404075

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not total to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... 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

Name of organization MAYO CLINIC HEALTH SYSTEM-ALBERT LEA
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
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	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3

Name of organization MAYO CLINIC HEALTH SYSTEM-ALBERT LEA
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
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 HEALTH SYSTEM-ALBERT LEA

Employer identification number

41-1404075

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

(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

(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

(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

(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:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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 HEALTH SYSTEM-ALBERT LEA

Employer identification number

41-1404075

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 .......

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

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)? ....................................

Yes No

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.

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.

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

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:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

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
1a	Beginning of year balance ....	301,543	301,543	230,192	299,260
b	Contributions ........
c	Net investment earnings, gains, and losses ...			71,351	-69,068
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......	301,543	301,543	301,543	230,192

Provide the estimated percentage of the year end balance (line 1g) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

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		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	4,192,536		4,192,536
b	Buildings ................	62,247,027	25,677,492	36,569,535
c	Leasehold improvements ............
d	Equipment ................	34,012,095	18,716,097	15,295,998
e	Other .................
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				56,058,069

Schedule D (Form 990) 2011

Page 3

Part VII

InvestmentsOther 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 CLINIC INVESTMENT POOL	61,405,884	F








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	61,405,884

Part VIII

InvestmentsProgram 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.)

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Book value
Federal Income Taxes
DEFERRED COMPENSATION LIABILITY		1,783,208
DUE TO AFFILIATES		192,996
ASSET RETIREMENT OBLIGATION		1,012,187






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		2,988,390
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

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
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	THE ENDOWMENT FUNDS PROVIDE A STABLE FUNDING SOURCE FOR EDUCATION AND PATIENT SUPPORT.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	AT DECEMBER 31, 2011 AND 2010, THERE WAS NO MATERIAL LIABILITY FOR UNRECOGNIZED TAX BENEFITS FOR THE FILING ORGANIZATION.

Schedule D (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,or if the organization entered more than $15,000 on Form 990-EZ, line 6a. 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 HEALTH SYSTEM-ALBERT LEA

Employer identification number

41-1404075

Part I

Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and e-mail solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

Yes

If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.

(i) Name and address of individual or entity (fundraiser)	(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
	(ii) Activity	Yes	No	(iv) Gross receipts from activity		(vi) Amount paid to (or retained by) organization
Total .................

List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2011

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.

		(a) Event #1 WALK/RUN (event type)	(b) Event #2 MEMORIES AGLOW (event type)	(c) Other Events 4 (total number)	(d) Total Events (Add col. (a) through col. (c))
1	Gross receipts . . .	2,859	4,830	7,839	15,528
2	Less: Charitable contributions . . .	2,859	4,830		7,689
3	Gross income (line 1 minus line 2) . . .			7,839	7,839
4	Cash prizes . . .
5	Non-cash prizes . .
6	Rent/facility costs . .
7	Food and beverages . .
8	Entertainment . . .
9	Other direct expenses .
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........
11	Net income summary. Combine lines 3 and 10 in column (d)............				7,839

Part III

Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

(a) Bingo

(b) Pull tabs/Instant
bingo/progressive bingo

(c) Other gaming

(d) Total gaming (Add col. (a) through col. (c))

Gross revenue . . . .

Cash prizes . . . .

Non-cash prizes . . .

Rent/facility costs . . .

Other direct expenses . .

Volunteer labor . . .

	Yes
	No

	Yes
	No

	Yes
	No

Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow

Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow

Enter the state(s) in which the organization operates gaming activities:

Is the organization licensed to operate gaming activities in each of these states? ............

YesNo

If "No," Explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....

YesNo

If "Yes," Explain:

Does the organization operate gaming activities with nonmembers? .................

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? ..........................

YesNo

Schedule G (Form 990 or 990-EZ) 2011

Page 3

Indicate the percentage of gaming activity operated in:

The organization's facility ......................

13a

An outside facility ........................

13b

Provide the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? ......................................

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? ............................

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)

Identifier	ReturnReference	Explanation

Schedule G (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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 HEALTH SYSTEM-ALBERT LEA

Employer identification number

41-1404075

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....

Yes

If "Yes," was it a written policy? .......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other

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: ............

Yes

200% 250% 300% 350% 400% Other

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.

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"? ..............

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......

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?...............

Did the organization prepare a community benefit report during the tax year?...........

Yes

If "Yes," did the organization make it available to the public? ...............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

	(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) ..	1		2,518,652		2,518,652	1.960 %
b Medicaid (from Worksheet 3, column a) .....			16,865,985	11,933,280	4,932,705	3.830 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .			2,652,147	893,615	1,758,532	1.370 %
dTotal Financial Assistance and Means-Tested Government Programs .....	1		22,036,784	12,826,895	9,209,889	7.160 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	23	75,511	122,359		122,359	0.100 %
f Health professions education (from Worksheet 5) ..	6	218	1,388,243	8,198	1,380,045	1.070 %
g Subsidized health services (from Worksheet 6) ..			6,603,170	3,848,629	2,754,541	2.140 %
h Research (from Worksheet 7)			55,071	51,063	4,008	0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....	16	506	257,090		257,090	0.200 %
jTotal Other Benefits ...	45	76,235	8,425,933	3,907,890	4,518,043	3.510 %
kTotal. Add lines 7d and 7j. ..	46	76,235	30,462,717	16,734,785	13,727,932	10.670 %

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	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	1		399	399	0 %
3	Community support	2		38,475	38,475	0.030 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	3	55	4,158	4,158	0 %
7	Community health improvement advocacy	2		1,673	1,673	0 %
8	Workforce development	2	150	1,236	1,236	0 %
9	Other
10	Total	10	205	45,941	45,941	0.030 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense........

2,173,056

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....

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

Enter total revenue received from Medicare (including DSH and IME).....

23,031,783

Enter Medicare allowable costs of care relating to payments on line 5.....

30,584,141

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-7,552,358

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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.......................

