HomeMy WebLinkAbout10/29/2015 DMCC Board Meeting - Agenda and Meeting Packet
DESTIN ATION
MEDICAL CENTER
CORPOR ATION
(DMCC)
BOARD MEETING
9:30 A.M. THURSDAY, OCTOBER 29, 2015
MAYO CIVIC CENTER - ROCHESTER
TO: Jim Bier, Treasurer
Kathleen Lamb, Attorney
FR: Dale Martinson, Assistant Treasurer
Date: October 21, 2015
RE: Sept 2015 Financial Summary
The attached financial summary for September reflects activity to date totaling $1,777,821 of
2015 budgeted expenditures plus $550,675 of total closeout work on the 2014 plan
development carryover costs. The total remaining 2015 budget of $2,294,982 represents 56%
to the original budget remaining with just three months (25%) of the year remaining.
Please note that the first payment was made in September to reimburse the DMC EDA working
capital loan for payroll expenses of the DMCC EDA. This amount of $22,858 represents starting
payroll from July, August, and part of September as new employees came on board. These
payroll expense are not included in the “Detail Cost Report #4” page following the financial
summary as that report lists only EDA contract costs processed by the Hammes Corporation.
Please feel free to contact me with any questions or concerns.
Destination Medical Center Corporation
Financial Budget Summary
September 2015
2015 Amended Curent Month September 2015 Amount Percent
Approved Budget September 2015 YTD Remaining Remaining
General Expenses 217,203 2,230 33,298 183,905 85%
Professional Services 780,600 204,500 576,100 74%
City Expenses 275,000 ‐ 275,000 100%
Subtotal DMCC 1,272,803 2,230 237,798 1,035,005 81%
Third Party Costs ‐ DMC EDA *
Payroll, Staff, Administration & Benefits‐EDA 218,000 22,858 22,858 195,142 90%
General Expenses ‐ EDA 79,000 1,490 77,510 98%
Economic Development Outreach 108,000 22,419 153,513 (45,513) ‐42%
Meeting Expenses ‐ ‐ ‐ ‐
Professional Services 2,295,000 154,140 1,339,362 955,638 42%
Miscellaneous Expenses 100,000 3,800 22,800 77,200 77%
Subtotal EDA 2,800,000 203,217 1,540,023 1,259,977 45%
Total DMCC 2015 4,072,803 205,447 1,777,821 2,294,982 56%
‐
‐ ‐
Plus 2014 EDA Project/Contract Carryover 570,106 *550,675 19,431 3%
DMCC Working Capital Note 1,000
* See Attached Contract Commitments for EDA Portion EDA Working Capital Note 50,000
*Carryover of 2014 Budget to complete plan as approved by board on 7/30/2015
Report 4002
10/19/2015 - 7:48 AM Page 1 of 1
DMC - ECONOMIC DEVELOPMENT AGENCY (2015)
DETAIL COST REPORT #4
Variance
Division Description
Master Project
Budget
A
Original
Contract
Amount
B
Contract
Revisions
C
Committed
Costs
B+C
Committed Direct
Owner Purchases
D
Un-Committed
Costs
E
Final Projected
Cost
B+C+D+E
Over/(Under)
Budget
(B+C+D+E)-A
Total Work
In Place
Percent
Complete
DEVELOPMENT COSTS
40-05-000 Architecture & Engineering $135,000.00 $13,390.47 $0.00 $13,390.47 $0.00 $121,609.53 $135,000.00 $0.00 $1,299.57 0.96%
40-05-300 Planning Services, Architecture, Engineering $135,000.00 $13,390.47 $0.00 $13,390.47 $0.00 $121,609.53 $135,000.00 $0.00 $1,299.57 0.96%
40-25-000 Marketing & Public Relations $318,000.00 $386,516.20 $0.00 $386,516.20 $0.00 ($68,516.20)$318,000.00 $0.00 $182,698.70 57.45%
40-25-300 Communications, Marketing & PR $108,000.00 $273,225.00 $0.00 $273,225.00 $0.00 ($165,225.00)$108,000.00 $0.00 $153,512.50 142.14%
40-25-310 Public Relations & Communications $210,000.00 $113,291.20 $0.00 $113,291.20 $0.00 $96,708.80 $210,000.00 $0.00 $29,186.20 13.90%
40-30-000 Development Services $1,900,000.00 $1,862,000.00 $0.00 $1,862,000.00 $0.00 $38,000.00 $1,900,000.00 $0.00 $1,262,000.00 66.42%
40-30-300 Development Services $1,860,000.00 $1,860,000.00 $0.00 $1,860,000.00 $0.00 $0.00 $1,860,000.00 $0.00 $1,260,000.00 67.74%
40-30-310 Financial, Accounting & Investment Services $40,000.00 $2,000.00 $0.00 $2,000.00 $0.00 $38,000.00 $40,000.00 $0.00 $2,000.00 5.00%
40-35-000 Legal Services $50,000.00 $46,329.33 $548.00 $46,877.33 $0.00 $3,122.67 $50,000.00 $0.00 $46,877.33 93.75%
40-35-300 Legal Services $50,000.00 $46,329.33 $548.00 $46,877.33 $0.00 $3,122.67 $50,000.00 $0.00 $46,877.33 93.75%
40-90-000 Other Development Costs $397,000.00 $39,264.76 $225.00 $39,489.76 $0.00 $357,510.24 $397,000.00 $0.00 $24,289.76 6.12%
40-90-115 Payroll, Staff, Administration & Benefits-EDA $218,000.00 $0.00 $0.00 $0.00 $0.00 $218,000.00 $218,000.00 $0.00 $0.00 0.00%
40-90-120 General Expenses-EDA $79,000.00 $1,264.76 $225.00 $1,489.76 $0.00 $77,510.24 $79,000.00 $0.00 $1,489.76 1.89%
40-90-300 Reimbursable Expenses $100,000.00 $38,000.00 $0.00 $38,000.00 $0.00 $62,000.00 $100,000.00 $0.00 $22,800.00 22.80%
Subtotal $2,800,000.00 $2,347,500.76 $773.00 $2,348,273.76 $0.00 $451,726.24 $2,800,000.00 $0.00 $1,517,165.36 54.18%
PROJECT CONTINGENCY
90-00-000 Project Contingency $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00%
Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00%
PROJECT TOTAL $2,800,000.00 $2,347,500.76 $773.00 $2,348,273.76 $0.00 $451,726.24 $2,800,000.00 $0.00 $1,517,165.36 54.18%
Work in PlaceSchedule of Values
September 30, 2015
An independent member of Nexia International
CliftonLarsonAllen LLP
109 North Main Street, PO Box 217
Austin, MN 55912-0217
507-434-7000 | fax 507-437-8997
CLAconnect.com
Destination Medical Center Corporation
IRS Form 990
October 29, 2015
Required filing for nonprofit entities – indicates “initial filing” for 2014
Informational filing
o Reconciles to audited financial statements – Part I, Part XI and Schedule D
o Mission/purpose – Part III
o Nature of business and transactions – Part IV and Part V
o Governance and policies – Part VI
o List of board members – Part VII
o Obtained an audit – Part XII
o Source of funding – Schedule A & B
o Schedule O – additional information, explanation and clarification
o Related parties – Schedule R
o Annual Report Form also submitted to State of Minnesota
No income tax due or payable
Questions
DRA
F
T
Check
if
self-employed
OMB No. 1545-0047
Department of the Treasury
Internal Revenue Service
Check ifapplicable:
Addresschange
Namechange
Initialreturn
Finalreturn/termin-ated Gross receipts $
Amendedreturn
Applica-tionpending
Are all subordinates included?
432001 11-07-14
| Do not enter social security numbers on this form as it may be made public.
Beginning of Current Year
Paid
Preparer
Use Only
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
Open to Public Inspection| Information about Form 990 and its instructions is at
A For the 2014 calendar year, or tax year beginning and ending
B C D Employer identification number
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H(b)
H(c)
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Yes No
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Website: |
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For Paperwork Reduction Act Notice, see the separate instructions.
(or P.O. box if mail is not delivered to street address)Room/suite
)501(c)(3)501(c) ((insert no.)4947(a)(1) or 527
|Corporation Trust Association OtherForm of organization:Year of formation:State of legal domicile:
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Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is
true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Signature of officer Date
Type or print name and title
Date PTINPrint/Type preparer's name Preparer's signature
Firm's name Firm's EIN
Firm's address
Phone no.
Form
Name of organization
Doing business as
Number and street Telephone number
City or town, state or province, country, and ZIP or foreign postal code
Is this a group return
for subordinates?Name and address of principal officer:~~
If "No," attach a list. (see instructions)
Group exemption number |
Tax-exempt status:
Briefly describe the organization's mission or most significant activities:
Check this box if the organization discontinued its operations or disposed of more than 25% of its net assets.
Number of voting members of the governing body (Part VI, line 1a)
Number of independent voting members of the governing body (Part VI, line 1b)
Total number of individuals employed in calendar year 2014 (Part V, line 2a)
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
Total number of volunteers (estimate if necessary)
Total unrelated business revenue from Part VIII, column (C), line 12
Net unrelated business taxable income from Form 990-T, line 34
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
••••••••••••••••••••••
Contributions and grants (Part VIII, line 1h)~~~~~~~~~~~~~~~~~~~~~
Program service revenue (Part VIII, line 2g)~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~Investment income (Part VIII, column (A), lines 3, 4, and 7d)
Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)~~~~~~~~
Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12)•••
Grants and similar amounts paid (Part IX, column (A), lines 1-3)
Benefits paid to or for members (Part IX, column (A), line 4)
Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10)
~~~~~~~~~~~
~~~~~~~~~~~~~
~~~
Professional fundraising fees (Part IX, column (A), line 11e)
Total fundraising expenses (Part IX, column (D), line 25)
~~~~~~~~~~~~~~
Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e)
Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25)
Revenue less expenses. Subtract line 18 from line 12
~~~~~~~~~~~~~
~~~~~~~
••••••••••••••••
Total assets (Part X, line 16)
Total liabilities (Part X, line 26)
Net assets or fund balances. Subtract line 21 from line 20
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~
••••••••••••••
May the IRS discuss this return with the preparer shown above? (see instructions)•••••••••••••••••••••
LHA Form (2014)
www.irs.gov/form990.
Part I Summary
Signature BlockPart II
990
Return of Organization Exempt From Income Tax990 2014
§
==
999
EXTENDED TO NOVEMBER 16, 2015
DESTINATION MEDICAL CENTER CORPORATION
46-4959371
X
201 4TH STREET SE 204 507-328-2850
5,416,447.
ROCHESTER, MN 55904
TINA FLINT SMITH X
SAME AS C ABOVE
X
WWW.DMCCORPORATION.ORG
X 2013 MN
PLANNING AND IMPLEMENTATION OF
DESTINATION MEDICAL CENTER DEVELOPMENT IN DOWNTOWN ROCHESTER,
8
8
0
30
0.
0.
5,416,446.
0.
1.
0.
5,416,447.
0.
0.
0.
0.
0.
5,416,447.
5,416,447.
0.
1,292,478.
1,292,478.
0.
TINA FLINT SMITH, CHAIR
CRAIG POPENHAGEN CRAIG POPENHAGEN 10/20/15 P01587689
CLIFTONLARSONALLEN LLP 41-0746749
P.O. BOX 217
AUSTIN, MN 55912 507-434-7000
X
SEE SCHEDULE O FOR ORGANIZATION MISSION STATEMENT CONTINUATION
DRA
F
T
Code:Expenses $including grants of $Revenue $
Code:Expenses $including grants of $Revenue $
Code:Expenses $including grants of $Revenue $
Expenses $including grants of $Revenue $
43200211-07-14
1
2
3
4
Yes No
Yes No
4a
4b
4c
4d
4e
Form 990 (2014)Page
Check if Schedule O contains a response or note to any line in this Part III ••••••••••••••••••••••••••••
Briefly describe the organization's mission:
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ?
If "Yes," describe these new services on Schedule O.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization cease conducting, or make significant changes in how it conducts, any program services?
If "Yes," describe these changes on Schedule O.
~~~~~~
Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses.
Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and
revenue, if any, for each program service reported.
() ()()
() ()()
() ()()
Other program services (Describe in Schedule O.)
()()
Total program service expenses |
Form (2014)
2
Statement of Program Service AccomplishmentsPart III
990
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
X
TO CARRY OUT THE GOALS AND INITIATIVES OF THE DMC LEGISLATION.
DESTINATION MEDICAL CENTER (DMC) IS THE STATE'S LARGEST-EVER ECONOMIC
DEVELOPMENT PROJECT THAT INCLUDES AN ESTIMATED $5.6 BILLION IN MAYO
CLINIC AND OTHER PRIVATE INVESTMENT OVER 20 YEARS. DMC OVERSEES THE
X
X
4,920,961.5,416,446.
DEVELOPMENT PLAN CREATION - IN DEPTH STUDY OF COMMUNITY STRENGTHS,
WEAKNESS, OPPORTUNITIES, AND THREATS WITH MASSIVE COMMUNITY INVOLVEMENT
AND COMPLETED COMPLEX PLANNING FRAMEWORK DOCUMENT FOR THE NEXT 20 YEARS
OF DEVELOPMENT IN THE COMMUNITY.
4,920,961.
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
2
DRA
F
T
43200311-07-14
Yes No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
1
2
3
4
5
6
7
8
9
10
Section 501(c)(3) organizations.
a
b
c
d
e
f
a
b
11a
11b
11c
11d
11e
11f
12a
12b
13
14a
14b
15
16
17
18
19
20a
20b
a
b
a
b
If "Yes," complete Schedule A
Schedule B, Schedule of Contributors
If "Yes," complete Schedule C, Part I
If "Yes," complete Schedule C, Part II
If "Yes," complete Schedule C, Part III
If "Yes," complete Schedule D, Part I
If "Yes," complete Schedule D, Part II
If "Yes," complete
Schedule D, Part III
If "Yes," complete Schedule D, Part IV
If "Yes," complete Schedule D, Part V
If "Yes," complete Schedule D,
Part VI
If "Yes," complete Schedule D, Part VII
If "Yes," complete Schedule D, Part VIII
If "Yes," complete Schedule D, Part IX
If "Yes," complete Schedule D, Part X
If "Yes," complete Schedule D, Part X
If "Yes," complete
Schedule D, Parts XI and XII
If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional
If "Yes," complete Schedule E
If "Yes," complete Schedule F, Parts I and IV
If "Yes," complete Schedule F, Parts II and IV
If "Yes," complete Schedule F, Parts III and IV
If "Yes," complete Schedule G, Part I
If "Yes," complete Schedule G, Part II
If "Yes,"
complete Schedule G, Part III
If "Yes," complete Schedule H
Form 990 (2014)Page
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Is the organization required to complete ?
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for
public office?
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization engage in lobbying activities, or have a section 501(h) election in effect
during the tax year?
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
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?
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures?
Did the organization maintain collections of works of art, historical treasures, or other similar assets?
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount in Part X, line 21, for escrow or custodial account liability; serve as a custodian for
amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services?
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent
endowments, or quasi-endowments?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~
If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X
as applicable.
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount for investments - other securities in Part X, line 12 that is 5% or more of its total
assets reported in Part X, line 16?
Did the organization report an amount for investments - program related in Part X, line 13 that is 5% or more of its total
assets reported in Part X, line 16?
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in
Part X, line 16?
Did the organization report an amount for other liabilities in Part X, line 25?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~
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)?
Did the organization obtain separate, independent audited financial statements for the tax year?
~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Was the organization included in consolidated, independent audited financial statements for the tax year?
~~~~~
Is the organization a school described in section 170(b)(1)(A)(ii)?
Did the organization maintain an office, employees, or agents outside of the United States?
~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any
foreign organization?
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to
or for foreign individuals?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX,
column (A), lines 6 and 11e? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines
1c and 8a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a?
Did the organization operate one or more hospital facilities?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?••••••••••
Form (2014)
3
Part IV Checklist of Required Schedules
990
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
3
DRA
F
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43200411-07-14
Yes No
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
21
22
23
24a
24b
24c
24d
25a
25b
26
27
28a
28b
28c
29
30
31
32
33
34
35a
35b
36
37
38
a
b
c
d
a
b
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations.
a
b
c
a
b
Section 501(c)(3) organizations.
Note.
(continued)
If "Yes," complete Schedule I, Parts I and II
If "Yes," complete Schedule I, Parts I and III
If "Yes," complete
Schedule J
If "Yes," answer lines 24b through 24d and complete
Schedule K. If "No", go to line 25a
If "Yes," complete Schedule L, Part I
If "Yes," complete
Schedule L, Part I
If "Yes,"
complete Schedule L, Part II
If "Yes," complete Schedule L, Part III
If "Yes," complete Schedule L, Part IV
If "Yes," complete Schedule L, Part IV
If "Yes," complete Schedule L, Part IV
If "Yes," complete Schedule M
If "Yes," complete Schedule M
If "Yes," complete Schedule N, Part I
If "Yes," complete
Schedule N, Part II
If "Yes," complete Schedule R, Part I
If "Yes," complete Schedule R, Part II, III, or IV, and
Part V, line 1
If "Yes," complete Schedule R, Part V, line 2
If "Yes," complete Schedule R, Part V, line 2
If "Yes," complete Schedule R, Part VI
Form 990 (2014)Page
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or
domestic government on Part IX, column (A), line 1? ~~~~~~~~~~~~~~
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on
Part IX, column (A), line 2? ~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization's current
and former officers, directors, trustees, key employees, and highest compensated employees?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease
any tax-exempt bonds?
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?
~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~
Did the organization engage in an excess benefit
transaction with a disqualified person during the year?
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?
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or
former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV
instructions for applicable filing thresholds, conditions, and exceptions):
A current or former officer, director, trustee, or key employee? ~~~~~~~~~~~
A family member of a current or former officer, director, trustee, or key employee?
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?
~~
~~~~~~~~~~~~~~~~~~~~~
Did the organization receive more than $25,000 in non-cash contributions?
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation
contributions?
~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization liquidate, terminate, or dissolve and cease operations?
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations
sections 301.7701-2 and 301.7701-3?
Was the organization related to any tax-exempt or taxable entity?
~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity
within the meaning of section 512(b)(13)?
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~
Did the organization make any transfers to an exempt non-charitable related organization?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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? ~~~~~~~~
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19?
All Form 990 filers are required to complete Schedule O •••••••••••••••••••••••••••••••
Form (2014)
4
Part IV Checklist of Required Schedules
990
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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Yes No
1
2
3
4
5
6
7
a
b
c
1a
1b
1c
a
b
2a
Note.
2b
3a
3b
4a
5a
5b
5c
6a
6b
7a
7b
7c
7e
7f
7g
7h
8
9a
9b
a
b
a
b
a
b
c
a
b
Organizations that may receive deductible contributions under section 170(c).
a
b
c
d
e
f
g
h
7d
8
9
10
11
12
13
14
Sponsoring organizations maintaining donor advised funds.
Sponsoring organizations maintaining donor advised funds.
a
b
Section 501(c)(7) organizations.
a
b
10a
10b
Section 501(c)(12) organizations.
a
b
11a
11b
a
b
Section 4947(a)(1) non-exempt charitable trusts. 12a
12b
Section 501(c)(29) qualified nonprofit health insurance issuers.
Note.
a
b
c
a
b
13a
13b
13c
14a
14b
e-file
If "No," to line 3b, provide an explanation in Schedule O
If "No," provide an explanation in Schedule O
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?
Form (2014)
Form 990 (2014)Page
Check if Schedule O contains a response or note to any line in this Part V •••••••••••••••••••••••••••
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ~~~~~~~~~~~
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable ~~~~~~~~~~
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming
(gambling) winnings to prize winners?•••••••••••••••••••••••••••••••••••••••••••
Enter 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 ~~~~~~~~~~
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
If the sum of lines 1a and 2a is greater than 250, you may be required to (see instructions)
~~~~~~~~~~
~~~~~~~~~~~
Did the organization have unrelated business gross income of $1,000 or more during the year?
If "Yes," has it filed a Form 990-T for this year?
~~~~~~~~~~~~~~
~~~~~~~~~~
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)?~~~~~~~
If "Yes," enter the name of the foreign country:
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
~~~~~~~~~~~~
~~~~~~~~~
If "Yes," to line 5a or 5b, did the organization file Form 8886-T?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
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?
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts
were not tax deductible?
~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," did the organization notify the donor of the value of the goods or services provided?
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required
to file Form 8282?
~~~~~~~~~~~~~~~
••••••••••••••••••••••••••••••••••••••••••••••••••••
If "Yes," indicate the number of Forms 8282 filed during the year
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
~~~~~~~~~~~~~~~~
~~~~~~~
~~~~~~~~~Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?
~
Did a donor advised fund maintained by the
sponsoring organization have excess business holdings at any time during the year?~~~~~~~~~~~~~~~~~~~
Did the sponsoring organization make any taxable distributions under section 4966?
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?
~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Enter:
Initiation fees and capital contributions included on Part VIII, line 12
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
~~~~~~~~~~~~~~~
~~~~~~
Enter:
Gross income from members or shareholders
Gross income from other sources (Do not net amounts due or paid to other sources against
amounts due or received from them.)
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Is the organization filing Form 990 in lieu of Form 1041?
If "Yes," enter the amount of tax-exempt interest received or accrued during the year ••••••
Is the organization licensed to issue qualified health plans in more than one state?
See the instructions for additional information the organization must report on Schedule O.
~~~~~~~~~~~~~~~~~~~~~
Enter the amount of reserves the organization is required to maintain by the states in which the
organization is licensed to issue qualified health plans
Enter the amount of reserves on hand
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization receive any payments for indoor tanning services during the tax year?
If "Yes," has it filed a Form 720 to report these payments?
~~~~~~~~~~~~~~~~
••••••••••
5
Part V Statements Regarding Other IRS Filings and Tax Compliance
990
J
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
1
0
0
X
X
X
X
X
X
X
X
X
X
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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432006 11-07-14
Yes No
1a
1b
1
2
3
4
5
6
7
8
9
a
b
2
3
4
5
6
7a
7b
8a
8b
9
a
b
a
b
Yes No
10
11
a
b
10a
10b
11a
12a
12b
12c
13
14
15a
15b
16a
16b
a
b
12a
b
c
13
14
15
a
b
16a
b
17
18
19
20
For each "Yes" response to lines 2 through 7b below, and for a "No" response
to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
If "Yes," provide the names and addresses in Schedule O
(This Section B requests information about policies not required by the Internal Revenue Code.)
If "No," go to line 13
If "Yes," describe
in Schedule O how this was done
(explain in Schedule O)
If there are material differences in voting rights among members of the governing body, or if the governing
body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts?
Form (2014)
Form 990 (2014)Page
Check if Schedule O contains a response or note to any line in this Part VI •••••••••••••••••••••••••••
Enter the number of voting members of the governing body at the end of the tax year
Enter the number of voting members included in line 1a, above, who are independent
~~~~~~
~~~~~~
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other
officer, director, trustee, or key employee?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization delegate control over management duties customarily performed by or under the direct supervision
of officers, directors, or trustees, or key employees to a management company or other person?~~~~~~~~~~~~~~
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
Did the organization become aware during the year of a significant diversion of the organization's assets?
Did the organization have members or stockholders?
~~~~~
~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or
more members of the governing body?
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or
persons other than the governing body?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The governing body?
Each committee with authority to act on behalf of the governing body?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the
organization's mailing address? •••••••••••••••••
Did the organization have local chapters, branches, or affiliates?
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates,
and branches to ensure their operations are consistent with the organization's exempt purposes?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
Describe in Schedule O the process, if any, used by the organization to review this Form 990.
Did the organization have a written conflict of interest policy? ~~~~~~~~~~~~~~~~~~~~
~~~~~~
Did the organization regularly and consistently monitor and enforce compliance with the policy?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization have a written whistleblower policy?
Did the organization have a written document retention and destruction policy?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
Did the process for determining compensation of the following persons include a review and approval by independent
persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
The organization's CEO, Executive Director, or top management official
Other officers or key employees of the organization
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a
taxable entity during the year?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation
in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization's
exempt status with respect to such arrangements?••••••••••••••••••••••••••••••••••••
List the states with which a copy of this Form 990 is required to be filed
Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 990-T (Section 501(c)(3)s only) available
for public inspection. Indicate how you made these available. Check all that apply.
Own website Another's website Upon request Other
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial
statements available to the public during the tax year.
State the name, address, and telephone number of the person who possesses the organization's books and records: |
6
Part VI Governance, Management, and Disclosure
Section A. Governing Body and Management
Section B. Policies
Section C. Disclosure
990
J
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
X
8
8
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
MN
X
DALE MARTINSON - 507-328-2850
201 4TH STREET SE ROOM 204, ROCHESTER, MN 55904
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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i
v
i
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o
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In
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n
a
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t
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Of
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Ke
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m
p
l
o
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Hi
g
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s
t
c
o
m
p
e
n
s
a
t
e
d
em
p
l
o
y
e
e
Fo
r
m
e
r
(do not check more than one
box, unless person is both an
officer and a director/trustee)
432007 11-07-14
current
Section A.Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a
current
current
former
former directors or trustees
(A)(B)(C)(D)(E)(F)
Form 990 (2014)Page
Check if Schedule O contains a response or note to any line in this Part VII •••••••••••••••••••••••••••
Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization's tax year.
¥ List all of the organization's officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation.Enter -0- in columns (D), (E), and (F) if no compensation was paid.¥ List all of the organization's key employees, if any. See instructions for definition of "key employee."
¥ List the organization's five highest compensated employees (other than an officer, director, trustee, or key employee) who received report-
able compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the organization and any related organizations.
¥ List all of the organization's officers, key employees, and highest compensated employees who received more than $100,000 of
reportable compensation from the organization and any related organizations.
¥ List all of the organization's that received, in the capacity as a former director or trustee of the organization,
more than $10,000 of reportable compensation from the organization and any related organizations.
List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
PositionName and Title Average
hours per
week
(list any
hours for
related
organizations
below
line)
Reportable
compensation
from
the
organization
(W-2/1099-MISC)
Reportable
compensation
from related
organizations
(W-2/1099-MISC)
Estimated
amount of
other
compensation
from the
organization
and related
organizations
Form (2014)
7
Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated
Employees, and Independent Contractors
990
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
X
(1) TINA FLINT SMITH 4.00
CHAIR X X 0.0.0.
(2) R.T. RYBAK 4.00
VICE CHAIR X X 0.0.0.
(3) JIM BIER 4.00
TREASURER X X 0.0.0.
(4) ARDELL F. BREDE 4.00
DIRECTOR X 0.0.0.
(5) JAMES CAMPBELL 4.00
DIRECTOR X 0.0.0.
(6) BILL GEORGE 4.00
DIRECTOR X 0.0.0.
(7) ED HRUSKA 4.00
DIRECTOR X 0.0.0.
(8) SUSAN RANI 4.00
DIRECTOR X 0.0.0.
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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t
e
d
em
p
l
o
y
e
e
Ke
y
e
m
p
l
o
y
e
e
(do not check more than one
box, unless person is both an
officer and a director/trustee)
43200811-07-14
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
(B)(C)(A)(D)(E)(F)
1 b
c
d
Sub-total
Total from continuation sheets to Part VII, Section A
Total (add lines 1b and 1c)
2
Yes No
3
4
5
former
3
4
5
Section B. Independent Contractors
1
(A)(B)(C)
2
(continued)
If "Yes," complete Schedule J for such individual
If "Yes," complete Schedule J for such individual
If "Yes," complete Schedule J for such person
Page Form 990 (2014)
PositionAverage
hours per
week
(list any
hours for
related
organizations
below
line)
Name and title Reportable
compensation
from
the
organization
(W-2/1099-MISC)
Reportable
compensation
from related
organizations
(W-2/1099-MISC)
Estimated
amount of
other
compensation
from the
organization
and related
organizations
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~|
~~~~~~~~~~|
••••••••••••••••••••••••|
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable
compensation from the organization |
Did the organization list any officer, director, or trustee, key employee, or highest compensated employee on
line 1a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization
and related organizations greater than $150,000? ~~~~~~~~~~~~~
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services
rendered to the organization? ••••••••••••••••••••••••
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from
the organization. Report compensation for the calendar year ending with or within the organization's tax year.
Name and business address Description of services Compensation
Total number of independent contractors (including but not limited to those listed above) who received more than
$100,000 of compensation from the organization |
Form (2014)
8
Part VII
990
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
0.0.0.
0.0.0.
0.0.0.
0
X
X
X
MCGRANN SHEA CARNIVAL STRAUGHN & LAMB, CHTD
800 NICOLLET MALL, SUITE 2600, MINNEAPOLIS,LEGAL SERVICES 400,000.
1
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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Noncash contributions included in lines 1a-1f: $
43200911-07-14
Total revenue.
(A)(B)(C)(D)
1 a
b
c
d
e
f
g
h
1
1
1
1
1
1
a
b
c
d
e
f
Co
n
t
r
i
b
u
t
i
o
n
s
,
G
i
f
t
s
,
G
r
a
n
t
s
an
d
O
t
h
e
r
S
i
m
i
l
a
r
A
m
o
u
n
t
s
Total.
Business Code
a
b
c
d
e
f
g
2
Pr
o
g
r
a
m
S
e
r
v
i
c
e
Re
v
e
n
u
e
Total.
3
4
5
6 a
b
c
d
a
b
c
d
7
a
b
c
8
a
b
9 a
b
c
a
b
10 a
b
c
a
b
Business Code
11 a
b
c
d
e Total.
Ot
h
e
r
R
e
v
e
n
u
e
12
Revenue excludedfrom tax undersections512 - 514
All other contributions, gifts, grants, and
similar amounts not included above
See instructions.
Form (2014)
Page Form 990 (2014)
Check if Schedule O contains a response or note to any line in this Part VIII •••••••••••••••••••••••••
Total revenue Related orexempt functionrevenue
Unrelatedbusinessrevenue
Federated campaigns
Membership dues
~~~~~~
~~~~~~~~
Fundraising events
Related organizations
~~~~~~~~
~~~~~~
Government grants (contributions)
~~
Add lines 1a-1f •••••••••••••••••|
All other program service revenue ~~~~~
Add lines 2a-2f •••••••••••••••••|
Investment income (including dividends, interest, and
other similar amounts)
Income from investment of tax-exempt bond proceeds
~~~~~~~~~~~~~~~~~|
|
Royalties •••••••••••••••••••••••|
(i) Real (ii) Personal
Gross rents
Less: rental expenses
Rental income or (loss)
Net rental income or (loss)
~~~~~~~
~~~
~~
••••••••••••••|
Gross amount from sales of
assets other than inventory
(i) Securities (ii) Other
Less: cost or other basis
and sales expenses
Gain or (loss)
~~~
~~~~~~~
Net gain or (loss)•••••••••••••••••••|
Gross income from fundraising events (not
including $of
contributions reported on line 1c). See
Part IV, line 18 ~~~~~~~~~~~~~
Less: direct expenses ~~~~~~~~~~
Net income or (loss) from fundraising events •••••|
Gross income from gaming activities. See
Part IV, line 19 ~~~~~~~~~~~~~
Less: direct expenses
Net income or (loss) from gaming activities
~~~~~~~~~
••••••|
Gross sales of inventory, less returns
and allowances ~~~~~~~~~~~~~
Less: cost of goods sold
Net income or (loss) from sales of inventory
~~~~~~~~
••••••|
Miscellaneous Revenue
All other revenue ~~~~~~~~~~~~~
Add lines 11a-11d ~~~~~~~~~~~~~~~|
|•••••••••••••
9
Part VIII Statement of Revenue
990
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
5,416,446.
5,416,446.
1.1.
5,416,447.0.0.1.
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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Check here if following SOP 98-2 (ASC 958-720)
432010 11-07-14
Total functional expenses.
Joint costs.
(A)(B)(C)(D)
1
2
3
4
5
6
7
8
9
10
11
a
b
c
d
e
f
g
12
13
14
15
16
17
18
19
20
21
22
23
24
a
b
c
d
e
25
26
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).
Grants and other assistance to domestic organizations
and domestic governments. See Part IV, line 21
Compensation not included above, to disqualified
persons (as defined under section 4958(f)(1)) and
persons described in section 4958(c)(3)(B)
Pension plan accruals and contributions (include
section 401(k) and 403(b) employer contributions)
Professional fundraising services. See Part IV, line 17
(If line 11g amount exceeds 10% of line 25,
column (A) amount, list line 11g expenses on Sch O.)
Other expenses. Itemize expenses not covered above. (List miscellaneous expenses in line 24e. If line24e amount exceeds 10% of line 25, column (A)amount, list line 24e expenses on Schedule O.)
Add lines 1 through 24e
Complete this line only if the organization
reported in column (B) joint costs from a combined
educational campaign and fundraising solicitation.
Form 990 (2014)Page
Check if Schedule O contains a response or note to any line in this Part IX ••••••••••••••••••••••••••
Total expenses Program serviceexpenses Management andgeneral expenses Fundraisingexpenses
~
Grants and other assistance to domestic
individuals. See Part IV, line 22 ~~~~~~~
Grants and other assistance to foreign
organizations, foreign governments, and foreign
individuals. See Part IV, lines 15 and 16 ~~~
Benefits paid to or for members ~~~~~~~
Compensation of current officers, directors,
trustees, and key employees ~~~~~~~~
~~~
Other salaries and wages ~~~~~~~~~~
Other employee benefits ~~~~~~~~~~
Payroll taxes ~~~~~~~~~~~~~~~~
Fees for services (non-employees):
Management
Legal
Accounting
Lobbying
~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
Investment management fees
Other.
~~~~~~~~
Advertising and promotion
Office expenses
Information technology
Royalties
~~~~~~~~~
~~~~~~~~~~~~~~~
~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
Occupancy ~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~Travel
Payments of travel or entertainment expenses
for any federal, state, or local public officials
Conferences, conventions, and meetings ~~
Interest
Payments to affiliates
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~
Depreciation, depletion, and amortization
Insurance
~~
~~~~~~~~~~~~~~~~~
~~
All other expenses
|
Form (2014)
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
10
Part IX Statement of Functional Expenses
990
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
455,165.455,165.
21,927.21,927.
3,174.3,174.
10,508.10,508.
4,712.4,712.
PROGRAM COSTS 4,920,961.4,920,961.
5,416,447.4,920,961.495,486.0.
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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(A)(B)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
1
2
3
4
5
6
7
8
9
10c
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
a
b
10a
10b
As
s
e
t
s
Total assets.
Li
a
b
i
l
i
t
i
e
s
Total liabilities.
Organizations that follow SFAS 117 (ASC 958), check here and
complete lines 27 through 29, and lines 33 and 34.
27
28
29
Organizations that do not follow SFAS 117 (ASC 958), check here
and complete lines 30 through 34.
30
31
32
33
34
Ne
t
A
s
s
e
t
s
o
r
F
u
n
d
B
a
l
a
n
c
e
s
Form 990 (2014)Page
Check if Schedule O contains a response or note to any line in this Part X •••••••••••••••••••••••••••••
Beginning of year End of year
Cash - non-interest-bearing
Savings and temporary cash investments
Pledges and grants receivable, net
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~
Accounts receivable, net ~~~~~~~~~~~~~~~~~~~~~~~~~~
Loans and other receivables from current and former officers, directors,
trustees, key employees, and highest compensated employees. Complete
Part II of Schedule L ~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Loans and other receivables from other disqualified persons (as defined under
section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing
employers and sponsoring organizations of section 501(c)(9) voluntary
employees' beneficiary organizations (see instr). Complete Part II of Sch L ~~
Notes and loans receivable, net
Inventories for sale or use
Prepaid expenses and deferred charges
~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
Land, buildings, and equipment: cost or other
basis. Complete Part VI of Schedule D
Less: accumulated depreciation
~~~
~~~~~~
Investments - publicly traded securities
Investments - other securities. See Part IV, line 11
Investments - program-related. See Part IV, line 11
Intangible assets
~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other assets. See Part IV, line 11 ~~~~~~~~~~~~~~~~~~~~~~
Add lines 1 through 15 (must equal line 34)••••••••••
Accounts payable and accrued expenses
Grants payable
Deferred revenue
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Tax-exempt bond liabilities
Escrow or custodial account liability. Complete Part IV of Schedule D
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~
Loans and other payables to current and former officers, directors, trustees,
key employees, highest compensated employees, and disqualified persons.
Complete Part II of Schedule L ~~~~~~~~~~~~~~~~~~~~~~~
Secured mortgages and notes payable to unrelated third parties ~~~~~~
Unsecured notes and loans payable to unrelated third parties ~~~~~~~~
Other liabilities (including federal income tax, payables to related third
parties, and other liabilities not included on lines 17-24). Complete Part X of
Schedule D ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines 17 through 25 ••••••••••••••••••
|
Unrestricted net assets
Temporarily restricted net assets
Permanently restricted net assets
~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~
|
Capital stock or trust principal, or current funds
Paid-in or capital surplus, or land, building, or equipment fund
Retained earnings, endowment, accumulated income, or other funds
~~~~~~~~~~~~~~~
~~~~~~~~
~~~~
Total net assets or fund balances ~~~~~~~~~~~~~~~~~~~~~~
Total liabilities and net assets/fund balances ••••••••••••••••
Form (2014)
11
Balance SheetPart X
990
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
2,740.
14,138.
0.1,275,600.
0.1,292,478.
1,265,340.
24,138.
0.3,000.
0.1,292,478.
X
0.
0.0.
0.1,292,478.
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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1
2
3
4
5
6
7
8
9
10
1
2
3
4
5
6
7
8
9
10
Yes No
1
2
3
a
b
c
2a
2b
2c
a
b
3a
3b
Form 990 (2014)Page
Check if Schedule O contains a response or note to any line in this Part XI •••••••••••••••••••••••••••
Total revenue (must equal Part VIII, column (A), line 12)
Total expenses (must equal Part IX, column (A), line 25)
Revenue less expenses. Subtract line 2 from line 1
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A))
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~
Net unrealized gains (losses) on investments
Donated services and use of facilities
Investment expenses
Prior period adjustments
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other changes in net assets or fund balances (explain in Schedule O)
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33,
column (B))
~~~~~~~~~~~~~~~~~~~
•••••••••••••••••••••••••••••••••••••••••••••••
Check if Schedule O contains a response or note to any line in this Part XII •••••••••••••••••••••••••••
Accounting method used to prepare the Form 990:Cash Accrual Other
If the organization changed its method of accounting from a prior year or checked "Other," explain in Schedule O.
Were the organization's financial statements compiled or reviewed by an independent accountant?~~~~~~~~~~~~
If "Yes," check a box below to indicate whether the financial statements for the year were compiled or reviewed on a
separate basis, consolidated basis, or both:
Separate basis Consolidated basis Both consolidated and separate basis
Were the organization's financial statements audited by an independent accountant?~~~~~~~~~~~~~~~~~~~
If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis,
consolidated basis, or both:
Separate basis Consolidated basis Both consolidated and separate basis
If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit,
review, or compilation of its financial statements and selection of an independent accountant?~~~~~~~~~~~~~~~
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit
Act and OMB Circular A-133?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit
or audits, explain why in Schedule O and describe any steps taken to undergo such audits ••••••••••••••••
Form (2014)
12
Part XI Reconciliation of Net Assets
Part XII Financial Statements and Reporting
990
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
5,416,447.
5,416,447.
0.
0.
0.
0.
X
X
X
X
X
X
X
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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OMB No. 1545-0047
Department of the Treasury
Internal Revenue Service
432021 09-17-14
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at
(i)(iii)(iv) (v)(vi)(ii) Name of supported
organization
Type of organization
(described on lines 1-9
above or IRC section
(see instructions))
Is the organizationlisted in yourgoverning document?
Amount of monetary
support (see
Instructions)
Amount of
other support (see
Instructions)
EIN
(Form 990 or 990-EZ)Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
| Attach to Form 990 or Form 990-EZ.
|
Open to Public
Inspection
Name of the organization Employer identification number
1
2
3
4
5
6
7
8
9
10
11
section 170(b)(1)(A)(i).
section 170(b)(1)(A)(ii).
section 170(b)(1)(A)(iii).
section 170(b)(1)(A)(iii).
section 170(b)(1)(A)(iv).
section 170(b)(1)(A)(v).
section 170(b)(1)(A)(vi).
section 170(b)(1)(A)(vi).
section 509(a)(2).
section 509(a)(4).
section 509(a)(1)section 509(a)(2)section 509(a)(3).
a
b
c
d
e
f
g
Type I.
You must complete Part IV, Sections A and B.
Type II.
You must complete Part IV, Sections A and C.
Type III functionally integrated.
You must complete Part IV, Sections A, D, and E.
Type III non-functionally integrated.
You must complete Part IV, Sections A and D, and Part V.
Yes No
Total
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Schedule A (Form 990 or 990-EZ) 2014
(All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
A church, convention of churches, or association of churches described in
A school described in (Attach Schedule E.)
A hospital or a cooperative hospital service organization described in
A medical research organization operated in conjunction with a hospital described in Enter the hospital's name,
city, and state:
An organization operated for the benefit of a college or university owned or operated by a governmental unit described in
(Complete Part II.)
A federal, state, or local government or governmental unit described in
An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in
(Complete Part II.)
A community trust described in (Complete Part II.)
An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from
activities related to its exempt functions - subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment
income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975.
See (Complete Part III.)
An organization organized and operated exclusively to test for public safety. See
An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or
more publicly supported organizations described in or . See Check the box in
lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.
A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving
the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting
organization.
A supporting organization supervised or controlled in connection with its supported organization(s), by having
control or management of the supporting organization vested in the same persons that control or manage the supported
organization(s).
A supporting organization operated in connection with, and functionally integrated with,
its supported organization(s) (see instructions).
A supporting organization operated in connection with its supported organization(s)
that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness
requirement (see instructions).
Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III
functionally integrated, or Type III non-functionally integrated supporting organization.
Enter the number of supported organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Provide the following information about the supported organization(s).
LHA
www.irs.gov/form990.
SCHEDULE A
Part I Reason for Public Charity Status
Public Charity Status and Public Support 2014
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
X
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Subtract line 5 from line 4.
43202209-17-14
Calendar year (or fiscal year beginning in)
Calendar year (or fiscal year beginning in) |
2
(a) (b) (c) (d) (e) (f)
1
2
3
4
5
Total.
6 Public support.
(a) (b) (c) (d) (e) (f)
7
8
9
10
11
12
13
Total support.
12
First five years.
stop here
14
15
14
15
16
17
18
a
b
a
b
33 1/3% support test - 2014.
stop here.
33 1/3% support test - 2013.
stop here.
10% -facts-and-circumstances test - 2014.
stop here.
10% -facts-and-circumstances test - 2013.
stop here.
Private foundation.
Schedule A (Form 990 or 990-EZ) 2014
|
Add lines 7 through 10
Schedule A (Form 990 or 990-EZ) 2014 Page
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization
fails to qualify under the tests listed below, please complete Part III.)
2010 2011 2012 2013 2014 Total
Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.")~~
Tax revenues levied for the organ-
ization's benefit and either paid to
or expended on its behalf ~~~~
The value of services or facilities
furnished by a governmental unit to
the organization without charge ~
Add lines 1 through 3 ~~~
The portion of total contributions
by each person (other than a
governmental unit or publicly
supported organization) included
on line 1 that exceeds 2% of the
amount shown on line 11,
column (f)~~~~~~~~~~~~
2010 2011 2012 2013 2014 Total
Amounts from line 4 ~~~~~~~
Gross income from interest,
dividends, payments received on
securities loans, rents, royalties
and income from similar sources ~
Net income from unrelated business
activities, whether or not the
business is regularly carried on ~
Other income. Do not include gain
or loss from the sale of capital
assets (Explain in Part VI.)~~~~
Gross receipts from related activities, etc. (see instructions)~~~~~~~~~~~~~~~~~~~~~~~
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3)
organization, check this box and •••••••••••••••••••••••••••••••••••••••••••••|
~~~~~~~~~~~~Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f))
Public support percentage from 2013 Schedule A, Part II, line 14
%
%~~~~~~~~~~~~~~~~~~~~~
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and
The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~|
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box
and The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~|
If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more,
and if the organization meets the "facts-and-circumstances" test, check this box and Explain in Part VI how the organization
meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~|
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or
more, and if the organization meets the "facts-and-circumstances" test, check this box and Explain in Part VI how the
organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ~~~~~~~~|
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions •••|
Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
Section A. Public Support
Section B. Total Support
Section C. Computation of Public Support Percentage
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
5,416,446.5,416,446.
5,416,446.5,416,446.
5,416,446.
5,416,446.5,416,446.
1.1.
5,416,447.
X
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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(Subtract line 7c from line 6.)
Amounts included on lines 2 and 3 received
from other than disqualified persons that
exceed the greater of $5,000 or 1% of the
amount on line 13 for the year
(Add lines 9, 10c, 11, and 12.)
432023 09-17-14
Calendar year (or fiscal year beginning in) |
Calendar year (or fiscal year beginning in) |
Total support.
3
(a) (b) (c) (d) (e) (f)
1
2
3
4
5
6
7
Total.
a
b
c
8 Public support
(a) (b) (c) (d) (e) (f)
9
10 a
b
c
11
12
13
14 First five years.
stop here
15
16
15
16
17
18
19
20
2014
2013
17
18
a
b
33 1/3% support tests - 2014.
stop here.
33 1/3% support tests - 2013.
stop here.
Private foundation.
Schedule A (Form 990 or 990-EZ) 2014
Unrelated business taxable income
(less section 511 taxes) from businesses
acquired after June 30, 1975
Schedule A (Form 990 or 990-EZ) 2014 Page
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to
qualify under the tests listed below, please complete Part II.)
2010 2011 2012 2013 2014 Total
Gifts, grants, contributions, and
membership fees received. (Do not
include any "unusual grants.")~~
Gross receipts from admissions,
merchandise sold or services per-
formed, or facilities furnished in
any activity that is related to the
organization's tax-exempt purpose
Gross receipts from activities that
are not an unrelated trade or bus-
iness under section 513 ~~~~~
Tax revenues levied for the organ-
ization's benefit and either paid to
or expended on its behalf ~~~~
The value of services or facilities
furnished by a governmental unit to
the organization without charge ~
~~~ Add lines 1 through 5
Amounts included on lines 1, 2, and
3 received from disqualified persons
~~~~~~
Add lines 7a and 7b ~~~~~~~
2010 2011 2012 2013 2014 Total
Amounts from line 6 ~~~~~~~
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources ~
~~~~
Add lines 10a and 10b ~~~~~~
Net income from unrelated businessactivities not included in line 10b, whether or not the business is regularly carried on ~~~~~~~
Other income. Do not include gainor loss from the sale of capitalassets (Explain in Part VI.)~~~~
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and ••••••••••••••••••••••••••••••••••••••••••••••••••••|
Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f))
Public support percentage from 2013 Schedule A, Part III, line 15
~~~~~~~~~~~~%
%••••••••••••••••••••
Investment income percentage for (line 10c, column (f) divided by line 13, column (f))
Investment income percentage from Schedule A, Part III, line 17
~~~~~~~~%
%~~~~~~~~~~~~~~~~~~
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not
more than 33 1/3%, check this box and The organization qualifies as a publicly supported organization ~~~~~~~~~~|
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3%, and
line 18 is not more than 33 1/3%, check this box and The organization qualifies as a publicly supported organization ~~~~|
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ••••••••|
Part III Support Schedule for Organizations Described in Section 509(a)(2)
Section A. Public Support
Section B. Total Support
Section C. Computation of Public Support Percentage
Section D. Computation of Investment Income Percentage
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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Yes No
1
2
3
4
5
6
7
8
9
10
1
2
3a
3b
3c
4a
4b
4c
5a
5b
5c
6
7
8
9a
9b
9c
10a
10b
a
b
c
a
b
c
a
b
c
a
b
c
a
b
Part VI
Type I or Type II only.
Substitutions only.
Schedule A (Form 990 or 990-EZ) 2014
If "No" describe in how the supported organizations are designated. If designated by
class or purpose, describe the designation. If historic and continuing relationship, explain.
If "Yes," explain in how the organization determined that the supported
organization was described in section 509(a)(1) or (2).
If "Yes," answer
(b) and (c) below.
If "Yes," describe in when and how the
organization made the determination.
If "Yes," explain in what controls the organization put in place to ensure such use.
If
"Yes" and if you checked 11a or 11b in Part I, answer (b) and (c) below.
If "Yes," describe in how the organization had such control and discretion
despite being controlled or supervised by or in connection with its supported organizations.
If "Yes," explain in what controls the organization used
to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B)
purposes.
If "Yes,"
answer (b) and (c) below (if applicable). Also, provide detail in including (i) the names and EIN
numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action,
(iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action
was accomplished (such as by amendment to the organizing document).
If "Yes," provide detail in
If "Yes," complete Part I of Schedule L (Form 990).
If "Yes," complete Part I of Schedule L (Form 990).
If "Yes," provide detail in
If "Yes," provide detail in
If "Yes," provide detail in
If "Yes," answer (b) below.
(Use Schedule C, Form 4720, to
determine whether the organization had excess business holdings.)
Schedule A (Form 990 or 990-EZ) 2014 Page
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A
and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete
Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Are all of the organization's supported organizations listed by name in the organization's governing
documents?
Did the organization have any supported organization that does not have an IRS determination of status
under section 509(a)(1) or (2)?
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)?
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and
satisfied the public support tests under section 509(a)(2)?
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)
(B) purposes?
Was any supported organization not organized in the United States ("foreign supported organization")?
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign
supported organization?
Did the organization support any foreign supported organization that does not have an IRS determination
under sections 501(c)(3) and 509(a)(1) or (2)?
Did the organization add, substitute, or remove any supported organizations during the tax year?
Was any added or substituted supported organization part of a class already
designated in the organization's organizing document?
Was the substitution the result of an event beyond the organization's control?
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to
anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class
benefited by one or more of its supported organizations; or (c) other supporting organizations that also
support or benefit one or more of the filing organization's supported organizations?
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial
contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent
controlled entity with regard to a substantial contributor?
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7?
Was the organization controlled directly or indirectly at any time during the tax year by one or more
disqualified persons as defined in section 4946 (other than foundation managers and organizations described
in section 509(a)(1) or (2))?
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which
the supporting organization had an interest?
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit
from, assets in which the supporting organization also had an interest?
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f)
(regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting
organizations)?
Did the organization have any excess business holdings in the tax year?
Part VI
Part VI
Part VI
Part VI
Part VI
Part VI,
Part VI.
Part VI.
Part VI.
Part VI.
Part IV Supporting Organizations
Section A. All Supporting Organizations
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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Yes No
11
a
b
c
11a
11b
11c
Yes No
1
2
1
2
Yes No
1
1
Yes No
1
2
3
1
2
3
1
2
3
a
b
c
Yes No
a
b
a
b
2a
2b
3a
3b
Schedule A (Form 990 or 990-EZ) 2014
If "Yes" to a, b, or c, provide detail in
If "No," describe in how the supported organization(s) effectively operated, supervised, or
controlled the organization's activities. If the organization had more than one supported organization,
describe how the powers to appoint and/or remove directors or trustees were allocated among the supported
organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
If "Yes," explain in
how providing such benefit carried out the purposes of the supported organization(s) that operated,
supervised, or controlled the supporting organization.
If "No," describe in how control
or management of the supporting organization was vested in the same persons that controlled or managed
the supported organization(s).
If "No," explain in how
the organization maintained a close and continuous working relationship with the supported organization(s).
If "Yes," describe in the role the organization's
supported organizations played in this regard.
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year
Complete below.
Complete below.
Describe in Part VI how you supported a government entity (see instructions).
If "Yes," then in
how these activities directly furthered their exempt purposes,
how the organization was responsive to those supported organizations, and how the organization determined
that these activities constituted substantially all of its activities.
If "Yes," explain in the
reasons for the organization's position that its supported organization(s) would have engaged in these
activities but for the organization's involvement.
the role played by the organization in this regard.
Schedule A (Form 990 or 990-EZ) 2014 Page
Has the organization accepted a gift or contribution from any of the following persons?
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c)
below, the governing body of a supported organization?
A family member of a person described in (a) above?
A 35% controlled entity of a person described in (a) or (b) above?
Did the directors, trustees, or membership of one or more supported organizations have the power to
regularly appoint or elect at least a majority of the organization's directors or trustees at all times during the
tax year?
Did the organization operate for the benefit of any supported organization other than the supported
organization(s) that operated, supervised, or controlled the supporting organization?
Were a majority of the organization's directors or trustees during the tax year also a majority of the directors
or trustees of each of the organization's supported organization(s)?
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the
organization's tax year, (1) a written notice describing the type and amount of support provided during the prior tax
year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the
organization's governing documents in effect on the date of notification, to the extent not previously provided?
Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supported
organization(s) or (ii) serving on the governing body of a supported organization?
By reason of the relationship described in (2), did the organization's supported organizations have a
significant voice in the organization's investment policies and in directing the use of the organization's
income or assets at all times during the tax year?
The organization satisfied the Activities Test.
The organization is the parent of each of its supported organizations.
The organization supported a governmental entity.
Activities Test.
Did substantially all of the organization's activities during the tax year directly further the exempt purposes of
the supported organization(s) to which the organization was responsive?
Did the activities described in (a) constitute activities that, but for the organization's involvement, one or more
of the organization's supported organization(s) would have been engaged in?
Parent of Supported Organizations.
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or
trustees of each of the supported organizations? Provide details in
Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each
of its supported organizations? If "Yes," describe in
Part VI.
Part VI
Part VI
Part VI
Part VI
Part VI
(see instructions):
line 2
line 3
Answer (a) and (b) below.
Part VI identify
those supported organizations and explain
Part VI
Answer (a) and (b) below.
Part VI.
Part VI
(continued)Part IV Supporting Organizations
Section B. Type I Supporting Organizations
Section C. Type II Supporting Organizations
Section D. Type III Supporting Organizations
Section E. Type III Functionally-Integrated Supporting Organizations
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1 See instructions.
Section A - Adjusted Net Income
1
2
3
4
5
6
7
8
1
2
3
4
5
6
7
8Adjusted Net Income
Section B - Minimum Asset Amount
1
2
3
4
5
6
7
8
a
b
c
d
e
1a
1b
1c
1d
2
3
4
5
6
7
8
Total
Discount
Part VI
Minimum Asset Amount
Section C - Distributable Amount
1
2
3
4
5
6
7
1
2
3
4
5
6
Distributable Amount.
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014 Page
Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. All
other Type III non-functionally integrated supporting organizations must complete Sections A through E.
(B) Current Year
(optional)(A) Prior Year
Net short-term capital gain
Recoveries of prior-year distributions
Other gross income (see instructions)
Add lines 1 through 3
Depreciation and depletion
Portion of operating expenses paid or incurred for production or
collection of gross income or for management, conservation, or
maintenance of property held for production of income (see instructions)
Other expenses (see instructions)
(subtract lines 5, 6 and 7 from line 4)
(B) Current Year
(optional)(A) Prior Year
Aggregate fair market value of all non-exempt-use assets (see
instructions for short tax year or assets held for part of year):
Average monthly value of securities
Average monthly cash balances
Fair market value of other non-exempt-use assets
(add lines 1a, 1b, and 1c)
claimed for blockage or other
factors (explain in detail in ):
Acquisition indebtedness applicable to non-exempt-use assets
Subtract line 2 from line 1d
Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount,
see instructions).
Net value of non-exempt-use assets (subtract line 4 from line 3)
Multiply line 5 by .035
Recoveries of prior-year distributions
(add line 7 to line 6)
Current Year
Adjusted net income for prior year (from Section A, line 8, Column A)
Enter 85% of line 1
Minimum asset amount for prior year (from Section B, line 8, Column A)
Enter greater of line 2 or line 3
Income tax imposed in prior year
Subtract line 5 from line 4, unless subject to
emergency temporary reduction (see instructions)
Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see
instructions).
Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
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Section D - Distributions Current Year
1
2
3
4
5
6
7
8
9
10
Part VI
Total annual distributions.
Part VI
(i)
Excess Distributions
(ii)
Underdistributions
Pre-2014
(iii)
Distributable
Amount for 2014Section E - Distribution Allocations (see instructions)
1
2
3
4
5
6
7
8
a
b
c
d
e
f
g
h
i
j
Total
a
b
c
Excess distributions carryover to 2015.
a
b
c
d
e
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014 Page
Amounts paid to supported organizations to accomplish exempt purposes
Amounts paid to perform activity that directly furthers exempt purposes of supported
organizations, in excess of income from activity
Administrative expenses paid to accomplish exempt purposes of supported organizations
Amounts paid to acquire exempt-use assets
Qualified set-aside amounts (prior IRS approval required)
Other distributions (describe in ). See instructions.
Add lines 1 through 6.
Distributions to attentive supported organizations to which the organization is responsive
(provide details in ). See instructions.
Distributable amount for 2014 from Section C, line 6
Line 8 amount divided by Line 9 amount
Distributable amount for 2014 from Section C, line 6
Underdistributions, if any, for years prior to 2014
(reasonable cause required-see instructions)
Excess distributions carryover, if any, to 2014:
From 2013
of lines 3a through e
Applied to underdistributions of prior years
Applied to 2014 distributable amount
Carryover from 2009 not applied (see instructions)
Remainder. Subtract lines 3g, 3h, and 3i from 3f.
Distributions for 2014 from Section D,
line 7:$
Applied to underdistributions of prior years
Applied to 2014 distributable amount
Remainder. Subtract lines 4a and 4b from 4.
Remaining underdistributions for years prior to 2014, if
any. Subtract lines 3g and 4a from line 2 (if amount
greater than zero, see instructions).
Remaining underdistributions for 2014. Subtract lines 3h
and 4b from line 1 (if amount greater than zero, see
instructions).
Add lines 3j
and 4c.
Breakdown of line 7:
Excess from 2013
Excess from 2014
(continued) Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
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Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014 Page
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12.
Also complete this part for any additional information. (See instructions).
Part VI Supplemental Information.
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Department of the Treasury
Internal Revenue Service
42345111-05-14
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
(Form 990, 990-EZ,or 990-PF)| Attach to Form 990, Form 990-EZ, or Form 990-PF.
| Information about Schedule B (Form 990, 990-EZ, or 990-PF) and
its instructions is at .
Name of the organization Employer identification number
Organization type
Filers of:Section:
not
General Rule Special Rule.
Note.
General Rule
Special Rules
(1) (2)
General Rule
Caution.
must
For Paperwork Reduction Act Notice, see the Instructions for Form 990, 990-EZ, or 990-PF.
exclusively
exclusively
exclusively
nonexclusively
(check one):
Form 990 or 990-EZ 501(c)() (enter number) organization
4947(a)(1) nonexempt charitable trust treated as a private foundation
527 political organization
Form 990-PF 501(c)(3) exempt private foundation
4947(a)(1) nonexempt charitable trust treated as a private foundation
501(c)(3) taxable private foundation
Check if your organization is covered by the or a
Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.
For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33 1/3% support test of the regulations under
sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from
any one contributor, during the year, total contributions of the greater of $5,000 or 2% of the amount on (i) Form 990, Part VIII, line 1h,
or (ii) Form 990-EZ, line 1. Complete Parts I and II.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the
year, total contributions of more than $1,000 for religious, charitable, scientific, literary, or educational purposes, or for
the prevention of cruelty to children or animals. Complete Parts I, II, and III.
For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the
year, contributions for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box
is checked, enter here the total contributions that were received during the year for an religious, charitable, etc.,
purpose. Do not complete any of the parts unless the applies to this organization because it received
religious, charitable, etc., contributions totaling $5,000 or more during the year ~~~~~~~~~~~~~~~|$
An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990, 990-EZ, or 990-PF),
but it answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to
certify that it does not meet the filing requirements of Schedule B (Form 990, 990-EZ, or 990-PF).
LHA
www.irs.gov/form990
Schedule B Schedule of Contributors
2014
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
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Name of organization Employer identification number
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
Person
Payroll
Noncash
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)Page
(see instructions). Use duplicate copies of Part I if additional space is needed.
$
(Complete Part II for
noncash contributions.)
$
(Complete Part II for
noncash contributions.)
$
(Complete Part II for
noncash contributions.)
$
(Complete Part II for
noncash contributions.)
$
(Complete Part II for
noncash contributions.)
$
(Complete Part II for
noncash contributions.)
2
Part I Contributors
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
1 CITY OF ROCHESTER X
201 4TH STREET SE 5,416,446.
ROCHESTER, MN 55904
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Name of organization Employer identification number
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
(a)
No.
from
Part I
(c)
FMV (or estimate)
(see instructions)
(b)
Description of noncash property given
(d)
Date received
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)Page
(see instructions). Use duplicate copies of Part II if additional space is needed.
$
$
$
$
$
$
3
Part II Noncash Property
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(Enter this info. once.)
For organizations
completing Part III, enter the total of exclusively religious,charitable, etc., contributions of $1,000 or less for the year.
423454 11-05-14
Name of organization Employer identification number
religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 forthe year from any one contributor. (a) (e) and
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
(a) No.fromPart I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
(a) No.fromPart I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
(e) Transfer of gift
Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee
Complete columns through the following line entry.
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)Page
| $
Use duplicate copies of Part III if additional space is needed.
Exclusively
4
Part III
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Held at the End of the Tax Year
(Form 990)| Complete if the organization answered "Yes" to Form 990,Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.| Attach to Form 990.| Information about Schedule D (Form 990) and its instructions is at
Open to PublicInspection
Name of the organization Employer identification number
(a) (b)
1
2
3
4
5
6
Yes No
Yes No
1
2
3
4
5
6
7
8
9
a
b
c
d
2a
2b
2c
2d
Yes No
Yes No
1
2
a
b
(i)
(ii)
a
b
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Schedule D (Form 990) 2014
Complete if the
organization answered "Yes" to Form 990, Part IV, line 6.
Donor advised funds Funds and other accounts
Total number at end of year
Aggregate value of contributions to (during year)
Aggregate value of grants from (during year)
Aggregate value at end of year
~~~~~~~~~~~~~~~
~~~~
~~~~~~
~~~~~~~~~~~~~
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds
are the organization's property, subject to the organization's exclusive legal control?~~~~~~~~~~~~~~~~~~
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only
for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring
impermissible private benefit?••••••••••••••••••••••••••••••••••••••••••••
Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
Purpose(s) of conservation easements held by the organization (check all that apply).
Preservation of land for public use (e.g., recreation or education)
Protection of natural habitat
Preservation of open space
Preservation of a historically important land area
Preservation of a certified historic structure
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last
day of the tax year.
Total number of conservation easements
Total acreage restricted by conservation easements
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Number of conservation easements on a certified historic structure included in (a)
Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure
listed in the National Register
~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax
year |
Number of states where property subject to conservation easement is located |
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of
violations, and enforcement of the conservation easements it holds?~~~~~~~~~~~~~~~~~~~~~~~~~
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year |
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year |$
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i)
and section 170(h)(4)(B)(ii)?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and balance sheet, and
include, if applicable, the text of the footnote to the organization's financial statements that describes the organization's accounting for
conservation easements.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII,
the text of the footnote to its financial statements that describes these items.
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical
treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts
relating to these items:
Revenue included in Form 990, Part VIII, line 1
Assets included in Form 990, Part X
~~~~~~~~~~~~~~~~~~~~~~~~~~~~|$
$~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~|
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide
the following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
Revenue included in Form 990, Part VIII, line 1
Assets included in Form 990, Part X
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~|$
$~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~|
LHA
www.irs.gov/form990.
Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts.
Part II Conservation Easements.
Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
SCHEDULE D Supplemental Financial Statements 2014
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4
5
a
b
c
d
e
Yes No
1
2
a
b
c
d
e
f
a
b
Yes No
1c
1d
1e
1f
Yes No
(a) (b) (c) (d) (e)
1
2
3
4
a
b
c
d
e
f
g
a
b
c
a
b
Yes No
(i)
(ii)
3a(i)
3a(ii)
3b
(a) (b) (c) (d)
1a
b
c
d
e
Total.
Schedule D (Form 990) 2014
(continued)
(Column (d) must equal Form 990, Part X, column (B), line 10c.)
Two years back Three years back Four years back
Schedule D (Form 990) 2014 Page
Using the organization's acquisition, accession, and other records, check any of the following that are a significant use of its collection items
(check all that apply):
Public exhibition
Scholarly research
Preservation for future generations
Loan or exchange programs
Other
Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII.
During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets
to be sold to raise funds rather than to be maintained as part of the organization's collection?••••••••••••
Complete if the organization answered "Yes" to Form 990, Part IV, line 9, or
reported an amount on Form 990, Part X, line 21.
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included
on Form 990, Part X?
If "Yes," explain the arrangement in Part XIII and complete the following table:
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amount
Beginning balance
Additions during the year
Distributions during the year
Ending balance
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII
~~~~~
•••••••••••••
Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
Current year Prior year
Beginning of year balance
Contributions
Net investment earnings, gains, and losses
Grants or scholarships
~~~~~~~
~~~~~~~~~~~~~~
~~~~~~~~~
Other expenditures for facilities
and programs
Administrative expenses
End of year balance
~~~~~~~~~~~~~
~~~~~~~~
~~~~~~~~~~
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
Board designated or quasi-endowment
Permanent endowment
Temporarily restricted endowment
The percentages in lines 2a, 2b, and 2c should equal 100%.
|%
|%
|%
Are there endowment funds not in the possession of the organization that are held and administered for the organization
by:
unrelated organizations
related organizations
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R?
Describe in Part XIII the intended uses of the organization's endowment funds.
~~~~~~~~~~~~~~~~~~~~~~
Complete if the organization answered "Yes" to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property Cost or other
basis (investment)
Cost or other
basis (other)
Accumulated
depreciation
Book value
Land
Buildings
Leasehold improvements
~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~
Equipment
Other
~~~~~~~~~~~~~~~~~
••••••••••••••••••••
Add lines 1a through 1e. |•••••••••••••
2
Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets
Part IV Escrow and Custodial Arrangements.
Part V Endowment Funds.
Part VI Land, Buildings, and Equipment.
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
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(including name of security)
43205310-01-14
Total.
Total.
(a) (b) (c)
(a) (b) (c)
(a) (b)
Total.
(a) (b) 1.
Total.
2.
Schedule D (Form 990) 2014
(Column (b) must equal Form 990, Part X, col. (B) line 15.)
(Column (b) must equal Form 990, Part X, col. (B) line 25.)
Description of security or category
(Col. (b) must equal Form 990, Part X, col. (B) line 12.) |
(Col. (b) must equal Form 990, Part X, col. (B) line 13.) |
Schedule D (Form 990) 2014 Page
Complete if the organization answered "Yes" to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
Book value Method of valuation: Cost or end-of-year market value
(1)
(2)
(3)
Financial derivatives
Closely-held equity interests
Other
~~~~~~~~~~~~~~~
~~~~~~~~~~~
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Complete if the organization answered "Yes" to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
Description of investment Book value Method of valuation: Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Complete if the organization answered "Yes" to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
Description Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
••••••••••••••••••••••••••••|
Complete if the organization answered "Yes" to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
Description of liability Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Federal income taxes
•••••|
Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the
organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
3
Part VII Investments - Other Securities.
Part VIII Investments - Program Related.
Part IX Other Assets.
Part X Other Liabilities.
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
ADVANCE TO DMC EDA 10,000.
DUE FROM OTHER GOVERNMENTS 1,265,600.
1,275,600.
DUE TO OTHER GOVERNMENTS 3,000.
3,000.
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1
2
3
4
5
1
a
b
c
d
e
2a
2b
2c
2d
2a 2d 2e
32e 1
a
b
c
4a
4b
4a 4b
3 4c.
4c
5
1
2
3
4
5
1
a
b
c
d
e
2a
2b
2c
2d
2a 2d
2e 1
2e
3
a
b
c
4a
4b
4a 4b
3 4c.
4c
5
Schedule D (Form 990) 2014
(This must equal Form 990, Part I, line 12.)
(This must equal Form 990, Part I, line 18.)
Schedule D (Form 990) 2014 Page
Complete if the organization answered "Yes" to Form 990, Part IV, line 12a.
Total revenue, gains, and other support per audited financial statements
Amounts included on line 1 but not on Form 990, Part VIII, line 12:
~~~~~~~~~~~~~~~~~~~
Net unrealized gains (losses) on investments
Donated services and use of facilities
Recoveries of prior year grants
Other (Describe in Part XIII.)
~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines through ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Subtract line from line ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amounts included on Form 990, Part VIII, line 12, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b
Other (Describe in Part XIII.)
~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines and
Total revenue. Add lines and
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
•••••••••••••••••
Complete if the organization answered "Yes" to Form 990, Part IV, line 12a.
Total expenses and losses per audited financial statements
Amounts included on line 1 but not on Form 990, Part IX, line 25:
~~~~~~~~~~~~~~~~~~~~~~~~~~
Donated services and use of facilities
Prior year adjustments
Other losses
Other (Describe in Part XIII.)
~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines through
Subtract line from line
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Amounts included on Form 990, Part IX, line 25, but not on line 1:
Investment expenses not included on Form 990, Part VIII, line 7b
Other (Describe in Part XIII.)
~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~
Add lines and
Total expenses. Add lines and
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
••••••••••••••••
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI,
lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return.
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.
Part XIII Supplemental Information.
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
5,416,447.
0.
5,416,447.
0.
5,416,447.
5,416,447.
0.
5,416,447.
0.
5,416,447.
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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OMB No. 1545-0047
Department of the Treasury
Internal Revenue Service
43221108-27-14
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
Complete to provide information for responses to specific questions onForm 990 or 990-EZ or to provide any additional information.| Attach to Form 990 or 990-EZ.|
(Form 990 or 990-EZ)
Open to PublicInspection
Employer identification number
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.Schedule O (Form 990 or 990-EZ) (2014)
Name of the organization
LHA
www.irs.gov/form990.
SCHEDULE O Supplemental Information to Form 990 or 990-EZ 2014
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:
MINNESOTA.
FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION:
PUBLIC INVESTMENT OF THE STATE OF MINNESOTA, THE CITY OF ROCHESTER, AND
OLMSTED COUNTY FOR INFRASTRUCTURE TO SUPPORT THIS PRIVATE INVESTMENT.
FORM 990, PART VI, SECTION A, LINE 7B:
ANNUAL FUNDING REQUESTS ARE SUBJECT TO FINAL APPROVAL BY THE CITY OF
ROCHESTER CITY COUNCIL.
FORM 990, PART VI, SECTION B, LINE 11:
THE 990 WILL BE PRESENTED AT A BOARD MEETING PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C:
CONFLICT OF INTEREST IS GOVERNED BY MINNESOTA STATUTE.
FORM 990, PART VI, SECTION B, LINE 15:
DESTINATION MEDICAL CENTER CORPORATION DOES NOT HAVE ANY EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19:
DESTINATION MEDICAL CENTER CORPORATION MAKES ITS GOVERNING DOCUMENTS,
CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON
REQUEST.
FORM 990, PART XII, LINE 2C
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2
Employer identification number
Schedule O (Form 990 or 990-EZ) (2014)
Schedule O (Form 990 or 990-EZ) (2014)Page
Name of the organization DESTINATION MEDICAL CENTER CORPORATION 46-4959371
THE CORPORATION'S BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR
OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF
ITS INDEPENDENT ACCOUNTANT.
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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OMB No. 1545-0047
Department of the TreasuryInternal Revenue Service
Section 512(b)(13)
controlled
entity?
43216108-14-14
SCHEDULE R
(Form 990)Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990. Open to PublicInspection|Information about Schedule R (Form 990) and its instructions is at
Employer identification number
Part I Identification of Disregarded Entities
(a)(b)(c)(d)(e)(f)
Identification of Related Tax-Exempt Organizations Part II
(a)(b)(c)(d)(e)(f)(g)
Yes No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Schedule R (Form 990) 2014
|
|
Name of the organization
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
Name, address, and EIN (if applicable)
of disregarded entity
Primary activity Legal domicile (state or
foreign country)
Total income End-of-year assets Direct controlling
entity
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exemptorganizations during the tax year.
Name, address, and EIN
of related organization
Primary activity Legal domicile (state or
foreign country)
Exempt Code
section
Public charity
status (if section
501(c)(3))
Direct controlling
entity
LHA
www.irs.gov/form990.
Related Organizations and Unrelated Partnerships 2014
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
DESTINATION MEDICAL CENTER ECONOMIC
DEVELOPMENT AGENCY - 46-4893585, 200 1ST PROVIDE SERVICES TO THE
STREET SW, ROCHESTER, MN 55905 DMCC MINNESOTA 501(C)(3)LINE 11A, I N/A X
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Disproportionate
allocations?
Legal
domicile
(state or
foreign
country)
General or
managing
partner?
Section512(b)(13)controlledentity?
Legal domicile
(state or
foreign
country)
432162 08-14-14
2
Identification of Related Organizations Taxable as a Partnership Part III
(a)(b)(c)(d)(e)(f)(g)(h)(i)(j)(k)
Yes No Yes No
Identification of Related Organizations Taxable as a Corporation or Trust Part IV
(a)(b)(c)(d)(e)(f)(g)(h)(i)
Yes No
Schedule R (Form 990) 2014
Predominant income(related, unrelated,excluded from tax undersections 512-514)
Schedule R (Form 990) 2014 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more relatedorganizations treated as a partnership during the tax year.
Name, address, and EINof related organization Primary activity Direct controllingentity Share of totalincome Share ofend-of-yearassets
Code V-UBIamount in box20 of ScheduleK-1 (Form 1065)
Percentageownership
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more relatedorganizations treated as a corporation or trust during the tax year.
Name, address, and EINof related organization Primary activity Direct controllingentity Type of entity(C corp, S corp,or trust)
Share of totalincome Share ofend-of-yearassets
Percentageownership
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
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Part V Transactions With Related Organizations
Note.Yes No
1
a
b
c
d
e
f
g
h
i
j
k
l
m
n
o
p
q
r
s
(i) (ii) (iii) (iv) 1a
1b
1c
1d
1e
1f
1g
1h
1i
1j
1k
1l
1m
1n
1o
1p
1q
1r
1s
2
(a)(b)(c)(d)
(1)
(2)
(3)
(4)
(5)
(6)
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
Receipt of interest, annuities, royalties, or rent from a controlled entity ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Gift, grant, or capital contribution to related organization(s)
Gift, grant, or capital contribution from related organization(s)
Loans or loan guarantees to or for related organization(s)
Loans or loan guarantees by related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dividends from related organization(s)~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sale of assets to related organization(s)
Purchase of assets from related organization(s)
Exchange of assets with related organization(s)
Lease of facilities, equipment, or other assets to related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Lease of facilities, equipment, or other assets from related organization(s)
Performance of services or membership or fundraising solicitations for related organization(s)
Performance of services or membership or fundraising solicitations by related organization(s)
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Sharing of paid employees with related organization(s)~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Reimbursement paid to related organization(s) for expenses
Reimbursement paid by related organization(s) for expenses
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Other transfer of cash or property to related organization(s)
Other transfer of cash or property from related organization(s)
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
••••••••••••••••••••••••••••••••••••••••••••••••••••••••
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
Name of related organization Transaction
type (a-s)
Amount involved Method of determining amount involved
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
DESTINATION MEDICAL CENTER ECONOMIC
DEVELOPMENT AGENCY P 4,920,961.ACTUAL AMOUNT
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Are allpartners sec.501(c)(3)orgs.?
Dispropor-tionate
allocations?
General or
managing
partner?
43216408-14-14
Yes No Yes No Yes N
4
Part VI Unrelated Organizations Taxable as a Partnership
(a)(b)(c)(d)(e)(f)(g)(h)(i)(j)(k)
o
Schedule R (Form 990) 2014
Predominant income(related, unrelated,excluded from tax undersections 512-514)
Code V-UBIamount in box 20of Schedule K-1(Form 1065)
Schedule R (Form 990) 2014 Page
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue)
that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
Name, address, and EIN
of entity
Primary activity Legal domicile
(state or foreign
country)
Share of
total
income
Share of
end-of-year
assets
Percentage
ownership
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
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Schedule R (Form 990) 2014
Schedule R (Form 990) 2014 Page
Provide additional information for responses to questions on Schedule R (see instructions).
Part VII Supplemental Information
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
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ATTORNEY GENERAL LORI SWANSON Annual Reporting Initial Registration
Office Use Only:ARF $25 $50 N (e-Postcard)990 EZ PF FES SIG BD SAL Audit
Legal Name of Organization:
Mailing Address of Organization (required)Physical Address of Organization (required)
Contact Person
Tel. No.
E-mail
Fax No.
SUITE 1200, BREMER TOWER
445 MINNESOTA STREET
ST. PAUL, MN 55101-2130
(651) 757-1311
(651) 296-1410 (TTY)
www.ag.state.mn.us
1.
2.
3.
4.
5.
6.
7.
8.
If annual reporting, is this a new name since the organization's last filing?Yes No
If so, please state former name:
List all names under which the organization solicits contributions:
Does the organization use the services of a professional fund-raiser (outside solicitor or consultant)?
Yes No
If so, provide name and address of any outside professional fund-raiser employed by the organization and state the total amount of
compensation each outside fund-raiser received from the filing organization during the year.
Name
Address
City State ZIP Compensation
a)
b)
Does this professional fund-raiser solicit or consult in Minnesota?Yes No
Is this professional fund-raiser registered to solicit or consult in Minnesota?Yes No
Month and day accounting year ends:
Has the organization included the filing fee, late fee (if any) and all attachments required by the instructions?Yes No
01/13 Upon request this material can be made available in alternate formats.
Attach schedule if more than one.
FEDERAL EIN NUMBER:
FOR YEAR ENDING:
SECTION A: REQUIRED INFORMATION FOR INITIAL REGISTRATION & ANNUAL REPORTING
CHARITABLE ORGANIZATION INITIAL REGISTRATION & ANNUAL REPORT FORM
STATE OF MINNESOTA
X
46-4959371
12/31/2014
DESTINATION MEDICAL CENTER CORPORATION
DESTINATION MEDICAL CENTER CORPORATION
201 4TH STREET SE 201 4TH STREET SE
ROCHESTER, MN 55904 ROCHESTER, MN 55904
DALE MARTINSON DMARTINSON@ROCHESTERMN.GOV
507-328-2850
X
12/31
X
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$
9.This Section A(9) must be completed by organizations filing a 990-N (e-Postcard) or organizations whose filing does not contain the information
requested below. This includes organizations that: 1) do not file an IRS Form 990, 2) file an IRS Form 990-EZ or 990-PF, or 3) organizations
that file a group return that does not include the filing organization's individual financial information.
Contributions from the public
Government Grants
Other revenue
$
$
$
EXCESS or DEFICIT
TOTAL Assets
TOTAL Liabilities
$
$
$
(Assets minus Liabilities)$
2
INCOME
TOTAL REVENUE
END OF YEAR FUND BALANCE/NET WORTH
0.
5,416,446.
1.
5,416,447.
0.
1,292,478.
1,292,478.
0.
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Attach
Attach
Attach
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Address of registered agent in the State of Minnesota or the address of the person who has custody of the organization's books and records if
not kept at the organization's office.
Name
Street and Number
City State ZIP Telephone #
Type of legal entity ( the creating document):
Nonprofit corporation Trust Unincorporated association Other
Place and date the organization was incorporated:
(state)(date)
Is the organization exempt from federal income taxes?
Yes ( a copy of the IRS determination letter)
No
Status: 501(c)()
Date organization submitted Form 1023 to the IRS
If the organization is not exempt from federal income taxes and uses a fiscal agent, state the fiscal agent's name, address and federal EIN:
Has the organization been denied the right to solicit contributions?
a.
b.
By any government agency?
By any court?
Yes
Yes
No
No
If yes, attach explanation.
If yes, attach explanation.
Explain in detail the charitable purposes of the organization, including major program activities.
Please mark all items that describe the organization's charitable mission:
Arts & Culture
Environment
Human Services
Mental Health
Civic/Lobbying
Education
International Health
Religious Other
Or: List the NTEE code(s) that describe the organization's purpose:
Which of the above two best describes the organization's primary purpose(s)?
1.2.
Check one or more methods of solicitation the organization anticipates using:
Telephone appeals
Direct mail
Grant writing
Internet
Sweepstakes
Media
Other
State the total contributions the organization received during the accounting year last ended:
$
a list of organization's officers, directors, trustees, and chief executive officer, including their titles, addresses, and total annual
compensation paid to each.Attached
3
SECTION B: REQUIRED FOR INITIAL REGISTRATION ONLY
SEE STATEMENT 1
DALE MARTINSON
201 4TH STREET SE, ROOM 204
ROCHESTER MN 55904 507-328-2850
X
MN 07/23/2013
X 3
X
X
DEVELOPMENT PLAN CREATION FOR THE DESTINATION MEDICAL CENTER.
X X
ARTS AND CULTURE HEALTH
5,416,446.
X
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We, the undersigned, state and acknowledge that we are duly constituted officers of this organization, being the
(Title) and (Title) respectively, and
that we execute this document on behalf of the organization pursuant to the resolution of the
(Board of Directors, Trustees, or Managing Group) adopted on the
day of , 20 , approving the contents of the document, and do hereby certify that the
(Board of Directors, Trustees, or Managing Group) has assumed, and will continue
to assume, responsibility for determining matters of policy, and have supervised, and will continue to supervise, the finances of the organization. We
further state that the information supplied is true, correct and complete to the best of our knowledge.
Name (Print)Name (Print)
Signature Signature
Title Title
Date Date
AG: #3124563-v1
6
SECTION D: REQUIRED FOR INITIAL REGISTRATION & ANNUAL REPORTING
BOARD OF DIRECTORS
SIGNATURES AND ACKNOWLEDGMENT
* NOTICE *
Documents required to be filed are public records. Please do not include social security numbers, driver's
license numbers or bank account numbers on the documents filed with this Office as they are not required, but
could become part of the public records. A charitable organization is not required to file a list of its donors. If it
is included, it may become part of the public file.
CHAIR
BOARD OF DIRECTORS
BOARD OF DIRECTORS
TINA FLINT SMITH
CHAIR
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~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
ANNUAL REPORT LIST OF OFFICERS, DIRECTORS AND TRUSTEES STATEMENT 1
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
NAME
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
TINA FLINT SMITH
TITLE TOTAL ANNUAL COMPENSATION
}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}}}}}}}}}}}}}}}}
CHAIR 0.
ADDRESS
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
201 4TH STREET SE ROCHESTER, MN 55904
NAME
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
R.T. RYBAK
TITLE TOTAL ANNUAL COMPENSATION
}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}}}}}}}}}}}}}}}}
VICE CHAIR 0.
ADDRESS
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
201 4TH STREET SE ROCHESTER, MN 55904
NAME
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
JIM BIER
TITLE TOTAL ANNUAL COMPENSATION
}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}}}}}}}}}}}}}}}}
TREASURER 0.
ADDRESS
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
201 4TH STREET SE ROCHESTER, MN 55904
NAME
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
ARDELL F. BREDE
TITLE TOTAL ANNUAL COMPENSATION
}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}}}}}}}}}}}}}}}}
DIRECTOR 0.
ADDRESS
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
201 4TH STREET SE ROCHESTER, MN 55904
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}
STATEMENT(S) 1
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NAME
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
JAMES CAMPBELL
TITLE TOTAL ANNUAL COMPENSATION
}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}}}}}}}}}}}}}}}}
DIRECTOR 0.
ADDRESS
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
201 4TH STREET SE ROCHESTER, MN 55904
NAME
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
BILL GEORGE
TITLE TOTAL ANNUAL COMPENSATION
}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}}}}}}}}}}}}}}}}
DIRECTOR 0.
ADDRESS
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
201 4TH STREET SE ROCHESTER, MN 55904
NAME
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
ED HRUSKA
TITLE TOTAL ANNUAL COMPENSATION
}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}}}}}}}}}}}}}}}}
DIRECTOR 0.
ADDRESS
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
201 4TH STREET SE ROCHESTER, MN 55904
NAME
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
SUSAN RANI
TITLE TOTAL ANNUAL COMPENSATION
}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}}}}}}}}}}}}}}}}
DIRECTOR 0.
ADDRESS
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}
201 4TH STREET SE ROCHESTER, MN 55904
DESTINATION MEDICAL CENTER CORPORATION 46-4959371
}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} }}}}}}}}}}
STATEMENT(S) 1
11441020 132902 094-08292400 2014.04030 DESTINATION MEDICAL CENTER 094-94G1
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DMC Energy Planning Update
October 29,2015
Mike Bull | Policy Director
Pg. 2
Goals for This Project
•Formulate options for
advancing DMC energy &
climate goals
•Coordinate on energy
infrastructure investments &
operating principles
•Identify metrics by which
benefits can be measured
Heart of the City
Discovery Square
Pg. 3
Updated Schedule
•Additional conversations with stakeholders
•Presentation at a public meeting of the Rochester Energy
Commission on November 10, to coordinate and seek input
•Presentation of Findings and Recommendations to DMCC
Board of Directors on November 19
•Written report to DMCC Board by end of November
Pg. 4
Who We’ve Talked To
•State Senator David Senjem
•State Representative Kim Norton
•State Senator Carla Nelson
•State Representative Tina Liebling
•Mayor Ardell Brede
•City Council members:
•Randy Staver, Ed Hruska, Michael
Wojcik, Nick Campion, Sandra Means,
Mark Hickey
•Lisa Clarke, EDA exec director
•Gary Neumann, Asst City Administrator
•Mike Berthelsen, U of MN Facilities Mgmt
•John Helmers, Olmsted County
•Brian Grzanek, Olmsted County
•Douglas J.Holtan, Mayo Clinic
•Brett Gorden, Mayo Clinic
•Jerry Williams, Rochester Public Utilities
•Mark Kochevar, Rochester Public Utilities
Walter Schlink, Rochester Public Utilities
•Anna Richey, Conservation MN
•Andrea Kiepa, Sierra Club
•Jon Hunter, American Lung Association
•Robert Moffit, American Lung Association
•Rory Lenton, MERC External Affairs Leader
•Erin Heitcamp, Wenck Associates
•Bill Brown, Wenck Associates
•Pat Sexton, Southern MN Association of
Realtors
Pg. 5
A Sense of Where We’re Headed
•The DMCC Board has set a high bar:
•Climate Vision: “Achieve climate neutrality across the Destination Medical
Center”
•Energy Vision: “Implement the most progressive, responsive, and
resilient district energy network in the country”
•The primary energy implementers in Rochester are each doing
good work in addressing their part of energy services within the City
•Mayo Clinic, Rochester Public Utilities, MN Energy Resources, City
•Achieving your vision will take focused, integrated, and sustained
attention by DMCC and energy implementers
•Progress toward that goal can enhance the DMC brand and assist
in marketing the DMC
More details on November 19th!
food
daycare
HOUSING
transportation
healthcare
education
Olmsted County
housing and redevelopment authority
Olmsted County HRA
•Established as the Olmsted County HRA in 1994
–Formerly the Rochester HRA
–Olmsted County area of operation
•HRA Board of Commissioners
–Directs and sets policies for programs and services
–7 member board appointed by Olmsted County and the city of
Rochester (through the end of 2015)
•January 2016—the Olmsted County Board of Commissioners become
the HRA Board of Commissioners
•Programs and Services
–Rental Assistance
–Owned Rental Units
–Home Improvement Loans
•Funded by Federal, State and Local Resources
housing needs
Types of Housing
•Subsidized Housing
–Units restricted to households earning at or below 30% of Area Median Income
•Low‐Income Housing/Affordable Housing
–Units affordable to households earning below 80% of Area Median Income
•Workforce Housing
–A subset of affordable housing and has some overlap with low‐income housing
–Units affordable to households earning generally between 60% and 80% of Area
Median Income (for rental units) but could be as high as 120%
•Market Rate Housing
–Units which are not subsidized (no income restrictions)
–Costs (e.g. rents) are based on market forces/or what the market will bear
Supportive Housing Rental Housing Homeownership
Emergency
Shelter
Transitional
Housing Affordable Workforce Market Rate
Affordable
Ownership
Market
Ownership
0% to 50% AMI 30% to 100% AMI 50% to 120%+ AMI
AMI= Area Median Income
housing needs
Income Groups and Jobs
Department of Housing and Urban Development Household Income Groups
Income Categories
Percent of
Area Median
Income
4‐person
Household Annual
Income
Examples of Occupations
Extremely Low Income At or below 30% $0 ‐$24,500 hotel desk clerk; home health aide; retail
sales clerk
Very Low Income 30% to 50% $24,501 ‐$40,850 bank teller; school bus driver; restaurant cook
Low Income 50% to 80% $40,851 ‐$65,350
carpenter; paralegal; police officer;
elementary school teacher; registered nurse;
accountant
Moderate Income 80% to 120% $65,350 ‐$98,050 human resources manager; school
administrator
Source: US Department of Housing and Urban Development and the Minnesota Department of Employment and Economic Development, Occupation Employment Statistics (OES) data
housing needs
Housing Needs Assessment
•Commissioned by Olmsted
County, Rochester Area
Foundation and the Mayo Clinic
•Released in early 2014
•Projected housing demand for
various types of housing in
Olmsted County from 2013 to
2030
Full report available at:
http://www.co.olmsted.mn.us/news/Pages/ComprehensiveH
ousingNeedsAssessmentReleased.aspx
Key Findings
•Cost Burdened Households
–22% of owner households and 45%
of renter households are paying
more than 30% of their income
towards housing costs
•Homeownership Rate
–74.9% (2010)
•Median Sales Price of a Home
–Single Family = $195,000
–Multi‐family = $137,950
•Average Rents
–1 bedroom $801
–2 bedroom $963
–3 bedroom $1,155
housing needs
Rental Housing Vacancy Rates
3.7%
4.3%
1.2%
0.9%
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
Overall Rental Vacancy
Rate
Market Rate Rental Affordable Rental Senior Affordable
Vacancy Rate
Stabilized Market
housing needs
Wage and Housing Cost Gap
$490.00 $543.00 $578.00 $592.00
$661.00
$‐
$200
$400
$600
$800
$1,000
$1,200
$1,400
Housekeeper
$9.41/hour
Hotel Desk Clerk
$10.44/hour
Home Health Aide
$11.12/hour
Retail Sales
$11.38/hour
Bank Teller
$12.72/hour
2 bedroom rent $963
Standard of Affordability = paying no more than 30% of
income towards housing costs
3 bedroom rent $1,155
Annual Income Needed to Afford Average Rents
Unit Type Average Rent Income Needed
Efficiency $555 $22,200
1 bedroom $801 $32,040
2 bedroom $963 $38,520
3 bedroom $1,155 $46,200
assessment findings
Housing Demand (2013‐2030)
11,363 7,074
Projected Housing Unit
Demand
Ownership Rental
41%
29%
30%
Rental Units
Market Rate Affordable Subsidized
assessment findings
Housing Demand (2013‐2030)
2,862
776
368
238
Senior Rental
Market Rate Affordable Subsidized Assisted Living
Over 4,200 units of senior
rental housing
–Market Rate
–Affordable
–Subsidized
–Affordable Assisted Living
affordable housing funding
Olmsted County HRA Levy
•County Board approved $1.35 million
•Provides a dedicated source of funding to be
used on housing issues
–Existing and/or New Programs
•Housing Development
•Preservation/Rehabilitation
•Housing Stability and supports
–Operating Support
•Administrative expenses, overhead costs
HRA Levy
OCCS Housing Continuum
Administrative Homeless Prevention
& Housing Stability
Housing
Development
Housing
Rehabilitation
$350,000 $100,000 $500,000 $400,000
•Funding Cuts and
Operational Costs
•Family housing stabilization
•Child safety and self
sufficiency focused
•Family unification
•School‐housing
connections
•Partnerships with private
& non‐profit developers
•Workforce
•Senior Housing
•Supportive Housing
•Repair existing
housing for low
income homeowners
including seniors
•Enhance existing city
of Rochester Program
•Homeless youth housing
stabilization
•Housing and case
management
•Housing Production Trust
Fund
•Gap Financing
•Target small cities
•Byron
•Chatfield
•Dover
•Eyota
•Oronoco
•Pine Island
•HRA Owned Units
•Transitional Housing •Conversion of market rate
rental units to affordable
rental units•Emergency Housing •Repair and update
existing HRA
properties
•Preservation of existing
affordable housing unitsBuild a continuum that addresses the needs of
vulnerable populations and the workforce so that
people reach their potential as contributing members
of the community
Cheryl Jacobson, Executive Director
jacobson.cheryl@co.olmsted.mn.us
507‐328‐7149
The Patient Experience
Research activities
Results summary
Closing the gap
Current Medical Environment Re-urbanization Trend
Situation Analysis
Integration
DMC
Minnesota
Community Mayo Clinic
Rochester
… to create the highest
quality patient, companion,
visitor and community
resident experience.
Our
Vision:
Mayo Clinic Operating Plan Objectives and Top Priority Initiatives
Transform
the Practice
Achieve Operational
Excellence Expand
Our Reach
PE
O
P
L
E
PR
O
C
E
S
S
E
S
OU
T
C
O
M
E
S
GO
A
L
S
Deliver Highest-Value Care to
Be Most Trusted and Affordable Achieve Mission-Advancing
Financial Performance
Invest in Talent and Technology
•Patient Experience Improvement
Enhance Patient Experience
Deliver an Unparalleled Patient Experience
Qualitative & Quantitative Data
2010 -2015
Experience Gap
Seamless Experience Pilot (Qual)DMC Market Segmentation Study (Quan)
2010 Census (Qual)
About YOU Study (Qual/Quan)
City Planning Analytics (Quan)
Arts & Culture Economic Impact (Quan)Rochester Visitors & Convention Bureau
(Quan)
(RCVB)
National Consumer Research (Qual)
Community Travel for Healthcare Project
(Qual)
Patient & Companion Journey Mapping (Qual)
Maxfield Housing Study (Quan)
Patient Satisfaction Scores (Quan)
AECOM Market Research
(Quan)
Market Segmentation Research
Journey Mapping Qualitative (2011)
Patients and Companions
Community
In-Depth Interviews
On-site Observation Sessions
Distance Traveled / Participants
* Source: PX Journey Mapping, 2011 Northwestern
Rh
MethodologiesMarkets
Market Segmentation Research
Quantitative (2011)
Patients
N=1204
MOE = +/-2.74%
Business
Travelers
N=100
MOE = +/-9.78%
Companions
N= 500
MOE = +/-4.33%
Community
Residents
N=1215
MOE = +/-3%
Total
N=3024
MOE: Margin of Error
67%Mayo Clinic
Visitors to Rochester –2.76
Million
Reason for Visit
9%Business 5%Leisure
3%Other Approximately 3,000Patients &CompanionsOn any Given Day19%
Conventions
& Sports
20%
Is Health Care
Related * Source: RCVB, Mayo Clinic Unique Patient Count, City Planning Analytics
Daily Commuters28,360
Patient
s& Companions
Arrive in
Patients & Companions –1.2 Million
2-4 Nights
Twos
* Source: DMC Market Segmentation, PX Journey Mapping, AECOM Market Research
Experience Gap
PATIENT / COMPANION
EXPERIENCE IN
ROCHESTER MAYO CLINIC
VISITOR
EXPERIENCE
ROCHESTER
VISITOR EXPERIENCE
Quality Gap
PERCEPTION OF QUALITY:
RATING OF HIGH LEVEL OF SATISFACTION
WITH ACTIVITIES/OFFERINGS IN
ROCHESTER
45
%29%
PATIENTS
RESIDENTS
Market Segmentation Research
Key Findings
* Source: PX Journey Mapping, DMC Market Segmentation, 2011, Q22: Overall satisfaction with activities and offerings
(1=very dissatisfied to 5=highly satisfied)
SPORTS,
RECREATION
& NATURE
LEARNING
ENVIRONMENTHEALTH &
WELLNESS
HOSPITALITY &
CONVENTION
ARTS,
CULTURE &
ENTERTAINMENT
COMMERCIAL,
RESEARCH &
TECHNOLOGY
LIVEABLE CITY
TRANSPORTATION
Eight Areas of Focus
*Source: DMC Development plan, volume 2 Section 6.0
Patients
Companions
Business Visitors
Market Segment Interest in Offerings
2323
43
46
48
34
A Center Focused
on Health,
Preventive Care,
Wellness, Nutrition
and Fitness
More High Quality
Hotel Options
*Source: DMC Segmentation Study, 2011, Q23: For Each Offering, how likely would you be to participate? (1= Not at all likely to 5= very
likely)
% Likely
Top 2 Rankings
More family entertainment options
Mid-scale retail options, such as Banana
Republic or J Crew
More community, cultural or public events
Educational programs, conferences and
lectures
Children's museum or science center
Health club or recreational opportunities
Up-scale, luxury retail options
Spa or wellness opportunities
More nightlife or entertainment options
More concierge or travel services
More business services
More Family
Entertainment
Options
17
19
14
Children’s Museum
Or Science Center
14
16
12
Patients
Companions
Business Visitors
*Source: DMC Segmentation Study, 2011, Q23: For Each Offering, how likely would you be to participate? (1= Not at all likely to 5= very
likely)
% Likely
Market Segment Interest in Offerings
% Likely
Top 2 Rankings
Community Members
More casual dining options
More family entertainment options
Live music or concert venues
Children's museum or science center
More community, cultural or public events
A center focused on health, wellness,etc*
A place to connect with other people like you
More on-going connections/web-based access to Mayo Clinic
More weather protected spaces for cultural events or entertainment
High-end grocery or organic foods, such as Whole Foods
Educational programs, conferences and lectures
A movie theatre downtown
More up-scale dining options
More nightlife or entertainment options
Mid-scale retail options, such as Banana Republic or J Crew
Health club or recreational opportunities
Spa or wellness opportunities
Up-scale, luxury retail options
More downtown housing
More Casual Dining
More Family Entertainment Options
44
41
*Source: DMC Segmentation Study, 2011, Q23: For Each Offering, how likely would you be to participate? (1= Not at all likely to 5= very
likely)
Live music or Concert Venues 40
Market Segment Interest in Offerings
% Likely
Top 2 Rankings
Shared Market Segment Wants
Patients &
Companions
Business
Visitors
Community
Patients &
Companions
Business
Visitors
Community
Shared Market Segment Wants
Programs -Products -Places
Authentic community experience
Diverse dining and shopping
Health and wellness programs
Museums and entertainment
High quality hotels
Indoor public spaces
Diverse housing
Family activities
Arts & cuuture
*Source: DMC Segmentation Study,
2011, Q23: For Each Offering, how
likely would you be to participate? (1=
Not at all likely to 5= very likely)
The Providers Perspective
Clinical Care
•Quality
•Safety
•Outcomes
The Patient’s Perspective
Service
•Access
•Responsiveness
•Physician/ provider
interaction
•Nurses and Allied Health
interactions
•Role of Facility and
Environment
•Getting Around
•Billing
Patient Satisfaction Survey
Mayo Clinic Patient Experience
CO
N
C
E
R
N
S
/
S
T
R
E
S
S
Patient Journey
Seamless Experience
Research & Choice Pre-Treatment/Prep Treatment Post TreatmentOrientationDeveloping Routines Treatment Treatment Completion
*Source: Seamless Experience Pilot, 2015 Qualitative
CO
N
C
E
R
N
S
/
S
T
R
E
S
S
Patient Journey
Seamless Experience
Research & Choice Pre-Treatment/Prep Treatment Post TreatmentOrientationDeveloping Routines Treatment Treatment Completion
Where will we stay
What will we need?
Where do we buy
groceries?
How do we get to
Our appointments?
What else can we
do in Rochester?
What happens when
I go home?
Where is the best place
for treatment?
*Source: Seamless Experience Pilot, 2015 Qualitative
CO
N
C
E
R
N
S
/
S
T
R
E
S
S
Patient Journey
Seamless Experience
Research & Choice Pre-Treatment/Prep Treatment Post TreatmentOrientationDeveloping Routines Treatment Treatment Completion
Where will we stay
What will we need?
Where do we buy
groceries?
How do we get to
Our appointments?
What else can we
do in Rochester?
What happens when
I go home?
Where is the best place
for treatment?
Health Care Concerns
*Source: Seamless Experience Pilot, 2015 Qualitative
CO
N
C
E
R
N
S
/
S
T
R
E
S
S
Patient Journey
Seamless Experience
Research & Choice Pre-Treatment/Prep Treatment Post TreatmentOrientationDeveloping Routines Treatment Treatment Completion
Where will we stay
What will we need?
Where do we buy
groceries?
How do we get to
Our appointments?
What else can we
do in Rochester?
What happens when
I go home?
Where is the best place
for treatment?
Health Care Concerns
Non-Care Related Concerns
*Source: Seamless Experience Pilot, 2015 Qualitative
DMC Service
Proton Beam Therapy
*Source: Seamless Experience Pilot, 2015 Qualitative
Family Unit
2-4 People
Patient: Ellen
Lives in: Madison, WI
2 Working Parents
Father Travels Home to Work
Age: 6
2 Year-old Sister
Seamless Patient Journey Distance
Patient Status
Support
Children
Duration
Cultural Preference None
Day
None
Alone
New
Local International
Return Patient
Well Supported
Pediatric Patient
Months
Many
The Waiting Room
Morning at RMH
Time Between
Appointments with Kids
Dad Working
Visits on Weekends
The Treatment After Treatment
Create the sense of welcoming places at key touch points
Facilitate patient, companion & visitor journey
Create opportunities for patients to just feel normal
Engage visitors and residents in health and wellness
DMC is Key to a High Quality Experience
Questions
HAMMES COMPANY SEPTEMBER 2015
TABLE OF CONTENTS
1.0 Executive Summary
2.0 Master Project Budget
3.0 Budget Allocation Report
4.0 Cost Report
5.0 Contract Summary Report
6.0 Master Application for Payment
7.0 Other Information
Major Tasks / Next 60 Days
The following provides an outline of the anticipated tasks to be
completed in the next 60 days.
• The DMC EDA will design the final Development Guide that
will be available to DMC development interests.
•The DMC EDA will complete the update to the DMC Capital
Improvement Plan based on feedback from the City of
Rochester.
•The DMC EDA will continue to work with the City to prepare
funding terms and a complete funding program for DMC
public infrastructure projects.
•The DMC EDA will prepare a Zoning and Land Developent
Guide for building and developing in the Destination Medical
Center.
•The DMC EDA will continue to focus communications on
elevating awareness through outreach across the state and
building national support for the DMC.
SEPTEMBER 2015
Major Accomplishments /
Last 30 Days
The following provides an outline of the tasks completed in the last
30 days.
•The DMC EDA staff is in place.
•The DMC website is complete and now live.
•The 2016 budget for the DMC EDA has been approved
by the DMC Corporation Board of Directors.
•There were 54 DMC related stories in the past month.
Mo
n
t
h
l
y
P
r
o
g
r
e
s
s
R
e
p
o
r
t
Mo
n
t
h
l
y
P
r
o
g
r
e
s
s
R
e
p
o
r
t
CU
M
U
L
A
T
I
V
E
D
R
A
W
T
O
D
A
T
E
SEPTEMBER 30, 2015
Monthly Progress Report MASTER BUDGET: $2,800,000.00
LE
G
A
L
S
E
R
V
I
C
E
S
93.75%
SE
P
T
E
M
B
E
R
3
0
,
2
0
1
5
SEPTEMBER, 2015
This report provides a summary of the activities undertaken by the Destination Medical Center Economic
Development Agency (DMC EDA) for the period stated above.
2015 WORK PLAN IMPLEMENTATION
DEVELOPMENT
•The DMC EDA continues to build the tools and processes necessary to seamlessly transition into the
implementation phase of the DMC initiative.
•The DMC EDA continues to coordinate with the City to track potential project activity and updates in the
DMC Development District.
•The DMC EDA continues to work with the City in developing a revised CIP for years 2015 - 2019 that
aligns potential uses with sources DMC funding.
•The DMC EDA proposed 2016 Workplan, which is focused on the Board-identified priorities (Heart of
the City, Discovery Square and Transportation initiatives), was approved by the DMC Corporation Board.
FINANCE
•The DMC EDA is currently operating within budget for 2015 and utilizing the Working Capital Loan
structure implemented by the DMC Corporation and the City.
•The DMC EDA 2016 proposed budget was approved by the DMC Corporation Board.
BUSINESS / ECONOMIC DEVELOPMENT
•The DMC EDA will move forward with a strategic marketing/advertising effort to evolve the DMC
brand identity and create marketing/collateral materials highlighting Discovery Square and Heart of
the City priorities.
•The DMC EDA continues to work with the City to prepare funding terms and a complete funding program
for DMC public infrastructure projects.
•The DMC EDA has composed a draft Development Guide that will act as a reference guide to building and
developing in the Destination Medical Center district.
•The DMC EDA is preparing a Zoning and Land Use Manual that will be available to development interests
as a quick reference guide to developing in the Destination Medical Center district.
EDA OPERATIONS
•Staff for the DMC EDA are transitioning into their roles.
•The DMC EDA has moved into its permanent office space.
COMMUNICATIONS, PUBLIC RELATIONS & COMMUNITY ENGAGEMENT
•The DMC website redesign is complete and the new website is now live. www.dmc.mn
•The DMC EDA continues their regional outreach and presentations to business/ civic organizations and
outstate communities.
•In the upcoming months the DMC EDA will meet with/ give presentations to the Greater Minneapolis
Leadersip Team, St. Paul Chamber, SE Minnesota Economic Forum, and the Life Sciences Alley Panel
Participation.
•Media results - 54 media stories in the last month.
•Topics included: Preparing for growth, becoming a “destination” city, and 2016 funding.
•The DMC EDA continues to coordinate meetings with local leaders and organizations to keep informed
and maintain relationships: community leaders, Community Engagement Committee, Social Service
coalition, Rochester Arts and Culture Collaborative
•The DMC EDA continues to work to coordinate support with key stakeholders for the MN Bike Share
program in Rochester and facilitate conversations with local groups.
•The DMC EDA continues to attend/partner with local and regional initiatives e.g.; Southern MN Initiatives
Foundation, J2G (Journey to Growth), Hospitality First, Comprehensive Plan, Workforce Housing.
66.42%
* This summary represents the approximately $2.8 M portion of the budget and/or expenses
that are managed and reported by the EDA. The balance of funding is DMCC and City of
Rochester funding and managed outside of the EDA budget.
SE
P
T
E
M
B
E
R
3
0
,
2
0
1
5
OT
H
E
R
DE
V
E
L
O
P
M
E
N
T
S
E
R
V
I
C
E
S
SOURCES OF FUNDS: Current Application
City Contribution $2,800,000
____________
TOTAL SOURCES $2,800,000
USES OF FUNDS: Current Application
Architecture $1,300
Marketing & PR $182,699
Development Services $1,262,000
Legal Services $46,877
Other Development Costs $24,290
TOTAL WORK IN PLACE $1,517,165
BALANCE TO COMPLETE $1,282,835
COMMITTED COSTS $2,348,274
UNCOMMITTED COSTS $451,726
TOTAL USES OF FUNDS $2,800,000
AR
C
H
I
T
E
C
H
T
U
R
E
&
E
N
G
I
N
E
E
R
I
N
G
MA
R
K
E
T
I
N
G
&
P
R
MASTER PROJECT BUDGET
41.35% DRAWN 0 500,000 1,000,000 1,500,000 2,000,000 2,500,000 3,000,000
ARCHITECTURE $ 135,000
$ 1,300
MARKETING & PR $ 318,000
$ 182,699
DEVELOPMENT SERVICES $ 1,900,000
$1,262,000
LEGAL SERVICES $ 50,000
$46,877
OTHER DEVELOPMENT COSTS $ 397,000
$ 24,290
COMMITTED COSTS
ACTUAL EXPENDITURES TO DATE
TOTAL EXPENDITURES TO DATE: $1,517,225
6.19%
00.96%
57.45%
HAMMES COMPANY SEPTEMBER 2015
The following Master Project Budget is included herein as Section 2.0.
Report 4001A
10/19/2015 - 7:45 AM
DMC - ECONOMIC DEVELOPMENT AGENCY (2015)
SOURCES AND USES REPORT #4 September 30, 2015
SOURCES OF FUNDS USES OF FUNDS
00-30-005 City Contribution 2,800,000.00$ 40-00-000 Development Costs 2,800,000.00$
90-00-000 Project Contingency -$
TOTAL SOURCES OF FUNDS 2,800,000.00$ TOTAL USES OF FUNDS 2,800,000.00$
Report 4001B
10/19/2015 - 7:46 AM Page 1 of 1
DMC - ECONOMIC DEVELOPMENT AGENCY (2015)
MASTER PROJECT BUDGET #4 September 30, 2015
Division Description Final Projected
Cost Notes
DEVELOPMENT COSTS
40-05-000 Architecture & Engineering $135,000.00
40-25-000 Marketing & Public Relations $318,000.00
40-30-000 Development Services $1,900,000.00
40-35-000 Legal Services $50,000.00
40-90-000 Other Development Costs $397,000.00
Subtotal $2,800,000.00
PROJECT CONTINGENCY
90-00-000 Project Contingency $0.00
Subtotal $0.00
PROJECT TOTAL $2,800,000.00
Report 4001B
10/19/2015 - 7:46 AM Page 1 of 1
DMC - ECONOMIC DEVELOPMENT AGENCY (2015)
DETAIL MASTER PROJECT BUDGET #4 September 30, 2015
Division Description Final Projected
Cost - Detail
Final Projected
Cost Notes
DEVELOPMENT COSTS
40-05-000 Architecture & Engineering $135,000.00
40-05-300 Planning Services, Architecture, Engineering $135,000.00
40-25-000 Marketing & Public Relations $318,000.00
40-25-300 Communications, Marketing & PR $108,000.00
40-25-310 Public Relations & Communications $210,000.00
40-30-000 Development Services $1,900,000.00
40-30-300 Development Services $1,860,000.00
40-30-310 Financial, Accounting & Investment Services $40,000.00
40-35-000 Legal Services $50,000.00
40-35-300 Legal Services $50,000.00
40-90-000 Other Development Costs $397,000.00
40-90-115 Payroll, Staff, Administration & Benefits-EDA $218,000.00
40-90-120 General Expenses-EDA $79,000.00
40-90-300 Reimbursable Expenses $100,000.00
Subtotal $2,800,000.00
PROJECT CONTINGENCY
90-00-000 Project Contingency $0.00
Subtotal $0.00
PROJECT TOTAL $2,800,000.00
HAMMES COMPANY SEPTEMBER 2015
The following Budget Allocation Report is included herein as Section 3.0 .
Report 4004
10/19/2015 - 7:47 AM Page 1 of 1
DMC - ECONOMIC DEVELOPMENT AGENCY (2015)
BUDGET ALLOCATION REPORT #4
Revision
No
Revision
Date Division Division
Description
Revision
Description
Revision
Amount
Revision
To
Revision
Method
Requested
By
Entered
By
BEGINNING CONTINGENCY BALANCE $0.00
ENDING CONTINGENCY BALANCE $0.00
September 30, 2015
Final Projected Cost
HAMMES COMPANY SEPTEMBER 2015
The following Cost Report is included herein as Section 4.0.
Report 4002
10/19/2015 - 7:49 AM Page 1 of 1
DMC - ECONOMIC DEVELOPMENT AGENCY (2015)
COST REPORT #4
Variance
Division Description
Master Project
Budget
A
Original
Contract
Amount
B
Contract
Revisions
C
Committed
Costs
B+C
Committed Direct
Owner Purchases
D
Un-Committed
Costs
E
Final Projected
Cost
B+C+D+E
Over/(Under)
Budget
(B+C+D+E)-A
Total Work
In Place
Percent
Complete
DEVELOPMENT COSTS
40-05-000 Architecture & Engineering $135,000.00 $13,390.47 $0.00 $13,390.47 $0.00 $121,609.53 $135,000.00 $0.00 $1,299.57 0.96%
40-25-000 Marketing & Public Relations $318,000.00 $386,516.20 $0.00 $386,516.20 $0.00 ($68,516.20)$318,000.00 $0.00 $182,698.70 57.45%
40-30-000 Development Services $1,900,000.00 $1,862,000.00 $0.00 $1,862,000.00 $0.00 $38,000.00 $1,900,000.00 $0.00 $1,262,000.00 66.42%
40-35-000 Legal Services $50,000.00 $46,329.33 $548.00 $46,877.33 $0.00 $3,122.67 $50,000.00 $0.00 $46,877.33 93.75%
40-90-000 Other Development Costs $397,000.00 $39,264.76 $225.00 $39,489.76 $0.00 $357,510.24 $397,000.00 $0.00 $24,289.76 6.12%
Subtotal $2,800,000.00 $2,347,500.76 $773.00 $2,348,273.76 $0.00 $451,726.24 $2,800,000.00 $0.00 $1,517,165.36 54.18%
PROJECT CONTINGENCY
90-00-000 Project Contingency $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00%
Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00%
PROJECT TOTAL $2,800,000.00 $2,347,500.76 $773.00 $2,348,273.76 $0.00 $451,726.24 $2,800,000.00 $0.00 $1,517,165.36 54.18%
Work in PlaceSchedule of Values
September 30, 2015
Report 4002
10/19/2015 - 7:48 AM Page 1 of 1
DMC - ECONOMIC DEVELOPMENT AGENCY (2015)
DETAIL COST REPORT #4
Variance
Division Description
Master Project
Budget
A
Original
Contract
Amount
B
Contract
Revisions
C
Committed
Costs
B+C
Committed Direct
Owner Purchases
D
Un-Committed
Costs
E
Final Projected
Cost
B+C+D+E
Over/(Under)
Budget
(B+C+D+E)-A
Total Work
In Place
Percent
Complete
DEVELOPMENT COSTS
40-05-000 Architecture & Engineering $135,000.00 $13,390.47 $0.00 $13,390.47 $0.00 $121,609.53 $135,000.00 $0.00 $1,299.57 0.96%
40-05-300 Planning Services, Architecture, Engineering $135,000.00 $13,390.47 $0.00 $13,390.47 $0.00 $121,609.53 $135,000.00 $0.00 $1,299.57 0.96%
40-25-000 Marketing & Public Relations $318,000.00 $386,516.20 $0.00 $386,516.20 $0.00 ($68,516.20)$318,000.00 $0.00 $182,698.70 57.45%
40-25-300 Communications, Marketing & PR $108,000.00 $273,225.00 $0.00 $273,225.00 $0.00 ($165,225.00)$108,000.00 $0.00 $153,512.50 142.14%
40-25-310 Public Relations & Communications $210,000.00 $113,291.20 $0.00 $113,291.20 $0.00 $96,708.80 $210,000.00 $0.00 $29,186.20 13.90%
40-30-000 Development Services $1,900,000.00 $1,862,000.00 $0.00 $1,862,000.00 $0.00 $38,000.00 $1,900,000.00 $0.00 $1,262,000.00 66.42%
40-30-300 Development Services $1,860,000.00 $1,860,000.00 $0.00 $1,860,000.00 $0.00 $0.00 $1,860,000.00 $0.00 $1,260,000.00 67.74%
40-30-310 Financial, Accounting & Investment Services $40,000.00 $2,000.00 $0.00 $2,000.00 $0.00 $38,000.00 $40,000.00 $0.00 $2,000.00 5.00%
40-35-000 Legal Services $50,000.00 $46,329.33 $548.00 $46,877.33 $0.00 $3,122.67 $50,000.00 $0.00 $46,877.33 93.75%
40-35-300 Legal Services $50,000.00 $46,329.33 $548.00 $46,877.33 $0.00 $3,122.67 $50,000.00 $0.00 $46,877.33 93.75%
40-90-000 Other Development Costs $397,000.00 $39,264.76 $225.00 $39,489.76 $0.00 $357,510.24 $397,000.00 $0.00 $24,289.76 6.12%
40-90-115 Payroll, Staff, Administration & Benefits-EDA $218,000.00 $0.00 $0.00 $0.00 $0.00 $218,000.00 $218,000.00 $0.00 $0.00 0.00%
40-90-120 General Expenses-EDA $79,000.00 $1,264.76 $225.00 $1,489.76 $0.00 $77,510.24 $79,000.00 $0.00 $1,489.76 1.89%
40-90-300 Reimbursable Expenses $100,000.00 $38,000.00 $0.00 $38,000.00 $0.00 $62,000.00 $100,000.00 $0.00 $22,800.00 22.80%
Subtotal $2,800,000.00 $2,347,500.76 $773.00 $2,348,273.76 $0.00 $451,726.24 $2,800,000.00 $0.00 $1,517,165.36 54.18%
PROJECT CONTINGENCY
90-00-000 Project Contingency $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00%
Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00%
PROJECT TOTAL $2,800,000.00 $2,347,500.76 $773.00 $2,348,273.76 $0.00 $451,726.24 $2,800,000.00 $0.00 $1,517,165.36 54.18%
Work in PlaceSchedule of Values
September 30, 2015
HAMMES COMPANY SEPTEMBER 2015
The following Contract Summary Report is included herein as Section 5.0.
Report 4003
10/19/2015 - 7:49 AM Page 1 of 1
DMC - ECONOMIC DEVELOPMENT AGENCY (2015)
CONTRACT SUMMARY REPORT #4
Division Description
Co
n
t
r
a
c
t
Vendor Name Contract
Number
Original
Contract
Amount
Contract
Revisions
Committed
Costs
Direct
Owner
Purchases
Work in
Place
Percent
Complete
DEVELOPMENT COSTS
40-05-000 Architecture & Engineering $13,390.47 $0.00 $13,390.47 $0.00 $1,299.57 9.71%
40-05-300 Planning Services, Architecture, Engineering X CARROLL, FRANCK & ASSOCIATES 4020 $13,390.47 $0.00 $13,390.47 $0.00 $1,299.57 9.71%
40-25-000 Marketing & Public Relations $386,516.20 $0.00 $386,516.20 $0.00 $182,698.70 47.27%
40-25-300 Communications, Marketing & PR X HIMLE RAPP & CO., INC.4017 $255,000.00 $0.00 $255,000.00 $0.00 $152,500.00 59.80%
40-25-300 Communications, Marketing & PR X GINA MARIA CHIRI-OSMOND 4027 $18,225.00 $0.00 $18,225.00 $0.00 $1,012.50 5.56%
40-25-310 Public Relations & Communications X BRANDHOOT 4016 $41,051.20 $0.00 $41,051.20 $0.00 $15,361.20 37.42%
40-25-310 Public Relations & Communications X SAM SMITH 4030 $72,240.00 $0.00 $72,240.00 $0.00 $13,825.00 19.14%
40-30-000 Development Services $1,862,000.00 $0.00 $1,862,000.00 $0.00 $1,262,000.00 67.78%
40-30-300 Development Services X HAMMES COMPANY SPORTS DEVEL.DMA $1,860,000.00 $0.00 $1,860,000.00 $0.00 $1,260,000.00 67.74%
40-30-310 Financial, Accounting & Investment Services X CLIFTONLARSONALLEN LLP 4041 $2,000.00 $0.00 $2,000.00 $0.00 $2,000.00 100.00%
40-35-000 Legal Services $46,329.33 $548.00 $46,877.33 $0.00 $46,877.33 100.00%
40-35-300 Legal Services X DORSEY & WHITNEY LLP 4015 $43,049.83 $0.00 $43,049.83 $0.00 $43,049.83 100.00%
40-35-300 Legal Services X MICHAEL BEST & FRIEDRICH LLP 4021 $3,279.50 $548.00 $3,827.50 $0.00 $3,827.50 100.00%
40-90-000 Other Development Costs $39,264.76 $225.00 $39,489.76 $0.00 $24,289.76 61.51%
40-90-120 General Expenses-EDA X CITY MARKET DOWNTOWN 4018 $97.79 $0.00 $97.79 $0.00 $97.79 100.00%
40-90-120 General Expenses-EDA X CWS, INC.4033 $900.00 $225.00 $1,125.00 $0.00 $1,125.00 100.00%
40-90-120 General Expenses-EDA X DELUXE BUSINESS PRODUCTS 4042 $266.97 $0.00 $266.97 $0.00 $266.97 100.00%
40-90-300 Reimbursable Expenses X HAMMES COMPANY SPORTS DEVEL.DMA $38,000.00 $0.00 $38,000.00 $0.00 $22,800.00 60.00%
Subtotal $2,347,500.76 $773.00 $2,348,273.76 $0.00 $1,517,165.36 64.61%
PROJECT CONTINGENCY
90-00-000 Project Contingency $0.00 $0.00 $0.00 $0.00 $0.00 0.00%
Subtotal $0.00 $0.00 $0.00 $0.00 $0.00 0.00%
PROJECT TOTAL $2,347,500.76 $773.00 $2,348,273.76 $0.00 $1,517,165.36 64.61%
September 30, 2015
Status
HAMMES COMPANY SEPTEMBER 2015
The following Master Application for Payment is included herein as
Section 6.0 .
There was no Master Application for Payment for the month of May.
MASTER APPLICATION FOR PAYMENT
MAP for undisputed labor, services, or materials
Page 1 of 1
MASTER APPLICATION FOR PAYMENT (Form 4020)
From:HAMMES COMPANY Application No.:4 Please Remit To:
Application Date:September 1, 2015
Hammes Project No:40050-06
To:DMC Economic Development Authority Period From:August 1, 2015
200 First Street SW Period To:August 31, 2015
Rochester, MN 55905 Project Name:DMC
Attention:Executive Director Economic Development Agency (2015)
PROJECT MANAGER:STATEMENT OF PROJECT:
ORIGINAL MASTER PROJECT BUDGET . . . . . . . . . . . . . . . . . . $
CURRENT MASTER PROJECT BUDGET . . . . . . . . . . . . . . . . . . $
Signed By:
Hammes Company Sports Development, Inc.
Date:September 1, 2015 TOTAL COMPLETED & STORED TO DATE . . . . . . . . . . . . . . . . $
Name:Robert P. Dunn RETAINAGE TO DATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
TOTAL COMPLETED LESS RETAINAGE . . . . . . . . . . . . . . . . . . $
SOURCES OF FUNDS:
City Contribution LESS PREVIOUS REQUESTS . . . . . . . . . . . . . . . . . . . . . . . . . . . $
CURRENT AMOUNT DUE (A + B) . . . . . . . . . . . . . . . . . . . . . . . . $
CURRENT PAYMENTS DUE (A) . . . . . . . . . . . . . . . . . . . . . . . . .$
CURRENT SOURCES OF FUNDS DIRECT OWNER PURCHASES DUE (B) . . . . . . . . . . . . . . . . . . $
USES OF FUNDS:APPROVALS:
40 - Development Costs
50 - Financing Costs
60 - Other Project Costs
90 - Project Contingency
EDA:Date
DMCC: Date
CURRENT USES OF FUNDS
157,940.00$
Current Application
-$
-$
157,940.00$
Acct Name:
Acct No:
Bank:
Notify:
2,800,000.00
2,800,000.00
1,517,165.36
-
1,517,165.36
Submitted in accordance with the Contract Documents for approval by the
EDA.
1,359,225.36
Current Application
157,940.00$
-
157,940.00
157,940.00
-$
157,940.00$
MAP for undisputed labor, services, or materials
Page 1 of 1
DETAIL SOURCES AND USES REPORT #4
Division Description Final Projected
Cost
Previous
Billings
Current
Billing
Total
Billed To Date
Balance to
Complete
SOURCES OF FUNDS
00-30-005 City Contribution $2,800,000.00 $1,359,225.36 $157,940.00 $1,517,165.36 $1,282,834.64
Total Sources of Funds $2,800,000.00 $1,359,225.36 $157,940.00 $1,517,165.36 $1,282,834.64
USES OF FUNDS
40-00-000 Development Costs $2,800,000.00 $1,359,225.36 $157,940.00 $1,517,165.36 $1,282,834.64
90-00-000 Project Contingency $0.00 $0.00 $0.00 $0.00 $0.00
Total Uses of Funds $2,800,000.00 $1,359,225.36 $157,940.00 $1,517,165.36 $1,282,834.64
September 1, 2015
MAP for undisputed labor, services, or materials
Page 1 of 1
DESTINATION MEDICAL CENTERECONOMIC DEVELOPMENT AUTHORITY (2015)
Division Description Vendor Contract
No
Previous
Billing
Current
Work In Place
Direct Owner
Purchase
Total
Work to Date
Percent
Complete
Previous
Retainage
Current
Retainage
Total
Retainage
DEVELOPMENT COSTS
40-05-000 Architecture & Engineering $1,299.57 $0.00 $0.00 $1,299.57 9.71%$0.00 $0.00 $0.00
40-05-300 Planning Services, Architecture, Engineering CARROLL, FRANCK & ASSOCIATES 4020 $1,299.57 $0.00 $0.00 $1,299.57 9.71%$0.00 $0.00 $0.00
40-25-000 Marketing & Public Relations $178,558.70 $4,140.00 $0.00 $182,698.70 47.27%$0.00 $0.00 $0.00
40-25-300 Communications, Marketing & PR HIMLE RAPP & CO., INC.4017 $152,500.00 $0.00 $0.00 $152,500.00 59.80%$0.00 $0.00 $0.00
40-25-300 Communications, Marketing & PR GINA MARIA CHIRI-OSMOND 4027 $1,012.50 $0.00 $0.00 $1,012.50 5.56%$0.00 $0.00 $0.00
40-25-310 Public Relations & Communications BRANDHOOT 4016 $11,221.20 $4,140.00 $0.00 $15,361.20 37.42%$0.00 $0.00 $0.00
40-25-310 Public Relations & Communications SAM SMITH 4030 $13,825.00 $0.00 $0.00 $13,825.00 19.14%$0.00 $0.00 $0.00
40-30-000 Development Services $1,112,000.00 $150,000.00 $0.00 $1,262,000.00 67.78%$0.00 $0.00 $0.00
40-30-300 Development Services HAMMES COMPANY SPORTS DEVEL.DMA $1,110,000.00 $150,000.00 $0.00 $1,260,000.00 67.74%$0.00 $0.00 $0.00
40-30-310 Financial, Accounting & Investment Services CLIFTONLARSONALLEN LLP 4041 $2,000.00 $0.00 $0.00 $2,000.00 100.00%$0.00 $0.00 $0.00
40-35-000 Legal Services $46,877.33 $0.00 $0.00 $46,877.33 100.00%$0.00 $0.00 $0.00
40-35-300 Legal Services DORSEY & WHITNEY LLP 4015 $43,049.83 $0.00 $0.00 $43,049.83 100.00%$0.00 $0.00 $0.00
40-35-300 Legal Services MICHAEL BEST & FRIEDRICH LLP 4021 $3,827.50 $0.00 $0.00 $3,827.50 100.00%$0.00 $0.00 $0.00
40-90-000 Other Development Costs $20,489.76 $3,800.00 $0.00 $24,289.76 61.51%$0.00 $0.00 $0.00
40-90-120 General Expenses-EDA CITY MARKET DOWNTOWN 4018 $97.79 $0.00 $0.00 $97.79 100.00%$0.00 $0.00 $0.00
40-90-120 General Expenses-EDA CWS, INC.4033 $1,125.00 $0.00 $0.00 $1,125.00 100.00%$0.00 $0.00 $0.00
40-90-120 General Expenses-EDA DELUXE BUSINESS PRODUCTS 4042 $266.97 $0.00 $0.00 $266.97 100.00%$0.00 $0.00 $0.00
40-90-300 Reimbursable Expenses HAMMES COMPANY SPORTS DEVEL.DMA $19,000.00 $3,800.00 $0.00 $22,800.00 60.00%$0.00 $0.00 $0.00
Subtotal $1,359,225.36 $157,940.00 $0.00 $1,517,165.36 64.61%$0.00 $0.00 $0.00
PROJECT CONTINGENCY
90-00-000 Project Contingency $0.00 $0.00 $0.00 $0.00 0.00%$0.00 $0.00 $0.00
Subtotal $0.00 $0.00 $0.00 $0.00 0.00%$0.00 $0.00 $0.00
PROJECT TOTAL $1,359,225.36 $157,940.00 $0.00 $1,517,165.36 $0.00 $0.00 $0.00
Current
Work In Place
Direct Owner
Purchase
Total
Current Work
Current Work In Place $157,940.00 $0.00 $157,940.00
Less Current Retainage Held $0.00 $0.00 $0.00
Net Amount Due $157,940.00 $0.00 $157,940.00
Retainage
September 1, 2015
Work Completed To Date
MASTER APPLICATION FOR PAYMENT DETAIL #4
MAP for undisputed labor, services, or materials
Page 1 of 1
DESTINATION MEDICAL CENTER
ECONOMIC DEVELOPMENT AUTHORITY (2015)
INVOICE SUMMARY REPORT #4
Vendor Name Description Invoice No Invoice Date Invoice Amount Retainage Held Amount Due Approval
BRANDHOOT Public Relations and Communications 1343 9/1/2015 $4,140.00 $0.00 $4,140.00
HAMMES COMPANY SPORTS DEVEL.Development Manager Agreement 5005-018 9/1/2015 $153,800.00 $0.00 $153,800.00
GRAND TOTAL $157,940.00 $0.00 $157,940.00
September 1, 2015
HAMMES COMPANY SEPTEMBER 2015