Form 990 for tax year 2022

Revenue

Part VIII, the statement of revenue.

• 2a · Program service revenue: PATIENT SERVICES

  total $159,318,229 · related or exempt $159,318,229

• 2b · Program service revenue: SERVICES TO AFFILIATES EXEMPT ORG

  total $19,056,721 · related or exempt $19,056,721

• 2c · Program service revenue: PREMIER PURCHASING

  total $1,401,103 · related or exempt $1,401,103

• 3 · Investment income

  total $327,238 · excluded $327,238

• 6a · Gross rents

  real property $12,000

• 6b · Less rental expenses

  real property $12,000

• 6c · Rental income or loss

  real property $0

• 11a · Other revenue: MISCELLANEOUS SERVICES

  total $35,024 · excluded $35,024

• 11e · Other revenue, total

  $35,024

Functional expenses

Part IX, the statement of functional expenses.

• 1 · Grants to domestic organizations and governments

  total $9,811 · program services $9,811

• 5 · Compensation of officers, directors and key employees

  total $10,427,430 · management and general $10,427,430

• 7 · Other salaries and wages

  total $7,283,794 · management and general $7,283,794

• 8 · Pension plan contributions

  total $129,683 · management and general $129,683

• 9 · Other employee benefits

  total $281,176 · management and general $281,176

• 10 · Payroll taxes

  total $350,990 · management and general $350,990

• 11b · Fees: legal

  total $120,615 · management and general $120,615

• 11g · Fees: other

  total $122,782,821 · program services $111,913,598 · management and general $10,869,223

• 12 · Advertising and promotion

  total $2,271,692 · program services $141,513 · management and general $2,130,179

• 13 · Office expenses

  total $1,005,772 · program services $752,146 · management and general $253,626

• 14 · Information technology

  total $35,624 · program services $25,091 · management and general $10,533

• 16 · Occupancy

  total $8,826,270 · program services $8,071,444 · management and general $754,826

• 17 · Travel

  total $105,885 · program services $71,373 · management and general $34,512

• 19 · Conferences, conventions and meetings

  total $25,401 · program services $12,646 · management and general $12,755

• 20 · Interest

  total $1,241,883 · program services $1,131,680 · management and general $110,203

• 22 · Depreciation, depletion and amortization

  total $4,944,670 · program services $4,944,670

• 23 · Insurance

  total $1,141,122 · program services $2,428 · management and general $1,138,694

• 24a · Other expenses: MEDICAL SUPPLIES AND EQ

  total $23,050,467 · program services $22,782,713 · management and general $267,754

• 24b · Other expenses: TAXES AND ASSESSMENTS

  total $2,289,323 · program services $2,289,323

• 24c · Other expenses: MISCELLANEOUS

  total $1,738,194 · program services $1,713,889 · management and general $24,305

• 24d · Other expenses: BAD DEBT

  total $1,378,000 · program services $1,378,000

• 24e · All other expenses

  total $958,623 · program services $19,301,019 · management and general -$18,342,396

Balance sheet

Part X, book values.

• 1 · Cash, non-interest-bearing

  beginning of year $150,761 · end of year $4,144,977

• 2 · Savings and temporary cash investments

  beginning of year $404,281,905 · end of year $486,185,601

• 4 · Accounts receivable

  beginning of year $145,592,450 · end of year $20,200,904

• 9 · Prepaid expenses and deferred charges

  beginning of year $774,578 · end of year $1,236,264

• 10a · Land, buildings and equipment: cost or other basis

  $103,740,799

• 10b · Land, buildings and equipment: accumulated depreciation

  $57,227,235

• 10c · Land, buildings and equipment, net

  beginning of year $48,144,680 · end of year $46,513,564

• 13 · Investments: program-related

  beginning of year $4,134,827 · end of year $83,950,071

• 15 · Other assets

  beginning of year $5,602,188 · end of year $11,749,401

• 17 · Accounts payable and accrued expenses

  beginning of year $581,158,772 · end of year $616,376,446

• 25 · Other liabilities

  beginning of year $36,783,925 · end of year $57,368,355

• 27 · Net assets without donor restrictions

  beginning of year -$9,261,308 · end of year -$19,764,019

Itemized on Schedule J with no Part VII listing of the same name on this return:

The filer's explanations (Part III)

PART I, LINE 3

THE PARK NICOLLET HEALTH SERVICES' BOARD OF DIRECTORS IS RESPONSIBLE FOR ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT AND OTHER EXECUTIVES.

PART I, LINE 4B

SCHEDULE J, PART I, LINE 4B: SENIOR LEADERS OF PARK NICOLLET HEALTH SERVICES AND AFFILIATES ARE GIVEN THE OPPORTUNITY TO PARTICIPATE IN THE CAPITAL ACCUMULATION ACCOUNT PLAN. THE CAPITAL ACCUMULATION ACCOUNT PLAN (CAA PLAN) PARTICIPATION IS LIMITED TO SENIOR LEADERS AND ALL THE VICE PRESIDENTS. EACH PARTICIPANT RECEIVES AN ANNUAL ALLOWANCE EQUAL TO THE SUM OF (I) A STATED PERCENT OF SALARY, (II) VOLUNTARY SALARY DEFERRALS. THE ALLOWANCE IS CREDITED TO A BOOKKEEPING ACCOUNT. EARNINGS ARE CREDITED TO THE ACCOUNT BASED ON THE PERFORMANCE OF SIMULATED INVESTMENTS. BENEFITS VEST UPON THE EARLIEST OF REMAINING EMPLOYED TO AN ELECTIVE VESTING DATE (TWO YEARS TO AGE 68), INVOLUNTARY TERMINATION WITHOUT CAUSE, DISABILITY, DEATH, OR NOT COMPETING FOR 24 MONTHS FOLLOWING VOLUNTARY OR FOR-CAUSE TERMINATION. BENEFITS ARE PAID IN A SINGLE LUMP SUM UPON VESTING. PARTICIPANTS ARE GENERAL CREDITORS OF THE EMPLOYER FOR THE PAYMENT OF THE BENEFITS. THE FOLLOWING PARTICIPANTS RECEIVED PAYOUTS FROM A RELATED ORGANIZATION, PARK NICOLLET HEALTH SERVICES, RELATED TO CAA PLAN: NAME COMPENSATION STEVEN M. CONNELLY, MD $ 79,995 THOMAS A. JONES $ 45,007 LAURA A. LOBERG $ 38,399 JOAN SANDSTROM $ 39,783 CATHERINE A. KLUGHERZ $ 39,417 JOSHUA O. ZIMMERMAN MD $ 37,088 KRISTI A. LYON $ 39,729 MELISSA F. SCHOENHERR $ 38,738 DUANE F. SPIEGLE $ 38,201 MARK R. SANNES $ 73,800 NANCY L. EVERT $ 47,347 JENNIFER L. MYSTER $ 22,205 NANCY A. MCLURE $ 44,974 ANDREA M. WALSH $ 276,551

PART I, LINE 7

PARK NICOLLET HEALTH SERVICE'S (PNHS) PRESIDENT AND ITS OFFICERS MAY RECEIVE COMPENSATION BASED ON THE PARK NICOLLET HEALTH SERVICES SENIOR EXECUTIVE INCENTIVE PROGRAM (SEIP). SEIP INCENTS AND REWARDS SENIOR BUSINESS LEADERS WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC FISCAL YEAR. THE PROGRAM IS A KEY ELEMENT OF THE PARTICIPANT'S TOTAL COMPENSATION PACKAGE. SEIP REWARDS ARE BASED ON POSITION IN THE ORGANIZATION (E.G. SENIOR VICE PRESIDENT, VICE PRESIDENT, SENIOR MEDICAL DIRECTOR) AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATION'S STRATEGIC PLAN AND WILL BE BALANCED. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO CLINIC AND HOSPITAL QUALITY MEASURES, PATIENT SAFETY, HEALTH EQUITY, HEALTH CARE AFFORDABILITY MEASURES, PATIENT AND MEMBER SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, HEALTH PLAN AND CARE DELIVERY MARKET SHARE, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE (OPERATING INCOME), ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. AN OPERATING INCOME THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. IN THEIR ROLES AS MANAGEMENT EMPLOYED BY PNHS, CERTAIN DIRECTORS AND MANAGERS MAY RECEIVE COMPENSATION BASED ON THE PARK NICOLLET MIDDLE MANAGEMENT INCENTIVE PROGRAM (MMIP). MMIP INCENTS AND REWARDS BUSINESS LEADERS WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC FISCAL YEAR. MMIP GOALS ARE SIMILAR IN NATURE TO THOSE IN THE SEIP HOWEVER THERE IS A DIFFERENCE AS MMIP GOALS INCLUDE BOTH AN ORGANIZATION FINANCIAL MEASURE AND A LOCAL DEPARTMENT FINANCIAL MEASURE. THE LOCAL MEASURES ARE BASED ON PNHS RESULTS . AN OPERATING INCOME THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND ONCE MET THE ULTIMATE MMIP PAYOUT DEPENDS ON THE RESULTS OF THE BUSINESS GOAL PERFORMANCE, THE ORGANIZATION FINANCIAL MEASURES, THE LOCAL OPERATIONAL MEASURES AND THE PERCENTAGE PAYOUT ALLOWED BASED ON THE PARTICIPATION LEVEL.

FORM 990, SCHEDULE J PART II, COLUMN F:

PRIOR REPORTED COMPENSATION COLUMN (F) INCLUDES AMOUNTS PAID TO PARTICIPANTS IN THE CURRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEAR'S 990'S, AS RETIREMENT AND DEFERRED COMPENSATION, FOR THE FOLLOWING DIRECTORS: STEVEN M. CONNELLY, MD $ 88,585 LAURA A. LOBERG $ 36,504 JOAN SANDSTROM $ 38,411 CATHERINE A. KLUGHERZ $ 38,057 JOSHUA O. ZIMMERMAN MD $ 36,167 KRISTI A. LYON $ 38,358 MELISSA F. SCHOENHERR $ 35,465 THOMAS A. JONES $ 81,684 MARK R. SANNES $ 51,156 DUANE F SPIEGLE $ 113,293 NANCY A. MCLURE $ 149,768 JENNIFER L. MYSTER $ 19,970 ANDREA M. WALSH $ 173,628 NANCY L. EVERT $ 37,844

Disregarded entities

Part I: entities that legally are the filer and file no return of their own.

• DEFERRED COMPENSATION TRUST

  INVESTMENTS · MN · income $32,584 · assets $865,632

  Directly controlled by PARK NICOLLET HEALTH SERVICES

• TRIA ORTHOPEDIC CENTER LLC

  HEALTH CARE · MN

  Directly controlled by PARK NICOLLET HEALTH SERVICES

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

• HEALTHPARTNERS ADMINISTRATORS INC

  C · THIRD PARTY ADMINISTRATOR · MN

  Directly controlled by HEALTHPARTNERS INC

• HEALTHPARTNERS ASSOCIATES INC

  C · MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT · MN

  Directly controlled by HEALTHPARTNERS ADMINISTRATORS INC

• HEALTHPARTNERS SERVICES INC

  C · MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT · MN

  Directly controlled by HEALTHPARTNERS ADMINISTRATORS INC

• HEALTHPARTNERS INSURANCE COMPANY

  C · MEDICAL AND DENTAL INSURANCE · MN

  Directly controlled by HEALTHPARTNERS ADMINISTRATORS INC

• DENTAL SPECIALITIES INC

  C · PROFESSIONAL DENAL SERVICES · MN

  Directly controlled by HEALTHPARTNERS ADMINISTRATORS INC