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

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		Other (Describe)
1	MAYO CLINIC HEALTH SYSTEM - ALBERT LEA 404 WEST FOUNTAIN STREET ALBERT LEA,MN56007	X	X	X

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 HEALTH SYSTEM - ALBERT LEA

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

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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

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

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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?7
Name and address		Type of Facility (describe)
1	MCHS AT HEALTH REACH 1705 SE BROADWAY ALBERT LEA,MN56007	OUTPATIENT PHYSICAL THERAPY
2	MCHS - ALBERT LEA IN LAKE MILLS 309 S 10TH AVE LAKE MILLS,IA50450	CLINIC
3	MCHS - ALBERT LEA IN NEW RICHLAND 318 FIRST ST SW NEW RICHLAND,MN56072	CLINIC
4	MCHS - ALBERT LEA IN ALDEN 192 WASHINGTON AVE ALDEN,MN56009	CLINIC
5	MCHS - ALBERT LEA IN WELLS 301 S BROADWAY WELLS,MN56097	CLINIC
6	MCHS - ALBERT LEA IN KIESTER 120 N MAIN ST KIESTER,MN56051	CLINIC
7	MCHS - EXPRESS CARE IN ALBERT LEA 2708 BRIDGE AVE ALBERT LEA,MN56007	EXPRESS CARE CLINIC
8
9
10

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: $1,638,157.
		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 $ 2173056.
		PART II: COMMUNITY BUILDING IS AN ESSENTIAL MAYO CLINIC HEALTH SYSTEM - ALBERT LEA (MCHS-AL) ACTIVITY. ON ITS LEADERSHIP DASHBOARD, BOTH COMMUNITY BUILDING AND COMMUNITY INVOLVEMENT ARE METRICS MEASURED MONTHLY. THE ORGANIZATION'S COMMUNITY INVOLVEMENT POLICY ENCOURAGES STAFF TO VOLUNTEER EIGHT HOURS ANNUALLY DURING WORK TIME. STAFF MAY CHOOSE FROM MCHS-AL ENDORSED COMMUNITY PROGRAMS AND RECEIVE THEIR REGULAR SALARIES WHILE VOLUNTEERING ON WORK TIME.IN 2011, OVER 129 STAFF VOLUNTEERED A TOTAL OF 636 HOURS FOR COMMUNITY PROGRAMS AND PROJECTS SUCH AS SALVATION ARMY, RED CROSS, SCHOOL PROJECTS, FOOD SHELVES AND CAR SEAT CLINICS. CRITERIA FOR COMMUNITY INVOLVEMENT:CANCER-RELATED ACTIVITY CHAMBER OR COMMUNITY BUILDING ACTIVITY HEALTH EDUCATION OR HEALTH SCREENING ACTIVITYSENIOR RESOURCES OR NURSING HOME/ASSISTED LIVING ACTIVITYSOCIAL SERVICES ACTIVITYYOUTH-RELATED OR SCHOOL ACTIVITYMCHS-AL'S 2011 LEADERSHIP ROLE AND STAFF INVOLVEMENT IN THE COMMUNITY'S BLUE ZONES/VITALITY PROJECT, FOR EXAMPLE, HELPED CREATE WALKING MOAIS (NEIGHBORHOOD OR WORK GROUPS THAT SOCIALIZE THROUGH WALKING,) WALKING SCHOOL BUSES, COMMUNITY GARDENING, PURPOSE WORKSHOPS, OPEN DOOR FAITH INITIATIVES, TOBACCO-FREE WORKPLACES AND SCHOOL FOOD IMPLEMENTED BY COMMUNITY VOLUNTEERS. ONGOING RECRUITMENT OF PARTICIPANTS COULD YIELD UP TO 33% PARTICIPATION TO THE CITY'S ADULT POPULATION WHICH, IN TURN, COULD LEAD TO AS MANY AS 10,000 YEARS ADDED TO PEOPLE'S LIVES, AS THEY COMMIT TO MAKING HEALTHY LIFESTYLE CHANGES. IN ADDITION, MCHS-AL ENCOURAGES INVOLVEMENT IN COMMUNITY BOARDS AND SPECIAL PROJECTS, LENDING EXPERTISE TO OUTSIDE GROUPS AND BRINGING BACK FRESH PERSPECTIVES AND FEEDBACK TO MCHS-AL INITIATIVES AND OPERATIONS. IN 2011, MCHS-AL STAFF PARTICIPATED IN THESE LOCAL BOARDS: ALBERT LEA BUSINESS DEVELOPMENT CENTER, ALBERT LEA PORT AUTHORITY, CONVENTION AND VISITOR'S BUREAU, CHAMBER OF COMMERCE, COMMUNITY FOUNDATION, EDUCATION FOUNDATION, FAMILY "Y", CURRICULUM COMMITTEE, COMMUNITY CHILD CARE BOARD, RED CROSS, MARCH OF DIMES, RELAY FOR LIFE, SALVATION ARMY, BOARD OF AGING, UNITED WAY, RIVERLAND FOUNDATION, FREEBORN COUNTY FAMILY SERVICES COLLABORATIVE, THORNECREST RETIREMENT CENTER, ALONG WITH OTHER SPECIAL PROJECT COMMITTEES.
		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.ACCOUNTS RECEIVABLE FOR MEDICAL SERVICES - 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: THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SHORTFALL REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY). HOWEVER, USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY ACTUALLY RESULTS IN A MEDICARE SHORTFALL OF $10,676,969 AS REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS.THE MOST COMMON REASONS FOR A DIFFERENCE BETWEEN THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H AND THE MEDICARE SHORTFALL REPORTED ON THE CORE FORM, PART III INCLUDE: (1) INCLUSION OF MEDICARE ADVANTAGE REVENUE AND EXPENSES; (2) INCLUSION OF PART B REVENUE AND EXPENSES; (3) INCLUSION OF OTHER FEE SCHEDULE REVENUE; AND (4) SOME TIMING ISSUES.REASONS WHY MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.
		PART III, LINE 9B: MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING EVERY REASONABLE ATTEMPT TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN 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 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 HEALTH SYSTEM - ALBERT LEA		PART V, SECTION B, LINE 13G: WITH REGARD TO THE POSTINGS WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMBEROUS 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.
MAYO CLINIC HEALTH SYSTEM - ALBERT LEA		PART V, SECTION B, LINE 19D: OUR POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 10% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE.
		PART VI, LINE 2: MAYO CLINIC HEALTH SYSTEM - ALBERT LEA'S COMMUNITY RELATIONS COMMITTEE SETS PRIORITY AREAS FOR MCHS-AL INVOLVEMENT AND CHARITABLE CONTRIBUTIONS. CURRENT CRITERIA FOR CONTRIBUTIONS INCLUDE:1. IMPROVING QUALITY OF LIFE2. PROMOTING YOUTH POTENTIAL3. IMPROVING COMMUNITY HEALTH AND WELLNESS4. PARTNERING FOR COMMUNITY GROWTH AND DEVELOPMENTMAYO CLINIC HEALTH SYSTEM - ALBERT LEA (MCHS-AL) PARTNERS WITH LOCAL GOVERNMENT, PUBLIC HEALTH, SOCIAL SERVICE AGENCIES, SCHOOLS, VITALITY PROJECT AND OTHER GROUPS TO DETERMINE COMMUNITY NEEDS. ALTHOUGH MCHS-AL DOES NOT CONDUCT AN INDEPENDENT ANNUAL NEEDS ASSESSMENT, THE ORGANIZATION REVIEWS LOCAL DATA AND ANECDOTAL INFORMATION FROM ITS PARTNERS TO SET PRIORITY AREAS FOR COMMUNITY NEED. BASED ON THAT INFORMATION, THE FIT FOREVER CHILDHOOD OBESITY PREVENTION PROGRAM WAS DEVELOPED IN 2008 WITH MANY OF THOSE PARTNERS, WHERE MCHS-AL TOOK THE LEAD AND CONTINUES TO DONATE RESOURCES AND STAFF TIME WITH IDENTIFIED INITIATIVES. IN ADDITION, MCHS-AL'S COMMUNITY INVOLVEMENT PROGRAM, WHERE STAFF IS ALLOWED EIGHT HOURS ANNUALLY TO VOLUNTEER DURING WORK TIME, IS ALSO BASED ON IDENTIFIED COMMUNITY NEEDS.
		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 HEALTH SYSTEM - ALBERT LEA IS THE SOLE HEALTH CARE PROVIDER IN FREEBORN COUNTY AND THE ONLY PROVIDER IN THE COMMUNITIES OF ALDEN, KIESTER AND NEW RICHLAND, MINNESOTA. FOUNTAIN CENTERS, AS A REGIONAL CHEMICAL DEPENDENCY TREATMENT CENTER, SERVES PATIENTS WITHIN AN 80 MILE RADIUS OF ALBERT LEA.MCHS-AL'S PRIMARY SERVICE AREA IS FREEBORN COUNTY, WITH A POPULATION OF ABOUT 31,000. AN ESTIMATED 21,000 UNIQUE PATIENTS WERE SEEN ANNUALLY AT MCHS-AL FROM 2007 THROUGH 2009. THE VARIANCE AMONG THOSE YEARS IS LESS THAN 2%. CUSTOMER GROUPS ARE COMPRISED OF MEDICARE PATIENTS, BUSINESS AND INDUSTRY LOCATED WITHIN A 20-MILE RADIUS, HEALTH PLANS INCLUDING MCHS-AL AND, GENERALLY, INDIVIDUAL PATIENTS SEEKING PRIMARY CARE. MAYO CLINIC HEALTH SYSTEM - ALBERT LEA, CARDIOLOGY, FOUNTAIN CENTERS, ORTHOPEDICS, OB/GYN AND WOUND CARE DEPARTMENTS REPRESENT UNIQUE SPECIALTY MARKETS REACHING BEYOND MCHS-AL'S TRADITIONAL MARKET AREA.FREEBORN COUNTY POPULATION CHARACTERISTICS (2010 ESTIMATE)AGE:PEOPLE UNDER 5 YEARS - 6.3% PEOPLE UNDER 18 YEARS - 20.8%PEOPLE 65 AND OLDER - 20.3%ALL OTHERS - 52.6% ETHNICITY:BLACK - 0.7%HISPANIC OR LATINO - 7.3%WHITE, NON HISPANIC - 90.7%ASIAN - .7%ALL OTHERS - .6%HOUSEHOLDS:TOTAL HOUSEHOLDS - 13,375 PERSONS PER HOUSEHOLD - 2.4MEDIAN HOUSEHOLD INCOME - $43,637PEOPLE BELOW POVERTY LEVEL - 8.6%
		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.SURPLUS FUNDS - MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE. THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, WHETHER IN HEALTH CARE POLICY, BUSINESS, GOVERNMENT OR ANOTHER FIELD. IN ADDITION TO THIS COMMUNITY REPRESENTATION AT THE PARENT ENTITY, THE FILING ORGANIZATION ALSO INVOLVES LOCAL COMMUNITY MEMBERS ON ITS GOVERNING BODY. OPEN V. CLOSED STAFF MODEL - STAFF PRIVILEGES ARE GENERALLY EXTENDED TO ALL QUALIFIED PHSYICIANS IN THE COMMUNITY.EMERGENCY ROOM - THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK, WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY.
		PART VI, LINE 6: THIS ORGANIZATION IS A PART OF MAYO CLINIC HEALTH SYSTEM (WHICH IS PART OF A LARGER GROUP OF ENTITIES AFFILIATED WITH MAYO CLINIC). THE MAYO CLINIC HEALTH SYSTEM IS DESCRIBED IN RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O). THAT STATEMENT ALSO DESCRIBES THE ROLES OF THE VARIOUS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.
	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:

- TIN:

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 HEALTH SYSTEM-ALBERT LEA

Employer identification number
41-1404075

Part I

General Information on Grants and Assistance

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? ....................................

Yes No

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	(h) Purpose of grant or assistance
(1) ALBERT LEA FAMILY YMCA2021 W MAIN ST ALBERT LEA,MN56007	41-1000679	501(C)(3)	10,000	FURTHER EXEMPT PURPOSE
(2) UNITED WAY OF FREEBORN COUNTY341 S BROADWAY ALBERT LEA,MN56007	41-0956396	501(C)(3)	18,000	FURTHER EXEMPT PURPOSE
(3) FOUNTAIN LAKE TREATMENT CENTER404 WEST FOUNTAIN STREET ALBERT LEA,MN56007	41-1404076	501(C)(3)	397,868	FURTHER EXEMPT PURPOSE
(4) CITY OF ALBERT LEA221 E CLARK STREET ALBERT LEA,MN56007	41-6004922	GOVT	5,000	COMMUNITY BENEFIT
(5) FREEBORN COUNTY HISTORICAL SOCIETY1031 BRIDGE AVENUE ALBERT LEA,MN56007	41-0872543	501(C)(3)	7,000	COMMUNITY BENEFIT
(6) NAEVE HEALTH CARE FOUNDATION404 WEST FOUNTAIN STREET ALBERT LEA,MN56007	41-1989509	501(C)(3)	10,000	FURTHER EXEMPT PURPOSE

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

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
(1) SCHOLARSHIPS	10	7,000

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:

- TIN:

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 HEALTH SYSTEM-ALBERT LEA

Employer identification number

41-1404075

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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....

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? ....

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ...............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

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.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

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 .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

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
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable 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
(1) AGERTER MD DAVID C	(i) (ii)	0 341,092	0 0	0 98,195	0 32,194	0 14,124	0 485,605	0 94,907
(2) CIOTA MD MARK R	(i) (ii)	861,046 0	0 0	0 0	17,150 0	27,203 0	905,399 0	0 0
(3) GABRIELSON SHARON R	(i) (ii)	0 165,658	0 0	0 1,002	0 15,443	0 21,528	0 203,631	0 0
(4) HEINZ MD DIETER	(i) (ii)	351,109 0	0 0	0 0	17,150 0	26,423 0	394,682 0	0 0
(5) MILLER MD ROBERT C	(i) (ii)	0 444,151	0 0	0 45,215	0 21,221	0 21,468	0 532,055	0 43,178
(6) RIZZO MD MARCO	(i) (ii)	0 498,493	0 0	0 30,646	0 18,288	0 19,968	0 567,395	0 28,294
(7) PARKS DOUGLAS A	(i) (ii)	0 173,183	0 0	0 1,416	0 13,141	0 23,293	0 211,033	0 0
(8) PILOT DAVID L	(i) (ii)	187,660 0	0 0	0 0	13,374 0	19,701 0	220,735 0	0 0
(9) WALDHOFF STEPHEN C	(i) (ii)	0 243,356	0 0	0 5,693	0 38,104	0 16,204	0 303,357	0 638
(10) BUCKMASTER DPM ROY W	(i) (ii)	259,694 0	0 0	0 0	17,150 0	18,328 0	295,172 0	0 0
(11) ECKSTROM MD MICHAEL T	(i) (ii)	867,368 0	0 0	0 0	17,150 0	25,780 0	910,298 0	0 0
(12) GRZYBOWSKI MD JOHN A	(i) (ii)	317,418 0	0 0	0 0	17,150 0	23,922 0	358,490 0	0 0
(13) LARSON VIRGINIA	(i) (ii)	156,852 0	0 0	0 0	11,150 0	23,138 0	191,140 0	0 0
(14) LOMBARDI MD JOSEPH M	(i) (ii)	334,140 0	0 0	0 0	17,150 0	23,758 0	375,048 0	0 0
(15) STOLTENBERG MD HEIDI G	(i) (ii)	193,285 0	0 0	0 0	13,859 0	20,053 0	227,197 0	0 0
(16) ULRICH MD MICHAEL D	(i) (ii)	337,537 0	0 0	0 0	17,150 0	26,808 0	381,495 0	0 0
(17) UNDERDAHL STEVE L	(i) (ii)	163,150 0	0 0	0 0	11,285 0	2,601 0	177,036 0	0 0
(18) WAGGONER MD JULIAN R	(i) (ii)	517,999 0	0 0	0 0	17,150 0	32,902 0	568,051 0	0 0
(19) BOYCE MD CORY A	(i) (ii)	646,445 0	0 0	0 0	17,150 0	24,678 0	688,273 0	0 0
(20) GUJRAL MD SAROJ K	(i) (ii)	574,508 0	0 0	0 0	17,150 0	19,567 0	611,225 0	0 0
(21) LOTTS MD JEFFREY P	(i) (ii)	577,024 0	0 0	0 0	17,150 0	30,648 0	624,822 0	0 0
(22) SKORIN JR DO LEONID	(i) (ii)	750,460 0	0 0	0 0	17,150 0	18,399 0	786,009 0	0 0
(23) THORN MD STEPHEN	(i) (ii)	116,879 0	0 0	442,281 0	8,182 0	6,538 0	573,880 0	0 0
(24) SHELHAMER MD LEONARD E	(i) (ii)	236,575 0	0 0	0 0	16,417 0	17,083 0	270,075 0	0 0

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, LINES 4A-B	IN 2011, DR. STEPHEN THORN RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $442,821. 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. DAVID C. AGERTER, M.D. $ 94,907 ROBERT C. MILLER, M.D. $ 43,178 MARCO RIZZO, M.D. $ 28,294 STEPHEN C. WALDHOFF $ 638
SUPPLEMENTAL INFORMATION	PART III	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. COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION.

Schedule J (Form 990) 2011

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

MAYO CLINIC HEALTH SYSTEM-ALBERT LEA

Employer identification number

41-1404075

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?
1(a) Name of disqualified person	(b) Description of transaction	Yes	No

Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image

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?
(a) Name of interested person and purpose	To	From	(c)Original principal amount	(d)Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

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

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) JULIE C SAVELKOUL	SPOUSE OF DONALD SAVELKOUL, BOARD MEMBER	35,285	EMPLOYMENT		No
(2) BEVERLY A LOMBARDI MD	SPOUSE OF JOSEPH M. LOMBARDI M.D., KEY EMPLOYEE	92,766	EMPLOYMENT		No
(3) PHILLIP HANSON	SPOUSE OF HEIDI G. STOLTENBERG M.D., KEY EMPLOYEE	42,798	EMPLOYMENT		No
(4) PETERSON SAVELKOUL KOLKER HAEDT & BENDA LTD	DON SAVELKOUL IS A LISTED PERSON AND MEMBER OF THE BOARD	10,003	LEGAL SRVC		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:

- TIN:

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 HEALTH SYSTEM-ALBERT LEA

Employer identification number

41-1404075

Identifier	Return Reference	Explanation
	FORM 990, PART VI, SECTION A, LINE 3	MAYO-AFFILIATED ENTITIES ROUTINELY DELEGATED VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO RELATED ENTITIES.
	FORM 990, PART VI, SECTION A, LINE 4	THE FILING ORGANIZATION MERGED WITH FOUNTAIN LAKE TREATMENT CENTER (FLTC) AT YEAR END OF 2011 AND EXERCISED THE ARTICLES OF MERGER.
	FORM 990, PART VI, SECTION A, LINE 6	THE SOLE CORPORATE MEMBER IS MAYO CLINIC.
	FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE CORPORATE MEMBER ELECTS TRUSTEES TO THE BOARD
	FORM 990, PART VI, SECTION A, LINE 7B	AMENDMENT OF ARTICLES OR BYLAWS REQUIRE APPROVAL BY BOTH THE GOVERNING BODY AND THE SOLE CORPORATE MEMBER. THE BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL, BUDGET, AND DEBT DECISIONS.
	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 SITE FINANCE STAFF AND THE SITE ADMINISTRATOR. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. HIGHLIGHTS ARE PRESENTED TO BOARD MEMBERS, AND THE REVIEW IS DOCUMENTED IN MEETING MINUTES. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990.
	FORM 990, PART VI, SECTION B, LINE 12C	MAYO CLINIC AND ITS AFFILIATES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS.
	FORM 990, PART VI, SECTION B, LINE 15	THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS AND ADMINISTRATIVE LEADERSHIP. IN ADDITION TO ANY REVIEW AND APPROVAL THAT MAY TAKE PLACE AT THE LOCAL ENTITY LEVEL, THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY IN THE FALL FOR THE NEXT YEAR'S COMPENSATION. THE SALARY OF THE CEO, CAO, BOARD VICE CHAIR, TREASURER AND SEVERAL BOARD MEMBERS WERE REVIEWED BY THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR MAYO CLINIC HEALTH SYSTEM PHYSICIANS. THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE INITIALLY REVIEWS THE COMPENSATION OF PHYSICIANS AND ADMINISTRATIVE LEADERSHIP FOR THE MAYO CLINIC HEALTH SYSTEM ENTITIES. THE COMMITTEE IS COMPRISED OF MAYO EMPLOYEES, BUT IS INDEPENDENT FOR INTERNAL REVENUE CODE 4958 FOR THE INDIVIDUALS WHOSE SALARY IS REVIEWED (WITH RECUSAL WHERE APPROPRIATE). THE MAYO CLINIC SALARY AND BENEFITS COMMITTEE THEN REVIEWS AND APPROVES THE COMPENSATION. FOR THOSE INDIVIDUALS FOR WHICH THE MAYO CLINIC HEALTH SYSTEM COMMITTEE CAN NOT SERVE AS THE INDEPENDENT REVIEW, THEIR COMPENSATION AND BENEFITS ARE REVIEWED BY THE GOVERNANCE COMMITTEE (DESCRIBED BELOW). THE COMPENSATION AND BENEFITS COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES. INFORMATION ON MAYO CLINIC HEALTH SYSTEM PHYSICIAN AND ADMINISTRATIVE LEADERSHIP COMPENSATION AND BENEFITS IS ALSO REVIEWED BY THE MAYO CLINIC COMMITTEE ON OFFICER SUCCESSION, COMPENSATION AND GOVERNANCE (GOVERNANCE COMMITTEE), WHICH IS COMPRISED OF SEVEN OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. IN ADDITION TO THE ABOVE COORDINATED REVIEW PROCESSES CONDUCTED BY MAYO CLINIC AND ITS AFFILIATES, MCHS-AL ALSO HAS ITS OWN COMPENSATION REVIEW PROCESS THAT INCLUDES REVIEW BY AN INDEPENDENT COMPENSATION COMMITTEE, BENCHMARK/COMPARABILITY DATA, AND DETERMINATION OF REASONABLENESS. MCHS-AL REVIEW PROCESS COVERS BOTH THE PHYSICIAN COMPENSATION PLAN AND THE ADMINISTRATOR COMPENSATION PLAN.
	FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS ARE NOT AVAILABLE FOR PUBLIC INSPECTION. FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THE CONFLICT OF INTEREST POLICY IS 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.
AVERAGE HOURS PER WEEK DEVOTED TO POSITION WITH RELATED ORGANIZATION	PART VII SECTION A	SHARON GABRIELSON 40.00 DAVID C. AGERTER, M.D. 40.00 ROBERT C. MILLER, M.D. 40.00 MARCO RIZZO, M.D. 40.00 DOUGLAS A. PARKS 37.00 DAVID L. PILOT 25.00 STEPHEN C. WALDHOFF 1.00
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED LOSSES ON INVESTMENTS: -614,807. OTHER CHANGES IN NET ASSETS-990 -156,338. TOTAL TO FORM 990, PART XI, LINE 5: -771,145.
INDEPENDENCE	FORM 990 PART VI LINE 1B	THE BOARD OF TRUSTEES OF MAYO CLINIC, THE PARENT ENTITY OF THE MAYO CLINIC-AFFILIATED ENTITIES, IS COMPRISED OF MORE THAN 50% PUBLIC TRUSTEES.

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:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

MAYO CLINIC HEALTH SYSTEM-ALBERT LEA

Employer identification number

41-1404075

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
(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	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

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	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	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)
(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

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

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 . . . . . . . . . . . . . . . . . . . . . . .

Yes

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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 -- METHODIST HOSPITAL	A	128,457	GAAP
(2) MMSI INC	R	6,120,903	GAAP
(3) MAYO CLINIC HEALTH SYSTEM--AUSTIN	P	79,379	GAAP
(4) FOUNTAIN LAKE TREATMENT CENTER	P	1,703,677	GAAP
(5) FOUNTAIN LAKE TREATMENT CENTER	G	2,047,902	GAAP
(6) MAYO CLINIC -- SAINT MARYS HOSPITAL	L	182,145	GAAP
(7) MAYO COLLABORATIVE SERVICES INC	L	780,868	GAAP
(8) MMSI INC	Q	11,130,681	GAAP
(9) MAYO CLINIC HEALTH SYSTEM--AUSTIN	O	130,048	GAAP
(10) MAYO CLINIC HEALTH SYSTEM--AUSTIN	N	446,132	GAAP

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)	(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 VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

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

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: HOSPITAL AND CLINICS
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	4
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	1,389
6	Total number of volunteers (estimate if necessary) ....	6	272
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,348,530	2,863,950
9	Program service revenue (Part VIII, line 2g) .........	129,948,350	131,401,614
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,567,720	2,085,674
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	737,772	720,417
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	133,602,372	137,071,655
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	701,582	548,476
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)	78,798,192	80,053,246
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	46,196,286	50,347,066
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	125,696,060	130,948,788
19	Revenue less expenses. Subtract line 18 from line 12.......	7,906,312	6,122,867
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	153,000,253	155,876,941
21	Total liabilities (Part X, line 26).............	12,169,183	9,694,149
22	Net assets or fund balances. Subtract line 21 from line 20.....	140,831,070	146,182,792

Sign Here

	Signature of officer	Date

	Type or print name and title.


4a	(Code: ) (Expenses $ 110,461,531 including grants of $ ) (Revenue $ 131,735,846 )
	PATIENT CARE (SCHEDULE O)PATIENT CARE:MAYO CLINIC HEALTH SYSTEM IS A FAMILY OF CLINICS, HOSPITALS AND HEALTH CARE FACILITIES SERVING COMMUNITIES IN MINNESOTA, IOWA AND WISCONSIN. AS PART OF MAYO CLINIC, MAYO CLINIC HEALTH SYSTEM OFFERS OUTSTANDING CARE CLOSE TO HOME. PHYSICIANS AND STAFF IN MAYO CLINIC HEALTH SYSTEM HAVE READY ACCESS TO THE KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC, YET CAN MEET PATIENTS' HEALTH CARE NEEDS LOCALLY. MAYO CLINIC HEALTH SYSTEM IS PART OF THE COMMUNITY, FOCUSED ON IMPROVING THE HEALTH OF THE COMMUNITIES IN WHICH WE LIVE AND WORK. MAYO CLINIC HEALTH SYSTEM TEAMS WITH MAYO CLINIC TO DELIVER UNPARALLELED HEALTH CARE TO COMMUNITIES THROUGH AN INTEGRATED NETWORK OF CLINICS AND HOSPITALS.IN 2011, MAYO CLINIC HEALTH SYSTEM SITES EMPLOYED APPROXIMATELY 900 PHYSICIANS AND 13,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT THE MAYO CLINIC HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN 72 COMMUNITIES, THE SYSTEM INCLUDES 18 OWNED HOSPITALS, SEVEN OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH TWO ADDITIONAL HOSPITALS, AND CONTRACT MANAGEMENT AGREEMENTS WITH AN ADDITIONAL HOSPITAL AND NURSING HOME. SINCE ITS INCEPTION IN 1992, MAYO CLINIC HEALTH SYSTEM HAS GROWN FROM A NEW IDEA TO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN AMERICA. MAYO CLINIC HEALTH SYSTEM COMPLETES MORE THAN TWO-MILLION PATIENT VISITS ANNUALLY. IT ALSO SERVES AS A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS BEING RECOGNIZED SIX TIMES BY THE AMERICAN MEDICAL GROUP ASSOCIATION'S ACCLAIM AWARD PROGRAM (2005 ACCLAIM AWARD RECIPIENT AND FIVE-TIME ACCLAIM AWARD HONOREE). THE ACCLAIM AWARDS HONOR PHYSICIAN-LED ORGANIZATIONS DELIVERING CARE ALIGNED WITH THE IDEAL DELIVERY MODEL WHERE PATIENTS EXPERIENCE SAFE, RELIABLE, RESPONSIVE, READILY AVAILABLE AND INTEGRATED CARE. IN ADDITION, THE MINNESOTA COUNCIL FOR QUALITY HAS RECOGNIZED MAYO CLINIC HEALTH SYSTEM THREE TIMES FOR ITS PERFORMANCE EXCELLENCE EFFORTS. INDIVIDUAL MAYO CLINIC HEALTH SYSTEM LOCATIONS HAVE ALSO BEEN HONORED FOR THEIR COMMITMENT TO QUALITY, SAFETY, SERVICE, PERFORMANCE AND THEIR COMMUNITIES.PEOPLE IN MINNESOTA, IOWA AND WISCONSIN CAN HAVE PEACE OF MIND KNOWING THAT MAYO CLINIC HEALTH SYSTEM AND MAYO CLINIC PARTNER TO ENSURE HEALTHIER LIVES IN THE REGION.MAYO CLINIC HEALTH SYSTEM-ALBERT LEA (MCHS-AL) IS A MINNESOTA NON-PROFIT CORPORATION, TAX EXEMPT AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. TO JUSTIFY THIS TAX EXEMPT STATUS, MCHS-AL PROVIDES SCHOLARSHIPS, CHARITY CARE, INTERPRETING AND EDUCATIONAL SERVICES, AND VARIOUS OTHER COMMUNITY BENEFITS. MCHS-AL PROVIDES PRIMARY CARE NEEDS, INCLUDING FAMILY PRACTICE, INTERNAL MEDICINE, OB/GYN, PEDIATRICS AND GENERAL SURGERY. IN ADDITION, MCHS-AL ALSO PROVIDES SPECIALTY CARE IN CARDIOLOGY, DERMATOLOGY, NEUROLOGY, ONCOLOGY, OPHTHALMOLOGY, OPTOMETRY, OCCUPATIONAL HEALTH, PHYSICAL MEDICINE & REHAB, PSYCHIATRY, RHEUMATOLOGY, AUDIOLOGY, ALLERGY, ORTHOPEDICS, ENT, PSYCHOLOGY, PODIATRY, PHYSICAL THERAPY, WOUND CARE, UROLOGY, AND PLASTIC SURGERY. IN 2011, MCHS-AL HAD 165,154 CLINIC VISITS. MCHS-AL OPERATES REGIONAL CLINICS IN ALDEN, KIESTER, NEW RICHLAND, AND WELLS, MINNESOTA AND LAKE MILLS, IOWA.MCHS-AL INCLUDES A 77-BED HOSPITAL. DURING 2011, HOSPITAL INPATIENT DAYS TOTALED 7,141 WITH 862 ADDITIONAL DAYS FOR NEWBORN CARE AND 45,734 OUTPATIENT VISITS. MCHS-AL ALSO OPERATES AN AMBULANCE SERVICE STAFFED BY PARAMEDICS AND EMTS.AS PART OF THE MAYO CLINC HEALTH SYSTEM, MCHS-AL ACCESSES EMERGENCY MEDICAL HELICOPTER SERVICE THROUGHOUT SOUTHERN MINNESOTA AND NORTHERN IOWA. THE HELICOPTER PROVIDES RAPID PATIENT TRANSPORT TO THE APPROPRIATE HEALTH CARE FACILITY ALONG WITH DELIVERING HIGH-LEVEL CRITICAL CARE. MCHS-AL HAS AN ACTIVE NON-PROFIT AFFILIATE, FOUNTAIN LAKE TREATMENT CENTER (FLTC). MCHS-AL PROVIDES MANAGEMENT SERVICES AND SUPPORT SERVICES AND MAINTAINS AND OPERATES THE BUILDINGS THAT HOUSE THIS ENTITY. CONSOLIDATING THESE SERVICES ALLOWS FOR GREATER COST EFFICIENCY, ENABLING THE MCHS-AL AFFILIATE TO ENHANCE THE SCOPE AND AVAILABILITY OF THEIR HEALTH CARE SERVICES. MCHS-AL OPERATES ON A NONDISCRIMINATORY BASIS REGARDLESS OF RACE, COLOR, SEX, RELIGION OR NATIONAL ORIGIN.CHARITY CARE: MCHS-AL PROVIDES A VARIETY OF FINANCIAL ASSISTANCE OPTIONS TO PATIENTS WHO MEET ESTABLISHED CRITERIA. ITS ALMCARE PROGRAM ALLOWS PATIENTS WHO MEET FINANCIAL GUIDELINES TO ENROLL ANNUALLY TO RECEIVE CARE DISCOUNTS FROM 10 TO 100%, WITH A $5 CO-PAY FOR PRESCRIPTIONS. SERVICES ARE ALSO PROVIDED TO BOTH MEDICARE AND MEDICAID AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. THE COST OF CHARITY CARE PROVIDED DURING 2011 WAS $2,518,652 AND THE COST OF UNCOMPENSATED MEDICAID FOR 2011 WAS APPROXIMATELY $4,932,705. THE UNREIMBURSED COST OF MEDICARE WAS $10,676,969. ADDITIONALLY, THE UNREIMBURSED COST OF OTHER MEANS TESTED PROGRAMS (INCLUDING MINNESOTA CARE - A PROGRAM THAT OFFERS HEALTHCARE ASSISTANCE TO LOW INCOME POPULATIONS) WAS $1,758,532.

4b	(Code: ) (Expenses $ 1,395,243 including grants of $ 7,000 ) (Revenue $ 8,198 )
	EDUCATION AND SUPPORT SERVICES (SCHEDULE O): EDUCATION AND SUPPORT SERVICES: MCHS-AL PROVIDES CONTINUING MEDICAL EDUCATION TO ITS STAFF. THERE ARE NUMEROUS HEALTH AND WELLNESS EDUCATION PROGRAMS, CLASSES AND SUPPORT GROUPS PROVIDED TO THE COMMUNITY THROUGHOUT THE YEAR. THESE CLASSES/SUPPORT GROUPS INCLUDE CHILDBIRTH PREPARATION CLASS, BABY PLACE TOURS, PRENATAL BREASTFEEDING EDUCATION, YOUNG PARENT CLASSES, INFANT & CHILD CARE SAFETY AND CPR, PRENATAL DIET HEALTH EDUCATION, BEREAVEMENT EDUCATION SUPPORT SERIES, CANCER SUPPORT GROUP, DIABETES SUPPORT GROUP, HYPERTENSION CLASS, PULMONARY/CARDIAC REHAB SUPPORT GROUP, RTS BEREAVEMENT SERVICES, STROKE SUPPORT GROUP, OSTOMY SUPPORT GROUP, MENTORS FOR HOPE, TOBACCO CESSATION SERVICES, SPORTS SCREENINGS, INDIVIDUAL SPORTS CONDITIONING AND SPORTS INJURY EVALUATIONS, ALL AT NO CHARGE.MCHS-AL PROVIDES CLASSES THROUGHOUT SOUTHEASTERN MINNESOTA. MCHS-AL ALSO PROVIDES FIRST AID, CPR, AND DEFIBRILLATOR TRAINING TO DAYCARE PROVIDERS AND INDUSTRIES IN THE AREA AND HELPS MAINTAIN THEIR SKILLS ON A REGULAR BASIS. MCHS-AL, VIA THE COMMUNITY TRAINING CENTER (IN ASSOCIATION WITH THE AMERICAN HEART ASSOCIATION), PROVIDES CPR AND ACLS CLASSES AND SUPPORT TO AREA BASIC LIFE SUPPORT AND ADVANCE LIFE SUPPORT PROVIDERS AND INSTRUCTORS. IN COLLABORATION WITH LOCAL AGENCIES AND GOVERNMENT, WE PROVIDE EMERGENCY PREPAREDNESS TRAINING. MCHS-AL AMBULANCE ALSO PROVIDES FREE EVENT COVERAGE FOR VARIOUS COMMUNITY ACTIVITIES. MCHS-AL'S PATIENT EDUCATION CENTER PROVIDES FREE BLOOD PRESSURE CHECKS AND HEALTH RESOURCES FOR THE COMMUNITY. LOCATED WITHIN THE FRONT CORRIDOR, THE CENTER'S LIBRARY AREA INCLUDES EASY ACCESS FOR COMMUNITY MEMBERS TO WRITTEN LITERATURE, DVDS, VCR TAPES, AND AUDIOTAPES AND USE OF FOUR PUBLIC COMPUTERS ALLOW PATIENTS A DIVERSE MEANS OF GETTING AND RECEIVING PATIENT EDUCATION ON A VARIETY OF MEDICAL AND HEALTH-RELATED SUBJECTS. ALSO LOCATED IN THE PATIENT EDUCATION CENTER IS MCHS-AL'S PATIENT ADVOCATE. SHE IS A CERTIFIED SENIOR HEALTH INSURANCE PROGRAM VOLUNTEER WHO FACILITATES MEDICATION ASSISTANCE FOR THOSE UNABLE TO AFFORD MEDICATION PRESCRIBED. SHE ALSO ASSISTS MEDICARE PARTICIPANTS ENROLLING IN THE PART D PLAN. EXPLAINING INSURANCE AND CLARIFYING INSURANCE ISSUES ARE ALSO OFFERED THROUGH THE PATIENT ADVOCATE. WITH THE DEVELOPMENT OF ALMCARE, SHE WORKS CLOSELY WITH THE FINANCE DEPARTMENT IN EDUCATING AND FOLLOWING UP WITH UNINSURED OR UNDERINSURED PATIENTS THAT ARE ACCEPTED INTO THIS PROGRAM.FREE EDUCATION PROGRAMS INCLUDE: - 10 HEALTH EDUCATION PROGRAMS - 52 HEALTH TALK RADIO PROGRAMS - 4 WELLNESS FAIRS AT LOCAL BUSINESSES - 1 WOMEN'S HEALTH SYMPOSIUM MCHS-AL ALSO PROVIDES PATIENT & FAMILY SOCIAL SERVICES, FREE HEALTH ASSESSMENTS AND SCREENINGS, COUNSELING SERVICES, FREE INTERPRETING SERVICES, AND SPACE FOR COMMUNITY MEETINGS AND SUPPORT GROUPS. SOME EXAMPLES OF THESE SERVICES ARE PROVIDED BELOW.

4c	(Code: ) (Expenses $ 379,449 including grants of $ 257,090 ) (Revenue $ 48,067 )
	COMMUNITY SUPPORT (SCHEDULE O): COMMUNITY SUPPORT: MCHS-AL HAS A HOME HEALTH PROGRAM IN WHICH PRIMARILY ELDERLY PATIENTS WITH CIRCULATORY, RESPIRATORY AND OTHER HEALTH PROBLEMS ARE PROVIDED ASSISTANCE WITH PERSONAL CARES AND ACTIVITIES OF DAILY LIVING. DURING 2011, THE HOME HEALTH PROGRAM SERVED 346 PATIENTS.MCHS-AL ALSO PROVIDES A HOSPICE FOR THE FAMILIES OF TERMINAL PATIENTS. IN 2011, 215 FAMILIES WERE SERVICED BY THIS HOSPICE.MCHS-AL OPERATES A PAIN CLINIC THAT SERVES THOSE INDIVIDUALS WITH PAIN UNRESPONSIVE TO CONVENTIONAL PAIN CONTROL MEASURES. DURING THE YEAR 2011, THE PROGRAM'S ANESTHESIOLOGIST AND THE ASSISTING RN'S HELPED 819 PATIENTS.MCHS-AL PROVIDES FREE SPORTS PHYSICALS TO STUDENT ATHLETES. DURING 2011, IT PROVIDED PHYSICALS TO 327 CHILDREN.MCHS-AL SPONSORS A SCHOLARSHIP PROGRAM FOR HIGH SCHOOL SENIORS AND NON-TRADITIONAL STUDENTS FROM THE MCHS-AL SERVICE AREA WHO ARE ENTERING THE HEALTHCARE FIELD. IN THE YEAR ENDING DECEMBER 31, 2011, 10 SCHOLARSHIPS WERE AWARDED TOTALING $7,000. IN ADDITION, MCHS-AL PROVIDES MEETING SPACE AND SPONSORS VARIOUS "ON-SITE" EDUCATION PROGRAMS INCLUDING SHADOWING, PRECEPTORSHIPS, AND INTERNSHIPS. THE ESTIMATED COST OF SUPERVISION AND SPACE FOR THESE PROGRAMS IS $1,401,172. MCHS-AL IS AN ACTIVE MEMBER OF THE COMMUNITY, SUPPORTING SUCH COMMUNITY SERVICES AS SENIOR RESOURCES, FREEBORN COUNTY FAMILY SERVICES COLLABORATIVE, RIVERLAND COMMUNITY COLLEGE, UNITED WAY, ALBERT LEA FAMILY Y, AREA FOOD SHELVES, MEALS ON WHEELS, NUMEROUS YOUTH ACTIVITIES, AND SEVERAL OTHER HEALTH-RELATED ORGANIZATIONS. DURING 2011, MCHS-AL MADE CASH AND EQUIPMENT DONATIONS TOTALING OVER $257,000 TO VARIOUS CHARITABLE AND COMMUNITY ORGANIZATIONS. ITS COMMUNITY INVOLVEMENT PROGRAM ALLOWS STAFF TO VOLUNTEER EIGHT HOURS ANNUALLY DURING WORK TIME. IN 2011, 89 MCHS-AL VOLUNTEERS PROVIDED 452 HOURS OF SERVICES TO ENDORSED COMMUNITY PROGRAMS AND PROJECTS. THE VALUE OF THIS DONATED TIME IS $9,850 BASED ON THE INDEPENDENT SECTORS AVERAGE ESTIMATED VALUE OF SUCH SERVICES. MCHS-AL ALSO BENEFITS FROM COMMUNITY VOLUNTEERS IN ITS AUXILIARY, HOSPICE AND FLTC PROGRAMS AND AS MOVERS AT THE FRONT INFORMATION DESK. DURING 2011, VOLUNTEERS DONATED APPROXIMATELY 14,282 HOURS TO THE MEDICAL CENTER. THE VALUE OF THIS DONATED TIME IS $311,205 BASED ON THE INDEPENDENT SECTORS AVERAGE ESTIMATED VALUE OF SUCH SERVICES. THESE SERVICE HOURS WERE PRIMARILY SPENT ORGANIZING AND MANAGING ACTIVITIES FOR THE BENEFIT OF THE MEDICAL CENTER'S PATIENTS, PATIENTS' FAMILIES, VISITORS, AND STAFF.

	(Code: ) (Expenses $ 339,457 including grants of $ 284,386 ) (Revenue $ 293,236 )
	RESEARCH AND OTHER ACTIVITIES: MCHS-AL STAFF WORK WITH MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM PHYSICIAN INVESTIGATORS TO COORDINATE CLINICAL RESEARCH STUDIES. IN 2011, MCHS-AL PARTICIPATED IN A NUMBER OF RESEARCH PROJECTS TO IMPROVE THE HEALTH OF OUR COMMUNITIES.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 339,457 including grants of $ 284,386 ) (Revenue $ 293,236 )
4e	Total program service expenses$ 112,575,680

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	8,026,402	2,048,100	934,439

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b		2,370
c	Fundraising events....1c		7,689
d	Related organizations...1d		2,839,891
e	Government grants (contributions)1e		14,000

f	All other contributions, gifts, grants, and similar amounts not included above1f
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			2,863,950
			Business Code
2a	NET PATIENT REVENUE		620,000	128,821,084	128,821,084
b	SHARED SERVICES		561,000	2,239,284	2,239,284
c	RENT FROM AFFILIATES		531,120	284,981	284,981
d	MEALS ON WHEELS		624,210	48,067	48,067
e	EDUCATION REVENUE		611,600	8,198	8,198
f	All other program service revenue .
g	Total. Add lines 2a–2f........			131,401,614
3	Investment income (including dividends, interest
	and other similar amounts).....			2,128,378			2,128,378
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross rents	5,670
b	Less: rental expenses	45,027
c	Rental income or (loss)	-39,357
d	Net rental income or (loss).......			-39,357			-39,357
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		443
b	Less: cost or other basis and sales expenses		43,147
c	Gain or (loss)		-42,704
d	Net gain or (loss)..........			-42,704			-42,704
8a	Gross income from fundraising events (not including $ 7,689 of contributions reported on line 1c). See Part IV, line 18 ...
	a		7,839
b	Less: direct expenses ...b		0
c	Net income or (loss) from fundraising events..			7,839			7,839
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		445
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities...			445			445
10a	Gross sales of inventory, less returns and allowances .
	a		152,263
b	Less: cost of goods sold ..b		92,706
c	Net income or (loss) from sales of inventory..			59,557			59,557
Miscellaneous Revenue			Business Code
11a	CAFETERIA/VENDING REVE		722,210	587,487	587,487
b	MEDICAL RECORD/TRANSCR		541,900	87,991	87,991
c	MISC. REVENUE		900,099	10,455	8,255		2,200
d	All other revenue ....			6,000			6,000
e	Total. Add lines 11a–11d ......			691,933
12	Total revenue. See Instructions....			137,071,655	132,085,347	0	2,122,358


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			535,539	1	237,343
2	Savings and temporary cash investments .......			0	2	0
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			20,655,239	4	25,537,157
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			2,506,561	8	2,531,108
9	Prepaid expenses and deferred charges ............			3,080,860	9	2,657,360
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	100,451,658
b	Less: accumulated depreciation. .....	10b	44,393,589	58,242,191	10c	56,058,069
11	Investments—publicly traded securities ..........				11
12	Investments—other securities. See Part IV, line 11 ......			59,836,100	12	61,405,884
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			8,143,763	15	7,450,020
16	Total assets. Add lines 1 through 15 (must equal line 34)...			153,000,253	16	155,876,941
17	Accounts payable and accrued expenses .			9,307,871	17	6,705,759
18	Grants payable ..........				18
19	Deferred revenue ..........				19
20	Tax-exempt bond liabilities ..........				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
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.....			2,861,312	25	2,988,390
26	Total liabilities. Add lines 17 through 25.....			12,169,183	26	9,694,149
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			139,494,445	27	145,194,739
28	Temporarily restricted net assets .....			1,035,082	28	686,510
29	Permanently restricted net assets .....			301,543	29	301,543
	Organizations that do not follow SFAS 117, check here 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 .....			140,831,070	33	146,182,792
34	Total liabilities and net assets/fund balances .....			153,000,253	34	155,876,941