Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 01-01-2014 , and ending 12-31-2014
BCheck if applicable:
CName of organization
PARK NICOLLET GROUP RETURN
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
6500 EXCELSIOR BLVD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
ST LOUIS PARK, MN55426
D Employer identification number

45-5023260
E Telephone number

G Gross receipts $ 1,651,417,053
F Name and address of principal officer:
CATHERINE LENAGH
6500 EXCELSIOR BLVD
ST LOUIS PARK,MN55426
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.PARKNICOLLET.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet5874
K Form of organization:
 
L Year of formation:  
M State of legal domicile: MN
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 19
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 15
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 1,327
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 3,722,228
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 13,492,826 13,935,944
9 Program service revenue (Part VIII, line 2g) ......... 1,220,725,539 1,265,600,379
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 25,398,507 29,858,118
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 6,862,518 6,657,544
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,266,479,390 1,316,051,985
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 422,828 312,601
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) 762,686,851 777,493,934
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet322,763    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 456,893,137 465,186,098
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,220,002,816 1,242,992,633
19 Revenue less expenses. Subtract line 18 from line 12....... 46,476,574 73,059,352
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,014,855,016 1,113,263,061
21 Total liabilities (Part X, line 26)............. 442,737,764 473,917,504
22 Net assets or fund balances. Subtract line 21 from line 20..... 572,117,252 639,345,557
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations 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 $ 1,005,519,749 including grants of $ 312,601 ) (Revenue $ 1,164,507,406 )
IN 2014, PARK NICOLLET HEALTH SERVICES AND AFFILIATES, A NATIONAL HEALTH CARE IMPROVEMENT LEADER, CONTINUED TO MAKE DRAMATIC PATIENT CARE ADVANCES, WIN PROMINENT AWARDS, EXPAND ACCESS TO SERVICES AND INTEGRATE EFFICIENCY INTO PARK NICOLLET HEALTH SERVICES' OPERATIONS. PARK NICOLLET HEALTH SERVICES AND AFFILIATES ALSO HAVE ENHANCED COMMUNITY HEALTH, INCREASED TEAM MEMBER SATISFACTION AND PROMOTED RESEARCH AND EDUCATION. PARK NICOLLET SPECIALTY CENTERS INCLUDE: ALEXANDER CENTER - THE LARGEST CLINIC IN MINNESOTA SERVING THE DEVELOPMENTAL AND BEHAVIORAL NEEDS OF CHILDREN AND THEIR FAMILIES. BARIATRIC SURGERY CENTER - A BARIATRIC CENTER OF EXCELLENCE THAT HAS PERFORMED MORE THAN 2,000 SURGERIES IN THE PAST FIVE YEARS. EMERGENCY CENTER - OPERATING OUT OF METHODIST HOSPITAL AND TREATING MEDICAL EMERGENCIES FOR MORE THAN 50,000 PATIENTS A YEAR. FAMILY BIRTH CENTER - FROM EXPERT CARE TEAMS TO LABOR, DELIVERY AND RECOVERY SUITES TO OUR SPECIAL CARE NURSERY, WE DELIVER AN EXCEPTIONAL EXPERIENCE FOR MOM AND BABY. FRAUENSHUH CANCER CENTER - MORE THAN 2,000 CANCER CASES PER YEAR ARE DIAGNOSED AT PARK NICOLLET. CANCER SERVICES INCLUDE MEDICAL ONCOLOGY, RADIATION ONCOLOGY, ONCOLOGY PSYCHIATRY AND PSYCHOTHERAPY, INTEGRATIVE THERAPIES, MUSIC THERAPY AND MORE. HEART AND VASCULAR CENTER - APPROXIMATELY 12,000 PATIENTS A YEAR USE THE CARDIAC REHAB DEPARTMENT, CARDIOLOGY CLINIC, INTERVENTIONAL CARDIOLOGY, HEART FAILURE CLINIC, SECONDARY PREVENTION CLINIC, CARDIOVASCULAR RESEARCH PROGRAM, INTERVENTIONAL RADIOLOGY, ELECTROPHYSIOLOGY, NEURO RADIOLOGY AND A NON-INVASIVE LAB. JANE BRATTAIN BREAST CENTER - SPECIALIZING IN BREAST IMAGING, ANNUAL SCREENING MAMMOGRAMS, BIOPSIES AND SURGERY. JOINT REPLACEMENT INSTITUTE - PROVIDING KNEE, HIP AND OTHER JOINT REPLACEMENTS FOR THOSE STRUGGLING WITH SEVERE PAIN. MORE THAN 1,000 JOINT REPLACEMENTS ARE PERFORMED ANNUALLY. MELROSE CENTER - HELPING PATIENTS WITH EATING DISORDERS FOR MORE THAN 25 YEARS. OUR MULTIDISCIPLINARY APPROACH INCLUDES MEDICAL, NUTRITIONAL, PSYCHOLOGICAL AND BEHAVIORAL CARE. STRUTHERS PARKINSON'S CENTER - SERVING PATIENTS WITH PARKINSON'S DISEASE THROUGH COMPREHENSIVE ASSESSMENT, INTERDISCIPLINARY TREATMENT, SUPPORT, RESEARCH AND EDUCATION. PARK NICOLLET HEALTH SERVICES MISSION IS TO TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. WE USE FOUR CORE VALUES TO ACCOMPLISH OUR MISSION: EXCELLENCE, COMPASSION, PARTNERSHIP AND INTEGRITY. HIGHLIGHTS OF 2014 THAT ILLUSTRATE PARK NICOLLET HEALTH SERVICE'S VALUES INCLUDE: OUTPATIENT REGIONAL CENTER- PARK NICOLLET BROKE GROUND ON A NEW OUTPATIENTREGIONAL CENTER IN MAPLE GROVE IN JULY. THE $48 MILLION PROJECT WILL BRING A WIDE VARIETY OF SERVICES TO THE NORTHWEST METRO, INCLUDING PRIMARY CARE, SPECIALTY CARE AND AMBULATORY SURGICAL SERVICES. WOMEN'S CENTER OPENS - PARK NICOLLET WOMEN'S CENTER IS A NEW CONCEPT IN WOMEN'S HEALTH THAT DELIVERS CARE, COMFORT AND CONVENIENCE TO THE WOMEN IN OUR COMMUNITY BY BRINGING MORE OF THE SERVICES WOMEN USE INTO A SINGLE LOCATION. DESIGNED FOR WOMEN'S BUSY LIVES, THE CENTER OFFERS MORE THAN 15 PREVENTIVE AND SPECIALTY CARE SERVICES UNDER ONE ROOF. FAMILY BIRTH CENTER OPENS - FROM EXPERT CARE TEAMS TO LABOR, DELIVERY AND RECOVERY SUITES TO OUR SPECIAL CARE NURSERY, WE DELIVER AN EXCEPTIONAL EXPERIENCE FOR MOM AND BABY. MELROSE CENTER OPENS IN ST. PAUL - THE NEW LOCATION IN ST. PAUL BRINGS SPECIALIZED EATING DISORDERS CARE TO THE EAST METRO COMMUNITY, WHERE MANY OF OUR PATIENTS RESIDE. LEADER IN LGBT - THE HUMAN RIGHTS CAMPAIGN RECOGNIZED PARK NICOLLET METHODIST HOSPITAL AS A LEADER IN LGBT HEALTHCARE EQUALITY IN THE HEALTHCARE EQUALITY INDEX 2014 REPORT. WE EARNED TOP MARKS FOR OUR COMMITMENT TO EQUITABLE, INCLUSIVE CARE FOR LGBT PATIENTS AND THEIR FAMILIES. YOUTH SERVED - FOUR SCHOOL-BASED HEALTH CENTERS PROVIDED OVER 2,300 FREE MEDICAL VISITS FOR UNINSURED AND UNDERINSURED YOUTH. SERVICES INCLUDED TREATMENT OF MINOR, ACUTE ILLNESSES; PHYSICALS; IMMUNIZATIONS; MENTAL HEALTH THERAPY; DENTAL CARE; AND VISION CHECKS. HEALTH CARE HOME CERTIFICATION - ALL 20 PARK NICOLLET CLINIC LOCATIONS RECEIVED HEALTH CARE HOME CERTIFICATION IN NOVEMBER. EMERGENCY CENTER - OPERATING OUT OF METHODIST HOSPITAL AND TREATING MEDICAL EMERGENCIES FOR MORE THAN 50,000 PATIENTS A YEAR.
4b (Code:   ) (Expenses $ 28,218,169 including grants of $   ) (Revenue $ 59,021,241 )
PARK NICOLLET HEALTH CARE PRODUCTS IS PART OF PARK NICOLLET HEALTH SERVICES, A NONPROFIT INTEGRATED CARE DELIVERY SYSTEM, STAFFED BY NATIONALLY RECOGNIZED HOSPITAL AND CLINIC DOCTORS, CLINICAL PROFESSIONALS, NURSES, RESEARCHERS AND OTHER STAFF AT PARK NICOLLET METHODIST HOSPITAL AND PARK NICOLLET CLINIC WHO HELP PATIENTS STAY HEALTHY AND TAKE CARE OF PATIENTS WHEN THEY ARE SICK. PARK NICOLLET HEALTH CARE PRODUCTS IS A SUPPORTING ORGANIZATION WITHIN PARK NICOLLET METHODIST HOSPITAL AND PARK NICOLLET CLINIC, PROVIDING DURABLE MEDICAL EQUIPMENT (DME)/SUPPLIES AND PHARMACEUTICALS SUPPORTING ONGOING PATIENT CARE. PARK NICOLLET HEALTH CARE PRODUCTS FOCUS ON THE HEALTH, HEALING AND LEARNING OF PATIENTS BY PROVIDING EASY ACCESS TO PRODUCTS AND SERVICES THAT SUPPORT SUCCESSFUL SELF-MANAGEMENT OF A HEALTH CONDITION AT HOME. THE PRODUCTS SUPPORT BOTH SHORT TERM ACUTE CONDITIONS AND CHRONIC LIFELONG CONDITIONS, SUCH AS EYEWEAR, HEARING AIDS, CPAP MACHINES AND MANY PRODUCTS THAT CROSS INTO ALMOST EVERY MEDICAL SUBSPECIALTY.PARK NICOLLET HEALTH CARE PRODUCTS, BRANDED AS THE STORES @ PARK NICOLLET, IS A GROUP OF DEPARTMENTS WITHIN PARK NICOLLET HEALTH SERVICES PROVIDING DURABLE MEDICAL EQUIPMENT (DME)/SUPPLIES SUPPORTING ONGOING PATIENT CARE. HCP PARTNERS WITH YOUR CLINICIAN TO PROVIDE PRODUCTS AND SERVICES TO HELP YOU LIVE MORE COMFORTABLY.THE HEALTH AND CARE STORES, WHICH MEET A GROWING DEMAND FOR SELF-CARE PRODUCTS AND SERVICES, LOCATED WITHIN PARK NICOLLET CLINICS, INCLUDE: HEALTH & CARE STORE OFFERING DME PRODUCTS AT 5 LOCATIONS, HEARING CENTER & STORE WITH 3 LOCATIONS, CPAP CLINIC/STORE WITH 3 LOCATIONS AND BREASTFEEDING CENTER, (1 LOCATION WITHIN THE MEADOWBROOK HEALTH & CARE STORE), ORTHOTICS & PROSTHETICS CLINIC, (2 LOCATION), THE CONTACT LENS AND OPTICAL STORE @ PARK NICOLLET HEALTH CARE PRODUCTS, WHICH MEET GROWING DEMAND FOR SELF-CARE EYEWARE AND SERVICES, ARE AT THESE PARK NICOLLET CLINIC SITES: BLOOMINGTON, BROOKDALE, BURNSVILLE, CARLSON PARKWAY (MINNETONKA), CHANHASSEN, MAPLE GROVE, MINNEAPOLIS, SHAKOPEE, AND ST. LOUIS PARK. WE ALSO PRODUCE OUR OWN EYE WARE IN HCP'S OPTICAL LAB.THE PHARMACY @ PARK NICOLLET MEETS GROWING DEMAND FOR SELF-CARE PRODUCTS AND SERVICES. THE PHARMACIES ARE AT THESE PARK NICOLLET CLINIC LOCATIONS: BLOOMINGTON, BROOKDALE, BURNSVILLE, CARLSON PARKWAY (MINNETONKA), CHANHASSEN, EAGAN, MAPLE GROVE, MINNEAPOLIS, ST. LOUIS PARK, TRIA, AND WAYZATA AS WELL AS HEART AND VASCULAR CENTER AND MEADOWBROOK AT THE PARK NICOLLET METHODIST HOSPITAL.THE PATIENT CARE EXPERIENCE DOES NOT END AT THE HOSPITAL OR CLINIC DOOR. PATIENTS HAVE MANY SELF-CARE NEEDS TO MANAGE BOTH THEIR ACUTE AND CHRONIC HEALTH CONDITIONS, AND PARK NICOLLET HEALTH CARE PRODUCTS IS EXPANDING ITS CAPACITY TO BETTER SERVE THESE GROWING NEEDS. MAJOR ACCOMPLISHMENTS FOR 2014 INCLUDE: ENHANCED PRODUCT ASSORTMENTS AVAILABLE FOR PATIENTS ESPECIALLY PATIENTS LIVING WITH CHRONIC HEALTH CONDITIONS SUCH AS DIABETES, CANCER, AND BONE AND JOINT DISEASE. NEW AND ROBUST DME POINT OF SALE, FINANCIAL REPORTING, INVENTORY, AND BILLING SYSTEM FOR BETTER PATIENT SERVICE AND EASE OF OBTAINING THEIR PRESCRIPTIONS EDUCATED PHYSICIANS AND CARE PROVIDER'S ABOUT SERVICES AND PRODUCTS TO BETTER LINK SOLUTIONS FOR PATIENT HEALTH CARE NEEDS, INCLUDING ANNUAL STAFF SKILLS REVIEW FOR DME APPLICATIONS. DEVELOPED STANDARDIZED PROVIDER REFERRALS TO ASSURE THAT PATIENTS HAVE THE PRODUCTS NEEDED AS THEY GO HOME FROM CLINIC OR HOSPITAL. UPDATED E-COMMERCE WEB SITE FOR DME, TO MAKE IT EASIER FOR PROVIDERS AND PATIENTS TO LOCATE AND PURCHASE HEALTH CARE PRODUCTS. ENHANCED OPTICAL PRODUCT ASSORTMENTS AVAILABLE FOR PATIENTS, ESPECIALLY PATIENTS LIVING WITH CHRONIC HEALTH CONDITIONS AFFECTING THEIR VISION. ENHANCED OPTICAL BENEFIT PROGRAM OFFERED TO PN EMPLOYEES TO INCREASE THE AFFORDABILITY OF EYEWEAR. EDUCATED PHYSICIANS AND CARE PROVIDER'S ABOUT HEALTH CARE STORES PRODUCT OFFERINGS TO BETTER LINK PATIENT HEALTH CARE NEEDS TO PRODUCT SOLUTIONS, INCLUDING SMOKING CESSATION. EXPANDED POINT OF CARE OPERATION AND SPECIALTY STORES IN TRIA ORTHOPEDICS AND THE NEW PLYMOUTH CLINIC. ALONG WITH DME PRODUCTS OFFERED THROUGH THE TARGET STORE CLINICS, BRINGING MORE PRODUCTS DIRECTLY INTO THE CARE ENVIRONMENT TO ASSIST BOTH PROVIDERS AND PATIENTS. EXPANDED PHARMACY SERVICES OFFERED IN THE INFECTIOUS DISEASE DEPARTMENT THROUGH MEDICATION THERAPY MANAGEMENT SERVICES AND DEDICATED RETAIL PHARMACIST ASSIGNED FOR THE DEPARTMENT. IMPLEMENTED RX TAKE BACK PROGRAM DROP SITE FOR PATIENTS AT OUR PHARMACY LOCATIONS IN HENNEPIN COUNTY. IMPLEMENTED A NEW PHARMACY SOFTWARE SYSTEM, ENTERPRISERX, TO IMPROVE WORKFLOW AND EFFICIENCY IN THE PHARMACY TO BETTER SERVE OUR PATIENTS AND EMPLOYEES.
4c (Code:   ) (Expenses $ 37,434,174 including grants of $   ) (Revenue $ 38,346,471 )
PARK NICOLLET HEALTH SERVICES AFFILIATES INCURS EXPENSES ON BEHALF OF AFFILIATED TAX EXEMPT ORGANIZATIONS, PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PNMC HOLDINGS, PARK NICOLLET HEALTH CARE PRODUCTS, AND PARK NICOLLET INSTITUTE, PROVIDING RENTAL SPACE AND LAB SERVICES TO ITS AFFILIATED ORGANIZATIONS IN ORDER TO ASSURE THE EFFICIENT AND PROFESSIONAL DELIVERY OF HEALTH CARE AND OTHER SERVICES TO THE COMMUNITY AND AIDS IN THE PROVISION OF LOW COST MEDICAL SERVICE.
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet1,071,172,092
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick 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 and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I.... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
466
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
 
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
 
No
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
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 or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
19
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
15
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
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
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
MN
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletCATHERINE LENAGH

6500 EXCELSIOR BLVD
ST LOUIS PARK,MN55426 (952) 993-3108
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) THOMAS JONES MD........................................................................
DIRECTOR
55.00
.......................1.00
X           769,664 0 55,907
(2) JEFF MENDELOFF MD........................................................................
DIRECTOR
55.00
.......................1.00
X           734,774 0 62,059
(3) ERIC SCHNED MD........................................................................
DIRECTOR
55.00
.......................1.00
X           286,647 0 48,422
(4) ANN WYNIA........................................................................
DIRECTOR & CHAIR
4.40
.......................  
X           0 40,000 0
(5) DONALD LEWIS........................................................................
DIRECTOR & VICE CHAIR
4.30
.......................  
X           0 28,000 0
(6) RUTH MICKELSEN........................................................................
DIRECTOR & SECRETARY
3.80
.......................  
X           0 28,000 0
(7) JAMES MALECHA........................................................................
DIRECTOR & TREASURER
4.00
.......................  
X           0 28,000 0
(8) THOMAS R BRINSKO........................................................................
DIRECTOR
3.50
.......................  
X           0 18,750 0
(9) JUDITH S CORSON........................................................................
DIRECTOR
3.80
.......................  
X           0 28,000 0
(10) LUZ MARIA FRIAS........................................................................
DIRECTOR
2.70
.......................  
X           0 28,000 0
(11) JOHN E GHERTY........................................................................
DIRECTOR
3.20
.......................  
X           0 28,000 0
(12) SUSAN L HOYT........................................................................
DIRECTOR
3.30
.......................  
X           0 25,000 0
(13) TERESA M MORROW........................................................................
DIRECTOR
2.50
.......................  
X           0 28,000 0
(14) LAURA SCHMALTZ OBERST........................................................................
DIRECTOR
3.00
.......................  
X           0 25,000 0
(15) BRIAN H RANK MD........................................................................
DIRECTOR
1.00
.......................63.00
X   X       0 790,523 225,543
(16) GREGORY S STRONG........................................................................
DIRECTOR
3.20
.......................  
X           0 25,000 0
(17) RICHARD E STRUTHERS........................................................................
DIRECTOR
2.90
.......................  
X           0 25,000 0
Form 990 (2014)
Form 990 (2014)
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 (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) CHRISTOPHER H TASHJIAN MD FAAFP........................................................................
DIRECTOR
2.90
.......................  
X           0 28,000 0
(19) KEN L THOME........................................................................
DIRECTOR
3.50
.......................  
X           0 28,000 0
(20) DAVID ABELSON MD........................................................................
SR EXEC VP & CEO PN
55.00
.......................1.00
    X       0 1,434,423 275,831
(21) BABETTE APLAND........................................................................
VP BEHAVIORAL HEALTH AND C
60.00
.......................1.00
    X       0 416,573 126,744
(22) CURT BOEHMMD........................................................................
CMIO
55.00
.......................1.00
    X       0 295,580 42,263
(23) STEVEN CONNELLY MD........................................................................
CMO SYSTEM ALIGNMENT & INT
55.00
.......................1.00
    X       0 736,135 138,194
(24) PAUL DAMROW MD........................................................................
CHIEF SURGICAL SERVICES
55.00
.......................1.00
    X       0 624,852 125,780
(25) JULIE FLASCHENRIEM........................................................................
VP AND CIO
55.00
.......................1.00
    X       0 456,979 43,819
(26) LAURA FRAZIER........................................................................
VP SURGICAL SERVICES
55.00
.......................1.00
    X       0 305,251 85,968
(27) ROXANNA GAPSTUR PHD........................................................................
SR VP & COO METHODIST HOSP
55.00
.......................1.00
    X       0 432,969 89,251
(28) CHRISTA GETCHELL........................................................................
PRESIDENT PNF, VP COMMUNIT
55.00
.......................1.00
    X       0 257,807 58,159
(29) DAVID HOMANS MD........................................................................
CHIEF SPECIALTY SSERVICES
55.00
.......................1.00
    X       0 635,374 107,375
(30) MICHAEL KAUPA........................................................................
EXEC VP & SYSTEM ALIGNMENT
55.00
.......................1.00
    X       0 1,715,391 59,184
(31) KATE KLUGHERZ........................................................................
VP SPECIALTY SERVICES
55.00
.......................1.00
    X       0 289,574 67,977
(32) CATHERINE LENAGH........................................................................
VP & CFO
55.00
.......................1.00
    X       0 358,129 95,444
(33) BRETT LONG........................................................................
VP STRATEGY & GROWTH, HR
55.00
.......................1.00
    X       0 335,066 94,260
(34) KRISTI LYON........................................................................
VP PAYER RELATIONS
55.00
.......................1.00
    X       0 211,797 69,926
(35) JOHN MISA MD........................................................................
CHIEF PRIMARY CARE
55.00
.......................1.00
    X       0 502,397 99,555
(36) JOAN SANDSTROM........................................................................
VP PRIMARY CARE
55.00
.......................1.00
    X       0 333,185 89,108
(37) MELISSA SCHOENHERR........................................................................
VP MARKETING AND COMMUNICA
55.00
.......................1.00
    X       0 294,340 60,710
(38) CYNTHIA TOHER MD........................................................................
CHIEF IMPATIENT SERVICES
55.00
.......................1.00
    X       0 694,708 117,517
(39) DUANE SPIEGLE........................................................................
VP REAL ESTATE AND SUPPORT
55.00
.......................1.00
    X       0 295,284 92,598
(40) KATHERINE TARVESTAD........................................................................
VP AND CARE GROUP COMPLIAN
55.00
.......................1.00
    X       0 390,883 77,369
(41) THEODORE WEGLEITNER........................................................................
COO TRIA
55.00
.......................1.00
    X       0 293,122 93,731
(42) JOSHUA ZIMMERMAN........................................................................
CHIEF OF BEHAVORIAL HEALTH
55.00
.......................1.00
    X       0 381,917 78,980
(43) NANCE MCCLURE........................................................................
CHIEF OPERATING OFFICER
55.00
.......................1.00
    X       0 827,398 213,162
(44) BARBARA TRETHEWAY........................................................................
SR. VP, GENERAL COUNSEL
55.00
.......................1.00
    X       0 661,426 167,082
(45) PRAVEEN BAIMEEDI MD........................................................................
MEDICAL DOCTOR
55.00
.......................  
        X   1,303,572 0 71,423
(46) OLIVER CASS MD........................................................................
MEDICAL DOCTOR
55.00
.......................  
        X   914,722 0 65,784
(47) ANTHONY BOTTINIMD........................................................................
MEDICAL DOCTOR
55.00
.......................  
        X   851,836 0 63,475
(48) TIMOTHY DIEGELMD........................................................................
MEDICAL DOCTOR
55.00
.......................  
        X   839,037 0 46,611
(49) ASRA MOHIUDDIN MD........................................................................
MEDICAL DOCTOR
55.00
.......................  
        X   749,489 0 62,273
(50) SHELIA MCMILLAN........................................................................
VP & CFO
55.00
.......................  
          X 0 608,274 16,074
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 6,449,741 14,990,107 3,287,558
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet1,217
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
GROUP HEALTH INC

8170 33RD AVE S
MINNEAPOLIS,MN55440
ADMINSTRATIVE SERVICES 12,047,880
KNUTSON CONSTRUCTION SERVICES

7515 WAYZATA BLVD
MINNEAPOLIS,MN55426
CONSTRUCTION SERVICES 10,646,616
UNIVERSITY OF MN PHYSICIANS

720 WASHINGTON AVENUE SE
MINNEAPOLIS,MN55407
MEDICAL SERVICES 9,743,369
RJM CONSTRUCTION

5455 HWY 169
PLYMOUTH,MN55442
CONSTRUCTION SERVICES 8,197,980
RYAN COMPANIES US INC

50 SOUTH 10TH STREET
MINNEAPOLIS,MN55403
CONSTRUCTION SERVICES 6,113,721
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet145
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 3,114,242
e Government grants (contributions)1e 4,855,888
f All other contributions, gifts, grants, and
similar amounts not included above
1f
5,965,814
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 13,935,944
 Program Service RevenueAmt Business Code
2a MEDICAL SERVICES 621400 770,846,068 770,846,068    
b MEDICARE/MEDICAID 621400 393,661,338 393,661,338    
c RETAIL SALES 446110 62,746,502 59,021,241 3,722,228 3,033
d SERVICES TO AFFILIATES 561000 38,346,471 38,346,471    
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 1,265,600,379
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 8,472,348     8,472,348
4 Income from investment of tax-exempt bond proceeds..MediumBullet 284,646     284,646
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 1,822,040  
b Less: rental expenses 1,514,498  
c Rental income or (loss) 307,542  
d Net rental income or (loss).......MediumBullet 307,542     307,542
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 352,589,649 1,994,601
b Less: cost or other basis and sales expenses 333,033,923 449,203
c Gain or (loss) 19,555,726 1,545,398
d Net gain or (loss)..........MediumBullet 21,101,124     21,101,124
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a 1,181,892
b Less: cost of goods sold ..b 367,444
c Net income or (loss) from sales of inventory..MediumBullet 814,448     814,448
Miscellaneous Revenue Business Code
11a PROPERTY MANAGEMENT 812930 2,869,189     2,869,189
b CAFETERIA 722210 2,620,956     2,620,956
c MISC SERVICES 722210 45,409     45,409
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 5,535,554
12 Total revenue. See Instructions......MediumBullet 1,316,051,985 1,261,875,118 3,722,228 36,518,695
Form 990 (2014)
Form 990 (2014)
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).Check if Schedule O contains a response or note to any line 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 domestic organizations and domestic governments. See Part IV, line 21 .... 262,601 262,601
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 50,000 50,000
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............    
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees .... 1,791,085 1,621,622 169,463  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages .... 630,305,942 550,346,440 79,689,953 269,549
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 36,885,512 31,692,166 5,177,792 15,554
9 Other employee benefits ....... 70,457,643 58,949,578 11,483,196 24,869
10 Payroll taxes ........... 38,053,752 32,568,961 5,472,000 12,791
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 219,837   219,837  
c Accounting ........... 248,512   248,512  
d Lobbying ........... 78,175   78,175  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 489,649   489,649  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 55,676,466 37,153,365 18,523,101  
12 Advertising and promotion .... 3,652,937 255,201 3,397,736  
13 Office expenses ....... 15,519,297 9,376,618 6,142,679  
14 Information technology ...... 21,974,855 8,928,673 13,046,182  
15 Royalties ..        
16 Occupancy ........... 43,706,079 40,387,469 3,318,610  
17 Travel ............ 1,366,298 1,062,613 303,685  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 570,208 513,976 56,232  
20 Interest ........... 7,830,917 7,830,917    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 52,024,913 47,063,042 4,961,871  
23 Insurance .............. 122,213 36,642 85,571  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES AND EQ 163,649,928 160,547,979 3,101,949  
b COST OF GOOD SOLD 39,204,589 39,204,589    
c BAD DEBT EXPENSE 20,751,882 20,751,882    
d MN CARE TAX EXPENSE 19,355,417 19,355,417    
e All other expenses 18,743,926 3,212,341 15,531,585  
25 Total functional expenses. Add lines 1 through 24e 1,242,992,633 1,071,172,092 171,497,778 322,763
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 8,597,067 1 441,974
2 Savings and temporary cash investments ......... 403,712 2 132,432
3 Pledges and grants receivable, net ........... 4,388,795 3 2,888,077
4 Accounts receivable, net ............. 134,983,015 4 140,182,902
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5 119
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
69,279 6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 10,696,185 8 11,932,766
9 Prepaid expenses and deferred charges .......... 17,813,781 9 8,778,692
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,077,917,338
b Less: accumulated depreciation ..... 10b 730,461,995 333,193,629 10c 347,455,343
11 Investments—publicly traded securities .......... 501,577,381 11 570,712,855
12 Investments—other securities. See Part IV, line 11 ..... 493,396 12 201,021
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 2,638,776 15 30,536,880
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 1,014,855,016 16 1,113,263,061
Liabilities 17 Accounts payable and accrued expenses ......... 70,382,843 17 71,275,027
18 Grants payable .................   18  
19 Deferred revenue ................ 4,727,727 19 3,644,827
20 Tax-exempt bond liabilities ............. 361,578,782 20 351,015,048
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other 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 .. 327,899 23 0
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 5,720,513 25 47,982,602
26 Total liabilities. Add lines 17 through 25......... 442,737,764 26 473,917,504
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 571,120,208 27 638,468,291
28 Temporarily restricted net assets ........... 717,797 28 595,829
29 Permanently restricted net assets ........... 279,247 29 281,437
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 572,117,252 33 639,345,557
34 Total liabilities and net assets/fund balances ........ 1,014,855,016 34 1,113,263,061
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,316,051,985
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,242,992,633
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
73,059,352
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
572,117,252
5
Net unrealized gains (losses) on investments ...............
5
-7,223,300
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
3,706,086
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-2,313,833
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
639,345,557
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total    

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
 
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions
 
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2014
(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)
 
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)
 
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2015. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
PART 1 PARK NICOLLET METHODIST HOSPITAL LINE 3: 170(B)(1)(A)(III) PARK NICOLLET CLINIC LINE 3: 170(B)(1)(A)(III) PARK NICOLLET INSTITUTE LINE 4: 170(B)(1)(A)(III) PARK NICOLLET HEALTH CARE PRODUCTS LINE 11 TYPE II, 509(A)(3) PNMC HOLDINGS LINE 11 TYPE II, 509(A)(3)
PART I LINE 11 SUPPORTING ORGANIZATIONS DETAIL: PNMC HOLDINGS AND PARK NICOLLET HEALTH CARE PRODUCTS PROVIDE SUPPORT TO THE FOLLOWING ORGANIZATIONS: PNMC HOLDINGS: LINE 11, COLUMN (I) PARK NICOLLET CLINIC, (II) 41-0834920, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $2,199,099 LINE 11, COLUMN (I) PARK NICOLLET HEALTH SERVICES, (II) 36-3465840, (III) 509(A)(2), (IV) YES, (V) $0, (VI) $0 PARK NICOLLET HEALTH SERVICES, WHICH IS A 509(A)(2) PUBLIC CHARITY, IS THE IDENTIFIED SUPPORTED ORGANIZATION IN PNMC HOLDINGS' ARTICLES OF INCORPORATION, IS ALSO THE PARENT OF PNMC HOLDINGS AND OF PARK NICOLLET CLINIC, AMONG OTHERS. PARK NICOLLET CLINIC IS CLOSELY RELATED IN PURPOSE AND FUNCTION TO PNMC HOLDINGS AND PARK NICOLLET HEALTH SERVICES. FURTHER, THE SAME PERSONS WHO SERVE AS THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES ALSO SERVE AS THE BOARD OF DIRECTORS OF PNMC HOLDINGS, AND OF PARK NICOLLET CLINIC. AS A RESULT, IT IS WITHIN THE MISSION AND PURPOSE OF PNMC HOLDINGS AND OF ITS SUPPORTED ORGANIZATION PARK NICOLLET HEALTH SERVICES TO PROVIDE SUPPORT TO PARK NICOLLET CLINIC. PNMC HOLDINGS IS NOT REQUIRED TO SPECIFICALLY IDENTIFY PARK NICOLLET CLINIC IN PNMC HOLDINGS' ARTICLES OF ORGANIZATION IN ORDER ALSO TO INCLUDE PARK NICOLLET CLINIC AS PNMC HOLDINGS' SUPPORTED ORGANIZATION. PARK NICOLLET HEALTH CARE PRODUCTS: LINE 11, COLUMN (I) PARK NICOLLET METHODIST HOSPITAL, (II) 41-0132080, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $3,198,415 LINE 11, COLUMN (I) PARK NICOLLET CLINIC, (II) 41-0834920, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $70,026,488 LINE 11, COLUMN (I) PARK NICOLLET HEALTH SERVICES, (II) 36-3465840, (III) 509(A)(2)(IV) YES, (V) $0, (VI) $0 PARK NICOLLET HEALTH SERVICES, WHICH IS A 509(A)(2) PUBLIC CHARITY, IS THE IDENTIFIED SUPPORTED ORGANIZATION IN PARK NICOLLET HEALTH CARE PRODUCTS' ARTICLES OF INCORPORATION, IS ALSO THE PARENT OF PARK NICOLLET HEALTH CARE PRODUCTS AND OF PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL, AMONG OTHERS. PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL ARE CLOSELY RELATED IN PURPOSE AND FUNCTION TO PARK NICOLLET HEALTH CARE PRODUCTS AND PARK NICOLLET HEALTH SERVICES. FURTHER, THE SAME PERSONS WHO SERVE AS THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES ALSO SERVE AS THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH CARE PRODUCTS, OF PARK NICOLLET CLINIC AND OF PARK NICOLLET METHODIST HOSPITAL. AS A RESULT, IT IS WITHIN THE MISSION AND PURPOSE OF PARK NICOLLET HEALTH CARE PRODUCTS AND OF ITS SUPPORTED ORGANIZATION PARK NICOLLET HEALTH SERVICES TO PROVIDE SUPPORT TO PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL. PARK NICOLLET HEALTH CARE PRODUCTS IS NOT REQUIRED TO SPECIFICALLY IDENTIFY PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL IN PARK NICOLLET HEALTH CARE PRODUCTS' ARTICLES OF ORGANIZATION IN ORDER ALSO TO INCLUDE PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL AS PARK NICOLLET HEALTH CARE PRODUCTS SUPPORTED ORGANIZATIONS.
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, 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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
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


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2014

Schedule C (Form 990 or 990-EZ) 2014
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2014


Schedule C (Form 990 or 990-EZ) 2014
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
143,687
j
Total. Add lines 1c through 1i ...............................
143,687
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: PARK NICOLLET REIMBURSES GROUP HEALTH INC. A RELATED ORGANIZATION FOR LOBBYING ACTIVITIES. PARK NICOLLET ALSO REIMBURSES CERTAIN PROFESSIONAL MEMBERSHIP DUES OF EMPLOYEES. A PORTION OF SUCH MEMBERSHIP DUES ARE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2014

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
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 value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 27,216,599 21,981,337 20,854,970 22,048,592 23,127,080
b Contributions ........ 2,515,547 4,508,387 2,046,767 1,489,934 1,474,161
c Net investment earnings, gains, and losses 526,563 2,715,649 877,865 -341,465 850,097
d Grants or scholarships ..... 3,042,770 1,988,774 1,798,265 2,342,091 3,402,746
e Other expenditures for facilities
and programs ........
         
f Administrative expenses ....          
g End of year balance ...... 27,215,939 27,216,599 21,981,337 20,854,970 22,048,592
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet42.000 %
c
Temporarily restricted endowment SchDMd Bullet58.000 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   27,661,044 27,661,044
b Buildings ................   511,279,727 297,708,740 213,570,987
c Leasehold improvements ............   51,968,164 37,492,512 14,475,652
d Equipment ................   474,016,388 394,676,534 79,339,854
e Other .................   12,992,015 584,209 12,407,806
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 347,455,343
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. 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.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
CAPITAL LEASE OBILGATION 2,982,602
SUBORDINATE NOTE TO RELATED THIRD PARTY 45,000,000







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 47,982,602
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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 (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 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 XIII.) ........... 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 XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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 XIII.) ............ 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 XIII.) ............ 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 XIII
Supplemental Information
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART V, LINE 4: THE TERM ENDOWMENT FUNDS FOR USE WITHIN PARK NICOLLET CLINIC, PARK NICOLLET INSTITUTE AND PARK NICOLLET METHODIST HOSPITAL ARE FOR GRANTS RELATED TO EDUCATION, RESEARCH AND PATIENT CARE.
PART X, LINE 2: HPIC, HPSI, HPA, HPAI, HPCMC, PNE, AND DSI, (THE TAXABLE GROUP) ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. DEFERRED INCOME TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE DIFFERENCES BETWEEN THE FINANCIAL AND INCOME TAX REPORTING BASIS OF ASSETS AND LIABILITIES BASED ON ENACTED TAX RATES AND LAWS. THE DEFERRED INCOME TAX PROVISION OR BENEFIT GENERALLY REFLECTS THE NET CHANGE IN DEFERRED INCOME TAX ASSETS AND LIABILITIES DURING THE YEAR. THE CURRENT INCOME TAX PROVISION REFLECTS THE TAX CONSEQUENCES OF REVENUES AND EXPENSES CURRENTLY TAXABLE OR DEDUCTIBLE ON VARIOUS INCOME TAX RETURNS FOR THE YEAR REPORTED. PARK NICOLLET'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. PARK NICOLLET RECORDED NO LIABILITIES AT DECEMBER 31, 2014 OR 2013 FOR UNRECOGNIZED TAX BENEFITS.
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants
and other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria
used to award the grants or assistance? ...........................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region
(f) Total expenditures
for and investments
in region
EAST ASIA AND THE PACIFIC 0 0 PROGRAM SERVICES EDUCATION 10,673
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 10,673
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 10,673
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(a)(c) Region (b)(d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of non-cash
assistance
(h) Description
of non-cash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
non-cash
assistance
(g) Description
of non-cash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)............................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713; do not file with Form 990).....................................
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2014
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

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

5a

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    8,904,545 240,668 8,663,877 0.700 %
b Medicaid (from Worksheet 3,
column a) ....
    137,202,278 87,206,181 49,996,097 4.020 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
           
d Total Financial Assistance
and Means-Tested
Government Programs .
    146,106,823 87,446,849 58,659,974 4.720 %
Other Benefits
  105,160 5,692,515 703,756 4,988,759 0.400 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
    7,276,112 3,123,638 4,152,474 0.330 %
g Subsidized health services
(from Worksheet 6) ..
           
h Research (from Worksheet 7)     6,119,288 3,781,981 2,337,307 0.190 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
           
j Total. Other Benefits ..   105,160 19,087,915 7,609,375 11,478,540 0.920 %
k Total. Add lines 7d and 7j .   105,160 165,194,738 95,056,224 70,138,514 5.640 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
11,808,634
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
145,624,465
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
142,528,355
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
3,096,110
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BLVD
ST LOUIS PARK,MN55426
PARKNICOLLET.COM
X X   X     X      
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
PARK NICOLLET METHODIST HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): WWW.PARKNICOLLET.COM
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

PARK NICOLLET METHODIST HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

PARK NICOLLET METHODIST HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual 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? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
PARK NICOLLET METHODIST HOSPITAL PART V, SECTION B, LINE 5: OVER 1,100 COMMUNITY MEMBERS REPRESENTING AREA GOVERNMENT, SCHOOLS, CHURCHES, SOCIAL SERVICE AGENCIES, AND HEALTHCARE PROVIDERS WERE IDENTIFIED TO PARTICIPATE IN AN ONLINE SURVEY AND FOCUS GROUP. AN ONLINE SURVEY WAS CONDUCTED USING SURVEY MONKEY. THE SURVEY TOOL WAS DESIGNED TO GAIN INFORMATION FROM THE RESPONDENTS ABOUT THERE GEOGRAPHIC LOCATION ALONG WITH CONNECTIONS IN THE COMMUNITY. IN ADDITION TO THE ONLINE SURVEY THESE COMMUNITY PARTICIPANTS WERE ALSO OFFERED THE OPPORTUNITY TO ATTEND ONE OF SEVEN CONNUNITY-BASED FOCUS GROUPS USING THE WORLD CAFE MODEL OF FACILITATION. THESE WERE OFFERED IN SEVEN DIFFERENT LOCATIONS AND PROVIDED THE OPPORTUNITY FOR PARTICIPATNS TO ENGAGE IN DIALOGUE THAT WOULD OFFER MORE IN-DEPTH ABOUT THEIR COMMUNITIES AND THE IDENTIFIED NEEDS. TEAM MEMBERS FROM PARK NICOLLET HEALTH SERVICES WERE PRESENT TO TAKE NOTES AND SUMMARIZE REPSONSES. THE COMMUNITY HEALTH NEEDS ASSESSMENT LEADERSHIP TEAM REVIEWED THE INPUT FROM BOTH THE SURVEYS AND THE FOCUS GROUPS AND IDENTIFIED SEVEN KEY THEMES THAT CONSISTENTLY EMERGED. AN ADDITIONAL THREE AREAS OF NEED WERE IDENTIFIED; ALTHOUGH NOT CONSISTENTLY REPORTED, THEY WERE FELT TO BE IMPORTANT FOR INCLUSION IN THIS REPORT.TO BROADEN THE INFORMATION RECEIVED, MEETINGS WERE HELD WITH SMALL GROUPS OF PROFESSIONALS FOR INSIGHT GATHERING AND TARGETED TO SPECIFIC AREAS IDENTIFIED BY OUR COMMUNITY PARTICIPANTS. ADDITIONAL MEETINGS WITH SOMALI COMMUNITY HEALTH WORKERS THROUGH WELLSHARE AND RETIRED PHYSICIANS FROM METHODIST HOSPITAL WERE ALSO HELD.FOCUS GROUP PARTICIPANTS INCLUDED COMMUNITY MEMBERS FROM THE FOLLWOING ORGANIZATIONS: CHILDREN FIRST, IOCP, PNF SUCCESSFUL AGING INITATIVE, CRISIS CONNECTION, PILLSBUY HOUSE, MISSION, INC. MINNEAPOLIS CRISIS NURSERY, SHALOM HOSPICE, TEENS ALONE, WELLSHARE, PATHWAYS, SAINTS HEALTHCARE FOUNDATION, SHAKOPEE SCHOOL DISTRICT, CITY OF SHAKOPEE, PRIOR LAKE/SAVAGE SCHOOL DISSTRICT, PNHS STROKE INSPIRE, ST. MARY'S HEALTH CLINICS, CITY OF ST. LOUIS PARK, DEPOT COFFEE HOUSE, STEP, YOUTH CARE, CHILDREN'S DENTAL SERVICE, BLOOMINGTON SCHOOL DISTRICT, ALZHEIMER'S ASSOCIATION, LENOX CENTER, COMMUNITY IN COLLABORATION COUNCIL, GREATER WAYZATA AREA OF COMMERCE, COMMUNITY EDUCATION ADVISORY COUNCIL, WAYZATA SCHOOL DISTRICT,ST. DAVID'S CENTER FOR CHILD AND FAMILY DEVELOPMENT, ST. LOUIS PARK SCHOOL DISTRICT, CITY OF CHANHASSEN, RELATE COUNSELING CENTER, HOPIKINS SCHOOL DISTRICT, ICA, STORE TO DOOR, CITY OF GOLDEN VALLEY, GREATER MINNEAPOLIS COUNCIL OF CHURCHES.
PARK NICOLLET METHODIST HOSPITAL PART V, SECTION B, LINE 7D: PARK NICOLLET HEALTH SERVICES BOARD OF DIRECTOR'S APPROVED THE IMPLEMENTATION STRATEGY FOR PARK NICOLLET METHODIST HOSPITAL DURING 2012. A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY IS POSTED TO THE PARK NICOLLET WEBSITE AT HTTP://WWW.PARKNICOLLET.COM/COMMUNITYANDVOLUNTEERISM/COMMUNITY-NEEDS-HEALTH-ASSESSMENT
PARK NICOLLET METHODIST HOSPITAL PART V, SECTION B, LINE 11: SEE PART VI QUESTION 5 FOR THE DESCRIPTION ON HOW PARK NICOLLET METHODIST HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA. PARK NICOLLET METHODIST HOSPITAL DID NOT ADDRESS THE FOLLOWING NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AS THESE PROGRAMS ARE ADEQUATELY FUNDED AT THE COUNTY LEVEL THROUGH FEDERAL, STATE AND COUNTY RESOURCES: TEEN PREGANCY AND TEEN PARENTINGTEEN AND YOUNG ADULT DRUG AND ALCOHOL ABUSE SMOKING CESSATION
PARK NICOLLET METHODIST HOSPITAL PART V, SECTION B, LINE 13B: IN ACCORDANCE WITH OUR AGREEMENT WITH THE MN ATTORNEY GENERAL, UNINSURED PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME IS LESS THAN $125,000 ARE ELIGIBLE FOR A DISCOUNT ON THEIR CHARGES. THE DISCOUNT IS ESTABLISHED AT THE AVERAGE CONTRACTUAL DISCOUNT FOR PARK NICOLLET HEALTH SERVICE'S LARGEST CONTRACT PAYOR. THIS DISCOUNT IS CURRENTLY 29.2% OF GROSS CHARGES. PATIENTS WHOSE RECEIVE THIS DISCOUNT ARE ALSO ELIGIBLE FOR OUR FAP PROGRAM BASED ON FPL.PART V, SECTION B, LINE 16A HTTP://WWW.PARKNICOLLET.COM/PATIENT-ACCOUNTS-SERVICES/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 16B HTTP://WWW.PARKNICOLLET.COM/PATIENT-ACCOUNTS-SERVICES/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 16C HTTP://WWW.PARKNICOLLET.COM/PATIENT-ACCOUNTS-SERVICES/FINANCIAL-ASSISTANCE
PARK NICOLLET METHODIST HOSPITAL PART V, SECTION B, LINE 16I: FAP AND FA APPLICATION WERE INCLUDED IN THE HOSPITAL INPATIENT BOOKLETS THAT ARE IN PATIENT'S ROOMS
PARK NICOLLET METHODIST HOSPITAL PART V, SECTION B, LINE 22D: PARK NICOLLET ESTABLISHED THE DISCOUNT AT THE AVERAGE CONTRACTUAL DISCOUNT FOR PARK NICOLLET HEALTH SERVICE'S LARGEST CONTRACT PAYOR.
PARK NICOLLET METHODIST HOSPITAL PART V, SECTION B, LINE 24: PARK NICOLLET CHARGES ITS PATIENTS GROSS CHARGES IF THE PATIENT HAS ELECTIVE SURGURY, WHICH IS NOT MEDICALLY NECESSARY.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section D. 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?34
Name and address Type of Facility (describe)
1 STRUTHER'S PARKINSON CENTER
6701 COUNTRY S PARKINSON CENTER
GOLDEN VALLEY,MN55427
RESEARCH AND TREATMENT OF PARKINSON'S DISEASE
2 PARK NICOLLET MELROSE CENTER
3625 MONTEREY DRIVE
ST LOUIS PARK,MN55416
EATING DISORDER CLINIC/GENERAL MEDICAL
3 3900 CLINICAMBULATORY SURGICAL CENTER
3900 PARK NICOLLET BOULEVARD
ST LOUIS PARK,MN55416
AMBULATORY SURGICAL CENTER AND GENERAL MEDICAL AND RETAIL
4 MEADOWBROOK MEDICAL BUILDING
3931 LOUISIANA AVE S
ST LOUIS PARK,MN55426
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
5 PRAIRIE CENTER
8455 FLYING CLOUD DRIVE
EDEN PRAIRIE,MN55344
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
6 BLOOMINGTON CLINIC
5320 HYLAND GREENS DRIVE
BLOOMINGTON,MN55437
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
7 BROOKDALE CLINIC
6000 EARLE BROWN DRIVE
BROOKLYN CENTER,MN55430
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
8 BURNSVILLE CLINIC
1400 FAIRVIEW DRIVE
BURNSVILLE,MN55337
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
9 CARLSON PARKWAY CLINIC
15111 TWELVE OAKS CENTER DRIVE
MINNETONKA,MN55305
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
10 CHANHASSEN CLINIC
300 LAKE DRIVE E
CHANHASSEN,MN55317
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
11 CREEKSIDE
6600 EXCELSIOR BLVD
ST LOUIS PARK,MN55426
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
12 ST LOUIS PARK IMAGING CENTER
4951 EXCELSIOR BLVD
ST LOUIS PARK,MN55416
IMAGING CENTER/OPTICAL RETAIL
13 EAGAN CLINIC
1885 PLAZA DRIVE
EAGAN,MN55122
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
14 GOLDEN VALLEY CLINIC
8240 GOLDEN VALLEY DRIVE
GOLDEN VALLEY,MN55427
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
15 LAKEVILLE CLNIC
18432 KENRICK AVE
LAKEVILLE,MN55044
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
16 MAPLE GROVE CLNIC
15800 95TH AVE N
MAPLE GROVE,MN55369
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
17 MAPLE GROVE OB
9855 HOSPITAL DRIVE SUITE 275
MAPLE GROVE,MN55369
OB SERVICES
18 MAPLE GROVE REHAB
9827 MAPLE GROVE PKWY N
MAPLE GROVE,MN55369
REHABILIATION SERVICES
19 MINNEAPOLIS CLINIC
2001 BLAISDELL AVE S
MINNEAPOLIS,MN55404
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
20 MINNETONKA - SHOREWOOD CLINIC
19685 HIGHWAY 7
SHOREWOOD,MN55331
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
21 PLYMOUTH CLINIC
4155 COUNTY ROAD 101
PLYMOUTH,MN55446
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
22 PRIOR LAKE CLINIC
4670 PARK NICOLLET AVE SE
PRIOR LAKE,MN55372
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
23 SHAKOPEE CLINIC
1415 ST FRANCIS AVE
SHAKOPEE,MN55379
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
24 SHAKOPEE CLINIC
1515 ST FRANCIS AVE
SHAKOPEE,MN55379
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
25 SHAKOPEE CLINIC
1601 ST FRANCIS AVE
SHAKOPEE,MN55379
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
26 ST LOUIS PARK CLINIC
3800 PARK NICOLLET BLVD
ST LOUIS PARK,MN55416
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
27 ST LOUIS PARK CLINIC
3850 PARK NICOLLET BLVD
ST LOUIS PARK,MN55416
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
28 WAYZATA MEDICAL BUILDING
250 CENTRAL AVE N
WAYZATA,MN55391
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
29 ROGERS CLINIC
13688 ROGERS DRIVE
ROGERS,MN55374
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES
30 CHAMPLIN CLINIC
12142 BUSINESS PARK BLVD N
CHAMPLIN,MN55316
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES
31 BURNSVILLE PEDIATRIC REHAB SERVICES
RIDGEPOINT MEDICAL BUILDING
BURNSVILLE,MN55337
PEDIATRIC REHAB SERVICES
32 MAPLE GROVE SPECIALITY CENTER
9325 UPLAND LANE N
MAPLE GROVE,MN55369
PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES
33 MELROSE CENTER ST PAUL
2550 UNIVERSITY AVE W
ST PAUL,MN55114
EATING DISORDER CLINIC/GENERAL MEDICAL
34 MELROSE CENTER MAPLE GROVE
9600 UPLAND LANE N SUITE 110
MAPLE GROVE,MN55369
EATING DISORDER CLINIC/GENERAL MEDICAL
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
PART I, LINE 3C: IN ACCORDANCE WITH OUR AGREEMENT WITH THE MN ATTORNEY GENERAL, UNINSURED PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME IS LESS THAN $125,000 ARE ELIGIBLE FOR A DISCOUNT ON THEIR CHARGES. THE DISCOUNT IS ESTABLISHED AT THE AVERAGE CONTRACTUAL DISCOUNT FOR PARK NICOLLET HEALTH SERVICE'S LARGEST CONTRACT PAYOR. THIS DISCOUNT IS CURRENTLY 29.2% OF GROSS CHARGES. PATIENTS WHOSE RECEIVE THIS DISCOUNT ARE ALSO ELIGIBLE FOR OUR FAP PROGRAM BASED ON FPL.
PART I, LINE 6A: PARK NICOLLET FOUNDATION A RELATED ORGANIZATION OF PARK NICOLLET METHODIST HOPSITAL COMPLETES AN ORGANIZATION WIDE ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES PARK NICOLLET METHODIST HOSPITAL AND OTHER AFFILIATED ENTITIES.
PART I, LINE 7: PARK NICOLLET METHODIST HOSPITAL USES THE COST-TO-CHARGE RATIO METHOD WHEN CALCULATING THE AMOUNTS REPORTED ON PART I. LINE 7. THE COST-TO-CHARGE RATIO WAS DERIVED USING WORKSHEET 2, RATIO OF PATIENT CARE-COST-TO-CHARGE, FROM THE SCHEDULE H INSTRUCTIONS.
PART III, LINE 2: BAD DEBT IS ACCOUNTED FOR ON THE FINANCIAL STATEMENTS BY ESTIMATING PATIENT LIABILITY NET OF ANY CHARITY CARE AND THEN CALUCULATING WHAT PORTION OF THAT WILL NOT BE COLLECTED BASED HISTORICAL UNCOLLECTABLE RATES. WHEN A PATIENT MEETS OUR FINICIAL REQUIREMENTS IT IS CLASSIFIED AS CHARITY CARE; IF THEY DO NOT QUALIFY, THEIR SERVICES WILL BE WRITTEN OFF AS BAD DEBT. PARK NICOLLET METHODIST HOSPITAL DOES NOT INCLUDE ANY CHARITY CARE IN THEIR BAD DEBT EXPENSE CALCULATION.
PART III, LINE 3: PARK NICOLLET METHODIST HOSPITAL AND ITS AFFILIATES WORK WITH THOSE QUALIFYING FOR CHARITY CARE ALONG EVERY STEP OF THE PROCESS INCLUDING ACCEPTING APPLICATIONS FOR FINANCIAL ASSISTANCE AFTER PREVIOUS ATTEMPTS TO WORK WITH THE PATIENT FAIL. EVERY EFFORT IS MADE TO WORK WITH THE PATIENT TO PROVIDE FINANCIAL ASSISTANCE WHEN APPROPRIATE. WHILE THERE ARE PEOPLE WHO DO NOT COOPERATE WITH THE HOSPITAL REGARDING PAYMENT PLANS, FINANCIAL ASSISTANCE OR WITH THOSE TRYING TO HELP THEM GET ON GOVERNMENT PROGRAMS, IT IS IMPOSSIBLE TO KNOW THEIR REASON FOR NOT COOPERATING AND THEREFORE KNOW WHETHER THEY MAY HAVE QUALIFIED FOR CHARITY CARE. PARK NICOLLET DOESN'T HAVE PREDICTIVE SOFTWARE WHICH WOULD MAKE ASSUMPTIONS BASED ON HOUSING SITUATION, CREDIT REPORTS, ETC. AND RECOMMEND ASSISTANCE WITHOUT A PROCESS FOR GATHERING INCOME VERIFICATION. IN LIGHT OF THE FOREGOING FACTS, PARK NICOLLET IS UNABLE TO REASONABLY DETERMINE WHETHER ANY AMOUNT OF BAD DEBT COULD HAVE BEEN CLASSIFIED AS CHARITY CARE.
PART III, LINE 4: PARK NICOLLET METHODIST HOSPITAL'S AUDITED FINANCIAL STATEMENTS INCLUDE A FOOTNOTE DISCUSSING BAD DEBT EXPENSE, AR ALLOWANCE OF DOUBTFUL ACCOUNTS. THE FOOTNOTE IS LOCATED ON PAGE 23 OF THE ATTACHED AUDIT REPORT.
PART III, LINE 8: PARK NICOLLET METHODIST HOSPITAL BELIEVES THAT ALL OF THE MEDICARE LOSS SHOULD BE CLASSIFIED AS A COMMUNITY BENEFIT. IF THESE SERVICES WERE NOT PROVIDED BY US THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT. BASED ON THIS, MEDICARE LOSSES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE LOSSES ARE INCURRED IN PERFORMING AN IMPORTANT PUBLIC SERVICE. THE MEDICARE LOSS FOR PARK NICOLLET METHODIST HOSPITAL IS BASED ON THE MEDICARE COST REPORT AS INSTRUCTED PER THE 990 SCHEDULE H INSTRUCTIONS. THE MEDICARE COST REPORT ONLY INCLUDES ALLOWABLE COSTS FOR TRADITIONAL MEDICARE PRODUCTS. ALLOWABLE COSTS ARE DEFINED BY THE CENTERS FOR MEDICARE AND MEDICAID AND DO NOT INCLUDE ALL OF THE COSTS THAT ARE INCURRED WHILE PROVIDING SERVICES. IF ALL COSTS WERE INCLUDED IN THE CALCULATION ALONG WITH OUR MEDICARE ADVANTAGE PRODUCTS OUR MEDICARE LOSS WOULD BE $75.7 MILLION.
PART III, LINE 9B: THE COLLECTION POLICY INCORPORATES THE REQUIREMENTS AS STATED BY THE MINNESOTA ATTORNEY GENERAL AND VIEWS ACCOUNT RESOLUTION THROUGH THE PARK NICOLLET FINANCIAL ASSISTANCE PROGRAM AS AN OPTION FOR ACCOUNT RESOLUTION. THIS OPTION IS SHARED WITH DEBTORS VIA STATEMENTS, LETTERS AND AS PART OF COLLECTION CALLS TO AND FROM DEBTORS FROM PARK NICOLLET AND COLLECTION AGENCIES. PARK NICOLLET'S FINANCIAL ASSISTANCE PROGRAM IS ALSO DESCRIBED IN PAMPHLETS AND ON OUR WEBSITE. THE WEBSITE INCLUDES A SUMMARY OF OUR FINANCIAL ASSISTANCE POLICY AS WELL AS FREQUENTLY ASKED QUESTIONS AND HOW TO APPLY DOCUMENTS. IF THE DEBTOR QUALIFIES FOR FINANCIAL ASSISTANCE, COLLECTION EFFORTS CEASE AND CHARGES ARE CLEARED FROM THEIR ACCOUNT.
PART VI, LINE 2: IN 2012, PARK NICOLLET HEALTH SERVICES METHODIST HOSPITAL COMPLETED ITS COMMUNITY HEALTH NEEDS ASSESSMENT. THIS ASSESSMENT WAS THE CULMINATION OF WORK THAT BEGAN IN 2011 AND WAS PRESENTED TO AND APPROVED BY THE PARK NICOLLET BOARD OF DIRECTORS IN DECEMBER 2012. THIS WORK RESULTED IN THE CREATION OF THE PARK NICOLLET METHODIST HOSPITAL 2013-2015 IMPLEMENTATION STRATEGY TO MEET COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THIS PROCESS.TO DEVELOP THIS NEEDS ASSESSMENT, PARK NICOLLET DREW UPON LONG-STANDING RELATIONSHIPS WITH THE BROADER COMMUNITY IT SERVES AND INTERNAL RESOURCES FOCUSING ON RESEARCH AND DATA ANALYTICS. FOR 23 YEARS, PARK NICOLLET HAS CONVENED POPULATIONS OF PATIENTS, GOVERNMENT AND SERVICE ORGANIZATIONS IN ITS SERVICE AREA IN ORDER TO IDENTIFY AND ACT UPON COMMUNITY NEEDS. THESE CONVENING ACTIVITIES BECAME A VALUABLE TOOL TO SURVEY AND IDENTIFY NEEDS ACROSS THE PARK NICOLLET METHODIST HOSPITAL AND PARK NICOLLET CLINIC SERVICE AREAS. PARK NICOLLET FOUNDATION DEVELOPED AND INTEGRATED A SUCCESSFUL COMMUNITY CONNECTIVITY MODEL IN ITS PLANNING PROCESS, DEVELOPING PRIORITIES AND GOALS ACROSS THE ENTIRE ORGANIZATION. AS A CONVENER OF COMMUNITIES ACROSS THE SERVICE AREA, PARK NICOLLET ENGAGED INDIVIDUALS WITHIN THE COMMUNITY, SOCIAL SERVICE AGENCIES BOTH PUBLIC AND PRIVATE, ESTABLISHED COMMUNITY ORGANIZATIONS AND COMMUNITY LEADERS IN ORDER TO IDENTIFY AREAS OF UNMET NEED WITHIN THE COMMUNITY. PARK NICOLLET ALSO BROUGHT TO BEAR INTERNAL EXPERTISE, HEALTH DATA AND ADMINISTRATIVE RESOURCES TO PARTNER WITH THE COMMUNITY TO IDENTIFY NEEDS. THESE RESOURCES INCLUDE MEDICAL EXPERTISE, DATA ANALYTICS AND RESEARCH STAFF, FINANCIAL AND BUSINESS SERVICES AND OTHER ADMINISTRATIVE SERVICES IDENTIFIED AS IMPORTANT THROUGH THE CONVENING PROCESS. THIS CONVENING ACTIVITY HAS RESULTED IN THE CREATION OF INITIATIVES ACROSS THE COMMUNITIES SERVED BY PARK NICOLLET METHODIST HOSPITAL AND PARK NICOLLET CLINIC. THESE INITIATIVES INCLUDE: PARK NICOLLET-SPONSORED COMMUNITY CLINICS GROWING THROUGH GRIEF - PROGRAMS PROVIDING GRIEF SUPPORT AND EDUCATION TO CHILDREN WHO HAVE EXPERIENCED DEATH OF A LOVED ONE NO SHOTS, NO SCHOOL IMMUNIZATION - INITIATIVES PROVIDING ENHANCED ACCESS FOR CHILDREN NEEDING IMMUNIZATIONS AS PART OF THE NO SHOTS, NO SCHOOL PROGRAM HEALTHY COMMUNITY COLLABORATIVES - GROUPS TO DISCUSS THE HEALTH NEEDS OF RESIDENTS IN THE COMMUNITY AND DEVELOPING PROGRAMS TO ADDRESS THOSE NEEDS. THERE ARE CURRENTLY THREE HEALTHY COMMUNITY COLLABORATIVES SUPPORTED BY THE PARK NICOLLET FOUNDATION, SERVING SCOTT COUNTY, DAKOTA COUNTY AND NORTHWEST HENNEPIN COUNTY. A SUCCESSFUL AGING INITIATIVE IN ST. LOUIS PARK - PROVIDING SUPPORT TO SENIOR CITIZENS IN THE COMMUNITY TO ADDRESS THEIR VARIOUS MEDICAL AND SOCIAL NEEDSCOMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESSTHE CONVENING ROLE PARK NICOLLET PLAYS IS SUCCESSFUL IN IDENTIFYING ONGOING NEEDS ACROSS THE MANY COMMUNITIES WE SERVE. IN 2011, PARK NICOLLET BEGAN A MORE FORMAL PROCESS TO IDENTIFY THE GREATEST AREAS OF UNMET NEED. THE CONVENING ROLE WE PLAY IS CRITICAL FOR IDENTIFYING AND CREATING CONNECTIONS TO ADDRESS NEEDS OF RESIDENTS IN THE COMMUNITY. HOWEVER, THE CHNA PROCESS WAS MORE FORMALIZED AND ANALYTIC IN NATURE TO PINPOINT AND PRIORITIZE THE MOST PREVALENT NEEDS IN THE COMMUNITY. DEMOGRAPHIC ANALYSIS/DATAA VARIETY OF DATA SOURCES WAS USED TO COLLECT AND ANALYZE THE GEOGRAPHIC, SOCIO-ECONOMIC AND HEALTH DATA ON THE COMMUNITIES IN THE PARK NICOLLET HEALTH SERVICES' SERVICE AREA. THESE DATA SOURCES PROVIDE A FRAMEWORK FOR REACHING OUT TO COMMUNITY MEMBERS, LOCAL GOVERNMENT AND SOCIAL SERVICE AGENCIES AND SOCIAL SUPPORT GROUPS WITHIN THE COMMUNITY. THE SOURCES USED TO UNDERTAKE OUR COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDE: THOMSON REUTERS MINNESOTA STATE DEMOGRAPHIC CENTER THE METROPOLITAN COUNCIL THE U.S. CENSUS BUREAU THE MINNESOTA DEPARTMENT OF EMPLOYMENT AND ECONOMIC DEVELOPMENT THE MINNESOTA DEPARTMENT OF HEALTH, CENTER FOR HEALTH STATISTICS THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE THE CENTERS FOR DISEASE CONTROL (CDC) AND PREVENTION'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) CDC NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION NATIONAL CENTER FOR HEALTH STATISTICS THE MINNESOTA HOSPITAL ASSOCIATION INTERNAL PARK NICOLLET DATAPARK NICOLLET THE CHNA PROCESS IS DESIGNED TO REACH BROADLY INTO THE COMMUNITY TO IDENTIFY NEEDS, GAPS AND BARRIERS TO HEALTH AND HEALTH SERVICES. DEPLOYING PRIMARY RESEARCH, DATA ANALYSIS, VALIDATION AND PRIORITIZATION, THE ASSESSMENT PROCESS IDENTIFIED THE FOLLOWING SEVEN KEY THEMES OF NEED:1. MENTAL HEALTH2. OBESITY3. SENIORS4. CONNECTING COMMUNITY RESOURCES5. ACCESS AND AFFORDABILITY OF CARE6. WELLNESS 7. CULTURALLY SENSITIVE CARETHE PROCESS ALSO IDENTIFIED THE NEED FOR TEEN AND YOUNG ADULT DRUG AND ALCOHOL ABUSE, TEEN PREGNANCY AND PARENTING AND SMOKING CESSATION; HOWEVER, THESE NEEDS DID NOT ELEVATE THEMSELVES TO THE LEVEL OF THE SEVEN IDENTIFIED THEMES DUE TO THE AVAILABILITY OF SERVICES ALREADY AVAILABLE IN THE COMMUNITY.PARK NICOLLET METHODIST HOSPITAL'S CHNA WAS DESIGNED TO PROVIDE BROAD COMMUNITY INPUT FROM BOTH PRIMARY RESEARCH AND ANALYSIS OF EXISTING COMMUNITY DATA. PARK NICOLLET WAS ABLE TO DRAW UPON THE ABOVE MENTIONED INITIATIVES AND PROCESSES TO UNDERTAKE THIS ANALYSIS OF COMMUNITY NEED. THE KEY ELEMENTS OF THE CHNA PROCESS INCLUDED THE FOLLOWING TEAMS AND PROCESSES:1. A LEADERSHIP TEAM THAT WAS CHARGED TO CONDUCT THE 2011/2012 NEEDS ASSESSMENT. THE RESPONSIBILITIES OF THIS TEAM INCLUDED RESEARCH AND UNDERSTANDING OF THE REQUIREMENTS OF A COMMUNITY HEALTH NEEDS ASSESSMENT, DEVELOPING A STRATEGIC DESIGN FOR PRIMARY RESEARCH AND DATA ANALYTICS, VALIDATION AND PRIORITIZATION OF THE RESULTS AND PREPARATION OF A FINAL FORMAL REPORT THAT WOULD BE PRESENTED TO THE PARK NICOLLET HEALTH SERVICES BOARD OF DIRECTORS. 2. A GUIDANCE GROUP. THE GUIDANCE GROUP PROVIDED THE SKILLS AND EXPERTISE OF A DIVERSE REPRESENTATION OF: PARK NICOLLET METHODIST HOSPITAL PARK NICOLLET FOUNDATION AREA SCHOOLS LOCAL SOCIAL SERVICE AGENCIES MEMBERS OF THE COMMUNITY COUNTY GOVERNMENT HEALTH AGENCIESTHE GUIDANCE GROUP MET THREE TIMES TO REVIEW THE PROPOSED PLAN DESIGN FOR THE CHNA, REVIEW PRELIMINARY RESULTS, ASSIST WITH PRIORITIZATION OF THE NEEDS IDENTIFIED AND PROVIDE INPUT INTO POTENTIAL RESPONSES TO THE IDENTIFIED NEEDS. 3. PRIMARY RESEARCH. MORE THAN 1,100 COMMUNITY MEMBERS REPRESENTING CHURCHES, GOVERNMENT, SCHOOLS, SOCIAL SERVICE AGENCIES AND HEALTH CARE PROVIDERS WERE IDENTIFIED TO PARTICIPATE IN AN ONLINE SURVEY AND FOCUS GROUP MEETINGS ACROSS OUR SERVICE AREA. PARK NICOLLET LEADERS WERE ALSO INVOLVED IN THIS SURVEY AND FOCUS GROUP PROCESS. THE SURVEY WAS CONDUCTED USING SURVEY MONKEY. THE SURVEY TOOL WAS DESIGNED TO OBTAIN INFORMATION FROM THE RESPONDENTS ABOUT THEIR GEOGRAPHIC LOCATION AND THEIR CONNECTIONS IN THE COMMUNITY. THE SURVEY ASKED THE FOLLOWING QUESTIONS OF RESPONDENTS: WHICH GEOGRAPHIC REGION DO YOU MOST AFFILIATE WITH? USING STATE DEMOGRAPHIC DATA FROM THE STATE DEMOGRAPHER, RESPONDENTS WERE GIVEN SEVEN GEOGRAPHIC LOCATIONS TO CHOOSE FROM WITHIN THE SERVICE AREA, WITH CITIES IDENTIFIED WITHIN EACH REGION. IN YOUR OPINION, WHAT ARE THE MAJOR HEALTH CARE CONCERNS IN YOUR COMMUNITY? WHICH HEALTH CARE CONCERNS OF THOSE LISTED IS THE MOST IMPORTANT FOR THE COMMUNITY TO ADDRESS? WHAT ROLE SHOULD PARK NICOLLET CLINIC AND METHODIST HOSPITAL PLAY IN RESPONDING TO THE MOST IMPORTANT CONCERNS YOU IDENTIFY? ARE YOU AWARE OF ANY SERVICES OFFERED IN YOUR COMMUNITY TO ADDRESS CONCERNS YOU IDENTIFIED?4. FOCUS GROUPS. USING THE WORLD CAF MODEL OF FACILITATION, COMMUNITY PARTICIPANTS WERE ALSO OFFERED THE OPPORTUNITY TO ATTEND ONE OF SEVEN COMMUNITY-BASED FOCUS GROUP MEETINGS. EACH FOCUS GROUP WAS ENCOURAGED TO DISCUSS: WHAT TOP NEEDS MOST IMPACT THE HEALTH AND WELLNESS OF INDIVIDUALS AND FAMILIES IN YOUR LOCAL COMMUNITY? WHAT WOULD IT TAKE TO CREATE THE CHANGE NEEDED TO ADDRESS THESE ISSUES? WHAT IS THE UNIQUE ROLE OF PARK NICOLLET METHODIST HOSPITAL IN RESPONDING TO THOSE NEEDS? WHO IN THE COMMUNITY SHOULD BE INVOLVED AND WHY SHOULD THEY CARE?THE RESULTS FROM THE SURVEY AND THE FOCUS GROUPS WERE TABULATED. THE LEADERSHIP TEAM THEN REVIEWED THE SUMMARIES AND IDENTIFIED SEVEN KEY THEMES THAT CONSISTENTLY EMERGED IN THE DATA. 5. ADDITIONAL GROUP MEETINGS. TO BROADEN THE INFORMATION GATHERED, ADDITIONAL MEETINGS WERE ALSO HELD WITH SMALL GROUPS OF PROFESSIONALS FOR INSIGHT GATHERING AND TARGETED TO SPECIFIC AREAS IDENTIFIED BY COMMUNITY PARTICIPANTS. AS A RESULT MEETINGS WERE ALSO HELD WITH SOMALI COMMUNITY HEALTH WORKERS AND RETIRED PHYSICIANS FROM METHODIST HOSPITAL.
PART VI, LINE 2: 6. VALIDATION PROCESS. ONCE THE KEY THEMES OF NEED WERE IDENTIFIED AND PRIORITIZED, MEETINGS WERE SCHEDULED WITH COUNTY HEALTH DEPARTMENTS TO DISCUSS OUR FINDINGS AND COMPARE THEM WITH RESULTS FROM THEIR OWN COUNTY NEEDS ASSESSMENTS, AND TO IDENTIFY ANY POTENTIAL GAPS THAT MAY EXIST FROM OUR OWN RESEARCH. PRIORITIZATION OF COMMUNITY HEALTH NEEDS. ONCE THE RESPONSES THROUGH THE SURVEY AND FOCUS GROUP PROCESS WERE COLLATED, THE RESULTS WERE PRESENTED TO THE CHNA GUIDANCE GROUP, PARK NICOLLET HEALTH SERVICES EXECUTIVE AND MANAGEMENT GROUP AND THE PARK NICOLLET FOUNDATION BOARD OF DIRECTORS FOR REVIEW, COMMENT AND PRIORITIZATION. PARTICIPANTS WERE ASKED TO RANK EACH IDENTIFIED THEME BASED ON TWO CRITERIA: IMPORTANCE OR IMPACT THAT THE THEME HAD ON COMMUNITY HEALTH NEED AND HOW STRONGLY THE THEME CORRELATED WITH PARK NICOLLET'S STRENGTHS AS A HEALTH CARE SYSTEM. THE RESULTS WERE THEN AGGREGATED, SUMMARIZED THROUGH AVERAGING OF RANK VALUES AND PLOTTED INTO A BUBBLE GRAPH. THIS PROCESS INFORMED PARK NICOLLET ON THE MAJOR THEMES OF NEED IDENTIFIED BY THE COMMUNITY AND RESULTED IN THE DEVELOPMENT OF A "PARK NICOLLET METHODIST HOSPITAL 2013-2015 IMPLEMENTATION STRATEGY" TO MEET COMMUNITY HEALTH NEEDS. SINCE THE CONCLUSION OF THIS PROCESS, PARK NICOLLET HIRED STAFF TO LEAD THIS PROCESS.
PART VI, LINE 3: PARK NICOLLET METHODIST HOSPITAL PARTICIPATES IN MULTIPLE UNIQUE FINANCIAL ASSISTANCE PROGRAMS, INCLUDING OUR OWN FINANCIAL ASSISTANCE (FA). WE INFORM OUR PATIENTS IN MULTIPLE WAYS ABOUT OUR FA PROGRAM AND OTHER FINANCIAL ASSISTANCE OPTIONS FOR SERVICES RECEIVED AT PNHS. APPROXIMATELY 14 PERCENT OF HOSPITAL PATIENTS PARTICIPATE IN STATE PUBLIC PROGRAMS AND APPROXIMATELY 2 PERCENT ARE UNINSURED. A LIST OF COMMUNICATIONS FOR PATIENTS RELATING TO FINANCIAL ASSISTANCE FOLLOWS: HOSPITAL BOOKLETS GIVEN TO INPATIENTS WEB SITE, FA INFORMATION FOUND IN BILLING AND INSURANCE SECTION FAQ ON FA FA CALCULATOR ONLINE CALCULATOR ALLOWS QUICK AND EASY ESTIMATION OF ELIGIBILITY UNDER THE PROGRAM FA APPLICATION APPLICATION MAY BE PRINTED FOR SUBMISSION INFORMATION ON MEDICAL ASSISTANCE, INCLUDING ELIGIBILITY AND APPLICATION PROCESS PATIENT STATEMENTS ALL BALANCE FORWARD STATEMENTS, REGARDLESS OF BALANCE, INCLUDE A FINANCIAL ASSISTANCE APPLICATION AND RESPONSES TO FREQUENTLY ASKED QUESTIONS REGARDING FAIN ADDITION TO THE WRITTEN MATERIAL, CUSTOMER SERVICE, COLLECTIONS AND HOSPITAL PATIENT ACCESS LIAISONS (PALS) INFORM PATIENTS ABOUT ASSISTANCE OPTIONS, INCLUDING GOVERNMENT PROGRAMS AND FA. PALS ARE ON-SITE IN THE HOSPITAL AND CAN MEET WITH PATIENTS IN THEIR ROOMS OR PRIOR TO ADMISSION. MOST CUSTOMER SERVICE AND COLLECTIONS WORK IS DONE THOUGH PHONE CALLS, BUT OUR MAIN CLINIC HAS AN ON-SITE LOCATION FOR PERSONAL CONVERSATIONS. PARK NICOLLET METHODIST HOSPITAL STAFF IS TRAINED IN HELPING PATIENTS APPLY FOR MEDICAL ASSISTANCE AND HAS ALSO CONTRACTED WITH OUTSIDE SERVICES TO ASSIST PATIENTS IN THE APPLICATION PROCESS FOR MEDICAL ASSISTANCE IN MORE COMPLICATED CIRCUMSTANCES.
PART VI, LINE 4: PARK NICOLLET HEALTH SERVICES IS AN INTEGRATED DELIVERY SYSTEM THAT INCLUDES PARK NICOLLET METHODIST HOSPITAL, 23 CLINIC LOCATIONS AND 11 SPECIALTY CARE CENTERS, ALL OF WHICH ARE LOCATED IN THE WEST METROPOLITAN AREA OF THE TWIN CITIES. THE SERVICE AREA FOR THE SYSTEM DEFINES THE COMMUNITIES WE SERVE AND PRIMARILY INCLUDES THE COUNTIES OF: HENNEPIN, CARVER, DAKOTA, AND SCOTT. PARK NICOLLET HEALTH SERVICES ALSO SERVES PATIENTS IN WRIGHT, RICE, SIBLEY AND LE SEUER COUNTIES. PARK NICOLLET HEALTH SERVICES DRAWS PATIENTS FROM A LARGER 96 ZIP CODE SERVICE AREA. PARK NICOLLET METHODIST HOSPITAL'S PRIMARY CATCHMENT AREA COVERS A SMALLER 28 ZIP CODE SERVICE AREA. NINETY PERCENT OF PARK NICOLLET'S OUTPATIENT CLINIC VISITS AND 88 PERCENT OF METHODIST HOSPITAL ADMISSIONS COME FROM THE 96 ZIP CODE SERVICE AREA. FIFTY-FOUR PERCENT OF METHODIST HOSPITAL ADMISSIONS COME FROM THE 28 ZIP CODE SERVICE AREA. THE POPULATION DENSITY IN THE PARK NICOLLET SERVICE AREA CONSISTS OF A MIX OF URBAN, SUBURBAN, EXURBAN AND RURAL COMMUNITIES. IN ORDER TO FIT OUR ANALYSIS TO MORE SPECIFIC COMMUNITIES WITHIN THE BROADER SERVICE AREA, OUR ASSESSMENT FOCUSED ON THE SUB SERVICES AREAS DEFINED IN THE FOLLOWING MANNER: CORE SERVICE AREA MINNEAPOLIS SERVICE AREA NORTH EAST SERVICE AREA NORTH WEST SERVICE AREA SOUTH EAST SERVICE AREA SOUTH WEST SERVICE AREA WEST SERVICE AREATHIS BREAKDOWN ASSURES THAT NEEDS ARE PROPERLY IDENTIFIED IN ACCORDANCE WITH THE SPECIFIC POPULATION OF PATIENTS SERVED BY SERVICE AREA AND REFLECTS POPULATION DENSITY SOCIO-ECONOMIC FACTORS. IT ALSO PERMITS SURVEY AND FOCUS GROUP RESPONDENTS TO SPEAK TO NEEDS BASED UPON THEIR OWN LOCAL COMMUNITY.POPULATION DEMOGRAPHICSBASED ON 2010 ESTIMATES, 1.65 MILLION PEOPLE RESIDE WITHIN THE PARK NICOLLET 96 ZIP CODE SERVICE AREA. 535,000 PEOPLE (ONE-THIRD) RESIDE WITHIN THE SMALLER 28 ZIP CODE SERVICE AREA. POPULATION DENSITY VARIES BY THE SEVEN SERVICE AREAS PARK NICOLLET SERVES AND IS DESCRIBED BELOW. CORE SERVICE AREA (401,085) MINNEAPOLIS SERVICE AREA (249,171) NORTH EAST SERVICE AREA (184,062) NORTH WEST SERVICE AREA (226,685) SOUTH EAST SERVICE AREA (334,393) SOUTH WEST SERVICE AREA (101,825) WEST SERVICE AREA (157,176)PARK NICOLLET'S SERVICE AREA (96 ZIP CODES) IS ESTIMATED TO GROW 3.2 PERCENT IN THE NEXT FIVE YEARS. THE MOST SIGNIFICANT GROWTH IN POPULATIONS IS PROJECTED TO OCCUR IN THE SUBURBAN AND EX-URBAN SERVICE AREAS WHILE THE CORE SERVICE AREA, THE MINNEAPOLIS SERVICE AREA, AND THE NORTH EAST SERVICE AREA POPULATIONS ARE EXPECTED TO EXPERIENCE NO GROWTH. DURING THE NEXT 20 YEARS THE POPULATION GROWTH IN THE BROADER PARK NICOLLET SERVICE AREA IS EXPECTED TO GROW BY LESS THAN 1 PERCENT PER YEAR, HOWEVER, THE BIGGEST CHANGE DURING THIS 20 YEAR PERIOD WILL BE THE AGING OF THE POPULATION SERVED BY PARK NICOLLET. DURING THE NEXT 20 YEARS THE 65-PLUS AGE GROUP IS ESTIMATED TO MORE THAN DOUBLE. THE FOLLOWING SECTION DESCRIBES THE DEMOGRAPHIC CONSTITUENCIES SERVED BY PARK NICOLLET HEALTH SERVICES: THE AGING POPULATION. THE CORE SERVICE AREA CONTAINS A MORE AGED DEMOGRAPHIC THAN THE OTHER SERVICE AREAS SERVED BY PARK NICOLLET. IN THE CORE SERVICE AREA, 15 PERCENT OF THE POPULATION IS 65-PLUS YEARS OLD AND 45 PERCENT ARE 45-PLUS YEARS OLD. THE NORTH WEST AND THE SOUTH EAST SERVICE AREAS HAVE A LOW DISTRIBUTION OF POPULATION AGED 65-PLUS. THE FIRST RING SUBURBS (GOLDEN VALLEY, RICHFIELD, ST. LOUIS PARK, NEW HOPE AND EDINA) HAVE LARGE SENIOR POPULATIONS. THERE ARE ALSO DENSE POCKETS OF AGED (65-PLUS) IN BURNSVILLE, APPLE VALLEY, MINNEAPOLIS, BROOKLYN CENTER, BROOKLYN PARK, WAYZATA AND EXCELSIOR. 30 PERCENT OF SENIORS IN THE PARK NICOLLET SERVICE AREA ARE CURRENTLY IN SITUATIONS WHERE THEY ARE LIVING ALONE. MINORITY POPULATIONS. PARK NICOLLET HEALTH SERVICES' SERVICE AREA CONTAINS A VERY DIVERSE POPULATION OF PATIENTS. THERE IS WIDE VARIATION IN POPULATIONS SERVED ACROSS THE SEVEN SUB-SERVICE AREAS. THE NORTH EAST SERVICE AREA AND THE MINNEAPOLIS SERVICE AREA HAVE THE LARGEST MINORITY POPULATIONS, 49 PERCENT AND 40 PERCENT RESPECTIVELY. THE WEST AND THE NORTH WEST SERVICE AREAS HAVE LOW MINORITY POPULATIONS, 7 PERCENT AND 8 PERCENT RESPECTIVELY. THE MOST PREVALENT MINORITY GROUPS ALSO VARY BY SERVICE AREA: HISPANIC POPULATION IS THE TOP MINORITY GROUP IN THREE OF SEVEN SERVICE AREAS (MINNEAPOLIS, SOUTH WEST AND WEST) ASIAN POPULATION IS THE TOP MINORITY GROUP IN THREE OF SEVEN SERVICE AREAS (CORE, NORTH WEST AND SOUTH EAST) BLACK POPULATION IS THE TOP MINORITY GROUP IN ONE OF THE SEVEN SERVICE AREAS (NORTH EAST)MINORITY POPULATION DENSITY IS GREATER IN AREAS IN OR NEAR TO THE URBAN CORE OF THE TWIN CITIES.DURING THE NEXT FIVE YEARS, THE PARK NICOLLET SERVICE AREA POPULATION IS ESTIMATED TO GROW BY 3.8 PERCENT. THE MINORITY POPULATIONS ARE EXPECTED TO ACCOUNT FOR 79 PERCENT OF THAT GROWTH. POPULATION GROWTH IN THE HISPANIC POPULATION IS EXPECTED TO SEE THE LARGEST INCREASE OVER THE NEXT FIVE YEARS (22.3 PERCENT). THE LARGEST PORTION OF THE INCREASE IN THE HISPANIC POPULATION IS EXPECTED TO OCCUR IN THE MINNEAPOLIS SERVICE AREA. NEARLY ALL SERVICE AREAS EXPECT TO SEE DOUBLE DIGIT INCREASES IN MINORITY POPULATIONS THROUGH 2015. POPULATION INCOME AND ACCESS TO INSURANCE. THE DIVERSITY IN INCOME IN THE PARK NICOLLET SERVICE AREA ALSO IS WIDE-RANGING. WHILE THE PARK NICOLLET SERVICE AREA CONTAINS 22 OF THE TOP 25 WEALTHIEST ZIP CODES (SITUATED IN THE WEST/NORTH WEST SERVICE AREAS), THE EASTERN SERVICE AREA CONTAINS SEVERAL LOW INCOME ZIP CODES (CORE, MINNEAPOLIS, NORTH EAST SERVICE AREAS). THE WEST, NORTH WEST, SOUTH EAST AND SOUTH WEST SERVICE AREAS HAVE THE HIGHEST DISTRIBUTION OF UPPER INCOME HOUSEHOLDS. LIKE INCOME, THE SUBURBAN/EXURBAN SERVICE AREAS (NORTH WEST, SOUTH EAST, SOUTH WEST AND WEST) HAVE A HIGH PERCENTAGE OF THE POPULATION THAT IS COMMERCIALLY INSURED (80-PLUS PERCENT). THE SUB-SERVICE AREAS WITH THE HIGHEST PERCENT OF MEDICARE PATIENTS INCLUDE THE CORE (16 PERCENT), MINNEAPOLIS (10.8 PERCENT), NORTH EAST (10.5 PERCENT) AND WEST (10.4 PERCENT). THE MINNEAPOLIS AND THE NORTH EAST SERVICE AREAS HAVE HIGH MEDICAID POPULATIONS COMPARED TO THE OTHER SERVICE AREAS, WITH THE MINNEAPOLIS SERVICE AREA HAVING 16.7 PERCENT AND THE NORTH EAST SERVICE AREA HAVING 14.3 PERCENT.
PART VI, LINE 5: PARK NICOLLET HEALTH SERVICES FURTHERS ITS EXEMPT PURPOSES IN MULTIPLE WAYS THROUGH METHODIST HOSPITAL, PARK NICOLLET CLINIC, SPECIALTY PROGRAMS AND ITS COMMITMENT TO RESEARCH AND EDUCATION. PARK NICOLLET STRIVES TO MEET ITS COMMITMENT TO THE TRIPLE AIM OF PROVIDING HIGH QUALITY HEALTH CARE AT AN AFFORDABLE COST TO THE COMMUNITY BY ENHANCING THE PATIENT EXPERIENCE. PARK NICOLLET'S COMMITMENT TO THE PATIENT AND FAMILY EXPERIENCE IS ARTICULATED THROUGH A FOCUS ON HEAD + HEART, TOGETHER (HHT)."HEAD" REFERS TO OUR WORK AROUND EVIDENCE-BASED MEDICINE, OUR ATTENTION TO CLINICAL OUTCOMES, THE WAY WE WILL USE DATA TO MAKE DECISIONS ABOUT THE BEST CARE PROTOCOL TO FOLLOW, AND TO THE BUSINESS OF RUNNING A LARGE HEALTHCARE SYSTEM. "HEART" IS ALL ABOUT PROVIDING COMPASSIONATE CARE IN THE MOMENT AND KEEPING OUR PATIENTS AT THE CENTER OF EVERYTHING WE DO AND EVERY DECISION WE MAKE. WHEN WE WORK ACROSS BOUNDARIES WITH OUR PATIENTS AND FAMILIES, WE WON'T DO THINGS "TO" OR "FOR" PATIENTS - WE WILL DO THINGS WITH PATIENTS AND THEIR FAMILIES."TOGETHER" MEANS DOING BOTH HEAD- AND HEART-CENTERED ACTIVITIES IN COMBINATION. IT ALSO MEANS WORKING AS A TEAM ACROSS DEPARTMENTS AND SPECIALTIES, ALL OF US UNITED AROUND CARING TOGETHER WITH OUR PATIENTS, THEIR FAMILIES IN THE COMMUNITIES WE SERVE.PARK NICOLLET HEALTH SERVICES FURTHERS ITS EXEMPT PURPOSE THROUGH ITS 426-BED METHODIST HOSPITAL IN ST. LOUIS PARK, 20 CLINIC LOCATIONS IN ITS 96 ZIP CODE SERVICE AREA, 55 MEDICAL SPECIALTIES AND SUBSPECIALTIES, AND 12 SPECIALTY CENTERS. PARK NICOLLET FOUNDATION SERVES AS THE CONVENER OF THE COMMUNITIES WE SERVE, INVOLVING ADMINISTRATIVE AND MEDICAL STAFF IN ITS INTEGRATED SYSTEM, TO ASSESS COMMUNITY NEED AND FACILITATE A BROAD ARRAY OF CLINICAL AND SPECIALTY SERVICES AND THE ADMINISTRATIVE SUPPORT TO MEET UNMET NEEDS IN THE COMMUNITY. PARK NICOLLET FOUNDATION ALSO PROVIDES FINANCIAL ASSISTANCE TO COMMUNITY ORGANIZATIONS AND SERVICES THAT ARE CONSISTENT WITH NEEDS IDENTIFIED IN THE CHNA AS PRIORITIZED BY ITS BOARD OF DIRECTORS. PARK NICOLLET FOUNDATION'S BOARD OF DIRECTORS IS A COMMUNITY BOARD AND PROVIDES ACTIVE PARTICIPATION IN THE NONPROFIT MISSION OF THE ORGANIZATION. PARK NICOLLET'S INTEGRATED SYSTEM PROVIDES COMMUNITY BENEFIT TO UNDERSERVED POPULATIONS THROUGH CONVENING OF COMMUNITIES, EDUCATION AND SUPPORT OF PATIENTS AND COMMUNITY MEMBERS DIAGNOSED WITH CHRONIC DISEASE, AND RESEARCH TO IMPROVE QUALITY OF LIFE. HEALTH PROFESSIONALS WITHIN THE INTEGRATED SYSTEM ASSIST PATIENTS IN THE COMMUNITY, IN THE STATE, IN THE NATION, AND AROUND THE WORLD WHO NEED SPECIALIZED PROGRAMS AND SERVICES FOR VARIOUS CONDITIONS. PARK NICOLLET ALSO IS A RECOGNIZED LEADER IN PROCESS IMPROVEMENTS TO COORDINATE PATIENT CARE AND PROVIDE PATIENTS WITH SOCIAL SUPPORT SYSTEMS TO IMPROVE POPULATION HEALTH. THIS HAS BEEN ACCOMPLISHED THROUGH ITS INITIATIVES THROUGH THE PHYSICIAN GROUP PRACTICE DEMONSTRATION PROGRAM SPONSORED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. PARK NICOLLET ALSO PARTICIPATES IN THE PIONEER ACO DEMONSTRATION THAT IS SPONSORED BY THE CENTER FOR MEDICARE AND MEDICAID INNOVATION. IN ADDITION TO INNOVATING AROUND CARE DELIVERY DESIGN AND PATIENT SUPPORT SERVICES, PARK NICOLLET PARTICIPATES IN MULTIPLE LEARNING INITIATIVES THROUGH THE DEMONSTRATION PROGRAM TO SHARE ITS KNOWLEDGE AND LESSONS LEARNED WITH OTHER ORGANIZATIONS ACROSS THE COMMUNITY AND THE COUNTRY. PARK NICOLLET HAS BEEN COMMITTED TO THESE EFFORTS IN SUPPORT OF ITS COMMITMENT TO THE TRIPLE AIM OF IMPROVING HEALTH, PATIENT EXPERIENCE AND AFFORDABILITY BY PROVIDING COMMUNITIES WITH SUPPORT SYSTEMS ASSISTING PATIENTS AND FAMILIES TO IMPROVE THEIR HEALTH. GRANTS AND COMMUNITY SUPPORT. IN 2014, PARK NICOLLET FOUNDATION GRANTED OVER $2 MILLION TO PARK NICOLLET DEPARTMENTS AND COMMUNITY 501(C)(3) ORGANIZATIONS TO FUND OUTREACH SERVICES AND SUPPORT PROGRAMS ADDRESSING OUR KEY PRIORITIES FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT - SENIORS, MENTAL HEALTH, ACCESS AND AFFORDABILITY AND CULTURALLY-SENSITIVE CARE.PARK NICOLLET SUPPORTS SCHOOL-BASED HEALTH CENTERS. IN 2014, WE OFFERED NO-CHARGE HEALTH CARE TO CHILDREN FROM INFANCY THROUGH HIGH SCHOOL GRADUATION AT OUR SCHOOL-BASED HEALTH CENTERS IN BROOKLYN CENTER, BURNSVILLE, ST. LOUIS PARK AND WAYZATA. NO-CHARGE AND LOW-COST DENTAL AND MENTAL HEALTH CARE IS AVAILABLE BY APPOINTMENT. PARTICIPATING FAMILIES INCLUDE THOSE WHO ARE UNABLE TO AFFORD HEALTH CARE, ARE NEW TO THE AREA OR HAVE SENSITIVE HEALTH CARE NEEDS. WALK-IN VISITORS ARE WELCOME AT ALL LOCATIONS. ALL HEALTH CENTERS ARE OPERATED IN PARTNERSHIP WITH LOCAL SCHOOL DISTRICTS AND FUNDED BY PARK NICOLLET FOUNDATION. IN 2014, THERE WERE MORE THAN 4,300 PRIMARY CARE AND DENTAL VISITS TO THESE HEALTH CENTERS. IMMUNIZATIONS. MINNESOTA LAW REQUIRES IMMUNIZATIONS, OR WRITTEN PROOF OF EXEMPTION, FOR SCHOOL-AGE CHILDREN TO ATTEND SCHOOL. PARK NICOLLET FOUNDATION COLLABORATES WITH SCHOOL DISTRICTS TO HAVE ALL CHILDREN IMMUNIZED. PARK NICOLLET OFFERS ENHANCED ACCESS FOR CHILDREN NEEDING IMMUNIZATIONS AS PART OF THE NO SHOTS, NO SCHOOL PROGRAM, WHICH IS AVAILABLE MAY, AUGUST AND THE FIRST TWO WEEKS OF SEPTEMBER. PARTICIPATING SCHOOL DISTRICTS ENCOURAGE PARENTS TO SCHEDULE APPOINTMENTS WITH A PRIMARY CARE DOCTOR EARLY TO ENSURE REQUIRED IMMUNIZATIONS ARE GIVEN AND DOCUMENTED WELL IN ADVANCE OF STARTING SCHOOL. IT TAKES AT LEAST FOUR MONTHS TO COMPLETE THE HEPATITIS B SERIES.PARK NICOLLET PROVIDES IMMUNIZATION-ONLY VISITS ON A SAME-DAY APPOINTMENT BASIS; IMMUNIZES CHILDREN WITHOUT A DOCTOR VISIT OR PREVENTIVE CARE EXAM AT THE TIME OF IMMUNIZATION; IMMUNIZES CHILDREN NOT PREVIOUSLY ESTABLISHED AS PATIENTS WITH THE CLINIC; AND PROVIDES IMMUNIZATIONS TO CHILDREN WITH NO DIRECT CHARGE TO FAMILIES.PARK NICOLLET SPONSORED COMMUNITY COLLABORATIVES. PARK NICOLLET FOUNDATION REGULARLY SPONSORS OR PARTICIPATES IN COLLABORATIVE GROUPS TO DISCUSS ISSUES AND TOPICS AFFECTING RESIDENTS IN THE COMMUNITY. THESE MEETINGS ARE HELD AT DIFFERENT LOCATIONS THROUGHOUT PARK NICOLLET'S SERVICE AREA. THE FOLLOWING ARE SOME EXAMPLES OF THIS WORK: CHILDREN FIRST DAKOTA COUNTY HEALTHY COMMUNITY COLLABORATIVE MEADOWBROOK COLLABORATIVE NORTHWEST HENNEPIN HEALTHY COMMUNITY PARTNERSHIP ST. LOUIS PARK SUCCESSFUL AGING INITIATIVE SCOTT COUNTY HEALTHY COMMUNITY COLLABORATIVE THE FOLLOWING ARE EXAMPLES OF SPECIFIC ACTIVITIES THAT ARE SUPPORTED BY THE PARK NICOLLET FOUNDATION AND PARK NICOLLET HEALTH SERVICES AND DEMONSTRATE THE ORGANIZATION'S COMMITMENT TO THE COMMUNITY AND MEETING UNMET COMMUNITY NEEDS. 1. RESEARCH AND EDUCATION ACTIVITIES - RESEARCH IS EMBEDDED IN DEPARTMENTS AND STRATEGIES ACROSS PARK NICOLLET TO SUPPORT QUALITY INITIATIVES AND THE PATIENT EXPERIENCE. RESEARCH ENCOMPASSES INVESTIGATOR-INITIATED STUDIES, CLINICAL TRIALS, PRACTICE-BASED RESEARCH, OUTCOMES AND QUALITY IMPROVEMENT PROJECTS, DATA ANALYTICS, STATISTICS, SURVEY DEVELOPMENT AND FOCUS GROUPS. AT PARK NICOLLET AND METRO MINNESOTA COMMUNITY CLINICAL ONCOLOGY PROGRAM, BETWEEN 400 AND 500 RESEARCH STUDIES ARE ACTIVE EACH YEAR. PARK NICOLLET AUTHORS PUBLISHED 62 PEER-REVIEWED PAPERS, BOOKS AND BOOK CHAPTERS IN 2014, SHARING THEIR FINDINGS WITH THE MEDICAL COMMUNITY. PARK NICOLLET INSTITUTE PROVIDES THE INFRASTRUCTURE AND RESOURCES TO SUPPORT RESEARCH AND CLINICAL QUALITY GOALS OF THE ORGANIZATION, WHICH INCLUDES THE FOLLOWING: NEEDS ASSESSMENT AND FEASIBILITY MENTORING AND TRAINING" SCIENTIFIC AND HUMANS SUBJECTS REVIEW REGULATORY COMPLIANCE AND REPORTING GRANT MANAGEMENT, INCLUDING APPLICATION PREPARATION AND SUBMISSION, CONTRACT AND AGREEMENT NEGOTIATION, FINANCE, BUDGET DEVELOPMENT, IDENTIFICATION OF FUNDING SOURCES PROTOCOL DEVELOPMENT AND RESEARCH DESIGN MANUSCRIPT AND POSTER/PRESENTATION PREPARATION DATABASE DEVELOPMENT, DATA CLEANING, STATISTICS AND ANALYTICS, SURVEY REVIEW AND DESIGN, FOCUS GROUP FACILITATION STUDY OPERATIONS SUPPORT INCLUDING RECRUITMENT, CONSENTING, ENROLLING, DATA COLLECTION/ENTRYPARK NICOLLET INSTITUTE'S PATIENT EDUCATION DEPARTMENT PROVIDES EDUCATIONAL TOOLS TO SUPPORT PATIENTS IN PREVENTING AND MANAGING ILLNESS AND IMPROVING HEALTH. WE PROVIDE PROGRAMS, CLASSES, VIDEOS, WEB CONTENT AND DECISION SUPPORT TOOLS TO HELP PATIENTS TAKE AN ACTIVE ROLE IN THEIR HEALTH. THESE RESOURCES HELP PATIENTS PREVENT AND MANAGE COMMON HEALTH PROBLEMS, LIVE WELL WITH CHRONIC CONDITIONS, PREPARE FOR PROCEDURES AND IMPROVE OVERALL HEALTH AND WELL-BEING. IN 2014, WE HELD 263 PATIENT EDUCATION CLASSES FOR 1,965 ATTENDEES. WE CONDUCTED 7,122 DIABETES EDUCATION VISITS. WE PUBLISHED 337 NEW OR REVISED PATIENT EDUCATION MATERIALS.
PART VI, LINE 5: OUR PARK NICOLLET HEALTH LIBRARY PROVIDES RESOURCES AND SERVICES FOR PATIENTS, FAMILY AND THE COMMUNITY. THIS INCLUDES LITERATURE SEARCHES AND DOCUMENT DELIVERY, AS WELL AS ACCESS TO PRINT, ONLINE AND INTERNET RESOURCES. IN 2014, THE LIBRARY RECEIVED 781 VISITORS AND CONDUCTED 346 INFORMATION SEARCHES FOR PATIENTS AND THEIR FAMILIES. THE INSTITUTE'S PROFESSIONAL EDUCATION DEPARTMENT PROVIDES LEARNING ACTIVITIES TO ENHANCE PHYSICIAN KNOWLEDGE, COMPETENCE AND PERFORMANCE. CONTINUING MEDICAL EDUCATION (CME) STAFF PARTNERS WITH PARK NICOLLET AND HEALTHPARTNERS PHYSICIANS AND DEPARTMENTS TO MANAGE A COMPREHENSIVE EDUCATIONAL PROGRAM THROUGH ACTIVITIES DESIGNED TO MEET INDIVIDUAL AND DEPARTMENT NEEDS. OUR OFFICE OF CONTINUING MEDICAL EDUCATION GRANTED 70,892 CME CREDITS THROUGH 429 PROFESSIONAL EDUCATION ACTIVITIES IN 2014, REACHING 24,821 PARTICIPANTS.2. GROWING THROUGH GRIEF PROGRAM - THIS SCHOOL SUPPORT PROGRAM PROVIDES 1:1 COUNSELING AND GROUPS FOR CHILDREN AND TEENS WHO HAVE EXPERIENCED THE DEATH OF SOMEONE IMPORTANT IN THEIR LIFE. SERVICES ARE FUNDED BY PARK NICOLLET FOUNDATION AND ARE FREE OF CHARGE TO PARTICIPANTS. MORE THAN 500 STUDENTS AND 13 SCHOOL DISTRICTS ARE SERVED BY THE PROGRAM ON A WEEKLY BASIS. THE CHILDREN RANGE IN AGE FROM 5 TO 18 YEAR OLDS. ALL SOCIO-ECONOMIC GROUPS ARE SERVED. STUDENTS SERVED ARE IN THE SCHOOL DISTRICTS OF: APPLE VALLEY-ROSEMOUNT-EAGAN; BURNSVILLE; CHASKA-CHANHASSEN; EDINA; HOPKINS; MINNEAPOLIS; MINNETONKA; MOUND-WESTONKA; OSSEO-MAPLE GROVE; PRIOR LAKE-SAVAGE; ST. LOUIS PARK; AND WAYZATA. COUNSELORS SERVE ON THE EMERGENCY RESPONSE TEAM FOR SCHOOLS AND ARE CERTIFIED TRAUMATOLOGISTS. 3. SCHOOL-BASED HEALTH CENTERS (SBHCS) - FOUR SCHOOL-BASED HEALTH CENTERS PROVIDED OVER 2,300 MEDICAL VISITS FOR UNINSURED AND UNDERINSURED YOUTH. SERVICES INCLUDED TREATMENT OF MINOR, ACUTE ILLNESSES; PHYSICALS; IMMUNIZATIONS; MENTAL HEALTH THERAPY; DENTAL CARE; AND VISION CHECKS. ALL MEDICAL SERVICES ARE PROVIDED FREE OF CHARGE TO PATIENTS. 4. PRESCRIPTIONS - PARK NICOLLET FOUNDATION FUNDED OVER $75,000 WORTH OF PRESCRIPTIONS FOR PATIENTS OF THE SBHCS. 5. FOOD AND VEGIE PRESCRIPTIONS - IN PARTNERSHIP WITH CUB FOODS, PARK NICOLLET PRIMARY CARE PHYSICIANS GAVE "PRESCRIPTIONS" FOR HEALTHY FOOD TO YOUNG PATIENTS. THE RX WERE ACCOMPANIED BY A $10 COUPON FOR FRUITS AND VEGETABLES. 2,700 FRUIT AND VEGGIE PRESCRIPTIONS WERE GIVEN OUT; 1,012 WERE REDEEMED.6. FIRE-FIGHTER OUTREACH - IN PARTNERSHIP WITH METHODIST HOSPITAL AND LOCAL FOOD SHELVES, THE FIRE DEPARTMENTS OF THREE COMMUNITIES VISIT RECENTLY-DISCHARGED, AT-RISK SENIORS TO CHECK ON THEIR SAFETY AND ENSURE THEY HAVE ADEQUATE FOOD.7. MAMMO-A-GO-GO - FOUNDATION GRANTS ENABLED THE MAMMO-A-GO-GO MOBILE VAN TO PROVIDE FREE MAMMOGRAM SCREENINGS TO 165 UNDERSERVED WOMEN.8. FLU SHOT CLINICS - OVER 150 FREE FLU SHOTS WERE ADMINISTERED AT TWO SPECIAL EVENTS.9. YUMPOWER - PARK NICOLLET FOUNDATION PROVIDED SUPPORT TO IMPLEMENT THE HEALTHPARTNERS' YUMPOWER PROGRAM ON HEALTHY EATING AT TWO ST. LOUIS PARK ELEMENTARY SCHOOLS.10. MELROSE CENTER COLLEGE OUTREACH - RAISING AWARENESS OF EATING DISORDERS AND RESOURCES AVAILABLE.11. HEALTH FAIRS AND COMMUNITY OUTREACH - PARK NICOLLET CARE TEAMS, DEPARTMENTS AND CLINICS PROVIDE FAIRS AND OUTREACH THROUGHOUT THE YEAR. EXAMPLES INCLUDE: WAYZATA CLINIC TEAM MEMBERS PARTICIPATED IN A MIDDLE SCHOOL PARENTING FORUM CHAMPLIN CLINIC TEAM MEMBERS OFFERED ADVANCE CARE PLANNING CLASSES AND GAVE A TALK ON THE FLU AT NORWEST COMMUNITY CENTER CHAMPLIN CLINIC TEAM MEMBERS PARTICIPATED IN BAG OF SMILES GOLF TOURNAMENT AND MAPLE GROVE HOSPITAL BABY BALL BLOOMINGTON CLINIC TEAM MEMBERS OFFERED A MONTHLY DIABETES SUPPORT GROUP BLOOMINGTON CLINIC TEAM MEMBERS PARTICIPATED IN RACE FOR THE CURE ST. LOUIS PARK CLINIC TEAM MEMBERS OFFERED MULTIPLE INITIATIVES FOR SENIORS ST. LOUIS PARK CLINIC TEAM MEMBERS PARTICIPATED AT PARKTACULAR, TWIN CITIES PRIDE, TOUR DE CURE FOR DIABETES AND WEST END HEALTH & SAFETY FITNESS EXPO MAPLE GROVE CLINIC TEAM MEMBERS PARTICIPATED AT MAPLE GROVE DAYS PARADE AND EXPO PLYMOUTH CLINIC TEAM MEMBERS PARTICIPATED IN A HEALTHY LIVING FAIR, MUSIC IN PLYMOUTH 5, PLYMOUTH ON PARADE, NIGHT TO UNITE CANCER BENEFIT, PLYMOUTH FIRE DEPARTMENT OPEN HOUSE AND PLYMOUTH FARMER'S MARKET BROOKDALE CLINIC TEAM MEMBERS PARTICIPATED IN THE EARLE BROWN PARADE, A FLU CLINIC AND A HIGH SCHOOL EVENT ROGERS CLINIC TEAM MEMBERS PARTICIPATED IN ROCKIN ROGERS PARADE, ST. MICHAEL DAZE & KNIGHTS, OTSEGO FESTIVAL AND MAPLE GROVE HOSPITAL BABY BALL WAZATA AND CARLSON PARKWAY CLINIC TEAM MEMBERS PARTICIPATED IN JAMES J. HILL DAYS AND PARADE AND REGIS CORPORATION EMPLOYEE HEALTH FAIR SHAKOPEE CLINIC TEAM MEMBERS PARTICIPATED IN A BABY FAIR, DERBY DAYS, RELAY FOR LIFE, ST. FRANCIS CANDY BUY-BACK AND SAVAGE PTC CARNIVAL LAKEVILLE CLINIC TEAM MEMBERS PARTICIPATED IN PAN O PROG PARADE, THRIVE FOR 5, CAREER JAMBOREE AT LAKEVILLE NORTH & SOUTH, LAKEVILLE HOME AND GARDEN EXPO AND HALLOWEEN ELKO/NEW MARKET EVENT, DAKOTA COUNTY HEALTHY COMMUNITIES COLLABORATIVE, LAKEVILLE PEDIATRIC MENTAL HEALTH/CHEMICAL USE COLLABORATIVE, MENTAL HEALTH SUMMIT, THRIVE BY FIVE LAKEVILLE COMMITTEE, LIVING LONGER, ADHD SUPPORT GROUPS, LOCAL TALKS AT THE LIBRARY REGARDING SCHOOL READINESS/READING AND LAKEVILLE HIGH SCHOOL ANNUAL PRE-PROM EVENTS METHODIST HOSPITAL TEAM MEMBERS OFFERED A SLEEP HEALTH FAIR VOLUNTEER SERVICES TEAM MEMBERS PARTICIPATED IN AN EMPLOYEE WELLNESS FAIR JANE BRATTAIN BREAST CENTER TEAM MEMBERS PARTICIPATED IN BE PINK WAYZATA AND BE PINK COMMUNITY OUTREACH PROGRAMS AND EVENTS CONGREGATION NURSES VISITED MEMBERS FROM THEIR CONGREGATION AND LOCAL COMMUNITY FOR HEALTH ASSESSMENT, HEALTH EDUCATION, HEALTH COUNSELING ASTHMA AND ALLERGY TEAM MEMBERS PARTICIPATED IN AMERICAN LUNG ASSOCIATION ASTHMA CAMPIN ADDITION TO THE INITIATIVES SITED ABOVE, PARK NICOLLET FOUNDATION PROVIDES FINANCIAL AND OTHER SUPPORT TO ASSIST COMMUNITY NON-PROFIT PARTNERS. IN 2014, COMMUNITY GRANTEES INCLUDED: FOOD ACCESS FOR LOW-INCOME SENIORS 360 COMMUNITIES ICA MOBILE FOOD SHELF PRISM ST. LOUIS PARK EMERGENCY PROGRAM (STEP) NORTH MINNEAPOLIS MEALS ON WHEELS OPEN ARMS MN STORE TO DOOR OTHER SERVICES FOR LOW-INCOME SENIORS CATHOLIC CHARITIES OF ST. PAUL AND MINNEAPOLIS - CARE COORDINATION AND MANAGEMENT INTERFAITH OUTREACH AND COMMUNITY PARTNERS (IOCP) - SOCIAL CONNECTIVITY NEIGHBORHOOD INVOLVEMENT PROGRAM - IN-HOME CHORES, SAFETY ASSESSMENTS, SOCIAL EVENTS SENIOR COMMUNITY SERVICES - CARE TEAM COORDINATION, REFERRALS, NEEDS ASSESSMENTS VEAP - TRANSPORTATION JEWISH FAMILY AND CHILDREN'S SERVICES OF MPLS. - SUPPORT DEMENTIA CAPABLE COMMUNITIES YOUTH MENTAL HEALTH AVENUES FOR HOMELESS YOUTH BROOKLYN CENTER COMMUNITY SCHOOLS GUADALUPE ALTERNATIVE PROGRAMS ST. LOUIS PARK SCHOOL DISTRICT MINNESOTA AIDS PROJECT MYHEALTH FOR TEENS AND YOUNG ADULTS NATIONAL ALLIANCE ON MENTAL ILLNESS MN NORTHWEST HENNEPIN FAMILY SERVICE COLLABORATIVE RELATE ROBBINSDALE AREA SCHOOLS ST. DAVID'S CENTER FOR CHILD & FAMILY DEVELOPMENT TEENS ALONE THE FAMILY PARTNERSHIP WALK-IN COUNSELING CENTER WASHBURN CENTER FOR CHILDREN ACCESS AND AFFORDABILITY CHILDREN'S DENTAL SERVICES DOORSTEP HEALTHCARE SERVICES - DENTAL CARE FOR LOW-INCOME SENIORS CULTURALLY-SENSITIVE SERVICES PILLSBURY UNITED COMMUNITIES - CLOSING HEALTH DISPARITY GAPS FOR EAST AFRICAN SENIORS WELLSHARE INTERNATIONAL - SOMALI HEALTHY COMMUNITY INITIATIVE
PART VI, LINE 6: 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. PARK NICOLLET METHODIST HOSPITAL IS PART OF PARK NICOLLET HEALTH SERVICES, AN INTEGRATED HEALTH SYSTEM. OTHER AFFILIATES INCLUDE 1) PARK NICOLLET CLINICS IN 23 LOCATIONS, AND OTHER CARE LOCATIONS, 2) PARK NICOLLET FOUNDATION, THE PHILANTHROPIC ARM OF PARK NICOLLET HEALTH SERVICES HELPING TO BRING RESOURCES TO NEEDS IN ITS COMMUNITIES, 3) PARK NICOLLET INSTITUTE, FOCUSED ON EDUCATION AND RESEARCH FOR PARK NICOLLET HEALTH SERVICES AND ITS COMMUNITY, 4)PARK NICOLLET HEALTH CARE PRODUCTS, PROVIDING RETAIL PHARMACY AND HEALTH RELATED PRODUCTS THROUGH EXISTING PARK NICOLLET LOCATIONS. TRIA ORTHOPAEDIC CENTER FOCUSED ON ORTHOPAEDIC CARE.ALL AFFILIATES ARE UNDER A COMMON BOARD OF DIRECTORS. PARK NICOLLET FOUNDATION HAS A SEPARATE BOARD WHICH IS OVERSEEN BY THE PARK NICOLLET HEALTH SERVICES BOARD. THE COMMUNITIES' HEALTH NEEDS ARE SHARED AMONG THE AFFILIATES AND DECISIONS REGARDING THE EFFECTIVE USE OF RESOURCES TO RESPOND TO THESE NEEDS ARE COORDINATED.A SPECIFIC EXAMPLE OF THIS COORDINATION OF SERVICES TO RESPOND TO COMMUNITY NEED IS WITH THE FOUR SCHOOL-AFFILIATED COMMUNITY CLINICS. INITIAL DEVELOPMENT, FUNDING AND ONGOING FACILITATION IS PROVIDED BY THE PARK NICOLET FOUNDATION, STAFFING THROUGH THE PARK NICOLLET CLINICS, LABORATORY AND OTHER DIAGNOSTIC SERVICES THROUGH PARK NICOLLET METHODIST HOSPITAL, AND OUTPATIENT MEDICATIONS, EYE GLASSES, AND DME SUPPLIES THROUGH PARK NICOLLET HEALTH CARE PRODUCTS.
PART VI, LINE 7, REPORTS FILED WITH STATES MN
Schedule H (Form 990) 2014
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number
45-5023260
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) PARK NICOLLET FOUNDATION
6500 EXCELSIOR BLVD
ST LOUIS PARK,MN55426
23-7346465 501(C)(3) 240,000       GRANT MONEY TO OTHER ORGANIZATIONS
(2) HOPE CHEST FOR BREAST CANCER
3850 SHORELINE DRIVE
ORONO,MN55391
41-2019565 501(C)(3) 6,000       SCHOOL OF NURSING
(3) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH
200 FIRST STREET SW
ROCHESTER,MN55905
41-1506440 501(C)(3) 5,000       RESEARCH AND EDUCATION


















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
3
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated 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
(1) SCHOLARSHIPS 20 50,000      












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2: THE PARK NICOLLET SERVICE LEAGUE HAS A STUDENT VOLUNTEER SCHOLARSHIP PROGRAM TO GIVE FINANCIAL SUPPORT TO STUDENT VOLUNTEERS WHO HAVE PROVIDED EXCEPTIONAL VOLUNTEER SERVICE AND ARE INTERESTED IN FURTHERING THEIR EDUCATIONS. APPLICANTS MUST BE AN ACTIVE STUDENT VOLUNTEER, A SENIOR IN HIGH SCHOOL AND WHO HAS APPLIED TO A POST-HIGH SCHOOL EDUCATION PROGRAM AND MUST BE DEDICATED VOLUNTEER AT PARK NICOLLET METHODIST HOSPITAL. OCCASIONALLY PARK NICOLLET METHODIST HOSPITAL GRANTS MONIES TO OTHER TAX-EXEMPT ORGANIZATIONS CONDUCTION PROGRAMS AND/OR RESEARCH THAT WILL ULTIMATELY BENEFIT THOSE SERVICED BY PARK NICOLLET HEALTH SERVICES AND AFFILIATES, DURING CALENDAR YEAR GRANTS WERE MADE TO PARK NICOLLET FOUNDATION FOR IMPROVEMENT TO MEDICAL SERVICES, MEDICAL RESEARCH AND HEALTHY PATIENTS.
Schedule I (Form 990) 2014


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
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 (E) amounts for that individual.
(A) Name and Title (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 in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1THOMAS JONES MDDIRECTOR (i)
(ii)
672,471
...............................
0
17,623
...............................
0
79,570
...............................
0
24,336
...............................
0
31,571
...............................
0
825,571
...............................
0
0
...............................
0
2JEFF MENDELOFF MDDIRECTOR (i)
(ii)
651,930
...............................
0
25,182
...............................
0
57,662
...............................
0
24,336
...............................
0
37,723
...............................
0
796,833
...............................
0
0
...............................
0
3ERIC SCHNED MDDIRECTOR (i)
(ii)
226,738
...............................
0
7,744
...............................
0
52,165
...............................
0
24,336
...............................
0
24,086
...............................
0
335,069
...............................
0
0
...............................
0
4BRIAN H RANK MDDIRECTOR (i)
(ii)
0
...............................
563,458
0
...............................
170,198
0
...............................
56,867
0
...............................
182,005
0
...............................
43,538
0
...............................
1,016,066
0
...............................
32,856
5DAVID ABELSON MDSR EXEC VP & CEO PN (i)
(ii)
0
...............................
933,438
0
...............................
355,500
0
...............................
145,485
0
...............................
212,674
0
...............................
63,157
0
...............................
1,710,254
0
...............................
135,325
6BABETTE APLANDVP BEHAVIORAL HEALTH AND C (i)
(ii)
0
...............................
309,323
0
...............................
82,668
0
...............................
24,582
0
...............................
87,751
0
...............................
38,993
0
...............................
543,317
0
...............................
8,716
7CURT BOEHMMDCMIO (i)
(ii)
0
...............................
244,722
0
...............................
47,903
0
...............................
2,955
0
...............................
24,336
0
...............................
17,927
0
...............................
337,843
0
...............................
0
8STEVEN CONNELLY MDCMO SYSTEM ALIGNMENT & INT (i)
(ii)
0
...............................
503,866
0
...............................
156,291
0
...............................
75,978
0
...............................
85,590
0
...............................
52,604
0
...............................
874,329
0
...............................
64,180
9PAUL DAMROW MDCHIEF SURGICAL SERVICES (i)
(ii)
0
...............................
525,147
0
...............................
87,316
0
...............................
12,389
0
...............................
87,336
0
...............................
38,444
0
...............................
750,632
0
...............................
0
10JULIE FLASCHENRIEMVP AND CIO (i)
(ii)
0
...............................
179,385
0
...............................
59,293
0
...............................
218,301
0
...............................
7,007
0
...............................
36,812
0
...............................
500,798
0
...............................
40,059
11LAURA FRAZIERVP SURGICAL SERVICES (i)
(ii)
0
...............................
237,166
0
...............................
41,800
0
...............................
26,285
0
...............................
53,489
0
...............................
32,479
0
...............................
391,219
0
...............................
19,894
12ROXANNA GAPSTUR PHDSR VP & COO METHODIST HOSP (i)
(ii)
0
...............................
330,216
0
...............................
63,446
0
...............................
39,307
0
...............................
64,311
0
...............................
24,940
0
...............................
522,220
0
...............................
29,405
13CHRISTA GETCHELLPRESIDENT PNF, VP COMMUNIT (i)
(ii)
0
...............................
195,508
0
...............................
39,755
0
...............................
22,544
0
...............................
39,154
0
...............................
19,005
0
...............................
315,966
0
...............................
13,727
14DAVID HOMANS MDCHIEF SPECIALTY SSERVICES (i)
(ii)
0
...............................
559,872
0
...............................
11,299
0
...............................
64,203
0
...............................
73,956
0
...............................
33,419
0
...............................
742,749
0
...............................
44,108
15MICHAEL KAUPAEXEC VP & SYSTEM ALIGNMENT (i)
(ii)
0
...............................
223,875
0
...............................
167,214
0
...............................
1,324,302
0
...............................
10,600
0
...............................
48,584
0
...............................
1,774,575
0
...............................
184,610
16KATE KLUGHERZVP SPECIALTY SERVICES (i)
(ii)
0
...............................
224,584
0
...............................
40,249
0
...............................
24,741
0
...............................
44,990
0
...............................
22,987
0
...............................
357,551
0
...............................
15,972
17CATHERINE LENAGHVP & CFO (i)
(ii)
0
...............................
285,398
0
...............................
45,167
0
...............................
27,564
0
...............................
59,897
0
...............................
35,547
0
...............................
453,573
0
...............................
17,553
18BRETT LONGVP STRATEGY & GROWTH, HR (i)
(ii)
0
...............................
261,581
0
...............................
46,471
0
...............................
27,014
0
...............................
57,090
0
...............................
37,170
0
...............................
429,326
0
...............................
18,453
19KRISTI LYONVP PAYER RELATIONS (i)
(ii)
0
...............................
172,086
0
...............................
31,390
0
...............................
8,321
0
...............................
35,237
0
...............................
34,689
0
...............................
281,723
0
...............................
0
20JOHN MISA MDCHIEF PRIMARY CARE (i)
(ii)
0
...............................
366,557
0
...............................
66,126
0
...............................
69,714
0
...............................
68,616
0
...............................
30,939
0
...............................
601,952
0
...............................
50,613
21JOAN SANDSTROMVP PRIMARY CARE (i)
(ii)
0
...............................
270,725
0
...............................
48,807
0
...............................
13,653
0
...............................
57,300
0
...............................
31,808
0
...............................
422,293
0
...............................
0
22MELISSA SCHOENHERRVP MARKETING AND COMMUNICA (i)
(ii)
0
...............................
229,061
0
...............................
47,720
0
...............................
17,559
0
...............................
44,170
0
...............................
16,540
0
...............................
355,050
0
...............................
9,977
23CYNTHIA TOHER MDCHIEF IMPATIENT SERVICES (i)
(ii)
0
...............................
520,493
0
...............................
82,665
0
...............................
91,550
0
...............................
73,961
0
...............................
43,556
0
...............................
812,225
0
...............................
80,888
24DUANE SPIEGLEVP REAL ESTATE AND SUPPORT (i)
(ii)
0
...............................
218,692
0
...............................
42,870
0
...............................
33,722
0
...............................
52,056
0
...............................
40,542
0
...............................
387,882
0
...............................
22,330
25KATHERINE TARVESTADVP AND CARE GROUP COMPLIAN (i)
(ii)
0
...............................
260,731
0
...............................
78,134
0
...............................
52,018
0
...............................
56,009
0
...............................
21,360
0
...............................
468,252
0
...............................
42,271
26THEODORE WEGLEITNERCOO TRIA (i)
(ii)
0
...............................
193,239
0
...............................
59,187
0
...............................
40,696
0
...............................
56,103
0
...............................
37,628
0
...............................
386,853
0
...............................
31,366
27JOSHUA ZIMMERMANCHIEF OF BEHAVORIAL HEALTH (i)
(ii)
0
...............................
318,346
0
...............................
48,983
0
...............................
14,588
0
...............................
51,259
0
...............................
27,721
0
...............................
460,897
0
...............................
0
28NANCE MCCLURECHIEF OPERATING OFFICER (i)
(ii)
0
...............................
532,589
0
...............................
147,256
0
...............................
147,553
0
...............................
169,454
0
...............................
43,708
0
...............................
1,040,560
0
...............................
125,058
29BARBARA TRETHEWAYSR. VP, GENERAL COUNSEL (i)
(ii)
0
...............................
466,923
0
...............................
140,620
0
...............................
53,883
0
...............................
131,825
0
...............................
35,257
0
...............................
828,508
0
...............................
38,188
30PRAVEEN BAIMEEDI MDMEDICAL DOCTOR (i)
(ii)
1,260,988
...............................
0
39,547
...............................
0
3,037
...............................
0
24,336
...............................
0
47,087
...............................
0
1,374,995
...............................
0
0
...............................
0
31OLIVER CASS MDMEDICAL DOCTOR (i)
(ii)
882,405
...............................
0
24,547
...............................
0
7,770
...............................
0
24,336
...............................
0
41,448
...............................
0
980,506
...............................
0
0
...............................
0
32ANTHONY BOTTINIMDMEDICAL DOCTOR (i)
(ii)
814,131
...............................
0
35,227
...............................
0
2,478
...............................
0
24,336
...............................
0
39,139
...............................
0
915,311
...............................
0
0
...............................
0
33TIMOTHY DIEGELMDMEDICAL DOCTOR (i)
(ii)
444,371
...............................
0
15,075
...............................
0
379,591
...............................
0
24,336
...............................
0
22,275
...............................
0
885,648
...............................
0
0
...............................
0
34ASRA MOHIUDDIN MDMEDICAL DOCTOR (i)
(ii)
666,450
...............................
0
21,571
...............................
0
61,468
...............................
0
24,336
...............................
0
37,937
...............................
0
811,762
...............................
0
0
...............................
0
35SHELIA MCMILLANVP & CFO (i)
(ii)
0
...............................
19,276
0
...............................
79,648
0
...............................
509,350
0
...............................
0
0
...............................
16,074
0
...............................
624,348
0
...............................
54,582
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
PART I, LINES 4A-B THE AMOUNT OF SEVERANCE COMPENSATION AND BENEFITS PROVIDED TO EACH OF THE INDIVIDUALS ON SEVERANCE DURING 2014 IS AS FOLLOWS: SHEILA MCMILLAN $454,846 MICHAEL KAUPA $1,060,000 JULIE FLASCHENRIEM $115,455 SCHEDULE J, PART I, LINE 4B: SENIOR LEADERS OF PARK NICOLLET HEALTH SERVICES AND AFFILIATES ARE GIVEN THE OPPORTUNITY TO PARTICIPATE IN THE CAPITAL ACCUMULATION ACCOUNT PLAN. THE CAPITAL ACCUMULATION ACCOUNT PLAN (CAA PLAN) PARTICIPATION IS LIMITED TO SENIOR LEADERS AND ALL THE VICE PRESIDENTS. EACH PARTICIPANT RECEIVES AN ANNUAL ALLOWANCE EQUAL TO THE SUM OF (I) A STATED PERCENT OF SALARY, (II) VOLUNTARY SALARY DEFERRALS. THE ALLOWANCE IS CREDITED TO A BOOKKEEPING ACCOUNT. EARNINGS ARE CREDITED TO THE ACCOUNT BASED ON THE PERFORMANCE OF SIMULATED INVESTMENTS. BENEFITS VEST UPON THE EARLIEST OF REMAINING EMPLOYED TO AN ELECTIVE VESTING DATE (TWO YEARS TO AGE 68), INVOLUNTARY TERMINATION WITHOUT CAUSE, DISABILITY, DEATH, OR NOT COMPETING FOR 24 MONTHS FOLLOWING VOLUNTARY OR FOR-CAUSE TERMINATION. BENEFITS ARE PAID IN A SINGLE LUMP SUM UPON VESTING. PARTICIPANTS ARE GENERAL CREDITORS OF THE EMPLOYER FOR THE PAYMENT OF THE BENEFITS. THE FOLLOWING PARTICIPANTS RECEIVED PAYOUTS FROM A RELATED ORGANIZATION, PARK NICOLLET HEALTH SERVICES, RELATED TO CAA PLAN: NAME 2014 COMPENSATION STEVEN CONNELLY, MD $ 64,180 JULIE FLASCHENRIEM $ 40,059 LAURA FRAZIER $ 19,894 ROXANNA GAPSTUR $ 29,405 DAVID HOMANS, MD $ 44,108 MICHAEL KAUPA $ 184,610 CATHERINE LENAGH $ 17,553 BRETT LONG $ 18,453 SHEILA MCMILLAN $ 54,582 JOHN MISA, MD $ 50,613 DUANE SPIEGLE $ 22,330 THEODORE WEGLEITNER $ 31,366 CATHERINE KLUGHERZ $ 15,972 CHRISTA GETCHELL $ 13,727 KATHERINE TARVESTAD $ 42,271 CYNTHIA TOHER, MD $ 80,888 MELISSA SCHOENHERR $ 9,977 OFFICERS AND DIRECTORS EMPLOYED BY HEALTHPARTNERS, INC HAVE DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II WHICH INCLUDE AMOUNTS FROM A NONQUALIFIED 457(F) PLAN, THE FOLLOWING PARTICIPANTS RECEIVED PAYOUTS: DAVID ABELSON, MD $ 135,325 BABETTTE APLAND $ 8,716 BRIAN RANK, MD $ 32,856 NANCE MCCLURE $ 125,058 BARBARA TRETHEWAY $ 38,138
PART I, LINE 7 ALL PHYSICIANS, EMPLOYED BY AND SEEING PATIENTS FOR PARK NICOLLET HEALTH SERVICES AND AFFILIATES, ARE ELIGIBLE FOR A 3% ACCESS INCENTIVE PAYOUT BASED ON THEIR DEPARTMENT REACHING CERTAIN GOALS INCLUDING ACCESS FOR PATIENTS AND QUALITY INITIATIVES. IN THEIR ROLES AS EXECUTIVES EMPLOYED BY PARK NICOLLET HEALTH SERVICES, THE EXECUTIVES ARE ELIGIBLE FOR INCENTIVE PAYOUTS. THE INCENTIVE AWARD WILL BE 40% FOR THE CFO, COO, CMO AND 30% FOR ALL OTHER EXECUTIVES WITH AN OPPORTUNITY FOR INCENTIVE CREDIT ABOVE THE TARGET LEVEL. THE ULTIMATE PAYOUT INCLUDES A REDUCTION/INCREASE MULTIPLIER DEPENDING ON WHETHER THE CONSOLIDATED PARK NICOLLET HEALTH SERVICES ORGANIZATION REACHED THAT YEAR'S OPERATING MARGIN GOAL AS SET BY THE BOARD OF DIRECTORS. EACH PARTICIPANT WILL BE RESPONSIBLE FOR TWO FINANCIAL GOALS, AND NOT LESS THAN THREE AND NOT MORE THAN FIVE INDIVIDUAL STRATEGIC OBJECTIVES. IN THEIR ROLES AS MANAGEMENT EMPLOYED BY PARK NICOLLET HEALTH SERVICES, CERTAIN DIRECTORS AND MANAGERS ARE ELIGIBLE FOR INCENTIVE PAYOUTS. THE INCENTIVE AWARD ELIGIBLE PARTICIPANTS WILL BE 20% AT THE DIRECTOR-LEVEL AND 15% AT THE MANAGER-LEVEL, USING THEIR ELIGIBLE ANNUAL BASE PAY COMPENSATION WITH AN OPPORTUNITY FOR INCENTIVE CREDIT ABOVE THE TARGET LEVEL. THE ULTIMATE PAYOUT DEPENDS ON INDIVIDUAL GOAL PERFORMANCE. THE PARTICIPANT MUST BE ASSIGNED AT LEAST THREE, AND NOT MORE THAN FOUR FOCUSED INCENTIVE OBJECTIVE, ONE OF WHICH MUST BE FINANCIAL IN NATURE
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
(1) ERIC SCHNED MD   SALARY DRAW IN EXCESS   X 119 119   No   No   No
Total ......Small Bullet $ 119
Part III
Grants or Assistance Benefiting 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 assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2014
Schedule L (Form 990 or 990-EZ) 2014
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) RANDI NORBY ROXANNA GAPSTUR, PHD 150,567 EMPLOYMENT Yes  
(2) SUSAN SPIEGLE DUANE SPIEGLE 47,387 EMPLOYMENT Yes  
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 6 PARK NICOLLET HEALTH SERVICES IS THE SOLE MEMBER OF PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PARK NICOLLET INSTITUTE AND PARK NICOLLET HEALTH CARE PRODUCTS. PARK NICOLLET CLINIC IS THE SOLE MEMBER OF PNMC HOLDINGS.
FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS OF PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PARK NICOLLET INSTITUTE, PNMC HOLDINGS AND PARK NICOLLET HEALTH CARE PRODUCTS ARE THOSE INDIVIDUALS WHO ARE CONTEMPORANEOUSLY MEMBERS OF THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES.
FORM 990, PART VI, SECTION A, LINE 7B ALL DECISIONS, INCLUDING DISSOLUTION OF THE ORGANIZATION, MADE BY THE GOVERNING BODY OF PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PARK NICOLLET INSTITUTE, PNMC HOLDINGS AND PARK NICOLLET HEALTH CARE PRODUCTS ARE SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES.
FORM 990, PART VI, SECTION B, LINE 11 PARK NICOLLET GROUP PREPARES THE FORM 990 WITHIN THE FINANCE DEPARTMENT WITH ASSISTANCE FROM INDIVIDUALS IN HUMAN RESOURCES, MARKETING, OPERATIONS AND LEGAL. UPON COMPLETION OF GATHERING THE NECESSARY INFORMATION FOR THE RETURN, THE FORM WAS REVIEWED BY THE PARK NICOLLET GROUP'S ACCOUNTING FIRM. DRAFTS OF THE FORM WERE ALSO REVIEWED BY THE ASSISTANT CONTROLLER - ACCOUNTING OPERATIONS, VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER, THE LEGAL DEPARTMENT AND THE AUDIT AND COMPLIANCE COMMITTEE. AFTER ALL REVIEWS WERE COMPLETE; THE FORM 990 WAS GIVEN TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12C AT PARK NICOLLET HEALTH SERVICES ALL KEY EMPLOYEES, DIRECTORS, AND OFFICERS ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST DISCLOSURE STATEMENT EACH YEAR; HOWEVER THE OBLIGATION TO REPORT POTENTIAL CONFLICTS IS ONGOING. PARK NICOLLET HEALTH SERVICES BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES PURSUANT TO ITS CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS AND OFFICERS ANNUALLY ARE PROVIDED A COPY OF THE POLICY AND REQUIRED TO COMPLETE A QUESTIONNAIRE INDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNCEL REVIEWS THE COMPLETED QUESTIONNAIRES AND PROVIDES A REPORT TO THE GOVERNANCE COMMITTEE OF THE BOARD. THE REPORT IDENTIFIES ANY SIGNIFICANT POTENTIAL CONFLICTS DISCLOSED IN THE COMPLETED QUESTIONNAIRES. A WRITTEN REPORT IS PROVIDED TO THE CHAIR AND CHIEF EXECUTIVE OFFICER (CEO). BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY.`
FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES AFFILIATES ARE THOSE INDIVIDUALS WHO ARE CONTEMPORANEOUSLY MEMBERS OF THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES. THE PARK NICOLLET HEALTH SERVICES' BOARD OF DIRECTORS IS RESPONSIBLE FOR THE IMPLEMENTATION AND OVERSIGHT OF EXECUTIVE COMPENSATION AND BENEFIT PLANS. PARK NICOLLET USES AN OUTSIDE CONSULTANT TO PROVIDE A YEARLY MARKET BASED INDEX OF SALARY ADJUSTMENTS FOR EXECUTIVES IN SIMILAR LEADERSHIP POSITIONS. THE BOARD OF DIRECTORS REVIEWS THE SALARY RANGES AND RECOMMENDS SALARY INCREASES FOR EACH EXECUTIVE, INCLUDING THE CEO, BASED UPON THE BOARD OF DIRECTORS' EVALUATION OF JOB PERFORMANCE AND EXPERIENCE LEVEL OF THE INDIVIDUAL WITHIN THE ORGANIZATION. THE AVERAGE SALARY INCREASES FOR ALL PARK NICOLLET EXECUTIVES CANNOT EXCEED THE AVERAGE MARKET SALARY INCREASE REPORTED FOR EXECUTIVES BY THE CONSULTANT. THE COMPENSATION COMMITTEE THEN REVIEWS AND APPROVES COMPENSATION ADJUSTMENTS BASED ON THE INFORMATION PROVIDED BY THE OUTSIDE CONSULTANTS AND THE BOARD OF DIRECTORS' RECOMMENDATIONS. FOR CERTAIN PHYSICIANS, THE MAJORITY OF PAY DISCLOSED IS FOR HIS/HER WORK AS A PHYSICIAN FOR PARK NICOLLET INSTITUTE OR PARK NICOLLET CLINIC. A SMALL STIPEND IS ADDED FOR SERVING ON THE BOARD OF DIRECTORS. THE FOLLOWING IS A DESCRIPTION OF HOW PAY FOR PHYSICIANS' PATIENT CARE WORK IS DETERMINED. THE PARK NICOLLET HEALTH SERVICES' BOARD OF DIRECTORS IS RESPONSIBLE FOR THE IMPLEMENTATION AND OVERSIGHT OF THE PHYSICIAN COMPENSATION AND BENEFIT PLANS. THE BOARD OF DIRECTORS DELEGATES THE DAY-TO-DAY ADMINISTRATION OF THE PHYSICIAN COMPENSATION PLAN TO THE CEO. THE CHIEF MEDICAL OFFICER, WHO REPORTS DIRECTLY TO THE CEO, ADMINISTERS THE COMPENSATION PROGRAM. A COMPENSATION AND BENEFITS COMMITTEE SERVES IN AN ADVISORY CAPACITY TO THE CMO IN ORDER TO ADMINISTER PHYSICIAN COMPENSATION WITHIN THE BUDGET TO ENSURE FAIRNESS AND ALIGNMENT WITH PARK NICOLLET HEALTH SERVICES' GOALS. THE RESPONSIBILITIES OF THE CMO: RECOMMENDING COMPENSATION POLICIES AND PLAN DESIGNS FOR PHYSICIANS TO THE CEO AND BOARD OF DIRECTORS; OVERSEEING COMPENSATION PLAN OPERATION AND PAYMENTS TO CLINICAL DEPARTMENTS; EVALUATING COMPENSATION PLAN FOR PERFORMANCE ON A PERIODIC BASIS; SERVING AS FINAL APPEAL PROCESS FOR ISSUES UNRESOLVED BY INDIVIDUALS, DEPARTMENT CHAIRS AND CHIEFS OF SERVICES. ANNUALLY, INFORMATION ON EACH PHYSICIAN'S PAY AND PRODUCTIVITY IS GRAPHED AGAINST THE SURVEY RESULTS FOR THE SAME YEAR. THIS INFORMATION IS PRESENTED TO THE COMPENSATION COMMITTEE OF THE PARK NICOLLET HEALTH SERVICES BOARD OF DIRECTORS FOR REVIEW. PARK NICOLLET HEALTH SERVICES' PHYSICIAN PAY PROGRAM IS DESIGNED TO ENSURE MARKET BASED PAY FOR MARKET BASED PRODUCTIVITY STANDARDS. THE MARKET IS DETERMINED BY THE AMERICAN MEDICAL GROUP ASSOCIATION (AMGA) NATIONAL PHYSICIAN COMPENSATION SURVEY DATA, WHICH PROVIDES MARKET DATA FOR BOTH COMPENSATION AND PRODUCTIVITY. WHEN APPROPRIATE, THE CMO MAY RECOMMEND ADJUSTMENTS TO THESE GUIDELINES WITH EVIDENCE OF LOCAL MARKET DATA.
FORM 990, PART VI, SECTION C, LINE 19 PARK NICOLLET GROUP MEMBERS' GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. PARK NICOLLET HEALTH SERVICES, AS THE PARENT ORGANIZATION OF THE PARK NICOLLET GROUP, MAILS ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS TO FINANCIAL INSTITUTIONS, GOVERNMENTAL INSTITUTIONS, BOARD MEMBERS, MEDIA REPRESENTATIVES, VENDORS, AND THE MINNESOTA HOSPITAL ASSOCIATION (MHA). PARK NICOLLET HEALTH SERVICES DISCLOSES QUARTERLY FINANCIAL STATEMENTS TO BONDHOLDERS AND MHA. THE ANNUAL AUDITED AND QUARTERLY FINANCIAL STATEMENTS ARE ALSO POSTED AT EMMA.MSRB.ORG. THE FORMS 990 ARE AVAILABLE UPON REQUEST OR FROM THE STATE OF MINNESOTA.
FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS -151,203. GRANTS RUN THROUGH THE FOUNDATION -2,162,630.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) 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 entity?
Yes No
(1) PARK NICOLLET HEALTH SERVICE
6500 EXCELSIOR BLVD

ST LOUIS PARK,MN55426
36-3465840
HEALTH CARE ADMINSTRATIONS MN 501(C)(3) 509(A)(2)  
 
No
(2) PARK NICOLLET FOUNDATION
6500 EXCELSIOR BLVD

ST LOUIS PARK,MN55426
23-7346465
GRANTS TO SERVE THE COMMUNITY MN 501(C)(3) 170(B)(1) (A)(VI) PARK NICOLLET HEALTH SERVICES
 
Yes
 
(3) TRIA ORTHOPEADIC CENTER RESEARCH INSTITUTE
8100 NOIRTHLAND DRIVE

BLOOMINGTON,MN55431
20-0033919
HEALTH CARE RESEARCH AND EDUCATION MN 501(C)(3) 509(A)(3) TYPE I PARK NICOLLET HEALTH SERVICES
 
Yes
 
(4) HEALTHPARTNERS INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1693838
HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(4)   N/A
Yes
 
(5) HPI - RAMSEY
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1793333
CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC
 
Yes
 
(6) GROUP HEALTH PLAN INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-0797853
STAFF MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(3) 170(B)(1) (A)(III) HEALTHPARTNERS INC
 
Yes
 
(7) HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1670163
HEALTHCARE EDUCATION & RESEARCH MN 501(C)(3) 509(A)(3) TYPE I GROUP HEALTH PLAN INC
 
Yes
 
(8) CAPITOL VIEW TRANSITIONAL CARE CENTER
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-2011453
POST HOSPITALIZATION PATIENT CARE MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY
 
Yes
 
(9) REGIONS HOSPITAL
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-0956618
HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY
 
Yes
 
(10) REGIONS HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1888902
PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 170(B)(1) (A)(VI) HPI - RAMSEY
 
Yes
 
(11) RHSC INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1891928
HEALTHCARE STAFFING MN 501(C)(3) 509(A)(3) TYPE II HEALTHPARTNERS INC
 
Yes
 
(12) RH-WISCONSIN
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
20-2287016
CORPORATE PLANNING AND OVERSIGHT WI 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY
 
Yes
 
(13) PHYSICIANS NECK AND BACK CLINICS
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
27-0684883
SPECIALTY PATIENT CARE MN 501(C)(3) 509(A)(3) TYPE II GROUP HEALTH PLAN INC
 
Yes
 
(14) HUDSON HOSPITAL INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
39-0804125
HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN
 
Yes
 
(15) HUDSON HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
39-1279567
PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT WI 501(C)(3) 170(B)(1) (A)(VI) HUDSON HOSPITAL INC
 
Yes
 
(16) WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
26-3616590
PROVIDE MEDICAL TRANSPORT SERVICES WI 501(C)(3) 509(A)(3) TYPE II RH-WISCONSIN
 
Yes
 
(17) LAKEVIEW MEMORIAL HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1386635
PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 509(A)(3) TYPE II STILLWATER HEALTH SYSTEM
 
Yes
 
(18) LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-0811697
HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) STILLWATER HEALTH SYSTEM
 
Yes
 
(19) STILLWATER MEDICAL GROUP
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
83-0379473
PHYSICIANS GROUP MN 501(C)(3) 509(A)(2) STILLWATER HEALTH SYSTEM
 
Yes
 
(20) STILLWATER HEALTH SYSTEM
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
30-0221189
CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY
 
Yes
 
(21) WESTFIELDS HOSPITAL INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
39-0808442
HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN
 
Yes
 
(22) WESTFIELDS HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
39-1770913
PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT WI 501(C)(3) 509(A)(3) TYPE I WESTFIELDS HOSPITAL INC
 
Yes
 
(23) RAMSEY INTEGRATED HEALTH SERVICES
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1503090
IN-HOME PATIENT CARE MN 501(C)(3) 509(A)(2) HPI - RAMSEY
 
Yes
 
(24) AMERY REGIONAL MEDICAL CENTER INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
39-0908320
HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN
 
Yes
 
(25) AMERY REGIONAL MEDICAL CENTER FOUNDATION
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
39-1726539
PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT WI 501(C)(3) 170(B)(1) (A)(VI) AMERY REGIONAL MEDICAL CENTER INC
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) METHODIST BRAIN LAB LEASING LLC

6500 EXCELSIOR BLVD
ST LOUIS PARK,MN55426
20-8725994
HEALTH CARE MN PARK NICOLLET METHODIST HOSPITAL
 
        No     No  












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) PARK NICOLLET ENTERPRISES

6500 EXCELSIOR BLVD
ST LOUIS PARK,MN55426
41-1656735
REAL ESTATE FOR RELATED ORGANICATION MN PARK NICOLLET HEATLH SERVICES
 
C -56,888 15,311,093 100.000 %   No
(2) HEALTHPARTNERS ADMINISTRATORS INC

8170 33RD AVE S PO BOX 1309
MPLS,MN554401309
41-1629390
THIRD PARTY ADMINISTRATOR MN HEALTHPARTNERS INC
 
C         No
(3) HEALTHPARTNERS ASSOCIATES INC

8170 33RD AVE S PO BOX 1309
MPLS,MN554401309
52-2365151
MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT MN HEALTHPARTNERS ADMINISTRATORS INC
 
C         No
(4) HEALTHPARTNERS SERVICES INC

8170 33RD AVE S PO BOX 1309
MPLS,MN554401309
41-1683568
MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT MN HEALTHPARTNERS ADMINISTRATORS INC
 
C         No
(5) HEALTHPARTNERS INSURANCE COMPANY

8170 33RD AVE S PO BOX 1309
MPLS,MN554401309
41-1683523
MEDICAL AND DENTAL INSURANCE MN HEALTHPARTNERS ADMINISTRATORS INC
 
C         No
(6) DENTAL SPECIALTIES INC

8170 33RD AVE S PO BOX 1309
MPLS,MN554401309
45-1297583
PROFESSIONAL DENTAL SERVICES MN HEALTHPARTNERS ADMINISTRATORS INC
 
C         No
(7) HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC

8170 33RD AVE S PO BOX 1309
MPLS,MN554401309
41-1236798
MEDICAL CLINIC STAFFING MN HEALTHPARTNERS ADMINISTRATORS INC
 
C         No
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
 
No
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) PARK NICOLLET HEALTH SERVICES

M 14,102,800 COST
(2) PARK NICOLLET HEALTH SERVICES

P 1,175,249,310 COST
(3) PARK NICOLLET HEALTH SERVICES

J 519,109 COST
(4) PARK NICOLLET HEALTH SERVICES

R 1,214,905,157 COST
(5) METHODIST BRAIN LAB LEASING LLC

K 538,340 COST
(6) METHODIST BRAIN LAB LEASING LLC

S 212,183 COST
(7) HEALTHPARTNERS INC

L 48,379,255 COST
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


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