2023-11-14T11:14:13-06:00 2022-12-31 450310328 BRADY MARTZ & ASSOCIATES PC PO BOX 14296 GRAND FORKS ND 582084296 990 2022-01-01 450310462 ALTRU HEALTH SYSTEM ALTR 7017805200 1200 S COLUMBIA RD GRAND FORKS ND 582014036 DEREK GOEBEL CFO 7017805200 2023-11-13 1 DEREK GOEBEL 999009999 0 ASHLEY ENGEL P01220321 7017754685 2023-11-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ALTRU HOSPITAL DEREK GOEBEL 1200 S COLUMBIA RD GRAND FORKS ND 582014036 727494193 0 X ALTRU.ORG X 1970 ND HEALTHCARE DELIVERY 9 5 4118 72 5673099 768044 3844954 11594891 599169946 600338365 10458209 18775497 137928 -42259 613611037 630666494 2382215 534987 0 0 333168941 346726282 201567 145746 145746 246328404 264466780 582081127 611873795 31529910 18792699 1039192012 974015924 679870026 631709340 359321986 342306584 X ALTRU HEALTH SYSTEM IS A COMMUNITY OF OVER 3,500 HEALTH PROFESSIONALS AND SUPPORT STAFF, AND WE'VE BEEN COMMITTED TO CARING FOR OUR REGION FOR MORE THAN 130 YEARS. SERVING OVER 230,000 RESIDENTS IN NORTHEAST NORTH DAKOTA AND NORTHWEST MINNESOTA, WE OFFER A WIDE ARRAY OF SERVICES TO MEET THE NEEDS OF COMMUNITY MEMBERS OF ALL AGES AND LEVELS OF HEALTH. 0 0 27808940 55398185 ONCOLOGY - ALTRU'S TEAM OF ONCOLOGISTS PROVIDE INPATIENT AND OUTPATIENT CANCER TREATMENT SERVICES TO PATIENTS WITHIN OUR SERVICE REGION AND ALSO PROVIDE OUTREACH CLINIC SERVICES TO COMMUNITIES THROUGHOUT OUR SERVICE AREA. IN 2022, THERE WERE 190 HOSPITAL DISCHARGES. 14838061 69916278 CARDIOLOGY - ALTRU OFFERS COMPREHENSIVE SERVICES INCLUDING INTERVENTIONAL AND MEDICAL CARDIOLOGY. ADDITIONAL SERVICES INCLUDE ECHOCARDIOGRAPHY, CARDIAC STRESS TESTS, AND CARDIAC REHAB. ALTRU HAS BEEN RECOGNIZED THREE TIMES AS A "100 TOP HOSPITALS" FOR CARDIOVASCULAR CARE. OUR CARDIOLOGY TEAM ALSO PROVIDES OUTREACH CLINIC SERVICES TO COMMUNITIES THROUGHOUT OUR SERVICE AREA. IN 2022, THERE WERE 1,052 HOSPITAL DISCHARGES. 28922109 94012048 GENERAL SURGERY - ALTRU'S TEAM OF GENERAL SURGEONS PERFORM INPATIENT AND OUTPATIENT SURGERY AND SEE PATIENTS AT ALTRU HOSPITAL, ALTRU CLINICS, AND SOME OF ALTRU'S REGIONAL CLINICS. IN 2022, THERE WERE 608 GENERAL SURGERY HOSPITAL DISCHARGES. 455088475 534987 371867681 OTHER PROGRAM SERVICES INCLUDE OTHER PATIENT CARE PROGRAMS. 455088475 534987 371867681 526657585 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 1 0 0 1 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 103 0 4118 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 5 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X THE ORGANIZATION 7017805203 1200 SOUTH COLUMBIA ROAD GRAND FORKS ND 58201 DANIEL ROLINE SECRETARY 1.00 X X 0 0 0 DAVID MOLMEN BOARD MEMBER/CEO (INTERIM THROUGH FEB 2022) 40.00 X X 235708 0 17716 ERIC HALVERSON BOARD MEMBER 1.00 X 0 0 0 JODY TREUER MD BOARD MEMBER/PHYSICIAN 40.00 X 1076205 0 45038 JOSHUA DEERE BOARD MEMBER/PRESIDENT 40.00 X X 626427 0 212178 KAREN THINGLESTAD CHAIR 1.00 X X 0 0 0 KEITH OKESON BOARD MEMBER 1.00 X 0 0 0 LAURA BLOCK BOARD MEMBER 1.00 X 0 0 0 STEVEN WEISER MD BOARD MEMBER/PRESIDENT (THROUGH FEB 2022) 40.00 X X 1258869 0 24791 TODD FORKEL BOARD MEMBER/CEO 40.00 X X 577025 0 218527 WILLIAM MCKINNON MD BOARD MEMBER/PHYSICIAN 40.00 X 423090 0 80920 DOUGLAS ARVIN CFO/TREASURER 40.00 X 549545 0 24962 ALEXSANDAR TODOROVIC DIRECTOR INFO SYSTEMS APPLICATIONS 40.00 X 265474 0 48767 ERIN NAVARRO DIRECTOR PHARMACY SVCS 40.00 X 241766 0 60683 HEATHER STRANDELL SENIOR DIRECTOR CLINIC OPERATIONS 40.00 X 247352 0 36216 JANICE HAMSCHER CHIEF NURSING OFFICER 40.00 X 1272581 0 32396 JENNIFER BERG DIRECTOR TOTAL REWARDS 40.00 X 177382 0 45034 JENNIFER ESTAD SENIOR DIRECTOR CLINIC OPERATIONS 40.00 X 201415 0 30025 JEREMY GARDNER MEDICAL DIRECTOR 40.00 X 991700 0 76124 JOEL LARSON DIRECTOR LEGAL & PRIVACY/GENERAL COUNSEL 40.00 X 244944 0 65026 JONATHAN HAUG MEDICAL DIRECTOR 40.00 X 691968 0 85772 KARI JENSEN DIRECTOR QUALITY & SAFETY 40.00 X 194320 0 57097 KRISTI HALL-JIRAN CHIEF PHILANTHROPY OFFICER 40.00 X 358461 0 85929 MARK WAIND CHIEF INFORMATION OFFICER 40.00 X 582005 0 45390 MARLENE MILLER DIRECTOR PEOPLE RESOURCES 40.00 X 237257 0 52407 MATTHEW SCHUMACHER DIRECTOR TECH & SUPPORT SVCS 40.00 X 234212 0 54480 MEGHAN COMPTON CHIEF CLINIC OPERATIONS OFFICER 40.00 X 555372 0 171330 MEVAN WIJETUNGA MEDICAL DIRECTOR 40.00 X 1532778 0 41338 REED REYMAN EVP - REGIONAL DEVELOPMENT 40.00 X 804208 0 32642 STAN SALWEI DIRECTOR REV CYCLE/PRIMARY CARE SVCS 40.00 X 215345 0 45368 SUNIL KARTHAM MEDICAL DIRECTOR 40.00 X 866377 0 71217 YVONNE GOMEZ MEDICAL DIRECTOR 40.00 X 524094 0 52181 BARRY BJORGAARD PHYSICIAN 40.00 X 1288649 0 47788 GRANT SEEGER PHYSICIAN 40.00 X 1424848 0 52497 IKECHUKWU ONYEKA PHYSICIAN 40.00 X 1406964 0 53497 JASON GO PHYSICIAN 40.00 X 1184080 0 52497 JOHN EICKMAN PHYSICIAN 40.00 X 1510254 0 15250 KELLEE FISK FORMER KEY EMPLOYEE 40.00 X 651678 0 8815 22652353 0 2043898 528 1 1 0 PCLCOMMUNITY 7101 METRO BLVD EDINA MN 55439 SERVICES 85991305 MEDEFIS CONSOLIDATED PO BOX 5068 NEW YORK NY 10087 SERVICES 20446560 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 SERVICES 3815140 SODEXO INC AND AFFILIATES PO BOX 360170 PITTSBURGH PA 15251 SERVICES 3625297 COMPHEALTH PO BOX 972651 DALLAS TX 75397 SERVICES 2085197 92 1351371 10243520 11594891 NET PATIENT SERVICE REVENUE 621110 562743338 562743338 PROGRAM SERVICE REVENUE 621110 19508098 10424407 5715358 3368333 340B REVENUE 621300 18026447 18026447 BIOMED SERVICES/SITE SERVICES FEE 541900 60482 60482 600338365 6341617 6341617 125911 192424 -66513 -66513 -66513 86761666 22307489 87786865 8848410 -1025199 13459079 12433880 12433880 PRINTING SERVICES 561000 9849 9849 SNOW REMOVAL 812900 8493 8493 TELECOMMUNICATIONS 517000 5912 5912 24254 630666494 591194192 5673099 22204312 534987 534987 16863592 5230257 11633335 279864869 236870093 42994776 11414328 9443876 1970452 22220453 18258609 3961844 16363040 13196763 3166277 145746 145746 1115420 1115420 767127 621109 146018 10338562 7792398 2546164 2284028 2035786 248242 5525280 3883529 1641751 27986103 19654714 8331389 4443334 3960405 482929 SUPPLIES 121681143 121204019 477124 UNRELATED BUSINESS TAX 239761 239761 PURCHASED SERVICES 48789924 43428992 5360932 CONSULTING AND PROFESSI 36447161 36024382 422779 4848937 4277905 571032 611873795 526657585 85070464 145746 322263 961710 43857237 25102866 75687802 82325054 453859 421180 9267938 9640362 6644891 5067551 775714771 449969644 221381287 325745127 598984874 384317857 33599757 86054258 48992104 54379959 1039192012 974015924 96576719 67377559 2262914 2117015 542006380 532377996 39024013 29836770 679870026 631709340 X 359321986 342306584 359321986 342306584 1039192012 974015924 X 18792699 -36216406 408305 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4286737 9527816 13814553 278041041 203573723 74467318 23454970 13442923 10012047 271310402 232952998 38357404 189093805 189093805 325745127 INVESTMENT IN SUBSIDIARY 36304132 C EQUITY METHOD INVESTMENTS 4031971 C ALTERNATIVE INVESTMENTS 45718155 C 86054258 ASSETS HELD UNDER TRUST AGREEMENTS 16526910 ROU ASSETS AND OTHER ASSETS 7049122 UNAMORTIZED BOND ISSUE AND OTHER CO 12564577 DUE FROM AFFIALIATES 59073 LEASE RECEIVABLE 18180277 54379959 OTHER 16274973 ESTIMATED THIRD PARTY LIABILITY 2000000 SPECIAL ASSESSMENTS PAYABLE 363075 ASSET RETIREMENT OBLIGATION 3000000 LEASE LIABILITY 8198722 29836770 X PART X, LINE 2: ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES THE ORGANIZATION'S POLICY IS TO EVALUATE THE LIKELIHOOD THAT ITS UNCERTAIN TAX POSITIONS WILL PREVAIL UPON EXAMINATION BASED ON THE EXTENT TO WHICH THOSE POSITIONS HAVE SUBSTANTIAL SUPPORT WITHIN THE INTERNAL REVENUE CODE AND REGULATIONS, REVENUE RULINGS, COURT DECISIONS AND OTHER EVIDENCE. IT IS THE OPINION OF MANAGEMENT THAT THE ORGANIZATION HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION. THE FEDERAL INCOME TAX RETURNS OF THE ORGANIZATION ARE SUBJECT TO EXAMINATION BY INTERNAL REVENUE SERVICE GENERALLY FOR THREE YEARS AFTER THEY WERE FILED; ALL FILINGS ARE CURRENT. CENTRAL AMERICA AND THE CARIBBEAN INVESTMENT 6359998 0 0 0 0 0 0 6359998 0 6359998 0 0 1 0 0 0 PART III ACCOUNTING METHOD: X X X X X 1 COMMUNITY COUNSELLING SERVICE CO LLC 527 MADISON AVENUE 5TH FLOOR NEW YORK NY 10022 CAPITAL CAMPAIGN PLANNING AND IMPLEMENTATION 0 0 145746 -145746 145746 -145746 ND 1 1 X 1 X 1 X 1 1 0 1 1 2648665 2648665 0.00430 33784521 29588802 4195719 0.00690 754083 754083 0.00120 37187269 29588802 7598467 0.01240 759098 759098 0.00120 1117763 1117763 0.00180 7417 7417 0.00000 9012 9012 0.00000 1893290 1893290 0.00300 39080559 29588802 9491757 0.01540 1 132081289 437012215 -304930926 X 1 1 3 1 ALTRU HOSPITAL 1200 S COLUMBIA RD GRAND FORKS ND 582066002 X X X A 2 ALTRU REHABILITATION CENTER 4500 S WASHINGTON ST GRAND FORKS ND 582066002 X A 3 ALTRU SPECIALTY CENTER 4500 S WASHINGTON ST GRAND FORKS ND 58201 X X A ALTRU HOSPITAL 0 0 1 X X X X X X X X X 22 1 1 1 1 X WWW.ALTRU.ORG 1 20 1 WWW.ALTRU.ORG 0 1 X 150.000000000000 250.000000000000 X X X X X X 1 1 X X X 1 X WWW.ALTRU.ORG X WWW.ALTRU.ORG X WWW.ALTRU.ORG X X X X 1 0 X X X 1 X 0 1 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: ALTRU HOSPITAL, - FACILITY 2: ALTRU REHABILITATION CENTER, - FACILITY 3: ALTRU SPECIALTY CENTER ALTRU HOSPITAL PART V, SECTION B, LINE 5: ALTRU HEALTH SYSTEM AND THE GRAND FORKS PUBLIC HEALTH DEPARTMENT ENGAGED MULTIPLE PARTNERS TO CONDUCT SURVEYS AND FOCUS GROUPS WITH COMMUNITY LEADERS AND SPECIAL POPULATIONS TO GET THEIR INSIGHT ABOUT THE HEALTH OF THE COMMUNITY AND HOW IT CAN BE IMPROVED. IT WAS AGREED TO USE THE UPDATED PROCESS FROM THE ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT (NINE STEP COMMUNITY HEALTH ASSESSMENT PROCESS).A COMMUNITY-BASED ADVISORY COMMITTEE WAS FORMED TO WORK WITH ALTRU AND GRAND FORKS PUBLIC HEALTH ON THE ASSESSMENT. LEADERSHIP FROM ALTRU AND GRAND FORKS PUBLIC HEALTH SERVED ON THE ADVISORY COMMITTEE, ALONG WITH INDIVIDUALS REPRESENTING THE FOLLOWING AGENCIES/ORGANIZATIONS:ALLUMAALTRU FAMILY YMCAALTRU HEALTH SYSTEMCHAMBER OF GRAND FORKS AND EAST GRAND FORKSCITY OF EAST GRAND FORKSCITY OF GRAND FORKSCOMMUNITY VIOLENCE INTERVENTION CENTEREAST GRAND FORKS PUBLIC SCHOOLSGRAND FORKS AIR FORCE BASEGRAND FORKS HERALDGRAND FORKS HOUSING AUTHORITYGRAND FORKS PARKS AND RECREATIONGRAND FORKS FIRE DEPARTMENTGRAND FORKS PARK DISTRICTGRAND FORKS POLICE DEPARTMENTGRAND FORKS PUBLIC SCHOOLSGRAND FORKS SENIOR CENTERGRAND FORKS ECONOMIC DEVELOPMENT CORPORATIONKORSMO FAMILY DENTISTRYNORTHEAST HUMAN SERVICE CENTERNORTHLANDS RESCUE MISSIONPOLK COUNTY PUBLIC HEALTHQUALITY HEALTH ASSOCIATESSAFE KIDSSHAREHOUSESPECTRA HEALTHTURTLE RIVER STATE PARKUNIVERSITY OF NORTH DAKOTA MASTERS OF PUBLIC HEALTH PROGRAMUNITED WAYGRAND FORKS PUBLIC HEALTH AND ALTRU HEALTH SYSTEM ENGAGED A STUDENT TEAM AT THE UNIVERSITY OF NORTH DAKOTA'S MASTER OF PUBLIC HEALTH PROGRAM WITH THE ASSISTANCE OF ASHLEY EVENSON, MPH, ASSISTANT DIRECTOR WITH THE PUBLIC HEALTH PROGRAM. THE STUDENT AND FACULTY TEAM CONDUCTED A COMMUNITY SURVEY ALONG WITH FOCUS GROUPS WITH COMMUNITY LEADERS AND SPECIAL POPULATIONS TO GET THEIR INSIGHT ABOUT THE HEALTH OF GRAND FORKS AND POLK COUNTY COMMUNITIES AND HOW IT CAN BE IMPROVED. ALTRU HOSPITAL PART V, SECTION B, LINE 6A: ALTRU 1300 COLUMBIA ALTRU HOSPITAL PART V, SECTION B, LINE 6B: GRAND FORKS PUBLIC HEALTH ALTRU HOSPITAL PART V, SECTION B, LINE 11: UPON APPROVAL OF THE PRIORITIES BY THE GOVERNING BODIES, A SMALL WORKGROUP OF COMMUNITY STAKEHOLDERS WAS ASSEMBLED TO DEVELOP THE FRAME FOR IMPROVEMENT OVER THE NEXT THREE YEARS. THESE STAKEHOLDERS REPRESENTED ALTRU HEALTH SYSTEM, GRAND FORKS PUBLIC HEALTH, SPECTRA HEALTH, MENTAL HEALTH MATTERS, BLUE ZONES PROJECT GRAND FORKS AND GRAND FORKS REGION ECONOMIC DEVELOPMENT CORPORATION. WITH THIS ASSESSMENT/IMPROVEMENT CYCLE, STAKEHOLDER CONVERSATIONS CHANGED TO REFLECT THE VERY DIFFERENT DYNAMICS IN THE COMMUNITY AND REGION POST PANDEMIC. THE INFLUENCE OF MENTAL HEALTH FACTORS ACROSS ALL PRIORITIES, THE FOCUS ON HEALTH EQUITY AND THE LINGERING IMPACTS OF THE PANDEMIC ARE IMPACTING HOW WE VIEW COMMUNITY WELL-BEING AND HOW WE NEED TO RESPOND WITH IMPROVEMENT INITIATIVES. IN ADDITION, THERE ARE NEW AND DIFFERENT COMMUNITY RESOURCES AT PLAY THAT WILL BE IMPORTANT TO THIS WORK AND HOW IT IS SUSTAINED. THE OVERARCHING STRATEGIES TO ADDRESS THE PRIORITIES IDENTIFIED ARE DIRECTED TOWARD COMMUNITY INFRASTRUCTURE TO ADDRESS SOCIAL DETERMINANTS OF HEALTH AND COMMUNITY BUILDING THROUGH HEALTHY CONNECTIONS:O STRATEGY 1: LEVERAGE COMMUNITY INFRASTRUCTURE TO ADDRESS SOCIAL DETERMINANTS OF HEALTH TO IMPROVE HEALTH EQUITY.O STRATEGY 2: EMPOWER COMMUNITY BUILDING AMONG INDIVIDUALS THROUGH HEALTHY CONNECTIONS AND NEIGHBORHOOD NETWORKS. ALTRU AND GRAND FORKS PUBLIC HEALTH WILL BE WORKING WITH BLUE ZONES PROJECT GRAND FORKS TO ADDRESS THESE BROAD STRATEGIES. THE INFRASTRUCTURE AND TEAM THAT HAS BEEN ASSEMBLED WILL BE LEVERAGED TO ACHIEVE MANY OF THE SAME OUTCOMES AS IDENTIFIED BY THE IMPROVEMENT PLAN/IMPLEMENTATION STRATEGY.THE SIX PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT ARE COMPLEX AND INTERWOVEN. THE CURRENT IMPROVEMENT PLAN/IMPLEMENTATION STRATEGY TAKES A DIFFERENT APPROACH THAN PREVIOUS IMPROVEMENT PLANS USING THE OVERARCHING COMMUNITY STRATEGIES THAT "LIVE UPSTREAM" WITH A PREVENTION FOCUS AND THE POTENTIAL TO HAVE IMPACT ACROSS THE PRIORITIES VERSUS ADDRESSING EACH INDIVIDUALLY. WITH THIS APPROACH, THE PRIORITY AREAS OF WORKFORCE DEVELOPMENT AND CHILDCARE WILL NOT BE AS DIRECTLY IMPACTED BY THE STRATEGIES AND TACTICS IDENTIFIED HERE. THERE ARE CONSIDERABLE LOCAL AND STATE RESOURCES ADDRESSING THESE AREAS, AND THE WORK GROUP FELT THAT WE COULD DEFER TO THESE OTHER ENTITIES CURRENTLY ENGAGED TO MAKE IMPROVEMENTS ON THESE TWO TOPICS. ADDITIONALLY, ACCESS TO CARE HAS LONG BEEN A PRIORITY OF ALTRU, GRAND FORKS PUBLIC HEALTH, AND OTHER COMMUNITY PARTNERS. THE WORK GROUP FELT THAT THE FOCUS OF THESE ORGANIZATIONS WILL CONTINUE INDEPENDENT OF THIS CHIP. THE WORK IDENTIFIED HERE CAN SUPPLEMENT AND SUPPORT THE VALUABLE GROUND THAT HAS BEEN GAINED. ALTRU HOSPITAL PART V, SECTION B, LINE 24: ALL PATIENTS ARE CHARGED THE GROSS CHARGE REGARDLESS OF INSURANCE STATUS. ADJUSTMENTS MAY BE APPLIED PROVIDING THE PATIENTS APPLY FOR AND QUALIFY FOR CHARITY CARE. 55 1 - ALTRU CANCER CENTER 960 S COLUMBIA RD GRAND FORKS ND 582066003 OUTPATIENT DEPT OF ALTRU HOSP - CLINIC 2 - TRUYU AESTHETIC CENTER 3165 DEMERS AVE GRAND FORKS ND 582066003 OUTPATIENT DEPT OF ALTRU HOSP - CLINIC 3 - ALTRU FAMILY MEDICINE CENTER 1380 S COLUMBIA RD GRAND FORKS ND 582066003 OUTPATIENT DEPT OF ALTRU HOSP - CLINIC 4 - ALTRU FAMILY MEDICINE RESIDENCY 725 HAMLINE STREET GRAND FORKS ND 58203 OUTPATIENT CLINIC 5 - ALTRU FAMILY MEDICINE RESIDENCY PHARMACY 725 HAMLINE STREET GRAND FORKS ND 58203 OUTPATIENT PHARMACY 6 - ALTRU CLINIC - DRAYTON 1003 N MAIN DRAYTON ND 582254650 OUTPATIENT CLINIC/THERAPY 7 - ALTRU 860 COLUMBIA 860 S COLUMBIA RD GRAND FORKS ND 582066002 OUTPATIENT DEPARTMENT - PSYCH SERVICES 8 - ALTRU OUTPATIENT CENTER 411 2ND ST NW EAST GRAND FORKS MN 56721 OUTPATIENT THERAPY 9 - ALTRU CLINIC - CAVALIER 201 E 3RD AVE S CAVALIER ND 582200040 OUTPATIENT CLINIC 10 - ALTRU CLINIC - DEVILS LAKE 1001 7TH STREET NE DEVILS LAKE ND 583012719 OUTPATIENT CLINIC 11 - ALTRU CLINIC - CROOKSTON 400 SOUTH MINNESOTA CROOKSTON MN 567160606 OUTPATIENT DEPT OF ALTRU HOSP - CLINIC 12 - ALTRU CLINIC - RED LAKE FALLS 312 INTERNATIONAL DRIVE RED LAKE FALLS MN 567504662 OUTPATIENT DEPT OF ALTRU HOSP - CLINIC 13 - ALTRU CLINIC - ERSKINE 113 VANCE AVE N ERSKINE MN 565354201 OUTPATIENT DEPT OF ALTRU HOSP - CLINIC 14 - ALTRU CLINIC - FERTILE 101 S MILL ST FERTILE MN 565404215 OUTPATIENT DEPT OF ALTRU HOSP - CLINIC 15 - ALTRU CLINIC - ROSEAU 711 DELMORE DRIVE ROSEAU MN 567511534 OUTPATIENT CLINIC 16 - ALTRU CLINIC - WARROAD 412 MAIN AVE NE WARROAD MN 567632342 OUTPATIENT CLINIC 17 - ALTRU CLINIC - GREENBUSH 19120 200TH ST GREENBUSH MN 567269280 OUTPATIENT CLINIC 18 - UNITY MEDICAL CENTER 164 WEST 13TH STREET GRAFTON ND 58237 HOME HEALTH/HOSPICE 19 - FIRST CARE HEALTH CENTER PO BOX I PARK RIVER ND 58270 HOME HEALTH/HOSPICE/THERAPY 20 - NELSON COUNTY HEALTH SYSTEM BOX 367 MCVILLE ND 58254 HOME HEALTH/HOSPICE 21 - CO ALTRU CLINIC - CAVALIER 201 E 3RD AVE S CAVALIER ND 58220 HOME HEALTH/HOSPICE 22 - ALTRU HOME SVCS-NORTH VALLEY HOME HEALTH 109 S MINNESOTA ST WARREN MN 56762 HOME HEALTH/HOSPICE 23 - ANETA PARKVIEW HEALTH CENTER BOX 287 ANETA ND 58212 OUTREACH CLINIC 24 - CAVALIER COUNTY MEMORIAL 909 2ND ST LANGDON ND 58249 OUTREACH CLINIC 25 - CENTRAL BOILER 20502 160TH ST GREENBUSH MN 56726 OUTREACH CLINIC 26 - COOPERSTOWN MEDICAL CENTER 1200 ROBERTS ST COOPERSTOWN ND 58425 OUTREACH CLINIC 27 - DEVILS LAKE GOOD SAMARITAN 302 7TH AVE DEVILS LAKE ND 58301 OUTREACH CLINIC 28 - FIRST CARE HEALTH CENTER 115 VIVIAN ST PARK RIVER ND 58270 OUTREACH CLINIC 29 - FRIENDSHIP 554 W 12TH ST GRAFTON ND 58327 OUTREACH CLINIC 30 - 4TH CORP 120 11TH ST NEW ROCKFORD ND 58356 OUTREACH CLINIC 31 - GRIGGS COUNTY HOSPITAL 1200 ROBERTS AVE NE COOPERSTOWN ND 58425 OUTREACH CLINIC 32 - HATTON PRAIRIE VILLAGE 930 DAKOTA AVE HATTON ND 58240 OUTREACH CLINIC 33 - HEARTLAND CARE CENTER 620 14TH AVE NE DEVILS LAKE ND 58301 OUTREACH CLINIC 34 - KARLSTAD HEALTH CARE 304 WASHINGTON AVE W KARLSTAD MN 56732 OUTREACH CLINIC 35 - KITTSON MEMORIAL HEALTH CARE CENTER 1010 S BIRCH HALLOCK MN 56728 OUTREACH CLINIC 36 - KITTSON MEMORIAL CLINIC OF KARLSTAD 1ST AND ROOSEVELT KARLSTAD MN 56732 OUTREACH CLINIC 37 - LAKE REGION CORP 224 3TH ST NW DEVILS LAKE ND 583012908 OUTREACH CLINIC 38 - LAKOTA GOOD SAMARITAN 608 4TH AVE SW HWY 2 LAKOTA ND 583447500 OUTREACH CLINIC 39 - MAPLE MANOR CARE CENTER 1116 9TH AVE LANGDON ND 58249 OUTREACH CLINIC 40 - MCINTOSH MANOR NURSING HOME 600 RIVERSIDE AVE NE MCINTOSH MN 56556 OUTREACH CLINIC 41 - NELSON COUNTY CARE CENTER 108 E NYHUS AVE MCVILLE ND 58254 OUTREACH CLINIC 42 - NELSON COUNTY HEALTH SYSTEM 200 NORTH MAIN MCVILLE ND 58254 OUTREACH CLINIC 43 - NORTHWOOD DEACONESS 4 N PARK ST NORTHWOOD ND 58267 OUTREACH CLINIC 44 - OAKLAND PARK COMMUNITIES INC 123 BAKEN STREET THIEF RIVER FALLS MN 56701 OUTREACH CLINIC 45 - PEMBILIER NURSING CENTER 500 DELANO AVE WALHALLA ND 58282 OUTREACH CLINIC 46 - PEMBINA COUNTY MEMORIAL HOSPITAL 301 MOUNTAIN STREET E CAVALIER ND 58220 OUTREACH CLINIC 47 - PIONEER MEMORIAL CARE CENTER 23028 347TH ST SE ERSKINE MN 565359466 OUTREACH CLINIC 48 - REM-GRAFTON 817 HILL AVE GRAFTON ND 58327 OUTREACH CLINIC 49 - VALLEY 4000 4004 24TH AVE SOUTH GRAND FORKS ND 58201 OUTREACH CLINIC 50 - VALLEY MEMORIAL HOMES 2900 14TH AVE SOUTH GRAND FORKS ND 58201 OUTREACH CLINIC 51 - WEDGEWOOD MANOR 804 MAIN STREET WEST CAVALIER ND 58220 OUTREACH CLINIC 52 - CENTER FOR PREVENTION & GENETICS 4401 S 11TH ST GRAND FORKS ND 58201 OUTREACH CLINIC 53 - ALTRU CLINIC - EAST GRAND FORKS 607 DEMERS AVE EAST GRAND FORKS MN 56721 OUTPATIENT DEPT OF ALTRU HOSP - CLINIC 54 - ALTRU PROFESSIONAL CENTER 4440 S WASHINGTON ST GRAND FORKS ND 58201 OUTPATIENT CLINIC 55 - ALTRU CLINIC - THIEF RIVER FALLS 1845 HWY 59 S STE 800 THIEF RIVER FALLS MN 56701 OUTPATIENT CLINIC PART I, LINE 6A: PREPARATION OF ANNUAL COMMUNITY BENEFIT REPORT: ALTRU HEALTH SYSTEM PREPARES ANNUALLY A COMMUNITY BENEFIT REPORT BASED ON FORMS DESIGNED BY THE CATHOLIC HEALTH ORGANIZATION. ONCE ALL REPORTING FORMS HAVE BEEN COMPILED FOR THE YEAR, THE CATHOLIC HEALTH ORGANIZATION'S REFERENCE GUIDE FROM "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT" IS USED TO DETERMINE WHAT ITEMS SHOULD BE REPORTED INTO WHAT CATEGORY. THE COMMUNITY BENEFIT REPORT IS PUBLISHED AS A PART OF THE CORPORATION'S ANNUAL REPORT, WHICH IS PLACED ON OUR WEB SITE FOR PUBLIC ACCESS. PART I, LINE 7: CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST: THE METHODOLOGY USED TO DETERMINE THE REPORTED AMOUNTS FOR THE CHARITY CARE IS A COST-TO-CHARGE RATIO BASED ON GROSS CHARGES WRITTEN OFF PURSUANT TO OUR CHARITY CARE AND MEANS-TESTED PROGRAMS ELIGIBILITY CRITERIA. OTHER COMMUNITY BENEFIT IS DETERMINED FROM INFORMATION THAT WAS COMPILED ON FORMS DESIGNED BY THE CATHOLIC HEALTH ORGANIZATION AND USING THEIR REFERENCE GUIDE, "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT," TO DETERMINE WHICH CATEGORY THE AMOUNTS ARE PROPERLY REPORTED UNDER. PART II, COMMUNITY BUILDING ACTIVITIES: NONE DOCUMENTED ON FORM 990. PART III, LINE 2: NO BAD DEBT EXPENSE WAS REPORTED IN OPERATING EXPENSE AS NOTED IN THE NET PATIENT SERVICE REVENUE NOTE IN THE FINANICAL STATEMENTS. DISCOUNTS AND ALLOWANCES ARE ACCOUNTED FOR SEPARATELY FROM BAD DEBT EXPENSE. PART III, LINE 3: IT IS POLICY TO MAKE FINANICAL ASSISTANCE AVAILABLE TO PATIENTS WHO FIT THE FINANICAL ASSISTANCE CRITERIA. IT IS THE ORGANIZATION'S GOAL TO MAKE CERTAIN THAT THEY ARE PROACTIVE IN THE DETERMINATION OF FINANCIAL ASSISTANCE. ALL EFFORTS ARE MADE TO ENSURE THAT FINANCIAL ASSISTANCE ELIGIGLE PATIENTS DO NOT PROGRESS TO BAD DEBTS AND THEREFORE NO DOLLAR AMOUNT FOR BAD DEBT IS INCLUDED. PART III, LINE 4: THE AUDITED FINANICAL STATEMENTS DO NOT INCLUDE A BAD DEBT FOOTNOTE. THE ORGANIZATION REPORTS BAD DEBT IN ACCORDANCE WITH GAAP. PART III, LINE 8: NONE OF THE SHORTFALL SHOWN ON PART III, LINE 7 OF $304,930,926 HAS BEEN TREATED AS COMMUNITY BENEFIT AS REPORTED ON SCHEDULE H. THE SOURCE OF THE AMOUNT SHOWN ON PART III, LINE 6 COMES FROM THE MEDICARE ALLOWABLE COSTS REPORTED IN ALTRU'S MEDICARE COST REPORT SUBMITTED FOR THE FISCAL YEAR ENDING DECEMBER 31, 2022, UTILIZING THE FOLLOWING WORKSHEETS: WORKSHEETS B PART I, H-7 PARTS 1&2, I-4, AND K-6. PART III, LINE 9B: PROVISION FOR COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE FOUND IN ALTRU'S POLICY 2614 "FINANICAL ASSISTANCE." ALTRU'S COMMUNITY CARE PROGRAM IS DESIGNED TO PROVIDE FINANCIAL ASSISTANCE TO THOSE WHO HAVE NO INSURANCE AND/OR LIMITED MEANS TO PAY FOR THEIR MEDICAL SERVICES AND DO NOT QUALIFY FOR OTHER PROGRAMS. IN ADDITION TO QUALITY HEALTHCARE, PATIENTS OF ALTRU HEALTH SYSTEM ARE PROVIDED FINANCIAL COUNSELING REGARDING THEIR MEDICAL BILLS, BY SOMEONE WHO CAN UNDERSTAND AND OFFER POSSIBLE SOLUTIONS FOR THOSE WHO CANNOT PAY IN FULL. PROGRAMS ARE ALSO AVAILABLE FOR UNINSURED PATIENTS, AND FOR THOSE FOUND TO BE IN MEDICAL HARDSHIP. PART VI, LINE 2: NEEDS ASSESSMENT: ALTRU HEALTH SYSTEM'S MISSION - IMPROVING HEALTH, ENRICHING LIFE - CONFIRMS THAT OUR RESPONSIBILITY TO THE REGION GOES BEYOND PROVIDING QUALITY HEALTHCARE SERVICES. ALL OF OUR RESOURCES ARE DEVOTED TO IMPROVING HEALTH IN THE COMMUNITIES WE SERVE. AT ALTRU, GOOD HEALTH MEANS THAT EVERY INDIVIDUAL SHOULD ENJOY THE BEST ACHIEVABLE AND SO SHOULD OUR COMMUNITIES. ALTRU'S FOURTH CYCLE OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN 2022; THE ASSESSMENT WAS APPROVED BY OUR BOARD OF DIRECTORS ON DECEMBER 19, 2022. AS A RESULT OF THE ASSESSMENT, ALTRU PRIORITIZED AND IS FOCUSING ON THE FOLLOWING SIX ISSUES: 1)MENTAL HEALTH - IMPROVE THE MENTAL WELL-BEING OF ALL RESIDENTS AND BUILD RESILIENCE. 2) WORKFORCE - COLLABORATE ACROSS SECTORS TO EXPAND THE AVAILABLE WORKFORCE. 3) ACCESS TO CARE - INCREASE ACCESS TO PRIMARY, SPECIALTY, BEHAVIORAL, AND ORAL HEALTH CARE WITH A FOCUS ON REDUCING BARRIERS. 4) SUBSTANCE USE - REDUCE THE PREVALENCE OF SUBSTANCE USE INCLUDING ALCOHOL, TOBACCO AND OTHER DRUGS. 5) CHILD CARE - DEVELOP STRATEGIES TO MEET THE CHILDCARE NEEDS OF THE REGION WITH A FOCUS ON ACCESS AND AFFORDABILITY. 6) OBESITY - REDUCE THE PREVALENCE OF OBESITY IN THE POPULATION THROUGH INCREASED ACCESS TO SUPPORTIVE SERVICES AND REDUCED COST BURDEN. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:ALTRU HAS SEVERAL AVENUES IN WHICH INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS COMMUNICATED TO PATIENTS. UNINSURED AND SELF-PAY PATIENTS IN THE HOSPITAL RECEIVE A VISIT FROM PATIENT REPRESENTATIVES AFTER INTAKE. DURING THIS MEETING, THEY ARE INFORMED OF VARIOUS FEDERAL, STATE AND COMMUNITY-BASED PROGRAMS THAT MAY PROVIDE ASSISTANCE. UNINSURED OR SELF-PAY PATIENTS FROM OUTPATIENTS RECEIVE CONTACT FROM PATIENT REPRESENTATIVES BY PHONE OR EMAIL INFORMING THEM OF POTENTIAL SOURCES OF FINANCIAL ASSISTANCE. BOTH SETS OF PATIENTS ARE ALSO PROVIDED INFORMATION ON HOW TO MOVE FORWARD IN APPLYING FOR THE PROGRAMS. IF PATIENTS ARE FOUND TO BE STRUGGLING WITH MEDICAL EXPENSES, OUR CREDIT AND COLLECTIONS REPRESENTATIVES UTILIZE LETTERS AND PHONE CALLS TO INFORM THEM OF VARIOUS RESOURCES THAT MAY PROVIDE ASSISTANCE.FINANCIAL ASSISTANCE INFORMATION IS ALSO AVAILABLE TO THE PUBLIC AS A WHOLE. ALTRU'S WEBSITE, ALTRU.ORG, INCLUDES FINANCIAL ASSISTANCE CONTACT INFORMATION AND ELIGIBILITY GUIDELINES. PATIENTS MAY REVIEW THIS ON THEIR OWN AND CONTACT AGENCIES THAT MAY PROVIDE ASSISTANCE BASED ON THEIR CIRCUMSTANCES. ALSO, ALTRU DISTRIBUTES BROCHURES FEATURING OUR COMMUNITY CARE PROGRAM AND OTHER FEDERAL AND STATE PROGRAMS. THESE BROCHURES ARE AVAILABLE TO BOTH PATIENTS AND VISITORS IN WAITING ROOMS OF OUR INPATIENT AND OUTPATIENT FACILITIES AS WELL AS IN ALL BUSINESS OFFICE LOCATIONS. PART VI, LINE 4: COMMUNITY INFORMATION:ALTRU HEALTH SYSTEM SERVES A 24-COUNTY AREA THAT IS DIVIDED INTO SEVEN DISTINCT SUB-SERVICE AREAS AND HAS A POPULATION OF APPROXIMATELY 229,000 PERSONS (SOURCE: OPTUM 2021 POPULATION AGE SEGMENTATION ANALYSIS, OPTUM HAD NOT UPDATED DATA FOR 2022 AT THE TIME OF RETURN PREPARATION) WHO RESIDE IN A DIVERSE AREA OF AGRICULTURE AND INDUSTRY. THE SERVICE AREA STRETCHES 265 MILES EAST AND WEST AND 120 MILES NORTH AND SOUTH. GRAND FORKS SITS IN THE CENTRAL SERVICE AREA IN THE MIDDLE OF THE RED RIVER VALLEY, ONE OF THE WORLD'S RICHEST AGRICULTURAL AREAS. PRINCIPAL CROPS INCLUDE SUGAR BEETS, POTATOES, EDIBLE BEANS, AND SMALL GRAINS SUCH AS WHEAT AND BARLEY. MUCH OF THE INDUSTRY IN THE AREA IS RELATED TO AGRICULTURE AND FOOD PROCESSING.THE CENTRAL SERVICE AREA, COMPRISED OF GRAND FORKS AND SURROUNDING COMMUNITIES WITHIN GRAND FORKS COUNTY, IS HOME TO APPROXIMATELY 73,327 PEOPLE (SOURCE: OPTUM 2021 POPULATION AGE SEGMENTATION ANALYSIS). LOCATED IN THIS SUB-SERVICE AREA ARE ALTRU HOSPITAL, ALTRU SPECIALTY CENTER, ALTRU REHABILITATION CENTER, ALTRU CANCER CENTER, AND 13 OTHER LOCATIONS THAT ARE HOME TO OUR PROVIDERS' CLINIC PRACTICES AND OTHER SERVICES OFFERED BY ALTRU. ALTRU HOSPITAL SERVES AS THE MAJOR REFERRAL CENTER FOR THE PEOPLE OF THE REGION. AS SUCH, IT PROVIDES A BROAD SPECTRUM OF PROGRAMS AND SERVICES. A FULL RANGE OF SERVICES ARE AVAILABLE FOR PATIENTS SUFFERING FROM CANCER, HEART DISEASE, END-STAGE RENAL DISEASE, NEUROLOGICAL DISORDERS, ALCOHOL OR CHEMICAL DEPENDENCY, HIGH RISK OBSTETRICAL COMPLICATIONS, AND PSYCHIATRIC DISORDERS. ALTRU HOSPITAL'S INPATIENT MARKET SHARE IN 2022 FOR OUR ENTIRE SERVICE AREA WAS 42 PERCENT BASED ON CLAIMS DATA. 70 PERCENT OF STAFF EMPLOYED BY ALTRU ARE MEDICAL STAFF WHICH IS DEFINED AS EMPLOYEES WHO WORK IN JOB FAMILY GROUPS OF: AMBULATORY SERVICES, HOSPITAL SERVICES, LAB, NURSING, NUTRITION, PATIENT SUPPORT SERVICES, PHARMACY, PROVIDERS, RADIOLOGY, SOCIAL WORK, AND THERAPY. ALSO LOCATED IN GRAND FORKS COUNTY IS NORTHWOOD COMMUNITY HEALTH CENTER (IN NORTHWOOD, ND). A COUPLE NOTABLE POPULATIONS ALTRU SERVES THAT ARE WITHIN OUR CENTRAL SERVICE AREA INCLUDE THE UNIVERSITY OF NORTH DAKOTA AND GRAND FORKS AIR FORCE BASE. THE UNIVERSITY OF NORTH DAKOTA IS THE STATE'S OLDEST INSTITUTION OF HIGHER LEARNING WITH AN ENROLLMENT OF 13,876 (FALL 2022). THE NUMBER OF RESIDENTS AT GRAND FORKS AIR FORCE BASE WAS COUNTED AT 2,002 (2020 CENSUS).THE EAST, NORTH, NORTHEAST, NORTHWEST, SOUTH AND WEST SERVICE AREAS INCLUDE 23 COUNTIES THAT HAVE A POPULATION OF 155,422 PEOPLE (SOURCE: OPTUM POPULATION AGE SEGMENTATION ANALYSIS); THIS AREA IS LARGELY RURAL AND AGRICULTURAL. WITHIN THIS AREA, ALTRU HAS ELEVEN REGIONAL CLINIC LOCATIONS. BEYOND THE CENTRAL SERVICE AREA, THERE ARE SEVERAL SMALL HOSPITALS LISTED BELOW. CAVALIER COUNTY MEMORIAL HOSPITAL: LANGDON, ND PEMBINA COUNTY HOSPITAL: CAVALIER, ND UNITY MEDICAL CENTER: GRAFTON, ND FIRST CARE HEALTH CENTER: PARK RIVER, ND NELSON COUNTY HEALTH SYSTEM: MCVILLE, ND KITTSON MEMORIAL HOSPITAL: HALLOCK, MN NORTH VALLEY HEALTH CENTER: WARREN, MN LAKEWOOD HEALTH CENTER: BAUDETTE, MN MERCY HOSPITAL: DEVILS LAKE, ND SANFORD-THIEF RIVER FALLS MEDICAL CENTER: THIEF RIVER FALLS, MN PRESENTATION MEDICAL CENTER: ROLLA, ND TOWNER COUNTY MEDICAL CENTER: CANDO, ND SANFORD MAYVILLE MEDICAL CENTER: MAYVILLE, ND LIFECARE MEDICAL CENTER: ROSEAU, MN QUENTIN N. BURDICK MEMORIAL HOSPITAL: BELCOURT, NDALTRU HEALTH SYSTEM EMPLOYS MANY PROVIDERS WITHIN THE SUB-SERVICE AREAS. ALL OF THESE PROVIDERS ARE ON MEDICAL STAFFS OF COMMUNITY HOSPITALS THROUGHOUT THE REGION AND REFER PATIENTS TO ALTRU HOSPITAL AND ELSEWHERE FOR SPECIALITY CARE.AS PREVIOUSLY MENTIONED, ALTRU'S 24-COUNTY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 229,000. USING DATA FROM OPTUM (A VENDOR SPECIALIZING IN HEALTH CARE PLANNING INFORMATION), THE INSURANCE COVERAGE FOR COMMUNITIES IN OUR SERVICE AREA IS ESTIMATED TO BE AS FOLLOWS: COVERAGE AS A PERCENT COMMERCIAL 57% MEDICARE - TYPE OF POLICY 21%MEDICAID - TYPE OF POLICY 10%SELF-PAY 5%OTHER 7%TOTAL 100%ALSO, FROM OPTUM, OUR TOTAL SERVICE AREA'S INCOME BY HOUSEHOLD IS AS FOLLOWS:INCOME RANGE 2021 PERCENTAGES$ < $ 5,000 3% $ 5,000 - $ 9,999 4%$ 10,000 - $ 14,999 5%$ 15,000 - $ 19,999 4%$ 20,000 - $ 24,999 4%$ 25,000 - $ 29,999 5%$ 30,000 - $ 34,999 5%$ 35,000 - $ 39,999 4%$ 40,000 - $ 44,999 4%$ 45,000 - $ 49,999 4%$ 50,000 - $ 54,999 5%$ 55,000 - $ 59,999 5%$ 60,000 - $ 64,999 4%$ 65,000 - $ 69,999 3%$ 70,000 - $ 74,999 3%$ 75,000 - $ 79,999 3%$ 80,000 - $ 84,999 3%$ 85,000 - $ 89,999 3%$ 90,000 - $ 94,999 3%$ 95,000 - $ 99,999 2%$100,000 - $124,999 10%$125,000 - $149,999 6%$150,000 - $199,999 5%$ > $200,000 4%ACCORDING TO THE WEBSITE FOR HEALTH RESOURCES AND SERVICES ADMINISTRATION, THE FOLLOWING AREAS IN OUR SERVICE AREA ARE MUA'S:NORTH DAKOTA:BENSON COUNTY: WEST/NORTHWEST SERVICE AREACAVALIER COUNTY: NORTH SERVICE AREAGRAND FORKS COUNTY: CENTRAL SERVICE AREANELSON COUNTY: WEST SERVICE AREAPEMBINA COUNTY: NORTH SERVICE AREAROLETTE COUNTY: NORTHWEST SERVICE AREATOWNER COUNTY: WEST/NORTHWEST SERVICE AREATRAILL COUNTY: SOUTH SERVICE AREAWALSH COUNTY: NORTH SERVICE AREAMINNESOTA:KITTSON COUNTY: NORTHEAST SERVICE AREAMARSHALL COUNTY: NORTHEAST SERVICE AREAPOLK COUNTY: EAST SERVICE AREAROSEAU COUNTY: NORTHEAST SERVICE AREA PART VI, LINE 5: ALL OF ALTRU'S RESOURCES ARE DEVOTED TO IMPROVING HEALTH IN THE COMMUNITIES WE SERVE. TO DO SO, WE KNOW THAT NOT ALL MEDICAL SERVICES WILL COME FROM STAFF EMPLOYED BY ALTRU HEALTH SYSTEM. ALTRU EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY FOR NEARLY ALL DEPARTMENTS. ALSO, OUR BOARD OF DIRECTORS IS MADE UP OF INDIVIDUALS FROM OUTSIDE ALTRU HEALTH SYSTEM. THESE PEOPLE ARE VOLUNTEERS WHO HAVE THE SAME DEDICATION AND FOCUS ON ALTRU'S MISSION AS OUR OWN STAFF. PART VI, LINE 6: ALTRU HEALTH SYSTEM IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. IN SEPTEMBER 2011, ALTRU HEALTH SYSTEM BECAME THE FIRST MEMBER OF THE MAYO CLINIC CARE NETWORK. THIS IS A NON-OWNERSHIP RELATIONSHIP THAT BENFITS THE ORGANIZATION'S PHYSICIANS AND PATIENTS FROM ENHANCED ACCESS TO MAYO PHYSICIANS AND CLINICAL RESOURCES. MORE SPECIFICALLY, PHYSICIANS HAVE ACCESS TO MAYO CLINIC'S EVIDENCE-BASED DISEASE MANAGEMENT PROTOCOLS, CLINIC CARE GUIDELINES, AND TREATMENT RECOMMENDATIONS AND REFERENCE MATERIALS FOR COMPLEX MEDICAL CONDITIONS.PART VI, LINE 7: ALTRU HEALTH SYSTEM IS NOT REQUIRED TO FILE OUR COMMUNITY BENEFIT REPORT WITH ANY OUTSIDE ORGANIZATIONS BUT HAS MADE OUR REPORT AVAILABLE TO ANYONE ON OUR WEB SITE. 1 GREATER GRAND FORKS YOUNG PROFESSIONALS 202 NORTH 3RD ST GRAND FORKS ND 58203 320134204 501(C)(6) 10000 0 GGFYP VISIONARY SPONSORSHIP FIRSTLINK 4357 13TH AVE S STE 107L FARGO ND 58107 450419491 501(C)(3) 10000 0 FUNDING FOR CARE AND SUPPORT PROGRAM PARTNERSHIP DAKOTA MEDICAL FOUNDATION 4141 28TH AVE S FARGO ND 58104 456012318 501(C)(3) 12500 0 RECOVERY REINVENTED SAKAKAWEA SPONSORSHIP UNITED WAY - GF EGF 1407 24TH AVE S STE 400 GRAND FORKS ND 58201 450255772 501(C)(3) 20600 0 2022 SUPPORT CHAMBER OF GRAND FORKS EAST GRAND FORKS 202 N 3RD ST GRAND FORKS ND 58203 202924979 501(C)(6) 25770 0 2022 SUPPORT LAKE REGION AMBULANCE SERVICE 5TH ST SE DEVILS LAKE ND 58301 450283168 501(C)(3) 31387 0 PURCHASE OF AN ALL TERRAIN AMBULANCE CITY OF EAST GRAND FORKS 600 DEMERS AVE NW EAST GRAND FORKS MN 56721 416005112 EAST GRAND FORKS, MN 45000 0 WELLNESS PROGRAM CITY OF GRAND FORKS 255 N 4TH ST GRAND FORKS ND 58203 456002085 GRAND FORKS, ND 87335 0 SOCIAL DETOX FACILITY, BACK THE BADGE, PSAP GRAND FORKS PUBLIC SCHOOLS 2400 47TH AVE S GRAND FORKS ND 58201 456000607 GRAND FORKS, ND 225000 0 GENERAL SUPPORT AND SUPPORT REPLACEMENT, MAINTENANCE ADN REPAIR OF THE TRACK/TURF AT CUSMAN FIELD ATHLETIC COMPLEX 7 2 PART I, LINE 2: THE MAJORITY OF GRANTS AND OTHER ASSISTANCE PROVIDED BY ALTRU ARE TO SUPPORT GENERAL OPERATIONS OF THE RECIPIENT. MAJORITY OF RECIPIENTS ARE INVOLVED IN BETTERING THE COMMUNITY AND REGION WHICH ALIGNS WITH ALTRU'S MISSION. FOR MULTIYEAR GIFTS AND SPONSORSHIPS, ALTRU REQUIRES SIGNATURE OF A FORMAL DONATION AGREEMENT OR MEMORIUM OF UNDERSTANDING THAT LISTS THE TERMS OF THE GIFT. SINCE MOST GIFTS ARE GENERAL SUPPORT, THERE IS NO FORMAL TRACKING FUNDS ARE USED FOR SPECIFIC PURPOSE; HOWEVER, ALTRU IS ACTIVELY INVOLVED IN THE COMMUNITY AND EVALUATES SPONSORSHIP RELATIONSHIPS . RECIPIENTS ARE REQUESTED TO SEND ALTRU INVOICE FOR ANNUAL GIFT INSTALLMENT AS SET OUT IN DONATION AGREEMENT. APPROVAL PROCESS FOR INVOICE BUILT INTO ACCOUNTING SYSTEM BEFORE PAYMENTS ARE MADE WHICH SERVES TO MONITOR REQUESTS FOR FUNDS. X X X X X X 1 1 0 0 0 0 0 0 0 MEVAN WIJETUNGA MEDICAL DIRECTOR 1495028 0 0 0 37750 0 15250 0 29548 0 1577576 0 0 0 JOHN EICKMAN PHYSICIAN 1489214 0 0 0 21040 0 15250 0 3223 0 1528727 0 0 0 GRANT SEEGER PHYSICIAN 1403808 0 0 0 21040 0 19250 0 36708 0 1480806 0 0 0 IKECHUKWU ONYEKA PHYSICIAN 1377642 0 0 0 29322 0 19250 0 37708 0 1463922 0 0 0 BARRY BJORGAARD PHYSICIAN 1237592 0 0 0 51057 0 19250 0 31874 0 1339773 0 0 0 JANICE HAMSCHER CHIEF NURSING OFFICER 563306 0 121051 0 588224 0 15250 0 20459 0 1308290 0 121051 0 STEVEN WEISER MD BOARD MEMBER/PRESIDENT (THROUGH FEB 81439 0 210524 0 966906 0 19250 0 6105 0 1284224 0 210524 0 JASON GO PHYSICIAN 1162770 0 0 0 21310 0 19250 0 36708 0 1240038 0 0 0 JODY TREUER MD BOARD MEMBER/PHYSICIAN 1026383 0 0 0 49822 0 19250 0 29248 0 1124703 0 0 0 JEREMY GARDNER MEDICAL DIRECTOR 929998 0 40392 0 21310 0 43118 0 36467 0 1071285 0 40392 0 SUNIL KARTHAM MEDICAL DIRECTOR 793065 0 32080 0 41232 0 37970 0 36708 0 941055 0 32080 0 JOSHUA DEERE BOARD MEMBER/PRESIDENT 546287 0 38600 0 41540 0 186390 0 29247 0 842064 0 38600 0 REED REYMAN EVP - REGIONAL DEVELOPMENT 342053 0 79196 0 382959 0 15250 0 20675 0 840133 0 79196 0 TODD FORKEL BOARD MEMBER/CEO 570210 0 0 0 6815 0 194668 0 26601 0 798294 0 0 0 JONATHAN HAUG MEDICAL DIRECTOR 615520 0 55138 0 21310 0 52525 0 36708 0 781201 0 55138 0 MEGHAN COMPTON CHIEF CLINIC OPERATIONS OFFICER 411196 0 102759 0 41417 0 138324 0 36402 0 730098 0 102759 0 KELLEE FISK FORMER KEY EMPLOYEE 0 0 121802 0 529876 0 7492 0 1577 0 660747 0 623995 0 MARK WAIND CHIEF INFORMATION OFFICER 430355 0 101252 0 50398 0 19600 0 29165 0 630770 0 101252 0 YVONNE GOMEZ MEDICAL DIRECTOR 446428 0 47363 0 30303 0 52181 0 3426 0 579701 0 47363 0 DOUGLAS ARVIN CFO/TREASURER 411569 0 107774 0 30202 0 15250 0 13126 0 577921 0 107774 0 WILLIAM MCKINNON MD BOARD MEMBER/PHYSICIAN 301955 0 71779 0 49356 0 60778 0 23249 0 507117 0 71779 0 KRISTI HALL-JIRAN CHIEF PHILANTHROPY OFFICER 245394 0 64412 0 48655 0 84372 0 4532 0 447365 0 64412 0 ALEXSANDAR TODOROVIC DIRECTOR INFO SYSTEMS APPLICATIONS 205924 0 37763 0 21787 0 34578 0 16679 0 316731 0 37763 0 JOEL LARSON DIRECTOR LEGAL & PRIVACY/GENERAL COU 194293 0 34919 0 15732 0 31779 0 35690 0 312413 0 34919 0 ERIN NAVARRO DIRECTOR PHARMACY SVCS 193767 0 32772 0 15227 0 32972 0 30092 0 304830 0 32772 0 MARLENE MILLER DIRECTOR PEOPLE RESOURCES 178006 0 31793 0 27458 0 29083 0 25682 0 292022 0 31793 0 MATTHEW SCHUMACHER DIRECTOR TECH & SUPPORT SVCS 186591 0 32696 0 14925 0 31914 0 24873 0 290999 0 32196 0 HEATHER STRANDELL SENIOR DIRECTOR CLINIC OPERATIONS 200389 0 31539 0 15424 0 33716 0 4862 0 285930 0 31539 0 STAN SALWEI DIRECTOR REV CYCLE/PRIMARY CARE SVCS 157497 0 30116 0 27732 0 26632 0 20835 0 262812 0 30116 0 DAVID MOLMEN BOARD MEMBER/CEO (INTERIM THROUGH FE 45942 0 172077 0 17689 0 12960 0 4847 0 253515 0 172077 0 KARI JENSEN DIRECTOR QUALITY & SAFETY 154151 0 27767 0 12402 0 28559 0 30472 0 253351 0 0 0 JENNIFER ESTAD SENIOR DIRECTOR CLINIC OPERATIONS 155565 0 25986 0 19864 0 28200 0 3759 0 233374 0 0 0 JENNIFER BERG DIRECTOR TOTAL REWARDS 139210 0 26499 0 11673 0 22459 0 24392 0 224233 0 0 0 PART I, LINES 4A-B KELLEE FISK, $502,193, SEVERANCE STEVEN WEISER, $939,699, SEVERANCE JANICE HAMSCHER, $541,473, SEVERANCE REED REYMAN, $345,736, SEVERANCE TODD FORKEL, $72,830, 457(F) CONTRIBUTION JOSHUA DEERE, $63,773, 457(F) CONTRIBUTION KRISTI HALL-JIRAN, $24,197, 457(F) CONTRIBUTION MEGHAN COMPTON, $47,609, 457(F) CONTRIBUTION DAVID MOLMEN, $58,133, 457(F) DISTRIBUTION JANICE HAMSCHER, $131,978, 457(F) DISTRIBUTION KELLEE FISK, $59, 457(F) DISTRIBUTION MARK WAIND, $75,229, 457(F) DISTRIBUTION REED REYMAN, $58,073, 457(F) DISTRIBUTION A CITY OF GRAND FORKS 456002085 38546WCR9 2017-07-12 65233846 REFUND BONDS ISSUED IN 2005; FINANCE FACILITIES, INFRASTRUCTURE, EQUIPMENT 0 0 0 B CITY OF GRAND FORKS 456002085 000000000 2017-09-06 21720835 REFUND BONDS ISSUED IN 2007 0 0 0 C CITY OF GRAND FORKS 456002085 000000000 2019-08-01 13520000 REFUND BONDS ISSUED IN 2011 AND 1996 0 0 0 D CITY OF GRAND FORKS 456002085 38546WDR8 2021-09-28 456996976 REFUND BONDS ISSUED IN 2012 & 2020; FINANCE CONSTRUCTION OF HOSPITAL & EQUIP 0 0 0 A 5745000 65861298 286267 19519 708166 40209015 24924958 2018 1 0 0 1 B 15388563 21775310 82447 2017 1 0 1 1 C 8027779 13520000 13520000 2019 1 0 1 1 D 456996976 18820174 2700766 3008634 2756830 93005960 150841735 174719715 1 0 0 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 1 0 0 0.02990 0.02990 0 0 1 A 0 0 0 1 0 0 0 0 0 B 0 0 1 0 0 0 0 0 0 C 0 1 0 0 0 0 0 0 0 D 0 1 0 0 0 0 0 0 0 A 0 B 0 C 0 D 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CITY OF GRAND FORKS DATE THE REBATE COMPUTATION WAS PERFORMED: 12/23/2021 SCHEDULE K, PART II, PROCEEDS, LINE 3: (A) TOTAL PROCEEDS OF ISSUE CONSIST OF SALES PROCEEDS OF $65,233,846 PLUS $627,452.32 OF INVESTMENT PROCEEDS. (B) TOTAL PROCEEDS OF ISSUE CONSIST OF SALES PROCEEDS OF $21,720,835 PLUS $54,475.04 OF INVESTMENT PROCEEDS. FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBER, ERIC HALVERSON'S FATHER IS MARRIED TO KEY EMPLOYEE, YVONNE GOMEZ. FORM 990, PART VI, SECTION B, LINE 11B AN ELECTRONIC COPY OF THE RETURN WAS SENT TO THE BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY IS REVIEWED AND SIGNED OFF ANNUALLY BY ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES. THESE FORMS ARE COLLECTED AND REVIEWED BY THE SECRETARY AND INTERNAL LEGAL COUNSEL. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE ALSO ADVISED TO REPORT SHOULD ANY CHANGES HAPPEN DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A: ALTRU DETERMINES THE TOP MANAGEMENT OFFICIALS' COMPENSATION BY REVIEW AND APPROVAL BY A GOVERNING BODY WITHOUT CONFLICTS OF INTEREST, USING COMPARABLE COMPENSATION DATA FOR FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS (WITH RELEVANT COMPARABLES DOCUMENTED IN AN ANNUAL STATEMENT OF REASONABLENESS LETTER FROM ALTRU'S COMPENSATION CONSULTANT), AND MADE CONTEMPORANEOUS DOCUMENTATION OF THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. ALTRU HAS A COMPENSATION COMMITTEE MADE UP OF COMMUNITY BOARD MEMBERS ALONG WITH THE PRESIDENT AND CEO. WE ALSO WORK WITH AN OUTSIDE CONSULTANT WHICH PROVIDES US WITH DATA ON FAIR MARKET COMPENSATION FOR THE ENTIRE EXECUTIVE STAFF. FOR DETERMINING THE COMPENSATION OF THE PRESIDENT AND CEO, THE COMMUNITY BOARD MEMBERS OBTAIN THE DATA FROM THE CONSULTANT, HAVE AN OPPORTUNITY TO DISCUSS WITH THE CONSULTANT AND HAVE ANY QUESTIONS ANSWERED AND THEN THEIR DECISION IS SHARED WITH THE NON-CONFLICTED BOARD MEMBERS FOR FINAL APPROVAL. THIS PROCESS WAS USED TO DETERMINE THE COMPENSATION FOR BOTH POSITIONS OF PRESIDENT AND CEO IN 2022. LINE 15B: ALTRU USES SIMILAR CRITERIA TO THE PROCESS DESCRIBED IN 15(A) ABOVE. THE PRESIDENT AND CEO DETERMINE THE SALARIES FOR EACH OF THE EXECUTIVES THAT REPORT TO THEM. ALTRU USES AN OUTSIDE COMPENSATION CONSULTANT WHICH PROVIDES DATA ON FAIR MARKET COMPENSATION FOR FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE PRESIDENT AND CEO PRESENT THEIR DECISIONS ON THE EXECUTIVE COMPENSATION TO THE BOARD, WHICH IS A GOVERNING BODY WITHOUT CONFLICTS OF INTEREST AS TO THE SUBJECT MATTER. THE BOARD DOES NOT RATIFY THE BASE COMPENSATION FOR THE EXECUTIVES THAT REPORT TO THE PRESIDENT AND CEO (THE PRESIDENT AND CEO HAVE FINAL SAY IN SETTING BASE COMPENSATION FOR THEIR EXECUTIVE TEAM BASED ON THE COMPENSATION DATA REFERENCED ABOVE), BUT THE BOARD DOES DETERMINE THE ANNUAL GOALS FOR THE ALTRU SYSTEM THAT ARE USED TO DETERMINE (BY FORMULA) POTENTIAL BONUS PAYOUTS FOR THE EXECUTIVE TEAM. THE PROCESS DESCRIBED ABOVE WAS FOLLOWED FOR ALL EXECUTIVES IN 2022. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATIONS 990 AND 990-T PUBLIC INSPECTION COPIES ARE AVAILABLE UPON REQUEST. FORM 1023 IS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC THROUGH PUBLISHED ANNUAL REPORTS. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: APPLICATION OF FASB TOPIC 715 408,305. 990, PAGE 1, HEADING ITEM C ALTRU 1300 COLUMBIA, ALTRU CANCER CENTER, ALTRU FAMILY MEDICINE CENTER, ALTRU FAMILY MEDICINE RESIDENCY, TRUYU AESTHETIC CENTER, ALTRU CLINIC-LAKE REGION, ALTRU CLINIC-CAVALIER, ALTRU CLINIC-DRAYTON, ALTRU CLINIC-CROOKSTON, ALTRU CLINIC-RED LAKE FALLS, ALTRU CLINIC-FERTILE, ALTRU CLINIC-ERSKINE, ALTRU CLINIC-ROSEAU, ALTRU CLINIC-WARROAD, ALTRU CLINIC-GREENBUSH, ALTRU CLINIC-KARLSTAD ALTRU HEALTH FOUNDATION 2501 DEMERS AVE GRAND FORKS ND 58201 450368330 FUNDRAISING ND 501(C)(3) LINE 12B, II ALTRU HEALTH SYSTEM 1 DAK-MINN BLOOD BANK 1200 S COLUMBIA RD GRAND FORKS ND 58201 363453164 BLOOD BANK ND 501(C)(3) LINE 12D, III-O N/A 0 ALTRU ALLIANCE 1200 S COLUMBIA RD GRAND FORKS ND 58201 237389089 SUPPORT HOSPITAL AND AFFILIATES ND 501(C)(3) LINE 12C, III-FI N/A 0 ALTRU SPECIALTY SERVICES INC 1200 S COLUMBIA RD GRAND FORKS ND 58201 450395652 DME SALES, RETAIL PHARMACY ND ALTRU HEALTH SYSTEM C 13727648 41468218 1.00000 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 1 ALTRU HEALTH FOUNDATION C 1351371 CASH DONATED ALTRU HEALTH FOUNDATION O 170074 COMPENSATION TO RELATED ORG ALTRU SPECIALTY SERVICES A 125911 RENT PAYMENT RECEIVED ALTRU HEALTH FOUNDATION B 104643 CASH DONATED