2025-05-09T08:55:57-05:00 2024-06-30 990 2023-07-01 261175213 INNOVIS HEALTH LLC INNO 7013648000 3000 32ND AVE S FARGO ND 58103 DOUG ARVIN VICE PRESIDENT, FINANCE 7013648000 2025-05-09 0 2023 2025-03-06 01:10:19Z ESSENTIA HEALTH WEST STEFANIE GEFROH ELLISON 3000 32ND AVE S FARGO ND 58103 626350530 0 X WWW.ESSENTIAHEALTH.ORG X LLC 2007 DE WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 8 5 3313 75 688819 403609 447105 436465 566663964 622015231 -2024687 -372647 6535707 3326795 571622089 625405844 1112980 921506 0 0 291094124 308564344 0 0 0 297688113 316622063 589895217 626107913 -18273128 -702069 320627613 320704145 351244759 351947823 -30617146 -31243678 X WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 0 0 572019908 921506 622015231 INNOVIS HEALTH, LLC, DBA ESSENTIA HEALTH WEST, IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES. IN FURTHERANCE OF ITS PURPOSES, ESSENTIA HEALTH WEST PROVIDES HEALTH CARE SERVICES IN MINNESOTA AND NORTH DAKOTA THROUGH ITS HOSPITAL AND 21 CLINICS, INCLUDING CHARITABLE CARE TO PERSONS UNABLE TO PAY.THE MULTI-SPECIALTY HOSPITAL WITH 142 LICENSED BEDS OFFERS A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR ITS PATIENTS, INCLUDING CRITICAL CARE, MEDICAL SURGICAL CARE, PEDIATRIC SERVICES, NEONATAL INTENSIVE CARE, AND MATERNITY CARE. ESSENTIA HEALTH WEST ALSO HAS SEVERAL OPERATING ROOM SUITES, WHICH INCLUDE BOTH INPATIENT AND DAY SURGERY, AND THE EMERGENCY DEPARTMENT IS OPEN 24 HOURS PER DAY. THE HOSPITAL IS ACCREDITED BY THE JOINT COMMISSION AND IS DESIGNED AS A LEVEL II TRAUMA CENTER AND COMPREHENSIVE STROKE CENTER.ESSENTIA HEALTH WEST EMPLOYS APPROXIMATELY 1,910 FULL TIME EQUIVALENTS. THE HOSPITAL PROVIDED APPROXIMATELY 41,000 HOSPITAL PATIENT DAYS AND 210,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2024. THE CLINICS HAD APPROXIMATELY 639,000 ENCOUNTERS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2024, ESSENTIA HEALTH WEST PROVIDED THE FOLLOWING COMMUNITY BENEFITS: $3.6 MILLION IN CHARITY CARE, $16.1 MILLION COSTS IN EXCESS OF MEDICAID PAYMENTS, $610,000 IN COMMUNITY SERVICES, AND $1.4 MILLION IN HEALTH PROFESSION EDUCATION.ESSENTIA HEALTH IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTH SYSTEM THAT INCLUDES THIS ORGANIZATION AND ALL ENTITIES THAT ARE OWNED OR CONTROLLED, DIRECTLY OR INDIRECTLY, BY ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM OR "ESSENTIA HEALTH"). 572019908 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 3313 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MN X DOUG ARVIN 7013648000 3000 32ND AVE S FARGO ND 58103 ADAM STIBBE MD PHYSICIAN & SECTION CHAIR 60.00 0.00 X 1689715 0 67093 BENJAMIN SMITH MD BOARD DIRECTOR & PHYSICIAN 56.00 4.00 X 1622550 4500 72548 DANIEL SMITH MD PHYSICIAN 60.00 0.00 X 1482681 0 63604 KIMBERLY KOLKHORST MD PHYSICIAN & SECTION CHAIR 60.00 0.00 X 1472390 0 63719 JEROME SAMPSON MD PHYSICIAN 60.00 0.00 X 1474056 0 49349 SCOTT REARDON MD PHYSICIAN 60.00 0.00 X 1416515 0 71151 WILLIAM HEEGAARD MD FORMER PRESIDENT 0.00 60.00 X 211048 668196 182878 TRACI MORRIS TREASURER/REL ORG CHIEF FINCL OFF 1.00 59.00 X 0 900190 125852 RICHARD VETTER MD INTERIM PRES THRU 8/23/CMO 58.00 2.00 X 725972 0 131548 AL HURLEY CHIEF OPERATING OFFICER 54.00 6.00 X 741059 0 111212 ALAN BRUNS MD FORMER KE/PHYSICIAN & DIVISION CHAIR 60.00 0.00 X 792923 0 31732 ROBERT GREEN FORMER VICE PRESIDENT, FINANCE 0.00 60.00 X 0 645032 140047 MICHAEL WATTERS SECRETARY/REL ORG CHIEF LEGAL OFF 1.00 59.00 X 0 645998 132655 JOSHUA GEBUR MD FORMER KE/PHYSICIAN & DIVISION CHAIR 60.00 0.00 X 643563 0 65846 STEFANIE GEFROH ELLISON MD INTERIM CMO THRU 8/23/PHY & DIV CHAIR 57.00 3.00 X 488999 0 68680 TANYA DIEGEL MD FORMER KE/PHYSICIAN & DIVISION CHAIR 60.00 0.00 X 480374 0 65198 ANDREW MOEN MD FORMER KE/PHYSICIAN & DIVISION CHAIR 60.00 0.00 X 464476 0 63477 TANNER GOODRICH SENIOR VICE PRESIDENT, OPERATIONS 57.00 3.00 X 391911 0 96304 TAYLOR MERTZ MD BD DIRECTOR/PHYSICIAN & SEC CHAIR 56.00 4.00 X 351219 0 65847 DOUG ARVIN VICE PRESIDENT, FINANCE 60.00 0.00 X 371448 0 13718 RAE SALUS SENIOR VP, OPERATIONS THRU 6/23 60.00 0.00 X 322210 0 25589 MICHELE THIEMAN MD FORMER KE/PHYSICIAN & DIVISION CHAIR 60.00 0.00 X 300084 0 37455 JAMES CHRISTENSEN MD BOARD DIRECTOR & PHYSICIAN 56.00 4.00 X 275772 3375 47567 MARK THOMPSON MD PRESIDENT 58.00 2.00 X 258393 0 47471 MICHELLE STENBECK CHIEF NURSING OFFICER THRU 1/24 60.00 0.00 X 268072 0 16014 JOSEPH WENDT FORMER KE/VP, ADMINISTRATOR 60.00 0.00 X 223212 0 52067 KERRY CARLSON FORMER KE/OPERATIONS SNR DIRECTOR 60.00 0.00 X 214060 0 51211 DAN BEAUCHAMP FORMER KE/FACILITIES SNR DIRECTOR 60.00 0.00 X 181830 0 48093 CHRISTY BRINKMAN FORMER KE/OPERATIONS SNR DIRECTOR 1.00 59.00 X 0 190152 12233 SUZANNE ZELTINGER OPERATIONS SENIOR DIRECTOR 60.00 0.00 X 167746 0 15342 TIMOTHY SAYLER FORMER CHIEF OPERATING OFFICER 0.00 0.00 X 116149 0 0 JOEL HAUGEN MD BOARD CHAIR/RETIRED PHYSICIAN 2.00 8.00 X X 101152 0 0 LAURIE LEWANDOWSKI BOARD DIRECTOR 1.00 8.00 X 0 24500 0 ARRICK JACKSON BOARD DIRECTOR 1.00 4.00 X 0 4500 0 MARK FINSTAD BOARD DIRECTOR THRU 2/24 1.00 4.00 X 0 4500 0 TIM HEILMAN BOARD VICE CHAIR 2.00 8.00 X X 0 3375 0 TRACEY ZAUN BOARD DIRECTOR THRU 12/23 1.00 4.00 X 0 2200 0 SISTER BEVERLY HORN BOARD DIRECTOR 1.00 4.00 X 0 0 0 17249579 3096518 2035500 584 1 1 0 0 223645 212820 436465 INPATIENT AND OUTPATIENT REVENUES 621110 621476066 621118598 357468 DAKOTA CLINIC PHARMACY INVESTMENT 900099 315809 315809 PARK RAPIDS AREA INVESTMENT 900099 223356 223356 622015231 11518 640 10878 1079489 393561 0 154685 1079489 238876 1318365 238876 1079489 148260 121647 145490 508582 2770 -386935 -384165 -384165 251433 135929 115504 91835 23669 CAFETERIA & VENDING SALES 722514 1843068 1843068 RELEASE OF INFORMATION 900099 41988 41988 GAIN ON LEASE TERMINATION 900099 7092 7092 778 778 1892926 625405844 621657763 688819 2622797 X 848506 848506 73000 73000 5146237 1206119 3940118 2633 2633 252187316 242905699 9281617 10540222 10094464 445758 25636115 23701123 1934992 15051821 14331679 720142 935 935 2682 2682 8370 8370 39685 39685 42575954 35747524 6828430 655457 186865 468592 17095789 13427522 3668267 14575664 14039215 536449 7756315 7470848 285467 1640825 1472363 168462 415858 133777 282081 8450812 8450812 21883277 21077875 805402 6251886 6197751 54135 MEDICAL SUPPLIES 106439147 106439147 UNRELATED BUSINESS TAX 49712 49712 AFFILIATE SUPPORT FEE 56153860 27510285 28643575 BAD DEBT EXPENSE 31678425 31678425 947410 5024276 -4076866 626107913 572019908 54088005 0 20423 4183220 117109 72668 59794886 69001265 3628534 4090419 12465781 12412089 5768716 5495749 445027634 240928383 216837702 204099251 308795 516652 2479252 2384667 9140362 7800897 10066053 10647268 320627613 320704145 59776211 61987147 28174 38523 126627709 123177388 123150347 120812051 41662318 45932714 351244759 351947823 X -30617146 -31243678 -30617146 -31243678 320627613 320704145 X -702069 26827 48710 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8370 8370 0 PART II-B, LINE 1: LOBBYING ACTIVITY EXPLANATION: ESSENTIA HEALTH WEST PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. 17137377 17137377 255021821 113241754 141780067 11550532 4698365 6852167 150248856 118959126 31289730 11069048 4029138 7039910 204099251 PAYABLES TO RELATED TAX-EXEMPT ORGANIZATIONS 35100000 OPERATING LEASES 10832714 45932714 NORTH AMERICA 0 0 SEND AGENTS TO SEMINAR 25559 0 0 0 0 0 0 25559 0 25559 0 0 0 0 0 0 1 1 X 1 X 0 1 1 1 0 1 1 3573486 3573486 0.00600 69723797 53618579 16105218 0.02710 73297283 53618579 19678704 0.03310 609759 609759 0.00100 1400933 1400933 0.00240 2010692 2010692 0.00340 75307975 53618579 21689396 0.03650 1 31678425 97552931 116502431 -18949500 X 1 1 1 1 ESSENTIA HEALTH WEST 3000 32ND AVE S FARGO ND 58103 WWW.ESSENTIAHEALTH.ORG 5067 X X X X ESSENTIA HEALTH WEST 0 0 1 X X X X X X X X X 21 1 1 1 1 X WWW.ESSENTIAHEALTH.ORG/ABOUT/CHNA/ X 1 21 1 WWW.ESSENTIAHEALTH.ORG/ABOUT/CHNA/ 0 1 X 200.000000000000 X X X X X 1 1 X X X X 1 X WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X X X X X 1 X 0 X X X X 1 X 0 0 ESSENTIA HEALTH WEST PART V, SECTION B, LINE 5: ESSENTIA HEALTH WEST SOLICITED BROAD FEEDBACK FROM THE COMMUNITY THROUGH A COMMUNITY SURVEY WHICH COLLECTED 1,088 RESPONSES, AND SEVEN LISTENING SESSIONS WITH 80 PARTICIPANTS; THE SURVEY WAS ADMINISTERED FROM MARCH THROUGH NOVEMBER 2021 AND LISTENING SESSIONS WERE CONDUCTED IN FALL 2021. THROUGHOUT THE PROCESS, A HEAVY EMPHASIS WAS PLACED ON CONSIDERING THE INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, SPECIFICALLY INDIVIDUALS FROM LOW-INCOME, MEDICALLY UNDERSERVED, OR MINORITY POPULATIONS AND THOSE WITH A SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH.THE STEERING COMMITTEE, WHICH GUIDED THE PROCESS, INCLUDED REPRESENTATION FROM SANFORD HEALTH, FAMILY HEALTHCARE, FARGO CASS PUBLIC HEALTH, AND CLAY COUNTY PUBLIC HEALTH.ESSENTIA HEALTH WEST DID NOT RECEIVE ANY COMMENTS ON THE PREVIOUS CHNA. IF RECEIVED, ANY COMMENTS WOULD HAVE BEEN TAKEN INTO CONSIDERATION IN THE CHNA UPDATE PROCESS. ESSENTIA HEALTH WEST PART V, SECTION B, LINE 6A: TO ALIGN RESOURCES AND STRENGTHS TO BETTER SERVE OUR COMMUNITY, THE CHNA WAS CONDUCTED IN COLLABORATION WITH SANFORD HEALTH, AN UNRELATED HOSPITAL FACILITY. ESSENTIA HEALTH WEST PART V, SECTION B, LINE 6B: ESSENTIA HEALTH WEST WORKED COLLABORATIVELY ON THE ASSESSMENT PROCESS WITH AFRO AMERICAN DEVELOPMENT ASSOCIATION, BLUE CROSS BLUE SHIELD, CASS AND CLAY COUNTY ECONOMIC DEVELOPMENT, CASS CLAY COMMUNITY LAND TRUST, CASS CLAY HUNGER COALITION, CASS CLAY SOCIAL SERVICES, CASS CLAY UNITED WAY, CLAY COUNTY PUBLIC HEALTH DEPARTMENT, CLAY COUNTY SOCIAL SERVICES, COMMUNITY UPLIFT, CONCORDIA COLLEGE, CULTURAL DIVERSITY RESOURCES, ETHNIC SELF HELP ALLIANCE FOR REFUGEE ASSISTANCE, FAMILY HEALTHCARE CENTER, FARGO CASS PUBLIC HEALTH DEPARTMENT, FIRSTLINK, FM HOMELESS COALITION, GREAT PLAINS FOOD BANK, JEREMIAH PROJECT, KONDIAL KEL INTERNATIONAL, LAKES AND PRAIRIES COMMUNITY ACTION PARTNERSHIP, MINNESOTA STATE UNIVERSITY MOORHEAD, MOORHEAD AND FARGO CITY COUNCIL, MOORHEAD RESILIENCY PROJECT, MINNESOTA STATE COMMUNITY AND TECHNICAL COLLEGE, NORTH DAKOTA STATE HEALTH EQUITY DEPARTMENT, NORTH DAKOTA STATE UNIVERSITY, MOORHEAD, FARGO, AND WEST FARGO SCHOOL DISTRICTS, SOUL SOLUTIONS, SOUTH SUDANESE FOUNDATION, AND THE LOTUS CENTER. ESSENTIA HEALTH WEST PART V, SECTION B, LINE 11: DURING FY 2024, ESSENTIA HEALTH WEST ADDRESSED SIGNIFICANT NEEDS IDENTIFIED IN THE FY 2022 ASSESSMENT: HEALTH EQUITY AND YOUTH MENTAL HEALTH. SOME ACTIVITIES WERE LED BY THE HOSPITAL, WHILE OTHERS WERE PART OF LARGER COLLABORATIVE EFFORTS WITH LOCAL PARTNERS.OTHER HEALTH NEEDS IDENTIFIED THROUGH THE CHNA PROCESS ARE HOUSING AND TRANSPORTATION, WHICH WILL NOT BE DIRECTLY ADDRESSED AS PRIORITIES BECAUSE FEASIBILITY WAS RANKED LOW. THESE NEEDS WILL BE ADDRESSED AS POSSIBLE THROUGH OTHER COMMUNITY INITIATIVES.THE FOLLOWING DESCRIBES SIGNIFICANT ACCOMPLISHMENTS AND OUTCOMES.PRIORITY AREA #1: HEALTH EQUITYTO PROMOTE HEALTH EQUITY, THE HOSPITAL ENGAGED IN SEVERAL COMMUNITY PARTNERSHIPS. IN FY 2024, WE PARTNERED WITH THE NEW AMERICAN CONSORTIUM FOR WELLNESS AND EMPOWERMENT TO SUPPORT CASE MANAGEMENT SERVICES, PROVIDE ENGLISH LANGUAGE CLASSES, AND SUPPORT THE DEVELOPMENT OF NEW AMERICAN-LED NON-PROFIT ORGANIZATIONS. THROUGH THIS PARTNERSHIP, 15 NEW AMERICAN FAMILIES WERE ASSISTED IN ACCESSING BENEFITS, SERVICES, AND EMPLOYMENT IN THE COMMUNITY AND 20 NEW AMERICAN INDIVIDUALS ACCESSED ENGLISH LANGUAGES CLASSES. FURTHERMORE, THIS PARTNERSHIP BUILT THE CAPACITY OF 11 NEW AMERICAN-LED NON-PROFIT ORGANIZATIONS THROUGH THE DEVELOPMENT OF BUSINESS, COMMUNICATION, AND LEADERSHIP SKILLS. THE HOSPITAL PROMOTED HEALTH EQUITY AMONG NEW AMERICAN INDIVIDUALS AND FAMILIES IN THE COMMUNITY THROUGH A PARTNERSHIP WITH THE AFRO AMERICAN DEVELOPMENT ASSOCIATION (AADA), A NON-PROFIT ORGANIZATION LOCATED IN MOORHEAD, MINNESOTA. THROUGH THIS PARTNERSHIP, AADA PROVIDED SUPPORT TO NEW AMERICAN JOB SEEKERS BY ASSISTING THEM IN FILLING OUT EMPLOYMENT APPLICATIONS, PROVIDING JOB SEARCH TRAINING AND INTERVIEW PREPARATION, AND PROVIDING TRANSPORTATION AND TRANSLATION SERVICES TO CLIENTS DURING THE JOB INTERVIEW PROCESS. IN MARCH 2023, THE HOSPITAL PARTNERED WITH THE IMMIGRANT DEVELOPMENT CENTER TO SPONSOR DRIVING TO SUCCESS, A PROGRAM AIMED AT ASSISTING NEW AMERICANS IN OBTAINING THEIR DRIVER'S LICENSE. IN 2023, THE PROGRAM SUCCESSFULLY PROVIDED CUSTOMIZED DRIVING EDUCATION AND BEHIND-THE-WHEEL INSTRUCTION TO 27 NEW AMERICANS IN THE FARGO-MOORHEAD COMMUNITY. BUILDING ON THIS SUCCESS, THE HOSPITAL RENEWED THEIR PARTNERSHIP WITH THE IMMIGRANT DEVELOPMENT CENTER IN 2024 TO SPONSOR A SECOND COHORT OF STUDENTS THROUGH THE DRIVING TO SUCCESS PROGRAM. THE FALL 2024 PROGRAM AIMS TO EMPOWER 30 ADDITIONAL NEW AMERICANS IN OBTAINING THEIR DRIVER'S LICENSE, FOSTERING GREATER INDEPENDENCE AND OPPORTUNITY. SINCE 2016, THE HOSPITAL HAS PARTNERED WITH MINNESOTA STATE UNIVERSITY MOORHEAD (MSUM) TO SPONSOR SCRUBS CAMP, A SUMMER OUTREACH PROGRAM THAT GIVES LOCAL HIGH SCHOOL STUDENTS AN OPPORTUNITY TO EXPLORE HEALTH SCIENCE PROFESSIONS THROUGH ENGAGING, HANDS-ON ACTIVITIES. THE HOSPITAL'S INVOLVEMENT IN THE PROGRAM ALLOWS PARTICIPANTS TO EXPLORE DIFFERENT PATHWAYS IN HEALTHCARE AND EXPERIENCE THE ROLE THAT HEALTHCARE PROFESSIONALS PLAY IN IMPROVING THE HEALTH OF THOSE IN THEIR CARE. FURTHERMORE, OUR INVESTMENT IN THE PROGRAM PROMOTES EQUITY BY DRIVING DOWN THE OVERALL COST OF THE CAMP FOR PARTICIPANTS AND HELPING TO REMOVE FINANCIAL BARRIERS OF ATTENDANCE. IN FY 2024, THE HOSPITAL'S INVESTMENT IN SCRUBS CAMP RESULTED IN 23 YOUTH RECEIVING EXPERIENCE IN A HEALTHCARE SETTING THROUGH HANDS-ON ACTIVITIES AND AN ADDITIONAL 10 STUDENTS BEING ABLE TO PARTICIPATE IN THE CAMP DURING 2023. THE SUMMER 2024 SCRUBS CAMP PROGRAM ANTICIPATES 30 YOUTH RECEIVING EXPERIENCE IN A HEALTHCARE SETTING THROUGH HANDS-ON ACTIVITIES AND AN ADDITIONAL 10 STUDENTS BEING ABLE TO PARTICIPATE IN THE CAMP DUE TO SCHOLARSHIP ASSISTANCE.ESSENTIA HEALTH WEST PROMOTED HEALTH EQUITY BY INCREASING OUTREACH IN NEW AMERICAN COMMUNITIES AND SUPPORTING THE NAVIGATION OF EMPLOYMENT OPPORTUNITIES AND WORKFORCE DEVELOPMENT AMONG NEW AMERICANS IN THE FARGO-MOORHEAD AREA. PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS INCLUDING NEW ROOTS MIDWEST AND FAMILIES UNITED FOR SELF EMPOWERMENT (FUSE) HELPED NEW AMERICAN FAMILIES AND JOB SEEKERS NAVIGATE EMPLOYMENT AND ECONOMIC DEVELOPMENT OPPORTUNITIES IN THE COMMUNITY. IN 2024, THE HOSPITAL PARTNERED WITH NEW ROOTS MIDWEST TO STRENGTHEN WORKFORCE DEVELOPMENT SERVICES AND COMMUNITY PARTNERSHIPS AT THE ORGANIZATION. THROUGH OUR SUPPORT, NEW ROOTS MIDWEST WAS ABLE TO PROVIDE TRANSLATION SERVICES TO CLIENTS, INCREASE TRAINING AND PROFESSIONAL DEVELOPMENT OPPORTUNITIES OFFERED TO JOB SEEKERS, AND STRENGTHEN PATHWAYS FOR JOB SEEKERS TO CONNECT WITH EMPLOYERS AND APPLY FOR OPEN POSITIONS IN THE COMMUNITY. TO DATE, THE HOSPITAL'S PARTNERSHIP WITH NEW ROOTS MIDWEST HAS RESULTED IN 21 INDIVIDUALS RECEIVING TRAINING, SKILL DEVELOPMENT, AND SUPPORT IN APPLYING FOR OPEN POSITIONS IN THE COMMUNITY. OF THESE 21 INDIVIDUALS, 16 HAVE BEEN HIRED FOR A POSITION IN THE COMMUNITY, EMPOWERING THESE INDIVIDUALS AND THEIR FAMILIES TO GAIN ECONOMIC INDEPENDENCE. IN 2024, THE HOSPITAL PARTNERED WITH FUSE TO SPONSOR A BACK-TO-SCHOOL EVENT AIMED AT PROMOTING HEALTH, WELL-BEING, AND EDUCATIONAL READINESS AMONG LOW-INCOME AND NEW AMERICAN FAMILIES IN THE FARGO-MOORHEAD COMMUNITY. THE EVENT OFFERED FREE BACKPACKS, SCHOOL SUPPLIES, SPORTS PHYSICALS, DENTAL SCREENINGS, AND VISION CHECKS TO PARTICIPATING CHILDREN, AIMING TO REACH OVER 350 INDIVIDUALS FROM 100 FAMILIES. IN ADDITION TO THESE SERVICES, INFORMATION AND RESOURCES WERE PROVIDED TO PARENTS VIA A RESOURCE FAIR, CONNECTING FAMILIES TO INFORMATION AND SUPPORT SERVICES FOR HEALTH, EDUCATION, AND EMPLOYMENT SERVICES.PRIORITY AREA #2: YOUTH MENTAL HEALTHTHE HOSPITAL PARTNERED WITH CLAY COUNTY PUBLIC HEALTH AND THE MOORHEAD ALTERNATIVE LEARNING CENTER (ALC) TO ADDRESS YOUTH MENTAL HEALTH DURING FY 2024. STUDENTS AND STAFF AT THE ALC PREVIOUSLY REPORTED HIGH RATES OF ANXIETY, DEPRESSION, AND EMOTIONAL DYSREGULATION, WHICH NEGATIVELY IMPACTED STUDENTS' ABILITY TO STAY IN CLASS AND SUCCESSFULLY COMPLETE HIGH SCHOOL. TO POSITIVELY SUPPORT STUDENT MENTAL HEALTH, ESSENTIA HEALTH WEST AND CLAY COUNTY PUBLIC HEALTH PARTNERED TO SUPPORT THE IMPLEMENTATION OF SOURCES OF STRENGTH CURRICULUM ON THE ALC CAMPUS. THE CURRICULUM, WHICH IS A BEST-PRACTICE YOUTH MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION PROGRAM, WAS INTRODUCED TO ALC TEACHERS AND STAFF DURING THE SPRING OF 2023 AND WAS UTILIZED WITH ALC STUDENTS DURING FY 2024. IN ADDITION TO SUPPORTING SOURCES OF STRENGTH CURRICULUM, THE HOSPITAL SUPPORTED THE IMPLEMENTATION OF #WINATSOCIAL CURRICULUM ON THE ALC CAMPUS. THE #WINATSOCIAL CURRICULUM WAS IMPLEMENTED DURING THE 2023-2024 SCHOOL YEAR AND PROVIDED 100% OF ALC STUDENTS AND STAFF WITH ACCESS TO ONLINE CURRICULUM THAT INCLUDED MODULES ON NAVIGATING SOCIAL MEDIA, TECHNOLOGY, AND CURRENT EVENTS IN HEALTHY WAYS. TO FURTHER SUPPORT YOUTH MENTAL HEALTH AT THE ALC, THE HOSPITAL IMPLEMENTED APPRECIATION EVENTS FOR ALC STAFF TO SUPPORT WELL-BEING, BOOST STAFF MORALE, AND SUPPORT STAFF IN CONTINUING TO SERVE STUDENTS. THROUGH THIS INITIATIVE, 20 STAFF PARTICIPATED IN APPRECIATION EVENTS THROUGH THE 2023-2024 SCHOOL YEAR WITH 80% OF STAFF REPORTING IMPROVED MENTAL WELLBEING AFTER THE APPRECIATION EVENTS AND 67% OF STAFF REPORTING THAT THEY FELT BETTER ABLE TO SERVE STUDENTS AS A RESULT OF PARTICIPATING IN APPRECIATION EVENTS. ESSENTIA HEALTH WEST PART V, SECTION B, LINE 23: OCCASIONALLY CERTAIN FAP-ELIGIBLE PATIENTS ARE CHARGED MORE THAN AMOUNTS GENERALLY BILLED ON SERVICES. THIS COULD OCCUR IF THE PATIENT PAYMENTS ARE APPLIED ON PATIENT BILLS BEFORE AND/OR AFTER THE FINANCIAL ASSISTANCE POLICY (FAP) ADJUSTMENTS WERE APPLIED. THE HOSPITAL PROVIDES THOSE PATIENTS WITH A $5 OR MORE OVERPAYMENT WITH A REFUND CHECK, EXPLANATION LETTER, AND DETAILED SUMMARY OF SERVICES IMPACTED.THE NUMBER OF PATIENTS AFFECTED AND THE TOTAL DOLLAR AMOUNT INVOLVED FOR FY24 WAS 3 INDIVIDUALS & $141.ESSENTIA HEALTH'S REVENUE CYCLE DEPARTMENT CONFIRMS IF ANY PATIENT PAYMENTS ARE MADE AFTER THE FAP APPLICATION HAS BEEN RECEIVED. IF SO, THE PATIENT PAYMENT IS UNAPPLIED AND THEN THE FAP ADJUSTMENT IS APPLIED. THE PATIENT PAYMENT IS THEN POSTED, AND IF THE PATIENT PAYMENT IS GREATER THAN THE REMAINING BALANCE ON THE BILL, A REFUND TO THE PATIENT IS PROVIDED. THERE COULD BE A FAP-ELIGIBLE PATIENT OVERPAYMENT DEPENDING ON THE TIMING OF THE PATIENT PAYMENT OR IF THE PATIENT IS STILL PAYING THEIR CO-PAYMENT AT THE TIME OF SERVICE. WE CONTACT THESE PATIENTS TO REMIND THEM THAT THEY HAVE CHARITY CARE AND DO NOT NEED TO PAY THEIR CHARGES UNTIL THEIR FAP ADJUSTMENTS HAVE BEEN MADE. WE REQUEST THE REFUND AT THE TIME OF PROCESSING THE FAP APPLICATION IF APPLICABLE. WE ALSO PERFORM AUDITS FOR ANY FAP OVERPAYMENTS DUE TO THE TIMING OF PATIENT PAYMENTS. ADDITIONAL DISCLOSURES NOT REQUIRED FOR PART V, SECTION C: SCHEDULE H, PART V, SECTION B, LINE 3E:ESSENTIA HEALTH WEST CONDUCTED A NEW CHNA IN FY22 AND CHOSE TO ADDRESS TWO PRIORITY HEALTH NEEDS BASED ON THE FEEDBACK OF 1,088 COMMUNITY MEMBERS. THE SIGNIFICANT HEALTH NEEDS ARE HEALTH EQUITY AND YOUTH MENTAL HEALTH. THE HEALTH NEEDS ARE NOT RANKED IN ORDER; BOTH NEEDS ARE CONSIDERED PRIORITIES. THE HOSPITAL WILL WORK ON ADDRESSING EACH NEED SIMULTANEOUSLY FROM FY23 - FY25.SCHEDULE H, PART V, SECTION B, LINE 16I:DUE TO THE SMALL SIZES OF THE LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS OF THE COMMUNITIES SERVED BY THE ORGANIZATION, THE ORGANIZATION WAS NOT REQUIRED TO TRANSLATE THE FINANCIAL ASSISTANCE POLICY (FAP), THE FAP APPLICATION FORM, OR THE PLAIN LANGUAGE SUMMARY OF THE FAP TO OTHER LANGUAGES. ALTHOUGH IT WAS NOT REQUIRED, THE ORGANIZATION TRANSLATED THE FAP APPLICATION FORM INTO SPANISH. 