TY 2011 Form 990

- TIN:

Form990

Department of the Treasury
Internal Revenue Service

Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

The organization may have to use a copy of this return to satisfy state reporting requirements.

OMB No. 1545-0047

2011

Open to Public Inspection

A For the calendar year, or tax year beginning 01-01-2011 and ending 12-31-2011

BCheck if applicable: Address change Name change Initial return Terminated Amended return Application pending

CName of organization
MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE
HOSPITAL INC

Doing Business As
FKA LUTHER HOSPITAL

Number and street (or P.O. box if mail is not delivered to street address)
1221 WHIPPLE STREET

Room/suite

City or town, state or country, and ZIP + 4
EAU CLAIRE, WI54703

D Employer identification number

39-0813418

E Telephone number

G Gross receipts $ 273,897,165

F Name and address of principal officer:
RANDALL LINTON MD
1221 WHIPPLE STREET
EAU CLAIRE,WI54703

Tax-exempt status: 501(c)(3) 501(c) ( ) LeftBullet

(insert no.) 4947(a)(1) or 527

Website:

WWW.MAYOCLINICHEALTHSYSTEM.ORG

H(a)

Is this a group return for
affiliates? Yes No

H(b)

Are all affiliates included?

Yes No

If "No," attach a list. (see instructions)

H(c)

Group exemption number MediumBullet

K Form of organization: Corporation Trust Association Other MediumBullet

L Year of formation: 1905

M State of legal domicile: WI

Part I

Summary

1	Briefly describe the organization’s mission or most significant activities: OPERATION OF A HOSPITAL.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a).....	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	5
5	Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...	5	2,098
6	Total number of volunteers (estimate if necessary) ....	6	482
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) .........	1,681,860	3,006,734
9	Program service revenue (Part VIII, line 2g) .........	241,768,393	264,022,907
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,340,527	3,466,428
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,820,822	2,730,401
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	248,611,602	273,226,470
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	3,090,017	5,002,051
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)	95,008,003	99,980,687
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 709,694
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	111,908,096	130,633,060
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	210,006,116	235,615,798
19	Revenue less expenses. Subtract line 18 from line 12.......	38,605,486	37,610,672
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	455,711,720	478,448,234
21	Total liabilities (Part X, line 26).............	136,099,786	139,304,474
22	Net assets or fund balances. Subtract line 21 from line 20.....	319,611,934	339,143,760

Part II

Signature Block

Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid preparer use only

Print/type preparer's name

Preparer's signature

Date

Check if
self-employed

PTIN

Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image

Firm's address Right pointing arrowhead image

Phone no.

May the IRS discuss this return with the preparer shown above? See instructions ......... bullet

YesNo

For Paperwork Reduction Act Notice, see the separate instructions.

Cat. No. 11282Y

Form 990 (2011)

Page 2

Part III

Statement of Program Service Accomplishments

Check if Schedule O contains a response to any question in this Part III .........

Briefly describe the organization’s mission: TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION, AND RESEARCH.

Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .................... Yes No

If “Yes,” describe these new services on Schedule O.

Did the organization cease conducting, or make significant changes in how it conducts, any program services? .......................... Yes No

If “Yes,” describe these changes on Schedule O.

Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.


4a	(Code: ) (Expenses $ 210,243,226 including grants of $ 5,002,000 ) (Revenue $ 264,888,559 )
	PATIENT CARE - SEE SCHEDULE O:MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE HOSPITAL, INC. (THE HOSPITAL) IS A MEMBER OF THE MAYO CLINIC HEALTH SYSTEM. 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.THE HOSPITAL IS A 304-BED HOSPITAL WHICH IS A REGIONAL CENTER FOR CARDIAC SURGERY AND NEUROSURGERY AND WHICH ALSO EMPHASIZES BEHAVIORAL HEALTH, ONCOLOGY, ORTHOPEDICS AND WOMEN'S HEALTH. IN 2011, THE HOSPITAL SERVED 11,874 INPATIENTS. IN ADDITION, 80,871 PEOPLE RECEIVED OUTPATIENT MEDICAL CARE INCLUDING 21,195 PATIENTS TREATED IN THE EMERGENCY ROOM. THE HOSPITAL HAS 18 OPERATING ROOMS WHERE 10,187 SURGICAL PROCEDURES WERE PERFORMED IN 2011.THE HOSPITAL, IN AFFILIATION WITH MAYO CLINIC HEALTH SYSTEM-EAU CLAIRE CLINIC (THE CLINIC), IS ONE OF THE MAIN PROVIDERS OF HEALTH CARE SERVICES IN THE SURROUNDING AREA. THE CLINIC IS A RELATED OUTPATIENT CLINIC EXEMPT UNDER SECTION 501(C)(3) OF THE CODE. THE HOSPITAL IS LOCATED ADJACENT TO THE MAIN CAMPUS OF THE CLINIC IN EAU CLAIRE, WISCONSIN. THE AFFILIATED ORGANIZATIONS ARE LOCALLY THOUGHT OF AS ONE HEALTHCARE ORGANIZATION. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. SERVICES ARE ALSO PROVIDED TO BOTH MEDICAID AND MEDICARE PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN ADDITION, SERVICES ARE PROVIDED TO PATIENTS UNDER OTHER MEANS TESTED GOVERNMENT PROGRAMS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN 2011, THE HOSPITAL PROVIDED APPROXIMATELY $3,673,270 OF FINANCIAL ASSISTANCE (AT COST) TO PATIENTS. THE UNREIMBURSED COST OF SERVICES TO MEDICAID PATIENTS WAS APPROXIMATELY $10,084,650 AND THE UNREIMBURSED COST OF SERVICES TO PATIENTS UNDER OTHER MEANS TESTED GOVERNMENT PROGRAMS WAS APPROXIMATELY $1,872,268.THE UNREIMBURSED COST OF SERVICES TO MEDICARE PATIENTS DETERMINED BY USING INFORMATION FROM THE HOSPITAL'S MEDICARE COST REPORT WAS APPROXIMATELY $158,894. IF USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY, THE UNREIMBURSED COST OF SERVICES TO MEDICARE PATIENTS WAS APPROXIMATELY $6,571,900.THE HOSPITAL, ALONG WITH THE CLINIC, VOLUNTARILY ENTERED INTO AN AGREEMENT WITH THE WISCONSIN ATTORNEY GENERAL RELATING TO CHARITY CARE. THE TERMS OF THE AGREEMENT INCLUDE AN AUTOMATIC DISCOUNT FOR UNINSURED PATIENTS, A PAYMENT CAP FOR THOSE UNINSURED PATIENTS THAT MEET THE HOSPITAL'S CHARITY CARE CRITERIA, AND A COMMITMENT TO MAKE INFORMATION AVAILABLE TO PATIENTS REGARDING THE CHARITY CARE PROGRAM. ADDITIONALLY, THE WISCONSIN ATTORNEY GENERAL REVIEWED AND APPROVED THE HOSPITAL'S BILLING AND COLLECTION POLICIES AND PRACTICES.

