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) THOMAS JONES MD...................................................................... DIRECTOR	55.00 ................. 1.00	X		692,168	0	80,680
(2) JEFF MENDELOFF MD...................................................................... DIRECTOR	55.00 ................. 1.00	X		773,701	0	63,835
(3) ERIC SCHNED MD...................................................................... DIRECTOR	55.00 ................. 1.00	X		266,382	0	48,611
(4) ANN WYNIA...................................................................... DIRECTOR	4.40 .................	X		0	25,000	0
(5) DONALD LEWIS...................................................................... DIRECTOR & CHAIR	4.30 .................	X		0	40,000	0
(6) RUTH MICKELSEN...................................................................... DIRECTOR & VICE CHAIR	3.80 .................	X		0	28,000	0
(7) JAMES MALECHA...................................................................... DIRECTOR & TREASURER	4.00 .................	X		0	28,000	0
(8) THOMAS R BRINSKO...................................................................... DIRECTOR, HP INSTITUTE CHAIR	3.50 .................	X		0	25,000	0
(9) JUDITH S CORSON...................................................................... DIRECTOR	3.80 .................	X		0	28,000	0
(10) LUZ MARIA FRIAS...................................................................... DIRECTOR	2.70 .................	X		0	28,000	0
(11) SUSAN L HOYT...................................................................... DIRECTOR	3.30 .................	X		0	28,000	0
(12) LAURA SCHMALTZ OBERST...................................................................... DIRECTOR	3.00 .................	X		0	28,000	0
(13) BRIAN H RANK MD...................................................................... DIRECTOR	1.00 ................. 63.00	X	X	0	794,689	144,358
(14) GREGORY S STRONG...................................................................... DIRECTOR	3.20 .................	X		0	28,000	0
(15) RICHARD E STRUTHERS...................................................................... DIRECTOR	2.90 .................	X		0	25,000	0
(16) CHRISTOPHER H TASHJIAN MD FAAFP...................................................................... DIRECTOR	2.90 .................	X		0	28,000	0
(17) KEN L THOME...................................................................... DIRECTOR & SECRETARY	3.50 .................	X		0	28,000	0

(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)
(18) BETH WATERMAN........................................................................ PNI INSTITUTE VICE CHAIR	3.00 .......................55.00	X				0	358,934	106,507
(19) BETHEL AVERBECK MD........................................................................ PNI INSTITUTE DIRECTOR	3.00 .......................55.00	X				0	509,826	97,342
(20) BILL DOHERTY PHD........................................................................ PNI INSTITUTE DIRECTOR	3.00 .......................	X				0	0	0
(21) DAVID DZIUK........................................................................ PNI INSTITUTE DIRECTOR	3.00 .......................55.00	X				0	588,090	150,863
(22) CHARLES FAZIO MD........................................................................ PNI INSTITUTE DIRECTOR	3.00 .......................55.00	X				0	438,706	92,820
(23) JOHN FINNEGAN PHD........................................................................ PNI INSTITUTE DIRECTOR	3.00 .......................	X				0	0	0
(24) GEORGE ISHAM MD........................................................................ PNI INSTITUTE DIRECTOR	3.00 .......................55.00	X				0	159,315	84,483
(25) BOB KNOPP MD........................................................................ PNI INSTITUTE DIRECTOR	3.00 .......................	X				0	0	0
(26) MEGAN REMARK........................................................................ PNI INSTITUTE DIRECTOR	3.00 .......................55.00	X				0	591,197	120,416
(27) MARK ROSENBERG........................................................................ PNI INSTITUTE DIRECTOR	3.00 .......................	X				0	0	0
(28) JOHN SCHOUSBOE MD........................................................................ PNI INSTITUTE DIRECTOR	55.00 .......................3.00	X				302,973	0	47,402
(29) BABETTE APLAND........................................................................ VP BEHAVIORAL HEALTH AND C	60.00 .......................1.00		X			0	431,113	111,637
(30) CURT BOEHMMD........................................................................ CMIO, HP INSTUTUTE DIRECTOR	55.00 .......................1.00		X			0	335,301	81,653
(31) STEVEN CONNELLY MD........................................................................ PRESIDENT PNHS, HP INSTUTUE DIRECTOR	55.00 .......................1.00		X			0	758,427	144,475
(32) PAUL DAMROW MD........................................................................ CHIEF SURGICAL SERVICES	55.00 .......................1.00		X			0	663,305	128,889
(33) LAURA FRAZIER........................................................................ VP SURGICAL SERVICES	55.00 .......................1.00		X			0	333,527	82,575
(34) ROXANNA GAPSTUR PHD........................................................................ SR VP & COO METHODIST HOSP	55.00 .......................1.00		X			0	476,971	97,049
(35) CHRISTA GETCHELL........................................................................ PRESIDENT PNF, VP COMMUNIT	55.00 .......................1.00		X			0	263,348	62,154
(36) CARA HULL........................................................................ VP HR AND PLANNING	55.00 .......................1.00		X			0	124,067	29,970
(37) DAVID HOMANS MD........................................................................ CHIEF SPECIALTY SSERVICES	55.00 .......................1.00		X			0	672,086	112,768
(38) STEVEN HOUSH........................................................................ VP, ORTHOPAEDIC SERVICES	55.00 .......................1.00		X			0	345,713	57,318
(39) KATE KLUGHERZ........................................................................ VP SPECIALTY SERVICES	55.00 .......................1.00		X			0	321,296	83,669
(40) CATHERINE LENAGH........................................................................ VP & CFO	55.00 .......................1.00		X			0	429,306	101,908
(41) KRISTI LYON........................................................................ VP PAYER RELATIONS	55.00 .......................1.00		X			0	266,560	79,313
(42) JOHN MISA MD........................................................................ SR MEDICAL DIRECTOR	55.00 .......................1.00		X			0	526,355	102,251
(43) JOAN SANDSTROM........................................................................ VP PRIMARY CARE	55.00 .......................1.00		X			0	385,197	89,069
(44) MARK SANNESMD........................................................................ SR MEDICAL DIRECTOR	55.00 .......................1.00		X			0	422,703	84,007
(45) MELISSA SCHOENHERR........................................................................ VP MARKETING AND COMMUNICA	55.00 .......................1.00		X			0	299,200	71,086
(46) CYNTHIA TOHER MD........................................................................ SR MEDICAL DIRECTOR	55.00 .......................1.00		X			0	693,949	119,098
(47) DUANE SPIEGLE........................................................................ VP REAL ESTATE AND SUPPORT	55.00 .......................1.00		X			0	344,814	97,566
(48) KATHERINE TARVESTAD........................................................................ VP AND CARE GROUP COMPLIAN	55.00 .......................1.00		X			0	304,815	31,664
(49) JOSHUA ZIMMERMAN........................................................................ SR MEDICAL DIRECTOR	55.00 .......................1.00		X			0	419,968	81,217
(50) NANCY MCCLURE........................................................................ CHIEF OPERATING OFFICER	55.00 .......................1.00		X			0	748,763	140,741
(51) BARBARA TRETHEWAY........................................................................ SR. VP, GENERAL COUNSEL	55.00 .......................1.00		X			0	696,225	113,678
(52) PRAVEEN BAIMEEDI MD........................................................................ MEDICAL DOCTOR	55.00 .......................			X		1,520,463	0	75,819
(53) OLIVER CASS MD........................................................................ MEDICAL DOCTOR	55.00 .......................			X		1,027,111	0	61,323
(54) KEITH HARMON MD........................................................................ MEDICAL DOCTOR	55.00 .......................			X		875,646	0	65,314
(55) ANTHONY BOTTINIMD........................................................................ MEDICAL DOCTOR	55.00 .......................			X		854,473	0	64,725
(56) SALIM KATHAWALLA MD........................................................................ MEDICAL DOCTOR	55.00 .......................			X		814,368	0	64,425
(57) JULIE FLASCHENRIEM........................................................................ FORMER VP AND CIO	0.00 .......................				X	453,529	0	13,923
(58) BRETT LONG........................................................................ FORMER VP STRATEGY & GROWTH, HR	0.00 .......................				X	340,555	0	12,285
(59) THEODORE WEGLEITNER........................................................................ FORMER COO TRIA	55.00 .......................1.00				X	0	449,576	86,819
(60) SHELIA MCMILLAN........................................................................ FORMER VP & CFO	0.00 .......................				X	113,206	0	8,660

(A) Name and business address	(B) Description of services	(C) Compensation
GROUP HEALTH PLAN INC 8170 33RD AVE S MINNEAPOLIS,MN55440	ADMINSTRATIVE SERVICES	46,116,977
RJM CONSTRUCTION 5455 HWY 169 PLYMOUTH,MN55442	CONSTRUCTION SERVICES	19,723,160
RYAN COMPANIES US INC 50 SOUTH 10TH STREET MINNEAPOLIS,MN55403	CONSTRUCTION SERVICES	16,195,183
UNIVERSITY OF MN PHYSICIANS 720 WASHINGTON AVENUE SE MINNEAPOLIS,MN55407	MEDICAL SERVICES	9,374,341
MA MORTENSON COMPANY 700 MEADOW LANE NORTH MINNEAPOLIS,MN55442	CONSTRUCTION SERVICES	9,096,038
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 162

- 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

PARK NICOLLET GROUP RETURN

Employer identification number

45-5023260

Part I

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

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

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
PART 1	PARK NICOLLET METHODIST HOSPITAL LINE 3: 170(B)(1)(A)(III) PARK NICOLLET CLINIC LINE 3: 170(B)(1)(A)(III) PARK NICOLLET INSTITUTE LINE 4: 170(B)(1)(A)(III) PARK NICOLLET HEALTH CARE PRODUCTS LINE 11 TYPE I, 509(A)(3) PNMC HOLDINGS LINE 11 TYPE II, 509(A)(3)
PART I LINE 11	SUPPORTING ORGANIZATIONS DETAIL: PNMC HOLDINGS AND PARK NICOLLET HEALTH CARE PRODUCTS PROVIDE SUPPORT TO THE FOLLOWING ORGANIZATIONS: PNMC HOLDINGS: LINE 11, COLUMN (I) PARK NICOLLET CLINIC, (II) 41-0834920, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $2,048,952 LINE 11, COLUMN (I) PARK NICOLLET HEALTH SERVICES, (II) 36-3465840, (III) 509(A)(2), (IV) YES, (V) $0, (VI) $0 PARK NICOLLET HEALTH SERVICES, WHICH IS A 509(A)(2) PUBLIC CHARITY, IS THE IDENTIFIED SUPPORTED ORGANIZATION IN PNMC HOLDINGS' ARTICLES OF INCORPORATION, IS ALSO THE PARENT OF PNMC HOLDINGS AND OF PARK NICOLLET CLINIC, AMONG OTHERS. PARK NICOLLET CLINIC IS CLOSELY RELATED IN PURPOSE AND FUNCTION TO PNMC HOLDINGS AND PARK NICOLLET HEALTH SERVICES. FURTHER, THE SAME PERSONS WHO SERVE AS THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES ALSO SERVE AS THE BOARD OF DIRECTORS OF PNMC HOLDINGS, AND OF PARK NICOLLET CLINIC. AS A RESULT, IT IS WITHIN THE MISSION AND PURPOSE OF PNMC HOLDINGS AND OF ITS SUPPORTED ORGANIZATION PARK NICOLLET HEALTH SERVICES TO PROVIDE SUPPORT TO PARK NICOLLET CLINIC. PNMC HOLDINGS IS NOT REQUIRED TO SPECIFICALLY IDENTIFY PARK NICOLLET CLINIC IN PNMC HOLDINGS' ARTICLES OF ORGANIZATION IN ORDER ALSO TO INCLUDE PARK NICOLLET CLINIC AS PNMC HOLDINGS' SUPPORTED ORGANIZATION. PARK NICOLLET HEALTH CARE PRODUCTS: LINE 11, COLUMN (I) PARK NICOLLET METHODIST HOSPITAL, (II) 41-0132080, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $3,825,916 LINE 11, COLUMN (I) PARK NICOLLET CLINIC, (II) 41-0834920, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $67,302,191 LINE 11, COLUMN (I) PARK NICOLLET HEALTH SERVICES, (II) 36-3465840, (III) 509(A)(2)(IV) YES, (V) $0, (VI) $0 PARK NICOLLET HEALTH SERVICES, WHICH IS A 509(A)(2) PUBLIC CHARITY, IS THE IDENTIFIED SUPPORTED ORGANIZATION IN PARK NICOLLET HEALTH CARE PRODUCTS' ARTICLES OF INCORPORATION, IS ALSO THE PARENT OF PARK NICOLLET HEALTH CARE PRODUCTS AND OF PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL, AMONG OTHERS. PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL ARE CLOSELY RELATED IN PURPOSE AND FUNCTION TO PARK NICOLLET HEALTH CARE PRODUCTS AND PARK NICOLLET HEALTH SERVICES. FURTHER, THE SAME PERSONS WHO SERVE AS THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES ALSO SERVE AS THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH CARE PRODUCTS, OF PARK NICOLLET CLINIC AND OF PARK NICOLLET METHODIST HOSPITAL. AS A RESULT, IT IS WITHIN THE MISSION AND PURPOSE OF PARK NICOLLET HEALTH CARE PRODUCTS AND OF ITS SUPPORTED ORGANIZATION PARK NICOLLET HEALTH SERVICES TO PROVIDE SUPPORT TO PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL. PARK NICOLLET HEALTH CARE PRODUCTS IS NOT REQUIRED TO SPECIFICALLY IDENTIFY PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL IN PARK NICOLLET HEALTH CARE PRODUCTS' ARTICLES OF ORGANIZATION IN ORDER ALSO TO INCLUDE PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL AS PARK NICOLLET HEALTH CARE PRODUCTS SUPPORTED ORGANIZATIONS.

Return Reference

Explanation

PART 1

PARK NICOLLET METHODIST HOSPITAL LINE 3: 170(B)(1)(A)(III) PARK NICOLLET CLINIC LINE 3: 170(B)(1)(A)(III) PARK NICOLLET INSTITUTE LINE 4: 170(B)(1)(A)(III) PARK NICOLLET HEALTH CARE PRODUCTS LINE 11 TYPE I, 509(A)(3) PNMC HOLDINGS LINE 11 TYPE II, 509(A)(3)

PART I LINE 11

SUPPORTING ORGANIZATIONS DETAIL: PNMC HOLDINGS AND PARK NICOLLET HEALTH CARE PRODUCTS PROVIDE SUPPORT TO THE FOLLOWING ORGANIZATIONS: PNMC HOLDINGS: LINE 11, COLUMN (I) PARK NICOLLET CLINIC, (II) 41-0834920, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $2,048,952 LINE 11, COLUMN (I) PARK NICOLLET HEALTH SERVICES, (II) 36-3465840, (III) 509(A)(2), (IV) YES, (V) $0, (VI) $0 PARK NICOLLET HEALTH SERVICES, WHICH IS A 509(A)(2) PUBLIC CHARITY, IS THE IDENTIFIED SUPPORTED ORGANIZATION IN PNMC HOLDINGS' ARTICLES OF INCORPORATION, IS ALSO THE PARENT OF PNMC HOLDINGS AND OF PARK NICOLLET CLINIC, AMONG OTHERS. PARK NICOLLET CLINIC IS CLOSELY RELATED IN PURPOSE AND FUNCTION TO PNMC HOLDINGS AND PARK NICOLLET HEALTH SERVICES. FURTHER, THE SAME PERSONS WHO SERVE AS THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES ALSO SERVE AS THE BOARD OF DIRECTORS OF PNMC HOLDINGS, AND OF PARK NICOLLET CLINIC. AS A RESULT, IT IS WITHIN THE MISSION AND PURPOSE OF PNMC HOLDINGS AND OF ITS SUPPORTED ORGANIZATION PARK NICOLLET HEALTH SERVICES TO PROVIDE SUPPORT TO PARK NICOLLET CLINIC. PNMC HOLDINGS IS NOT REQUIRED TO SPECIFICALLY IDENTIFY PARK NICOLLET CLINIC IN PNMC HOLDINGS' ARTICLES OF ORGANIZATION IN ORDER ALSO TO INCLUDE PARK NICOLLET CLINIC AS PNMC HOLDINGS' SUPPORTED ORGANIZATION. PARK NICOLLET HEALTH CARE PRODUCTS: LINE 11, COLUMN (I) PARK NICOLLET METHODIST HOSPITAL, (II) 41-0132080, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $3,825,916 LINE 11, COLUMN (I) PARK NICOLLET CLINIC, (II) 41-0834920, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $67,302,191 LINE 11, COLUMN (I) PARK NICOLLET HEALTH SERVICES, (II) 36-3465840, (III) 509(A)(2)(IV) YES, (V) $0, (VI) $0 PARK NICOLLET HEALTH SERVICES, WHICH IS A 509(A)(2) PUBLIC CHARITY, IS THE IDENTIFIED SUPPORTED ORGANIZATION IN PARK NICOLLET HEALTH CARE PRODUCTS' ARTICLES OF INCORPORATION, IS ALSO THE PARENT OF PARK NICOLLET HEALTH CARE PRODUCTS AND OF PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL, AMONG OTHERS. PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL ARE CLOSELY RELATED IN PURPOSE AND FUNCTION TO PARK NICOLLET HEALTH CARE PRODUCTS AND PARK NICOLLET HEALTH SERVICES. FURTHER, THE SAME PERSONS WHO SERVE AS THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES ALSO SERVE AS THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH CARE PRODUCTS, OF PARK NICOLLET CLINIC AND OF PARK NICOLLET METHODIST HOSPITAL. AS A RESULT, IT IS WITHIN THE MISSION AND PURPOSE OF PARK NICOLLET HEALTH CARE PRODUCTS AND OF ITS SUPPORTED ORGANIZATION PARK NICOLLET HEALTH SERVICES TO PROVIDE SUPPORT TO PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL. PARK NICOLLET HEALTH CARE PRODUCTS IS NOT REQUIRED TO SPECIFICALLY IDENTIFY PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL IN PARK NICOLLET HEALTH CARE PRODUCTS' ARTICLES OF ORGANIZATION IN ORDER ALSO TO INCLUDE PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL AS PARK NICOLLET HEALTH CARE PRODUCTS SUPPORTED ORGANIZATIONS.

Schedule A (Form 990 or 990-EZ) 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

PARK NICOLLET GROUP RETURN

Employer identification number

45-5023260

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 PARK NICOLLET GROUP RETURN

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 PARK NICOLLET GROUP RETURN		Employer identification number 45-5023260

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

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

Page 4


Name of organization PARK NICOLLET GROUP RETURN			Employer identification number 45-5023260
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ 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

PARK NICOLLET GROUP RETURN

Employer identification number

45-5023260

Part I-A

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

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

87,743

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

87,743

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:	PARK NICOLLET REIMBURSES GROUP HEALTH PLAN INC. A RELATED ORGANIZATION FOR LOBBYING ACTIVITIES. PARK NICOLLET ALSO REIMBURSES CERTAIN PROFESSIONAL MEMBERSHIP DUES OF EMPLOYEES. A PORTION OF SUCH MEMBERSHIP DUES ARE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES.

Schedule C (Form 990 or 990EZ) 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

PARK NICOLLET GROUP RETURN

Employer identification number

45-5023260

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" 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 ....	27,215,939	27,216,599	21,981,337	20,854,970	22,048,592
b	Contributions ...	3,506,786	2,515,547	4,508,387	2,046,767	1,489,934
c	Net investment earnings, gains, and losses	239,474	526,563	2,715,649	877,865	-341,465
d	Grants or scholarships ...	4,636,136	3,042,770	1,988,774	1,798,265	2,342,091
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	26,326,063	27,215,939	27,216,599	21,981,337	20,854,970

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

43.000 %

Temporarily restricted endowment SchDMd Bullet

57.000 %

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)

Yes

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

Yes

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 ...	27,661,044		27,661,044
b	Buildings	590,049,975	316,794,860	273,255,115
c	Leasehold improvements	58,348,512	40,774,736	17,573,776
d	Equipment ...	496,130,213	416,679,555	79,450,658
e	Other ...	11,454,012	5,857,402	5,596,610
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				403,537,203

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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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
CAPITAL LEASE OBILGATION	2,870,366
SUBORDINATE NOTE TO RELATED THIRD PARTY	43,212,500
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	46,082,866
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 V, LINE 4:

THE TERM ENDOWMENT FUNDS FOR USE WITHIN PARK NICOLLET CLINIC, PARK NICOLLET INSTITUTE AND PARK NICOLLET METHODIST HOSPITAL ARE FOR GRANTS RELATED TO EDUCATION, RESEARCH AND PATIENT CARE.

PART X, LINE 2:

HPIC, HPSI, HPA, HPAI, HPCMC, PNE, AND DSI, (THE TAXABLE GROUP) ARE SUBJECT TO FEDERAL AND STATE INCOME TAXES. DEFERRED INCOME TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE DIFFERENCES BETWEEN THE FINANCIAL AND INCOME TAX REPORTING BASIS OF ASSETS AND LIABILITIES BASED ON ENACTED TAX RATES AND LAWS. THE DEFERRED INCOME TAX PROVISION OR BENEFIT GENERALLY REFLECTS THE NET CHANGE IN DEFERRED INCOME TAX ASSETS AND LIABILITIES DURING THE YEAR. THE CURRENT INCOME TAX PROVISION REFLECTS THE TAX CONSEQUENCES OF REVENUES AND EXPENSES CURRENTLY TAXABLE OR DEDUCTIBLE ON VARIOUS INCOME TAX RETURNS FOR THE YEAR REPORTED. PARK NICOLLET'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. PARK NICOLLET RECORDED NO LIABILITIES AT DECEMBER 31, 2015 OR 2014 FOR UNRECOGNIZED TAX BENEFITS.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

See separate instructions. Right pointing arrow large image

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization
PARK NICOLLET GROUP RETURN

Employer identification number

45-5023260

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

For grantmakers.Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in region	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	EAST ASIA AND THE PACIFIC	0		PROGRAM SERVICES	EDUCATION	13,049
















3a	Sub-total .....	0	0			13,049
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	0			13,049

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2015

Schedule F (Form 990) 2015

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(a)(c) Region	(b)(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2015

Schedule F (Form 990) 2015Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

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

Schedule F (Form 990) 2015

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2015

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

ReturnReference	Explanation

Schedule F (Form 990) 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

PARK NICOLLET GROUP RETURN

Employer identification number

45-5023260

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 27500.0000000000 %

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 38500.0000000000 %

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		(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		6,914,799	152,713	6,762,086	0.490 %
b	Medicaid (from Worksheet 3, column a) . . . . .		157,912,258	101,670,168	56,242,090	4.110 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		164,827,057	101,822,881	63,004,176	4.600 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	103,324	6,515,736	814,552	5,701,184	0.420 %
f	Health professions education (from Worksheet 5) . . .		6,329,452	2,324,889	4,004,563	0.290 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .		6,079,430	4,345,068	1,734,362	0.130 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	103,324	18,924,618	7,484,509	11,440,109	0.840 %
k	Total. Add lines 7d and 7j .	103,324	183,751,675	109,307,390	74,444,285	5.440 %

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.

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

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

10,950,287

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).....

163,667,747

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

160,112,692

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

3,555,055

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?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	PARK NICOLLET METHODIST HOSPITAL 6500 EXCELSIOR BLVD ST LOUIS PARK,MN55426 PARKNICOLLET.COM	X	X	X	X

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)

	PARK NICOLLET METHODIST HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

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 15

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): WWW.PARKNICOLLET.COM

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 15

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

Yes

If "Yes" (list url): WWW.PARKNICOLLET.COM

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

10b

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)

	PARK NICOLLET METHODIST HOSPITAL
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 275.000000000000% and FPG family income limit for eligibility for discounted care of 385.000000000000%

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):

HTTP://WWW.PARKNICOLLET.COM/PATIENT-ACCOUNTS-SERVICES/FINANCIAL-ASSISTANCE

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

HTTP://WWW.PARKNICOLLET.COM/PATIENT-ACCOUNTS-SERVICES/FINANCIAL-ASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
HTTP://WWW.PARKNICOLLET.COM/PATIENT-ACCOUNTS-SERVICES/FINANCIAL-ASSISTANC

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)

	PARK NICOLLET METHODIST HOSPITAL
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? ...........................

Yes

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
PARK NICOLLET METHODIST HOSPITAL	PART V, SECTION B, LINE 5: TO COLLECT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, PARK NICOLLET METHODIST HOSPITAL PARTICIPATED IN COMMUNITY INITIATIVES WITH COUNTY PUBLIC HEALTH DEPARTMENTS AND DREW FROM THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND THE EXPERTISE OF THOSE DEPARTMENTS. IN HENNEPIN COUNTY, FIVE COMMUNITY HEALTH BOARDS HAVE PUBLIC HEALTH RESPONSIBILITIES. THESE BOARDS UTILIZED THE MOBILIZING FOR ACTION THROUGH PARTNERSHIPS AND PLANNING (MAPP) PROCESS, A COMMUNITY ENGAGEMENT PLANNING TOOL, TO GATHER INPUT ABOUT HEALTH NEEDS FROM COMMUNITY STAKEHOLDERS. STAKEHOLDERS ENGAGED WERE DRAWN FROM DIFFERENT TYPES OF ORGANIZATIONS FROM ACROSS THE GEOGRAPHY OF THE COUNTY AND INCLUDED REPRESENTATION FROM PROVIDERS SERVING VULNERABLE OR AT-RISK POPULATIONS, COMMUNITIES EXPERIENCING HEALTH DISPARITIES AND CULTURAL GROUPS THAT LIVE WITHIN THE COUNTY. NEARLY 2000 CONTACTS RECEIVED AN ON-LINE SURVEY WITH A RESPONSE RATE OVER 10 PERCENT. APPROXIMATELY 110 STAKEHOLDERS ATTENDED ONE OR MORE SESSIONS OF A THREE-PART FORUM SERIES.THE PUBLIC HEALTH DEPARTMENT OF DAKOTA COUNTY ALSO UTILIZED MAPP MODEL TO GATHER INPUT FOR ITS CHNA. ALONG WITH COLLATING HEALTH AND DEMOGRAPHIC DATA FROM LOCAL, STATE AND NATIONAL DATABASES, THE DEPARTMENT CONDUCTED A COMMUNITY HEALTH OPINION SURVEY THAT PROVIDED INSIGHTS ABOUT THE HEALTH CONCERNS OF PEOPLE WHO LIVE AND WORK IN THE COUNTY. THAT SURVEY WAS FOLLOWED WITH A SHORTER OPINION SURVEY OF TARGETED POPULATIONS. ADDITIONAL INFORMATION WAS DRAWN FROM THE 2013 DAKOTA COUNTY RESIDENT SURVEY.IN SCOTT COUNTY, THE PUBLIC HEALTH AGENCY CONDUCTED COMMUNITY FORUMS THAT INCLUDED CITIZENS INVITED VIA ADVERTISEMENTS IN THE COMMUNITY PAPER, COMMUNITY LEADERS INVITED BY LETTERS FROM THE COMMUNITY HEALTH BOARD, COUNTY COMMISSIONERS AND PUBLIC HEALTH STAFF. AT EACH FORUM, FACILITATORS PRESENTED HEALTH DATA, FOLLOWED BY STRUCTURED QUESTIONS TO GATHER ATTENDEES' INPUT RELATED TO PUBLIC HEALTH CONCERNS. INFORMATION WAS ALSO COLLECTED FROM VARIOUS REGIONAL DATA SOURCES AND DISCUSSIONS WITH PARTICIPANTS IN THE SCOTT COUNTY HEALTH CARE SYSTEMS COLLABORATIVE, WHICH CONSISTS OF REPRESENTATIVES OF HEALTH PLANS, HOSPITALS, CLINICS AND PUBLIC HEALTH.TO GATHER INPUT ON ISSUES SPECIFICALLY RELATED TO SENIORS, PARK NICOLLET FOUNDATION FACILITATED MEETINGS OF THE SUCCESSFUL AGING INITIATIVE IN ST. LOUIS PARK, MINNESOTA, AND THE 55+ COLLABORATIVE IN MINNETONKA, MINNESOTA. EACH OF THESE GROUPS INCLUDE SENIOR MEMBERS OF THE COMMUNITIES AND PROVIDERS OF SERVICES FOR SENIORS.
PARK NICOLLET METHODIST HOSPITAL	PART V, SECTION B, LINE 6A: PARK NICOLLET METHODIST HOSPITAL COLLABORATED WITH OTHER HOSPITALS IN THE HEALTHPARTNERS' SYSTEM IN DEVELOPING THE CHNA METHODOLOGY, COLLECTING DATA AND DRAFTING THE FINAL REPORT. THOSE HOSPITALS ARE REGIONS HOSPITAL, LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, HUDSON HOSPITAL, WESTFIELDS HOSPITAL AND AMERY REGIONAL MEDICAL CENTER. HOWEVER, WE INDIVIDUALLY ASSESSED INPUT FROM OUR OWN COMMUNITY AND PREPARED FINDINGS AND AN IMPLEMENTATION PLAN SPECIFICALLY RELEVANT TO THIS COMMUNITY. THE PARK NICOLLET BOARD OF DIRECTORS APPROVED THE CHNA.
PARK NICOLLET METHODIST HOSPITAL	PART V, SECTION B, LINE 6B: PARK NICOLLET FOUNDATION AND PARK NICOLLET CLINIC.
PARK NICOLLET METHODIST HOSPITAL	PART V, SECTION B, LINE 7D: PARK NICOLLET HEALTH SERVICES BOARD OF DIRECTOR'S APPROVED THE IMPLEMENTATION STRATEGY FOR PARK NICOLLET METHODIST HOSPITAL DURING 2015. A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY IS POSTED TO THE PARK NICOLLET WEBSITE AT HTTP://WWW.PARKNICOLLET.COM/COMMUNITYANDVOLUNTEERISM/COMMUNITY-NEEDS-HEALTH-ASSESSMENT
PARK NICOLLET METHODIST HOSPITAL	PART V, SECTION B, LINE 11: PARK NICOLLET METHODIST HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA THROUGH ITS DETAILED IMPLEMENTATION STRATEGY, AVAILABLE AT THE WEBSITE NOTED IN QUESTION 10A ABOVE. NEEDS IDENTIFIED THAT ARE NOT BEING ADDRESSED ARE DRUG AND ALCOHOL DEPENDENCY AND ABUSE. THESE NEEDS RECEIVE SIGNIFICANT FUNDING AND OTHER RESOURCES FROM GOVERNMENT AND OTHER PRIVATE SOURCES.
PARK NICOLLET METHODIST HOSPITAL	PART V, SECTION B, LINE 13B: IN ACCORDANCE WITH OUR AGREEMENT WITH THE MN ATTORNEY GENERAL, UNINSURED PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME IS LESS THAN $125,000 ARE ELIGIBLE FOR A DISCOUNT ON THEIR CHARGES. THE DISCOUNT IS ESTABLISHED AT THE AVERAGE CONTRACTUAL DISCOUNT FOR PARK NICOLLET HEALTH SERVICE'S LARGEST CONTRACT PAYOR. THIS DISCOUNT IS CURRENTLY 29.2% OF GROSS CHARGES. PATIENTS WHOSE RECEIVE THIS DISCOUNT ARE ALSO ELIGIBLE FOR OUR FAP PROGRAM BASED ON FPL.
PARK NICOLLET METHODIST HOSPITAL	PART V, SECTION B, LINE 22D: PARK NICOLLET ESTABLISHED THE DISCOUNT AT THE AVERAGE CONTRACTUAL DISCOUNT FOR PARK NICOLLET HEALTH SERVICE'S LARGEST CONTRACT PAYOR.
PARK NICOLLET METHODIST HOSPITAL	PART V, SECTION B, LINE 24: PARK NICOLLET CHARGES ITS PATIENTS GROSS CHARGES IF THE PATIENT HAS ELECTIVE SURGERY, WHICH IS NOT MEDICALLY NECESSARY.

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?37
Name and address		Type of Facility (describe)
1	1 - STRUTHER'S PARKINSON CENTER 6701 COUNTRY S PARKINSON CENTER GOLDEN VALLEY,MN55427	RESEARCH AND TREATMENT OF PARKINSON'S DISEASE
2	1 - PARK NICOLLET MELROSE CENTER 3625 MONTEREY DRIVE ST LOUIS PARK,MN55416	EATING DISORDER CLINIC/GENERAL MEDICAL
3	1 - 3900 CLINICAMBULATORY SURGICAL CENTER 3900 PARK NICOLLET BOULEVARD ST LOUIS PARK,MN55416	AMBULATORY SURGICAL CENTER AND GENERAL MEDICAL AND RETAIL
4	1 - MEADOWBROOK MEDICAL BUILDING 3931 LOUISIANA AVE S ST LOUIS PARK,MN55426	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
5	1 - PRAIRIE CENTER 8455 FLYING CLOUD DRIVE EDEN PRAIRIE,MN55344	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
6	1 - BLOOMINGTON CLINIC 5320 HYLAND GREENS DRIVE BLOOMINGTON,MN55437	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
7	1 - BROOKDALE CLINIC 6000 EARLE BROWN DRIVE BROOKLYN CENTER,MN55430	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
8	1 - BURNSVILLE CLINIC 1400 FAIRVIEW DRIVE BURNSVILLE,MN55337	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
9	1 - CARLSON PARKWAY CLINIC 15111 TWELVE OAKS CENTER DRIVE MINNETONKA,MN55305	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
10	1 - CHANHASSEN CLINIC 300 LAKE DRIVE E CHANHASSEN,MN55317	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
11	1 - CREEKSIDE 6600 EXCELSIOR BLVD ST LOUIS PARK,MN55426	PHYSICAN OFFICES, AND ANCILLARY MEDICAL SERVICES
12	1 - ST LOUIS PARK IMAGING CENTER 4951 EXCELSIOR BLVD ST LOUIS PARK,MN55416	IMAGING CENTER/OPTICAL RETAIL
13	1 - EAGAN CLINIC 1885 PLAZA DRIVE EAGAN,MN55122	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
14	1 - GOLDEN VALLEY CLINIC 8240 GOLDEN VALLEY DRIVE GOLDEN VALLEY,MN55427	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
15	1 - LAKEVILLE CLNIC 18432 KENRICK AVE LAKEVILLE,MN55044	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
16	1 - MAPLE GROVE CLNIC 15800 95TH AVE N MAPLE GROVE,MN55369	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
17	1 - MAPLE GROVE OB 9855 HOSPITAL DRIVE SUITE 275 MAPLE GROVE,MN55369	OB SERVICES
18	1 - MAPLE GROVE REHAB 9827 MAPLE GROVE PKWY N MAPLE GROVE,MN55369	REHABILIATION SERVICES
19	1 - MINNEAPOLIS CLINIC 2001 BLAISDELL AVE S MINNEAPOLIS,MN55404	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
20	1 - MINNETONKA - SHOREWOOD CLINIC 19685 HIGHWAY 7 SHOREWOOD,MN55331	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
21	1 - PLYMOUTH CLINIC 4155 COUNTY ROAD 101 PLYMOUTH,MN55446	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
22	1 - PRIOR LAKE CLINIC 4670 PARK NICOLLET AVE SE PRIOR LAKE,MN55372	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
23	1 - SHAKOPEE CLINIC 1415 ST FRANCIS AVE SHAKOPEE,MN55379	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
24	1 - SHAKOPEE CLINIC 1515 ST FRANCIS AVE SHAKOPEE,MN55379	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
25	1 - SHAKOPEE CLINIC 1601 ST FRANCIS AVE SHAKOPEE,MN55379	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
26	1 - ST LOUIS PARK CLINIC 3800 PARK NICOLLET BLVD ST LOUIS PARK,MN55416	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
27	1 - ST LOUIS PARK CLINIC 3850 PARK NICOLLET BLVD ST LOUIS PARK,MN55416	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
28	1 - WAYZATA MEDICAL BUILDING 250 CENTRAL AVE N WAYZATA,MN55391	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
29	1 - ROGERS CLINIC 13688 ROGERS DRIVE ROGERS,MN55374	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES
30	1 - CHAMPLIN CLINIC 12142 BUSINESS PARK BLVD N CHAMPLIN,MN55316	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES
31	31 - BURNSVILLE PEDIATRIC REHAB SERVICES RIDGEPOINT MEDICAL BUILDING BURNSVILLE,MN55337	PEDIATRIC REHAB SERVICES
32	32 - MAPLE GROVE SPECIALITY CENTER 9325 UPLAND LANE N MAPLE GROVE,MN55369	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES
33	33 - MELROSE CENTER ST PAUL 2550 UNIVERSITY AVE W ST PAUL,MN55114	EATING DISORDER CLINIC/GENERAL MEDICAL
34	34 - MELROSE CENTER MAPLE GROVE 9600 UPLAND LANE N SUITE 110 MAPLE GROVE,MN55369	EATING DISORDER CLINIC/GENERAL MEDICAL
35	35 - MAPLE GROVE REGIONAL SPECIALITY CENTER 9555 UPLAND LANE N MAPLE GROVE,MN55369	PHYSICAN OFFICES, ANCILLARY MEDICAL SERVICES
36	36 - AIRPORT PROFESSIONAL BUILDING 7550 34TH AVE SOUTH MINNEAPOLIS,MN55450	NURSE CALL CENTER
37	37 - BURNSVILLE RIDGES SPECIALITY CENTER 14101 FAIRVIEW DRIVE STE 420 BURNSVILLE,MN55337	OB SERVICES

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:	IN ACCORDANCE WITH OUR AGREEMENT WITH THE MN ATTORNEY GENERAL, UNINSURED PATIENTS WHOSE ANNUAL HOUSEHOLD INCOME IS LESS THAN $125,000 ARE ELIGIBLE FOR A DISCOUNT ON THEIR CHARGES. THE DISCOUNT IS ESTABLISHED AT THE AVERAGE CONTRACTUAL DISCOUNT FOR PARK NICOLLET HEALTH SERVICE'S LARGEST CONTRACT PAYOR. THIS DISCOUNT IS CURRENTLY 29.2% OF GROSS CHARGES. PATIENTS WHOSE RECEIVE THIS DISCOUNT ARE ALSO ELIGIBLE FOR OUR FAP PROGRAM BASED ON FPL.
PART I, LINE 6A:	PARK NICOLLET FOUNDATION A RELATED ORGANIZATION OF PARK NICOLLET METHODIST HOPSITAL COMPLETES AN ORGANIZATION WIDE ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES PARK NICOLLET METHODIST HOSPITAL AND OTHER AFFILIATED ENTITIES.
PART I, LINE 7:	PARK NICOLLET METHODIST HOSPITAL USES THE COST-TO-CHARGE RATIO METHOD WHEN CALCULATING THE AMOUNTS REPORTED ON PART I. LINE 7. THE COST-TO-CHARGE RATIO WAS DERIVED USING WORKSHEET 2, RATIO OF PATIENT CARE-COST-TO-CHARGE, FROM THE SCHEDULE H INSTRUCTIONS.
PART III, LINE 2:	BAD DEBT IS ACCOUNTED FOR ON THE FINANCIAL STATEMENTS BY ESTIMATING PATIENT LIABILITY NET OF ANY CHARITY CARE AND THEN CALUCULATING WHAT PORTION OF THAT WILL NOT BE COLLECTED BASED HISTORICAL UNCOLLECTABLE RATES. WHEN A PATIENT MEETS OUR FINICIAL REQUIREMENTS IT IS CLASSIFIED AS CHARITY CARE; IF THEY DO NOT QUALIFY, THEIR SERVICES WILL BE WRITTEN OFF AS BAD DEBT. PARK NICOLLET METHODIST HOSPITAL DOES NOT INCLUDE ANY CHARITY CARE IN THEIR BAD DEBT EXPENSE CALCULATION.
PART III, LINE 3:	PARK NICOLLET METHODIST HOSPITAL AND ITS AFFILIATES WORK WITH THOSE QUALIFYING FOR CHARITY CARE ALONG EVERY STEP OF THE PROCESS INCLUDING ACCEPTING APPLICATIONS FOR FINANCIAL ASSISTANCE AFTER PREVIOUS ATTEMPTS TO WORK WITH THE PATIENT FAIL. EVERY EFFORT IS MADE TO WORK WITH THE PATIENT TO PROVIDE FINANCIAL ASSISTANCE WHEN APPROPRIATE. WHILE THERE ARE PEOPLE WHO DO NOT COOPERATE WITH THE HOSPITAL REGARDING PAYMENT PLANS, FINANCIAL ASSISTANCE OR WITH THOSE TRYING TO HELP THEM GET ON GOVERNMENT PROGRAMS, IT IS IMPOSSIBLE TO KNOW THEIR REASON FOR NOT COOPERATING AND THEREFORE KNOW WHETHER THEY MAY HAVE QUALIFIED FOR CHARITY CARE. PARK NICOLLET DOESN'T HAVE PREDICTIVE SOFTWARE WHICH WOULD MAKE ASSUMPTIONS BASED ON HOUSING SITUATION, CREDIT REPORTS, ETC. AND RECOMMEND ASSISTANCE WITHOUT A PROCESS FOR GATHERING INCOME VERIFICATION. IN LIGHT OF THE FOREGOING FACTS, PARK NICOLLET IS UNABLE TO REASONABLY DETERMINE WHETHER ANY AMOUNT OF BAD DEBT COULD HAVE BEEN CLASSIFIED AS CHARITY CARE.
PART III, LINE 4:	PARK NICOLLET METHODIST HOSPITAL'S AUDITED FINANCIAL STATEMENTS INCLUDE A FOOTNOTE DISCUSSING BAD DEBT EXPENSE, AR ALLOWANCE OF DOUBTFUL ACCOUNTS. THE FOOTNOTE IS LOCATED ON PAGE 23 OF THE ATTACHED AUDIT REPORT.
PART III, LINE 8:	PARK NICOLLET HEALTH SERVICES BELIEVES THAT THE LOSS WE INCUR WHILE PROVIDING CARE TO MEDICARE BENEFICIARIES SHOULD BE CLASSIFIED AS A COMMUNITY BENEFIT. IF THESE SERVICES WERE NOT PROVIDED BY US THEY WOULD BECOME THE OBLIGATION OF THE FEDERAL GOVERNMENT. THE MEDICARE LOSS CLAIMED ON PART III, LINE 8 ONLY INCLUDES ALLOWABLE HOSPITAL COSTS THAT ARE DEFINED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AND DO NOT INCLUDE ALL OF THE COSTS THAT ARE INCURRED WHILE PROVIDING SERVICES. PARK NICOLLET CLINIC ALSO PROVIDES SERVICES TO MEDICARE BENEFICIARIES BUT THERE IS NO PLACE TO REPORT A MEDICARE LOSS FOR A FREE STANDING CLINIC ON THE FORM SET. IF ALL SYSTEM WIDE COSTS WERE INCLUDED IN THE CALCULATION ALONG WITH OUR MEDICARE ADVANTAGE PRODUCTS OUR MEDICARE LOSS WOULD BE $86.0 MILLION FOR ALL OF PARK NICOLLET HEALTH SERVICES SYSTEM WIDE.
PART III, LINE 9B:	THE COLLECTION POLICY INCORPORATES THE REQUIREMENTS AS STATED BY THE MINNESOTA ATTORNEY GENERAL AND VIEWS ACCOUNT RESOLUTION THROUGH THE PARK NICOLLET FINANCIAL ASSISTANCE PROGRAM AS AN OPTION FOR ACCOUNT RESOLUTION. THIS OPTION IS SHARED WITH DEBTORS VIA STATEMENTS, LETTERS AND AS PART OF COLLECTION CALLS TO AND FROM DEBTORS FROM PARK NICOLLET AND COLLECTION AGENCIES. PARK NICOLLET'S FINANCIAL ASSISTANCE PROGRAM IS ALSO DESCRIBED IN PAMPHLETS AND ON OUR WEBSITE. THE WEBSITE INCLUDES OUR FINANCIAL ASSISTANCE POLICY. IF THE DEBTOR QUALIFIES FOR FINANCIAL ASSISTANCE, COLLECTION EFFORTS CEASE AND CHARGES ARE CLEARED FROM THEIR ACCOUNT.
PART VI, LINE 2:	IN ADDITION TO CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENTS (REPORTED IN PART V, SECTION B LINE #5), PARK NICOLLET HEALTH SERVICES METHODIST HOSPITAL HAS SEVERAL MEANS OF ASSESSING THE HEALTH CARE NEEDS OF THE POPULATION WE SERVE: CONVENING/PARTICIPATING IN ONGOING COMMUNITY COLLABORATIVES FOCUSED ON IDENTIFYING AND ADDRESSING COMMUNITY HEALTH CONCERNS. THESE COLLABORATIVES INCLUDE: -CENTER FOR COMMUNITY HEALTH: A UNIQUE COLLABORATIVE OF HOSPITALS, PUBLIC HEALTH AGENCIES AND HEALTH PLANS SHARING THE FINDINGS AND DATA FROM THEIR CHNAS. -DAKOTA COUNTY HEALTH COMMUNITIES COLLABORATIVE -NORTHWEST HENNEPIN HEALTHY COMMUNITY PARTNERSHIP -THE DAKOTA COUNTY AND NORTHWEST HENNEPIN GROUPS INCLUDE REPRESENTATIVES OF OTHER HEALTH CARE PROVIDERS, GOVERNMENT AGENCIES, EDUCATIONAL INSTITUTIONS, FAITH-BASED CONGREGATIONS AND SOCIAL SERVICE ORGANIZATIONS. -SCOTT COUNTY HEALTHCARE SYSTEM COLLABORATIVE -SUCCESSFUL AGING -WESTERN SUBURBS 55+ COLLABORATIVESUCCESSFUL AGING AND THE 55+ COLLABORATIVE INCLUDE SENIOR CITIZENS AND PROVIDERS OF SENIOR SERVICES. -BETTER TOGETHER HENNEPIN: A BROAD COLLABORATIVE OF STAKEHOLDERS ON THE TOPIC OF REDUCING TEEN PREGNANCY -YMCA ACTIVE OLDER ADULTS: A CONVENING OF A CROSS-SECTION OF COMMUNITY MEMBERS FOCUSED ON END-OF-LIFE CARE AND PLANNING. -HEALTH IN THE PARK: A COMMUNITY-WIDE INITIATIVE IN THE CITY OF ST. LOUIS PARK TO IDENTIFY NEEDS AND DEVELOP RESPONSES IN THE AREAS OF MENTAL HEALTH, ACTIVE LIVING AND HEALTHY EATING. -CHILDREN FIRST: A PROGRAM IN THE CITY OF ST. LOUIS PARK TO PROMOTE THE SEARCH INSTITUTE'S 40 DEVELOPMENTAL ASSETS FOR YOUTH, INCLUDING ADDRESSING HEALTH-RELATED NEEDS.OPERATING SCHOOL-BASED CLINICS. WITH PHILANTHROPIC SUPPORT TO BUILD AND OPERATE FOUR SCHOOL-BASED CLINICS, PARK NICOLLET PHYSICIANS ARE ABLE TO PROVIDE FREE HEALTH CARE TO UN- AND UNDERINSURED YOUTH. THIS GIVES THEM THE OPPORTUNITY TO ASSESS FIRST-HAND AND MONITOR THE GAPS IN CARE FACED BY YOUNG COMMUNITY MEMBERS WITH THE GREATEST HEALTHCARE NEEDS.PARTNERING WITH NON-PROFIT, SOCIAL SERVICE ORGANIZATIONS. PARK NICOLLET FOUNDATION ANNUALLY SOLICITS GRANT APPLICATIONS FROM COMMUNITY NON-PROFITS. A KEY COMPONENT OF THE APPLICATION PROCESS ASKS APPLICANTS TO IDENTIFY AND QUANTIFY THE HEALTHCARE-RELATED NEEDS THEY ARE SEEKING TO ADDRESS. REVIEW OF THESE APPLICATIONS YEAR-OVER-YEAR PROVIDES A GOOD PICTURE OF COMMUNITY NEEDS AND HOW THEY EVOLVE OVER TIME.ANALYZING HEALTH DATA FROM A VARIETY OF SOURCES. THESE SOURCES INCLUDE: -HENNEPIN COUNTY SURVEY OF THE HEALTH OF ALL THE POPULATION AND THE ENVIRONMENT (SHAPE SURVEY) -CENTERS FOR DISEASE CONTROL AND PREVENTION BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) -NATIONAL CENTER FOR HEALTH STATISTICS -MINNESOTA HOSPITAL ASSOCIATION -INTERNAL PARK NICOLLET RECORDS
PART VI, LINE 3:	PARK NICOLLET METHODIST HOSPITAL PARTICIPATES IN MULTIPLE UNIQUE FINANCIAL ASSISTANCE PROGRAMS, INCLUDING OUR OWN FINANCIAL ASSISTANCE (FA). WE INFORM OUR PATIENTS IN MULTIPLE WAYS ABOUT OUR FA PROGRAM AND OTHER FINANCIAL ASSISTANCE OPTIONS FOR SERVICES RECEIVED AT PNHS. A LIST OF COMMUNICATIONS FOR PATIENTS RELATING TO FINANCIAL ASSISTANCE FOLLOWS: HOSPITAL BOOKLETS OR INFORMATION PACKETS GIVEN TO EMERGENCY CENTER PATIENTS AND INPATIENTS. WEB SITE HAS FA INFORMATION FOUND UNDER PATIENT ACCOUNTS AND BILLING. A LIST OF FREQUENTLY ASKED QUESTIONS AND ANSWERS RELATED TO THE PROGRAM. A "HOW TO APPLY" DOCUMENT A SUMMARY OF OUR FINANCIAL ASSISTANCE POLICY FA APPLICATION APPLICATION MAY BE PRINTED FOR SUBMISSION ALL BALANCE FORWARD STATEMENTS, REGARDLESS OF BALANCE, INCLUDE A FINANCIAL ASSISTANCE APPLICATION AND INSTRUCTION TO COMPLETE THE APPLICATION ALONG WITH ANSWERS TO RESPONSES TO FREQUENTLY ASKED QUESTIONS REGARDING FA.IN ADDITION TO THE WRITTEN MATERIAL, CUSTOMER SERVICE, COLLECTIONS AND ACCOUNT SPECIALISTS INFORM PATIENTS ABOUT ASSISTANCE OPTIONS, INCLUDING GOVERNMENT PROGRAMS AND FA. MOST CUSTOMER SERVICE AND COLLECTIONS WORK IS DONE OVER THE PHONE, THOUGH MANY OF OUR CLINICS AND THE HOSPITAL HAVE STAFF ON-SITE TO ASSSIST IN APPLYING FOR FA AND GOVERNMENT PROGRAMS. OUR THIRD PARTY COLLECTION AGENCIES ARE ALSO TRAINED TO INFORM PATIENTS ABOUT OUR FIANCIAL ASSISTANCE PROGRAM. MANY PARK NICOLLET METHODIST HOSPITAL AND CLINIC STAFF HAVE BEEN TRAINED IN HELPING PATIENTS APPLY FOR MEDICAL ASSISTANCE AND HAS ALSO CONTRACTED WITH OUTSIDE SERVICES TO ASSIST PATIENTS IN THE APPLICATION PROCESS FOR MEDICAL ASSISTANCE IN MORE COMPLICATED CIRCUMSTANCES.
PART VI, LINE 4:	PARK NICOLLET HEALTH SERVICES IS AN INTEGRATED DELIVERY SYSTEM THAT INCLUDES PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PARK NICOLLET FOUNDATION AND PARK NICOLLET INSTITUTE. PARK NICOLLET HAS OVER 8,200 EMPLOYEES, INCLUDING MORE THAN 1,000 PHYSICIANS ON STAFF. PARK NICOLLET CLINIC IS ONE OF THE LARGEST MULTISPECIALTY CLINICS IN THE UNITED STATES, PROVIDING CARE IN MORE THAN 55 MEDICAL SPECIALTIES AND SUBSPECIALTIES AT 29 CLINICS AND OTHER CARE LOCATIONS IN METROPOLITAN AND SUBURBAN MINNEAPOLIS/ST. PAUL, MINNESOTA. METHODIST HOSPITAL IS A 426-BED HOSPITAL IN ST. LOUIS PARK, MINNESOTA RECOGNIZED AS A LEADER IN CANCER CARE, CARDIOVASCULAR SERVICES, MATERNITY CARE AND NEURO-REHABILITATION MEDICINE.THE SERVICE AREA FOR THE SYSTEM DEFINES THE COMMUNITIES WE SERVE AND PRIMARILY INCLUDES THE COUNTIES OF: HENNEPIN, CARVER, DAKOTA, AND SCOTT. PARK NICOLLET HEALTH SERVICES ALSO SERVES PATIENTS IN WRIGHT, RICE, SIBLEY AND LE SEUER COUNTIES. BASED ON 2016 MARKET ESTIMATES, 1.89 MILLION PEOPLE RESIDE WITHIN THE PARK NICOLLET 103 ZIP CODE SERVICE AREA. THE POPULATION DENSITY IN THE PARK NICOLLET SERVICE AREA CONSISTS OF A MIX OF URBAN, SUBURBAN, EXURBAN AND RURAL COMMUNITIES. PARK NICOLLET'S SERVICE AREA IS ESTIMATED TO GROW 4.9 PERCENT IN THE NEXT FIVE YEARS. PEOPLE AGES 18 TO 44 MAKE UP 36.3 PERCENT OF THE POPULATION AND THAT GROUP IS EXPECTED TO GROW BY 1 PERCENT IN THE NEXT FIVE YEARS. THE AGE GROUP OF 65-PLUS IS EXPECTED TO GROW BY 24 PERCENT IN THE NEXT FIVE YEARS. OVER THE PAST DECADE, PEOPLE OF COLOR HAVE ACCOUNTED FOR 92 PERCENT OF THE POPULATION GROWTH IN THE TWIN CITIES REGION. THE METROPOLITAN COUNCIL REGIONAL FORECASTS SHOW THAT BY 2040, TWO IN EVERY FIVE RESIDENTS WILL BE PEOPLE OF COLOR.
PART VI, LINE 5:	PARK NICOLLET HEALTH SERVICES FURTHERS ITS EXEMPT PURPOSES IN MULTIPLE WAYS THROUGH METHODIST HOSPITAL, PARK NICOLLET CLINIC, SPECIALTY PROGRAMS AND ITS COMMITMENT TO RESEARCH AND EDUCATION. PARK NICOLLET STRIVES TO MEET ITS COMMITMENT TO THE TRIPLE AIM OF PROVIDING HIGH QUALITY HEALTH CARE AT AN AFFORDABLE COST TO THE COMMUNITY BY ENHANCING THE PATIENT EXPERIENCE. PARK NICOLLET'S COMMITMENT TO THE PATIENT AND FAMILY EXPERIENCE IS ARTICULATED THROUGH A FOCUS ON HEAD + HEART, TOGETHER (HHT)."HEAD" REFERS TO OUR WORK AROUND EVIDENCE-BASED MEDICINE, OUR ATTENTION TO CLINICAL OUTCOMES, THE WAY WE WILL USE DATA TO MAKE DECISIONS ABOUT THE BEST CARE PROTOCOL TO FOLLOW, AND TO THE BUSINESS OF RUNNING A LARGE HEALTHCARE SYSTEM. "HEART" IS ALL ABOUT PROVIDING COMPASSIONATE CARE IN THE MOMENT AND KEEPING OUR PATIENTS AT THE CENTER OF EVERYTHING WE DO AND EVERY DECISION WE MAKE. WHEN WE WORK ACROSS BOUNDARIES WITH OUR PATIENTS AND FAMILIES, WE WON'T DO THINGS "TO OR "FOR" PATIENTS - WE WILL DO THINGS WITH PATIENTS AND THEIR FAMILIES."TOGETHER" MEANS DOING BOTH HEAD- AND HEART-CENTERED ACTIVITIES IN COMBINATION. IT ALSO MEANS WORKING AS A TEAM ACROSS DEPARTMENTS AND SPECIALTIES, ALL OF US UNITED AROUND CARING TOGETHER WITH OUR PATIENTS, THEIR FAMILIES IN THE COMMUNITIES WE SERVE.PARK NICOLLET HEALTH SERVICES FURTHERS ITS EXEMPT PURPOSE THROUGH ITS 426-BED METHODIST HOSPITAL IN ST. LOUIS PARK, 25 CLINIC LOCATIONS IN ITS 96 ZIP CODE SERVICE AREA, 55 MEDICAL SPECIALTIES AND SUBSPECIALTIES, AND 12 SPECIALTY CENTERS. PARK NICOLLET FOUNDATION SERVES AS THE CONVENER OF THE COMMUNITIES WE SERVE, INVOLVING ADMINISTRATIVE AND MEDICAL STAFF IN ITS INTEGRATED SYSTEM, TO ASSESS COMMUNITY NEED AND FACILITATE A BROAD ARRAY OF CLINICAL AND SPECIALTY SERVICES AND THE ADMINISTRATIVE SUPPORT TO MEET UNMET NEEDS IN THE COMMUNITY. PARK NICOLLET FOUNDATION ALSO PROVIDES FINANCIAL ASSISTANCE TO COMMUNITY ORGANIZATIONS AND SERVICES THAT ARE CONSISTENT WITH NEEDS IDENTIFIED IN THE CHNA AS PRIORITIZED BY ITS BOARD OF DIRECTORS. PARK NICOLLET FOUNDATION'S BOARD OF DIRECTORS IS A COMMUNITY BOARD AND PROVIDES ACTIVE PARTICIPATION IN THE NONPROFIT MISSION OF THE ORGANIZATION. PARK NICOLLET'S INTEGRATED SYSTEM PROVIDES COMMUNITY BENEFIT TO UNDERSERVED POPULATIONS THROUGH CONVENING OF COMMUNITIES, EDUCATION AND SUPPORT OF PATIENTS AND COMMUNITY MEMBERS DIAGNOSED WITH CHRONIC DISEASE, AND RESEARCH TO IMPROVE QUALITY OF LIFE. HEALTH PROFESSIONALS WITHIN THE INTEGRATED SYSTEM ASSIST PATIENTS IN THE COMMUNITY, IN THE STATE, IN THE NATION, AND AROUND THE WORLD WHO NEED SPECIALIZED PROGRAMS AND SERVICES FOR VARIOUS CONDITIONS. PARK NICOLLET ALSO IS A RECOGNIZED LEADER IN PROCESS IMPROVEMENTS TO COORDINATE PATIENT CARE AND PROVIDE PATIENTS WITH SOCIAL SUPPORT SYSTEMS TO IMPROVE POPULATION HEALTH. THIS HAS BEEN ACCOMPLISHED THROUGH ITS INITIATIVES THROUGH THE PHYSICIAN GROUP PRACTICE DEMONSTRATION PROGRAM SPONSORED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. PARK NICOLLET ALSO PARTICIPATES IN THE PIONEER ACO DEMONSTRATION THAT IS SPONSORED BY THE CENTER FOR MEDICARE AND MEDICAID INNOVATION. IN ADDITION TO INNOVATING AROUND CARE DELIVERY DESIGN AND PATIENT SUPPORT SERVICES, PARK NICOLLET PARTICIPATES IN MULTIPLE LEARNING INITIATIVES THROUGH THE DEMONSTRATION PROGRAM TO SHARE ITS KNOWLEDGE AND LESSONS LEARNED WITH OTHER ORGANIZATIONS ACROSS THE COMMUNITY AND THE COUNTRY. PARK NICOLLET HAS BEEN COMMITTED TO THESE EFFORTS IN SUPPORT OF ITS COMMITMENT TO THE TRIPLE AIM OF IMPROVING HEALTH, PATIENT EXPERIENCE AND AFFORDABILITY BY PROVIDING COMMUNITIES WITH SUPPORT SYSTEMS ASSISTING PATIENTS AND FAMILIES TO IMPROVE THEIR HEALTH. GRANTS AND COMMUNITY SUPPORT. IN 2015, PARK NICOLLET FOUNDATION GRANTED $2 MILLION TO PARK NICOLLET DEPARTMENTS AND COMMUNITY 501(C)(3) ORGANIZATIONS TO FUND OUTREACH SERVICES AND SUPPORT PROGRAMS ADDRESSING OUR KEY PRIORITIES FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT.PARK NICOLLET SUPPORTS SCHOOL-BASED HEALTH CENTERS. IN 2015, WE OFFERED NO-CHARGE HEALTH CARE TO CHILDREN FROM INFANCY THROUGH HIGH SCHOOL GRADUATION AT OUR SCHOOL-BASED HEALTH CENTERS IN BROOKLYN CENTER, BURNSVILLE, AND ST. LOUIS PARK. NO-CHARGE AND LOW-COST DENTAL AND MENTAL HEALTH CARE IS AVAILABLE BY APPOINTMENT. PARTICIPATING FAMILIES INCLUDE THOSE WHO ARE UNABLE TO AFFORD HEALTH CARE, ARE NEW TO THE AREA OR HAVE SENSITIVE HEALTH CARE NEEDS. WALK-IN VISITORS ARE WELCOME AT ALL LOCATIONS. ALL HEALTH CENTERS ARE OPERATED IN PARTNERSHIP WITH LOCAL SCHOOL DISTRICTS AND FUNDED BY PARK NICOLLET FOUNDATION. IMMUNIZATIONS. MINNESOTA LAW REQUIRES IMMUNIZATIONS, OR WRITTEN PROOF OF EXEMPTION, FOR SCHOOL-AGE CHILDREN TO ATTEND SCHOOL. PARK NICOLLET FOUNDATION COLLABORATES WITH SCHOOL DISTRICTS TO HAVE ALL CHILDREN IMMUNIZED. PARK NICOLLET OFFERS ENHANCED ACCESS FOR CHILDREN NEEDING IMMUNIZATIONS AS PART OF THE NO SHOTS, NO SCHOOL PROGRAM, WHICH IS AVAILABLE MAY, AUGUST AND THE FIRST TWO WEEKS OF SEPTEMBER. WE ALSO GIVE FREE IMMUNIZATIONS YEAR-ROUND AT THE SCHOOL-BASED HEALTH RESOURCE CENTERS. PARK NICOLLET PROVIDES IMMUNIZATION-ONLY VISITS ON A SAME-DAY APPOINTMENT BASIS; IMMUNIZES CHILDREN WITHOUT A DOCTOR VISIT OR PREVENTIVE CARE EXAM AT THE TIME OF IMMUNIZATION; IMMUNIZES CHILDREN NOT PREVIOUSLY ESTABLISHED AS PATIENTS WITH THE CLINIC; AND PROVIDES IMMUNIZATIONS TO CHILDREN WITH NO DIRECT CHARGE TO FAMILIES.PARK NICOLLET SPONSORED COMMUNITY COLLABORATIVES. PARK NICOLLET FOUNDATION REGULARLY SPONSORS OR PARTICIPATES IN COLLABORATIVE GROUPS TO DISCUSS ISSUES AND TOPICS AFFECTING RESIDENTS IN THE COMMUNITY. THESE MEETINGS ARE HELD AT DIFFERENT LOCATIONS THROUGHOUT PARK NICOLLET'S SERVICE AREA. THE FOLLOWING ARE SOME EXAMPLES OF THIS WORK: CHILDREN FIRST DAKOTA COUNTY HEALTHY COMMUNITY COLLABORATIVE MEADOWBROOK COLLABORATIVE NORTHWEST HENNEPIN HEALTHY COMMUNITY PARTNERSHIP ST. LOUIS PARK SUCCESSFUL AGING INITIATIVE SCOTT COUNTY HEALTHY COMMUNITY COLLABORATIVE THE FOLLOWING ARE EXAMPLES OF SPECIFIC ACTIVITIES THAT ARE SUPPORTED BY THE PARK NICOLLET FOUNDATION AND PARK NICOLLET HEALTH SERVICES AND DEMONSTRATE THE ORGANIZATION'S COMMITMENT TO THE COMMUNITY AND MEETING UNMET COMMUNITY NEEDS. 1. RESEARCH AND EDUCATION ACTIVITIES - RESEARCH IS EMBEDDED IN DEPARTMENTS AND STRATEGIES ACROSS PARK NICOLLET TO SUPPORT QUALITY INITIATIVES AND THE PATIENT EXPERIENCE. RESEARCH ENCOMPASSES INVESTIGATOR-INITIATED STUDIES, CLINICAL TRIALS, PRACTICE-BASED RESEARCH, OUTCOMES AND QUALITY IMPROVEMENT PROJECTS, DATA ANALYTICS, STATISTICS, SURVEY DEVELOPMENT AND FOCUS GROUPS. WE PARTICIPATE IN OVER 200 STUDIES ANNUALLY AND ARE A MAJOR SITE FOR THE CLINICAL EVALUATION OF NEW MEDICATIONS AND MEDICAL DEVICES. OUR PRACTICE-BASED, HEALTH SERVICES RESEARCH CONTRIBUTES TO BETTER HEALTH OUTCOMES AND INCREASED VALUE. PARK NICOLLET INSTITUTE PROVIDES THE INFRASTRUCTURE AND RESOURCES TO SUPPORT RESEARCH AND CLINICAL QUALITY GOALS OF THE ORGANIZATION, WHICH INCLUDES THE FOLLOWING: NEEDS ASSESSMENT AND FEASIBILITY MENTORING AND TRAINING SCIENTIFIC AND HUMANS SUBJECTS REVIEW REGULATORY COMPLIANCE AND REPORTING GRANT MANAGEMENT, INCLUDING APPLICATION PREPARATION AND SUBMISSION, CONTRACT AND AGREEMENT NEGOTIATION, FINANCE, BUDGET DEVELOPMENT, IDENTIFICATION OF FUNDING SOURCES PROTOCOL DEVELOPMENT AND RESEARCH DESIGN MANUSCRIPT AND POSTER/PRESENTATION PREPARATION DATABASE DEVELOPMENT, DATA CLEANING, STATISTICS AND ANALYTICS, SURVEY REVIEW AND DESIGN, FOCUS GROUP FACILITATION STUDY OPERATIONS SUPPORT INCLUDING RECRUITMENT, CONSENTING, ENROLLING, DATA COLLECTION/ENTRYPARK NICOLLET INSTITUTE'S PATIENT EDUCATION DEPARTMENT PROVIDES EDUCATIONAL TOOLS TO SUPPORT PATIENTS IN PREVENTING AND MANAGING ILLNESS AND IMPROVING HEALTH. WE PROVIDE PROGRAMS, CLASSES, VIDEOS, WEB CONTENT AND DECISION SUPPORT TOOLS TO HELP PATIENTS AND THE BROADER COMMUNITY TAKE AN ACTIVE ROLE IN THEIR HEALTH. THESE RESOURCES HELP PATIENTS PREVENT AND MANAGE COMMON HEALTH PROBLEMS, LIVE WELL WITH CHRONIC CONDITIONS, PREPARE FOR PROCEDURES AND IMPROVE OVERALL HEALTH AND WELL-BEING. OUR PARK NICOLLET HEALTH LIBRARY PROVIDES RESOURCES AND SERVICES FOR PATIENTS, FAMILY AND THE COMMUNITY. THIS INCLUDES LITERATURE SEARCHES AND DOCUMENT DELIVERY, AS WELL AS ACCESS TO PRINT, ONLINE AND INTERNET RESOURCES.
PART VI, LINE 6:	IF THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, DESCRIBE THE RESPECTIVE ROLES OF THE ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED. PARK NICOLLET METHODIST HOSPITAL IS PART OF PARK NICOLLET HEALTH SERVICES, AN INTEGRATED HEALTH SYSTEM. OTHER AFFILIATES INCLUDE 1) PARK NICOLLET CLINIC IN 25 LOCATIONS, AND OTHER CARE LOCATIONS, 2) PARK NICOLLET FOUNDATION, THE PHILANTHROPIC ARM OF PARK NICOLLET HEALTH SERVICES HELPING TO BRING RESOURCES TO NEEDS IN ITS COMMUNITIES, 3) PARK NICOLLET INSTITUTE, FOCUSED ON EDUCATION AND RESEARCH FOR PARK NICOLLET HEALTH SERVICES AND ITS COMMUNITY, 4) PARK NICOLLET HEALTH CARE PRODUCTS, PROVIDING RETAIL PHARMACY AND HEALTH RELATED PRODUCTS THROUGH EXISTING PARK NICOLLET LOCATIONS. 5) TRIA ORTHOPAEDIC CENTER, A LEADER IN ORTHOPEADIC TREATMENT, PROVIDING COMPREHENSIVE CARE FROM DIAGNOSIS, TO TREATMENT, TO REHABILITATION. ALL AFFILIATES ARE UNDER A COMMON BOARD OF DIRECTORS. PARK NICOLLET FOUNDATION HAS A SEPARATE BOARD WHICH IS OVERSEEN BY THE PARK NICOLLET HEALTH SERVICES BOARD. THE COMMUNITIES' HEALTH NEEDS ARE SHARED AMONG THE AFFILIATES AND DECISIONS REGARDING THE EFFECTIVE USE OF RESOURCES TO RESPOND TO THESE NEEDS ARE COORDINATED.A SPECIFIC EXAMPLE OF THIS COORDINATION OF SERVICES TO RESPOND TO COMMUNITY NEED IS WITH THE THREE SCHOOL-AFFILIATED COMMUNITY CLINICS. INITIAL DEVELOPMENT, FUNDING AND ONGOING FACILITATION IS PROVIDED BY PARK NICOLET FOUNDATION, STAFFING THROUGH PARK NICOLLET CLINIC, LABORATORY AND OTHER DIAGNOSTIC SERVICES THROUGH PARK NICOLLET METHODIST HOSPITAL, AND OUTPATIENT MEDICATIONS, EYE GLASSES AND DME SUPPLIES THROUGH PARK NICOLLET HEALTH CARE PRODUCTS.
PART VI, LINE 7, REPORTS FILED WITH STATES	MN
SCHEDULE H PART VI QUESTION 5 CONTINUED	2. GROWING THROUGH GRIEF PROGRAM - THIS SCHOOL SUPPORT PROGRAM PROVIDES 1:1 COUNSELING AND GROUPS FOR CHILDREN AND TEENS WHO HAVE EXPERIENCED THE DEATH OF SOMEONE IMPORTANT IN THEIR LIFE. SERVICES ARE FUNDED BY PARK NICOLLET FOUNDATION AND ARE FREE OF CHARGE TO PARTICIPANTS. MORE THAN 500 STUDENTS AND 13 SCHOOL DISTRICTS ARE SERVED BY THE PROGRAM ON A WEEKLY BASIS. THE CHILDREN RANGE IN AGE FROM 5 TO 18 YEAR OLDS. ALL SOCIO-ECONOMIC GROUPS ARE SERVED. STUDENTS SERVED ARE IN THE SCHOOL DISTRICTS OF: APPLE VALLEY-ROSEMOUNT-EAGAN; BURNSVILLE; CHASKA-CHANHASSEN; EDINA; HOPKINS; MINNEAPOLIS; MINNETONKA; MOUND-WESTONKA; OSSEO-MAPLE GROVE; PRIOR LAKE-SAVAGE; ST. LOUIS PARK; AND WAYZATA. COUNSELORS SERVE ON THE EMERGENCY RESPONSE TEAM FOR SCHOOLS AND ARE CERTIFIED TRAUMATOLOGISTS. 3. SCHOOL-BASED HEALTH CENTERS (SBHCS) - THREE SCHOOL-BASED HEALTH CENTERS PROVIDED OVER 5,000 SERVICES FOR UNINSURED AND UNDERINSURED YOUTH. SERVICES INCLUDED TREATMENT OF MINOR, ACUTE ILLNESSES; PHYSICALS; IMMUNIZATIONS; MENTAL HEALTH THERAPY; DENTAL CARE; AND VISION CHECKS. ALL MEDICAL SERVICES ARE PROVIDED FREE OF CHARGE TO PATIENTS. 4. PRESCRIPTIONS - PARK NICOLLET FOUNDATION FUNDED OVER $60,000 WORTH OF PRESCRIPTIONS FOR PATIENTS OF THE SBHCS. 5. FOOD AND VEGGIE PRESCRIPTIONS - IN PARTNERSHIP WITH CUB FOODS, PARK NICOLLET PRIMARY CARE PHYSICIANS GAVE "PRESCRIPTIONS" FOR HEALTHY FOOD TO YOUNG PATIENTS AS A WAY TO START CONVERSATIONS ABOUT FRUIT AND VEGETABLE CONSUMPTION. A TOTAL OF $15,000 IN $10 FRUIT AND VEGETABLE PRESCRIPTION COUPONS WERE DISTRIBUTED.6. FIRE-FIGHTER OUTREACH - IN PARTNERSHIP WITH METHODIST HOSPITAL AND LOCAL FOOD SHELVES, THE FIRE DEPARTMENTS OF FIVE COMMUNITIES VISIT RECENTLY-DISCHARGED, AT-RISK SENIORS TO CHECK ON THEIR SAFETY AND ENSURE THEY HAVE ADEQUATE FOOD. PARK NICOLLET FOUNDATION PROVIDED $10,000 IN FOOD SHELF AND TRANSPORTATION SUPPORT; HOME SAFETY SUPPLIES WORTH $2,500; $1,800 IN FOOD SHELF CARDS AND $4453.05 IN INFORMATIONAL MATERIALS FOR COMMUNITY RESOURCES. 7. MELROSE CENTER OUTREACH - TO ALLOW THE MELROSE COMMUNITY RELATIONS TEAM TO CONTINUE THEIR IMPORTANT WORK IN THE COMMUNITY OF PROVIDING EXTENSIVE OUTREACH, EDUCATION AND EARLY INTERVENTION FOR PEOPLE WITH EATING DISORDERS AND THEIR COMMUNITY, THE FOUNDATION PROVIDED $32,000.8. PARISH/CONGREGATIONAL OUTREACH - OUR PARISH/CONGREGATIONAL NURSES VISIT MEMBERS FROM THEIR CONGREGATION AND LOCAL COMMUNITY FOR HEALTH ASSESSMENTS, HEALTH EDUCATION, HEALTH COUNSELING, REFERRALS TO COMMUNITY RESOURCES, AND FOR ASSISTANCE NAVIGATING THE COMPLEX HEALTH CARE SYSTEM. THEIR MINISTRY INCLUDES 1:1 VISITS, LARGE AND SMALL GROUPS AND CLASSES, AND HEALTH FAIRS. IN 2015 THEY SERVED OVER 500 PEOPLE. 9. ADVOCARE - ADVOCARE SERVES ANY PARK NICOLLET PATIENT, STAFF OR COMMUNITY MEMBER LIVING IN AN ABUSIVE SITUATION. ADVOCARE ADVOCATES PROVIDE CRISIS SUPPORT, EDUCATION ABOUT ABUSE, SAFETY PLANNING AND LEGAL OPTIONS. ALL ADVOCARE SERVICES ARE FREE AND CONFIDENTIAL. WE ALSO PROVIDE EDUCATION TO PARK NICOLLET STAFF, SUCH AS IDENTIFYING DYNAMICS OF ABUSE, IDENTIFYING PATIENTS BEING ABUSED, DOCUMENTING ABUSE IN THE MEDICAL RECORD AND PROVIDING THE PROPER RESPONSE TO BATTERED PATIENTS. ADVOCARE SERVED OVER 1,000 PEOPLE IN 2015. 10. NOW (NO OBSTACLES TO WELL-BEING) - THIS PROGRAM USES TELE-HEALTH TECHNOLOGY TO CONNECT ST. LOUIS PARK MIDDLE SCHOOL STUDENTS TO QUALIFIED MENTAL HEALTH CARE PROVIDERS. THE PARK NICOLLET THERAPIST PROVIDED 220 THERAPY HOURS FREE OF CHARGE TO STUDENTS AND THEIR FAMILIES.11. HEALTH FAIRS AND COMMUNITY OUTREACH - PARK NICOLLET CARE TEAMS, DEPARTMENTS AND CLINICS PROVIDE FAIRS AND OUTREACH THROUGHOUT THE YEAR. EXAMPLES INCLUDE: PRESENTED STROKE WARNING SIGNS AND SYMPTOMS PROVIDED ATTENDEES WITH STROKE EDUCATION AND AWARENESS INFORMATION AT CHURCHES, SCHOOLS AND PARKS PRESENTATION TO 50 MEMBERS OF FARIBAULT FIRE DEPT ON HEALTH AND FITNESS FOR THE TACTICAL ATHLETE OUR SENIOR SERVICES TEAMS PARTICIPATED IN THE LIVING LONGER SUMMIT AND BURSNVILLE SENIOR HEALTH FAIR EXPERTS FROM STRUTHERS PARKINSON'S CENTER PROVIDED EDUCATION TO COMMUNITY MEMBERS ON PARKINSON'S DISEASE AND EXERCISE PROGRAMS AT THE NATIONAL PARKINSON FOUNATION MOVING DAY MOVEMENT PAVILION. ADDITIONALLY, THE STRUTHERS TULIPS PROGRAM BRINGS TRAININGS TO NUMEROUS ASSISTED LIVING AND NURSING FACILITIES AROUND THE UPPER MIDWEST. SLEEP EDUCATION WAS PROVIDED FOR A VARIETY OF GROUPS, INCLUDING A PRESENTATION FOR SHIFT WORKERS AT THE MALL OF AMERICA. A VARIETY OF SUPPORT GROUPS FOR COMMUNITY MEMBERS AND LOVED ONES AFFECTED BY PARKINSON'S DISEASE, STROKE, SLEEP DISORDERS, CANCER AND MORE. MAPLE GROVE WOMEN'S SERVICES TEAMS OFFERED HEALTH EDUCATION AND INFORMATION AT TWO COMMUNITY EVENTS: JEANS, JEWELS & GENERATIONS AND THE BABY BALL. ORTHOPEDICS TEAM PRESENTED TO HIGH SCHOOL AND COLLEGE AGED STUDENTS ON CAREERS IN PHYSICAL THERAPY SPONSORED THE DAKOTA COUNTY HEALTHY COMMUNITY COLLABORATIVE'S 2015 MENTAL HEALTH SUMMITIN ADDITION TO THE INITIATIVES SITED ABOVE, PARK NICOLLET FOUNDATION PROVIDES FINANCIAL AND OTHER SUPPORT TO ASSIST COMMUNITY NON-PROFIT PARTNERS. IN 2015, COMMUNITY GRANTEES INCLUDED: FOOD ACCESS FOR LOW-INCOME SENIORS 360 COMMUNITIES INTERCONGREGATION COMMUNITIES ASSOCIATION MOBILE FOOD SHELF PRISM ST. LOUIS PARK EMERGENCY PROGRAM (STEP) SECOND HARVEST HEARTLAND STORE TO DOOR OTHER SERVICES FOR LOW-INCOME SENIORS DARTS TRANSPORTATION SERVICE INTERFAITH OUTREACH AND COMMUNITY PARTNERS (IOCP) - SOCIAL CONNECTIVITY VEAP - TRANSPORTATION YOUTH MENTAL HEALTH CHANGE, INC. - TRAINING AFRICAN AMERICAN MALES AS MENTAL HEALTH AIDES IN MINNEAPOLIS PUBLIC SCHOOLS. COMUNIDADES LATINAS UNIDAS EN SERVICIO - MENTAL HEALTH CARE FOR UNACCOMPANIED LATINO MINORS ST. LOUIS PARK SCHOOL DISTRICT - SPARKS ELEMENTARY SCHOOL COUNSELORS MYHEALTH FOR TEENS AND YOUNG ADULTS NORTHWEST HENNEPIN FAMILY SERVICE COLLABORATIVE - FAMILY SCHOOL COORDINATORS RECLAIM - THERAPY SERVICES FOR SOUTHEAST ASIAN LGBTQ YOUTH RELATE - EARLY CHILDHOOD MENTAL HEALTH SERVICES THROUGH MINNETONKS ECFE ROBBINSDALE AREA SCHOOLS - ELEMENTARY MENTAL HEALTH SERVICES ST. DAVID'S CENTER FOR CHILD & FAMILY DEVELOPMENT WATERCOURSE COUNSELING CENTER - TRAUMA-INFORMED THERAPY FOR IMMIGRANT STUDENTS ACCESS AND AFFORDABILITY CHILDREN'S DENTAL SERVICES THE MILLS HEALTH CLINIC - PRESCRIPTION SUPPORT FOR A LOW-COST CLINIC IN MINNETONKA RIVER VALLEY COMMUNITY PARTNERSHIP - SAFETY NET MEDICAL PROVIDER

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
PARK NICOLLET GROUP RETURN

Employer identification number
45-5023260

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) PARK NICOLLET FOUNDATION
6500 EXCELSIOR BLVD
ST LOUIS PARK,MN55426

23-7346465

501(C)(3)

112,469

GRANT MONEY TO OTHER ORGANIZATIONS

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	20	50,000
(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 PARK NICOLLET SERVICE LEAGUE HAS A STUDENT VOLUNTEER SCHOLARSHIP PROGRAM TO GIVE FINANCIAL SUPPORT TO STUDENT VOLUNTEERS WHO HAVE PROVIDED EXCEPTIONAL VOLUNTEER SERVICE AND ARE INTERESTED IN FURTHERING THEIR EDUCATIONS. APPLICANTS MUST BE AN ACTIVE STUDENT VOLUNTEER, A SENIOR IN HIGH SCHOOL AND WHO HAS APPLIED TO A POST-HIGH SCHOOL EDUCATION PROGRAM AND MUST BE DEDICATED VOLUNTEER AT PARK NICOLLET METHODIST HOSPITAL. OCCASIONALLY PARK NICOLLET METHODIST HOSPITAL GRANTS MONIES TO OTHER TAX-EXEMPT ORGANIZATIONS CONDUCTION PROGRAMS AND/OR RESEARCH THAT WILL ULTIMATELY BENEFIT THOSE SERVICED BY PARK NICOLLET HEALTH SERVICES AND AFFILIATES, DURING CALENDAR YEAR GRANTS WERE MADE TO PARK NICOLLET FOUNDATION FOR IMPROVEMENT TO MEDICAL SERVICES, MEDICAL RESEARCH AND HEALTHY PATIENTS.

Schedule I (Form 990) 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

PARK NICOLLET GROUP RETURN

Employer identification number

45-5023260

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 .........

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? ..

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

Yes

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

Yes

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

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

Only 501(c)(3), 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 ............

Yes

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)
1THOMAS JONES MDDIRECTOR	(i) (ii)	599,174 ------------- 0	20,260 ------------- 0	72,734 ------------- 0	47,259 ------------- 0	33,421 ------------- 0	772,848 ------------- 0	0 ------------- 0
2JEFF MENDELOFF MDDIRECTOR	(i) (ii)	683,548 ------------- 0	26,094 ------------- 0	64,059 ------------- 0	24,843 ------------- 0	38,992 ------------- 0	837,536 ------------- 0	0 ------------- 0
3ERIC SCHNED MDDIRECTOR	(i) (ii)	207,607 ------------- 0	5,923 ------------- 0	52,852 ------------- 0	24,529 ------------- 0	24,082 ------------- 0	314,993 ------------- 0	0 ------------- 0
4BRIAN H RANK MDDIRECTOR	(i) (ii)	0 ------------- 581,191	0 ------------- 156,086	0 ------------- 57,412	0 ------------- 99,590	0 ------------- 44,768	0 ------------- 939,047	0 ------------- 33,761
5BETH WATERMANPNI INSTITUTE VICE CHAIR	(i) (ii)	0 ------------- 277,158	0 ------------- 81,776	0 ------------- 0	0 ------------- 66,075	0 ------------- 40,432	0 ------------- 465,441	0 ------------- 0
6BETHEL AVERBECK MDPNI INSTITUTE DIRECTOR	(i) (ii)	0 ------------- 457,908	0 ------------- 30,000	0 ------------- 21,918	0 ------------- 56,288	0 ------------- 41,054	0 ------------- 607,168	0 ------------- 21,918
7DAVID DZIUKPNI INSTITUTE DIRECTOR	(i) (ii)	0 ------------- 440,985	0 ------------- 129,378	0 ------------- 17,727	0 ------------- 108,030	0 ------------- 42,833	0 ------------- 738,953	0 ------------- 17,727
8CHARLES FAZIO MDPNI INSTITUTE DIRECTOR	(i) (ii)	0 ------------- 371,319	0 ------------- 66,240	0 ------------- 1,147	0 ------------- 58,281	0 ------------- 34,539	0 ------------- 531,526	0 ------------- 0
9GEORGE ISHAM MDPNI INSTITUTE DIRECTOR	(i) (ii)	0 ------------- 157,800	0 ------------- 0	0 ------------- 1,515	0 ------------- 68,825	0 ------------- 15,658	0 ------------- 243,798	0 ------------- 0
10MEGAN REMARKPNI INSTITUTE DIRECTOR	(i) (ii)	0 ------------- 450,937	0 ------------- 117,300	0 ------------- 22,960	0 ------------- 75,296	0 ------------- 45,120	0 ------------- 711,613	0 ------------- 13,311
11JOHN SCHOUSBOE MDPNI INSTITUTE DIRECTOR	(i) (ii)	291,803 ------------- 0	3,899 ------------- 0	7,271 ------------- 0	22,544 ------------- 0	24,858 ------------- 0	350,375 ------------- 0	0 ------------- 0
12BABETTE APLANDVP BEHAVIORAL HEALTH AND C	(i) (ii)	0 ------------- 316,765	0 ------------- 88,374	0 ------------- 25,974	0 ------------- 72,305	0 ------------- 39,332	0 ------------- 542,750	0 ------------- 9,615
13CURT BOEHMMDCMIO, HP INSTUTUTE DIRECTOR	(i) (ii)	0 ------------- 282,960	0 ------------- 48,174	0 ------------- 4,167	0 ------------- 58,339	0 ------------- 23,314	0 ------------- 416,954	0 ------------- 0
14STEVEN CONNELLY MDPRESIDENT PNHS, HP INSTUTUE DIRECTOR	(i) (ii)	0 ------------- 546,352	0 ------------- 139,096	0 ------------- 72,979	0 ------------- 90,843	0 ------------- 53,632	0 ------------- 902,902	0 ------------- 59,768
15PAUL DAMROW MDCHIEF SURGICAL SERVICES	(i) (ii)	0 ------------- 547,461	0 ------------- 102,784	0 ------------- 13,060	0 ------------- 89,481	0 ------------- 39,408	0 ------------- 792,194	0 ------------- 0
16LAURA FRAZIERVP SURGICAL SERVICES	(i) (ii)	0 ------------- 252,039	0 ------------- 46,582	0 ------------- 34,906	0 ------------- 54,871	0 ------------- 27,704	0 ------------- 416,102	0 ------------- 27,724
17ROXANNA GAPSTUR PHDSR VP & COO METHODIST HOSP	(i) (ii)	0 ------------- 347,188	0 ------------- 83,702	0 ------------- 46,081	0 ------------- 66,017	0 ------------- 31,032	0 ------------- 574,020	0 ------------- 36,785
18CHRISTA GETCHELLPRESIDENT PNF, VP COMMUNIT	(i) (ii)	0 ------------- 214,919	0 ------------- 38,414	0 ------------- 10,015	0 ------------- 42,768	0 ------------- 19,386	0 ------------- 325,502	0 ------------- 0
19CARA HULLVP HR AND PLANNING	(i) (ii)	0 ------------- 76,895	0 ------------- 44,984	0 ------------- 2,188	0 ------------- 17,500	0 ------------- 12,470	0 ------------- 154,037	0 ------------- 0
20DAVID HOMANS MDCHIEF SPECIALTY SSERVICES	(i) (ii)	0 ------------- 585,414	0 ------------- 11,540	0 ------------- 75,132	0 ------------- 75,753	0 ------------- 37,015	0 ------------- 784,854	0 ------------- 0
21STEVEN HOUSHVP, ORTHOPAEDIC SERVICES	(i) (ii)	0 ------------- 305,713	0 ------------- 40,000	0 ------------- 0	0 ------------- 19,875	0 ------------- 37,443	0 ------------- 403,031	0 ------------- 0
22KATE KLUGHERZVP SPECIALTY SERVICES	(i) (ii)	0 ------------- 247,031	0 ------------- 43,913	0 ------------- 30,352	0 ------------- 54,585	0 ------------- 29,084	0 ------------- 404,965	0 ------------- 19,353
23CATHERINE LENAGHVP & CFO	(i) (ii)	0 ------------- 320,659	0 ------------- 71,209	0 ------------- 37,438	0 ------------- 63,963	0 ------------- 37,945	0 ------------- 531,214	0 ------------- 25,549
24KRISTI LYONVP PAYER RELATIONS	(i) (ii)	0 ------------- 205,525	0 ------------- 33,885	0 ------------- 27,150	0 ------------- 41,956	0 ------------- 37,357	0 ------------- 345,873	0 ------------- 16,628
25JOHN MISA MDSR MEDICAL DIRECTOR	(i) (ii)	0 ------------- 385,374	0 ------------- 71,911	0 ------------- 69,070	0 ------------- 70,274	0 ------------- 31,977	0 ------------- 628,606	0 ------------- 48,487
26JOAN SANDSTROMVP PRIMARY CARE	(i) (ii)	0 ------------- 285,298	0 ------------- 53,276	0 ------------- 46,623	0 ------------- 58,631	0 ------------- 30,438	0 ------------- 474,266	0 ------------- 32,165
27MARK SANNESMDSR MEDICAL DIRECTOR	(i) (ii)	0 ------------- 380,000	0 ------------- 37,790	0 ------------- 4,913	0 ------------- 48,843	0 ------------- 35,164	0 ------------- 506,710	0 ------------- 0
28MELISSA SCHOENHERRVP MARKETING AND COMMUNICA	(i) (ii)	0 ------------- 244,137	0 ------------- 47,168	0 ------------- 7,895	0 ------------- 54,124	0 ------------- 16,962	0 ------------- 370,286	0 ------------- 0
29CYNTHIA TOHER MDSR MEDICAL DIRECTOR	(i) (ii)	0 ------------- 545,104	0 ------------- 89,315	0 ------------- 59,530	0 ------------- 75,758	0 ------------- 43,340	0 ------------- 813,047	0 ------------- 48,578
30DUANE SPIEGLEVP REAL ESTATE AND SUPPORT	(i) (ii)	0 ------------- 243,151	0 ------------- 68,030	0 ------------- 33,633	0 ------------- 54,897	0 ------------- 42,669	0 ------------- 442,380	0 ------------- 21,040
31KATHERINE TARVESTADVP AND CARE GROUP COMPLIAN	(i) (ii)	0 ------------- 191,597	0 ------------- 72,271	0 ------------- 40,947	0 ------------- 13,593	0 ------------- 18,071	0 ------------- 336,479	0 ------------- 32,668
32JOSHUA ZIMMERMANSR MEDICAL DIRECTOR	(i) (ii)	0 ------------- 332,158	0 ------------- 39,941	0 ------------- 47,869	0 ------------- 52,466	0 ------------- 28,751	0 ------------- 501,185	0 ------------- 31,427
33NANCY MCCLURECHIEF OPERATING OFFICER	(i) (ii)	0 ------------- 552,471	0 ------------- 148,212	0 ------------- 48,080	0 ------------- 97,971	0 ------------- 42,770	0 ------------- 889,504	0 ------------- 24,314
34BARBARA TRETHEWAYSR. VP, GENERAL COUNSEL	(i) (ii)	0 ------------- 481,391	0 ------------- 128,478	0 ------------- 86,356	0 ------------- 78,345	0 ------------- 35,333	0 ------------- 809,903	0 ------------- 69,674
35PRAVEEN BAIMEEDI MDMEDICAL DOCTOR	(i) (ii)	1,476,239 ------------- 0	41,320 ------------- 0	2,904 ------------- 0	24,843 ------------- 0	50,976 ------------- 0	1,596,282 ------------- 0	0 ------------- 0
36OLIVER CASS MDMEDICAL DOCTOR	(i) (ii)	990,453 ------------- 0	28,879 ------------- 0	7,779 ------------- 0	24,843 ------------- 0	36,480 ------------- 0	1,088,434 ------------- 0	0 ------------- 0
37KEITH HARMON MDMEDICAL DOCTOR	(i) (ii)	768,833 ------------- 0	28,110 ------------- 0	78,703 ------------- 0	24,843 ------------- 0	40,471 ------------- 0	940,960 ------------- 0	0 ------------- 0
38ANTHONY BOTTINIMDMEDICAL DOCTOR	(i) (ii)	820,952 ------------- 0	31,043 ------------- 0	2,478 ------------- 0	24,843 ------------- 0	39,882 ------------- 0	919,198 ------------- 0	0 ------------- 0
39SALIM KATHAWALLA MDMEDICAL DOCTOR	(i) (ii)	639,800 ------------- 0	19,614 ------------- 0	154,954 ------------- 0	24,843 ------------- 0	39,582 ------------- 0	878,793 ------------- 0	0 ------------- 0
40JULIE FLASCHENRIEMFORMER VP AND CIO	(i) (ii)	43,775 ------------- 0	34,755 ------------- 0	374,999 ------------- 0	0 ------------- 0	13,923 ------------- 0	467,452 ------------- 0	40,178 ------------- 0
41BRETT LONGFORMER VP STRATEGY & GROWTH, HR	(i) (ii)	8,398 ------------- 0	51,833 ------------- 0	280,324 ------------- 0	0 ------------- 0	12,285 ------------- 0	352,840 ------------- 0	30,024 ------------- 0
42THEODORE WEGLEITNERFORMER COO TRIA	(i) (ii)	0 ------------- 343,418	0 ------------- 72,178	0 ------------- 33,980	0 ------------- 48,981	0 ------------- 37,838	0 ------------- 536,395	0 ------------- 33,980
43SHELIA MCMILLANFORMER VP & CFO	(i) (ii)	0 ------------- 0	0 ------------- 0	113,206 ------------- 0	0 ------------- 0	8,660 ------------- 0	121,866 ------------- 0	12,129 ------------- 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, LINES 4A-B

THE AMOUNT OF SEVERANCE COMPENSATION AND BENEFITS PROVIDED TO EACH OF THE INDIVIDUALS ON SEVERANCE DURING 2015 IS AS FOLLOWS: SHEILA MCMILLAN $101,077 BRETT LONG $250,204 JULIE FLASCHENRIEM $334,821 SCHEDULE J, PART I, LINE 4B: SENIOR LEADERS OF PARK NICOLLET HEALTH SERVICES AND AFFILIATES ARE GIVEN THE OPPORTUNITY TO PARTICIPATE IN THE CAPITAL ACCUMULATION ACCOUNT PLAN. THE CAPITAL ACCUMULATION ACCOUNT PLAN (CAA PLAN) PARTICIPATION IS LIMITED TO SENIOR LEADERS AND ALL THE VICE PRESIDENTS. EACH PARTICIPANT RECEIVES AN ANNUAL ALLOWANCE EQUAL TO THE SUM OF (I) A STATED PERCENT OF SALARY, (II) VOLUNTARY SALARY DEFERRALS. THE ALLOWANCE IS CREDITED TO A BOOKKEEPING ACCOUNT. EARNINGS ARE CREDITED TO THE ACCOUNT BASED ON THE PERFORMANCE OF SIMULATED INVESTMENTS. BENEFITS VEST UPON THE EARLIEST OF REMAINING EMPLOYED TO AN ELECTIVE VESTING DATE (TWO YEARS TO AGE 68), INVOLUNTARY TERMINATION WITHOUT CAUSE, DISABILITY, DEATH, OR NOT COMPETING FOR 24 MONTHS FOLLOWING VOLUNTARY OR FOR-CAUSE TERMINATION. BENEFITS ARE PAID IN A SINGLE LUMP SUM UPON VESTING. PARTICIPANTS ARE GENERAL CREDITORS OF THE EMPLOYER FOR THE PAYMENT OF THE BENEFITS. THE FOLLOWING PARTICIPANTS RECEIVED PAYOUTS FROM A RELATED ORGANIZATION, PARK NICOLLET HEALTH SERVICES, RELATED TO CAA PLAN: NAME 2015 COMPENSATION STEVEN CONNELLY, MD $ 59,768 JULIE FLASCHENRIEM $ 40,178 LAURA FRAZIER $ 27,724 ROXANNA GAPSTUR $ 36,785 DAVID HOMANS, MD $ 49,620 CATHERINE LENAGH $ 25,549 BRETT LONG $ 30,024 SHEILA MCMILLAN $ 12,129 JOHN MISA, MD $ 48,487 DUANE SPIEGLE $ 21,040 THEODORE WEGLEITNER $ 33,980 CATHERINE KLUGHERZ $ 19,353 KATHERINE TARVESTAD $ 32,668 CYNTHIA TOHER, MD $ 48,578 JOSHUA ZIMMERMAN MD $ 31,427 KRISTI LYON $ 16,628 JOAN SANDSTROM $ 32,165 OFFICERS AND DIRECTORS EMPLOYED BY HEALTHPARTNERS, INC HAVE DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II WHICH INCLUDE AMOUNTS FROM A NONQUALIFIED 457(F) PLAN, THE FOLLOWING PARTICIPANTS RECEIVED PAYOUTS: BABETTTE APLAND $ 9,615 BRIAN RANK, MD $ 33,761 NANCY MCCLURE $ 24,314 BARBARA TRETHEWAY $ 69,674 BETHAL AVERBECK $ 21,918 DAVID DZIUK $ 17,727 MEGAN REMARK $ 13,311

PART I, LINE 7

ALL PHYSICIANS, EMPLOYED BY AND SEEING PATIENTS FOR PARK NICOLLET HEALTH SERVICES AND AFFILIATES, ARE ELIGIBLE FOR A 3% ACCESS INCENTIVE PAYOUT BASED ON THEIR DEPARTMENT REACHING CERTAIN GOALS INCLUDING ACCESS FOR PATIENTS AND QUALITY INITIATIVES. IN THEIR ROLES AS EXECUTIVES EMPLOYED BY PARK NICOLLET HEALTH SERVICES, THE EXECUTIVES ARE ELIGIBLE FOR INCENTIVE PAYOUTS. THE INCENTIVE AWARD WILL BE 40% FOR THE CFO, COO, CMO AND 30% FOR ALL OTHER EXECUTIVES. EACH PARTICIPANT WILL BE RESPONSIBLE FOR TWO FINANCIAL GOALS, AND NOT LESS THAN THREE AND NOT MORE THAN FIVE INDIVIDUAL STRATEGIC OBJECTIVES. IN THEIR ROLES AS MANAGEMENT EMPLOYED BY PARK NICOLLET HEALTH SERVICES, CERTAIN DIRECTORS AND MANAGERS ARE ELIGIBLE FOR INCENTIVE PAYOUTS. THE INCENTIVE AWARD ELIGIBLE PARTICIPANTS WILL BE 20% AT THE DIRECTOR-LEVEL AND 15% AT THE MANAGER-LEVEL, USING THEIR ELIGIBLE ANNUAL BASE PAY COMPENSATION WITH AN OPPORTUNITY FOR INCENTIVE CREDIT ABOVE THE TARGET LEVEL. THE ULTIMATE PAYOUT DEPENDS ON INDIVIDUAL GOAL PERFORMANCE. THE PARTICIPANT MUST BE ASSIGNED AT LEAST THREE, AND NOT MORE THAN FOUR FOCUSED INCENTIVE OBJECTIVE, ONE OF WHICH MUST BE FINANCIAL IN NATURE

Schedule J (Form 990) 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

PARK NICOLLET GROUP RETURN

Employer identification number

45-5023260

Part I

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

1(a) Name of disqualified person	(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
(1) OLIVER CASS MD		SALARY DRAW IN EXCESS		X	777	777		No		No		No
(2) KEITH HARMON MD		SALARY DRAW IN EXCESS		X	11,296	11,296		No		No		No








Total ............... $						12,073

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) RANDI NORBY	RANDI NORBY IS THE SISTER OF ROXANNA GAPSTUR,PHD AN OFFICER OF PARK NICOLL	149,597	EMPLOYMENT		No
(2) SUSAN SPIEGLE	SUSAN SPIEGLE IS THE SPOUSE OF DUANE SPIEGLE, AN OFFICER OF PARK NICOLLET	47,781	EMPLOYMENT		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 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