21 1 - ESSENTIA HEALTH SOUTH UNIVERSITY CLINIC 1702 S UNIVERSITY DR FARGO ND 58103 MULTI-SPECIALTY CLINIC 2 - ESSENTIA HEALTH 32ND AVENUE CLINIC 3000 32ND AVE S FARGO ND 58103 MULTI-SPECIALTY CLINIC 3 - ESSENTIA HEALTH 52ND AVENUE CLINIC 4110 51ST AVE S FARGO ND 58103 MULTI-SPECIALTY CLINIC 4 - ESSENTIA HEALTH WAHPETON CLINIC 275 11TH ST S WAHPETON ND 58075 MULTI-SPECIALTY CLINIC 5 - ESSENTIA HEALTH WEST FARGO CLINIC 1401 13TH AVE E WEST FARGO ND 58078 MULTI-SPECIALTY CLINIC 6 - ESSENTIA HEALTH-MID DAKOTA BISMARCK 9TH 401 N 9TH ST BISMARCK ND 58501 MULTI-SPECIALTY CLINIC 7 - ESSENTIA HEALTH-WEST FARGO THE LIGHTS CL 3150 SHEYENNE ST STE 240 WEST FARGO ND 58078 MULTI-SPECIALTY CLINIC 8 - ESSENTIA HEALTH WEST ACRES CLINIC 3902 13TH AVE S STE 3704 FARGO ND 58103 PRIMARY CARE CLINIC 9 - ESSENTIA HEALTH-MID DAKOTA BISMARCK GATE 2700 STATE ST BISMARCK ND 58503 PRIMARY CARE CLINIC 10 - ESSENTIA HEALTH JAMESTOWN CLINIC 2430 20TH ST SW JAMESTOWN ND 58401 MULTI-SPECIALTY CLINIC 11 - ESSENTIA HEALTH MOORHEAD CLINIC 801 BELSLY BLVD MOORHEAD MN 56560 PRIMARY CARE CLINIC 12 - ESSENTIA HEALTH 45TH STREET CLINIC 4476 31ST AVE S STE 101 FARGO ND 58104 PRIMARY CARE CLINIC 13 - ESSENTIA HEALTH VALLEY CITY CLINIC 132 4TH AVE NE VALLEY CITY ND 58072 MULTI-SPECIALTY CLINIC 14 - ESSENTIA HEALTH DOWNTOWN MOORHEAD CLINIC 720 MAIN AVE MOORHEAD MN 56560 PRIMARY CARE CLINIC 15 - ESSENTIA HEALTH-MID DAKOTA BISMARCK KIRK 727 KIRKWOOD MALL BISMARCK ND 58504 PRIMARY CARE CLINIC 16 - ESSENTIA HEALTH MID DAKOTA WOMEN'S CENTE 1000 E ROSSER AVE BISMARCK ND 58501 MULTI-SPECIALTY CLINIC 17 - ESSENTIA HEALTH OSGOOD CLINIC 4622 40TH AVE S FARGO ND 58104 MULTI-SPECIALTY CLINIC 18 - ESSENTIA HEALTH LISBON CLINIC 819 MAIN ST LISBON ND 58054 MULTI-SPECIALTY CLINIC 19 - ESSENTIA HEALTH NORTH FARGO 1100 19TH AVE N STE L-M FARGO ND 58102 MULTI-SPECIALTY CLINIC 20 - ESSENTIA HEALTH CASSELTON CLINIC 5 9TH AVE N CASSELTON ND 58102 PRIMARY CARE CLINIC 21 - ESSENTIA HEALTH HANKINSON CLINIC 501 MAIN AVE S HANKINSON ND 58041 PRIMARY CARE CLINIC PART I, LINE 3C: ASSETS WILL BE CONSIDERED ALONG WITH THE PATIENT'S INCOME TO DETERMINE ELIGIBILITY FOR THE FINANCIAL ASSISTANCE PROGRAM. TO BE ELIGIBLE, REPORTABLE ASSETS MAY NOT EXCEED $75,000 FOR A HOUSEHOLD OF ONE (1), OR $150,000 FOR A HOUSEHOLD OF TWO (2) OR MORE. ASSETS MAY INCLUDE, BUT ARE NOT LIMITED TO, SUCH ITEMS AS CHECKING AND SAVINGS ACCOUNTS, IRAS, 401(K)S, PENSIONS, HEALTH SAVINGS ACCOUNTS, ADDITIONAL PROPERTY, AND ANY OTHER RETIREMENT FUNDING. PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT INFORMATION IS INCLUDED ON ESSENTIA HEALTH'S (EMPLOYER IDENTIFICATION NUMBER 20-0360007) WEBSITE AT WWW.ESSENTIAHEALTH.ORG. ESSENTIA HEALTH, HEADQUARTERED IN DULUTH, MINNESOTA, IS THE PARENT OF AN INTEGRATED HEALTH SYSTEM SERVING PATIENTS IN MINNESOTA, WISCONSIN, AND NORTH DAKOTA. PART I, LINE 7: THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES WAS USED TO CALCULATE THE COSTS FOR THE FOLLOWING COMMUNITY BENEFITS: CHARITY CARE AND UNREIMBURSED MEDICAID. ACTUAL COSTS WERE USED FOR THE REMAINDER OF THE COMMUNITY BENEFITS REPORTED. PART I, LN 7 COL(F): BAD DEBT EXPENSE THAT WAS SUBTRACTED FROM TOTAL EXPENSE TO OBTAIN THE % OF COMMUNITY BENEFIT TO TOTAL EXPENSE AMOUNTED TO $31,678,425. PART III, LINE 2: DISCOUNTS, CHARITY CARE, AND BAD DEBT EXPENSE ARE ACCOUNTED FOR AS REDUCTIONS TO REVENUE. BAD DEBT EXPENSE IS CALCULATED AFTER ALL ESTIMATED DISCOUNTS AND APPLICABLE PAYMENTS ARE APPLIED TO A PATIENT ACCOUNT. BAD DEBT EXPENSE IS A COMBINATION OF THE ACTUAL ACCOUNT WRITE-OFFS TO A COLLECTION AGENCY FOR ACCOUNTS DEEMED UNCOLLECTIBLE, ALONG WITH ESTIMATED EXPENSE FOR ACCOUNTS WITH A REMAINING BALANCE IN ACCOUNTS RECEIVABLE. IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE. PART III, LINE 3: ESSENTIA HEALTH PROVIDES FULL CHARITY CARE THROUGH ITS TRADITIONAL APPLICATION PROCESS. FULL CHARITY CARE IS A COMPLETE WRITE-OFF OF ELIGIBLE GROSS HOSPITAL AND CLINIC CHARGES. THIS IS BASED ON THE PATIENT'S INCOME IN RELATION TO THE FEDERAL POVERTY GUIDELINES. CATASTROPHIC CHARITY CARE IS FINANCIAL ASSISTANCE THAT PROVIDES A ONE-TIME DISCOUNT BASED ON AN APPLICATION FOR TRADITIONAL CHARITY CARE AND DOES NOT QUALIFY BUT HAS A BALANCE GREATER THAN $5,000. PATIENT, OR THEIR GUARANTOR, MAY BE GRANTED CATASTROPHIC CHARITY CARE ASSISTANCE FOR ELIGIBLE SERVICES IF THEY COMPLETE A FINANCIAL ASSISTANCE APPLICATION AND PROVIDE REQUIRED DOCUMENTATION. THE PATIENT AND/OR GUARANTOR WILL NOT PAY MORE THAN 20% OF ANNUAL INCOME BASED ON ELIGIBLE CHARGES. ESSENTIA HEALTH ALSO RECOGNIZES THAT IT IS NOT FEASIBLE, OR SOMETIMES NECESSARY, FOR ALL PATIENTS TO COMPLETE FINANCIAL ASSISTANCE APPLICATIONS AND PROVIDE DOCUMENTATION REQUIRED THROUGH THE TRADITIONAL PROCESS. ESSENTIA HEALTH IMPLEMENTED AN ALTERNATIVE DOCUMENTATION AND PRESUMPTIVE PROCESS USING A TOOL THAT IDENTIFIES ACCOUNTS THAT AUTOMATICALLY QUALIFY FOR CHARITY CARE AND RECLASSIFIED THOSE ACCOUNTS TO CHARITY CARE ALLOWANCE. AS A RESULT, WE ESTIMATE $0 OF PATIENT ACCOUNTS WRITTEN OFF TO BAD DEBT WOULD QUALIFY FOR CHARITY CARE.ESSENTIA HEALTH WEST INCORPORATES THE COST OF BAD DEBT AS A COMMUNITY BENEFIT. AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE THE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THAT CARE. IN DOING SO, WE MAKE QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS. PART III, LINE 4: PAGES 16-18 OF ESSENTIA HEALTH'S CONSOLIDATED AUDIT REPORT CONTAIN THE FOOTNOTE DESCRIBING THE ORGANIZATION'S BAD DEBT EXPENSE. PART III, LINE 8: RECONCILIATION FOR MEDICARE SHORTFALL BETWEEN TOTAL MEDICARE PROGRAM AND WHAT IS ALLOWED ON THE COST REPORT:THE HOSPITAL'S TOTAL MEDICARE SHORTFALL IS $61,273,860, OF WHICH A SHORTFALL OF $18,949,500 (CONSISTING OF $97,552,931 REVENUE AND $116,502,431 COST) IS INCLUDED IN PART III, SECTION B, LINES 5-7, AND A SHORTFALL OF $42,324,360 (CONSISTING OF $99,661,716 REVENUE AND $141,986,076 COST) REPRESENT ALL OTHER MEDICARE SERVICES NOT INCLUDED IN THE ANNUAL COST REPORT.THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6:THE METHODOLOGY USED IN DETERMINING THE REPORTED MEDICARE ALLOWABLE COST BEGINS WITH THE HOSPITAL'S GENERAL LEDGER SYSTEM. THE COSTS ARE OBTAINED FROM THE GENERAL LEDGER AND THEN ADJUSTED AND REPORTED IN ACCORDANCE WITH CENTERS FOR MEDICARE SERVICES (CMS) "COST FINDING" GUIDELINES AS PUBLISHED IN THEIR PROVIDER REIMBURSEMENT MANUAL. ONCE THE MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE HOSPITAL'S COST REPORT, ANY COSTS ATTRIBUTED TO SUBSIDIZED HEALTH SERVICES AND MEDICAL EDUCATION ARE REMOVED AND REPORTED SEPARATELY.EXPLANATION FOR ANY PRIOR YEAR SETTLEMENTS FOR MEDICARE-RELATED SERVICES IN THE CURRENT TAX YEAR:EACH ESSENTIA HEALTH HOSPITAL IS REQUIRED TO FILE A MEDICARE COST REPORT 5 MONTHS AFTER THE CLOSE OF THEIR FISCAL YEAR. THE COST REPORT PROVIDES MEDICARE WITH INFORMATION THAT IS USED TO DETERMINE UTILIZATION AND SPENDING TRENDS BUT ALSO IS USED TO SET FUTURE PAYMENT RATES FOR MOST MEDICARE SERVICES. IF THE INTERIM PAYMENTS PAID TO A HOSPITAL ARE HIGHER OR LOWER THAN THE FILED COST REPORT ALLOWABLE REIMBURSEMENT, THERE WILL BE A SETTLEMENT FOR THAT FISCAL YEAR. THIS CAN BE DUE TO CHANGES IN UTILIZATION OR COST OF PROVIDING SERVICES FOR CRITICAL ACCESS HOSPITALS (CAH) OR DIFFERENCES BETWEEN INTERIM AND FINAL PAYMENT FACTORS FOR DISPROPORTIONATE SHARE, BAD DEBTS, OR INDIRECT MEDICAL EDUCATION FOR NON-CAH HOSPITALS. AN ESTIMATE FOR THESE SETTLEMENTS IS RECORDED AT THE CLOSE OF THE FISCAL YEAR. IF THE ESTIMATE VARIES FROM THE FINAL SETTLEMENT RECEIVED 6-7 MONTHS AFTER THE FISCAL YEAR ENDS, THEN THESE AMOUNTS ARE RECORDED AS PRIOR YEAR MEDICARE REVENUE.THE EXTENT TO WHICH ANY SHORTFALL REPORTED IN PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT AND THE RATIONALE FOR THE ORGANIZATION'S OPINION:ESSENTIA HEALTH WEST IS A PART OF ESSENTIA HEALTH, AN INTEGRATED HEALTH SYSTEM. ESSENTIA HEALTH AND ITS MEMBER ORGANIZATIONS INCORPORATE THE FULL VALUE OF THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. THE RATIONALE FOR THE ORGANIZATION'S OPINION IS PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. MANY MEDICARE BENEFICIARIES ARE POOR AND ARE ELIGIBLE FOR MEDICAID IN ADDITION TO MEDICARE. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY. PART III, LINE 9B: THE POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR ESSENTIA HEALTH'S FINANCIAL ASSISTANCE POLICY (FAP) AND FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR FINANCIAL ASSISTANCE FROM ESSENTIA HEALTH, AND THE PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH THEIR PAYMENT AGREEMENTS. THE ORGANIZATION OFFERS EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS AND WILL NOT IMPOSE LIENS ON PRIMARY RESIDENCES NOR REPORT PATIENTS TO A CREDIT RATING AGENCY FOR OUTSTANDING PATIENT BILLS.THE ORGANIZATION WILL NOT CHARGE A PATIENT THE GROSS AMOUNT OF CHARGES FOR ANY UNINSURED TREATMENT. UNINSURED DISCOUNTS WILL BE APPLIED TO THE GROSS CHARGES PRIOR TO ANY FINANCIAL ASSISTANCE OR OTHER DISCOUNTS.IF AT ANY TIME THE ORGANIZATION RECOGNIZES THAT A PATIENT MAY BE ELIGIBLE FOR STATE OR FEDERAL PROGRAMS, A REPRESENTATIVE WILL ASSIST THE PATIENT IN OBTAINING INFORMATION ABOUT THESE PROGRAMS OR PROVIDE CONTACT INFORMATION FOR THESE PROGRAMS. THE ORGANIZATION CONTRACTS WITH AN OUTSIDE PATIENT ADVOCACY AGENCY, WHICH MAY PROVIDE ASSISTANCE TO THE UNINSURED PATIENT IN APPLYING TO CERTAIN STATE AND FEDERAL PROGRAMS.AT ANY STAGE OF THE PATIENT EXPERIENCE AND UP THROUGH THE COLLECTION PROCESS, THE PATIENT MAY EXPRESS A CONCERN THAT THEY ARE UNABLE TO PAY THEIR BILL IN FULL OR MEET THE PAYMENT PLAN REQUIREMENTS. AT THAT TIME, THE PATIENT WILL BE GIVEN EVERY OPPORTUNITY TO COMPLETE AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE.THE ORGANIZATION TRAINS ITS OUTSIDE DEBT COLLECTION AGENCIES AND ATTORNEYS ABOUT THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION ABOUT THE FAP OR SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE ORGANIZATION REQUIRES ITS OUTSIDE COLLECTION AGENCIES AND ATTORNEYS TO REFER PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE TO ESSENTIA HEALTH. IF A PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, THE ORGANIZATION SUSPENDS ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND ESSENTIA HEALTH HAS NOTIFIED THE PATIENT OF ITS DECISION. PATIENTS ARE ADVISED AT THAT TIME TO NOTIFY THE COLLECTION AGENCY TO HOLD THEIR ACCOUNT. THE OUTSIDE DEBT COLLECTION AGENCIES ARE NOTIFIED BY ESSENTIA HEALTH ONCE AN ACCOUNT ADJUSTMENT HAS BEEN MADE. PART VI, LINE 2: NEEDS ASSESSMENT:WE ASSESS AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE IN MANY WAYS, INCLUDING THE FOLLOWING:MARKETING RESEARCH - THE ESSENTIA HEALTH MARKETING RESEARCH DEPARTMENT CONDUCTS SURVEYS, FOCUS GROUPS, AND REVIEWS INTERNAL DATA TO BETTER UNDERSTAND THE NEEDS AND USE(S) OF OUR SERVICES. THIS INCLUDES ACCESS TO SERVICE AREAS (E.G., PRIMARY CARE), PAYOR INFORMATION (E.G., ESSENTIA CARE), AND OVERALL GAPS IN SERVICES. ASSESSMENTS HAVE RESULTED IN INTERNAL CHANGES IN BOTH STAFFING AND PROCESSES.ESSENTIA HEALTH POPULATION CARE MANAGEMENT - WE USE AN ANALYSIS OF MULTIPLE POPULATIONS; ONE SUCH GROUP IS "ACO POPULATIONS." THE ANALYSES DONE INCLUDE THE IDENTIFICATION OF PATIENTS WHO HAVE UNCONTROLLED ASTHMA, UNCONTROLLED DIABETES, ARE PRE-DIABETIC, OR WHO HAVE DEPRESSION; THE RESULTS ARE USED IN TARGETED OUTREACH BY THE POPULATION CARE TEAM. TARGETED OUTREACH HAS PROVEN TO LEAD TO BETTER OUTCOMES FOR THESE POPULATIONS.COMMUNITY GIVING - THROUGH OUR COMMUNITY GIVING PROCESS WE ENGAGE TO UNDERSTAND COMMUNITY NEEDS ACROSS A BROAD SPECTRUM OF COMMUNITY ORGANIZATIONS. WE REVIEW REQUESTS FOR FINANCIAL SUPPORT GENERATED BY COMMUNITY NON-PROFITS AND EVALUATE FUNDING BASED ON POTENTIAL OF PROGRAMS AND PROJECTS TO HAVE A POSITIVE AND SUSTAINABLE IMPACT ON THE HEALTH AND VITALITY OF OUR COMMUNITIES. THIS INCLUDES COMPLEMENTING OUR COMMUNITY FUNDING BY GATHERING PERSPECTIVES ON COMMUNITY EFFORTS AND THE ROLE ESSENTIA HEALTH CAN PLAY IN ADDRESSING COMMUNITY NEEDS AS A COLLABORATIVE PARTNER.INTERNAL QUALITY INDICATORS - WE TRACK DATA THAT LEADS TO THE IMPROVED CARE AND TREATMENT OF PATIENTS WITH CHRONIC DISEASES, TOBACCO USE, AND MENTAL HEALTH CONDITIONS. THIS DATA INCLUDES PATIENT ACTIVITY AND OUTCOMES, WHICH ALLOWS ESSENTIA HEALTH TO BETTER IDENTIFY THE NEEDS OF THE PATIENTS AND CAN BE UTILIZED TO ASSESS THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE.HEALTH DATA PROVIDED BY PAYOR ORGANIZATIONS, NAMELY GOVERNMENT AND COMMERCIAL HEALTH INSURERS - THIS HEALTH DATA TYPICALLY INVOLVES MEDICAL TREATMENT AND OUTCOMES THAT REFLECT TRENDS OF UNHEALTHY LIFESTYLES AND BEHAVIORS. OUR OBJECTIVE IS TO UNDERSTAND THESE RELATIONSHIPS AND TO DEVELOP ACTION STEPS TO INTERVENE ON THE FRONT END TO PREVENT SUCH MEDICAL SITUATIONS FROM OCCURRING.ESSENTIA HEALTH HUMAN RESOURCES DEPARTMENT - THE ANALYSIS OF CURRENT STAFFING TRENDS AIDS IN PROVIDING HEALTHCARE ACCESS APPROPRIATELY TO THE COMMUNITIES WE SERVE.ESSENTIA INSTITUTE OF RURAL HEALTH (EIRH) - EIRH PROVIDES RESEARCH OF PATIENT DATA, COMMUNITY DATA, AND THE OUTCOMES ASSOCIATED WITH CURRENT CLINICAL PRACTICES, INTERVENTIONS, AND PREVENTION STRATEGIES (E.G., OPIOID USE DISORDER, SOCIAL DETERMINANTS OF HEALTH). PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE ORGANIZATION MAKES INFORMATION ON ITS FINANCIAL ASSISTANCE POLICY (FAP) READILY AVAILABLE TO PATIENTS. INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS IS AVAILABLE ON THE ESSENTIA HEALTH WEBSITE (WWW.ESSENTIAHEALTH.ORG, SELECT PATIENTS & VISITORS) WHERE THE INFORMATION AND APPLICATION IS EASILY ACCESSIBLE TO BE VIEWED, DOWNLOADED, AND PRINTED AT NO CHARGE TO THE PATIENT. PATIENTS CAN ALSO APPLY FOR FAP VIA MYCHART. NOTICES ON THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE CONSPICUOUSLY POSTED IN EMERGENCY ROOM DEPARTMENTS. FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE DURING THE PRE-ADMISSION FINANCIAL SCREENING, AT THE TIME OF REGISTRATION, AND PRIOR TO A HOSPITAL DISCHARGE. INFORMATION ABOUT THE FAP IS IN ALL COLLECTION LETTERS AND PATIENT STATEMENTS.FAP INFORMATION AND/OR APPLICATIONS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. THE ORGANIZATION EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS PROVIDING DIRECT PATIENT TREATMENT AND WHO WORK IN ADMISSIONS, BILLING, AND COLLECTIONS, ABOUT THE EXISTENCE OF THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION. ANNUAL EDUCATION/AWARENESS OF THE FAP IS PROVIDED TO ENSURE ALL EMPLOYEES WITH PATIENT CONTACT ARE AWARE OF THE PROGRAM AND HOW PATIENTS CAN OBTAIN ADDITIONAL INFORMATION. CLINICAL AND HOSPITAL STAFF WHO PROVIDE DIRECT PATIENT CARE HAVE KNOWLEDGE OF THE FAP AND KNOW TO DIRECT PATIENTS TO A REGISTRATION INTERVIEWER OR BUSINESS OFFICE REPRESENTATIVE. REGISTRATION STAFF HAVE AN UNDERSTANDING OF THE POLICY, KNOWLEDGE OF WHERE THE RELATED DOCUMENTS ARE LOCATED, AND WHERE TO DIRECT THE PATIENT FOR MORE INFORMATION ON THE FAP. DESIGNATED EMPLOYEES (PATIENT FINANCIAL SERVICES COUNSELORS & PATIENT FINANCIAL SERVICES REPRESENTATIVES) HAVE A THOROUGH UNDERSTANDING OF THE FAP AND OFFER THE INFORMATION ON THE FAP TO THOSE PATIENTS WHO MAKE AN INQUIRY ABOUT THE PROGRAM OR ARE DETERMINED THROUGH A FINANCIAL SCREENING TO BE ELIGIBLE FOR THIS PROGRAM. PATIENT ADVOCACY SERVICES ALSO INFORM THE PATIENT ABOUT THE AVAILABILITY OF ASSISTANCE. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT, A PATIENT'S GUARANTOR, A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. THE ORGANIZATION RESPONDS TO ANY ORAL OR WRITTEN REQUESTS FOR MORE GENERAL INFORMATION ON THE FAP MADE BY A PATIENT OR ANY INTERESTED PARTY. PART VI, LINE 4: COMMUNITY INFORMATION:ESSENTIA HEALTH WEST IS LOCATED IN FARGO, ND AND IS A PART OF ESSENTIA HEALTH, WHICH IS DEFINED IN PART VI, LINE 6. THE ORGANIZATION OPERATES 1 HOSPITAL AND 21 CLINICS THAT PRIMARILY SERVE CASS, CLAY, AND BURLEIGH COUNTIES. THE OVERALL COMMUNITY IS CLASSIFIED AS A COMBINATION OF SUBURBAN AND RURAL.ESSENTIA HEALTH WEST COVERS A SERVICE AREA OF APPROXIMATELY 490,000 PEOPLE. THE SERVICE AREA AGE DISTRIBUTION IS 21% UNDER THE AGE OF 18; 60% BETWEEN THE AGES OF 18 AND 65; AND 19% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE AREA IS 90% CAUCASIAN; 2% AFRICAN AMERICAN; 1% ASIAN; 2% HISPANIC; AND 5% OTHER. THE GENDER SPLIT RATIO IS 50% WOMEN AND 50% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY $60,000.ESSENTIA HEALTH WEST, AS PART OF ESSENTIA HEALTH, IS COMMITTED TO SERVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. APPROXIMATELY 2.5% GROSS REVENUE DOLLARS WERE FROM SELF-PAY PATIENTS AND 12.0% FROM MEDICAID RECIPIENTS. CLAY AND RANSOM COUNTIES ALONG WITH HANKINSON, ND ARE CURRENTLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS.AS MENTIONED ABOVE, ESSENTIA HEALTH WEST IS PART OF ESSENTIA HEALTH. ESSENTIA HEALTH STAFFS HOSPITALS AND CLINICS IN FEDERALLY-RECOGNIZED UNDERSERVED AREAS AND SUPPORTS THE HEALTH OF ITS COMMUNITIES THROUGH AN ACTIVE OUTREACH PROGRAM THAT BRINGS SPECIALISTS LIKE ONCOLOGISTS, CARDIOLOGISTS, NEUROLOGISTS, AND OTHERS INTO ITS SMALLER COMMUNITIES. THIS ELIMINATES BARRIERS TO CARE FOR MANY PATIENTS, PARTICULARLY THOSE WHO ARE ELDERLY, LIVING ON LOW INCOMES, OR ARE FACED WITH OTHER CHALLENGES THAT MAKE IT DIFFICULT TO TRAVEL LONG DISTANCES FOR CARE. THERE ARE 14 OTHER HOSPITALS OUTSIDE OF THE ESSENTIA HEALTH UMBRELLA THAT SERVICE THE COMMUNITY. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:THE ORGANIZATION'S BOARD OF DIRECTORS IS COMPOSED MAINLY OF VOLUNTEER REPRESENTATIVES FROM THE COMMUNITIES IT SERVES. THE ORGANIZATION HAS AN OPEN MEDICAL STAFF, SO ANY QUALIFIED PHYSICIAN OF THE COMMUNITY IS ALLOWED TO APPLY. ALL APPLICANTS WHO APPLY MUST MEET THE CREDENTIALING STANDARDS AND BE APPROVED BY THE ESSENTIA HEALTH WEST GOVERNING BOARD, IN ORDER TO PROVIDE SERVICES AT ESSENTIA HEALTH. IN ADDITION, THE HOSPITAL PROVIDES ON-SITE CLINICAL EXPERIENCES FOR MEDICAL STUDENTS AND RESIDENTS, ADVANCED PRACTICE AND PRE-LICENSURE NURSES, PHARMACISTS, THERAPISTS, TECHNICIANS, AND THOSE IN OTHER HEALTH CARE VOCATIONS.WE REINVEST IN THE ORGANIZATION BY ACQUIRING THE LATEST STATE-OF-THE-ART EQUIPMENT AND BY INVESTING IN PROGRAMS THAT ARE NEEDED IN OUR COMMUNITY.IN ADDITION TO THE ACTIVITIES LISTED IN PART I, LINE 7 AS WELL AS PART V, SECTION B, LINE 11, THE ORGANIZATION SUPPORTS THE HEALTH AND VITALITY OF OUR COMMUNITIES THROUGH A SPECIAL DEDICATION TO MAKING A DIFFERENCE IN AREAS THAT POSITIVELY IMPACT THE SOCIAL DETERMINANTS OF HEALTH. WE MAKE SIGNIFICANT CONTRIBUTIONS TO COMMUNITY NON-PROFITS WORKING TO ENCOURAGE ACCESS TO HEALTHY FOODS, MENTAL WELL-BEING, AND HEALTHY YOUTH DEVELOPMENT. ADDITIONALLY, WE ENCOURAGE OUR COLLEAGUES TO CONTRIBUTE THEIR TIME IN MEANINGFUL WAYS THROUGH A FORMAL EMPLOYEE VOLUNTEER PROGRAM THAT INCENTIVIZES COMMUNITY VOLUNTEERING BY PROVIDING A $100 DONATION TO A NONPROFIT OF THE EMPLOYEE'S CHOICE AFTER VOLUNTEERING AT LEAST 20 HOURS. IN FY24, MORE THAN 19,500 IMPACTFUL VOLUNTEER HOURS WERE REPORTED FOR ESSENTIA HEALTH COLLEAGUES. OUR LEADERS ARE ACTIVELY ENGAGED IN LENDING THEIR EXPERTISE ON COMMUNITY BOARDS, INCLUDING WORKFORCE DEVELOPMENT EFFORTS THAT CONTRIBUTE TO THE ECONOMIC VITALITY OF OUR REGION. LASTLY, THE HOSPITAL ENGAGES COMMUNITIES IN COMING TOGETHER AND CREATING SOCIAL CONNECTIVITY THROUGH SUPPORT OF VARIOUS LOCAL EVENTS, FUNDRAISERS, AND OUTINGS, MANY OF WHICH INVOLVE PHYSICAL ACTIVITY AND SUPPORT ORGANIZATIONS THAT ENHANCE THE VIABILITY OF OUR COMMUNITIES.ESSENTIA HEALTH WEST IS A PART OF ESSENTIA HEALTH, AN INTEGRATED HEALTH SYSTEM WITH FACILITIES IN MINNESOTA, WISCONSIN, AND NORTH DAKOTA. AS A NON-PROFIT ORGANIZATION, ESSENTIA HEALTH REINVESTS SURPLUS REVENUES INTO MEDICAL TRAINING, PROGRAMS, AND TECHNOLOGY DESIGNED TO REDUCE THE RISK OF PREVENTABLE HARM TO OUR PATIENTS AND INCREASE THE HEALTH AND VITALITY OF THE COMMUNITIES WE SERVE.ESSENTIA HEALTH PROVIDES SERVICES PREDOMINANTLY IN RURAL COMMUNITIES AND IS COMMITTED TO ELIMINATING GEOGRAPHIC BARRIERS TO CARE. MANY OF ESSENTIA HEALTH'S CLINICS AND COMMUNITY HOSPITALS ARE LOCATED IN COMMUNITIES THAT ARE FEDERALLY RECOGNIZED AS BEING MEDICALLY UNDERSERVED. WE INVEST IN FACILITY UPGRADES, TECHNOLOGY, AND STAFFING THAT ENHANCE CARE IN THESE COMMUNITIES TO ENSURE PATIENTS CAN RECEIVE AS MUCH CARE AS POSSIBLE CLOSE TO HOME. THIS IS A VITAL COMPONENT OF COMMUNITY HEALTH IN AREAS WHERE RESIDENTS ARE OFTEN ELDERLY, LIVING ON LIMITED INCOMES, AND RESTRICTED IN THEIR TRANSPORTATION OPTIONS.RESIDENTS OF GEOGRAPHICALLY ISOLATED COMMUNITIES SERVED BY ESSENTIA HEALTH ALSO BENEFIT FROM TELEHEALTH SERVICES THAT PROVIDE LOCAL ACCESS TO SPECIALISTS AND SPECIALTY SERVICES USUALLY AVAILABLE ONLY IN LARGER URBAN AREAS. SERVICES ARE AVAILABLE IN MORE THAN 20 SPECIALTIES, RANGING FROM BEHAVIORAL HEALTH TO PHYSICAL, OCCUPATIONAL, AND SPEECH-LANGUAGE THERAPY. PATIENTS TREATED IN SMALLER ESSENTIA HEALTH EMERGENCY DEPARTMENTS BENEFIT FROM TELEHEALTH CONNECTIONS THAT ALLOW COMMUNITY HOSPITAL PHYSICIANS AND NURSES TO COMMUNICATE WITH TRAUMA AND OTHER SPECIALISTS LOCATED IN ESSENTIA HEALTH'S LARGER HOSPITALS. PATIENTS CAN ALSO STAY IN THEIR HOME FOR FOLLOW-UP VISITS WITH THEIR PRIMARY CARE PROVIDER OR SPECIALISTS, WHEN APPROPRIATE, WHICH ALLOWS THEM TO ACCESS THEIR PROVIDERS WITHIN THE COMFORT OF THEIR HOME. IN ADDITION, PATIENTS CAN RECEIVE THE CARE THEY NEED WHERE AND WHEN THEY WANT IT. ESSENTIA OFFERS 24/7 VIDEO VISITS ON DEMAND FOR URGENT NEEDS ANY TIME, ONLINE E-VISITS FOR COMMON CONDITIONS AND FREE MEDICAL ADVICE FROM OUR REGISTERED NURSES ANY TIME OF THE DAY OR NIGHT THROUGH OUR NURSE CARE LINE.WE FOLLOW CORE STANDARDS OF VALUE-BASED CARE ORGANIZATIONS, INCLUDING PATIENT-CENTERED PRIMARY CARE, ACCESS TO CARE, CARE COORDINATION, AND QUALITY IMPROVEMENT. PATIENT-CENTERED PRIMARY CARE ENCOMPASSES STRATEGIES AND SERVICES ORIENTED AROUND THE PATIENT TO ACHIEVE THEIR BEST HEALTH. IMPROVING PATIENTS' ACCESS TO CARE IS AN IMPORTANT FOCUS IN OUR POPULATION HEALTH PROGRAM. AT THE CORE OF PATIENT-CENTERED CARE IS THE CONNECTION VIA THE ELECTRONIC HEALTH RECORD (EHR). CLINICAL DATA REGISTRIES ARE CREATED TO INTEGRATE EHR AND PAYER DATA. THE REGISTRIES STRATIFY THE POPULATION, IDENTIFYING THOSE WITH THE HIGHEST LEVEL OF NEEDS. USING THIS INFORMATION, THE TEAM CAN ENGAGE WITH THE PATIENT TO DEVELOP AN INDIVIDUALIZED CARE MANAGEMENT PLAN AND CLOSE ANY CARE GAPS. OUR CARE TEAMS WORK TOGETHER TO DEVELOP PROGRAMS THAT ADDRESS THE NEEDS OF OUR PATIENTS, INCLUDING THOSE IN GOVERNMENT-BASED PROGRAMS AND THOSE PATIENTS AT HIGHER RISK FOR ADVERSE OUTCOMES. THESE EFFORTS RESULT IN IMPROVED HEALTH OUTCOMES, BETTER PATIENT EXPERIENCE, AND LOWER OVERALL UTILIZATION AND COST.MANY PATIENTS STRUGGLE TO MAINTAIN GOOD HEALTH DUE TO BARRIERS SUCH AS THE COST OF HEALTHY FOODS, HOUSING, TRANSPORTATION, AND UTILITY EXPENSES. TO ADDRESS THESE CHALLENGES, WE ROUTINELY ASK ALL PATIENTS ABOUT THEIR NEEDS IN THESE AREAS AND CONNECT THEM WITH COMMUNITY SERVICES THAT CAN HELP. IN THE PAST FISCAL YEAR, WE SCREENED OVER 200,000 PATIENTS ACROSS OUR SYSTEM FOR SOCIAL NEEDS DURING CLINIC VISITS OR HOSPITAL ADMISSIONS. PATIENTS WHO EXPRESS INTEREST IN RECEIVING SUPPORT ARE CONNECTED WITH EITHER A COMMUNITY HEALTH WORKER OR A SOCIAL WORKER.WE ALSO OFFER A PROGRAM CALLED "RESOURCEFUL," A PUBLIC RESOURCE DIRECTORY THAT CONNECTS COMMUNITY MEMBERS WITH THOUSANDS OF VERIFIED PROGRAMS PROVIDING FREE AND REDUCED-COST SERVICES. INFORMATION IS AVAILABLE AT WWW.WEARERESOURCEFUL.ORG. LAST YEAR, MORE THAN 15,000 PEOPLE USED THE WEBSITE, RESULTING IN 6,831 REFERRALS TO COMMUNITY-BASED ORGANIZATIONS. ADDITIONALLY, THROUGH VARIOUS COMMUNITY ENGAGEMENT ACTIVITIES, WE ADDED 346 NEW PROGRAMS TO THE DIRECTORY THIS YEAR.SINCE MOST HEALTH CARE COSTS ARE DIRECTLY RELATED TO CARING FOR PATIENTS WHO HAVE CHRONIC CONDITIONS, ESSENTIA HEALTH IS COMMITTED TO IMPROVING HEALTH OUTCOMES FOR PATIENTS, ESPECIALLY THOSE WITH CHRONIC DISEASES. FOR EXAMPLE, ESSENTIA HEALTH OFFERS ONE-ON-ONE IN PERSON TOBACCO CESSATION COUNSELING BY TRAINED SPECIALISTS AT OVER 20 SITES ACROSS MINNESOTA, WISCONSIN, AND NORTH DAKOTA. WE ALSO OFFER VIRTUAL TOBACCO CESSATION COUNSELING ACROSS OUR CARE AREA, FROM SMALL RURAL COMMUNITIES TO MORE URBAN LOCATIONS, OFTEN SERVING PEOPLE LIVING ON LOW AND MODERATE INCOMES. ESSENTIA HEALTH OFFERS DIABETES PREVENTION EDUCATION AND FALLS PREVENTION PROGRAMS IN OUR COMMUNITIES. THIS WORK HAS BEEN RECOGNIZED BY A NUMBER OF COMMENDATIONS AND AWARDS FROM GOVERNMENT AGENCIES. THESE COMMUNITY-BASED EFFORTS ARE FREE TO THE PUBLIC AND ALL INDIVIDUALS ARE WELCOME.ADDITIONALLY, ESSENTIA HEALTH SUPPORTS THE HEALTH OF OUR COMMUNITIES THROUGH ACTIVE RESEARCH AND CLINICAL TRIALS THROUGH THE ESSENTIA INSTITUTE OF RURAL HEALTH (EIRH). EIRH CONDUCTS CLINICAL, TRANSLATIONAL, AND HEALTH SERVICES RESEARCH WITH A PRIMARY FOCUS ON THE NEEDS OF RURAL AMERICANS. VARIOUS ESSENTIA HEALTH ORGANIZATIONS CONTRIBUTED APPROXIMATELY $3.8 MILLION IN SUPPORT TO EIRH DURING THE PAST YEAR. ESSENTIA HEALTH IS ALSO A PRIMARY SUPPORTER OF MEDICAL EDUCATION, PARTICULARLY IN THE AREA OF RURAL PRIMARY CARE. ESSENTIA HEALTH PHYSICIANS SERVE AS FACULTY AND PRECEPTORS FOR THE UNIVERSITY OF MINNESOTA SCHOOL OF MEDICINE IN DULUTH, MN. ESSENTIA HEALTH ALSO PROVIDES FUNDING, ADMINISTRATIVE SUPPORT, AND RESIDENCY OPPORTUNITIES FOR THE DULUTH FAMILY PRACTICE RESIDENCY PROGRAM. THIS PROGRAM IS VITAL IN ADDRESSING THE GROWING SHORTAGE OF PRIMARY CARE PHYSICIANS IN RURAL COMMUNITIES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:ESSENTIA HEALTH WEST IS PART OF ESSENTIA HEALTH, AN INTEGRATED HEALTH SYSTEM WITH 14 HOSPITALS, APPROXIMATELY 80 CLINICS, SIX LONG-TERM CARE FACILITIES, TWO ASSISTED LIVING FACILITIES, THREE INDEPENDENT LIVING FACILITIES, SEVERAL REHABILITATION CENTERS, SEVEN AMBULANCE SERVICES, 27 RETAIL PHARMACIES, ONE RESEARCH INSTITUTE, AND HOME HEALTH SERVICES IN THREE STATES: MINNESOTA, WISCONSIN, AND NORTH DAKOTA. ESSENTIA HEALTH SERVES A PREDOMINANTLY RURAL POPULATION WHOSE MEDIAN INCOMES GENERALLY FALL BELOW THE AVERAGES OF THE STATES WHERE THEY LIVE. THE PRESENCE OF OUR CLINICS AND HOSPITALS ENSURES THAT PEOPLE WITH FEW ECONOMIC RESOURCES DO NOT HAVE TO DRIVE AN HOUR OR MORE TO RECEIVE BASIC (AND IN SOME CASES LIFESAVING) MEDICAL CARE.IN ADDITION TO STAFFING HOSPITALS AND CLINICS IN FEDERALLY RECOGNIZED UNDERSERVED AREAS, ESSENTIA HEALTH SUPPORTS THE HEALTH OF COMMUNITIES THROUGH ACTIVE OUTREACH PROGRAMS THAT BRING ONCOLOGISTS, CARDIOLOGISTS, AND OTHERS INTO SMALL HOSPITALS AND CLINICS. ESSENTIA HEALTH'S SIZE AND INTEGRATED STRUCTURE ALSO ALLOW US TO EXTEND SERVICES LIKE CHEMOTHERAPY, WOUND CARE, AND HOSPICE CARE TO SMALLER COMMUNITIES.PATIENTS ARE ABLE TO TRAVEL SEAMLESSLY BETWEEN ESSENTIA HEALTH'S SMALLER COMMUNITY CLINICS AND ITS LARGER SPECIALTY CARE CENTERS THANKS TO SIGNIFICANT INVESTMENTS IN ELECTRONIC HEALTH RECORDS (EHRS). ALMOST EVERY ESSENTIA HEALTH HOSPITAL AND CLINIC IS LINKED TO THIS SYSTEM, ALLOWING CLINICIANS TO SHARE EVERYTHING FROM LAB RESULTS AND RADIOLOGY IMAGES TO NOTES ON CLINIC VISITS, HOSPITAL STAYS, AND SERVICES LIKE PHYSICAL REHABILITATION.THE EHR IS ALSO AN INCREASINGLY VALUABLE TOOL FOR PATIENTS AND THEIR FAMILIES, THANKS TO MYCHART, WHICH OFFERS PATIENTS SECURE, 24/7 ONLINE ACCESS TO THEIR MEDICAL RECORD. MYCHART ALSO ALLOWS PATIENTS TO CONTACT THEIR PHYSICIAN OR CLINIC, SCHEDULE APPOINTMENTS, AND ORDER MEDICATION REFILLS. THESE SERVICES ARE ALL OFFERED AT NO COST TO PATIENTS AND THEIR AUTHORIZED FAMILY, FRIENDS, AND CAREGIVERS.ESSENTIA HEALTH ALSO PROMOTES THE HEALTH OF ALL OF ITS COMMUNITIES THROUGH ADHERENCE TO EVIDENCE-BASED BEST PRACTICE STANDARDS AND CLINICAL QUALITY GOALS DESIGNED TO ENSURE THAT PATIENTS RECEIVE THE SAME HIGH STANDARD OF CARE AT ANY ESSENTIA HEALTH HOSPITAL OR CLINIC.THE ESSENTIA INSTITUTE OF RURAL HEALTH (EIRH) ACTIVELY SUPPORTS COMMUNITY HEALTH THROUGH ITS TRANSLATIONAL AND HEALTH SERVICES RESEARCH WITH A PRIMARY FOCUS ON THE NEEDS OF RURAL AMERICANS. EIRH ALSO SPONSORS A NUMBER OF CONFERENCES AND OTHER EDUCATIONAL EVENTS, OPEN TO ALL MEDICAL PROFESSIONALS IN THE REGION, TO ENSURE THAT RURAL CLINICIANS HAVE ACCESS TO CURRENT MEDICAL EDUCATION AND TRAINING CLOSE TO HOME.TELEHEALTH ALLOWS PATIENTS TO RECEIVE CARE FROM A SPECIALIST WHO IS NOT AVAILABLE IN THEIR HOME COMMUNITY. TELEHEALTH APPOINTMENTS TAKE PLACE IN LOCAL CLINICS OR HOSPITALS THROUGH SECURE INTERACTIVE VIDEOCONFERENCING. PATIENTS FEEL LIKE THEY ARE IN THE SAME ROOM AS THEIR DOCTOR. THIS EXPERIENCE OFFERS THE SAME HIGH-QUALITY CARE THAT PATIENTS EXPECT DURING AN IN-PERSON VISIT. TELEHEALTH CAN BE USED FOR SERVICES SUCH AS BEHAVIORAL HEALTH, CARDIOLOGY, STROKE CARE, PRIMARY CARE, AND ENDOCRINOLOGY/DIABETES CARE. IN ADDITION, PATIENTS CAN RECEIVE THE CARE THEY NEED WHERE AND WHEN THEY WANT IT. ESSENTIA OFFERS 24/7 VIDEO VISITS ON DEMAND FOR URGENT NEEDS ANY TIME, ONLINE E-VISITS FOR COMMON CONDITIONS AND FREE MEDICAL ADVICE FROM OUR REGISTERED NURSES ANY TIME OF THE DAY OR NIGHT THROUGH OUR NURSE CARE LINE.ESSENTIA HEALTH'S HOSPITALS AND CLINICS PLAY ADDITIONAL ROLES IN PROMOTING HEALTH WITHIN THEIR COMMUNITIES. EACH ESSENTIA HEALTH HOSPITAL CONDUCTS A COMMUNITY HEALTH ASSESSMENT TO DETERMINE THE UNIQUE HEALTH NEEDS OF COMMUNITY RESIDENTS. THESE ASSESSMENTS, WHICH ARE BASED ON INPUT FROM A BROAD RANGE OF COMMUNITY RESIDENTS AND STAKEHOLDERS, ARE THE BASIS FOR ACTION PLANS AIMED AT ADDRESSING THE COMMUNITY'S MOST PRESSING HEALTH NEEDS. MOST RECENTLY, TOPICS OF CONCERN HAVE INCLUDED ELIMINATING SOCIAL AND ECONOMIC BARRIERS TO HEALTH AND WELLNESS, IMPROVING MENTAL HEALTH SERVICES AND AWARENESS, ADDRESSING YOUTH SUBSTANCE ABUSE, FOOD INSECURITY, AND OBESITY. THESE ISSUES ARE THEN ADDRESSED THROUGH COLLABORATION WITH PRIVATE BUSINESSES, GOVERNMENT AGENCIES, AND OTHER NON-PROFITS.IN AN EFFORT TO HELP SOME OF OUR COMMUNITIES' AT-RISK POPULATIONS REMAIN AT HOME AND OUT OF THE HOSPITAL OR NURSING HOME, ESSENTIA HEALTH HAS COMMUNITY PARAMEDIC PROGRAMS IN FARGO, ND, AS WELL AS BRAINERD, DETROIT LAKES, DEER RIVER, VIRGINA AND ADA, MN. PARAMEDICS MAKE HOUSE CALLS TO PATIENTS WHO HAVE BEEN IDENTIFIED AS AT RISK FOR EMERGENCY DEPARTMENT VISITS. DURING THE CALLS, THEY TAKE VITAL SIGNS, ASSESS POSSIBLE HEALTH AND SAFETY RISKS, AND DETERMINE IF PATIENTS MAY BENEFIT FROM ADDITIONAL COMMUNITY RESOURCES.ESSENTIA HEALTH EMPLOYEES CONTRIBUTE DIRECTLY TO THE HEALTH AND WELLNESS OF THEIR COMMUNITIES BY VOLUNTEERING IN PROGRAMS RANGING FROM HABITAT FOR HUMANITY TO UNITED WAY TO FOOD AND CLOTHING DRIVES. THEY ARE ACTIVE FUNDRAISERS FOR HEALTH-RELATED ORGANIZATIONS IN THEIR COMMUNITIES, LIKE LOCAL CHAPTERS OF THE AMERICAN HEART ASSOCIATION. ESSENTIA HEALTH ENCOURAGES AND SUPPORTS THESE VOLUNTEER EFFORTS IN A VARIETY OF WAYS, INCLUDING SPONSORSHIPS, FINANCIAL CONTRIBUTIONS, AND VOLUNTEER RECOGNITION.WE ALSO SUPPORT COMMUNITY HEALTH THROUGH CONTRIBUTIONS THAT FOCUS ON PROGRAMS AND SERVICES THAT BENEFIT THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. SOME EXAMPLES OF THESE PROGRAMS ARE FARMERS MARKETS, COMMUNITY GARDENS, WORKFORCE DEVELOPMENT PROGRAMS, AND TRANSPORTATION ACCESS PROGRAMS. PART VI, LINE 7: LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT:N/A 1 ABUSED ADULT RESOURCE CENTER 218 W BROADWAY AVE BISMARCK ND 58501 450363127 501(C)3 5200 0 PROGRAM SUPPORT BIO GIRLS 556 LIZZIE PLACE EAST WEST FARGO ND 58078 810792142 501(C)3 20500 0 PROGRAM SUPPORT CASS CLAY COMMUNITY LAND TRUST 109 1/2 BROADWAY NORTH 203 FARGO ND 58102 834077611 501(C)3 10000 0 PROGRAM SUPPORT CULTURAL DIVERSITY RESOURCES 112 N UNIVERSITY D STE 306 FARGO ND 58102 411896836 501(C)3 8000 0 PROGRAM SUPPORT ESSENTIA HEALTH FOUNDATION 502 E 2ND ST DULUTH MN 55805 271984704 501(C)3 673856 0 PROGRAM SUPPORT FAITH4HOPE SCHOLARSHIP FUND 1321 19TH AVE N FARGO ND 58102 814085396 501(C)3 7800 0 PROGRAM SUPPORT GREATER FARGO MOORHEAD ECONOMIC DEVELOPMENT CORPORATION 51 BROADWAY SUITE 500 FARGO ND 58102 456011769 501(C)3 10000 0 PROGRAM SUPPORT HOUSE OF EVERYDAY LEARNING 3001 11TH ST S FARGO ND 58103 262143138 501(C)3 7500 0 PROGRAM SUPPORT NORTH DAKOTA DENTAL FOUNDATION 4141 28TH AVE S FARGO ND 58104 363487515 501(C)3 10000 0 PROGRAM SUPPORT SOUP CAFE 220 N 23RD ST BISMARCK ND 58501 264411573 501(C)3 5100 0 PROGRAM SUPPORT UNITED WAY OF CASS CLAY PO BOX 1609 FARGO ND 58107 410810008 501(C)3 25000 0 PROGRAM SUPPORT 11 0 SCHOLARSHIPS 75 73000 FMV PAYMENTS MADE DIRECTLY TO UNIVERSITIES PART I, LINE 2: PROCEDURES FOR MONITORING GRANTS: ESSENTIA HEALTH WEST PROVIDES GRANT MONIES TO NON-PROFIT ORGANIZATIONS, SCHOOLS, CIVIC ORGANIZATIONS, GOVERNMENT ENTITIES AND FAITH-BASED ORGANIZATIONS THAT DEMONSTRATE THE MISSION OR VALUES OF ESSENTIA HEALTH. A COMMUNITY CONTRIBUTIONS COMMITTEE IS RESPONSIBLE FOR REVIEWING AND DISTRIBUTING A POOL OF FUNDS DEDICATED TO COMMUNITY BENEFITS. GRANT RECIPIENTS ARE REQUIRED TO SUBMIT A FINAL REPORT WITHIN ONE YEAR OF RECEIVING FUNDS. CONTRIBUTIONS TO THE ESSENTIA HEALTH FOUNDATION, A RELATED ORGANIZATION, ARE MADE TO COVER THEIR OPERATING EXPENSES. ESSENTIA HEALTH WEST MAY ALSO MAKE DESIGNATED DONATIONS TO THE ESSENTIA HEALTH FOUNDATION'S UNRESTRICTED FUND. ADDITIONALLY, ESSENTIA HEALTH WEST PROVIDES SCHOLARSHIPS TO GRADUATING HIGH SCHOOL SENIORS GOING INTO THE MEDICAL FIELD. SEPARATE SCHOLARSHIP COMMITTEES EXIST FOR EACH HIGH SCHOOL WITHIN ESSENTIA HEALTH WEST'S SERVICE AREA. SCHOLARSHIP WINNERS ARE SELECTED BY THE SCHOLARSHIP COMMITTEES BASED ON FINANCIAL NEED, GRADE POINT AVERAGE, AND VOLUNTEERISM. X X 1 1 X X X X 1 1 0 0 0 0 0 0 1 1 ADAM STIBBE MD PHYSICIAN & SECTION CHAIR 1688689 0 0 0 1026 0 26400 0 40693 0 1756808 0 0 0 BENJAMIN SMITH MD BOARD DIRECTOR & PHYSICIAN 1621410 4500 0 0 1140 0 26400 0 46148 0 1695098 4500 0 0 DANIEL SMITH MD PHYSICIAN 1473537 0 0 0 9144 0 26400 0 37204 0 1546285 0 0 0 KIMBERLY KOLKHORST MD PHYSICIAN & SECTION CHAIR 1471294 0 0 0 1096 0 23256 0 40463 0 1536109 0 0 0 JEROME SAMPSON MD PHYSICIAN 1464168 0 0 0 9888 0 23910 0 25439 0 1523405 0 0 0 SCOTT REARDON MD PHYSICIAN 1415375 0 0 0 1140 0 26400 0 44751 0 1487666 0 0 0 WILLIAM HEEGAARD MD FORMER PRESIDENT 182514 510017 25000 150228 3534 7951 120532 19988 12961 29397 344541 717581 0 0 TRACI MORRIS TREASURER/REL ORG CHIEF FINCL OFF 0 669563 0 146723 0 83904 0 123590 0 2262 0 1026042 0 63527 RICHARD VETTER MD INTERIM PRES THRU 8/23/CMO 557980 0 104855 0 63137 0 90376 0 41172 0 857520 0 44511 0 AL HURLEY CHIEF OPERATING OFFICER 437036 0 98285 0 205738 0 85036 0 26176 0 852271 0 184950 0 ALAN BRUNS MD FORMER KE/PHYSICIAN & DIVISION CHAIR 787599 0 0 0 5324 0 26400 0 5332 0 824655 0 0 0 ROBERT GREEN FORMER VICE PRESIDENT, FINANCE 0 528350 0 105198 0 11484 0 100969 0 39078 0 785079 0 0 MICHAEL WATTERS SECRETARY/REL ORG CHIEF LEGAL OFF 0 489927 0 111318 0 44753 0 93066 0 39589 0 778653 0 28999 JOSHUA GEBUR MD FORMER KE/PHYSICIAN & DIVISION CHAIR 642852 0 0 0 711 0 26400 0 39446 0 709409 0 0 0 STEFANIE GEFROH ELLISON MD INTERIM CMO THRU 8/23/PHY & DIV CHAI 484549 0 0 0 4450 0 26400 0 42280 0 557679 0 0 0 TANYA DIEGEL MD FORMER KE/PHYSICIAN & DIVISION CHAIR 479479 0 0 0 895 0 26400 0 38798 0 545572 0 0 0 ANDREW MOEN MD FORMER KE/PHYSICIAN & DIVISION CHAIR 464000 0 0 0 476 0 26400 0 37077 0 527953 0 0 0 TANNER GOODRICH SENIOR VICE PRESIDENT, OPERATIONS 318475 0 72194 0 1242 0 66256 0 30048 0 488215 0 0 0 TAYLOR MERTZ MD BD DIRECTOR/PHYSICIAN & SEC CHAIR 350856 0 0 0 363 0 26308 0 39539 0 417066 0 0 0 DOUG ARVIN VICE PRESIDENT, FINANCE 327597 0 32188 0 11663 0 0 0 13718 0 385166 0 0 0 RAE SALUS SENIOR VP, OPERATIONS THRU 6/23 161024 0 0 0 161186 0 12997 0 12592 0 347799 0 0 0 MICHELE THIEMAN MD FORMER KE/PHYSICIAN & DIVISION CHAIR 299681 0 0 0 403 0 24177 0 13278 0 337539 0 0 0 JAMES CHRISTENSEN MD BOARD DIRECTOR & PHYSICIAN 273739 3375 0 0 2033 0 22434 0 25133 0 323339 3375 0 0 MARK THOMPSON MD PRESIDENT 184312 0 50000 0 24081 0 37334 0 10137 0 305864 0 0 0 MICHELLE STENBECK CHIEF NURSING OFFICER THRU 1/24 238488 0 28594 0 990 0 0 0 16014 0 284086 0 0 0 JOSEPH WENDT FORMER KE/VP, ADMINISTRATOR 222302 0 0 0 910 0 11776 0 40291 0 275279 0 0 0 KERRY CARLSON FORMER KE/OPERATIONS SNR DIRECTOR 213181 0 0 0 879 0 11262 0 39949 0 265271 0 0 0 DAN BEAUCHAMP FORMER KE/FACILITIES SNR DIRECTOR 174715 0 0 0 7115 0 9623 0 38470 0 229923 0 0 0 CHRISTY BRINKMAN FORMER KE/OPERATIONS SNR DIRECTOR 0 189895 0 0 0 257 0 9562 0 2671 0 202385 0 0 SUZANNE ZELTINGER OPERATIONS SENIOR DIRECTOR 167447 0 0 0 299 0 7517 0 7825 0 183088 0 0 0 TIMOTHY SAYLER FORMER CHIEF OPERATING OFFICER 0 0 0 0 116149 0 0 0 0 0 116149 0 0 0 PART I, LINE 1A BENEFITS PROVIDED: DURING CALENDAR YEAR 2023, CHARTER TRAVEL WAS USED BY ONE DIRECTOR, TWO OFFICERS, THREE KEY EMPLOYEES, AND ONE FORMER OFFICER FOR TRAVEL BETWEEN ESSENTIA HEALTH WEST AND OTHER ORGANIZATIONS. THE USE OF CHARTER TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION TO THESE INDIVIDUALS AS ALL TRAVEL WAS BUSINESS RELATED. DURING CALENDAR YEAR 2023, OFFICER MARK THOMPSON, MD RECEIVED A HOUSING ALLOWANCE. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION. PART I, LINE 3 ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA HEALTH WEST'S PRESIDENT'S COMPENSATION: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B SEVERANCE PAYMENT: KEY EMPLOYEE RAE SALUS RECEIVED PAYMENTS TOTALING $157,542 IN CALENDAR YEAR 2023 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, SALUS WILL RECEIVE PAY TOTALING $480,012 & BENEFITS TOTALING $17,362 FROM JUNE 20, 2023 TO DECEMBER 20, 2024. ALL OTHER INDIVIDUALS LISTED AS FORMERS IN FORM 990, PART VII, SECTION A, LINE 1A DID NOT RECEIVE A SEVERANCE PAYMENT DURING CALENDAR YEAR 2023. SOME OF THESE INDIVIDUALS REMAIN EMPLOYED WITHIN ESSENTIA HEALTH AND ITS SUBSIDIARIES. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ESSENTIA HEALTH'S NONQUALIFIED RETIREMENT PLAN IS OFFERED TO DESIGNATED ESSENTIA HEALTH EXECUTIVES. THERE IS A MINIMUM FOUR YEAR VESTING DATE, OR VESTING IS AUTOMATIC UPON REACHING RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. BENEFITS ARE SUBJECT TO INCOME TAXES UPON VESTING AND PAYABLE FROM ESSENTIA HEALTH'S GENERAL ASSETS. REPORTED AS OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B (III), THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A RECEIVED PAYMENT OF THE VESTED BENEFIT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: TRACI MORRIS $79,902 RICHARD VETTER, MD $52,278 AL HURLEY $195,546 MICHAEL WATTERS $33,314 REPORTED AS RETIREMENT AND OTHER DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C, ESSENTIA HEALTH MADE CONTRIBUTIONS, SUBJECT TO THE VESTING TERMS, DURING THE YEAR INTO THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A: WILLIAM HEEGAARD, MD $103,603 TRACI MORRIS $97,190 RICHARD VETTER, MD $63,976 AL HURLEY $59,141 ROBERT GREEN $74,569 MICHAEL WATTERS $68,732 TANNER GOODRICH $39,935 MARK THOMPSON, MD $37,334 PART I, LINE 8 INITIAL CONTRACT EXCEPTION: ESSENTIA HEALTH WEST'S VICE PRESIDENT OF FINANCE, DOUG ARVIN, ITS PRESIDENT, MARK THOMPSON, MD, AND ITS CHIEF NURSING OFFICER, MICHELLE STENBECK, RECEIVED COMPENSATION DURING THE YEAR UNDER INITIAL EMPLOYMENT AGREEMENTS SUBJECT TO THE INITIAL CONTRACT EXCEPTION. THROUGH THE ESSENTIA HEALTH EXECUTIVE COMPENSATION COMMITTEE, THESE COMPENSATION ARRANGEMENTS WERE REVIEWED AND APPROVED BY INDEPENDENT PERSONS USING COMPARABILITY DATA; DELIBERATIONS AND DECISIONS WERE DOCUMENTED. A DULUTH ECONOMIC DEVELOPMENT AUTHORITY 900848286 26444CHF2 2018-11-01 704253406 SRS 2018A (SEE PART VI) 0 0 0 B CASS COUNTY NORTH DAKOTA 456002205 148047BF9 2018-11-01 42050194 SRS 2018B (SEE PART VI) 0 0 0 C CASS COUNTY NORTH DAKOTA 456002205 000000000 2020-02-18 61320000 SRS 2020A (SEE PART VI) 0 0 0 D WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 000000000 2020-02-18 13095000 SRS 2020B (SEE PART VI) 0 0 0 A 27710387 239569 27470818 2023 1 0 1 1 B 42050194 380994 41669200 2018 1 0 1 1 C 15103729 54188 15049541 2020 1 0 1 1 D 3225430 29557 3195873 2020 1 0 1 1 A 0 0 1 0 0 0 0 1 B 0 0 1 0 0 0 0 1 C 0 0 1 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 0 0 1 0 0 1 SEE PART VI 1 1 1 B 0 0 0 1 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: DULUTH ECONOMIC DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2023 ISSUER NAME: CASS COUNTY, NORTH DAKOTA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2023 ISSUER NAME: BURLEIGH COUNTY, NORTH DAKOTA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2024 SCHEDULE K: ADDITIONAL INFORMATION/COMMENTS RELATING TO THE REPORTING OF LIABILITIES BY RELATED ORGANIZATIONS: ESSENTIA HEALTH HAS AN OBLIGATED GROUP CREATED UNDER THE MASTER TRUST INDENTURE WHICH IS COMPOSED OF THE FOLLOWING MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, ST. MARY'S INNOVIS HEALTH, THE DULUTH CLINIC, LTD. AND ESSENTIA HEALTH WEST (THE "OBLIGATED GROUP MEMBERS"). THE OBLIGATED GROUP MEMBERS ARE JOINTLY AND SEVERALLY OBLIGATED ON ALL INDEBTEDNESS EVIDENCED OR SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. SERIES 2018A: THE SERIES 2018A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2018A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH DULUTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2018B: THE SERIES 2018B BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH EAST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH DULUTH, AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2018B BONDS. THE CONDUIT BORROWER ESSENTIA HEALTH WEST HAS RECORDED THE BOND LIABILITY ON ITS BALANCE SHEET WHICH IS CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020A: THE SERIES 2020A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020B: THE SERIES 2020B BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020B BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020C: THE SERIES 2020C BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020C BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2023A: THE SERIES 2023A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2023A BONDS. THE CONDUIT BORROWER ESSENTIA HEALTH WEST HAS RECORDED THE BOND LIABILITY ON ITS BALANCE SHEET WHICH IS CONSOLIDATED WITH ESSENTIA HEALTH. SCHEDULE K, PART 1, COLUMN (F): DESCRIPTION OF PURPOSE: SERIES 2018A: ACQUIRE, CONSTRUCT, BUILD, AND EQUIP MEDICAL CAMPUS PROJECT IN DULUTH, MN; REFUND SERIES 2008E BONDS ISSUED MAY 2, 2008 TO REFINANCE SERIES 1997 BONDS ISSUED DECEMBER 18, 1997 TO FINANCE EQUIPMENT PURCHASES IN DULUTH, MN AND FINANCE PROPERTY ACQUISITIONS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN NORTHERN MINNESOTA; AND REFUND SERIES 2014 BONDS ISSUED JULY 29, 2014 TO REFINANCE PRIOR NOTE USED FOR CAPITAL IMPROVEMENTS TO SKILLED NURSING FACILITY LOCATED IN DETROIT LAKES, MN AND VARIOUS CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN BAXTER, FRAZEE, AND PELICAN RAPIDS, MN AND FINANCE CAPITAL EXPENDITURES TO REPLACE THE CHILLER UNIT FOR ESSENTIA HEALTH VIRGINIA, RENOVATE APPROXIMATELY 118,000 SQUARE FEET OF CLINIC SPACE FOR ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, REMODEL AND EQUIP EXISTING CLINIC SPACE IN EMILY, MN FOR ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, AND EXPAND AND REMODEL THE IMAGING AREA IN THE EMERGENCY ROOM OF ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES' HOSPITAL. SERIES 2018B: REFUND SERIES 2014 BONDS ISSUED JUNE 30, 2014 TO FINANCE CONSTRUCTING AND EQUIPPING 125,000 SQUARE FOOT EXPANSION TO IN-PATIENT HOSPITAL FACILITIES LOCATED IN FARGO, ND AND RELATED REMODELING. SERIES 2020A: REFUND SERIES 2008A BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFINANCE A PORTION OF THE ACQUISITION OF CERTAIN ASSETS OF ESSENTIA HEALTH WEST IN CONNECTION WITH THE AFFILIATION OF ESSENTIA HEALTH WITH ESSENTIA HEALTH WEST. SERIES 2020B: REFUND SERIES 2008B BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 1999B BONDS ISSUED MAY 18, 1999 FOR CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN SUPERIOR, WI AND VARIOUS DULUTH CLINIC LOCATIONS IN NORTHWESTERN WISCONSIN. SERIES 2020C: REFUND SERIES 2008C BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 2004 BONDS ISSUED MARCH 19, 2004 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN DULUTH, BRAINERD, AND DETROIT LAKES, MN AND REFUND SERIES 1999A BONDS ISSUED MAY 18, 1999 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN BRAINERD, DETROIT LAKES AND DULUTH, MN AND VARIOUS DULUTH CLINIC SITES IN NORTHERN MINNESOTA. SERIES 2023A: ACQUIRE CERTAIN HEALTH FACILITIES IN BISMARCK, ND. SCHEDULE K, PART II, LINE 3: ISSUE PRICE: SERIES 2018A, 2018B, 2020A, 2020B, 2020C, AND 2023A BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. THE ISSUE PRICE LISTED IN ESSENTIA HEALTH WEST'S SCHEDULE K, PART I, COLUMN (E) REPRESENTS THE ESSENTIA HEALTH OBLIGATED GROUP'S TOTAL BORROWING. SCHEDULE K, PART II, LINES 3 THROUGH 12: PROCEEDS: SERIES 2018A, 2018B, 2020A, 2020B, 2020C, AND 2023A BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. A PORTION OF THE SERIES 2018A, 2018B, 2020A, 2020B, 2020C, AND 2023A BORROWINGS WERE ALLOCATED TO ESSENTIA HEALTH WEST, AN ESSENTIA HEALTH OBLIGATED GROUP MEMBER. THE PROCEEDS LISTED IN ESSENTIA HEALTH WEST'S SCHEDULE K, PART II, LINES 3 THROUGH 12 REPRESENT ESSENTIA HEALTH WEST'S ALLOCATED PORTION OF THE PROCEEDS. SCHEDULE K, PART IV, LINE 5B: NAME OF PROVIDER OF GIC: NATIXIS FUNDING CORP & THE TORONTO-DOMINION BANK A DULUTH ECONOMIC DEVELOPMENT AUTHORITY 900848286 000000000 2020-02-18 116955000 SRS 2020C (SEE PART VI) 0 0 0 B BURLEIGH COUNTY NORTH DAKOTA 456002204 000000000 2023-06-22 21265000 SRS 2023A (SEE PART VI) 0 0 0 A 13635722 28807187 177343 28629844 2020 1 0 1 1 B 21265000 291616 20973384 2023 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 1 0 0 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 A 1 B 1 GREGORY SPERLE MD RELATED TO MICHELE THIEMAN, MD 131340 COMPENSATION OF FAMILY MEMBER OF FORMER KEY EMPLOYEE 0 FORM 990, PART V, LINE 1A: 1099 REPORTING: VENDOR PAYMENTS AND FORM 1099S WERE PROCESSED THROUGH ESSENTIA HEALTH ON BEHALF OF THE LEGAL ENTITIES COMPRISING ESSENTIA HEALTH. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: DURING THE FISCAL YEAR ENDED JUNE 30, 2024, THE OPERATING AGREEMENT OF ESSENTIA HEALTH WEST WAS AMENDED TO MODIFY THE COMPOSITION OF THE BOARD OF MANAGERS TO CONSIST OF NO MORE THAN FIFTEEN VOTING MANAGERS INCLUDING UP TO THREE PHYSICIAN MEMBERS, AT LEAST TWO OF WHOM ARE ESSENTIA HEALTH EMPLOYED PHYSICIANS; ONE BENEDICTINE SISTER OF ST. SCHOLASTICA MONASTERY OF DULUTH (SSMD) OR A NOMINEE OF SSMD; AND THE REMAINING VOTING MEMBERS BROADLY REPRESENTING ESSENTIA HEALTH WEST'S SERVICE AREA. THE OPERATING AGREEMENT WAS AMENDED TO MODIFY THE SECRETARY TO BE THE ESSENTIA HEALTH CHIEF LEGAL OFFICER AND THE TREASURER TO BE THE ESSENTIA HEALTH CHIEF FINANCIAL OFFICER. THE OPERATING AGREEMENT WAS ALSO AMENDED TO CLARIFY AND UPDATE THE RESERVED POWERS AND RIGHTS OF ESSENTIA HEALTH AND THE BENEDICTINE SISTERS OF SSMD. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF ORGANIZATION: ESSENTIA HEALTH IS THE SOLE MEMBER OF ESSENTIA HEALTH WEST AND MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7A. ESSENTIA HEALTH AND THE BENEDICTINE SISTERS OF ST. SCHOLASTICA MONASTERY OF DULUTH HAVE RESERVED POWERS WITH RESPECT TO ESSENTIA HEALTH WEST AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7B. FORM 990, PART VI, SECTION A, LINE 7A MEMBER WITH RIGHT TO ELECT GOVERNING BODY: ESSENTIA HEALTH HAS THE POWER TO APPOINT AND REMOVE ESSENTIA HEALTH WEST'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS WITH RIGHT TO APPROVE GOVERNING BODY DECISION: ESSENTIA HEALTH SHALL HAVE THE FOLLOWING RESERVED POWERS, FOR THE PURPOSES OF SERVING AS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTH CARE NETWORK THAT INCLUDES ALL ENTITIES THAT ARE OWNED OR CONTROLLED, DIRECTLY OR INDIRECTLY, BY ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"): (A) STRATEGIC AND BUSINESS PLANS. AUTHORITY TO CREATE, APPROVE AND AMEND THE COMPANY'S STRATEGIC AND BUSINESS PLANS. (B) MISSION. AUTHORITY TO CREATE, APPROVE AND AMEND THE COMPANY'S MISSION, PURPOSE AND VISION STATEMENTS. (C) DEBT. APPROVAL OF THE INCURRENCE OF DEBT AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE COMPANY'S ASSETS IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE MEMBER'S BOARD OF DIRECTORS, AND THE AUTHORITY TO CAUSE THE COMPANY TO PARTICIPATE IN SYSTEM BORROWING. (D) GOVERNING INSTRUMENTS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AMENDMENTS TO THE COMPANY'S CERTIFICATE OF FORMATION AND OPERATING AGREEMENT. (E) APPOINTMENT AND REMOVAL OF DIRECTORS. AUTHORITY TO APPOINT AND REMOVE ALL MANAGERS ON THE COMPANY'S BOARD, WITH OR WITHOUT CAUSE. (F) MERGERS, AFFILIATIONS, AND DISSOLUTION. AUTHORITY TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AFFILIATIONS, JOINT VENTURES, OTHER ALLIANCES WITH THIRD PARTIES, AND DISSOLUTION OF THE COMPANY. (G) TRANSFER OF ASSETS WITHIN THE SYSTEM. AUTHORITY TO TRANSFER THE COMPANY'S ASSETS, INCLUDING CASH, BETWEEN AND AMONG ENTITIES WITHIN THE SYSTEM; PROVIDED, HOWEVER, THAT THE MEMBER SHALL NOT HAVE AUTHORITY TO REQUIRE THE COMPANY TO TRANSFER ASSETS THAT WOULD CAUSE IT TO BE IN DEFAULT OF ITS COVENANTS OR OBLIGATIONS UNDER ANY BOND OR OTHER FINANCING DOCUMENTS. (H) TRANSFER OF ASSETS OUTSIDE THE SYSTEM. AUTHORITY TO CAUSE, AND TO APPROVE, THE SALE, LEASE OR OTHER TRANSFER OF THE COMPANY'S ASSETS TO PARTIES OUTSIDE OF THE SYSTEM WHEN THE ASSETS' VALUE EXCEEDS THE SINGLE OR AGGREGATE LIMITS PRESCRIBED IN WRITING BY THE MEMBER'S BOARD OF DIRECTORS. (I) SERVICES. AUTHORITY TO CAUSE, AND TO APPROVE, THE OFFERING OR DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS BY THE COMPANY. (J) BUDGETS. APPROVAL OF THE COMPANY'S CAPITAL AND OPERATING BUDGETS. (K) PROFESSIONAL SERVICES. SELECTION OF THE COMPANY'S GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS. (L) CORPORATE ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL CORPORATE ACQUISITIONS BY THE COMPANY. (M) MARKETING. THE COMPANY'S PARTICIPATION IN SYSTEM-WIDE MARKETING AND PROMOTIONAL ACTIVITIES. (N) COMPLIANCE PLANS. AUTHORITY TO CREATE, APPROVE AND AMEND THE COMPANY'S COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS. (O) QUALITY PLAN. AUTHORITY TO CREATE, APPROVE AND AMEND THE COMPANY'S QUALITY PLAN. (P) NON-BUDGETED PURCHASES. APPROVAL OF NON-BUDGETED CAPITAL PURCHASES AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE MEMBER'S BOARD OF DIRECTORS. (Q) HUMAN RESOURCES. AUTHORITY TO CREATE, APPROVE AND AMEND THE COMPANY'S HUMAN RESOURCE POLICIES AND PROCEDURES. (R) SYSTEM COMPENSATION. AUTHORITY, ON BEHALF OF THE COMPANY, TO DEVELOP AND IMPLEMENT COMPENSATION STRATEGIES, POLICIES AND PROCEDURES ON A SYSTEM-WIDE BASIS. THE BENEDICTINE SISTERS OF ST. SCHOLASTICA MONASTERY OF DULUTH OR ITS CANONICALLY AUTHORIZED SUCCESSOR (COLLECTIVELY, "SSMD") HOLD CERTAIN RESERVED POWERS OVER ESSENTIA HEALTH WEST. SSMD HAS THE RESERVED POWER TO APPROVE ANY AMENDMENTS TO ESSENTIA HEALTH WEST'S GOVERNING DOCUMENTS THAT WOULD ALTER THE NUMBER OF SSMD REPRESENTATIVES SERVING ON THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE 2023 FORM 990, INCLUDING ALL SCHEDULES, WAS REVIEWED BY MANAGEMENT AND THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. THE FINANCE LEADER REVIEWED THE FORM AND SCHEDULES AND ANY QUESTIONS WERE DISCUSSED. EACH CURRENT DIRECTOR OF THE GOVERNING BODY RECEIVED A FINAL COPY OF THE 2023 FORM 990. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCING CONFLICT OF INTEREST POLICY: ESSENTIA HEALTH'S COMPREHENSIVE CONFLICT OF INTEREST PROGRAM PREVENTS, DETECTS, AND RESOLVES ACTUAL CONFLICTS OF INTERESTS OR THE ACTUAL OR POTENTIAL APPEARANCE OF SUCH. FIDUCIARIES, DEFINED AS AN ESSENTIA HEALTH BOARD MEMBER/TRUSTEE, OFFICER, BOARD COMMITTEE MEMBER, SENIOR MANAGEMENT EMPLOYEE, OR ANY OTHERS CONSIDERED TO BE IN A POSITION OF INFLUENCE, ARE COVERED UNDER ESSENTIA HEALTH'S CONFLICT OF INTEREST PROGRAM. UPON INITIAL APPOINTMENT, EACH FIDUCIARY MUST COMPLETE AN INITIAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AT THE CONCLUSION OF EACH CALENDAR YEAR, EACH FIDUCIARY MUST COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AS NEEDED, A FIDUCIARY WILL UPDATE THEIR MOST RECENTLY COMPLETED QUESTIONNAIRE EACH TIME THE FIDUCIARY BECOMES AWARE OF A FINANCIAL INTEREST, A POTENTIAL CONFLICT, OR CHANGE TO ANY INFORMATION THAT THE FIDUCIARY PREVIOUSLY REPORTED. ESSENTIA HEALTH'S CHIEF COMPLIANCE OFFICER WILL COLLECT THE QUESTIONNAIRES AND EVALUATE THE DISCLOSURES. IF A FIDUCIARY HAS A POTENTIAL CONFLICT OF INTEREST, THE CHIEF COMPLIANCE OFFICER OR THEIR DESIGNEE MAY REQUEST ADDITIONAL INFORMATION FROM THE FIDUCIARY, THE MANAGEMENT TEAM, AND OTHERS. DURING THE EVALUATION PROCESS, THE CHIEF COMPLIANCE OFFICER MAY ALSO CONSULT WITH ESSENTIA HEALTH'S BOARD AND AUDIT COMMITTEE CHAIRS, SENIOR MANAGEMENT, LEGAL DEPARTMENT, OR APPROPRIATE REPRESENTATIVES FROM ESSENTIA HEALTH. THE CHIEF COMPLIANCE OFFICER REPORTS TO THE ESSENTIA HEALTH AUDIT COMMITTEE AND THE ESSENTIA HEALTH BOARD OF DIRECTORS ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY THE FIDUCIARY, ALONG WITH RECOMMENDED ACTIONS. THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) WILL THEN DETERMINE WHETHER TO APPROVE THE SITUATION OR TO IMPLEMENT SPECIAL CONTROLS TO MANAGE THE POTENTIAL CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER WILL THEN OFFICIALLY NOTIFY THE FIDUCIARY IN WRITING OF THE BOARD'S DECISION. THE DECISION OF WHETHER OR NOT THE DISCLOSURE CONSTITUTES A CONFLICT WILL BE AT THE ESSENTIA HEALTH BOARD OF DIRECTOR'S (OR DESIGNEE) SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF ESSENTIA HEALTH AND ITS AFFILIATE(S) AND THE ADVANCEMENT OF ITS PURPOSES. WHEN THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) CONSIDERS A FIDUCIARY'S DISCLOSURE AS A CONFLICT OF INTEREST, SPECIAL CONTROLS WILL BE IDENTIFIED TO MANAGE, ELIMINATE OR REDUCE THE LIKELIHOOD AND/OR APPEARANCE OF A CONFLICT ARISING. CONTROLS MAY INCLUDE, BUT ARE NOT LIMITED TO: A. IF THE CONFLICT INVOLVES AN ON-GOING MATTER OR RELATIONSHIP, THE FIDUCIARY MUST NOT PARTICIPATE IN BOARD, BOARD COMMITTEE, OR MANAGEMENT DISCUSSIONS RELATED TO THE CONFLICT AND MUST RECUSE THEMSELVES AND, IF APPROPRIATE, WITHDRAW FROM ANY BOARD MEETING OR PORTION THEREOF WHERE THE MATTER IS BEING DISCUSSED AND DURING THE VOTE ON THE POTENTIAL CONFLICT OF INTEREST. THE FIDUCIARY MAY ANSWER QUESTIONS AT THE BOARD'S OR THE BOARD COMMITTEE'S REQUEST. B. IF THE CONFLICT INVOLVES A SPECIFIC TRANSACTION OR DECISION, THE FIDUCIARY WILL FULLY DISCLOSE THEIR INTEREST AND ALL RELATED MATERIAL FACTS. THE BOARD OR COMMITTEE OF THE BOARD WILL DETERMINE WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO ESSENTIA HEALTH OR ITS AFFILIATE(S). IF THE BOARD DETERMINES A CONFLICT DOES NOT EXIST, THE FIDUCIARY MAY PROCEED WITH THE TRANSACTION; HOWEVER, THEY WILL NOT BE ELIGIBLE TO VOTE ON RELATED ISSUES SHOULD THEY ARISE. IF THE BOARD DETERMINES A CONFLICT DOES EXIST, THE FIDUCIARY WILL BE NOTIFIED OF THE DECISION REGARDING WHETHER THE CONTEMPLATED TRANSACTION WILL BE AUTHORIZED AS JUST, FAIR, AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION: THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF ESSENTIA HEALTH'S BOARD OF DIRECTORS IS AUTHORIZED TO FULFILL THE BOARD'S RESPONSIBILITIES REGARDING EXECUTIVE COMPENSATION CONSISTENT WITH ESSENTIA'S MISSION, VALUES AND TAX-EXEMPT STATUS, AND THE EXECUTIVE COMPENSATION COMMITTEE'S CHARTER. THE EXECUTIVE COMPENSATION COMMITTEE MEETS AT LEAST TWICE ANNUALLY TO CARRY OUT ITS RESPONSIBILITIES, WHICH INCLUDE, BUT ARE NOT LIMITED TO, ESTABLISHING, REVIEWING AND MODIFYING, AS APPROPRIATE, REASONABLE COMPENSATION AND BENEFITS FOR DESIGNATED ESSENTIA EXECUTIVES WHO ARE OFFICERS OR KEY EMPLOYEES OF ESSENTIA OR ANY OF ITS AFFILIATES WHICH MAY BE PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINIONS ON TOTAL COMPENSATION REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE MAY REQUEST ITS INDEPENDENT ADVISORS TO: MONITOR COMPARABILITY DATA AND MARKETPLACE TRENDS; MAKE APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES; AND PERIODICALLY REVIEW THE MARKET COMPETITIVENESS OF ESSENTIA EXECUTIVE COMPENSATION PACKAGES. PRIOR TO ESTABLISHING OR ADJUSTING EXECUTIVE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE WILL OBTAIN AND RELY UPON APPROPRIATE DATA AS TO COMPARABILITY OF THE PROPOSED COMPENSATION OR ADJUSTMENTS. THE EXECUTIVE COMPENSATION COMMITTEE WILL ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THOSE DETERMINATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MINUTES WILL INCLUDE: THE TERMS OF THE APPROVED COMPENSATION AND THE DATE APPROVED; THE EXECUTIVE COMPENSATION COMMITTEE MEMBERS PRESENT DURING THE REVIEW, DISCUSSION AND APPROVAL OF THE PROPOSED COMPENSATION AND THOSE WHO VOTED ON THE PROPOSED COMPENSATION; IDENTIFICATION OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE EXECUTIVE COMPENSATION COMMITTEE AND HOW THE DATA WAS OBTAINED; ANY ACTIONS BY A MEMBER OF THE EXECUTIVE COMPENSATION COMMITTEE HAVING A CONFLICT OF INTEREST; AND DOCUMENTATION OF THE BASIS FOR THE DETERMINATION. THIS PROCESS WAS LAST UNDERTAKEN IN 2024 FOR ESSENTIA HEALTH WEST'S CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER, SENIOR VICE PRESIDENT OF OPERATIONS, AND PRESIDENT, AND IN 2023 FOR ITS VICE PRESIDENT OF FINANCE, CHIEF NURSING OFFICER, AND OPERATIONS SENIOR DIRECTOR. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART IX, LINE 24E: AFFILIATE REVENUE AND EXPENSE ALLOCATION: ESSENTIA HEALTH WEST, ESSENTIA HEALTH ADA, ESSENTIA HEALTH FOSSTON, ESSENTIA HEALTH HOLY TRINITY HOSPITAL, AND ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES ALLOCATE CERTAIN REVENUES AND EXPENSES DIRECTLY TO ESSENTIA HEALTH ADA, ESSENTIA HEALTH FOSSTON, ESSENTIA HEALTH HOLY TRINITY HOSPITAL, AND ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ALL RELATED ORGANIZATIONS. NET AFFILIATE REVENUE AND EXPENSE ALLOCATIONS OF ($7,496,835) INCLUDE THE FOLLOWING TYPES OF REVENUE AND EXPENSES: NONPATIENT REVENUE; AMORTIZATION AND DEPRECIATION; PURCHASED SERVICES; PROFESSIONAL FEES; AGENCY FEES; REPAIRS AND MAINTENANCE; SALARIES, WAGES, AND RELATED BENEFITS; SUPPLIES; UTILITIES; PROVIDER AND OTHER TAXES; AND OTHER EXPENSES. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS WITH RELATED ORGANIZATIONS 48,710. BRAINERD LAKES INTEGRATED HEALTH SYSTEM 2024 S 6TH ST BRAINERD MN 56401 371532145 SUPPORTING ORG MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 1 BRAINERD MEDICAL CENTER INC 2024 S 6TH ST BRAINERD MN 56401 371532148 CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 BRIDGES MEDICAL CENTER 201 9TH ST W ADA MN 56510 200479568 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 DEER RIVER HEALTHCARE CENTER INC 115 10TH AVE NE DEER RIVER MN 56636 410844574 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ESSENTIA HEALTH 502 E 2ND ST DULUTH MN 55805 200360007 SUPPORTING ORG MN 501(C)(3) LINE 12C, III-FI N/A 0 ESSENTIA HEALTH FOUNDATION 502 E 2ND ST DULUTH MN 55805 271984704 FOUNDATION MN 501(C)(3) LINE 7 ESSENTIA HEALTH 1 ESSENTIA HEALTH MOOSE LAKE 4572 COUNTY ROAD 61 MOOSE LAKE MN 55767 845099016 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ESSENTIA HEALTH SURGERY CENTERS 502 E 2ND ST DULUTH MN 55805 881577422 SURGERY CENTER MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ESSENTIA INSTITUTE OF RURAL HEALTH 502 E 2ND ST DULUTH MN 55805 271291124 RESEARCH MN 501(C)(3) LINE 4 THE DULUTH CLINIC LTD 1 FIRST CARE MEDICAL SERVICES 900 HILLIGOSS BLVD SE FOSSTON MN 56542 410706143 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 GRACEVILLE HEALTH CENTER 115 WEST 2ND ST GRACEVILLE MN 56240 410726173 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC 502 E 2ND ST DULUTH MN 55805 411674021 MEDICAL EQUIPMENT MN 501(C)(3) LINE 10 ST MARY'S MEDICAL CENTER 1 NORTHERN PINES MEDICAL CENTER 5211 HWY 110 AURORA MN 55705 410841441 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 PINE MEDICAL CENTER 705 LUNDORFF DR S SANDSTONE MN 55072 411884597 HOSPITAL MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 POLINSKY MEDICAL REHABILITATION CENTER 530 E 2ND ST DULUTH MN 55805 410691275 REHABILITATION SERVICES MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 SMDC MEDICAL CENTER 502 E 2ND ST DULUTH MN 55805 411878730 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST JOSEPH'S MEDICAL CENTER 523 N 3RD ST BRAINERD MN 56401 410695602 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 502 E 2ND ST DULUTH MN 55805 411836633 SUPPORTING ORG MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 1 ST MARY'S EMS 1027 WASHINGTON AVE DETROIT LAKES MN 56501 411805811 EMERGENCY SERVICES MN 501(C)(3) LINE 10 ESSENTIA HEALTH 1 ST MARY'S HOSPITAL OF SUPERIOR 3500 TOWER AVE SUPERIOR WI 54880 411811073 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST MARY'S INNOVIS HEALTH 1027 WASHINGTON AVE DETROIT LAKES MN 56501 262861321 PHARMACY MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST MARY'S MEDICAL CENTER 402 E 2ND ST DULUTH MN 55805 410695604 HOSPITAL MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST MARY'S REGIONAL HEALTH CENTER 1027 WASHINGTON AVE DETROIT LAKES MN 56501 411620386 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 THE DULUTH CLINIC LTD 400 E 3RD ST DULUTH MN 55805 410883623 CLINIC DE 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ESSENTIA HEALTH INSURANCE SERVICES SPC LTD PO BOX 1159 GRAND CAYMAN CJ K71-1102 000000000 SELF INSURANCE CJ N/A C 1 MID DAKOTA CLINIC INC 502 E 2ND ST DULUTH MN 55805 450311334 CLINIC OPERATIONS CEASED 9/30/22 ND INNOVIS HEALTH LLC C 146277 1.00000 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 ESSENTIA HEALTH M 55330420 ACTUAL COSTS ESSENTIA HEALTH P 31972386 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION B 673856 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION C 223645 ACTUAL COSTS ESSENTIA INSTITUTE OF RURAL HEALTH R 823440 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER A 765534 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER S 3600000 ACTUAL COSTS SCHEDULE R, PART II, COLUMN (A) THE FOLLOWING ESSENTIA HEALTH ENTITIES HAVE A DOING BUSINESS AS NAME: LEGAL NAME; DOING BUSINESS AS NAME BRAINERD MEDICAL CENTER, INC.; ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC BRIDGES MEDICAL CENTER; ESSENTIA HEALTH ADA DEER RIVER HEALTHCARE CENTER, INC.; ESSENTIA HEALTH DEER RIVER FIRST CARE MEDICAL SERVICES; ESSENTIA HEALTH FOSSTON GRACEVILLE HEALTH CENTER; ESSENTIA HEALTH HOLY TRINITY HOSPITAL INNOVIS HEALTH, LLC; ESSENTIA HEALTH WEST MIDWEST MEDICAL EQUIPMENT AND SUPPLIES, INC.; ESSENTIA HEALTH MEDICAL EQUIPMENT & SUPPLIES NORTHERN PINES MEDICAL CENTER; ESSENTIA HEALTH NORTHERN PINES PINE MEDICAL CENTER; ESSENTIA HEALTH SANDSTONE POLINSKY MEDICAL REHABILITATION CENTER; ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER SMDC MEDICAL CENTER; ESSENTIA HEALTH DULUTH ST. JOSEPH'S MEDICAL CENTER; ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ST. MARY'S DULUTH CLINIC HEALTH SYSTEM; ESSENTIA HEALTH EAST ST. MARY'S EMS; ESSENTIA HEALTH EMS ST. MARY'S HOSPITAL OF SUPERIOR; ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR ST. MARY'S MEDICAL CENTER; ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER ST. MARY'S REGIONAL HEALTH CENTER; ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES