2023-10-26T19:00:15+00:00 2022-12-31 990 2022-01-01 411293970 Range Regional Health Services RANG 2183626657 750 East 34th Street Hibbing MN 55746 Jean MacDonell President/CEO 2023-10-26 Jean MacDonell 999009999 2022 2023-04-26 12:10:37Z Jean MacDonell 750 East 34th Street Hibbing MN 55746 125262478 false X www.range.fairview.org X 1998 MN To provide a regional integrated network of health care services through physicians, ambulatory care, and hospital facilities. 12 6 1123 43 652972 0 4614806 221991 127531733 124421978 3990710 422663 106290 117648 136243539 125184280 0 0 85348734 86064345 0 0 42757229 47375387 128105963 133439732 8137576 -8255452 112982579 88927814 47253691 32388148 65728888 56539666 Range Regional Health Services is an integrated health care system meeting the needs of our patients in an exemplary manner. false false 116030932 124421978 Range Regional Medical Center maintains and operates a hospital to provide medical and surgical care to the sick, infirm, aged, or injured. Patients are connected to the most comprehensive health care network in northeastern Minnesota through Range Regional Medical Center in Hibbing, Minnesota. The 175 bed facility offers more than 60 medical services, including ear, nose and throat care; surgery; urology; occupational therapy; cardiac rehabilitation; radiation therapy; a sleep center; sports medicine; obstetrics-gynecology and emergency care. Range Regional Health Services is part of Fairview Health Services. Fairview Health Services is an industry-leading, award-winning, nonprofit, integrated health system providing exceptional health care across the full spectrum of health care services. Founded in 1906, Fairview serves the twelve-county Minneapolis/St. Paul Metro Area, as well as communities throughout greater Minnesota and portions of Northern Iowa and Western Wisconsin and is one of the most comprehensive and geographically accessible systems in Minnesota. Fairview, the University of Minnesota and the University of Minnesota Physicians approved an agreement which became effective in late 2018 (the "M Health Fairview Agreement"). While the parties maintain their separate governance, the M Health Fairview Agreement further integrated operations across the clinical delivery system and enhances research and education by creating a joint clinical enterprise among the parties. The M Health Fairview Agreement brings together not only UMMC and its related service lines, but also Fairview's other hospitals, primary care clinics, and other services. All are part of a shared care delivery system that is led by a single structure that includes academic physician leadership. The goal of the joint clinical enterprise is to create a nationally renowned academic health system. This care system was united under a single brand, M Health Fairview, which is inclusive of the Fairview Hospitals and Clinics Fairview owns and operates the following hospitals: UMMC, M Health Fairview Southdale Hospital, M Health Fairview Ridges Hospital, M Health Fairview Lakes Medical Center, M Health Fairview Northland Medical Center, Fairview University Medical Center - Mesabi ("Range"), Grand Itasca Clinic and Hospital, M Health Fairview St. John's Hospital, M Health Fairview Woodwinds Hospital and M Health Fairview Bethesda Hospital. As of December 31, 2022, the Fairview System Hospitals had a total of 3,529licensed beds and 1,824 staffed beds. Fairview operates their more than 80 primary and specialty care clinics throughout the Metro Area, greater Minnesota and western Wisconsin. These clinics offer services in over 70 medical specialties, including family medicine, pediatrics, obstetrics, gynecology, heart care, cancer care, otolaryngology, transplant care, and orthopedics. As of December 30, 2022, Fairview owned all or a portion of seven ambulatory surgery centers located in the Metro Area. Through its mission and its role as an anchor institution, Fairview is in a unique position to be a catalyst for progress and change. Fairview continues to invest heavily in the health and wellness of its communities in which it operates. This commitment includes education, training, community programs and research, as well as significant investments in care delivery. The COVID-19 pandemic exposed persistent health inequities for communities of color and has exacerbated racial disparities. Communities of color experienced statistically higher rates of COVID-19, including higher rates of hospitalization and death. To reduce the impact on Black, Indigenous, or people of color ("BIPOC"), vaccinations must be accessible, free and provided within a trusted space with appropriate language and cultural considerations. Fairview has led a multi-cultural mobile vaccination program for the past 15 years, which excels at reaching BIPOC communities facing barriers to immunization. Based on this established and successful model, Fairview was able to quickly adapt and partner with public health agencies for its COVID-19 response, including testing and vaccination clinics. Further, Fairview's longstanding relationship with local public health agencies and community partners has allowed Fairview to provide staffing, coordination, and outreach for a remarkable program called the Minnesota Immunization Network Initiative (MINI). MINI is a collaboration led by Fairview and supported by over 150 community partners, works to reduce barriers to vaccinations for communities experiencing health disparities. MINI provides flu, COVID, Mpox and other immunizations free of charge to community members aged six months and older. More than 110,000 influenza and almost 60,000 COVID vaccines have been administered. The MINI clinics are hosted in community-based locations such as local churches, mosques, temples, schools, community centers, public high rises, libraries, food pantries, and homeless shelters. The clinics are hosted by the local partner who provides the space, promotion, and serves as a trusted messenger for community members. Fairview provides the vaccine and clinical team - including interpreters and support staff - and information about other local community resources. Vaccinations are provided at no charge to participants, ages six months and older. The past several years, MINI clinics have expanded their reach to include other services such as blood pressure screening and cardiovascular health education, free dental varnish treatments, oral health education and opioid overdose prevention education. Services are often provided in conjunction with MINI vaccination clinics or on their own. During the COVID-19 pandemic, the MINI program leveraged over 15 years of experience providing mobile clinical services in diverse settings to respond to the urgent public health crisis. MINI launched a large scale, low barrier testing initiative in partnership with Saint Paul Ramsey County Public Health and the Minnesota Department of Health. This collaboration enabled thousands of community members to receive a free COVID-19 test in convenient, trusted community spaces. In total, MINI supported 47 testing events and administered almost 20,000 tests. Once the COVID-19 vaccine became available, MINI immediately pivoted to providing COVID-19 vaccinations. To date, MINI has provided 1,250 community based COVID vaccination clinics and given over 59,000 vaccinations. MINI is also supporting Mpox outreach response efforts and launched a Mpox vaccination effort in October of 2022. 116030932 true true false true false false false false false true true false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true false false false true 0 0 1123 true true true false false false false false false false false false false false X 12 6 false false false false true false false true true false false false true true true true true true true false MN X Todd Christensen 2183626638 750 E 34TH STREET HIBBING MN 55746 Amanda McDonald MD Director 40.0 0.0 X 275989 0 14077 Andy McCoy Director, ended 12-2022 2.0 40.0 X 0 405074 23074 Brian Amdahl Director 2.0 40.0 X 0 477659 34259 Dan Aageness Director, ended 12-2020 0.0 0.0 X 0 0 0 David Milbrandt Director 2.0 40.0 X 0 495310 39407 Hannah Forti Director 2.0 0.0 X 0 0 0 James Borland Director, ended 3-2022 2.0 0.0 X 0 0 0 Jeffrey Lee Director, new July 2022 2.0 0.0 X 0 0 0 Jessalyn Sabin Chair 2.0 0.0 X 0 0 0 Kasey Kapella MD Secretary 40.0 0.0 X 238233 0 13525 Laura Reed Director 2.0 40.0 X 0 1544185 191815 Mark Gardeski Director 2.0 0.0 X 0 0 0 Mike Raich Chair, ended 12-2020 0.0 0.0 X 0 0 0 Patrick Furlong Director 2.0 0.0 X 0 0 0 Susan Hoyum MD Director 40.0 0.0 X 248163 0 27618 Victoria Hagberg Vice Chair 2.0 0.0 X 0 0 0 James Hereford Officer 2.0 40.0 X 0 3370758 116860 Jean MacDonell President & CEO 20.0 20.0 X 0 515552 71098 Todd Christensen VP Finance 20.0 20.0 X 0 216190 34081 Ari Yazdan MD Physician 40.0 0.0 X 627536 0 28551 Arvydas Urbonas MD Physician 40.0 0.0 X 531652 0 35483 Kristin Fredrickson MD Physician 40.0 0.0 X 547097 0 38090 Lane Meyer MD Physician 40.0 0.0 X 580116 0 49825 Scott Stenstrom MD Physician 40.0 0.0 X 487395 0 39876 3536180 7024728 757639 0 false true false 0 578 81871 139542 221991 Patient Services 622110 51423660 51423660 Pharmacy 446110 48827054 48827054 Laboratory 621500 22697487 22697487 Cafeteria 722310 503721 503721 Healthline Patient Billing 561000 480142 480142 489914 313528 172830 3556 124421978 32939 32939 117648 117648 0 117648 117648 445492 22430 78198 445492 -55768 389724 389724 0 0 0 0 0 125184280 123765450 652972 543867 817604 817604 0 0 66432800 56717999 9714801 3487433 2977448 509985 10795137 9216510 1578627 4531371 3868726 662645 1452847 1350939 101908 9905 9905 5222 5222 13299666 12487597 812069 0 58096 60 58036 2392218 1654388 737830 1793367 1693935 99432 337646 307846 29800 329884 313009 16875 408256 408256 2891869 2546783 345086 176433 176433 Medical Supplies 16919032 16514425 404607 Taxes - Medical 2366318 2366318 General Supplies 1139222 1031598 107624 Utilities, Repair & Maintenance 836963 817762 19201 2958443 763296 2195147 0 133439732 116030932 17408800 0 10949885 4354853 27159954 14365651 14142452 14586392 0 0 0 0 2488273 2381221 563066 1216159 87003176 67633757 20765569 19369419 22365993 18870937 11413076 11396641 0 3134311 2386541 112982579 88927814 30888392 30197472 7357828 30000 0 0 9007471 2160676 47253691 32388148 65517248 56319264 211640 220402 65728888 56539666 112982579 88927814 X -8255452 -4516335 3582565 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 5222 5222 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY THE ORGANIZATION PAYS ANNUAL MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE MINNESOTA HOSPITAL ASSOCIATION. A PORTION OF THESE ANNUAL DUES ARE DETERMINED TO BE USED FOR LOBBYING PURPOSES. 374539 374539 59446825 46736031 12710794 25375237 19545594 5829643 1806575 1352132 454443 19369419 Hedge Funds 4844940 Private Capital Investments 1218192 Fixed Income Investments 864211 Equity Investments 4469298 11396641 Lease Liabilities 118507 Pension Liability 2040735 Derivative Financial Instruments 1434 2160676 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote Range Regional Health Services is part of Fairview Health Services. Fairview recognizes all tax positions, including those positions in a previously filed tax return or a position expected to be taken in a future tax filing that is reflected in measuring current or deferred income tax assets and liabilities, when it is more likely than not (likelihood of greater than 50%) that, based on technical merits, the position will be sustained upon examination. There are $8,400,000 and $14,540,000 uncertain tax positions recorded on the consolidated balance sheets as of December 31, 2022 and 2021, respectively. Fairview has made reasonable estimates of the provision for income taxes and on existing deferred tax balances based on accounting guidance included in ASC 740, Income Taxes. Fairview does not expect that there will be a significant change in the total amount of unrecognized tax benefits within the next 12 months. true true X true X true X true true false true true 1468860 417785 1051075 0.0079 26487876 19372462 7115414 0.0533 0 0.0 0 0 27956736 19790247 8166489 0.0612 383081 383081 0.0029 748760 748760 0.0056 781353 532357 248996 0.0019 0 0.0 16290 16290 0.0001 0 0 1929484 532357 1397127 0.0105 0 0 29886220 20322604 9563616 0.0717 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 1379885 27598 31787480 50179351 -18391871 X true true 1 1 Range Regional Health Services 750 East 34th Street Hibbing MN 55746 www.range.fairview.org 405679 X X X Range Regional Health Services 1 false false true X X X X X X X X X 21 true false false true X https://www.fairview.org/our-community-commitment/local-health-needs X true 22 true https://www.fairview.org/our-community-commitment/local-health-needs false true X 200.0 300.0 X X X X X X false true X X X X true X https://www.fairview.org/billing/financial-assistance X http://www.fvfiles.com/2266.pdf X https://www.fairview.org/billing/financial-assistance X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E Fairview is committed to transparency and accountability in all we do, including our efforts to assess - and respond to - our community's most pressing health needs. The community benefit work that we do across Fairview must reflect our community's actual needs, not our assumptions about what those needs might or should be. Because we understand that change cannot happen when we work in silos, and it cannot happen in a single year, we grounded our 2021 CHNA process in alignment with our 2018 CHNA needs, existing data, and the voices of community members and community partners. Once we had collected, analyzed, and synthesized the information we received from both primary and secondary data sources, we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. Having a consistent, defined process helps reduce the skewing effect of conscious and unconscious biases and enables us to define priority need areas that reflect our community's top health needs rather than our perception of those needs. We evaluated areas of need based on four broad criteria: -Has this need been voiced by the community? Has this need been vetted by the community? -Does this need align with Fairview's strategies and priorities? -Does this need align with existing public health strategies and community health assessments? -Does this need build upon Fairview's 2018 CHNA priority needs? Our process resulted in the identification of three priority need areas. They are: -Navigating and accessing care and resources -Healing, connectedness, and mental health -Addressing structural racism and barriers to achieving health equity. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Range Regional Health Services. The assessment process and data collection methods we used during this CHNA cycle were different than ever before due to the COVID-19 pandemic. COVID- 19 caused delays in data collection among local, state, and national organizations. As a result of these delays, the U.S. Census Bureau had not yet released finalized data from the 2020 U.S. Census by the time we began the CHNA process. As a result, we used 2015-2019 American Community Survey data. Local public health agencies also were not able to provide updated data as they have in the past. We acknowledge that, due to these setbacks, the data we used is less recent than desired. Additionally, COVID-19 required us to add new safety precautions to our method of gathering community voice data. For example, all conversations and interviews, which had previously been in-person meetings, took place in a virtual format instead. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations. The process included discussions with community benefit and assessment committees, our community advisory council, the HOPE Commission listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Each hospital within Fairview has a community committee that is involved in the CHNA process throughout the three-year cycle. Each committee is comprised of local community and organizational leaders and staffed by the Fairview Community Advancement department. Community Health Steering Committees met four times between April and October in 2021, three of which were individual committee meetings and one of which was a system-wide Community Impact Summit that brought all the committees together. Each committee meeting consisted of facilitated discussions through which our team gathered input about top community needs. The Fairview Community Advisory Council, composed of key community leaders and staffed by Community Advancement, reviews the CHNA report and written implementation strategy and recommends it to the Patient Care and Experience Committee of the Fairview Board of Directors for review and adoption. Each member represents the member's respective community, and members represent a broad range of sectors, among them community organizations serving cultural communities, higher education organizations, banks, and a nonprofit electric company. The Community Advisory Council met from May through November 2021 to participate in the CHNA process, give feedback, and ultimately recommend the CHNA and implementation strategy for adoption. The HOPE Commission is a multi-year transformational change effort of M Health Fairview to drive more equitable outcomes and inclusive environments and experiences for our patients, employees, and communities. The Commission conducted a series of listening and learning sessions in 2020 and 2021. The objective was to hold a mirror to Fairview to assess where we are now and how we can make lasting change. Part of being an anti-racist health system is developing a candid understanding of our shortcomings. We particularly sought to hear perspectives and ideas from the most impacted populations: BIPOC employees and patients, front-line workers who care for underserved and marginalized patients, and those patients themselves. A survey was also made available each year to gather insights and suggestions from employees and patients who could not directly participate in a listening and learning session. In 2020, the commission convened 32 virtual listening and learning sessions and two town halls involving more than 1,500 participants across Fairview sites. The sessions focused on employees but included patients and community members as well. In September 2021, the HOPE Commission continued the listening and learning sessions following the same model. In this iteration, however, the focus was primarily on gathering input from patients (and employees as patients). In both 2020 and 2021's listening and learning sessions, the facilitators and note takers reflected the community represented by the session's group to the greatest degree possible. In August and September 2021, Fairview's Community Advancement team conducted a series of interviews with staff members who work with communities. Each conversation followed a consistent interview protocol developed for this purpose, and each interview was captured by means of detailed notes. The goal of these interviews was to draw on staff expertise to gain a deeper understanding of our priority needs and to determine whether there are any emerging needs that we should be considering. Between Aug. 31 and Sept.17, 2021, we conducted 17 interviews. In August 2021, we held two focus groups in partnership with other organizations. We convened the first focus group in partnership with HealthPartners and Allina Health, and the participants were faith community nurses. We convened the second focus group in partnership with the organizations that are a part of the East Side Health and Well-being Collaborative. This meeting's focus was on accessing care and resources for different cultural communities. Fairview also participated in two large surveys. KRC Research conducted a survey around health and health care needs in St. Paul between June 8 and July 7, 2021, and administered it to community members, Fairview employees, patients, and community partners. Responses were received from 294 residents, more than 1,000 employees, 221 patients, and 20 partners. The survey was offered online and by phone and in five languages: English, Spanish, Hmong, Somali, and Karen. Fairview also supported and was a partner organization in Bridge to Health, a survey that assesses the health needs of northern Minnesota residents. The Bridge to Health survey was administered between Aug. 28 and Oct. 23, 2020. The geographic areas that were sampled included Aitkin, Carlton, Cook, Itasca, Koochiching, Lake, St. Louis, and Pine counties in Minnesota, as well as Douglas County in Wisconsin. As a foundational part of program planning and evaluation, Community Advancement staff are continuously soliciting feedback from community partners and program participants. We capture this information on an ongoing basis and use it to provide valuable context and drive insights into the needs of the communities we serve. Fairview staff developed standardized tools, processes, instructions, and facilitator, interviewer, and note-taker protocols and training. All primary data was compiled, cleaned, and analyzed. Community conversations lasted various lengths from 30-120 minutes. All community input was captured by a note-taker. The Fairview team contracted with the following groups to support our assessment process: -Loren Blinde, PhD of Writing Power, a copywriter and content strategist, on the writing of the report. -Kristi Fordyce, an independent contractor, for analysis support. -Weber Shandwick, for data collection and analysis of focus groups and stakeholder interviews focused on St. Paul. -KRC Research for the administration and analysis of the St. Paul Community Survey Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Range Regional Health Services. Our triennial community health needs assessment (CHNA) process provides an important opportunity to engage with and understand our community, analyze what has changed-for better or worse-since the last assessment, and prioritize together with the community the issues we must urgently address in order to improve wellbeing and resilience. As part of the 2021 CHNA process, we reexamined and built upon the extensive community insights shared during our 2018 CHNA, while also surveying the community for current and emerging needs. Our 2021 CHNA used social determinants of health as a lens through which we frame our understanding of our community's most significant health needs. A social determinants of health lens enable us to identify inequitable distribution of resources and access that negatively impacts health. Through this lens we looked at both qualitative and quantitative data. Quantitative data included data points related demographics, physical environment, socioeconomic factors, health care and health outcomes. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations. Fairview Range has a community advisory committee (CAC) that is involved in the CHNA process. The committee is comprised of local community and organizational leaders, such as local public health, social services organizations, higher education institutions, school districts, and local businesses. In 2022 the charter was reviewed and updated, and the membership is being evaluated to assure diverse representation and in particular membership from the two identified priority populations. The process also included discussions with our community advisory council, the listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Bringing together both the qualitative and quantitative data we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. We prioritized areas of need based on four broad criteria: 1) Has this need been voiced by the community? Has this need been vetted by the community? 2) Does this need align with Fairview's strategies and priorities? 3) Does this need align with existing public health strategies and community health assessments? 4) Does this need build upon Fairview's 2018 CHNA priority needs? Fairview Range identified three system-wide priority need areas, and will collaborate with other Fairview hospitals, medical centers, and shared services to address these priorities. Our specific response varies by hospital based on the ways in which the priority needs manifest across a given community as well as the partnerships, both ongoing and new, that we have developed to address those needs. 1. Navigating and accessing care and resources. 2. Healing, connectedness, and mental health. 3. Addressing structural racism and barriers to equity. Each priority has a set of anticipated impacts, described in more detail below, and can be found in the Fairview Range Hospital implementation strategy. We also identified two priority populations, across the lifespan, rural to urban, Racial or ethnic populations experiencing health disparities and people experiencing poverty. Fairview Range Hospital CHNA Implementation Strategy Report (2022-2024): https://www.fairview.org/our-community-commitment/local-health-needs In 2022 we created brief explainer video on our CHNA process in 5 languages, English, Spanish, Somali, Hmong, and Karen, to increase accessibility and awareness of our process. To view these videos, please visit the following link: https://www.fairview.org/our-community-commitment/local-health-needs For more details about our priority needs and the priority populations as they relate to Fairview Range, please see https://www.fairview.org/our-community-commitment/local-health-needs Development of Implementation Strategies Over the past 10 years of responding to our communities' biggest needs we have learned important lessons which have guided us in the development of our Fairview Health Services 2022-2024 implementation strategies. 1) Despite best efforts, health needs and health inequities continue to grow and deepen 2) Collective action is critical 3) Transformational change requires sustained and focused commitment. In response to our 2021 community health needs assessment and our lessons learned, all Fairview hospitals and medical centers will work collaboratively amongst each other, as well as in partnership with local and statewide organizations to address communities' most pressing needs. To rise to the challenge, we put forth a 10-year vision of increased community health equity and a set of 3 strategies which will help to address the priority need areas in distinct ways while collectively moving us closer to our vision of increased community health equity. The three strategies are: Strategy 1: Addressing SDOH - Addressing the social determinants of health (SDOH) as well as individual social risks and social needs through the creation and expansion of programs; initiatives; collaborations; research; and policy, system, and environmental work. Strategy 2: Community engagement infrastructure - Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. Strategy 3: Inclusive institution - Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. For this three-year cycle, we are implementing our strategies to work toward distinct anticipated impacts for each priority need and ultimately our 10-year vision of increased community health equity. For more information, the https://www.fairview.org/our-community-commitment/local-health-needs outlines the major strategies and actions we will deploy throughout the 2022-2024 assessment cycle as well as the ties between Fairview Range CHNA implementation strategies, anticipated impacts, objectives, and key responses. Fairview Range Hospital Community Health Needs Assessments Implementation Strategy Reports (2022-2024): https://www.fairview.org/our-community-commitment/local-health-needs Community action plan. Additionally, Fairview Range has an annual action plan that supports our vision of increased community health equity, rolls up to our system CHNA implementation strategies, and addresses priority needs. The Fairview Health Services Community Action Plan details the specific and measurable steps the system will take during the year to drive change and the Fairview Range Action Plan details the specific and measurable steps Fairview Range will take. This report is shared with the Fairview Range Community Advisory Committee, the Board of Directors, and is publicly available on the website: Fairview Range Community Action Plan: https://www.fairview.org/our-community-commitment/local-health-needs Fairview Health Services Community Action Plan: https://www.fairview.org/our-community-commitment/local-health-needs Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - Range Regional Health Services - Continued. Relationship with our partners. Fairview has a long partnership with the University of Minnesota and University of Minnesota Physicians, now represented in the M Health Fairview brand. Together, we offer access to breakthrough medical research and specialty expertise as part of a continuum of care that reaches all ages and health needs. Policy, systems, and environmental change initiatives are implemented across the system (hospitals, clinics, etc.) and in some instances across the M Health Fairview partners to create sustainable and lasting change to advance health equity and community wellbeing. Where indicated, community responses as a part of strategy 2 (Community engagement infrastructure) and strategy 3 (Inclusive institution) represent the work of Fairview in collaboration with the other M Health Fairview partners. Evaluation of Impact. To best evaluate our impact and track progress towards our anticipated impacts, we used a multi-tiered and tailored evaluation approach. We ground our work in understanding core information about our communities. This includes identifying and understanding the community need being addressed, the population or community being impacted, and current and/or potential partners to work with to address the need, and the impacts we anticipate. Community needs are determined in several ways. In addition to being determined through our formal CHNA process, we also respond to emerging needs brought to us by a community partner, public health, or through patient or community data showing significant health disparities. We have standardized several key measures to assess that we are meeting the needs of the CHNA priority populations, focusing our efforts on equity, and satisfying participants. These measures are monitored and reviewed quarterly. A subset of established programs and initiatives are set up and supported for deeper evaluation. We are guided by the Centers for Disease Control and Prevention (CDC) model for program evaluation to establish primary outcomes, process measures, and demographics. We evaluate program impact and success from a variety of approaches using both qualitative and quantitative data. For many of the programs we talk about here we are reporting out our reach or outputs through counts on a variety of levels. We offer a variety of programs that vary the spectrum of low touch and high count or high touch and lower count, or more generally put, the effort and impacts of the programs are not the same. This is a purposeful approach as we want a variety of programs and to "right-size" programs to address the needs. We provide outcomes for programs here when we are able, acknowledging not all programs run on a calendar year and analysis may not be complete for some of the programs we do deeper evaluation on. We are currently in the process of building an evaluative approach and capacity for our ten-year vision, increased community health equity, and three social determinants of health initiatives: Housing is Health, Food is Fairview Range Example 2022 Highlights . The following highlights of our implementation strategy work for each of our three priority needs. For a more comprehensive view of what we are doing to impact community needs please see our Fairview Range Action Plan to view a list of Fairview Range's programming. Fairview Range Community Action Plan: https://www.fairview.org/our-community-commitment/local-health-needs The primary way we are directly addressing the three priority needs is through strategy 1 (Addressing SDOH). Through this strategy we create programs and partner with community organizations to address social risk factors, social needs and social determinants of health. Strategy 2 (Engagement Infrastructure) and strategy 3 (Inclusive Institution) focus on building infrastructure and creating system changes so that we can more effectively respond to these priority needs in the future, as well as any emerging needs. https://www.fairview.org/our-community-commitment/local-health-needs Fairview's mission and vision extend beyond traditional healthcare settings, driving a healthier future for the communities we serve. One of the approaches we take is policy, system and environmental change initiatives which are implemented across the system (hospitals, clinics, etc.) to create sustainable and lasting change to advance health equity and community well-being. These initiatives are in service to addressing our priority needs. We are currently in the process of standing up three Social Determinants of Health Initiatives. 1) "Food is Medicine" is a Health Initiative to address food insecurity and hunger, for all Fairview patients and community members. 2) " Housing is Health" supports health and affordable housing for all as a foundation for healthy, vibrant communities and inclusive growth. 3) "Connection is Cure" aims to address social isolation and improve community mental health and well-being by strengthening the connection between patients and the healthcare system. Fairview Range Highlight from the 2022 Action Plans: Priority Need: Navigating and accessing care and resources. Fairview Range has a variety of programs that work as a part of strategy 1 to address barriers related to navigating and accessing care and resources. Through Strategy 1 (Addressing the SDoH), the Fairview Range Action Plan programs work toward two anticipated impacts to address this priority need: 1) Remove barriers to care by providing community-placed care, co-located services, and navigation supports that address cultural and language barriers; 2) Increase awareness of, knowledge about, and access to healthcare and community-based resources that support opportunities for health and wellbeing. Following is more information on a selection of programs from the Fairview Range Action Plan that are working to meet the two anticipated impacts. Fairview Range Key Initiative Highlights. Exercise with a Doc at Silver Sneakers in Hibbing is a collaborative program between Fairview Range and the Duluth Area YMCA. This program began in 2019. The goal of the programming is to connect senior adults and Fairview Range providers through exercise, education, and relationship-building. Providers exercise at a Silver Sneakers session with participants and then stay afterward for topic-specific presentations/discussion. This programming is widely recognized in the local aging community as a catalyst for social connection and navigation of health care resources. In 2022, Fairview Range hosted six Exercise with a Doc Sessions attended by more than 20 participants each session. Fairview Range's Partnership with Project Care was formed in 2015. The goal of this partnership is to provide and increase healthcare access, share information, and expand outreach to underserved and uninsured individuals in the Hibbing and Virginia area. Fairview Range providers and nurses donated 221 volunteer hours in 2022 providing medical care between the two Project Care clinics. Fairview Range also provides virtual Juniper classes for the community. This programming began in 2015 with in-person classes and has evolved to virtual classes that are offered to the local community as well as greater MN and NW Wisconsin. The classes are offered at no cost. These are evidence-based, small group wellness classes that provide tools for managing chronic health conditions. The following classes are offered: Living Well with Chronic Conditions, Living Well with Chronic Pain, and Living Well with Diabetes. In 2022, Fairview Range offered 6 classes with 22 total program completers. For more information about the action plan programs that are addressing the priority need Navigating and Accessing Care and Resources please see our Fairview Range Action Plan. Fairview Range Community Action Plan: https://www.fairview.org/our-community-commitment/local-health-needs Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - Range Regional Health Services - Continued. Priority Need: Addressing Structural Racism and Barriers to Equity. Fairview Range, as a part of Strategy 1 (Addressing the SDoH), incorporates a variety of programs, events and education as a part of the Fairview Range Action Plan that work toward the anticipated impact to develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, to address structural racism and barriers to equity. Fairview Range highlights. One of the Fairview social determinants of health initiatives, Food is Medicine, utilizes the knowledge and resources of a large healthcare institution to work toward transforming the food system into something just, equitable, and sustainable. Fairview Range seeks to increased access to healthy food and education about healthy eating. One of the "Food is Medicine" initiative programmatic responses is our Food Insecurity Boxes/Bags. This programming began in late 2019 and was extremely impactful to our patients during the height of the COVID-19 Pandemic. The boxes were a campus-wide program created to immediately provide shelf-stable food items and resources to patients in need. It has been considered a 'best practice' for serving oncology/infusion and homebound patients. In 2022, Fairview Range distributed 30 Food Boxes and 68 Food Bags to patients reporting food insecurity. Fairview Range provided 50 You MATTER Positive Messages snack bags to Behavioral Health Home and Suboxone MAT program patients. Fairview Range also developed a partnership with the Hibbing Farmer's Market and distributed 40 $5 Farmer's Market Produce Vouchers to care coordinators and clinic diabetes, wound care, pediatrics, and oncology departments to provide to patients. The goal of the partnership with the Hibbing Farmer's Market is to continue to develop sustainable programming for Fairview Range patients and the greater community. Equitable access to healthy, nutritious foods, education opportunities, and resources are all integral parts of the programming being created and implemented. Another Fairview Range program seeking to address the social determinants of health as well as individual social risks is our Hygiene Support Bags and Homeless Backpacks programming. The Homeless Backpack program was created in 2018. These are backpacks containing toiletries (such as menstrual supplies, soap, toothbrush and toothpaste), socks, a space blanket, a towel, winter clothing etc. as well as a community resource list and a card of encouragement. They may be distributed in the hospital or clinics to any person deemed in need by staff or volunteers. There are no set criteria to receive a backpack, but recipients are often being discharged from one of our MHAS units or the Emergency Department and are experiencing homelessness. The Hygiene Support Bags, created in 2022, are similar, but contain more personal hygiene items such as shampoo, soap, nail clippers, and lotion. These can be widely distributed to patients identified as in need of these essential personal care items. In 2022, 30 Hygiene Support Bags and 40 Homeless Backpacks were distributed. For more information about the action plan programs that are addressing the priority need Structural Racism and Barriers to Equity please see our Fairview Range Action Plan. Fairview Range Community Action Plan: https://www.fairview.org/our-community-commitment/local-health-needs Priority Need: Healing, connectedness, and mental health. Fairview Range, through Strategy 1, (Addressing the SDoH), has a variety of programs, events, and education as a part of the Fairview Range Action Plan that work toward the anticipated impact to develop, grow, and sustain programs, educational offerings, partnerships, and initiatives, address barriers to healing, connectedness and mental health. In response to the priority need, healing, connectedness and mental health, we are in the early stages of building the social determinants of health initiative, "Connection is Cure," which aims to address social isolation, improve community mental health and well-being, and build trust, by strengthening the connection between Fairview, its patients, community members, and employees. Additionally, we are responding with a variety of evidence-based programs, as well as trainings and educations. "Feeding Hope" is a series of virtual one-hour learning sessions focused on positive, hopeful topics that support wellbeing in the general community. This series is offered in partnership with all Fairview hospitals and medical centers and is open to anyone across all of Fairview's communities. In 2022, there were four sessions held with a combined 650 attendees. "Psychological First Aid" is an evidence-informed training for all community members and professionals. Trainees will learn how to support healthy recovery in individuals following a traumatic event, public health emergency, natural disaster, or personal crisis. The curriculum integrates public health, community health and individual psychology by drawing upon skills the trainees probably already have. PFA is a two-hour training. In 2022, in partnership with Grand Itasca Hospital and Clinic, Fairview Range offered one Psychological First Aid class with 19 completers across both service areas. "Refresh and Reset your Resiliency" promotes resiliency skills, offers wellness-care tools for mind, body, and spirit, and encourages the development of a personal plan for self-care. In 2022, in partnership with Grand Itasca Hospital and Clinics, Fairview Range held one Refresh and Reset your Resiliency workshop in 2022 for employees which was attended by 10 employees from Fairview Range. Fairview Range has also been a partner in the creation and sustainment of the Youth Mental Health Night community events. 2022 was the second year the one-night event was held. This event is co-hosted through a partnership between Fairview Range and the MN Discovery Center in Chisholm, MN. The event is held at the Discovery Center and brings together Fairview Range and area behavioral and mental health providers. It is a resource and education fair for people of all ages and offers community connection and engagement, along with inspirational speakers, entertainment, and food. This event is intended to improve community access to resources, spark community partnerships and conversation, reduce stigma, and help our youth connect with each other and the larger community. In 2022, the event welcomed over 400 attendees. We are anticipating continued growth and interest in this event and the potential for creation of an additional, larger multi-day event geared toward area students in 2023. For more information about the action plan programs that are addressing the priority need Healing, Connectedness, and Mental Health please see our Fairview Range Community Action Plan: https://www.fairview.org/our-community-commitment/local-health-needs In addition to strategy 1 (Addressing SDOH) and the programmatic work included on our Action Plans, we are striving to reduce health disparities and increase community health equity through two additional system strategies. Whiles strategy 1 (Addressing SDOH) allows us to directly respond to the three prioritized needs from our community health needs assessment, strategy 2 (Engagement Infrastructure) and strategy 3 (Inclusive institution) focus on building the structures and systems for us do the work better. In order to address our three priority needs and respond to emerging needs we need to have infrastructure that supports building and sustaining strong community partnerships and allows for ongoing, trusting exchanges between Fairview and community members. Strategy 2 (Engagement Infrastructure): Creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. Anticipated Impacts for this strategy are 1. Build and expand feedback systems for patients and community members; embed process improvement in the health system's response to community voice. 2. Create sustainable structures to convene and engage community voice around addressing social determinants of health. Schedule H, Part V, Section B, Line 11 Facility , 4 Facility , 4 - Range Regional Health Services - Continued. The M Health Fairview Center for Community Health Equity (the Center), was launched in August 2022. As a part of the Center, we are taking steps to build upon our existing community engagement to creating community engagement infrastructure that builds trusting partnerships and enables community voice to inform and influence the institution. Additionally, we laid the groundwork to develop a Center for Community Health Equity Model of Community Engagement. The model will share our approach to community engagement, community voice, and community partnerships to advance community health equity. The center is also building standard practices for community voice to influence our social determents of health initiatives. For example, as a part of Food is Medicine, planning began in 2022 to pilot hosting community meal conversations in all hospital and medical center communities to ensure that our Food is Medicine approach had a system approach, but also one that responds to local and unique community needs and assets. Enabling community voice, particularly the voices of priority populations, to influence and inform and influence the health system, is integral to strategy two. A few examples of how this was accomplished in 2022 are as follows. M Health Fairview HOPE Commission - healing, opportunity, people, and equity, is a multi-year transformational change effort to drive more equitable outcomes and inclusive environments and experiences for our patients, employees, and communities. Finally, core to this strategy is building and sustaining trusting partnerships. We continue to support and build on existing structures and support existing collaboratives. Our Fairview Range Community Advisory Committee has updated its charter and expanded the focus. Additionally, work to intentionally recruit participants to expand representation on the committees started and continues. At Fairview Range, we support and participate in multiple collaborative groups. We seek out spaces and opportunities where we can do ongoing listening and relationship-building with community partners and community members. These structures, strong partnerships, and built trust allow us to work closely with community to develop responses to the priority needs but also respond to emerging needs. Collaborations and partnerships are vital to the success of our efforts. One of Fairview Range's closest partnerships is with the Central Mesabi Medical Foundation (CMMF). Through their allocations and grants process, the CMMF has collaborated with Fairview Range to provide much-need financial support to enhance healthcare, tackling critical issues such as food insecurity, social connectedness, addiction, and many other social determinants of health. In the midst of the COVID-19 pandemic, the CMMF and Community Advancement created the Food Insecurity Program, providing boxes of shelf-stable food and community resource lists to patients who were food insecure. The support for vulnerable patients receiving chemotherapy and cancer treatments was highlighted and praised as a 'best practice' in effectively serving this population. In response to a Community Advancement-held focus group, the Silver Sneakers Exercise with a Doc program was established, bringing together seniors and Fairview Range providers in a melding of exercise, information-sharing, and social connectedness. Supportive and trusted relationships have formed between participants and Fairview Range providers, leading to mental health benefits, stress reduction, and overall healthier lifestyles. Fairview Range and the CMMF came together and partnered to provide support services for patients suffering from substance use disorders. Transportation, education, food, and rapid access to life-saving medications are funded in a unique program developed to address and reduce substance abuse. With the challenges facing resource-stretched health systems today, collaboration is needed more than ever to advance and drive community health improvements. Strategy 3: Transforming internal structures to create an antiracist and inclusive environment and to build community health by building wealth. Our anticipated impacts that are tied to strategy 3 (Inclusive Institution) are: 1) Build internal and external processes and structures to provide spaces that are safe and welcoming to all, responsive to community needs, and based on a culture of inclusion; 2) Using an anti-racist approach, work to identify and eliminate racism by changing systems, organizational structures, policies, practices, and attitudes; 3) Leverage everyday business practices to build community wealth, promoting economic and racial equity and justice. This strategy is partially operationalized through the HOPE Commission. The work of the HOPE Commission has been to identify foundational and transformational opportunities for our organizations to advance health equity (HE) and promote diversity, equity, and inclusion (DEI). To learn more about the goals, strategies and successes of the HOPE commission please see the 2022 HOPE Commission Report. The HOPE Commission website: https://mhealthfairview.org/About-Us/health-equity/hope-commission A few key achievements of the HOPE Commission in 2022 include 1. Creating new roles and offices to further imbed DEI into daily work 2. New and innovative reporting data infrastructure to better capture information equitably 3. Presented the HOPE Commission model at national conferences to educate and influence other healthcare organizational leaders. Additional successes from 2022 include continued expansion of the Employee Resource Groups (ERG). As of 2022, there are now eight ERGs with participation across our system. The newest ERG is Comunidades Latinas for Engagement, Advancement, and Development (LEAD). Significant needs not addressed. Prioritizing needs that are the root causes of almost all health disparities allows us to develop upstream strategies that will have a large and lasting impact in our communities. The significant needs we have identified will ultimately be positively impacted by addressing the root causes we have identified as our priority needs. The following needs were not directly addressed because this issue is beyond what Fairview Range Hospital resources can support at this time: Cost of care, insurance and medications, childcare and employment benefits. The following needs were directly not addressed because this issue will be addressed as part of patient care but falls outside of the scope of the CHNA Implementation Strategy: Clinic/hospital hours, limited time spent with provider, limited specialty care. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - Range Regional Health Services. The Minnesota Attorney General agreement was used in the determination of the eligibility for financial assistance. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Range Regional Health Services. The organization attaches a summary of the policy to billing invoices and also communicates to patients during admission, financial counseling and collection calls that there is a financial assistance program and that an application can be provided to them. A summary of the Financial Assistance Policy is posted in various locations in the hospital. 3 Fairview Mesaba Clinic - Hibbing 3605 Mayfair Ave Hibbing MN 557452935 Outpatient Clinic Fairview Mesaba Clinic - Mountain Iron 8496 Enterprise Dr S Mountain Iron MN 557688226 Outpatient Clinic Fairview Mesaba Clinic - Nashwauk 402 E Platt Ave Nashwauk MN 557691147 Outpatient Clinic Schedule H, Part I, Line 7f Exclusions from Percent of Total Expense The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in healthcare coverage, and other collection indicators. There is no bad debt expense included in Form 990 Part IX as an expense. Due to the adoption of new GAAP reporting, the bad debt expense has been included with "discounts" netted against patient service revenue on Part VIII of Form 990. Schedule H, Part I, Line 3c Patients that are eligible for the organization's Community Care Program or other Charity Care Plans may receive a reduction on amounts owed or up to 100% of total charges. The organization informs patients about the Community Care Program prior to delivery of services if feasible and as appropriate and during the billing process. Uninsured patients with household income up to 200% of the federal poverty level qualify for a 100% discount of the total charges. Uninsured patients who are residents of Minnesota or Wisconsin with a household income greater than 300% of the federal poverty level and equal to or below $125,000 AND RECEIVE MEDICALLY NECESSARY HOSPITAL OR HOSPITAL BASED SERVICES are charged a discount rate equal to the rate from the hospital's highest volume private payor contract. Schedule H, Part I, Line 7g Subsidized Health Services THERE ARE NO COSTS ASSOCIATED WITH PHYSICIAN CLINICS INCLUDED IN LINE 7G. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE AMOUNTS REPORTED ON FORM 990, SCHEDULE H, PART I, LINE 7A THROUGH 7C WERE DETERMINED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 IN THE SCHEDULE H, FORM 990 INSTRUCTIONS. FORM 990, SCHEDULE H, PART I, LINES 7E THROUGH 7J ARE REPORTED AT CHARGES AS RECORDED BY THE ORGANIZATION. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in healthcare coverage, and other collection indicators. The amount of bad debt expense included on form 990, Part VIII, line 2a, column (B) is used as a reduction to income according to accepted GAAP principles. Schedule H, Part III, Line 3 Bad Debt Expense Methodology The bad debt expense attributable to patients that may be eligible for financial assistance is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in healthcare coverage, and other collection indicators. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Subsequent changes to the estimate of the transaction price (determined on a portfolio basis when applicable) are generally recorded as adjustments to patient service revenue in the period of the change. For the years ended December 31, 2022 and 2021, changes in Fairview's estimates of implicit price concessions, discounts, contractual adjustment, or other reductions to expected payments for performance obligations satisfied in prior periods were not significant. Portfolio collection estimates are updated monthly based on collection trends. Subsequent changes that are determined to be the result of an adverse change in the patient's ability to pay (determined on a portfolio basis when applicable) are recorded as bad debt expense. Bad debt expense for the years ended December 31, 2022 and 2021, was not significant. See page 22 of the audited financial statements for additional information. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Range Regional Health Services uses the cost to charge ratio method for determining expenses. The Medicare cost to charge ratio reporting is calculated service line by service line. Other expenses are calculated using the overall cost to charge ratio. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance After our patients have received services, it is the policy of Range Regional Health Services to bill patients and their applicable payors on a timely and accurate basis. During this billing and collection process, Fairview staff are committed to providing quality customer service and timely follow up on all outstanding accounts. Billing: It is the goal of Range Regional Health Services to bill all claims accurately and on a timely basis. Although dependent on information and communications from patients and payors, Range Regional Health Services will provide sufficient follow up service to ensure that patients receive accurate account and billing information and have the opportunity to make payment and/or apply for community care. Fairview Health Services has agreed to certain billing and collection practices by an agreement with the Minnesota Attorney General's office and Range Regional Health Services follows this agreement. There are financial counselors at every entity Monday through Friday who interact with the patients in person and over the phone to inform them about available programs as well as assisting them in applying for these programs. The information about needing help paying the bill is on signs in the hospitals and materials are distributed to self-pay patients by registration staff. The statements sent out after the visit provide this information as well. If a patient/family member calls the Central Business Office customer service staff to request assistance with paying their bill, they are informed of options at that time. Range provides a phone interpreter service to call that will interpret conversations over the phone. This service can be used either as a three-way phone call or the Financial Counselor, in a room with the patient or family can make the call together to the interpreter phone service. The interpreter services can accommodate close to 200 languages. The billing process will be assisted by the following guidelines: 1) For all insured patients, Range will bill all third-party payor information (as provided by or verified by the patient) on a timely and accurate basis. 2)For all uninsured patients with Minnesota residency receiving hospital-based services deemed medically necessary. Fairview will apply an uninsured discount equal to the discount provider to our largest contracted non-government payor, any remaining balance will be billed to the patient in a timely manner. 3) All billed patients have the opportunity to contact Range regarding financial assistance for their accounts. Financial assistance may include Community Care, payment arrangements, medical assistance or other applicable programs. 4) If a patient contacts Range Regional Health Services regarding Community Care, the account will not be referred to a collection agency or attorney. Once the application and required documentation is received (income verification etc.), the account will then be processed based on the outcome of the Community Care determination. 5) If a patient contacts Range Regional Health Services regarding Community Care after their account has been referred to a collection agency or attorney, Fairview will send an application to the patient provided the account meets the Community Care requirements. If the completed application with required documents (income verification, etc.) is submitted, all collection action will be suspended until the patient is notified of Range's determination. Schedule H, Part V, Section B, Line 16a FAP website - Range Regional Health Services: Line 16a URL: https://www.fairview.org/billing/financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - Range Regional Health Services: Line 16b URL: http://www.fvfiles.com/2266.pdf; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Range Regional Health Services: Line 16c URL: https://www.fairview.org/billing/financial-assistance; Schedule H, Part VI, Line 2 Needs assessment Beyond the formal needs assessments, Organization leadership is engaged in their respective communities. Involvement includes participation on community boards, foundations, schools and more. Fairview also seeks community involvement through, community leaders serving on hospital boards and committees. Information gleaned through these connections are equally as important as the formal needs assessments. These connections can often identify emerging issues. Our triennial community health needs assessment process provides an important opportunity to engage with and understand our community, analyze what has changed-for better or worse-since the last assessment, and prioritize together with the community the issues we must urgently address in order to improve wellbeing and resilience. Fairview's 2021 Community Health Needs Assessment (CHNA) builds upon previous assessments and was developed in partnership with community members and organizations, local public health agencies, and other hospitals and health systems. It serves as a tool for guiding policy, advocacy, and program planning. It also fulfills Internal Revenue Service (IRS) requirements for CHNA pursuant to the Affordable Care Act of 2010, which requires 501(c)(3) nonprofit hospitals to conduct an assessment at least every three years and provide an annual evaluation of the previous implementation strategy's impact. Through this process, we aim to: -Intentionally engage with community members and organizations, public health agencies, and other hospitals and health systems to identify and understand significant health needs in the community. -Understand the needs of the community it serves by analyzing current demographics and social determinants of health indicators, as well as by collecting direct input from community members and organizations. -Inform the CHNA implementation strategy and action plan development. As part of the 2021 CHNA process, we reexamined and built upon the extensive community insights shared during our 2018 CHNA, while also surveying the community for current and emerging needs. We have identified three system-wide priority need areas, and we will collaborate with our hospitals and shared services to address these priorities. Our specific response will vary by hospital based on the ways in which the priority needs manifest across a given community as well as the partnerships, both ongoing and new, that we have developed to address those needs. Our community commitment - creating a healthier future and Improving the health and wellbeing of our communities. The healthcare people receive in a hospital or clinic is only a small part of a person's overall health. That's why our commitment to advancing health equity goes beyond the walls of our facilities and reaches out into the community. We collaborate with community partners to improve health and wellbeing and advance health equity. Our priorities include: * Bringing clinical services into neighborhoods to expand access * Advancing our anchor mission initiatives - local hiring, local purchasing, local investing, and leading and serving locally * Addressing social risk factors through food access and housing programs and community education and outreach. Why is this a priority for our healthcare system? Nearly 80 percent of health is influenced by factors outside of clinical care. These factors, called the social determinants of health, are our health behaviors and the economic and social conditions in which we live. To help address the social determinants of health, we are creating a health and wellness hub in downtown St. Paul that will focus on health, housing, and supportive services for the community. All this work is closely tied to our HOPE Commission's health equity and anti-racism efforts. It's designed to be culturally appropriate and to meet the specific needs of the community. We seek to do "with not "to" the communities we belong to and are proud to contribute to our community in so many ways. Fairview Health Services is committed to the health and wellbeing of our communities. For generations we have served the people of Minnesota, cared for our patients, and invested in the people and partnerships that make us stronger, together. As a nonprofit health system and an anchor institution-an organization rooted in our communities-we have a commitment to intentionally apply our long-term, place-based economic power and human capital in partnership with community to mutually benefit the long-term wellbeing of both. We recognize that this commitment begins in and with our communities. This work cannot be done alone, we must collaborate with community-based organizations, local public health departments, and other health systems. Our efforts, resources, and commitments are investments in the health and wellbeing of our communities where we live, work, learn, play, and worship. Our community benefit programs and activities focus on our mission to heal, discover, and educate for longer, healthier lives and must meet at least one of these objectives: * Improve access to health care services. * Enhance the health of the community. * Advance medical or health care knowledge. * Relieve the burden of government to improve health. Fairview Health Services, is committed to providing exceptional care, delivering breakthrough research and innovation to healthcare, improving health and wellbeing, and promoting health equity. As anchor institutions rooted in the hearts of the communities we serve, this commitment goes beyond our walls and into the community. THERE ARE DIFFERENT WAYS OUR HEALTH SYSTEM FULFILLS THIS PROMISE INCLUDING: * Allocating resources to benefit the community. The process is guided by our community health needs assessments, developed collaboratively with the communities we serve, and implemented in partnership with local organizations and leaders. - The priority needs identified in our 2021 assessment are: healing, connectedness, and mental health; addressing structural racism and barriers to achieving health equity; and navigating and accessing care and resources. Our efforts will center on people experiencing poverty as well as racial or ethnic populations experiencing health disparities. * Bringing clinical services into neighborhoods to expand access. These free healthcare services are offered in diverse and/or under-resourced neighborhoods. * Addressing social risk factors, known as the social determinants of health, through food access and housing programs, and community education and outreach. The goal is to improve community health and wellbeing. * Advancing our HOPE (Healing, Opportunity, People, and Equity) Commission's - health equity and anti-racism efforts to drive more equitable outcomes and inclusive environments and experiences for our patients, employees, and communities. Success stories include: improving patient sociodemographic data to better understand the populations we serve and more accurately assess for disparities and increasing the representation of diverse populations in clinical trials. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Range Regional Health Services has financial advocates working with uninsured patients to assist them in completing application for various programs that may provide them coverage for medical services. Schedule H, Part VI, Line 4 Community information The CHNA community of each hospital and medical center is defined as a subset of zip codes within the Fairview service area, where 90 percent of its patients live. Each of the hospitals and medical centers were attributed unique zip codes and geographies. The Fairview Range Medical Center community is comprised of 15 zip codes. Our definition of communities includes all community members, including those who are patients and employees who live, work, and play in our service areas. Schedule H, Part VI, Line 5 Promotion of community health In addition to the community benefits and activities described in other parts of this filing, the organization furthers its tax-exempt charitable purpose and promotes the health of the communities it serves including, but not limited to the following: The organization's hospitals extend medical staff privileges to all qualified physicians in the community. Being part of a non-profit, tax-exempt healthcare system, the organization reinvests any excess revenues back into the core operations of the organization for which the tax-exemption was granted. The organization offers various health care classes, health screenings, support groups and other events related to the promotion of health. The organization is governed by a board of directors that are members of the community the organization serves. Schedule H, Part VI, Line 6 Affiliated health care system RANGE REGIONAL HEALTH SERVICES IS A COMMUNITY-FOCUSED, NON-PROFIT HEALTH CARE ORGANIZATION THAT IS PART OF FAIRVIEW HEALTH SERVICES. RANGE REGIONAL HEALTH SERVICES PROVIDES INNOVATIVE TECHNOLOGY, COMPASSIONATE CARE, AND A FULL SPECTRUM OF FAMILY HEALTH SERVICES. FAIRVIEW HEALTH SERVICES IS A MINNEAPOLIS-BASED NONPROFIT HEALTH SYSTEM DRIVEN TO HEAL, DISCOVER, AND EDUCATE FOR LONGER, HEALTHIER LIVES. FOUNDED IN 1906, FAIRVIEW PROVIDES EXCEPTIONAL CARE TO PATIENTS AND COMMUNITIES AS ONE OF THE MOST COMPREHENSIVE AND GEOGRAPHICALLY ACCESSIBLE SYSTEMS IN MINNESOTA, SERVING THE GREATER TWIN CITIES METRO AREA AND NORTH-CENTRAL MINNESOTA. THROUGH A CLOSE RELATIONSHIP WITH THE UNIVERSITY OF MINNESOTA, FAIRVIEW OFFERS ACCESS TO BREAKTHROUGH MEDICAL RESEARCH AND SPECIALTY EXPERTISE AS PART OF A CONTINUUM OF CARE THAT REACHES ALL AGES AND HEALTH NEEDS. OUR MISSION: FAIRVIEW IS DRIVEN TO HEAL, DISCOVER, AND EDUCATE FOR LONGER, HEALTHIER LIVES. THE FAIRVIEW SYSTEM CONSISTS OF 11 HOSPITALS, IT CONTROLS AND OPERATES UNIVERSITY OF MINNESOTA MEDICAL CENTER, THE ADULT AND PEDIATRIC TEACHING HOSPITAL OF THE UNIVERSITY OF MINNESOTA MEDICAL SCHOOL, HAS 10 COMMUNITY BASED GENERAL ACUTE CARE HOSPITALS AND 1 LONG-TERM ACUTE CARE HOSPITAL; OVER 80 PRIMARY AND SPECIALTY CARE CLINICS; OFFERS OVER 100 SPECIALTY CARE SERVICES; URGENT CARE CLINICS; OCCUPATIONAL HEALTH CLINICS; 36 RETAIL AND SPECIALTY PHARMACIES; PHARMACY BENEFIT MANAGEMENT SERVICES; REHABILITATION CENTERS; COUNSELING; HOSPICE SERVICES; 90+ OWNED AND MANAGED SENIOR CARE FACILITIES AND LONG-TERM CARE HOUSING FACILITIES (THROUGH EBENEZER SOCIETY, A FAIRVIEW SUBSIDIARY); AND EMERGENCY MEDICAL TRANSPORTATION. FAIRVIEW'S 34,000+ EMPLOYEES AND NETWORK OF 5,000+ SYSTEM PROVIDERS EMBRACE INNOVATION AND NEW THINKING TO DRIVE A HEALTHIER FUTURE THROUGH HEALING, DISCOVERY AND EDUCATION. FAIRVIEW HOSPITALS AND MEDICAL CENTERS INCLUDED: BETHESDA HOSPITAL (ST. PAUL) FAIRVIEW LAKES MEDICAL CENTER (WYOMING) FAIRVIEW NORTHLAND MEDICAL CENTER (PRINCETON) FAIRVIEW RANGE MEDICAL CENTER (HIBBING) FAIRVIEW RIDGES HOSPITAL (BURNSVILLE) FAIRVIEW SOUTHDALE HOSPITAL (EDINA) GRAND ITASCA CLINIC & HOSPITAL (GRAND RAPIDS) ST. JOHN'S HOSPITAL (MAPLEWOOD) ST. JOSEPH'S HOSPITAL (ST. PAUL) UNIVERSITY OF MINNESOTA MEDICAL CENTER AND UNIVERSITY OF MINNESOTA MASONIC CHILDREN'S HOSPITAL (MINNEAPOLIS) WOODWINDS HEALTH CAMPUS (WOODBURY) Schedule H, Part VI, Line 7 State filing of community benefit report MN false true false false false false false true false Laura Reed Director 0 989718 0 469914 0 84553 0 175641 0 16174 0 1736000 0 76997 Brian Amdahl Director 0 422092 0 52530 0 3037 0 18300 0 15959 0 511918 0 0 Andy McCoy Director, ended 12-2022 0 325345 0 42104 0 37624 0 9150 0 13924 0 428148 0 0 David Milbrandt Director 0 440431 0 52874 0 2005 0 18300 0 21107 0 534717 0 0 Susan Hoyum MD Director 219716 0 22707 0 5740 0 14661 0 12957 0 275781 0 0 0 Amanda McDonald MD Director 231202 0 17634 0 27153 0 14077 0 0 0 290065 0 0 0 Kasey Kapella MD Secretary 208180 0 26108 0 3946 0 13525 0 0 0 251758 0 0 0 James Hereford Officer 0 1753793 0 1399311 0 217654 0 100535 0 16325 0 3487618 0 208150 Jean MacDonell President & CEO 0 372868 0 142100 0 584 0 69797 0 1302 0 586650 0 0 Todd Christensen VP Finance 0 190824 0 24600 0 766 0 13318 0 20763 0 250271 0 0 Ari Yazdan MD Physician 597396 0 7829 0 22311 0 18428 0 10123 0 656087 0 0 0 Lane Meyer MD Physician 522925 0 21762 0 35429 0 20686 0 29140 0 629942 0 0 0 Kristin Fredrickson MD Physician 496452 0 27376 0 23270 0 23511 0 14579 0 585187 0 0 0 Arvydas Urbonas MD Physician 517369 0 3350 0 10933 0 16791 0 18692 0 567134 0 0 0 Scott Stenstrom MD Physician 447265 0 2338 0 37791 0 20344 0 19532 0 527271 0 0 0 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD, LAURA REED, JEAN MACDONELL DUE TO A VESTING EVENT, THE FOLLOWING INDIVIDUALS HAD INCOME IN PART VII AND SCHEDULE J RELATED TO A NONQUALIFIED RETIREMENT PLAN: JAMES HEREFORD $208,150 LAURA REED $76,998 Schedule J, Part I, Line 7 Non-fixed payments The organization provides lump sum financial awards based on system-wide, business unit and/or departments financial and quality measures. Annual goals, specifically tied to productivity and quality indicators, are set for the year and an incentive paid out annually if key goals and measures are achieved. Schedule J, Part I, Line 3 Related Org to establish compensation THE ORGANIZATION IS PART OF THE FAIRVIEW HEALTH SERVICES SYSTEM AND FAIRVIEW HEALTH SERVICES HUMAN RESOURCES USES COMPARABLES TO ESTABLISH COMPENSATION FOR THE CEO/EXECUTIVE DIRECTOR ACCORDING TO MARKET STANDARDS. Schedule J, Part I, Line 4b The nonqualified plan (the Plan) is only open to a select group of highly compensated employees. The plan contributes the difference of what 403(b) employer contributions were missed for participants who earn more than the IRS limit on eligible compensation for qualified retirement plans. Participants may not elect to defer compensation. Contributions will be made in the form of a credit to the participant's account. Within 60 days after a participant becomes vested in a contribution, the Plan shall pay to the participant an amount equal to the amount the Participant is required to pay Federal, state, local, and foreign income taxes and employment taxes due to the vesting. The remaining amount in the participant's account shall not be paid until the separation from service payment date. A participant's account shall be distributed in cash. The plan complies with section 457(f) of the Code. Form 990, Part VI, Line 6 Classes of members or stockholders The members of the corporation are the individuals who constitute the Directors of the corporation. Form 990, Part VI, Line 11b Review of form 990 by governing body The Tax Department conducts a detailed review of the completed return. The Form 990 is presented to the Finance Committee for review of content. The Form 990 is subsequently provided to the members of the Board of Directors prior to filing. Upon approval from the Board of Directors, the Form 990 is filed. Form 990, Part VI, Line 12c Conflict of interest policy The board annually completes a conflict of interest statement. The CFO discloses the conflicts to the entire board. The CFO monitors board motions to ensure disclosure of potential conflicts with votes. Form 990, Part VI, Line 15a Process to establish compensation of top management official Compensation is market based and based on data compiled by Fairview Health Services Corporate Human Resources. Form 990, Part VI, Line 15b Process to establish compensation of other employees Compensation is market based and based on data compiled by Fairview Health Services. Form 990, Part VI, Line 19 Required documents available to the public The documents are available upon request in the organization's administration office. Form 990, Part VII, Section B, Line 1 Form 1099's were filed by a related organization Fairview Health Services, a 501(c)(3) non-profit, tax-exempt organizations. Form 990, Part VIII, Line 2f Other Program Service Revenue Investment in Org Revenue - Total Revenue: 287321, Related or Exempt Function Revenue: 287321, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Healthline Patient Transport - Total Revenue: 172830, Related or Exempt Function Revenue: , Unrelated Business Revenue: 172830, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other Medical Services - Total Revenue: 25286, Related or Exempt Function Revenue: 25286, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Other Operating Revenue - Total Revenue: 4477, Related or Exempt Function Revenue: 921, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 3556; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Defined Pension Adjustment - 3713345; Restricted Assets Adjustment - -130780; Healthline LLC 750 East 34th Street Hibbing MN 55746 411463518 Medical Supply and Transportation MN 4571676 Range Regional Health Services Ebenezer Society 7505 Metro Blvd Suite 100 Edina MN 55439 410706141 Nursing MN 501(c)(3) 10 Fairview Health Services false Fairview Foundation 2450 Riverside Avenue South Minneapolis MN 55454 411573810 Fundraising MN 501(c)(3) 1 Fairview Health Services false Fairview Health Services 2450 Riverside Avenue Minneapolis MN 55454 410991680 Hospital MN 501(c)(3) 3 NA false Fairview Home Care and Hospice 2450 26th Avenue South Minneapolis MN 55454 411434246 Home Health MN 501(c)(3) 10 Fairview Health Services false Fairview Physician Associates Netwo 3400 West 66th Street Minneapolis MN 55435 411753325 Clinical MN 501(c)(3) 10 Fairview Health Services false Grand Itasca Clinic and Hosptial 1601 Golf Course Road Grand Rapids MN 55744 411865874 Hospital MN 501(c)(3) 3 Fairview Health Services false Fairview Bethesda Hospital 2450 Riverside Avenue South Minneapolis MN 55454 363517697 Hospital MN 501(c)(3) 3 Fairview Health Services false HealthEast Medical Research Institute 2450 Riverside Avenue South Minneapolis MN 55454 411765832 Med Resear MN 501(c)(3) 4 Fairview Health Services false HealthEast Professional Services 2450 Riverside Avenue South Minneapolis MN 55454 261226617 Physician MN 501(c)(3) 11 Fairview Health Services false HealthEast St John's Hospital 2450 Riverside Avenue South Minneapolis MN 55454 411456897 Hospital MN 501(c)(3) 3 Fairview Health Services false HealthEast St Joseph's Hospital 2450 Riverside Avenue South Minneapolis MN 55454 410693880 Hospital MN 501(c)(3) 3 Fairview Health Services false HealthEast Woodwinds Hospital 2450 Riverside Avenue South Minneapolis MN 55454 411592761 Hospital MN 501(c)(3) 3 Fairview Health Services false PreferredOne Community Health Plan 6105 Golden Hills Drive Golden Valley MN 55416 411796007 Insurance MN 501(c)(4) Fairview Health Services false Ridges Surgery Center LLC 14101 Fairview Drive Ste 400 Burnsville MN 55337 462441825 Surgery Center MN Fairview Health Services N/A SouthHealth ASC LLC 4200 Dahlberg Drive Suite 300 Golden Valley MN 55422 822364607 Surgery Center MN Fairview Health Services N/A Fairview Clinics 2450 Riverside Avenue South Minneapolis MN 55454 411761760 Physician MN Fairview Health Services C Corporation false Fairview Physician and Clinic Services 2450 Riverside Avenue South Minneapolis MN 55454 411544996 Physician MN Fairview Health Services C Corporation false Fairview Development Company 2450 Riverside Avenue South Minneapolis MN 55454 411568579 Leasehold MN Fairview Health Services C Corporation false Fairview Express Care 2450 Riverside Avenue South Minneapolis MN 55454 205996177 Physician MN Fairview Health Services C Corporation false FHS Assurance Limited 2450 Riverside Avenue South Minneapolis MN 55454 980417513 Self insur MN Fairview Health Services C Corporation false HealthEast Diversified Services Inc 2450 Riverside Avenue South Minneapolis MN 55454 411388583 Lab & Real MN Fairview Health Services C Corporation false false false false false false false false false false false false true false false false true true true false