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
HENNEPIN HEALTHCARE SYSTEM INC
 
Doing business as
HENNEPIN COUNTY MEDICAL CENTER
 
Number and street (or P.O. box if mail is not delivered to street address)
701 PARK AVENUE P-1
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MINNEAPOLIS, MN55415
D Employer identification number

42-1707837
E Telephone number

G Gross receipts $ 835,331,502
F Name and address of principal officer:
LARRY A KRYZANIAK
701 PARK AVENUE
MINNEAPOLIS,MN55415
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.HCMC.ORG
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 MediumBullet  
K Form of organization:
 
L Year of formation: 2007
M State of legal domicile: MN
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: WE PARTNER WITH OUR COMMUNITY, OUR PATIENTS AND THEIR FAMILIES TO ENSURE ACCESS TO OUTSTANDING CARE FOR EVERYONE, WHILE IMPROVING HEALTH AND WELLNESS THROUGH TEACHING, PATIENT AND COMMUNITY EDUCATION, AND RESEARCH.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 8
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 7,112
6 Total number of volunteers (estimate if necessary) ............. 6 591
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,574,150
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 27,642,939 44,977,475
9 Program service revenue (Part VIII, line 2g) ......... 761,060,378 788,017,563
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 343,476 1,383,881
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 155,437 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 789,202,230 834,378,919
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 621,330 431,987
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 551,682,571 566,855,876
16a Professional fundraising fees (Part IX, column (A), line 11e).....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 261,146,931 255,621,808
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 813,450,832 822,909,671
19 Revenue less expenses. Subtract line 18 from line 12....... -24,248,602 11,469,248
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 480,179,554 537,723,414
21 Total liabilities (Part X, line 26)............. 184,284,588 230,282,259
22 Net assets or fund balances. Subtract line 21 from line 20..... 295,894,966 307,441,155
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: WE PARTNER WITH OUR COMMUNITY, OUR PATIENTS AND THEIR FAMILIES TO ENSURE ACCESS TO OUTSTANDING CARE FOR EVERYONE, WHILE IMPROVING HEALTH AND WELLNESS THROUGH TEACHING, PATIENT AND COMMUNITY EDUCATION, AND RESEARCH.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations 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 $ 657,229,504 including grants of $ 368,677 ) (Revenue $ 733,890,156 )
HHS INC. (D/B/A HCMC) (HEREAFTER HHS) IS AN INTEGRATED NETWORK OF PHYSICIANS, HOSPITAL, AMBULATORY CARE SERVICES, PHARMACIES AND AMBULANCE SERVICE. HHS PROVIDES ACCESS TO A RANGE OF HEALTH CARE SERVICES IN MINNEAPOLIS AND THE SURROUNDING METROPOLITAN AREA. THE CAPACITY AND WILLINGNESS TO PROVIDE COMPREHENSIVE SERVICES TO ANYONE IN NEED SETS HHS APART FROM OTHER PROVIDERS. AS OF DECEMBER 31, 2014, HHS OPERATED A HOSPITAL WITH LICENSED CAPACITY OF 894 BEDS AND 65 BASSINETS, OF WHICH 472 BEDS AND 62 BASSINETS WERE AVAILABLE, AS WELL AS 12 PRIMARY CARE CLINICS AND 34 SPECIALTY CARE CLINICS, 6 PHARMACY LOCATIONS, AND EMPLOYED APPROXIMATELY 701 PROVIDERS,222 RESIDENTS AND 135 PHARMACISTS.
4b (Code:   ) (Expenses $ 18,965,262 including grants of $ 37,531 ) (Revenue $ 49,928,973 )
HHS STAFF AND TRAINEES RECEIVE TRAINING ON QUALITY AND SAFETY, PATIENT- AND FAMILY-CENTERED CARE, CULTURALLY-COMPETENT CARE, AND OTHER HEALTH ISSUES AFFECTING HIGH-RISK AND SPECIAL NEEDS PATIENTS. HHS OFFERS TRAINING TO THOUSANDS OF PHYSICIANS, NURSES, PARAMEDICS, EMT'S, TECHNICIANS, SOCIAL WORKERS, PHARMACISTS, PHYSICIAN ASSISTANTS, SPEECH PATHOLOGISTS, POLICE, SHERIFF, AND FIRE DEPARTMENT "FIRST RESPONDERS", AMBULANCE AND AIR-LINK CREWS, AND STATEWIDE EMERGENCY DEPARTMENT HEALTH PERSONNEL AND OTHER HEALTH CARE PROVIDERS EACH YEAR IN MORE THAN 50 PROGRAMS INCLUDING IN EMERGENCY AND TRAUMA CARE. STUDENTS FROM MORE THAN 140 HOSPITALS, COLLEGES, UNIVERSITIES, AND OTHER FACILITIES ACROSS THE WORLD COME TO HHS FOR CLINICAL TRAINING.
4c (Code:   ) (Expenses $ 631,736 including grants of $ 25,779 ) (Revenue $ 4,198,434 )
HHS CONDUCTS ITS RESEARCH ACTIVITIES THROUGH THE MINNEAPOLIS MEDICAL RESEARCH FOUNDATION (MMRF). THE CRITICAL RESEARCH MISSION FOSTERS HHS' EFFORTS TOWARDS IMPROVING THE HEALTH OF OUR COMMUNITY. THE RESEARCH MISSION CONTRIBUTES TO ATTRACTING EXCELLENT CLINICIANS WHO CAN BETTER SERVE THE CURRENT AND FUTURE HEALTH NEEDS OF HHS' PATIENTS AND THE BROADER COMMUNITY.
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet676,826,502
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
 
No
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
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI 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.........
14b
 
No
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 IV
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...
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
 
No
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....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
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................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV ..........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, 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
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 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
1,268
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
7,112
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” 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
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
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
13
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
8
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
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
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:
MediumBulletCHARLES ESLER CONTROLLER
701 PARK AVENUE P-1
MINNEAPOLIS,MN55415 (612) 873-6518
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) JON L PRYOR MD MBA........................................................................
CEO
40.00
.......................  
X   X       726,088 0 42,692
(2) DOUGLAS B BRUNETTE MD........................................................................
DIRECTOR
40.00
.......................  
X           440,756 0 43,929
(3) TARA GUSTILO MD........................................................................
DIRECTOR
32.00
.......................  
X           282,836 0 42,127
(4) MICHAEL OPAT MPP........................................................................
DIRECTOR
2.00
.......................40.00
X           0 104,703 26,434
(5) JANIS CALLISON MA JD........................................................................
DIRECTOR
2.00
.......................40.00
X           0 103,262 13,674
(6) ANNE PEREIRA MD........................................................................
DIRECTOR
20.00
.......................  
X           97,662 0 13,074
(7) CHRISTOPHER PUTO PHD........................................................................
CHAIR, FINAN
2.00
.......................  
X           0 0 0
(8) SHARON SAYLES BELTON........................................................................
BOARD CHAIR
2.00
.......................  
X           0 0 0
(9) ATUM AZZAHIR........................................................................
DIRECTOR
2.00
.......................  
X           0 0 0
(10) SAMUEL E CARLSON MD FACP........................................................................
DIRECTOR
2.00
.......................  
X           0 0 0
(11) SUZANNA DE BACA MBA........................................................................
DIRECTOR
2.00
.......................  
X           0 0 0
(12) DAVID EBEL MA........................................................................
DIRECTOR
2.00
.......................  
X           0 0 0
(13) BRIAN RANALLO........................................................................
DIRECTOR
2.00
.......................  
X           0 0 0
(14) SHEILA RIGGS DDS DMSC........................................................................
DIRECTOR
2.00
.......................  
X           0 0 0
(15) RAY WALDRON........................................................................
DIRECTOR
2.00
.......................  
X           0 0 0
(16) LARRY A KRYZANIAK MS........................................................................
CFO
40.00
.......................  
    X       426,015 0 35,542
(17) DONALD M JACOBS MD........................................................................
CHIEF CLINIC
40.00
.......................  
      X     501,556 0 39,717
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) MICHAEL B BELZER MD........................................................................
CHIEF MEDICA
40.00
.......................  
      X     409,590 0 32,248
(19) KATHY WILDE RN MA........................................................................
CHIEF NURSIN
40.00
.......................  
      X     367,629 0 36,887
(20) STEVEN P STERNER MD FACEP........................................................................
CHIEF PROVID
40.00
.......................  
      X     363,725 0 31,816
(21) SCOTT WORDELMAN FACHE........................................................................
VP AMBULATOR
40.00
.......................  
      X     362,824 0 26,307
(22) WALTER T CHESLEY JD........................................................................
VP HUMAN RES
40.00
.......................  
      X     282,062 0 31,412
(23) NANCY GARRETT PHD........................................................................
CHIEF ANALYT
40.00
.......................  
      X     272,480 0 35,725
(24) CHARLES L TRUWIT MD........................................................................
PHYSICIAN CH
40.00
.......................  
        X   678,502 0 43,929
(25) CONSTANTIN N STARCHOOK MD........................................................................
PHYSICIAN
40.00
.......................  
        X   676,439 0 43,929
(26) GOPAL V PUNJABI MD........................................................................
PHYSICIAN
40.00
.......................  
        X   600,381 0 43,929
(27) ANTHONY L SEVERT MD........................................................................
PHYSICIAN -
40.00
.......................  
        X   600,081 0 43,929
(28) PRATEEK SAHGAL MD........................................................................
PHYSICIAN -
40.00
.......................  
        X   600,081 0 43,929




