4A (Expenses $ 456798970 including grants of $ 0) (Revenue $ 617684328)
"PATIENT CARE (SEE SCHEDULE O)PATIENT CARE: MAYO CLINIC - METHODIST HOSPITAL (MCMH) WORKS COLLABORATIVELY WITH AFFILIATED ENTITIES IN ROCHESTER (MAYO CLINIC AND MAYO CLINIC - SAINT MARYS HOSPITAL) TO FORM AN INTEGRATED MEDICAL CENTER DEDICATED TO PROVIDING COMPREHENSIVE DIAGNOSIS AND TREATMENT IN VIRTUALLY EVERY MEDICAL AND SURGICAL SPECIALTY. UTILIZING COMMON GOVERNANCE, SHARED SYSTEMS AND STANDARDIZED POLICIES AND PROCEDURES WHENEVER POSSIBLE, MCMH AND ITS AFFILIATED ENTITIES STRIVE TO PROVIDE CONSISTENT, HIGH QUALITY HEALTH CARE SERVICES AND KNOWLEDGE DELIVERY REGARDLESS OF WHERE AND HOW THESE ARE PROVIDED. MAYO CLINIC IS THE SOLE MEMBER OF MCMH. AS OF DECEMBER 31, 2013, MCMH MERGED WITH MAYO CLINIC - SAINT MARYS HOSPITAL TO FORM A SINGLE LEGAL ENTITY CALLED MAYO CLINIC HOSPITAL - ROCHESTER.OVERALL GOVERNANCE FOR MAYO CLINIC AND ITS AFFILIATED ENTITIES IS PROVIDED BY A 32-MEMBER BOARD OF TRUSTEES COMPOSED OF A MAJORITY OF PUBLIC MEMBERS ALONG WITH MAYO CLINIC PHYSICIANS AND ADMINISTRATORS. THIS BOARD OF TRUSTEES ENSURES THE ENTIRE ORGANIZATION, INCLUDING MCMH, REMAINS TRUE TO ITS MISSION OF PROVIDING FOR THE HEALTH CARE NEEDS OF THE PUBLIC RATHER THAN FOR PRIVATE BENEFIT. A SEPARATE 16-MEMBER BOARD OF DIRECTORS PROVIDES GOVERNANCE AND POLICY DIRECTION FOR MCMH.MAYO CLINIC IS THE FIRST AND LARGEST INTEGRATED, NOT-FOR-PROFIT MEDICAL GROUP PRACTICE IN THE WORLD. ITS STYLE OF CARE BRINGS TOGETHER TEAMS OF EXPERTS TO PROVIDE HIGH-QUALITY, AFFORDABLE AND COMPASSIONATE CARE TO EACH PATIENT CONSISTENT WITH OUR 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"". MCMH COMBINES ITS HERITAGE OF MEDICAL EXPERTISE, CAREFUL ATTENTION TO INDIVIDUAL PATIENT NEEDS AND THE EXPERTISE AND RESOURCES OF OUR AFFILIATED ENTITIES TO PROVIDE A THOROUGH AND PERSONAL APPROACH TO HEALTH CARE TO MEET THE NEEDS OF OUR PATIENTS.MCMH PROVIDES A BROAD RANGE OF SERVICES IN MOST MEDICAL SPECIALTIES. SOME OF THESE TREATMENT AREAS INCLUDE: TRANSPLANT PROGRAMS FOR LIVER, KIDNEY, PANCREAS, BLOOD AND BONE MARROW; OBSTETRICS AND GYNECOLOGY (INCLUDING A PERINATAL CENTER FOR CARE OF HIGH-RISK PREGNANCIES), A WOMEN'S CANCER PROGRAM, AN INTRA-OPERATIVE RADIATION SURGICAL SUITE AND A SPECIAL UNIT FOR TREATING PSORIASIS AND OTHER DERMATOLOGICAL PROBLEMS. MCMH HAS 794 LICENSED BEDS, 11 BIRTHING UNITS, A 21 BED ICU AND 41 OPERATING ROOMS WHERE 26,821 SURGICAL PROCEDURES WERE PERFORMED IN 2013. DURING 2013, 17,043 PATIENTS WERE ADMITTED TO MCMH, FOR A TOTAL OF 72,402 PATIENT DAYS AND THERE WERE 1,173 OBSERVATION UNIT STAYS. MCMH OPERATES ON A NONDISCRIMINATORY BASIS, REGARDLESS OF RACE, COLOR, SEX, RELIGION OR NATIONAL ORIGIN. MCMH PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AND SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. CHARITY CARE IS ALSO PROVIDED FOR PATIENTS THAT ARE FINANCIALLY UNABLE TO PAY FOR SERVICES PROVIDED. IN 2013, THE COST OF CHARITY CARE PROVIDED WAS APPROXIMATELY $3,853,000. THE COST OF UNCOMPENSATED CARE PROVIDED IN 2013 TO LOW INCOME PATIENTS THROUGH MEDICAID WAS APPROXIMATELY $14,125,000. THIS AMOUNT INCLUDES UNCOMPENSATED CARE PROVIDED TO MEDICAID PATIENTS OF $6,339,000 AND $6,193,000 OF UNCOMPENSATED CARE PROVIDED TO MINNESOTACARE PATIENTS (A PROGRAM THAT PROVIDES HEALTH CARE FOR LOW INCOME MINNESOTA RESIDENTS).MAYO CLINIC - METHODIST HOSPITAL LEASES SPACE AND PROVIDES SUPPORT SERVICES TO AFFILIATED ORGANIZATIONS TO HELP FURTHER THEIR PATIENT CARE EXEMPT PURPOSE."

4B (Expenses $ 97334 including grants of $ 7750) (Revenue $ 131044)
EDUCATION (SEE SCHEDULE O)EDUCATION: MCMH IS INTEGRAL TO THE EDUCATION PROGRAMS OF MAYO CLINIC COLLEGE OF MEDICINE, PROVIDING ESSENTIAL CLINICAL CARE EXPERIENCES FOR RESIDENTS, STUDENTS AND TRAINEES. AS A TEACHING HOSPITAL, IN 2013 MCMH PROVIDED EDUCATIONAL EXPERIENCE TO THE MORE THAN 1,500 RESIDENTS OF MAYO SCHOOL OF GRADUATE MEDICAL EDUCATION. MCMH ALSO PROVIDES CLINICAL EXPERIENCES FOR SEVERAL MAYO SCHOOL OF HEALTH SCIENCES PROGRAMS. THESE INCLUDE A DIETETIC INTERNSHIP PROGRAM, PHARMACY RESIDENCY PROGRAM, CHAPLAINCY INTERNSHIP PROGRAM, AND OTHERS.

4C (Expenses $ 4650 including grants of $ 4650) (Revenue $ 0)
"COMMUNITY BENEFIT (SEE SCHEDULE O)COMMUNITY BENEFIT: MCMH PROVIDES A MULTITUDE OF COMMUNITY ACTIVITIES AND SERVICES THAT ARE HEAVILY SUBSIDIZED BY THE HOSPITAL. THESE ACTIVITIES INCLUDE: PERINATAL EDUCATION, WHICH OFFERS A WIDE SELECTION OF CLASSES TO HELP FAMILIES PLAN AND PREPARE FOR CHILDBIRTH AND CARE OF A BABY. THESE CLASSES INCLUDE: PRECONCEPTION, INFANT PASSENGER SAFETY, PRENATAL COURSES, CESAREAN BIRTH, VAGINAL BIRTH AFTER CESAREAN, BREASTFEEDING AND A BREASTFEEDING SUPPORT NETWORK, COURSES TO PREPARE SIBLINGS FOR A NEW BABY AND GRAND PARENTING CLASSES. IN AGGREGATE, 220 CLASSES WITH 2,575 PARTICIPANTS WERE OFFERED IN 2013. OBSTETRICS TOURS ARE OFFERED THROUGHOUT THE YEAR. IN 2013, 47 TOURS WERE CONDUCTED WITH 502 PEOPLE ATTENDING.PRIVATE PRENATAL EDUCATION SESSIONS ARE AVAILABLE FOR WOMEN CONFINED TO BED REST AT HOME AND FAMILIES UNABLE TO TRAVEL LONG DISTANCES. IN ADDITION, INTERPRETERS ARE PROVIDED FOR OBSTETRIC TOURS AND EDUCATIONAL SESSIONS ARRANGED FOR SPEAKERS OF OTHER LANGUAGES. MEETING SPACE IS PROVIDED FOR A VARIETY OF ORGANIZATIONS INCLUDING: PAP SUPPORT GROUP, TOASTMASTERS, AND TOPS; DAILY PUBLIC TOURS OF THE HOSPITAL; DAILY CHAPEL SERVICES; NED'S CAFETERIA (NUTRITION-EDUCATION-DINING) WHERE REGISTERED DIETICIANS PROVIDE CONSULTATION FOR PATIENTS, VISITORS AND EMPLOYEES.MCMH HAS VERY ACTIVE AND ENGAGED VOLUNTEERS. IN 2013, 515 ACTIVE VOLUNTEERS PROVIDED 41,900 HOURS OF DONATED TIME AND HAD 122,355 SERVICE CONTACTS WITH PATIENTS, VISITORS AND STAFF OF MCMH. THE ESTIMATED VALUE OF THE TIME DONATED BY THESE VOLUNTEERS WAS APPROXIMATELY $944,845 AS VALUED BY THE INDEPENDENT SECTOR'S AVERAGE ESTIMATED HOURLY VALUE OF SUCH SERVICE. MCMH VOLUNTEERS SUPPORT ACTIVITIES ON BEHALF OF PATIENTS AND VISITORS TO THE HOSPITAL. SOME OF THE ACTIVITIES CONDUCTED BY THE VOLUNTEERS INCLUDE:- STAFFING 4 INFORMATION DESKS THROUGHOUT THE HOSPITAL TO HELP VISITORS AND PATIENTS NAVIGATE THROUGH THE HOSPITAL.- OPERATING THE HOSPITAL GIFT SHOP WITH THE PROCEEDS GOING TO THE GOOD SAMARITAN FUND WHICH ASSISTS NEEDY PATIENTS WITH THEIR MEDICAL EXPENSES.- OFFERING HOSPITALITY SERVICES TO PATIENTS SUCH AS SERVICE TO FAMILIES AND VISITORS ON THE ONCOLOGY/HEMATOLOGY AND TRANSPLANT UNITS WITH COFFEE AND CONVERSATION.- MAKING BEREAVEMENT CLOTHING FOR NEONATES WHO DO NOT SURVIVE AND STUFFED ANIMALS FOR CHILDREN WHO ARE HAVING MEDICAL PROCEDURES.- PROVIDING A SHOPPING CART SERVICE FOR PATIENTS.- GIVING GENTLE, NON-THERAPEUTIC HAND MASSAGES FOR PATIENTS AND THEIR FAMILY MEMBERS. CERTIFIED REIKI AND HEALING TOUCH PRACTITIONERS PROVIDE HEALING ENHANCEMENTS FOR PATIENTS. - STAFFING THE PATIENT LIBRARY.- ASSISTING FAMILY MEMBERS IN THE SURGICAL WAITING ROOM, OUT-PATIENT SURGERY AND GI PROCEDURE AREAS. - PROVIDING VIGIL COMPANIONS TO PATIENTS IN THEIR LAST HOURS OF LIFE WHO HAVE NO FAMILY OR FRIENDS TO BE WITH THEM THROUGH A PROGRAM CALLED ""NO ONE DIES ALONE"". IN 2013, 159 VOLUNTEERS PROVIDED 413 HOURS OF SERVICE TO 21 MAYO CLINIC PATIENTS UNDER THIS PROGRAM.THE VOLUNTEERS ALSO ADMINISTER THE MAYO CLINIC ERICKSON HAIR AND SKIN CARE CENTER TO PROVIDE PRODUCTS, SERVICES AND EDUCATION FOR PATIENTS EXPERIENCING THE COSMETIC SIDE EFFECTS OF CANCER TREATMENT. THE CENTER WAS DEVELOPED IN RESPONSE TO EMOTIONAL SUFFERING EXPERIENCED BY INDIVIDUALS WHO LOSE THEIR HAIR BECAUSE OF CHEMOTHERAPY OR OTHER CANCER TREATMENTS. THE CENTER, WHICH IS STAFFED BY 2 LICENSED COSMETOLOGISTS AND 16 VOLUNTEERS, PROVIDES WIGS AND CAPS AT NO COST TO PATIENTS. DURING 2013, THE CENTER SERVED 1,811 PATIENTS AND GAVE AWAY 346 WIGS AND 579 CAPS. IN ADDITION, THE CENTER PROVIDED ""LOOK GOOD - FEEL BETTER"" CLASSES FOR CANCER PATIENTS. IN 2013, 13 GROUP CLASSES WERE OFFERED, SERVING 44 PATIENTS."

MAYO CLINIC - METHODIST HOSPITAL
PART V, SECTION B, LINE 3: THE DIRECTOR OF OLMSTED COUNTY PUBLIC HEALTH WAS AN ACTIVE PARTICIPANT IN THE OLMSTED COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (OCCHNA), ON WHICH THE HOSPITAL'S CHNA IS BASED. THE OCCHNA TEAM INVOLVED MULTIPLE LAYERS OF COMMUNITY INPUT, INCLUDING: LEADERS OF COMMUNITY HUMAN SERVICE AND NONPROFIT ORGANIZATIONS, RANDOMLY SELECTED OLMSTED COUNTY RESIDENTS FOR A TELEPHONE SURVEY, AND FOCUS GROUPS WITH LOCAL UNDERSERVED AND MINORITY COMMUNITY POPULATION REPRESENTATIVES. INPUT WAS ALSO PROVIDED BY A DEDICATED WORKGROUP OF THE OLMSTED COUNTY COMMUNITY HEALTHCARE ACCESS COLLABORATIVE, A 23-MEMBER CONSORTIUM THAT HAS EXISTED SINCE 2007 TO IDENTIFY AND ADDRESS HEALTH CARE AND HEALTH CARE ACCESS ISSUES FOR OLMSTED COUNTY RESIDENTS, WITH SPECIAL FOCUS ON DIVERSE AND UNDERSERVED POPULATION.

MAYO CLINIC - METHODIST HOSPITAL
PART V, SECTION B, LINE 4: MAYO CLINIC (REPRESENTING MAYO CLINIC - ST. MARYS HOSPITAL AND MAYO CLINIC - METHODIST HOSPITAL) PARTNERED WITH OLMSTED MEDICAL CENTER AND OLMSTED COUNTY PUBLIC HEALTH TO CONDUCT THE CHNA.

MAYO CLINIC - METHODIST HOSPITAL
PART V, SECTION B, LINE 5D: A FULL COPY OF THE OLMSTED COMMUNITY HEALTH NEEDS ASSESSMENT REPORT, WHICH IS REFERENCED IN THE HOSPITAL'S CHNA REPORT, CAN BE ACCESSED AT: HTTP:///WWW.CO.OLMSTED.MN.US/OCPHS/ REPORTS/PAGES/COMMUNITYHEALTHNEEDSASSESSMENT.ASPX.

MAYO CLINIC - METHODIST HOSPITAL
PART V, SECTION B, LINE 12I: THE REGIONAL PROXIMITY OF A PATIENT'S RESIDENCY IS A FACTOR FOR PRESCHEDULED SERVICES ONLY AND SECONDARY TO MEDICAL NEED AND UNIQUENESS OF CARE. REGIONAL PROXIMITY IS NOT A FACTOR FOR EMERGENCY CARE PROVIDED.

MAYO CLINIC - METHODIST HOSPITAL
PART V, SECTION B, LINE 14G: WITH REGARD TO THE POSTINGS WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.

MAYO CLINIC - METHODIST HOSPITAL
PART V, SECTION B, LINE 18E: FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE TO EVERY PATIENT VIA MAYO'S PUBLIC WEBSITE, FROM CUSTOMER SERVICE AND PATIENT ACCESS LOCATIONS, AND IS REFERENCED ON MAYO'S AUTHORIZATION FORMS AND STATEMENTS. IN ADDITION, BROCHURES ARE AVAILABLE IN THE ADMISSIONS AREA AND THE PROCESS OF HOW TO APPLY IS AVAILABLE ON THE MAYO CLINIC WEBSITE.UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, MAYO DISCUSSES ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE.MONTHLY STATEMENTS ARE SENT TO PATIENTS THAT OUTLINE CURRENT CHARGES AND ACTIONS WITH INSURANCE AND INCLUDES INFORMATION ABOUT MAYO'S CHARITY CARE POLICY. SOME MAYO SITES UTILIZE ADVOCATES TO CONTACT THE PATIENT UPON DISCHARGE TO HELP THEM SECURE GOVERNMENTAL ASSISTANCE OR FINANCIAL ASSISTANCE.EACH CHARITY CARE REVIEW IS DOCUMENTED IN MAYO'S BILLING SYSTEM AND COMMUNICATED TO THE PATIENT. COMPLETED CHARITY CARE FORMS ARE MAINTAINED EITHER IN PAPER OR ELECTRONIC FORMAT. THE PATIENT IS INFORMED REGARDING THE OUTCOME OF THE REVIEW.MAYO OFTEN IDENTIFIES CHARITY CARE OPPORTUNITIES AFTER THE PATIENT HAS BEEN DISMISSED. IN MANY CASES, THIS IS DUE TO LIMITED INSURANCE COVERAGE OR INSURANCE DENIALS AFTER THE SERVICE WAS PERFORMED. IN THESE CASES, WHEN A PATIENT EXPRESSES AN INABILITY TO PAY FOR THEIR SERVICES, STAFF WILL INITIATE A CHARITY REVIEW AS INDICATED BY THE FINANCIAL ASSISTANCE POLICY, WHICH IS AVAILABLE FOR EVERY PATIENT AT MAYOCLINIC.ORG.

MAYO CLINIC - METHODIST HOSPITAL
PART V, SECTION B, LINE 20D: OUR POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 20% TO ELIGIBLE INDIVIDUALS WHICH RESULTS IN AN AMOUNT LESS THAN THE AVERAGE OF THE THREE BEST NEGOTIATED COMMERCIAL RATES OR THE BEST NEGOTIATED COMMERCIAL RATE.

PART I, LINE 6A:
THE ANNUAL REPORT FOR THE FILING ORGANIZATION IS PART OF A CONSOLIDATED REPORT PREPARED BY MAYO CLINIC.

PART I, LINE 7:
A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS).THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO-CHARGE RATIO.

PART I, LINE 7G:
THERE WAS NO NET COMMUNITY BENEFIT COST ATTRIBUTED TO PHYSICIAN CLINICS THAT WERE INCLUDED IN SUBSIDIZED HEALTH SERVICES.

PART I, LINE 7, COLUMN (F):
THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 6,747,371.

PART II, COMMUNITY BUILDING ACTIVITIES:
MAYO IS DEDICATED TO SUPPORTING THE HEALTH OF THE LOCAL COMMUNITIES NEAREST ITS FACILITIES AND TO POSITIVELY IMPACTING LOCAL, REGIONAL AND NATIONAL HEALTH FOR ALL PEOPLE THROUGH PROLIFERATION OF ITS ADVANCES IN MEDICAL PRACTICE, RESEARCH AND EDUCATION. MAYO CLINIC'S COMMUNITY BUILDING ACTIVITIES REFLECT ITS BELIEF THAT IN ADDITION TO TRADITIONAL MEDICAL CARE, COMMUNITY HEALTH IS LARGELY IMPACTED BY MANY SOCIETAL INFLUENCES, SUCH AS SOCIAL, LIFESTYLE, EDUCATIONAL, ECONOMIC, AND ENVIRONMENTAL FACTORS.THROUGH ITS OFFICE OF COMMUNITY RELATIONS, MAYO CLINIC INVESTS IN, AND PARTNERS WITH, COMMUNITY GROUPS AND ORGANIZATIONS TO ENSURE ITS LOCAL COMMUNITY IS A WELCOMING, HEALTHY ENVIRONMENT AND AN ENVIRONMENT THAT ATTRACTS AND SUSTAINS A DIVERSE WORKFORCE TO DELIVER THE BEST PATIENT CARE, RESEARCH AND EDUCATION FOR THE PROMOTION OF THE HEALTH AND WELL BEING OF PATIENTS AND THE GENERAL PUBLIC.AS PART OF ITS COMMUNITY CONTRIBUTIONS PROGRAM, MAYO CLINIC PROVIDES FUNDING AND IN-KIND SUPPORT FOR NEW AND ONGOING PROGRAMS THAT ULTIMATELY SUPPORT HEALTH, SUCH AS BASIC HUMAN SERVICES, EDUCATION AND WORKFORCE DEVELOPMENT, YOUTH AND ELDERLY ENRICHMENT OPPORTUNITIES, THE ARTS AND CULTURAL ENRICHMENT, DIVERSITY, AND OTHERS. MAYO GUIDELINES STATE THAT ITS PHILANTHROPIC SUPPORT AND COMMUNITY BUILDING ACTIVITIES SHOULD ADDRESS SIGNIFICANT AND EMERGENT NEEDS WITHIN THE COMMUNITY (EDUCATION AND WORKFORCE DEVELOPMENT, AFFORDABLE AND ACCESSIBLE COMMUNITY RESOURCES, DIVERSITY), ENHANCE MAYO'S CAPACITY TO MEET ITS MISSION, IMPROVE THE HEALTH OF INDIVIDUALS IN THE COMMUNITY, ENABLE LONG-TERM CAPACITY BUILDING AND SUSTAINABILITY FOR MEETING COMMUNITY NEEDS, AND DEMONSTRATE PARTNERSHIP BUILDING AND COLLABORATION WITH COMMUNITY PARTNERSIN ADDITION TO DIRECT AND INDIRECT MONETARY AND IN-KIND SUPPORT, MAYO APPOINTS REPRESENTATIVES FROM ITS STAFF TO SERVE ON NONPROFIT BOARDS AND COMMUNITY TASK FORCES TO ENHANCE THE CAPACITY OF LOCAL ORGANIZATIONS FOR SUSTAINABILITY, COMMUNITY COLLABORATION, EFFICIENCY AND IMPACT. MAYO REPRESENTATIVES WORK WITH COMMUNITY GROUPS TO DEVELOP AND NURTURE A SHARED VISION TO SOLVE COMPLEX AND SYSTEMIC COMMUNITY CHALLENGES SUCH AS HUNGER, GANG ACTIVITY AND YOUTH MENTORSHIP, EARLY CHILDHOOD DEVELOPMENT, DIVERSITY AND INCLUSIVENESS AND HEALTH CARE EDUCATION AND ACCESS.

PART III, LINE 2:
THE FILING ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES SET FORTH BY GAAP.METHODOLOGY FOR SCHEDULE H, PART III, LINE 2:BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED IN THE ACCOUNTS RECEIVABLE FOOTNOTE OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS.

PART III, LINE 4:
FOOTNOTES RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCE FOR DOUBTFUL ACCOUNTS CAN BE FOUND ON PAGES 5, 6, 8 AND 9 OF MAYO CLINIC'S 2013 CONSOLIDATED AUDITED FINANCIAL STATEMENTS.

PART III, LINE 8:
THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III, SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SHORTFALL REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY). REASONS WHY MEDICARE SHORTFALL REPORTED ON LINE 7, IF ANY, SHOULD BE TREATED AS COMMUNITY BENEFIT ARE: (1) ABSENT THE MEDICARE PROGRAM, IT IS LIKELY MANY OF THE INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS; (2) BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (3) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS; AND (4) THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.

PART III, LINE 9B:
MAYO CLINIC AND ITS AFFILIATES STRIVE TO ASSIST ALL PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION PRIOR TO ENLISTING THE ASSISTANCE OF A COLLECTION AGENCY BY MAKING REASONABLE ATTEMPTS TO COLLECT FROM INSURANCE COMPANIES AND OTHER THIRD-PARTY PAYORS. IN ADDITION, MAYO CLINIC AND ITS AFFILIATES ACCEPT REASONABLE PAYMENT PLANS FROM PATIENTS WHEN AN ACCOUNT IS THE PATIENT'S RESPONSIBILITY AND TRY TO IDENTIFY THOSE PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE. FINANCIAL ASSISTANCE IS OFFERED TO ANY PATIENT IF THE FACTS AND CIRCUMSTANCES SUGGEST THAT THE PATIENT DOES NOT HAVE THE ABILITY TO PAY THEIR BILL IN WHOLE OR IN PART. IN THE EVENT THAT AN ACCOUNT IS REFERRED TO A COLLECTION AGENCY, GUIDELINES ARE FOLLOWED; INCLUDING SUSPENDING ALL COLLECTION ACTIVITY IF A FINANCIAL ASSISTANCE APPLICATION HAS BEEN SUBMITTED AFTER THE ACCOUNT HAS BEEN REFERRED FOR COLLECTION. IF A COLLECTION AGENCY IDENTIFIES A PATIENT AS MEETING MAYO CLINIC'S FINANCIAL ASSISTANCE ELIGIBILTY CRITERIA OR THE PATIENT ASKS TO APPLY FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY IS SUSPENDED UNTIL MAYO REVIEWS THE ACCOUNT FOR FINANCIAL ASSISTANCE ELIGIBILITY BASED ON SUBMISSION OF REQUESTED INFORMATION. COLLECTION ACTIVITY WOULD ONLY RESUME IF MAYO WOULD TELL THE COLLECTION AGENCY TO PURSUE COLLECTIONS ON THE BALANCE OR PARTIAL BALANCE IF THERE WAS A CHARITY ADJUSTMENT.

PART VI, LINE 2:
"MAYO CLINIC ATTRACTS PATIENTS FROM AREAS FAR BEYOND THE IMMEDIATE COMMUNITIES WHERE ITS FACILITIES ARE LOCATED. IN 2013, PATIENTS CAME TO MAYO FROM EVERY STATE AND NEARLY 135 FOREIGN COUNTRIES. BESIDES ITS PRINCIPAL FACILITIES LOCATED IN ROCHESTER, MN, PHOENIX AND SCOTTSDALE, AZ AND JACKSONVILLE, FL, MAYO CLINIC HAS A NETWORK OF COMMUNITY BASED HEALTH CARE PROVIDERS IN MORE THAN 70 COMMUNITIES THROUGHOUT MINNESOTA, IOWA, WISCONSIN AND GEORGIA. MAYO CLINIC SUPPORTS AND COORDINATES EFFORTS TO IMPROVE THE HEALTH AND WELL BEING WITHIN EACH OF THE COMMUNITIES WHERE IT IS LOCATED AND ALSO CONDUCTS MEDICAL EDUCATION AND RESEARCH ACTIVITIES TO ADVANCE THE SCIENCE OF HEALTH CARE DELIVERY TO BENEFIT BROADER REGIONAL, NATIONAL AND INTERNATIONAL COMMUNITIES.IN ADDITION, MAYO CLINIC HAS ESTABLISHED THE MAYO CLINIC CARE NETWORK. THE NETWORK INCLUDES HEALTH-CARE ORGANIZATIONS THAT SHARE A COMMON GOAL OF IMPROVING THE DELIVERY OF HEALTH CARE IN THEIR COMMUNITIES THROUGH HIGH -QUALITY, DATA DRIVEN AND EVIDENCE BASED MEDICAL CARE. MEMBERS OF THE NETWORK CAN USE ELECTRONIC CARE REFERENCE AND COLLABORATION TOOLS THAT CONNECT THEM DIRECTLY TO MAYO CLINIC SPECIALISTS, DISEASE MANAGEMENT PROTOCOLS, CLINICAL CARE GUIDELINES AND TREATMENT RECOMMENDATIONS. THE MAIN GOAL OF THE NETWORK IS TO HELP PEOPLE GAIN THE BENEFITS OF MAYO CLINIC EXPERTISE WITHOUT HAVING TO TRAVEL TO A MAYO CLINIC FACILITY. IN 2013, THE NETWORK HAD 25 MEMBERS. IN ROCHESTER, MAYO CLINIC WORKS COLLABORATIVELY WITH ITS AFFILIATED ENTITIES (MAYO CLINIC - SAINT MARYS HOSPITAL AND MAYO CLINIC - METHODIST HOSPITAL), THROUGH COMMON GOVERNANCE AND SHARED SYSTEMS, POLICIES AND PROCEDURES TO MEET THE HEALTH CARE NEEDS OF THE LOCAL OLMSTED COUNTY COMMUNITY OF APPROXIMATELY 120,000 RESIDENTS. THESE ENTITIES ARE COLLECTIVELY REFERRED TO AS ""MAYO"" FOR PURPOSES OF THIS DESCRIPTION.MAYO'S EFFORTS TO ASSESS THE HEALTH NEEDS OF OLMSTED COUNTY REST ON FOUR GUIDING PRINCIPLES DEVELOPED WITH COMMUNITY PARTNERS AND AFFIRMED BY MAYO LEADERSHIP:1. HEALTH IS VALUED BY BOTH THE COMMUNITY AND MAYO.2. ""HEALTH"" IS DETERMINED BY BOTH MEDICAL AND NON-MEDICAL (E.G., SOCIAL AND BEHAVIORAL) FACTORS AND BOTH MUST BE ADDRESSED.3. MAYO IS COMMITTED TO PRODUCING MEASURABLE IMPROVEMENTS IN THE HEALTH OF ALL OLMSTED COUNTY RESIDENTS.4. STRATEGIES TO IMPROVE COMMUNITY HEALTH ARE BEST DETERMINED AND IMPLEMENTED THROUGH PARTNERSHIPS BETWEEN HEALTH CARE PROVIDERS AND COMMUNITY MEMBERS.WITH THESE PRINCIPLES AS THE BASIS OF ITS DECISION MAKING, AND CONSISTENT WITH ITS PRIMARY VALUE OF ""THE NEEDS OF THE PATIENT COME FIRST,"" MAYO REGULARLY SEEKS INPUT TO COORDINATE EFFORTS TO ADDRESS COMMUNITY NEEDS IN A TIMELY, EFFICIENT AND EFFECTIVE MANNER. MAYO ANNUALLY REVIEWS COMMUNITY NEEDS ASSESSMENTS CONDUCTED BY THE PUBLIC HEALTH DEPARTMENT, SOCIAL SERVICES, AND OTHER COMMUNITY ORGANIZATIONS SUCH AS UNITED WAY AND THE SALVATION ARMY THAT SERVE BROAD COMMUNITY HEALTH NEEDS. THESE ASSESSMENTS ARE USED TO DETERMINE SERVICES CURRENTLY AVAILABLE AND TO IDENTIFY GAPS THAT CAN BE ADDRESSED IN MAYO'S RESPONSE TO MEET THE COMMUNITY'S HEALTH CARE NEEDS. IN 2013, MAYO CLINIC PARTNERED WITH OLMSTED PUBLIC HEALTH SERVICES AND OLMSTED MEDICAL CENTER TO JOINTLY CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AND TO BEGIN PREPARING A COMMUNITY HEALTH IMPROVEMENT PLAN.MAYO ALSO PROVIDES SHARED LEADERSHIP FOR THE OLMSTED COUNTY COALITION OF COMMUNITY HEALTH INTEGRATION (CCHI) AND THE COMMUNITY HEALTHCARE ACCESS COLLABORATIVE (CHAC). CCHI IS COMPOSED OF LEADERSHIP FROM MAJOR ORGANIZATIONS IN OLMSTED COUNTY. ITS MISSION IS TO CREATE OPPORTUNITIES TO COORDINATE AND INTEGRATE EFFICIENT AND EFFECTIVE SERVICES ACROSS ORGANIZATIONS TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY AND THE CLIENTS WE SERVE. CHAC IS A MULTICULTURAL VOLUNTEER COALITION OF OVER 20 HEALTH CARE RELATED SERVICE PROVIDERS, PUBLIC HEALTH, SOCIAL SERVICE, AND OTHER ORGANIZATIONS FROM THE GOVERNMENT, PRIVATE AND NOT-FOR-PROFIT SECTORS. CCHI AND CHAC WORK TO ADDRESS HEALTH CARE NEEDS FOR ALL RESIDENTS OF OLMSTED COUNTY WITH SPECIAL EMPHASIS ON DIVERSE AND UNDER-RESOURCED POPULATIONS. PRIORITIES ARE ESTABLISHED BASED ON THE REVIEW OF COMMUNITY-WIDE NEEDS, AN ANALYSIS OF EXISTING SERVICES AND BY IMPLEMENTING STRATEGIES TO CLOSE GAPS. THE PLANNING PROCESS FOR CHAC ACTIVITY OCCURS THROUGH A COMMON COMMUNICATION PROCESS, INCLUDING MONTHLY MEETINGS AND A PUBLICLY ACCESSIBLE WEB SITE (WWW.CHACMN.ORG ) SUPPLEMENTED BY INPUT FROM A COMMUNITY ADVISORY BOARD (CAB). THE CAB IS COMPRISED OF 25 MEMBERS DRAWN FROM DIVERSE REPRESENTATIVES OF RACIAL, ETHNIC, GENDER ORIENTATION, RELIGIOUS, GEOGRAPHIC, SOCIOECONOMIC AND OTHER GROUPS THAT MAKE UP THE COMMUNITY. ACTIVITIES OF THE CAB INCLUDE SETTING PRIORITIES FOR HEALTH IMPROVEMENT PROJECTS, PROVIDING INPUT TO COLLABORATIVE PROJECTS AMONG SERVICE PROVIDERS AND FACILITATING DIALOG BETWEEN PROVIDERS AND THE COMMUNITY.WITHIN MAYO, COMMUNITY HEALTH ASSESSMENT INITIATIVES ARE COORDINATED THROUGH THE COMMUNITY ENGAGEMENT COMMITTEE (CEC). CEC INCLUDES REPRESENTATIVES FROM PRACTICE, EDUCATION AND RESEARCH WITHIN MAYO AS WELL AS MEMBERS FROM THE COMMUNITY. THE ROLES OF THE CEC ARE TO MONITOR IMPLEMENTATION OF OVERALL MAYO COMMUNITY ENGAGEMENT STRATEGIES AND TO FOSTER THE DEVELOPMENT OF LONG-TERM, MUTUALLY BENEFICIAL RELATIONSHIPS BETWEEN MAYO AND THE COMMUNITY. THE CEC MEETS MONTHLY AND REPORTS REGULARLY TO THE MAYO PRESIDENT AND CEO AS WELL AS TO INSTITUTIONAL COMMITTEES. WITHIN THE PRACTICE FUNCTION OF MAYO, A COMMUNITY HEALTH COUNCIL (CHC) FACILITATES COMMUNITY ACCESS TO AND PARTICIPATION IN PATIENT CARE AND COMMUNITY OUTREACH INITIATIVES. CHC IS GUIDED BY CEC, WITH INPUT FROM COMMUNITY ADVISORY BOARDS (CAB) DESCRIBED ABOVE.CHC IS PART OF AN INTEGRATED PRACTICE UNIT THAT FOCUSES ON PRIMARY CARE DELIVERY FOR THE LOCAL COMMUNITY WHICH REQUIRES DIFFERENT APPROACHES THAN THOSE PATIENTS WHO UTILIZE MAYO'S SPECIALTY CARE SERVICES. CHC SERVES TO OVERSEE, COORDINATE AND LINK INITIATIVES IN PRACTICE AND EDUCATION THAT HAVE THE POTENTIAL TO IMPACT THE COMMUNITY OR LOCAL HEALTH-RELATED SERVICE PROVIDERS. ALTHOUGH CHC IS PRIMARILY FOCUSED ON PRACTICE AND EDUCATION ACTIVITIES, IT HAS LINKS TO RESEARCH RESOURCES WHICH CAN BE DIRECTED TOWARDS COMMUNITY INITIATIVES THAT WOULD BENEFIT FROM A RESEARCH APPROACH OR TECHNICAL EXPERTISE. AN 18 MEMBER CAB CHAIRED BY COMMUNITY MEMBERS HELPS CHC IDENTIFY AND PRIORITIZE NEEDS, CONNECTS THE COMMUNITY TO MAYO PERSONNEL, REVIEWS PROPOSALS FOR MAYO OUTREACH ACTIVITIES, PROVIDES FEEDBACK ON THE RESULTS OF THESE ACTIVITIES AND GIVES INPUT FOR NEW PROGRAMS.FROM A RESEARCH PERSPECTIVE, MAYO'S CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCE (CCATS) PLANS INPUT SESSIONS WITH REPRESENTATIVES OF LOCAL COMMUNITY GROUPS TO IDENTIFY, PLAN AND CARRY OUT COMMUNITY BASED RESEARCH TO IMPROVE HEALTH OUTCOMES AMONG UNDERSERVED POPULATIONS. CCATS SUPPORTS SIGNIFICANT EFFORTS WITHIN THE CLINICAL RESEARCH UNIT AT MAYO TO INCREASE COMMUNITY INVOLVEMENT IN RESEARCH AND TO RECRUIT A DIVERSE POPULATION OF RESEARCH SUBJECTS. IN PARTNERSHIP WITH CCATS EDUCATION RESOURCES, CCATS HAS DEVELOPED A SERIES OF COMMUNITY ENGAGEMENT EDUCATION MODULES FOR RESEARCH INVESTIGATORS. THESE EFFORTS HAVE RESULTED IN A VARIETY OF RESEARCH ACTIVITIES THAT INVOLVE NOT ONLY THE OLMSTED COUNTY COMMUNITY BUT ALSO OTHER COMMUNITIES THROUGHOUT THE REGION. EXAMPLES OF THESE ACTIVITIES INCLUDE COLLABORATIONS WITH OTHER PROVIDERS, PUBLIC HEALTH SERVICES, PUBLIC SCHOOLS AND UNIVERSITIES, CITY AND COUNTY GOVERNMENT AND COMMUNITY ORGANIZATIONS SUCH AS THE INTERCULTURAL MUTUAL ASSISTANCE ASSOCIATION, MIGRANT HEALTH SERVICES, OLMSTED COUNTY CHILD CARE RESOURCE AND REFERRAL, ELDER NETWORK, ROCHESTER SENIOR CENTER, IGLESIA DE DIOS EMMANUEL DE ROCHESTER, THE RED CROSS, ASIAN HEALTHCARE LEADERS ASSOCIATION, INDIAN HEALTH SERVICES AND MANY OTHERS.ANOTHER RESEARCH EFFORT WITHIN MAYO IS THE OFFICE OF HEALTH DISPARITIES RESEARCH (OHDR). OHDR SUPPORTS MEANINGFUL RESEARCH PROGRAMS TO IDENTIFY, DEVELOP AND DEPLOY STRATEGIES TO ELIMINATE HEALTH DISPARITIES IN UNDERSERVED POPULATIONS IN OUR COMMUNITIES.A CRITICAL COMPONENT OF MEETING THE NEEDS OF THE COMMUNITY IS THE ROCHESTER EPIDEMIOLOGY PROJECT (REP), A COLLABORATION OF MAYO WITH OLMSTED MEDICAL CENTER AND ROCHESTER FAMILY MEDICINE CLINIC. REP LINKS TOGETHER NEARLY ALL THE MEDICAL RECORDS OF THE RESIDENTS OF OLMSTED COUNTY, MAKING IT POSSIBLE TO CONDUCT POPULATION-BASED RESEARCH OF MOST MEDICAL CONDITIONS. THIS UNIQUE RESEARCH INFRASTRUCTURE PROVIDES AN EXTENSIVE DATA REPOSITORY OF CARE DELIVERED TO COMMUNITY RESIDENTS FOR ALMOST HALF A CENTURY AND IS VIRTUALLY UNPARALLELED IN THE UNITED STATES. REP HAS BEEN USED BY HUNDREDS OF INVESTIGATORS TO DEVELOP STUDIES ON A WIDE RANGE OF MEDICAL CONDITIONS AND HAS RESULTED IN OVER 2,000 PUBLICATIONS SINCE 1966."

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MEASURES TO PUBLICIZE FINANCIAL ASSISTANCE POLICY:MAYO CLINIC IS COMMITTED TO OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY FOR THEIR MEDICAL SERVICES IN WHOLE OR IN PART. IN ORDER TO ACCOMPLISH THIS CHARITABLE GOAL, MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM SITES WIDELY PUBLICIZE THIS POLICY IN THE COMMUNITIES THAT THE INDIVIDUAL MAYO CLINIC AFFILIATED SITES SERVE. MAYO CLINIC AFFILIATED SITES MAKE COPIES OF THIS POLICY AND APPLICATIONS AVAILABLE BY POSTING IT ON THEIR WEBPAGE INCLUDING THE ABILITY TO DOWNLOAD A COPY OF THE POLICY AND APPLICATION FREE OF CHARGE. INDIVIDUALS IN THE COMMUNITY SERVED WILL BE ABLE TO OBTAIN A COPY OF THE POLICY IN LOCATIONS THROUGHOUT EACH MAYO CLINIC AFFILIATED SITE OR UPON REQUEST. THE POLICY EXPLAINS THE FINANCIAL ASSISTANCE PROGRAM AND FACTORS AFFECTING ELIGIBILITY. WITHIN THE HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED.

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MAYO SERVES THE POPULATION OF OLMSTED COUNTY IN MINNESOTA AS WELL AS A WIDER REGIONAL, NATIONAL, AND EVEN INTERNATIONAL POPULATION. OLMSTED COUNTY HAS A POPULATION OF 144,248 RESIDENTS IN 60,495 HOUSING UNITS ACCORDING TO THE 2010 CENSUS. FOURTEEN PERCENT OF THESE RESIDENTS ARE NONWHITE AND 74% LIVE WITHIN THE CITY OF ROCHESTER. THE MAJORITY OF MAYO PATIENTS COME FROM A 150 MILE RADIUS OF ROCHESTER MINNESOTA; HOWEVER, PATIENTS COME TO MAYO FROM ALL 50 STATES AND MORE THAN 130 FOREIGN COUNTRIES. ALTHOUGH IT SERVES A WIDE RANGE OF HEALTH CARE NEEDS INCLUDING PRIMARY AND COMMUNITY CARE, MAYO IS ESPECIALLY FOCUSED IN PROVIDING TERTIARY CARE AND SPECIALTY TREATMENT OF THE MORE UNUSUAL AND DIFFICULT MEDICAL CASES.

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"THIS FILING ORGANIZATION IS AN AFFILIATE OF MAYO CLINIC. MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF ""THE NEEDS OF THE PATIENT COME FIRST"". THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION - EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO CLINIC HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY - IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED. PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.SURPLUS FUNDS:MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE. COMMUNITY REPRESENTATION ON GOVERNING BODY:THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, EXPERIENCE, AND OTHER CRITERIA ESTABLISHED BY THE INDEPENDENT NOMINATING COMMITTEE OF THE BOARD OF TRUSTEES. AREAS OF EXPERTISE AND EXPERIENCE INCLUDE SUCH AREAS AS HEALTH CARE POLICY, RESEARCH, EDUCATION, BUSINESS, AND GOVERNMENT. THE FILING ORGANIZATION, WHICH IS CONTROLLED BY MAYO CLINIC, RELIES ON THE COMMUNITY REPRESENTATION OF THE MAYO CLINIC BOARD OF TRUSTEES TO FULFILL THIS REQUIREMENT. OPEN V. CLOSED STAFF MODEL: SEVERAL OF MAYO CLINIC'S HOSPITAL ENTITIES HAVE OBTAINED LETTER RULINGS APPROVING A STAFF MODEL IN WHICH ONLY MAYO CLINIC EMPLOYED PHYSICIANS ARE GIVEN STAFF PRIVILEGES IN ORDER TO MAINTAIN STANDARD METHODS OF PRACTICE AND PROTOCOLS. FOR THOSE ENTITIES, THE PHYSICIANS ARE SALARIED EMPLOYEES AND THUS THE ISSUE OF PRIVATE INUREMENT AND PRIVATE BENEFIT ADDRESSED BY THE OPEN STAFF REQUIREMENT ARE OTHERWISE ADDRESSED. THE FILING ORGANIZATION IS ONE OF THE ENTITIES WHICH OPERATES BASED ON THE CLOSED STAFF MODEL. EMERGENCY ROOM: THE PATIENTS OF THE FILING ORGANIZATION HAVE ACCESS TO AN EMERGENCY ROOM OPERATED BY A RELATED ENTITY ADJACENT TO OR IN CLOSE PROXIMITY TO THE FILING ORGANIZATION."

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"THIS ORGANIZATION IS PART OF A GROUP OF HEALTHCARE ENTITIES AFFILIATED WITH MAYO CLINIC. MAYO CLINIC IS THE FIRST AND LARGEST INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICE IN THE WORLD. DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF ""THE NEEDS OF THE PATIENT COME FIRST."" MORE THAN 4,000 STAFF PHYSICIANS AND SCIENTISTS, 3,400 RESIDENTS, FELLOWS, AND STUDENTS, AND 53,000 ALLIED HEALTH STAFF WORK AT MAYO CLINIC, WHICH HAS SITES IN ROCHESTER, MINNESOTA, JACKSONVILLE, FLORIDA, AND SCOTTSDALE/PHOENIX, ARIZONA, AS WELL AS A REGIONAL NETWORK OF HOSPITALS AND CLINICS IN MINNESOTA, WISCONSIN, AND IOWA. COLLECTIVELY, MORE THAN HALF A MILLION PEOPLE ARE TREATED EACH YEAR.SPECIFICALLY, THE FILING ORGANIZATION PROVIDES HOSPITAL SERVICES AT THE ROCHESTER, MINNESOTA LOCATION. FOR MORE SPECIFIC DESCRIPTION, SEE THE RESPONSE TO CORE FORM, PART III, STATEMENT OF PROGRAM ACCOMPLISHMENTS, LINE 4A (REPORTED IN SCHEDULE O)."

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NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO A STATE HOSPITAL ASSOCIATION.