TY 2015 Form 990

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) ANIL MD GOKHAN...................................................................... DIRECTOR	40.00 ................. 0.00	X		516,739	57,514
(2) BINN MD MARTHA C...................................................................... DIRECTOR	40.00 ................. 0.00	X		288,826	47,907
(3) ERICKSON ERIC B...................................................................... DIRECTOR	40.00 ................. 0.00	X		232,471	42,346
(4) FITZGERALD MD KEVIN...................................................................... DIRECTOR	40.00 ................. 0.00	X		283,923	49,934
(5) GRAU MD THOMAS J...................................................................... DIRECTOR	40.00 ................. 0.00	X		296,305	24,898
(6) GRENISEN MD MARGARET M...................................................................... DIRECTOR	40.00 ................. 0.00	X		245,291	45,432
(7) HAGER NICKIJO L...................................................................... DIRECTOR	40.00 ................. 0.00	X		161,424	31,757
(8) HOLMAY DIANE K...................................................................... DIRECTOR	40.00 ................. 0.00	X		233,626	52,309
(9) HUGHES PETER R...................................................................... DIRECTOR	40.00 ................. 0.00	X		267,069	68,984
(10) JOHNSON MD TIMOTHY J...................................................................... DIRECTOR/CHAIR/CEO	40.00 ................. 0.00	X	X	516,503	67,415
(11) JUNGCK MD MARK C...................................................................... DIRECTOR	40.00 ................. 0.00	X		299,263	64,907
(12) KORDUCKI MD JANE M...................................................................... DIRECTOR	40.00 ................. 0.00	X		267,345	70,092
(13) KRIEN MD JOSEPH S...................................................................... DIRECTOR	40.00 ................. 0.00	X		294,022	53,529
(14) KRUSE JOSEPH J...................................................................... DIRECTOR/VICE CHAIR/SECRETARY/CAO	40.00 ................. 0.00	X	X	301,466	67,831
(15) MOLLING DO PAUL E...................................................................... DIRECTOR	40.00 ................. 0.00	X		282,109	51,521
(16) NOEL AMY J...................................................................... DIRECTOR	40.00 ................. 0.00	X		228,843	55,852
(17) RUSHLOW MD DAVID R...................................................................... DIRECTOR	40.00 ................. 0.00	X		334,603	57,420

(A) Name and business address	(B) Description of services	(C) Compensation
MAYO FOUNDATION FOR MEDICAL EDUCATION AN 200 1ST STREET SW ROCHESTER,MN55905	PROCUREMENT AGENT	9,981,970
MAYO CLINIC 200 1ST STREET SW ROCHESTER,MN55905	HEALTHCARE SERVICES	6,275,975
FOWLER & HAMMER INC 313 MONITOR STREET LA CROSSE,WI54603	CONSTRUCTION	1,835,904
WEATHERBY LOCUMS 6541 NORTH FEDERAL HWY SUITE 800 FORT LAUDERDALE,FL33308	HEALTHCARE SERVICES	1,493,539
LINDE HEALTHCARE STAFFING INC PO BOX 790051 SAINT LOUIS,MO63179	HEALTHCARE SERVICES	795,345
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 31

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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

2015

Open to Public
Inspection

Name of the organization

MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number

39-0806374

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

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

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

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

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

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

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

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

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

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

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)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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.

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2015

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)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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.)..

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

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2015

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

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

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.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

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.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) 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.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

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

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described in (a) above?

11b

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

Section B. Type I Supporting Organizations

Yes

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

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

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) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

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 2015 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-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

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) 2015

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number

39-0806374

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

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

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on 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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER INC

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER INC		Employer identification number 39-0806374

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) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER INC			Employer identification number 39-0806374
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

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

2015

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on 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

MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number

39-0806374

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................
c	Total lobbying expenditures (add lines 1a and 1b) .......................................................................
d	Other exempt purpose expenditures .........................................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ..............................................................................................................	Yes No

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) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

10,419

Total. Add lines 1c through 1i ....................................................................................................

10,419

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	THE AMOUNT IN "OTHER ACTIVITIES" REPRESENTS A PORTION OF PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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

2015

Open to Public Inspection

Name of the organization

MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number

39-0806374

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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 ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2015

Page 2

Part III

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

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

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

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

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" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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' on 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 ...		11,655,679		11,655,679
b	Buildings		174,398,897	102,037,112	72,361,785
c	Leasehold improvements		253,811	253,811	0
d	Equipment ...	8,582	88,309,198	63,554,853	24,762,927
e	Other ...		4,101,370		4,101,370
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					112,881,761

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on 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
(3)Other (A) MAYO POOLED INVESTMENTS	68,946,593	F
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	68,946,593

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) DUE FROM AFFILIATES				33,530,936
(2) DEFERRED COMPENSATION				15,042,043
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				48,572,979

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	-7,496
DUE TO AFFILIATES	79,532,887
DEFERRED COMPENSATION LIABILITY	15,042,043
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	94,567,434
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) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART IV, LINE 2B:	ASSISTED LIVING SECURITY DEPOSITS.
PART X, LINE 2:	AT DECEMBER 31, 2015 AND 2014, THE RESERVE FOR UNRECOGNIZED TAX BENEFITS WAS NOT SIGNIFICANT, AND AS A RESULT, THERE IS NO RESERVE FOR UNRECOGNIZED TAX BENEFITS RECORDED FOR THE FILING ORGANIZATION.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

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

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number

39-0806374

Part I

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

Form 990-EZ filers are not required to complete this part.

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

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

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

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

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

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

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2015

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 DRAGON BOAT FESTIVAL (event type)	(b) Event #2 TINY TIM (event type)	(c) Other events 2 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	61,589	60,355	82,044	203,988
2	Less: Contributions . . . .	29,448	27,693	19,835	76,976
3	Gross income (line 1 minus line 2) . . . . . .	32,141	32,662	62,209	127,012

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .		18,883		18,883
8	Entertainment . . . .
9	Other direct expenses . . .	60,414	1,634	36,320	98,368
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				117,251
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				9,761

Part III

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

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .	60,414	1,634	36,320	98,368

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

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

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

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

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

YesNo

If "No," explain:

10a

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

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2015

Page 3

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

YesNo

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

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

YesNo

Indicate the percentage of gaming activity conducted in:

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

13a

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

13b

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

Name

Address

15a

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

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

YesNo

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

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

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

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

YesNo

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

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

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on 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

2015

Open to Public Inspection

Name of the organization

MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number

39-0806374

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

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

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) 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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

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.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

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

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

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	2,909,420		2,909,420	0.700 %
b	Medicaid (from Worksheet 3, column a) . . . . .	53,507,532	20,963,651	32,543,881	7.790 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	56,416,952	20,963,651	35,453,301	8.490 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	159,001	6,247	152,754	0.040 %
f	Health professions education (from Worksheet 5) . . .	3,148,199	1,291,335	1,856,864	0.440 %
g	Subsidized health services (from Worksheet 6) . . . .	17,879,164	10,367,538	7,511,626	1.800 %
h	Research (from Worksheet 7) .	149,884	126,949	22,935	0.010 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	229,219	68,692	160,527	0.040 %
j	Total. Other Benefits . .	21,565,467	11,860,761	9,704,706	2.330 %
k	Total. Add lines 7d and 7j .	77,982,419	32,824,412	45,158,007	10.820 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

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.

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	4,323		4,323	0 %
2	Economic development
3	Community support	118,308	3,500	114,808	0.030 %
4	Environmental improvements	936		936	0 %
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	123,567	3,500	120,067	0.030 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

12,203,483

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. ......

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

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

55,083,566

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

80,224,684

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

-25,141,118

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(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) 2015

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?2 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)								Facility reporting group
1	FRANCISCAN MEDICAL CENTER - LA CROSSE 700 WEST AVENUE SOUTH LA CROSSE,WI546014796 MAYOCLINICHEALTHSYSTEM.ORG 24	X	X	X		X		A
2	FRANCISCAN MEDICAL CENTER - SPARTA 310 WEST MAIN STREET SPARTA,WI546562142 MAYOCLINICHEALTHSYSTEM.ORG 1009	X	X		X		X	A

Schedule H (Form 990) 2015

Page 4

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)

	FACILITY REPORTING GROUP - A
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):

Yes

Community Health Needs Assessment

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

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

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

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 13

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

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

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

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): MAYOCLINICHEALTHSYSTEM.ORG

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

If "Yes" (list url):

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Yes

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on 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) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000% and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

MAYOCLINICHEALTHSYSTEM.ORG

The FAP application form was widely available on a website (list url):

MAYOCLINICHEALTHSYSTEM.ORG

A plain language summary of the FAP was widely available on a website (list url):
MAYOCLINICHEALTHSYSTEM.ORG

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

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
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: FRANCISCAN MEDICAL CENTER - LA CROSSE, - FACILITY 2: FRANCISCAN MEDICAL CENTER - SPARTA
GROUP A-FACILITY 1 -- FRANCISCAN MEDICAL CENTER - LA CROSSE PART V, SECTION B, LINE 5:
GROUP A-FACILITY 1 -- FRANCISCAN MEDICAL CENTER - LA CROSSE PART V, SECTION B, LINE 6A:
GROUP A-FACILITY 1 -- FRANCISCAN MEDICAL CENTER - LA CROSSE PART V, SECTION B, LINE 6B:
GROUP A-FACILITY 1 -- FRANCISCAN MEDICAL CENTER - LA CROSSE PART V, SECTION B, LINE 11:	ALCOHOL USE:MCHS-LA CROSSE DESIGNATED COMMUNITY INVESTMENT DOLLARS TO PROGRAMS PROMOTING PREVENTION EDUCATION SUCH AS THE DRUG & ALCOHOL RESISTANCE EDUCATION (DARE) PROGRAM; COULEE COUNCIL ON ADDICTIONS' TURNED LEAF FESTIVAL & HOME RUN 5K; COULEECAP'S HOUSING FIRST AND HOMELESS COALITION THAT IDENTIFIES DRUG & ALCOHOL ABUSE AND REFERS PARTICIPANTS FOR TREATMENT AS A REQUIREMENT FOR PARTICIPATION IN THE PROGRAM; AND THE "DRUG FREE ZONE" AT LA CROSSE'S ANNUAL OKTOBERFEST. CASH CONTRIBUTIONS TOTALED $12,000. MCHS-LA CROSSE CONTINUED ITS PARTICIPATION IN THE LA CROSSE HEALTH SCIENCE CONSORTIUM'S RISKY DRINKING BEHAVIORS COALITION COMPRISED OF COMMUNITY GROUPS, STUDENTS, PARENTS, GOVERNMENT AGENCIES, AND BUSINESSES. THE COALITION SUPPORTS POLICIES AND PRACTICES THAT MAKE IT EASIER FOR THOSE WHO DRINK TO DO SO SAFELY AND RESPONSIBLY.MCHS-LA CROSSE PROVIDED IN-KIND CONTRIBUTIONS RELATED TO SUBSTANCE ABUSE INCLUDING: A PHYSICIAN TO SERVE ON THE BOARD OF COULEE COUNCIL ON ADDICTIONS; A PHYSICIAN REPRESENTATIVE FOR THE LA CROSSE COUNTY HEROIN TASK FORCE; AND AN AODA COUNSELOR TO PRESENT "FAMILY ADJUSTMENTS TO LIVING WITH ADDICTION" AT COULEE COUNCIL ON ADDICTIONS. IN-KIND CONTRIBUTIONS TOTAL $1,020.HEALTH CARE ACCESS:MCHS-LA CROSSE OPERATES ST. CLARE HEALTH MISSION, A FREE, PRIMARY CARE CLINIC SERVING INDIVIDUALS WHO HAVE NO MEDICAL INSURANCE AND DO NOT QUALIFY FOR PUBLIC ASSISTANCE. THE MISSION SEES PATIENTS FROM A 5-COUNTY AREA AND IS OPEN 2 EVENINGS PER WEEK. PRESCRIPTIONS WRITTEN AT THE MISSION ARE FILLED AT NO COST TO PATIENTS VIA AN ON-SITE PHARMACY. FOR INDIVIDUALS WITH UNSTABLE CHRONIC MEDICAL CONDITIONS, THE MISSION ALSO OPERATES A CONTINUITY CLINIC ONE DAY PER WEEK THAT PROVIDES NUTRITION COUNSELING, DIABETES EDUCATION, SMOKING CESSATION, FOOT CARE AND SPECIALTY MEDICAL CARE. PATIENTS WHO REQUIRE SPECIALTY PROCEDURES OR SURGERY RECEIVE TREATMENT AT MCHS-LA CROSSE AT NO COST. MORE THAN 300 PATIENTS RECEIVED FREE CARE AND PRESCRIPTION MEDICATIONS IN 2015.MCHS-LA CROSSE CONTINUED ITS PARTICIPATION IN THE MINNESOTA BREAST & CERVICAL CANCER PROGRAM AND THE WISCONSIN WELL WOMAN PROGRAM, EXPANDING HEALTHCARE ACCESS FOR LOW-INCOME, UNINSURED AND UNDERINSURED WOMEN. SERVICES INCLUDE SCREENINGS, PREVENTION AND TREATMENT.MCHS-LA CROSSE PARTNERED WITH THE LA CROSSE YMCA, LA CROSSE COUNTY HEALTH DEPARTMENT AND GUNDERSEN HEALTH SYSTEM TO HOLD FREE COMMUNITY HEALTH SCREENINGS FOR CHOLESTEROL, BLOOD SUGAR, BLOOD PRESSURE AND BODY MASS INDEX. PARTICIPANTS RECEIVED COUNSELING BASED ON THEIR RESULTS AND INFORMATION ON HOW TO ACCESS FOLLOW UP CARE AT AREA MEDICAL CENTERS AND FREE CLINICS. IN-KIND CONTRIBUTIONS TOTALED $2,500.MCHS-LA CROSSE PROVIDED EDUCATIONAL OPPORTUNITIES FOR HIGH SCHOOL STUDENTS ENROLLED IN THE LA CROSSE SCHOOL DISTRICT'S HEALTH SCIENCE ACADEMY. SCHOLARSHIPS WERE PROVIDED FOR SENIORS PURSUING HIGHER EDUCATION IN HEALTHCARE. CASH & IN-KIND CONTRIBUTIONS TOTALED $6,500.MCHS-LA CROSSE DESIGNATED COMMUNITY INVESTMENT DOLLARS TO PROGRAMS SUPPORTING ACCESS TO CARE INCLUDING: THE RETIRED SENIOR VOLUNTEER PROGRAM THAT PROVIDES SENIORS AND DISABLED ADULTS WITH RIDES TO/FROM MEDICAL APPOINTMENTS; THE LA CROSSE COUNTY HEALTH DEPARTMENT FOR ITS ANNUAL HMONG HEALTH FAIR AND ITS COMMUNITY-WIDE HPV VACCINATION CAMPAIGN; THE FAMILY & CHILDREN'S CENTER FOR ITS HEALTHY FAMILIES PROGRAM THAT PROVIDES REGULAR HOME VISITS TO EDUCATE PARENTS AND PREVENT CHILD ABUSE/NEGLECT IN AT-RISK HOMES. CASH CONTRIBUTIONS TOTALED $12,000.MENTAL HEALTH:MCHS-LA CROSSE OFFERS AN ARRAY OF OUTPATIENT, INPATIENT AND RESIDENTIAL MENTAL HEALTH SERVICES INCLUDING 4 COMMUNITY BASED RESIDENTIAL FACILITIES: SIENA HALL - SERVING ADULTS WITH MENTAL HEALTH DISORDERS; LAAR HOUSE AND SCARSETH HOUSE - SERVING WOMEN AND INDIVIDUALS RESPECTIVELY WITH SUBSTANCE ABUSE AND/OR CO-OCCURRING DISORDERS; AND GERARD HALL - SERVING WOMEN WHO ARE PREGNANT OR PARENTING AND HAVE MENTAL HEALTH AND/OR CO-OCCURRING DISORDERS. MCHS-LA CROSSE ENTERED INTO A UNIQUE 3-YEAR PARTNERSHIP WITH THE LA CROSSE AREA BOYS & GIRLS CLUBS (LABGC) AND RONALD MCDONALD HOUSE CHARITIES (RMHC) TO PLACE A FULL-TIME BEHAVIORAL HEALTH SPECIALIST AT THE LABGC - MATHY CENTER. THE BEHAVIORAL HEALTH SPECIALIST IS EMPLOYED BY MCHS-LA CROSSE AND IS MENTORED/SUPERVISED BY SENIOR STAFF IN THE BEHAVIORAL HEALTH DEPARTMENT. RMHC FUNDS THE SALARY & BENEFITS.MCHS-LA CROSSE PROVIDED OFFICE AND MEETING SPACE IN A HOME IT OWNS IN LA CROSSE'S WASHBURN NEIGHBORHOOD FOR A SOCIAL WORKER OF THE LA CROSSE COUNTY FAMILY COLLABORATIVE. BASED ON A SUCCESSFUL PROGRAM IN MADISON, WI, THE COLLABORATIVE SEEKS TO PROVIDE SERVICES FOR AT-RISK INDIVIDUALS AND FAMILIES WHERE THEY RESIDE. THE SOCIAL WORKER CONNECTS PEOPLE IN THE NEIGHBORHOOD WITH COMMUNITY RESOURCES, INCLUDING MENTAL HEALTH SERVICES. MCHS-LA CROSSE'S SAFE PATH PROGRAM IDENTIFIES PATIENTS SUFFERING ABUSE AT HOME AND PROVIDES COUNSELING, REFERRALS, AND FINANCIAL ASSISTANCE TO ENSURE A PATIENT'S SAFETY. MCHS-LA CROSSE STAFF ALSO CONSULT WITH VARIOUS COMMUNITY AGENCIES PROVIDING SHELTER/CARE FOR VICTIMS OF DOMESTIC VIOLENCE.MCHS-LA CROSSE SERVES AS A RESOURCE AND SUPERVISED CLINICAL SETTING FOR VITERBO UNIVERSITY STUDENTS WORKING TOWARD MASTERS DEGREES IN MENTAL HEALTH COUNSELING. MCHS-LA CROSSE PARTICIPATED IN THE "CAMPAIGN TO CHANGE DIRECTION," A COLLABORATIVE, COMMUNITY-WIDE EFFORT TO REDUCE THE STIGMA OF MENTAL ILLNESS AND ENCOURAGE PEOPLE TO SEEK HELP FOR THEMSELVES OR FOR LOVED ONES. IN-KIND CONTRIBUTION TOTALED $316.MCHS-LA CROSSE DESIGNATED COMMUNITY INVESTMENT DOLLARS TO SUPPORT THE ANNUAL SUICIDE PREVENTION SUMMIT IN LA CROSSE, AN EDUCATION AND AWARENESS EVENT FOR BEHAVIORAL HEALTH PROFESSIONALS AND THE PUBLIC. CASH CONTRIBUTION TOTALED $2,000.MCHS-LA CROSSE PROVIDED A QUALIFIED BOARD MEMBER FOR THE MENTAL HEALTH COALITION OF GREATER LA CROSSE, WHICH IS COMPRISED OF ORGANIZATIONS, HEALTHCARE PROVIDERS, AND CITIZENS. COALITION PROJECTS INCLUDE CREATING AWARENESS THAT SUICIDE IS A PREVENTABLE PUBLIC HEALTH PROBLEM; IMPROVING OUTCOMES WHEN LAW ENFORCEMENT COMES IN CONTACT WITH INDIVIDUALS WITH MENTAL ILLNESS; AND WORKING TO ENSURE THAT DISCHARGE PLANS AID IN MAKING A SAFE TRANSITION BACK INTO THE COMMUNITY. OBESITY:MCHS-LA CROSSE DESIGNATED COMMUNITY INVESTMENT DOLLARS TO COMMUNITY PROGRAMS THAT PROMOTE HEALTHY EATING SUCH AS HEALTHY SNACKS FOR SUMMER CAMP, SUPPORT FOR THE 'ACTIVE EARLY WORK' CHILDHOOD OBESITY PROGRAM AT THE PARENTING PLACE; AND SPONSORSHIP OF TWO EDUCATIONAL PRESENTATIONS IN THE COMMUNITY BY RENOWNED URBAN AGRICULTURE GURU, WILL ALLEN. CASH CONTRIBUTIONS TOTALED $6,800.MCHS-LA CROSSE INITIATED AN EDIBLE LANDSCAPE PROGRAM AT THE HOSPITAL AND ITS REGIONAL CLINICS TO DEMONSTRATE SMALL-SPACE GARDENING TECHNIQUES AND ENGAGE PATIENTS, VISITORS & STAFF IN CONVERSATIONS ABOUT GROWING AND CONSUMING FRESH HEALTHY FOODS. RAISED BED PLANTERS AT THE HOSPITAL ALLOWED PATIENTS OF ALL ABILITIES TO ACCESS GROWING PLANTS. THE RAISED BEDS ALSO SERVED AS THE SETTING FOR A CARDIAC REHABILITATION CLASS ON COOKING WITH HERBS. VEGETABLES GROWN IN THE PLANTERS/BEDS WERE FEATURED IN THE HOSPITAL CAFETERIA ON SEVERAL OCCASIONS.MCHS-LA CROSSE WORKS WITH THE WASHBURN NEIGHBORHOOD ASSOCIATION AND THE CITY OF ONALASKA PARKS & RECREATION DEPARTMENT TO PROVIDE SPACE ON ITS PROPERTIES IN LA CROSSE AND ONALASKA FOR COMMUNITY GARDENING. MCHS-LA CROSSE PROVIDES STAFF AND EQUIPMENT TO STAKE PLOTS, TILL SOIL, MOVE DIRT, ETC., AND PAYS FOR WATER SERVICE AT BOTH SITES AND PORTABLE RESTROOMS FOR THE ONALASKA SITE. IN-KIND CONTRIBUTIONS TOTALED $7,500.A MOBILE TEACHING KITCHEN WAS USED AT A VARIETY OF LOCAL EVENTS AND ON THE MCHS-LA CROSSE CAMPUS TO DEMONSTRATE QUICK, TASTY AND HEALTHY FOOD PREPARATION. IN-KIND CONTRIBUTIONS TOTALED $4,225.MCHS-LA CROSSE SERVED AS THE CORPORATE SPONSOR OF GROW LA CROSSE, INC., A NONPROFIT ORGANIZATION WHOSE MISSION IS "CONNECTING CHILDREN WITH HEALTHY FOOD AND NATURE." PARTNERING WITH GROW LA CROSSE, MCHS-LA CROSSE SUPPORTED ELEMENTARY SCHOOL GARDENS, CLASSROOM EDUCATION, TASTE-TESTING SESSIONS, AND WEEK-LONG "FARM CAMP" SESSIONS, INCLUDING SCHOLARSHIPS FOR DISADVANTAGED YOUTH. CASH & IN-KIND DONATIONS TOTALED $14,000.MCHS-LA CROSSE PARTNERED WITH HILLVIEW URBAN AGRICULTURE AND UW-LA CROSSE (UW-L) TO CREATE A VERMICOMPOSTING CENTER (VC) ON ITS LA CROSSE CAMPUS. THE VC USES WORMS TO TURN PRE-CONSUMER KITCHEN WASTE INTO HIGH-DENSITY ORGANIC FERTILIZER FOR GARDEN SOIL. UW-L DONATED THE VERMICOMPOSTING UNITS AND PROVIDES AGRICULTURAL EXPERTISE AND STUDENTS TO ASSIST WITH THE PROGRAM. HILLVIEW OPERATES THE VC, DONATING A PORTION OF THE "VERMIGOLD AND SELLING THE REST AT A MODEST COST TO SUPPORT ITS EDUCATIONAL PROGRAMS. MCHS-LA CROSSE PROVIDES A GARAGE WITH A FULL BASEMENT, FURNACE, AIR CONDITIONER & WATER SUPPLY, MAINTAINS THE PROPERTY, AND COVERS COSTS ASSOCIATED WITH WATER, ELECTRICITY, GAS, TRASH & SNOW REMOVAL. CASH & IN-KIND CONTRIBUTIONS TOTALED $25,000.
GROUP A-FACILITY 1 -- FRANCISCAN MEDICAL CENTER - LA CROSSE PART V, SECTION B, LINE 13B:
GROUP A-FACILITY 1 -- FRANCISCAN MEDICAL CENTER - LA CROSSE PART V, SECTION B, LINE 13H:
GROUP A-FACILITY 1 -- FRANCISCAN MEDICAL CENTER - LA CROSSE PART V, SECTION B, LINE 16I:
GROUP A-FACILITY 1 -- FRANCISCAN MEDICAL CENTER - LA CROSSE PART V, SECTION B, LINE 20E:
GROUP A-FACILITY 1 -- FRANCISCAN MEDICAL CENTER - LA CROSSE PART V, SECTION B, LINE 22D:
GROUP A-FACILITY 2 -- FRANCISCAN MEDICAL CENTER - SPARTA PART V, SECTION B, LINE 5:
GROUP A-FACILITY 2 -- FRANCISCAN MEDICAL CENTER - SPARTA PART V, SECTION B, LINE 6A:
GROUP A-FACILITY 2 -- FRANCISCAN MEDICAL CENTER - SPARTA PART V, SECTION B, LINE 6B:
GROUP A-FACILITY 2 -- FRANCISCAN MEDICAL CENTER - SPARTA PART V, SECTION B, LINE 11:	ALCOHOL USE:MAYO CLINIC HEALTH SYSTEM - IN SPARTA (MCHS-SPARTA) CONTINUES TO PROVIDE ALCOHOL AND OTHER DRUG TREATMENT AND PREVENTION SERVICES THAT ADDRESS THE NEEDS OF ITS PATIENTS. MCHS-SPARTA ALSO PARTICIPATED IN MONROE COUNTY ALCOHOL AND OTHER DRUG ABUSE INITIATIVE AND WORKED WITH TRI-COUNTY HEROIN ADDICTION COALITION AS A TREATMENT RESOURCE FOR THE LAW ENFORCEMENT AGENCIES IN LA CROSSE, VERNON AND MONROE COUNTIES. IN-KIND CONTRIBUTIONS TOTAL $5,274.ACCESS TO HEALTH CARE:MCHS-SPARTA OPERATES ST. CLARE HEALTH MISSION OF SPARTA, A FREE, BASIC HEALTH CARE CLINIC THAT SERVES INDIVIDUALS WHO RESIDE IN MONROE COUNTY AND HAVE NO MEDICAL INSURANCE OR DO NOT QUALIFY FOR PUBLIC ASSISTANCE. PHYSICIANS AND STAFF VOLUNTEER AT THE CLINIC. THE CLINIC FILLS PRESCRIPTIONS WRITTEN AT THE MISSION FREE OF CHARGE AT THE ON-SITE PHARMACY. MCHS-SPARTA ALSO CONTINUES TO PROVIDE PREVENTION AND TREATMENT SERVICES THAT ADDRESS PATIENTS' NEEDS AND PARTICIPATES IN THE WISCONSIN WELL WOMAN PROGRAM PROVIDING UNINSURED AND UNDERINSURED PATIENTS WITH ACCESS TO SCREENINGS.MCHS-SPARTA SERVES AS A PARTNER FACILITY FOR SCENIC BLUFFS COMMUNITY HEALTH CENTER WHICH OPERATES LOCATIONS IN CASHTON AND NORWALK, WISCONSIN. THE CENTER OFFERS PRIMARY AND BEHAVIORAL HEALTH CARE AND OUTREACH SERVICES TO PATIENTS ON A SLIDING FEE SCALE, INCLUDING INSURED PATIENTS WITH HIGH DEDUCTIBLES. ADDITIONAL CASH CONTRIBUTIONS TO SCENIC BLUFFS TOTALED $1,100.MENTAL HEALTH:MCHS-SPARTA CONTINUES TO OFFER MENTAL HEALTH TREATMENT AND PREVENTION SERVICES THAT ADDRESS THE NEEDS OF ITS PATIENTS. MCHS-SPARTA PARTICIPATES IN MONROE COUNTY MENTAL HEALTH WORKGROUP INITIATIVES, WHICH INCLUDES INCREASING INDIVIDUAL AND COMMUNITY KNOWLEDGE OF DEPRESSION SYMPTOMS AND SUICIDE. MCHS-SPARTA ALSO PARTICIPATES IN THE COUNTY'S EDUCATIONAL SESSIONS ON ANTI-BULLYING. MCHS-SPARTA DESIGNATED COMMUNITY INVESTMENT DOLLARS FOR NAMI (NATIONAL ALLIANCE FOR MENTAL ILLNESS) OF MONROE COUNTY FOR PROGRAMS THAT EDUCATE THE COMMUNITY ABOUT MENTAL ILLNESS. CASH CONTRIBUTION TOTALED $1,200.OBESITY:MCHS-SPARTA CONTINUES TO OFFER HEALTHY EATING, PHYSICAL ACTIVITY AND STRESS REDUCTION PROGRAMS THAT MEET THE NEEDS OF PATIENTS AND EMPLOYEES INCLUDING A COMMUNITY SUPPORT AGRICULTURE (CSA) BENEFIT AS PART OF ITS HEALTH PLAN. MCHS-SPARTA INSTALLED THREE EDIBLE LANDSCAPE PLANTERS AT THE HOSPITAL'S MAIN ENTRANCE TO DEMONSTRATE SMALL-SPACE GARDENING TECHNIQUES AND ENGAGE PATIENTS, VISITORS AND STAFF IN CONVERSATION ABOUT GROWING AND CONSUMING HEALTHY FOODS. MCHS-SPARTA PARTICIPATED IN MONROE COUNTY PROGRAMS TO INCREASE INDIVIDUAL AND COMMUNITY KNOWLEDGE RELATED TO NUTRITION AND PHYSICAL ACTIVITY.MCHS-SPARTA DESIGNATED COMMUNITY INVESTMENT DOLLARS TO SUPPORT A HEALTHY LIVING PROGRAM OFFERED BY THE TOMAH AREA SCHOOL DISTRICT. CASH CONTRIBUTION TOTALED $500. DENTAL CARE ACCESS AND COST:MCHS-SPARTA OPERATES AN ORAL SURGERY PROGRAM THAT PROVIDES DENTAL SURGERY ACCESS AND MINOR RESTORATIVE PROCEDURES TO PEDIATRIC PATIENTS WHO CANNOT FIND AN AREA DENTIST TO PROVIDE THESE SERVICES.MCHS-SPARTA ALSO SUPPORTED DENTAL CARE FOR LOW INCOME AND RURAL RESIDENTS OF MONROE COUNTY THROUGH ITS SUPPORT OF SCENIC BLUFFS COMMUNITY HEALTH CENTER.
GROUP A-FACILITY 2 -- FRANCISCAN MEDICAL CENTER - SPARTA PART V, SECTION B, LINE 13B:
GROUP A-FACILITY 2 -- FRANCISCAN MEDICAL CENTER - SPARTA PART V, SECTION B, LINE 13H:
GROUP A-FACILITY 2 -- FRANCISCAN MEDICAL CENTER - SPARTA PART V, SECTION B, LINE 16I:
GROUP A-FACILITY 2 -- FRANCISCAN MEDICAL CENTER - SPARTA PART V, SECTION B, LINE 20E:
GROUP A-FACILITY 2 -- FRANCISCAN MEDICAL CENTER - SPARTA PART V, SECTION B, LINE 22D:
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: FRANCISCAN MEDICAL CENTER - LA CROSSE, - FACILITY 2: FRANCISCAN MEDICAL CENTER - SPARTA
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5:	THE COALITION THAT CONDUCTED THE "COMPASS NOW" ASSESSMENT ON WHICH THIS CHNA IS BASED INCLUDED PARTICIPATION OF THE PUBLIC HEALTH DEPARTMENTS OF HOUSTON, LA CROSSE, MONROE, TREMPEALEAU, AND VERNON COUNTIES. THE "COMPASS NOW" ASSESSMENT RECEIVED INPUT FROM THE FOLLOWING SOURCES: RANDOMLY SELECTED HOUSEHOLD SURVEYS, KEY STAKEHOLDER MEETINGS, AND FOCUS GROUPS.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A:	THE COALITION THAT CONDUCTED THE "COMPASS NOW" ASSESSMENT ON WHICH THIS CHNA REPORT IS BASED INCLUDED MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER-LA CROSSE CAMPUS, MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER-SPARTA CAMPUS, GUNDERSEN LUTHERAN HEALTH SYSTEM, ST. JOSEPH'S HEALTH SERVICES-GUNDERSEN LUTHERAN, TOMAH MEMORIAL HOSPITAL, TRI-COUNTY MEMORIAL HOSPITAL, AND VERNON MEMORIAL HOSPITAL.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B:	THE COALITION THAT CONDUCTED THE "COMPASS NOW" ASSESSMENT ON WHICH THIS CHNA REPORT IS BASED INCLUDED GREAT RIVERS UNITED WAY, HOUSTON COUNTY HEALTH DEPARTMENT, LA CROSSE COUNTY HEALTH DEPARTMENT, MONROE COUNTY HEALTH DEPARTMENT, TREMPEALEAU COUNTY HEALTH DEPARTMENT, VERNON COUNTY HEALTH DEPARTMENT, AND LA CROSSE COMMUNITY FOUNDATION.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13B:	IF A PATIENT'S BALANCE EXCEEDS 25% OF THEIR ANNUAL HOUSEHOLD INCOME, BUT THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE BASED ON FPG, CHARITY CARE WILL BE ADJUSTED TO A MINIMUM OF THE AMOUNT GENERALLY BILLED (AGB). THE AGB IS DETERMINED USING THE LOOK-BACK METHOD AND CALCULATED USING ALL CLAIMS ALLOWED BY PRIVATE PAY INSURERS (INCLUDING MEDICARE ADVANTAGE) AND MEDICARE (TRADITIONAL) FOR INPATIENT AND OUTPATIENT SERVICES FOR THE YEAR.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H:	THE REGIONAL PROXIMITY OF A PATIENT'S RESIDENCY IS A FACTOR FOR PRESCHEDULED SERVICES ONLY AND SECONDARY TO MEDICAL NEED. REGIONAL PROXIMITY IS NOT A FACTOR FOR EMERGENCY CARE PROVIDED.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16I:	WITH REGARD TO THE POSTINGS WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBED THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE AND EXPRESSES AN INABILITY TO PAY, ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE ARE DISCUSSED WITH THE PATIENT.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 20E:	FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE TO EVERY PATIENT VIA MAYO'S PUBLIC WEBSITE, FROM CUSTOMER SERVICE AND PATIENT ACCESS LOCATIONS, AND IS REFERENCED ON MAYO'S AUTHORIZATION FORMS AND STATEMENTS. IN ADDITION, BROCHURES ARE AVAILABLE IN THE ADMISSIONS AREA AND THE PROCESS OF HOW TO APPLY IS AVAILABLE ON THE MAYO CLINIC WEBSITE.UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, MAYO DISCUSSES ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE.MONTHLY STATEMENTS ARE SENT TO PATIENTS THAT OUTLINE CURRENT CHARGES AND ACTIONS WITH INSURANCE AND INCLUDES INFORMATION ABOUT MAYO'S CHARITY CARE POLICY. SOME MAYO SITES UTILIZE ADVOCATES TO CONTACT THE PATIENT UPON DISCHARGE TO HELP THEM SECURE GOVERNMENTAL ASSISTANCE OR FINANCIAL ASSISTANCE.EACH CHARITY CARE REVIEW IS DOCUMENTED IN MAYO'S BILLING SYSTEM AND COMMUNICATED TO THE PATIENT. COMPLETED CHARITY CARE FORMS ARE MAINTAINED EITHER IN PAPER OR ELECTRONIC FORMAT. THE PATIENT IS INFORMED REGARDING THE OUTCOME OF THE REVIEW.MAYO OFTEN IDENTIFIES CHARITY CARE OPPORTUNITIES AFTER THE PATIENT HAS BEEN DISMISSED. IN MANY CASES, THIS IS DUE TO LIMITED INSURANCE COVERAGE OR INSURANCE DENIALS AFTER THE SERVICE WAS PERFORMED. IN THESE CASES, WHEN A PATIENT EXPRESSES AN INABILITY TO PAY FOR THEIR SERVICES, STAFF WILL INITIATE A CHARITY REVIEW AS INDICATED BY THE FINANCIAL ASSISTANCE POLICY, WHICH IS AVAILABLE FOR EVERY PATIENT AT MAYOCLINIC.ORG.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 22D:	OUR POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 50% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE.

