Form990
Click to see list of attachments
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
A For the 2020 calendar year, or tax year beginning 01-01-2020 , and ending 12-31-2020
BCheck if applicable:
CName of organization
PARK NICOLLET GROUP RETURN
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
6500 EXCELSIOR BLVD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
ST LOUIS PARK, MN55426
D Employer identification number

45-5023260
E Telephone number

G Gross receipts $ 1,721,685,337
F Name and address of principal officer:
STEVEN M CONNELLY MD
6500 EXCELSIOR BLVD
SLP,MN55426
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.PARKNICOLLET.COM
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet5874
K Form of organization:  
L Year of formation:  
M State of legal domicile: MN
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) ...... 5 0
6 Total number of volunteers (estimate if necessary) ............. 6 686
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 12,674,166 58,235,487
9 Program service revenue (Part VIII, line 2g) ......... 1,683,325,963 1,554,710,940
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 22,398,742 15,599,731
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 7,336,298 5,029,476
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,725,735,169 1,633,575,634
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 88,599 34,373
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) 1,079,442,091 1,039,675,898
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet428,459    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 576,157,249 537,298,909
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,655,687,939 1,577,009,180
19 Revenue less expenses. Subtract line 18 from line 12....... 70,047,230 56,566,454
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,328,602,033 1,495,285,312
21 Total liabilities (Part X, line 26)............. 464,832,720 543,591,968
22 Net assets or fund balances. Subtract line 21 from line 20..... 863,769,313 951,693,344
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2020)
Form 990 (2020)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,356,320,735 including grants of $ 34,373 ) (Revenue $ 1,554,710,940 )
SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet1,356,320,735
Form 990 (2020)
Form 990 (2020)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2020)
Form 990 (2020)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
Form 990 (2020)
Form 990 (2020)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
0
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
 
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2020)
Form 990 (2020)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
15
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
MN
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletSHARILYN A CAMPBELL8170 33RD AVE S   BLOOMINGTON,MN55440 (952) 883-5613
Form 990 (2020)
Form 990 (2020)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) JEFF M MENDELOFF MD......................................................................
DIRECTOR
59.00
.................
1.00
X           968,765 0 75,686
(2) RAE ANN WILLIAMS MD......................................................................
DIRECTOR
1.00
.................
54.00
X           0 352,809 46,153
(3) BRAD WOZNEY MD......................................................................
DIRECTOR
2.50
.................
0.00
X           0 30,000 0
(4) SHARON PIERCE......................................................................
DIRECTOR
2.70
.................
0.00
X           0 30,000 0
(5) JAMES MALECHA......................................................................
DIRECTOR & CHAIR
4.20
.................
0.00
X   X       0 50,000 0
(6) THOMAS BRINSKO......................................................................
DIRECTOR
2.90
.................
0.00
X           0 33,000 0
(7) LUZ MARIA FRIAS......................................................................
DIRECTOR
1.00
.................
0.00
X           0 16,250 0
(8) SUSAN HOYT......................................................................
DIRECTOR
2.50
.................
0.00
X           0 33,000 0
(9) MORRIS GOODWIN......................................................................
DIRECTOR
3.00
.................
0.00
X           0 33,000 0
(10) DEBORAH HOPP......................................................................
DIRECTOR
2.60
.................
0.00
X           0 33,000 0
(11) LAURA OBERST......................................................................
DIRECTOR & VICE CHAIR
2.70
.................
0.00
X   X       0 33,000 0
(12) AMY LANGER......................................................................
DIRECTOR
3.10
.................
0.00
X           0 36,000 0
(13) PHILIP DONALDSON......................................................................
DIRECTOR & TREASURER
2.40
.................
0.00
X   X       0 33,000 0
(14) SONDRA SAMUELS......................................................................
DIRECTOR
1.00
.................
0.00
X           0 30,000 0
(15) BRIAN H RANK MD......................................................................
DIRECTOR & MEDICAL DIRECTO
3.20
.................
56.80
X   X       0 1,122,954 302,832
(16) ANDREA M WALSH......................................................................
DIRECTOR & CEO
1.00
.................
59.00
X   X       0 2,001,423 580,224
(17) PAHOUA YANG HOFFMAN......................................................................
DIRECTOR
1.10
.................
0.00
X           0 12,500 0
Form 990 (2020)
Form 990 (2020)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) NATHAN G BLAD........................................................................
OLIVIA PRESIDENT
44.00
.......................1.00
    X       0 173,582 33,152
(19) STEVEN M CONNELLY MD........................................................................
PRESIDENT PNHS
59.00
.......................1.00
    X       0 985,997 158,930
(20) TRICIA L DEGE........................................................................
CFO CARE DELIVERY
20.00
.......................25.00
    X       0 491,096 160,824
(21) NIMA A DESAI MD........................................................................
VP MEDICAL AFFAIRS, CMO
50.00
.......................0.00
    X       0 348,045 43,126
(22) NANCY L EVERT........................................................................
SR VP GENERAL COUNSEL
13.10
.......................41.90
    X       0 488,856 145,290
(23) STEVEN C HOUSH........................................................................
VP ORTHOPEDIC SERVICES
25.00
.......................29.00
    X       0 417,363 57,974
(24) THOMAS A JONES MD........................................................................
SR. MEDICAL DIRECTOR, SURG
59.00
.......................1.00
    X       0 857,194 110,572
(25) KATE E KEIPER........................................................................
VP HUMAN RESOURCES
50.00
.......................0.00
    X       0 329,717 43,602
(26) CATHERINE S KLUGHERZ........................................................................
VP SPECIALTY SERVICES
49.00
.......................1.00
    X       0 401,245 100,761
(27) LAURA A LOBERG........................................................................
VP SURGICAL SERVICES
44.00
.......................1.00
    X       0 394,546 93,380
(28) KRISTI A LYON........................................................................
VP PAYER RELATIONS
49.00
.......................1.00
    X       0 411,975 108,324
(29) JAMES P LYONS........................................................................
HUTCHINSON PRESIDENT
5.00
.......................50.00
    X       0 297,306 70,670
(30) NANCY A MCCLURE........................................................................
CHIEF OPERATING OFFICER
20.50
.......................34.50
    X       0 1,131,428 299,600
(31) JENNIFER L MYSTER........................................................................
METHODIST PRESIDENT
54.50
.......................0.50
    X       0 542,896 114,958
(32) KASEY L PAULUS........................................................................
VP INPATIENT & CNO
49.00
.......................1.00
    X       0 284,634 61,841
(33) JOAN SANDSTROM RN........................................................................
VP PRIMARY CARE
39.00
.......................1.00
    X       0 420,407 91,804
(34) MARK R SANNESMD........................................................................
SR MEDICAL DIRECTOR
64.00
.......................1.00
    X       0 644,347 124,451
(35) MELISSA F SCHOENHERR........................................................................
VP MARKETING AND COMMUNICA
47.00
.......................1.00
    X       0 421,310 82,242
(36) DUANE F SPIEGLE........................................................................
VP REAL ESTATE AND SUPPORT
47.00
.......................1.00
    X       0 361,201 98,596
(37) THOMAS M WALSH MD........................................................................
SR. MEDICAL DIRECTOR ORTHO
49.00
.......................1.00
    X       0 882,383 83,490
(38) MATTHEW T WESTERLUND........................................................................
VP QUALITY AND SAFTEY
54.00
.......................1.00
    X       0 232,247 38,655
(39) JOSHUA O ZIMMERMAN........................................................................
SR MEDICAL DIRECTOR
39.00
.......................1.00
    X       0 516,928 93,840
(40) MICHAEL B SEIM MD........................................................................
MEDICAL AFFAIRS & CMO
39.00
.......................1.00
    X       0 145,703 17,992
(41) GREGORY R HILDEBRAND........................................................................
MEDICAL DOCTOR
70.00
.......................0.00
        X   1,331,387 0 57,647
(42) ROBERT WERLING MD........................................................................
MEDICAL DOCTOR
45.00
.......................0.00
        X   1,091,719 0 76,672
(43) CHRISTINE M PUI........................................................................
MEDICAL DOCTOR
52.00
.......................0.00
        X   1,024,461 0 52,073
(44) KENNETH D OLSEN........................................................................
MEDICAL DOCTOR
55.00
.......................0.00
        X   1,017,085 0 78,896
(45) BRIAN L WALTERS MD........................................................................
MEDICAL DOCTOR
90.00
.......................0.00
        X   946,167 0 76,764
(46) CARA M HULL........................................................................
FORMER VP HUMAN RESOURCES
0.00
.......................40.00
          X 0 449,303 58,535
(47) CATHERINE F LENAGH........................................................................
FORMER VP & CFO
0.00
.......................0.00
          X 0 407,480 14,446
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 6,379,584 15,917,125 3,654,002
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet1,751
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
GROUP HEALTH PLAN INC

8170 33RD AVE S
MINNEAPOLIS,MN55440
ADMINSTRATIVE SERVICES 50,702,777
KNUTSON CONSTRUCTION SERVICES

7515 WAYZATA BLVD
MINNEAPOLIS,MN55426
CONSTRUCTION SERVICES 16,655,883
RJM CONSTRUCTION

830 BOONE AVE N
GOLDEN VALLEY,MN55427
CONSTRUCTION SERVICES 13,027,286
INTEREUM

9800 8TH AVE N
PLYMOUTH,MN55441
STAFFING 4,119,057
HARVARD SERVICES GROUP INC

59 MAIDEN LANE FL17
NEW YORK,NY10038
CLEANING SERVICES 3,623,459
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet75
Form 990 (2020)
Form 990 (2020)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 5,600,471
e Government grants (contributions)1e 52,635,016
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 58,235,487
 Program Service RevenueAmt Business Code
2a MEDICAL SERVICES 621400 1,442,862,312 1,442,862,312    
b SERVICES TO AFFILIATES 561000 78,789,430 78,789,430    
c RETAIL SALES 446110 33,059,198 33,059,198    
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 1,554,710,940
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 9,108,760     9,108,760
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   1,308,264 6a
b Less: rental expenses   810,730 6b
c Rental income or (loss)   497,534 6c
d Net rental income or (loss).......MediumBullet 497,534     497,534
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 159,935 93,563,080 7a
b Less: cost or other basis and sales expenses 615,309 86,616,735 7b
c Gain or (loss) -455,374 6,946,345 7c
d Net gain or (loss).........MediumBullet 6,490,971     6,490,971
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a 96,999
b Less: cost of goods sold .. 10b 66,929
c Net income or (loss) from sales of inventory..MediumBullet 30,070     30,070
Business Code Miscellaneous Revenue
11a PROPERTY MANAGEMENT 812930 2,402,048     2,402,048
b CAFETERIA 722210 1,973,340     1,973,340
c MISC 722210 126,484     126,484
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 4,501,872
12 Total revenue. See instructions.....MediumBullet 1,633,575,634 1,554,710,940 0 20,629,207
Form 990 (2020)
Form 990 (2020)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 34,373 34,373
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 1,044,451 208,890 835,561  
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........ 912,717,981 796,708,822 115,678,050 331,109
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 45,945,053 40,119,855 5,786,258 38,940
9 Other employee benefits ....... 34,543,196 30,126,926 4,396,800 19,470
10 Payroll taxes ........... 45,425,217 39,665,927 5,720,350 38,940
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 280,323   280,323  
c Accounting ........... 138   138  
d Lobbying ........... 26,776   26,776  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 385,607   385,607  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 50,050,707 39,068,916 10,981,791  
12 Advertising and promotion .... 1,131,753 648,906 482,847  
13 Office expenses ....... 9,313,890 5,839,973 3,473,917  
14 Information technology ...... 6,508,192 3,392,232 3,115,960  
15 Royalties ..        
16 Occupancy ........... 39,620,356 31,981,607 7,638,749  
17 Travel ............ 956,532 823,479 133,053  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 120,120 87,008 33,112  
20 Interest ........... 14,087,283 14,087,283    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 68,542,468 57,712,354 10,830,114  
23 Insurance ... 10,898,889 10,898,889    
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 DR 242,987,163 242,357,924 629,239  
b SUBSCRIPTIONS, FEES, DU 36,913,874 10,571,167 26,342,707  
c TRAINING AND EDUCATION 21,792,680 21,786,792 5,888  
d MANAGEMENT FEES 21,315,924   21,315,924  
e All other expenses 12,366,234 10,199,412 2,166,822  
25 Total functional expenses. Add lines 1 through 24e 1,577,009,180 1,356,320,735 220,259,986 428,459
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2020)
Form 990 (2020)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 290,276 1 389,938
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 169,630,985 4 167,864,314
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............ 12,732,222 8 14,575,824
9 Prepaid expenses and deferred charges ...... 3,113,312 9 2,023,608
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,476,759,780
b Less: accumulated depreciation 10b 978,360,070 491,230,785 10c 498,399,710
11 Investments—publicly traded securities . 485,203,983 11 527,996,641
12 Investments—other securities. See Part IV, line 11 ..... 1,709,504 12 1,904,947
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 164,690,966 15 282,130,330
16 Total assets. Add lines 1 through 15 (must equal line 33)... 1,328,602,033 16 1,495,285,312
Liabilities 17 Accounts payable and accrued expenses ..... 66,433,892 17 83,047,401
18 Grants payable ...   18  
19 Deferred revenue ......... 563,594 19 84,305,477
20 Tax-exempt bond liabilities ......... 305,252,865 20 346,215,611
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  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 92,582,369 25 30,023,479
26 Total liabilities. Add lines 17 through 25.. 464,832,720 26 543,591,968
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 863,318,737 27 950,402,283
28 Net assets with donor restrictions ........... 450,576 28 1,291,061
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 863,769,313 32 951,693,344
33 Total liabilities and net assets/fund balances ........ 1,328,602,033 33 1,495,285,312
Form 990 (2020)
Form 990 (2020)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,633,575,634
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,577,009,180
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
56,566,454
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
863,769,313
5
Net unrealized gains (losses) on investments ...............
5
29,263,253
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
2,094,324
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
951,693,344
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2020)
Form 990 (2020)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
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 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
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 failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (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.
6
 
 
7
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 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.
9c
 
 
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
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in 11a above?
11b
 
 
c
A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (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?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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 0.015 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 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2020 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2020
(iii)
Distributable
Amount for 2020
1 Distributable amount for 2020 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2020:
a From 2015.......  
b From 2016.......  
c From 2017.......  
d From 2018.......  
e From 2019.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2020 distributable amount  
i Carryover from 2015 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2020 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2020 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2020, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.
 