PARK NICOLLET GROUP RETURN

Employer identification number

45-5023260

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 4	PARK NICOLLET INSTITUTE UPDATED THEIR BYLAWS TO CHANGE THE COMPOSITION OF THEIR BOARD. THERE ARE NOW 14 DIRECTORS COMPRISED OF EXOFFICIO AND MEMBER-APPOINTED DIRECTORS WHO FIT WITHIN PRESCRIBED CATEGORIES. OFFICERS OF PARK NICOLLET INSTITUTE ARE SUBJECT TO MEMBER APPROVAL OF PARK NICOLLET HEALTH SERVICES BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 6	PARK NICOLLET HEALTH SERVICES IS THE SOLE MEMBER OF PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PARK NICOLLET INSTITUTE PARK NICOLLET HEALTH CARE PRODUCTS AND PNMC HOLDINGS. HEALTHPARTNERS, INC. IS THE SOLE MEMBER OF PARK NICOLLET HEALTH SERVICES.
FORM 990, PART VI, SECTION A, LINE 7A	THE BOARD OF DIRECTORS OF PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PNMC HOLDINGS AND PARK NICOLLET HEALTH CARE PRODUCTS ARE THOSE INDIVIDUALS WHO ARE CONTEMPORANEOUSLY MEMBERS OF THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES. PARK NICOLLET INSTITUTE HAS A SEPERATE BOARD OF DIRECTORS WHO REPORTS TO THE OVERALL PARK NICOLLET HEALTH SERICES BOARDS.
FORM 990, PART VI, SECTION A, LINE 7B	ALL DECISIONS, INCLUDING DISSOLUTION OF THE ORGANIZATION, MADE BY THE GOVERNING BODY OF PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PARK NICOLLET INSTITUTE, PNMC HOLDINGS AND PARK NICOLLET HEALTH CARE PRODUCTS ARE SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS OF PARK NICOLLET HEALTH SERVICES.
FORM 990, PART VI, SECTION B, LINE 11	PARK NICOLLET GROUP PREPARES THE FORM 990 WITHIN THE FINANCE DEPARTMENT WITH ASSISTANCE FROM INDIVIDUALS IN HUMAN RESOURCES, MARKETING, OPERATIONS AND LEGAL. UPON COMPLETION OF GATHERING THE NECESSARY INFORMATION FOR THE RETURN, THE FORM WAS REVIEWED BY THE PARK NICOLLET GROUP'S ACCOUNTING FIRM. DRAFTS OF THE FORM WERE ALSO REVIEWED BY THE ASSISTANT CONTROLLER - ACCOUNTING OPERATIONS, VICE PRESIDENT OF FINANCE, CHIEF FINANCIAL OFFICER, THE LEGAL DEPARTMENT AND THE AUDIT AND COMPLIANCE COMMITTEE. AFTER ALL REVIEWS WERE COMPLETE; THE FORM 990 WAS GIVEN TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12C	AT PARK NICOLLET HEALTH SERVICES ALL KEY EMPLOYEES, DIRECTORS, AND OFFICERS ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST DISCLOSURE STATEMENT EACH YEAR; HOWEVER THE OBLIGATION TO REPORT POTENTIAL CONFLICTS IS ONGOING. PARK NICOLLET HEALTH SERVICES BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES PURSUANT TO ITS CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS AND OFFICERS ANNUALLY ARE PROVIDED A COPY OF THE POLICY AND REQUIRED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNCIL REVIEWS THE COMPLETED QUESTIONNAIRES AND PROVIDES A REPORT TO THE GOVERNANCE COMMITTEE OF THE BOARD. THE REPORT IDENTIFIES ANY SIGNIFICANT POTENTIAL CONFLICTS DISCLOSED IN THE COMPLETED QUESTIONNAIRES. A WRITTEN REPORT IS PROVIDED TO THE CHAIR AND CHIEF EXECUTIVE OFFICER (CEO). BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY.
FORM 990, PART VI, SECTION B, LINE 15	PARK NICOLLET HAS AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF ITS PRESIDENT AND ITS OTHER OFFICERS. EVERY THREE YEARS, UNDER THE DIRECTION OF THE BOARD OF DIRECTORS' COMPENSATION AND LEADERSHIP DEVELOPMENT COMMITTEE (COMPENSATION COMMITTEE), A TOTAL COMPENSATION MARKET REVIEW IS COMPLETED BY AN EXTERNAL COMPENSATION CONSULTANT. THE REVIEW INCLUDES ALL COMPONENTS OF COMPENSATION; BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE INDEPENDENT BOARD COMPENSATION COMMITTEE. BASED ON THIS MARKET DATA, THE COMPENSATION COMMITTEE DETERMINES MINIMUM AND MAXIMUM TOTAL COMPENSATION RANGES FOR EACH OFFICER. IN INTERIM YEARS, GROUP HEALTH PLAN, INC. (AN AFFILIATE OF PNHS) HUMAN RESOURCES STAFF, UNDER THE DIRECTION OF THE COMPENSATION COMMITTEE, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION CONSULTANT FOR THE COMPENSATION COMMITTEE. FOR CERTAIN POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED TO SET SALARY RANGES BASED ON THE COMPETITIVE MARKET DATA SPECIFIC TO THOSE POSITIONS. THE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S COMPENSATION RESULTS. IN ALL CASES, COMMITTEE MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMPENSATION COMMITTEE MEMBERS' INDEPENDENCE AND THIS IS UPDATED AT ANY MEETING AT WHICH DECISIONS ARE BEING MADE. STAFF (OTHER THAN THE SECRETARY TO THE BOARD) IS NOT IN THE ROOM DURING DELIBERATIONS OR VOTE INCLUDING EXECUTIVE SESSIONS, AND CONTEMPORANEOUS MINUTES ARE KEPT. THE BOARD HAS DELEGATED TO THE TO THE PRESIDENT & CEO (WITH AUTHORITY TO FURTHER DELEGATE TO EXECUTIVES WITH LEADERSHIP ROLES OF PARK NICOLLET OFFICERS) THE ACCOUNTABILITY TO CONDUCT ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL PARK NICOLLET OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMPENSATION COMMITTEE. ANY EXCEPTIONS TO COMPENSATION IN EXCESS OF THE APPROVED RANGES ARE APPROVED BY THE COMPENSATION COMMITTEE. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND W2 STATEMENTS.
FORM 990, PART VI, SECTION C, LINE 19	PARK NICOLLET GROUP MEMBERS' GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. PARK NICOLLET HEALTH SERVICES, AS THE PARENT ORGANIZATION OF THE PARK NICOLLET GROUP, MAILS ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS TO FINANCIAL INSTITUTIONS, GOVERNMENTAL INSTITUTIONS, BOARD MEMBERS, MEDIA REPRESENTATIVES, VENDORS, AND THE MINNESOTA HOSPITAL ASSOCIATION (MHA). PARK NICOLLET HEALTH SERVICES DISCLOSES QUARTERLY FINANCIAL STATEMENTS TO BONDHOLDERS AND MHA. THE ANNUAL AUDITED AND QUARTERLY FINANCIAL STATEMENTS ARE ALSO POSTED AT EMMA.MSRB.ORG. THE FORMS 990 ARE AVAILABLE UPON REQUEST OR FROM THE STATE OF MINNESOTA.
FORM 990, PART IV, LINE 24A	HEALTHPARTNERS INC., ALONG WITH RELATED ORGANIZATIONS, IS JOINTLY LIABLE FOR THE TAX EXEMPT BONDS HELD BY HEALTHPARTNERS INC. UNDER A MASTER TRUST AGREEMENT. THE MEMBERS OF THE JOINTLY LIABLE GROUP, WHICH IS COLLECTIVELY REFERRED TO AS THE "OBLIGATED GROUP", INCLUDE PARK NICOLLET HEALTH SERVICES, PARK NICOLLET CLINIC, PARK NICOLLET METHODIST HOSPITAL, PNMC HOLDINGS, REGIONS HOSPITAL, AND PARK NICOLLET HEALTH CARE PRODUCTS, GROUP HEALTH PLAN INC, HEALTHPARTNERS ADMINISTRATORS INC., HEALTHPARTNERS INSURANCE COMPANY. IN ACCORDANCE WITH REPORTING REQUIREMENTS FOR SCHEDULE K, ALL OUTSTANDING TAX EXEMPT BONDS ARE REPORTED SOLELY ON THE SCHEDULE K OF GROUP HEALTH PLAN INC.
FORM 990, PART XI, LINE 9:	NET ASSETS RELEASED FROM RESTRICTIONS -88,396. GRANTS RUN THROUGH THE FOUNDATION -1,768,647.
FORM 990, PART IX	IN 2015, PARK NICOLLET REFINANCED ITS BOND OFFERING RESULTING IN A ONE-TIME CHARGE OF $61 MILLION. TEH POSITIVE EFFECTS OF THE BOND REFINANCING ARE REFLECTED IN A LOWER INTEREST EXPENSE EACH YEAR, FOR THE LIFE OF THE BONDS.

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

PARK NICOLLET GROUP RETURN

Employer identification number

45-5023260

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(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)PARK NICOLLET HEALTH SERVICE 6500 EXCELSIOR BLVD ST LOUIS PARK,MN55426 36-3465840	HEALTH CARE ADMINSTRATIONS	MN	501(C)(3)	509(A)(2)			No
(2)PARK NICOLLET FOUNDATION 6500 EXCELSIOR BLVD ST LOUIS PARK,MN55426 23-7346465	GRANTS TO SERVE THE COMMUNITY	MN	501(C)(3)	170(B)(1) (A)(VI)	PARK NICOLLET HEALTH SERVICES		No
(3)TRIA ORTHOPEADIC CENTER RESEARCH INSTITUTE 8100 NOIRTHLAND DRIVE BLOOMINGTON,MN55431 20-0033919	HEALTH CARE RESEARCH AND EDUCATION	MN	501(C)(3)	509(A)(3) TYPE I	PARK NICOLLET HEALTH SERVICES		No
(4)HEALTHPARTNERS INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-1693838	HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION	MN	501(C)(4)		N/A		No
(5)HPI - RAMSEY 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-1793333	CORPORATE PLANNING AND OVERSIGHT	MN	501(C)(3)	509(A)(3) TYPE I	HEALTHPARTNERS INC		No
(6)GROUP HEALTH PLAN INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-0797853	STAFF MODEL HEALTH MAINTENANCE ORGANIZATION	MN	501(C)(3)	170(B)(1) (A)(III)	HEALTHPARTNERS INC		No
(7)HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-1670163	HEALTHCARE EDUCATION & RESEARCH	MN	501(C)(3)	509(A)(3) TYPE I	HEALTHPARTNERS INC		No
(8)CAPITOL VIEW TRANSITIONAL CARE CENTER 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-2011453	POST HOSPITALIZATION PATIENT CARE	MN	501(C)(3)	170(B)(1) (A)(III)	HPI - RAMSEY		No
(9)REGIONS HOSPITAL 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-0956618	HOSPITAL	MN	501(C)(3)	170(B)(1) (A)(III)	HPI - RAMSEY		No
(10)REGIONS HOSPITAL FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-1888902	PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT	MN	501(C)(3)	170(B)(1) (A)(VI)	HPI - RAMSEY		No
(11)RHSC INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-1891928	HEALTHCARE STAFFING	MN	501(C)(3)	509(A)(3) TYPE II	HEALTHPARTNERS INC		No
(12)RH-WISCONSIN 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 20-2287016	CORPORATE PLANNING AND OVERSIGHT	WI	501(C)(3)	509(A)(3) TYPE II	HPI - RAMSEY		No
(13)PHYSICIANS NECK AND BACK CLINICS 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 27-0684883	SPECIALTY PATIENT CARE	MN	501(C)(3)	509(A)(3) TYPE II	GROUP HEALTH PLAN INC		No
(14)HUDSON HOSPITAL INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 39-0804125	HOSPITAL	WI	501(C)(3)	170(B)(1) (A)(III)	RH-WISCONSIN		No
(15)HUDSON HOSPITAL FOUNDATION INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 39-1279567	PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT	WI	501(C)(3)	170(B)(1) (A)(VI)	HUDSON HOSPITAL INC		No
(16)WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 26-3616590	PROVIDE MEDICAL TRANSPORT SERVICES	WI	501(C)(3)	509(A)(3) TYPE I	RH-WISCONSIN		No
(17)LAKEVIEW MEMORIAL HOSPITAL FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-1386635	PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT	MN	501(C)(3)	509(A)(3) TYPE II	STILLWATER HEALTH SYSTEM		No
(18)LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-0811697	HOSPITAL	MN	501(C)(3)	170(B)(1) (A)(III)	STILLWATER HEALTH SYSTEM		No
(19)STILLWATER MEDICAL GROUP 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 83-0379473	PHYSICIANS GROUP	MN	501(C)(3)	509(A)(2)	STILLWATER HEALTH SYSTEM		No
(20)STILLWATER HEALTH SYSTEM 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 30-0221189	CORPORATE PLANNING AND OVERSIGHT	MN	501(C)(3)	509(A)(3) TYPE II	HPI - RAMSEY		No
(21)WESTFIELDS HOSPITAL INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 39-0808442	HOSPITAL	WI	501(C)(3)	170(B)(1) (A)(III)	RH-WISCONSIN		No
(22)WESTFIELDS HOSPITAL FOUNDATION INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 39-1770913	PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT	WI	501(C)(3)	509(A)(3) TYPE I	WESTFIELDS HOSPITAL INC		No
(23)RAMSEY INTEGRATED HEALTH SERVICES 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-1503090	IN-HOME PATIENT CARE	MN	501(C)(3)	509(A)(2)	HPI - RAMSEY		No
(24)AMERY REGIONAL MEDICAL CENTER INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 39-0908320	HOSPITAL	WI	501(C)(3)	170(B)(1) (A)(III)	RH-WISCONSIN		No
(25)AMERY REGIONAL MEDICAL CENTER FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 39-1726539	PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT	WI	501(C)(3)	170(B)(1) (A)(VI)	AMERY REGIONAL MEDICAL CENTER INC& GROUP HEALTH PLAN INC		No

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) METHODIST BRAIN LAB LEASING LLC 6500 EXCELSIOR BLVD ST LOUIS PARK,MN55426 20-8725994	HEALTH CARE	MN	PARK NICOLLET METHODIST HOSPITAL				No			No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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) PARK NICOLLET ENTERPRISES 6500 EXCELSIOR BLVD ST LOUIS PARK,MN55426 41-1656735	REAL ESTATE FOR RELATED ORGANICATION	MN	PARK NICOLLET HEATLH SERVICES	C	54,745	14,109,282	100.000 %		No
(2) HEALTHPARTNERS ADMINISTRATORS INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-1629390	THIRD PARTY ADMINISTRATOR	MN	HEALTHPARTNERS INC	C					No
(3) HEALTHPARTNERS ASSOCIATES INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 52-2365151	MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT	MN	HEALTHPARTNERS ADMINISTRATORS INC	C					No
(4) HEALTHPARTNERS SERVICES INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-1683568	MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT	MN	HEALTHPARTNERS ADMINISTRATORS INC	C					No
(5) HEALTHPARTNERS INSURANCE COMPANY 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-1683523	MEDICAL AND DENTAL INSURANCE	MN	HEALTHPARTNERS ADMINISTRATORS INC	C					No
(6) DENTAL SPECIALTIES INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 45-1297583	PROFESSIONAL DENTAL SERVICES	MN	HEALTHPARTNERS ADMINISTRATORS INC	C					No
(7) HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC 8170 33RD AVE S PO BOX 1309 MPLS,MN554401309 41-1236798	MEDICAL CLINIC STAFFING	MN	HEALTHPARTNERS ADMINISTRATORS INC	C					No

Schedule R (Form 990) 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 .....................

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

Yes

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

Yes

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

Yes

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

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

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) PARK NICOLLET HEALTH SERVICES	M	14,411,575	COST
(2) PARK NICOLLET HEALTH SERVICES	P	1,294,807,675	COST
(3) PARK NICOLLET HEALTH SERVICES	J	491,136	COST
(4) PARK NICOLLET HEALTH SERVICES	R	1,468,070,723
(5) METHODIST BRAIN LAB LEASING LLC	K	572,093	COST
(6) METHODIST BRAIN LAB LEASING LLC	S	365,349	COST
(7) HEALTHPARTNERS INC	L	56,111,253	COST

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: TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
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	0
6	Total number of volunteers (estimate if necessary) .............	6	1,467
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,782,706
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	13,935,944	20,273,326
9	Program service revenue (Part VIII, line 2g) .........	1,265,600,379	1,319,315,921
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	29,858,118	13,245,549
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	6,657,544	7,156,794
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,316,051,985	1,359,991,590
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	312,601	173,046
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)	777,493,934	783,192,936
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 306,588
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	465,186,098	585,473,774
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,242,992,633	1,368,839,756
19	Revenue less expenses. Subtract line 18 from line 12.......	73,059,352	-8,848,166
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,113,263,061	1,111,149,840
21	Total liabilities (Part X, line 26).............	473,917,504	490,695,543
22	Net assets or fund balances. Subtract line 21 from line 20.....	639,345,557	620,454,297

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,137,500,681 including grants of $ 173,046 ) (Revenue $ 1,213,752,919 )
	IN 2015, PARK NICOLLET HEALTH SERVICES AND AFFILIATES, A NATIONAL HEALTH CARE IMPROVEMENT LEADER, CONTINUED TO MAKE SIGNIFICANT PATIENT CARE ADVANCES, WIN PROMINENT AWARDS, EXPAND ACCESS TO SERVICES AND INTEGRATE EFFICIENCY INTO PARK NICOLLET HEALTH SERVICES' OPERATIONS. PARK NICOLLET HEALTH SERVICES AND AFFILIATES ALSO HAVE ENHANCED COMMUNITY HEALTH, INCREASED TEAM MEMBER SATISFACTION AND PROMOTED RESEARCH AND EDUCATION. PARK NICOLLET SPECIALTY CENTERS INCLUDE: BARIATRIC SURGERY CENTER - DESIGNATED A BARIATRIC CENTER OF EXCELLENCE BY THE AMERICAN SOCIETY FOR BARIATRIC SURGEONS, THE CENTER PREFORMS MORE THAN 400 SURGERIES EACH YEAR. CHILD AND FAMILY BEHAVIORAL HEALTH - FORMERLY ALEXANDER CENTER THIS IS THE LARGEST CLINIC IN MINNESOTA SERVING THE DEVELOPMENTAL AND BEHAVIORAL NEEDS OF CHILDREN AND THEIR FAMILIES. EMERGENCY CENTER - OPERATING OUT OF METHODIST HOSPITAL AND TREATING MEDICAL EMERGENCIES FOR MORE THAN 50,000 PATIENTS A YEAR. FAMILY BIRTH CENTER - FROM EXPERT CARE TEAMS TO LABOR, DELIVERY AND RECOVERY SUITES TO OUR SPECIAL CARE NURSERY, WE DELIVER AN EXCEPTIONAL EXPERIENCE FOR MOM AND BABY. FRAUENSHUH CANCER CENTER - MORE THAN 2,000 CANCER CASES PER YEAR ARE DIAGNOSED AT PARK NICOLLET. CANCER SERVICES INCLUDE MEDICAL ONCOLOGY, RADIATION ONCOLOGY, ONCOLOGY PSYCHIATRY AND PSYCHOTHERAPY, INTEGRATIVE THERAPIES, MUSIC THERAPY AND MORE. HEART AND VASCULAR CENTER - APPROXIMATELY 12,000 PATIENTS A YEAR USE THE CARDIAC REHAB DEPARTMENT, CARDIOLOGY CLINIC, INTERVENTIONAL CARDIOLOGY, HEART FAILURE CLINIC, SECONDARY PREVENTION CLINIC, CARDIOVASCULAR RESEARCH PROGRAM, INTERVENTIONAL RADIOLOGY, ELECTROPHYSIOLOGY, NEURO RADIOLOGY AND A NON-INVASIVE LAB. INTERNATIONAL DIABETES CENTER - THE CENTER PROVIDES WORLD-CLASS CARE, EDUCATION AND CLINICAL RESEARCH TO MEET THE NEEDS OF PEOPLE WITH DIABETES, THEIR FAMILIES AND THE HEALTH PROFESSIONALS WHO CARE FOR THEM. JANE BRATTAIN BREAST CENTER - SPECIALIZING IN BREAST IMAGING, ANNUAL SCREENING MAMMOGRAMS, BIOPSIES AND SURGERY. JOINT REPLACEMENT INSTITUTE - PROVIDING KNEE, HIP AND OTHER JOINT REPLACEMENTS FOR THOSE STRUGGLING WITH SEVERE PAIN. MORE THAN 1,000 JOINT REPLACEMENTS ARE PERFORMED ANNUALLY. MELROSE CENTER - HELPING PATIENTS WITH EATING DISORDERS FOR MORE THAN 25 YEARS. OUR MULTIDISCIPLINARY APPROACH INCLUDES MEDICAL, NUTRITIONAL, PSYCHOLOGICAL AND BEHAVIORAL CARE. STRUTHERS PARKINSON'S CENTER - SERVING PATIENTS WITH PARKINSON'S DISEASE THROUGH COMPREHENSIVE ASSESSMENT, INTERDISCIPLINARY TREATMENT, SUPPORT, RESEARCH AND EDUCATION. WOMEN'S CENTER - DESIGNED FOR WOMEN'S BUSY LIVES, THE CENTER OFFERS MORE THAN 15 PREVENTIVE AND SPECIALTY CARE SERVICES UNDER ONE ROOF. PARK NICOLLET HEALTH SERVICES MISSION IS TO TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. WE USE FOUR CORE VALUES TO ACCOMPLISH OUR MISSION: EXCELLENCE, COMPASSION, PARTNERSHIP AND INTEGRITY. HIGHLIGHTS OF 2015 THAT ILLUSTRATE PARK NICOLLET HEALTH SERVICE'S VALUES INCLUDE: METHODIST HOSPITAL RENOVATION AND EXPANSION - IN 2015 WORK CONTINUED AT METHODIST HOSPITAL ON A FOUR-YEAR RENOVATION AND EXPANSION PROJECT THAT WILL ADD TWO FLOORS TO THE HOSPITAL, ENHANCE THE SURGERY AREA AND CONVERT NEARLY ALL THE PATIENT ROOMS TO PRIVITE. NEW SUSTAINABILITY FEATURES WILL REDUCE THE HOSPITAL'S ENERGY CONSUMPTION BY 10 PERCENT. OUTPATIENT REGIONAL CENTER- MAPLE GROVE CLINIC & SPECIALITY CENTER OPENED IN OCTOBER, BRINGING MORE THAN 25 PRIMARY CARE SERVICES TO THE NORTHWEST METRO WOMEN'S CENTER OPENS - PARK NICOLLET WOMEN'S CENTER IS A NEW CONCEPT IN WOMEN'S HEALTH THAT DELIVERS CARE, COMFORT AND CONVENIENCE TO THE WOMEN IN OUR COMMUNITY BY BRINGING MORE OF THE SERVICES WOMEN USE INTO A SINGLE LOCATION. DESIGNED FOR WOMEN'S BUSY LIVES, THE CENTER OFFERS MORE THAN 15 PREVENTIVE AND SPECIALTY CARE SERVICES UNDER ONE ROOF. YOUTH SERVED - PARK NICOLLET CLINIC PARTNERS WITH PARK NICOLLET FOUNDATION IN THREE SCHOOL-BASED HEALTH CENTERS WHICH SERVED OVER 5,000 CHILDREN, OFFERING FREE MEDICAL VISITGS FOR UNINSURED AND UNDERINSURED YOUTH. SERVICES INSLUDED TREATMENT OF MINOR ACUTE ILLNESSES, PHYSICALS, IMMUNIZATIONS, MENATAL HEALTH THERAPY, DENTAL CARE AND VISION CHECKS. REACH OUT AND READ - THIS CLINIC-BASED PROGRAM TO PROMOTE LITERACY AND EARLY BRAIN DEVELOPMENT EXPANDED TO PARK NICOLLET IN 2015. THE PROGRAM ENCOURAGES PARENTS TO READ TO THEIR CHILDREN EVERY DAY, AND IS APART OF THE ORGANIZATION'S CHILDREN'S HEALTH INITATIVE. LEADER IN LGBT - EVERY YEAR SINCE 2009, THE HUMAN RIGHTS CAMPAIGN RECOGNIZED PARK NICOLLET METHODIST HOSPITAL AS A LEADER IN LGBT HEALTHCARE EQUALITY IN THE HEALTHCARE EQUALITY INDEX REPORT. WE EARNED TOP MARKS FOR OUR COMMITMENT TO EQUITABLE, INCLUSIVE CARE FOR LGBT PATIENTS AND THEIR FAMILIES.

4b	(Code: ) (Expenses $ 22,097,685 including grants of $ ) (Revenue $ 63,403,051 )
	PARK NICOLLET HEALTH CARE PRODUCTS IS PART OF PARK NICOLLET HEALTH SERVICES, A NONPROFIT INTEGRATED CARE DELIVERY SYSTEM, STAFFED BY NATIONALLY RECOGNIZED HOSPITAL AND CLINIC DOCTORS, CLINICAL PROFESSIONALS, NURSES, RESEARCHERS AND OTHER STAFF AT PARK NICOLLET METHODIST HOSPITAL AND PARK NICOLLET CLINIC WHO HELP PATIENTS STAY HEALTHY AND TAKE CARE OF PATIENTS WHEN THEY ARE SICK. PARK NICOLLET HEALTH CARE PRODUCTS IS A SUPPORTING ORGANIZATION WITHIN PARK NICOLLET METHODIST HOSPITAL AND PARK NICOLLET CLINIC, PROVIDING DURABLE MEDICAL EQUIPMENT (DME)/SUPPLIES AND PHARMACEUTICALS SUPPORTING ONGOING PATIENT CARE. PARK NICOLLET HEALTH CARE PRODUCTS FOCUS ON THE HEALTH, HEALING AND LEARNING OF PATIENTS BY PROVIDING EASY ACCESS TO PRODUCTS AND SERVICES THAT SUPPORT SUCCESSFUL SELF-MANAGEMENT OF A HEALTH CONDITION AT HOME. THE PRODUCTS SUPPORT BOTH SHORT TERM ACUTE CONDITIONS AND CHRONIC LIFELONG CONDITIONS, SUCH AS EYEWEAR, HEARING AIDS, CPAP MACHINES AND MANY PRODUCTS THAT CROSS INTO ALMOST EVERY MEDICAL SUBSPECIALTY.PARK NICOLLET HEALTH CARE PRODUCTS IS AN ENTITY WITHIN PARK NICOLLET HEALTH SERVICES PROVIDING DURABLE MEDICAL EQUIPMENT (DME)/SUPPLIES SUPPORTING ONGOING PATIENT CARE. HCP PARTNERS WITH YOUR CLINICIAN TO PROVIDE PRODUCTS AND SERVICES TO HELP YOU LIVE MORE COMFORTABLY.THE HEALTH AND CARE STORES, WHICH MEET A GROWING DEMAND FOR SELF-CARE PRODUCTS AND SERVICES, LOCATED WITHIN PARK NICOLLET CLINICS, INCLUDE: HEALTH & CARE STORE OFFERING DME PRODUCTS AT 6 LOCATIONS, HEARING CENTER & STORE WITH 4 LOCATIONS, CPAP CLINIC/STORE WITH 4 LOCATIONS AND BREASTFEEDING CENTER, (1 LOCATION WITHIN THE MEADOWBROOK HEALTH & CARE STORE), ORTHOTICS & PROSTHETICS CLINIC WITH 3 LOCATIONS. THE CONTACT LENS AND OPTICAL STORE @ PARK NICOLLET HEALTH CARE PRODUCTS, WHICH MEET GROWING DEMAND FOR SELF-CARE EYEWARE AND SERVICES, ARE AT THESE PARK NICOLLET CLINIC SITES: BLOOMINGTON, BROOKDALE, BURNSVILLE, CARLSON PARKWAY (MINNETONKA), CHANHASSEN, MAPLE GROVE, MINNEAPOLIS, SHAKOPEE, AND ST. LOUIS PARK. WE ALSO PRODUCE OUR OWN EYE WARE IN HCP'S OPTICAL LAB.THE PHARMACY @ PARK NICOLLET MEETS GROWING DEMAND FOR SELF-CARE PRODUCTS AND SERVICES. THE PHARMACIES ARE AT THESE PARK NICOLLET CLINIC LOCATIONS: BLOOMINGTON, BROOKDALE, BURNSVILLE, CARLSON PARKWAY (MINNETONKA), CHANHASSEN, EAGAN, MAPLE GROVE, MINNEAPOLIS, ST. LOUIS PARK, TRIA, AND WAYZATA AS WELL AS HEART AND VASCULAR CENTER AND MEADOWBROOK AT THE PARK NICOLLET METHODIST HOSPITAL.THE PATIENT CARE EXPERIENCE DOES NOT END AT THE HOSPITAL OR CLINIC DOOR. PATIENTS HAVE MANY SELF-CARE NEEDS TO MANAGE BOTH THEIR ACUTE AND CHRONIC HEALTH CONDITIONS, AND PARK NICOLLET HEALTH CARE PRODUCTS IS EXPANDING ITS CAPACITY TO BETTER SERVE THESE GROWING NEEDS. MAJOR ACCOMPLISHMENTS FOR 2015 INCLUDE: ENHANCED PRODUCT ASSORTMENTS AVAILABLE FOR PATIENTS ESPECIALLY PATIENTS LIVING WITH CHRONIC HEALTH CONDITIONS SUCH AS DIABETES, CANCER, AND BONE AND JOINT DISEASE. A ROBUST DME POINT OF SALE, FINANCIAL REPORTING, INVENTORY, AND BILLING SYSTEM FOR BETTER PATIENT SERVICE AND EASE OF OBTAINING THEIR PRESCRIPTIONS EDUCATED PHYSICIANS AND CARE PROVIDER'S ABOUT SERVICES AND PRODUCTS TO BETTER LINK SOLUTIONS FOR PATIENT HEALTH CARE NEEDS, INCLUDING ANNUAL STAFF SKILLS REVIEW FOR DME APPLICATIONS. DEVELOPED STANDARDIZED PROVIDER REFERRALS TO ASSURE THAT PATIENTS HAVE THE PRODUCTS NEEDED AS THEY GO HOME FROM CLINIC OR HOSPITAL. UPDATED E-COMMERCE WEB SITE FOR DME, TO MAKE IT EASIER FOR PROVIDERS AND PATIENTS TO LOCATE AND PURCHASE HEALTH CARE PRODUCTS. ENHANCED OPTICAL PRODUCT ASSORTMENTS AVAILABLE FOR PATIENTS, ESPECIALLY PATIENTS LIVING WITH CHRONIC HEALTH CONDITIONS AFFECTING THEIR VISION. ENHANCED OPTICAL BENEFIT PROGRAM OFFERED TO PN EMPLOYEES TO INCREASE THE AFFORDABILITY OF EYEWEAR. EDUCATED PHYSICIANS AND CARE PROVIDERS ABOUT HEALTH CARE STORES PRODUCT OFFERINGS TO BETTER LINK PATIENT HEALTH CARE NEEDS TO PRODUCT SOLUTIONS, INCLUDING SMOKING CESSATION. DEVELOPMENT OF ADDITIONAL SERVICES IN MAPLE GROVE, HEALTH AND CARE STORE, CPAP, AND ORTHOTICS AND PROSTHETIC SERVICES. EXPANDED PHARMACY SERVICES OFFERED IN THE INFECTIOUS DISEASE DEPARTMENT THROUGH MEDICATION THERAPY MANAGEMENT SERVICES AND DEDICATED RETAIL PHARMACIST ASSIGNED FOR THE DEPARTMENT. EDUCATED PHYSICIANS AND CARE PROVIDER'S ABOUT PHARMACY SERVICES AND PRODUCTS TO BETTER LINK SOLUTIONS FOR PATIENT HEALTH CARE NEEDS. EXPANDED PHARMACY MEDICATION THERAPY MANAGEMENT SERVICES DIRECTLY INTO THE CARE ENVIROMENT TO ASSIST BOTH PROVIDERS AND PATIENTS ALIKE.

4c	(Code: ) (Expenses $ 40,025,073 including grants of $ ) (Revenue $ 39,333,512 )
	PARK NICOLLET HEALTH SERVICES AFFILIATES INCURS EXPENSES ON BEHALF OF AFFILIATED TAX EXEMPT ORGANIZATIONS, PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET CLINIC, PNMC HOLDINGS, PARK NICOLLET HEALTH CARE PRODUCTS, AND PARK NICOLLET INSTITUTE, PROVIDING RENTAL SPACE AND LAB SERVICES TO ITS AFFILIATED ORGANIZATIONS IN ORDER TO ASSURE THE EFFICIENT AND PROFESSIONAL DELIVERY OF HEALTH CARE AND OTHER SERVICES TO THE COMMUNITY AND AIDS IN THE PROVISION OF LOW COST MEDICAL SERVICE.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses1,199,623,439

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,034,575	14,520,342	3,594,365

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	9,713,756
e	Government grants (contributions)		1e	4,332,058

f	All other contributions, gifts, grants, and similar amounts not included above		1f	6,227,512

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		20,273,326

			Business Code
2a	MEDICAL SERVICES	621400	777,721,223	777,721,223
b	MEDICARE/MEDICAID	621400	436,069,865	436,069,865
c	RETAIL SALES	446110	66,191,321	63,403,051	2,782,706	5,564
d	SERVICES TO AFFILIATES	561000	39,333,512	39,333,512
e
f	All other program service revenue.
g Total.Add lines 2a–2f.....			1,319,315,921

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			9,399,007			9,399,007
4 Income from investment of tax-exempt bond proceeds			-18,680			-18,680
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		1,541,845
b	Less: rental expenses		1,208,711
c	Rental income or (loss)		333,134
d	Net rental income or (loss)......			333,134			333,134
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	113,511	148,860,471
b	Less: cost or other basis and sales expenses	151,680	144,957,080
c	Gain or (loss)	-38,169	3,903,391
d	Net gain or (loss).....			3,865,222	-38,169		3,903,391
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a		1,187,864
b	Less: cost of goods sold ..b		325,286
c	Net income or (loss) from sales of inventory..			862,578			862,578
Business Code			Miscellaneous Revenue
11a	PROPERTY MANAGEMENT		812930	3,068,904			3,068,904
b	CAFETERIA		722210	2,855,555			2,855,555
c	MISC SERVICES		722210	36,623			36,623
d	All other revenue ....
e	Total. Add lines 11a–11d ......			5,961,082
12	Total revenue. See Instructions......			1,359,991,590	1,316,489,482	2,782,706	20,446,076

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	123,046	123,046
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	50,000	50,000
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	1,925,377	1,671,304	254,073
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	633,935,615	575,492,289	58,188,578	254,748
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	37,204,632	33,302,563	3,887,308	14,761
9	Other employee benefits .......	72,498,446	63,923,807	8,549,267	25,372
10	Payroll taxes ...........	37,628,866	33,818,424	3,798,735	11,707
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	382,853		382,853
c	Accounting ...........	345,385		345,385
d	Lobbying ...........	87,743		87,743
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	617,995		617,995
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	101,160,757	52,768,676	48,392,081
12	Advertising and promotion ....	3,755,442	151,165	3,604,277
13	Office expenses .......	14,815,903	8,351,069	6,464,834
14	Information technology ......	15,180,365	5,820,271	9,360,094
15	Royalties ..
16	Occupancy ...........	36,490,515	33,416,850	3,073,665
17	Travel ............	1,158,191	926,119	232,072
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	720,580	619,993	100,587
20	Interest ...........	9,443,325	9,443,325
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	55,335,205	49,682,402	5,652,803
23	Insurance ...	7,963,384	7,842,987	120,397
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES AND EQ	178,564,848	175,861,580	2,703,268
b	EXPENSE TO REFINANCE DE	61,089,294	61,089,294
c	COST OF GOOD SOLD	43,444,222	43,444,222
d	BAD DEBT EXPENSE	19,144,181	19,144,181
e	All other expenses	35,773,586	22,679,872	13,093,714
25	Total functional expenses. Add lines 1 through 24e	1,368,839,756	1,199,623,439	168,909,729	306,588
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 ........			441,974	1	414,386
2	Savings and temporary cash investments .........			132,432	2	239,994
3	Pledges and grants receivable, net ......			2,888,077	3	3,074,683
4	Accounts receivable, net .............			140,182,902	4	149,213,342
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
				119	5	12,073
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			11,932,766	8	9,506,067
9	Prepaid expenses and deferred charges ......			8,778,692	9	7,698,705
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,183,643,756
b	Less: accumulated depreciation	10b	780,106,553	347,455,343	10c	403,537,203
11	Investments—publicly traded securities .			570,712,855	11	523,436,528
12	Investments—other securities. See Part IV, line 11 .....			201,021	12	1,538,680
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			30,536,880	15	12,478,179
16	Total assets. Add lines 1 through 15 (must equal line 34)...			1,113,263,061	16	1,111,149,840

17	Accounts payable and accrued expenses .....	71,275,027	17	74,460,873
18	Grants payable ...		18
19	Deferred revenue .........	3,644,827	19	3,238,783
20	Tax-exempt bond liabilities .........	351,015,048	20	366,913,021
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	47,982,602	25	46,082,866
26	Total liabilities. Add lines 17 through 25..	473,917,504	26	490,695,543

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	638,468,291	27	619,694,066
28	Temporarily restricted net assets ...........	595,829	28	478,794
29	Permanently restricted net assets	281,437	29	281,437
	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 ...........	639,345,557	33	620,454,297
34	Total liabilities and net assets/fund balances ........	1,113,263,061	34	1,111,149,840

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No