Schedule H (Form 990) 2015

Page 8

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?25
Name and address		Type of Facility (describe)
1	1 - FRANCISCAN MEDICAL CENTER - LA CROSSE 800 WEST AVENUE SOUTH LA CROSSE,WI546014796	CLINIC, PHARMACY
2	2 - ONALASKA CLINIC 191 THEATER ROAD ONALASKA,WI54650	CLINIC, BEHAVIORAL HEALTH CLINIC, PHARMACY, DME
3	3 - TOMAH CLINIC 325 BUTTS AVENUE TOMAH,WI546600610	CLINIC, BEHAVIORAL HEALTH CLINIC
4	4 - BEHAVORIAL HEALTH SERVICE - LA CROSSE 212 11TH STREET SOUTH LA CROSSE,WI54601	BEHAVIORAL HEALTH CLINIC
5	5 - HOLMEN CLINIC 1303 MAIN STREET S HOLMEN,WI546369337	CLINIC, BEHAVIORAL HEALTH CLINIC
6	6 - ARCADIA CLINIC 464 SOUTH ST JOSEPH AVENUE ARCADIA,WI546121499	CLINIC, BEHAVIORAL HEALTH CLINIC, DME
7	7 - SPARTA CLINIC 310 WEST MAIN STREET SPARTA,WI546562142	CLINIC, BEHAVIORAL HEALTH CLINIC, DME
8	8 - FRANCISCAN LA CROSSE CLINIC DME 620 SOUTH 11TH STREET LA CROSSE,WI546014711	DME
9	9 - WAUKON CLINIC 105 EAST MAIN STREET WAUKON,IA52172	CLINIC
10	10 - PRAIRIE DU CHIEN CLINIC 800 EAST BLACKHAWK AVENUE PRAIRIE DU CHIEN,WI53821	CLINIC, BEHAVIORAL HEALTH CLINIC
11	11 - PROFESSIONAL ARTS BUILDING 615 SOUTH 10TH STREET LA CROSSE,WI54601	ALLERGY, ORAL SURGERY
12	12 - FRANCISCAN FAMILY HEALTH CLINIC 815 SOUTH 10TH STREET LA CROSSE,WI54601	FAMILY HEALTH CLINIC
13	13 - FRANCISCAN-HOME CARE PHARMACY 700 WEST AVENUE SOUTH LA CROSSE,WI54601	PHARMACY
14	14 - CALEDONIA CLINIC 701 NORTH PRAGUE STREET CALEDONIA,MN559211066	CLINIC, BEHAVIORAL HEALTH CLINIC, DME
15	15 - LA CRESCENT CLINIC 524 NORTH ELM LA CRESCENT,MN559471027	CLINIC
16	16 - FRANCISCAN OCCUPATIONAL HEALTH CLINIC 630 10TH STREET LA CROSSE,WI54601	OCCUPATIONAL HEALTH CLINIC
17	17 - SIENA HALL 608 11TH STREET SOUTH LA CROSSE,WI54601	BEHAVIORAL HEALTH
18	18 - VILLAGE ON 9TH 621 SOUTH 9TH STREET LA CROSSE,WI54601	ELDERLY HOUSING
19	19 - VILLA SUCCESS 121 PRAIRIE STREET PRAIRIE DU CHIEN,WI53821	BEHAVIORAL HEALTH
20	20 - WOMEN'S LAAR HOUSE 1005 JACKSON STREET LA CROSSE,WI54601	BEHAVIORAL HEALTH
21	21 - ST CLARE HEALTH MISSION 916 FERRY STREET LA CROSSE,WI54601	CLINIC
22	22 - SCARSETH HOUSE 535 SOUTH 17TH STREET LA CROSSE,WI54601	BEHAVIORAL HEALTH
23	23 - GROUP HOME I 518 10TH STREET SOUTH LA CROSSE,WI54601	BEHAVIORAL HEALTH
24	24 - VILLAGE ON CASS 225 24TH STREET SOUTH LA CROSSE,WI54601	ELDERLY HOUSING
25	25 - GERARD HALL 940 DIVISION STREET LA CROSSE,WI54601	MATERNITY HOME

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C:	MEDICAL INDIGENCY MAY BE USED TO DETERMINE ELIGIBILITY IN ADDITION TO FPG.IF A PATIENT BALANCE EXCEEDS 25% OF THE ANNUAL HOUSEHOLD INCOME, BUT THE PATIENT DOES NOT QUALIFY BASED ON FPG, CHARITY WILL BE ADJUSTED TO A MINIMUM OF THE AMOUNT GENERALLY BILLED (AGB). THE AGB IS DETERMINED USING THE LOOK-BACK METHOD AND CALCULATED USING ALL CLAIMS ALLOWED BY PRIVATE PAY INSURERS (INCLUDING MEDICARE ADVANTAGE) AND MEDICARE (TRADITIONAL) FOR INPATIENT AND OUTPATIENT SERVICES FOR THE YEAR.
PART I, LINE 7:	A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO.
PART I, LINE 7G:	THE FOLLOWING NET COMMUNITY BENEFIT COST ATTRIBUTED TO A PHYSICIAN CLINIC WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES: $7,511,626.
PART I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 12,203,483.
SCHEDULE H, PART I, LINE 5A	THE FILING ORGANIZATION ESTIMATES CHARITY CARE FOR FINANCIAL PLANNING PURPOSES ONLY. THE ESTIMATED AMOUNT OF CHARITY CARE DOES NOT INFLUENCE OR HAVE ANY IMPACT ON THE AMOUNT OF CHARITY CARE PROVIDED.
PART II, COMMUNITY BUILDING ACTIVITIES:	THROUGH DONATIONS AND GRANTS TO PUBLIC, PRIVATE, AND NONPROFIT ORGANIZATIONS, THE FILING ORGANIZATION ASSISTS WITH SUSTAINING AND ENHANCING THE COMMUNITIES IT SERVES.
PART III, LINE 2:	PART III, SECTION A, LINE 1:THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.METHODOLOGY FOR SCHEDULE H, PART III, LINE 2:BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED IN THE ACCOUNTS RECEIVABLE FOOTNOTE OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 4:	FOOTNOTES RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS CAN BE FOUND ON PAGES 5, 7, 8 AND 9 OF MAYO CLINIC'S 2015 CONSOLIDATED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:	THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SHORTFALL REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY). HOWEVER, USING A FINANCIAL STATEMENT COST-TO-CHARGE RATIO METHODOLOGY ACTUALLY RESULTS IN A MEDICARE SHORTFALL OF APPROXIMATELY $60,331,000 AS REPORTED IN THE CORE FORM, PART III, PROGRAM SERVICE ACCOMPLISHMENTS.THE MOST COMMON REASONS FOR A DIFFERENCE BETWEEN THE MEDICARE SHORTFALL REPORTED ON SCHEDULE H AND THE MEDICARE SHORTFALL REPORTED ON THE CORE FORM, PART III INCLUDE: (1) INCLUSION OF MEDICARE ADVANTAGE REVENUE AND EXPENSES; (2) INCLUSION OF PART B REVENUE AND EXPENSES; (3) INCLUSION OF OTHER FEE SCHEDULE REVENUE; AND (4) SOME TIMING ISSUES.REASONS WHY MEDICARE SHORTFALL REPORTED ON LINE 7, IF ANY, SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.
PART III, LINE 9B:	MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING REASONABLE ATTEMPTS TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN ADDITION, MAYO CLINIC AND ITS AFFILIATES ACCEPT REASONABLE PAYMENT PLANS FROM PATIENTS WHEN AN ACCOUNT IS THE PATIENT'S RESPONSIBILITY AND TRY TO IDENTIFY THOSE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS OFFERED TO ANY PATIENT IF THE FACTS AND CIRCUMSTANCES SUGGEST THAT THE PATIENT DOES NOT HAVE THE ABILITY TO PAY THEIR BILL IN WHOLE OR IN PART. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED; INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS POTENTIALLY MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY BASED ON SUBMISSION OF REQUESTED INFORMATION. COLLECTION ACTIVITY WOULD ONLY RESUME IF THE PATIENT IS DETERMINED TO BE INELIGIBLE FOR FINANCIAL ASSISTANCE OR IS ELIGIBLE FOR ONLY PARTIAL FINANCIAL ASSISTANCE AND DOES NOT AGREE TO PAY THE REMAINING BALANCE.
PART VI, LINE 2:	MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER COLLABORATES WITH PUBLIC AND PRIVATE GROUPS IN ASSESSING THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. THESE GROUPS AND DATA SOURCES INCLUDE: 2015 COMMUNITY NEEDS ASSESSMENT IN PARTNERSHIP WITH THE GREAT RIVERS UNITED WAY AND GUNDERSON LUTHERAN MEDICAL CENTER;HEALTHIEST WISCONSIN 2020 (PLAN OF WI DHS); POPULATION HEALTH PROJECT OF THE LA CROSSE MEDICAL HEALTH SCIENCE CONSORTIUM, WHICH COLLECTS AND ANALYZES DATA FROM A 20 COUNTY AREA THAT MIRRORS THE REPORTING ORGANIZATION'S SERVICE AREA. MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER ALSO HAS REPRESENTATION ON NUMEROUS LOCAL HEALTH ADVOCACY GROUPS THAT TARGET SPECIFIC DISEASES AND CONDITIONS (CHILDHOOD OBESITY, DIABETES, SMOKING CESSATION, SUICIDE PREVENTION, ETC.). WE USE INFORMATION AND DATA FROM THESE GROUPS AS WELL TO HELP PLAN EVENTS IN THE SERVICE AREA.
PART VI, LINE 3:	MEASURES TO PUBLICIZE FINANCIAL ASSISTANCE POLICY:MAYO CLINIC IS COMMITTED TO OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY FOR THEIR MEDICAL SERVICES IN WHOLE OR IN PART. IN ORDER TO ACCOMPLISH THIS CHARITABLE GOAL, MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM SITES WIDELY PUBLICIZE THIS POLICY IN THE COMMUNITIES THAT THE INDIVIDUAL MAYO CLINIC AFFILIATED SITES SERVE. MAYO CLINIC AFFILIATED SITES MAKE COPIES OF THIS POLICY AND APPLICATIONS AVAILABLE BY POSTING IT ON THEIR WEBPAGE INCLUDING THE ABILITY TO DOWNLOAD A COPY OF THE POLICY AND APPLICATION FREE OF CHARGE. INDIVIDUALS IN THE COMMUNITY SERVED WILL BE ABLE TO OBTAIN A COPY OF THE POLICY IN LOCATIONS THROUGHOUT EACH MAYO CLINIC AFFILIATED SITE OR UPON REQUEST. THE POLICY EXPLAINS THE FINANCIAL ASSISTANCE PROGRAM AND FACTORS AFFECTING ELIGIBILITY. WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED. ADDITIONALLY, CHARITABLE CARE AND FINANCIAL ASSISTANCE IS REFERENCED ON PATIENT CORRESPONDENCE INCLUDING: THE MONTHLY STATEMENT OF ACCOUNT, ACCOUNT BALANCE LETTERS, AND LATE PAYMENT NOTIFICATIONS. ALL PATIENT CORRESPONDENCE REFERENCING CHARITABLE CARE AND FINANCIAL ASSISTANCE INCLUDE INTERNET, PHONE, AND MAILING ADDRESS CONTACT INFORMATION.
PART VI, LINE 4:	MAYO CLINIC HEALTH SYSTEM-FRANCISCAN MEDICAL CENTER, INC. IS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM THAT SERVES THE RESIDENTS OF BUFFALO, TREMPEALEAU, JACKSON, MONROE, LA CROSSE, JUNEAU, VERNON, CRAWFORD, RICHLAND, SAUK, AND GRANT COUNTIES IN WISCONSIN, WABASHA, WINONA, FILLMORE, AND HOUSTON COUNTIES IN MINNESOTA, AND WINNESHIEK, AND ALLAMAKEE COUNTIES IN IOWA. THE CITIES OF LA CROSSE (50K) AND WINONA (35K) REPRESENT SMALL METROPOLITAN AREAS AND THE BALANCE OF THE SERVICE AREA IS EITHER RURAL OR SMALL TOWNS (500 TO 10K). THE SERVICE AREA INCLUDES A GROWING NUMBER OF HISPANIC AND HMONG RESIDENTS. THE AREA POPULATION ALSO TRENDS OLDER, POORER AND LESS EDUCATED THAN THE STATEWIDE AVERAGE.
PART VI, LINE 5:	THIS FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF "THE NEEDS OF THE PATIENT COME FIRST." THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION- EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO CLINIC HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY - IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.SURPLUS FUNDS:MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE. COMMUNITY REPRESENTATION ON GOVERNING BODY:THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, EXPERIENCE, AND OTHER CRITERIA ESTABLISHED BY THE INDEPENDENT NOMINATING COMMITTEE OF THE BOARD OF TRUSTEES. AREAS OF EXPERTISE AND EXPERIENCE INCLUDE SUCH AREAS AS HEALTH CARE POLICY, RESEARCH, EDUCATION, BUSINESS, AND GOVERNMENT. THE FILING ORGANIZATION, WHICH IS CONTROLLED BY MAYO CLINIC, RELIES ON THE COMMUNITY REPRESENTATION OF THE MAYO CLINIC BOARD OF TRUSTEES TO FULFILL THIS REQUIREMENT.OPEN V. CLOSED STAFF MODEL:STAFF PRIVILEGES ARE GENERALLY EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. EMERGENCY ROOM:THE FILING ORGANIZATION MAINTAINS AN EMERGENCY ROOM 24 HOURS A DAY, 7 DAYS A WEEK, WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY.
PART VI, LINE 6:	THIS ORGANIZATION IS A PART OF MAYO CLINIC HEALTH SYSTEM (WHICH IS PART OF A LARGER GROUP OF ENTITIES AFFILIATED WITH MAYO CLINIC). THE MAYO CLINIC HEALTH SYSTEM IS DESCRIBED IN RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O). THAT STATEMENT ALSO DESCRIBES THE ROLES OF THE VARIOUS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED.
PART VI, LINE 7	NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO A STATE HOSPITAL ASSOCIATION.

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on 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

2015

Open to Public
Inspection

Name of the organization
MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number
39-0806374

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on 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) LA CROSSE MEDICAL HEALTH SCIENCE CONSORTIUM INC 1725 STATE STREET LA CROSSE,WI54601	39-1804725	501(C)(3)	34,565	SUPPORT CHARITABLE PROGRAMS
(2) LA CROSSE AREA CHAMBER OF COMMERCE 601 7TH STREET NORTH LA CROSSE,WI54601	39-0414500	501(C)(6)	10,000	SUPPORT EXEMPT PURPOSE
(3) GREAT RIVERS UNITED WAY INC 1855 EAST MAIN STREET ONALASKA,WI54650	39-0848188	501(C)(3)	10,000	SUPPORT CHARITABLE PROGRAMS
(4) CITY OF LA CROSSE 400 LA CROSSE ST LA CROSSE,WI54601	39-6005490	CTY OF LA CROSSE	13,375	GENERAL SUPPORT
(5) PAWS 4 INDEPENDENCE 15612 PRAIRIE RIDGE RD CALEDONIA,MN55921	80-0895834	501(C)(3)	7,000	SUPPORT CHARITABLE PROGRAMS
(6) YMCA 1140 MAIN ST LA CROSSE,WI54601	39-0806172	501(C)(3)	6,000	SUPPORT CHARITABLE PROGRAMS
(7) WISCORPS INC 789 MYRICK PARK DRIVE LA CROSSE,WI54601	27-0774779	501(C)(3)	5,999	SUPPORT CHARITABLE PROGRAMS
(8) WAFER 403 CAUSEWAY BLVD LA CROSSE,WI54601	39-1552632	501(C)(3)	5,040	SUPPORT CHARITABLE PROGRAMS
(9) MCHS-FRANCISCAN HEALTHCARE FOUNDATION INC 700 WEST AVENUE SOUTH LA CROSSE,WI54601	39-1186647	501(C)(3)	36,953	SUPPORT CHARITABLE PROGRAMS

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of non-cash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of non-cash assistance

(1) SCHOLARSHIPS	8	10,000
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference

Explanation

PART I, LINE 2:

THE FILING ORGANIZATION CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY WITH PROGRAMS THAT ENHANCE THE MISSION OF THE FILING ORGANIZATION. THE FILING ORGANIZATION ONLY CONSIDERS REQUESTS FOR FUNDING AND IN-KIND SUPPORT TO ORGANIZATIONS IN THE COMMUNITY THAT ADDRESS UNMET OR UNDER-FUNDED COMMUNITY NEEDS IN THE AREAS OF HEALTHCARE, EDUCATION, RESEARCH, DIVERSITY AND EQUALITY OF OPPORTUNITY. NO ADDITIONAL MONITORING IS PERFORMED. TRANSFERS OR GRANTS TO TAX-EXEMPT ORGANIZATIONS AND/OR AFFILIATED TAX-EXEMPT ORGANIZATIONS WILL BE USED PURSUANT TO THE POLICIES AND PROCEDURES OF THE GRANTEE ORGANIZATIONS AND TO FURTHER THE EXEMPT PURPOSES OF THE GRANTEE ORGANIZATIONS. BOTH THE FILING ORGANIZATION AND THE GRANTEE ORGANIZATION MAINTAIN ADEQUATE BOOKS AND RECORDS OF SUCH TRANSFERS OR GRANTS. NO ADDITIONAL MONITORING IS PERFORMED. SCHOLARSHIPS ARE AWARDED TO INDIVIDUALS PURSUING A DEGREE IN A HEALTHCARE FIELD. THESE SCHOLARSHIPS ARE PAID DIRECTLY TO THE COLLEGE OR UNIVERSITY.

Schedule I (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on 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

2015

Open to Public Inspection

Name of the organization

MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number

39-0806374

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

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

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

Yes

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

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

Any related organization?

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

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

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

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2015

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 on 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 on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1ANIL MD GOKHANDIRECTOR	(i) (ii)	475,227 ------------- 0	0 ------------- 0	41,512 ------------- 0	26,600 ------------- 0	30,914 ------------- 0	574,253 ------------- 0	0 ------------- 0
2BINN MD MARTHA CDIRECTOR	(i) (ii)	284,958 ------------- 0	0 ------------- 0	3,868 ------------- 0	25,981 ------------- 0	21,926 ------------- 0	336,733 ------------- 0	0 ------------- 0
3ERICKSON ERIC BDIRECTOR	(i) (ii)	228,228 ------------- 0	0 ------------- 0	4,243 ------------- 0	35,112 ------------- 0	7,234 ------------- 0	274,817 ------------- 0	0 ------------- 0
4FITZGERALD MD KEVINDIRECTOR	(i) (ii)	279,407 ------------- 0	0 ------------- 0	4,516 ------------- 0	29,474 ------------- 0	20,460 ------------- 0	333,857 ------------- 0	0 ------------- 0
5GRAU MD THOMAS JDIRECTOR	(i) (ii)	278,031 ------------- 0	0 ------------- 0	18,274 ------------- 0	5,893 ------------- 0	19,005 ------------- 0	321,203 ------------- 0	0 ------------- 0
6GRENISEN MD MARGARET MDIRECTOR	(i) (ii)	239,649 ------------- 0	0 ------------- 0	5,642 ------------- 0	42,804 ------------- 0	2,628 ------------- 0	290,723 ------------- 0	0 ------------- 0
7HAGER NICKIJO LDIRECTOR	(i) (ii)	159,125 ------------- 0	0 ------------- 0	2,299 ------------- 0	24,792 ------------- 0	6,965 ------------- 0	193,181 ------------- 0	0 ------------- 0
8HOLMAY DIANE KDIRECTOR	(i) (ii)	224,494 ------------- 0	0 ------------- 0	9,132 ------------- 0	42,425 ------------- 0	9,884 ------------- 0	285,935 ------------- 0	0 ------------- 0
9HUGHES PETER RDIRECTOR	(i) (ii)	251,540 ------------- 0	0 ------------- 0	15,529 ------------- 0	52,252 ------------- 0	16,732 ------------- 0	336,053 ------------- 0	0 ------------- 0
10JOHNSON MD TIMOTHY JDIRECTOR/CHAIR/CEO	(i) (ii)	470,439 ------------- 0	0 ------------- 0	46,064 ------------- 0	49,324 ------------- 0	18,091 ------------- 0	583,918 ------------- 0	0 ------------- 0
11JUNGCK MD MARK CDIRECTOR	(i) (ii)	264,902 ------------- 0	0 ------------- 0	34,361 ------------- 0	49,781 ------------- 0	15,126 ------------- 0	364,170 ------------- 0	0 ------------- 0
12KORDUCKI MD JANE MDIRECTOR	(i) (ii)	213,544 ------------- 0	0 ------------- 0	53,801 ------------- 0	46,703 ------------- 0	23,389 ------------- 0	337,437 ------------- 0	0 ------------- 0
13KRIEN MD JOSEPH SDIRECTOR	(i) (ii)	288,291 ------------- 0	0 ------------- 0	5,731 ------------- 0	31,187 ------------- 0	22,342 ------------- 0	347,551 ------------- 0	0 ------------- 0
14KRUSE JOSEPH JDIRECTOR/VICE CHAIR/SECRETARY/CAO	(i) (ii)	290,161 ------------- 0	0 ------------- 0	11,305 ------------- 0	46,805 ------------- 0	21,026 ------------- 0	369,297 ------------- 0	0 ------------- 0
15MOLLING DO PAUL EDIRECTOR	(i) (ii)	278,448 ------------- 0	0 ------------- 0	3,661 ------------- 0	28,105 ------------- 0	23,416 ------------- 0	333,630 ------------- 0	0 ------------- 0
16NOEL AMY JDIRECTOR	(i) (ii)	225,189 ------------- 0	0 ------------- 0	3,654 ------------- 0	40,271 ------------- 0	15,581 ------------- 0	284,695 ------------- 0	0 ------------- 0
17RUSHLOW MD DAVID RDIRECTOR	(i) (ii)	322,174 ------------- 0	0 ------------- 0	12,429 ------------- 0	34,652 ------------- 0	22,768 ------------- 0	392,023 ------------- 0	0 ------------- 0
18TIGGELAAR THOMAS HDIRECTOR/TREASURER/CFO	(i) (ii)	245,585 ------------- 0	0 ------------- 0	2,889 ------------- 0	41,501 ------------- 0	14,030 ------------- 0	304,005 ------------- 0	0 ------------- 0
19MORRISSEY MD JOHN EPHYSICIAN	(i) (ii)	817,629 ------------- 0	0 ------------- 0	188,946 ------------- 0	49,983 ------------- 0	23,693 ------------- 0	1,080,251 ------------- 0	0 ------------- 0
20NOLTE DO CHARLES PPHYSICIAN	(i) (ii)	706,126 ------------- 0	0 ------------- 0	89,775 ------------- 0	36,196 ------------- 0	21,076 ------------- 0	853,173 ------------- 0	0 ------------- 0
21RADEMACHER MD DANA EPHYSICIAN	(i) (ii)	658,687 ------------- 0	0 ------------- 0	107,405 ------------- 0	36,350 ------------- 0	21,299 ------------- 0	823,741 ------------- 0	0 ------------- 0
22STEVENS MD MARK KPHYSICIAN	(i) (ii)	746,891 ------------- 0	0 ------------- 0	177,683 ------------- 0	50,469 ------------- 0	26,795 ------------- 0	1,001,838 ------------- 0	0 ------------- 0
23UY MD JONATHAN JPHYSICIAN	(i) (ii)	629,330 ------------- 0	0 ------------- 0	104,772 ------------- 0	42,381 ------------- 0	21,987 ------------- 0	798,470 ------------- 0	0 ------------- 0
24NESSE MD ROBERT EFORMER OFFICER	(i) (ii)	0 ------------- 769,366	0 ------------- 0	0 ------------- 148,330	0 ------------- 10,600	0 ------------- 17,553	0 ------------- 945,849	0 ------------- 0
25SAATHOFF BARBARA LFORMER OFFICER	(i) (ii)	193,861 ------------- 0	0 ------------- 0	2,884 ------------- 0	37,310 ------------- 0	22,266 ------------- 0	256,321 ------------- 0	0 ------------- 0
26MAHANY DOUGLAS AFORMER KEY EMPLOYEE	(i) (ii)	0 ------------- 157,733	0 ------------- 0	0 ------------- 3,449	0 ------------- 25,984	0 ------------- 12,304	0 ------------- 199,470	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 1A	GOKHAN ANIL, M.D. RECEIVED TUITION REIMBURSEMENT AS GROSSED-UP TAXABLE COMPENSATION. TIMOTHY J. JOHNSON, M.D. AND PETER R, HUGHES EACH RECEIVED A $400 MEMBERSHIP TO THE LA CROSSE CLUB AS PART OF THEIR RESPONSIBILITIES FOR COMMUNITY ENGAGEMENT WHICH INCLUDES RELATIONSHIP MANAGEMENT WITH KEY COMMUNITY AND BUSINESS LEADERS.
PART I, LINE 3	THE FILING ORGANIZATION RELIED ON A RELATED ORGANIZATION FOR ESTABLISHING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE CORE 990 PART VI SECTION B LINE 15 FOR FURTHER INFORMATION REGARDING THE PROCESS UTILIZED.
PART I, LINE 4B	THIS ENTITY OR ITS AFFILIATE HAS A SUPPLEMENTAL RETIREMENT PLAN (SRP) DESIGNED TO ROUGHLY APPROXIMATE AN EXTENSION OF THE BENEFITS UNDER THE MAYO PENSION PLAN TO INCOME ABOVE THE INTERNAL REVENUE CODE QUALIFIED PLAN LIMIT IN SECTION 401(A)(17). STARTING JANUARY 1, 2011, ALL SRP BENEFITS ARE PAID AS AN ANNUAL TAXABLE CASH PAYMENT. THE FOLLOWING INDIVIDUALS PARTICIPATED IN OR RECEIVED A PAYMENT FROM THE SUPPLEMENTAL RETIREMENT PLAN. AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III). ANIL M.D., GOKHAN $ 14,945 BINN M.D., MARTHA C. $ 1,597 FITZGERALD M.D., KEVIN $ 3,285 GRAU M.D., THOMAS J. $ 5,358 GRENISEN M.D., MARGARET M. $ 2,294 JOHNSON M.D., TIMOTHY J. $ 37,115 JUNGCK M.D., MARK C. $ 7,772 KORDUCKI M.D., JANE M. $ 1,214 KRIEN M.D., JOSEPH S. $ 4,451 KRUSE, JOSEPH J. $ 7,434 MOLLING D.O., PAUL E. $ 2,621 MORRISSEY M.D., JOHN E. $171,330 NESSE M.D., ROBERT E. $137,631 NOLTE D.O., CHARLES P. $ 72,070 RADEMACHER M.D., DANA E. $ 92,344 RUSHLOW M.D., DAVID R. $ 10,294 STEVENS M.D., MARK K. $159,841 UY M.D., JONATHAN J. $100,572
PART II:	COMPENSATION PAID TO BOARD MEMBERS IS PRIMARILY FOR PROFESSIONAL RESPONSIBILITIES AS PHYSICIANS, ADMINISTRATORS, OR EMPLOYEES OF THE ORGANIZATION.

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number

39-0806374

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

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

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










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

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) LORI A JUNGCK	FAMILY MEMBER OF DIRECTOR MARK C. JUNGCK M.D.	36,758	COMPENSATION		No
(2) ANJA DROGSETH	FAMILY MEMBER OF DIRECTOR MARK C. JUNGCK M.D.	54,267	COMPENSATION		No
(3) JOHN W COCHRAN MD	FAMILY MEMBER OF DIRECTOR MARGARET GRENISEN M.D.	343,445	COMPENSATION		No
(4) STACI M ANIL	FAMILY MEMBER OF DIRECTOR GOKHAN ANIL M.D.	50,548	COMPENSATION		No
(5) BEN MY KRUSE	FAMILY MEMBER OF DIRECTOR JOSEPH J. KRUSE	78,966	COMPENSATION		No
(6) JENIFER J MAHANY	FAMILY MEMBER OF FORMER KEY EMPLOYEE DOUGLAS A. MAHANY	72,817	COMPENSATION		No
(7) HEATHER M MOLLING	FAMILY MEMBER OF DIRECTOR PAUL E. MOLLING D.O.	73,757	COMPENSATION		No
(8) CONOR P JOHNSON	FAMILY MEMBER OF DIRECTOR TIMOTHY J. JOHNSON M.D.	64,281	COMPENSATION		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

Attach to Form 990.
Right pointing arrow large image

Information about Schedule M (Form 990) and its instructions is at www.irs.gov/form990

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number

39-0806374

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...	X	1	790,000	APPRAISAL
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

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

Yes

30a

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

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

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

30a

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

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

Yes

32a

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

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

32a

If "Yes," describe in Part II.

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

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2015)

Page 2

Part II

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

Return Reference	Explanation

Schedule M (Form 990) (2015)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 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

2015

Open to Public
Inspection

Name of the organization

MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number

39-0806374

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	TIGGELAAR, THOMAS H., KRUSE, JOSEPH J., JOHNSON M.D., TIMOTHY J., HUGHES, PETER R., HAVE A BUSINESS RELATIONSHIP AS THEY SERVE AS AN OFFICER, DIRECTOR, OR TRUSTEE OF HEALTH TRADITION HEALTH PLAN, A RELATED TAXABLE ENTITY.
FORM 990, PART VI, SECTION A, LINE 3	MAYO CLINIC, MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH, AND OTHER RELATED COMPANIES PROVIDE MANAGEMENT SERVICES TO THE ENTIRE SYSTEM OF ENTITIES. SINCE THE ENTITIES ARE RELATED ORGANIZATIONS, COMPENSATION FOR THE OFFICERS, DIRECTORS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES HAS BEEN DISCLOSED IN PART VII AND SCHEDULE J AS REQUIRED.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE CORPORATE MEMBER IS MAYO CLINIC HEALTH SYSTEM-FRANCISCAN HEALTHCARE, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THE GOVERNING BODY IS SUBJECT TO APPROVAL BY THE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B	THE ARTICLES OF INCORPORATION PROVIDE THE SOLE CORPORATE MEMBER CERTAIN RESERVED POWERS IN AREAS SUCH AS AMENDMENT OF ARTICLES AND BYLAWS, CERTAIN LARGE TRANSACTIONS, AND OTHER KEY DECISIONS.
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 IS PREPARED BY MAYO CORPORATE TAX WITH ASSISTANCE FROM SITE ACCOUNTING STAFF. THE TAX RETURN GOES THROUGH TWO LEVELS OF REVIEW WITHIN THE CORPORATE TAX UNIT. IT IS THEN REVIEWED BY THE CHIEF FINANCIAL OFFICER AND FINANCE STAFF. A COPY OF THE FORM 990 IS THEN PROVIDED TO EACH MEMBER OF THE FILING ORGANIZATION'S GOVERNING BODY VIA US MAIL, E-MAIL, OR DISTRIBUTION AT A BOARD MEETING. ALL QUESTIONS ARE ADDRESSED PRIOR TO FILING THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12C	MAYO CLINIC AND ITS AFFILIATES HAVE A COMPREHENSIVE CONFLICT OF INTEREST POLICY APPLICABLE TO ALL OF THE AFFILIATED ENTITIES AND TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES OF THOSE ENTITIES. ALL CURRENT AND FORMER OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO WE ANTICIPATE WILL BE LISTED ON A FORM 990 ARE ASKED TO COMPLETE AN "ANNUAL TAX AND COMPLIANCE DISCLOSURE" FORM. THIS INFORMATION IS REVIEWED BY BOTH THE CORPORATE TAX DEPARTMENT AND THE OFFICE OF CONFLICT OF INTEREST REVIEW. ALL DISCLOSURES OF CURRENT OR PROPOSED ACTIVITY THAT REQUIRE ACTION UNDER THE POLICY ARE THE SUBJECT OF ONGOING REVIEW AND ACTION THROUGH THE OFFICE OF CONFLICT OF INTEREST REVIEW AND THE CONFLICT OF INTEREST REVIEW BOARD. INVOLVED INDIVIDUALS ARE INFORMED OF ALL REQUIRED ACTION. MANY TYPES OF RELATIONSHIPS THAT COULD CREATE CONFLICTS OF INTEREST ARE PROHIBITED. OTHER TYPES OF RELATIONSHIPS ARE PERMITTED SUBJECT TO COMPLIANCE WITH THE MANAGEMENT PLAN ESTABLISHED BY THE CONFLICT OF INTEREST REVIEW BOARD. A COMMON MANAGEMENT STRATEGY FOR PERMITTED ACTIVITIES IS TO REQUIRE BILATERAL RECUSAL AND APPROPRIATE DOCUMENTATION IN THE MINUTES OF THE MAYO CLINIC (AND/OR AFFILIATE) AND THE OUTSIDE ENTITY. ADDITIONAL CONFLICT OF INTEREST POLICIES AND PROCEDURES EXIST FOR CERTAIN ENTITIES CONCERNING RESEARCH CONTRACTS AND OTHER TYPES OF POTENTIAL CONFLICTS.
FORM 990, PART VI, SECTION B, LINE 15	THE FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES HAVE A COORDINATED PROCESS FOR REVIEWING AND APPROVING COMPENSATION AND BENEFITS FOR PHYSICIANS, EXECUTIVE AND SENIOR ADMINISTRATIVE LEADERSHIP, ALONG WITH ALLIED HEALTH STAFF. IN ADDITION TO ANY REVIEW AND APPROVAL THAT MAY TAKE PLACE AT THE LOCAL ENTITY OR REGIONAL LEVEL, THE FOLLOWING INDEPENDENT APPROVAL PROCESS OCCURS ANNUALLY PRIOR TO IMPLEMENTATION OF THE RESPECTIVE COMPENSATION INCREASE. THE SALARIES AND BENEFIT PROGRAMS OF THE CHIEF EXECUTIVE OFFICER (CEO) AND THE CHIEF ADMINISTRATIVE OFFICER (CAO) WERE REVIEWED AND APPROVED BY THE PROCESS DESCRIBED BELOW FOR SENIOR ADMINISTRATIVE LEADERSHIP. THE COMPENSATION AND BENEFIT PROGRAMS FOR SENIOR ADMINISTRATIVE LEADERSHIP FOR ALL CAMPUSES, INCLUDING THE MAYO CLINIC HEALTH SYSTEM LOCATIONS, ARE REVIEWED AND APPROVED BY THE MAYO CLINIC BOARD OF TRUSTEES GOVERNANCE AND NOMINATING COMMITTEE. THE MAYO CLINIC BOARD OF TRUSTEES GOVERNANCE AND NOMINATING COMMITTEE IS COMPRISED OF NINE OF THE EXTERNAL INDEPENDENT MEMBERS OF THE MAYO CLINIC BOARD OF TRUSTEES. THIS GROUP REVIEWS AND APPROVES THE COMPENSATION AND BENEFIT PROGRAMS FOR PHYSICIANS FROM ALL CAMPUSES, AS WELL AS CERTAIN SENIOR ADMINISTRATIVE AND EXECUTIVE LEADERSHIP (INCLUDING ALL PERSONS BELIEVED TO BE DISQUALIFIED PERSONS). THIS PROCESS ESTABLISHES ACCEPTABLE RANGES FOR VARIOUS POSITIONS, LEVELS, AND SPECIALTIES. THE COMMITTEE USES COMPARABILITY DATA (INCLUDING THIRD-PARTY BENCHMARKING SURVEYS) IN ITS REVIEW AND DOCUMENTS DECISIONS IN ITS MINUTES.
FORM 990, PART VI, SECTION C, LINE 19	THE FILING ORGANIZATION'S GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST AND ALSO ON THE MAYOCLINIC.ORG WEBSITE. THE FILING ORGANIZATION IS A HOSPITAL AFFILIATED WITH MAYO CLINIC. AS SUCH, MAYO CLINIC'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FILING ORGANIZATION'S FORM 990 AND WOULD BE AVAILABLE UPON REQUEST OF THE FORM 990.
FORM 990, PART XI, LINE 9:	PENSION-POST RETIREMENT (PER FASB A 28,828,874.
FILING OF CERTAIN FOREIGN FORMS	DISCLOSURE STATEMENT RELATED TO FORMS 5713: FORM 5713 HAS BEEN FILED BY THE FOLLOWING MEMBERS OF THE CONTROLLED GROUP: MAYO CLINIC (EIN: 41-6011702) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH (EIN: 41-1506440) DISCLOSURE STATEMENT RELATED TO FORMS 5471: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 5471, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS, AS A CATEGORY 4 AND 5 FILER WITH RESPECT TO CERTAIN CONTROLLED FOREIGN CORPORATIONS (CFCS). THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 5471 FOR THESE CFCS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED TAXPAYER NAME: MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 5471 WAS FILED: 41-1506440 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED DISCLOSURE STATEMENT RELATED TO FORMS 8865: UNDER THE CONSTRUCTIVE OWNERSHIP RULES OF IRC SECTIONS 958(A) AND (B), THE TAXPAYER IS REQUIRED TO FILE FORMS 8865, INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN PARTNERSHIPS, AS A CATEGORY 2 AND 3 FILER. THESE FILING REQUIREMENTS ARE OR WILL BE SATISFIED THROUGH THE FILING OF FORMS 8865 FOR THESE PARTNERSHIPS BY OTHER U.S. TAXPAYERS IDENTIFIED BELOW WHO HAVE THE SAME FILING REQUIREMENT. TAXPAYER NAME: MAYO CLINIC ADDRESS: 200 FIRST STREET SW, ROCHESTER, MN 55905 ID NUMBER OF U.S. TAX RETURN WITH WHICH FORM 8865 WAS FILED: 41-6011702 IRS SERVICE CENTER WHERE U.S. TAX RETURN WAS OR WILL BE FILED: E-FILED

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

MAYO CLINIC HEALTH SYSTEM-FRANCISCAN
MEDICAL CENTER INC

Employer identification number

39-0806374

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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)BLOOMER LAKEVIEW INC 2110 DUNCAN ROAD BLOOMER,WI54724 39-1450617	LOW INCOME HOUSING	WI	501(C)(3)	7	MCHS--CHIPPEWA VALLEY INC	Yes
(2)CHARTERHOUSE INC 200 FIRST STREET SW ROCHESTER,MN55905 41-1405254	RETIREMENT LIVING CENTER	MN	501(C)(3)	9	MAYO CLINIC	Yes
(3)DESTINATION MEDICAL CENTER EDA 50 SOUTH SIXTH STREET SUITE 1500 MINNEAPOLIS,MN554021498 46-4893585	ECONOMIC DEVELOPMENT	MN	501(C)(3)	11-I	MAYO CLINIC	Yes
(4)GOLD CROSS AMBULANCE SERVICE 200 FIRST STREET SW ROCHESTER,MN55905 41-1917516	AMBULANCE SERVICE	MN	501(C)(3)	9	MFMER	Yes
(5)LUTHER LAKESIDE APARTMENTS INC PO BOX 1510 EAU CLAIRE,WI54702 39-1409024	LOW INCOME HOUSING FOR ELDERLY	WI	501(C)(3)	9	MCHS--EAU CLAIRE HOSPITAL INC	Yes
(6)MAYO CLINIC 200 FIRST STREET SW ROCHESTER,MN55905 41-6011702	PATIENT CARE - CLINIC	MN	501(C)(3)	9	N/A	Yes
(7)MAYO CLINIC ARIZONA 13400 EAST SHEA BOULEVARD SCOTTSDALE,AZ85259 86-0800150	HOSPITAL AND CLINIC	AZ	501(C)(3)	3	MAYO CLINIC	Yes
(8)MAYO CLINIC FLORIDA (A NONPROFIT CORPORATION) 4500 SAN PABLO ROAD JACKSONVILLE,FL32224 59-0714831	HOSPITAL	FL	501(C)(3)	3	MAYO CLINIC JACKSONVILLE	Yes
(9)MAYO CLINIC HOSPITAL -- ROCHESTER 200 FIRST STREET SW ROCHESTER,MN55905 41-0944601	HOSPITAL	MN	501(C)(3)	3	MAYO CLINIC	Yes
(10)MAYO CLINIC JACKSONVILLE 4500 SAN PABLO ROAD JACKSONVILLE,FL32224 59-3337028	PATIENT CARE - CLINIC	FL	501(C)(3)	7	MAYO CLINIC	Yes
(11)MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH 200 FIRST STREET SW ROCHESTER,MN55905 41-1506440	CHARITABLE, EDUCATIONAL & SCIENTIFIC ACTIVITIES	MN	501(C)(3)	9	MAYO CLINIC	Yes
(12)MAYO CLINIC STIFTUNG 60486 FRANKFURT AM MAIN FRANKFURT GM	FUNDRAISING FOUNDATION	GM			MFMER	Yes
(13)MCHS IN WAYCROSS INC 1900 TEBEAU STREET WAYCROSS,GA31501 58-1667166	HOSPITAL	GA	501(C)(3)	3	MAYO CLINIC JACKSONVILLE	Yes
(14)MCHS--ALBERT LEA AND AUSTIN 1000 FIRST DRIVE NW AUSTIN,MN55912 41-1404075	HOSPITAL AND CLINIC	MN	501(C)(3)	3	MAYO CLINIC	Yes
(15)MCHS--AUSTIN FOUNDATION 1000 FIRST DRIVE NW AUSTIN,MN55912 30-0107471	FUNDRAISING FOUNDATION	MN	501(C)(3)	7	MCHS--ALBERT LEA AND AUSTIN	Yes
(16)MCHS--CANNON FALLS 32021 COUNTY ROAD 24 BLVD CANNON FALLS,MN55009 20-4156428	HOSPITAL AND CLINIC	MN	501(C)(3)	3	MAYO CLINIC	Yes
(17)MCHS--CHIPPEWA VALLEY INC 1501 THOMPSON STREET BLOOMER,WI54724 39-0980343	HOSPITAL AND CLINIC	WI	501(C)(3)	3	MCHS--EAU CLAIRE HOSPITAL INC	Yes
(18)MCHS--EAU CLAIRE CLINIC INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE,WI54702 39-1735831	PATIENT CARE - CLINIC	WI	501(C)(3)	3	MAYO CLINIC	Yes
(19)MCHS--EAU CLAIRE FOUNDATION INC 733 W CLAIREMONT AVE PO BOX 1510 EAU CLAIRE,WI54702 39-1633407	GRANTMAKING FOUNDATION	WI	501(C)(3)	11-I	MCHS--EAU CLAIRE CLINIC INC	Yes
(20)MCHS--EAU CLAIRE HOSPITAL INC 1221 WHIPPLE STREET EAU CLAIRE,WI54703 39-0813418	HOSPITAL	WI	501(C)(3)	3	MAYO CLINIC	Yes
(21)MCHS--FAIRMONT 800 MEDICAL CENTER DRIVE PO BOX 800 FAIRMONT,MN56031 41-0760836	HOSPITAL AND CLINIC	MN	501(C)(3)	3	MCHS--MANKATO	Yes
(22)MCHS--FRANCISCAN HEALTHCARE FOUNDATION INC 700 WEST AVE SOUTH LA CROSSE,WI54601 39-1186647	FUNDRAISING FOUNDATION	WI	501(C)(3)	7	MCHS--FRANCISCAN HEALTHCARE INC	Yes
(23)MCHS--FRANCISCAN HEALTHCARE INC 700 WEST AVE SOUTH LA CROSSE,WI54601 39-1411999	HEALTHCARE SYSTEM PARENT	WI	501(C)(3)	11-I	MAYO CLINIC	Yes
(24)MCHS--FRANCISCAN MEDICAL CENTER INC 700 WEST AVE SOUTH LA CROSSE,WI54601 39-0806374	HOSPITAL AND CLINIC	WI	501(C)(3)	3	MCHS--FRANCISCAN HEALTHCARE INC	Yes
(25)MCHS--LAKE CITY 500 WEST GRANT STREET LAKE CITY,MN55041 41-1906820	HOSPITAL	MN	501(C)(3)	3	MAYO CLINIC	Yes
(26)MCHS--MANKATO 1025 MARSH STREET MANKATO,MN56002 41-1236756	HOSPITAL AND CLINIC	MN	501(C)(3)	3	MAYO CLINIC	Yes
(27)MCHS--MANKATO HEALTH CARE FOUNDATION 1025 MARSH STREET MANKATO,MN56002 41-1663357	FUNDRAISING FOUNDATION	MN	501(C)(3)	7	MCHS--MANKATO	Yes
(28)MCHS--NEW PRAGUE 301 SECOND STREET NE NEW PRAGUE,MN56071 41-0723639	HOSPITAL AND CLINIC	MN	501(C)(3)	3	MCHS--MANKATO	Yes
(29)MCHS--NORTHLAND INC 1222 EAST WOODLAND AVENUE BARRON,WI54812 39-0920634	HOSPITAL AND CLINIC	WI	501(C)(3)	3	MCHS--EAU CLAIRE HOSPITAL INC	Yes
(30)MCHS--OAKRIDGE INC 13025 EIGHTH STREET PO BOX 70 OSSEO,WI54758 39-1029430	HOSPITAL AND CLINIC	WI	501(C)(3)	3	MCHS--EAU CLAIRE HOSPITAL INC	Yes
(31)MCHS--OWATONNA 134 SOUTHVIEW ST OWATONNA,MN55060 41-1862132	PATIENT CARE - CLINIC	MN	501(C)(3)	3	MAYO CLINIC	Yes
(32)MCHS--RED CEDAR INC 2321 STOUT ROAD MENOMONIE,WI54751 51-0190875	HOSPITAL AND CLINIC	WI	501(C)(3)	3	MCHS--EAU CLAIRE HOSPITAL INC	Yes
(33)MCHS--RED WING 701 HEWITT BOULEVARD RED WING,MN55066 41-1713783	PATIENT CARE SERVICES	MN	501(C)(3)	3	MAYO CLINIC	Yes
(34)MCHS--SPRINGFIELD 625 NORTH JACKSON AVENUE SPRINGFIELD,MN56087 41-1893827	HOSPITAL AND CLINIC	MN	501(C)(3)	3	MCHS--MANKATO	Yes
(35)MCHS--ST JAMES 1101 MOULTON PARSONS DR PO BOX 460 ST JAMES,MN56081 41-0797368	HOSPITAL AND CLINIC	MN	501(C)(3)	3	MCHS--MANKATO	Yes
(36)MCHS--WASECA 501 NORTH STATE STREET WASECA,MN56093 36-3606405	HOSPITAL AND CLINIC	MN	501(C)(3)	3	MCHS--MANKATO	Yes
(37)MILES AND SHIRLEY FITERMAN ENDOWMENT FUND FOR DIGESTIVE DISEASES 200 FIRST STREET SW ROCHESTER,MN55905 41-2020392	SUPPORT RESEARCH, PRACTICE & EDUCATION	MN	501(C)(3)	11-I	MAYO CLINIC	Yes
(38)POVERELLO FOUNDATION 200 FIRST STREET SW ROCHESTER,MN55905 41-1494881	FUNDRAISING FOUNDATION	MN	501(C)(3)	7	MAYO CLINIC HOSPITAL - ROCHESTER	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) FRANKLIN HEATING STATION 119 THIRD ST SW ROCHESTER,MN55902 41-0264830	UTILITY	MN	N/A
(2) LATIGO PETROLEUM LLC PO BOX 14230 ODESSA,TX79768 36-4767494	OIL & GAS EXPLORATION	DE	N/A
(3) WATERSHED CAP INSTL PRTNRS III LP ONE MARITIME PLAZA SUITE 1525 SAN FRANCISCO,CA94111 46-2982848	INVESTMENT ACTIVITIES	DE	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) AMBIENT CLINICAL ANALYTICS INC 221 1ST AVE SW SUITE 202 ROCHESTER,MN55902 80-0928405	SOFTWARE	DE	N/A	C			Yes
(2) BWL HOLDINGS INC 1209 ORANGE STREET WILMINGTON,DE19801 47-2413749	OIL & GAS EXPLORATION	DE	N/A	C			Yes
(3) CAVALRY CLO III LTD PO BOX 1093 GT QUEENSGATE HOUSE S GRAND CAYMAN CJ	INVESTMENT ACTIVITIES	CJ	N/A	C			Yes
(4) CAVALRY CLO IV LTD PO BOX 1093 GT QUEENSGATE HOUSE S GRAND CAYMAN CJ	INVESTMENT ACTIVITIES	CJ	N/A	C			Yes
(5) GMO GLOBAL BOND INVESTMENT FUND 78 SIR JOHN ROGERSONS QUAY DUBLIN 2 EI	OTHER FINANCIAL INVESTMENT ACTIVITIES	EI	N/A				Yes
(6) HEALTH TRADITION HEALTH PLAN 1808 EAST MAIN STREET ONALASKA,WI54650 39-1545987	MEDICAL SERVICES COMPANY	WI	N/A	C			Yes
(7) LOBSS NETWORK SUPPORT 2002 INC 200 FIRST STREET SW ROCHESTER,MN55905 48-1276150	ADMINISTRATIVE SERVICES	MN	N/A	C			Yes
(8) MAYO CLINIC GBS MAURITIUS 2ND FLOOR EBENE MEWS 57 EBENE CYBERCITY MP	HEALTHCARE MANAGEMENT	MP	N/A	C			Yes
(9) MAYO CLINIC SUPPORT SERVICES TEXAS 200 FIRST STREET SW ROCHESTER,MN55905 47-1751102	HEALTH SERVICES	TX	N/A	C			Yes
(10) MAYO HOLDING COMPANY 200 FIRST STREET SW ROCHESTER,MN55905 41-1578020	HOLDING COMPANY	MN	N/A	C			Yes
(11) MAYO INSURANCE COMPANY LTD 200 FIRST STREET SW ROCHESTER,MN55905	SELF INSURANCE POOL	CJ	N/A	C			Yes
(12) MCHS--DECORAH CLINIC PHYSICIANS 907 MONTGOMERY STREET DECORAH,IA52101 41-1711329	PATIENT CARE - CLINIC	IA	N/A	C			Yes
(13) MCHS--PHARMACY & HOME MEDICAL INC 1221 WHIPPLE STREET EAU CLAIRE,WI54703 39-1528920	PHARMACY SERVICES	WI	N/A	C			Yes
(14) MMSI INC 200 FIRST STREET SW ROCHESTER,MN55905 41-1547003	THIRD PARTY ADMINISTRATION SERVICES	MN	N/A	C			Yes
(15) RESOUNDANT INC 221 1ST AVE SW SUITE 202 ROCHESTER,MN55902 46-1661978	MANUFACTURING MEDICAL DEVICE COMPONENT	MN	N/A	C			Yes
(16) ROCHESTER AIRPORT COMPANY 200 FIRST STREET SW ROCHESTER,MN55905 41-0506870	AIRPORT MANAGEMENT	MN	N/A	C			Yes
(17) SUPERBLOCK 3 PROPERTY OWNERS ASSOCIATION 13400 E SHEA BLVD SCOTTSDALE,AZ85259 86-0870505	COMMERCIAL PROPERTY OWNERS ASSOCIATION	AZ	N/A	C			Yes
(18) THE STABILE BUILDING OWNERS' ASSOCIATION 200 FIRST STREET SW ROCHESTER,MN55905 20-8994499	COMMERCIAL PROPERTY OWNERS ASSOCIATION	MN	N/A	C			Yes
(19) CHARITABLE LEAD TRUST	CHARITABLE TRUST	CA	N/A	T			Yes
(20) PERPETUAL TRUST	CHARITABLE TRUST	ND	N/A	T			Yes
(21) PERPETUAL TRUST	CHARITABLE TRUST	AZ	N/A	T			Yes
(22) PERPETUAL TRUST	CHARITABLE TRUST	LA	N/A	T			Yes
(23) PERPETUAL TRUST (2)	CHARITABLE TRUST	MA	N/A	T			Yes
(24) PERPETUAL TRUST	CHARITABLE TRUST	MO	N/A	T			Yes
(25) CHARITABLE REMAINDER TRUST	CHARITABLE TRUST	AZ	N/A	T			Yes
(26) CHARITABLE REMAINDER TRUST	CHARITABLE TRUST	CO	N/A	T			Yes
(27) CHARITABLE REMAINDER TRUST (8)	CHARITABLE TRUST	FL	N/A	T			Yes
(28) CHARITABLE REMAINDER TRUST	CHARITABLE TRUST	LA	N/A	T			Yes
(29) CHARITABLE REMAINDER TRUST	CHARITABLE TRUST	MA	N/A	T			Yes
(30) CHARITABLE REMAINDER TRUST (77)	CHARITABLE TRUST	MN	N/A	T			Yes
(31) CHARITABLE REMAINDER TRUST (2)	CHARITABLE TRUST	NC	N/A	T			Yes
(32) CHARITABLE REMAINDER TRUST	CHARITABLE TRUST	TX	N/A	T			Yes
(33) CHARITABLE REMAINDER TRUST	CHARITABLE TRUST	CO	N/A	T			Yes
(34) CHARITABLE REMAINDER TRUST	CHARITABLE TRUST	IL	N/A	T			Yes
(35) CHARITABLE REMAINDER TRUST	CHARITABLE TRUST	MI	N/A	T			Yes
(36) CHARITABLE REMAINDER TRUST (64)	CHARITABLE TRUST	MN	N/A	T			Yes
(37) CHARITABLE REMAINDER TRUST (7)	CHARITABLE TRUST	MN	N/A	T			Yes

Schedule R (Form 990) 2015

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

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

Yes

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

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

Yes

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

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

f Dividends from related organization(s) ............................

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) HEALTH TRADITION HEALTH PLAN	A	40,625	GAAP
(2) HEALTH TRADITION HEALTH PLAN	L	3,088,902	GAAP
(3) MAYO CLINIC HOSPITAL - ROCHESTER	A	106,164	GAAP
(4) MAYO CLINIC HOSPITAL - ROCHESTER	Q	73,162	GAAP
(5) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH	L	114,541	GAAP
(6) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH	P	103,505,189	GAAP
(7) MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH	S	375,169	GAAP
(8) MCHS-FRANCISCAN HEALTHCARE FOUNDATION INC	C	2,070,782	GAAP
(9) MCHS-FRANCISCAN HEALTHCARE FOUNDATION INC	L	96,366	GAAP
(10) MMSI INC	S	30,406,198	GAAP

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: HOSPITALS AND CLINICS
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	18
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	0
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	7,317
6	Total number of volunteers (estimate if necessary) .............	6	765
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,104,815
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	64,465

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,495,370	4,192,298
9	Program service revenue (Part VIII, line 2g) .........	446,428,272	429,484,764
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-316,266	93,702
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,501,997	2,681,365
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	452,109,373	436,452,129
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	117,905	162,577
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	271,698,620	268,977,728
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	161,009,389	161,049,452
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	432,825,914	430,189,757
19	Revenue less expenses. Subtract line 18 from line 12.......	19,283,459	6,262,372
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	265,174,897	311,934,704
21	Total liabilities (Part X, line 26).............	105,157,797	116,826,358
22	Net assets or fund balances. Subtract line 21 from line 20.....	160,017,100	195,108,346

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 401,224,957 including grants of $ ) (Revenue $ 429,377,039 )
	PATIENT CARE (SCHEDULE O)PATIENT CARE:MAYO CLINIC HEALTH SYSTEM FRANCISCAN MEDICAL CENTER, INC. (FMCI) IS PART OF THE MAYO CLINIC HEALTH SYSTEM (MCHS), A FAMILY OF CLINICS, HOSPITALS AND HEALTH CARE FACILITIES SERVING COMMUNITIES IN MINNESOTA, IOWA, WISCONSIN AND GEORGIA. AS PART OF MAYO CLINIC, THE HEALTH SYSTEM OFFERS CARE DESIGNED FOR THE WHOLE BODY CLOSE TO THE PATIENT'S HOME WHEN THEY NEED IT. A MULTIDISCIPLINARY TEAM OF EXPERTS HAS READY ACCESS TO KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC AND COLLABORATES ON PROVIDING EXACTLY THE CARE THE PATIENT NEEDS.MCHS SITES EMPLOY APPROXIMATELY 1,000 PHYSICIANS AND 15,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN MORE THAN 60 COMMUNITIES, MCHS INCLUDES 19 OWNED HOSPITALS, TWO OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH ONE ADDITIONAL HOSPITAL, AND CONTRACT MANAGEMENT AGREEMENTS WITH TWO ADDITIONAL HOSPITALS AND ONE NURSING HOME. SINCE ITS INCEPTION IN 1992, MCHS HAS GROWN INTO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN THE UNITED STATES. MORE THAN 600,000 UNIQUE PATIENTS ACCOUNT FOR MORE THAN 2.6 MILLION VISITS ANNUALLY IN MCHS. IT IS ALSO A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS.AS A MEMBER OF MCHS, FMCI PROVIDES MEDICAL SERVICES AND ENHANCES THE GENERAL HEALTH AND WELLBEING OF THOSE LIVING ACROSS THE TRI-STATE REGION OF SOUTHWEST WISCONSIN, SOUTHEAST MINNESOTA AND NORTHEAST IOWA. FMCI OPERATES A 124-BED HOSPITAL IN LA CROSSE, WI AND A 12-BED CRITICAL ACCESS HOSPITAL IN SPARTA, WI. IN ADDITION, FMCI OPERATES PRIMARY CARE CLINICS IN LA CROSSE AND SPARTA, AS WELL AS IN ARCADIA, TOMAH, HOLMEN, ONALASKA AND PRAIRIE DU CHIEN, ALL IN WISCONSIN; CALEDONIA AND LA CRESCENT, IN MINNESOTA, AND WAUKON, IOWA. IN DECORAH, IOWA, FMCI PROVIDES MANAGEMENT FOR THE WINNESHIEK MEDICAL CENTER THROUGH A MANAGEMENT CONTRACT. FOR 2015 FMCI RECORDED 7,091 INPATIENT ADMISSIONS, 8,486 SURGERIES, AND 931 DELIVERIES. IN ADDITION A TOTAL OF 496,392 OUTPATIENT VISITS WERE RECORDED, INCLUDING 29,177 EMERGENCY DEPARTMENT VISITS. FMCI PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS FINANCIAL ASSISTANCE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. SERVICES ARE ALSO PROVIDED TO MEDICAID AND MEDICARE PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. IN 2015, FMCI PROVIDED APPROXIMATELY $2,909,000 IN FINANCIAL ASSISTANCE TO PATIENTS. THE TOTAL COST OF UNCOMPENSATED CARE PROVIDED TO LOW INCOME PATIENTS THROUGH MEDICAID WAS APPROXIMATELY $32,544,000 WHICH INCLUDES THE MEDICAID SURCHARGE OF $5,395,826. THE UNREIMBURSED COST OF SERVICES TO MEDICARE PATIENTS WAS APPROXIMATELY $60,331,000. FMCI OPERATES FREE, PRIMARY CARE CLINICS IN LA CROSSE AND SPARTA, IN COOPERATION WITH THE GUNDERSEN HEALTH SYSTEM. MEDICAL CARE IS PROVIDED AT NO CHARGE AT THESE CLINICS TO LOW INCOME INDIVIDUALS WHO DO NOT HAVE HEALTH INSURANCE AND WHO ARE NOT ENROLLED IN MEDICAL ASSISTANCE PROGRAMS. FUNDING FOR THESE CLINICS IS SUPPORTED THROUGH CHARITABLE DONATIONS. STAFF ASSIST PATIENTS IN APPLYING FOR PROGRAMS FOR WHICH THEY MAY QUALIFY. DURING 2015 THE FREE CLINICS RECORDED 1,437 VISITS. 4,541 PRESCRIPTIONS WERE FILLED AT NO COST TO THE PATIENTS. WHILE ITS HOSPITAL BUILDINGS ARE TAX EXEMPT, FMCI NONETHELESS PAYS A VARIETY OF TAXES EACH YEAR. TAXES FOR THE 2015 TAX REPORTING YEAR EXCEEDED $20 MILLION AND INCLUDED $5,395,826 IN WISCONSIN HEALTHCARE TAX (MEDICAID): $50,366 IN MINNESOTA CARE TAX; $12,812 IN UNRELATED BUSINESS INCOME TAX; $13,169,928 IN FICA TAX; $21,768 IN SALES TAXES. $1,441,122 IN PROPERTY TAXES PAID IN THE STATE OF WISCONSIN $33,433 IN THE STATE OF MINNESOTA; AND $64,885 IN IOWA.THE LA CROSSE CAMPUS OF FMCI SERVES AS THE MAIN LOCATION FROM WHICH MOST OF THE MEDICAL SPECIALTY SERVICES ARE OFFERED. MANY PROVIDERS OF SPECIALTY CARE ALSO TRAVEL AND EXTEND OUTREACH SERVICES TO THE COMMUNITIES SERVED BY FMCI. ON THE LA CROSSE CAMPUS THE FOLLOWING SERVICES ARE OFFERED: ALLERGY, ASTHMA, ANESTHESIOLOGY, ANTICOAGULATION, BEHAVIORAL HEALTH, BIRTHING, HEMATOLOGY, ORTHOPEDICS, BREAST CARE, CANCER, CARDIAC REHABILITATION, CARDIOLOGY, PEDIATRIC & ADOLESCENT MEDICINE, INTENSIVE CARE, DERMATOLOGY, ENDOCRINOLOGY, DIABETES EDUCATION, INPATIENT AND OUTPATIENT DIALYSIS, GASTROENTEROLOGY / HEPATOLOGY, DOMESTIC ABUSE/SEXUAL ASSAULT, OTORHINOLARYNGOLOGY, ELDER SERVICES, EMERGENCY MEDICINE, OPHTHALMOLOGY, OPTOMETRY, FAMILY MEDICINE, PODIATRY, GERIATRICS, HEALTH PROMOTION, AUDIOLOGY, HOME CARE, HOSPICE, HOSPITAL MEDICINE, INFECTIOUS DISEASES, MEDICAL GENETICS, RHEUMATOLOGY, NEPHROLOGY, PATHOLOGY, PULMONOLOGY, MAMMOGRAPHY, MASSAGE THERAPY, MEDICAL SUPPLY STORE, MEDICAL TRANSPORT, NEUROLOGY, NEONATAL INTENSIVE CARE, NEUROSURGERY, OBSTETRICS AND GYNECOLOGY, OCCUPATIONAL MEDICINE, OCCUPATIONAL THERAPY, OPHTHALMOLOGY, OPTICAL SERVICES, OPTOMETRY, ORTHOPEDIC SURGERY, PALLIATIVE CARE, PHARMACY, PHYSICAL MEDICINE AND REHABILITATION, PHYSICAL THERAPY, PLASTIC & RECONSTRUCTIVE SURGERY, PSYCHIATRY & PSYCHOLOGY, RADIOLOGY AND IMAGING, REHABILITATION THERAPIES, SLEEP MEDICINE, SPEECH LANGUAGE THERAPY, SPORTS MEDICINE, SURGERY, TOBACCO TREATMENT, TRAUMA, URGENT CARE, UROLOGY, WEIGHT MANAGEMENT, WELLNESS COACHING, WOMEN'S HEALTH, WOUND CARE.FMCI OFFERS THE FOLLOWING SERVICES THROUGH SPECIALIZED CENTERS OF CARE: CANCER SERVICES: THE LA CROSSE-CAMPUS CANCER CENTER, WHICH OPENED IN 2004, INTEGRATES THE MAYO CLINIC HEALTH SYSTEM MEDICAL ONCOLOGY PRACTICE WITH RADIATION ONCOLOGY SERVICES PROVIDED BY THE DIVISION OF RADIATION ONCOLOGY, MAYO CLINIC ROCHESTER, TO CREATE A COMPREHENSIVE AND PATIENT CENTERED CANCER PROGRAM. THE CANCER CENTER OFFERS A VARIETY OF OPTIONAL SERVICES TO PROVIDE COMFORT DURING TREATMENT. THESE SERVICES PROMOTE HEALING, WELLNESS, AND A HEALTHFUL LIFESTYLE. THEY ARE AVAILABLE FOR PATIENTS AND CARE GIVERS. THE SERVICES INCLUDE: HEALING TOUCH AND REIKI, MASSAGE THERAPY, GROUP ACUPUNCTURE AND OTHER WELLNESS PROGRAMS. THE CENTER FOR BREAST CARE UTILIZES A TEAM APPROACH TO PROVIDE EVALUATION, TREATMENT AND FOLLOW-UP SERVICES. THE TEAM INCLUDES PHYSICIANS, CLINICAL NURSE BREAST HEALTH SPECIALISTS, AND TECHNOLOGISTS WHO DEVELOP COMPREHENSIVE PLANS AS NEEDED BY PATIENTS. SPECIALISTS FROM BREAST IMAGING, GENERAL SURGERY, PLASTIC SURGERY, MEDICAL ONCOLOGY, RADIATION ONCOLOGY, PATHOLOGY, GENETIC EDUCATION AND NURSING ARE AVAILABLE TO COLLABORATE AS NEEDED. THE CENTER WAS ESTABLISHED IN 2005 AND WAS ACCREDITED BY THE NATIONAL ACCREDITATION PROGRAM FOR BREAST CENTERS (NAPBC) IN 2009. A MOBILE HEALTH CARE DELIVERY SYSTEM OFFERS ACCESSIBLE, QUALITY CARE AND CONVENIENCE, WITH FLEXIBLE AND EXTENDED HOURS. BIRTHING CENTER: FROM PREGNANCY INFORMATION AND CHILDBIRTH CLASSES TO BIRTHING TIPS AND PARENTING CLASSES, FMCI OFFERS COMPREHENSIVE BIRTHING SERVICES. THESE INCLUDE THE AVAILABILITY OF MATERNITY COUNSELORS TO ASSIST IN DEVELOPING A BIRTH PLAN, ADDRESSING ISSUES FROM PAIN MANAGEMENT TO PARTNER INVOLVEMENT, BONDING TIME, BREASTFEEDING, EDUCATION AND SUPPORT. FMCI ALSO OFFERS CARE FOR NEWBORNS WITH CHALLENGING MEDICAL CONDITIONS IN ITS NEONATAL INTENSIVE CARE UNIT IN LA CROSSE. SLEEP DISORDERS: THE FMCI SLEEP DISORDERS CENTER EMPLOYS A WIDE VARIETY OF DIAGNOSTIC TOOLS TO ASSESS BREATHING AND SLEEP DIFFICULTIES. THE CENTER OFFERS THE FOLLOWING DIAGNOSTIC SERVICES: ELECTROENCEPHALOGRAM (EEG); EEG WITH VIDEO MONITORING; AMBULATORY EEG; EVOKED POTENTIALS: EVOKED POTENTIAL MONITORING DURING SURGERY; EEG MONITORING DURING SURGERY; POLYSOMNOGRAM; MULTIPLE SLEEP LATENCY TEST (MSLT); MAINTENANCE OF WAKEFULNESS TEST (MWT). THE CENTER IS ACCREDITED BY AMERICAN ACADEMY OF SLEEP MEDICINE AND THE AMERICAN BOARD OF REGISTRATIONS OF ELECTROENCEPHALOGRAPHIC AND EVOKED POTENTIAL TECHNOLOGISTS, INC.SURGERY: GENERAL SURGERY SERVICES ARE PROVIDED ON BOTH THE LA CROSSE AND SPARTA CAMPUSES. BREAST, COLORECTAL AND GENERAL SURGEONS ARE CERTIFIED BY THE AMERICAN BOARD OF SURGERY. THE DEPARTMENT OF SURGERY WORKS CLOSELY WITH THE CENTER FOR BREAST CARE AND PLASTIC AND RECONSTRUCTIVE SURGERY. IN ADDITION TO TRADITIONAL SURGERY THE DA VINCI SURGICAL SYSTEM PROVIDES SURGEONS ON THE LA CROSSE CAMPUS WITH AN ALTERNATIVE TO BOTH TRADITIONAL OPEN SURGERY AND CONVENTIONAL LAPAROSCOPY, PUTTING THE SURGEON'S HANDS AT THE CONTROLS OF A STATE-OF-THE ART ROBOTIC PLATFORM. BENEFITS OF ROBOTIC SURGERY MAY INCLUDE: LESS PAIN; LESS BLOOD LOSS; LESS SCARRING; SHORTER RECOVERY TIME; FASTER RETURN TO NORMAL ACTIVITIES; BETTER CLINICAL OUTCOMES.THE FILING ORGANIZATION LEASES SPACE AND PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR EXEMPT PURPOSE OF PROVIDING PATIENT CARE.

4b	(Code: ) (Expenses $ 3,298,083 including grants of $ ) (Revenue $ 1,468,367 )
	EDUCATION AND RESEARCH (SCHEDULE O) EDUCATIONFMCI PROVIDES OPPORTUNITIES FOR EDUCATION IN THE HEALTH PROFESSIONS THROUGH FORMALIZED PROGRAMS INCLUDING: THE MAYO CLINIC HEALTH SYSTEM - FRANCISCAN HEALTHCARE SCHOOL OF ANESTHESIA, ACCREDITED BY THE COUNCIL ON ACCREDITATION (COA) OF NURSE ANESTHESIA EDUCATIONAL PROGRAMS, A SPECIALIZED ACCREDITING BODY RECOGNIZED BY THE COUNCIL ON HIGHER EDUCATION ACCREDITATION AND THE U.S. DEPARTMENT OF EDUCATION. UPON COMPLETION OF THE COURSE OF STUDY AND FULFILLMENT OF THE TERMINAL OBJECTIVES AND OTHER OBLIGATIONS OF THE PROGRAM, STUDENTS OF THE SCHOOL OF ANESTHESIA WILL HAVE ACHIEVED ELIGIBILITY TO WRITE THE QUALIFYING EXAMINATION OF THE COUNCIL ON CERTIFICATION OF NURSE ANESTHETISTS. THROUGH A PARTNERSHIP WITH THE UNIVERSITY OF WISCONSIN-LA CROSSE, STUDENTS WHO COMPLETE THE 31 GRADUATE CREDITS REQUIRED OF THE PROGRAM ALSO EARN A MASTER OF SCIENCE DEGREE IN BIOLOGY. 10 STUDENTS GRADUATED FROM THE PROGRAM IN AUGUST 2015. PHARMACY RESIDENCY, A COMPREHENSIVE PROGRAM BUILDING ON DOCTOR OF PHARMACY EDUCATION AND OUTCOMES TO CONTRIBUTE TO THE DEVELOPMENT OF CLINICAL PHARMACISTS RESPONSIBLE FOR MEDICATION-RELATED CARE OF PATIENTS WITH A WIDE RANGE OF CONDITIONS, ELIGIBLE FOR BOARD CERTIFICATION, AND ELIGIBLE FOR POSTGRADUATE YEAR TWO PHARMACY RESIDENCY TRAINING. THIS RESIDENCY OFFERS A VARIETY OF ACUTE CARE TRAINING OPPORTUNITIES THROUGH INDIVIDUALIZED TRAINING PLANS THAT ARE CREATED BASED ON THE RESIDENT'S KNOWLEDGE, SKILLS, AND INTERESTS, IN ACCORDANCE WITH ACCREDITATION STANDARDS FOR PGY1 PHARMACY RESIDENCY PROGRAMS (ASHP). IN ADDITION TO COMPREHENSIVE TRAINING AS A MEMBER OF THE INTERDISCIPLINARY TEAM, PHARMACY RESIDENTS AT FMCI ARE AFFORDED COUNTLESS LEARNING OPPORTUNITIES, INCLUDING BUT NOT LIMITED TO: ADVANCED CARDIAC LIFE SUPPORT TRAINING AND MEDICAL EMERGENCY PARTICIPATION, CO-PRECEPTOR AND INTERDISCIPLINARY TEACHING OPPORTUNITIES, DELIVERY OF ACPE-ACCREDITED CONTINUING EDUCATION PRESENTATIONS, STRUCTURED RESEARCH SEMINAR, TEACHING CERTIFICATE. THE LA CROSSE-MAYO FAMILY MEDICINE RESIDENCY, WAS FOUNDED IN 1976, AND IS FULLY-ACCREDITED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION TO TRAIN FUTURE FAMILY PHYSICIANS. IN 2015 SIX RESIDENTS GRADUATED FROM THE RESIDENCY. TO DATE, 198 FAMILY PHYSICIANS HAVE COMPLETED THEIR TRAINING HERE. COLLECTIVELY, THEY PRACTICE IN 19 STATES AND AS FAR AWAY AS NEW ZEALAND. ONE OF THE GOALS OF THE LA CROSSE-MAYO FAMILY MEDICINE RESIDENCY IS TO GIVE RESIDENTS THE KNOWLEDGE, SKILLS AND ATTITUDES NECESSARY FOR FUTURE PRACTICE, NOT ONLY IN SMALL COMMUNITIES, BUT ALSO FOR SUCCESSFUL PRACTICE IN AN EVER-CHANGING MEDICAL ENVIRONMENT. TO ACHIEVE THIS, OUR OUTSTANDING FACULTY MEMBERS WORK CLOSELY WITH A HIGHLY MOTIVATED TEAM OF PHYSICIANS, NURSES, PSYCHOLOGISTS AND OTHERS, EACH COMMITTED TO TRAINING COMPETENT, CARING FAMILY PHYSICIANS. RESIDENTS LEARN TO FOCUS ON PATIENTS' INDIVIDUAL NEEDS AND TO CARE FOR THE WHOLE PERSON IN THE CONTEXT OF FAMILY AND COMMUNITY. THROUGHOUT THE ENTIRE CURRICULUM, THERE IS A FOCUS ON THE CONCEPT OF FAMILY SYSTEMS AND THE BIOPSYCHOSOCIAL MODEL IS THE CORNERSTONE. PREVENTION AND WELLNESS ARE EMPHASIZED. OUR GRADUATES ARE ACTIVELY RECRUITED, BOTH REGIONALLY AND NATIONALLY, AND OUR PROGRAM HAS A NATIONAL REPUTATION AS A GREAT PLACE TO LEARN FAMILY MEDICINE. THROUGHOUT THE YEAR FMCI STAFF PROVIDE TRAINING FOR HEALTHCARE PROVIDERS AS WELL AS FOR THE GENERAL PUBLIC IN BASIC AND ADVANCED CARDIAC LIFE SUPPORT, CPR AND RELATED FIRST AID TECHNIQUES. DURING 2015 STAFF OFFERED 1,420 CLASSES AND REGISTERED A TOTAL OF 6,341 STUDENTS. APPROXIMATELY 838 CLASSES WERE HELD, AND 3,639 STUDENTS TRAINED, ON THE FMCI LA CROSSE CAMPUS.GERIATRICS: FMCI ORGANIZES THREE SUPPORT GROUPS, EACH MEETING TWICE PER MONTH FOR ONE HOUR SESSIONS. THE EARLY STAGE MEMORY DISORDERS GROUP, THE SOCIALIZATION/ACTIVITY GROUP, AND THE MEMORY DISORDERS FAMILY SUPPORT GROUP FOR FAMILY CAREGIVERS. THIS GROUP ALLOWS FOR SUPPORT AND EDUCATION WHILE COPING WITH THE VARIOUS DISEASES. FMCI OFFERS THE SUCCESSFUL AGING PROGRAM, PROVIDING EDUCATION ON A VARIETY OF TOPICS PERTINENT TO SENIORS IN OUR COMMUNITY. THIS PROGRAM IS OFFERED ONCE PER MONTH ON THE FMCI LA CROSSE CAMPUS. TOPICS RANGE FROM MEDICAL TO SOCIAL TO FINANCIAL ASPECTS OF THE AGING PROCESS. ATTENDANCE AT THESE SESSIONS RANGES FROM 25 TO 80. OTHER COMMUNITY PROGRAMS INCLUDE THE SEPTEMBER SERIES ON DEMENTIA, A SERIES OF THREE PROGRAMS ON VARIOUS DEMENTIA RELATED TOPICS. ATTENDANCE RANGES FROM 60 TO 100 PARTICIPANTS EACH YEAR, AND NATIONAL MEMORY SCREENING DAY, A FREE MEMORY SCREENING CLINIC OFFERED TO COMMUNITY MEMBERS EACH NOVEMBER. ATTENDANCE HAS AVERAGED BETWEEN 50 AND 100 PARTICIPANTS.RESEARCHFMCI PHYSICIANS AND STAFF PARTICIPATE IN NUMEROUS CLINICAL RESEARCH PROTOCOLS, MANY OF WHICH ARE MULTI-SITE STUDIES; OTHERS ARE INVESTIGATOR-INITIATED. ALL ARE REVIEWED AND APPROVED BY THE MAYO CLINIC INSTITUTIONAL REVIEW BOARD (IRB). STUDIES HAVE VARIOUS FUNDING SOURCES, INCLUDING PRIVATE FOUNDATIONS, GOVERNMENT SOURCES AND INDUSTRY. RESEARCH STUDY PARTICIPATION IS OFFERED TO PATIENTS WITH VARIOUS DISEASES AND MEDICAL CONDITIONS EITHER AS A PRIMARY TREATMENT OPTION, AS IN THE CASE OF CANCER PATIENTS, OR AS AN ADDED OPPORTUNITY TO TRADITIONAL CLINICAL CARE. OTHER STUDIES FOCUS ON PREVENTIVE HEALTH OR EVALUATION OF PROCESSES OF CARE DELIVERY. RESEARCH PROTOCOLS WERE ACTIVE IN THE FOLLOWING MEDICAL SPECIALTY AREAS DURING 2015: MEDICAL AND RADIATION ONCOLOGY, CARDIOLOGY, FAMILY MEDICINE, GERIATRICS, NEUROLOGY, AND PEDIATRICS, AMONG OTHERS. RESEARCH IS ONE OF THE THREE MAYO CLINIC SHIELDS AND IS SEEN AS A CRITICAL COMPONENT OF THE PURSUIT OF EXCELLENCE IN HEALTH CARE BY FOSTERING AN ENVIRONMENT OF INQUIRY AND COLLABORATION, AND LINKING SCIENTIFIC DISCOVERIES TO DIRECT PATIENT CARE. WITH INCREASING EMPHASIS ON EVIDENCED BASED MEDICINE, RESEARCH IS CRITICAL TO THE FUTURE OF MEDICAL CARE AND HEALTH CARE IN GENERAL.

4c	(Code: ) (Expenses $ 388,220 including grants of $ 162,577 ) (Revenue $ 78,439 )
	COMMUNITY BENEFIT(SCHEDULE O) COMMUNITY BENEFIT:FMCI ORGANIZES AND HOLDS AN ANNUAL EVENT, THE BIG BLUE DRAGON BOAT FESTIVAL, TO PROMOTE HEALTH AND FITNESS WHILE RAISING MONEY FOR BREAST CANCER RESEARCH AND TREATMENT. IN 2015 THE FESTIVAL WAS HELD JUNE 17 & 18 AT COPELAND PARK IN LA CROSSE. THE EVENT ATTRACTED MORE THAN 1,000 PARTICIPANTS AND RAISED MORE THAN $100,000.ON BEHALF OF THE BLOOD CENTER OF WISCONSIN, FMCI HOLDS BLOOD DRIVES ON ITS LA CROSSE AND SPARTA CAMPUSES. DURING 2015, FIVE BLOOD DRIVES WERE HELD OVER A TOTAL OF TEN DAYS IN LA CROSSE, RESULTING IN THE COLLECTION OF 389 UNITS OF BLOOD. SEVERAL BLOOD DRIVES WERE ALSO HELD ON FMCI CAMPUS IN SPARTA. FMCI ENTHUSIASTICALLY COLLABORATES WITH OTHER ORGANIZATIONS TO ADVANCE THE HEALTH OF THE COMMUNITIES WE SERVE. ALONG WITH GUNDERSEN HEALTH SYSTEM, WESTERN TECHNICAL COLLEGE, VITERBO UNIVERSITY AND THE UNIVERSITY OF WISCONSIN-LA CROSSE, FMCI IS A FOUNDING PARTNER OF THE LA CROSSE MEDICAL HEALTH SCIENCE CONSORTIUM. THE CONSORTIUM WAS FOUNDED IN 1993 AS A 501(C)(3) NONPROFIT CORPORATION TO ADDRESS PROJECTED HEALTHCARE WORKFORCE SHORTAGES, FACILITATE IMPROVEMENTS IN REGIONAL HEALTH AND HEALTHCARE, AND SUPPORT APPLIED RESEARCH IN HEALTH AND MEDICALLY-RELATED DISCIPLINES. IN COLLABORATION WITH VITERBO UNIVERSITY AND THE LA CROSSE POLICE DEPARTMENT, FMCI IS CONTRIBUTING MORE THAN $100,000 TO SUPPORT TWO COMMUNITY POLICE OFFICER POSITIONS SERVING THE WASHBURN NEIGHBORHOOD FOR THREE YEARS. IN 2015 FMCI HIRED AND DEPLOYED A MASTER'S DEGREE SOCIAL WORKER TO SERVE YOUTH AS A FULL TIME CASE WORKER AT THE BOYS AND GIRLS CLUBS OF LA CROSSE. THIS PROJECT WAS UNDERTAKEN IN COLLABORATION WITH THE LA CROSSE AREA BOYS AND GIRLS CLUBS AS WELL AS RONALD MCDONALD HOUSE CHARITIES OF WESTERN WISCONSIN AND SOUTHEASTERN MINNESOTA. THE CASE WORKER OFFERS FREE AND CONFIDENTIAL COUNSELING.SINCE 1952 THE FMCI AUXILIARY HAS HELD FUNDRAISING EVENTS AND ACTIVITIES TO SUPPORT LOCAL PROGRAMS AND SERVICES. IN 2015 THE AUXILIARY HELD SEVERAL EVENTS SUCH AS ITS ANNUAL GERANIUM SALE, CHARITABLE GOLF TOURNAMENT, TINY TIM GALA, SEASON OF LIGHT, LINEN SALES, BOOK SALES, AND JEWELRY SALES.DURING 2015, APPROXIMATELY 765 VOLUNTEERS DONATED APPROXIMATELY 48,875 HOURS OF SERVICE VALUED AT APPROXIMATELY $1,151,495 BASED ON THE INDEPENDENT SECTOR'S VALUE OF VOLUNTEER TIME. THESE SERVICE HOURS WERE SPENT ORGANIZING AND MANAGING ACTIVITIES FOR THE BENEFIT OF PATIENTS, PATIENTS' FAMILIES, VISITORS AND STAFF.AS A MAJOR EMPLOYER AND COMMITTED CORPORATE CITIZEN, FMCI FINANCIALLY SUPPORTS A VARIETY OF CHARITABLE, COMMUNITY AND CIVIC ENDEAVORS THROUGHOUT ITS SERVICE AREA. FUNDING FOR THIS PURPOSE IS PROVIDED THROUGH THE FMCI OPERATING BUDGET AS WELL AS THROUGH A GRANT FROM MCHS-FH FOUNDATION, AND TOTALED MORE THAN $270,000 FOR 2015. SUPPORT WAS PROVIDED TO NUMEROUS ORGANIZATIONS AND AGENCIES INCLUDING: 7 RIVERS ALLIANCE, 7 RIVERS CHAPTER SUDDEN CARDIAC ARREST ASS., 7 RIVERS ROBOTIC COALITION, ABLE FOUNDATION, AFRICAN AMERICAN MUTUAL ASSISTANCE, ALLAMAKEE CO EXTENSION, ALLAMAKEE COUNTY FAIR, ALLAMAKEE COUNTY FOOD SHELF, ALLAMAKEE MUSIC BOOSTERS, ALZHEIMER'S ASSOCIATION, AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, AMERICAN LUNG ASSOCIATION, AMERICAN RED CROSS, APPLEFEST, AQUINAS BOOSTER CLUB, AQUINAS BOOSTER CLUB, AQUINAS GOLF SCRAMBLE, ARCADIA ATHLETIC DEPT., ARCADIA FOOD PANTRY, ARCADIA HIGH SCHOOL, ARCADIA LIONS CLUB, ARCADIA PUBLIC LIBRARY, BIG BROTHERS/BIG SISTERS, BLAIR CHEESE FESTIVAL, BOYS & GIRLS CLUB OF LA CROSSE, BOYS & GIRLS CLUB OF SPARTA, CALEDONIA BOYS BASKETBALL, CALEDONIA CHAMBER OF COMMERCE, CALEDONIA HIGH SCHOOL, CALEDONIA POLICE DEPARTMENT, CALEDONIA SINGS, CAMP WINNEBAGO, CAMP WINNEBAGO, CATHOLIC CHARITIES, CEA FOUNDATION, CELEBRATIONS TEAM, CHILDREN'S ADVISORY BOARD, CHILDREN'S ADVISORY BOARD, CHILDREN'S SAFETY & HEALTHCARE, CHURCH OF THE CRUCIFIXION, CITIZEN ADVOCACY, COMMUNITIES OFF N' RUNNING, COMMUNITY CHEST OF TREMPEALEAU, CONSUMER CREDIT COUNSELING SVS, COULEE CAP COMMUNITY FOOD PANTRY, COULEE COUNCIL ON ADDICTIONS, COULEE PARTNERS FOR SUSTAINABILITY, COULEE REGION HUMANE SOCIETY, COULEE REGION MARDI GRAS, COULEE REGION VOLUNTEER COORD., COULEECAP, INC., CRAWFORD COUNTY COMMUNITY FUND, CROSSING RIVERS HEALTH FOUNDATION, CULTURAL HERITAGE OF INDIA, DOWN SYNDROME ASSOC OF WI, DOWNTOWN MAINSTREET,INC., DRIFTLESS REGION BICYCLE COALITION, DRIFTLESS WISCONSIN GROWN CDA, EVERYBODY CAN DANCE, FORT MCCOY MWR MARKETING, FRATERNAL ORDER OF EAGLES, FREEDOM HONOR FLIGHT, FRIENDS OF WEST SALEM BASEBALL, G.E.T. SCHOOL DISTRICT, GATEWAY AREA BSA,G.E.T. EDUCATIONAL FOUNDATION, GREAT RIVERS UNITED WAY, HABITAT FOR HUMANITY, HOLMEN AREA FOUNDATION, HOLMEN YOUTH BASEBALL PARENTS ASS., HOUSTON COUNTY PUBLIC HEALTH, HOUSTON COUNTY FAIR, HOUSTON LIONS ROOT RIVER TRIATHLON, IDENTITY WORKS, INTERNATIONAL OWL CENTER, IRISHFEST, JUBILEE CENTER, INC., JUNE DAIRY DAYS, JUNIOR ACHIEVEMENT, JUVENILE DIABETES RESEARCH FOUND., KEE HIGH SCHOOL, KIWANIS CLUB OF SPARTA, KNIGHTS OF COLUMBUS, LA CRESCENT AREA FOOD BASKET, LA CRESCENT AREA HEALTH COMMUNITY, LA CRESCENT AREA HEALTHY COMMUNITY, LA CRESCENT CHAMBER OF COMMERCE, LA CRESCENT HIGH SCHOOL, LA CRESCENT HOKAH ELEMENTARY SCHOOL, LA CRESCENT HOKAH SCHOOL DISTRICT FOUND., LA CRESCENT YOUTH HOCKEY, LA CROSSE AREA AUTISM FOUND., LA CROSSE AREA LAW ENFORCEMENT CHAPLAINCY, LA CROSSE CHAMBER OF COMMERCE, LA CROSSE COMMUNITY FOUNDATION, LA CROSSE COMMUNITY THANKSGIVING DINNER, LA CROSSE CONCERT BAND, LA CROSSE COUNTY AGING, LA CROSSE COUNTY AGING UNIT, LA CROSSE COUNTY HEALTH DEPT., LA CROSSE COUNTY JUNIOR LIVESTOCK, LA CROSSE COUNTY MOUNTED DRILL TEAM, LA CROSSE FESTIVALS, INC., LA CROSSE FIRE DEPARTMENT, LA CROSSE LIONS, LA CROSSE POLICE DEPARTMENT, LA CROSSE PUBLIC ED FOUND, LACVB, LADCO, LOCAL LUPUS ALLIANCE, MARCH OF DIMES FOUNDATION, MISS ARCADIA ORGANIZATION, MISS ONALASKA ORGANIZATION, MONROE COUNTY HISTORY ROOM MUSEUM, NAMI MONROE CO., NEIGHBOR FOR NEIGHBOR, NEIGHBORHOOD CITY CHURCH, NEIGHBORS IN ACTION, ONALASKA ENHANCEMENT FOUNDATION, ONALASKA/HOLMEN EMERGENCY FOOD BASKET, ONALASKA FIRE DEPARTMENT, PRAIRIE DU CHIEN AREA CHAMBER OF COMMERCE, PRAIRIE DU CHIEN KIWANIS CLUB, PRAIRIE DU CHIEN SCHOLARSHIP COMMITTEE, PLACE OF GRACE, PRAIRIE DU CHIEN FIRE DEPARTMENT, PRAIRIE DU CHIEN HIGH SCHOOL, REMEMBERING JESSE PARKER, INC., RETIRED SENIOR VOLUNTEER PROGRAM, RIVERFEST, ROTARY WORKS FOUNDATION, SALVATION ARMY, SANTA FUN RUN, SCENIC BLUFFS COMM. HEALTH CTR, SCENIC BLUFFS COMMUNITY HEALTH CENTERS, SEMCAC, HOUSTON COMMUNITY FOOD SHELF, SERRA CLUB, SERRA CLUB OF LA CROSSE, SHELBY YOUTH BASEBALL, SPARTA AREA CHAMBER OF COMMERCE, SPARTA BREAD BASKET, SPARTA CHAMBER OF COMMERCE, ST. PATRICK SCHOOL, SUSTAINABILITY INSTITUTE, THE PARENTING PLACE, THE PLACE OF GRACE, TOMAH AREA CHAMBER OF COMMERCE, TOMAH AREA SCHOOL DISTRICT, TOMAH FIRE DEPARTMENT, TOMAH POLICE DEPT., UNITED FUND FOR THE ARTS & HUMANITIES, UNIVERSITY OF MINNESOTA EXTENSION, UNTIL WE MEET AGAIN, UW EXTENSION, UW-L FOUNDATION, UW-LA CROSSE, VERNON MEMORIAL HEALTHCARE FOUNDATION, VETERANS MEMORIAL HEALTH CARE FOUND., VILLAGE OF HOLMEN PARK & REC, VITERBO ATHLETICS, WAFER, WASHBURN NEIGHBORHOOD ASSOCIATION, WAUKON AREA CHAMBER OF COMMERCE, WAUKON LIONS CLUB, WAUKON STATE BANK, WAUKON SWIM MEET, WEST SALEM HIGH SCHOOL, WEST SALEM PARK & REC, WESTERN FOUNDATION, WIS CORPS, WISCONSIN BADGER CAMP, WISCONSIN CSA, WOMEN'S FUND, WORLD SERVICES, YMCA, YWCA.

	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )
	PATIENT CARE (CONTINUED)WOMEN'S HEALTH: CLINICAL SERVICES: THE FMCI CENTER FOR WOMEN'S HEALTH PROVIDES A MENU OF CLINICAL SERVICES INCLUDING ACUTE AND CHRONIC CONDITIONS; BREAST HEALTH SERVICES; MINOR INJURY TREATMENT; ADOLESCENT HEALTH SERVICES; PSYCHOLOGICAL COUNSELING; MASSAGE THERAPY; LABORATORY/EKG/X-RAY DOMESTIC ABUSE AND SEXUAL ASSAULT COUNSELING; FERTILITY SERVICES.ANCILLARY SERVICES: IN ADDITION TO ITS MEDICAL SPECIALTY SERVICES, FMCI OFFERS ANCILLARY SERVICES TO ASSIST PATIENTS AND THEIR FAMILIES INCLUDING ADVANCE CARE PLANNING: A FREE SERVICE TO HELP FACILITATE THE DEVELOPMENT OF ADVANCE DIRECTIVES, WHICH HELP MAKE KNOWN AN INDIVIDUAL'S WISHES IN THE EVENT THAT HE/SHE BECOMES INCAPACITATED/UNABLE TO SPEAK WITH A MEDICAL PROVIDER. HOSPICE AND HOME HEALTH: HOSPICE STAFF PROVIDE A COMPREHENSIVE NETWORK OF SERVICES THAT MAKES IT POSSIBLE FOR PERSONS WITH A LIFE-THREATENING ILLNESS TO RECEIVE CARE IN THE SETTING OF THEIR CHOICE - AT HOME, IN A NURSING HOME, OR IN A HOSPITAL. HOSPICE SERVICES INCLUDE: SKILLED NURSING CARE, MEDICAL SOCIAL SERVICES, SPIRITUAL CARE, HOME HEALTH ASSISTANCE, PHYSICAL AND OCCUPATIONAL THERAPY, BEREAVEMENT, PHARMACY, RESPITE CARE. IN 2015 FMCI SERVED 121 PATIENTS IN HOSPICE AND 148 PATIENTS IN HOME HEALTH. LANGUAGE AND TRANSLATION ASSISTANCE: FMCI PROVIDES CONFIDENTIAL LANGUAGE SERVICES AT ALL TIMES. QUALIFIED INTERPRETERS ARE ON STAFF TO PROVIDE SPANISH, HMONG, AND AMERICAN SIGN LANGUAGE TRANSLATION IN-PERSON AS NEEDED. SERVICES ARE ALSO AVAILABLE OVER-THE-PHONE AND/OR THROUGH VIDEO RELAY WHEN AN IN-PERSON INTERPRETER IS NOT AVAILABLE TO MEET THE LANGUAGE NEEDS OF PATIENTS.ORGAN & TISSUE DONATION: FMCI COLLABORATES WITH THREE RECOVERY AGENCIES TO HONOR PATIENT'S WISHES FOR ORGAN, TISSUE AND EYE DONATION AT THE TIME OF DEATH. THESE AGENCIES INCLUDE UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS ORGAN PROCUREMENT; WISCONSIN TISSUE BANK AND LION'S EYE BANK OF WISCONSIN. AT DEATH, ALL PATIENTS ARE EVALUATED AND IF MEDICALLY ELIGIBLE, RECOVERY IS COORDINATED WITH THE APPROPRIATE RECOVERY AGENCY. RECOVERY OCCURS IN THE OPERATING ROOM, DOES NOT DELAY FUNERAL ARRANGEMENTS OR AN OPEN CASKET VIEWING. THERE IS NO ADDITIONAL MEDICAL EXPENSE TO THE FAMILY OF AN ORGAN OR TISSUE DONOR. SAFE PATH: FREE DOMESTIC ABUSE AND SEXUAL ASSAULT SERVICES FOR PATIENTS, STAFF AND COMMUNITY MEMBERS. SERVICES INCLUDE SCREENING AND ASSESSMENT, SAFETY PLANNING, COUNSELING AND SUPPORT, LEGAL ADVOCACY, RESOURCE INFORMATION AND REFERRAL. DURING 2015 THIS PROGRAM SERVED 254 PATIENTS AND RECORDED A TOTAL OF 1,481 PATIENT CONTACTS. SPIRITUAL CARE: PROFESSIONAL CHAPLAINS AND SUPPORT PERSONNEL PROVIDE AND FACILITATE AN EFFECTIVE, COMPASSIONATE RESPONSE TO THE SPIRITUAL NEEDS OF PATIENTS, FAMILIES AND VISITORS AS WELL AS STAFF. SERVICES ARE OFFERED TO ALL REGARDLESS OF AFFILIATION OR LACK OF AFFILIATION WITH ANY PARTICULAR RELIGIOUS DENOMINATION OR SECT. WORSHIP SERVICES ARE OFFERED IN THE ROMAN CATHOLIC TRADITION ON A REGULAR BASIS THROUGHOUT THE YEAR IN THE CHAPEL. ECUMENICAL SERVICES ARE OFFERED AROUND SPECIFIC RELIGIOUS HOLIDAYS OR CELEBRATIONS OR WHENEVER APPROPRIATE. AN INTERDENOMINATIONAL SERVICE IS OFFERED ON SUNDAY FOR PSYCHIATRIC PATIENTS AND ON THURSDAY FOR SUB-ACUTE UNIT PATIENTS AND THEIR FAMILIES. STAFF CHAPLAINS MAKE SACRAMENTS AND OTHER RELIGIOUS OBSERVANCES AVAILABLE OR ARRANGE THOSE SERVICES FROM COMMUNITY CLERGY. A BI-MONTHLY ECUMENICAL MEMORIAL SERVICE IS OFFERED FOR ALL FAMILY MEMBERS WHO HAVE EXPERIENCED THE DEATH OF A LOVED ONE IN THE MEDICAL CENTER AND ALSO FOR EMPLOYEES WHO HAVE EXPERIENCED THE LOSS OF A FAMILY MEMBER. STAFF CHAPLAINS ARE OCCASIONALLY CALLED UPON BY THE FAMILIES OF UNCHURCHED PATIENTS TO PERFORM FUNERALS OF THEIR LOVED ONES WHO HAVE DIED AT OUR FACILITY. ALL CLINICAL MEMBERS OF THE SPIRITUAL CARE DEPARTMENT ARE BOARD-CERTIFIED BY A RECOGNIZED NATIONAL ACCREDITING AGENCY. THE SIX CHAPLAINS THAT COVER EMERGENT CARE ON AN ON-CALL BASIS REPRESENT THE EPISCOPAL, CATHOLIC, PRESBYTERIAN, UCC AND METHODIST FAITHS. IN ADDITION, A ROMAN CATHOLIC PRIEST IS ALWAYS ON BACKUP CALL FOR SACRAMENTAL NEEDS. SPIRITUAL CARE CHAPLAINS ARE PART OF THE SHARE PROGRAM IN THE FAMILY BIRTHPLACE AND CLINIC WHEN PARENTS EXPERIENCE THE LOSS OF THEIR CHILD THROUGH MISCARRIAGE, STILLBIRTH OR DEATH OCCURRING SHORTLY AFTER BIRTH; THE SPIRITUAL CARE CHAPLAINS ALSO ASSIST WITH ADVANCE CARE PLANNING; SERVE AS CERTIFIED REQUESTORS FOR CASES INVOLVING ORGAN DONATION; SERVE ON THE ONCOLOGY TEAM THAT FOLLOWS THE PATIENT THROUGH THE COURSE OF THEIR CANCER TREATMENT; AND AS PART OF THE PATIENT CARE TEAM ON SEVERAL OF THE HOSPITAL UNITS; THE SPIRITUAL CARE TEAM ALSO OFFERS THE HEALING THROUGH GRIEF SERIES TO ASSIST THOSE COPING WITH LOSS AND GRIEF. BEHAVIORAL HEALTH SERVICES: FMCI PROVIDES A VARIETY OF BEHAVIORAL HEALTH SERVICES IN LA CROSSE, ARCADIA, HOLMEN, PRAIRIE DU CHIEN, SPARTA AND TOMAH. THESE INCLUDE: CLINICAL ASSESSMENT SERVICES; MENTAL HEALTH, SUBSTANCE ABUSE, PSYCHIATRY, AND PSYCHOLOGICAL TESTING, ALCOHOL AND SUBSTANCE ABUSE, CHILD & ADOLESCENT SERVICES; EATING DISORDERS, AND COMPREHENSIVE DIALECTICAL BEHAVIOR THERAPY. SERVICES ARE ALSO PROVIDED THROUGH PROGRAMS HOUSED IN SEVERAL COMMUNITY BASED RESIDENTIAL FACILITIES. THE GOAL OF EACH PROGRAM IS TO MEET RESIDENTS AT THEIR STAGE OF THE RECOVERY PROCESS AND TO HELP FACILITATE INTERNAL CHANGES TOWARD A MORE SUCCESSFUL RECOVERY. STAFF ASSIST RESIDENTS IN MAKING HEALTHY LIFE CHANGES THROUGH MOTIVATIONAL INTERVIEWING, COGNITIVE BEHAVIORAL THERAPY, CASE MANAGEMENT SERVICES AND WHEN APPROPRIATE, USE OF A 12-STEP MODEL; THE FACILITIES INCLUDE: GERARD HALL, AN 8-BED CLASS A AMBULATORY FACILITY FOR FEMALES WITH MENTAL HEALTH AND/OR AODA ISSUES SPECIALIZING IN PREGNANCY AND PARENTING. THE FACILITY IS LICENSED UNDER HFS 83 AS A COMMUNITY BASED RESIDENTIAL FACILITY. SCARSETH HOUSE, AN 8-BED CLASS A AMBULATORY FACILITY FOR MALES WITH CO-OCCURRING MENTAL HEALTH AND CHEMICAL DEPENDENCY DISORDERS. THE FACILITY IS LICENSED UNDER HFS 83 AS A COMMUNITY BASED RESIDENTIAL FACILITY. IT IS ALSO LICENSED TO PROVIDE TRANSITIONAL RESIDENTIAL TREATMENT AND MEDICALLY MONITORED TREATMENT UNDER DHS 75. SIENA HALL, A 20-BED CLASS A AMBULATORY FACILITY FOR MALES AND FEMALES WITH MENTAL HEALTH AND CO-OCCURRING DISORDERS. THE FACILITY IS LICENSED UNDER HFS 83 AS A COMMUNITY BASED RESIDENTIAL FACILITY. WOMEN'S LAAR HOUSE, A 9-BED CLASS A AMBULATORY FACILITY FOR WOMEN WITH CHEMICAL DEPENDENCE, AND MENTAL HEALTH DISORDERS. THE FACILITY IS LICENSED UNDER HFS 83 AS A COMMUNITY BASED RESIDENTIAL TREATMENT FACILITY, AND LICENSED TO PROVIDE MEDICALLY MONITORED TREATMENT AND TRANSITIONAL RESIDENTIAL TREATMENT UNDER DHS 75.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses404,911,260

(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
(A) Name and Title
(18) TIGGELAAR THOMAS H........................................................................ DIRECTOR/TREASURER/CFO	40.00 .......................0.00	X	X			248,474	0	55,531
(19) MORRISSEY MD JOHN E........................................................................ PHYSICIAN	40.00 .......................0.00			X		1,006,575	0	73,676
(20) NOLTE DO CHARLES P........................................................................ PHYSICIAN	40.00 .......................0.00			X		795,901	0	57,272
(21) RADEMACHER MD DANA E........................................................................ PHYSICIAN	40.00 .......................0.00			X		766,092	0	57,649
(22) STEVENS MD MARK K........................................................................ PHYSICIAN	40.00 .......................0.00			X		924,574	0	77,264
(23) UY MD JONATHAN J........................................................................ PHYSICIAN	40.00 .......................0.00			X		734,102	0	64,368
(24) NESSE MD ROBERT E........................................................................ FORMER OFFICER	0.00 .......................40.00				X	0	917,696	28,153
(25) SAATHOFF BARBARA L........................................................................ FORMER OFFICER	40.00 .......................0.00				X	196,745	0	59,576
(26) MAHANY DOUGLAS A........................................................................ FORMER KEY EMPLOYEE	0.00 .......................40.00				X	0	161,182	38,288

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	9,722,291	1,078,878	1,421,425

1a	Federated campaigns..		1a
b	Membership dues..		1b	895
c	Fundraising events..		1c	76,976
d	Related organizations		1d	2,042,357
e	Government grants (contributions)		1e	1,212,303

f	All other contributions, gifts, grants, and similar amounts not included above		1f	859,767

g	Noncash contributions included in lines 1a-1f:$ 790,000
h Total.Add lines 1a-1f.......		4,192,298

		Business Code
2a	NET PATIENT REVENUE	620000	424,560,705	424,162,095	398,610
b	SHARED SERVICES	561000	3,347,704	258,802		3,088,902
c	RESIDENT REVENUE	623000	807,777	807,777
d	RENT FROM AFFILIATES	531120	446,013	446,013
e	EDUCATION REVENUE	611600	285,425	285,425
f	All other program service revenue.			37,140	37,140
g Total.Add lines 2a–2f.....			429,484,764

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			239,764		40,625	199,139
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents	8,582	106,489
b	Less: rental expenses	8,582	118,159
c	Rental income or (loss)	0	-11,670
d	Net rental income or (loss)......			-11,670			-11,670
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	730,433
b	Less: cost or other basis and sales expenses	876,495
c	Gain or (loss)	-146,062
d	Net gain or (loss).....			-146,062			-146,062
8a	Gross income from fundraising events (not including $ 76,976of contributions reported on line 1c). See Part IV, line 18 ....
	a		127,012
b	Less: direct expenses ...b		117,251
c	Net income or (loss) from fundraising events..			9,761			9,761
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		1,985
b	Less: direct expenses ...b		2,033
c	Net income or (loss) from gaming activities..			-48			-48
10a	Gross sales of inventory, less returns and allowances ..
	a		149,245
b	Less: cost of goods sold ..b		142,854
c	Net income or (loss) from sales of inventory..			6,391			6,391
Business Code			Miscellaneous Revenue
11a	CAFETERIA/VENDING		722210	1,860,240	1,356,804	500,380	3,056
b	MEDICAL DIRECTOR FEES		541900	296,215			296,215
c	MISC. REVENUE		900099	251,388	73,500		177,888
d	All other revenue ....			269,088	8,777	165,200	95,111
e	Total. Add lines 11a–11d ......			2,676,931
12	Total revenue. See Instructions......			436,452,129	427,436,333	1,104,815	3,718,683

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	151,827	151,827
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	10,750	10,750
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	6,263,480	3,600,466	2,663,014
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	1,086,878	757,773	329,105
7	Other salaries and wages	198,392,091	194,912,512	3,479,579
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	18,186,736	17,867,761	318,975
9	Other employee benefits .......	31,548,891	30,995,558	553,333
10	Payroll taxes ...........	13,499,652	13,262,883	236,769
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	180,584		180,584
c	Accounting ...........	512		512
d	Lobbying ...........	10,419	10,419
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	42,946,046	29,010,491	13,935,555
12	Advertising and promotion ....	815,788	815,788
13	Office expenses .......	28,948,846	28,441,071	507,775
14	Information technology ......	1,371,330	1,361,888	9,442
15	Royalties ..	1,603	1,603
16	Occupancy ...........	10,903,355	9,045,325	1,858,030
17	Travel ............	2,892,210	2,787,797	104,413
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	245,298	219,593	25,705
20	Interest ...........	570,588	570,588
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	13,886,257	12,893,867	992,390
23	Insurance ...	988,878	963,543	25,335
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	UNRELATED BUSINESS TAX	52,658		52,658
b	MEDICAL SUPPLIES	38,214,549	38,214,549
c	BAD DEBT EXPENSE	12,203,483	12,203,483
d	MEDICAID SURCHARGE	5,395,826	5,395,826
e	All other expenses	1,421,222	1,415,899	5,323
25	Total functional expenses. Add lines 1 through 24e	430,189,757	404,911,260	25,278,497	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			23,376	1	21,837
2	Savings and temporary cash investments .........			73,151	2	0
3	Pledges and grants receivable, net ......			11,520	3	46,334
4	Accounts receivable, net .............			74,678,557	4	58,129,609
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 ....			1,314,296	7	18,514,971
8	Inventories for sale or use ........			7,364,027	8	4,561,684
9	Prepaid expenses and deferred charges ......			16,768,240	9	258,936
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	278,727,537
b	Less: accumulated depreciation	10b	165,845,776	112,519,832	10c	112,881,761
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			34,424,789	12	68,946,593
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			17,997,109	15	48,572,979
16	Total assets. Add lines 1 through 15 (must equal line 34)...			265,174,897	16	311,934,704

17	Accounts payable and accrued expenses .....	75,005,260	17	22,241,352
18	Grants payable ...		18
19	Deferred revenue .........	856,977	19	16,374
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D	44,776	21	1,198
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	29,250,784	25	94,567,434
26	Total liabilities. Add lines 17 through 25..	105,157,797	26	116,826,358

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	160,017,100	27	195,108,346
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	160,017,100	33	195,108,346
34	Total liabilities and net assets/fund balances ........	265,174,897	34	311,934,704