Mayo Clinic

“Between meetings of mayo clinic's board of trustees, mayo clinic's bylaws delegate to the mayo clinic board of governors, an executive committee of the board of trustees, broad authority to exercise the powers of the board of trustees within certain limitations of time and topic.”

“The following individual(s) is/are employed by a related organization: dahlen, dennis e., uhlenkamp, susan m., noseworthy m.d., john h., norby, mark l., murphy, joshua b., hubert, sherry l., froisland, jeffrey r., francis, james r., brown, william a., bolton, jeffrey w., adkins jr.,kedrick d., weber, joan a., resulting in a business relationship with the following individual(s) who is/are associated with the related organization as an officer, director, or trustee: zorn, christina k., menkosky, paula e., hoffman iii, harry n., murphy, joshua b., hubert, sherry l., froisland, jeffrey r., francis, james r., brown, william a., adkins jr.,kedrick d., the following individual(s) is/are employed by a related organization: menkosky, paula e., krahn m.d., lois e., decker m.d., wyatt w., resulting in a business relationship with the following individual(s) who is/are associated with the related organization as an officer, director, or trustee: menkosky, paula e., krahn m.d., lois e., decker m.d., wyatt w., froisland, jeffrey r., the following individual(s) is/are employed by a related organization: zorn, christina k., lockett, kevin m., farrugia m.d., gianrico, buskirk m.d., steven j., resulting in a business relationship with the following individual(s) who is/are associated with the related organization as an officer, director, or trustee: zorn, christina k., lockett, kevin m., farrugia m.d., gianrico, buskirk m.d., steven j., ********************** hoffman iii, harry n., haeflinger, ricky j., have a business relationship as they serve as an officer, director, or trustee of bwl holdings, inc, a related taxable entity. Hubert, sherry l., hayes m.d., david l., have a business relationship as they serve as an officer, director, or trustee of mayo clinic support services, texas, a related taxable entity. Menkosky, paula e., froisland, jeffrey r., have a business relationship as they serve as an officer, director, or trustee of superblock 3 property owners association, a related taxable entity. Murphy, joshua b., hubert, sherry l., adkins jr., kedrick d., have a business relationship as they serve as an officer, director, or trustee of mayo holding company, a related taxable entity. Hoffman iii, harry n., froisland, jeffrey r., have a business relationship as they serve as an officer, director, or trustee of mayo insurance company, ltd, a related taxable entity. Uhlenkamp, susan m., hoffman iii, harry n., haeflinger, ricky j., have a business relationship as they serve as an officer, director, or trustee of latigo petroleum, a related taxable entity.”

“Mayo foundation for medical education and research and other related companies provide management services to the entire system of entities which would include 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.”

“The form 990 is prepared by mayo corporate tax with assistance from accounting staff. The tax return goes through two levels of review within the corporate tax unit and is reviewed by the tax director. It is then reviewed by the chair of finance mayo clinic in the midwest, chair of financial and accounting services, chair and vice chair of financial reporting, the chief financial officer, the chair of development, general counsel, the chief administrative officer, and the chief executive officer. A copy of the form 990 is then provided to each member of mayo clinic's governing body via us mail, e-mail, or distribution at a board meeting. All questions are addressed prior to filing the form 990.”

“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. This policy applies to the organization's disregarded entity.”

“Mayo clinic and its affiliates have a coordinated process for reviewing and approving compensation and benefits for physicians, scientists, 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 compensation and benefits of the chief executive officer (ceo) was reviewed and approved by the process described below for executive leadership. The compensation and benefits of the executive 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 and scientists 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. In addition, the mayo clinic board of trustees governance and nominating committee directly retains an independent third-party compensation consultant to provide relevant, contemporaneous benchmark information for a small group of senior physician, administrative, and executive leadership positions for which an individualized review and recommendation is made. The compensation and benefit program of the chief investment officer was 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 and scientists 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.”

“Mayo clinic's articles of incorporation are available through the secretary of state's office or upon request from mayo clinic. Bylaws and other governance documents are available upon request for purposes that mayo clinic deems appropriate. The conflict of interest policy is available on mayo clinic's website or upon request. Mayo clinic's consolidated financial statements and federal form 990 are available upon request or through the minnesota attorney general's office.”

“Mayo clinic is included in a group exemption. The group exemption covers mayo clinic (the central organization) and mayo clinic's affiliated subsidiaries (the subordinate organizations). For 2017, a group return (mayo clinic group return - ein: 38-3952644) was filed that included thirty of mayo clinic's subordinate organizations. In accordance with reg. 1.6033-2(d)(5), with respect to the central organization, mayo clinic has reported the information required by reg. 1.6033-2(a)(2)(ii)(f), (g) and (h) on its form 990 for the 2017 tax year. This is in lieu of consolidating such information with its subordinate organizations and reporting such information on the 2016 mayo clinic group return.”

“Medical education: medical education, research training, continuous medical life-long learning and a committed quest for new knowledge are integral functions of mayo clinic. Our world-renowned educational programs inform, instruct, and empower physicians, researchers, medical professionals, patients, students and our communities to improve public health and well-being. These programs span the continuum of health care and ensure the mayo model of care is perpetuated and shared broadly. Mayo clinic is committed to providing useful, timely knowledge and skills that reflect its standards of excellence and its dedication to finding answers for unmet patient needs: *educating the next generation of physicians, medical researchers and health professionals with transformative curricula that focuses not only on helping the patient, but also improving the health care system; *sharing knowledge and innovative best practices freely in the spirit of collaboration to advance the science of medicine and the art of compassionate, patient-centered care; *empowering people to manage their health through patient education and shared decision-making medical training; *spreading mayo's medical expertise, education and research findings throughout the world to improve health care for all. *working collaboratively at a national level to modernize and transform medical education to address areas such as improving health care delivery, physician burn-out, population health issues, and team-based care. The educational activities of mayo clinic are centered in mayo clinic college of medicine and science's five schools: 1. Mayo clinic school of graduate medical education is one of the nation's largest schools of graduate medical education with a total enrollment of more than 1,738 resident and fellow physicians in training. More than 23,000 alumni have been trained since its inception in 1915. The school trains doctors in 291 residency and fellowship programs, representing virtually every medical specialty. Ninety-six percent of 2016-17 graduates completed mayo clinic quality academy training - a concerted effort to educate and prepare trainees to continuously explore ways to improve patient safety, quality care and eliminate health disparities. 2. Mayo clinic school of medicine provides a four-year medical education program leading to doctor of medicine degrees and joint md/ph.d. Degrees. As a national medical school, approximately 258 students are enrolled on the rochester, minnesota campus. In 2017, the school expanded to include an inaugural class of 50 students on its new arizona campus. By 2020, the school will double in size with a total of over 400 students across these two campuses. In 2017, the school also initiated a 3rd- and 4th-year program on its florida campus. The innovative and transformative curriculum of mayo clinic school of medicine focuses on educating future physician leaders in patient-centered, science-driven, team-based, high value health care. Students across all campuses are some of the first nationwide to train and first nationwide to receive a science of health care delivery certificate in addition to a medical degree. The integrated curriculum is part of an initiative to better prepare students for the challenges of delivering patient care in a complex health care environment. Additional offerings at the school include visiting medical student clerkship programs and summer minority medical student programs. The school, which is ranked no. 6 in the nation for best medical schools in research training, cultivates students to continually pursue new knowledge through discovery, translation and clinical application to meet the needs of their patients. Mayo clinic school of medicine students participate in underserved and outreach care programs, along with primary care and community care experiential learning opportunities at mayo clinic health system sites. 3. Mayo clinic graduate school of biomedical sciences has a distinguishe”

“Mayo clinic's multidisciplinary simulation centers in arizona, florida, and minnesota enable state-of-the-art simulation training for real-life patient care situations, giving health care professionals, residents, fellows, and students an unprecedented opportunity to refine and perfect skills and team interactions on patient actors and computerized mannequins that can imitate all the challenges of real patients. Mayo clinic college of medicine and science also has initiated mayo clinic online learning to develop and deliver online educational opportunities for faculty development, student education and future patient education. Online learning modules provide consistent knowledge delivery across multi-specialties and allow for more interactive faculty/student participation in the classroom setting. Online learning also facilitates the ability for mayo clinic to share and expand the latest medical knowledge and innovative learning opportunities with others outside mayo clinic. Another initiative implemented through mayo clinic college of medicine and science is the office of applied scholarship and education science (oases). This innovative office provides expertise and support in faculty development, education evaluation and principles and practices of education science to ensure the highest quality of education delivery within each of the schools within the college. Mayo clinic's social media network - the first of its kind focused on health care - is a network of health care organizations, hospitals and medical professionals committed to broader and deeper engagement in social media to help improve health care literacy, health care delivery and population health worldwide. In 2017, mayo clinic engaged with more than 6 million people through social media channels. Mayo clinic libraries reflect an integrated system of libraries, knowledge centers and archives including extensive online resources and efficient delivery systems. The breadth and depth of these resources and their integration using common online management systems and a knowledge portal makes the mayo clinic libraries among the most comprehensive in north america. Special collections include hospital-based patient libraries supporting the needs of hospitalized patients and their families. Mayo clinic libraries support employees and students in their care of patients and biomedical research with a network of online and print resources. Mayo libraries participate in regional and national interlibrary loan networks including the national network of libraries of medicine. All of these educational efforts to discover, deliver, expand and share medical knowledge promote mayo's clinic's ability to perpetuate the highest quality and safety in patient care. Mayo clinic funding plus extramural funding for educational activities were $234.8 million in 2017.”

“Patient care: mayo clinic is the first and largest integrated, not-for-profit medical group practice in the world. Its standard of care brings together teams of experts to provide high-quality, affordable and compassionate care to each patient consistent with mayo clinic's primary value - "the needs of the patient come first." mayo clinic's mission is "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." mayo clinic's heritage of collaborative medical expertise is combined with careful attention to individual patient needs, resulting in a thorough and personal approach to health care. To accomplish its mission, mayo clinic not only provides a variety of programs in direct patient care, medical education and research, but also serves as the parent organization of a multi-entity organization consisting of hospitals, clinics, health care providers and other entities providing health care-related services and knowledge delivery to the public throughout the world. In rochester, mayo clinic works collaboratively with mayo clinic hospital - rochester, an affiliated entity comprised of saint marys campus and methodist campus to form an integrated medical center dedicated to providing comprehensive diagnosis and treatment in virtually every medical and surgical specialty. Mayo clinic is also the sole member of mayo clinic arizona and mayo clinic jacksonville which provide services to patients in the southwest and southeast regions of the united states. In the midwest, mayo clinic health system serves more than 60 communities in minnesota, wisconsin, and iowa through a network of community-based physicians to provide quality health care close to home, and is also supported by the highly specialized expertise and resources of mayo clinic. Utilizing common governance, shared systems and standardized policies and procedures whenever possible, mayo clinic strives to provide consistent, high quality health care services and knowledge delivery within every aspect of care. A 31-member board of trustees comprised of a majority of public members along with mayo physicians and administrators ensure the entire organization remains true to its mission and culture of providing for the health care needs of the public rather than for private benefit. Patient care advanced through education and research is the foundation of mayo clinic's mission. Each year, people from all 50 states and more than 137 countries come to mayo clinic for care. In rochester, over 36,000 patient care physicians, residents and allied health staff provided services for more than 1.3 million outpatient visits in 2017. Mayo clinic provides care to people covered by governmental programs such as medicare and medicaid, at substantial discounts from standard fees. Charity care is also provided for patients that are financially unable to pay for services provided. In 2017, the cost of uncompensated care provided through medicaid and minnesota care (a program that provides medical assistance for low income populations) was approximately $168,975,000. This amount includes $47,475,000 paid to minnesotacare. The cost of uncompensated care provided through medicare was approximately $872,536,000 and the cost of charity care provided in 2017 was approximately $22,774,000. In 2017, with system-wide revenues of $12 billion, mayo clinic and its affiliates provided $575.4 million in care to people in need. This total includes $72.2 million in charity care and $503.2 million in unpaid portions of medicaid and other indigent care programs for people who are uninsured or underinsured. Mayo also provided $1.9 billion in unpaid portions of medicare and other senior programs. More than 53 percent of mayo's total medical services provided are for medicare and medicaid patients. Mayo clinic and its affiliates contributed $11 million in cash and in-kind donations to local communities. Mayo cli”

“Research: mayo clinic is one of the premier medical research organizations in the world. Innovation and improvement of science and the delivery of health care are enhanced through mayo clinic's research programs. Clinical practice observations become the basis for research studies and the findings from research flow back into the practice to improve patient care and outcomes. Physician/researchers and career scientists work in tandem to advance medicine and to improve the health and wellbeing of not just mayo clinic patients, but also the public at large, as these findings are disseminated worldwide. Research at mayo clinic involves thousands of medical professionals committed to searching for answers to complex medical problems with the goal of bringing new solutions and advanced care rapidly to patients throughout the world. In 2017, 234 full-time scientific faculty members, 740 physicians and 3,842 full-time research personnel were actively engaged in research activities. These activities include basic science research, clinical trials, translational research and human research studies. During 2017, more than 7,200 research and review articles based on mayo clinic research were published in peer-reviewed journals. Also in 2017 there were more than 12,000 active research studies and 2,800 new human studies were approved by the institutional review board. Through mayo clinic's center for clinical and translational science, mayo clinic collaborates with diverse community members to help community medical providers incorporate practice-based and research-based knowledge to improve overall community health outcomes and eliminate health disparities. One critical component of mayo clinic's research efforts is the rochester epidemiology project, a collaboration that links together nearly all of the medical records of the residents of olmsted county in minnesota. This unique database provides an extensive data repository of medical care delivered to community residents for over half a century and is virtually unparalleled in the united states. Mayo clinic is also improving patient care with the activities of its center for the science of health care delivery, the center for individualized medicine and the center for regenerative medicine. These strategic centers are changing how medicine is practiced through direct application of innovations and best practices. The regenerative and individualized medicine centers are actively pursuing answers to complex clinical problems through cutting edge methodologies. Funding of research activities at mayo clinic comes from grants and contracts as well as from mayo funds and gifts from generous benefactors. Mayo clinic and extramural funding for research activities in 2017 was $603,216,000.”

“I/c purchased services: program service expenses 640,588,160. Management and general expenses 429,462,374. Fundraising expenses 4,520,589. Total expenses 1,074,571,123. Other purchased services: program service expenses 223,596,643. Management and general expenses 16,525,590. Fundraising expenses 3,765,942. Total expenses 243,888,175.”

“Return of capital from taxable subsidiary 10,000,000. Pension-post retirement (per fasb asc 715) -621,905,428. Refunds of contributions -108,800. Losses on uncollectible pledges -3,006,672.”