Centracare Health System-Long Prairie, Long Prairie Hospital & Nursing Hom in Long Prairie, Minnesota (MN)

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Table of contents:

• Overview
• Detailed Reports
  • Checklist
  • Statements Regarding Other IRS Filings and Tax Compliance
  • Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
  • Statement of Revenue
  • Statement of Functional Expenses
  • Balance Sheet
  • Reason for Public Charity Status
  • Revenue, Expenses, and Changes in Net Assets or Fund Balances
  • Statement of Functional Expenses
  • Balance Sheets
  • Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
  • Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
  • Current Officers, Directors, Trustees, and Key Employees
  • Other Information
  • Analysis of Income-Producing Activities
  • Information Regarding Taxable Subsidiaries and Disregarded Entities
  • Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees
  • Statements About Activities
  • Reason for Non-Private Foundation Status
  • Support Schedule
  • Lobbying Expenditures by Electing Public Charities
• Organizations performing similar types of work

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Centracare Health System-Long Prairie, Long Prairie Hospital & Nursing Hom
Employer Identification Number (EIN)	411924645
Name of Organization	Centracare Health System-Long Prairie
Secondary Name	Long Prairie Hospital & Nursing Hom
In Care of Name	James Davis Pres
Address	20 9th St Se, Long Prairie, MN 56347-1404
Subsection	Charitable Organization
Ruling Date	07/1999
Deductibility	Contributions are deductible
Foundation	Hospital or medical research organization
Organization	Corporation
Exempt Organization Status	Unconditional Exemption
Tax Period	06/2013
Assets	$10,000,000 to $49,999,999
Income	$10,000,000 to $49,999,999
Filing Requirement	990 (all other) or 990EZ return
Asset Amount	$20,945,664
Amount of Income	$26,008,072
Form 990 Revenue Amount	$26,008,072
National Taxonomy of Exempt Entities (NTEE)	Health - General and Rehabilitative: Community Health Systems

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Amount of income in 2013: $26,008,072

This organization:	$26,008,072
Other organizations performing similar types of work:	$6,791,313

Assets in 2013: $20,945,664

This organization:	$20,945,664
Other organizations performing similar types of work:	$5,000,000

Expenses in 2013: $24,100,525

Centracare Health System-Long Prairie, Long Prairie Hospital & Nursing Hom:	$24,100,525
Other organizations performing similar types of work:	$5,603,496

Income to expenses ratio in 2013: 1.1

Centracare Health System-Long Prairie, Long Prairie Hospital & Nursing Hom:	1.1
Other organizations performing similar types of work:	1.1

Expenses allocated to program services in 2002: 72.3%

This organization:	72.3%
Other organizations performing similar types of work:	86.4%

Number of employees in 2013: 285

Centracare Health System-Long Prairie, Long Prairie Hospital & Nursing Hom:	285
Other organizations performing similar types of work:	83

Employees paid over $100,000 in 2013: 4.6%

This organization:	4.6%
Other organizations performing similar types of work:	0.0%

Grants share in income in 2013: 0.1%

This organization:	0.1%
Other organizations performing similar types of work:	0.5%

Financial snapshot ($)

Revenue for 2013

Assets at the end of 2013

Functional expenses for 2013

Checklist
	2012	2013
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?	Yes	Yes
Is the organization required to complete Schedule B, Schedule of Contributors?	No	No
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office?	No	No
Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year?	No	No
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?	No	No
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?	Yes	No
Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures?	No	No
Did the organization maintain collections of works of art, historical treasures, or other similar assets?	No	No
Did the organization report an amount for escrow or custodial account liability; serve as a custodian or provide credit counseling, debt management, credit repair, or debt negotiation services?	Yes	Yes
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments?	No	No
Did the organization report an amount for land, buildings, and equipment?	Yes	Yes
Did the organization report an amount for investments-other securities that is 5% or more of its total assets?	Yes	Yes
Did the organization report an amount for investments-program related that is 5% or more of its total assets?	No	No
Did the organization report an amount for other assets that is 5% or more of its total assets?	No	No
Did the organization report an amount for other liabilities?	Yes	Yes
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)?	Yes	No
Did the organization obtain separate, independent audited financial statements for the tax year?	Yes	No
Was the organization included in consolidated, independent audited financial statements for the tax year?	No	Yes
Is the organization a school described in section 170(b)(1)(A)(ii)?	No	No
Did the organization maintain an office, employees, or agents outside of the United States?	No	No
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?	No	No
Did the organization report more than $5,000 of grants or other assistance to or for any foreign organization?	No	No
Did the organization report more than $5,000 of aggregate grants or other assistance to or for foreign individuals?	No	No
Did the organization report a total of more than $15,000 of expenses for professional fundraising services?	No	No
Did the organization report more than $15,000 total of fundraising event gross income and contributions?	No	No
Did the organization report more than $15,000 of gross income from gaming activities?	No	No
Did the organization operate one or more hospital facilities?	Yes	Yes
Did the organization attach a copy of its audited financial statements?	Yes	Yes
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government?	Yes	Yes
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals?	No	No
Did the organization answer 'Yes' about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees?	Yes	Yes
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?	No	No
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?	No	No
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?	No	No
Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year?	No	No
Did the organization engage in an excess benefit transaction with a disqualified person during the year?	No	No
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?	No	No
Did the organization report any amount for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?	No	No
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons?	No	No
Was the organization a party to a business transaction with one of the following parties
A current or former officer, director, trustee, or key employee?	No	No
A family member of a current or former officer, director, trustee, or key employee?	No	No
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner?	No	No
Did the organization receive more than $25,000 in non-cash contributions?	No	No
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions?	No	No
Did the organization liquidate, terminate, or dissolve and cease operations?	No	No
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?	No	No
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3?	No	No
Was the organization related to any tax-exempt or taxable entity?	Yes	Yes
Did the organization have a controlled entity within the meaning of section 512(b)(13)?	No	Yes
Did the organization make any transfers to an exempt non-charitable related organization?	No	No
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?	No	No

Statements Regarding Other IRS Filings and Tax Compliance
	2011	2012	2013
The number reported in Box 3 of Form 1096		34	34
The number of Forms W-2G		0	0
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?		No	Yes
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		286	285
Did the organization file all required federal employment tax returns?		Yes	Yes
Did the organization have unrelated business gross income of $1,000 or more during the year?	No	No	No
Has it filed a Form 990-T for this year?		No	No
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)?		No	No
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?		No	No
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?		No	No
Did the organization file Form 8886-T?		No	No
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?		No	No
Did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?		No	No
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?		No	No
Did the organization notify the donor of the value of the goods or services provided?		No	No
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?		No	No
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?		No	No
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?		No	No
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?		No	No
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?		No	No
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?		No	No
Did the sponsoring organization make any taxable distributions under section 4966?		No	No
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?		No	No
Initiation fees and capital contributions	$0	$0	$0
Gross receipts for public use of club facilities	$0	$0	$0
Gross income from members or shareholders	$0	$0	$0
Gross income from other sources	$0	$0	$0
Is the organization filing Form 990 in lieu of Form 1041?		No	No
The amount of tax-exempt interest received or accrued during the year		$0	$0
Is the organization licensed to issue qualified health plans in more than one state?		No	No
The amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans		$0	$0
The amount of reserves on hand		$0	$0
Did the organization receive any payments for indoor tanning services during the tax year?		No	No
Has it filed a Form 720 to report these payments?		No	No

Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
	2012	2013
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
Total reportable compensation from the organization	$686,509	$702,463
Total reportable compensation from related organizations	$3,438,626	$3,978,423
Total estimated amount of other compensation from the organization and related organizations	$746,532	$696,115
Total number of individuals who received more than $100,000 of reportable compensation from the organization	9	10
Total number of independent contractors who received more than $100,000 of compensation from the organization	3	3

Statement of Revenue
	2011	2012	2013
Total revenue	$24,462,155	$24,072,080	$26,008,072
Contributions, Gifts, Grants and Other Similar Amounts	$28,517	$33,537	$13,191
Program Service Revenue	$23,797,199	$23,370,646	$24,088,775
900099		$22,973,496	$24,088,775
All other program service revenue		$0	$0
Other Revenue
Investment income (including dividends, interest, and other similar amounts)	$4,472	$6,843	$442,087
Income from investment of tax-exempt bond proceeds	$0	$0	$0
Royalties	$0	$0	$0
Net rental income	$40,072	$41,188	$47,440
Gross rents (Real / Personal)	$40,072 / $0	$41,188 / $0	$47,440 / $0
Less: rental expenses (Real / Personal)	$0 / $0	$0 / $0	$0 / $0
Rental income or (loss) (Real / Personal)	$40,072 / $0	$41,188 / $0	$47,440 / $0
Net gain/loss from sales of assets other than inventory	$440,613	$368,575	$7,204
Gross amount from sales of assets other than inventory (Securities / Other)	$453,002 / $228,084	$373,198 / $1,500	$0 / $7,204
Less: cost or other basis and sales expenses (Securities / Other)	$0 / $240,473	$0 / $6,123	$0 / $0
Gain or (loss) (Securities / Other)	$453,002 / $-12,389	$373,198 / $-4,623	$0 / $7,204
Net income/loss from fundraising events	$0	$0	$0
Net income/loss from gaming activities	$0	$0	$0
Net income/loss from sales of inventory	$0	$0	$0
Miscellaneous Revenue	$151,282	$251,291	$1,409,375
900099		$198,551	$869,810
900099		$52,740	$253,149
All other revenue		$0	$286,416

Statement of Functional Expenses
	2011	2012	2013
Total functional expenses	$23,533,299	$24,163,353	$24,100,525
Grants and other assistance to domestic organizations and domestic governments		$533,222	$50,365
Grants and other assistance to domestic individuals		$3,523	$0
Grants and other assistance to foreign organizations, foreign governments, and foreign individuals		$0	$0
Benefits paid to or for members		$0	$0
Compensation of current officers, directors, trustees, and key employees	$0	$0	$0
Compensation not included above, to disqualified persons		$0	$0
Other salaries and wages	$10,260,646	$10,698,117	$11,081,085
Pension plan accruals and contributions		$457,866	$567,779
Other employee benefits		$3,024,271	$3,127,160
Payroll taxes	$641,787	$664,428	$700,463
Fees for services (non-employees)
Management		$0	$0
Legal		$46,820	$54,259
Accounting		$94,386	$79,557
Lobbying		$0	$0
Professional fundraising services	$0	$0	$0
Investment management fees		$0	$0
Other		$1,537,438	$1,776,585
Advertising and promotion		$4,646	$48,624
Office expenses		$1,199,047	$256,742
Information technology		$389,705	$369,977
Royalties		$0	$0
Occupancy		$539,777	$650,257
Travel		$94,233	$35,799
Payments of travel or entertainment expenses for any federal, state, or local public officials		$0	$0
Conferences, conventions, and meetings		$479	$88,612
Interest		$151,246	$147,186
Payments to affiliates		$0	$117,059
Depreciation, depletion, and amortization		$757,309	$761,892
Insurance		$104,141	$144,599
Other expenses		$2,045,041	$1,842,770
Other expenses		$699,910	$694,271
Other expenses		$316,948	$531,386
Other expenses		$226,875	$405,844
Other expenses		$573,925	$568,254

Balance Sheet
	2011	2012	2013
Total assets	$19,640,698	$19,395,442	$20,945,664
Cash - non-interest-bearing		$1,788,867	$3,281,076
Savings and temporary cash investments		$0	$0
Pledges and grants receivable, net		$0	$0
Accounts receivable, net		$3,347,382	$3,527,708
Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees		$0	$0
Loans and other receivables from other disqualified persons, persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations		$0	$0
Notes and loans receivable, net		$0	$0
Inventories for sale or use		$312,449	$300,224
Prepaid expenses and deferred charges		$173,785	$168,171
Land, buildings, and equipment: cost or other basis		$7,468,332	$7,630,294
Investments - publicly traded securities		$0	$0
Investments - other securities		$5,554,750	$5,255,135
Investments - program-related		$632,363	$496,856
Intangible assets		$0	$0
Other assets		$117,514	$286,200
Total liabilities	$5,077,823	$5,168,512	$5,416,061
Accounts payable and accrued expenses		$1,916,671	$2,497,266
Grants payable		$0	$0
Deferred revenue		$0	$0
Tax-exempt bond liabilities	$0	$0	$0
Escrow or custodial account liability		$17,021	$15,559
Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons		$0	$0
Secured mortgages and notes payable to unrelated third parties	$8,508	$6,724	$0
Unsecured notes and loans payable to unrelated third parties	$2,611,293	$2,535,244	$2,461,890
Other liabilities (including federal income tax, payables to related third parties, and other liabilities)		$692,852	$441,346
Total net assets or fund balances	$14,562,875	$14,226,930	$15,529,603
Unrestricted net assets		$14,203,003	$15,502,347
Temporarily restricted net assets		$23,927	$27,256
Permanently restricted net assets		$0	$0
Capital stock or trust principal, or current funds		$0	$0
Paid-in or capital surplus, or land, building, or equipment fund		$0	$0
Retained earnings, endowment, accumulated income, or other funds	$0	$0	$0

Reason for Public Charity Status (for 2013)
The organization is not a private foundation because it is:	A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii)
Number of organizations supported	0
Sum of amounts of support	$0

Revenue, Expenses, and Changes in Net Assets or Fund Balances
	2002
Total revenue	$14,942,933
Contributions, gifts, grants, and similar amounts received	$67,391
Contributions to donor advised funds
Direct public support	$43,129
Indirect public support	$0
Government contributions (grants)	$24,262
Program service revenue including government fees and contracts	$14,307,622
Membership dues and assessments	$0
Interest on savings and temporary cash investments	$284
Dividends and interest from securities	$0
Net rental income or (loss)	$106,227
Gross rents	$106,227
Less: rental expenses	$0
Other investment income	$0
Gain or (loss) from sales of assets other than inventory	$-7,145
Gross amount from sales of assets other than inventory	$0
Less: cost or other basis and sales expenses	$7,145
Net income or (loss) from special events and activities	$0
Gross revenue	$0
Less: direct expenses other than fundraising expenses	$0
Gross profit or (loss) from sales of inventory	$0
Gross sales of inventory, less returns and allowances	$0
Less: cost of goods sold	$0
Other revenue	$468,554
Total expenses	$14,122,375
Program services	$10,211,686
Management and general	$3,910,689
Fundraising	$0
Payments to affiliates	$0
Net assets or fund balances at end of year	$6,117,188
Excess or (deficit) for the year	$820,558
Net assets or fund balances at beginning of year	$5,281,018
Other changes in net assets or fund balances	$15,612

Statement of Functional Expenses (for 2002)
	Total	Program services	Management and general	Fundraising
Total functional expenses	$14,122,375	$10,211,686	$3,910,689	$0
Grants paid from donor advised funds
Other grants and allocations		$0
Specific assistance to individuals		$0
Benefits paid to or for members		$0
Compensation of current officers, directors, key employees, etc.	$165,681	$0	$165,681	$0
Compensation of former officers, directors, key employees, etc.
Compensation and other distributions, not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)
Salaries and wages of employees not included above	$6,100,606	$4,448,922	$1,651,684	$0
Pension plan contributions not included above	$183,757	$130,140	$53,617	$0
Employee benefits not included above	$1,279,488	$887,600	$391,888	$0
Payroll taxes	$430,357	$315,153	$115,204	$0
Professional fundraising fees	$0	$0	$0	$0
Accounting fees	$38,645	$0	$38,645	$0
Legal fees	$1,314	$0	$1,314	$0
Supplies	$2,001,449	$1,485,028	$516,421	$0
Telephone	$49,993	$10,321	$39,672	$0
Postage and shipping	$11,140	$907	$10,233	$0
Occupancy	$371,170	$17,903	$353,267	$0
Equipment rental and maintenance	$761,739	$643,048	$118,691	$0
Printing and publications	$135	$0	$135	$0
Travel	$59,733	$31,629	$28,104	$0
Conferences, conventions, and meetings	$52,697	$38,638	$14,059	$0
Interest	$173,714	$173,714	$0	$0
Depreciation, depletion, etc.	$657,406	$657,406	$0	$0
Other expenses not covered above	$1,783,351	$1,371,277	$412,074	$0

Balance Sheets
	2002
Total assets	$10,779,291
Cash - non-interest-bearing	$789,102
Savings and temporary cash investments	$0
Accounts receivable less allowance for doubtful accounts	$2,386,730
Pledges receivable less allowance for doubtful accounts	$0
Grants receivable	$0
Receivables from current and former officers, directors, trustees, and key employees	$0
Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B)
Other notes and loans receivable less allowance for doubtful accounts	$0
Inventories for sale or use	$226,232
Prepaid expenses and deferred charges	$111,213
Investments - publicly-traded securities
Investments - other securities	$0
Investments - land, buildings, and equipment less accumulated depreciation	$0
Investments - other	$423,189
Land, buildings, and equipment less accumulated depreciation	$6,760,492
Other assets, including program-related investments	$82,333
Total liabilities	$4,662,103
Accounts payable and accrued expenses	$1,032,214
Grants payable	$0
Deferred revenue	$0
Loans from officers, directors, trustees, and key employees	$0
Tax-exempt bond liabilities	$0
Mortgages and other notes payable	$3,038,316
Other liabilities	$591,573
Total liabilities and net assets/fund balances	$10,779,291
Total net assets or fund balances	$6,117,188

Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
	2002
Total revenue	$14,942,933
Total revenue, gains, and other support per audited financial statements	$14,919,334
Other expenses	$0
Net unrealized gains on investments	$0
Donated services and use of facilities	$0
Recoveries of prior year grants	$0
Other	$0
Other revenue	$23,599
Investment expenses	$0
Other	$23,599

Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
	2002
Total expenses	$14,122,375
Total expenses and losses per audited financial statements	$14,122,375
Other revenue	$0
Donated services and use of facilities	$0
Prior year adjustments	$0
Losses	$0
Other	$0
Other expenses	$0
Investment expenses	$0
Other	$0

Current Officers, Directors, Trustees, and Key Employees

Total number of officers, directors, and trustees permitted to vote on organization business at board meetings	0
Are any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, related to each other through family or business relationships?
Do any officers, directors, trustees, or key employees listed in Form 990, Part V-A, or highest compensated employees listed in Schedule A, Part I, or highest compensated professional and other independent contractors listed in Schedule A, Part II-A or II-B, receive compensation from any other organizations, whether tax exempt or taxable, that are related to the organization?
Does the organization have a written conflict of interest policy?

Other Information
Did the organization have unrelated business gross income of $1,000 or more during the year covered by this return, and has it filed a tax return on Form 990-T for this year?	No
Was there a liquidation, dissolution, termination, or substantial contraction during the year?	No
Is the organization related (other than by association with a statewide or nationwide organization) through common membership, governing bodies, trustees, officers, etc., to any other exempt or nonexempt organization?	Yes
Direct and indirect political expenditures	$0
Did the organization file Form 1120-POL for this year?	No
Were substantially all dues nondeductible by members?
Did the organization make only in-house lobbying expenditures of $2,000 or less?
Dues, assessments, and similar amounts from members	$0
Section 162(e) lobbying and political expenditures	$0
Aggregate nondeductible amount of section 6033(e)(1)(A) dues notices	$0
Taxable amount of lobbying and political expenditures	$0
Does the organization elect to pay the section 6033(e) tax on the amount above?
If section 6033(e)(1)(A) dues notices were sent, does the organization agree to add the amount above to its reasonable estimate of dues allocable to nondeductible lobbying and political expenditures for the following tax year?
Initiation fees and capital contributions	$0
Gross receipts for public use of club facilities	$0
At any time during the year, did the organization, directly or indirectly, own a controlled entity within the meaning of section 512(b)(13)?
Amount of tax imposed on the organization during the year under: section 4911	$0
Amount of tax imposed on the organization during the year under: section 4912	$0
Amount of tax imposed on the organization during the year under: section 4955	$0
Did the organization engage in any section 4958 excess benefit transaction during the year or did it become aware of an excess benefit transaction from a prior year?	No
Amount of tax imposed on the organization managers or disqualified persons during the year under sections 4912, 4955, and 4958	$0
Amount of tax above, reimbursed by the organization	$0
At any time during the tax year, was the organization a party to a prohibited tax shelter transaction?
Did the organization acquire a direct or indirect interest in any applicable insurance contract?
Did the supporting organization, or a fund maintained by a sponsoring organization, have excess business holdings at any time during the year?
Number of employees employed in the pay period that includes March 12, 2006	253

Analysis of Income-Producing Activities (for 2002)
	Unrelated business income		Excluded by section 512, 513, or 514		Related or exempt function income
	Business code	Amount	Exclusion code	Amount
Total		$0		$567,920	$14,307,622
Program service revenue
Program service revenue 1	000000	$0	00	$0	$14,015,855
Program service revenue 2	000000	$0	00	$0	$147,002
Program service revenue 3	000000	$0	00	$0	$143,322
Program service revenue 4	000000	$0	00	$0	$1,443
Program service revenue 5	000000	$0	00	$0	$0
Medicare/Medicaid payments	000000	$0	00	$0	$0
Fees and contracts from government agencies	000000	$0	00	$0	$0
Membership dues and assessments	000000	$0	00	$0	$0
Interest on savings and temporary cash investments	000000	$0	Dividends, interest, payments with respect to securities loans, annuities, income from notional principal contracts, loan commitment fees, and other substantially similar income from ordinary and routine investments excluded by section 512(b)(1)	$284	$0
Dividends and interest from securities	000000	$0	00	$0	$0
Net rental income or (loss) from real estate
debt-financed property	000000	$0	00	$0	$0
not debt-financed property	000000	$0	Real property rental income that does not depend on the income or profits derived by the person leasing the property and is excluded by section 512(b)(3)	$106,227	$0
Net rental income or (loss) from personal property	000000	$0	00	$0	$0
Other investment income	000000	$0	00	$0	$0
Gain or (loss) from sales of assets other than inventory	000000	$0	Gain (or loss, to the extent allowed) from the sale of investments and other non-inventory property and from certain property acquired from financial institutions that are in conservatorship or receivership (sections 512(b)(5) and 512(b)(16)(A))	$-7,145	$0
Net income or (loss) from special events	000000	$0	00	$0	$0
Gross profit or (loss) from sales of inventory	000000	$0	00	$0	$0
Other revenue	000000	$0	Dividends, interest, payments with respect to securities loans, annuities, income from notional principal contracts, loan commitment fees, and other substantially similar income from ordinary and routine investments excluded by section 512(b)(1)	$468,554	$0

Information Regarding Taxable Subsidiaries and Disregarded Entities (for 2002)
EIN of corporation, partnership, or disregarded entity	Percentage of ownership interest	Total income	End-of-year assets
	0%	$0	$0
	0%	$0	$0
	0%	$0	$0
	0%	$0	$0

Compensation of the Five Highest Paid Employees Other Than Officers, Directors, and Trustees (for 2002)
Compensation	Contributions to employee benefit plans & deferred compensation	Expense account and other allowances
$100,559	$16,543	$0
$91,849	$23,380	$0
$71,967	$16,924	$0
$70,156	$15,560	$0
$63,420	$17,725	$0

Total number of other employees paid over $50,000

12

Statements About Activities (for 2002)
Expenses paid or incurred in connection with the lobbying activities	$0
Did the organization receive or hold an easement for conservation purposes, including easements to preserve open space, the environment, historic land areas or historic structures?
Did the organization provide credit counseling, debt management, credit repair, or debt negotiation services?
Did the organization maintain any donor advised funds?
Did the organization make any taxable distributions under section 4966?
Did the organization make a distribution to a donor, donor advisor, or related person?
The total number of donor advised funds owned at the end of the tax year
The aggregate value of assets held in all donor advised funds owned at the end of the tax year
The total number of separate funds or accounts owned at the end of the tax year (excluding donor advised funds included above) where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts
The aggregate value of assets held in all funds or accounts included above at the end of the tax year

Reason for Non-Private Foundation Status
The organization is not a private foundation because it is	Hospital, or a cooperative hospital service organization

Support Schedule
	2001
Total	$0
Gifts, grants, and contributions received	$0
Membership fees received	$0
Gross receipts from admissions, merchandise sold or services performed, or furnishing of facilities in any activity that is related to the organization's charitable, etc., purpose	$0
Gross income from interest, dividends, amounts received from payments on securities loans (section 512(a)(5)), rents, royalties, and unrelated business taxable income (less section 511 taxes) from businesses acquired by the organization after June 30, 1975	$0
Net income from unrelated business activities not included above	$0
Tax revenues levied for the organization's benefit and either paid to it or expended on its behalf	$0
The value of services or facilities furnished to the organization by a governmental unit without charge. Do not include the value of services or facilities generally furnished to the public without charge	$0
Other income	$0

Lobbying Expenditures by Electing Public Charities (for 2002)
Total exempt purpose expenditures	$0
Total lobbying expenditures	$0
Total lobbying expenditures to influence public opinion (grassroots lobbying)	$0
Total lobbying expenditures to influence a legislative body (direct lobbying)	$0
Other exempt purpose expenditures	$0
Lobbying nontaxable amount	$0
Grassroots nontaxable amount	$0

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Organizations performing similar types of work
Id	Name	Address	State	Established	Total Income
1	Mayo Clinic	200 1st St Sw, Rochester, MN 55905-0001	MN	1947-01	$6,024,621,187
2	Mayo Clinic, Mayo Fndn For Medical Ed & Research	200 First Street Sw, Rochester, MN 55905-0001	MN	2014-03	$1,069,644,456
3	Mayo Clinic, Mayo Clinic Hospital Rochester	200 First Street Sw, Rochester, MN 55905-0001	MN	2014-03	$989,100,186
4	Mayo Clinic, Mayo Clinic Health System-Mankato	1025 Marsh St, Mankato, MN 56001-4752	MN	2014-03	$320,182,073
5	Mayo Clinic, Mayo Clinc Hs Albert Lea And Austin	1000 1st Dr Nw, Austin, MN 55912-2941	MN	2014-03	$278,727,003
6	Mayo Clinic, Mayo Clinic Health System Red Wing	PO BOX 95, Red Wing, MN 55066-0095	MN	2014-03	$99,279,658
7	Mayo Clinic, Mayo Clinic Health System-Fairmont	800 Medical Center Dr, Fairmont, MN 56031-4575	MN	2014-03	$82,393,676
8	Sanford, Sanford Med Cntr Thief River Falls	3001 Sanford Pkwy, Thief Rvr Fls, MN 56701-2700	MN	2011-04	$68,971,183
9	Mayo Clinic, Mayo Clinic Health System-Owatonna	2200 Nw 26th St, Owatonna, MN 55060-5503	MN	2014-03	$85,694,271
10	Mayo Clinic, Mayo Clinic Hlth Systems-St James	1101 Moulton And Parsons Dr, St James, MN 56081-5550	MN	2014-03	$18,632,891
11	United Family Practice Health Center	1026 7th St W, Saint Paul, MN 55102-3828	MN	2004-01	$13,275,223
12	Mayo Clinic, Springfield	625 N Jackson Ave, Springfield, MN 56087-1714	MN	2014-03	$12,575,419
13	Viewcrest Health Center Inc	801 Nevada Ave Ste 100, Morris, MN 56267-1874	MN	1996-10	$7,778,865
14	Sanford Medical Center Wheaton	401 12th Street North, Wheaton, MN 56296	MN	2011-04	$7,598,332
15	Zumbrota Health Services, Zumbrota Care Ctr-Bridges	801 Nevada Ave Ste 100, Morris, MN 56267-1874	MN	2004-07	$3,539,846
16	Rural Aids Action Network	300 E Saint Germain St Ste 220, Saint Cloud, MN 56304-2500	MN	1995-01	$1,071,141
17	Mayo Clinic, St James Health Care Foundation	1101 Moulton And Parsons Dr, St James, MN 56081-5550	MN	2014-03	$206,648
18	Minnetonka Outreach	16609 Park Lane, Wayzata, MN 55391	MN	2009-09	$0
19	Rochester Students Health Services Corporation	37 Woodlake Drive Se, Rochester, MN 55904	MN	2014-08	$0
20	Zandu Health Initiative	1816 Granite Drive, Shakopee, MN 55379	MN	2014-07	$0

Number of organizations performing similar types of work
Alabama 6 Arkansas 5 Arizona 2 California 34 Colorado 11 Connecticut 6 District of Columbia 3 Delaware 2 Florida 20 Georgia 23 Hawaii 9 Iowa 2 Idaho 5 Illinois 23 Indiana 10 Kansas 8 Kentucky 8 Louisiana 5 Massachusetts 67 Maryland 7 Maine 6 Michigan 36 Minnesota 39 Missouri 15 Mississippi 4 Montana 3	North Carolina 27 North Dakota 14 Nebraska 4 New Hampshire 3 New Jersey 33 New Mexico 3 Nevada 2 New York 45 Ohio 26 Oklahoma 7 Oregon 6 Pennsylvania 46 Rhode Island 5 South Carolina 2 South Dakota 10 Tennessee 7 Texas 62 Utah 3 Virginia 29 Vermont 2 Washington 8 Wisconsin 25 West Virginia 8 Wyoming 1 International 1
Total	738

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