4b	(Code: ) (Expenses $ 1,303,998 including grants of $ 0 ) (Revenue $ 534,409 )
	MEDICAL EDUCATION - SEE SCHEDULE O:THE HOSPITAL, IN AFFILIATION WITH THE CLINIC, HAS NUMEROUS AGREEMENTS WITH EDUCATIONAL ORGANIZATIONS TO PROVIDE FORMAL EDUCATION AND EXPERIENCE FOR STUDENTS STUDYING TO BECOME HEALTHCARE PROFESSIONALS. CURRENTLY THESE AGREEMENTS ARE WITH THE FOLLOWING ORGANIZATIONS:- UNIVERSITY OF WISCONSIN MEDICAL SCHOOL- UNIVERSITY OF WISCONSIN-MADISON- UNIVERSITY OF WISCONSIN-EAU CLAIRE - CHIPPEWA VALLEY TECHNICAL COLLEGE - UNIVERSITY OF WISCONSIN-LACROSSE- WESTERN WISCONSIN TECHNICAL COLLEGE OF LACROSSE- UNIVERSITY OF MINNESOTA-MINNEAPOLIS- UNIVERSITY OF CINCINNATI - UNIVERSITY OF MINNESOTA-DULUTH - COLLEGE OF ST. CATHERINE'S - COLLEGE OF ST. SCHOLASTICA - WINONA STATE UNIVERSITY - UNIVERSITY OF WISCONSIN-STOUT - WI TECHNICAL COLLEGE-RICE LAKE - WI TECHNICAL COLLEGE-NEW RICHMOND - MAYO CLINIC SCHOOL OF HEALTH RELATED SCIENCES- CONCORDIA UNIVERSITY - LAKE SUPERIOR COLLEGE - UNIVERSITY OF WISCONSIN - OSHKOSH - ARGOSY UNIVERSITY- DES MOINES UNIVERSITY- FINLANDIA UNIVERSITY- CARROLL UNIVERSITY- CREIGHTON UNIVERSITY- GLOBE UNIVERSITY- NORTHEAST WISCONSIN TECHNICAL COLLEGE- VITERBO UNIVERSITY- AT STILL UNIVERSITY- COLORADO STATE UNIVERSITY- FRONTIER SCHOOL OF MIDWIFERY- GEORGE WASHINGTON UNIVERSITY- INVER HILLS/CENTURY COLLEGE- KAPIOLANI COMMUNITY COLLEGE- KAPLAN UNIVERSITY- KEISER UNIVERSITY- MILWAUKEE AREA TECHNICAL COLLEGE- MINNESOTA STATE COMMUNITY & TECHNICAL COLLEGE- VANDERBILT UNIVERSITY- WALDEN UNIVERSITYTHE HOSPITAL ALSO ACTIVELY PROVIDES A CONTINUING EDUCATION PROGRAM FOR ITS MEDICAL STAFF.

4c	(Code: ) (Expenses $ 421,466 including grants of $ 51 ) (Revenue $ 1,320 )
	COMMUNITY BENEFIT - SEE SCHEDULE O:THE HOSPITAL, OFTEN IN AFFILIATION WITH THE CLINIC, PROVIDES COMMUNITY CLASSES, EDUCATIONAL OPPORTUNITIES AND SERVICES. THESE PROGRAMS AND CLASSES INCLUDE SEVERAL HEALTH RELATED TOPICS. ADDITIONAL INFORMATION REGARDING SOME OF THE SPECIFIC EVENTS ARE LISTED BELOW. APPROXIMATELY 1,050 PEOPLE PARTICIPATED IN CHILDBIRTH CLASSES GIVEN FOR EXPECTANCT PARENTS AND THEIR CHILDREN IN 2011.EMPLOYEE HEALTHCARE PROFESSIONALS OFFER PRESENTATIONS ON A VARIETY OF HEALTHCARE TOPICS MONTHLY, DRAWING ANYWHERE FROM 40-75 PARTICIPANTS. PRESENTATIONS ARE INFORMAL AND OFFER DISCUSSION TOPICS IMPORTANT TO COMMUNITY MEMBERS. SINCE 1998, THE HOSPTIAL AND CLINIC HAVE SPONSORED A PERMANENT KIOSK IN THE MACY'S WING OF OAKWOOD MALL (A MAJOR SHOPPING CENTER). THE KIOSK IS STAFFED AT VARIOUS TIMES BY CLINICIANS AND EMPLOYEES WHO ARE AVAILABLE TO ANSWER CONSUMER QUESTIONS AND DISTRIBUTE HEALTH RELATED INFORMATION. FREE BLOOD PRESSURE SCREENINGS, COMBINED WITH INFORMAL EDUCATION IS OFFERED EVERY THURSDAY TO AREA RESIDENTS. IN 2011, OVER 2,000 SCREENINGS WERE CONDUCTED FREE OF CHARGE. HEALTH FAIRS AND OTHER SPECIAL EVENTS ARE HELD SEVERAL TIMES THROUGHOUT THE YEAR TO OFFER COMMUNITY MEMBERS THE OPPORTUNITY TO LEARN ABOUT NUTRITION, EXERCISE AND SEVERAL OTHER TOPICS. MORE THAN 150 WALKERS ARE PART OF THE "HEART 'N SOLE" WALKING CLUB AT THE MALL AND RECEIVE EXERCISE AND FITNESS TIPS IN A QUARTERLY NEWSLETTER.THE TRAUMA DEPARTMENT HAS PARTNERED WITH LOCAL BUSINESSES SINCE 1998 TO PRESENT "SAFETY CAMP" - AN OPPORTUNITY FOR AREA FOURTH GRADERS TO SPEND TWO DAYS LEARNING ABOUT WATER SAFETY, BIKE SAFETY, ANIMAL SAFETY AND MANY OTHER TOPICS. ADDITIONALLY, THE DEPARTMENT OFFERS A BIANNUAL CAR CONTROL CLASS - A PROGRAM DESIGNED TO PROVIDE TEEN DRIVERS WITH REAL-WORLD ACCIDENT SITUATIONS IN A SAFE ENVIRONMENT AND THEN LEARN HOW TO CORRECT THEM.THE TRAUMA DEPARTMENT ALSO PROVIDES ONGOING OUTREACH PROGRAMS INCLUDING PROM TRAUMA SIMULATIONS AT AREA HIGH SCHOOLS, CONCUSSION AWARENESS PRESENTATIONS, DRIVERS' EDUCATION PRESENTATIONS, DISTRIBUTION OF FIRST-AID KITS TO LOCAL YOUTH SPORTS PROGRAMS, AND CAR SEAT CHECKS FOR NEW OR EXPECTANT PARENTS. THE DEPARTMENT ALSO PROVIDES FREE BICYCLE HELMETS AND CAR SEATS TO PATIENTS.IN 2011, HOSPITAL AND CLINIC EMPLOYEES RAISED $34,652 FOR THE "RELAY FOR LIFE" EVENT HELD TO BENEFIT THE AMERICAN CANCER SOCIETY. THE HOSPITAL AND THE CLINIC WERE A CORPORATE SPONSOR FOR THE EVENT.THE HOSPITAL AND THE CLINIC WERE A CORPORATE SPONSOR FOR THE "AMERICAN HEART WALK" TO RAISE MONEY FOR THE AMERICAN HEART ASSOCIATION. MORE THAN 20 TEAMS, APPROXIMATELY 200 WALKERS, RAISED $17,000.THE HOSPITAL AND THE CLINIC WERE A CORPORATE SPONSOR FOR THE "EPILEPSY STROLL IN THE PARK" EVENT WHICH RAISED MORE THAN $24,000. THE HOSPITAL AND THE CLINIC ALSO SPONSORED THE "SHARE THE FLAME" EVENT AND RAISED ANOTHER $17,800 FOR THE EPILEPSY FOUNDATION.THE HEALTH INFORMATION CENTER PROVIDES HEALTH-RELATED VIDEOS, MODELS, COMPUTER SOFTWARE, PRINTED HEALTH INFORMATION, AND OTHER EDUCATIONAL MATERIALS FOR AREA RESIDENTS TO USE FREE OF CHARGE TO INCREASE HEALTH AWARENESS WITHIN THE COMMUNITY.THE "HERS" WOMEN'S CENTER REGULARLY REACHES OUT TO WOMEN OF ALL AGES IN THE COMMUNITY BY PROVIDING FREE HEALTH INFORMATION AND EDUCATION REGARDING SELF-BREAST EXAMS AT LOCAL HEALTH FAIRS, OAKWOOD MALL, AND TO GIRL SCOUT TROOPS.SPIRITUAL CARE SERVICES INCLUDE 24-HOUR ON-CALL SERVICES, INCLUDING DAILY CARE ROUNDS, DAILY PATIENT AND FAMILY VISITS, ASSISTANCE WITH END-OF-LIFE DECISIONS, BEREAVEMENT SUPPORT, LIAISON WITH COMMUNITY CLERGY AND INSTRUCTION IN CLINICAL PASTORAL EDUCATION.APPROXIMATELY 482 COMMUNITY VOLUNTEERS PROVIDED APPROXIMATELY 55,018 HOURS OF DONATED TIME TO THE HOSPITAL IN 2011. VOLUNTEER ACTIVITIES INCLUDED STAFFING THE AUXILIARY-OPERATED COFFEE AND GIFT SHOPS AND PROVIDING HOSPITALITY SERVICES TO PATIENTS, FAMILIES AND VISITORS. THE DONATED SERVICES PROVIDED BY THE VOLUNTEERS IN 2011 IS VALUED AT APPROXIMATELY $1,198,842 BASED ON STATISTICS FROM THE INDEPENDENT SECTOR.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses$ 211,968,690

