2024-05-03T09:19:04-05:00 2023-06-30 420714325 RSM US LLP 227 W 1ST ST STE 700 DULUTH MN 558021926 990 2022-07-01 261175213 INNOVIS HEALTH LLC INNO 7013648000 3000 32ND AVE S FARGO ND 58103 DOUG ARVIN VICE PRESIDENT, FINANCE 7013648000 2024-05-03 1 DOUG ARVIN XXX-XX-XXXX 1 JULIE BOYER P01278549 2187275025 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ESSENTIA HEALTH WEST MARK THOMPSON MD 3000 32ND AVE S FARGO ND 58103 574978856 0 X WWW.ESSENTIAHEALTH.ORG X LLC 2007 DE WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 10 7 3127 85 700829 208911 11674190 447105 482707265 566663964 2240629 -2024687 2207194 6535707 498829278 571622089 1115893 1112980 0 0 239926427 291094124 0 0 0 260770090 297688113 501812410 589895217 -2983132 -18273128 292983163 320627613 305707220 351244759 -12724057 -30617146 X WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 1 0 534229895 1112980 566663964 INNOVIS HEALTH, LLC, DBA ESSENTIA HEALTH WEST, IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES. IN FURTHERANCE OF ITS PURPOSES, ESSENTIA HEALTH WEST PROVIDES HEALTH CARE SERVICES IN MINNESOTA AND NORTH DAKOTA THROUGH ITS 142 BED HOSPITAL AND 21 CLINICS, INCLUDING CHARITABLE CARE TO PERSONS UNABLE TO PAY.THE MULTI-SPECIALTY HOSPITAL OFFERS A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR ITS PATIENTS, INCLUDING CRITICAL CARE, MEDICAL SURGICAL CARE, PEDIATRIC SERVICES, NEONATAL INTENSIVE CARE, AND MATERNITY CARE. THE HOSPITAL'S EMERGENCY DEPARTMENT IS OPEN 24 HOURS PER DAY AND IS DESIGNED AS A LEVEL II TRAUMA CENTER. THE HOSPITAL ALSO HAS SEVERAL OPERATING ROOM SUITES, WHICH INCLUDE BOTH INPATIENT AND DAY SURGERY.ESSENTIA HEALTH WEST EMPLOYS APPROXIMATELY 1,900 FULL TIME EQUIVALENTS. THE HOSPITAL PROVIDED FOR APPROXIMATELY 43,000 HOSPITAL PATIENT DAYS AND 196,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2023. THE CLINICS HAD APPROXIMATELY 566,000 ENCOUNTERS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2023, ESSENTIA HEALTH WEST PROVIDED THE FOLLOWING COMMUNITY BENEFITS: $3 MILLION IN CHARITY CARE, $18.2 MILLION COSTS IN EXCESS OF MEDICAID PAYMENTS, $407,000 IN COMMUNITY SERVICES, AND $1.2 MILLION IN HEALTH PROFESSION EDUCATION. 534229895 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 3127 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 7 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MN X DOUG ARVIN 7013648000 3000 32ND AVE S FARGO ND 58103 PRASAD SAWARDEKER MD PHYSICIAN - SECTION CHAIR 60.00 0.00 X 1317815 0 63078 KIMBERLY KOLKHORST MD PHYSICIAN - SECTION CHAIR 60.00 0.00 X 1288790 0 59556 BENJAMIN SMITH MD BOARD DIRECTOR 60.00 0.00 X 1229142 1125 68078 MICKEY SYRQUIN MD PHYSICIAN 60.00 0.00 X 1182405 0 59634 MITCHELL CRIDER MD PHYSICIAN - SECTION CHAIR 60.00 0.00 X 1172792 0 60641 JEROME SAMPSON MD PHYSICIAN 60.00 0.00 X 1154418 0 46166 WILLIAM HEEGAARD MD PRESIDENT THRU 3/23 1.00 59.00 X 902097 0 138409 RICHARD VETTER MD INTERIM PRESIDENT/CHIEF MED OFFICER 58.00 2.00 X 714040 0 109548 ALAN BRUNS MD PHYSICIAN - DIVISION CHAIR 60.00 0.00 X 743821 0 26704 JOSHUA GEBUR MD PHYSICIAN - DIVISION CHAIR 60.00 0.00 X 699956 0 60974 AL HURLEY CHIEF OPERATING OFFICER 55.00 5.00 X 624072 0 92838 STEFANIE GEFROH ELLISON MD PHYSICIAN - DIVISION CHAIR 57.00 3.00 X 574111 30000 64402 ROBERT GREEN VICE PRESIDENT, FINANCE THRU 8/22 10.00 50.00 X 331589 229156 38858 ANDREW MOEN MD PHYSICIAN - DIVISION CHAIR 60.00 0.00 X 482558 0 62091 TANNER GOODRICH SENIOR VICE PRESIDENT, OPERATIONS 58.00 2.00 X 436762 0 97171 RAE SALUS SVP, OPERATIONS THRU 6/23 60.00 0.00 X 442264 0 81180 TANYA DIEGEL MD PHYSICIAN - DIVISION CHAIR 60.00 0.00 X 417063 0 60534 TAYLOR MERTZ MD BOARD DIRECTOR 60.00 0.00 X 339281 1125 62086 JAMES CHRISTENSEN MD BOARD DIRECTOR 60.00 0.00 X 338315 4500 47506 NICOLE CHRISTENSEN CHIEF NURSING OFFICER THRU 5/22 60.00 0.00 X 335902 0 8747 MICHELE THIEMAN MD PHYSICIAN - DIVISION CHAIR 60.00 0.00 X 302307 0 36140 KERRY CARLSON OPERATIONS SENIOR DIRECTOR 60.00 0.00 X 228189 0 46863 JOSEPH WENDT OPERATIONS SENIOR DIRECTOR 60.00 0.00 X 213658 0 48875 DAN BEAUCHAMP FACILITIES SENIOR DIRECTOR 60.00 0.00 X 186760 0 45685 JOHN SPERRAZZA SVP, OPERATIONS THRU 1/22 1.00 59.00 X 35078 172122 4572 CHRISTY BRINKMAN OPERATIONS SENIOR DIRECTOR 1.00 59.00 X 0 190363 12241 SUZANNE ZELTINGER OPERATIONS SENIOR DIRECTOR 60.00 0.00 X 158994 0 17329 TIMOTHY SAYLER FORMER CHIEF OPERATING OFFICER 0.00 0.00 X 143333 0 0 JOEL HAUGEN MD BOARD CHAIR 2.00 0.00 X X 99812 0 0 LAURIE LEWANDOWSKI BOARD DIRECTOR 1.00 4.00 X 0 25375 0 ARRICK JACKSON BOARD DIRECTOR 1.00 0.00 X 0 4500 0 TIM HEILMAN BOARD VICE CHAIR 2.00 0.00 X X 0 4500 0 TRACEY ZAUN BOARD DIRECTOR 1.00 0.00 X 0 4500 0 MARK FINSTAD BOARD SECRETARY/TREASURER 2.00 0.00 X X 0 2250 0 SISTER BEVERLY HORN BOARD DIRECTOR 1.00 4.00 X 0 0 0 DOUG ARVIN VICE PRESIDENT, FINANCE 60.00 0.00 X 0 0 0 16095324 669516 1519906 522 1 1 0 0 235567 207697 3841 447105 INPATIENT AND OUTPATIENT REVENUES 621110 566512502 566254781 257721 DAKOTA CLINIC PHARMACY INVESTMENT 900099 113651 113651 PARK RAPIDS AREA INVESTMENT 900099 37811 37811 566663964 69355 69355 902925 375527 0 147135 902925 228392 1131317 228392 902925 869647 62840 840812 2185717 28835 -2122877 -2094042 -2094042 419561 183103 236458 214716 21742 GAIN ON ASSET PURCHASE 900099 3355724 3355724 CAFETERIA & VENDING SALES 722514 1733874 1733874 RELEASE OF INFORMATION 900099 36275 36275 42059 42059 5167932 571622089 566406243 700829 4067912 X 1106529 1106529 6451 6451 7973305 2954820 5018485 243704 144797 98907 236416561 229758300 6658261 9309115 9124257 184858 22431525 21370497 1061028 14719914 14071979 647935 84872 84872 1464 1464 16789 16789 11338 11338 47299679 36649277 10650402 816325 258127 558198 17577546 13255356 4322190 13142264 12772135 370129 7300127 7094532 205595 2157129 2005079 152050 366352 168739 197613 8301239 8301239 22620513 21983446 637067 5379495 5348640 30855 UNRELATED BUSINESS TAX 43908 43908 MEDICAL SUPPLIES 92498341 92498341 AFFILIATE SUPPORT FEE 56873662 27201168 29672494 BAD DEBT EXPENSE 23202004 23202004 -4934 4954182 -4959116 589895217 534229895 55665322 0 20422 20423 5792361 117109 51384712 59794886 2710559 3628534 12330514 12465781 4653635 5768716 440738268 223900566 192167393 216837702 10747869 308795 2910590 2479252 3186206 9140362 7078902 10066053 292983163 320627613 49755268 59776211 32015 28174 109097868 126627709 116260038 123150347 30562031 41662318 305707220 351244759 X -12724057 -30617146 -12724057 -30617146 292983163 320627613 X -18273128 3485905 -3105866 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 16789 16789 0 PART II-B, LINE 1: LOBBYING ACTIVITY EXPLANATION: ESSENTIA HEALTH WEST PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. 17137377 17137377 251585019 104014093 147570926 12344658 3942008 8402650 147750452 112308561 35441891 11920762 3635904 8284858 216837702 PAYABLES TO RELATED TAX-EXEMPT ORGANIZATIONS 31500000 OPERATING LEASES 10162318 41662318 1 1 X 1 X 0 1 1 0 1 1 3047644 3047644 0.00540 73531807 55358901 18172906 0.03210 76579451 55358901 21220550 0.03750 407104 407104 0.00070 1214482 1214482 0.00210 86 86 0.00000 1621672 1621672 0.00280 78201123 55358901 22842222 0.04030 1 23202004 97342426 125720048 -28377622 X 1 1 1 1 ESSENTIA HEALTH WEST 3000 32ND AVE S FARGO ND 58103 WWW.ESSENTIAHEALTH.ORG 5067 X X X X ESSENTIA HEALTH WEST 0 0 1 X X X X X X X X X 21 1 1 1 1 X WWW.ESSENTIAHEALTH.ORG/ABOUT/CHNA/ X 1 21 1 WWW.ESSENTIAHEALTH.ORG/ABOUT/CHNA/ 0 1 X 200.000000000000 X X X X X 1 1 X X X X 1 X WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X X X X X 1 X 0 X X X X 1 X 0 0 ESSENTIA HEALTH WEST PART V, SECTION B, LINE 5: ESSENTIA HEALTH WEST SOLICITED BROAD FEEDBACK FROM THE COMMUNITY THROUGH A COMMUNITY SURVEY WHICH COLLECTED 1,088 RESPONSES, AND SEVEN LISTENING SESSIONS WITH 80 PARTICIPANTS; THE SURVEY WAS ADMINISTERED FROM MARCH THROUGH NOVEMBER 2021 AND LISTENING SESSIONS WERE CONDUCTED IN FALL 2021. THROUGHOUT THE PROCESS, A HEAVY EMPHASIS WAS PLACED ON CONSIDERING THE INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, SPECIFICALLY INDIVIDUALS FROM LOW-INCOME, MEDICALLY UNDERSERVED, OR MINORITY POPULATIONS AND THOSE WITH A SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH.THE STEERING COMMITTEE, WHICH GUIDED THE PROCESS, INCLUDED REPRESENTATION FROM SANFORD HEALTH, FAMILY HEALTHCARE, FARGO CASS PUBLIC HEALTH, AND CLAY COUNTY PUBLIC HEALTH.ESSENTIA HEALTH WEST DID NOT RECEIVE ANY COMMENTS ON THE PREVIOUS CHNA. IF RECEIVED, ANY COMMENTS WOULD HAVE BEEN TAKEN INTO CONSIDERATION IN THE CHNA UPDATE PROCESS. ESSENTIA HEALTH WEST PART V, SECTION B, LINE 6A: TO ALIGN RESOURCES AND STRENGTHS TO BETTER SERVE OUR COMMUNITY, THE CHNA WAS CONDUCTED IN COLLABORATION WITH SANFORD HEALTH, AN UNRELATED HOSPITAL FACILITY. ESSENTIA HEALTH WEST PART V, SECTION B, LINE 6B: ESSENTIA HEALTH WEST WORKED COLLABORATIVELY ON THE ASSESSMENT PROCESS WITH AFRO AMERICAN DEVELOPMENT ASSOCIATION, BLUE CROSS BLUE SHIELD, CASS AND CLAY COUNTY ECONOMIC DEVELOPMENT, CASS CLAY COMMUNITY LAND TRUST, CASS CLAY HUNGER COALITION, CASS CLAY SOCIAL SERVICES, CASS CLAY UNITED WAY, CLAY COUNTY PUBLIC HEALTH DEPARTMENT, CLAY COUNTY SOCIAL SERVICES, COMMUNITY UPLIFT, CONCORDIA COLLEGE, CULTURAL DIVERSITY RESOURCES, ETHNIC SELF HELP ALLIANCE FOR REFUGEE ASSISTANCE, FAMILY HEALTHCARE CENTER, FARGO CASS PUBLIC HEALTH DEPARTMENT, FIRSTLINK, FM HOMELESS COALITION, GREAT PLAINS FOOD BANK, JEREMIAH PROJECT, KONDIAL KEL INTERNATIONAL, LAKES AND PRAIRIES COMMUNITY ACTION PARTNERSHIP, MINNESOTA STATE UNIVERSITY MOORHEAD, MOORHEAD AND FARGO CITY COUNCIL, MOORHEAD RESILIENCY PROJECT, MINNESOTA STATE COMMUNITY AND TECHNICAL COLLEGE, NORTH DAKOTA STATE HEALTH EQUITY DEPARTMENT, NORTH DAKOTA STATE UNIVERSITY, MOORHEAD, FARGO, AND WEST FARGO SCHOOL DISTRICTS, SOUL SOLUTIONS, SOUTH SUDANESE FOUNDATION, AND THE LOTUS CENTER. ESSENTIA HEALTH WEST PART V, SECTION B, LINE 11: DURING FY 2023, ESSENTIA HEALTH FARGO ADDRESSED SIGNIFICANT NEEDS IDENTIFIED IN THE FY 2022 ASSESSMENT: HEALTH EQUITY AND YOUTH MENTAL HEALTH. SOME ACTIVITIES WERE LED BY THE HOSPITAL, WHILE OTHERS WERE PART OF LARGER COLLABORATIVE EFFORTS WITH LOCAL PARTNERS.OTHER HEALTH NEEDS IDENTIFIED THROUGH THE CHNA PROCESS ARE HOUSING AND TRANSPORTATION, WHICH WILL NOT BE DIRECTLY ADDRESSED AS PRIORITIES BECAUSE FEASIBILITY WAS RANKED LOW. THESE NEEDS WILL BE ADDRESSED AS POSSIBLE THROUGH OTHER COMMUNITY INITIATIVES.THE FOLLOWING DESCRIBES SIGNIFICANT ACCOMPLISHMENTS AND OUTCOMES.PRIORITY AREA #1: HEALTH EQUITYTO PROMOTE HEALTH EQUITY, ESSENTIA HEALTH ENGAGED IN SEVERAL COMMUNITY PARTNERSHIPS. ESSENTIA HEALTH PARTNERED WITH THE WOMEN INITIATIVE NETWORK OF LIBERIA (WIN-LIBERIA), A NON-PROFIT ORGANIZATION IN FARGO, NORTH DAKOTA, WHICH PROVIDES SUPPORT SERVICES TO SINGLE MOTHERS, CHILDREN, AND VULNERABLE ADULTS IN THE FARGO-MOORHEAD AREA. THIS PARTNERSHIP, WHICH STARTED IN DECEMBER 2022, WILL PROMOTE YOUTH ACADEMIC AND SOCIAL DEVELOPMENT BY PROVIDING SUPPORT SERVICES SUCH AS TRANSPORTATION AND CHILDCARE ASSISTANCE TO FAMILIES. ESSENTIA HEALTH PROMOTED HEALTH EQUITY AMONG NEW AMERICAN YOUTH AND FAMILIES IN THE COMMUNITY THROUGH A PARTNERSHIP WITH THE NEW AMERICAN DEVELOPMENT AGENCY (NADA), A NON-PROFIT ORGANIZATION LOCATED IN MOORHEAD, MINNESOTA. THROUGH THIS PARTNERSHIP, NADA WAS ABLE TO REGISTER 40 STUDENTS FOR STEM (SCIENCE, TECHNOLOGY, ENGINEERING, AND MATHEMATICS) CAMP DURING JUNE-JULY 2023. PARTICIPANTS WERE PROVIDED WITH FREE CAMP TUITION, TRANSPORTATION TO AND FROM CAMP, AND CAMP SUPPLIES. COLLECTIVELY, 16 FAMILIES FROM 9 DIFFERENT NEW AMERICAN COMMUNITIES WERE ASSISTED THROUGH THIS PARTNERSHIP. ANOTHER PARTNERSHIP THAT PROMOTED HEALTH EQUITY IN THE COMMUNITY WAS BETWEEN ESSENTIA HEALTH AND THE SOUTH SUDANESE FOUNDATION (SSF), A NON-PROFIT ORGANIZATION SERVING NEW AMERICANS IN WEST CENTRAL MINNESOTA AND SOUTHEASTERN NORTH DAKOTA. THE PURPOSE OF THIS PARTNERSHIP WAS TO PROVIDE NEW AMERICAN YOUTH AND FAMILIES WITH AFTERSCHOOL ACADEMIC AND SOCIAL SUPPORT INCLUDING CULTURALLY APPROPRIATE TUTORING IN ENGLISH LANGUAGE AND MATH, AS WELL AS PROVIDING INDIVIDUAL MENTORING FOR YOUTH BY CULTURALLY SIMILAR ADULTS. THROUGH THIS PARTNERSHIP, AN ANTICIPATED 650 YOUTH WILL BE POSITIVELY IMPACTED DURING THE 2023-2024 SCHOOL YEAR. IN MARCH 2023, ESSENTIA HEALTH PARTNERED WITH THE IMMIGRANT DEVELOPMENT CENTER TO SPONSOR DRIVING TO SUCCESS, A PROGRAM AIMED AT ASSISTING LOW-INCOME WOMEN EXPERIENCING LANGUAGE BARRIERS IN OBTAINING THEIR DRIVER'S LICENSE. OVER THE PERIOD OF 9 MONTHS, THE PROGRAM ANTICIPATES SUPPORTING 32 WOMEN IN SUCCESSFULLY OBTAINING THEIR DRIVER'S LICENSE, WHICH WILL IMPROVE ACCESS TO EMPLOYMENT, HEALTHCARE, AND EDUCATIONAL OPPORTUNITIES FOR PROGRAM PARTICIPANTS. ESSENTIA HEALTH PARTNERED WITH MINNESOTA STATE UNIVERSITY MOORHEAD (MSUM) TO SPONSOR THE SUMMER 2023 SCRUBS CAMP, AN OUTREACH PROGRAM THAT GIVES LOCAL HIGH SCHOOL STUDENTS AN OPPORTUNITY TO EXPLORE HEALTH SCIENCE PROFESSIONS THROUGH ENGAGING, HANDS-ON ACTIVITIES. ESSENTIA HEALTH'S INVESTMENT IN THE CAMP PROMOTED EQUITY BY DRIVING DOWN THE OVERALL COST OF THE CAMP FOR PARTICIPANTS AND HELPING TO REMOVE FINANCIAL BARRIERS OF ATTENDANCE, WHICH RESULTED IN AN ADDITIONAL 10 STUDENTS BEING ABLE TO PARTICIPATE IN THE CAMP DURING FY 2023.ESSENTIA HEALTH CONTINUED A PARTNERSHIP WITH JASMIN CHILD CARE AND PRESCHOOL TO SUPPORT THE EXPANSION OF THEIR CHILDCARE CENTER IN FARGO, NORTH DAKOTA. THROUGH THIS PARTNERSHIP, JASMIN WAS ABLE TO ADD 35 NEW CHILDCARE SPOTS AND EXPAND THEIR HOURS TO OFFER EVENING AND OVERNIGHT CHILDCARE SERVICES. JASMIN SERVES PRIMARILY LOW-INCOME AND BIPOC FAMILIES IN THE FARGO-MOORHEAD COMMUNITY AND OFFERS MULTICULTURAL AND HOLISTIC CHILDCARE SERVICES TO CHILDREN AND FAMILIES. ESSENTIA HEALTH'S PARTNERSHIP WITH JASMIN CHILD CARE AND PRESCHOOL ALLOWED THE ORGANIZATION TO SERVE 79 TOTAL CHILDREN DURING FY 2023. IN ADDITION TO SUPPORTING CHILDCARE EXPANSION IN THE COMMUNITY, ESSENTIA HEALTH HOSTED A YEAR-LONG BUILDING EQUITY COMMUNITY OF PRACTICE, WHICH ENGAGED COMMUNITY LEADERS IN WEST CENTRAL MINNESOTA AND EASTERN NORTH DAKOTA IN INCREASING THEIR CAPACITY TO RECOGNIZE AND ADDRESS DIVERSITY, EQUITY, AND INCLUSION AT THE SYSTEM LEVEL WITHIN THEIR RESPECTIVE ORGANIZATIONS. OVER THE COURSE OF THE 12-MONTH COMMUNITY OF PRACTICE, OVER 100 INDIVIDUALS ENGAGED IN LEARNING SESSIONS AND GUIDED DISCUSSIONS THAT WERE LED BY TRAINERS FROM THE ORGANIZATION 4 FULL PARTICIPATION LOCATED IN FERGUS FALLS, MINNESOTA. THE BUILDING EQUITY COMMUNITY OF PRACTICE MET MONTHLY WITH AN AVERAGE OF 21 MEMBERS ATTENDING THE LIVE ZOOM LEARNING SESSIONS. AT THE END OF THE 12-MONTH COMMUNITY OF PRACTICE, ESSENTIA HEALTH CONTINUED TO SUPPORT EQUITY-RELATED WORK THROUGH AN EXTENDED 6-MONTH LEARNING COHORT HOSTED BY THE ORGANIZATION 4 FULL PARTICIPATION. DURING THIS 6-MONTH COHORT, AN AVERAGE OF 7 MEMBERS ATTENDED LIVE ZOOM LEARNING SESSIONS IN WHICH THEY APPLIED CONDITIONS OF SYSTEM CHANGE TO RACIAL HEALTH EQUITY.ESSENTIA HEALTH PROMOTED HEALTHY EQUITY BY INCREASING OUTREACH IN NEW AMERICAN COMMUNITIES AND SUPPORTING THE NAVIGATION OF EMPLOYMENT OPPORTUNITIES AND WORKFORCE DEVELOPMENT AMONG NEW AMERICANS IN THE FARGO-MOORHEAD AREA. PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS INCLUDING THE ETHNIC SELF-HELP ALLIANCE FOR REFUGEES ASSISTANCE (ESHARA), AFRO AMERICAN DEVELOPMENT ASSOCIATION (AADA), SOUTHEASTERN NORTH DAKOTA COMMUNITY ACTION AGENCY (SENDCAA), AND LAKES AND PRAIRIES COMMUNITY ACTION PARTNERSHIP (CAP-LP), HELPED NEW AMERICAN JOB SEEKERS TO NAVIGATE EMPLOYMENT OPPORTUNITIES IN THE COMMUNITY AND MOBILIZE A CAREER LADDER FOR INDIVIDUALS IN THE HEALTHCARE FIELD, INCLUDING CERTIFIED NURSING ASSISTANTS (CNAS). DURING FY 2023, WORKFORCE DEVELOPMENT PARTNERSHIPS WITH AADA, SENDCAA, AND CAP-LP SUPPORTED 63 NEW AMERICAN APPLICANTS IN APPLYING FOR POSITIONS IN HEALTHCARE WITH 23 APPLICANTS BEING HIRED AT ESSENTIA HEALTH. IN DECEMBER 2022, ESSENTIA HEALTH PARTNERED WITH ESHARA TO STRENGTHEN WORKFORCE DEVELOPMENT SERVICES AND COMMUNITY PARTNERSHIPS AT THE ORGANIZATION. THROUGH SUPPORT FROM ESSENTIA HEALTH, ESHARA WAS ABLE TO PROVIDE ADDITIONAL TRANSLATION SERVICES TO EMPLOYERS, INCREASE TRAINING AND PROFESSIONAL DEVELOPMENT OPPORTUNITIES OFFERED TO JOB SEEKERS, AND STRENGTHEN PATHWAYS FOR JOB SEEKERS TO CONNECT WITH EMPLOYERS AND APPLY FOR OPEN POSITIONS IN THE COMMUNITY.PRIORITY AREA #2: YOUTH MENTAL HEALTHESSENTIA HEALTH PARTNERED WITH CLAY COUNTY PUBLIC HEALTH AND THE MOORHEAD ALTERNATIVE LEARNING CENTER (ALC) TO ADDRESS YOUTH MENTAL HEALTH DURING FY 2023. STUDENTS AND STAFF AT THE ALC PREVIOUSLY REPORTED HIGH RATES OF ANXIETY, DEPRESSION, AND EMOTIONAL DYSREGULATION, WHICH NEGATIVELY IMPACTED STUDENTS' ABILITY TO STAY IN CLASS AND SUCCESSFULLY COMPLETE HIGH SCHOOL. TO POSITIVELY SUPPORT STUDENT MENTAL HEALTH AT THE ALC, ESSENTIA HEALTH AND CLAY COUNTY PUBLIC HEALTH DEVELOPED AND IMPLEMENTED A CALMING ROOM ON THE ALC CAMPUS. TO SUPPORT TEACHERS AND STAFF AT THE ALC IN IMPLEMENTING THE CALMING ROOM, ESSENTIA HEALTH SPONSORED A STAFF TRAINING IN WHICH A SPEAKER FROM AN ALC IN OSSEO, MINNESOTA, WAS BROUGHT IN TO DISCUSS THEIR EXPERIENCE AND LESSONS LEARNED IN IMPLEMENTING A CALMING ROOM ON THEIR CAMPUS. TO FURTHER SUPPORT STUDENT MENTAL HEALTH, ESSENTIA HEALTH AND CLAY COUNTY PUBLIC HEALTH PARTNERED TO SUPPORT THE IMPLEMENTATION OF SOURCES OF STRENGTH CURRICULUM ON THE ALC CAMPUS. THE CURRICULUM, WHICH IS A BEST PRACTICE YOUTH MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION PROGRAM, WAS INTRODUCED TO ALC TEACHERS AND STAFF DURING THE SPRING OF 2023 AND WILL BE UTILIZED WITH ALC STUDENTS DURING FY 2024. IN SEPTEMBER 2022, ESSENTIA HEALTH PARTNERED WITH FRIENDS OF THE CHILDREN FARGO MOORHEAD, A NATIONAL YOUTH MENTORING ORGANIZATION WITH A LOCAL CHAPTER IN FARGO, NORTH DAKOTA. THROUGH THIS PARTNERSHIP, 64 YOUTHS WERE ABLE TO PARTICIPATE IN WEEKLY ONE-ON-ONE SESSIONS WITH MENTORS. THROUGH THESE SESSIONS, YOUTH WERE ABLE TO ACHIEVE SUCCESS IN SEVERAL AREAS INCLUDING INCREASED SCHOOL ATTENDANCE AND HOMEWORK COMPLETION, HEALTHY SOCIAL DEVELOPMENT, PARTICIPATION IN POSITIVE EXTRACURRICULAR ACTIVITIES, SETTING AND ACHIEVING SHORT- AND LONG-TERM GOALS, AND INCREASED PHYSICAL ACTIVITY. ESSENTIA HEALTH PARTNERED WITH FIRSTLINK, A 24/7 SUICIDE CRISIS LIFELINE FOR NORTH DAKOTA AND MINNESOTA RESIDENTS, TO SUPPORT THEIR OPERATIONS DURING FY 2023. DUE TO INCREASED CALL VOLUME, FIRSTLINK IDENTIFIED THE NEED FOR A LARGER OFFICE SPACE, AS WELL AS EQUIPMENT TO SUPPORT TWO ADDITIONAL CALL CENTER STAFF. IN DECEMBER 2022, ESSENTIA HEALTH ASSISTED FIRSTLINK IN THEIR RELOCATION TO A LARGER OFFICE SPACE IN FARGO, NORTH DAKOTA, IN ADDITION TO PURCHASING 9 NEW COMPUTERS AND 18 COMPUTER MONITORS FOR CALL CENTER STAFF. DURING FY 2023, FIRSTLINK PROVIDED MENTAL HEALTH CRISIS RESOURCES AND SERVICES TO 85,000 INDIVIDUALS IN NORTH DAKOTA AND MINNESOTA. ESSENTIA HEALTH WEST PART V, SECTION B, LINE 23: OCCASIONALLY CERTAIN FAP-ELIGIBLE PATIENTS ARE CHARGED MORE THAN AMOUNTS GENERALLY BILLED ON SERVICES. THIS COULD OCCUR IF THE PATIENT PAYMENTS ARE APPLIED ON PATIENT BILLS BEFORE AND/OR AFTER THE FINANCIAL ASSISTANCE POLICY (FAP) ADJUSTMENTS WERE APPLIED. THE HOSPITAL PROVIDES THOSE PATIENTS WITH A $5 OR MORE OVERPAYMENT WITH A REFUND CHECK, EXPLANATION LETTER, AND DETAILED SUMMARY OF SERVICES IMPACTED.THE NUMBER OF PATIENTS AFFECTED AND THE TOTAL DOLLAR AMOUNT INVOLVED FOR FY23 WAS 1 INDIVIDUAL & $216.ESSENTIA HEALTH'S REVENUE CYCLE DEPARTMENT CONFIRMS IF ANY PATIENT PAYMENTS ARE MADE AFTER THE FAP APPLICATION HAS BEEN RECEIVED. IF SO, THE PATIENT PAYMENT IS UNAPPLIED AND THEN THE FAP ADJUSTMENT IS APPLIED. THE PATIENT PAYMENT IS THEN POSTED, AND IF THE PATIENT PAYMENT IS GREATER THAN THE REMAINING BALANCE ON THE BILL, A REFUND TO THE PATIENT IS PROVIDED. THERE COULD BE A FAP-ELIGIBLE PATIENT OVERPAYMENT DEPENDING ON THE TIMING OF THE PATIENT PAYMENT OR IF THE PATIENT IS STILL PAYING THEIR CO-PAYMENT AT THE TIME OF SERVICE. WE CONTACT THESE PATIENTS TO REMIND THEM THAT THEY HAVE CHARITY CARE AND DO NOT NEED TO PAY THEIR CHARGES UNTIL THEIR FAP ADJUSTMENTS HAVE BEEN MADE. WE REQUEST THE REFUND AT THE TIME OF PROCESSING THE FAP APPLICATION IF APPLICABLE. WE ALSO PERFORM AUDITS FOR ANY FAP OVERPAYMENTS DUE TO THE TIMING OF PATIENT PAYMENTS. ADDITIONAL DISCLOSURES NOT REQUIRED FOR PART V, SECTION C: SCHEDULE H, PART V, SECTION B, LINE 3E:ESSENTIA HEALTH FARGO CONDUCTED A NEW CHNA IN FY22 AND CHOSE TO ADDRESS TWO PRIORITY HEALTH NEEDS BASED ON THE FEEDBACK OF 1,088 COMMUNITY MEMBERS. THE SIGNIFICANT HEALTH NEEDS ARE HEALTH EQUITY AND YOUTH MENTAL HEALTH. THE HEALTH NEEDS ARE NOT RANKED IN ORDER; BOTH NEEDS ARE CONSIDERED PRIORITIES. THE HOSPITAL WILL WORK ON ADDRESSING EACH NEED SIMULTANEOUSLY FROM FY23 - FY25.SCHEDULE H, PART V, SECTION B, LINE 16I:DUE TO THE SMALL SIZES OF THE LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS OF THE COMMUNITIES SERVED BY THE ORGANIZATION, THE ORGANIZATION WAS NOT REQUIRED TO TRANSLATE THE FINANCIAL ASSISTANCE POLICY (FAP), THE FAP APPLICATION FORM, OR THE PLAIN LANGUAGE SUMMARY OF THE FAP TO OTHER LANGUAGES. ALTHOUGH IT WAS NOT REQUIRED, THE ORGANIZATION TRANSLATED THE FAP APPLICATION FORM INTO SPANISH. 21 1 - ESSENTIA HEALTH SOUTH UNIVERSITY CLINIC 1702 S UNIVERSITY DR FARGO ND 58103 MULTI-SPECIALTY CLINIC 2 - ESSENTIA HEALTH 32ND AVENUE CLINIC 3000 32ND AVE S FARGO ND 58103 MULTI-SPECIALTY CLINIC 3 - ESSENTIA HEALTH 52ND AVENUE CLINIC 4110 51ST AVE S FARGO ND 58103 MULTI-SPECIALTY CLINIC 4 - ESSENTIA HEALTH WEST ACRES CLINIC 3902 13TH AVE S STE 3704 FARGO ND 58103 PRIMARY CARE CLINIC 5 - ESSENTIA HEALTH WAHPETON CLINIC 275 11TH ST S WAHPETON ND 58075 MULTI-SPECIALTY CLINIC 6 - ESSENTIA HEALTH WEST FARGO CLINIC 1401 13TH AVE E WEST FARGO ND 58078 MULTI-SPECIALTY CLINIC 7 - ESSENTIA HEALTH JAMESTOWN CLINIC 2430 20TH ST SW JAMESTOWN ND 58401 MULTI-SPECIALTY CLINIC 8 - ESSENTIA HEALTH MOORHEAD CLINIC 801 BELSLY BLVD MOORHEAD MN 56560 PRIMARY CARE CLINIC 9 - ESSENTIA HEALTH VALLEY CITY CLINIC 132 4TH AVE NE VALLEY CITY ND 58072 MULTI-SPECIALTY CLINIC 10 - ESSENTIA HEALTH-WEST FARGO THE LIGHTS CL 3150 SHEYENNE ST STE 240 WEST FARGO ND 58078 MULTI-SPECIALTY CLINIC 11 - ESSENTIA HEALTH DOWNTOWN MOORHEAD CLINIC 720 MAIN AVE MOORHEAD MN 56560 PRIMARY CARE CLINIC 12 - ESSENTIA HEALTH OSGOOD CLINIC 4622 40TH AVE S FARGO ND 58104 MULTI-SPECIALTY CLINIC 13 - ESSENTIA HEALTH 45TH STREET CLINIC 4476 31ST AVE S STE 101 FARGO ND 58104 PRIMARY CARE CLINIC 14 - ESSENTIA HEALTH LISBON CLINIC 819 MAIN ST LISBON ND 58054 MULTI-SPECIALTY CLINIC 15 - ESSENTIA HEALTH NORTH FARGO 1100 19TH AVE N STE L-M FARGO ND 58102 MULTI-SPECIALTY CLINIC 16 - ESSENTIA HEALTH CASSELTON CLINIC 5 9TH AVE N CASSELTON ND 58102 PRIMARY CARE CLINIC 17 - ESSENTIA HEALTH HANKINSON CLINIC 501 MAIN AVE S HANKINSON ND 58041 PRIMARY CARE CLINIC 18 - ESSENTIA HEALTH-MID DAKOTA BISMARCK KIRK 727 KIRKWOOD MALL BISMARCK ND 58504 PRIMARY CARE CLINIC 19 - ESSENTIA HEALTH-MID DAKOTA BISMARCK 9TH 401 N 9TH ST BISMARCK ND 58501 MULTI-SPECIALTY CLINIC 20 - ESSENTIA HEALTH-MID DAKOTA BISMARCK GATE 2700 STATE ST BISMARCK ND 58503 PRIMARY CARE CLINIC 21 - ESSENTIA HEALTH MID DAKOTA WOMEN'S CENTE 1000 E ROSSER AVE BISMARCK ND 58501 MULTI-SPECIALTY CLINIC PART I, LINE 3C: ASSETS WILL BE CONSIDERED ALONG WITH THE PATIENT'S INCOME TO DETERMINE ELIGIBILITY FOR THE FINANCIAL ASSISTANCE PROGRAM. TO BE ELIGIBLE, REPORTABLE ASSETS MAY NOT EXCEED $75,000 FOR A HOUSEHOLD OF ONE (1), OR $150,000 FOR A HOUSEHOLD OF TWO (2) OR MORE. ASSETS MAY INCLUDE, BUT ARE NOT LIMITED TO, SUCH ITEMS AS CHECKING AND SAVINGS ACCOUNTS, IRAS, 401(K)S, PENSIONS, HEALTH SAVINGS ACCOUNTS, ADDITIONAL PROPERTY, AND ANY OTHER RETIREMENT FUNDING. PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT INFORMATION IS INCLUDED ON ESSENTIA HEALTH'S (EMPLOYER IDENTIFICATION NUMBER 20-0360007) WEBSITE AT WWW.ESSENTIAHEALTH.ORG. ESSENTIA HEALTH, HEADQUARTERED IN DULUTH, MINNESOTA, IS THE PARENT OF A FULLY INTEGRATED HEALTH SYSTEM SERVING PATIENTS IN MINNESOTA, WISCONSIN, AND NORTH DAKOTA. PART I, LINE 7: THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES WAS USED TO CALCULATE THE COSTS FOR THE FOLLOWING COMMUNITY BENEFITS: CHARITY CARE AND UNREIMBURSED MEDICAID. ACTUAL COSTS WERE USED FOR THE REMAINDER OF THE COMMUNITY BENEFITS REPORTED. PART I, LN 7 COL(F): BAD DEBT EXPENSE THAT WAS SUBTRACTED FROM TOTAL EXPENSE TO OBTAIN THE % OF COMMUNITY BENEFIT TO TOTAL EXPENSE AMOUNTED TO $23,202,004. PART III, LINE 2: DISCOUNTS, CHARITY CARE, AND BAD DEBT EXPENSE ARE ACCOUNTED FOR AS REDUCTIONS TO REVENUE. BAD DEBT EXPENSE IS CALCULATED AFTER ALL ESTIMATED DISCOUNTS AND APPLICABLE PAYMENTS ARE APPLIED TO A PATIENT ACCOUNT. BAD DEBT EXPENSE IS A COMBINATION OF THE ACTUAL ACCOUNT WRITE-OFFS TO A COLLECTION AGENCY FOR ACCOUNTS DEEMED UNCOLLECTIBLE, ALONG WITH ESTIMATED EXPENSE FOR ACCOUNTS WITH A REMAINING BALANCE IN ACCOUNTS RECEIVABLE. IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE. PART III, LINE 3: ESSENTIA HEALTH PROVIDES FULL CHARITY CARE THROUGH ITS TRADITIONAL APPLICATION PROCESS. FULL CHARITY CARE IS A COMPLETE WRITE-OFF OF ELIGIBLE GROSS HOSPITAL AND CLINIC CHARGES. THIS IS BASED ON THE PATIENT'S INCOME IN RELATION TO THE FEDERAL POVERTY GUIDELINES. CATASTROPHIC CHARITY CARE IS FINANCIAL ASSISTANCE THAT PROVIDES A ONE-TIME DISCOUNT BASED ON AN APPLICATION FOR TRADITIONAL CHARITY CARE AND DOES NOT QUALIFY BUT HAS A BALANCE GREATER THAN $5,000. PATIENT, OR THEIR GUARANTOR, MAY BE GRANTED CATASTROPHIC CHARITY CARE ASSISTANCE FOR ELIGIBLE SERVICES IF THEY COMPLETE A FINANCIAL ASSISTANCE APPLICATION AND PROVIDE REQUIRED DOCUMENTATION. THE PATIENT AND/OR GUARANTOR WILL NOT PAY MORE THAN 20% OF ANNUAL INCOME BASED ON ELIGIBLE CHARGES. ESSENTIA HEALTH ALSO RECOGNIZES THAT IT IS NOT FEASIBLE, OR SOMETIMES NECESSARY, FOR ALL PATIENTS TO COMPLETE FINANCIAL ASSISTANCE APPLICATIONS AND PROVIDE DOCUMENTATION REQUIRED THROUGH THE TRADITIONAL PROCESS. ESSENTIA HEALTH IMPLEMENTED AN ALTERNATIVE DOCUMENTATION AND PRESUMPTIVE PROCESS USING A TOOL THAT IDENTIFIES ACCOUNTS THAT AUTOMATICALLY QUALIFY FOR CHARITY CARE AND RECLASSIFIED THOSE ACCOUNTS TO CHARITY CARE ALLOWANCE. AS A RESULT, WE ESTIMATE $0 OF PATIENT ACCOUNTS WRITTEN OFF TO BAD DEBT WOULD QUALIFY FOR CHARITY CARE.ESSENTIA HEALTH WEST IS A PART OF A LARGER ORGANIZATION, ESSENTIA HEALTH. ESSENTIA HEALTH AND ITS MEMBER ORGANIZATIONS INCORPORATE THE COST OF BAD DEBT AS A COMMUNITY BENEFIT. AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE THE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THAT CARE. IN DOING SO, ESSENTIA HEALTH MAKES QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS. PART III, LINE 4: PAGES 16-18 OF ESSENTIA HEALTH'S CONSOLIDATED AUDIT REPORT CONTAIN THE FOOTNOTE DESCRIBING THE ORGANIZATION'S BAD DEBT EXPENSE. PART III, LINE 8: RECONCILIATION FOR MEDICARE SHORTFALL BETWEEN TOTAL MEDICARE PROGRAM AND WHAT IS ALLOWED ON THE COST REPORT:THE HOSPITAL FACILITY'S TOTAL MEDICARE SHORTFALL IS $65,694,818, OF WHICH A SHORTFALL OF $28,377,622 (CONSISTING OF $97,342,426 REVENUE AND $125,720,048 COST) IS INCLUDED IN PART III, SECTION B, LINES 5-7, AND A SHORTFALL OF $37,317,196 (CONSISTING OF $81,425,380 REVENUE AND $118,742,576 COST) REPRESENT ALL OTHER MEDICARE SERVICES NOT INCLUDED IN THE ANNUAL COST REPORT.THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6:THE METHODOLOGY USED IN DETERMINING THE REPORTED MEDICARE ALLOWABLE COST BEGINS WITH THE HOSPITAL'S GENERAL LEDGER SYSTEM. THE COSTS ARE OBTAINED FROM THE GENERAL LEDGER AND THEN ADJUSTED AND REPORTED IN ACCORDANCE WITH CENTERS FOR MEDICARE SERVICES (CMS) "COST FINDING" GUIDELINES AS PUBLISHED IN THEIR PROVIDER REIMBURSEMENT MANUAL. ONCE THE MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE HOSPITAL'S COST REPORT, ANY COSTS ATTRIBUTED TO SUBSIDIZED HEALTH SERVICES AND MEDICAL EDUCATION ARE REMOVED AND REPORTED SEPARATELY.EXPLANATION FOR ANY PRIOR YEAR SETTLEMENTS FOR MEDICARE-RELATED SERVICES IN THE CURRENT TAX YEAR:EACH ESSENTIA HEALTH HOSPITAL IS REQUIRED TO FILE A MEDICARE COST REPORT 5 MONTHS AFTER THE CLOSE OF THEIR FISCAL YEAR. THE COST REPORT PROVIDES MEDICARE WITH INFORMATION THAT IS USED TO DETERMINE UTILIZATION AND SPENDING TRENDS BUT ALSO IS USED TO SET FUTURE PAYMENT RATES FOR MOST MEDICARE SERVICES. IF THE INTERIM PAYMENTS PAID TO A HOSPITAL ARE HIGHER OR LOWER THAN THE FILED COST REPORT ALLOWABLE REIMBURSEMENT, THERE WILL BE A SETTLEMENT FOR THAT FISCAL YEAR. THIS CAN BE DUE TO CHANGES IN UTILIZATION OR COST OF PROVIDING SERVICES FOR CRITICAL ACCESS HOSPITALS (CAH) OR DIFFERENCES BETWEEN INTERIM AND FINAL PAYMENT FACTORS FOR DISPROPORTIONATE SHARE, BAD DEBTS, OR INDIRECT MEDICAL EDUCATION FOR NON-CAH HOSPITALS. AN ESTIMATE FOR THESE SETTLEMENTS IS RECORDED AT THE CLOSE OF THE FISCAL YEAR. IF THE ESTIMATE VARIES FROM THE FINAL SETTLEMENT RECEIVED 6-7 MONTHS AFTER THE FISCAL YEAR ENDS, THEN THESE AMOUNTS ARE RECORDED AS PRIOR YEAR MEDICARE REVENUE.THE EXTENT TO WHICH ANY SHORTFALL REPORTED IN PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT AND THE RATIONALE FOR THE ORGANIZATION'S OPINION:ESSENTIA HEALTH WEST IS A PART OF A LARGER ORGANIZATION, ESSENTIA HEALTH. ESSENTIA HEALTH AND ITS MEMBER ORGANIZATIONS INCORPORATE THE FULL VALUE OF THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. THE RATIONALE FOR THE ORGANIZATION'S OPINION IS PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE AND IT IS LIKELY TO GET WORSE. MANY MEDICARE BENEFICIARIES ARE POOR AND ARE ELIGIBLE FOR MEDICAID IN ADDITION TO MEDICARE. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY. PART III, LINE 9B: THE POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR ESSENTIA HEALTH'S FINANCIAL ASSISTANCE POLICY (FAP) AND FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR FINANCIAL ASSISTANCE FROM ESSENTIA HEALTH, AND THE PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS. THE ORGANIZATION OFFERS EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS AND WILL NOT IMPOSE LIENS ON PRIMARY RESIDENCES NOR REPORT PATIENTS TO A CREDIT RATING AGENCY FOR OUTSTANDING PATIENT BILLS.THE ORGANIZATION WILL NOT CHARGE A PATIENT THE GROSS AMOUNT OF CHARGES FOR ANY UNINSURED TREATMENT. UNINSURED DISCOUNTS WILL BE APPLIED TO THE GROSS CHARGES PRIOR TO ANY FINANCIAL ASSISTANCE OR OTHER DISCOUNTS.IF AT ANY TIME THE ORGANIZATION RECOGNIZES THAT A PATIENT MAY BE ELIGIBLE FOR STATE OR FEDERAL PROGRAMS, A REPRESENTATIVE WILL ASSIST THE PATIENT IN OBTAINING INFORMATION ABOUT THESE PROGRAMS OR PROVIDE CONTACT INFORMATION FOR THESE PROGRAMS. THE ORGANIZATION CONTRACTS WITH AN OUTSIDE PATIENT ADVOCACY AGENCY, WHICH MAY PROVIDE ASSISTANCE TO THE UNINSURED PATIENT IN APPLYING TO CERTAIN STATE AND FEDERAL PROGRAMS.AT ANY STAGE OF THE PATIENT EXPERIENCE AND UP THROUGH THE COLLECTION PROCESS, THE PATIENT MAY EXPRESS A CONCERN THAT THEY ARE UNABLE TO PAY THEIR BILL IN FULL OR MEET THE PAYMENT PLAN REQUIREMENTS. AT THAT TIME, THE PATIENT WILL BE GIVEN EVERY OPPORTUNITY TO COMPLETE AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE.THE ORGANIZATION TRAINS ITS OUTSIDE DEBT COLLECTION AGENCIES AND ATTORNEYS ABOUT THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION ABOUT THE FAP OR SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE ORGANIZATION REQUIRES ITS OUTSIDE COLLECTION AGENCIES AND ATTORNEYS TO REFER PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE TO ESSENTIA HEALTH. IF A PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, THE ORGANIZATION SUSPENDS ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND ESSENTIA HEALTH HAS NOTIFIED THE PATIENT OF ITS DECISION. PATIENTS ARE ADVISED AT THAT TIME TO NOTIFY THE COLLECTION AGENCY TO HOLD THEIR ACCOUNT. THE OUTSIDE DEBT COLLECTION AGENCIES ARE NOTIFIED BY ESSENTIA HEALTH ONCE AN ACCOUNT ADJUSTMENT HAS BEEN MADE. PART VI, LINE 2: NEEDS ASSESSMENT:WE ASSESS AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE THROUGH MANY WAYS INCLUDING THE FOLLOWING:MARKETING RESEARCH - THE ESSENTIA HEALTH MARKETING RESEARCH DEPARTMENT CONDUCTS SURVEYS, FOCUS GROUPS AND REVIEWS INTERNAL DATA TO BETTER UNDERSTAND THE NEEDS AND USE(S) OF OUR SERVICES. THIS INCLUDES ACCESS TO SERVICE AREAS (E.G., PRIMARY CARE), PAYOR INFORMATION (E.G., ESSENTIA CARE), AND OVERALL GAPS IN SERVICES. ASSESSMENTS HAVE RESULTED IN INTERNAL CHANGES IN BOTH STAFFING AND PROCESSES.ESSENTIA HEALTH POPULATION CARE MANAGEMENT - WE USE AN ANALYSIS OF MULTIPLE POPULATIONS; ONE SUCH GROUP IS "ACO POPULATIONS." THE ANALYSES DONE INCLUDE THE IDENTIFICATION OF PATIENTS WHO HAVE UNCONTROLLED ASTHMA, UNCONTROLLED DIABETES, ARE PRE-DIABETIC, OR WHO HAVE DEPRESSION; THE RESULTS ARE USED IN TARGETED OUTREACH BY THE POPULATION CARE TEAM. TARGETED OUTREACH HAS PROVEN TO LEAD TO BETTER OUTCOMES FOR THESE POPULATIONS. PLANNED INTERACTION WITH VARIOUS COMMUNITY HEALTH, HEALTHCARE, AND SOCIAL WELFARE GROUPS - THIS INCLUDES GATHERING PERSPECTIVES ON COMMUNITY NEEDS AND THE ROLE ESSENTIA HEALTH CAN PLAY IN ADDRESSING THOSE NEEDS AS A COLLABORATIVE PARTNER.INTERNAL QUALITY INDICATORS - WE TRACK DATA THAT LEADS TO THE IMPROVED CARE AND TREATMENT OF PATIENTS WITH CHRONIC DISEASES, TOBACCO USE, AND MENTAL HEALTH CONDITIONS. THIS DATA INCLUDES PATIENT ACTIVITY AND OUTCOMES, WHICH ALLOWS FOR ESSENTIA HEALTH TO BETTER IDENTIFY THE NEEDS OF THE PATIENTS AND CAN BE UTILIZED TO ASSESS THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE.HEALTH DATA PROVIDED BY PAYOR ORGANIZATIONS, NAMELY GOVERNMENT AND COMMERCIAL HEALTH INSURERS - THIS HEALTH DATA TYPICALLY INVOLVES MEDICAL TREATMENT AND OUTCOMES THAT REFLECT TRENDS OF UNHEALTHY LIFESTYLES AND BEHAVIORS. OUR OBJECTIVE IS TO UNDERSTAND THESE RELATIONSHIPS AND TO DEVELOP ACTION STEPS TO INTERVENE ON THE FRONT END TO PREVENT SUCH MEDICAL SITUATIONS FROM OCCURRING.ESSENTIA HEALTH HUMAN RESOURCES DEPARTMENT - THE ANALYSIS OF CURRENT STAFFING TRENDS AIDS IN PROVIDING HEALTHCARE ACCESS APPROPRIATELY TO THE COMMUNITIES WE SERVE.ESSENTIA INSTITUTE OF RURAL HEALTH (EIRH) - EIRH PROVIDES RESEARCH OF PATIENT DATA, COMMUNITY DATA, AND THE OUTCOMES ASSOCIATED WITH CURRENT CLINICAL PRACTICES, INTERVENTIONS, AND PREVENTION STRATEGIES (E.G., OPIOID USE DISORDER, SOCIAL DETERMINANTS OF HEALTH). PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE ORGANIZATION MAKES INFORMATION ON ITS FINANCIAL ASSISTANCE POLICY (FAP) READILY AVAILABLE TO PATIENTS. INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS IS AVAILABLE ON THE ESSENTIA HEALTH WEBSITE (WWW.ESSENTIAHEALTH.ORG, SELECT PATIENTS & VISITORS) WHERE THE INFORMATION AND APPLICATION IS EASILY ACCESSIBLE TO BE VIEWED, DOWNLOADED, AND PRINTED AT NO CHARGE TO THE PATIENT. PATIENTS CAN ALSO APPLY FOR FAP VIA MYCHART. NOTICES ON THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE CONSPICUOUSLY POSTED IN EMERGENCY ROOM DEPARTMENTS. FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE DURING THE PRE-ADMISSION FINANCIAL SCREENING, AT THE TIME OF REGISTRATION, AND PRIOR TO A HOSPITAL DISCHARGE. INFORMATION ABOUT THE FAP IS IN ALL COLLECTION LETTERS AND PATIENT STATEMENTS.FAP INFORMATION AND/OR APPLICATIONS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. THE ORGANIZATION EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS PROVIDING DIRECT PATIENT TREATMENT AND WHO WORK IN ADMISSIONS, BILLING, AND COLLECTIONS, ABOUT THE EXISTENCE OF THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION. ANNUAL EDUCATION/AWARENESS OF THE FAP IS PROVIDED TO ENSURE ALL EMPLOYEES WITH PATIENT CONTACT ARE AWARE OF THE PROGRAM AND HOW PATIENTS CAN OBTAIN ADDITIONAL INFORMATION. CLINICAL AND HOSPITAL STAFF WHO PROVIDE DIRECT PATIENT CARE HAVE KNOWLEDGE OF THE FAP AND KNOW TO DIRECT PATIENTS TO A REGISTRATION INTERVIEWER OR BUSINESS OFFICE REPRESENTATIVE. REGISTRATION STAFF HAVE AN UNDERSTANDING OF THE POLICY, KNOWLEDGE OF WHERE THE RELATED DOCUMENTS ARE LOCATED, AND WHERE TO DIRECT THE PATIENT FOR MORE INFORMATION ON THE FAP. DESIGNATED EMPLOYEES (PATIENT FINANCIAL SERVICES COUNSELORS & PATIENT FINANCIAL SERVICES REPRESENTATIVES) HAVE A THOROUGH UNDERSTANDING OF THE FAP AND OFFER THE INFORMATION ON THE FAP TO THOSE PATIENTS WHO MAKE AN INQUIRY ABOUT THE PROGRAM OR ARE DETERMINED THROUGH A FINANCIAL SCREENING TO BE ELIGIBLE FOR THIS PROGRAM. PATIENT ADVOCACY SERVICES ALSO INFORM THE PATIENT ABOUT THE AVAILABILITY OF ASSISTANCE. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT, A PATIENT'S GUARANTOR, A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. THE ORGANIZATION RESPONDS TO ANY ORAL OR WRITTEN REQUESTS FOR MORE GENERAL INFORMATION ON THE FAP MADE BY A PATIENT OR ANY INTERESTED PARTY. PART VI, LINE 4: COMMUNITY INFORMATION:ESSENTIA HEALTH WEST IS LOCATED IN FARGO, ND. ESSENTIA HEALTH WEST IS A PART OF ESSENTIA HEALTH, WHICH IS DEFINED IN PART VI, LINE 6. ESSENTIA HEALTH WEST OPERATES 1 HOSPITAL AND 21 CLINICS THAT PRIMARILY SERVE CASS, CLAY, AND BURLEIGH COUNTIES. THE OVERALL COMMUNITY IS CLASSIFIED AS A COMBINATION OF SUBURBAN AND RURAL. ESSENTIA HEALTH WEST COVERS A SERVICE AREA OF APPROXIMATELY 490,000 PEOPLE. THE SERVICE AREA AGE DISTRIBUTION IS 21% UNDER THE AGE OF 18; 60% BETWEEN THE AGES OF 18 AND 65; AND 19% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE AREA IS 90% CAUCASIAN; 2% AFRICAN AMERICAN; 1% ASIAN; 2% HISPANIC; AND 5% OTHER. THE GENDER SPLIT RATIO IS 50% WOMEN AND 50% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY $60,000. ESSENTIA HEALTH WEST, AS PART OF ESSENTIA HEALTH, IS COMMITTED TO SERVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. APPROXIMATELY 2.2% GROSS REVENUE DOLLARS WERE FROM SELF-PAY PATIENTS AND 13.3% FROM MEDICAID RECIPIENTS. ESSENTIA HEALTH WEST HAS CLINICS IN BECKER, CLAY, AND RANSOM COUNTIES ALONG WITH HANKINSON, ND WHICH ARE CURRENTLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS. AS MENTIONED ABOVE, ESSENTIA HEALTH WEST IS PART OF ESSENTIA HEALTH. ESSENTIA HEALTH STAFFS HOSPITALS AND CLINICS IN FEDERALLY-RECOGNIZED UNDERSERVED AREAS AND SUPPORTS THE HEALTH OF ITS COMMUNITIES THROUGH AN ACTIVE OUTREACH PROGRAM THAT BRINGS SPECIALISTS LIKE ONCOLOGISTS, CARDIOLOGISTS, NEUROLOGISTS, AND OTHERS INTO ITS SMALLER COMMUNITIES. THIS ELIMINATES BARRIERS TO CARE FOR MANY PATIENTS, PARTICULARLY THOSE WHO ARE ELDERLY, LIVING ON LOW INCOMES, OR ARE FACED WITH OTHER CHALLENGES THAT MAKE IT DIFFICULT TO TRAVEL LONG DISTANCES FOR CARE. THERE ARE 14 OTHER HOSPITALS OUTSIDE OF THE ESSENTIA HEALTH UMBRELLA THAT SERVICE THE COMMUNITY. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:THE ORGANIZATION'S BOARD OF DIRECTORS IS COMPOSED MAINLY OF VOLUNTEER REPRESENTATIVES FROM THE COMMUNITIES IT SERVES. ESSENTIA HEALTH WEST HAS AN OPEN MEDICAL STAFF, SO ANY QUALIFIED PHYSICIAN OF THE COMMUNITY IS ALLOWED TO APPLY. ALL APPLICANTS WHO APPLY MUST MEET THE CREDENTIALING STANDARDS AND BE APPROVED BY THE ESSENTIA HEALTH WEST GOVERNING BOARD, IN ACCORDANCE WITH THE RESERVED POWERS, IN ORDER TO PROVIDE SERVICES AT ESSENTIA HEALTH. IN ADDITION, THE HOSPITAL PROVIDES ON-SITE CLINICAL EXPERIENCES FOR MEDICAL STUDENTS AND RESIDENTS, ADVANCED PRACTICE AND PRE-LICENSURE NURSES, PHARMACISTS, THERAPISTS, TECHNICIANS, AND THOSE IN OTHER HEALTHCARE VOCATIONS.WE REINVEST IN THE ORGANIZATION BY ACQUIRING THE LATEST STATE-OF-THE-ART EQUIPMENT AND BY INVESTING IN PROGRAMS THAT ARE NEEDED IN OUR COMMUNITY.IN ADDITION TO THE ACTIVITIES LISTED IN PART I, LINE 7 AS WELL AS PART V, SECTION B, LINE 11, THE ORGANIZATION SUPPORTS THE HEALTH AND VITALITY OF OUR COMMUNITIES THROUGH A SPECIAL DEDICATION TO MAKING A DIFFERENCE IN AREAS THAT POSITIVELY IMPACT THE SOCIAL DETERMINANTS OF HEALTH. WE MAKE SIGNIFICANT CONTRIBUTIONS TO COMMUNITY NON-PROFITS WORKING TO ENCOURAGE ACCESS TO HEALTHY FOODS, MENTAL WELL-BEING, AND HEALTHY YOUTH DEVELOPMENT. ADDITIONALLY, WE ENCOURAGE OUR COLLEAGUES TO CONTRIBUTE THEIR TIME IN MEANINGFUL WAYS THROUGH A FORMAL EMPLOYEE VOLUNTEER PROGRAM THAT INCENTIVIZES COMMUNITY VOLUNTEERING BY PROVIDING A $100 DONATION TO A NONPROFIT OF THE EMPLOYEE'S CHOICE AFTER VOLUNTEERING AT LEAST 20 HOURS. IN FY23, MORE THAN 18,000 IMPACTFUL VOLUNTEER HOURS WERE REPORTED FOR ESSENTIA HEALTH COLLEAGUES. OUR LEADERS ARE ACTIVELY ENGAGED IN LENDING THEIR EXPERTISE ON COMMUNITY BOARDS, INCLUDING WORKFORCE DEVELOPMENT EFFORTS THAT CONTRIBUTE TO THE ECONOMIC VITALITY OF OUR REGION. LASTLY, THE HOSPITAL ENGAGES COMMUNITIES IN COMING TOGETHER AND CREATING SOCIAL CONNECTIVITY THROUGH SUPPORT OF VARIOUS LOCAL EVENTS, FUNDRAISERS, AND OUTINGS, MANY OF WHICH INVOLVE PHYSICAL ACTIVITY AND SUPPORT BUSINESSES THAT ENHANCE THE VIABILITY OF OUR COMMUNITIES.ESSENTIA HEALTH WEST IS A PART OF ESSENTIA HEALTH, A FULLY INTEGRATED HEALTH SYSTEM WITH FACILITIES IN MINNESOTA, WISCONSIN, AND NORTH DAKOTA. AS A NON-PROFIT ORGANIZATION, ESSENTIA HEALTH REINVESTS SURPLUS REVENUES INTO MEDICAL TRAINING, PROGRAMS, AND TECHNOLOGY DESIGNED TO REDUCE THE RISK OF PREVENTABLE HARM TO OUR PATIENTS AND INCREASE THE HEALTH AND VITALITY OF THE COMMUNITIES WE SERVE.ESSENTIA HEALTH PROVIDES SERVICES PREDOMINANTLY IN RURAL COMMUNITIES AND IS COMMITTED TO ELIMINATING GEOGRAPHIC BARRIERS TO CARE. MANY OF ESSENTIA HEALTH'S CLINICS AND COMMUNITY HOSPITALS ARE LOCATED IN COMMUNITIES THAT ARE FEDERALLY RECOGNIZED AS BEING MEDICALLY UNDERSERVED. WE INVEST IN FACILITY UPGRADES, TECHNOLOGY, AND STAFFING THAT ENHANCE CARE IN THESE COMMUNITIES TO ENSURE PATIENTS CAN RECEIVE AS MUCH CARE AS POSSIBLE CLOSE TO HOME. THIS IS A VITAL COMPONENT OF COMMUNITY HEALTH IN AREAS WHERE RESIDENTS ARE OFTEN ELDERLY, LIVING ON LIMITED INCOMES, AND RESTRICTED IN THEIR TRANSPORTATION OPTIONS.RESIDENTS OF GEOGRAPHICALLY ISOLATED COMMUNITIES SERVED BY ESSENTIA HEALTH ALSO BENEFIT FROM TELEHEALTH SERVICES THAT PROVIDE LOCAL ACCESS TO SPECIALISTS AND SPECIALTY SERVICES USUALLY AVAILABLE ONLY IN LARGER URBAN AREAS. SERVICES ARE AVAILABLE IN MORE THAN 30 SPECIALTIES, RANGING FROM BEHAVIORAL HEALTH TO PHYSICAL, OCCUPATIONAL, AND SPEECH-LANGUAGE THERAPY. PATIENTS TREATED IN SMALLER ESSENTIA HEALTH EMERGENCY DEPARTMENTS BENEFIT FROM TELEHEALTH CONNECTIONS THAT ALLOW COMMUNITY HOSPITAL PHYSICIANS AND NURSES TO COMMUNICATE WITH TRAUMA AND OTHER SPECIALISTS LOCATED IN ESSENTIA HEALTH'S LARGER HOSPITALS. PATIENTS CAN ALSO STAY IN THEIR HOME FOR FOLLOW-UP VISITS WITH THEIR PRIMARY CARE PROVIDER OR SPECIALISTS, WHEN APPROPRIATE, WHICH ALLOWS THEM TO ACCESS THEIR PROVIDERS WITHIN THE COMFORT OF THEIR HOME. IN ADDITION, PATIENTS CAN RECEIVE THE CARE THEY NEED WHERE AND WHEN THEY WANT IT. ESSENTIA OFFERS 24/7 VIDEO VISITS ON DEMAND FOR URGENT NEEDS ANY TIME, ONLINE E-VISITS FOR 20 COMMON CONDITIONS AND FREE MEDICAL ADVICE FROM OUR REGISTERED NURSES ANY TIME OF THE DAY OR NIGHT THROUGH OUR NURSE CARE LINE.WE FOLLOW CORE STANDARDS OF VALUE-BASED CARE ORGANIZATIONS, INCLUDING PATIENT-CENTERED PRIMARY CARE, ACCESS TO CARE, CARE COORDINATION, AND QUALITY IMPROVEMENT. PATIENT-CENTERED PRIMARY CARE ENCOMPASSES STRATEGIES AND SERVICES ORIENTED AROUND THE PATIENT TO ACHIEVE THEIR BEST HEALTH. IMPROVING PATIENTS' ACCESS TO CARE IS AN IMPORTANT FOCUS IN OUR POPULATION HEALTH PROGRAM. AT THE CORE OF PATIENT-CENTERED CARE IS THE CONNECTION VIA THE ELECTRONIC HEALTH RECORD (EHR). CLINICAL DATA REGISTRIES ARE CREATED TO INTEGRATE EHR AND PAYER DATA. THE REGISTRIES STRATIFY THE POPULATION, IDENTIFYING THOSE WITH THE HIGHEST LEVEL OF NEEDS. USING THIS INFORMATION, THE TEAM CAN ENGAGE WITH THE PATIENT TO DEVELOP AN INDIVIDUALIZED CARE MANAGEMENT PLAN AND CLOSE ANY CARE GAPS. OUR CARE TEAMS WORK TOGETHER TO DEVELOP PROGRAMS THAT ADDRESS THE NEEDS OF OUR PATIENTS, INCLUDING THOSE IN GOVERNMENT-BASED PROGRAMS AND THOSE PATIENTS AT HIGHER RISK FOR ADVERSE OUTCOMES. THESE EFFORTS RESULT IN IMPROVED HEALTH OUTCOMES, BETTER PATIENT EXPERIENCE, AND LOWER OVERALL UTILIZATION AND COST.SINCE MOST HEALTH CARE COSTS ARE DIRECTLY RELATED TO CARING FOR PATIENTS WHO HAVE CHRONIC CONDITIONS, ESSENTIA HEALTH IS COMMITTED TO IMPROVING HEALTH OUTCOMES FOR PATIENTS, ESPECIALLY THOSE WITH CHRONIC DISEASES. FOR EXAMPLE, ESSENTIA HEALTH OFFERS ONE-ON-ONE TOBACCO CESSATION COUNSELING AT NEARLY 30 SITES ACROSS MINNESOTA, WISCONSIN, AND NORTH DAKOTA. THESE SITES COVER A WIDE GEOGRAPHY, FROM SMALL RURAL COMMUNITIES TO LARGER URBAN AREAS, AND OFTEN SERVE PEOPLE LIVING ON LOW AND MODERATE INCOMES.ESSENTIA HEALTH OFFERS DIABETES PREVENTION EDUCATION AND FALLS PREVENTION PROGRAMS IN OUR COMMUNITIES. THIS WORK HAS BEEN RECOGNIZED BY A NUMBER OF COMMENDATIONS AND AWARDS FROM GOVERNMENT AGENCIES. THESE COMMUNITY-BASED EFFORTS ARE FREE TO THE PUBLIC AND ALL INDIVIDUALS ARE WELCOME.ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND IMPROVING HEALTH EQUITY IS A KEY FOCUS FOR ESSENTIA HEALTH AS WELL. ACROSS OUR SERVICE AREA, FOOD INSECURITY REMAINS A PROBLEM WITH SOME COUNTIES SEEING AS HIGH AS 18% OF THE POPULATION WITH FOOD INSECURITY COMPARED TO THE MINNESOTA STATE AVERAGE OF 10%. A FIVE-QUESTION "SOCIAL NEEDS" QUESTIONNAIRE IS SENT TO ALL PRIMARY CARE AND PEDIATRIC PATIENTS THROUGH MYCHART, WHICH OFFERS PATIENTS SECURE, 24/7 ONLINE ACCESS TO THEIR MEDICAL RECORD. PATIENTS WHO ANSWER THAT THEY HAVE A SOCIAL-DETERMINANT NEED AND WOULD LIKE SUPPORT ARE CONNECTED WITH OUR COMMUNITY CARE ASSOCIATES AND COMMUNITY HEALTH WORKERS. THESE ESSENTIA HEALTH COLLEAGUES DEVELOP A TRUSTING RELATIONSHIP WITH PATIENTS, MAKE REFERRALS TO CONNECT THEM WITH SERVICES, AND FOLLOW UP WITH THEM TO ENSURE NEW RESOURCES AND REFERRALS ARE HELPFUL.IN 2021, ESSENTIA HEALTH PARTNERED WITH FIND HELP TO PROVIDE A FREE ONLINE RESOURCE GUIDE (WEARERESOURCEFUL.ORG) TO HELP OUR COMMUNITY MEMBERS FIND FREE AND REDUCED COST SERVICES. RESOURCEFUL HELPS PEOPLE CONNECT TO SOCIAL SERVICE PROGRAMS, INCLUDING FOOD, SHELTER, HEALTH CARE, WORK, TRANSPORTATION, FINANCIAL ASSISTANCE AND OTHER RESOURCES. RESOURCEFUL IS USED BY OUR CARE TEAM MEMBERS TO PLACE AND TRACK REFERRALS TO COMMUNITY RESOURCES. IT'S ALSO USED BEYOND THE WALLS OF OUR HOSPITALS AND CLINICS BY COMMUNITY ORGANIZATIONS, HELPERS AND NAVIGATORS, FAMILIES, AND INDIVIDUALS FOR FREE. AS OF SPRING 2023, MORE THAN 13,000 REFERRALS TO COMMUNITY RESOURCES HAD BEEN PLACED THROUGH THE PLATFORM.ADDITIONALLY, ESSENTIA HEALTH SUPPORTS THE HEALTH OF OUR COMMUNITIES THROUGH ACTIVE RESEARCH AND CLINICAL TRIALS THROUGH THE ESSENTIA INSTITUTE OF RURAL HEALTH (INSTITUTE). THE INSTITUTE CONDUCTS CLINICAL, TRANSLATIONAL, AND HEALTH SERVICES RESEARCH WITH A PRIMARY FOCUS ON THE NEEDS OF RURAL AMERICANS. VARIOUS ESSENTIA HEALTH ORGANIZATIONS CONTRIBUTED APPROXIMATELY $3.8 MILLION IN SUPPORT TO THE INSTITUTE DURING THE PAST YEAR. ESSENTIA HEALTH IS ALSO A PRIMARY SUPPORTER OF MEDICAL EDUCATION, PARTICULARLY IN THE AREA OF RURAL PRIMARY CARE. ESSENTIA HEALTH PHYSICIANS SERVE AS FACULTY AND PRECEPTORS FOR THE UNIVERSITY OF MINNESOTA SCHOOL OF MEDICINE IN DULUTH, MN. ESSENTIA HEALTH ALSO PROVIDES FUNDING, ADMINISTRATIVE SUPPORT, AND RESIDENCY OPPORTUNITIES FOR THE DULUTH FAMILY PRACTICE RESIDENCY PROGRAM. THIS PROGRAM IS VITAL IN ADDRESSING THE GROWING SHORTAGE OF PRIMARY CARE PHYSICIANS IN RURAL COMMUNITIES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:ESSENTIA HEALTH WEST IS PART OF ESSENTIA HEALTH, A FULLY INTEGRATED HEALTH SYSTEM WITH 14 HOSPITALS, APPROXIMATELY 78 CLINICS, SIX LONG-TERM CARE FACILITIES, TWO ASSISTED LIVING FACILITIES, THREE INDEPENDENT LIVING FACILITIES, SEVERAL REHABILITATION CENTERS, SEVEN AMBULANCE SERVICES, 27 RETAIL PHARMACIES, ONE RESEARCH INSTITUTE, AND HOME HEALTH SERVICES IN THREE STATES: MINNESOTA, WISCONSIN, AND NORTH DAKOTA. ESSENTIA HEALTH SERVES A PREDOMINANTLY RURAL POPULATION WHOSE MEDIAN INCOMES GENERALLY FALL BELOW THE AVERAGES OF THE STATES WHERE THEY LIVE. THE PRESENCE OF OUR CLINICS AND HOSPITALS ENSURES THAT PEOPLE WITH FEW ECONOMIC RESOURCES DO NOT HAVE TO DRIVE AN HOUR OR MORE TO RECEIVE BASIC (AND IN SOME CASES LIFESAVING) MEDICAL CARE.IN ADDITION TO STAFFING HOSPITALS AND CLINICS IN FEDERALLY RECOGNIZED UNDERSERVED AREAS, ESSENTIA HEALTH SUPPORTS THE HEALTH OF COMMUNITIES THROUGH ACTIVE OUTREACH PROGRAMS THAT BRING ONCOLOGISTS, CARDIOLOGISTS, AND OTHERS INTO SMALL HOSPITALS AND CLINICS. ESSENTIA HEALTH'S SIZE AND INTEGRATED STRUCTURE ALSO ALLOW THE ORGANIZATION TO EXTEND SERVICES LIKE CHEMOTHERAPY, WOUND CARE, AND HOSPICE CARE TO SMALLER COMMUNITIES.PATIENTS ARE ABLE TO TRAVEL SEAMLESSLY BETWEEN ESSENTIA HEALTH'S SMALLER COMMUNITY CLINICS AND ITS LARGER SPECIALTY CARE CENTERS THANKS TO SIGNIFICANT INVESTMENTS IN ELECTRONIC HEALTH RECORDS (EHRS). ALMOST EVERY ESSENTIA HEALTH HOSPITAL AND CLINIC IS LINKED TO THIS SYSTEM, ALLOWING CLINICIANS TO SHARE EVERYTHING FROM LAB RESULTS AND RADIOLOGY IMAGES TO NOTES ON CLINIC VISITS, HOSPITAL STAYS, AND SERVICES LIKE PHYSICAL REHABILITATION.THE EHR IS ALSO AN INCREASINGLY VALUABLE TOOL FOR PATIENTS AND THEIR FAMILIES, THANKS TO MYCHART, WHICH OFFERS PATIENTS SECURE, 24/7 ONLINE ACCESS TO THEIR MEDICAL RECORD. MYCHART ALSO ALLOWS PATIENTS TO CONTACT THEIR PHYSICIAN OR CLINIC, SCHEDULE APPOINTMENTS, AND ORDER MEDICATION REFILLS. THESE SERVICES ARE ALL OFFERED AT NO COST TO PATIENTS AND THEIR AUTHORIZED FAMILY, FRIENDS, AND CAREGIVERS.ESSENTIA HEALTH ALSO PROMOTES THE HEALTH OF ALL OF ITS COMMUNITIES THROUGH ADHERENCE TO EVIDENCE-BASED BEST PRACTICE STANDARDS AND CLINICAL QUALITY GOALS DESIGNED TO ENSURE THAT PATIENTS RECEIVE THE SAME HIGH STANDARD OF CARE AT ANY ESSENTIA HEALTH HOSPITAL OR CLINIC.THE ESSENTIA INSTITUTE OF RURAL HEALTH (INSTITUTE) ACTIVELY SUPPORTS COMMUNITY HEALTH THROUGH ITS TRANSLATIONAL AND HEALTH SERVICES RESEARCH WITH A PRIMARY FOCUS ON THE NEEDS OF RURAL AMERICANS. THE INSTITUTE ALSO SPONSORS A NUMBER OF CONFERENCES AND OTHER EDUCATIONAL EVENTS, OPEN TO ALL MEDICAL PROFESSIONALS IN THE REGION, TO ENSURE THAT RURAL CLINICIANS HAVE ACCESS TO CURRENT MEDICAL EDUCATION AND TRAINING CLOSE TO HOME.TELEHEALTH ALLOWS PATIENTS TO RECEIVE CARE FROM A SPECIALIST WHO IS NOT AVAILABLE IN THEIR HOME COMMUNITY. TELEHEALTH APPOINTMENTS TAKE PLACE IN LOCAL CLINICS OR HOSPITALS THROUGH SECURE INTERACTIVE VIDEOCONFERENCING. PATIENTS FEEL LIKE THEY ARE IN THE SAME ROOM AS THEIR DOCTOR. THIS EXPERIENCE OFFERS THE SAME HIGH-QUALITY CARE THAT PATIENTS EXPECT DURING AN IN-PERSON VISIT. TELEHEALTH CAN BE USED FOR SERVICES SUCH AS BEHAVIORAL HEALTH, CARDIOLOGY, STROKE CARE, PRIMARY CARE, AND ENDOCRINOLOGY/DIABETES CARE. IN ADDITION, PATIENTS CAN RECEIVE THE CARE THEY NEED WHERE AND WHEN THEY WANT IT. ESSENTIA OFFERS 24/7 VIDEO VISITS ON DEMAND FOR URGENT NEEDS ANY TIME, ONLINE E-VISITS FOR MORE THAN 20 COMMON CONDITIONS AND FREE MEDICAL ADVICE FROM OUR REGISTERED NURSES ANY TIME OF THE DAY OR NIGHT THROUGH OUR NURSE CARE LINE.ESSENTIA HEALTH'S HOSPITALS AND CLINICS PLAY ADDITIONAL ROLES IN PROMOTING HEALTH WITHIN THEIR COMMUNITIES. EACH ESSENTIA HEALTH HOSPITAL CONDUCTS A COMMUNITY HEALTH ASSESSMENT TO DETERMINE THE UNIQUE HEALTH NEEDS OF COMMUNITY RESIDENTS. THESE ASSESSMENTS, WHICH ARE BASED ON INPUT FROM A BROAD RANGE OF COMMUNITY RESIDENTS AND STAKEHOLDERS, ARE THE BASIS FOR ACTION PLANS AIMED AT ADDRESSING THE COMMUNITY'S MOST PRESSING HEALTH NEEDS. MOST RECENTLY, TOPICS OF CONCERN HAVE INCLUDED ELIMINATING SOCIAL AND ECONOMIC BARRIERS TO HEALTH AND WELLNESS, IMPROVING MENTAL HEALTH SERVICES AND AWARENESS, ADDRESSING YOUTH SUBSTANCE ABUSE, FOOD INSECURITY, AND OBESITY. THESE ISSUES ARE THEN ADDRESSED THROUGH COLLABORATION WITH PRIVATE BUSINESSES, GOVERNMENT AGENCIES, AND OTHER NON-PROFITS.CURRENTLY, TWO OF THE MOST PROMINENT COLLABORATIONS ARE WITH CROW WING ENERGIZED AND BRIDGING HEALTH DULUTH, JOINT PUBLIC-PRIVATE PARTNERSHIPS AIMED AT IMPROVING THE OVERALL HEALTH STATUS OF THESE COMMUNITIES THROUGH COORDINATED PROGRAMMING AIMED AT LIFESTYLE ISSUES RANGING FROM EXERCISE TO HEALTHY EATING TO ADDRESS SOCIAL DETERMINANTS OF HEALTH.IN AN EFFORT TO HELP SOME OF OUR COMMUNITIES' AT-RISK POPULATIONS REMAIN AT HOME AND OUT OF THE HOSPITAL OR NURSING HOME, ESSENTIA HEALTH HAS COMMUNITY PARAMEDIC PROGRAMS IN FARGO, ND, AS WELL AS BRAINERD, DETROIT LAKES, DEER RIVER, AND DULUTH, MN. PARAMEDICS MAKE HOUSE CALLS TO PATIENTS WHO HAVE BEEN IDENTIFIED AS AT RISK FOR EMERGENCY DEPARTMENT VISITS. DURING THE CALLS, THEY TAKE VITAL SIGNS, ASSESS POSSIBLE HEALTH AND SAFETY RISKS, AND DETERMINE IF PATIENTS MAY BENEFIT FROM ADDITIONAL COMMUNITY RESOURCES.ESSENTIA HEALTH EMPLOYEES CONTRIBUTE DIRECTLY TO THE HEALTH AND WELLNESS OF THEIR COMMUNITIES BY VOLUNTEERING IN PROGRAMS RANGING FROM HABITAT FOR HUMANITY TO UNITED WAY TO FOOD AND CLOTHING DRIVES. THEY ARE ACTIVE FUNDRAISERS FOR HEALTH-RELATED ORGANIZATIONS IN THEIR COMMUNITIES, LIKE LOCAL CHAPTERS OF THE AMERICAN HEART ASSOCIATION. ESSENTIA HEALTH ENCOURAGES AND SUPPORTS THESE VOLUNTEER EFFORTS IN A VARIETY OF WAYS, INCLUDING SPONSORSHIPS, FINANCIAL CONTRIBUTIONS, AND VOLUNTEER RECOGNITION.WE ALSO SUPPORT COMMUNITY HEALTH THROUGH CONTRIBUTIONS THAT FOCUS ON PROGRAMS AND SERVICES THAT BENEFIT THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. SOME EXAMPLES OF THESE PROGRAMS ARE FARMERS MARKETS, COMMUNITY GARDENS, WORKFORCE DEVELOPMENT PROGRAMS, AND TRANSPORTATION ACCESS PROGRAMS. PART VI, LINE 7: LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT:N/A 1 CASS CLAY COMMUNITY LAND TRUST 109 1/2 BROADWAY NORTH 203 FARGO ND 58102 834077611 501(C)3 10000 0 PROGRAM SUPPORT EMERGING PRARIE 118 BROADWAY N STE S1 FARGO ND 58107 810742137 501(C)3 25000 0 PROGRAM SUPPORT ESSENTIA HEALTH FOUNDATION 502 E 2ND ST DULUTH MN 55805 271984704 501(C)3 705829 0 PROGRAM SUPPORT FAITH4HOPE SCHOLARSHIP FUND 1321 19TH AVE N FARGO ND 58102 814085396 501(C)3 31250 0 PROGRAM SUPPORT FIRSTLINK 4357 13TH AVE S STE 107L FARGO ND 58103 450419491 501(C)3 15100 0 PROGRAM SUPPORT FRIENDS OF THE CHILDREN FARGO-MOORHEAD 200 45TH ST S FARGO ND 58103 834476757 501(C)3 10000 0 PROGRAM SUPPORT GREATER FARGO MOORHEAD ECONOMIC DEVELOPMENT CORPORATION 51 BROADWAY SUITE 500 FARGO ND 58102 456011769 501(C)3 10000 0 PROGRAM SUPPORT IMMIGRANT DEVELOPMENT CENTER 810 4TH AVE S STE 100 MOORHEAD MN 56560 203368647 501(C)3 15000 0 PROGRAM SUPPORT JASMIN SERVICES 4720 7TH AVE S FARGO ND 58103 823422274 501(C)3 25000 0 PROGRAM SUPPORT JEREMIAH PROGRAM 615 1ST AVE NE STE 210 MINNEAPOLIS MN 55413 411801834 501(C)3 12000 0 PROGRAM SUPPORT LAKES & PRAIRIES COMMUNITY ACTION PARTNERSHIP 891 BELSLY BLVD MOORHEAD MN 56560 410905871 501(C)3 19000 0 PROGRAM SUPPORT MINNESOTA STATE UNIVERSITY-MOORHEAD 1104 7TH AVE S MOORHEAD MN 56563 411687554 UNIVERSITY OF MN 105000 0 PROGRAM SUPPORT NEW AMERICAN DEVELOPMENT AGENCY 3505 8TH ST S MOORHEAD MN 56560 810781184 501(C)3 15000 0 PROGRAM SUPPORT RISING NOMADS IMPACT 2512 7TH AVE S STE 1A FARGO ND 58103 872623784 501(C)3 10000 0 PROGRAM SUPPORT SOUL SOLUTIONS RECOVERY CENTER 1801 38TH ST S FARGO ND 58103 843025490 501(C)3 50100 0 PROGRAM SUPPORT SOUTH SUDANESE FOUNDATION 6074 59TH ST S FARGO ND 58104 834476088 501(C)3 10000 0 PROGRAM SUPPORT UNITED WAY OF CASS CLAY PO BOX 1609 FARGO ND 58107 410810008 501(C)3 16000 0 PROGRAM SUPPORT WOMEN INITIATIVE NETWORK OF LIBERIA IN FARGO ND 15 21ST ST S STE 104 FARGO ND 58103 831823044 501(C)3 6500 0 PROGRAM SUPPORT 18 0 SCHOLARSHIPS 3 2500 FMV PAYMENTS MADE DIRECTLY TO UNIVERSITIES PATIENT ASSISTANCE 3 3951 PART I, LINE 2: PROCEDURES FOR MONITORING GRANTS: ESSENTIA HEALTH WEST MANAGEMENT REVIEWS THE GRANT ACTIVITY BY REVIEWING AND DOCUMENTING EACH EXPENDITURE REQUEST AND APPROVING THE EXPENSE. ESSENTIA HEALTH WEST PROVIDES SCHOLARSHIPS TO GRADUATING HIGH SCHOOL SENIORS GOING INTO THE MEDICAL FIELD. SEPARATE SCHOLARSHIP COMMITTEES EXIST FOR EACH HIGH SCHOOL WITHIN ESSENTIA HEALTH WEST'S SERVICE AREA. SCHOLARSHIP WINNERS ARE SELECTED BY THE SCHOLARSHIP COMMITTEES BASED ON FINANCIAL NEED, GRADE POINT AVERAGE, AND VOLUNTEERISM. X X 1 1 X X X X 1 1 0 0 0 0 0 0 1 1 PRASAD SAWARDEKER MD PHYSICIAN - SECTION CHAIR 1316675 0 0 0 1140 0 24400 0 38678 0 1380893 0 0 0 KIMBERLY KOLKHORST MD PHYSICIAN - SECTION CHAIR 1287878 0 0 0 912 0 21633 0 37923 0 1348346 0 0 0 BENJAMIN SMITH MD BOARD DIRECTOR 1228002 1125 0 0 1140 0 24400 0 43678 0 1297220 1125 0 0 MICKEY SYRQUIN MD PHYSICIAN 1175673 0 0 0 6732 0 24400 0 35234 0 1242039 0 0 0 MITCHELL CRIDER MD PHYSICIAN - SECTION CHAIR 1171082 0 0 0 1710 0 22173 0 38468 0 1233433 0 0 0 JEROME SAMPSON MD PHYSICIAN 1144530 0 0 0 9888 0 22293 0 23873 0 1200584 0 0 0 WILLIAM HEEGAARD MD PRESIDENT THRU 3/23 623417 0 267196 0 11484 0 101311 0 37098 0 1040506 0 0 0 RICHARD VETTER MD INTERIM PRESIDENT/CHIEF MED OFFICER 483985 0 192485 0 37570 0 73802 0 35746 0 823588 0 26574 0 ALAN BRUNS MD PHYSICIAN - DIVISION CHAIR 738277 0 0 0 5544 0 24400 0 2304 0 770525 0 0 0 JOSHUA GEBUR MD PHYSICIAN - DIVISION CHAIR 699284 0 0 0 672 0 24400 0 36574 0 760930 0 0 0 AL HURLEY CHIEF OPERATING OFFICER 421495 0 179556 0 23021 0 68251 0 24587 0 716910 0 7608 0 STEFANIE GEFROH ELLISON MD PHYSICIAN - DIVISION CHAIR 524623 30000 0 0 49488 0 24400 0 40002 0 638513 30000 0 0 ROBERT GREEN VICE PRESIDENT, FINANCE THRU 8/22 323934 139554 0 64126 7655 25476 0 0 27828 11030 359417 240186 0 0 ANDREW MOEN MD PHYSICIAN - DIVISION CHAIR 482150 0 0 0 408 0 24400 0 37691 0 544649 0 0 0 TANNER GOODRICH SENIOR VICE PRESIDENT, OPERATIONS 307909 0 127876 0 977 0 68855 0 28316 0 533933 0 0 0 RAE SALUS SVP, OPERATIONS THRU 6/23 297014 0 119704 0 25546 0 68683 0 12497 0 523444 0 0 0 TANYA DIEGEL MD PHYSICIAN - DIVISION CHAIR 416235 0 0 0 828 0 23604 0 36930 0 477597 0 0 0 TAYLOR MERTZ MD BOARD DIRECTOR 338946 1125 0 0 335 0 24400 0 37686 0 401367 1125 0 0 JAMES CHRISTENSEN MD BOARD DIRECTOR 334352 4500 0 0 3963 0 23710 0 23796 0 385821 4500 0 0 NICOLE CHRISTENSEN CHIEF NURSING OFFICER THRU 5/22 116928 0 35457 0 183517 0 7716 0 1031 0 344649 0 0 0 MICHELE THIEMAN MD PHYSICIAN - DIVISION CHAIR 302001 0 0 0 306 0 24315 0 11825 0 338447 0 0 0 KERRY CARLSON OPERATIONS SENIOR DIRECTOR 216662 0 7000 0 4527 0 11896 0 34967 0 275052 0 0 0 JOSEPH WENDT OPERATIONS SENIOR DIRECTOR 203359 0 6000 0 4299 0 11250 0 37625 0 262533 0 0 0 DAN BEAUCHAMP FACILITIES SENIOR DIRECTOR 173843 0 6000 0 6917 0 9824 0 35861 0 232445 0 0 0 JOHN SPERRAZZA SVP, OPERATIONS THRU 1/22 33463 94812 0 0 1615 77310 0 4016 152 404 35230 176542 0 0 CHRISTY BRINKMAN OPERATIONS SENIOR DIRECTOR 0 184118 0 6000 0 245 0 9574 0 2667 0 202604 0 0 SUZANNE ZELTINGER OPERATIONS SENIOR DIRECTOR 149905 0 6000 0 3089 0 8328 0 9001 0 176323 0 0 0 TIMOTHY SAYLER FORMER CHIEF OPERATING OFFICER 0 0 0 0 143333 0 0 0 0 0 143333 0 0 0 PART I, LINE 1A BENEFITS PROVIDED: DURING CALENDAR YEAR 2022, CHARTER TRAVEL WAS USED BY ONE DIRECTOR, THREE OFFICERS AND TWO KEY EMPLOYEES FOR TRAVEL BETWEEN ESSENTIA HEALTH WEST AND OTHER ORGANIZATIONS. THE USE OF CHARTER TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION TO THESE INDIVIDUALS AS ALL TRAVEL WAS BUSINESS RELATED. DURING CALENDAR YEAR 2022, KEY EMPLOYEE JOHN SPERRAZZA RECEIVED A HOUSING ALLOWANCE. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION. PART I, LINE 3 ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A SUPPORTING ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA HEALTH WEST'S PRESIDENT'S COMPENSATION: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B SEVERANCE PAYMENT: KEY EMPLOYEE NICOLE CHRISTENSEN RECEIVED PAYMENTS TOTALING $145,858 IN CALENDAR YEAR 2022 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, CHRISTENSEN WILL RECEIVE PAY TOTALING $166,042 FROM MAY 24, 2022 TO MAY 23, 2023. KEY EMPLOYEE JOHN SPERRAZZA RECEIVED PAYMENTS TOTALING $72,504 IN CALENDAR YEAR 2022 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, SPERRAZZA RECEIVED ALL SEVERANCE PAYMENTS DURING CALENDAR YEAR 2022. ALL OTHER INDIVIDUALS LISTED AS FORMERS IN FORM 990, PART VII, SECTION A, LINE 1A DID NOT RECEIVE A SEVERANCE PAYMENT DURING CALENDAR YEAR 2022. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ESSENTIA HEALTH'S NONQUALIFIED RETIREMENT PLAN IS OFFERED TO DESIGNATED ESSENTIA HEALTH EXECUTIVES. THERE IS A MINIMUM FOUR YEAR VESTING DATE, OR VESTING IS AUTOMATIC UPON REACHING RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. BENEFITS ARE SUBJECT TO INCOME TAXES UPON VESTING AND PAYABLE FROM ESSENTIA HEALTH'S GENERAL ASSETS. REPORTED AS OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B (III), THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A RECEIVED PAYMENT OF THE VESTED BENEFIT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: RICHARD VETTER, MD $26,574 AL HURLEY $13,160 REPORTED AS RETIREMENT AND OTHER DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C, ESSENTIA HEALTH MADE CONTRIBUTIONS, SUBJECT TO THE VESTING TERMS, DURING THE YEAR INTO THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A: WILLIAM HEEGAARD, MD $78,203 RICHARD VETTER, MD $49,402 AL HURLEY $44,418 TANNER GOODRICH $45,923 RAE SALUS $44,283 PART I, LINE 8 INITIAL CONTRACT EXCEPTION: ESSENTIA HEALTH WEST'S PHYSICIAN - SECTION CHAIR, KIMBERLY KOLKHORST, MD, RECEIVED COMPENSATION DURING THE YEAR UNDER AN INITIAL EMPLOYMENT AGREEMENT SUBJECT TO THE INITIAL CONTRACT EXCEPTION. THROUGH THE ESSENTIA HEALTH PHYSICIAN AND PROVIDER COMPENSATION COMMITTEE, THIS COMPENSATION ARRANGEMENT WAS REVIEWED AND APPROVED BY INDEPENDENT PERSONS USING COMPARABILITY DATA AND THE BASIS FOR DETERMINATION WAS DOCUMENTED. A DULUTH ECONOMIC DEVELOPMENT AUTHORITY 900848286 26444CHF2 2018-11-01 704253406 SRS 2018A (SEE PART VI) 0 0 0 B CASS COUNTY NORTH DAKOTA 456002205 148047BF9 2018-11-01 42050194 SRS 2018B (SEE PART VI) 0 0 0 C CASS COUNTY NORTH DAKOTA 456002205 000000000 2020-02-18 61320000 SRS 2020A (SEE PART VI) 0 0 0 D WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 000000000 2020-02-18 13095000 SRS 2020B (SEE PART VI) 0 0 0 A 27710387 239569 27470818 1 0 1 1 B 42050194 380994 41669200 2018 1 0 1 1 C 15103729 54188 15049541 2020 1 0 1 1 D 3225430 29557 3195873 2020 1 0 1 1 A 0 0 1 0 0 0 0 1 B 0 0 1 0 0 0 0 1 C 0 0 1 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 0 0 1 0 0 1 SEE PART VI 1 1 1 B 0 0 0 1 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: DULUTH ECONOMIC DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2023 ISSUER NAME: CASS COUNTY, NORTH DAKOTA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2023 SCHEDULE K: ADDITIONAL INFORMATION/COMMENTS RELATING TO THE REPORTING OF LIABILITIES BY RELATED ORGANIZATIONS: ESSENTIA HEALTH HAS AN OBLIGATED GROUP CREATED UNDER THE MASTER TRUST INDENTURE WHICH IS COMPOSED OF THE FOLLOWING MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, BRAINERD LAKES INTEGRATED HEALTH SYSTEM, ST. MARY'S INNOVIS HEALTH, THE DULUTH CLINIC, LTD. AND ESSENTIA HEALTH WEST (THE "OBLIGATED GROUP MEMBERS"). THE OBLIGATED GROUP MEMBERS ARE JOINTLY AND SEVERALLY OBLIGATED ON ALL INDEBTEDNESS EVIDENCED OR SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. SERIES 2018A: THE SERIES 2018A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, BRAINERD LAKES INTEGRATED HEALTH SYSTEM, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2018A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH DULUTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2018B: THE SERIES 2018B BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH EAST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH DULUTH, AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2018B BONDS. THE CONDUIT BORROWER ESSENTIA HEALTH WEST HAS RECORDED THE BOND LIABILITY ON ITS BALANCE SHEET WHICH IS CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020A: THE SERIES 2020A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020B: THE SERIES 2020B BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020B BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020C: THE SERIES 2020C BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020C BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2023A: THE SERIES 2023A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2023A BONDS. THE CONDUIT BORROWER ESSENTIA HEALTH WEST HAS RECORDED THE BOND LIABILITY ON ITS BALANCE SHEET WHICH IS CONSOLIDATED WITH ESSENTIA HEALTH. SCHEDULE K, PART 1, COLUMN (F): DESCRIPTION OF PURPOSE: SERIES 2018A: ACQUIRE, CONSTRUCT, BUILD, AND EQUIP MEDICAL CAMPUS PROJECT IN DULUTH, MN; REFUND SERIES 2008E BONDS ISSUED MAY 2, 2008 TO REFINANCE SERIES 1997 BONDS ISSUED DECEMBER 18, 1997 TO FINANCE EQUIPMENT PURCHASES IN DULUTH, MN AND FINANCE PROPERTY ACQUISITIONS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN NORTHERN MINNESOTA; AND REFUND SERIES 2014 BONDS ISSUED JULY 29, 2014 TO REFINANCE PRIOR NOTE USED FOR CAPITAL IMPROVEMENTS TO SKILLED NURSING FACILITY LOCATED IN DETROIT LAKES, MN AND VARIOUS CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN BAXTER, FRAZEE, AND PELICAN RAPIDS, MN AND FINANCE CAPITAL EXPENDITURES TO REPLACE THE CHILLER UNIT FOR ESSENTIA HEALTH VIRGINIA, RENOVATE APPROXIMATELY 118,000 SQUARE FEET OF CLINIC SPACE FOR ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, REMODEL AND EQUIP EXISTING CLINIC SPACE IN EMILY, MN FOR ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, AND EXPAND AND REMODEL THE IMAGING AREA IN THE EMERGENCY ROOM OF ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES' HOSPITAL. SERIES 2018B: REFUND SERIES 2014 BONDS ISSUED JUNE 30, 2014 TO FINANCE CONSTRUCTING AND EQUIPPING 125,000 SQUARE FOOT EXPANSION TO IN-PATIENT HOSPITAL FACILITIES LOCATED IN FARGO, ND AND RELATED REMODELING. SERIES 2020A: REFUND SERIES 2008A BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFINANCE A PORTION OF THE ACQUISITION OF CERTAIN ASSETS OF ESSENTIA HEALTH WEST IN CONNECTION WITH THE AFFILIATION OF ESSENTIA HEALTH WITH ESSENTIA HEALTH WEST. SERIES 2020B: REFUND SERIES 2008B BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 1999B BONDS ISSUED MAY 18, 1999 FOR CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN SUPERIOR, WI AND VARIOUS DULUTH CLINIC LOCATIONS IN NORTHWESTERN WISCONSIN. SERIES 2020C: REFUND SERIES 2008C BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 2004 BONDS ISSUED MARCH 19, 2004 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN DULUTH, BRAINERD, AND DETROIT LAKES, MN AND REFUND SERIES 1999A BONDS ISSUED MAY 18, 1999 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN BRAINERD, DETROIT LAKES AND DULUTH, MN AND VARIOUS DULUTH CLINIC SITES IN NORTHERN MINNESOTA. SERIES 2023A: ACQUIRE CERTAIN HEALTH FACILITIES IN BISMARCK, ND. SCHEDULE K, PART II, LINE 3: ISSUE PRICE: SERIES 2018A, SERIES 2018B, SERIES 2020A, SERIES 2020B, SERIES 2020C, AND SERIES 2023A BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. THE ISSUE PRICE LISTED IN ESSENTIA HEALTH WEST'S SCHEDULE K, PART I, COLUMN (E) REPRESENTS THE ESSENTIA HEALTH OBLIGATED GROUP'S TOTAL BORROWING. SCHEDULE K, PART II, LINES 3 THROUGH 12: PROCEEDS: SERIES 2018A, SERIES 2018B, SERIES 2020A, SERIES 2020B, SERIES 2020C, AND SERIES 2023A BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. A PORTION OF THE SERIES 2018A, SERIES 2018B, SERIES 2020A, SERIES 2020B, SERIES 2020C, AND 2023A BORROWINGS WERE ALLOCATED TO ESSENTIA HEALTH WEST, AN ESSENTIA HEALTH OBLIGATED GROUP MEMBER. THE PROCEEDS LISTED IN ESSENTIA HEALTH WEST'S SCHEDULE K, PART II, LINES 3 THROUGH 12 REPRESENT ESSENTIA HEALTH WEST'S ALLOCATED PORTION OF THE PROCEEDS. SCHEDULE K, PART IV, LINE 5B: NAME OF PROVIDER OF GIC: NATIXIS FUNDING CORP & THE TORONTO-DOMINION BANK A DULUTH ECONOMIC DEVELOPMENT AUTHORITY 900848286 000000000 2020-02-18 116955000 SRS 2020C (SEE PART VI) 0 0 0 B BURLEIGH COUNTY NORTH DAKOTA 456002204 000000000 2023-06-22 21265000 SRS 2023A (SEE PART VI) 0 0 0 A 10210781 28807187 177343 28629844 2020 1 0 1 1 B 21265000 291616 20973384 2023 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 JULIE ARVIN RELATED TO DOUG ARVIN 158456 COMPENSATION OF FAMILY MEMBER OF OFFICER 0 RACHEL GEBUR RELATED TO JOSHUA GEBUR, MD 10415 COMPENSATION OF FAMILY MEMBER OF KEY EMPLOYEE 0 MELODY JAHNKE RELATED TO CHRISTY BRINKMAN 98906 COMPENSATION OF FAMILY MEMBER OF KEY EMPLOYEE 0 GREGORY SPERLE MD RELATED TO MICHELE THIEMAN, MD 266757 COMPENSATION OF FAMILY MEMBER OF KEY EMPLOYEE 0 FORM 990, PART III, LINE 2 ESSENTIA HEALTH WEST ACQUIRED MID DAKOTA CLINIC, A MULTI-CLINIC HEALTH SYSTEM IN BISMARCK, ND, ON OCTOBER 1, 2022. THE FOUR CLINICS OFFER SERVICES SIMILAR TO THOSE PROVIDED BY ESSENTIA HEALTH WEST AS DESCRIBED IN FORM 990, PART III, LINE 4. FORM 990, PART V, LINE 1A 1099 REPORTING: VENDOR PAYMENTS AND FORM 1099S WERE PROCESSED THROUGH ESSENTIA HEALTH ON BEHALF OF THE LEGAL ENTITIES COMPRISING ESSENTIA HEALTH. FORM 990, PART VI, SECTION A, LINE 3 MANAGEMENT COMPANY: DURING THE FISCAL YEAR ENDING JUNE 30, 2023, LESLEY WININGER SERVED AS ESSENTIA HEALTH WEST'S INTERIM CHIEF NURSING OFFICER THROUGH BE SMITH, LLC. BE SMITH WAS PAID $99,780 DURING THE SAME TIME PERIOD FOR THESE SERVICES. NO COMPENSATION WAS PAID TO WININGER DURING CALENDAR YEAR 2022. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF ORGANIZATION: ESSENTIA HEALTH IS THE SOLE MEMBER OF ESSENTIA HEALTH WEST AND MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7A. ESSENTIA HEALTH AND BENEDICTINE SISTERS BENEVOLENT ASSOCIATION HAVE RESERVED POWERS WITH RESPECT TO ESSENTIA HEALTH WEST AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7B. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS WITH RIGHT TO ELECT GOVERNING BODY: ESSENTIA HEALTH APPOINTS AND REMOVES ESSENTIA HEALTH WEST'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS WITH RIGHT TO APPROVE GOVERNING BODY DECISION: ESSENTIA HEALTH WEST IS A SUBSIDIARY OF ESSENTIA HEALTH, WHOSE BOARD OF DIRECTORS HAS RESERVED POWERS WITH RESPECT TO THIS CORPORATION AND ITS SUBSIDIARIES, AND ALL OF THE OTHER DIRECT AND INDIRECT SUBSIDIARIES OF ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"). ESSENTIA HEALTH'S RESERVED POWERS ARE AS FOLLOWS: STRATEGIC AND BUSINESS PLANS. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S STRATEGIC AND BUSINESS PLANS. MISSION. AUTHORITY TO CREATE, AND TO APPROVE, THE MISSION, PURPOSE AND VISION STATEMENTS FOR ALL ENTITIES IN THE SYSTEM BY THE AFFIRMATIVE VOTE OF AT LEAST 67% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS. DEBT. APPROVAL OF THE INCURRENCE OF DEBT BY, AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE ASSETS OF, ALL ENTITIES IN THE SYSTEM IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS, AND THE AUTHORITY TO CAUSE ALL ENTITIES IN THE SYSTEM TO PARTICIPATE IN SYSTEM BORROWING. GOVERNING INSTRUMENTS. AUTHORITY TO CAUSE, AND TO APPROVE, AMENDMENTS OF THE ARTICLES OF INCORPORATION, BYLAWS AND OTHER GOVERNING DOCUMENTS OF ALL ENTITIES IN THE SYSTEM. MERGERS AND ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF ALL ENTITIES IN THE SYSTEM. AFFILIATIONS AND JOINT VENTURES. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES WITH THIRD PARTIES OF ALL ENTITIES IN THE SYSTEM. TRANSFER OF ASSETS WITHIN THE SYSTEM. AUTHORITY TO TRANSFER ASSETS, INCLUDING CASH, BETWEEN AND AMONG ENTITIES WITHIN THE SYSTEM; PROVIDED, HOWEVER, THAT ESSENTIA HEALTH SHALL NOT HAVE AUTHORITY TO REQUIRE ANY ENTITY IN THE SYSTEM TO TRANSFER ASSETS (A) THAT WOULD CAUSE SUCH ENTITY TO BE IN DEFAULT OF ITS COVENANTS OR OBLIGATIONS UNDER ANY BOND OR OTHER FINANCING DOCUMENTS; (B) FROM THE CATHOLIC ENTITIES TO THE SECULAR ENTITIES OR FROM THE SECULAR ENTITIES TO THE CATHOLIC ENTITIES IN A MANNER OR TO AN EXTENT THAT WOULD CAUSE THE CATHOLIC ENTITIES TO BE IN VIOLATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS) IN THE JUDGMENT OF THE LOCAL ORDINARY; OR (C) SUCH THAT MONEY GENERATED BY SERVICES AT SECULAR FACILITIES WITHIN THE SYSTEM BY PROCEDURES THAT ARE CONTRARY TO THE ERDS WOULD BE USED AT THE CATHOLIC ENTITIES OR MONEY GENERATED BY CATHOLIC ENTITIES WOULD BE USED IN THE PROVIDING OF SERVICES CONTRARY TO THE ERDS AT SECULAR FACILITIES WITHIN THE SYSTEM. TRANSFER OF ASSETS OUTSIDE THE SYSTEM. AUTHORITY TO CAUSE, AND TO APPROVE, THE SALE, LEASE OR OTHER TRANSFER OF ASSETS OF ALL ENTITIES IN THE SYSTEM TO PARTIES OUTSIDE OF THE SYSTEM WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS. SERVICES. AUTHORITY TO CAUSE, AND TO APPROVE, THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS WITHIN ALL ENTITIES IN THE SYSTEM. BUDGETS. APPROVAL OF CAPITAL AND OPERATING BUDGETS OF ALL ENTITIES IN THE SYSTEM. PROFESSIONAL SERVICES. SELECTION OF THE GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS OF ALL ENTITIES IN THE SYSTEM. ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL ACQUISITIONS BY AND FORMATIONS OF ENTITIES IN THE SYSTEM. MARKETING. AUTHORITY TO IMPLEMENT SYSTEM-WIDE MARKETING AND PROMOTIONAL ACTIVITIES. COMPLIANCE PLANS. AUTHORITY TO CREATE, AND TO APPROVE, CORPORATE COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS FOR ENTITIES WITHIN THE SYSTEM. QUALITY PLAN. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S QUALITY PLAN. NON-BUDGETED PURCHASES. APPROVAL OF NON-BUDGETED CAPITAL PURCHASES AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY ESSENTIA HEALTH FOR ENTITIES WITHIN THE SYSTEM. HUMAN RESOURCES. AUTHORITY TO CREATE HUMAN RESOURCE POLICIES AND PROCEDURES WITHIN THE SYSTEM. RESERVED POWERS. AUTHORITY TO CREATE ADDITIONAL ESSENTIA HEALTH RESERVED POWERS BY THE AFFIRMATIVE VOTE OF AT LEAST 80% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS (EXCLUDING THE ESSENTIA HEALTH CEO); PROVIDED, HOWEVER, THAT ANY ADDITIONAL ESSENTIA HEALTH RESERVED POWERS SHALL NOT CONTRAVENE OR HINDER THE RESERVED POWERS OF BENEDICTINE SISTERS BENEVOLENT ASSOCIATION. THE BENEDICTINE SISTERS BENEVOLENT ASSOCIATION ("BSBA") ALSO HAS CERTAIN RESERVED POWERS OVER ESSENTIA HEALTH'S CATHOLIC FACILITIES. BSBA'S RESERVED POWERS ARE AS FOLLOWS: MISSION. AUTHORITY TO APPROVE THE MISSION AND PURPOSE STATEMENTS FOR CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM. *ADHERENCE TO ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS). AUTHORITY TO APPROVE THE METHODS, POLICIES AND PROCEDURES PERTAINING TO THE ADHERENCE OF CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM TO THE ERDS. *OFFICIAL CATHOLIC DIRECTORY. AUTHORITY TO OVERSEE THE LISTING OF QUALIFIED ENTITIES AND FACILITIES WITHIN THE SYSTEM IN THE OFFICIAL CATHOLIC DIRECTORY, SUBJECT TO THE APPROVAL OF APPLICABLE CATHOLIC AUTHORITIES. *CATHOLIC HEALTH ASSOCIATION. AUTHORITY TO REQUIRE CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM TO JOIN THE MEMBERSHIP OF THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES. ALIENATION OF STABLE PATRIMONY OR ECCLESIASTICAL GOODS. AUTHORITY TO APPROVE ALIENATION OF EITHER STABLE PATRIMONY OR OTHER ECCLESIASTICAL GOODS WITHIN THE SYSTEM IF SUCH GOODS INVOLVED IN A SPECIFIC TRANSACTION APPROVED BY ESSENTIA HEALTH PURSUANT TO THE AFFILIATION AGREEMENT, HAVE A DOLLAR VALUE EQUAL TO OR GREATER THAN 70% OF THE AMOUNT ESTABLISHED FROM TIME TO TIME THAT REQUIRES APPROVAL FROM THE HOLY SEE; PROVIDED, HOWEVER, THAT IT IS THE INTENT OF THE PARTIES THAT THIS PROVISION NOT BE APPLIED TO RESTRICT OR TO IMPEDE ESSENTIA HEALTH FROM ACTING AND MAKING DECISIONS ON BEHALF OF THE SYSTEM IN THE ORDINARY COURSE OF BUSINESS BUT BE APPLIED TO PREVENT THE TRANSFER OF SUBSTANTIAL ASSETS OF CATHOLIC ENTITIES WITHIN THE SYSTEM TO SUPPORT THE SECULAR ENTITIES WITHIN THE SYSTEM WITHOUT THE PRIOR APPROVAL OF BSBA. *MISSION EFFECTIVENESS. AUTHORITY TO APPROVE ANNUAL PLANS AND EVALUATIONS RELATING TO MISSION EFFECTIVENESS AND CHAPLAINCY FOR CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM, INCLUDING THE USE OF RELIGIOUS SYMBOLS AND PRAYERS. AMENDMENTS. AUTHORITY TO APPROVE ANY AMENDMENTS TO THE GOVERNING DOCUMENTS OF ESSENTIA HEALTH, ESSENTIA HEALTH EAST (SMDC), ESSENTIA HEALTH CENTRAL (BLIHS), ESSENTIA HEALTH WEST (INNOVIS) OR CRITICAL ACCESS GROUP (CAG), THAT WOULD ALTER THE NUMBER OF DULUTH BENEDICTINES OR BSBA BOARD OF DIRECTOR MEMBERS OR OTHER APPOINTEES OF THE DULUTH BENEDICTINES SERVING AS MEMBERS OF SUCH ENTITY'S BOARD OF DIRECTORS; AUTHORITY TO APPROVE ANY AMENDMENTS TO THE GOVERNING DOCUMENTS OF THE CATHOLIC CAG SUBSIDIARIES, THE CATHOLIC SMDC SUBSIDIARIES, THE CATHOLIC BLIHS SUBSIDIARIES OR THE CATHOLIC SUBSIDIARIES OF INNOVIS, WHICH COULD MATERIALLY AFFECT SUCH ENTITY'S IDENTITY AS A CATHOLIC INSTITUTION, INCLUDING WITHOUT LIMITATION ANY AMENDMENT THAT WOULD ALTER THE NUMBER OF DULUTH BENEDICTINES OR BSBA BOARD OF DIRECTOR MEMBERS OR OTHER APPOINTEES OF THE DULUTH BENEDICTINES SERVING AS MEMBERS OF SUCH ENTITY'S BOARD OF DIRECTORS, AND AUTHORITY TO CAUSE ESSENTIA HEALTH TO MAKE AMENDMENTS TO THE GOVERNING DOCUMENTS OF THE CATHOLIC SUBSIDIARIES OF ESSENTIA HEALTH'S DIRECT SUBSIDIARIES, WHICH AMENDMENTS BSBA DETERMINES IN GOOD FAITH ARE NECESSARY TO PRESERVE SUCH ENTITY'S IDENTITY AS A CATHOLIC INSTITUTION. MERGERS AND DISSOLUTION. SUBJECT TO THE APPROVAL OF THE DULUTH BENEDICTINES, AUTHORITY TO APPROVE A PROPOSED MERGER, CONSOLIDATION, LIQUIDATION, DISSOLUTION OF ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER (SMMC), AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER (SJMC), OR THE DISPOSITION OF ALL OR SUBSTANTIALLY ALL THE ASSETS OF SMMC AND SJMC. BSBA SPONSORSHIP. AUTHORITY TO ESTABLISH, ACCEPT, TRANSFER OR TERMINATE BSBA SPONSORSHIP OR CO-SPONSORSHIP OF A HEALTHCARE FACILITY. *RESERVED POWER CURRENTLY DELEGATED TO THE SPONSORSHIP COUNCIL. NOTE: SOME OF THE RESERVED POWERS OF THE BSBA BOARD LISTED ABOVE MAY ALSO BE RESERVED TO THE CHAPTER OF THE BSBA. PRIOR TO THESE MATTERS GOING TO THE BSBA CHAPTER, ORDINARILY THEY WILL BE CONSIDERED AND ACTED UPON BY THE BSBA BOARD. THE FOLLOWING ACTIONS OF THE BSBA BOARD ARE SUBJECT TO APPROVAL BY THE BSBA CHAPTER: 1. APPROVE MERGERS, CONSOLIDATIONS, LIQUIDATIONS, OR DISSOLUTIONS INVOLVING SMMC OR SJMC. 2. APPROVE THE ACQUISITION OR DISPOSITION OF REAL ESTATE OWNED BY BSBA. 3. APPROVE DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, ASSETS OF SMMC OR SJMC. 4. APPROVE INDEBTEDNESS THAT WILL BE GUARANTEED BY BSBA. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE 2022 FORM 990, INCLUDING ALL SCHEDULES, WAS REVIEWED BY MANAGEMENT AND THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. THE FINANCE LEADER REVIEWED THE FORM AND SCHEDULES AND ANY QUESTIONS WERE DISCUSSED. EACH CURRENT DIRECTOR OF THE GOVERNING BODY RECEIVED A FINAL COPY OF THE 2022 FORM 990. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCING CONFLICT OF INTEREST POLICY: ESSENTIA HEALTH'S COMPREHENSIVE CONFLICT OF INTEREST PROGRAM PREVENTS, DETECTS, AND RESOLVES ACTUAL CONFLICTS OF INTERESTS OR THE ACTUAL OR POTENTIAL APPEARANCE OF SUCH. FIDUCIARIES, DEFINED AS AN ESSENTIA HEALTH BOARD MEMBER/TRUSTEE, OFFICER, BOARD COMMITTEE MEMBER, SENIOR MANAGEMENT EMPLOYEE, OR ANY OTHERS CONSIDERED TO BE IN A POSITION OF INFLUENCE, ARE COVERED UNDER ESSENTIA HEALTH'S CONFLICT OF INTEREST PROGRAM. UPON INITIAL APPOINTMENT, EACH FIDUCIARY MUST COMPLETE AN INITIAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AT THE CONCLUSION OF EACH CALENDAR YEAR, EACH FIDUCIARY MUST COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AS NEEDED, A FIDUCIARY WILL UPDATE HIS/HER MOST RECENTLY COMPLETED QUESTIONNAIRE EACH TIME THE FIDUCIARY BECOMES AWARE OF A FINANCIAL INTEREST, A POTENTIAL CONFLICT, OR CHANGE TO ANY INFORMATION THAT THE FIDUCIARY PREVIOUSLY REPORTED. ESSENTIA HEALTH'S CHIEF COMPLIANCE OFFICER WILL COLLECT THE QUESTIONNAIRES AND EVALUATE THE DISCLOSURES. IF A FIDUCIARY HAS A POTENTIAL CONFLICT OF INTEREST, THE CHIEF COMPLIANCE OFFICER OR DESIGNEE MAY REQUEST ADDITIONAL INFORMATION FROM THE FIDUCIARY, THE MANAGEMENT TEAM, AND OTHERS. DURING THE EVALUATION PROCESS, THE CHIEF COMPLIANCE OFFICER MAY ALSO CONSULT WITH ESSENTIA HEALTH'S BOARD AND AUDIT COMMITTEE CHAIRS, SENIOR MANAGEMENT, LEGAL DEPARTMENT, OR APPROPRIATE REPRESENTATIVES FROM ESSENTIA HEALTH. THE CHIEF COMPLIANCE OFFICER REPORTS TO THE ESSENTIA HEALTH AUDIT COMMITTEE AND THE ESSENTIA HEALTH BOARD OF DIRECTORS ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY THE FIDUCIARY, ALONG WITH RECOMMENDED ACTIONS. THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) WILL THEN DETERMINE WHETHER TO APPROVE THE SITUATION OR TO IMPLEMENT SPECIAL CONTROLS TO MANAGE THE POTENTIAL CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER WILL THEN OFFICIALLY NOTIFY THE FIDUCIARY IN WRITING OF THE BOARD'S DECISION. THE DECISION OF WHETHER OR NOT THE DISCLOSURE CONSTITUTES A CONFLICT WILL BE AT THE ESSENTIA HEALTH BOARD OF DIRECTOR'S (OR DESIGNEE) SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF ESSENTIA HEALTH AND ITS AFFILIATE(S) AND THE ADVANCEMENT OF ITS PURPOSES. WHEN THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) CONSIDERS A FIDUCIARY'S DISCLOSURE AS A CONFLICT OF INTEREST, SPECIAL CONTROLS WILL BE IDENTIFIED TO MANAGE, ELIMINATE OR REDUCE THE LIKELIHOOD AND/OR APPEARANCE OF A CONFLICT ARISING. CONTROLS MAY INCLUDE, BUT ARE NOT LIMITED TO: A. IF THE CONFLICT INVOLVES AN ON-GOING MATTER OR RELATIONSHIP, THE FIDUCIARY MUST NOT PARTICIPATE IN BOARD, BOARD COMMITTEE, OR MANAGEMENT DISCUSSIONS RELATED TO THE CONFLICT AND MUST RECUSE THEMSELVES AND IF APPROPRIATE, WITHDRAW, FROM ANY BOARD MEETING OR PORTION THEREOF WHERE THE MATTER IS BEING DISCUSSED AND DURING THE VOTE ON THE POTENTIAL CONFLICT OF INTEREST. THE FIDUCIARY MAY ANSWER QUESTIONS AT THE BOARD'S OR THE BOARD COMMITTEE'S REQUEST. B. IF THE CONFLICT INVOLVES A SPECIFIC TRANSACTION OR DECISION, THE FIDUCIARY WILL FULLY DISCLOSE THEIR INTEREST AND ALL RELATED MATERIAL FACTS. THE BOARD OR COMMITTEE OF THE BOARD WILL DETERMINE WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO ESSENTIA HEALTH OR ITS AFFILIATE(S). IF THE BOARD DETERMINES A CONFLICT DOES NOT EXIST, THE FIDUCIARY MAY PROCEED WITH THE TRANSACTION; HOWEVER, HE OR SHE WILL NOT BE ELIGIBLE TO VOTE ON RELATED ISSUES SHOULD THEY ARISE. IF THE BOARD DETERMINES A CONFLICT DOES EXIST, THE FIDUCIARY WILL BE NOTIFIED OF THE DECISION REGARDING WHETHER THE CONTEMPLATED TRANSACTION WILL BE AUTHORIZED AS JUST, FAIR, AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION: THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF ESSENTIA HEALTH'S BOARD OF DIRECTORS IS AUTHORIZED TO FULFILL THE BOARD'S RESPONSIBILITIES REGARDING EXECUTIVE COMPENSATION CONSISTENT WITH ESSENTIA'S MISSION, VALUES AND TAX-EXEMPT STATUS, AND THE EXECUTIVE COMPENSATION COMMITTEE'S CHARTER. THE EXECUTIVE COMPENSATION COMMITTEE MEETS AT LEAST TWICE ANNUALLY TO CARRY OUT ITS RESPONSIBILITIES, WHICH INCLUDE, BUT ARE NOT LIMITED TO, ESTABLISHING, REVIEWING AND MODIFYING, AS APPROPRIATE, REASONABLE COMPENSATION AND BENEFITS FOR DESIGNATED ESSENTIA EXECUTIVES WHO ARE OFFICERS OR KEY EMPLOYEES OF ESSENTIA OR ANY OF ITS AFFILIATES WHICH MAY BE PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINIONS ON TOTAL COMPENSATION REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE MAY REQUEST ITS INDEPENDENT ADVISORS TO: MONITOR COMPARABILITY DATA AND MARKETPLACE TRENDS; MAKE APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES; AND PERIODICALLY REVIEW THE MARKET COMPETITIVENESS OF ESSENTIA EXECUTIVE COMPENSATION PACKAGES. PRIOR TO ESTABLISHING OR ADJUSTING EXECUTIVE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE WILL OBTAIN AND RELY UPON APPROPRIATE DATA AS TO COMPARABILITY OF THE PROPOSED COMPENSATION OR ADJUSTMENTS. THE EXECUTIVE COMPENSATION COMMITTEE WILL ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THOSE DETERMINATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MINUTES WILL INCLUDE: THE TERMS OF THE APPROVED COMPENSATION AND THE DATE APPROVED; THE EXECUTIVE COMPENSATION COMMITTEE MEMBERS PRESENT DURING THE REVIEW, DISCUSSION AND APPROVAL OF THE PROPOSED COMPENSATION AND THOSE WHO VOTED ON THE PROPOSED COMPENSATION; IDENTIFICATION OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE EXECUTIVE COMPENSATION COMMITTEE AND HOW THE DATA WAS OBTAINED; ANY ACTIONS BY A MEMBER OF THE EXECUTIVE COMPENSATION COMMITTEE HAVING A CONFLICT OF INTEREST; AND DOCUMENTATION OF THE BASIS FOR THE DETERMINATION. THE YEAR THIS PROCESS WAS LAST UNDERTAKEN FOR ESSENTIA HEALTH WEST'S PRESIDENT, CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER, VICE PRESIDENT OF FINANCE, SENIOR VICE PRESIDENTS OF OPERATIONS, AND CHIEF NURSING OFFICER WAS 2023. THE YEAR THIS PROCESS WAS LAST UNDERTAKEN FOR ESSENTIA HEALTH WEST'S OPERATIONS SENIOR DIRECTORS AND FACILITIES SENIOR DIRECTOR WAS 2022. THE ESSENTIA HEALTH PHYSICIAN AND PROVIDER COMPENSATION COMMITTEE HAS AN ANNUAL COMPENSATION PROCESS THAT INCLUDES A REVIEW AND RECOMMENDATION OF THE UPCOMING FISCAL YEAR'S PHYSICIAN AND PROVIDER COMPENSATION PLAN RATES AND THE COMPENSATION PLAN METHODOLOGY. COMPENSATION RATES FOR THE ESSENTIA HEALTH PHYSICIAN LEADERSHIP ARE RECOMMENDED BY THE ESSENTIA HEALTH SYSTEM EXECUTIVE LEADERSHIP TEAM BASED ON ITS REVIEW OF MARKET SURVEYS, REGIONAL COMPETITIVE FACTORS, AND THE ANNUAL BUDGET PROCESS. THE COMPENSATION OF ESSENTIA HEALTH PHYSICIAN, PROVIDER AND PHYSICIAN LEADERSHIP, INCLUDING APPOINTED CHIEF AND CHAIR POSITIONS, IS REVIEWED AND APPROVED BY THE ESSENTIA HEALTH BOARD OF DIRECTORS. THE YEAR THIS PROCESS WAS LAST UNDERTAKEN FOR ESSENTIA HEALTH WEST'S PHYSICIAN DIVISION CHAIRS WAS 2023. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART IX, LINE 24E: AFFILIATE REVENUE AND EXPENSE ALLOCATION: ESSENTIA HEALTH WEST, ESSENTIA HEALTH ADA, ESSENTIA HEALTH FOSSTON, ESSENTIA HEALTH HOLY TRINITY HOSPITAL, AND ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES ALLOCATE CERTAIN REVENUES AND EXPENSES DIRECTLY TO ESSENTIA HEALTH ADA, ESSENTIA HEALTH FOSSTON, ESSENTIA HEALTH HOLY TRINITY HOSPITAL, AND ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ALL RELATED ORGANIZATIONS. NET AFFILIATE REVENUE AND EXPENSE ALLOCATIONS OF ($7,812,440) INCLUDE THE FOLLOWING TYPES OF REVENUE AND EXPENSES: NONPATIENT REVENUE; AMORTIZATION AND DEPRECIATION; PURCHASED SERVICES; PROFESSIONAL FEES; AGENCY FEES; REPAIRS AND MAINTENANCE; SALARIES, WAGES, AND RELATED BENEFITS; SUPPLIES; UTILITIES; PROVIDER AND OTHER TAXES; AND OTHER EXPENSES. FORM 990, PART XI, LINE 9: NET ASSET TRANSFER OF MID DAKOTA CLINIC -1,239,291. NET ASSET TRANSFERS WITH RELATED ORGANIZATION -1,866,575. BRAINERD LAKES INTEGRATED HEALTH SYSTEM 2024 S 6TH ST BRAINERD MN 56401 371532145 SUPPORTING ORG MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 1 BRAINERD MEDICAL CENTER INC 2024 S 6TH ST BRAINERD MN 56401 371532148 CLINIC MN 501(C)(3) LINE 3 BRAINERD LAKES INTEGRATED HEALTH SYSTEM 1 BRIDGES MEDICAL CENTER 201 9TH ST W ADA MN 56510 200479568 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 DEER RIVER HEALTHCARE CENTER INC 115 10TH AVE NE DEER RIVER MN 56636 410844574 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ESSENTIA HEALTH 502 E 2ND ST DULUTH MN 55805 200360007 SUPPORTING ORG MN 501(C)(3) LINE 12C, III-FI N/A 0 ESSENTIA HEALTH FOUNDATION 502 E 2ND ST DULUTH MN 55805 271984704 FOUNDATION MN 501(C)(3) LINE 7 ESSENTIA HEALTH 1 ESSENTIA HEALTH MOOSE LAKE 4572 COUNTY ROAD 61 MOOSE LAKE MN 55767 845099016 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ESSENTIA HEALTH SURGERY CENTERS 502 E 2ND ST DULUTH MN 55805 881577422 SURGERY CENTER MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ESSENTIA INSTITUTE OF RURAL HEALTH 502 E 2ND ST DULUTH MN 55805 271291124 RESEARCH MN 501(C)(3) LINE 4 THE DULUTH CLINIC LTD 1 FIRST CARE MEDICAL SERVICES 900 HILLIGOSS BLVD SE FOSSTON MN 56542 410706143 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 GRACEVILLE HEALTH CENTER 115 WEST 2ND ST GRACEVILLE MN 56240 410726173 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC 502 E 2ND ST DULUTH MN 55805 411674021 MEDICAL EQUIPMENT MN 501(C)(3) LINE 10 ST MARY'S MEDICAL CENTER 1 NORTHERN PINES MEDICAL CENTER 5211 HWY 110 AURORA MN 55705 410841441 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 PINE MEDICAL CENTER 705 LUNDORFF DR S SANDSTONE MN 55072 411884597 HOSPITAL MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 POLINSKY MEDICAL REHABILITATION CENTER 530 E 2ND ST DULUTH MN 55805 410691275 REHABILITATION SERVICES MN 501(C)(3) LINE 3 ST MARY'S MEDICAL CENTER 1 SMDC MEDICAL CENTER 502 E 2ND ST DULUTH MN 55805 411878730 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ST JOSEPH'S MEDICAL CENTER 523 N 3RD ST BRAINERD MN 56401 410695602 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 BRAINERD LAKES INTEGRATED HEALTH SYSTEM 1 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 502 E 2ND ST DULUTH MN 55805 411836633 SUPPORTING ORG MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 1 ST MARY'S EMS 1027 WASHINGTON AVE DETROIT LAKES MN 56501 411805811 EMERGENCY SERVICES MN 501(C)(3) LINE 10 INNOVIS HEALTH LLC 1 ST MARY'S HOSPITAL OF SUPERIOR 3500 TOWER AVE SUPERIOR WI 54880 411811073 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ST MARY'S MEDICAL CENTER 1 ST MARY'S INNOVIS HEALTH 1027 WASHINGTON AVE DETROIT LAKES MN 56501 262861321 PHARMACY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 ST MARY'S MEDICAL CENTER 402 E 2ND ST DULUTH MN 55805 410695604 HOSPITAL MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ST MARY'S REGIONAL HEALTH CENTER 1027 WASHINGTON AVE DETROIT LAKES MN 56501 411620386 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 THE DULUTH CLINIC LTD 400 E 3RD ST DULUTH MN 55805 410883623 CLINIC MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 PMC-GATEWAY IMAGING LLC THRU 1132022 705 LUNDORFF DR S SANDSTONE MN 55072 261634764 IMAGING SERVICES MN N/A N/A 0 0 HORSESHOE SURGERY CENTER LLC 1542 GOLF COURSE ROAD GRAND RAPIDS MN 55744 202137172 SURGERY CENTER MN N/A N/A 0 0 ESSENTIA HEALTH INSURANCE SERVICES SPC LTD PO BOX 1159 GRAND CAYMAN CJ 000000000 SELF INSURANCE CJ N/A C 1 MID DAKOTA CLINIC INC 502 E 2ND ST DULUTH MN 55805 450311334 CLINIC OPERATIONS CEASED 9/30/22 ND INNOVIS HEALTH LLC C 56322373 2398445 1.00000 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 ESSENTIA HEALTH M 56050212 ACTUAL COSTS ESSENTIA HEALTH P 35057274 ACTUAL COSTS ESSENTIA HEALTH R 2000000 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION B 705829 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION C 235567 ACTUAL COSTS ESSENTIA INSTITUTE OF RURAL HEALTH R 823450 ACTUAL COSTS FIRST CARE MEDICAL SERVICES Q 58320 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER A 763677 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER P 15496280 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER R 20100000 ACTUAL COSTS SCHEDULE R, PART II, COLUMN (A) THE FOLLOWING ESSENTIA HEALTH ENTITIES HAVE A DOING BUSINESS AS NAME: LEGAL NAME; DOING BUSINESS AS NAME BRAINERD MEDICAL CENTER, INC.; ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC BRIDGES MEDICAL CENTER; ESSENTIA HEALTH ADA DEER RIVER HEALTHCARE CENTER, INC.; ESSENTIA HEALTH DEER RIVER FIRST CARE MEDICAL SERVICES; ESSENTIA HEALTH FOSSTON GRACEVILLE HEALTH CENTER; ESSENTIA HEALTH HOLY TRINITY HOSPITAL INNOVIS HEALTH, LLC; ESSENTIA HEALTH WEST MIDWEST MEDICAL EQUIPMENT AND SUPPLIES, INC.; ESSENTIA HEALTH MEDICAL EQUIPMENT & SUPPLIES NORTHERN PINES MEDICAL CENTER; ESSENTIA HEALTH NORTHERN PINES PINE MEDICAL CENTER; ESSENTIA HEALTH SANDSTONE POLINSKY MEDICAL REHABILITATION CENTER; ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER SMDC MEDICAL CENTER; ESSENTIA HEALTH DULUTH ST. JOSEPH'S MEDICAL CENTER; ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ST. MARY'S DULUTH CLINIC HEALTH SYSTEM; ESSENTIA HEALTH EAST ST. MARY'S EMS; ESSENTIA HEALTH EMS ST. MARY'S HOSPITAL OF SUPERIOR; ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR ST. MARY'S MEDICAL CENTER; ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER ST. MARY'S REGIONAL HEALTH CENTER; ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES