2024-05-15T15:15:39-05:00 2023-06-30 861065772 DELOITTE TAX LLP 111 S WACKER DRIVE CHICAGO IL 60606 990 2022-07-01 411813221 CENTRACARE HEALTH SYSTEM CENT 3202512700 1406 6TH AVENUE NORTH ST CLOUD MN 56303 MICHAEL A BLAIR CFO/TREASURER 3202512700 2024-05-14 1 MICHAEL BLAIR 999009999 0 MONIKA YADAV P01473820 3124861000 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z KENNETH D HOLMEN MD 1406 6TH AVENUE NORTH ST CLOUD MN 56303 606298184 0 X WWW.CENTRACARE.COM X 1995 MN INTEGRATED MULTI-ORGANIZATIONAL HEALTH CARE SYSTEM DESIGNED TO PROVIDE ACCESS TO QUALITY HEALTH CARESERVICES AT AN AFFORDABLE PRICE. 13 8 15425 265 1430532 461869 12396639 5644170 492064992 551776656 9603783 23802359 108868131 15266198 622933545 596489383 986934 490166 0 0 261249843 296258866 0 0 0 210014214 225410923 472250991 522159955 150682554 74329428 913072774 1066347810 574209803 624465810 338862971 441882000 X WE'RE HERE FOR YOUR WHOLE LIFE TO LISTEN, THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING. 0 0 175786239 384078 204562168 CENTRACARE HEALTH SYSTEM (CCHS) IS AN INTEGRATED HEALTH SYSTEM, INCLUDING COMPRISED OF SEVEN CRITICAL ACCESS HOSPITALS, TWO ACUTE CARE HOSPITALS, A MULTI-SPECIALITY CLINIC, SURGICAL CENTER, RETAIL PHARMACY NETWORK, NURSING HOME AND A FOUNDATION. CCHS SERVES ITS PATIENTS IN SIX MAIN AREAS.CENTRACARE LABORATORY SERVICES ALL HOSPITALS UNDER ITS UMBRELLA AS WELL AS CENTRACARE CLINIC. IT ALSO PERFORMS TESTS FOR VARIOUS FACILITIES IN THE REGION. CENTRACARE LABORATORY PERFORMED 2,153,466 TESTS IN FISCAL YEAR 2023. IN FISCAL YEAR 2023 CENTRACARE LABORATORY GENERATED $189,567,294 OF PROGRAM REVENUE AND INCURRED $163,820,132 OF PROGRAM EXPENSE. CENTRACARE SURGICAL CENTER PROVIDES ELECTIVE SURGERY PROCEDURES TO PATIENTS IN THE CENTRAL MN REGION. IN FY 2023, THE CENTER PERFORMED 6,698 SURGERIES AND GENERATED $14,994,875 OF PROGRAM REVENUE AND $11,966,108 OF PROGRAM EXPENSE. 144577607 73007 203760116 CARRIS HEALTH, LLC IS CONSIDERED A DISREGARDED ENTITY OF CCHS FOR PURPOSES OF 990 REPORTING. CARRIS HEALTH, LLC INCLUDES THE SUBSIDIARY CENTRACARE HEALTH RICE MEMORIAL HOSPITAL, WHICH HAS 136 LICENSED BEDS. DURING FISCAL YEAR 2023 RICE MEMORIAL HOSPITAL CARED FOR 2,422 INPATIENT ADMISSIONS WITH 8,231 ASSOCIATED PATIENT DAYS. INPATIENT SERVICES INCLUDE MEDICAL AND SURGICAL CARE, BIRTHING SERVICES, PEDIATRIC SERVICES, BEHAVIORAL HEALTH CARE SERVICES, AND REHABILITATION SERVICES. OUTPATIENT ENCOUNTERS DURING FISCAL YEAR 2023 WERE 95,105 AND INCLUDED EMERGENCY ROOM SERVICES, DIALYSIS, IMAGING, RESPIRATORY THERAPY, A REHABILITATION CENTER, SAME DAY SURGERY AND OTHER AMBULATORY CARE SERVICES. CARRIS HEALTH ALSO OFFERS A CERTIFIED SKILLED NURSING FACILITY LOCATED IN WILLMAR, MN WITH 78 LICENSED BEDS. CARRIS HEALTH HAS REALIZED 21,785 RESIDENT DAYS IN THE LONG TERM CARE AND SHORT TERM THERAPY SUITES AREAS OF THE FACILITY DURING FISCAL YEAR 2023. CARRIS HEALTH ALSO HAS AN ACCREDITED AMBULATORY SURGICAL CENTER LOCATED IN WILLMAR, MN. CARRIS HEALTH SURGICAL CENTER COMPLETED 7,100 OUTPATIENT (SAME DAY) PRODECURES. IN FISCAL YEAR 2023 CARRIS HEALTH GENERATED $147,848,717 OF PROGRAM REVENUE AND $106,579,671 OF PROGRAM EXPENSE.CARRIS HEALTH, LLC INCLUDES THE SUBSIDIARY CARRIS HEALTH - REDWOOD AREA HOSPITAL, WHICH IS A 25 BED CRITICAL ACCESS HOSPITAL. DURING FISCAL YEAR 2023 THEY HAD 524 INPATIENT ADMISSIONS WITH 1,572 ASSOCIATED PATIENT DAYS, 51,493 OUTPATIENT VISITS AND 5,305 EMERGENCY ROOM VISITS. IN FISCAL YEAR 2023, REDWOOD GENERATED $55,911,399 OF PROGRAM REVENUE AND $37,997,936 OF PROGRAM EXPENSE. 66565529 30401 98601112 CENTRACARE HEALTH - MONTICELLO HOSPITAL IS CONSIDERED A DISREGARDED ENTITY FOR PURPOSES OF 990 REPORTING, THUS IT IS INCLUDED WITH THIS 990 FILING. MONTICELLO HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL AND ALSO OPERATES A 10 BED ACUTE GERIATRIC PSYCHIATRIC UNIT. IN FISCAL YEAR 2023, THEY HAD 5,051 PATIENT DAYS, 45,114 OUTPATIENT VISITS AND 15,840 EMERGENCY ROOM VISITS' WHICH GENERATED $98,601,112 OF PROGRAM REVENUE AND $66,565,529 OF PROGRAM EXPENSE. 29607875 2680 43236150 CENTRACARE HEALTH - PAYNESVILLE HOSPITAL IS CONSIDERED A DISREGARDED ENTITY FOR PURPOSES OF 990 REPORTING, THUS IT IS INCLUDED WITH THIS 990 FILING. CENTRACARE HEALTH - PAYNESVILLE HOSPITAL IS A 25 BED CRITICAL ACCESS HOSPITAL. IN FISCAL YEAR 2023 THEY HAD 2,227 PATIENT DAYS, 45,929 OUTPATIENT VISITS AND 4,879 EMERGENCY ROOM VISITS. IN FISCAL YEAR 2023, PAYNESVILLE GENERATED $43,236,150 OF PROGRAM REVENUE AND $29,607,875 OF PROGRAM EXPENSE. 6637725 9445343 BENSON HOSPITAL WAS ACQUIRED BY CENTRACARE HEALTH SYSTEM IN JANUARY OF 2023. CENTRACARE HEALTH - BENSON HOSPITAL IS CONSIDERED A DISREGARDED ENTITY FOR PURPOSES OF 990 REPORTING, THUS IT IS INCLUDED WITH THIS 990 FILING. CENTRACARE HEALTH - BENSON HOSPITAL IS A 21 BED CRITICAL ACCESS HOSPITAL. IN THE SIX MONTHS OF FISCAL YEAR 2023 THEY HAD 201 PATIENT DAYS, 10,797 OUTPATIENT VISITS AND 905 EMERGENCY ROOM VISITS. IN THE SIX MONTHS OF FISCAL YEAR 2023, BENSON GENERATED $9,445,343 OF PROGRAM REVENUE AND $6,637,725OF PROGRAM EXPENSE. 36245600 2680 52681493 423174975 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 0 1 569 0 1 15425 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 13 8 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 MN X MICHAEL BLAIR 3202512700 1406 6TH AVENUE NORTH ST CLOUD MN 56303 KENNETH HOLMEN PRESIDENT/CEO 7.00 33.00 X X 1695149 0 66805 CHRISTIAN SCHMIDT DIRECTOR 36.00 4.00 X 533299 0 75411 BRYAN ROLPH DIRECTOR 36.00 4.00 X 536482 0 2519 RICHARD WEHSELER DIRECTOR 36.00 4.00 X 415417 0 53982 DAVID ANFINSON VICE CHAIR 1.00 1.00 X X 33500 0 0 STEVE LARAWAY BOARD CHAIR 1.00 1.00 X X 31500 0 0 TIM WENSMAN DIRECTOR 1.00 1.00 X 14638 0 0 JEFF GAU DIRECTOR 1.00 1.00 X 12000 0 0 MICHELLE JOHNSON DIRECTOR 1.00 1.00 X 10000 0 0 RENEE FRAUENDIENST DIRECTOR 1.00 3.00 X 0 10000 0 DAN ABDUL DIRECTOR 1.00 1.00 X 8000 0 0 JAMES HEBL DIRECTOR 1.00 1.00 X 4000 0 0 FATHER TOM KNOBLACH DIRECTOR 1.00 1.00 X 0 0 0 JOY PLAMANN COO/SR VP 7.00 33.00 X 820436 0 40069 MICHAEL BLAIR CFO/SR VP/ TREASURER 7.00 33.00 X 707279 0 73386 SANTO CRUZ CLO/SR VP/ SECRETARY 7.00 33.00 X 534452 0 51904 JOSEPH BLONSKI VICE PRESIDENT 20.00 20.00 X 783635 0 53772 THOMAS SCHRUP CPO/EVP 20.00 20.00 X 778663 0 56287 CINDY FIRKINS SMITH VICE PRESIDENT 40.00 0.00 X 760562 0 56068 JOSEPH KALKMAN CAO/SR VP 20.00 20.00 X 695205 0 75913 CHRISTOPHER BOELTER VICE PRESIDENT 20.00 20.00 X 662072 0 1836 MARIA MALLORY VICE PRESIDENT 20.00 20.00 X 585316 0 39699 AMY PORWOLL CISO/SR VP 8.00 32.00 X 570663 0 46279 GEORGE MORRIS VICE PRESIDENT 40.00 0.00 X 554883 0 54766 DEBRA PETERSON VICE PRESIDENT 40.00 0.00 X 502740 0 39286 KATHLEEN PARSONS VICE PRESIDENT 40.00 0.00 X 452084 0 71762 LYNN MCFARLING VICE PRESIDENT 40.00 0.00 X 418017 0 69145 JOSEPH HELLIE VICE PRESIDENT 40.00 0.00 X 418016 0 52438 ULRIKA WIGERT VICE PRESIDENT 40.00 0.00 X 420765 0 47282 DIANE BUSCHENA-BRENNA VICE PRESIDENT 20.00 20.00 X 383630 0 74061 DAVID LARSON VICE PRESIDENT 40.00 0.00 X 396632 0 47918 ANTHONY GARDNER CMCO/SR VP 8.00 32.00 X 393247 0 38169 BRADLEY KONKLER VICE PRESIDENT 40.00 0.00 X 381533 0 36778 MATTHEW KUNKEL VICE PRESIDENT 20.00 20.00 X 360056 0 37151 PHILIP LUITJENS VICE PRESIDENT 20.00 20.00 X 345215 0 40019 ZACHARY BORK VICE PRESIDENT 40.00 0.00 X 272271 0 29525 LEAH SCHAMMEL PHYSICIAN 40.00 0.00 X 1127625 0 72432 NATHANIEL SLINKARD PHYSICIAN 40.00 0.00 X 1048684 0 48608 DEXTER CASTA PHYSICIAN 40.00 0.00 X 902460 0 40516 SASAN MOSHIRZADEH PHYSICIAN 40.00 0.00 X 831976 0 52665 TOD SPEER PHYSICIAN 40.00 0.00 X 769609 0 66464 CRAIG BROMAN FORMER OFFICER 0.00 0.00 X 384531 0 0 JOHN HERING FORMER KEY EMPLOYEE 40.00 0.00 X 486729 0 77807 MICHAEL SCHRAMM FORMER KEY EMPLOYEE 40.00 0.00 X 476504 0 53059 21519475 10000 1743781 1934 1 1 0 M A MORTENSON COMPANY 700 MEADOW LANE N MINNEAPOLIS MN 55422 CONSTRUCTION 13876374 MAHOWALD INSURANCE AGENCY 916 W ST GERMAIN STREET SUITE 100 ST CLOUD MN 56301 INSURANCE 10527063 MEDLINE INDUSTRIES LP DEPT CH 14400 PALATINE IL 600554400 SUPPLIES 6336060 METRO ANESTHESIA CONSULTANTS 9855 AETNA AVE NE MONTICELLO MN 55362 STAFFING SERVICES 1853739 STELLIS HEALTH PA 1700 HIGHWAY 25 N BUFFALO MN 55313 STAFFING SERVICES 1747885 60 1127772 4061470 454928 5644170 PATIENT & SERVICE REV. 621110 498073028 496817863 1255165 HEALTH INS. PREMIUMS 621110 33633060 33633060 SHARED SERVICES REV. 621110 9264396 9123282 141114 10806172 10772565 33607 551776656 22451549 22451549 11620199 6517992 5102207 5102207 5102207 2105021 754211 1350810 1350810 1350810 4872356 2536598 2335758 2335758 OTHER SERVICES SOLD 900099 9977554 9977554 MISC NON-OPERATING REV 900099 745560 744914 646 LOSS ON JOINT VENTURE 900099 -2894881 -2894881 7828233 596489383 558174357 1430532 31240324 418894 418894 71272 71272 13482248 10191464 3290784 993118 750715 242403 220973355 167037574 53935781 18086469 13671874 4414595 20234521 15295624 4938897 22489155 16999941 5489214 3005351 2271797 733554 344114 260122 83992 25308477 24357777 950700 632879 478404 154475 3889485 2940129 949356 17088419 12917431 4170988 3845636 2906983 938653 945946 715057 230889 1699734 1284858 414876 4814315 3639224 1175091 23837446 18019137 5818309 2979252 2252068 727184 DRUGS/MEDICAL SUPPLIES 79188988 79188988 EQUIPMENT RENT & MAINT. 35047493 26493005 8554488 IMPLICIT PRICE CONCES. 8197011 8197011 MEDICAID/MNCARE 7331662 7331662 7254715 5483964 1770751 522159955 423174975 98984980 0 7739 8453 101288005 72105431 87732875 98761423 9122997 7991327 18277021 16241947 512402062 236185969 262128561 276216093 222447929 579952295 212067647 15070841 913072774 1066347810 104198958 84776627 3279325 3913656 398434616 377807799 46344121 42869277 21952783 115098451 574209803 624465810 X 334948341 437729121 3914630 4152879 338862971 441882000 913072774 1066347810 X 74329428 17000293 11689308 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 0 0 1 81508 81508 0 PART II-B, LINE 1: CENTRACARE HEALTH SYSTEM PAID $81,508 TO STATE AND NATIONAL ASSOCIATIONS TO CONDUCT LOBBYING ACTIVITIES ON ITS BEHALF, AS A MEMBER OF THE ASSOCIATION 19947717 19947717 344843405 144511778 200331627 8352842 6329253 2023589 139117008 85344938 53772070 141090 141090 276216093 FUNDS HELD BY TRUSTEE UNDER TRUST AND ESCROW AGREEMENT 4031726 F FUNDS HELD BY TRUSTEE UNDER BOND INDENTURES 28007317 F FUNDS HELD BY BOARD FOR FUTURE PROPERTY & EQUIP 530012655 F INVESTMENT IN JOINT VENTURES 15976127 F INVESTMENT IN MUTUAL SERVICE CORP 1924470 F 579952295 THIRD PARTY PAYOR SETTLEMENTS 4603799 INTEREST PAYABLE 2792729 LEASE LIABILITY 10932534 ASSET RETIREMENT OBLIGATION 422847 CONTINGENT CONSIDERATION 1356526 OTHER LONG TERM LIABILITIES 5811951 DUE FROM AFFILIATES 89178065 115098451 1 1 X 1 X 175.000000000000 1 X 1 1 1 0 1 1 542787 542787 0.00110 58522976 45547883 12975093 0.02520 59065763 45547883 13517880 0.02630 81772 81772 0.00020 902165 571248 330917 0.00060 32 32 0.00000 3428 3428 0.00000 987397 571248 416149 0.00080 60053160 46119131 13934029 0.02710 5756 5756 0.00000 5756 5756 0.00000 1 5742238 0 64631919 69687975 -5056056 X 1 1 5 1 CENTRACARE HEALTH - MONTICELLO 1013 HART BLVD MONTICELLO MN 55362 WWW.CENTRACARE.COM/LOCATIONS/MONTICELL 414809 X X X X DISTINCT PSYCH UNIT 2 CENTRACARE HEALTH - PAYNESVILLE 200 WEST FIRST STREET PAYNESVILLE MN 56362 WWW.CENTRACARE.COM/LOCATIONS/PAYNESVIL 414924 X X X X 3 CENTRACARE - RICE MEMORIAL HOSPITAL 301 BECKER AVE SW WILLMAR MN 56201 HTTPS://WWW.CENTRACARE.COM/LOCATIONS/C 415093 X X X 4 CENTRACARE - REDWOOD AREA HOSPITAL 100 FALLWOOD ROAD REDWOOD FALLS MN 56283 HTTPS://WWW.CENTRACARE.COM/LOCATIONS/C 414903 X X X 5 CENTRACARE HEALTH - BENSON 1815 WISCONSIN AVE BENSON MN 56215 HTTPS://WWW.CENTRACARE.COM/LOCATIONS/C 415503 X X X X CENTRACARE HEALTH - MONTICELLO 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X SEE SECTION C SUPPLEMENTAL INFORMATION X 1 21 1 SEE SECTION C SUPPLEMENTAL INFORMATION 0 1 X 175.000000000000 250.000000000000 X X 1 1 X X X 1 X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X 1 X 0 0 CENTRACARE HEALTH - PAYNESVILLE 2 0 0 1 X X X X X X X X X X 21 1 1 1 1 X SEE SECTION C SUPPLEMENTAL INFORMATION X 1 21 1 SEE SECTION C SUPPLEMENTAL INFORMATION 0 1 X 175.000000000000 250.000000000000 X X 1 1 X X X 1 X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X 1 X 0 0 CENTRACARE - RICE MEMORIAL HOSPITAL 3 0 0 0 1 1 100000 1 X 175.000000000000 250.000000000000 X X 1 1 X X X 1 X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X 1 X 0 0 CENTRACARE - REDWOOD AREA HOSPITAL 4 0 0 0 1 1 100000 1 X 175.000000000000 250.000000000000 X X 1 1 X X X 1 X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X 1 X 0 0 CENTRACARE HEALTH - BENSON 5 0 1 0 0 1 X 175.000000000000 250.000000000000 X X 1 1 X X X 1 X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X WWW.CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X 1 X 0 0 CENTRACARE HEALTH - BENSON PART V, SECTION B, LINE 2: BENSON HOSPITAL WAS ACQUIRED BY CENTRACARE HEALTH SYSTEM AS OF JANUARY 1, 2023. PRIOR TO THE ACQUISITION BENSON HOSPITAL WAS A GOVERNMENTAL HOSPITAL. CENTRACARE HEALTH - PAYNESVILLE PART V, SECTION B, LINE 3J: CENTRACARE UTILIZED THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) PROCESS TO CONDUCT THE CHNA AND PREPARE THE IMPLEMENTATION STRATEGY WHICH WE CALLED THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE MAPP PROCESS INCLUDES A LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, STAKEHOLDER INTERVIEWS, COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH THREE COUNTY PUBLIC HEALTH DEPARTMENTS, AND SEVERAL COMMUNITY MEETINGS TO GATHER INFORMATION ON FORCES THAT CREATE HEALTH, TRENDS, FACTORS AND EVENTS AFFECTING HEALTH, AND STRATEGIES TO OVERCOME BARRIERS TO HEALTHY LIVING. THE CHNA INCLUDED A HEALTH EQUITY ASSESSMENT AND INFORMATION ON NATIONAL, STATE, AND OTHER LOCAL PLANNING PROCESSES RELATED TO HEALTH.AS A FOLLOW UP TO A PRIOR CHNA PROCESS WHERE PUBLIC HEALTH DATA WAS A SIGNIFICANT GAP, THIS CHNA AND SUBSEQUENT CHIP WAS A COLLABORATIVE EFFORT EXECUTED WITH BENTON COUNTY PUBLIC HEALTH, SHERBURNE COUNTY PUBLIC HEALTH, AND STEARNS COUNTY PUBLIC HEALTH. THE RESULT WAS A JOINT CHNA AND CHIP. CENTRACARE HEALTH - MONTICELLO PART V, SECTION B, LINE 5: TO BETTER UNDERSTAND HEALTH ISSUES FACING THE COMMUNITIES OF WRIGHT COUNTY, BUFFALO HOSPITAL, PART OF ALLINA HEALTH, CENTRACARE MONTICELLO, WRIGHT COUNTY PUBLIC HEALTH AND WRIGHT COUNTY COMMUNITY ACTION PARTNERED TO DEVELOP AND CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). IN EARLY 2017, THE ORGANIZATIONS FORMED WRIGHT COUNTY COMMUNITY HEALTH COLLABORATIVE IN AN EFFORT TO COLLECT AND PRIORITIZE DATA FROM VARIOUS SOURCES, AND DEVELOP A JOINT COMMUNITY HEALTH IMPLEMENTATION PLAN. THE PURPOSE OF THE COLLABORATIVE GROUP IS TO SYSTEMATICALLY IDENTIFY AND ANALYZE HEALTH ISSUES IN THE COMMUNITY AND CREATE A PLAN FOR HOW TO ADDRESS THEM. THE GROUP INCLUDES ALL WRIGHT COUNTY ORGANIZATIONS WHO ARE ENCOURAGED OR REQUIRED TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE COLLABORATIVE EMPLOYED THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) FRAMEWORK WHICH EMPHASIZES COLLABORATION OF HEALTH CARE ENTITIES, PUBLIC HEALTH AND COMMUNITY ORGANIZATIONS AND IS CENTERED UPON COMMUNITY ENGAGEMENT. THE CHNA UTILIZED A VARIETY OF INFORMATION SOURCES AND COMMUNITY INPUT TO ANALYZE AND PRIORITIZE COMMUNITY HEALTH ISSUES. THIS INFORMATION WAS USED TO DEVELOP THE HEALTH IMPROVEMENT ACTION PLAN TO ADDRESS THE IDENTIFIED ISSUES. IMPORTANT ACTIVITIES IN THE CHNA PROCESS ARE OUTLINED IN THE CHNA, AS WELL AS ROLES AND RESPONSIBILITIES AMONG THE PARTNERS IN THE COLLABORATIVE. THE CHNA PROCESS WAS BASED ON THE PARTNERSHIP BETWEEN FOUR ORGANIZATIONS: BUFFALO HOSPITAL, PART OF ALLINA HEALTH, CENTRACARE MONTICELLO, WRIGHT COUNTY PUBLIC HEALTH AND WRIGHT COUNTY COMMUNITY ACTION. MAJOR CHNA DECISIONS WERE BASED ON CONSENSUS AND OPEN DIALOGUE BETWEEN THE PARTNERS, AS WELL AS COMMUNITY INPUT. THE COLLABORATIVE AGREED THAT THE DEFINITION OF HEALTH ENCOMPASSES A BROAD RANGE OF CONDITIONS, NOT JUST HEALTH IN TERMS OF HEALTHCARE. IMPROVING HEALTH IS NO LONGER ABOUT TREATING AND PREVENTING MEDICAL CONDITIONS; IT IS THE IMPROVEMENT OF COMPLETE PHYSICAL, MENTAL, SPIRITUAL AND SOCIAL WELL-BEING. REPRESENTATIVES FROM PARTNERING ORGANIZATIONS MET REGULARLY FROM SEPTEMBER 2017 TO JULY 2019 FOR PROGRESS UPDATES, DISCUSSION ON UPCOMING CHNA ACTIVITIES AND EVENT PLANNING. ALL CORE PARTNERS IN THE COLLABORATIVE CONTRIBUTED TO THE COMPLETION OF THE PROCESS TO THE BEST OF THEIR ABILITY AND UTILIZED THE STRENGTHS AND CAPACIT OF VARIOUS GROUP MEMBERS. THE PARTNERSHIP ADOPTED THE MAPP MODEL FOR ASSESSMENT AND PLANNING. MAPP IS A COMMUNITY DRIVEN STRATEGIC PLANNING PROCESS FOR IMPROVING COMMUNITY HEALTH. FACILITATED BY PUBLIC HEALTH LEADERS, THIS FRAMEWORK HELPS COMMUNITIES APPLY STRATEGIC THINKING TO PRIORITIZE PUBLIC HEALTH ISSUES AND IDENTIFY RESOURCES TO ADDRESS THEM. MAPP IS NOT AN AGENCY-FOCUSED ASSESSMENT PROCESS; RATHER, IT IS AN INTERACTIVE PROCESS THAT CAN IMPROVE THE EFFICIENCY, EFFECTIVENESS, AND ULTIMATELY THE PERFORMANCE OF LOCAL PUBLIC HEALTH SYSTEMS. COMMUNITY OWNERSHIP IS A KEY COMPONENT OF MAPP. PARTICIPATION FROM THE BROADER COMMUNITY LEADS TO COLLECTIVE THINKING AND SUSTAINABLE SOLUTIONS TO COMPLEX PROBLEMS. THIS EFFORT INCLUDED: (1) COMPLETION OF A CHNA TO SYSTEMATICALLY IDENTIFY AND ANALYZE HEALTH PRIORITIES IN THE COMMUNITY, AND (2) DEVELOPMENT OF A PLAN TO ADDRESS THESE PRIORITIES AS A COLLABORATIVE AND IN PARTNERSHIP WITH OTHERS. THROUGH THIS PROCESS, THE COLLABORATIVE ENGAGED WITH COMMUNITY STAKEHOLDERS TO BETTER UNDERSTAND THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES, IDENTIFIED INTERNAL AND EXTERNAL RESOURCES FOR HEALTH PROMOTION AND CREATED AN IMPLEMENTATION PLAN THAT LEVERAGES THOSE RESOURCES TO IMPROVE COMMUNITY HEALTH. CENTRACARE HEALTH - PAYNESVILLE PART V, SECTION B, LINE 5: CENTRACARE POPULATION HEALTH CONDUCTED SPECIFIC AND COMPREHENSIVE EVALUATION OF ZIP CODE 56304 THAT HAS THE WORST HEALTH OUTCOMES IN THE THREE COUNTIES INCLUDED IN THE CHNA AND CHIP. THIS EVALUATION INCLUDED DATA EVALUATION, KEY INFORMANT INTERVIEWS, AND HEALTH INDICATORS FOR MINORITY GROUPS. THE CENTRAL MN ALLIANCE ALSO COMPLETED SEVERAL SURVEYS AND ASSESSMENTS TO GET INPUT FROM MULTIPLE SECTORS OF EACH COMMUNITY REPRESENTING DIFFERENT POPULATIONS IN ORDER TO COMPILE A LIST OF TOP PRIORITIES IN THE REGION:THREE ASSESSMENTS WERE COMPLETED FROM JULY 2021 THROUGH FEBRUARY 2022: COMMUNITY STATUS, COMMUNITY CONTEXT AND COMMUNITY PARTNERS. IT WAS A GOAL TO IMPART MORE EMPHASIS ON WHAT RESULTED FROM THE COMMUNITY CONTEXT AND COMMUNITY PARTNER ASSESSMENTS THAN FROM THE QUANTITATIVE DATA WITHIN THE STATUS ASSESSMENT.THE COMMUNITY CONTEXT ASSESSMENT BUILDS ON THE FORMER COMMUNITY THEMES AND STRENGTHS ASSESSMENT, DIGGING DEEPER TO UNDERSTAND INEQUITIES, FILL IN DATA GAPS FROM THE COMMUNITY STATUS ASSESSMENT, AND EXPLORES THE CONTEXT OF THE COMMUNITY THROUGH THE LENS OF THOSE WITH LIVED EXPERIENCE. THIS ASSESSMENT IS DESIGNED TO MOVE BEYOND PERCEIVED COMMUNITY NEEDS AND PERPETUATION OF DEPENDENCY ON PROGRAMS AND SERVICES TO UNDERSTANDING A COMMUNITY'S STRENGTHS, ASSETS, AND CULTURE, RECOGNIZING THAT ALL COMMUNITIES HAVE A VIBRANCY THAT MUST BE LEVERAGED IN COMMUNITY IMPROVEMENT.COMMITTEE MEMBERS REFLECTED ON THE ABOVE AREAS AND GATHERED INFORMATION FOR EACH OF THEIR RESPECTIVE AGENCIES TO ASSESS THE CONTEXT OF OUR COMMUNITIES WITHIN EACH OF THE DOMAIN AREAS, COMPLETING A CONTEXT COMMITTEE ASSESSMENT, ONE FOR EACH OF THE CMA MEMBERS OF BENTON, STEARNS, SHERBURNE AND CENTRACARE. THIS ASSESSMENT TOOL COMPLETION WAS DEVELOPED THROUGH INFORMATION GATHERING, PARTNERSHIP, COMMUNITY CONVERSATIONS, INDIVIDUAL CONVERSATIONS, AND OBSERVATIONS OF COMMUNITY NEEDS. CMA MEMBERS BROUGHT EACH OF THEIR CONTEXT ASSESSMENT TOOLS BACK TO THE CONTEXT COMMITTEE. THE CONTEXT COMMITTEE IDENTIFIED SHARED FINDINGS, TRENDS, GAPS AND UNIQUE FEATURES FOR EACH OF THE DOMAINS FOR THE REGION. THE CONTEXT COMMITTEE THEN PRESENTED TO THE LARGER LEADERSHIP GROUP WHERE THE GROUP HAD AN OPPORTUNITY TO ASK QUESTIONS, CLARIFY CONCERNS, AND MAKE RECOMMENDATIONS. FOLLOWING THE LEADERSHIP GROUP MEETING, THE CONTEXT COMMITTEE UPDATED THE CONTEXT ASSESSMENT TOOL THAT CAPTURED THE MOST SIGNIFICANT FINDINGS AMONG OUR CMA REGION. THE COMMITTEE TOOK THE FEEDBACK GAINED FROM THE LARGER LEADERSHIP GROUP BACK TO THE CONTEXT COMMITTEE AND COMPLETED AN IMPORTANCE/RELEVANCE PRIORITIZATION ACTIVITY TO IDENTIFY THE TOP DOMAINS WITHIN OUR CENTRAL MINNESOTA ALLIANCE.REPLACING THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT (LPHSA), THE COMMUNITY PARTNER ASSESSMENT PROVIDES STRUCTURE FOR ALL COMMUNITY PARTNERS TO LOOK CRITICALLY WITHIN THEIR OWN SYSTEMS AND PROCESSES, REFLECT ON THEIR ROLE IN THE COMMUNITY'S HEALTH AND WELL-BEING, AND UNDERSTAND THE DEGREE TO WHICH THEY ARE ADDRESSING OR PERPETUATING HEALTH INEQUITIES ACROSS A SPECTRUM OF ACTION RANGING FROM THE INDIVIDUAL TO SYSTEMIC AND STRUCTURAL LEVELS. IT WILL OFFER AN ASSESSMENT INSTRUMENT WHICH, IN CONTRAST TO THE LPHSA, WILL BE INCLUSIVE OF BUT NOT GROUNDED IN THE 10 ESSENTIAL PUBLIC HEALTH SERVICES TO BROADEN ITS RELEVANCE TO COMMUNITY PARTNERS OUTSIDE OF THE HEALTH AND HUMAN SERVICES SECTOR. SINCE THE ASSESSMENT TOOL WAS NOT AVAILABLE FOR OUR GROUP TO UTILIZE DURING THIS TIME FRAME, WE ADAPTED BY CREATING A TABLE WITH THE DOMAIN AREAS. EACH CMA MEMBER WAS RESPONSIBLE TO "ASSESS" PARTNERS IN THEIR GEOGRAPHIC OR SERVICE AREA BY THE 9 DOMAIN AREAS. MEMBERS ATTENDED MEETINGS, RESEARCHED WEBSITES, OBSERVED PARTNERS WITHIN THE COMMUNITY, REVIEWED STRATEGIC DOCUMENTS, COMPLETED SURVEYS, ENGAGED IN ONE-ON-ONE CONVERSATIONS WITH COMMUNITY RESIDENTS AND/OR WITH PARTNERS ON BEHALF OF A COMMUNITY, PROVIDED LIVED EXPERIENCES, AND ATTENDED EVENTS THAT EXEMPLIFIED THE WORK AND MISSION OF THE PARTNER. ONCE THE CMA MEMBERS COMPLETED THEIR ASSESSMENTS, THE GROUP THEN SHARED FINDINGS AND IDENTIFIED TRENDS, GAPS AND UNIQUE FEATURES FOR EACH OF THE DOMAINS. THIS WAS THEN PRESENTED TO THE LARGER CMA LEADERSHIP GROUP WHERE THE GROUP HAD AN OPPORTUNITY TO ASK QUESTIONS, CLARIFY CONCERNS AND MAKE RECOMMENDATIONS. FOLLOWING THE CMA LEADERSHIP GROUP MEETING, WE UPDATED THE REGIONAL DOCUMENT THAT CAPTURED THE MOST SIGNIFICANT FINDINGS AMONG OUR CMA MEMBERS, PARTNERS, AND GEOGRAPHIC AREAS.THE COMMUNITY STATUS ASSESSMENT COMMITTEE CONDUCTED A MODIFIED ASSESSMENT BY CONTINUING THE TRENDING OF THE TOP DATA POINTS OF CONCERN FROM THE 2019-2022 PROCESS AS WELL AS ANALYZING NEW COMMUNITY DATA. THE COMMITTEE REVIEWED THE LIST OF DATA SOURCES TO EXPLORE AND EACH COMMITTEE MEMBER IDENTIFIED A SOURCH FOR WHICH THEY FELT INTEREST AND THEY EXPLORED THAT DATA.THE THIRD ITERATION OF THE CENTRAL MN COMMUNITY HEALTH SURVEY WAS CONDUCTED IN 2021. THE SURVEY INSTRUMENT WAS DEVELOPED FROM 9/16/20 THROUGH 4/1/21. THE CMA WORKED WITH THE MN DEPARTMENT OF HEALTH AND VENDOR SSI INC. TO CONDUCT A STATISTICALLY DESIGNED RANDOM SAMPLE MAILED SURVEY; IT WAS IN THE FIELD FROM 4/1/21 THROUGH 6/18/21. THE SAME INSTRUMENT WAS CONVERTED TO A WEBBASED SURVEY USING ARCGIS SURVEY 123 AND THAT WAS IN THE FIELD FROM 5/18/21 THROUGH 9/30/21 AND WAS AVAILABLE VIA CONVENIENCE SAMPLE.IN ORDER TO BETTER ENGAGE INDIVIDUALS OR ORGANIZATIONS WITH A PERSPECTIVE OF AT-RISK POPULATIONS, A HEALTH EQUITY ASSESSMENT WAS ALSO COMPLETED. INTERVIEWS WITH ELEVEN COMMUNITY LEADERS REPRESENTING THE DIVERSITY OF THE EAST ST. CLOUD NEIGHBORHOOD REVEALED MAJOR THEMESE RELEVANT TO COMMUNITY HEALTH IN THE 56304 - ZIP CODE AREA. THE 56304 QUANITITATIVE SUTDY HIGHLIGHTED THE IMPORTANCE OF THE INTERCONNECTEDNESS OF HEALTH AND SOCIOECONOMIC ISSUES. CONCERNS ABOUT HEALTH WERE FOCUSED ON POVERTY AND LACK OF ACCESS TO HEALTH FOOD AND MENTAL AND BEHAVIORAL HEALTH.THE FOCUS OF THE 2022-2025 CMA CHIP WILL BE THE FOLLOWING DRIVERS OF INEQUITIES: DATA ACCESS & SYSTEMS, STRUCTURAL RACISM, LIVED EXPERIENCE AND HISTORICAL CONTEXT. CENTRACARE HEALTH - MONTICELLO PART V, SECTION B, LINE 6A: CENTRACARE HEALTH - MONTICELLO CONDUCTED THE CHNA WITH ALLINA HEALTH BUFFALO HOSPITAL. CENTRACARE HEALTH - PAYNESVILLE PART V, SECTION B, LINE 6A: CENTRACARE HEALTH SYSTEM - PAYNESVILLE CONDUCTED THE CHNA WITH CENTRACARE - MELROSE, CENTRACARE - SAUK CENTRE, AND ST. CLOUD HOSPITAL. CENTRACARE HEALTH - MONTICELLO PART V, SECTION B, LINE 6B: CENTRACARE HEALTH - MONTICELLO CONDUCTED THE CHNA WITH WRIGHT COUNTY COMMUNITY ACTION AND WRIGHT COUNTY PUBLIC HEALTH. CENTRACARE HEALTH - PAYNESVILLE PART V, SECTION B, LINE 6B: CENTRACARE HEALTH SYSTEM - PAYNESVILLE CONDUCTED THE CHNA WITH BENTON COUNTRY PUBLIC HEALTH, SHERBURNE COUNTRY PUBLIC HEALTH AND STEARNS COUNTRY PUBLIC HEALTH. CENTRACARE HEALTH - MONTICELLO PART V, SECTION B, LINE 11: COMMUNITY MEMBERS, COMMUNITY ORGANIZATIONS, PUBLIC HEALTH AND HOSPITAL/HEALTH SYSTEM STAFF PARTICIPATED IN A PROCESS THAT IDENTIFIED THE FOLLOWING PRIORITY AREAS FOR COMMUNITY HEALTH IN THE COMMUNITIES SERVED BY THE COLLABORATIVE: 1) MENTAL HEALTH AND WELLNESS 2) DENTAL CARE 3) SUBSTANCE USE AND ABUSE IN 2018-19, STAFF SOLICITED COMMUNITY INPUT, ASSESSED EXISTING RESOURCES AND DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN FOR 2020-2022 IN ORDER TO ADDRESS THESE PRIORITIES. THIS IMPLEMENTATION PLAN INCLUDES THE FOLLOWING GOALS, EACH OF WHICH IS SUPPORTED BY MULTIPLE STRATEGIES AND WILL BE IMPLEMENTED THROUGH A VARIETY OF ACTIVITIES MONITORED FOR PROGRESS AND OUTCOMES OVER TIME. MENTAL HEALTH AND WELLNESS GOAL: REDUCE THE RATE OF MENTAL HEALTH CARE DELAY AND THE NUMBER OF NOT GOOD" MENTAL HEALTH DAYS IN WRIGHT COUNTY. DENTAL CARE GOAL: REDUCE THE RATE OF DENTAL CARE DELAY IN WRIGHT COUNTY. SUBSTANCE USE AND ABUSE GOAL: SUPPORT LOCAL PREVENTION EFFORTS AND ADVOCATE FOR POLICY CHANGES TO ADDRESS SUBSTANCE ABUSE IN WRIGHT COUNTY. DATA REVIEW AND ISSUE PRIORITIZATION APPROXIMATELY 150 STAKEHOLDERS REPRESENTING BROAD INTERESTS OF THE COMMUNITY AND 40 COMMUNITY ORGANIZATIONS PARTICIPATED IN KEY INFORMANT INTERVIEWS AND/OR ATTENDED AT LEAST ONE OF SEVERAL MEETINGS TO REVIEW AND DISCUSS THE CHNA DATA GATHERED AND HELP IDENTIFY THREE PRIORITY HEALTH ISSUES. THE REVIEW PROCESS INCLUDED A FORMAL PRIORITIZATION TOOL KNOWN AS THE HANLON METHOD, WHICH INCLUDES RANKING HEALTH PRIORITIES BASED ON THREE PRIMARY CRITERIA: THE SIZE OF THE PROBLEM, INCLUDING PROJECTION OF FUTURE TRENDS; THE SERIOUSNESS OF THE PROBLEM, INCLUDING DISPARATE HEALTH BURDENS WITHIN THE POPULATION; AND THE EFFECTIVENESS AND FEASIBILITY OF INTERVENTIONS ON THE PART OF HEALTH CARE. AS A RESULT OF THE PRIORITIZATION SESSION, THE COLLABORATIVE ARRIVED AT 10 TOP HEALTH PRIORITIES FACING THE POPULATION OF WRIGHT COUNTY. AFTER COLLECTING EXTENSIVE FEEDBACK AND CONDUCTING COMMUNITY CONVERSATIONS AND DIALOGUES, THE COLLABORATIVE ARRIVED AT TOP 10 PRIORITIES, WHICH WERE THEN REVIEWED BY EACH ORGANIZATIONS' STAKEHOLDER GROUPS. EACH GROUP CONSISTED OF KEY STAKEHOLDERS, INCLUDING SENIOR LEADERS AND MANAGERS. ALL FOUR GROUPS FOCUSED ON DEFINING WHAT HEALTH PRIORITIES ARE THE MOST RELEVANT TO THE POPULATION EACH ORGANIZATION SERVES, AND HOW THE POPULATION IS AFFECTED BY THE GAPS IDENTIFIED IN THE CHNA PROCESS. EACH GROUP ARRIVED AT THEIR OWN PRIORITIZED LIST OF HEALTH ISSUES FACING WRIGHT COUNTY. THE LISTS WERE THEN COMBINED BY THE CORE GROUP AND ISSUES WERE AGAIN PRIORITIZED BASED ON THE RANKINGS FROM INDIVIDUAL ORGANIZATIONS. THE CORE GROUP FOCUSED ON THE ISSUES FACING THE MAJORITY OF THE POPULATION SERVED AND THE SEVERITY AND MAGNITUDE OF THE HEALTH CONCERNS. THE COLLABORATIVE CHOSE THE TOP THREE PRIORITIES BASED ON TRUE COMMUNITY NEED, VERSUS JUST THE ABILITY TO PROVIDE INTERVENTIONS. THE COLLABORATIVE BELIEVES THAT PART OF THE SOLUTION IS STARTING THE CONVERSATION AROUND THE TOPICS THAT HAVE NOT YET BEEN ADDRESSED, AND ENGAGING COMMUNITY PARTNERS AND OTHER ORGANIZATIONS TO ASSIST IN IMPLEMENTATION PLANNING AND DEVELOPMENT OF TACTICS/ACTIVITIES TO ADDRESS THOSE PRIORITIES. NEEDS IDENTIFIED BUT NOT INCLUDED IN THE CHNA: GOING INTO THE HANLON PRIORITIZATION, THE CORE GROUP HAD A LIST OF 20 IDENTIFIED HEALTH ISSUES THAT NEEDED TO BE DISCUSSED AND ARRANGED ACCORDING TO THE WEIGHT OF ITS SIZE, SERIOUSNESS AND EFFECTIVENESS. AFTER ALL THE HEALTH ISSUES WERE RANKED, THE CORE GROUP REALIZED THERE WERE SEVERAL IDENTIFIED ISSUES THAT COULD BE COMBINED WITH TOP PRIORITIES. FOR EXAMPLE, SUICIDE AWARENESS AND PREVENTION CAN BE COMBINED WITH ONE OF THE TOP PRIORITIES OF MENTAL HEALTH AND WELLNESS. OTHER ISSUES THAT WERE IDENTIFIED INCLUDED STRESS, LACK OF PHYSICAL ACTIVITY AND SOCIAL CONNECTEDNESS/ISOLATION. WHILE THE CORE GROUP UNDERSTANDS THAT ALL OF THESE ISSUES ARE IMPORTANT AND NEED CONCENTRATED EFFORTS IN ORDER TO RESOLVE, THEY WILL BE CONSCIOUSLY DISCUSSED AND NATURALLY ADDRESSED IN THE STRATEGIES AND TACTICS EACH ORGANIZATION CREATES. WHILE TOPICS SUCH AS DISTRACTED DRIVING RANKED AS A HIGH NEED IN WRIGHT COUNTY, THERE ARE CURRENTLY MANY GROUPS ALREADY WORKING ON THIS ISSUE AND ACTIVELY PURSUING INTERVENTIONS AROUND THIS CONCERN (SAFE COMMUNITIES OF WRIGHT COUNTY, HIGHWAY 55 COALITION, HIGHWAY 12 COALITION AND I94 WEST CHAMBER OF COMMERCE). SOME OF THE PRIORITIES IDENTIFIED IN 2017-2019 IMPLEMENTATION PLAN ARE STILL RELEVANT TO THE WORK OF THE COLLABORATIVE (FOOD INSECURITY, OBESITY, PHYSICAL ACTIVITY, ACCESS TO CARE). THE COLLABORATIVE MADE SIGNIFICANT STRIDES IN ADDRESSING THOSE PRIORITIES AND WILL CONTINUE TO SUPPORT THE EFFORTS AROUND THESE INITIATIVES THROUGH CURRENT WORKFLOWS AND SERVICE MODELS. THE NEEDS NOT ADDRESSED WITHIN THE CURRENT YEAR CHNA WERE UNABLE TO BE FULLY ADDRESSED DUE TO FUNDING AND STAFFING. CENTRACARE HEALTH - PAYNESVILLE PART V, SECTION B, LINE 11: AFTER THE DRIVERS OF INEQUITIES HAD BEEN IDENTIFIED, THE CMA LEADERSHIP GROUP STARTED WORK ON DEVELOPING POTENTIAL GOALS AND ACTION STEPS THAT WOULD FIT UNDER EACH CATEGORY. MEMBERS OF THE LEADERSHIP GROUP USED A GOALS AND ACTION STEPS WORKSHEET STORED ON MICROSOFT TEAMS TO COLLABORATIVELY, PREPARE A LIST OF GOALS AND ACTION STEPS. THIS WAS DISCUSSED AT THE JANUARY 27TH, FEBRUARY 10TH, AND FEBRUARY 22ND LEADERSHIP MEETINGS. TO KEEP THE CHIP AT A WORKABLE LEVEL, IT WAS DECIDED THAT WE WOULD TRY TO IDENTIFY ONE GOAL WITH ACTION STEPS TO INCLUDE IN THE CHIP. ON MARCH 25TH, A PRIORITIZATION EXERCISE WAS COMPLETED USING MIRO.COM TO IDENTIFY THE GOAL WITH ACTION STEPS THAT WOULD BE INCLUDED IN THE CHIP DOCUMENT. JUST BECAUSE THE GOAL WAS NOT INCLUDED IN THE CHIP, DOES NOT MEAN THAT THE CMA WILL NOT WORK ON IT.IT IS THE INTENTION OF THE CMA MEMBERS THAT THE CHIP WILL BE A LIVING DOCUMENT AND AS MORE CONVERSATIONS TAKE PLACE WITH COMMUNITY PARTNERS, THE GOALS AND ACTION STEPS MAY CHANGE. THE CHANGES TO THE DOCUMENT WILL BE REPORTED AT LEAST ANNUALLY WHEN LOCAL PUBLIC HEALTH IS REQUIRED TO REPORT ON CHIP WORK.THE PRIORITIES IDENTIFIED WERE AS FOLLOWS IN COMMUNITY INFORMED RANKING: 1) BUILDING FAMILIES, 2) MENTAL HEALTH, 3) ENCOURAGING SOCIAL CONNECTION, 4) ADVERSE CHILDHOOD EXPERIENCES (ACES), 5) TOBACCO/NICOTINE USE, 6) HEALTH CARE, 7) RISKY YOUTH BEHAVIOR, 8) FINANCIAL STRESS, 9) TRAUMA, AND 10) EDUCATING POLICY MAKERS AND KEY COMMUNITY STAKEHOLDERS. DUE TO THE NEWNESS OF THE COLLABORATION ON THIS WORK, A DECISION WAS MADE TO FOCUS ON THE TOP TWO PRIORITIES (BUILDING FAMILIES AND MENTAL HEALTH) FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN. THE PRIORITIES ENCOURAGING SOCIAL CONNECTION, ADVERSE CHILDHOOD EXPERIENCES (ACES), TOBACCO/NICOTINE USE, HEALTH CARE, RISKY YOUTH BEHAVIOR, FINANCIAL STRESS, TRAUMA, AND EDUCATING POLICY MAKERS AND KEY COMMUNITY STAKEHOLDERS WILL NOT SPECIFICALLY BE ADDRESSED THROUGH ACTION PLANNING OR MEASUREMENT DUE TO FINANCIAL AND STAFFING RESTRAINTS, HOWEVER, THERE ARE WAYS MANY OF THESE PRIORITIES ARE BEING ADDRESSED EITHER WITHIN THE TOP TWO PRIORITIES OR THE COMMUNITY. IN THE FUTURE, THE GROUP WILL ASSESS THE CAPACITY TO EXPAND THE NUMBER OF PRIORITIES BEING ADDRESSED AND MEASURED. ALTHOUGH NOT DIRECTLY ADDRESSED IN THE PLAN, CENTRACARE DOES ACTIVELY SUPPORT OTHER ORGANIZATIONS WITHIN THE COMMUNITY WHO ARE WORKING ON DETERMINANTS OF HEALTH IDENTIFIED DURING THE CHNA PROCESS LIKE ACES, TOBACCO, TRAUMA, EDUCATING POLICYMAKERS, ETC.THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS THE ACTION PLAN THAT USES GUIDING PRINCIPLES AND STRATEGIES TO ADDRESS THE COMMUNITY PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. THE TOP PRIORITIES ARE BUILDING FAMILIES AND MENTAL HEALTH. WE WILL USE THE GUIDING PRINCIPLES OF COMMUNITY COLLABORATION, AWARENESS, RESILIENCE, EQUITY, EDUCATION, AND HEALTH ORGANIZATIONS TO DRIVE OUR STRATEGIES.THE ST. CLOUD HOSPITAL, CENTRACARE- MELROSE HOSPITAL, CENTRACARE- SAUK CENTRE, AND CENTRACARE- PAYNESVILLE WILL MAINTAIN THEIR ENGAGEMENTS WITH THE CENTRAL MN ALLIANCE AND FOLLOW THE MAPP LEADERSHIP STRUCTURE TO CARRY OUT THE STRATEGIES OUTLINED IN THE CHIP. THERE WILL BE MEETINGS AS OUTLINED IN THE CHIP UNDER LEADERSHIP SYSTEM & PROCESS FOR MONITORING AND REVISION. CENTRACARE HEALTH - MONTICELLO PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE. PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN: (A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT CENTRACARE HEALTH - PAYNESVILLE PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE. PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN: (A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT CENTRACARE - RICE MEMORIAL HOSPITAL PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE. PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN: (A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT CENTRACARE - REDWOOD AREA HOSPITAL PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE. PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN: (A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT CENTRACARE HEALTH - BENSON PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE.PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT CENTRACARE HEALTH - MONTICELLO PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. CENTRACARE HEALTH - PAYNESVILLE PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. CENTRACARE - RICE MEMORIAL HOSPITAL PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. CENTRACARE - REDWOOD AREA HOSPITAL PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. CENTRACARE HEALTH - BENSON PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. CENTRACARE HEALTH - MONTICELLO: PART V, SECTION B, LINE 7A: THE HOSPITAL'S CHNA CAN BE FOUND ON ITS WEBSITE AT HTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/WRIGHT-COUNTY-COMMUNITY-HEALTH-COLLABORATIVE-CHNA-2019-2022-VERSION-1-UPDATED-10.19.PDF CENTRACARE HEALTH - MONTICELLO: PART V, SECTION B, LINE 10A: THE HOSPITAL'S IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT HTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/WRIGHT-COUNTY-COMMUNITY-HEALTH-COLLABORATIVE-CHNA-2019-2022-VERSION-1-UPDATED-10.19.PDF CENTRACARE HEALTH - PAYNESVILLE: PART V, SECTION B, LINE 7A: THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT HTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CENTRAL-MN-ALLIANCE-CHIP-CHNA-2022-2025-VERSION-1-UPDATED-6.29.22.PDF CENTRACARE HEALTH - PAYNESVILLE: PART V, SECTION B, LINE 10A: THE HOSPITAL'S CHNA AND IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT HTTPS://WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CENTRAL-MN-ALLIANCE-CHIP-CHNA-2022-2025-VERSION-1-UPDATED-6.29.22.PDF CENTRACARE HEALTH - MONTICELLO: PART V, SECTION B, LINES 4 AND 9: THE FOLLOWING DISCLOSURE IS IN ACCORDANCE WITH REVENUE PROCEDURE 2015-21 SECTION 7 IN REGARDS TO SCHEDULE H, PART V, SECTION B, LINE 4 AND 9. DURING THE TAX YEAR ENDED JUNE 30, 2022, CENTRACARE HEALTH MONTICELLO WAS REQUIRED TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AND ADOPT AN IMPLEMENTATION STRATEGY. THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY WAS SUBSTANTIALLY CONDUCTED BETWEEN JULY 2021 AND FEBRUARY 2022 AND POSTED TO THE CENTRACARE WEBSITE BY JUNE 30, 2022. HOWEVER, THE CENTRACARE MONTICELLO OPERATING COMMITTEE, A DELEGATE OF THE CENTRACARE HEALTH SERVICES BOARD OF DIRECTORS, DID NOT APPROVE THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY UNTIL AUGUST 18, 2022, WHICH WAS A MONTH AND A HALF AFTER THE REQUIRED DATE OF APPROVAL FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS ERROR WAS MINOR AND INADVERTENT AND CORRECTIVE ACTIONS WERE TAKEN TO CORRECT THIS ERROR ONCE THE OPERATING COMMITTEE APPROVED THE COMMUNITY HEALTH NEEDS ASSESSMENT. CENTRACARE HEALTH - PAYNESVILLE: PART V, SECTION B, LINES 4 AND 9:THE FOLLOWING DISCLOSURE IS IN ACCORDANCE WITH REVENUE PROCEDURE 2015-21 SECTION 7 IN REGARDS TO SCHEDULE H, PART V, SECTION B, LINE 4 AND 9. DURING THE TAX YEAR ENDED JUNE 30, 2022, CENTRACARE HEALTH PAYNESVILLE WAS REQUIRED TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AND ADOPT AN IMPLEMENTATION STRATEGY. THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY WAS SUBSTANTIALLY CONDUCTED BETWEEN JULY 2021 AND FEBRUARY 2022 AND POSTED TO THE CENTRACARE WEBSITE BY JUNE 30, 2022. HOWEVER, THE CENTRACARE PAYNESVILLE OPERATING COMMITTEE, A DELEGATE OF THE CENTRACARE HEALTH SERVICES BOARD OF DIRECTORS, DID NOT APPROVE THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY UNTIL SEPTEMBER 26, 2022, WHICH WAS ALMOST THREE MONTHS AFTER THE REQUIRED DATE OF APPROVAL FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. THIS ERROR WAS MINOR AND INADVERTENT AND CORRECTIVE ACTIONS WERE TAKEN TO CORRECT THIS ERROR ONCE THE OPERATING COMMITTEE APPROVED THE COMMUNITY HEALTH NEEDS ASSESSMENT. 12 1 - MONTICELLO CARE CENTER 1104 EAST RIVER STREET MONTICELLO MN 55362 SKILLED NURSING FACILITY 2 - CENTRACARE - MONTICELLO SPECIALTY CLINIC 1107 HART BLVD MONTICELLO MN 55362 CLINIC 3 - CCH PAYNESVILLE - EDEN VALLEY CLINIC 405 MEEKER AVENUE EDEN VALLEY MN 55362 CLINIC 4 - CCH PAYNESVILLE - PAYNESVILLE CLINIC 200 WEST FIRST STREET PAYNESVILLE MN 55362 CLINIC 5 - CCH PAYNESVILLE - RICHMOND CLINIC 130 FIRST STREET NE RICHMOND MN 56368 CLINIC 6 - RICE CARE CENTER 1801 WILLMAR AVE SW WILLMAR MN 56201 SKILLED NURSING FACILITY 7 - RICE HOME MEDICAL 1033 19TH AVE SW WILLMAR MN 56201 DURABLE MEDICAL EQUIPMENT PROVIDER 8 - CARRIS HEALTH SURGERY CENTER WILLMAR 1310 1ST STREET S WILLMAR MN 56201 AMBULATORY SURGICAL CENTER 9 - CARRIS HEALTH-REDWOOD HEALTH PAVILION 1110 E BRIDGE ST REDWOOD FALLS MN 56283 HOME CARE, HOSPICE AND ADULT DAY SERVICES 10 - CARRIS HEALTH - REDWOOD SEASONS HOUSE 400 VEDA DR REDWOOD FALLS MN 56283 ADULT FOSTER CARE WITH SERVICES (END OF LIFE CARE) 11 - RICE REHABILITATION CENTER 311 SW 3RD ST WILLMAR MN 56201 PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY 12 - MARSHALL SURGERY CENTER 1521 CARLSON ST 200 MARSHALL MN 56258 OUTPATIENT SURGERY PART I, LINE 6A: CENTRACARE HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES ALL RELATED ORGANIZATIONS. PART I, LINE 7: THE ORGANIZATIONS TOTAL EXPENSES WERE REDUCED BY THEIR NON-OPERATING REVENUE, MEDICAID SURCHARGE AND MN CARE TAX. THE NET TOTAL EXPENSES WERE THEN DIVIDED BY GROSS CHARGES TO DETERMINE THE COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS THEN APPLIED TO THE FINANCIAL ASSISTANCE ON LINE 7A. MEDICAID COMMUNITY BENEFIT EXPENSE AND DIRECT OFFSETTING REVENUES ON LINE 7B ARE REPORTED AT COST. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS ON LINE 7E ARE REPORTED AT COST. HEALTH PROFESSIONALS EDUCATION AND DIRECT OFFSETING REVENUES ON LINE 7F ARE REPORTED AT COST. CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT ON LINE 7I ARE REPORTED AT COST. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5,742,238. PART II, COMMUNITY BUILDING ACTIVITIES: THE HEALTH SYSTEM PROVIDED DRIVE THROUGH TEST SITES, FREE VACCINATION CLINICS, MANDATED EMPLOYEE VACCINATION, TRAINING, SCREENING, PRODUCTS TO ENSURE SAFE ENVIRONMENTS, AND OTHER VARIOUS SERVICES/PRODUCTS. PART III, LINE 2: THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PART III, LINE 4: THE FOLLOWING IS FROM THE "ACCOUNTS RECEIVABLE" PARAGRAPH INCLUDED IN NOTE 2 OF THE ORGANIZATION'S AUDITED FINANCIALS. "THE SYSTEM REPORTS PATIENT AND RESIDENT SERVICE REVENUE AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE SYSTEM EXPECTS TO BE ENTITLED TO IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS AND THIRD-PARTY PAYORS (INCLUDING MEDICARE, MEDICAID, BLUE CROSS AND OTHER THIRD-PARTY PAYORS). CERTAIN REIMBURSEMENT ARRANGEMENTS INCLUDE VARIABLE CONSIDERATION FOR AMOUNTS SUBJECT TO RETROACTIVE AUDIT AND ADJUSTMENT. DIFFERENCES BETWEEN AMOUNTS ORIGINALLY RECORDED AND FINALLY SETTLED ARE INCLUDED IN OPERATIONS IN THE YEAR IN WHICH THE DIFFERENCES ARE KNOWN. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED." PART III, LINE 8: THE AMOUNT ON LINE 6 OF PART III WAS DETERMINED BY UTILIZING THE MEDICARE COST REPORT, PRIMARILY THE D SERIES AND E SERIES. PART III, LINE 9B: THE COLLECTION POLICIES AT THE HOSPITALS REQUIRE COLLECTION STAFF TO OFFER CHARITY TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY, ALL OTHER COLLECTION EFFORTS MUST CEASE, IF A PATIENT QUALIFIES FOR PARTIAL CHARITY, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THESE PROVISIONS APPLY TO BOTH HOSPITAL EMPLOYED COLLECTION STAFF AND COLLECTION AGENCY STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY OR NOT, ARE REPORTED TO CREDIT RATING AGENCIES. PART VI, LINE 2: THE ORGANIZATIONS' STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS AND A DIVERSE OPERATING COMMITTEE THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS AND RECOMMENDATIONS FOR HEALTH CARE SERVICES. PART VI, LINE 3: INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF THE ORGANIZATION'S BILLING DEPARTMENT EXPLAINS THE CHARITY CARE POLICY TO PATIENTS. THEY ALSO EXPLAIN THE SELF PAY DISCOUNT AND SCREENS THE PATIENT FOR ELIGIBILITY FOR ANY STATE OR FEDERAL PROGRAMS. THEY ALSO ASSIST THE PATIENT WITH ANY PAPERWORK REQUIRED TO APPLY FOR SUCH PROGRAMS. OUTPATIENTS WHO ARE SELF PAY RECEIVE AN AUTOMATIC SELF PAY DISCOUNT. IF THE PATIENT DOES NOT REMIT PAYMENT, COLLECTION STAFF ATTEMPT TO REACH THE PATIENT BY PHONE. PATIENTS ARE TOLD ABOUT THE CHARITY PROGRAM. FOR BOTH INPATIENTS AND OUTPATIENTS, ALL STATEMENTS CONTAIN A LETTER REGARDING THE AVAILABILITY OF CHARITY CARE. ALSO ALL PRECOLLECTION LETTERS HAVE THIS SAME LANGUAGE INDICATING THE AVAILABILITY AND PROCESS OF OBTAINING CHARITY CARE. PART VI, LINE 4: CENTRACARE HEALTH - MONTICELLO IS LOCATED IN CENTRAL MINNESOTA IN WRIGHT COUNTY IN WHICH THERE IS 1 HOSPITAL. THE ESTIMATED 2023 CENSUS SHOWS A POPULATION OF 21,223, WITH A PROJECTED 2028 GROWTH PERCENTAGE OF 4.59% TO 22,197 POPULATION LEVEL. THIS AREA OF THE STATE IS SHOWING A SIGNIFICANT INCREASE IN POPULATION AND IS EXPECTED TO CONTINUE INTO THE FUTURE. THE PROJECTED CHANGE BY AGE BRACKET FROM 2023 TO 2028 IS AS FOLLOWS: 0-17: -0.90%, 18-44: 1.28%, 45-64: 6.19%, 65+: 20.61%. THE ESTIMATED 2023 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 84.87%, AFRICAN AMERICAN: 1.84%, ASIAN: 1.43%, HISPANIC: 6.84%, OTHER: 5.02%. THE ESTIMATED 2023 AVERAGE INCOME IS $105,568. THE ESTIMATED MEDICAL UNDERSERVICE SCORE IS 59.80. CENTRACARE HEALTH - PAYNESVILLE IS LOCATED IN CENTRAL MINNESOTA IN STEARNS COUNTY IN WHICH THERE IS 1 HOSPITAL. THE ESTIMATED 2023 CENSUS SHOWS A POPULATION OF 5,766 AND IS PROJECTED TO INCREASE SLIGHTLY TO 5,881 BY 2028 WHICH REPRESENTS A 1.99% INCREASE. THE PROJECTED CHANGE BY AGE BRACKET FROM 2023 TO 2028 IS AS FOLLOWS: 0-17: 2.92%, 18-44: 3.95%, 45-64: -7.87%, 65+: 7.87%. THE ESTIMATED 2023 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 92.18%, AFRICAN AMERICAN: 0.66%, ASIAN: 0.35%, HISPANIC: 2.93%, OTHER: 3.88%. THE ESTIMATED 2023 AVERAGE INCOME IS $97,973. THE ESTIMATED MEDICAL UNDERSERVICE SCORE OF 58.0. CENTRACARE HEALTH - RICE MEMORIAL HOSPITAL IS LOCATED IN CENTRAL MINNESOTA IN KANDIYOHI COUNTY IN WHICH THERE IS 1 HOSPITAL. THE ESTIMATED 2023 CENSUS SHOWS A POPULATION OF 24,752 AND IS PROJECTED TO INCREASE SLIGHTLY TO 25,148 BY 2028 WHICH REPRESENTS A 1.60% INCREASE. THE PROJECTED CHANGE BY AGE BRACKET FROM 2023 TO 2028 IS AS FOLLOWS: 0-17: -0.11%, 18-44: 1.57%, 45-64: -4.15%, 65+: 10.32%. THE ESTIMATED 2023 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 56.88%, AFRICAN AMERICAN: 15.11%, ASIAN: 3.22%, HISPANIC: 21.45%, OTHER: 3.34%. THE ESTIMATED 2023 AVERAGE INCOME IS $85,974. CENTRACARE HEALTH - REDWOOD FALLS HOSPITAL IS LOCATED IN REDWOOD COUNTY, MINNESOTA IN WHICH THERE IS 1 HOSPITAL. THE ESTIMATED 2023 CENSUS SHOWS A POPULATION OF 6,432 AND IS PROJECTED TO DECREASE SLIGHTLY TO 6,407 BY 2028 WHICH REPRESENTS A 0.39% DECREASE. THE PROJECTED CHANGE BY AGE BRACKET FROM 2023 TO 2028 IS AS FOLLOWS: 0-17: -1.59%, 18-44: 0.81%, 45 64: -8.17%, 65+: 7.19%. THE ESTIMATED 2023 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 79.76%, AFRICAN AMERICAN: 1.06%, ASIAN: 0.72%, HISPANIC: 5.32%, OTHER: 13.15%. THE ESTIMATED 2023 AVERAGE INCOME IS $82,159. THE ESTIMATED MEDICAL UNDERSERVICE SCORE OF 61.10. PART VI, LINE 5: THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY IN SEVERAL IMPORTANT WAYS. ONE OF THESE WAYS IS THROUGH THE COMMUNITY COLLABORATION COMMITTEE (CCC), A STANDING COMMITTEE OF THE CENTRACARE HEALTH FOUNDATION. THE CCC HAS A MEMBERSHIP OF OVER 30 PERSONS REPRESENTING HEALTHCARE AND COMMUNITY NEEDS ACROSS CENTRAL MINNESOTA. A MAJORITY OF THE COMMITTEE IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA THAT ARE NOT EMPLOYEES OR INDEPENDENT CONTRACTORS OF THE ORGANIZATION AND ARE NOT FAMILY MEMBERS THEREOF. THE CCC MEETS MONTHLY TO DISCUSS WAYS TO ADDRESS TYPICAL HEALTH ISSUES THROUGH AWARENESS BUILDING, EDUCATION AND/OR AN INTERVENTION PROJECT. THERE ARE SEVERAL COMMUNITY HEALTH OUTREACH INITIATIVES THAT THE FOUNDATION IS INVOLVED WITH. THESE INITIATIVES INCLUDE: 1) BLEND CHILDHOOD OBESITY COALITION OF CENTRAL MINNESOTA, 2) SMOKE FREE COMMUNITIES (CONTINUED EFFORTS TO CREATE CLEAN INDOOR AND OUTDOOR AIR FOR ALL), 3) TOBACCO CESSATION SERVICES CLINICS (COLLABORATION WITH CLINIC), 4) CENTRACARE CLINIC TEAM BASED CARE PILOT, 5) ST. CLOUD HOSPITAL - TRANSITION OF CARE PILOT (CREATE MORE SEAMLESS INTEGRATION FROM CARE SETTING TO CARE SETTING, AND 6) CLINIC - DIVERSITY AND CULTURAL COMPETENCY TRAINING. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES AND FACILITIES AND EQUIPMENT, PATIENT CARE, MEDICAL TRAINING, EDUCATION AND RESEARCH. PART VI, LINE 6: THE ORGANIZATION IS PART OF CENTRACARE HEALTH SYSTEM (CCHS) WHICH PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES TO THE PATIENTS OF CENTRAL MINNESOTA. CCHS IS DEDICATED TO IMPROVING THE HEALTH OF PEOPLE LIVING AND WORKING IN THE COMMUNITIES IT SERVES. TO ACCOMPLISH ITS GOALS IT WORKS ACTIVELY WITH ITS AFFILIATE HEALTH CARE ORGANIZATIONS. CCHS CONTINUES TO FOCUS ON PROVIDING THE BEST CARE POSSIBLE AND IN REINVESTING INTO THE COMMUNITY. CCHS ALSO PROMOTES WELLNESS BY SPONSORING PROGRAMS AND EVENTS IN LOCAL COMMUNITIES THAT FOCUS ON HEALTHY EATING AND EXERCISE, AND BY CONDUCTING SCREENINGS FOR CONDITIONS SUCH AS HIGH BLOOD PRESSURE. PART VI, LINE 7, REPORTS FILED WITH STATES MN 1 CITY OF WAITE PARK PO BOX 339 WAITE PARK MN 56387 416005608 GOVERNMENT ENTITY 6120 0 CHARITABLE CONTRIBUTION TO THE CITY FOR PARKING GARAGE COMMUNITY GIVING 101 7TH AVE S SUITE 100 ST CLOUD MN 56301 363412544 501(C)(3) 10000 0 BUILDING EQUITY THROUGH ACTION CENTRAL MN HABITAT FOR HUMANITY 3335 W ST GERMAIN ST SUITE 108 ST CLOUD MN 56301 411634218 501(C)(3) 100000 0 BREAKFAST FOR HUMANITY SPONSORSHIP/ANNUAL DONATIONS REGIONS HOSPITAL FOUNDATION 640 JACKSON ST ST PAUL MN 55101 411888902 501(C)(3) 25000 0 SUPPORT HEALTH PARTNERS LITTLE MOMENTS COUNT FUND FOR BRAIN DEVELOPMENT WORK. SARTELL YOUTH RECREATION CENTER 1109 1ST ST S SARTELL MN 56377 020679589 501(C)(3) 100000 0 CAMPAIGN FOR GROWTH - YOUTH SPORTS AND RECREATION ACTIVE CENTRAL MN PO BOX 458 WAITE PARK MN 56387 832118678 501(C)(3) 40000 0 ANNUAL SPONSORSHIP ST CLOUD AREA FAMILY YMCA 2001 STOCKINGER DR ST CLOUD MN 56303 410952420 501(C)(3) 9000 0 BERNICK'S FITNESS SERIES THE RAE MACKENZIE GROUP 333 WASHINGTON AVE N SUITE 300 MINNEAPOLIS MN 55401 411888541 501(C)(3) 6000 0 PEOPLE OF COLOR CAREER FAIR UNITED WAY OF WEST CENTRAL MN PO BOX 895 WILLMAR MN 56201 410844871 501(C)(3) 18823 0 THE WORKFORCE HOUSING EVENT, LITTLE BUMS OF WILLMAR, VILLAGE CHILDREN'S MUSEUM WILLMAR STINGERS BASEBALL ASSOCIATION PO BOX 201 WILLMAR MN 56201 270923795 501(C)(4) 10000 0 PARTNERSHIP SPONSORSHIP 9 1 LTC SCHOLARSHIP FOR EDUCATION 67 71272 PART I, LINE 2: CONTRIBUTIONS MUST BE IN KEEPING WITH THE MISSION OF CENTRACARE HEALTH, WHICH IS TO WORK TO IMPROVE THE HEALTH OF EVERY PATIENT, EVERY DAY. CONTRIBUTIONS WILL BE MADE TO ORGANIZATIONS RATHER THAN TO INDIVIDUALS WITHIN THE CENTRAL MINNESOTA REGION. CENTRACARE'S CHARITABLE FUNDS MAY NOT BE USED TO SUPPORT ANY ORGANIZATION OR EVENT THAT WOULD RESULT IN BENEFITS OF ANY KIND TO AN EMPLOYEE OF THE HEALTH SYSTEM OR A MEMBER OF THE VARIOUS BOARDS OF DIRECTORS, EITHER DIRECTLY OR INDIRECTLY. ONE EXCEPTION EXISTS TO THE GUIDELINE REGARDING BENEFIT TO EMPLOYEES: WE WILL SUPPORT, VIA SCHOLARSHIPS AND THE PURCHASE OF SUPPLIES, THE MEDICAL MISSION WORK OF OUR STAFF AND PHYSICIANS. THE CENTRACARE HEALTH CONTRIBUTIONS COMMITTEE IS MADE UP OF: ONE REPRESENTATIVE FROM CENTRACARE HEALTH FOUNDATION; ONE REPRESENTATIVE FROM ST. CLOUD HOSPITAL HUMAN RESOURCES/DIVERSITY COMMITTEE; THE DIRECTOR OF CENTRACARE HEALTH'S COMMUNICATION DEPARTMENT AND THE COMMUNICATION/MARKETING FOR ST. BENEDICT'S SENIOR COMMUNITY; THE DIRECTOR OF CENTRACARE HEALTH'S MARKETING DEPARTMENT; THE DIRECTOR OF ST. CLOUD HOSPITAL VOLUNTEER SERVICES; AND ST. CLOUD HOSPITAL'S DIRECTOR OF MISSION & SPIRITUAL CARE. THE COMMITTEE MEETS MONTHLY TO ENSURE A STREAMLINED, COORDINATED PROCESS OF REVIEWING REQUESTS AND DETERMINING FUNDING. OTHER CENTRACARE ENTITIES INCLUDING CENTRACARE HEALTH - LONG PRAIRIE, MELROSE, MONTICELLO, PAYNESVILLE, AND SAUK CENTRE, MAY DEVELOP A BUDGET FOR APPROVAL AND IMPLEMENT THEIR OWN CONTRIBUTION DECISIONS WITHIN THE GUIDELINES OF THIS DOCUMENT. CONTRIBUTIONS MAY NOT EXCEED THE STATED BUDGET AND NO MULTI-YEAR COMMITMENTS TO ORGANIZATIONS MAY BE MADE WITHOUT APPROVAL FROM THE CENTRACARE HEALTH EXECUTIVE COUNCIL. INDIVIDUALS AND DEPARTMENTS FORM THROUGHOUT ST. CLOUD HOSPITAL AND CENTRACARE CLINIC SHOULD FORWARD ALL OUTSIDE FUNDING REQUESTS TO A MEMBER OF THE COMMITTEE FOR THE FULL GROUP'S CONSIDERATION. THOSE REQUESTING FUNDS SHOULD BE ASKED TO SUBMIT REQUESTS IN WRITING. X X X X X 0 1 0 0 0 0 0 1 0 KENNETH HOLMEN PRESIDENT/CEO 1201731 0 191893 0 301525 0 37813 0 28992 0 1761954 0 299833 0 LEAH SCHAMMEL PHYSICIAN 1089228 0 38217 0 180 0 41000 0 31432 0 1200057 0 0 0 NATHANIEL SLINKARD PHYSICIAN 1014472 0 34032 0 180 0 20500 0 28108 0 1097292 0 0 0 DEXTER CASTA PHYSICIAN 881623 0 20657 0 180 0 27736 0 12780 0 942976 0 0 0 SASAN MOSHIRZADEH PHYSICIAN 453262 0 378444 0 270 0 41000 0 11665 0 884641 0 0 0 JOY PLAMANN COO/SR VP 692137 0 68730 0 59569 0 17550 0 22519 0 860505 0 59155 0 JOSEPH BLONSKI VICE PRESIDENT 449116 0 36244 0 298275 0 27000 0 26772 0 837407 0 297087 0 TOD SPEER PHYSICIAN 754108 0 14313 0 1188 0 37320 0 29144 0 836073 0 0 0 THOMAS SCHRUP CPO/EVP 587778 0 71688 0 119197 0 27000 0 29287 0 834950 0 118423 0 CINDY FIRKINS SMITH VICE PRESIDENT 611626 0 54760 0 94176 0 27000 0 29068 0 816630 0 92988 0 MICHAEL BLAIR CFO/SR VP/ TREASURER 618584 0 62370 0 26325 0 47500 0 25886 0 780665 0 25551 0 JOSEPH KALKMAN CAO/SR VP 535495 0 65208 0 94502 0 47500 0 28413 0 771118 0 93728 0 CHRISTOPHER BOELTER VICE PRESIDENT 555286 0 41785 0 65001 0 0 0 1836 0 663908 0 64587 0 MARIA MALLORY VICE PRESIDENT 561733 0 23169 0 414 0 20500 0 19199 0 625015 0 0 0 AMY PORWOLL CISO/SR VP 436278 0 43742 0 90643 0 27000 0 19279 0 616942 0 89869 0 GEORGE MORRIS VICE PRESIDENT 446057 0 36184 0 72642 0 27000 0 27766 0 609649 0 71868 0 CHRISTIAN SCHMIDT DIRECTOR 516124 0 15987 0 1188 0 47239 0 28172 0 608710 0 0 0 SANTO CRUZ CLO/SR VP/ SECRETARY 461820 0 46457 0 26175 0 24100 0 27804 0 586356 0 25995 0 JOHN HERING FORMER KEY EMPLOYEE 399924 0 32278 0 54527 0 47500 0 30307 0 564536 0 54113 0 DEBRA PETERSON VICE PRESIDENT 482310 0 19211 0 1219 0 27000 0 12286 0 542026 0 0 0 BRYAN ROLPH DIRECTOR 516563 0 19505 0 414 0 0 0 2519 0 539001 0 0 0 MICHAEL SCHRAMM FORMER KEY EMPLOYEE 385219 0 30747 0 60538 0 25482 0 27577 0 529563 0 60124 0 KATHLEEN PARSONS VICE PRESIDENT 370986 0 29190 0 51908 0 47250 0 24512 0 523846 0 50720 0 LYNN MCFARLING VICE PRESIDENT 361710 0 29553 0 26754 0 47500 0 21645 0 487162 0 25566 0 JOSEPH HELLIE VICE PRESIDENT 334964 0 27502 0 55550 0 27000 0 25438 0 470454 0 54776 0 RICHARD WEHSELER DIRECTOR 399751 0 15252 0 414 0 27000 0 26982 0 469399 0 0 0 ULRIKA WIGERT VICE PRESIDENT 398554 0 21941 0 270 0 20500 0 26782 0 468047 0 0 0 DIANE BUSCHENA-BRENNA VICE PRESIDENT 323194 0 26337 0 34099 0 47500 0 26561 0 457691 0 32911 0 DAVID LARSON VICE PRESIDENT 322399 0 26216 0 48017 0 20500 0 27418 0 444550 0 47837 0 ANTHONY GARDNER CMCO/SR VP 298678 0 29892 0 64677 0 27000 0 11169 0 431416 0 63489 0 BRADLEY KONKLER VICE PRESIDENT 297631 0 24477 0 59425 0 8737 0 28041 0 418311 0 58651 0 MATTHEW KUNKEL VICE PRESIDENT 334196 0 25680 0 180 0 9752 0 27399 0 397207 0 0 0 PHILIP LUITJENS VICE PRESIDENT 319075 0 25960 0 180 0 19501 0 20518 0 385234 0 0 0 CRAIG BROMAN FORMER OFFICER 0 0 0 0 384531 0 0 0 0 0 384531 0 384531 0 ZACHARY BORK VICE PRESIDENT 247588 0 14113 0 10570 0 13508 0 16017 0 301796 0 0 0 PART I, LINE 4B THE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME TIME IN THE FUTURE. THE EXECUTIVES HAVE NO LEGAL RIGHT TO THESE DOLLARS UNTIL, AND UNLESS, CERTAIN FUTURE EVENTS OCCUR. IN ACCORDANCE WITH THE INSTRUCTIONS TO FORM 990, THE AMOUNTS LISTED IN PART VII AND SCHEDULE J, PART II, COLUMN C REFLECT TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON THE FORM 990. ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF AND WHEN IT IS PAID TO THE EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: AMY PORWOLL - $89,869 ANTHONY GARDNER - $63,489 BRADLEY KONKLER - $58,651 CHRISTOPHER BOELTER - $64,587 CINDY FIRKINS SMITH - $92,988 CRAIG BROMAN - $384,531 DAVID LARSON - $47,837 DIANE BUSCHENA-BRENNA - $32,911 GEORGE MORRIS - $71,868 JOHN HERING - $54,113 JOSEPH BLONSKI - $297,087 JOSEPH HELLIE - $54,776 JOSEPH KALKMAN - $93,728 JOY PLAMANN - $59,155 KATHLEEN PARSONS - $50,720 KENNETH HOLMEN - $299,833 LYNN MCFARLING - $25,566 MICHAEL BLAIR - $25,551 MICHAEL SCHRAMM - $60,124 SANTO CRUZ - $25,995 THOMAS SCHRUP - $118,423 PART I, LINE 7 THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON FOUR DISCRETE AREAS: 1. STEWARDSHIP, THROUGH A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FOR ST CLOUD HOSPITAL AND/OR CENTRACARE HEALTH SYSTEM AS WELL THROUGH ACHIEVING METRICS FOR AN IDENTIFIED COST REDUCTION PROGRAM. 2. QUALITY, THROUGH ACHIEVING ST CLOUD HOSPITAL AND SYSTEM QUALITY METRICS. 3. PATIENT EXPERIENCE, THROUGH ACHIEVEMENT OF PATIENT SATISFACTION GOALS AS COMPARED TO NATIONAL AND BASELINE RANKINGS. 4. PEOPLE/EMPLOYEES, THROUGH ACHIEVEMENT OF SPECIFIED EMPLOYMENT SATISFACTION GOALS AND HIRING AND/OR RETENTION GOALS. THE INCENTIVE COMPENSATION PAID OUT IS NOT A PORTION OR PERCENTAGE OF ACTUAL NET EARNINGS OF ANY CENTRACARE HEALTH SYSTEM AFFILIATE. HOWEVER, NET EARNINGS GOALS ARE REQUIRED TO BE MET BEFORE THE INCENTIVE COMPENSATION IS PAID. A THE CITY OF ST CLOUD 416005515 78916VCZ1 2014-11-19 48876925 TO REFUND BOND ISSUED 2/3/2010 0 0 0 B THE CITY OF ST CLOUD 416005515 000000000 2014-08-01 128310000 SEE PART VI 0 0 0 C THE CITY OF ST CLOUD 416005515 78916VDR8 2016-05-12 216598436 SEE PART VI 0 0 0 D THE CITY OF ST CLOUD 416005515 78916VDW7 2019-03-28 143227442 SEE PART VI 0 0 0 A 31320000 48876925 550981 48325944 0 1 1 1 B 14000000 128311829 15001829 113310000 2016 1 0 1 1 C 4630000 216956117 1760260 53368448 161827409 2017 0 1 1 1 D 146296972 1512827 108624296 8156941 28002908 1 0 0 1 A 0 1 1 1 1 1 0.02370 0.02370 0 0 1 B 0 1 1 1 1 1 0.00610 0.00610 0 0 1 C 0 1 1 1 1 1 0.01880 0.01880 0 0 1 D 0 0 0 0 0.01010 0.01010 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 0 1 1 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 1 0 0 0 0 0 1 1 A 1 B 1 C 1 D 1 PART IV, LINE 6, COLUMNS A AND C THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS. DIFFERENCES BETWEEN THE ISSUE PRICE (PART I) AND TOTAL PROCEEDS (PART II, LINE 3) ARE DUE TO INVESTMENT EARNINGS. PART I, ROW B, COLUMN F TO REFUND BONDS ISSUED 8/10/2009 AND 9/19/2012, AND TO FINANCE CONSTRUCTION OF CHATEAU WATERS PART I, ROW C, COLUMN F TO REFUND BONDS ISSUED 8/10/2009 AND 2/3/2010 , AND TO FINANCE MELROSE HOSPITAL, LONG PRAIRIE HOSPITAL, AND LONG PRAIRIE NURSING HOME PART I, ROW D, COLUMN F TO REFUND BOND ISSUED 12/13/2011, AND TO FINANCE REDWOOD HOSPITAL. PLEASE NOTE THAT FORM 8038 FOR THIS ISSUE ERRONEOUSLY LISTS THE ISSUE DATE OF THE REFUNDED DEBT AS 11/30/2018. SCHEDULE K, PART IV, ARBITRAGE, LINE 2C: (A) ISSUER NAME: THE CITY OF ST CLOUD DATE THE REBATE COMPUTATION WAS PERFORMED: 07/09/2019 (A) ISSUER NAME: THE CITY OF ST CLOUD DATE THE REBATE COMPUTATION WAS PERFORMED: 10/11/2021 JANET WENSMAN SPOUSE OF BOARD MEMBER 50088 WAGES 0 FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS HAS DELEGATED THE APPROVAL AUTHORITY OF FORM 990 TO THE AUDIT COMMITTEE. ANNUALLY, AT THE AUDIT COMMITTEE MEETING, PRIOR TO FILING WITH THE IRS, THE AUDIT COMMITTEE REVIEWS AND APPROVES FORM 990. A COPY OF FORM 990 IS THEN PROVIDED FOR THE FULL BOARD TO REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT-OF-INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN A CONFLICT-OF-INTEREST FORM ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND EXTERNAL COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICT-OF-INTEREST RELATED TO THE BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT-OF-INTEREST ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HERSELF FROM THE DECISION-MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS THE BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT-OF-INTEREST MAY ARISE. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION AND BENEFITS OF THE PRESIDENT AND THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT-OF-INTEREST POLICY AVAILABLE TO THE PUBLIC. THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES PROVIDE AN ANNUAL REPORT TO THE COMMUNITY IN WHICH FINANCIAL RESULTS ARE REPORTED TO AND DISCUSSED WITH THE PUBLIC. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE. FORM 990, PART XI, LINE 9: NET TRANSFERS TO NON-CONTROLLING INTEREST -4,000,000. NET EQUITY TRANSFER TO RELATED PARTIES -1,511,135. OTHER CHANGES TO NET ASSETS 234,430. NON-CONTROLLING INTEREST JOINT VENTURE 2,417,774. ACQUISITION OF BENSON NET ASSETS 14,548,239. COMMUNITY BENEFIT - COVID 19 ACTIVITIES: WHERE APPLICABLE, THE IMPACT RESULTING FROM THE COVID-19 PANDEMIC DURING THE PERIOD ENDED JUNE 30, 2023, HAS BEEN CONSIDERED, SOURCES OF RELIEF INCLUDED THE CORONAVIRUS AID RELIEF AND ECONOMIC SECURITY ACT (THE "CARES ACT"), WHICH WAS ENACTED ON MARCH 27, 2020; AND THE PAYCHECK PROTECTION PROGRAM AND HEALTH CARE ENHANCEMENT ACT (THE "PPPHCE ACT"), WHICH WAS ENACTED ON APRIL 24, 2020. TOGETHER, THE CARES ACT AND THE PPHCE ACT INCLUDED $178 BILLION IN FUNDING TO BE DISTRIBUTED TO ELIGIBLE PROVIDERS THROUGH PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND (THE "PHSSEF"). IN ADDITION, THE CARES ACT PROVIDED FOR AN EXPANSION OF THE MEDICARE ACCELERATED AND ADVANCE PAYMENT PROGRAM WHEREBY INPATIENT ACUTE CARE HOSPITALS AND OTHER ELIGIBLE PROVIDERS MAY REQUEST ACCELERATED PAYMENT OF UP TO 100 PERCENT OF THEIR MEDICARE PAYMENT AMOUNT FOR A SIX-MONTH PERIOD TO BE REPAID THROUGH WITHHOLDING OF FUTURE MEDICARE FEE-FOR-SERVICE PAYMENTS BEGINNING 365 DAYS AFTER RECEIPT. CENTRACARE WAS THE BENEFICIARY OF THESE STIMULUS MEASURES. DURING THE YEAR ENDED JUNE 30, 2023, CENTRACARE HEALTH SYSTEM SERVED OVER 11,000 COMMUNITY MEMBERS BY HOSTING VARIOUS EVENTS AND ACTIVITIES. SOME OF THE EVENTS AND ACTIVITIES HOSTED INCLUDED: HIGH SCHOOL CAREER FAIRS, BETTER TOGETHER EVENT, FARMFEST EVENT, COMMUNITY EDUCATION AND INTERNSHIPS. 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