6 Remaining underdistributions for 2020. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.
 
7 Excess distributions carryover to 2021. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2016.....  
b Excess from 2017.....  
c Excess from 2018.....  
d Excess from 2019.....  
e Excess from 2020.....  
Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020
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 I PARK NICOLLET METHODIST HOSPITAL LINE 3: 170(B)(1)(A)(III) PARK NICOLLET CLINIC LINE 3: 170(B)(1)(A)(III) PARK NICOLLET HEALTH CARE PRODUCTS LINE 12 TYPE I, 509(A)(3) PNMC HOLDINGS LINE 12 TYPE II, 509(A)(3)
PART I , LINE 12 SUPPORTING ORGANIZATIONS DETAIL: PNMC HOLDINGS AND PARK NICOLLET HEALTH CARE PRODUCTS PROVIDE SUPPORT TO THE FOLLOWING ORGANIZATIONS: PNMC HOLDINGS: LINE 12, COLUMN (I) PARK NICOLLET CLINIC, (II) 41-0834920, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $1,905,278 LINE 12, 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 12, COLUMN (I) PARK NICOLLET METHODIST HOSPITAL, (II) 41-0132080, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $2,701,104 LINE 12, COLUMN (I) PARK NICOLLET CLINIC, (II) 41-0834920, (III) 170(B)(1)(A)(III), (IV) NO, (V) $0, (VI) $23,523,121 LINE 12, 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) 2020


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

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






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2
Name of organization
PARK NICOLLET GROUP RETURN
 
Employer identification number
45-5023260
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
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) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Page 4
Name of organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
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.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

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

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
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) 2020

Schedule C (Form 990 or 990-EZ) 2020
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2017 (b) 2018 (c) 2019 (d) 2020 (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) 2020


Schedule C (Form 990 or 990-EZ) 2020
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|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
75,953
j
Total. Add lines 1c through 1i ....................................................................................................
75,953
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: PARK NICOLLET REIMBURSES GROUP HEALTH 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) 2020


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," 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.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
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 ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB 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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" 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 .... 49,871,951 38,225,552 31,964,574 31,153,525 26,326,063
b Contributions ... 3,300,014 15,200,835 4,218,839 4,637,534 6,201,514
c Net investment earnings, gains, and losses 1,960,935 2,519,420 -457,678 1,952,529 804,937
d Grants or scholarships ... 1,580,281 6,073,856 2,499,817 5,779,014 2,178,989
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ...... 53,552,619 49,871,951 38,225,552 31,964,574 31,153,525
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet27.000 %
c
Term endowment SchDMd Bullet73.000 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .......................
3a(i)
 
No
(ii) Related organizations .......................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" 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 .....   31,168,064 31,168,064
b Buildings ....   793,584,505 451,717,037 341,867,468
c Leasehold improvements   86,487,357 60,566,841 25,920,516
d Equipment ....   554,074,793 466,076,192 87,998,601
e Other .....   11,445,061   11,445,061
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 498,399,710
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 3
Part VII
Investments - Other 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' 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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)INTERCOMPANY RECEIVABLE 230,698,663
(2)RIGHT OF USE ASSET 25,065,398
(3)OTHER ASSETS 26,366,269
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 282,130,330
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  
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 30,023,479
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) 2020

Schedule D (Form 990) 2020
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, AND PARK NICOLLET METHODIST HOSPITAL ARE FOR GRANTS RELATED TO EDUCATION, RESEARCH AND PATIENT CARE.
PART X, LINE 2: 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, 2020 OR 2019 FOR UNRECOGNIZED TAX BENEFITS.
Schedule D (Form 990) 2020


Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

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

4

Yes

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

5a

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
 
No
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
 
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    9,467,780 195,824 9,271,956 0.590 %
b Medicaid (from Worksheet 3, column a) . . . . .     196,078,054 117,927,076 78,150,978 4.960 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     205,545,834 118,122,900 87,422,934 5.550 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     4,252,167 59,266 4,192,901 0.270 %
f Health professions education (from Worksheet 5) . . .     8,009,823 2,848,213 5,161,610 0.330 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .     12,261,990 2,907,479 9,354,511 0.600 %
k Total. Add lines 7d and 7j .     217,807,824 121,030,379 96,777,445 6.150 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
21,055,039
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
136,259,096
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
149,079,878
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-12,820,782
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BLVD
ST LOUIS PARK,MN55426
PARKNICOLLET.COM
385120
PN METHODIST HOSPITAL
410132080
X X   X     X      
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
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):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
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.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): WWW.PARKNICOLLET.COM/COMMUNITYANDVOLUNTEERISM/COMMUNITY-NEEDS-HEALTH
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2020
Schedule H (Form 990) 2020
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 No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTPS://WWW.HEALTHPARTNERS.COM/CONTENT/DAM/HOT/BRAND-IDENTITY/PDFS/CARE/FI
b
HTTPS://WWW.HEALTHPARTNERS.COM/CONTENT/DAM/HOT/BRAND-IDENTITY/PDFS/CARE/FIN
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
PARK NICOLLET METHODIST HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
PARK NICOLLET METHODIST HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24 Yes  
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 8
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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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: BETWEEN 2016 AND 2018, HEALTHPARTNERS AND PARK NICOLLET HEALTH SERVICES, INCLUDING PARK NICOLLET METHODIST HOSPITAL, ENGAGED WITH LOCAL PUBLIC HEALTH PARTNERS IN DAKOTA, HENNEPIN AND SCOTT COUNTIES, AS WELL AS LOCAL COALITIONS, THE CENTER FOR COMMUNITY HEALTH (CCH) AND COMMUNITY PARTNERS TO CONDUCT A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA IDENTIFIES THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS WELL AS MEASURES AND RESOURCES TO ADDRESS THOSE NEEDS. THE RESULTS WILL ENABLE METHODIST HOSPITAL IN COLLABORATION WITH ITS COMMUNITY PARTNERS TO MORE STRATEGICALLY ESTABLISH PRIORITIES, DEVELOP INTERVENTIONS AND DIRECT RESOURCES TO IMPROVE THE HEALTH OF PEOPLE LIVING IN THE COMMUNITY.IN 2018, HEALTHPARTNERS AND PARK NICOLLET HEALTH SERVICES CONTRACTED WITH THE IMPROVE GROUP TO ANALYZE AND REPORT ON DATA DESCRIBING THE COMMUNITY WE SERVE. BECAUSE THE WORK OF METHODIST HOSPITAL IS SO INTEGRATED WITH THE WORK OF THE SYSTEM AS A WHOLE, PARK NICOLLET HEALTH SERVICES HAS ELECTED TO LOOK AT THE HEALTH NEEDS OF ITS SYSTEM SERVICE AREA. HEALTHPARTNERS PROVIDED THE IMPROVE GROUP WITH THE DEFINITIONS OF THE SERVICE AREA, THE INDICATORS TO STUDY FOR THE HEALTH AND DEMOGRAPHIC DATA SUMMARIES AND DATA COLLECTED DURING COMMUNITY CONVERSATIONS. COMMUNITY INPUT WAS COLLECTED IN PARTNERSHIP WITH HEALTHPARTNERS THROUGH COMMUNITY CONVERSATIONS AND MULTIPLE SURVEYS. THE IMPROVE GROUP THEN GATHERED SECONDARY DATA FROM PUBLIC SOURCES, ANALYZED COMMUNITY INPUT DATA AND DEVELOPED SUMMARY REPORTS TO GUIDE A PRIORITIZATION PROCESS.THE HEALTHPARTNERS CHNA TEAM INCLUDED REPRESENTATIVES FROM EACH HEALTHPARTNERS HOSPITAL AND HEALTHPARTNERS LEADERSHIP. IN SEPTEMBER 2018, THE CHNA TEAM MET TO REVIEW THE DATA AND PRIORITIZE THE COMMUNITY HEALTH NEEDS ACROSS THE SYSTEM. HEALTHPARTNERS COLLECTIVELY PRIORITIZED COMMUNITY HEALTH NEEDS USING A PROCESS INFORMED BY THE HANLON METHOD AND OTHER COMMONLY USED PRIORITIZATION METHODS. EACH HOSPITAL SHARED ITS 4 OR 5 PRIORITY TOPIC AREAS AND RATIONALE FOR EACH TOPIC AREA BASED ON: SIZE, SERIOUSNESS, EQUITY, VALUE AND CHANGE. HEALTHPARTNERS CHNA TEAM WORKED IN A THOROUGH, FACILITATED LARGE AND SMALL GROUP PROCESS TO REACH CONSENSUS ON TOP PRIORITIES USING BOTH THE CRITERIA DESCRIBED ABOVE AND COMMUNITY INPUT DATA.
PARK NICOLLET METHODIST HOSPITAL PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES INCLUDED IN THE 2018 HEALTHPARTNERS CHNA WERE:- AMERY REGIONAL MEDICAL CENTER, AMERY, WI- HUDSON HOSPITAL, INC., HUDSON, WI- LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, STILLWATER, MN- REGIONS HOSPITAL, ST. PAUL, MN- WESTFIELDS HOSPITAL, INC. NEW RICHMOND, WIPARK NICOLLET METHODIST HOSPITAL:PART V, SECTION B, LINE 6B: PARK NICOLLET FOUNDATION AND PARK NICOLLET CLINICPARK NICOLLET METHODIST HOSPITAL:
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 METHODIST HOSPITAL'S BOARD APPROVED THE IMPLEMENTATION STRATEGY FOR PARK NICOLLET METHODIST HOSPITAL IN FALL 2018. A COPY OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY IS POSTED ON THE HEALTHPARTNERS WEBSITE ATHTTPS://WWW.HEALTHPARTNERS.COM/CONTENT/DAM/HOT/BRAND-IDENTITY/PDFS/CARE/2018-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-IMPLEMENTATION-PLAN.PDF
PARK NICOLLET METHODIST HOSPITAL PART V, SECTION B, LINE 11: THE 2018 HEALTHPARTNERS CHNA PROCESS IDENTIFIED THE FOLLOWING SYSTEM-WIDE PRIORITIES, WHICH PARK NICOLLET METHODIST HOSPITAL THEN CUSTOMIZED THROUGH ITS OWN IMPLEMENTATION PLAN. COMPLETED ACTIONS IN 2020 ARE LISTED AFTER EACH PRIORITY.PRIORITY 1: ACCESS TO CARE PNC OUTPATIENT BH BEGAN OFFERING TELEPHONE AND TELEVIDEO VISITS IN MARCH 2020. COMMUNITY-BASED PALLIATIVE CARE HAS BEEN OPERATIONAL THROUGHOUT 2020 DESPITE THE PANDEMIC. IMPLEMENTATION OF TELEHEALTH SUPPORT WAS CRITICAL TO THE SUCCESS OF THIS PROGRAM DURING THE PANDEMIC. ANNUAL BENEFITS TO SUPPORT THE MAMMO A GO GO PROGRAM CONTINUE TO BE HELD IN OCTOBER AND IN 2020 THIS EVENT WAS VIRTUAL TO ADHERE TO COVID-19 GUIDELINES. THE PROGRAM DID HAVE TO PAUSE FOR A BIT DURING 2020 DUE TO COVID-19, BUT IS UP AND RUNNING AT FULL CAPACITY ONCE AGAIN. PRIMARY CARE INCREASED EXTENDED HOURS AT ALL LOCATIONS. INCREASED VIRTUAL PATIENT CARE OPTIONS THROUGHOUT ALL CLINIC LOCATIONS. CONTINUED TO SUPPORT EXISTING PARK NICOLLET SCHOOL-BASED HEALTH CENTERS PROVIDING FREE OR LOWCOST MEDICAL, DENTAL AND VISION SERVICES TO YOUTH IN NEED. 2,589 CHILDREN AND YOUTH PROVIDED CARE, 3,312 HEALTH NEEDS ADDRESSED, AND 754 IMMUNIZATIONS PROVIDED, DESPITE PANDEMIC IMPACT. PROVIDED SCHOOL CLINIC HOURS AND VIRTUAL CARE AS NEED IN PARTNERSHIP WITH THE FOUR SBHC SCHOOL DISTRICTS. PROVIDED $15,000 TO STEP FOR TRANSPORTATION DURING COVID PANDEMIC AND FOOD SUPPORT.PRIORITY 2: ACCESS TO HEALTH ADDED CULTURALLY DIVERSE BOARD MEMBERS TO OUR GRANT COMMITTEE. PROVIDED FOOD SUPPORT AND PPE DONATIONS TO THE BURNSVILLE SCHOOL DISTRICT. $16,000 GRANT TO PORTICO HEALTHNET TO ASSIST WITH HEALTH INSURANCE NAVIGATION IN OUR SBHC COMMUNITIES OF RICHFIELD AND BROOKLYN CENTER. $55,000 GRANT TO CHILDREN'S DENTAL SERVICES TO PROVIDE DENTAL CARE IN THESE HIGH NEED AREAS AS WELL. $11,000 GRANTS EACH TO BROOKLYN CENTER AND RICHFIELD SCHOOL DISTRICTS TO COORDINATE CARE AND INCREASE ACCESS FOR EQUITABLE CARE.PRIORITY 3: MENTAL HEALTH AND WELLBEING PROVIDED TRAINING IN JANUARY 2020 SO OUR STAFF CAN BETTER ASSESS AND DIAGNOSE PTSD IN PATIENTS. WE WILL BE IMPLEMENTING A STANDARDIZED PROCESS FOR THIS DURING OUR INTAKE PROCESS. BETWEEN MARCH AND JUNE WE HAVE CLOSE TO 30 PROVIDERS BEING TRAINED IN 4 DIFFERENT EVIDENCE BASED TREATMENTS FOR PTSD SO WE CAN PROVIDE CO-OCCURRING TREATMENT FOR OUR PATIENTS WITH BOTH EATING DISORDERS AND PTSD. FOUNDATION AND COMMUNITY STAFF SERVE ON CCH CACI COMMITTEE TO PROMOTE AND BROADEN MAKE IT OK. NEW REPLACEMENT MENTAL HEALTH MODULES FOR BEATING THE BLUES LAUNCHED. STAFF CONTINUE TO SERVE ON THE CENTER FOR COMMUNITY HEALTH COLLECTIVE ACTION COMMITTEE, CONDUCTED TRAINING FOR HP BCSN STAFF ON ACES. GROWING THROUGH GRIEF (GTG) PROGRAM EXPANSION TO SOUTH WASHINGTON COUNTY (BY REGIONS FOUNDATION SUPPORT) AND NEW RICHMOND, WI SCHOOLS (BY WESTFIELDS HOSPITAL FINANCIAL SUPPORT). IMPLEMENTED AND OPERATIONAL IN 2020. INCREASE TRAINING MODULES ON GRIEF SENSITIVITY AND CONDUCTED TRAINING FOR 500 SCHOOL STAFF, COMMUNITY MEMBERS, LAW ENFORCEMENT ETC. CONDUCTED NATIONAL PILOT WITH SCHOOL DISTRICT IN TEXAS, PROVING THE VALUE OF ONLINE SERVICE MODULES FOR GTG CURRICULUM. GTG NOW IN 95 SCHOOLS AND 15 SCHOOL DISTRICTS. NOW! (NO OBSTACLES TO WELL BEING!) TELEHEALTH PROGRAM SERVED 58 STUDENTS AND CONTINUED TO OPERATE FOR STUDENTS DURING THE PANDEMIC, MOVING FROM THE SCHOOL LOCATION TO PHONES, HOME COMPUTERS, OR WHEREVER THE STUDENTS WERE ABLE. SLP MENTAL HEALTH COLLABORATIVE PROVIDED ONE CITYWIDE MEDITATION EVENT, IMPACTED 1,096 RESIDENTS, PROVIDED MENTAL HEALTH TOOLS TO 296 PEOPLE, DISTRIBUTED 70 STRESS RELIEF FACE MASKS/PARK ART TO CHILDREN.PRIORITY 4: SUBSTANCE ABUSE IN 2020, OVER 1,000 MEDICINE DISPOSAL PACKET WERE DISTRIBUTED AND USED BY HOSPICE PATIENTS/FAMILIES. THESE PACKETS ARE USED AT THE TIME OF HOSPICE ADMISSION TO DISPOSE OF MEDICINES NO LONGER NEEDED BY THE PATIENT AND AT THE TIME OF THE PATIENT'S DEATH. THIS DIMINISHES THE AMOUNT OF CONTROLLED SUBSTANCES AVAILABLE IN THE COMMUNITY.PRIORITY 5: NUTRITION AND PHYSICAL ACTIVITY PROVIDED $15,000 GRANT TO BURNSVILLE BRAINPOWER IN A BACKPACK -THEIR ELEMENTARY SCHOOL EMERGENCY FOOD PROGRAM. BUILT AWARENESS AND RELATIONSHIPS WITH PN SOCIAL WORKERS AND EPIC TAB FOR HUNGER SOLUTIONS.A FULL REPORT OF PARK NICOLLET METHODIST'S 2018 CHNA AND IMPLEMENTATION PLAN IS POSTED ON THE HEALTHPARTNERS WEBSITE AT HTTPS://WWW.HEALTHPARTNERS.COM/CONTENT/DAM/HOT/BRAND-IDENTITY/PDFS/CARE/2019-2021-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-IMPLEMENTATION-PLAN.PDF, WHICH PROVIDES A DETAILED DESCRIPTION OF ALL THE ACTIVITIES.
PARK NICOLLET METHODIST HOSPITAL PART V, SECTION B, LINE 13B: IN ACCORDANCE WITH OUR AGREEMENT WITH THE MINNESOTA 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 PAYER. THE DISCOUNT FOR 2020 WAS 35.6% OF GROSS CHARGES. PATIENTS WHO RECEIVE THIS DISCOUNT ARE ALSO ELIGIBLE FOR OUR FAP PROGRAM BASED ON FPL.
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.
PART V, SECTION B, LINE 3E PARK NICOLLET ADDRESSES THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY THROUGH OUR CHNA.
PART V SECTION C LINE 20 PARK NICOLLET DOES NOT PERFORM ANY ECAS (EXTRAORDINARY COLLECTION ACTIONS), THEREFORE WE WOULD NOT GIVE A PATIENT A WRITTEN NOTICE OF DOING SO.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 9
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?41
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 2 - PARK NICOLLET MELROSE CENTER
3525 MONTEREY DRIVE
ST LOUIS PARK,MN55416
EATING DISORDER CLINIC/GENERAL MEDICAL
3 3 - 3900 CLINICAMBULATORY SURGICAL CENTER
3900 PARK NICOLLET BOULEVARD
ST LOUIS PARK,MN55416
AMBULATORY SURGICAL CENTER AND GENERAL MEDICAL AND RETAIL
4 4 - MEADOWBROOK MEDICAL BUILDING
3931 LOUISIANA AVE S
ST LOUIS PARK,MN55426
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
5 5 - PRAIRIE CENTER
8455 FLYING CLOUD DRIVE
EDEN PRAIRIE,MN55344
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
6 6 - BLOOMINGTON CLINIC
5320 HYLAND GREENS DRIVE
BLOOMINGTON,MN55437
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
7 7 - BROOKDALE CLINIC
6000 EARLE BROWN DRIVE
BROOKLYN CENTER,MN55430
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
8 8 - BURNSVILLE CLINIC
14000 FAIRVIEW DRIVE
BURNSVILLE,MN55337
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
9 9 - CARLSON PARKWAY CLINIC
15111 TWELVE OAKS CENTER DRIVE
MINNETONKA,MN55305
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
10 10 - CHANHASSEN CLINIC
300 LAKE DRIVE E
CHANHASSEN,MN55317
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
11 11 - CREEKSIDE
6600 EXCELSIOR BLVD
ST LOUIS PARK,MN55426
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
12 12 - ST LOUIS PARK IMAGING CENTER
4951 EXCELSIOR BLVD
ST LOUIS PARK,MN55416
IMAGING CENTER/OPTICAL RETAIL
13 13 - EAGAN CLINIC
1885 PLAZA DRIVE
EAGAN,MN55122
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
14 14 - GOLDEN VALLEY CLINIC
8240 GOLDEN VALLEY DRIVE
GOLDEN VALLEY,MN55427
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
15 15 - LAKEVILLE CLNIC
18432 KENRICK AVE
LAKEVILLE,MN55044
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
16 16 - MAPLE GROVE SURGERY CENTER
15800 95TH AVE N
MAPLE GROVE,MN55369
AMBULATORY SURGICAL CENTER
17 17 - MAPLE GROVE OB
9855 HOSPITAL DRIVE SUITE 275
MAPLE GROVE,MN55369
OB SERVICES
18 18 - MAPLE GROVE REHAB
15301 GROVE CIRCLE
MAPLE GROVE,MN55369
REHABILIATION SERVICES
19 19 - MINNEAPOLIS CLINIC
2001 BLAISDELL AVE S
MINNEAPOLIS,MN55404
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
20 20 - PLYMOUTH CLINIC
4155 COUNTY ROAD 101
PLYMOUTH,MN55446
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
21 21 - PRIOR LAKE CLINIC
4670 PARK NICOLLET AVE SE
PRIOR LAKE,MN55372
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
22 22 - SHAKOPEE CLINIC
1415 ST FRANCIS AVE
SHAKOPEE,MN55379
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
23 23 - SHAKOPEE MOB PN SPECIALITY SUITE
1515 ST FRANCIS AVE
SHAKOPEE,MN55379
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
24 24 - SHAKOPEE MOB ORTHO NEURO CENTER
1601 ST FRANCIS AVE
SHAKOPEE,MN55379
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
25 25 - ST LOUIS PARK CLINIC
3800 PARK NICOLLET BLVD
ST LOUIS PARK,MN55416
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
26 26 - ST LOUIS PARK CLINIC
3850 PARK NICOLLET BLVD
ST LOUIS PARK,MN55416
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
27 27 - WAYZATA MEDICAL BUILDING
250 CENTRAL AVE N
WAYZATA,MN55391
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES AND MEDICAL RETAIL
28 28 - ROGERS CLINIC
13688 ROGERS DRIVE
ROGERS,MN55374
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES
29 29 - CHAMPLIN CLINIC
12142 BUSINESS PARK BLVD N
CHAMPLIN,MN55316
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES
30 30 - BURNSVILLE PEDIATRIC REHAB SERVICES
RIDGEPOINT MEDICAL BUILDING
BURNSVILLE,MN55337
PEDIATRIC REHAB SERVICES
31 31 - BURNSVILLE BEHAVIORAL HEALTH
675 NICOLLET BLVD E
BURNSVILLE,MN55337
BEHAVIORAL HEALTH SERVICES
32 32 - MELROSE CENTER ST PAUL
2550 UNIVERSITY AVE W
ST PAUL,MN55114
EATING DISORDER CLINIC/GENERAL MEDICAL
33 33 - MELROSE CENTER MAPLE GROVE
9600 UPLAND LANE N SUITE 110
MAPLE GROVE,MN55369
EATING DISORDER CLINIC/GENERAL MEDICAL
34 34 - MAPLE GROVE REGIONAL SPECIALITY CENTER
9555 UPLAND LANE N
MAPLE GROVE,MN55369
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES
35 35 - AIRPORT PROFESSIONAL BUILDING
7550 34TH AVE SOUTH
MINNEAPOLIS,MN55450
NURSE CALL CENTER, AND DERMATOLOGY
36 36 - BURNSVILLE RIDGES SPECIALITY CENTER
14101 FAIRVIEW DRIVE STE 420
BURNSVILLE,MN55337
OB SERVICES
37 37 - SHAKOPEE RETAIL CENTER
1455 ST FRANCIS AVE
SHAKOPEE,MN55379
MEDICAL RETAIL
38 38 - BURNSVILLE REHAB
14451 GRAND AVE S
BURNSVILLE,MN55306
REHABILIATION SERVICES
39 39 - 5400 SPECIALITY BUILDING
5400 EXCELSIOR BLVD
ST LOUIS PARK,MN55416
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES
40 40 - BURNSVILLE MELROSE
675 NICOLLET BLVD E
BURNSVILLE,MN55337
EATING DISORDER CLINIC
41 41 - BURNSVILLE SPECIALITY & SURGERY CENTER
14000 FAIRVIEW DRIVE
BURNSVILLE,MN55337
PHYSICIAN OFFICES, ANCILLARY MEDICAL SERVICES
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page 10
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 PAYER. THIS DISCOUNT FOR 2020 WAS 35.6% OF GROSS CHARGES. PATIENTS WHOSE RECEIVE THIS DISCOUNT ARE ALSO ELIGIBLE FOR OUR FAP PROGRAM BASED ON FPL.
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 CALCULATING WHAT PORTION OF THAT WILL NOT BE COLLECTED BASED HISTORICAL UNCOLLECTABLE RATES. WHEN A PATIENT MEETS OUR FINANCIAL 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, AND ALLOWANCE OF DOUBTFUL ACCOUNTS. THE FOOTNOTE IS LOCATED ON PAGE 24 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 $160.0 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 PATIENTS VIA STATEMENTS, LETTERS AND AS PART OF COLLECTION CALLS TO AND FROM PATIENTS 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 PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, COLLECTION EFFORTS CEASE AND CHARGES ARE CLEARED FROM THEIR ACCOUNT.
PART VI, LINE 2: IN 2018, WE WERE PART OF A COMPREHENSIVE, COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") THAT INCLUDED ALL THE HOSPITALS IN THE HEALTHPARTNERS SYSTEM. THE ASSESSMENT ANALYZED HEALTH DATA AND INPUT FROM COMMUNITY MEMBERS TO IDENTIFY THE BIGGEST NEEDS. FINAL PRIORITIZED NEEDS ACCESS TO CARE ACCESS TO HEALTH MENTAL HEALTH AND WELLBEING SUBSTANCE ABUSE NUTRITION AND PHYSICAL ACTIVITYA FULL REPORT OF PARK NICOLLET METHODIST'S CHNA AND IMPLEMENTATION PLAN IS POSTED ON PARK NICOLLET'S WEBPAGE AT HTTP://WWW.PARKNICOLLET.COM/COMMUNITYANDVOLUNTEERISM/COMMUNITY-NEEDS-HEALTH-ASSESSMENTIN ADDITION TO CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENTS, PARK NICOLLET HAS SEVERAL MEANS OF ASSESSING THE HEALTH CARE NEEDS OF THE POPULATION WE SERVE:CONVENING/PARTICIPATING IN ONGOING COMMUNITY COLLABORATIVE 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.-WEST METRO CHNA COLLABORATIVE-DAKOTA COUNTY HEALTHY COMMUNITIES COLLABORATIVE-HMONG COMMUNITY STROKE EDUCATION AND AWARENESS INITIATIVE-MINNESOTA DEPARTMENT OF HEALTH HEALTHY MINNESOTA PARTNERSHIP-MINNESOTA DEPARTMENT OF HEALTH MENTAL WELL-BEING & RESILIENCE LEARNING COMMUNITY-COMMUNITY HEALTH ACTION TEAM (CHAT)-CATHOLIC CHARITIES HIGHER GROUND STEERING COMMITTEE-RACIAL EQUITY ACTION SUPPORT NETWORK (REASN)-HEALTHCARE FOR THE HOMELESS-SCOTT COUNTY HEALTH SYSTEM COLLABORATIVE-NORTHWEST HENNEPIN HEALTHY COMMUNITY PARTNERSHIP-DAKOTA COUNTY SCHOOL MENTAL HEALTH PRACTICE GROUP-CENTRAL CLINIC ADVISORY COMMITTEE-SHIP COMMUNITY LEADERSHIP TEAMPARK NICOLLET FOUNDATION ANNUALLY SOLICITS GRANT APPLICATIONS FROM COMMUNITY NON-PROFITS. A KEY COMPONENT OF THE APPLICATION PROCESS ASKS APPLICANTS TO IDENTIFY AND QUANTIFY THE HEALTH CARE-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.
PART VI, LINE 3: 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: PATIENTS AT THE HOSPITAL ARE OFFERED OUR FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY AT THE TIME OF CHECK-IN.HOSPITAL BOOKLETS OR INFORMATION PACKETS GIVEN TO EMERGENCY CENTER PATIENTS AND INPATIENTS.WEB SITE HAS FA INFORMATION FOUND UNDER PATIENT ACCOUNTS AND BILLING. OUR FINANCIAL ASSISTANCE APPLICATION OUR FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY (PLS) OUR FINANCIAL ASSISTANCE POLICYALL BALANCE FORWARD STATEMENTS, WITH A BALANCE OF $200 OR GREATER AND NOT ALREADY ON A PAYMENT PLAN, INCLUDE AN FA APPLICATION AND INSTRUCTION TO COMPLETE THE APPLICATION ALONG WITH ANSWERS TO FREQUENTLY ASKED QUESTIONS ABOUT THE FA PROGRAM.IN ADDITION TO THE WRITTEN MATERIAL, CUSTOMER SERVICE, COLLECTIONS, FINANCIAL COUNSELORS AND ACCOUNT SPECIALISTS INFORM PATIENTS ABOUT ASSISTANCE OPTIONS, INCLUDING GOVERNMENT PROGRAMS AND FA. MOST CUSTOMER SERVICE AND COLLECTION WORK IS DONE OVER THE PHONE, THOUGH MANY OF OUR CLINICS AND THE HOSPITAL HAVE STAFF ON SITE TO ASSIST IN APPLYING FOR FA AND GOVERNMENT PROGRAMS. OUR THIRD PARTY COLLECTION AGENCIES ARE ALSO TRAINED TO INFORM PATIENTS ABOUT OUR FINANCIAL ASSISTANCE PROGRAM. WE ALSO CONTRACT WITH OUTSIDE SERVICES TO ASSIST PATIENTS IN THE GOVERNMENT PROGRAM APPLICATION PROCESS 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, PARK NICOLLET HEALTH CARE PRODUCTS, HUTCHINSON HEALTH AND TRIA ORTHOPAEDIC CENTER, LLC. PARK NICOLLET HEALTH SERVICES ACCOUNTABLE CARE ORGANIZATION, LLC, WAS ORGANIZED AS AN LLC IN 2018, FOR WHICH PNC IS THE SOLE MEMBER. PARK NICOLLET HAS OVER 8,200 EMPLOYEES, INCLUDING MORE THAN 1,200 PHYSICIANS. 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 MORE THAN 30 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 ORTHOPAEDIC CARE.WHILE PARK NICOLLET HEALTH SERVICES SERVES PATIENTS FROM EVERYWHERE, 75 PERCENT OF OUR PATIENTS LIVE IN DAKOTA, HENNEPIN AND SCOTT COUNTIES IN MINNESOTA. PARK NICOLLET METHODIST HOSPITAL IS LOCATED IN THE CITY OF ST. LOUIS PARK IN HENNEPIN COUNTY. THESE THREE COUNTIES THAT MAKE UP OUR COMMUNITY HAVE 2.4 MILLION PEOPLE. IN 2017, NEARLY 600,000 PATIENTS LIVING IN THESE COUNTIES RECEIVED CARE FROM PARK NICOLLET HEALTH SERVICES.THE MEDIAN AGE OF OUR COMMUNITY IS BETWEEN 35 AND 38 YEARS OLD. ABOUT 1 IN 4 PEOPLE IN OUR COMMUNITY IS UNDER 18, AND 1 IN 6 PEOPLE IN OUR COMMUNITY IS OVER 65. SCOTT COUNTY HAS A HIGHER PERCENTAGE OF PEOPLE UNDER AGE 18 AND A LOWER PERCENTAGE OF PEOPLE OVER AGE 65 THAN THE OTHER COUNTIES AND THE STATE AVERAGE.PEOPLE OF COLOR ARE DISPROPORTIONATELY IMPACTED BY SOCIAL AND ENVIRONMENTAL CONDITIONS THAT AFFECT HEALTH. HENNEPIN COUNTY IS MORE RACIALLY DIVERSE THAN THE REST OF THE STATE, WITH 27 PERCENT OF HENNEPIN COUNTY RESIDENTS IDENTIFYING AS A RACE OTHER THAN WHITE. IN COMPARISON, 16 PERCENT OF PEOPLE IN DAKOTA AND SCOTT COUNTIES IDENTIFY AS A RACE OTHER THAN WHITE. BETWEEN 5 AND 7 PERCENT OF PEOPLE IN OUR COMMUNITY IDENTIFY AS HISPANIC OR LATINO.PEOPLE WHO ARE EXPERIENCING POVERTY FACE HEALTH DISPARITIES. PEOPLE WHO LIVE IN HOUSEHOLDS EARNING AT OR BELOW 200 PERCENT OF THE FEDERAL POVERTY LEVEL (FPL) ARE CONSIDERED LOW INCOME. IN OUR COMMUNITY, POVERTY IS MORE CONCENTRATED IN HENNEPIN COUNTY, WITH 26 PERCENT OF RESIDENTS AND 33 PERCENT OF CHILDREN LIVING IN LOW INCOME HOUSEHOLDS. WHILE RATES ARE HIGHER IN HENNEPIN COUNTY, MORE THAN 1 IN 5 PEOPLE IN THE COMMUNITY WE SERVE ARE CURRENTLY LIVING IN LOW INCOME HOUSEHOLDS. ACROSS OUR COMMUNITY, THE PERCENTAGE OF PEOPLE OF COLOR IN POVERTY IS 3 TO 4 TIMES HIGHER THAN THAT OF PEOPLE WHO IDENTIFY AS WHITE.AN INDIVIDUAL'S EDUCATION LEVEL CAN IMPACT THEIR ABILITY TO BE HEALTHY. PEOPLE WITH LESS THAN A HIGH SCHOOL EDUCATION ARE MORE LIKELY TO EXPERIENCE HEALTH DISPARITIES THAN PEOPLE WITH HIGHER EDUCATION LEVELS. HIGHER LEVELS OF EDUCATION ARE ALSO STRONGLY ASSOCIATED WITH HIGHER INCOMES. IN OUR COMMUNITY, 8 IN 10 STUDENTS GRADUATE FROM HIGH SCHOOL IN FOUR YEARS. HOWEVER, SIGNIFICANT DISPARITIES EXIST BY RACE. IN HENNEPIN COUNTY, ONLY 6 IN 10 STUDENTS WHO IDENTIFY AS BLACK OR HISPANIC GRADUATE IN FOUR YEARS. ACROSS OUR COMMUNITY, FOUR-YEAR GRADUATION RATES ARE LOWEST AMONG STUDENTS WHO IDENTIFY AS AMERICAN INDIAN; THESE RATES RANGE FROM 35 PERCENT IN HENNEPIN COUNTY TO 58 PERCENT IN SCOTT COUNTY.
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 THE BUSINESS OF RUNNING A LARGE HEALTH CARE 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 AND 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 NEXT GENERATION ACCOUNTABLE CARE ORGANIZATION PROGRAM 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 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 2018, PARK NICOLLET FOUNDATION GRANTED $6.3 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 2020, WE OFFERED NO-CHARGE HEALTH CARE TO CHILDREN FROM INFANCY THROUGH HIGH SCHOOL GRADUATION AT OUR SCHOOL-BASED HEALTH CENTERS IN BROOKLYN CENTER, BURNSVILLE, RICHFIELD, 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 IN 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 SPONSORED COMMUNITY COLLABORATIVE - 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 COLLABORATIVEMEADOWBROOK COLLABORATIVENORTHWEST HENNEPIN HEALTHY COMMUNITY PARTNERSHIPST. LOUIS PARK SUCCESSFUL AGING INITIATIVESCOTT COUNTY HEALTHY COMMUNITY COLLABORATIVETHE 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.INNOVATION AND RESEARCH - 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.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.VOLUNTEER SERVICES AS A PART OF THE FOUNDATION, PARK NICOLLET VOLUNTEER SERVICES SUPPORTS AND MANAGES VOLUNTEERS TO ENHANCE PATIENT CARE ACROSS ALL OF PARK NICOLLET HEALTH SERVICES. MORE THAN 700 VOLUNTEERS PROVIDED 43,289 HOURS OF SERVICE. COMMUNITY PARTNERSHIP - PARK NICOLLET FOUNDATION PARTNERS WITH PARK NICOLLET HEALTH SERVICES, 14 SCHOOL DISTRICTS, 82 PUBLIC SCHOOLS AND AREA NONPROFITS TO ADDRESS UNMET HEALTH NEEDS AND IMPROVE ACCESS TO CARE. PATIENT AND FAMILY EXPERIENCE - PARK NICOLLET FOUNDATION BRINGS ENHANCED CARE TO PARK NICOLLET CLINICS, SPECIALTY CENTERS AND METHODIST HOSPITAL BY PARTNERING TO GIVE PEOPLE THE SAFE AND CARING ENVIRONMENT THEY NEED TO HEAL, THROUGH THE FOLLOWING PROGRAMS: GROWING THROUGH GRIEF - A SCHOOL-SUPPORT PROGRAM FOR CHILDREN AND TEENS WHO HAVE EXPERIENCED THE DEATH OF A FAMILY MEMBER OR FRIEND. MAMMO A-GO-GO COMMUNITY OUTREACH PROGRAM - OUR MOBILE MAMMO A-GO-GO COMMUNITY OUTREACH PROGRAM PROVIDES NO-FEE BREAST CANCER SCREENING, DIAGNOSTIC SERVICES AND EDUCATION TO WOMEN IN NEED IN OUR COMMUNITY. SCHOOL-BASED HEALTH RESOURCE CENTERS - PROVIDING NO-FEE SCHOOL-BASED MEDICAL CARE TO CHILDREN AND YOUTH FROM BIRTH THROUGH HIGH SCHOOL GRADUATION AT FOUR CENTER LOCATIONS. NOW!(NO OBSTACLES TO WELL-BEING) - SCHOOL BASED TELEMENTAL HEALTH PROVIDED NO FEE MENTAL HEALTH SERVICES, VIA SECURE VIDEO, IN THREE SCHOOL DISTRICTS. SUPPORT IS PROVIDED TO STUDENTS STRUGGLING WITH ANXIETY, DEPRESSION, COMPLEX GRIEF, FAMILY DYSFUNCTION, TRAUMA AND MORE.
PART VI, LINE 6: PARK NICOLLET METHODIST HOSPITAL IS PART OF PARK NICOLLET HEALTH SERVICES, AN INTEGRATED HEALTH SYSTEM. OTHER AFFILIATES INCLUDE 1) PARK NICOLLET CLINIC IN MORE THAN 30 CLINICS, 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 HEALTH CARE PRODUCTS, PROVIDING RETAIL PHARMACY AND HEALTH RELATED PRODUCTS THROUGH EXISTING PARK NICOLLET LOCATIONS, 4) TRIA ORTHOPAEDIC CENTER, LLC, A LEADER IN ORTHOPAEDIC TREATMENT, PROVIDING COMPREHENSIVE CARE FROM DIAGNOSIS, TO TREATMENT, TO REHABILITATION.THE SAME GROUP OF PEOPLE SERVE AS THE DIRECTORS FOR THE BOARD OF EACH OF THE AFFILIATES, EXCEPT THAT PARK NICOLLET FOUNDATION IS GOVERNED BY A DIFFERENT GROUP OF PEOPLE. EACH AFFILIATE FOCUSES ON MEETING COMMUNITY HEALTH NEEDS AND DECISIONS REGARDING THE EFFECTIVE USE OF RESOURCES TO RESPOND TO THESE NEEDS ARE COORDINATED. A SPECIFIC EXAMPLE OF THIS COORDINATION OF SERVICES TO RESPOND TO COMMUNITY NEED IS WITH THE FOUR SCHOOL-AFFILIATED COMMUNITY CLINICS. INITIAL DEVELOPMENT, FUNDING AND ONGOING FACILITATION IS PROVIDED BY PARK NICOLLET 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 (Form 990) 2020
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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number
45-5023260
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" 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
noncash assistance
(h) Purpose of grant
or assistance
(1) NATIONAL EATING DISORDERS ASSOCIATION
1500 BROADWAY ST E 1101
NEW YORK,NY10036
13-3444882 501(C)(3) 12,500       PROGRAM SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020

Schedule I (Form 990) 2020
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
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(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) 2020



Additional Data


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1ANDREA M WALSH
DIRECTOR & CEO
(i)

(ii)
0
-------------
1,327,906
0
-------------
496,699
0
-------------
176,818
0
-------------
521,444
0
-------------
58,780
0
-------------
2,581,647
0
-------------
152,088
2NANCY A MCCLURE
CHIEF OPERATING OFFICER
(i)

(ii)
0
-------------
612,331
0
-------------
130,736
0
-------------
388,361
0
-------------
252,550
0
-------------
47,050
0
-------------
1,431,028
0
-------------
288,293
3BRIAN H RANK MD
DIRECTOR & MEDICAL DIRECTO
(i)

(ii)
0
-------------
646,676
0
-------------
136,357
0
-------------
339,921
0
-------------
255,904
0
-------------
46,928
0
-------------
1,425,786
0
-------------
263,482
4GREGORY R HILDEBRAND
MEDICAL DOCTOR
(i)

(ii)
1,287,675
-------------
0
0
-------------
0
43,712
-------------
0
26,185
-------------
0
31,462
-------------
0
1,389,034
-------------
0
0
-------------
0
5ROBERT WERLING MD
MEDICAL DOCTOR
(i)

(ii)
1,044,352
-------------
0
0
-------------
0
47,367
-------------
0
26,185
-------------
0
50,487
-------------
0
1,168,391
-------------
0
0
-------------
0
6STEVEN M CONNELLY MD
PRESIDENT PNHS
(i)

(ii)
0
-------------
623,991
0
-------------
277,973
0
-------------
84,033
0
-------------
102,325
0
-------------
56,605
0
-------------
1,144,927
0
-------------
67,220
7KENNETH D OLSEN
MEDICAL DOCTOR
(i)

(ii)
831,638
-------------
0
0
-------------
0
185,447
-------------
0
26,185
-------------
0
52,711
-------------
0
1,095,981
-------------
0
0
-------------
0
8CHRISTINE M PUI
MEDICAL DOCTOR
(i)

(ii)
1,020,081
-------------
0
0
-------------
0
4,380
-------------
0
26,185
-------------
0
25,888
-------------
0
1,076,534
-------------
0
0
-------------
0
9JEFF M MENDELOFF MD
DIRECTOR
(i)

(ii)
894,634
-------------
0
7,258
-------------
0
66,873
-------------
0
26,185
-------------
0
49,501
-------------
0
1,044,451
-------------
0
0
-------------
0
10BRIAN L WALTERS MD
MEDICAL DOCTOR
(i)

(ii)
815,657
-------------
0
0
-------------
0
130,510
-------------
0
26,185
-------------
0
50,579
-------------
0
1,022,931
-------------
0
0
-------------
0
11THOMAS A JONES MD
SR. MEDICAL DIRECTOR, SURG
(i)

(ii)
0
-------------
704,449
0
-------------
81,036
0
-------------
71,709
0
-------------
69,024
0
-------------
41,548
0
-------------
967,766
0
-------------
41,480
12THOMAS M WALSH MD
SR. MEDICAL DIRECTOR ORTHO
(i)

(ii)
0
-------------
768,248
0
-------------
91,285
0
-------------
22,850
0
-------------
26,185
0
-------------
57,305
0
-------------
965,873
0
-------------
0
13MARK R SANNESMD
SR MEDICAL DIRECTOR
(i)

(ii)
0
-------------
455,092
0
-------------
98,221
0
-------------
91,034
0
-------------
71,750
0
-------------
52,701
0
-------------
768,798
0
-------------
75,706
14JENNIFER L MYSTER
METHODIST PRESIDENT
(i)

(ii)
0
-------------
441,050
0
-------------
67,860
0
-------------
33,986
0
-------------
77,327
0
-------------
37,631
0
-------------
657,854
0
-------------
0
15TRICIA L DEGE
CFO CARE DELIVERY
(i)

(ii)
0
-------------
404,077
0
-------------
84,240
0
-------------
2,779
0
-------------
123,302
0
-------------
37,522
0
-------------
651,920
0
-------------
0
16NANCY L EVERT
SR VP GENERAL COUNSEL
(i)

(ii)
0
-------------
376,852
0
-------------
90,480
0
-------------
21,524
0
-------------
121,394
0
-------------
23,896
0
-------------
634,146
0
-------------
0
17JOSHUA O ZIMMERMAN
SR MEDICAL DIRECTOR
(i)

(ii)
0
-------------
416,422
0
-------------
58,284
0
-------------
42,222
0
-------------
61,486
0
-------------
32,354
0
-------------
610,768
0
-------------
33,612
18KRISTI A LYON
VP PAYER RELATIONS
(i)

(ii)
0
-------------
313,683
0
-------------
47,021
0
-------------
51,271
0
-------------
63,625
0
-------------
44,699
0
-------------
520,299
0
-------------
36,006
19JOAN SANDSTROM RN
VP PRIMARY CARE
(i)

(ii)
0
-------------
321,406
0
-------------
47,530
0
-------------
51,471
0
-------------
63,676
0
-------------
28,128
0
-------------
512,211
0
-------------
36,658
20CARA M HULL
FORMER VP HUMAN RESOURCES
(i)

(ii)
0
-------------
369,877
0
-------------
74,300
0
-------------
5,126
0
-------------
21,375
0
-------------
37,160
0
-------------
507,838
0
-------------
0
21MELISSA F SCHOENHERR
VP MARKETING AND COMMUNICA
(i)

(ii)
0
-------------
311,278
0
-------------
45,999
0
-------------
64,033
0
-------------
62,691
0
-------------
19,551
0
-------------
503,552
0
-------------
55,082
22CATHERINE S KLUGHERZ
VP SPECIALTY SERVICES
(i)

(ii)
0
-------------
309,258
0
-------------
46,795
0
-------------
45,192
0
-------------
63,331
0
-------------
37,430
0
-------------
502,006
0
-------------
35,962
23LAURA A LOBERG
VP SURGICAL SERVICES
(i)

(ii)
0
-------------
307,732
0
-------------
45,590
0
-------------
41,224
0
-------------
62,372
0
-------------
31,008
0
-------------
487,926
0
-------------
35,036
24STEVEN C HOUSH
VP ORTHOPEDIC SERVICES
(i)

(ii)
0
-------------
361,106
0
-------------
53,473
0
-------------
2,784
0
-------------
21,375
0
-------------
36,599
0
-------------
475,337
0
-------------
0
25DUANE F SPIEGLE
VP REAL ESTATE AND SUPPORT
(i)

(ii)
0
-------------
299,753
0
-------------
45,197
0
-------------
16,251
0
-------------
62,185
0
-------------
36,411
0
-------------
459,797
0
-------------
0
26CATHERINE F LENAGH
FORMER VP & CFO
(i)

(ii)
0
-------------
0
0
-------------
44,496
0
-------------
362,984
0
-------------
0
0
-------------
14,446
0
-------------
421,926
0
-------------
0
27RAE ANN WILLIAMS MD
DIRECTOR
(i)

(ii)
0
-------------
312,389
0
-------------
11,250
0
-------------
29,170
0
-------------
9,010
0
-------------
37,143
0
-------------
398,962
0
-------------
0
28NIMA A DESAI MD
VP MEDICAL AFFAIRS, CMO
(i)

(ii)
0
-------------
341,181
0
-------------
1,816
0
-------------
5,048
0
-------------
26,185
0
-------------
16,941
0
-------------
391,171
0
-------------
0
29KATE E KEIPER
VP HUMAN RESOURCES
(i)

(ii)
0
-------------
287,307
0
-------------
42,095
0
-------------
315
0
-------------
26,185
0
-------------
17,417
0
-------------
373,319
0
-------------
0
30JAMES P LYONS
HUTCHINSON PRESIDENT
(i)

(ii)
0
-------------
263,041
0
-------------
26,928
0
-------------
7,337
0
-------------
26,185
0
-------------
44,485
0
-------------
367,976
0
-------------
0
31KASEY L PAULUS
VP INPATIENT & CNO
(i)

(ii)
0
-------------
246,697
0
-------------
35,610
0
-------------
2,327
0
-------------
26,185
0
-------------
35,656
0
-------------
346,475
0
-------------
0
32MATTHEW T WESTERLUND
VP QUALITY AND SAFTEY
(i)

(ii)
0
-------------
207,506
0
-------------
21,460
0
-------------
3,281
0
-------------
15,172
0
-------------
23,483
0
-------------
270,902
0
-------------
0
33NATHAN G BLAD
OLIVIA PRESIDENT
(i)

(ii)
0
-------------
171,393
0
-------------
0
0
-------------
2,189
0
-------------
13,231
0
-------------
19,921
0
-------------
206,734
0
-------------
0
34MICHAEL B SEIM MD
MEDICAL AFFAIRS & CMO
(i)

(ii)
0
-------------
86,163
0
-------------
58,616
0
-------------
924
0
-------------
0
0
-------------
17,992
0
-------------
163,695
0
-------------
0
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
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 SCHEDULE J, PART I LINE 4A: SEVERANCE PAYMENT CATHERINE F. LENAGH $362,984 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 COMPENSATION STEVEN M. CONNELLY, MD $ 76,140 LAURA A. LOBERG $ 36,187 JOAN SANDSTROM $ 37,491 CATHERINE S. KLUGHERZ $ 37,146 JOSHUA O. ZIMMERMAN MD $ 35,301 KRISTI A. LYON $ 37,440 MELISSA F. SCHOENHERR $ 36,506 DUANE P. SPIEGLE $ 36,000 THOMAS A. JONES $ 42,839 MARK R. SANNES $ 45,565 NANCY L. EVERT $ 34,471 JENNIFER L. MYSTER $ 17,830 TRICIA L. DEGE $ 34,748 BRIAN H. RANK $ 148,211 NANCY A. MCLURE $ 143,682 ANDREA M. WALSH $ 166,046
PART I, LINE 7 PARK NICOLLET HEALTH SERVICE'S (PNHS) PRESIDENT AND ITS OFFICERS MAY RECEIVE COMPENSATION BASED ON THE PARK NICOLLET HEALTH SERVICES SENIOR EXECUTIVE INCENTIVE PROGRAM (SEIP). SEIP INCENTS AND REWARDS SENIOR BUSINESS LEADERS WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC FISCAL YEAR. THE PROGRAM IS A KEY ELEMENT OF THE PARTICIPANT'S TOTAL COMPENSATION PACKAGE. SEIP REWARDS ARE BASED ON POSITION IN THE ORGANIZATION (E.G. SENIOR VICE PRESIDENT, VICE PRESIDENT, SENIOR MEDICAL DIRECTOR) AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATION'S STRATEGIC PLAN AND WILL BE BALANCED. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO CLINIC AND HOSPITAL QUALITY MEASURES, PATIENT SAFETY, HEALTH EQUITY, HEALTH CARE AFFORDABILITY MEASURES, PATIENT AND MEMBER SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, HEALTH PLAN AND CARE DELIVERY MARKET SHARE, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE (OPERATING INCOME), ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. AN OPERATING INCOME THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. IN THEIR ROLES AS MANAGEMENT EMPLOYED BY PNHS, CERTAIN DIRECTORS AND MANAGERS MAY RECEIVE COMPENSATION BASED ON THE PARK NICOLLET MIDDLE MANAGEMENT INCENTIVE PROGRAM (MMIP). MMIP INCENTS AND REWARDS BUSINESS LEADERS WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC FISCAL YEAR. MMIP GOALS ARE SIMILAR IN NATURE TO THOSE IN THE SEIP HOWEVER THERE IS A DIFFERENCE AS MMIP GOALS INCLUDE BOTH AN ORGANIZATION FINANCIAL MEASURE AND A LOCAL DEPARTMENT FINANCIAL MEASURE. THE LOCAL MEASURE IS BASED ON FINANCIAL RESULTS OF THE DEPARTMENT OR SERVICE LINE AND IS THE ONLY MMIP GOAL THAT ALLOWS AN OPPORTUNITY FOR INCENTIVE CREDIT ABOVE THE TARGET LEVEL BASED ON THE RESULTS. AN OPERATING INCOME THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND ONCE MET THE ULTIMATE MMIP PAYOUT DEPENDS RESULTS OF THE BUSINESS GOAL PERFORMANCE, THE ORGANIZATION AND LOCAL FINANCIAL MEASURES AND THE PERCENTAGE PAYOUT ALLOWED BASED ON THE PARTICIPATION LEVEL.
FORM 990, SCHEDULE J PART II, COLUMN F: PRIOR REPORTED COMPENSATION COLUMN (F) INCLUDES AMOUNTS PAID TO PARTICIPANTS IN THE CURRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEAR'S 990'S, AS RETIREMENT AND DEFERRED COMPENSATION, FOR THE FOLLOWING DIRECTORS: STEVEN M. CONNELLY, MD $ 67,220 LAURA A. LOBERG $ 35,036 JOAN SANDSTROM $ 36,658 CATHERINE S. KLUGHERZ $ 35,962 JOSHUA O. ZIMMERMAN MD $ 33,612 KRISTI A. LYON $ 36.006 MELISSA F. SCHOENHERR $ 55,082 THOMAS A. JONES $ 41,480 MARK R. SANNES $ 75,706 BRIAN H. RANK $ 263,482 NANCY A. MCLURE $ 288,293 ANDREA M. WALSH $ 152,088
Schedule J (Form 990) 2020

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
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 section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
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) 2020
Schedule L (Form 990 or 990-EZ) 2020
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) ALISON ECKHOFF ALISON ECKHOFF, THE SPOUSE OF MARK SANNES, MD, AN OFFICER OF PARK NICOLLET 206,957 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) 2020


Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
PARK NICOLLET GROUP RETURN
 
Employer identification number

45-5023260
Return Reference Explanation
FORM 990, PART III, LINE 4A, EXEMPT PURPOSE AND ACHEIVEMENTS CORPORATE STRUCTURE, PURPOSE, GOVERNANCE THE PARK NICOLLET GROUP RETURN (GROUP) INCLUDES PARK NICOLLET METHODIST HOSPITAL (METHODIST), PARK NICOLLET CLINIC (PNC), PARK NICOLLET HEALTH CARE PRODUCTS (PNHCP), AND PNMC HOLDINGS ALL OF WHICH ARE SUBSIDIARIES OF PARK NICOLLET HEALTH SERVICE (PNHS), A MINNESOTA NONPROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3). PNHS IS THE PARENT ORGANIZATION TO AN INTEGRATED CARE SYSTEM THAT INCLUDES METHODIST, PNC, PNHCP, PNMC HOLDINGS, PARK NICOLLET FOUNDATION (PNF), PARK NICOLLET ENTERPRISES (PNE), HUTCHINSON HEALTH (HH), AND TRIA ORTHOPAEDIC CENTER, LLC (TRIA). PARK NICOLLET HEALTH SERVICES ACCOUNTABLE CARE ORGANIZATION, LLC, WAS ORGANIZED AS AN LLC IN 2018, FOR WHICH PNC IS THE SOLE MEMBER. FOR THE SECOND YEAR, BECKER'S HOSPITAL REVIEW, A HIGHLY RESPECTED HEALTH CARE PUBLICATION, IS RECOGNIZING PARK NICOLLET AS ONE OF THE ACCOUNTABLE CARE ORGANIZATIONS TO KNOW. THIS RECOGNITION IS BASED ON FACTORS INCLUDING QUALITY AND COST. THERE ARE ABOUT 650 PRIVATE AND PUBLIC ACOS IN THE U.S. ABOUT 20 PERCENT OF MEDICARE BENEFICIARIES RECEIVE CARE FROM AN ACO. PARK NICOLLET HAS PARTICIPATED IN CMS ACO MODELS SINCE 2012. SINCE THEN, IT HAS SAVED MEDICARE MORE THAN $6 MILLION DOLLARS. PNHS IS A NONPROFIT, INTEGRATED CARE DELIVERY SYSTEM. IT IS STAFFED BY NATIONALLY RECOGNIZED HOSPITAL AND CLINIC DOCTORS, CLINICAL PROFESSIONALS, NURSES AND OTHER TEAM MEMBERS WHO HELP PATIENTS STAY HEALTHY AND TAKE CARE OF THEM WHEN THEY ARE SICK. PNHS IS PART OF THE HEALTHPARTNERS ORGANIZATION, "HEALTHPARTNERS." FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED HEALTH CARE ORGANIZATION, PROVIDING HEALTH CARE SERVICES AND HEALTH PLAN FINANCING AND ADMINISTRATION, AND IS THE LARGEST CONSUMER-GOVERNED NONPROFIT HEALTH CARE ORGANIZATION IN THE COUNTRY. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTH CARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY. HEALTHPARTNERS, INC. (HPI) IS A MINNESOTA NONPROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4) AND IS THE PARENT ENTITY OF HEALTHPARTNERS ORGANIZATIONS REFERRED TO COLLECTIVELY AS "HEALTHPARTNERS". HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS. HEALTHPARTNERS PROVIDES A FULL RANGE OF HEALTH CARE DELIVERY AND HEALTH PLAN SERVICES INCLUDING INSURANCE, PATIENT CARE, ADMINISTRATION AND HEALTH AND WELL-BEING PROGRAMS. HEALTHPARTNERS HEALTH PLANS SERVE MORE THAN 1.8 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,800 EMPLOYED PHYSICIANS AND DENTISTS, EIGHT OWNED HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, OVER 129 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES AND DENTAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN SERVING MORE THAN 1.27 MILLION PATIENTS. HEALTHPARTNERS HEALTH PLANS CONTRACT WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS TO SERVE PLAN MEMBERS. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUNDRAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. HEALTHPARTNERS COLLABORATES WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES CONTINUING IN 2020 ARE TOTAL COST OF CARE MEASUREMENTS (A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN HEALTHPARTNERS, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. PNHS IS ONE OF THE NATION'S LARGEST CARE SYSTEMS. WE CARE FOR PATIENTS AT MORE THAN 30 LOCATIONS IN THE TWIN CITIES. THESE INCLUDE PRIMARY AND SPECIALTY CARE CLINICS AND HOSPITALS. WITHIN PNHS ARE SEVERAL NATIONALLY-RENOWNED SPECIALTY CARE FACILITIES, INCLUDING: PARK NICOLLET BARIATRIC SURGERY & WEIGHT CENTER HAS BEEN HELPING PATIENTS ACHIEVE THEIR WEIGHT LOSS GOALS FOR MORE THAN 40 YEARS AND HAS BEEN NATIONALLY RECOGNIZED AS A COMPREHENSIVE CENTER BY THE METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM (MBSAQIP). BLUE CROSS AND BLUE SHIELD HAS GIVEN US A BLUE DISTINCTION PLUS (+) DESIGNATION FOR BARIATRIC SURGERY, RECOGNIZING US FOR OUR EXPERTISE, EFFICIENCY AND QUALITY OF CARE. WE'VE ALSO BEEN NAMED A CENTER OF EXCELLENCE BY INSURANCE PROVIDERS PREFERREDONE AND UNITED RESOURCE NETWORK, AND A PREFERRED PROVIDER BY MEDICA AND HEALTHPARTNERS. PARK NICOLLET FRAUENSHUH CANCER CENTER OFFERS A FULL RANGE OF SERVICES AND STATE-OF-THE-ART TECHNOLOGY TO FIGHT CANCER, INCLUDING SURGERY, CHEMOTHERAPY AND RADIATION THERAPY. CANCER CARE AND TREATMENT IS PERSONALIZED FOR EACH PATIENT. FAMILIES AND PATIENTS CAN BENEFIT FROM SERVICES, INCLUDING PSYCHOTHERAPY, SUPPORT AND EDUCATION ALL IN THE PATIENT'S ROOM AND IN ONE LOCATION. PARK NICOLLET HEART AND VASCULAR CENTER OFFERS EXTENSIVE CARDIOVASCULAR SERVICES AND PROCEDURES CENTERED ON THE PATIENT. WE PROVIDE AROUND-THE-CLOCK SUPPORT FROM A HIGHLY SPECIALIZED TEAM USING THE LATEST INNOVATIONS ALL IN A PEACEFUL ENVIRONMENT DESIGNED FOR COMFORT AND HEALING. OUR TEAM-BASED APPROACH DRAWS FROM SPECIALISTS IN CARDIOLOGY, RADIOLOGY, NEUROLOGY, SURGERY, PHYSIOLOGY, REHABILITATION AND MORE. THAT MEANS WE CAN OFFER COMPREHENSIVE AND COORDINATED CARE FOR ALL HEART AND VASCULAR CONDITIONS. PARK NICOLLET JANE BRATTAIN BREAST CENTER OFFERS COMPREHENSIVE BREAST HEALTH SERVICES TO ALL WOMEN AT ALL LIFE STAGES. OUR TEAM OF EXPERTS IS CONNECTED TO OUR TEAM OF ONCOLOGISTS, SURGEONS AND OTHER SPECIALISTS. WE USE THE LATEST TECHNOLOGIES, INCLUDING 3D MAMMOGRAMS. PARK NICOLLET MELROSE CENTER HAS PROVIDED COMPASSIONATE, EXPERT CARE FOR ALL TYPES OF EATING DISORDERS FOR PEOPLE OF EVERY AGE AND GENDER FOR OVER 30 YEARS. WE'VE HELPED GUIDE THOUSANDS OF PEOPLE TOWARD RECOVERY USING EVIDENCE-BASED TREATMENT. THIS MEANS THAT WE BASE OUR PROGRAMS ON THE LATEST RESEARCH AND TREATMENTS PROVEN TO HELP. PARK NICOLLET STRUTHERS PARKINSON'S CENTER IS DEDICATED TO PROVIDING COMPREHENSIVE ASSESSMENT, TREATMENT, SUPPORT, EDUCATION AND RESEARCH TO IMPROVE THE QUALITY OF LIFE OF PEOPLE AFFECTED BY PARKINSON'S. STRUTHERS PARKINSON'S CENTER IS A NATIONAL PARKINSON'S FOUNDATION CENTER OF EXCELLENCE. THE WOMEN'S CENTER IN ST. LOUIS PARK WAS DESIGNED FOR BUSY WOMEN. THEY GET CARE, COMFORT AND CONVENIENCE, AND WE BRING ALL THE SERVICES TO THEM IN ONE LOCATION. THIS MEANS THEY CAN ADDRESS MULTIPLE NEEDS IN ONE VISIT. WE OFFER A FULL RANGE OF WOMEN'S HEALTH SERVICES, INCLUDING OBSTETRICS AND PRENATAL CARE, GYNECOLOGY AND UROGYNECOLOGY, BIRTH CONTROL, MENOPAUSE, INCONTINENCE AND PELVIC FLOOR DISORDERS. METHODIST HAS 426 PATIENT BEDS AND ADMITS NEARLY 30,000 PATIENTS ANNUALLY. THERE ARE MORE THAN 50,000 EMERGENCY CENTER PATIENTS TREATED EACH YEAR. WE DELIVER NEARLY 3,000 BABIES EACH YEAR AT THE FAMILY BIRTH CENTER. WE OFFER SPECIALTY CARE INCLUDING ONCOLOGY, CARDIOLOGY, MATERNITY, NEUROLOGY, CRITICAL CARE AND BARIATRICS. IT'S LOCATED IN ST. LOUIS PARK, MINNESOTA. METHODIST IS RENOWNED FOR HIGH QUALITY PATIENT CARE, CLOSE TO HOME. RECOGNIZED AS AN AREA LEADER IN CANCER, NEUROLOGY, CARDIOVASCULAR AND MATERNITY CARE, OUR TEAM OF EXPERTS IS HIGHLY TRAINED TO PROVIDE PERSONALIZED TREATMENT FOR OUR PATIENTS AND THEIR FAMILY.
PART III, CONT. PNHCP PROVIDES DURABLE MEDICAL EQUIPMENT (DME)/SUPPLIES SUPPORTING ONGOING PATIENT CARE FOR METHODIST AND PNC PATIENTS. PNHCP IS A RECOGNIZED LEADER IN PROVIDING PATIENTS WITH CONVENIENT ACCESS TO PROVIDER RECOMMENDED HEALTH RELATED PRODUCTS. PNHCP IS VIEWED BY PARK NICOLLET AS AN EXTENSION OF THE PROVIDER'S CARE, BY PROVIDING PRODUCTS USED AT HOME TO HELP PATIENTS ENSURE SUCCESS WITH SELF-MANAGING ANY NUMBER OF HEALTH ISSUES. PARK NICOLLET HEALTH CARE PRODUCTS' DME DIVISION IS MADE UP OF 10 PRODUCT LINES AND MULTIPLE SALES CHANNELS, (SEVEN STORE LOCATIONS, E-COMMERCE, AND MORE THAN 300 POINT OF CARE CLOSETS FOR THE IMMEDIATE DISBURSEMENT OF DME PRODUCT TO OUR PATIENTS). THE DIVISION EMPLOYS 140 STAFF LOCATED AT 35 CLINIC AND ADMINISTRATIVE SITES. PRODUCT LINES INCLUDE DURABLE MEDICAL EQUIPMENT, MEDICAL SUPPLIES, INCLUDING OSTOMY AND WOUND CARE, SKIN CARE SERVICES AND PRODUCTS, CUSTOM ORTHOTICS AND PROSTHETICS, SLEEP EQUIPMENT AND SUPPLIES. 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 PNHCP IS EXPANDING ITS CAPACITY TO BETTER SERVE THESE GROWING NEEDS. CONTINUED EXPANSION OF DME TO THE HEALTHPARTNERS MEDICAL GROUP ADDED AN ADDITIONAL POINT OF CARE CLOSETS TO 19 MORE HEALTHPARTNERS CLINIC LOCATIONS. EXPANDED THE GAME READY PROGRAM TO LAKEVIEW HOSPITAL IN Q4 2020. CONTINUED TO ADD/ENHANCED PRODUCT LINES TO OUR EXISTING RETAIL LOCATIONS LAUNCHED AN UNDERGARMENT PRODUCT LINE WHILE ACTIVELY PARTNERING WITH SURGICAL PRACTITIONERS AT THE 401 PHALEN WOODBURY CLINIC. ADDED PHARMACY OTC ITEMS INTO THE STORES THAT WERE REQUESTED BY PN DEPARTMENTS WHEN PHARMACIES CLOSED. TO ACHIEVE PRODUCT-MARKET FIT, THE BREAST PUMP UPGRADE PROGRAM WAS DEVELOPED AND ROLLED OUT WHICH MIRRORS THE INDUSTRY'S VARIABLE PRODUCT OPTIONS, GIVING OUR CUSTOMERS THE CHOICE TO CHOOSE THE BEST PRODUCTS AND UPGRADE PACKAGE TO MEET THEIR NEEDS AT A REASONABLE VALUE. DEVELOPED NEW AND EASIER WAY FOR PATIENTS TO RECEIVE PRODUCT FROM US. WE ESTABLISHED A MAIL-OUT PROCESS FOR FOOT ORTHOTICS TO EASE THE CONCERN OF HOW OUR PATIENTS RECEIVE THEIR PRODUCTS. CPAP MAIL-OUT ORDERS RAPIDLY INCREASED FROM WHEN COVID-19 STARTED. A DEVISED WORKAROUND PLAN WAS IMPLEMENTED TO PROCESS THE INCREASE OF CPAP MAIL-OUTS. WE HAD A 70% INCREASE IN TOTAL NUMBER OF PRODUCTS MAILED OUT COMPARING JULY 2019 TO JULY 2020. DEVELOPED A PARTNERSHIP WITH THE NEUROSCIENCE TEAM BY PROVIDING THERAPISTS WITH IN-SERVICE TRAINING ON HOW TO MEASURE COMPRESSION FOR PATIENTS FOLLOWED BY ORDERING OF THE COMPRESSION THROUGH THE HEALTH AND CARE STORES. EXPANDED OPTICAL AND CONTACT LENS SERVICES TO LAKEVILLE TO BETTER SERVE OUR PATIENTS. BENEFIT TO THE COMMUNITY: PANDEMIC RESPONSE HOSPITALS SERVE AS A CENTER OF STRENGTH FOR A COMMUNITY, EVEN IN THE BEST OF TIMES. DURING DISASTERS AND COMMUNITY HEALTH CRISES LIKE THE COVID-19 PANDEMIC, COMMUNITIES EXPECT HEALTH CARE FACILITIES TO NOT ONLY PROVIDE THE ADDITIONAL CARE THAT'S NEEDED, BUT ALSO CONTINUE THE COMMUNITY SUPPORT THAT INDIVIDUALS AND SOCIAL ENTITIES HAVE COME TO RELY ON. IN 2020, METHODIST HOSPITAL DIRECTLY SUPPORTED COMMUNITY NEEDS THAT AROSE BECAUSE OF THE PANDEMIC IN A NUMBER OF WAYS, INCLUDING: SHARED VENTILATORS WITH OTHER HOSPITALS (IE. REGIONS HOSPITAL) AND OTHER SUPPLIES WHEN ONE AREA EXPERIENCED GAPS OR SHORTAGES STRONG SYSTEM MEDICAL STAFF RESPONSE DURING THE PANDEMIC WITH CLINIC DOCTORS HELPING IN THE HOSPITAL INITIATED THE PATIENT OXIMETRY PROGRAM WITH AN OXIMETER DEVICE IN THE EMERGENCY DEPARTMENT USED INNOVATIVE CARE MODEL APPROACHES SUCH AS THE REMOTE VENT MONITORING MODEL, PRONING TEAMS, PLACING IV PUMPS OUTSIDE THE ROOM, N95 STERILIZATION PROGRAMALL OF THESE EFFORTS WERE TO TRY TO CONSERVE PPE AS MUCH AS POSSIBLE SO WE COULD KEEP OUR STAFF SAFE AND CARE FOR MORE PATIENTS. IMPLEMENTED VIRTUAL VISIT CAPABILITIES FOR HOSPITAL FOLLOW UP VISITS OFFERED PERSONAL PROTECTIVE EQUIPMENT (PPE) TO PATIENTS AND VISITORS ENTERING FACILITY TO AID IN PROTECTIVE MEASURES. STAFFED DOOR SCREENERS AT ENTRANCES TO AID IN PROTECTIVE MEASURES (I.E. VISITOR TRACKING, PPE PLACEMENT, AND SECURITY SUPPORT). CREATED AND MAINTAINED A ROBUST LAB TESTING PROCESS AMID CHANGING SUPPLY AVAILABILITY, ALLOCATION AND TAT VARIABILITY PARTICIPATED IN COMMUNITY MESSAGING BY HAVING PROVIDERS SHARE INSIGHTS AND RECOMMENDATIONS ON DIFFERENT PLATFORMS. PROVIDED COMMUNITY MASS COVID-19 VACCINATION SITE AND CONTINUE TO SUPPORT THESE EFFORTS. PROVIDED INFLUENZA AND COVID VACCINATION. PROVIDED IPADS FOR PATIENT USE TO COMMUNICATE WITH FAMILY AND FRIENDS WHILE HOSPITALIZED. ADDITIONALLY, THE HOSPITAL WAS ABLE TO CONTINUE ITS ONGOING COMMUNITYBASED PARTNERSHIPS BY MAKING THE NECESSARY ADAPTATIONS. WITH THE PANDEMIC REQUIRING SOCIAL DISTANCING, OUTREACH AND ACCESS WERE SEVERELY LIMITED, BUT ADJUSTMENTS ALLOWED THE PROGRAMS TO CONTINUE. FOR INSTANCE: EXPANDED CAPACITY BY ADDING 12 MORE OPERATIONAL BEDS EMERGENCY CENTER COMPLETED EXPANSION TO SUPPORT GROWING NEEDS OF THE COMMUNITY BY ADDING 6 MORE EXAMINATION ROOMS USED OTHER NON-TRADITIONAL SPACES TO ADD COVID PATIENT CARE CAPACITY- SAME DAY EXTENDED RECOVERY, OUTPATIENT CARE UNIT SUPPORTED THE INCREASED DEMAND FOR PATIENTS REQUIRING ICU CARE BY SURGING INTO ALTERNATIVE SPACES PARTNERED WITH OUR OTHER HEALTHPARTNERS HOSPITALS TO CREATE AND FIND BEDS TO MEET PATIENT NEEDS ADJUSTED OUR STANDING ORDER FOR PRESCRIPTION REFILL MANAGEMENT TO ALLOW FOR EXTENDED REFILLS. CONTINUED TO OFFER SOCIALLY DISTANCED GROUP THERAPIES AND CHEMICAL DEPENDENCY TREATMENT TO SUPPORT INDIVIDUALS DURING THE PANDEMIC. IMPLEMENTED VIRTUAL INTERVIEWS. WITH CARE MODELS BEING FORCED TO CHANGE, THE HOSPITAL CONVENED AND PARTICIPATED IN SEVERAL COMMUNITYBASED COLLABORATIVE EFFORTS TO IMPROVE ACCESS TO COMMUNITY AND MENTAL HEALTH SERVICES, INCLUDING: PROVIDED VIRTUAL MENTAL HEALTH FOR THE DAYBRIDGE PROGRAM. CREATED A BLOOD BANK SUBGROUP TO OUTLINE CRISIS STANDARDS AND STRATEGIES TO ADDRESS SCARCE BLOOD PRODUCTS AS A RESULT OF FEWER DONATIONS DURING THE PANDEMIC. USED COMMUNITY PARAMEDIC PROGRAM TO HELP US WITH FOLLOW-UP CARE FOR COVID PATIENTS VIRTUAL APPOINTMENTS FOR PATIENT CARE FOLLOW-UP APPOINTMENTS PROVIDED VACCINATION CLINICS. ADDITIONALLY, THE HOSPITAL WAS ABLE TO MAKE THE MOST OF THE COVID-19 RESPONSE AND RESILIENCE FUNDS IT RECEIVED, USING THOSE DOLLARS TO: SUPPORT DOOR SCREENING POSITIONS. SUPPORT PPE NEEDS. ASSIST WITH PAYMENT FOR COVID-19 POSITIVE EMPLOYEES WHO CONTRACTED THE ILLNESS AT WORK. SUPPORT STAFFING AND RESOURCES FOR COVID VACCINATION CLINICS. SUPPORT ADDITIONAL CRITICAL CARE AND ALL OTHER PATIENT CARE STAFFING COSTS REQUIRED TO CARE FOR COVID-19 PATIENTS.
PART III, CONT. COMMUNITY HEALTH SERVICES: PATIENT EDUCATION - PARK NICOLLET'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. PARK NICOLLET PARTICIPATED IN MANY ACTIVITIES IN 2020 TO HELP BRING AWARENESS AND EDUCATION TO THE COMMUNITY. HEART HEALTH AWARENESS MONTH COORDINATE EFFORTS ACROSS OUR ORGANIZATION TO INCREASE HEART HEALTH AWARENESS IN THE COMMUNITIES WE SERVE SOCIAL MEDIA (PAID) BLOGS INTERNAL COMMUNICATION BILLBOARDS STROKE AWARENESS MONTH BLOGS BILLBOARDS PRINT ADS IN VALLEY SOCIAL MEDIA (ORGANIC) MARCH OF DIMES MINNESOTA DUE TO COVID, THE MARCH FOR BABIES EVENT BECAME VIRTUAL. AS AN ALTERNATIVE FOR OUR SPONSORSHIP, WE UTILIZED THE MARCH OF DIMES MINNESOTA FACEBOOK PLATFORM TO SUPPORT MESSAGING OF HEALTH TIPS AND EDUCATION ON A WIDE VARIETY OF CHILDHOOD TOPICS. REACHED ALMOST 6000 NEW PARENTS AND CREATED AWARENESS FOR PROGRAMS SUCH AS POWERUP AND LITTLE MOMENTS COUNT MENTAL HEALTH AWARENESS MONTH - AS AN ORGANIZATION, WE ARE WORKING TO REDUCE MENTAL ILLNESS STIGMA. MENTAL ILLNESSES WILL AFFECT ONE IN FIVE PEOPLE, BUT MANY PEOPLE WON'T SEEK TREATMENT FOR YEARS BECAUSE THEY FEEL SHAME. MAY IS MENTAL HEALTH AWARENESS MONTH AND MANY PEOPLE AND ORGANIZATIONS USE THIS TIME TO EXPLORE THE TOPIC. INTERNAL COMMUNICATIONS SOCIAL MEDIA POSTS ON MENTAL HEALTH RESOURCES COVID-19 RESOURCE LIST EMPLOYEE STORYTELLING MAKE IT OK SOCIAL CAMPAIGN ON WELL-BEING TIPS AND REDUCING STIGMA COVID-19 RESOURCES RECRUITING AND TRAINING OF AMBASSADORS VIA DIGITAL PLATFORM CONTINUED AMBASSADOR PARTNERSHIPS ACROSS MN, ND, SD, IOWA AND WI GENERATED OVER 8200 VISITS TO WEBSITE COLON CANCER AWARENESS MONTH COORDINATED EFFORTS ACROSS OUR ORGANIZATION TO INCREASE COLON CANCER AWARENESS IN THE COMMUNITIES WE SERVE. PARK NICOLLET HAD A BILLBOARD CLINIC MONITORS - ORG-WIDE BLOG - ORG-WIDE (HTTPS://WWW.HEALTHPARTNERS.COM/BLOG/WHAT-YOU-NEED-TO-KNOW-ABOUT-COLON-C ANCER-SCREENINGS/) BREAST HEALTH AWARENESS MONTH COORDINATE EFFORTS ACROSS OUR ORGANIZATION TO INCREASE BREAST HEALTH AWARENESS IN THE COMMUNITIES WE SERVE. PARK NICOLLET FOUNDATION HOSTS BEPINK / COUNTRY FOR A CAUSE VIRTUAL EVENTS HOSTED BY PARK NICOLLET FOUNDATION TO RAISE FUNDS FOR JANE BRATTAIN BREAST CENTER'S MAMMO-A-GO-GO PROGRAM OPIOID AWARENESS MONTH - TO BE A LEADER IN EDUCATION AND AWARENESS OF OPIOIDS FOR OUR ORGANIZATION AND THE COMMUNITIES WE SERVE, WE REPEATED OUR 2019 CAMPAIGN ENTITLED CUT SHORT. WE WANT TO RAISE AWARENESS BY IDENTIFYING COMMON OPIOIDS AND RISKS OF ADDICTION AND EDUCATE ON SAFE DISPOSAL OF OPIOIDS. SOCIAL MEDIA, VIDEOS, CHANNEL 45 BROADCAST PSAS INTERNAL COMMUNICATIONS LITTLE MOMENTS COUNT CAMPAIGN LITTLE MOMENTS COUNT IS A MOVEMENT ACROSS TWO STATES WITH MANY COMMUNITY PARTNERS WHO ALL STRONGLY SUPPORT THE MESSAGE TO ENCOURAGE EARLY INTERACTION WITH BABIES AND CHILDREN. WE'RE TURNING THE SPOTLIGHT ON THE IMPORTANCE OF TALKING, PLAYING, READING, AND SINGING TO FOSTER EARLY BRAIN DEVELOPMENT. WE'RE BRINGING OUR PASSIONS FOR CHILDREN'S HEALTH AND OUR COMMUNITY TOGETHER, IN OUR NEW LITTLE MOMENTS COUNT CAMPAIGN. INTERNAL COMMUNICATION EFFORTS LAUNCHED COVID-19 RESOURCES PAGE FOR PARENTS AND PARTNERS LAUNCHED RACIAL AND SOCIAL RESOURCES PAGE FOR PARENTS AND PARTNERS HEALTH FAIRS AND COMMUNITY OUTREACH - PARK NICOLLET CARE TEAMS, DEPARTMENTS AND CLINICS PROVIDED FAIRS AND OUTREACH THROUGHOUT THE YEAR IN A NUMBER OF DIFFERENT EDUCATIONAL AND HEALTH SETTINGS. COMMUNITY BLOOD DRIVE HOSTED IN PARTNERSHIP WITH AMERICAN RED CROSS, ST. PAUL SAINTS AND REGIONS HOSPITAL AT CHS FIELD. 162 DONORS REGISTERED 149 UNITS COLLECTED TO SAVE UP TO 447 LIVES. 9 REGIONS' LAB VOLUNTEERS. PROVIDED GIVEAWAYS OF HAND SANITIZERS AND MASKS TO ALL DONORS REGISTERED. TEACHER OF THE WEEK SPONSORSHIP IN PARTNERSHIP WITH KS95, WE HAD THE OPPORTUNITY TO REACH LOCAL EDUCATORS WITH IMPACTFUL HEALTH INFORMATION. OUR GOAL WAS TO COORDINATE ENGAGING, HELPFUL TOPICS, TIPS AND TRIVIA THAT TEACHERS, SOCIAL WORKERS AND PARENTS COULD USE WITH THEIR "STUDENTS". THIS WAS PARTICULARLY USEFUL FOR AT HOME OR DISTANCE LEARNING. SOCIAL MEDIA POSTS SOCIAL MEDIA VIDEOS INFOGRAPHIC POSTERS ON HEALTH CARE TIPS YMCA PARTNERSHIP SUPPORTED 4 CYCLEHEALTH SOCIALLY-DISTANCED OUTDOOR EVENTS DESIGNED TO GET FAMILIES ENGAGED IN PHYSICAL ACTIVITIES DURING THE PANDEMIC. OVER 3770 ATTENDED AND EXPERIENCED POWERUP MOMENTS THROUGHOUT EACH COURSE. POWER UP MOMENTS INCLUDED MINDFULNESS, STRENGTH AND FLEXIBILITY EXERCISES AND RELAXATION MOMENTS. PRIDE - HEALTHPARTNERS AND PARK NICOLLET HAVE BEEN A PART OF THE PRIDE FESTIVAL FOR 24 YEARS AND THE PRIDE PARADE FOR THREE YEARS. HEALTHPARTNERS AND PARK NICOLLET CLINICS ARE PROUD TO BE LONG TERM ADVOCATES FOR THE LGBTQA+ COMMUNITY AND ACTIVE PARTICIPANTS IN THE PRIDE FESTIVAL AND PARADE. PARTICIPATED IN 2020 VIRTUAL MARKETPLACE, HOSTED VIRTUAL CHAT ROOMS WITH GENDER SERVICES AND MELROSE CLINICIANS FOR THE LGBTQ COMMUNITY. HEALTH PROFESSIONAL EDUCATION HEALTH PROFESSIONAL EDUCATION AT PARK NICOLLET IS COORDINATED BY THE HEALTHPARTNERS INSTITUTE. SEVERAL DEPARTMENTS THROUGHOUT PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL HOST NURSING STUDENTS AND RESIDENTS TO HELP EXPAND THEIR EDUCATION AND GIVE THEM THE PATIENT EXPERIENCE. WE TRAIN LABORATORY STUDENTS FROM A VARIETY OF SCHOOLS, COLLEGES AND UNIVERSITIES AT PARK NICOLLET LOCATIONS.
PART III, CONT. UNDERGRADUATE NURSING STUDENTS CAME TO METHODIST HOSPITAL IN GROUPS OR AS SINGLE STUDENTS FOR CLINICAL EXPOSURE TO THE HEALTH CARE TEAM. SUBSIDIZED HEALTH SERVICES YOUTH SERVED - FOUR SCHOOL-BASED HEALTH CENTERS, PROVIDING FREE MEDICAL VISITS WITHIN THE SCHOOL AND COMMUNITY TO CHILDREN FROM BIRTH TO GRADUATION WHO MAY HAVE BARRIERS TO ACCESSING HEALTH CARE. SERVICES INCLUDED TREATMENT OF MINOR, ACUTE ILLNESSES; PHYSICALS; IMMUNIZATIONS; MENTAL HEALTH THERAPY; DENTAL CARE; AND VISION CHECKS. RESEARCH RESEARCH AT PARK NICOLLET IS COORDINATED AND SPONSORED BY HEALTHPARTNERS INSTITUTE AND 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. ORGANIZATION AWARDS AND ACHIEVEMENTS AT METHODIST HOSPITAL OUR TEAM OF BOARD-CERTIFIED DOCTORS, SPECIALISTS AND HOSPITAL STAFF WORK HARD TO ACHIEVE THE HIGHEST LEVEL OF CARE FOR OUR PATIENTS. WE ARE GRATEFUL TO RECEIVE AWARDS AND RECOGNITION FROM MANY ORGANIZATIONS THAT SHOW OUR DEDICATION TO OUR PATIENTS AND COMMUNITY. METHODIST IS GETTING NATIONAL RECOGNITION FOR OUR HIGH QUALITY CARE. U.S. NEWS & WORLD REPORT NAMED METHODIST A 2020-21 BEST REGIONAL HOSPITAL. WE WERE ALSO RECOGNIZED AS HIGH PERFORMING IN SIX PROCEDURES AND CONDITIONS. THE MAGAZINE'S RANKINGS ARE BASED ON FACTORS LIKE QUALITY OF NURSING, DISCHARGE RATES AND OTHER CARE-RELATED CATEGORIES. WE ARE PROUD TO BE NAMED ONE OF THE TOP 25 ENVIRONMENTAL EXCELLENCE AWARD BY PRACTICE GREENHEALTH, THEIR HIGHEST HONOR FOR HOSPITALS. THIS AWARD RECOGNIZES HOSPITALS FOR EXCELLENCE AND DEDICATION TO SUSTAINABILITY IN HEALTH CARE. PRACTICE GREENHEALTH IS THE NATION'S LEADING HEALTH CARE SUSTAINABILITY COMMUNITY, EMPOWERING ITS MEMBERS TO IMPROVE THEIR ENVIRONMENTAL STEWARDSHIP. METHODIST IS A PART OF THE AMERICAN HEART ASSOCIATION'S (AHA) GET WITH THE GUIDELINES PROGRAM, WHICH MAKES IT EASIER FOR OUR TEAMS TO PUT PROVEN KNOWLEDGE AND GUIDELINES TO WORK ON A DAILY BASIS. WE WERE RECENTLY RECOGNIZED WITH THE AHA'S GET WITH THE GUIDELINES STROKE GOLD PLUS ACHIEVEMENT AWARD. THIS MEANS WE REACHED AN AGGRESSIVE GOAL OF TREATING PATIENTS WITH 85% OR HIGHER COMPLIANCE TO AHA CORE STANDARD LEVELS OF CARE FOR THE PAST TWO YEARS AND DEMONSTRATED AT LEAST 75% COMPLIANCE IN SEVEN OUT OF 10 STROKE QUALITY MEASURES. WE WERE ALSO AWARDED WITH THE TARGET: STROKE HONOR ROLL, WHICH RECRECOGNIZES IMPRESSIVE STROKE TREATMENT TIMES. HANDOUT CLINIC AND DEPARTMENT BROCHURES GIVEAWAYS - ROCKET WRITER PENS, CHAP STICK, GEL PACKS AND WATER BOTTLES JACK O LANTERN SPECTACULAR - SPONSOR A FAMILY FUN EVENT FOCUSED ON STAYING ACTIVE DURING THE EVENING HOURS OF OCTOBER, WHILE ENJOYING A WONDERFUL OUTDOOR EXHIBIT OF 5,000 JACK-O-LANTERNS. INTRODUCE POWERUP PROGRAM TO THE METRO AREA BY ENCOURAGING FAMILIES TO ENJOY FRUIT AS AN AFTER DINNER SNACK AND TO ENGAGE IN POWERUP ACTIVITIES. 105,575 ATTENDEES DISTRIBUTED OVER 66 CASES OF CLEMENTINES 43 VOLUNTEERS ON SELECT WEEKENDS, TWO MARKETING STAFF AND TWO MASCOTS ON ALL WEEKENDS AND SELECT EVENINGS. VEGGIE GIVEAWAYS - MAKE GOOD HAPPEN BY SUPPORTING THE COMMUNITIES WE SERVE WITH A BAG OF FRESH VEGGIES WHILE SHARING THE POWERUP MESSAGE TO "TRY FOR 5!" ATTENDANCE OF 2,070 AT 7 HP AND PN CLINIC LOCATIONS POWERUP BIKE DEPLOYMENT - UTILIZE THE POWERUP BIKE TO SHARE HEALTHPARTNERS POWERUP MESSAGE TO CHILDREN AND THEIR FAMILIES TO TRY FOR 5 FRUITS AND VEGETABLES EVERY DAY. THE BIKE OFFERS SNACK OPTIONS AT COMMUNITY EVENTS AND AFTER RACES! HANDED OUT 7,944 POWERUP SNACKS (APPLES, BANANAS, ORANGES, CARROTS AND CHEESE STICKS) AT EVENTS IN 2019 OVERALL ATTENDANCE FOR 19 EVENTS = 35,000+ VEGGIE RX - FROM JUNE 4 THROUGH JULY 27, KIDS HAVING A WELL EXAM AT HEALTHPARTNERS, PARK NICOLLET AND STILLWATER MEDICAL GROUP CLINICS RECEIVED A $10 VOUCHER REDEEMABLE FOR FRESH FRUITS AND VEGETABLES AT ANY CUB FOODS OR COLBURNS IN MINNESOTA, PLUS ECONO FOODS OR FAMILY FRESH MARKET IN WISCONSIN. VOUCHERS WERE EFFECTIVE THROUGH SEPTEMBER 30TH. PROVIDE TOOLS FOR CLINICIANS TO HAVE CONVERSATIONS ABOUT EATING BETTER WITH FAMILIES ENCOURAGE KIDS AND FAMILIES TO EAT MORE FRUITS AND VEGETABLES AMPLIFY HEALTHPARTNERS AS THE GO-TO RESOURCE FOR HEALTH, WELL-BEING AND NUTRITION 31,425 PRINTED, 4-PANEL BROCHURES WITH DETACHABLE VOUCHER AND SURVEY HEALTH PROFESSIONAL EDUCATION HEALTH PROFESSIONAL EDUCATION AT PARK NICOLLET IS COORDINATED BY THE HEALTHPARTNERS INSTITUTE. SEVERAL DEPARTMENTS THROUGHOUT PARK NICOLLET CLINIC AND PARK NICOLLET METHODIST HOSPITAL HOST NURSING STUDENTS AND RESIDENTS TO HELP EXPAND THEIR EDUCATION AND GIVE THEM THE PATIENT EXPERIENCE. STUDENTS FROM RADIOLOGY PROGRAMS PERFORM THEIR CLINICAL HOURS AT PARK NICOLLET LOCATIONS. OUR RADIOLOGY TECHNOLOGISTS SUPERVISE AND TEACH THE STUDENTS THE ART OF PERFORMING X-RAYS. OTHER MENTORSHIPS FOR A GRADUATE PROGRAM FOR ANESTHESIA STUDENTS, 1 MEDIAL ASSISTANT, 2 LPN STUDENT ROTATIONS, AN RN STUDENT ROTATION WITH A CARE COORDINATION RN AND 2 DNP STUDENT ROTATIONS WITH MDS. UNDERGRADUATE NURSING STUDENTS CAME TO METHODIST HOSPITAL IN GROUPS OR AS SINGLE STUDENTS FOR CLINICAL EXPOSURE TO THE HEALTH CARE TEAM. SUBSIDIZED HEALTH SERVICES YOUTH SERVED - FOUR SCHOOL-BASED HEALTH CENTERS HAD MORE THAN 5,800 CHILDREN VISITS, PROVIDING FREE MEDICAL VISITS WITHIN THE SCHOOL AND COMMUNITY TO CHILDREN FROM BIRTH TO GRADUATION WHO MAY HAVE BARRIERS TO ACCESSING HEALTH CARE. SERVICES INCLUDED TREATMENT OF MINOR, ACUTE ILLNESSES; PHYSICALS; IMMUNIZATIONS; MENTAL HEALTH THERAPY; DENTAL CARE; AND VISION CHECKS. RESEARCH RESEARCH AT PARK NICOLLET IS COORDINATED AND SPONSORED BY HEALTHPARTNERS INSTITUTE AND 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. ORGANIZATION AWARDS AND ACHIEVEMENTS AT METHODIST HOSPITAL OUR TEAM OF BOARD-CERTIFIED DOCTORS, SPECIALISTS AND HOSPITAL STAFF WORK HARD TO ACHIEVE THE HIGHEST LEVEL OF CARE FOR OUR PATIENTS. WE ARE GRATEFUL TO RECEIVE AWARDS AND RECOGNITION FROM MANY ORGANIZATIONS THAT SHOW OUR DEDICATION TO OUR PATIENTS AND COMMUNITY. WE'RE PROUD TO BE ONE OF THE HIGHEST-PERFORMING HOSPITALS IN THE NATION. METHODIST HOSPITAL IS ONE OF THE WATSON HEALTH 2019 100 TOP HOSPITALS. AWARD-WINNING HOSPITALS DEMONSTRATE TOP PERFORMANCE ON MEASURES OF CLINICAL QUALITY, OPERATIONAL EFFICIENCY, FINANCIAL STABILITY AND PATIENT SATISFACTION. METHODIST IS GETTING NATIONAL RECOGNITION FOR OUR HIGH QUALITY CARE. U.S. NEWS & WORLD REPORT NAMED METHODIST A 2019-20 BEST HOSPITAL. WE WERE ALSO RECOGNIZED AS HIGH PERFORMING IN EIGHT PROCEDURES AND CONDITIONS, AND TIED FOR THIRD BEST HOSPITAL IN THE TWIN CITIES AND FIFTH BEST IN MINNESOTA. THE MAGAZINE'S RANKINGS ARE BASED ON FACTORS LIKE QUALITY OF NURSING, DISCHARGE RATES AND OTHER CARE-RELATED CATEGORIES. EACH YEAR, THE AMERICAN HOSPITAL ASSOCIATION RECOGNIZES HEALTH CARE LEADERSHIP AND INNOVATION IN IMPROVING QUALITY AND ADVANCING HEALTH IN COMMUNITIES WITH THEIR ANNUAL QUEST FOR QUALITY AWARDS. THIS YEAR METHODIST HOSPITAL WAS ONE OF FOUR HOSPITALS NATIONWIDE TO RECEIVE THE QUEST FOR QUALITY CITATION OF MERIT. ALL RECIPIENTS OF THIS AWARD DEMONSTRATE A COMMITMENT TO IMPROVING ACCESS; PROVIDING HIGH QUALITY, SAFE CARE; CREATING VALUE; AND PARTNERING WITH PATIENTS AND FAMILIES; FOCUSING ON WELL-BEING; AND PROVIDING SEAMLESS, COORDINATED CARE. WE ARE PROUD TO BE NAMED ONE OF THE TOP 25 ENVIRONMENTAL EXCELLENCE AWARD BY PRACTICE GREENHEALTH, THEIR HIGHEST HONOR FOR HOSPITALS. THIS AWARD RECOGNIZES HOSPITALS FOR EXCELLENCE AND DEDICATION TO SUSTAINABILITY IN HEALTH CARE. PRACTICE GREENHEALTH IS THE NATION'S LEADING HEALTH CARE SUSTAINABILITY COMMUNITY, EMPOWERING ITS MEMBERS TO IMPROVE THEIR ENVIRONMENTAL STEWARDSHIP. METHODIST ALSO RECEIVED THE 2019 MINNESOTA GOVERNOR'S SAFETY AWARD.
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 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.
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, 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 11B 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 DIRECTOR OF FINANCE, 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 THE PARK NICOLLET BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, AND KEY EMPLOYEES ("COVERED PERSONS") BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, COVERED PERSONS ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND ASKED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTERESTS. THE LEGAL DEPARTMENT OF HEALTHPARTNERS REVIEWS THE QUESTIONNAIRE RESPONSES AND DEVELOPS A REPORT DETAILING ANY POTENTIALLY MATERIAL CONFLICTS FOR THE PRESIDENT AND CHAIR OF THE BOARD. A VERBAL SUMMARY IS ALSO GIVEN TO THE FULL BOARD OR APPROPRIATE COMMITTEE ENDING WITH A REMINDER TO COVERED PERSONS OF THE POLICY'S MANDATE THAT EACH PERSON IS OBLIGATED TO DISCLOSE ANY NEW POTENTIAL CONFLICTS AS THEY MAY ARISE THROUGHOUT THE YEAR. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY.
FORM 990, PART VI, SECTION B, LINE 15 PARK NICOLLET HEALTH SERVICE'S (PNHS) PRESIDENT AND ITS OFFICERS ARE EMPLOYED BY EITHER GROUP HEALTH PLAN, INC. (GHI), A RELATED ORGANIZATION, OR BY PNHS. GHI AND PNHS HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF THE PNHS'S PRESIDENT AND OTHER OFFICERS. EVERY THREE YEARS, THE INDEPENDENT COMPENSATION COMMITTEE OF THE GHI BOARD OF DIRECTORS (THE "COMMITTEE"), RETAINS AN EXTERNAL COMPENSATION EXPERT TO CONDUCT AN EXTENSIVE MARKET COMPARABILITY REVIEW FOR ALL OFFICERS OF THE ORGANIZATION. THE REVIEW INCLUDES ALL COMPONENTS OF TOTAL COMPENSATION: BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE APPROPRIATE COMMITTEE. BASED ON THIS DATA, THE COMPENSATION COMMITTEE OF GHI (THE "COMMITTEES") DETERMINE MINIMUM AND MAXIMUM TOTAL COMPENSATION RANGES FOR EACH EMPLOYED OFFICER. IN INTERIM YEARS, GHI'S HUMAN RESOURCES STAFF, UNDER THE COMMITTEES' DIRECTION, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION CONSULTANT FOR THE COMMITTEE. FOR CERTAIN POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED TO SET SALARY RANGES BASED ON THE COMPETITIVE MARKET DATA SPECIFIC TO THOSE POSITIONS. THE 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 CEO OF GHI CONDUCTS THE ANNUAL PERFORMANCE REVIEW AND DETERMINES THE COMPENSATION OF THE PNHS PRESIDENT. THE PNHS PRESIDENT OR OTHER OFFICERS DELEGATED BY THE PNHS PRESIDENT (WITH AUTHORITY TO FURTHER DELEGATE TO EXECUTIVES WITH LEADERSHIP ROLES OF PARK NICOLLET OFFICERS) CONDUCTS ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL PNHS-EMPLOYED OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMMITTEE. ANY EXCEPTIONS IN EXCESS OF THE APPROVED RANGES NEED TO BE APPROVED BY THE EXECUTIVE COMMITTEE. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND ON THE EMPLOYEE'S W-2
FORM 990, PART VI, SECTION C, LINE 19 PN GROUP'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSONS WHO REQUESTS THE INFORMATION FROM PNHS. THE GROUP'S ARTICLES OF INCORPORATION ARE AVAILABLE BY ANYONE WHO REQUEST THEM OR THROUGH THE MINNESOTA SECRETARY OF STATE'S OFFICE. THE FORMS 990 ARE AVAILABLE UPON REQUEST OR FROM THE STATE OF MINNESOTA OR AT GUIDESTAR.ORG.
FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS 10,000. GRANTS RUN THROUGH THE FOUNDATION -6,863. CAPITAL CONTRIBUTION 2,091,187.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2020


Additional Data


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

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2020
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

(1) PARK NICOLLET HEALTH SERVICES ACCOUNTABLE CARE ORGANIZATION LLC
3800 PARK NICOLLET BLVD
ST LOUIS PARK,MN55416
HEALTH CARE MN 0 0 PARK NICOLLET CLINIC
 










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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)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
(2)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
(3)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
(4)RH WISCONSIN INC
8171 33RD AVE S PO BOX 1309

MPLS,MN554401309
20-2287016
CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE I HPI - RAMSEY
 
 
No
(5)HEALTHPARTNERS INSTITUTE
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1670163
HEALTHCARE EDUCATION AND RESEARCH MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC
 
 
No
(6)CAPITOL VIEW TRANSITIONAL CARE CENTER
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-2011453
TRANSITIONAL CARE SERVICES, STEP DOWN FROM INPATIENT HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY
 
 
No
(7)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
(8)REGIONS HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1888902
PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH MN 501(C)(3) 170(B)(1) (A)(VI) HPI - RAMSEY
 
 
No
(9)RHSC INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1891928
HEALTHCARE STAFFING AND INTENSE REHAB SERVICES MN 501(C)(3) 509(A)(3) TYPE II HEALTHPARTNERS INC
 
 
No
(10)PHYSICIANS NECK & 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
(11)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 INC
 
 
No
(12)HUDSON HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
39-1279567
PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH WI 501(C)(3) 170(B)(1) (A)(VI) HUDSON HOSPITAL INC
 
 
No
(13)LAKEVIEW HEALTH FOUNDATION
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1386635
PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH MN 501(C)(3) 170(B)(1) (A)(VI) LAKEVIEW HEALTH
 
 
No
(14)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) LAKEVIEW HEALTH
 
 
No
(15)STILLWATER MEDICAL GROUP
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
83-0379473
CLINIC STAFF AND FACILITIES MN 501(C)(3) 509(A)(3) TYPE I LAKEVIEW HEALTH
 
 
No
(16)LAKEVIEW HEALTH
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
(17)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 INC
 
 
No
(18)WESTFIELDS HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
39-1770913
PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH WI 501(C)(3) 170(B)(1) (A)(VI) WESTFIELDS HOSPITAL INC
 
 
No
(19)RAMSEY INTEGRATED HEALTH SERVICES
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1503090
HOME CARE AND HOSPICE MN 501(C)(3) 509(A)(2) HPI - RAMSEY
 
 
No
(20)PARK NICOLLET FOUNDATION
6500 EXCELSIOR BLVD

ST LOUIS PARK,MN55426
23-7346465
SUPPORT TO RELATED ENTITIES AND COMMUNITY HEALTH MN 501(C)(3) 170(B)(1) (A)(VI) PARK NICOLLET HEALTH SERVICES
 
 
No
(21)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 INC
 
 
No
(22)AMERY REGIONAL MEDICAL CENTER FOUNDATION INC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
39-1726539
PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH WI 501(C)(3) 170(B)(1) (A)(VI) AMERY REGIONAL MEDICAL CENTER INC
 
 
No
(23)HUTCHINSON HEALTH
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
84-1715908
HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) PARK NICOLLET HEALTH SERVICES
 
 
No
(24)HUTCHINSON HEALTH FOUNDATION
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
36-3317820
PROVIDE SUPPORT TO HOSPITAL MN 501(C)(3) 509(A)(3) TYPE I HUTCHINSON HEALTH
 
 
No
(25)HEALTHPARTNERS RC
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
84-4261122
HOSPITAL MN 501(C)(3) 170(B)(1)(A)(III) PARK NICOLLET HEALTH SERVICES
 
 
No
(26)OLIVIA HOSPITAL & CLINIC FOUNDATION
8170 33RD AVE S PO BOX 1309

MPLS,MN554401309
41-1839619
PROVIDE SUPPORT TO HOSPITAL MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS RC
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No












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

6500 EXCELSIOR BLVD
ST LOUIS PARK,MN55426
41-1656735
REAL ESTATE FOR RELATED ORGANICATION MN PARK NICOLLET HEATLH SERVICES
 
C 76,481 7,973,589 100.000 %   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) 2020
Schedule R (Form 990) 2020
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) PARK NICOLLET HEALTH SERVICES

M 3,088,902 COST
(2) PARK NICOLLET HEALTH SERVICES

P 1,330,242,629 COST
(3) PARK NICOLLET HEALTH SERVICES

J 6,071,792 COST
(4) PARK NICOLLET HEALTH SERVICES

R 1,207,093,602 COST
(5) HEALTHPARTNERS INC

L 105,775,062 COST

Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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


Yes No Yes No Yes No






























Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
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) 2020

Additional Data


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