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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
HENNEPIN HEALTHCARE SYSTEM INC
 
Employer identification number
42-1707837
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) CHILDREN HOSPITAL & CLINICS OF MINNESOTA
2525 CHICAGO AVE SOUTH
MINNEAPOLIS,MN55404 		41-1754276 501(C)(3) 511,452       EMERGENCY PREPAREDNESS
(2) HENNEPIN HEALTHCARE RESEARCH INSITUTE
701 PARK AVE PP7700
MINNEAPOLIS,MN55415 		41-1677920 501(C)(3) 389,000       RESEARCH PROGRAM SUPPORT
(3) HEALTHPARTNERS INSTITUTE
8170 33RD AVENUE SOUTH
BLOOMINGTON,MN554254516 		41-1670163 501(C)(3) 177,865       EMERGENCY PREPAREDNESS
(4) FAIRVIEW HEALTH SERVICES
333 NORTH SMITH AVENUE
ST PAUL,MN55102 		36-3261413 501(C)(3) 116,264       EMERGENCY PREPAREDNESS
(5) REGENTS OF THE UNIVERSITY OF MINNESOTA
NW 5960 PO BOX 1450
MINNEAPOLIS,MN554855960 		41-6007513 501(C)(3) 99,907       EDUCATION
(6) ALLINA HEALTH SYSTEM
PO BOX 43
MINNEAPOLIS,MN55440 		36-3261413 501(C)(3) 84,407       EMERGENCY PREPAREDNESS FOR MERCY HOSPITAL, UNITY HOSPITAL, & REGINA MEDICAL CENTER
(7) MASA CONSULTING INC
13033 RIDGEDALE DRIVE SUITE 112
MINNEAPOLIS,MN553051807 		41-1910796   45,405       EMERGENCY PREPAREDNESS
(8) HENNEPIN COUNTY
300 S 6TH STREET
MINNEAPOLIS,MN55487 		41-6005801 GOVERNMENT 32,917       PCA ASSESSMENT
(9) PATTERSON DENTAL
1031 MENDOTA HEIGHTS ROAD
ST PAUL,MN55120 		41-1833619 501(C)(3) 28,185       DENTISTRY CLINIC
(10) REGIONS HOSPITAL
640 JACKSON STREET
ST PAUL,MN55369 		41-0956618 501(C)(3) 22,205       EMERGENCY PREPAREDNESS
(11) LAKEVIEW HOSPITAL
927 W CHURCHILL STREET
STILLWATER,MN55082 		41-0811697 501(C)(3) 22,131       EMERGENCY PREPAREDNESS
(12) PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BOULEVARD
ST LOUIS PARK,MN55426 		41-0132080 501(C)(3) 20,845       EMERGENCY PREPAREDNESS
(13) MAYO CLINIC HEALTH SYSTEM NEW PRAGUE
301 SECOND STREET NE
NEW PRAGUE,MN56071 		41-0723639 501(C)(3) 20,675       EMERGENCY PREPAREDNESS
(14) ST FRANCIS REGIONAL MEDICAL CENTER
1455 ST FRANCIS AVENUE
SHAKOPEE,MN55379 		41-0907986 501(C)(3) 20,622       EMERGENCY PREPAREDNESS
(15) ABBOTT NORTHWESTERN HOSPITAL
800 E 29TH STREET
MINNEAPOLIS,MN55407 		36-3261413 501(C)(3) 19,954       EMERGENCY PREPAREDNESS
(16) NORTH MEMORIAL HEALTH CARE
701 PARK AVENUE SOUTH
MINNEAPOLIS,MN55415 		41-0729979 501(C)(3) 19,914       EMERGENCY PREPAREDNESS
(17) MAPLE GROVE HOSPITAL CORPORATION
9875 HOSPITAL DRIVE
MAPLE GROVE,MN55369 		20-8316475 501(C)(3) 19,588       EMERGENCY PREPAREDNESS
(18) NORTHFIELD HOSPITAL
2000 NORTH AVENUE
NORTHFIELD,MN55057 		41-6038368 501(C)(3) 19,300       EMERGENCY PREPAREDNESS
(19) HEALTHEAST WOODWINDS HOSPITAL
NW 7205 PO BOX 1450
MINNEAPOLIS,MN55485 		36-3517697 501(C)(3) 17,587       EMERGENCY PREPAREDNESS
(20) HENRY SCHEIN PRACTICE SOLUTIONS
DEPT CH 14200
PALATINE,IL600554200 		87-0426590   15,000       DENTISTRY CLINIC
(21) DENTSPLY TULSA DENTAL SPECIALTIES
5100 E SKELLY DR STE 300
TULSA,OK74135 		23-2830736   9,454       DENTISTRY CLINIC
(22) RIDGEVIEW MEDICAL CENTER
500 SOUTH MAPLE STREET
WACONIA,MN55387 		31-1667875 501(C)(3) 8,423       FAMILY HEALTH
(23) GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
200 E UNIVERSITY AVE
ST PAUL,MN55101 		36-3379150 501(C)(3) 7,199       EMERGENCY PREPAREDNESS
(24) PRAIRIECARE LLC
9400 ZANE AVE NORTH
BROOKLYN PARK,MN55443 		26-1545791   6,577       EMERGENCY PREPAREDNESS
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
20
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
4
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020
Page 2

Schedule I (Form 990) 2020
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS: THE HENNEPIN HEALTHCARE FOUNDATION RAISES AND ADMINISTERS PHILANTHROPIC SUPPORT FOR HENNEPIN HEALTHCARE SYSTEM, INC. THE SUPPORT INCLUDES A GRANT MANAGEMENT DEPARTMENT WHICH COORDINATES THE TASK OF MONITORING GRANT RECEIPTS AND GRANT DISBURSEMENTS FROM FEDERAL, STATE, LOCAL OR INDIVIDUAL BENEFICIARIES. THE HENNEPIN HEALTHCARE FOUNDATION WORKS CLOSELY WITH HHS TO ENSURE PROPER CONTROLS ARE IN PLACE BY USE OF RECONCILIATIONS AND COMPLIANCE MONITORING AND REPORTING.
Schedule I (Form 990) 2020



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