Form 990 (2011)

Page 3

Part IV

Checklist of Required Schedules

Yes

Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule A Click to see attachment

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

Yes

Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment

........

Yes

Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........

Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................

Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................

Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part I Click to see attachment

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

Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part II Click to see attachment

...

Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment

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

Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IV Click to see attachment

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

Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part V Click to see attachment

Yes

If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:

Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI. Click to see attachment

11a

Yes

Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII. Click to see attachment

11b

Yes

Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII. Click to see attachment

11c

Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX. Click to see attachment

11d

Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X. Click to see attachment

11e

Yes

Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X. Click to see attachment

11f

Yes

12a

Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment

12a

Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment

12b

Yes

Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E

14a

Did the organization maintain an office, employees, or agents outside of the United States?....

14a

Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........

14b

Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..

Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..

Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I

Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........

Yes

Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................

20a

Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment

20a

Yes

If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see attachment

20b

Yes

Form 990 (2011)

Page 4

Part IV

Checklist of Required Schedules (continued)

Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment

Yes

Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment

Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment

Yes

24a

Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment

24a

Yes

Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...

24b

Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................

24c

Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...

24d

25a

Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment

25a

Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment

25b

Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II......................... Click to see attachment

Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment

Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):

A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment

28a

A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment

28b

Yes

An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment

28c

Yes

Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M Click to see attachment

Yes

Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment

Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................

Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................

Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment

Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment

Yes

35a

Did the organization have a controlled entity within the meaning of section 512(b)(13)?

35a

Yes

If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment

35b

Yes

Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment

Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VI Click to see attachment

Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............

Yes

Form 990 (2011)

Page 5

Part V

Statements Regarding Other IRS Filings and Tax Compliance

Check if Schedule O contains a response to any question in this Part V .........

Yes

Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......

Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.

Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................

Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................

2,098

If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)

Yes

Did the organization have unrelated business gross income of $1,000 or more during the year?.............................

If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....

At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................

If "Yes," enter the name of the foreign country: MediumBullet

See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.

Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..

Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?

If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........

Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........

If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................

Organizations that may receive deductible contributions under section 170(c).

Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................

Yes

If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....

Yes

Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................

If “Yes,” indicate the number of Forms 8282 filed during the year ....

Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................

Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..

If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................

If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............

Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................

Sponsoring organizations maintaining donor advised funds.

Did the organization make any taxable distributions under section 4966?.........

Did the organization make a distribution to a donor, donor advisor, or related person?......

Section 501(c)(7) organizations. Enter:

Initiation fees and capital contributions included on Part VIII, line 12 ...

10a

Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities

10b

Section 501(c)(12) organizations. Enter:

Gross income from members or shareholders .........

11a

Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........

11b

12a

Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?

12a

If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.

12b

Section 501(c)(29) qualified nonprofit health insurance issuers.

Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.

13a

Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.

13b

Enter the aggregate amount of reserves on hand.

13c

14a

Did the organization receive any payments for indoor tanning services during the tax year?.....

14a

If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..

14b

Form 990 (2011)

Page 6

Part VI

Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.

Check if Schedule O contains a response to any question in this Part VI .........

Section A. Governing Body and Management

Yes

Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.

Enter the number of voting members included in line 1a, above, who are independent .................

Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................

Yes

Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .

Yes

Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?

Yes

Did the organization become aware during the year of a significant diversion of the organization’s assets? .

Did the organization have members or stockholders? ................

Yes

Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................

Yes

Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............

Yes

Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:

The governing body? .........................

Yes

Each committee with authority to act on behalf of the governing body? ..........

Yes

Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....

Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)

Yes

10a

Did the organization have local chapters, branches, or affiliates? ............

10a

Yes

If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....

10b

Yes

11a

Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?

11a

Yes

Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....

12a

Did the organization have a written conflict of interest policy? If “No,” go to line 13.......

12a

Yes

Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................

12b

Yes

Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................

12c

Yes

Did the organization have a written whistleblower policy? ...............

Yes

Did the organization have a written document retention and destruction policy? .........

Yes

Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?

The organization’s CEO, Executive Director, or top management official ...........

15a

Other officers or key employees of the organization ................

15b

If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).

16a

Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................

16a

If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............

16b

Section C. Disclosure

List the States with which a copy of this Form 990 is required to be filed MediumBullet

Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.

Own website Another's website Upon request

Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.

State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet

CHRISTIE LOHKAMP
200 FIRST STREET SW
ROCHESTER,MN55905
(507) 538-1297

Form 990 (2011)

Page 7

Part VII

Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors

Check if Schedule O contains a response to any question in this Part VII .........

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees

1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet

List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

List all of the organization’s current key employees, if any. See instructions for definition of "key employee."

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.

Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(1) BOLTON JEFFREY W DIRECTOR	1.00	X			0	715,940	50,237
(2) CLUMPNER DANIEL DIRECTOR	1.00	X			0	0	0
(3) HORECKI MD RICHARD J VICE CHAIR	1.00	X	X		0	328,168	62,270
(4) KORSMO JEFFREY O DIRECTOR	1.00	X			0	306,813	42,089
(5) LARSON THOMAS SECRETARY/TREASURER	1.00	X	X		0	0	0
(6) LINTON MD RANDALL L CHAIR/CEO	25.00	X	X		0	535,571	62,753
(7) NESSE MD ROBERT E DIRECTOR	1.00	X			0	750,263	15,004
(8) OLSON RICK DIRECTOR	1.00	X			0	0	0
(9) PEDERSON DUANE DIRECTOR	1.00	X			0	0	0
(10) SIMPSON MD HENRY J DIRECTOR	1.00	X			0	274,871	45,611
(11) SWENSEN MD STEPHEN J DIRECTOR	1.00	X			0	660,394	48,407
(12) WAHL BETTE DIRECTOR	1.00	X			0	0	0
(13) BAMMEL PAUL M CFO	25.00		X		0	279,544	56,293
(14) DICKEY JOHN M CAO	25.00		X		0	344,388	56,100
(15) KILNESS RUTH A ASST. SECRETARY	1.00		X		0	73,838	24,802
(16) FRANK LINDA A VP - NURSING	50.00			X	224,703	0	25,378
(17) POPE DENNIS W VP - OPERATIONS	50.00			X	208,005	0	23,501

Form 990 (2011)

Page 8

Part VII

Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) WITTROCK EDWARD A VP -REGIONAL SYSTEM	50.00	X		190,727	0	23,522
(19) BAKER THOMAS F DIRECTOR - SUPPLY CHAIN	40.00		X	133,247	0	1,379
(20) GIERHART KENT H SUPERVISOR - PHARMACY	40.00		X	134,119	0	2,949
(21) HARELSTAD JULIA M DIRECTOR - NURSING	40.00		X	136,987	0	19,226
(22) HITZKE RONALD S DIRECTOR - PHARMACY	40.00		X	160,283	0	19,721
(23) WINTER MARK D PHARMACIST	40.00		X	132,354	0	27,268

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	1,320,425	4,269,790	606,510

Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet

Yes

Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............

For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................

Yes

Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....

Section B. Independent Contractors

Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.

(A) Name and business address	(B) Description of services	(C) Compensation
MAYO FOUNDATION FOR MEDICAL EDUCATION & 200 FIRST STREET SW ROCHESTER,MN55905	PROCUREMENT/SUPPORT SERVICES	36,270,858
MAYO CLINIC 200 FIRST STREET SW ROCHESTER,MN55905	MEDICAL/SUPPORT SERVICES	5,057,081
MAYO COLLABORATIVE SERVICES INC 200 FIRST STREET SW ROCHESTER,MN55905	LAB SERVICES	522,154
MCHS - EAU CLAIRE CLINIC INC PO BOX 1510 EAU CLAIRE,WI54702	MEDICAL/SUPPORT SERVICES	425,017
MMSI INC 200 FIRST STREET SW ROCHESTER,MN55905	CLAIMS PROCESSING	377,421
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 6

Form 990 (2011)

Page 9

Part VIII

Statement of Revenue

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c		149,451
d	Related organizations...1d		2,272,346
e	Government grants (contributions)1e		584,937

f	All other contributions, gifts, grants, and similar amounts not included above1f
g	Noncash contributions included in lines 1a-1f:$ 52,791
h	Total. Add lines 1a-1f.......			3,006,734
			Business Code
2a	NET PATIENT REVENUE		620,000	257,452,298	257,452,298
b	RENT FROM AFFILIATES		531,120	3,556,336	3,556,336
c	SHARED SERVICES		561,000	2,904,248	2,904,248
d	WOMEN'S HEALTH CENTER		621,300	100,264	100,264
e	EDUCATION REVENUE		611,600	9,761	9,761
f	All other program service revenue .
g	Total. Add lines 2a–2f........			264,022,907
3	Investment income (including dividends, interest
	and other similar amounts).....			3,491,392			3,491,392
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross rents	124,709
b	Less: rental expenses	113,485
c	Rental income or (loss)	11,224
d	Net rental income or (loss).......			11,224			11,224
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		261,806
b	Less: cost or other basis and sales expenses		286,770
c	Gain or (loss)		-24,964
d	Net gain or (loss)..........			-24,964			-24,964
8a	Gross income from fundraising events (not including $ 149,451 of contributions reported on line 1c). See Part IV, line 18 ...
	a		46,733
b	Less: direct expenses ...b		103,183
c	Net income or (loss) from fundraising events..			-56,450			-56,450
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		3,860
b	Less: direct expenses ...b		4,564
c	Net income or (loss) from gaming activities...			-704			-704
10a	Gross sales of inventory, less returns and allowances .
	a		259,406
b	Less: cost of goods sold ..b		162,693
c	Net income or (loss) from sales of inventory..			96,713			96,713
Miscellaneous Revenue			Business Code
11a	CAFETERIA/VENDING		722,210	1,343,850	1,343,850
b	EMPLOYEE CHILDCARE		624,410	1,181,775			1,181,775
c	MISC. REVENUE		900,099	88,967	57,531		31,436
d	All other revenue ....			65,026			65,026
e	Total. Add lines 11a–11d ......			2,679,618
12	Total revenue. See Instructions....			273,226,470	265,424,288	0	4,795,448

Form 990 (2011)

Page 10

Part IX

Statement of Functional Expenses

Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.		(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the United States. See Part IV, line 21	5,002,051	5,002,051
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
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 ....	695,836	250,081	445,755
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	220,823	97,812	123,011
7	Other salaries and wages	85,605,375	76,321,706	9,006,013	277,656
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	2,166,902	1,921,175	238,793	6,934
9	Other employee benefits .......	5,112,994	4,571,993	524,408	16,593
10	Payroll taxes ...........	6,178,757	5,478,086	680,899	19,772
11	Fees for services (non-employees):
a	Management ......	375,454	260,111	115,343
b	Legal .........	38,197	272	37,925
c	Accounting ...........	929,591		929,591
d	Lobbying ...........
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......	42,076		42,076
g	Other ..........	26,704,731	24,769,760	1,680,917	254,054
12	Advertising and promotion ....	803,622	6,142	797,480
13	Office expenses .......	11,304,334	9,566,410	1,705,416	32,508
14	Information technology ......	2,292,003	1,249,032	1,042,971
15	Royalties ..	750	750
16	Occupancy ...........	5,825,055	1,887,831	3,843,954	93,270
17	Travel ............	525,509	417,744	103,188	4,577
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	1,730	1,212	478	40
20	Interest ...........	4,715,604	4,715,503	101
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	21,190,695	19,900,349	1,288,976	1,370
23	Insurance ..............	209,104	209,104
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	38,984,403	38,984,403
b	BAD DEBT EXPENSE	8,752,448	8,752,448
c	MEDICAID SURCHARGE	7,514,824	7,514,824
d	EMPLOYEE EXPENSES	371,087	55,040	315,223	824
e
f	All other expenses	51,843	34,851	14,896	2,096
25	Total functional expenses. Add lines 1 through 24f	235,615,798	211,968,690	22,937,414	709,694
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).

Form 990 (2011)

Page 11


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			107,996	1	6,694
2	Savings and temporary cash investments .......				2	72,964
3	Pledges and grants receivable, net .........			7,722,517	3	3,086,521
4	Accounts receivable, net .........			35,103,652	4	43,904,545
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 .............			8,254	7	26,526
8	Inventories for sale or use ..............			3,240,709	8	861,242
9	Prepaid expenses and deferred charges ............			7,034,043	9	5,830,833
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	410,586,578
b	Less: accumulated depreciation. .....	10b	148,551,163	265,071,563	10c	262,035,415
11	Investments—publicly traded securities ..........			1,800	11
12	Investments—other securities. See Part IV, line 11 ......			129,970,452	12	149,625,707
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			7,450,734	15	12,997,787
16	Total assets. Add lines 1 through 15 (must equal line 34)...			455,711,720	16	478,448,234
17	Accounts payable and accrued expenses .			23,563,482	17	30,939,035
18	Grants payable ..........				18
19	Deferred revenue ..........			23,043	19	18,307
20	Tax-exempt bond liabilities ..........			90,000,000	20	87,130,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....			22,513,261	25	21,217,132
26	Total liabilities. Add lines 17 through 25.....			136,099,786	26	139,304,474
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			310,124,320	27	334,773,226
28	Temporarily restricted net assets .....			8,858,414	28	3,716,268
29	Permanently restricted net assets .....			629,200	29	654,266
	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 .....			319,611,934	33	339,143,760
34	Total liabilities and net assets/fund balances .....			455,711,720	34	478,448,234

Form 990 (2011)

Page 12

Part XI

Reconcilliation of Net Assets

Check if Schedule O contains a response to any question in this Part XI .........

Total revenue (must equal Part VIII, column (A), line 12) ...

273,226,470

Total expenses (must equal Part IX, column (A), line 25) ....

235,615,798

Revenue less expenses. Subtract line 2 from line 1 ...

37,610,672

Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..

319,611,934

Other changes in net assets or fund balances (explain in Schedule O) ...

-18,078,846

Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....

339,143,760

Part XII

Financial Statements and Reporting

Check if Schedule O contains a response to any question in this Part XII .........

Yes

Accounting method used to prepare the Form 990: Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.

Were the organization’s financial statements compiled or reviewed by an independent accountant?....