1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 7,688,707 207,965 671,229
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet811
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. 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
UNIVERSITY OF MINNESOTA

1425 UNIVERSITY AVENUE SE
MINNEAPOLIS,MN55455
PHYSICIAN SVCS 7,420,003
MEDICA

PO BOX 1450
MINNEAPOLIS,MN55485
HLTH PLAN ADMIN 5,883,767
EPIC SYSTEMS CORPORATION

PO BOX 88314
MILWAUKEE,WI53288
INFO TECHNOLOGY 3,333,296
MCGOUGH CONSTRUCTION INC

2737 FAIRVIEW AVENUE NORTH
ST PAUL,MN55113
CONSTRUCTION 2,958,198
HEALTH SYSTEMS CO-OP LAUNDRIES

725 MINEHAHA AVE E
ST PAUL,MN55106
LAUNDRY SERVICE 2,637,369
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet256
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 37,341,365
f All other contributions, gifts, grants, and
similar amounts not included above
1f
7,636,110
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 44,977,475
 Program Service RevenueAmt Business Code
2a MEDICARE/ MEDICAID REVENUE 624100 483,759,243 483,759,243    
b MANAGED CARE - COMMERCIAL 621990 207,325,390 207,325,390    
c RETAIL PHARMACY REVENUE 621990 47,817,068 47,817,068    
d UPPER PAYMENT LIMIT REVENUE 446110 39,355,191 39,355,191    
e OTHER OPERATING REVENUE 900099 6,492,435     6,492,435
f All other program service revenue . 3,268,236   1,574,150 1,694,086
g Total. Add lines 2a–2f........MediumBullet 788,017,563
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 1,264,022     1,264,022
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 676,110  
b Less: rental expenses 676,110  
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 396,332  
b Less: cost or other basis and sales expenses 276,473  
c Gain or (loss) 119,859  
d Net gain or (loss)..........MediumBullet 119,859     119,859
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet  
12 Total revenue. See Instructions......MediumBullet 834,378,919 778,256,892 1,574,150 9,570,402
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 .... 431,987 431,987
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ....    
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 .... 4,944,696 1,463,756 3,480,940  
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 .... 437,192,236 348,470,263 88,721,973  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 30,280,233 23,965,615 6,314,618  
9 Other employee benefits ....... 66,417,486 52,566,832 13,850,654  
10 Payroll taxes ........... 28,021,225 22,177,699 5,843,526  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 1,187,918 940,190 247,728  
c Accounting ........... 414,964   414,964  
d Lobbying ........... 187,527 187,527    
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 134,969 106,823 28,146  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 11,882,953 9,404,891 2,478,062  
12 Advertising and promotion .... 906,021 717,080 188,941  
13 Office expenses ....... 7,159,394 5,666,379 1,493,015  
14 Information technology ...... 12,550,864 9,933,516 2,617,348  
15 Royalties ..        
16 Occupancy ........... 13,937,422 11,030,922 2,906,500  
17 Travel ............ 716,548 567,120 149,428  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 1,131,354 895,422 235,932  
20 Interest ........... 274,271 217,075 57,196  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 33,028,784 26,140,985 6,887,799  
23 Insurance .............. 1,280,921 1,013,799 267,122  
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 DRUGS & SUPPLIES 83,466,988 83,466,988    
b PURCHASED SERVICES 43,651,479 34,557,517 9,093,962  
c BAD DEBTS 22,191,966 22,191,966    
d TAXES 17,608,318 17,608,318    
e All other expenses 3,909,147 3,103,832 805,315  
25 Total functional expenses. Add lines 1 through 24e 822,909,671 676,826,502 146,083,169 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here 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 ............. 41,047,821 1 49,344,464
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 189,815,847 4 232,311,641
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  
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
  6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 4,003,324 8 4,712,581
9 Prepaid expenses and deferred charges .......... 3,625,536 9 6,992,648
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 617,181,310
b Less: accumulated depreciation ..... 10b 378,494,282 236,426,338 10c 238,687,028
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ..... 5,254,050 12 5,668,414
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 6,638 15 6,638
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 480,179,554 16 537,723,414
Liabilities 17 Accounts payable and accrued expenses ......... 150,986,878 17 156,762,070
18 Grants payable .................   18  
19 Deferred revenue ................ 2,422,805 19 1,898,395
20 Tax-exempt bond liabilities .............   20  
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 ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 30,874,905 25 71,621,794
26 Total liabilities. Add lines 17 through 25......... 184,284,588 26 230,282,259
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 ..............   27  
28 Temporarily restricted net assets ...........   28  
29 Permanently restricted net assets ...........   29  
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 ..... 235,240,618 31 238,991,882
32 Retained earnings, endowment, accumulated income, or other funds 60,654,348 32 68,449,273
33 Total net assets or fund balances ........... 295,894,966 33 307,441,155
34 Total liabilities and net assets/fund balances ........ 480,179,554 34 537,723,414
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
834,378,919
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
822,909,671
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
11,469,248
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
295,894,966
5
Net unrealized gains (losses) on investments ...............
5
76,941
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
 
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
307,441,155
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: ENTERPRISE
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
 
No
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
 
 
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
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
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
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
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

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





Form 990-PF




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

42-1707837
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
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
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
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
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
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

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

1
Provide a description of the organization’s direct and indirect political campaign activities 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) ...... 187,527  
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ................... 187,527  
d Other exempt purpose expenditures ........................ 822,722,144  
e Total exempt purpose expenditures (add lines 1c and 1d) ............... 822,909,671  
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
1,000,000  
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) ................. 250,000  
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the 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 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
b Lobbying ceiling amount
(150% of line 2a, column(e))
6,000,000
c Total lobbying expenditures 138,751 134,460 206,597 187,527 667,335
d Grassroots nontaxable amount 250,000 250,000 250,000 250,000 1,000,000
e Grassroots ceiling amount
(150% of line 2d, column (e))
1,500,000
f Grassroots lobbying expenditures 138,751 134,460 206,597 187,527 667,335
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? .........................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
 
c
Media advertisements? ....................................
 
 
 
d
Mailings to members, legislators, or the public? .........................
 
 
 
e
Publications, or published or broadcast statements? .......................
 
 
 
f
Grants to other organizations for lobbying purposes? .......................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
 
 
i
Other activities? ..........................
 
 
 
j
Total. Add lines 1c through 1i ...............................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
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
SCHEDULE C, PART IV SCHEDULE C, PART 1-A, LINE 1 HENNEPIN HEALTHCARE SYSTEM INC.'S (HHS INC.) HAS A SERVICE AGREEMENT IN FORCE WITH HENNEPIN COUNTY INTERGOVERNMENTAL RELATIONS (IGT) TO FURNISH STATE AND FEDERAL GRASSROOT LOBBYING SERVICES RELATED TO HHS INC.'S MISSION AND PURPOSE. IN ADDITION, HHS INC. IS ASSOCIATED WITH ORGANIZATIONS SUCH MINNESOTA HOSPITAL ASSOCIATION AND THE AMERICA'S ESSENTIAL HOSPITALS WHICH ENGAGE IN LOBBYING ACTIVITIES AT THE STATE AND NATIONAL LEVEL ON BEHALF OF ITS MEMBER ENTITIES. THE LOBBYING EXPENSES ARE MADE UP AS BELOW: HENNEPIN COUNTY IGR PAYMENTS 130,000 MINNESOTA HOSPITAL ASSOCIATION 50,000 AMERICA'S ESSENTIAL HOSPITALS 7,527 TOTAL GRASSROOTS LOBBYING EXPENDITURE 187,527
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
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate 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 .... 2,754,332 2,187,882      
b Contributions ........          
c Net investment earnings, gains, and losses 183,917 566,450      
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
         
f Administrative expenses ....          
g End of year balance ...... 2,956,178 2,754,332      
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 Bullet63.690 %
c
Temporarily restricted endowment SchDMd Bullet36.310 %
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)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
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 .................   19,320,377 19,320,377
b Buildings ................   362,564,113 227,131,771 135,432,342
c Leasehold improvements ............   15,609,929 8,292,319 7,317,610
d Equipment ................   201,682,620 139,141,526 62,541,094
e Other .................   18,004,271 3,928,666 14,075,605
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 238,687,028
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  
RELATED PARTY PAYABLES 61,147,911
TAXES 7,304,855
LEASE REVENUE REFUNDING CERTIFICATES 3,169,028






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 71,621,794
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 ....... 1 811,909,759
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a 76,941
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 76,941
3 Subtract line 2e from line 1..................... 3 811,832,818
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 22,546,101
c Add lines 4a and 4b....................... 4c 22,546,101
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 834,378,919
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 ........... 1 800,363,570
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..................... 3 800,363,570
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 22,546,101
c Add lines 4a and 4b....................... 4c 22,546,101
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 822,909,671
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
SCHEDULE D, PAGE 2, PART V, LINE 4 THE ENDOWMENT CONSISTS ENTIRELY OF DONOR-RESTRICTED FUNDS ESTABLISHED TO SUPPORT RESEARCH ACTIVITIES AND THE NON-SURGERY ENDOWMENT. HHS, INC. POLICY PROVIDES FOR THE ABILITY TO APPROPRIATE FOR DISTRIBUTION EACH YEAR AN AGREED PROPORTION PLUS RELATED ACCUMULATED EARNINGS BASED UPON BALANCES OF THE PRECEDING YEAR AND MAINTAINING A RECOMMENDED PURCHASING POWER OF THE ENDOWMENT. DISTRIBUTIONS ARE NOT MADE IN PERIODS SUBSEQUENT TO A DETERMINATION THAT THE FAIR MARKET VALUE OF THE PERMANENTLY RESTRICTED NET ASSETS FALLS BELOW CORPUS.
SCHEDULE D, PAGE 4, PART XI, LINE 4B BAD DEBT RECLASS 22,191,966 LOSS ON SALE/DISPOSAL OF ASSETS 119,858 RELATED PARTY REIMBURSEMENTS 234,277
SCHEDULE D, PAGE 4, PART XII, LINE 4B BAD DEBT RECLASS 22,191,966 LOSS ON SALE/DISPOSAL OF ASSETS 119,858 RELATED PARTY REIMBURSEMENTS 234,277
Schedule D (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
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
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

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
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) ..
    15,949,898   15,949,898 1.940 %
b Medicaid (from Worksheet 3,
column a) ....
    310,879,030 284,844,492 26,034,538 3.160 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
           
d Total Financial Assistance
and Means-Tested
Government Programs .
    326,828,928 284,844,492 41,984,436 5.100 %
Other Benefits
  112,111 4,086,991 2,822,206 1,264,785 0.150 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
    75,912,774 49,928,973 25,983,801 3.160 %
g Subsidized health services
(from Worksheet 6) ..
    24,558   24,558  
h Research (from Worksheet 7)     9,449   9,449  
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
    41,112   41,112  
j Total. Other Benefits ..   112,111 80,074,884 52,751,179 27,323,705 3.320 %
k Total. Add lines 7d and 7j .   112,111 406,903,812 337,595,671 69,308,141 8.420 %
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   2,600,000 1,265,615 1,026,917 238,698 0.030 %
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building     89,080   89,080 0.010 %
7 Community health improvement advocacy     40,191   40,191  
8 Workforce development            
9 Other            
10 Total   2,600,000 1,394,886 1,026,917 367,969 0.040 %
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
22,191,966
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
566,638
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
159,351,431
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
217,679,113
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-58,327,682
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 HENNEPIN HEALTHCARE SYSTEM INC
HENNEPIN COUNTY MEDICAL CENTER
701 PARK AVENUE
MINNEAPOLIS,MN55415
WWW.HCMC.ORG
STATE LIC. 367142
X X X X   X X   LEVEL 1 TRAUMA HOSPITAL  
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)
HENNEPIN HEALTHCARE SYSTEM INC
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 13
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   No
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 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
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)

HENNEPIN HEALTHCARE SYSTEM INC
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)

HENNEPIN HEALTHCARE SYSTEM INC
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 Yes  
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   No
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
FACILITY 1, HENNEPIN HEALTHCARE SYSTEM, INC. - PART V, LINE 3J AS LEGISLATED BY MINNESOTA STATUTE 383B.918, HHS IS REQUIRED TO PREPARE "A HEALTH SERVICES PLAN THAT DRAWS FROM A POPULATION HEALTH NEEDS ASSESSMENT AND DELINEATES THE ORGANIZATION'S ROLE IN THE COMMUNITY, INCLUDING EDUCATION, RESEARCH, AND PATIENT CARE SERVICES TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY INCLUDING INDIGENT POPULATIONS." THE HEALTH SERVICES PLAN IS APPROVED ANNUALLY BY THE HHS, INC. BOARD AND THE HENNEPIN COUNTY BOARD OF COMMISSIONERS.
FACILITY 1, HENNEPIN HEALTHCARE SYSTEM, INC. - PART V, LINE 5 QUANTITATIVE AND QUALITATIVE DATA WAS COLLECTED IN ORDER TO IDENTIFY COMMUNITY HEALTH NEEDS. THE PRIMARY QUANTITATIVE DATA SOURCE WAS THE 2010 SURVEY OF THE HEALTH OF ALL THE POPULATION AND THE ENVIRONMENT (SHAPE), CONDUCTED BY THE HENNEPIN COUNTY HUMAN SERVICES AND PUBLIC HEALTH DEPARTMENT. THE ADULT SURVEY COLLECTED RESPONSES FROM MORE THAN 7000 HENNEPIN COUNTY RESIDENTS, AND THE CHILD SURVEY COLLECTED RESPONSES FROM NEARLY 2200 HENNEPIN COUNTY RESIDENTS. THE RESULTS WERE REPORTED FOR HENNEPIN COUNTY AS A WHOLE AND FOR LOCAL GEOGRAPHIC AREAS WITHIN THE COUNTY. THE DATA WAS REPORTED BY DEMOGRAPHIC VARIABLES INCLUDING GENDER, AGE, GRADE LEVEL (WHERE APPLICABLE), AND HOUSEHOLD INCOME. HHS STAFF REVIEWED HENNEPIN COUNTY'S PUBLIC HEALTH ASSESSMENT ON-LINE COMMUNITY HEALTH ASSESSMENT INDICATORS, WHICH INCLUDE DATA FROM SHAPE, THE MINNESOTA STUDENT SURVEY, AND VITAL RECORDS INFORMATION. ADDITIONAL DATA SOURCES INCLUDED STATE- AND COUNTY-LEVEL MORBIDITY AND MORTALITY DATA FROM THE CENTER FOR DISEASE CONTROL AND MINNESOTA DEPARTMENT OF HEALTH, AS WELL AS 2012 MINNESOTA LGBT SURVEY DATA COLLECTED FROM 1867 RESPONDENTS BY THE RAINBOW HEALTH INITIATIVE. KEY INFORMANT INTERVIEWS WERE CONDUCTED DURING SUMMER 2013 TO GATHER QUALITATIVE DATA AND CONSULT WITH COMMUNITY MEMBERS AND EXPERTS. HHS STAFF MET WITH REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS: -ANDREW RESIDENCE -CITY OF MINNEAPOLIS HEALTH DEPARTMENT -ELLIOT PARK NEIGHBORHOOD, INC. -HENNEPIN COUNTY HUMAN SERVICES AND PUBLIC HEALTH DEPARTMENT -MINNESOTA DEPARTMENT OF HEALTH, OFFICE OF MINORITY AND MULTICULTURAL HEALTH -MINNESOTA VISITING NURSE AGENCY / HOSPICE OF THE TWIN CITIES -NORTHWEST HENNEPIN FAMILY SERVICE COLLABORATIVE -PORTICO HEALTHNET -RAINBOW HEALTH INITIATIVE -UNIVERSITY OF MINNESOTA, DEPARTMENT OF PRIMARY DENTAL CARE INFORMATION WAS ALSO OBTAINED FROM THE 2012 COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP (CHIP) COLLABORATION CONVENED BY HENNEPIN COUNTY HUMAN SERVICES AND PUBLIC HEALTH. THE CHIP PROJECT ENGAGED COMMUNITY STAKEHOLDER ORGANIZATIONS TO IDENTIFY HEALTH NEEDS, OPPORTUNITIES AND PARTNERS FOR CHANGE, AND THE TOP FIVE STRATEGIC HEALTH ISSUES FOR HENNEPIN COUNTY. THE PROCESS INVOLVED A SURVEY COMPLETED BY 239 COMMUNITY ORGANIZATIONS DOING HEALTH-RELATED WORK AND THREE CHIP FORUM SESSIONS ATTENDED BY 110 INDIVIDUALS FROM MULTIPLE SECTORS SERVING HENNEPIN COUNTY. FINALLY, HHS STAFF PRESENTED THE DRAFT HEALTH SERVICES PLAN DOCUMENT TO PATIENTS AND THE COMMUNITY DURING TWO COMMUNITY HEALTH OPEN HOUSE EVENTS IN FALL 2013. FEEDBACK FROM PARTICIPANTS WAS INCORPORATED INTO THE FINAL DOCUMENT.
FACILITY 1, HENNEPIN HEALTHCARE SYSTEM, INC. - PART V, LINE 11 HHS' 2014 HEALTH SERVICES PLAN LOCATED AT HTTP://WWW.HCMC.ORG/CS/GROUPS/PUBLIC/DOCUMENTS/WEBCONTENT/HCMC_P_050360.PDF DESCRIBES STRATEGIES TO ADDRESS THE SIGNIFICANT AREAS OF HEALTH NEED IDENTIFIED IN HHS' 2013 CHNA. THE FOLLOWING NARRATIVE DESCRIBES HOW NEEDS WERE ADDRESSED: ADDRESSING MATERNAL AND CHILD HEALTH AQU PARA T (APT) / HERE FOR YOU: STARTED IN 2002, THIS BICULTURAL, CLINIC-BASED, YOUTH DEVELOPMENT PROGRAM PROVIDES MEDICAL CARE, BEHAVIORAL HEALTH CONSULTATIONS, COACHING, HEALTH EDUCATION, AND REFERRALS TO LATINO YOUTH AND THEIR PARENTS. A MULTIDISCIPLINARY TEAM OF BILINGUAL, BICULTURAL PROVIDERS HELPS YOUTH AND THEIR PARENTS ACCESS CULTURALLY APPROPRIATE RESOURCES AND COACHES YOUTH TO AVERT PREGNANCY AND SEXUALLY TRANSMITTED INFECTIONS, REMAIN IN SCHOOL, AND IMPROVE FAMILY RELATIONSHIPS. HENNE-TEEN: BASED ON THE SUCCESSFUL MODEL OF AQU PARA T, THE GOAL OF THIS INITIATIVE IS TO ENSURE CONFIDENTIAL, TEEN-FRIENDLY HEALTH CARE THROUGHOUT HHS SYSTEM. 2015 EFFORTS INCLUDE IMPLEMENTING MODIFICATIONS TO THE ELECTRONIC HEALTH RECORD SYSTEM, MAKING IT POSSIBLE TO DOCUMENT, ORDER LABS, ORDER TREATMENTS, PROCESS BILLING AND PRINT OUT VISIT SUMMARIES WHILE PROTECTING TEEN CONFIDENTIALITY. SAFER SEX INITIATIVE: HHS PARTNERS WITH BETTER TOGETHER HENNEPIN AND THE FEDERAL OFFICE OF ADOLESCENT HEALTH TO PROVIDE THIS SEXUALLY TRANSMITTED INFECTION AND PREGNANCY PREVENTION PROGRAM AT THE DOWNTOWN PEDIATRIC CLINIC, OB/GYN CLINIC, AND THE RICHFIELD CLINIC. THE SAFER SEX INITIATIVE OFFERS YOUNG WOMEN A CHANCE TO MEET ONE-ON-ONE WITH A FEMALE HEALTH EDUCATOR WHO CAN HELP THEM WORK OUT WAYS TO STAY SAFE AND HEALTHY. IN 2014 -2015 THE PROGRAM WILL EXPAND ITS FOCUS TO INCLUDE GIRLS WHO ARE CURRENTLY PREGNANT AS WELL AS THOSE NOT YET SEXUALLY ACTIVE. BABY-FRIENDLY HOSPITAL DESIGNATION: HHS IS IN THE PROCESS OF BECOMING A BABY-FRIENDLY HOSPITAL, WHICH MEANS HHS WILL PROMOTE AND SUPPORT BREASTFEEDING BY IMPLEMENTING THE TEN STEPS TO SUCCESSFUL BREASTFEEDING AND FOLLOWING THE WORLD HEALTH ORGANIZATION'S INTERNATIONAL CODE FOR THE MARKETING OF BREAST MILK SUBSTITUTES. THIS INITIATIVE WILL ALLOW HHS TO BETTER SUPPORT NEW MOMS' BREASTFEEDING GOALS. CENTERINGPREGNANCY IS PRENATAL CARE IN A GROUP WITH OTHER WOMEN WHO ARE ALSO PREGNANT. GROUPS OF 8-12 WOMEN ARE SEEN TOGETHER THROUGHOUT THEIR ENTIRE PREGNANCIES. GROUP SESSIONS, AVAILABLE IN BOTH ENGLISH AND SPANISH, ARE LED BY A DOCTOR OR MIDWIFE AND A PRENATAL EDUCATOR. GROUP PARTICIPANTS SPEND MORE TIME WITH THEIR PROVIDER AND WITH OTHERS WITH SIMILAR HEALTH CONCERNS, GIVING THEM AN OPPORTUNITY TO LEARN TOGETHER AND FROM EACH OTHER. RESEARCH SHOWS THAT OUTCOMES FOR PEOPLE GETTING CARE IN GROUP ARE UNIFORMLY BETTER THAN FOR THOSE IN TRADITIONAL CARE. MOTHER-BABY PROGRAM: THIS PROGRAM OPENED IN 2013 AND INCLUDES THE MOTHER- BABY HOPE LINE, A TRIAGE AND RESOURCE TELEPHONE "WARM" LINE WHICH PROVIDES MENTAL HEALTH ASSESSMENT FOR PREGNANT AND POSTPARTUM WOMEN; ASSESSMENT OF CONCERNS RELATED TO INFANT MENTAL HEALTH, MOTHER-BABY ATTACHMENT AND CAREGIVING CONCERNS; REFERRAL TO APPROPRIATE RESOURCES; AND BRIEF THERAPEUTIC INTERVENTIONS. IT ALSO INCLUDES THE MOTHER-BABY DAY HOSPITAL, AN INTENSIVE OUTPATIENT MENTAL HEALTH TREATMENT PROGRAM FOR PREGNANT WOMEN OR MOTHERS OF VERY YOUNG CHILDREN WHO ARE EXPERIENCING MODERATE OR SEVERE MENTAL HEALTH SYMPTOMS. PRIMARY CARE EARLY CHILDHOOD SOCIAL-EMOTIONAL SCREENING AND REFERRAL PARTNERSHIPS PROJECT: HHS' PEDIATRIC CLINIC IS PARTICIPATING AS A PILOT SITE IN THIS HENNEPIN COUNTY CHILDREN'S MENTAL HEALTH COLLABORATIVE PROJECT. CHILDREN'S LITERACY PROGRAM: HHS' CHILDREN'S LITERACY PROGRAM IS RESPONSIBLE FOR DISTRIBUTING MORE THAN 30,000 BOOKS EVERY YEAR ACROSS THE DOWNTOWN CAMPUS. CHILDREN'S SUMMER MEAL PROGRAM: THIS IS A FEDERALLY-FUNDED PROGRAM OPERATED NATIONALLY BY THE US DEPARTMENT OF AGRICULTURE AND ADMINISTERED LOCALLY BY THE MINNESOTA DEPARTMENT OF EDUCATION. THE PROGRAM PROVIDES NUTRITIOUS MEALS TO CHILDREN DURING SUMMER VACATION WHEN FREE OR REDUCED PRICE SCHOOL MEALS ARE NOT AVAILABLE. ADDRESSING SOCIAL CONNECTEDNESS THE AMERICAN INDIAN PATIENT ADVOCATE PROGRAM AT HHS STARTED IN 2010 AND CONTINUES TO PROVIDE SUPPORT FOR AMERICAN INDIAN PATIENTS AND THEIR FAMILIES. HHS COMMUNITY HEALTH WORKERS WORK TO REMOVE BARRIERS TO HEALTH CARE AND DEVELOP RELATIONSHIPS AND TRUST WITH THE COMMUNITIES THEY SERVE. THE PRIMARY ROLE OF COMMUNITY HEALTH WORKERS IS TO WORK AS A PART OF AN INTERDISCIPLINARY CARE TEAM TO PROVIDE CULTURAL- AND LANGUAGE-SPECIFIC NAVIGATION OF THE HEALTHCARE SYSTEM, CONNECT PATIENTS TO HHS AND COMMUNITY RESOURCES, SUPPORT PATIENTS IN SETTING AND ACHIEVING GOALS TO IMPROVE THEIR HEALTH, AND HELP ELIMINATE BARRIERS TO CARE. WORKING IN 14 CLINIC-BASED HEALTH CARE HOMES AND ELSEWHERE ACROSS THE ORGANIZATION, THEY PROVIDE CARE COORDINATION TO PATIENTS WITH VARIED PSYCHOSOCIAL ISSUES AND DIVERSE BACKGROUNDS. FULL SPECTRUM OF MENTAL HEALTH SERVICES: HHS WILL CONTINUE TO OPERATE SERVICES AT FULL CAPACITY, INCLUDING INPATIENT PSYCHIATRY, ACUTE PSYCHIATRIC SERVICES, PARTIAL HOSPITAL PROGRAM, CHILD/ADOLESCENT CLINIC, DAY TREATMENT PROGRAM, WOMEN'S MENTAL HEALTH PROGRAM, PSYCHOLOGY, MOTHER- BABY PROGRAM, OCCUPATIONAL THERAPY, RECREATIONAL THERAPY AND SOCIAL SERVICES. HENNEPIN HEALTH IS AN INNOVATIVE, INTEGRATED, HEALTH CARE DELIVERY PROGRAM FOR ADULTS ELIGIBLE FOR MEDICAL ASSISTANCE AND WITHOUT DEPENDENT CHILDREN IN HENNEPIN COUNTY. THE PROGRAM TAKES A HOLISTIC VIEW, FOCUSING ON EACH MEMBER'S MEDICAL, MENTAL HEALTH, AND SOCIAL NEEDS. ADDRESSING NUTRITION, OBESITY, AND PHYSICAL ACTIVITY TAKING STEPS TOGETHER (TST): HHS' PEDIATRIC AND NUTRITION DEPARTMENTS CONTINUE THEIR SIX YEAR COMMITMENT TO PATIENT AND FAMILY CENTERED CARE THROUGH TST'S NUTRITION AND HEALTHY LIFESTYLE PROGRAM. OVER THE PAST SIX YEARS TST HAS SERVED OVER 500 HHS PATIENTS AND FAMILY MEMBERS. TST OFFERS COMMUNITY-BASED, CULTURALLY APPROPRIATE, SPANISH-ENGLISH BILINGUAL PROGRAMMING. THERAPEUTIC FOOD PHARMACY: CONTINUING IN 2015, THE HHS THERAPEUTIC FOOD PHARMACY ADDRESSES HUNGER AND FOOD INSECURITY AMONG PATIENTS AND FAMILIES, WITH A LONG TERM VISION OF A HUNGER-FREE HOSPITAL AND COMMUNITY WHERE ALL FAMILIES HAVE THE HEALTHFUL FOOD THEY NEED EVERY DAY. ONE OF ONLY TWO FOOD SHELVES IN THE NATION LOCATED IN A HOSPITAL SETTING, HHS' THERAPEUTIC FOOD PHARMACY PROVIDES SERVICES IN TWENTY HOSPITAL-BASED CLINICS AND SIX COMMUNITY CLINICS. WE CAN PREVENT DIABETES: THIS PROGRAM IS A JOINT PARTNERSHIP WITH THE MINNESOTA DEPARTMENT OF HEALTH AND MINNESOTA DEPARTMENT OF HUMAN SERVICES IN IDENTIFYING MN MEDICAID PATIENTS WHO HAVE A DIAGNOSIS OF PRE-DIABETES OR HAVE A SIGNIFICANT RISK FOR DEVELOPING TYPE 2 DIABETES. THE PROGRAM AIMS TO TEACH INDIVIDUALS HOW TO MAKE BETTER FOOD CHOICES AS WELL AS HOW TO INCREASE PHYSICAL ACTIVITY, WITH THE GOAL OF HELPING INDIVIDUALS AVOID DEVELOPING DIABETES.
FACILITY 1, HENNEPIN HEALTHCARE SYSTEM, INC. - PART V, LINE 16I PATIENTS CAN REQUEST TO SEE FINANCIAL COUNSELORS WHO CAN HELP DETERMINE ELIGIBILITY FOR MANY FINANCIAL ASSISTANCE PROGRAMS. UPON REGISTRATION, PATIENTS ARE SCREENED USING ESTABLISHED GUIDELINES AS SET BY HHS AND WHENEVER POSSIBLE, THE PATIENT OR PATIENT'S FAMILY CAN FILL OUT AN APPLICATION FOR MEDICAL ASSISTANCE AND/OR HENNEPIN CARE. FOR THOSE THAT DO NOT QUALIFY FOR CHARITY CARE, HENNEPIN CARE MAY BE ELIGIBLE FOR AN UNINSURED DISCOUNT. HHS HAS ISSUED A NEW BROCHURE "WHAT'S YOUR PLAN" THAT ASSISTS PATIENTS NAVIGATE THE PROGRAMS AVAILABLE. THESE BROCHURES ARE AVAILABLE THROUGHOUT THE CAMPUS. ANOTHER TOOL FOR PATIENTS IS ON THE HHS WEBSITE WWW.HCMC.ORG - "PATIENT BILLING PORTAL" FUNCTIONS AS AN ONLINE "WHAT'S YOUR PLAN" BROCHURE.
FACILITY 1, HENNEPIN HEALTHCARE SYSTEM, INC. - PART V, LINE 22D PART III SECTION C LINE 9B HHS USES A COMBINATION OF DISCOUNT AND COLLECTION POLICIES. PATIENTS ARE SCREENED USING ESTABLISHED GUIDELINES AS SET BY THE HOSPITAL AND WHENEVER POSSIBLE THE PATIENT OR PATIENT'S FAMILY CAN FILL OUT AN APPLICATION FOR FINANCIAL ASSISTANCE. THOSE THAT DO NOT QUALIFY FOR MEDICAL ASSISTANCE, HENNEPIN HEALTH, CHARITY CARE OR HENNEPIN CARE, OR WHO ARE UNINSURED, WILL BE OFFERED AN UNINSURED DISCOUNT. PATIENTS WITH SELF PAY BALANCES WHO ARE CONSIDERED ABLE TO PAY BASED ON FINANCIAL SCREENING MAY BE TURNED OVER TO COLLECTIONS IF THE HOSPITAL DEEMS THAT THEY HAVE THE ABILITY TO PAY FOR SERVICES. HHS, AS A GOVERNMENT ENTITY, IS ALLOWED TO PARTICIPATE IN STATE OF MINNESOTA REVENUE RECAPTURE PROGRAM. THIS PROGRAM ALLOWS HHS TO SUBMIT CLAIMS AGAINST PATIENT INCOME TAX REFUNDS, PROPERTY TAX REFUNDS, AND LOTTERY WINNINGS TO RECOVER PAST DUE BALANCES AFTER OTHER COLLECTION EFFORTS ARE EXHAUSTED. HHS USES THE FEDERAL POVERTY GUIDELINES TO CALCULATE BOTH FREE AND DISCOUNTED CARE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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?6
Name and address Type of Facility (describe)
1 HCMC CLINICS - 43 CLINICS
OUTPATIENT SPECIALTY CARE SERVICE
701 PARK AVENUE
MINNEAPOLIS,MN55415
HOSPITAL-BASED UNDER NPI 1407897309
2 HCMC PHARMACIES - 6 LOCATIONS
701 PARK AVENUE
MINNEAPOLIS,MN55415
PHARMACY SERVICES
3 HCMC-BE WELL CLINIC
300 SOUTH SIXTH STREET
GOVERNMENT CENTER - A120
MINNEAPOLIS,MN55487
FREE STANDING CLINIC
4 HCMC-CONVENIENCE CARE AT WALMART
715 EAST 78TH STREET
BLOOMINGTON,MN55420
FREE STANDING CLINIC
5 HCMC - GOLDEN VALLEY CLINIC
5653 DULUTH STREET
GOLDEN VALLEY,MN55422
FREE STANDING CLINIC
6 PARKSIDE PATCH CLINIC
825 SOUTH 8TH STREET
SUITE 1122
MINNEAPOLIS,MN55404
FREE STANDING CLINIC
7
8
9
10
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 7 - COSTING METHODOLOGY EXPLANATION HHS IS COMMITTED TO PROVIDING MEDICALLY NECESSARY CARE TO ALL PERSONS. FOR COSTING PURPOSES, HHS USES A COMBINATION OF STANDARD COSTING, WHERE APPLICABLE, AND THE FEDERAL POVERTY GUIDELINES.
PART II - COMMUNITY BUILDING ACTIVITIES HHS PARTICIPATES IN SEVERAL COMMUNITY BUILDING ACTIVITIES. HHS COORDINATED THE DEVELOPMENT OF THE METROPOLITAN HOSPITAL COMPACT, BRINGING COMMUNITY HOSPITALS TOGETHER TO COORDINATE DISASTER PREPAREDNESS AND RESPONSE. AS THE REGIONAL HOSPITAL RESOURCE CENTER FOR THE 7 COUNTY METRO REGION (2.6 MN PEOPLE) HHS COORDINATES 30 HOSPITALS AND THEIR AFFILIATED CLINICS, LONG TERM CARE FACILITIES AND THE UNAFFILIATED CLINICS. HHS IS A PARTICIPANT IN THE SUSPECTED CHILD ABUSE AND NEGLECT TEAM (SCANT). SCANT IS A MULTI-DISCIPLINARY, INTERDEPARTMENTAL TEAM OF PROFESSIONALS FROM HHS, INCLUDING PEDIATRICIANS, SOCIAL WORKERS, NURSES, CHAPLAINS, AND PSYCHOLOGISTS, AS WELL AS INDIVIDUALS FROM COLLABORATING AGENCIES INCLUDING THE MINNEAPOLIS POLICE DEPARTMENT, HENNEPIN COUNTY CHILD PROTECTION, THE HENNEPIN COUNTY ATTORNEY'S OFFICE, AND THE HENNEPIN COUNTY MEDICAL EXAMINER'S OFFICE. HHS IS A SITE FOR THE SUMMER MEALS PROGRAMS THROUGH THE US DEPARTMENT OF AGRICULTURE. APPROXIMATELY 42 CHILDREN RECEIVE FREE BREAKFAST OR LUNCH EVERY DAY DURING THE SUMMER.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY BAD DEBT EXPENSE IN THE AMOUNT OF 22,191,966 IS THE AMOUNT RECORDED DURING 2014 WHICH IS WRITTEN OFF OR SENT TO COLLECTIONS NET OF RECOVERIES AND NET OF BOOK RESERVES FOR ADJUSTMENTS TO THE ON-GOING BAD DEBT ALLOWANCE ON OPEN ACCOUNTS RECEIVABLE.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE THE COST OF CHARGES WRITTEN OFF AS BAD DEBT EXPENSE TOTALED 9,054,194 FOR 2014. THIS WAS CALCULATED AS THE PERCENTAGE OF ADJUSTED PATIENT CHARGES DIVIDED BY OPERATING EXPENSE TO ACHIEVE A COST TO CHARGE RATIO. THE BAD DEBT AMOUNT IS THE PRODUCT OF THE RATIO OF THE COST TO CHARGES MULTIPLIED BY THE BAD DEBT EXPENSE. HHS, INC. COLLECTIONS/CUSTOMER SERVICE AREAS PROCESS DISCOUNT ADJUSTMENTS TO PATIENT ACCOUNTS SUBJECT TO PROPER ADJUSTMENT APPROVALS AND GUIDELINES. PATIENTS ARE ELIGIBLE FOR DISCOUNTS BASED ON PATIENT HOUSEHOLD SIZE AND INCOME IN RELATION TO FEDERAL POVERTY GUIDELINES. PATIENTS WHO MAY BE ELIGIBLE FOR GOVERNMENT PROGRAMS ARE REQUIRED TO APPLY FOR THOSE PROGRAMS. IF BENEFITS ARE DENIED, THE APPROPRIATE APPLICABLE DISCOUNT SHALL APPLY. FINANCIAL COUNSELORS COLLECT AND RECORD THE PATIENTS' NET AND GROSS INCOME AND FAMILY SIZE TO DETERMINE THE APPROPRIATE DISCOUNT. HHS, INC. USES FEDERAL GUIDELINES FOR DETERMINING DISCOUNTS AND CHARITY CARE.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS HHS INCLUDES DISCUSSION OF ACCOUNTS RECEIVABLE AND BAD DEBT EXPENSE IN THE ATTACHED AUDITED FINANCIAL STATEMENTS ON PAGE 9, 10 AND 15.
PART VI, LINE 2 - NEEDS ASSESSMENT SEE PART V SECTION B DETAILED DESCRIPTION IN PART V SECTION C
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SEE PART V LINE 9
PART VI, LINE 4 - COMMUNITY INFORMATION HHS IS A PUBLIC CORPORATION SAFETY NET HOSPITAL AND CLINIC SYSTEM ENGAGED IN THE DELIVERY OF HEALTHCARE AND RELATED SERVICES TO THE GENERAL PUBLIC IN THE STATE OF MINNESOTA INCLUDING THE INDIGENT AS DEFINED BY THE STATE AND FEDERAL LAW AS DETERMINED BY THE HENNEPIN COUNTY BOARD OF COMMISSIONERS. IT HAS A "TREAT FIRST" POLICY REGARDLESS OF A PATIENT'S ABILITY TO PAY FOR MEDICAL NECESSITY.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH HHS PROVIDES MORE CARE TO MINNESOTA HEALTH CARE PROGRAM (MHCP) RECIPIENTS AND THE UNINSURED THAN DO OUR NON-TEACHING PEERS, NEARLY 50% OF HHS' VOLUME IS PROVIDED TO LOW INCOME POPULATIONS. HHS IS MINNESOTA'S LARGEST PROVIDER OF SERVICE TO THE POOR BY A SUBSTANTIAL MARGIN. HHS TREATS HENNEPIN COUNTY'S AND THE REGION'S MORE SEVERELY ILL PATIENTS, SUCH AS THOSE REFERRED FROM OTHER HOSPITALS AND THOSE REQUIRING EXTENSIVE SUPPORT SERVICES. HHS' PHYSICIANS AND ALUMNI ARE INTEGRAL TO THE REGION'S EMERGENCY PREPAREDNESS AND STAND-BY CAPABILITIES. HHS PROVIDES MANY SPECIALIZED INPATIENT AND OUTPATIENT SERVICES SUCH AS INTENSIVE NEONATAL CARE, ORGAN TRANSPLANTATION, ONCOLOGY SERVICES AND SOPHISTICATED RECONSTRUCTIVE SURGERY TO THE REGION'S POPULATION. HHS FACILITATES THE TRANSITIONS OF NEW SERVICES AND TECHNOLOGIES INTO THE MAINSTREAM AND HELPS TO RAISE THE REGIONAL HEALTH PROVISION STANDARDS.
ADDITIONAL INFORMATION PART I LINE 3C HHS USES THE FEDERAL POVERTY GUIDELINES TO CALCULATE BOTH FREE AND DISCOUNTED CARE. PART I LINE 6 THE COMMUNITY BENEFIT REPORT IS A FOOTNOTE DISCLOSURE IN THE HHS' ANNUAL AUDITED FINANCIAL STATEMENT. HHS, AS AN ENTERPRISE FUND OF HENNEPIN COUNTY, ALSO APPEARS ON HENNEPIN COUNTY'S FINANCIAL STATEMENTS. HHS' AUDITED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AND ARE ALSO FILED WITH THE MINNESOTA ATTORNEY GENERAL'S OFFICE. PART I LINE 7F HHS TRAINS PRACTITIONERS IN MORE THAN 50 DIFFERENT HEALTH PROFESSIONS TO PROVIDE MEDICAL CARE ACROSS MINNESOTA. IN 2014, HHS TRAINED OVER 700 MEDICAL STUDENTS FROM THE UNIVERSITY OF MINNESOTA AND 21 OTHER INSTITUTIONS IN THE U.S. AND ABROAD. HHS ALSO TRAINS RESIDENT PHYSICIANS IN 15 HHS- BASED RESIDENCY AND FELLOWSHIP PROGRAMS AND TRAINS ROTATING RESIDENTS FROM 44 PROGRAMS AT THE UNIVERSITY OF MINNESOTA. IN 2014, HHS TRAINED OVER 500 RESIDENT PHYSICIANS, INCLUDING APPROXIMATELY 200 IN HHS-BASED RESIDENCIES AND 430 ROTATING RESIDENTS FROM THE UNIVERSITY OF MINNESOTA, REGIONS HOSPITAL, AND THE MAYO SCHOOL OF GRADUATE MEDICAL EDUCATION. HHS TRAINS OVER 1000 NURSING STUDENTS PER YEAR PROVIDING OVER 35,000 CLINICAL HOURS OF TRAINING, 70 NURSE PRACTITIONERS AND PHYSICIAN ASSISTANT TRAINEES, 11 PHARMACY RESIDENTS WITH TOXICOLOGY ROTATIONS IN THE HENNEPIN REGIONAL POISON CENTER. HHS ALSO TRAINS APPROXIMATELY 6-8 OPHTHALMIC TECHNICIANS, 8 MEDICAL LABORATORY SCIENTISTS AND 4-6 PHLEBOTOMY TECHNICIANS PER YEAR. HHS OUTREACH TRAINING PROGRAMS ARE OFFERED IN CITIES AND COMMUNITIES ACROSS THE STATE BY THE HENNEPIN REGIONAL POISON CENTER, TRAUMA OUTREACH STAFF, EMERGENCY PREPAREDNESS STAFF, EMERGENCY MEDICAL SERVICES, AND FACULTY FROM DIVERSE CLINICAL DEPARTMENTS. HHS IS THE LARGEST CME PROVIDER ACCREDITED BY THE MINNESOTA MEDICAL ASSOCIATION. IN 2014, DIVERSE CONTINUING EDUCATION OPPORTUNITIES INCLUDED MORE THAN 568 HOURS OF CONTINUING MEDICAL EDUCATION (CME) INSTRUCTION FOR PHYSICIANS AND NON- PHYSICIANS IN COURSES AND REGULARLY SCHEDULED SERIES AT HHS AS WELL AS ONLINE. HHS ALSO PROVIDES CONTINUING NURSING EDUCATION, INCLUDING PROGRAMS SUCH AS THE TRAUMA & CRITICAL CARE EDUCATION SERIES (TRA-CCS), OFFERED THROUGH TRAUMA SERVICES. PART III LINE 8 MEDICARE IN THE COMMUNITY BENEFIT FOOTNOTE TO THE AUDITED FINANCIAL STATEMENTS, MEDICARE SHORTFALL IS CONSIDERED AN ADDITIONAL COMMUNITY CONTRIBUTION, NOT INCLUDED IN COMMUNITY BENEFIT. THE SHORTFALL IS CALCULATED BY SUBTRACTING MEDICARE REVENUE FROM MEDICARE ALLOWABLE COSTS. MEDICARE ALLOWABLE COSTS ARE DETERMINED BY MULTIPLYING ALL MEDICARE CHARGES BY THE 2014 COST TO CHARGE RATIO. PART III SECTION C LINE 9B HHS USES A COMBINATION OF DISCOUNT AND COLLECTION POLICIES. PATIENTS ARE SCREENED USING ESTABLISHED GUIDELINES AS SET BY THE HOSPITAL AND WHENEVER POSSIBLE THE PATIENT OR PATIENT'S FAMILY CAN FILL OUT AN APPLICATION FOR FINANCIAL ASSISTANCE. THOSE THAT DO NOT QUALIFY FOR MEDICAL ASSISTANCE, HENNEPIN HEALTH, CHARITY CARE OR HENNEPIN CARE, OR WHO ARE UNINSURED, WILL BE OFFERED AN UNINSURED DISCOUNT. PATIENTS WITH SELF PAY BALANCES WHO ARE CONSIDERED ABLE TO PAY BASED ON FINANCIAL SCREENING MAY BE TURNED OVER TO COLLECTIONS IF THE HOSPITAL DEEMS THAT THEY HAVE THE ABILITY TO PAY FOR SERVICES. HHS, AS A GOVERNMENT ENTITY, IS ALLOWED TO PARTICIPATE IN STATE OF MINNESOTA REVENUE RECAPTURE PROGRAM. THIS PROGRAM ALLOWS HHS TO SUBMIT CLAIMS AGAINST PATIENT INCOME TAX REFUNDS, PROPERTY TAX REFUNDS, AND LOTTERY WINNINGS TO RECOVER PAST DUE BALANCES AFTER OTHER COLLECTION EFFORTS ARE EXHAUSTED.
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
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number
42-1707837
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to 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) PHILLIPS EYE INSTITUTE
2215 PARK AVENUE
MINNEAPOLIS,MN55404
36-3261413 501C3 11,362       EMERGENCY PREP
(2) RIDGEVIEW MEDICAL CENTER
500 SOUTH MAPLE STREET
WACONIA,MN55387
31-1667875 501C3 14,582       EMERGENCY PREP
(3) MAYO CLINIC HEALTH SYSTEM NEW PRAGU
301 SECOND STREET NE
NEW PRAGUE,MN56071
41-0723639 501C3 14,582       EMERGENCY PREP
(4) ST FRANCIS REGIONAL MEDICAL CENTER
1455 ST FRANCIS AVENUE
SHAKOPEE,MN55379
41-0907986 501C3 14,582       EMERGENCY PREP
(5) FAIRVIEW HEALTH SERVICES
6401 FRANCE AVENUE SOUTH
EDINA,MN55435
41-0991680 501C3 31,259       EMERGENCY PREP
(6) LAKEVIEW MEMORIAL HOSPITAL ASSOCIAT
927 CHURCHILL STREET WEST
STILLWATER,MN55082
41-0811697 501C3 8,357       EMERGENCY PREP
(7) NORTHFIELD HOSPITAL & CLINICS
2000 NORTH AVENUE
NORTHFIELD,MN55057
41-6038368 501C3 15,978       EMERGENCY PREP
(8) UNITY HOSPITAL
550 OSBORNE ROAD
FRIDLEY,MN55432
36-3261413 501C3 16,092       EMERGENCY PREP
(9) REGINA MEDICAL CENTER
1175 NININGER ROAD
HASTINGS,MN55033
41-0740678 501C3 11,568       EMERGENCY PREP
(10) REGIONS HOSPITAL
640 JACKSON STREET
ST PAUL,MN55101
41-0956618 501C3 16,310       EMERGENCY PREP
(11) MAPLE GROVE HOSPITAL CORPORATION
9875 HOSPITAL DR
MAPLE GROVE,MN55369
20-8316475 501C3 16,092       EMERGENCY PREP
(12) MERCY HOSPITAL
4050 COON RAPIDS BLVD
COON RAPIDS,MN55433
36-3261413 501C3 17,092       EMERGENCY PREP
(13) PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BLVD
ST LOUIS PARK,MN55426
45-5023260 501C3 30,722       EMERGENCY PREP
(14) UNITED HOSPITAL
333 NORTH SMITH AVENUE
SAINT PAUL,MN55102
36-3261413 501C3 17,975       EMERGENCY PREP
(15) NORTH MEMORIAL HEALTH CARE
3500 FRANCE AVENUE NORTH SUITE 106
ROBBINSDALE,MN55422
41-0729979 501C3 18,436       EMERGENCY PREP
(16) CHILDREN'S HOSPITALS & CLINICS OF M
2525 CHICAGO AVENUE
MINNEAPOLIS,MN55404
41-1754276 501C3 34,528       EMERGENCY PREP
(17) STATE OF SOUTH DAKOTA
SAD 133 BOX 2201
BROOKINGS,SD57007
46-6000364   42,269       EDUCATION & RESEARCH
(18) ABBOTT NORTHWESTERN HOSPITAL
800 E 29TH STREET
MINNEAPOLIS,MN55407
36-3261413 501C3 18,975       EMERGENCY PREP
(19) MINNEAPOLIS MEDICAL RESEARCH FOUNDA
914 SOUTH 8TH STREET
MINNEAPOLIS,MN55404
41-1677920 501C3 25,779       EDUCATION & RESEARCH
(20) UNIVERSITY OF MINNESOTA MEDICAL CEN
2450 RIVERSIDE AVENUE
MINNEAPOLIS,MN55454
41-0991680 501C3 37,531       EDUCATION & RESEARCH
(21) AUGUSTANA COMMUNITY PARTNERS
1007 EAST 14TH STREET
MINNEAPOLIS,MN55404
41-1783680 501C3 6,553       EMERGENCY PREP
(22) GILLETTE CHILDREN' SPECIALTY
200 UNIVERSITY AVENUE EAST
SAINT PAUL,MN55101
41-1200302 501C3 11,363       EMERGENCY PREP
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
21
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
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












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
SCHEDULE I, PAGE 1, PART I, LINE 2 HENNEPIN HEALTHCARE SYSTEM, INC HAS A GRANT MANAGEMENT DEPARTMENT TASKED WITH MONITORING GRANT RECEIPTS AND GRANT DISBURSEMENTS FROM FEDERAL, STATE, LOCAL OR INDIVIDUAL TO BENEFICIARIES. THE GRANT MANAGEMENT DEPARTMENT WORKS CLOSELY WITH FINANCE TO ENSURE PROPER CONTROLS ARE IN PLACE BY USE OF RECONCILIATIONS AND COMPLIANCE MONITORING AND REPORTING.
Schedule I (Form 990) 2014


Additional Data


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, 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
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement 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
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 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
Yes
 
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in 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
1JON L PRYOR MD MBACEO (i)
(ii)
725,572
...............................
 
 
...............................
 
516
...............................
 
26,000
...............................
 
16,692
...............................
 
768,780
...............................
 
 
...............................
 
2DOUGLAS B BRUNETTE MDDIRECTOR (i)
(ii)
440,240
...............................
 
 
...............................
 
516
...............................
 
22,880
...............................
 
21,049
...............................
 
484,685
...............................
 
 
...............................
 
3TARA GUSTILO MDDIRECTOR (i)
(ii)
282,656
...............................
 
 
...............................
 
180
...............................
 
22,185
...............................
 
19,942
...............................
 
324,963
...............................
 
 
...............................
 
4LARRY A KRYZANIAK MSCFO (i)
(ii)
425,223
...............................
 
 
...............................
 
792
...............................
 
18,850
...............................
 
16,692
...............................
 
461,557
...............................
 
 
...............................
 
5DONALD M JACOBS MDCHIEF CLINICAL OFF (i)
(ii)
500,032
...............................
 
 
...............................
 
1,524
...............................
 
22,880
...............................
 
16,837
...............................
 
541,273
...............................
 
 
...............................
 
6MICHAEL B BELZER MDCHIEF MEDICAL OFF (i)
(ii)
408,066
...............................
 
 
...............................
 
1,524
...............................
 
15,600
...............................
 
16,648
...............................
 
441,838
...............................
 
 
...............................
 
7KATHY WILDE RN MACHIEF NURSING OFF (i)
(ii)
366,837
...............................
 
 
...............................
 
792
...............................
 
20,550
...............................
 
16,337
...............................
 
404,516
...............................
 
 
...............................
 
8STEVEN P STERNER MD FACEPCHIEF PROVIDER SERV (i)
(ii)
362,933
...............................
 
 
...............................
 
792
...............................
 
15,600
...............................
 
16,216
...............................
 
395,541
...............................
 
 
...............................
 
9SCOTT WORDELMAN FACHEVP AMBULATORY ADMIN (i)
(ii)
362,308
...............................
 
 
...............................
 
516
...............................
 
15,600
...............................
 
10,707
...............................
 
389,131
...............................
 
 
...............................
 
10WALTER T CHESLEY JDVP HUMAN RESOURCES (i)
(ii)
281,270
...............................
 
 
...............................
 
792
...............................
 
15,600
...............................
 
15,812
...............................
 
313,474
...............................
 
 
...............................
 
11NANCY GARRETT PHDCHIEF ANALYTICS OFF (i)
(ii)
272,360
...............................
 
 
...............................
 
120
...............................
 
15,600
...............................
 
20,125
...............................
 
308,205
...............................
 
 
...............................
 
12CHARLES L TRUWIT MDPHYSICIAN CHIEF (i)
(ii)
677,710
...............................
 
 
...............................
 
792
...............................
 
22,880
...............................
 
21,049
...............................
 
722,431
...............................
 
 
...............................
 
13CONSTANTIN N STARCHOOK MDPHYSICIAN (i)
(ii)
676,319
...............................
 
 
...............................
 
120
...............................
 
22,880
...............................
 
21,049
...............................
 
720,368
...............................
 
 
...............................
 
14GOPAL V PUNJABI MDPHYSICIAN (i)
(ii)
600,261
...............................
 
 
...............................
 
120
...............................
 
22,880
...............................
 
21,049
...............................
 
644,310
...............................
 
 
...............................
 
15ANTHONY L SEVERT MDPHYSICIAN - MANAGING (i)
(ii)
599,901
...............................
 
 
...............................
 
180
...............................
 
22,880
...............................
 
21,049
...............................
 
644,010
...............................
 
 
...............................
 
16PRATEEK SAHGAL MDPHYSICIAN - MANAGING (i)
(ii)
599,901
...............................
 
 
...............................
 
180
...............................
 
22,880
...............................
 
21,049
...............................
 
644,010
...............................
 
 
...............................
 
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
SCHEDULE J, PAGE 1, PART I, LINE 6A HHS, INC. CONTINGENT COMPENSATION PROGRAMS INCLUDE SHARING SUCCESS AND THE MANAGEMENT AND PHYSICIAN INCENTIVE PLANS. ELIGIBLE AND QUALIFYING EMPLOYEES CAN BE COMPENSATED BASED UPON ACHIEVEMENT OF PRE-ESTABLISHED CRITERIA AROUND ITEMS SUCH AS QUALITY, VOLUMES, AND ACCESS. THE CONTINGENT COMPENSATION MAY BE TIED TO FINANCIAL MEASURES. THE BOARD OF DIRECTORS RETAINS THE RIGHT TO DETERMINE AND AWARD ANY INCENTIVE PAYOUTS.
Schedule J (Form 990) 2014

Additional Data


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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
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Return Reference Explanation
FORM 990, PAGE 1, PART I, LINE 6 VOLUNTEERING AT HHS, INC GIVES PEOPLE THE OPPORTUNITY TO WORK WITHIN OUR COMMUNITY OF DIVERSE VOLUNTEERS, STAFF, VISITORS AND PATIENTS. VOLUNTEERS HELP SUPPLEMENT AND ENHANCE HOSPITAL SERVICES AND PROGRAMS. MOST VOLUNTEERS SCHEDULE A 3-4 HOUR SHIFT ONCE PER WEEK FOR 3-6 MONTHS. A COORDINATOR WILL WORK WITH A VOLUNTEER TO FIND A POSITION THAT FITS THEIR SCHEDULE AND INTERESTS FROM AMONG VARIOUS OPENINGS. DAYTIME, EVENING AND WEEKEND HOURS ARE AVAILABLE.
FORM 990, PAGE 6, PART VI, LINE 6 AS PER THE CORPORATE BYLAWS, THE CORPORATION SHALL HAVE ONE CLASS OF MEMBERS; A GOVERNING MEMBER. THE GOVERNING MEMBER OF THE CORPORATION IS THE COUNTY OF HENNEPIN OF MINNESOTA AND IS REPRESENTED BY THE HENNEPIN COUNTY BOARD OF COMMISSIONERS.
FORM 990, PAGE 6, PART VI, LINE 7A THE GOVERNING MEMBER, COUNTY OF HENNEPIN, MINNESOTA HAS RETAINED THE RIGHTS, DUTIES AND PRIVILEGES SPECIFIED UNDER THE BYLAWS OF HHS UPTO AND INCLUDING THE AUTHORITY TO APPOINT THE DIRECTORS OF HHS. THE HHS BOARD OF DIRECTORS IS EMPOWERED TO EXECUTE THE RIGHTS, DUTIES AND PRIVILEGES OF THE CORPORATION TO THE EXTENT AS SPECIFIED IN HHS BYLAWS.
FORM 990, PAGE 6, PART VI, LINE 7B AS EXPLAINED IN PART VI LINE 7A, THE GOVERNING MEMBER, HENNEPIN COUNTY OF MN RETAINS THE APPROVAL RIGHTS TO APPOINTING THE HHS BOARD OF DIRECTORS, THE HHS BUDGET, ANY ADDITIONAL INDEBTEDNESS, FINANCE COMMITTEE RECOMMENDATIONS AND EXECUTIVE COMMITTEE AS WELL AS APPROVING THE ANNUAL HHS HEALTH SERVICES PLAN WHICH IS REQUIRED BY STATE LAW.
FORM 990, PAGE 6, PART VI, LINE 11B FORM 990 IS COMPLETED AND REVIEWED INTERNALLY FOR ACCURACY, COMPLETENESS AND VALIDITY. THE FORM 990 IS THEN REVIEWED BY THE HHS BOARD OF DIRECTORS AND THE FINANCE COMMITTEE. ANY QUESTIONS THAT THE BOARD HAS ARE ANSWERED BY THE NEXT MEETING BEFORE APPROVAL. AT THE MONTHLY BOARD MEETING, THE FORM 990 IS FORMALLY APPROVED VIA A LINE ITEM MOTION. IT IS THEN SIGNED AND FILED ELECTRONICALLY AS REQUIRED BY THE IRS.
FORM 990, PAGE 6, PART VI, LINE 12C HHS HAS A POLICY ON CONFLICT OF INTEREST AND CONFIDENTIALITY WHICH REQUIRES THAT AN INTERESTED PERSON WHO IS A DIRECTOR, OFFICER, OR MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS MUST DISCLOSE IN WRITING WHEN POSSIBLE, OR ORALLY WHEN TIME DOES NOT ALLOW FOR WRITTEN DISCLOSURE. THE EXISTENCE AND NATURE OF HIS/HER RELATIONSHIP OR MATERIAL FINANCIAL INTEREST TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT AT OR PRIOR TO THE MEETING OF THE BOARD OR COMMITTEE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AN INTERESTED PERSON SHALL NOT ATTEMPT TO EXERT HIS OR HER PERSONAL INFLUENCE WITH RESPECT TO THE MATTER EITHER AT OR OUTSIDE THE MEETING. COPIES OF DISCLOSURES ARE MAINTAINED BY CORPORATE LEGAL COUNSEL WHO ALSO DOES MONITORING. EVERY YEAR THE ORGANIZATION IS AUDITED SEPARATELY FROM HENNEPIN COUNTY OF MINNESOTA AND A SEPARATE AUDIT REPORT IS PREPARED AND PRESENTED TO THE BOARD OF DIRECTORS AND TO THE HENNEPIN COUNTY, MN BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 15A HHS BOARD OF DIRECTORS ENGAGES AN INDEPENDENT CONSULTING FIRM EXPERT TO EVALUATE THE BASE AND TOTAL CASH COMPENSATION FOR THE CEO AND OTHER TOP OFFICIALS. THE COMPARABLE DATA COLLECTED BY INDEPENDENT CONSULTING FIRM EXPERT RELEVANTLY APPLIES REVENUE, EMPLOYEE SIZE AND GEOGRAPHIC LOCATION IN DELINEATING THE COMPARISON GROUP. THE DATA IS REVIEWED BY THE COMPENSATION SUBCOMMITTEE AND FURTHER SUBMITTED FOR DISCUSSION AND APPROVAL BY THE HHS, INC. BOARD OF DIRECTORS.
FORM 990, PAGE 6, PART VI, LINE 15B SEE EPLANATION IN PART VI LINE 15A
FORM 990, PAGE 6, PART VI, LINE 19 FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST DURING NORMAL BUSINESS HOURS FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D).
FORM 990, PAGE 7, PART VII PARENT ORGANIZATION HAS FILED A SEPARATE RETURN
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


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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" 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
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number

42-1707837
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (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) HENNEPIN COUNTY
300 SOUTH 6TH STREET

MINNEAPOLIS,MN55487
41-6005801
GOV'T UNIT MN   6 NA
 
 
No
(2) METROPOLITAN HEALTH PLAN
400 SOUTH FOURTH STREET SUITE 201

MINNEAPOLIS,MN55415
GOV'T UNIT MN   5 NA
 
 
No
(3) HENNEPIN HEALTH FOUNDATION
701 PARK AVENUE

MINNEAPOLIS,MN55415
41-0845733
PUB SUPPT MN 501C3 11A HHS INC
 
Yes
 
(4) MINNEAPOLIS MED RESEARCH FOUNDATION
701 PARK AVENUE PP7700

MINNEAPOLIS,MN55415
41-1677920
RESEARCH MN 501C3 4 HHS 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












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












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
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f 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
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
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) HENNEPIN COUNTY MN

C 4,132,033 CASH
(2) HENNEPIN COUNTY MN

M 130,000 CASH
(3) HENNEPIN COUNTY MN

K 4,109,246 CASH
(4) HENNEPIN COUNTY MN

Q 8,343,703 CASH
(5) HENNEPIN COUNTY MN

R 23,337,244 CASH
(6) HENNEPIN HEALTH FOUNDATION

N 345,399 FAIR VALUE
(7) HENNEPIN HEALTH FOUNDATION

C 348,440 CASH
(8) HENNEPIN HEALTH FOUNDATION

O 961,180 CASH
(9) MINNEAPOLIS MED RESEARCH FOUNDATION

A 630,916 CASH
(10) MINNEAPOLIS MED RESEARCH FOUNDATION

Q 955,827 CASH
(11) MINNEAPOLIS MED RESEARCH FOUNDATION

O 2,611,691 CASH
(12) METROPOLITAN HEALTH PLAN

Q 50,925,610 CASH
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 HHS, INC (HEREAFTER REFERRED TO AS HHS) PROVIDES ALL ADMINISTRATION COSTS, STAFF, INFORMATION TECHNOLOGY SYSTEMS, OFFICE SUPPLIES AND PROFESSIONAL SERVICES TO HENNEPIN HEALTH FOUNDATION. HHS SUPPORTS THE HENNEPIN HEALTH FOUNDATION BY PROVIDING SPACE FOR THE GENERAL OFFICE, GIFT SHOP, COFFEE SHOP, AND SPACE FOR COLLECTIONS OF THE HENNEPIN HISTORICAL CENTER AND THE INSPIRE ARTS PROGRAM. CERTAIN PERSONNEL OF HENNEPIN HEALTH FOUNDATION ARE EMPLOYEES OF HHS. THE HENNEPIN HEALTH FOUNDATION SUPPORTS HHS WITH FUNDS GIVEN TO MAINTAIN PROGRAMS, PROVIDE URGENT NEEDS, ASSIST IN PATIENT CARE AND PROVIDE SEED MONEY FOR NEW INITIATIVES. THE ARTWORK COLLECTION OF THE HENNEPIN HEALTH FOUNDATION IS USED AND DISPLAYED BY HHS.
Schedule R (Form 990) 2014
Additional Data


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