4A (Expenses $ 117496329 including grants of $ 76417625) (Revenue $ 595931)
SEE SCHEDULE O

4B (Expenses $ 14522018 including grants of $ 39583) (Revenue $ 55975987)
SEE SCHEDULE O

MAYO CLINIC HEALTH SYSTEM IN WAYCROSS
PART V, SECTION B, LINE 5: PRIMARY DATA COLLECTION METHODS INCLUDED INTERVIEWS AND A FOCUS GROUP WITH KEY COMMUNITY REPRESENTATIVES. TO GATHER INPUT FROM AN EXTENSIVE RANGE OF PEOPLE WHO REPRESENT THE BROAD INTERESTS OF WARE AND PIERCE COUNTIES, A FOCUS GROUP AND ONE-ON-ONE INTERVIEWS WERE CONDUCTED IN MARCH 2016. IN TOTAL, INTERVIEWS WERE CONDUCTED WITH 18 INDIVIDUALS AND 6 FOCUS GROUP PARTICIPANTS WHO WERE KEY COMMUNITY REPRESENTATIVES. THE PURPOSE OF THE INTERVIEWS AND FOCUS GROUP WAS TO GAIN DIRECT INPUT FROM THESE INDIVIDUALS REGARDING HEALTH NEEDS, COMMUNITY ASSETS, AND OTHER RELATED TOPICS, INCLUDING PRIMARY AND CHRONIC DISEASE NEEDS AND OTHER HEALTH ISSUES ASSOCIATED WITH UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. FOCUS GROUP AND INTERVIEW PARTICIPANTS INCLUDED COMMUNITY STAKEHOLDERS REPRESENTING HEALTH CARE AND SOCIAL SERVICES PROVIDERS, SCHOOL SYSTEMS, RELIGIOUS ORGANIZATIONS, ECONOMIC ORGANIZATIONS, POLITICAL AND OTHER COMMUNITY OFFICIALS AND THE ELDERLY/SENIOR POPULATION. MANY OF THE FOCUS GROUP AND INTERVIEW PARTICIPANTS REPRESENTED, AND WERE VERY FAMILIAR WITH, THE HEALTH NEEDS ASSOCIATED WITH THE MEDICALLY UNDERSERVED, LOW INCOME, MINORITY, AND POPULATIONS WITH CHRONIC AND ACUTE DISEASES IN WARE AND PIERCE COUNTIES.

MAYO CLINIC HEALTH SYSTEM IN WAYCROSS
PART V, SECTION B, LINE 11: ADDRESSING OBESITY IN OUR COMMUNITY: WITH OBESITY AS ONE OF THE MOST SIGNIFICANT RISK FACTORS FOR SEVERAL DISEASES AFFECTING RESIDENTS OF WARE AND PIERCE COUNTIES, IT INCLUDES CARDIOVASCULAR DISEASE, DIABETES, AND HYPERTENSION. A MAJOR FACTOR CAUSING THE SUBSTANTIAL CARDIOVASCULAR DISEASE MORTALITY RATES IN THE REGION IS THE LEVEL OF OBESITY, WITH ONE-THIRD OF THE ADULT POPULATION IN WARE AND PIERCE COUNTIES CONSIDERED OBESE. MCHS IN WAYCROSS CONTINUES TO WORK WITH THE YMCA IN SUPPORT OF CAMP REVEILLE, A CAMP FOR UNDERSERVED CHILDREN, TO PROMOTE HEALTHY EATING AND EXERCISE. TO ADDRESS THE ADULT POPULATION, MCHS IN WAYCROSS HAS REACHED OUT TO COMMUNITY MEMBERS AND COMMUNITY ORGANIZATIONS THROUGH EDUCATIONAL TALKS, LECTURES AND PRESENTATIONS ON HEALTH ISSUES CONDUCTED BY PHYSICIANS AND CLINICAL STAFF, RAISING THE AWARENESS OF HEALTHY EATING CHOICES AMONG COMMUNITY MEMBERS. AT ALL MCHS IN WAYCROSS COMMUNITY EVENTS, A HEALTHY SNACK AND EDUCATIONAL LITERATURE ARE OFFERED TO REINFORCE OUR MISSION.ADDRESSING SMOKING/TOBACCO USAGE: TO ENCOURAGE THE DEVELOPMENT OF HEALTHY EATING HABITS AND LIFESTYLES, MCHS IN WAYCROSS WORKS WITH MEMORIAL DRIVE ELEMENTARY AND BLACKSHEAR ELEMENTARY SCHOOLS TO ENGAGE STUDENTS IN EDUCATION PROGRAMS ABOUT THE DANGERS OF OBESITY AND TOBACCO USE. AN ADDITIONAL GOAL OF THESE EFFORTS IS TO ENCOURAGE STUDENTS TO STRESS THE IMPORTANCE OF HEALTHY LIFESTYLES TO THEIR PARENTS.MCHS IN WAYCROSS' RESPIRATORY DEPARTMENT COLLABORATES WITH WARE AND PIERCE COUNTY SCHOOL SYSTEMS TO OFFER EDUCATION ON SMOKING AND GENERAL TOBACCO USE AS AN ONGOING PUBLIC EDUCATION PROGRAM THAT IS OFFERED TO ALL RESPIRATORY PATIENTS AND THEIR FAMILIES REGARDLESS OF A REPORTED INCIDENCE OF SMOKING. ALL PATIENTS ARE PRESENTED WITH A DISCHARGE PACKET REGARDING THE USE OF TOBACCO AND SMOKING, WHICH FURTHER ASSISTS COMMUNITY MEMBERS IN QUITTING AND/OR NEVER STARTING TO USE TOBACCO.MCHS IN WAYCROSS IS A SMOKE FREE CAMPUS.ADDRESSING HEALTH CARE ACCESS AND COST: INCREASING ACCESS TO HEALTH CARE IS A CHALLENGING GOAL GIVEN LIMITED RESOURCES AND STRONG DEMAND. IN RESPONSE, MCHS IN WAYCROSS HAS RECRUITED NEW PHYSICIANS AND PHYSICIAN ASSISTANTS TO EXPAND SERVICES OFFERED AT OUR FACILITY, AND COMMUNICATED THE AVAILABILITY OF MCHS IN WAYCROSS SERVICES TO COMMUNITY LEADERS AND CITIZENS. MCHS IN WAYCROSS PHYSICIANS AND CLINICAL STAFF HAVE ALSO MADE MANY HEALTH EDUCATION PRESENTATIONS TO THE COMMUNITY. NEEDS THAT ARE NOT BEING ADDRESSED: SUBSTANCE ABUSE AND MENTAL HEALTH WERE MENTIONED BY MANY FOCUS GROUP AND INTERVIEW PARTICIPANTS AS A SIGNIFICANT HEALTH ISSUE IN WARE AND PIERCE COUNTIES. ALTHOUGH THERE IS LITTLE SECONDARY DATA TO SUPPORT THESE CONCERNS, IT IS APPARENT THAT TREATMENT OPTIONS TO ADDRESS THIS HEALTH ISSUE ARE LIMITED. DUE TO SEVERAL FACTORS, INCLUDING A LIMITED OPPORTUNITY TO INTERVENE AT THE PREVENTION LEVEL, RELATIVELY LOW EXPECTED EFFECTIVENESS OF POSSIBLE INTERVENTIONS, AND LACK OF COMPETENCY TO ADDRESS THESE NEEDS BEYOND THE SERVICES PROVIDED THROUGH ITS SENIOR BEHAVIORAL UNIT, MAYO CLINIC HEALTH SYSTEM IN WAYCROSS BELIEVES IT IS MOST APPROPRIATE TO FOCUS ITS EFFORTS ON OBESITY, SMOKING/TOBACCO CESSATION AND ACCESS TO HEALTH CARE.

MAYO CLINIC HEALTH SYSTEM IN WAYCROSS
PART V, SECTION B, LINE 13B: MEDICAL INDIGENCY MAY BE USED TO DETERMINE ELIGIBILITY. IF A PATIENT BALANCE EXCEEDS 25% OF THE ANNUAL HOUSEHOLD INCOME, BUT THE PATIENT DOES NOT QUALIFY BASED ON FPG, CHARITY WILL BE ADJUSTED TO A MINIMUM OF THE AMOUNT GENERALLY BILLED (AGB). THE AGB IS DETERMINED USING THE LOOK-BACK METHOD AND CALCULATED USING ALL CLAIMS ALLOWED BY PRIVATE PAY INSURERS (INCLUDING MEDICARE ADVANTAGE) AND MEDICARE (TRADITIONAL) FOR INPATIENT AND OUTPATIENT SERVICES.

MAYO CLINIC HEALTH SYSTEM IN WAYCROSS
PART V, SECTION B, LINE 13H: THE REGIONAL PROXIMITY OF A PATIENT'S RESIDENCY IS A FACTOR FOR PRESCHEDULED SERVICES ONLY AND SECONDARY TO MEDICAL NEED. REGIONAL PROXIMITY IS NOT A FACTOR FOR EMERGENCY CARE PROVIDED.

MAYO CLINIC HEALTH SYSTEM IN WAYCROSS
PART V, SECTION B, LINE 15E: REFER PATIENT TO APPLY FOR MEDICAL ASSISTANCE PROGRAMS.

MAYO CLINIC HEALTH SYSTEM IN WAYCROSS
PART V, SECTION B, LINE 16J: UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE ARE DISCUSSED WITH THE PATIENT.

MAYO CLINIC HEALTH SYSTEM IN WAYCROSS
PART V, SECTION B, LINE 20E: FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE TO EVERY PATIENT VIA MAYO'S PUBLIC WEBSITE, FROM CUSTOMER SERVICE AND PATIENT ACCESS LOCATIONS, AND IS REFERENCED ON MAYO'S AUTHORIZATION FORMS, STATEMENTS, AND LETTERS. IN ADDITION, BROCHURES ARE AVAILABLE IN THE ADMISSIONS AREA AND THE PROCESS OF HOW TO APPLY IS AVAILABLE ON THE MAYO CLINIC WEBSITE.UPON ADMISSION, IF THE PATIENT DOES NOT HAVE INSURANCE OR EXPRESSES AN INABILITY TO PAY, MAYO DISCUSSES ALL AVAILABLE OPTIONS INCLUDING STATE AND FEDERAL FUNDING AS WELL AS CHARITY CARE.MONTHLY STATEMENTS ARE SENT TO PATIENTS THAT OUTLINE CURRENT CHARGES AND ACTIONS WITH INSURANCE AND INCLUDES INFORMATION ABOUT MAYO'S CHARITY CARE POLICY. SOME MAYO SITES UTILIZE ADVOCATES TO CONTACT THE PATIENT UPON DISCHARGE TO HELP THEM SECURE GOVERNMENTAL ASSISTANCE OR FINANCIAL ASSISTANCE.EACH CHARITY CARE REVIEW IS DOCUMENTED IN MAYO'S BILLING SYSTEM AND COMMUNICATED TO THE PATIENT. COMPLETED CHARITY CARE FORMS ARE MAINTAINED EITHER IN PAPER OR ELECTRONIC FORMAT. THE PATIENT IS INFORMED REGARDING THE OUTCOME OF THE REVIEW.MAYO OFTEN IDENTIFIES CHARITY CARE OPPORTUNITIES AFTER THE PATIENT HAS BEEN DISMISSED. IN MANY CASES, THIS IS DUE TO LIMITED INSURANCE COVERAGE OR INSURANCE DENIALS AFTER THE SERVICE WAS PERFORMED. IN THESE CASES, WHEN A PATIENT EXPRESSES AN INABILITY TO PAY FOR THEIR SERVICES, STAFF WILL INITIATE A CHARITY REVIEW AS INDICATED BY THE FINANCIAL ASSISTANCE POLICY, WHICH IS AVAILABLE FOR EVERY PATIENT AT MAYOCLINIC.ORG.

PART I, LINE 3C:
MEDICAL INDIGENCY MAY BE USED TO DETERMINE ELIGIBILITY. IF A PATIENT BALANCE EXCEEDS 25% OF THE ANNUAL HOUSEHOLD INCOME, BUT THE PATIENT DOES NOT QUALIFY BASED ON FPG, CHARITY WILL BE ADJUSTED TO A MINIMUM OF THE AMOUNT GENERALLY BILLED (AGB). THE AGB IS DETERMINED USING THE LOOK-BACK METHOD AND CALCULATED USING ALL CLAIMS ALLOWED BY PRIVATE PAY INSURERS (INCLUDING MEDICARE ADVANTAGE) AND MEDICARE (TRADITIONAL) FOR INPATIENT AND OUTPATIENT SERVICES

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

PART I, LINE 7G:
THE FOLLOWING NET COMMUNITY BENEFIT COST ATTRIBUTED TO A PHYSICIAN CLINIC WAS INCLUDED AS SUBSIDIZED HEALTH SERVICES: $211,318.

PART I, LINE 7, COLUMN (F)
THE ORGANIZATION IS USING THE TOTAL EXPENSES FOR JANUARY THROUGH APRIL WHEN CALCULATING THE PERCENT OF TOTAL EXPENSES. THIS AMOUNT REFLECTS THE EXPENSES OF THE ORGANIZATION WHILE OPERATING THE HOSPITAL.

PART III, LINE 2:
BAD DEBT EXPENSE IS DETERMINED BASED ON GAAP AND IS EXPLAINED IN THE ACCOUNTS RECEIVABLE FOOTNOTE OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS.

PART III, LINE 4:
PLEASE SEE NOTE 2 ON PAGE 10 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.

PART III, LINE 8:
THE MEDICARE SHORTFALL REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATION'S MEDICARE COST REPORT (USING A MEDICARE COST REPORT STEP-DOWN METHODOLOGY).

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

PART VI, LINE 2:
"MAYO CLINIC HEALTH SYSTEM IN WAYCROSS' EFFORTS TO ASSESS THE HEALTH CARE NEEDS OF ITS LOCAL COMMUNITY RESTS ON FOUR GUIDING PRINCIPLES DEVELOPED IN CONJUNCTION WITH COMMUNITY PARTNERS AND AFFIRMED BY MAYO CLINIC LEADERSHIP:1. HEALTH IS VALUED BY BOTH THE COMMUNITY AND MAYO CLINIC.2. ""HEALTH"" IS DETERMINED BY BOTH MEDICAL AND NON-MEDICAL (E.G., SOCIAL AND BEHAVIORAL) FACTORS AND BOTH CATEGORIES OF FACTORS MUST BE ADDRESSED.3. MAYO CLINIC IS COMMITTED TO PRODUCING MEASURABLE IMPROVEMENTS IN THE HEALTH OF LOCAL COUNTY RESIDENTS AND BEYOND.4. STRATEGIES TO IMPROVE COMMUNITY HEALTH ARE BEST DETERMINED AND IMPLEMENTED THROUGH PARTNERSHIPS BETWEEN HEALTH CARE PROVIDERS AND COMMUNITY MEMBERS.WITH THESE PRINCIPLES AS THE BASIS OF ITS DECISION MAKING, AND CONSISTENT WITH ITS PRIMARY VALUE OF ""THE NEEDS OF THE PATIENT COME FIRST"", MAYO CLINIC HEALTH SYSTEM IN WAYCROSS' APPROACH TO ASSESS THE NEEDS OF THE COMMUNITY IS ORGANIZED INTO TWO MAIN FUNCTIONS: 1) MECHANISMS TO ENGAGE AND UTILIZE INPUT FROM THE COMMUNITY AND 2) MECHANISMS TO SUPPORT AND COORDINATE INITIATIVES WITHIN MAYO CLINIC HEALTH SYSTEM IN WAYCROSS."

PART VI, LINE 3:
MAYO CLINIC IS COMMITTED TO OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS WHO DO NOT HAVE THE ABILITY TO PAY FOR THEIR MEDICAL SERVICES IN WHOLE OR IN PART. IN ORDER TO ACCOMPLISH THIS CHARITABLE GOAL, MAYO CLINIC AND MAYO CLINIC HEALTH SYSTEM SITES WIDELY PUBLICIZE THE FINANCIAL ASSISTANCE POLICY IN THE COMMUNITIES THAT THE INDIVIDUAL MAYO CLINIC AFFILIATED SITES SERVE. MAYO CLINIC AFFILIATED SITES MAKE COPIES OF THIS POLICY AND APPLICATIONS AVAILABLE ON THEIR WEBPAGES, INCLUDING THE ABILITY TO DOWNLOAD A COPY OF THE POLICY AND APPLICATION FREE OF CHARGE. INDIVIDUALS IN THE COMMUNITY SERVED WILL BE ABLE TO OBTAIN A COPY OF THE POLICY IN LOCATIONS THROUGHOUT EACH MAYO CLINIC AFFILIATED SITE OR UPON REQUEST IN PERSON OR BY PHONE. THE FINANCIAL ASSISTANCE POLICY (FAP) AND THE PLAIN LANGUAGE SUMMARY (PLS) EXPLAIN THE FINANCIAL ASSISTANCE PROGRAM AND OUTLINES ELIGIBILITY CRITERIA AND PROVIDES INSTRUCTIONS TO SUBMIT AN APPLICATION. WITHIN EACH HOSPITAL FACILITY, A BROCHURE IS MADE AVAILABLE IN NUMEROUS LOCATIONS THROUGHOUT THE FACILITY WHICH DESCRIBES THE FINANCIAL ASSISTANCE POLICY, HOW TO APPLY FOR FINANCIAL ASSISTANCE, AND GIVES THE INTERNET ADDRESS WHERE THE COMPLETE POLICY CAN BE OBTAINED. ADDITIONALLY, CHARITABLE CARE AND FINANCIAL ASSISTANCE IS REFERENCED ON PATIENT CORRESPONDENCE INCLUDING: THE MONTHLY STATEMENT OF ACCOUNT, ACCOUNT BALANCE LETTERS, AND LATE PAYMENT NOTIFICATIONS. ALL PATIENT CORRESPONDENCE REFERENCING CHARITABLE CARE AND FINANCIAL ASSISTANCE INCLUDE INTERNET, PHONE, AND MAILING ADDRESS CONTACT INFORMATION. PATIENTS MAY ALSO BE MADE AWARE OF THE FAP VIA THEIR PROVIDER AND/OR OTHER MAYO CLINIC EMPLOYEES, WHO CAN PUT A PATIENT IN CONTACT WITH RESOURCES AVAILABLE TO ASSIST WITH THE APPLICATION PROCESS.

PART VI, LINE 4:
MCHS IN WAYCROSS SERVES A NINE-COUNTY REGION IN SOUTHEAST GEORGIA WITH THE MAJORITY OF PATIENTS COMING FROM WARE COUNTY.DEMOGRAPHICS: BASED ON U.S. CENSUS BUREAU QUICK FACTS AS OF JULY 1, 2016, WARE COUNTY HAD AN ESTIMATED POPULATION OF 35,738, OF WHICH AN ESTIMATED 23.9% OF THE POPULATION WAS UNDER THE AGE OF 18 AND AN ESTIMATED 16.7% WAS 65 YEARS OF AGE OR OLDER. THE ESTIMATED MEDIAN HOUSEHOLD INCOME FOR 2011 TO 2015 WAS $34,747 WITH APPROXIMATELY 28.4% OF THE POPULATION BELOW THE POVERTY LEVEL.

PART VI, LINE 7
NEITHER THE FILING ORGANIZATION, NOR ANY RELATED ORGANIZATION, FILES A COMMUNITY BENEFIT REPORT WITH ANY STATE OTHER THAN THE EXTENT TO WHICH COMMUNITY BENEFIT INFORMATION IS INCLUDED IN OTHER REPORTING REQUIREMENTS SUCH AS INFORMATION PROVIDED TO A STATE HOSPITAL ASSOCIATION.

PART VI, LINE 5:
"MAYO CLINIC AND ITS AFFILIATES ARE LARGE, MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICES AND HEALTH SYSTEMS. AT MAYO CLINIC, DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF ""THE NEEDS OF THE PATIENT COME FIRST."" THE ORGANIZATIONS (INCLUDING HOSPITAL AND NON-HOSPITAL ENTITIES) WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, NATIONAL, AND GLOBAL LEVELS. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION, AND RESEARCH. SPECIFICALLY, THE TAX-EXEMPT PURPOSE OF MAYO CLINIC AND ITS AFFILIATES IS THREE-FOLD:PRACTICE - PRACTICE MEDICINE AS AN INTEGRATED TEAM OF COMPASSIONATE, MULTI-DISCIPLINARY PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS WHO ARE FOCUSED ON THE NEEDS OF PATIENTS FROM OUR COMMUNITIES, REGIONS, THE NATION AND THE WORLD.EDUCATION - EDUCATE PHYSICIANS, SCIENTISTS AND ALLIED HEALTH PROFESSIONALS AND BE A DEPENDABLE SOURCE OF HEALTH INFORMATION FOR OUR PATIENTS AND THE PUBLIC.RESEARCH - CONDUCT BASIC AND CLINICAL RESEARCH PROGRAMS TO IMPROVE PATIENT CARE AND TO BENEFIT SOCIETY, INCLUDING PARTNERING WITH MAYO CLINIC HEALTH SYSTEM PRACTICES TO PERFORM PRACTICE-BASED RESEARCH DESIGNED TO IMPROVE PATIENT CARE.THROUGH ITS MISSION, MAYO CLINIC AND ITS AFFILIATES ENRICH THE COMMUNITIES IN WHICH THEY OPERATE AS WELL AS THE BROADER COMMUNITY IMPROVING MEDICINE THROUGH RESEARCH, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROVIDERS, AND PROVIDING CARE AND SUPPORT TO PEOPLE IN NEED.PLEASE REFER TO THE PROGRAM SERVICE ACCOMPLISHMENTS ON FORM 990, PART III, FOR FURTHER DESCRIPTION OF THE FILING ORGANIZATION'S ACTIVITIES.SURPLUS FUNDS - MAYO CLINIC AND ITS AFFILIATES REINVEST THEIR NET OPERATING INCOME TO ADVANCE MEDICAL RESEARCH AND TEACH THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS, AS WELL AS TO ALLOW THE INDIVIDUAL ENTITY TO SUSTAIN ITS MISSION AND PREPARE FOR THE FUTURE.COMMUNITY REPRESENTATION ON GOVERNING BODY - THE BOARD OF TRUSTEES IS THE GOVERNING BODY OF MAYO CLINIC. A MAJORITY OF ITS MEMBERS ARE EXTERNAL, INDEPENDENT TRUSTEES. IT HAS OVERALL RESPONSIBILITY FOR THE CHARITABLE, CLINICAL PRACTICE, SCIENTIFIC AND EDUCATIONAL MISSION AND PURPOSES OF MAYO CLINIC AND ITS AFFILIATES AS SET FORTH IN ITS ARTICLES OF INCORPORATION AND BYLAWS. BECAUSE OF MAYO CLINIC'S NATIONAL PRESENCE, THESE TRUSTEES ARE SELECTED BASED ON THEIR AREAS OF EXPERTISE, EXPERIENCE, AND OTHER CRITERIA ESTABLISHED BY THE INDEPENDENT NOMINATING COMMITTEE OF THE BOARD OF TRUSTEES. AREAS OF EXPERTISE AND EXPERIENCE INCLUDE SUCH AREAS AS HEALTH CARE POLICY, RESEARCH, EDUCATION, BUSINESS, AND GOVERNMENT. MAYO CLINIC HEALTH SYSTEM IN WAYCROSS, WHICH IS CONTROLLED BY MAYO CLINIC, RELIES ON THE COMMUNITY REPRESENTATION OF THE MAYO CLINIC BOARD OF TRUSTEES TO FULFILL THIS REQUIREMENT. OPEN V. CLOSED STAFF MODEL - SEVERAL OF MAYO CLINIC'S HOSPITAL ENTITIES HAVE OBTAINED LETTER RULINGS APPROVING A STAFF MODEL IN WHICH ONLY MAYO CLINIC EMPLOYED PHYSICIANS ARE GIVEN STAFF PRIVILEGES IN ORDER TO MAINTAIN STANDARD METHODS OF PRACTICE AND PROTOCOLS. FOR THOSE ENTITIES, THE PHYSICIANS ARE SALARIED EMPLOYEES AND THUS THE ISSUE OF PRIVATE INUREMENT AND PRIVATE BENEFIT ADDRESSED BY THE OPEN STAFF REQUIREMENT ARE OTHERWISE ADDRESSED. EMERGENCY ROOM MAYO CLINIC HEALTH SYSTEM IN WAYCROSS MAINTAINS AN EMERGENCY ROOM WITHIN THE HOSPITAL FACILITY 24 HOURS A DAY, 7 DAYS A WEEK, WHICH IS OPEN TO ALL WITHOUT REGARD TO THE ABILITY TO PAY."

PART VI, LINE 6:
"MAYO CLINIC IS THE FIRST AND LARGEST INTEGRATED, NOT-FOR-PROFIT GROUP PRACTICE IN THE WORLD. DOCTORS FROM EVERY MEDICAL SPECIALTY WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF ""THE NEEDS OF THE PATIENT COME FIRST."" MORE THAN 4,500 STAFF PHYSICIANS AND SCIENTISTS AND OVER 58,000 ADMINISTRATIVE AND ALLIED HEALTH STAFF WORK AT MAYO CLINIC, WHICH HAS SITES IN ROCHESTER, MINNESOTA, JACKSONVILLE, FLORIDA, AND SCOTTSDALE/PHOENIX, ARIZONA, AS WELL AS A REGIONAL NETWORK OF HOSPITALS AND CLINICS IN MINNESOTA, WISCONSIN, IOWA, AND GEORGIA. COLLECTIVELY, MORE THAN 1.3 MILLION PEOPLE ARE TREATED EACH YEAR. MAYO CLINIC AND ITS AFFILIATES PROVIDE ONE OR MORE OF THE FOLLOWING SERVICES AT THEIR RESPECTIVE LOCATIONS: MEDICAL EDUCATION, RESEARCH, HOSPITAL AND CLINIC SERVICES."