Were the organization’s financial statements audited by an independent accountant?........

Yes

If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................

Yes

If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:

Separate basis Consolidated basis Both consolidated and separated basis

As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................

If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..

Form 990 (2011)

Additional Data

Software ID:
Software Version:

Form 990, Special Condition Description:

Special Condition Description

- 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 - EAU CLAIRE
HOSPITAL INC

Employer identification number

39-0813418

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 - EAU CLAIRE
HOSPITAL INC

Employer identification number

39-0813418

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 - EAU CLAIRE HOSPITAL INC
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 - EAU CLAIRE HOSPITAL INC
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 - EAU CLAIRE
HOSPITAL INC

Employer identification number

39-0813418

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 - EAU CLAIRE
HOSPITAL INC

Employer identification number

39-0813418

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 ....	18,368,773	12,955,759	11,636,431	14,172,465
b	Contributions ........	25,066	11,095	4,299	31,307
c	Net investment earnings, gains, and losses ...	1,890,948	5,401,919	1,315,029	-2,567,341
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......	20,284,787	18,368,773	12,955,759	11,636,431

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

Board designated or quasi-endowment SchDMd Bullet

95.000 %

Permanent endowment SchDMd Bullet

2.000 %

Temporarily restricted endowment SchDMd Bullet

3.000 %

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 .................	8,726,869		8,726,869
b	Buildings ................	285,669,111	77,259,935	208,409,176
c	Leasehold improvements ............
d	Equipment ................	107,114,916	71,291,228	35,823,688
e	Other .................	9,075,682		9,075,682
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				262,035,415

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	149,625,707	F








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	149,625,707

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
DUE TO AFFILIATES		21,217,132








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		21,217,132
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 INTEREST EARNED ON THE FILING ORGANIZATION'S ENDOWMENT FUNDS WILL BE APPLIED TOWARDS CAPITAL EXPENDITURES IN SUBSEQUENT FISCAL YEARS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X:	AT DECEMBER 31, 2011 AND 2010 THERE WAS NO SIGNIGICANT 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 - EAU CLAIRE
HOSPITAL INC

Employer identification number

39-0813418

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 GOLF OUTING (event type)	(b) Event #2 HOLIDAY CELEBRATION (event type)	(d) Total Events (Add col. (a) through col. (c))
1	Gross receipts . . .	94,377	101,807	196,184
2	Less: Charitable contributions . . .	70,174	79,277	149,451
3	Gross income (line 1 minus line 2) . . .	24,203	22,530	46,733
4	Cash prizes . . .
5	Non-cash prizes . .	18,775	30,667	49,442
6	Rent/facility costs . .	10,001	1,000	11,001
7	Food and beverages . .	5,489	16,578	22,067
8	Entertainment . . .		4,100	4,100
9	Other direct expenses .	2,333	14,240	16,573
10	Direct expense summary. Add lines 4 through 9 in column (d) ...........			103,183
11	Net income summary. Combine lines 3 and 10 in column (d)............			-56,450

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 - EAU CLAIRE
HOSPITAL INC

Employer identification number

39-0813418

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?......

Yes

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

	(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) ..	3,673,270		3,673,270	1.620 %
b Medicaid (from Worksheet 3, column a) .....	23,371,190	13,286,540	10,084,650	4.450 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .	3,446,769	1,574,501	1,872,268	0.830 %
dTotal Financial Assistance and Means-Tested Government Programs .....	30,491,229	14,861,041	15,630,188	6.900 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....	388,862	1,320	387,542	0.170 %
f Health professions education (from Worksheet 5) ..	1,303,998	524,648	779,350	0.340 %
g Subsidized health services (from Worksheet 6) ..	54,127,132	30,210,600	23,916,532	10.540 %
h Research (from Worksheet 7)
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....	5,034,605		5,034,605	2.220 %
jTotal Other Benefits ...	60,854,597	30,736,568	30,118,029	13.270 %
kTotal. Add lines 7d and 7j. ..	91,345,826	45,597,609	45,748,217	20.170 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011

Schedule H (Form 990) 2011

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

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........

8,752,448

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).....

49,984,376

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

50,143,270

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

-158,894

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	MCHS - EAU CLAIRE HOSPITAL INC 1221 WHIPPLE STREET EAU CLAIRE,WI54703	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)

MCHS - EAU CLIARE HOSPITAL INC

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

Page

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care?.................		10	Yes
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.000000000000% 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

Page

Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
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: THERE WAS NO NET COMMUNITY BENEFIT COST ATTRIBUTED TO PHYSICIAN CLINICS THAT WERE INCLUDED IN SUBSIDIZED HEALTH SERVICES.
		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 $ 8752448.
		PART III, LINE 4: FOOTNOTE FROM MAYO CLINIC 2011 CONSOLIDATED AUDITED FINANCIAL STATEMENTS: ACCOUNTS RECEIVABLE FOR MEDICAL SERVICES ARE STATED AT NET REALIZABLE VALUE. THE CLINIC ESTIMATES THE ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS BASED ON HISTORIC WRITE-OFFS AND THE AGING OF THE ACCOUNTS. ACCOUNTS ARE WRITTEN OFF WHEN COLLECTION EFFORTS HAVE BEEN EXHAUSTED.METHODOLOGY FOR SCHEDULE H, PART III, LINE 2:BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED IN THE ACCOUNTS RECEIVABLE FOOTNOTE OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS.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.
		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 $6,571,900. BOTH AMOUNTS ARE 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, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY BASED ON SUBMISSION OF REQUESTED INFORMATION. COLLECTION ACTIVITY WOULD ONLY RESUME IF MAYO WOULD TELL THE COLLECTION AGENCY TO PURSUE COLLECTIONS ON THE BALANCE OR PARTIAL BALANCE IF THERE WAS A CHARITY ADJUSTMENT.
MCHS - EAU CLIARE HOSPITAL, INC.		PART V, SECTION B, LINE 13G: IN REGARDS TO THE POSTINGS 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.
MCHS - EAU CLIARE HOSPITAL, INC.		PART V, SECTION B, LINE 19D: THE POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 50% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN USING THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERICIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE.
		PART VI, LINE 2: THE FILING ORGANIZATION'S ADMINISTRATION, ALONG WITH MEMBERS OF THE MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE FOUNDATION (A RELATED TAX-EXEMPT ORGANIZATION) WORK CLOSELY WITH LOCAL EDUCATIONAL INSTITUTIONS, THE LOCAL UNITED WAY AGENCY, AREA FREE CLINICS, CHARITIES AND HEALTH DEPARTMENTS TO ASSESS HEALTH CARE NEEDS. MONETARY DONATIONS, SERVICES, EDUCATION, VOLUNTEERS AND GOODS ARE SUPPLIED ONCE THOSE NEEDS ARE ASSESSED. REQUESTS FOR ASSISTANCE ARE TRIAGED THROUGH THE PUBLIC AFFAIRS DEPARTMENT AND EVALUATED BASED ON ANNUAL STRATEGY. PART OF THAT STRATEGY INCLUDES INPUT FROM THE RESPONSIBLE VICE PRESIDENT AND ULTIMATELY REVIEWED BY THE FOUNDATION ACCORDING TO THE DONATION REQUEST FLOWCHART. THE FOUNDATION'S ANNUAL STRATEGY IS BASED ON COMMUNITY HEALTH NEED, THE ORGANIZATION'S STRATEGIC INITIATIVES AND COMMUNITY ASSESSMENTS.
		PART VI, LINE 3: 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: THE FILING ORGANIZATION IS LOCATED IN EAU CLAIRE, WISCONSIN PRIMARILY SERVING RESIDENTS OF EAU CLAIRE COUNTY. SECONDARY SERVICE AREAS INCLUDE PEOPLE IN THE COUNTIES OF BARRON, BUFFALO, CHIPPEWA, DUNN AND TREMPEALEAU.THE POPULATION OF EAU CLAIRE COUNTY (WHICH COMPRISES MOST OF THE FILING ORGANIZATION'S SERVICE AREA) IS APPROXIMATELY 99,000. OF THIS POPULATION, MORE THAN 93% ARE OF WHITE ETHNICITY; THE NEXT CLOSEST RACE PERCENTAGE IS ASIAN AT 3.3%. AVERAGE INCOME IN EAU CLAIRE COUNTY IS $45,846 ACCORDING TO 2010 U.S. CENSUS BUREAU INFORMATION.ACCORDING TO A STATE OF WISCONSIN 2010 COUNTY PROFILE, APPROXIMATELY 14.7% OF EAU CLAIRE INDIVIDUALS ARE LIVING BELOW THE POVERTY LEVEL. AN ESTIMATED 11% ARE ON MEDICAID AND 10% RECEIVE MEDICARE COVERAGE.ACCORDING TO INFORMATION PROVIDED BY THE 2011 COUNTY HEALTH RANKINGS WEBSITE, EAU CLAIRE COUNTY RANKS 19TH (OUT OF 72 COUNTIES) IN HEALTH OUTCOMES, RANKING FIFTH IN CLINICAL CARE AND SIXTH IN HEALTH FACTORS. THIS SAME WEBSITE SHOWS THAT APPROXIMATELY 11% OF EAU CLAIRE COUNTY ADULTS WERE UNINSURED.A RECENT UNITED WAY REPORT SHOWS THAT MAJOR HEALTH CONCERNS FACING OUR COMMUNITY ARE OBESITY, TOBACCO USE, MENTAL HEALTH ISSUES, ALCOHOL USE AND LACK OF DENTAL CARE.THE FILING ORGANIZATION IS ONE OF TWO MAJOR HOSPITALS IN THE EAU CLAIRE AREA, AND IS THE ONLY VERIFIED TRAUMA CENTER IN NORTHWEST WISCONSIN. BY MAINTAINING LEVEL II VERIFICATION FROM THE AMERICAN COLLEGE OF SURGEONS, WE PROVIDE THE HIGHEST LEVEL OF TRAUMA CARE AVAILABLE IN THE REGION.EAU CLAIRE COUNTY IS A FEDERALLY-DESIGNATED, MEDICALLY-UNDERSERVED AREA INDICATING A SIGNIFICANT SHORTAGE OF PRIMARY CARE PHYSICIANS FOR THE POPULATION ALONG WITH A SHORTAGE OF DENTISTS PROVIDING CARE TO THE LOW-INCOME POPULATION.
		PART VI, LINE 5: THIS FILING ORGANIZATION IS AN AFFILIATE OF THE 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 HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY - IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE. THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, 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. THE FILING ORGANIZATION'S STAFF PRIVILEGES ARE GENERALLY EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY.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 FILING 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.SPECIFICALLY, THE FILING ORGANIZATION PROVIDES HOSPITAL SERVICES AT ITS EAU CLAIRE, WISCONSIN LOCATION. FOR MORE SPECIFIC DESCRIPTION, SEE THE RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O).
		PART VI, LINE 7: NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED ON THE MINNESOTA HOSPITAL ANNUAL REPORT OR TO THE WISCONSIN HOSPITAL ASSOCIATION.

Schedule H (Form 990) 2011

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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 - EAU CLAIRE
HOSPITAL INC

Employer identification number
39-0813418

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) MAYO CLINIC HEALTH SYSTEM - OAKRIDGE13025 8TH STREET OSSEO,WI54758	39-1029430	501(C)(3)	3,000,000	HEALTH CARE
(2) MAYO CLINIC HEALTH SYSTEM - HOME HEALTH & HOSPICE4033 123RD STREET CHIPPEWA FALLS,WI54729	39-1491516	501(C)(3)	1,502,000	HEALTH CARE
(3) MAYO CLINIC HEALTH SYSTEM - SUPPORTIVE HOMECARE4033 123RD STREET CHIPPEWA FALLS,WI54729	39-1686673	501(C)(3)	500,000	GENERAL SUPPORT

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	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.

Identifier	Return Reference	Explanation
PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	PART I, LINE 2:	SCHEDULE I, PART I, LINE 2: THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY AND EQUALITY OF OPPORTUNITY. FEDERAL AWARDS THAT ARE SUBCONTRACTED TO OTHER ORGANIZATIONS ARE MONITORED BY THE FILING ORGANIZATION AS PRESCRIBED IN OMB CIRCULAR A-133. NO ADDITIONAL MONITORING IS PERFORMED. TRANSFERS OR GRANTS TO 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

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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 - EAU CLAIRE
HOSPITAL INC

Employer identification number

39-0813418

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....

Yes

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? ....

Yes

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

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) BOLTON JEFFREY W	(i) (ii)	0 624,800	0 0	0 91,140	0 29,749	0 20,488	0 766,177	0 85,363
(2) HORECKI MD RICHARD J	(i) (ii)	0 224,336	0 8,435	0 95,397	0 25,170	0 37,100	0 390,438	0 0
(3) KORSMO JEFFREY O	(i) (ii)	0 265,451	0 0	0 41,362	0 24,113	0 17,976	0 348,902	0 27,019
(4) LINTON MD RANDALL L	(i) (ii)	0 472,794	0 50,000	0 12,777	0 25,170	0 37,583	0 598,324	0 0
(5) NESSE MD ROBERT E	(i) (ii)	0 546,068	0 0	0 204,195	0 0	0 15,004	0 765,267	0 193,896
(6) SIMPSON MD HENRY J	(i) (ii)	0 274,271	0 600	0 0	0 14,700	0 30,911	0 320,482	0 0
(7) SWENSEN MD STEPHEN J	(i) (ii)	0 567,370	0 0	0 93,024	0 28,003	0 20,404	0 708,801	0 86,647
(8) BAMMEL PAUL M	(i) (ii)	0 255,446	0 18,052	0 6,046	0 25,170	0 31,123	0 335,837	0 0
(9) DICKEY JOHN M	(i) (ii)	0 310,821	0 21,921	0 11,646	0 25,170	0 30,930	0 400,488	0 0
(10) FRANK LINDA A	(i) (ii)	195,748 0	26,501 0	2,454 0	0 0	25,378 0	250,081 0	0 0
(11) POPE DENNIS W	(i) (ii)	191,726 0	13,716 0	2,563 0	0 0	23,501 0	231,506 0	0 0
(12) WITTROCK EDWARD A	(i) (ii)	175,803 0	12,584 0	2,340 0	0 0	23,522 0	214,249 0	0 0
(13) HARELSTAD JULIA M	(i) (ii)	134,431 0	2,556 0	0 0	0 0	19,226 0	156,213 0	0 0
(14) HITZKE RONALD S	(i) (ii)	151,854 0	7,029 0	1,400 0	0 0	19,721 0	180,004 0	0 0
(15) WINTER MARK D	(i) (ii)	130,763 0	1,500 0	91 0	0 0	27,268 0	159,622 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, LINE 1A	TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: THE FILING ORGANIZATION MAY REQUIRE THE USE OF CELLULAR PHONES BY SOME OF ITS EMPLOYEES TO FULFILL THEIR JOB DUTIES. IF THE SERVICE IS APPROVED AS NECESSARY TO PERFORM MAJOR FUNCTIONS OF A JOB, THERE IS A GROSS-UP ADDED TO HELP OFFSET THE TAX IMPACT OF ADDING THE SERVICE COST TO TAXABLE WAGES. THE FILING ORGANIZATION FOLLOWED A WRITTEN POLICY ALLOWING FOR THE GROSS-UP ON THE USE OF CELLULAR PHONES BY EMPLOYEES.
	PART I, LINE 4B	THE FILING ORGANIZATION 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. JEFFREY W. BOLTON - $85,363 STEPHEN J. SWENSEN, M.D. - $86,647 JEFFREY O. KORSMO - $27,019 ROBERT E. NESSE, M.D. - $193,896
SUPPLEMENTAL INFORMATION	PART III	PART I, LINE 3: THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990 PART VI SECTION B LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED.
SUPPLEMENTAL INFORMATION	PART III	PART II: COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION.

Schedule J (Form 990) 2011

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- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990. SchKMediumBullet

See separate instructions.

OMB No. 1545-0047

2011

Open to Public
Inspection

Name of the organization
MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE
HOSPITAL INC

Employer identification number
39-0813418

Part I

Bond Issues

(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	(g) Defeased		(h) On Behalf of Issuer		(i) Pool financing
(a) Issuer Name		(b) Issuer EIN	(c) CUSIP #	(d) Date Issued	(e) Issue Price	(f) Description of Purpose	Yes	No	Yes	No	Yes	No
A	WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY	39-1337855	97670GAA7	04-10-2008	90,000,000	TO FINANCE THE ACQUISITION & CONSTRUCTION OF HEALTH CARE FACILITIES		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . .
2 Amount of bonds legally defeased . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . .	92,530,169
4 Gross proceeds in reserve funds . . . . . . . .
5 Capitalized interest from proceeds . . . . . . . . . .	7,644,961
6 Proceeds in refunding escrows . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . .	1,003,911
8 Credit enhancement from proceeds . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . .	83,881,297
11 Other spent proceeds . . . . . . . . . . .
12 Other unspent proceeds . . . . . . . . . . .
13 Year of substantial completion . . . . . . . . . . .	2010
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . .		X
15 Were the bonds issued as part of an advance refunding issue? . . . .		X
16 Has the final allocation of proceeds been made? . . . . . .	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . .	X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X

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

Cat. No. 50193E

Schedule K (Form 990) 2011

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . .	X
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . .	X
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0.00000%		%		%		%
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0%		%		%		%
6 Total of lines 4 and 5 . . .. . . . . . . . .	0%		%		%		%
7 Does the bond issue meet the private security or payment test? . . .	X
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?	X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .		X
2 Is the bond issue a variable rate issue?		X
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider . . . . . . . .
c Term of hedge . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was a hedge terminated? . . . . .
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .		X
b Name of provider . . . . . .
c Term of GIC . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .		X
6 Did the bond issue qualify for an exception to rebate? .		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X

Schedule K (Form 990) 2011

Page 3

Part V

Procedures To Undertake Corrective Action

Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . . YesNo

Part VI

Supplemental Information

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

Identifier	Return Reference	Explanation
		PART II, LINE 3: THE DIFFERENCE BETWEEN THE ISSUE PRICE REPORTED IN PART I AND THE TOTAL PROCEEDS OF ISSUE REPORTED IN PART II IS INVESTMENT EARNINGS.

Schedule K (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 - EAU CLAIRE
HOSPITAL INC

Employer identification number

39-0813418

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) MAYO COLLABORATIVE SERVICES INC	BUSINESS RELATIONSHIP - BOARD OVERLAP	522,154	LAB SERVICES		No
(2) MCHS - PHARMACY & HOME MEDICAL	BUSINESS RELATIONSHIP - BOARD OVERLAP	12,903,457	RENTAL OF PROPERTY, PAYROLL TRANSACTIONS & SUPPLY PURCHASES		No
(3) MMSI INC	BUSINESS RELATIONSHIP - BOARD OVERLAP	15,672,885	CLAIMS PROCESSING SERVICES & PAYMENTS FOR MEDICAL SERVICES		No
(4) KESSEA REITZNER	FAMILY MEMBER OF LINDA FRANK, KEY EMPLOYEE	41,134	EMPLOYMENT		No
(5) PATRICIA POPE	FAMILY MEMBER OF DENNIS POPE, KEY EMPLOYEE	123,011	EMPLOYMENT		No
(6) JANEL WITTROCK	FAMILY MEMBER OF EDWARD WITTROCK, KEY EMPLOYEE	56,678	EMPLOYMENT		No

Part V

Supplemental Information

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

Identifier	Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2011

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

NonCash Contributions

Complete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.

OMB No. 1545-0047

2011

Open to Public Inspection

Name of the organization

MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE
HOSPITAL INC

Employer identification number

39-0813418

Part I

Types of Property

	(a) Check if applicable	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......	X	52,791	FAIR MARKET VALUE
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it

must hold for at least three years from the date of the initial contribution, and which is not required to be used

for exempt purposes for the entire holding period? ..................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ............................

32a

Yes

If "Yes," describe in Part II.

If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) 2011

Page 2

Part II

Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33 and whether the organization is reporting in Part I, column (b) the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
THIRD PARTY USE:	PART I, LINE 32B:	AS AN AFFILIATE OF MAYO CLINIC, THE FILING ORGANIZATION MAY USE MAYO CLINIC'S DEVELOPMENT OFFICE TO SOLICIT, PROCESS OR SELL NON-CASH GIFTS. IN ADDITION, THE FILING ORGANIZATION MAY USE A THIRD-PARTY INVESTMENT BROKER TO SELL STOCK GIFTS RECEIVED.

Schedule M (Form 990) 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 - EAU CLAIRE
HOSPITAL INC

Employer identification number

39-0813418

Identifier	Return Reference	Explanation
	FORM 990, PART VI, SECTION A, LINE 2	DUE TO OVERLAP OF BOARD MEMBERSHIP AND EMPLOYMENT ON RELATED EXEMPT ENTITIES, THE FOLLOWING INDIVIDUALS: PAUL M. BAMMEL DANIEL CLUMPNER JOHN M. DICKEY THOMAS LARSON RANDALL L. LINTON M.D. RICK OLSON DUANE PEDERSON BETTE WAHL HAVE A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS: PAUL M. BAMMELL JOHN M. DICKEY RICHARD J. HORECKI M.D. RUTH A. KILNESS RANDALL L. LINTON M.D. DUE TO OVERLAP OF BOARD MEMBERSHIP AND EMPLOYMENT ON RELATED EXEMPT ENTITIES, THE FOLLOWING INDIVIDUALS: JEFFREY W. BOLTON ROBERT E. NESSE M.D. HAVE A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL: JEFFREY W. BOLTON DUE TO OVERLAP OF BOARD MEMBERSHIP AND EMPLOYMENT ON RELATED EXEMPT ENTITIES, THE FOLLOWING INDIVIDUALS: JEFFREY W. BOLTON JEFFREY O. KORSMO ROBERT E. NESSE M.D. STEPHEN J. SWENSEN M.D. HAVE A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS: JEFFREY O. KORSMO ROBERT E. NESSE M.D. STEPHEN J. SWENSEN M.D. DUE TO OVERLAP OF BOARD MEMBERSHIP AND EMPLOYMENT ON RELATED EXEMPT ENTITIES, THE FOLLOWING INDIVIDUALS: RANDALL L. LINTON M.D. ROBERT E. NESSE M.D. HENRY J. SIMPSON M.D. HAVE A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUAL: HENRY J. SIMPSON M.D. DUE TO OVERLAP OF BOARD MEMBERSHIP AND EMPLOYMENT ON RELATED TAXABLE ENTITIES, THE FOLLOWING INDIVIDUALS: JEFFREY W. BOLTON ROBERT E. NESSE M.D. HAVE A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS: JEFFREY W. BOLTON ROBERT E. NESSE M.D. DUE TO OVERLAP OF BOARD MEMBERSHIP AND EMPLOYMENT ON RELATED TAXABLE ENTITIES, THE FOLLOWING INDIVIDUALS: THOMAS LARSON RANDALL L. LINTON M.D. EDWARD A. WITTROCK HAVE A BUSINESS RELATIONSHIP WITH THE FOLLOWING INDIVIDUALS: THOMAS LARSON RANDALL L. LINTON M.D. EDWARD A. WITTROCK
	FORM 990, PART VI, SECTION A, LINE 3	THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO-AFFILIATED ENTITIES ROUTINELY DELEGATED VARIOUS MANAGEMENT AND SUPPORT FUNCTIONS TO RELATED ENTITIES.
	FORM 990, PART VI, SECTION A, LINE 4	THE FILING ORGANIZATION CHANGED ITS GOVERNING DOCUMENTS IN 2011 TO REFLECT A NAME CHANGE. THIS NAME CHANGE WAS PREVIOUSLY COMMUNICATED TO AND APPROVED BY THE IRS DURING THE TAX YEAR.
	FORM 990, PART VI, SECTION A, LINE 6	THE SOLE CORPORATE MEMBER OF THE FILING ORGANIZATION IS MAYO CLINIC.
	FORM 990, PART VI, SECTION A, LINE 7A	THE SOLE CORPORATE MEMBER ELECTS OR APPROVES ALL MEMBERS OF THE GOVERNING BODY OF THE FILING ORGANIZATION. A NOMINATING COMMITTEE NOMINATES A SLATE OF COMMUNITY MEMBERS.
	FORM 990, PART VI, SECTION A, LINE 7B	THE ARTICLES AND BYLAWS PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS CAPITAL BUDGET, DEBT, AMENDMENT OF THE ARTICLES OR BYLAWS, AND GENERAL OPERATION DECISIONS.
	FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 FOR THE FILING ORGANIZATION IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA U.S. MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. HIGHLIGHTS ARE PRESENTED TO BOARD MEMBERS, AND THE REVIEW IS DOCUMENTED IN MEETING MINUTES. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990.
	FORM 990, PART VI, SECTION B, LINE 12C	THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. 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 THE 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, LINES 15A & 15B: THE FILING ORGANIZATION'S CEO, ALONG WITH WITH OTHER TOP MANAGEMENT OFFICIALS, ARE PAID BY MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE CLINIC (A RELATED OUTPATIENT CLINIC EXEMPT UNDER SECTION 501(C)(3) OF THE CODE). THE INTERNAL PROCESS USED AT THE LOCAL LEVEL FOR DETERMINING COMPENSATION FOR THE FILING ORGANIZATION'S CEO AND OTHER TOP MANAGEMENT OFFICIALS INCLUDED REVIEW OF COMPARABILITY DATA FOR SIMILAR SIZED ORGANIZATIONS BY AN INDEPENDENT COMMITTEE OF THE BOARD (PUBLIC MEMBERS ONLY). SALARIES FOR THE PAST YEAR AND RANGES FOR THE NEXT YEAR WERE REVIEWED FOR REASONABLENESS. CONTEMPORANEOUS MEETING MINUTES OF THE COMPENSATION COMMITTEE ARE KEPT ON FILE. THE FILING ORGANIZATION IS ALSO 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 FILING ORGANIZATION'S CEO, CAO, AND BOARD VICE CHAIR WERE REVIEWED BY THE MAYO CLINIC HEALTH SYSTEM COMPENSATION AND BENEFITS COMMITTEE PURSUANT TO THE PROCESS DESCRIBED BELOW FOR MAYO CLINIC HEALTH SYSTEM PHYSICIANS AND ADMINISTRATORS. 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.
	FORM 990, PART VI, SECTION C, LINE 19	THE FILING ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. THE FILING ORGANIZATION IS A HOSPITAL AFFILIATED WITH MAYO CLINIC. AS SUCH, MAYO CLINIC'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FILING ORGANIZATION'S FORM 990 AND WOULD BE AVAILABLE UPON REQUEST OF THE FORM 990.
		FORM 990, PART VII, SECTION A, AVERAGE HOURS PER WEEK DEVOTED TO POSITION WITH RELATED ORGANIZATIONS: PAUL BAMMEL - 25 HOURS JOHN DICKEY - 25 HOURS RICHARD HORECKI, M.D. - 50 HOURS JEFFREY BOLTON - 40 HOURS RUTH KILNESS - 40 HOURS JEFFREY KORSMO - 40 HOURS RANDALL LINTON, M.D. - 25 HOURS HENRY SIMPSON, M.D. - 40 HOURS STEPHEN SWENSEN, M.D. - 40 HOURS
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED LOSSES ON INVESTMENTS: -1,130,384. UNCOLLECTIBLE PLEDGE -1,494,207. FAS 158 PENSION ADJUSTMENT -15,454,255. TOTAL TO FORM 990, PART XI, LINE 5: -18,078,846.

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 - EAU CLAIRE
HOSPITAL INC

Employer identification number

39-0813418

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 MU	HEALTHCARE MANAGEMENT	MU	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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

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) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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) . . . . . . . . . . . . . . . . . . . . .

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

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

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 COLLABORATIVE SERVICES INC	L	522,154	GAAP
(2) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH	G	98,665,139	GAAP
(3) MMSI INC	L	377,421	GAAP
(4) GOLD CROSS AMBULANCE INC	L	240,000	GAAP
(5) MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC	O	5,523,543	GAAP
(6) MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC	N	5,170,979	GAAP
(7) MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC	L	425,017	GAAP
(8) MAYO CLINIC HEALTH SYSTEM--NORTHLAND INC	N	134,197	GAAP
(9) MAYO CLINIC HEALTH SYSTEM--OAKRIDGE INC	N	101,672	GAAP
(10) MAYO CLINIC HEALTH SYSTEM--OAKRIDGE INC	B	3,000,000	GAAP
(11) MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC	N	278,144	GAAP
(12) MAYO CLINIC HEALTH SYSTEM--PHARMACY & HOME MEDICAL INC	N	56,156	GAAP
(13) MAYO CLINIC HEALTH SYSTEM--PHARMACY & HOME MEDICAL INC	G	104,566	GAAP
(14) MAYO CLINIC HEALTH SYSTEM--HOME HEALTH & HOSPICE INC	B	1,502,000	GAAP
(15) MAYO CLINIC HEALTH SYSTEM--SUPPORTIVE HOME CARE INC	B	500,000	GAAP
(16) MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC	H	160,994	GAAP
(17) MMSI INC	R	15,295,465	GAAP
(18) MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC	R	764,587	GAAP
(19) MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC	K	3,254,234	GAAP
(20) MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC	N	5,871,816	GAAP
(21) MAYO CLINIC HEALTH SYSTEM--EAU CLAIRE CLINIC INC	A	3,100,916	GAAP
(22) MAYO CLINIC HEALTH SYSTEM--NORTHLAND INC	K	1,052,943	GAAP
(23) MAYO CLINIC HEALTH SYSTEM--NORTHLAND INC	N	293,790	GAAP
(24) MAYO CLINIC HEALTH SYSTEM--HOME HEALTH & HOSPICE INC	N	114,200	GAAP
(25) MAYO CLINIC HEALTH SYSTEM--OAKRIDGE INC	K	535,445	GAAP
(26) MAYO CLINIC HEALTH SYSTEM--OAKRIDGE INC	N	167,182	GAAP
(27) MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC	K	1,269,919	GAAP
(28) MAYO CLINIC HEALTH SYSTEM--CHIPPEWA VALLEY INC	N	451,495	GAAP
(29) MAYO CLINIC HEALTH SYSTEM--RED CEDAR INC	K	985,808	GAAP
(30) MAYO CLINIC HEALTH SYSTEM--RED CEDAR INC	A	79,107	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: