Civic Intelligence

Mayo Clinic Health System - New Prague

EIN 41-0723639 • 501(c)3 • New Prague, MN

Profile

To inspire hope and contribute to health and well-being by providing the best care to every patient through integrated clinical practice, education, and research.

301 Second Street NortheastNew Prague, MN 56071

www.mayoclinichealthsystem.org

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

49th percentile

0.21x

Higher debt load relative to assets than 49% of similar nonprofits.

501(c)3 • $25M-$50M nonprofits • Source year 2014

Liabilities / Revenue

30th percentile

0.12x

Higher debt load relative to revenue than 30% of similar nonprofits.

501(c)3 • $25M-$50M nonprofits • Source year 2014

Net Margin

48th percentile

3.7%

Higher net margin than 48% of similar nonprofits.

501(c)3 • $25M-$50M nonprofits • Source year 2014

Top Officer Pay

85th percentile

$564,844

Higher top officer pay than 85% of similar nonprofits.

Top officer pay equals 1.5% of source-year revenue.

501(c)3 • $25M-$50M nonprofits • Source year 2014

Asset Growth

30th percentile

0.1%

Faster asset growth than 30% of similar nonprofits.

501(c)3 • $25M-$50M nonprofits • Annualized from 2013 to 2014

Revenue Growth

40th percentile

3.9%

Faster revenue growth than 40% of similar nonprofits.

501(c)3 • $25M-$50M nonprofits • Annualized from 2013 to 2014

Assets

Up

$23,063,611

Up $15,781 (+0.1%) from 2013

Liabilities

Down

$4,785,981

Down $1,398,404 (-23%) from 2013

Net Assets

Up

$18,277,630

Up $1,414,185 (+8.4%) from 2013

Revenue

Up

$38,429,635

Up $1,439,944 (+3.9%) from 2013

Expenses

Up

$37,015,450

Up $326,266 (+0.9%) from 2013

Net Income

Up

$1,414,185

Up $1,113,678 (+371%) from 2013

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$40M$30M$20M$10M$0Assets 2010: $31,428,821Liabilities 2010: $8,510,593Net Assets 2010: $22,918,2282010Assets 2011: $34,060,840Liabilities 2011: $7,989,874Net Assets 2011: $26,070,9662011Assets 2012: $22,123,496Liabilities 2012: $5,560,558Net Assets 2012: $16,562,9382012Assets 2013: $23,047,830Liabilities 2013: $6,184,385Net Assets 2013: $16,863,4452013Assets 2014: $23,063,611Liabilities 2014: $4,785,981Net Assets 2014: $18,277,6302014

Highlighted filing

2014

Assets$23,063,611
Liabilities$4,785,981
Net Assets$18,277,630

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$40M$30M$20M$10M$0-$10MExpenses 2010: $31,827,8842010Expenses 2011: $30,918,3252011Revenue 2012: $36,926,410Expenses 2012: $37,013,342Net Income 2012: -$86,9322012Revenue 2013: $36,989,691Expenses 2013: $36,689,184Net Income 2013: $300,5072013Revenue 2014: $38,429,635Expenses 2014: $37,015,450Net Income 2014: $1,414,1852014

Highlighted filing

2014

Revenue$38,429,635
Expenses$37,015,450
Net Income$1,414,185

Filings

Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2014 to Dec 31, 2014
Signed
Nov 9, 2015
Return Version
2014v5.0
Gross Receipts
$38,450,430
Mission and Program Overview

Mission

To inspire hope and contribute to health and well-being by providing the best care to every patient through integrated clinical practice, education, and research.

HOSPITAL AND CLINIC

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$12,269,865$11,549,487▼ $720,378
Investments Other Securities$3,256,699$4,980,102▲ $1,723,403
Accounts Receivable$5,916,400$4,623,040▼ $1,293,360
Inventories for Sale or Use$525,863$372,811▼ $153,052
Cash and Non-Interest-Bearing Accounts$639$915▲ $276
Total Assets$23,047,830$23,063,611▲ $15,781
Other Assets Total$1,078,364$1,537,256▲ $458,892
Liabilities
Other Liabilities$4,238,190$3,390,523▼ $847,667
Accounts Payable and Accrued Expenses$1,884,118$1,395,458▼ $488,660
Mortgage Notes Payable Secured by Investment Property$62,077$0▼ $62,077
Total Liabilities$6,184,385$4,785,981▼ $1,398,404
Net Assets / Fund Balance
Unrestricted Net Assets$15,935,260$17,275,251▲ $1,339,991
Temporarily Rstr Net Assets$910,055$983,146▲ $73,091
Permanently Rstr Net Assets$18,130$19,233▲ $1,103
Total Net Assets Fund Balance$16,863,445$18,277,630▲ $1,414,185
Total Liabilities and Net Assets / Fund Balance$23,047,830$23,063,611▲ $15,781

Asset Categories

AssetBook ValueDepreciationBasis
Buildings$6,848,709$2,143,050$8,991,759
Equipment$2,675,247$929,419$3,604,666
Land$2,020,000-$2,020,000
Other Land Buildings$5,531-$5,531
Other Assets Org$1,002,379--
Other Securities$4,980,102--

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2014$18,134-▲ $1,099-$19,233
2013-$18,340▼ $206-$18,134
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Jensen Christopher TCrnaFT$237,117$34,140$271,257
Stupica BruceCrnaFT$239,653$10,945$250,598
Klimp Mary JSite AdministratorFT$213,964$25,988$239,952
Simon CarolCharge NurseFT$136,656$50,499$187,155
Hopkins Laura HNurse AdministratorFT$166,136$15,186$181,322
Chinna Lekshmi Mercy CCharge NurseFT$144,710$35,513$180,223

Board Members and Trustees

NameTitle
Herrmann Md Martin JDirector/chair
Kutcher Md Gregory RDir/president/region CEO
Schoenbauer BradDirector/vice Chair
Brod ReneeDirector
Miller JoshDirector
Moga Md C NicDirector
Wolf BruceDirector
Wornson RichardDirector
Grace Richard WDirector/VP/region CAO
Koch Mark BAssistant Secretary
Tarasovitch James JDir/secy/treas/region CFO
Cardwell Md Bret aFormer Highest Paid
Overgaard Shawn MFormer Highest Paid

Highest Paid Contractors

ContractorServicesLocationCompensation
Mayo Foundation For Medical Education AnPurchasing Agent200 FIRST STREET SW, Rochester, MN 55905$1,112,304
Allina Hospital And ClinicsClinical ServicesPO BOX 9383, Minneapolis, MN 55440$490,771
Sodexo INC And AffiliatesDietary & Environmental Services10 EARHART DRIVE, Williamsbill, NY 14221$322,979
Shared Medical ServicesMobile RadiologyPO BOX 330, Cottage Grove, WI 53527$269,565
Consulting Radiologists LtdRadiology Physicians3300 OAKDALE AVE SUITE 1300, Robbinsdale, MN 55422$213,153
Revenue and Support

Revenue Composition

Contributions and Grants
$303,366
Program Service Revenue
$37,565,224
Investment Income
$7,593
Other Revenue
$553,452
All Other Contributions
$2,560
Change in Net Assets
$1,414,185
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$19,985,967
Other Expenses$17,021,774
Grants and Similar Amounts Paid$7,709
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$15,693,223$244,277-$15,937,500
Fees for Services Other$5,296,022$2,318,970-$7,614,992
Other Employee Benefits$1,915,279$49,546-$1,964,825
Occupancy$923,261$588,819-$1,512,080
Depreciation Depletion$1,168,416$39,188-$1,207,604
Payroll Taxes$1,008,020$38,409-$1,046,429
Office Expenses$713,930$80,266-$794,196
Pension Plan Contributions$489,910$19,008-$508,918
Comp Disqual Persons$138,733$149,609-$288,342
Other Expenses$135,110$110,934-$246,044
Current Officers, Directors, Trustees, and Key Employees-$239,953-$239,953
All Other Expenses$85,049$75,007-$160,056
Travel$129,234$17,998-$147,232
Insurance-$114,592-$114,592
Fees for Services Management$9,746$130-$9,876
Grants to Domestic Orgs$7,709--$7,709
Information Technology$7,640--$7,640
Advertising$2,372$4,362-$6,734
Conferences and Meetings$645$4,324-$4,969
Fees for Services Legal-$3,168-$3,168
Fees for Services Lobbying$304--$304
Total Functional Expenses$32,768,278$4,247,172$0$37,015,450
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Gross Income$932
Fundraising Direct Expenses$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
Anna HerrmannSpouse of Director Martin HerrmannCompensationNo$149,609
Paige NytesFamily Member of Director Renee BrodCompensationNo$72,813
Mary NytesFamily Member of Director Renee BrodCompensationNo$33,233
Rachel GraceSpouse of Director Josh MillerCompensationNo$32,688
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Due to Affiliates$3,390,523
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with family members
Yes
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
Yes

Governance Explanations

Form 990, Part VI, Section A, Line 2

The following individuals are employed by a related organization: moga m.d., c. Nic herrmann m.d., martin j. Resulting in a business relationship with the following individuals who are associated with the related organization as an officer, director, or trustee: koch, mark b. Tarasovitch, james j. Kutcher m.d., gregory r. Grace, richard w. The following individuals are employed by a related organization: tarasovitch, james j. Kutcher m.d., gregory r. Grace, richard w. Resulting in a business relationship with the following individuals who are associated with the related organization as an officer, director, or trustee: schoenbauer, brad . Koch, mark b. Tarasovitch, james j. Kutcher m.d., gregory r. Grace, richard w. Herrmann m.d., martin j.

Form 990, Part VI, Section A, Line 3

Mayo clinic, mayo foundation for medical education and research, and other related companies provide management services to the entire system of entities. Mayo clinic health system - mankato also provides management services on a regional basis that includes the filing organization. Since the entities are related organizations, compensation for the officers, directors, key employees, and highest compensated employees has been disclosed in part vii and schedule j as required.

Form 990, Part VI, Section A, Line 6

The sole corporate member is mayo clinic health system-mankato

Form 990, Part VI, Section A, Line 7A

The sole corporate member appoints the four member directors and designates members of the nominating committee for the seven community members. Ultimate election is by the board of directors of the corporation.

Form 990, Part VI, Section A, Line 7B

Certain transactions require approval by the member before action can be taken such as amendment to the articles and bylaws, merger or other restructuring, and incurrence of debt.

Form 990, Part VI, Section B, Line 11

The form 990 is prepared by mayo corporate tax with assistance from site accounting staff. The tax return goes through two levels of review within the corporate tax unit. It is then reviewed by the region chief financial officer and finance director, along with site finance staff. A copy of the form 990 is then provided to each member of the filing organization's governing body via us mail, e-mail, or distribution at a board meeting. All questions are addressed prior to filing the form 990.

Form 990, Part VI, Section B, Line 12C

Mayo clinic and its affiliates have a comprehensive conflict of interest policy applicable to all of the affiliated entities and to all directors, officers, and employees of those entities. All current and former officers, directors, trustees, key employees and highest compensated employees who we anticipate will be listed on a form 990 are asked to complete an "annual tax and compliance disclosure" form. This information is reviewed by both the corporate tax department and the office of conflict of interest review. All disclosures of current or proposed activity that require action under the policy are the subject of ongoing review and action through the office of conflict of interest review and the conflict of interest review board. Involved individuals are informed of all required action. Many types of relationships that could create conflicts of interest are prohibited. Other types of relationships are permitted subject to compliance with the management plan established by the conflict of interest review board. A common management strategy for permitted activities is to require bilateral recusal and appropriate documentation in the minutes of mayo clinic (and/or affiliate) and the outside entity. Additional conflict of interest policies and procedures exist for certain entities concerning research contracts and other types of potential conflicts.

Form 990, Part VI, Section B, Line 15

The filing organization is an affiliate of mayo clinic. Mayo clinic and its affiliates have a coordinated process for reviewing and approving compensation and benefits for physicians, executive and senior administrative leadership, along with allied health staff. In addition to any review and approval that may take place at the local entity or regional level, the following independent approval process occurs annually prior to implementation of the respective compensation increase. The salaries and benefit programs of the chief executive officer (ceo) and the chief administrative officer (cao) were reviewed and approved by the process described below for senior administrative leadership. The compensation and benefit programs for senior administrative leadership for all campuses, including the mayo clinic health system locations, are reviewed and approved by the mayo clinic board of trustees governance and nominating committee. The mayo clinic board of trustees governance and nominating committee is comprised of nine of the external independent members of the mayo clinic board of trustees. This group reviews and approves the compensation and benefit programs for physicians from all campuses, as well as certain senior administrative and executive leadership (including all persons believed to be disqualified persons). This process establishes acceptable ranges for various positions, levels, and specialties. The committee uses comparability data (including third-party benchmarking surveys) in its review and documents decisions in its minutes.

Form 990, Part VI, Section C, Line 19

The filing organization's governing documents are not available to the public. The conflict of interest policy is available upon request and also on the mayoclinic.org website. The filing organization is a hospital affiliated with mayo clinic. As such, mayo clinic's consolidated audited financial statements are attached to the filing organization's form 990 and would be available upon request of the form 990.

Filing and Contact Details

Filer

Filer Name
Mayo Clinic Health System - New Prague
EIN
41-0723639
Phone
5075381297
Address
301 SECOND STREET NORTHEAST, NEW PRAGUE, MN 56071

Signing Officer

Name
James J Tarasovitch
Title
Region CFO
Phone
5073856449
Signed
2015-11-09

Organization Details

Principal Officer
Gregory R Kutcher Md
Formed
1951
Legal Domicile
Mn
Voting Board Members
10
Independent Board Members
4
Employees
577
Volunteers
103
Supplemental Narrative

Additional Explanations

Form 990, Part IX, Line 11G

Ic purchased services : program service expenses 3,980,183. Management and general expenses 2,253,191. Fundraising expenses 0. Total expenses 6,233,374. Other purchased services : program service expenses 1,315,839. Management and general expenses 65,779. Fundraising expenses 0. Total expenses 1,381,618.

Filing of Certain Foreign Forms

Disclosure statement related to forms 5713: form 5713 has been filed by the following members of the controlled group: mayo clinic (ein: 41-6011702) mayo foundation for medical education and research (ein: 41-1506440) mayo clinic arizona (ein: 86-0800150) mayo clinic jacksonville (ein: 59-3337028) disclosure statement related to forms 5471: under the constructive ownership rules of irc sections 958(a) and (b), the taxpayer is required to file forms 5471, information return of u.s. Persons with respect to certain foreign corporations, as a category 4 and 5 filer with respect to certain controlled foreign corporations (cfcs). These filing requirements are or will be satisfied through the filing of forms 5471 for these cfcs by other u.s. Taxpayers identified below who have the same filing requirement. Taxpayer name: mayo clinic address: 200 first street sw, rochester, mn 55905 id number of u.s. Tax return with which form 5471 was filed: 41-6011702 irs service center where u.s. Tax return was or will be filed: e-filed taxpayer name: mayo foundation for medical education and research address: 200 first street sw, rochester, mn 55905 id number of u.s. Tax return with which form 5471 was filed: 41-1506440 irs service center where u.s. Tax return was or will be filed: e-filed disclosure statement related to forms 8865: under the constructive ownership rules of irc sections 958(a) and (b), the taxpayer is required to file forms 8865, information return of u.s. Persons with respect to certain foreign partnerships, as a category 2 and 3 filer. These filing requirements are or will be satisfied through the filing of forms 8865 for these partnerships by other u.s. Taxpayers identified below who have the same filing requirement. Taxpayer name: mayo clinic address: 200 first street sw, rochester, mn 55905 id number of u.s. Tax return with which form 8865 was filed: 41-6011702 irs service center where u.s. Tax return was or will be filed: e-filed

Financial Statement Notes

PART V, LINE 4:

The endowment funds provide a stable funding source for pastoral care, cardiac rehab, and nursing education.

PART X, LINE 2:

At december 31, 2014 and 2013, the reserve for unrecognized tax benefits was not significant, and as a result, there is no longer a reserve for unrecognized tax benefits recorded for the filing organization.

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This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/Desc0PATIENT CARE (SEE SCHEDULE O)PATIENT CARE:MAYO CLINIC HEALTH SYSTEM IS A FAMILY OF CLINICS, HOSPITALS AND HEALTH CARE FACILITIES SERVING COMMUNITIES IN MINNESOTA, IOWA, WISCONSIN AND GEORGIA. AS PART OF MAYO CLINIC, THE HEALTH SYSTEM OFFERS CARE DESIGNED FOR THE WHOLE BODY CLOSE TO THE PATIENT'S HOME, WHEN THEY NEED IT. A MULTIDISCIPLINARY TEAM OF EXPERTS HAS READY ACCESS TO KNOWLEDGE, RESOURCES, AND EXPERTISE OF MAYO CLINIC AND COLLABORATES ON PROVIDING EXACTLY THE CARE THE PATIENT NEEDS. MAYO CLINIC HEALTH SYSTEM SITES EMPLOY APPROXIMATELY 1,000 PHYSICIANS AND 15,000 ALLIED HEALTH STAFF. IN ADDITION, MAYO CLINIC PHYSICIANS FROM MULTIPLE SPECIALTIES REGULARLY SEE PATIENTS AT HEALTH SYSTEM FACILITIES. BESIDES HAVING HEALTH CARE FACILITIES IN NEARLY 70 COMMUNITIES, MAYO CLINIC HEALTH SYSTEM INCLUDES 19 OWNED HOSPITALS, FIVE OWNED NURSING HOMES, PHYSICIAN SERVICE AGREEMENTS WITH ONE ADDITIONAL HOSPITAL, AND CONTRACT MANAGEMENT AGREEMENTS WITH TWO ADDITIONAL HOSPITALS AND ONE NURSING HOME. SINCE ITS INCEPTION IN 1992, MAYO CLINIC HEALTH SYSTEM HAS GROWN INTO ONE OF THE MOST SUCCESSFUL REGIONAL HEALTH CARE SYSTEMS IN THE UNITED STATES. MORE THAN 600,000 UNIQUE PATIENTS ACCOUNT FOR MORE THAN 2.6 MILLION VISITS ANNUALLY IN MAYO CLINIC HEALTH SYSTEM. IT IS ALSO A NATIONAL LEADER IN QUALITY AND SAFETY EFFORTS. AS OUR MISSION STATES, OUR ORGANIZATION AIMS TO INSPIRE HOPE AND CONTRIBUTE TO HEALTH AND WELL-BEING BY PROVIDING THE BEST CARE TO EVERY PATIENT THROUGH INTEGRATED CLINICAL PRACTICE, EDUCATION, AND RESEARCH. OUR VISION IS TO ACHIEVE THE HIGHEST STANDARDS FOR MEDICAL CARE AND HEALTH IMPROVEMENT IN THE COMMUNITIES IN WHICH WE LIVE AND WORK. OUR FIRST PRIORITY IS TO MEET PATIENT NEEDS GUIDED BY THE CORE VALUES OF INTEGRITY, CONTINUOUS IMPROVEMENT, SERVICE, TEAMWORK, INNOVATION, BALANCE AND FINANCIAL INTEGRITY.AS A MEMBER OF MAYO CLINIC HEALTH SYSTEM, MCHS - NEW PRAGUE PROVIDES QUALITY HEALTH CARE CLOSE TO HOME WITH DIRECT ACCESS TO HIGHLY SPECIALIZED CARE IF THE NEED ARISES.INPATIENT SERVICES: MCHS - NEW PRAGUE IS A 25 BED CRITICAL ACCESS HOSPITAL LOCATED IN NEW PRAGUE, MINNESOTA. MCHS - NEW PRAGUE HAD 736 ADMISSIONS AND HAD 152 BIRTHS IN 2014.OUTPATIENT CLINIC SERVICES: A TOTAL OF 60,000 OUTPATIENT REGISTRATIONS WERE RECORDED, INCLUDING LAB, RADIOLOGY, SPECIALTY CLINIC VISITS, THERAPY, SLEEP STUDIES, AND AMBULATORY SURGERIES. THERE WERE 6,800 PATIENTS SEEN IN THE EMERGENCY DEPARTMENT.MEDICAL STAFF: MCHS - NEW PRAGUE HAS ACTIVE MEDICAL STAFF WHICH CONSISTS OF FAMILY PRACTICE, WOMEN'S HEALTH, INTERNAL MEDICINE, PEDIATRIC PHYSICIANS, ER PHYSICIANS AND A GENERAL SURGEON. CONSULTING SPECIALISTS INCLUDE ALLERGY, CARDIOLOGY, ORAL/MAXILLOFACIAL SURGERY, ENT GASTROENTEROLOGY, INFECTIOUS DISEASES, NEPHROLOGY, NEUROLOGY, ONCOLOGY, ORTHOPEDICS, OB/GYN, OPHTHALMOLOGY, PULMONOLOGY, RADIOLOGY/TELE-RADIOLOGY, GASTROENTEROLOGY, RHEUMATOLOGY, UROLOGY, DENTISTRY, AND PODIATRY.UNCOMPENSATED CARE: MCHS - NEW PRAGUE PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. MCHS - NEW PRAGUE IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND IS REIMBURSED BASED ON ITS COST OF PROVIDING SERVICES FOR HOSPITAL MEDICARE PATIENTS.CHARITY CARE IS ALSO PROVIDED FOR PATIENTS THAT ARE FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. THE COST OF CHARITY CARE PROVIDED IN 2014 WAS APPROXIMATELY $207,200.THE COST OF UNCOMPENSATED CARE IN 2014 PROVIDED TO OTHER GOVERNMENTAL AND LOW INCOME PATIENTS THROUGH MEDICAID WAS APPROXIMATELY $2,230,000. THIS AMOUNT INCLUDES THE MEDICAID SURCHARGE AND MINNESOTACARE TAX (A PROGRAM THAT PROVIDES HEALTH CARE FOR LOW INCOME POPULATIONS). THE AMOUNT OF THE MEDICAID SURCHARGE AND MINNESOTACARE TAX PAID IN 2014 WAS $246,044 AND $342,441, RESPECTIVELY.THE COST OF UNCOMPENSATED CARE PROVIDED THROUGH MEDICARE WAS APPROXIMATELY $800,600.MCHS - NEW PRAGUE ALSO PROVIDES DISCOUNTS TO UNINSURED PATIENTS. THE TOTAL DISCOUNTS GIVEN IN 2014 WE
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