2025-05-09T08:45:16-05:00 2024-06-30 990 2023-07-01 410844574 DEER RIVER HEALTHCARE CENTER INC DEER 2182462900 115 10TH AVE NE DEER RIVER MN 56636 JOSHUA SENGER FINANCE DIRECTOR 2182462900 2025-05-09 0 2023 2025-03-06 01:10:19Z ESSENTIA HEALTH DEER RIVER AMANDA REED 115 10TH AVE NE DEER RIVER MN 56636 54335668 0 X WWW.ESSENTIAHEALTH.ORG X 1956 MN WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 7 7 250 14 149 0 88961 113717 43017352 46124623 384533 781542 80740 72781 43571586 47092663 24500 0 0 0 19159713 19043684 0 0 0 22209088 22803175 41393301 41846859 2178285 5245804 46005651 53655611 7607395 8625016 38398256 45030595 X WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 0 0 33805293 46124623 DEER RIVER HEALTHCARE CENTER, INC., DBA ESSENTIA HEALTH DEER RIVER, IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES. MORE SPECIFICALLY, ESSENTIA HEALTH DEER RIVER IS CREATED AND ORGANIZED TO OWN, MAINTAIN, OPERATE AND CONDUCT, DIRECTLY OR INDIRECTLY, AND TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, AND CARE FOR THE AGED AND SOCIAL SERVICES, INCLUDING CHARITABLE CARE TO PERSONS UNABLE TO PAY.ESSENTIA HEALTH DEER RIVER HAS A CRITICAL ACCESS HOSPITAL WITH 20 LICENSED BEDS AND MULTI-SPECIALTY CLINICS SERVING ITASCA COUNTY AND NORTHEASTERN CASS COUNTY. ESSENTIA HEALTH DEER RIVER IS A LEVEL IV TRAUMA CENTER. IT OFFERS EMERGENCY CARE 24 HOURS A DAY, SEVEN DAYS A WEEK.ESSENTIA HEALTH DEER RIVER HAS A SKILLED NURSING FACILITY CONNECTED TO THE HOSPITAL THAT PROVIDES 24 HOUR SKILLED NURSING AND PERSONAL CARE. RESIDENTS HAVE ACCESS TO PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES. IN ADDITION, ESSENTIA HEALTH DEER RIVER'S SENIOR LIVING APARTMENTS PROVIDE A FULL SPECTRUM OF SENIOR LIVING OPPORTUNITIES.ESSENTIA HEALTH DEER RIVER EMPLOYS 155 FULL TIME EQUIVALENTS. THE HOSPITAL PROVIDED APPROXIMATELY 2,000 HOSPITAL PATIENT DAYS AND 25,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2024. THE CLINICS HAD OVER 14,000 ENCOUNTERS AND THE SKILLED NURSING FACILITY PROVIDED OVER 7,000 RESIDENT DAYS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2024, ESSENTIA HEALTH DEER RIVER PROVIDED THE FOLLOWING COMMUNITY BENEFITS: $140,000 IN CHARITY CARE, $80,000 COSTS IN EXCESS OF MEDICAID PAYMENTS, $80,000 IN COMMUNITY SERVICES, AND $77,000 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"). 33805293 1 1 0 1 0 0 0 0 1 1 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 250 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 1 1 MN X JOSHUA SENGER 2182462900 115 10TH AVE NE DEER RIVER MN 56636 KRISTA SKORUPA MD BD DIRECT THRU 4/24/REL ORG PRESIDENT 1.00 59.00 X 0 469439 86202 TAMMY KRITZER BD DIRECT THRU 4/24/REL ORG SVP, OPS 1.00 59.00 X 0 447009 82399 SARA LOKSTAD MD ASSOCIATE CHIEF MEDICAL OFFICER 1.00 59.00 X 0 320356 20866 MICHAEL LARSON FORMER INTERIM ADMINISTRATOR 0.00 60.00 X 0 264107 34076 KEVIN BARSNESS CRNA 60.00 0.00 X 248951 0 27304 LORI SUTHERLAND CRNA SUPERVISOR 60.00 0.00 X 257870 0 13916 JOSHUA SENGER FINANCE DIRECTOR 1.00 59.00 X 0 197979 10912 STEPHANIE ALEXANDER NURSE PRACTITIONER 60.00 0.00 X 192042 0 10559 AMANDA REED ADMINISTRATOR 60.00 0.00 X 151273 0 46654 KRISTINE MOSHER NURSE PRACTITIONER 60.00 0.00 X 161126 0 24173 BERTIL LINDQUIST CRNA 60.00 0.00 X 147453 0 13296 APRIL JESPERSON BOARD DIRECTOR 1.00 0.00 X 0 0 0 ARA ANDERSON BOARD VICE CHAIR 2.00 0.00 X X 0 0 0 DAVID DELAWYER BOARD DIRECTOR 1.00 0.00 X 0 0 0 KYLE FAIRBANKS BOARD DIRECTOR 1.00 0.00 X 0 0 0 LYNETTE HOW BOARD SECRETARY/TREASURER 2.00 0.00 X X 0 0 0 NEAL WALKER BOARD CHAIR 2.00 0.00 X X 0 0 0 PAM THOMPSON BOARD DIRECTOR 1.00 0.00 X 0 0 0 TOM DIMICH BOARD DIRECTOR THRU 10/23 1.00 0.00 X 0 0 0 1158715 1698890 370357 18 1 1 0 0 101328 12389 113717 INPATIENT AND OUTPATIENT REVENUES 621110 42565521 42565372 149 SKILLED NURSING FACILITY REVENUE 623000 3217860 3217860 ASSISTED & INDEPENDENT LIVING REV 623000 268278 268278 EQUITY SHARE IN CENTRAL MN DIAGNO 900099 181044 181044 GAIN/LOSS ON CDI GRAND RAPIDS LLC 900099 -108080 -108080 46124623 606483 606483 1300 0 1300 1300 1300 7380914 37150 7243005 0 137909 37150 175059 175059 CAFETERIA REVENUE 722514 70953 70953 MISCELLANEOUS REVENUE 900099 528 528 71481 47092663 46124474 149 854323 X 203266 203266 15132275 13667882 1464393 605763 540485 65278 2155088 1938103 216985 947292 840139 107153 4511 4511 674 674 50374 50374 1177644 960679 216965 8438 8438 1750736 1311864 438872 48049 43399 4650 738290 666844 71446 107970 83061 24909 13255 3782 9473 114423 114423 1658310 1497831 160479 166272 156213 10059 MEDICAL SUPPLIES 6804487 6804487 AFFILIATE SUPPORT FEE 4904544 2438539 2466005 AFFILIATE EXP & REV ALL 2793038 414181 2378857 BAD DEBT EXPENSE 1518736 1518736 943424 804645 138779 41846859 33805293 8041566 0 177079 178352 4211792 4781583 4655014 5615269 429619 488156 938786 1400290 68052 82948 22263496 11961682 10780020 10301814 13876910 25982883 202475 10665904 4824316 46005651 53655611 2660171 2937008 184649 2570362 2108100 1759 2420 9724 800460 2365379 2592379 7607395 8625016 X 38096349 44728688 301907 301907 38398256 45030595 46005651 53655611 X 5245804 1746235 -359700 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 1 674 674 0 PART II-B, LINE 1: LOBBYING ACTIVITY EXPLANATION: ESSENTIA HEALTH DEER RIVER PAYS DUES TO A CERTAIN ORGANIZATION RELATED TO THE INDUSTRY WHICH HAS LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. 0 1 X 301907 301907 301907 301907 301907 301907 301907 301907 301907 301907 0.00000 0.00000 1.00000 0 0 383772 383772 16680527 10691367 5989160 484806 298964 185842 4801908 1405369 3396539 -87517 -434018 346501 10301814 POOLED INVESTMENT FUND 25982883 F 25982883 RECEIVABLES FROM RELATED TAX-EXEMPT ORGANIZATIONS 3000000 OPERATING LEASE ASSETS 1824316 4824316 OPERATING LEASES 1858058 PAYABLES TO RELATED TAX-EXEMPT ORGANIZTIONS 561654 ASSET RETIREMENT OBLIGATION (FIN47) 172667 2592379 PART IV, LINE 2B: ESSENTIA HEALTH DEER RIVER ACTS AS CUSTODIAN FOR THE FUNDS OF THE SKILLED NURSING FACILITY RESIDENTS. RESIDENT TRUST FUNDS TOTALED $2,420 AT JUNE 30, 2024. PART V, LINE 4: ESSENTIA HEALTH DEER RIVER'S INTENDED USE OF ITS ENDOWMENT FUNDS IS FOR CAPITAL AND OTHER IMPROVEMENTS THAT FURTHER ESSENTIA HEALTH DEER RIVER'S MISSION. 1 1 X 1 X 0 1 1 0 1 1 140208 140208 0.00350 7670358 7590261 80097 0.00200 7810566 7590261 220305 0.00550 80161 80161 0.00200 77199 77199 0.00190 157360 157360 0.00390 7967926 7590261 377665 0.00940 19833 19833 0.00050 19833 19833 0.00050 1 1518736 11951174 12087299 -136125 X 1 1 1 1 ESSENTIA HEALTH DEER RIVER 115 10TH AVE NE DEER RIVER MN 56636 WWW.ESSENTIAHEALTH.ORG 414707 X X X X X ESSENTIA HEALTH DEER RIVER 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 DEER RIVER PART V, SECTION B, LINE 5: ESSENTIA HEALTH DEER RIVER SOLICITED BROAD FEEDBACK FROM THE COMMUNITY THROUGH FOCUS GROUPS AND A COMMUNITY SURVEY; THE FOCUS GROUPS WERE CONDUCTED IN FALL 2021, AND THE SURVEY WAS ADMINISTERED 12/9/2021 TO 1/28/2022. 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.FOCUS GROUP PARTICIPANTS, WHICH TOTALED 300 PEOPLE IN SEVEN GROUPS, INCLUDED STUDENTS FROM DEER RIVER SCHOOLS. 156 COMMUNITY MEMBERS OF ALL AGE GROUPS PARTICIPATED IN THE COMMUNITY SURVEY.THE STEERING COMMITTEE, WHICH GUIDED THE PROCESS, INCLUDED REPRESENTATION FROM FAIRVIEW GRAND ITASCA MEDICAL CENTER, ITASCA COUNTY PUBLIC HEALTH AND HUMAN SERVICES, LEECH LAKE BAND OF OJIBWE, DEER RIVER SCHOOLS, GET FIT ITASCA, ARROWHEAD ECONOMIC OPPORTUNITY AGENCY, SECOND HARVEST NORTH CENTRAL FOOD BANK, DEER RIVER BOYS AND GIRLS CLUB, COMMUNITY ECONOMIC DEVELOPMENT ASSOCIATES, FORWARD HEALTH FOUNDATION, CITY OF DEER RIVER, ELDERCIRCLE, ARROWHEAD AREA AGENCY ON AGING, AND ITASCA COUNTY EXTENSION OFFICE.ESSENTIA HEALTH DEER RIVER DID NOT RECEIVE ANY COMMENTS ON ITS PREVIOUS CHNA. IF RECEIVED, ANY COMMENTS WOULD HAVE BEEN TAKEN INTO CONSIDERATION IN THE CHNA UPDATE PROCESS. ESSENTIA HEALTH DEER RIVER PART V, SECTION B, LINE 6A: TO ALIGN RESOURCES AND STRENGTHS TO BETTER SERVE OUR COMMUNITY, THE CHNA WAS CONDUCTED IN COLLABORATION WITH GRAND ITASCA, AN UNRELATED HOSPITAL LOCATED IN GRAND RAPIDS, MN. ESSENTIA HEALTH DEER RIVER PART V, SECTION B, LINE 6B: ESSENTIA HEALTH DEER RIVER WORKED COLLABORATIVELY ON THE ASSESSMENT PROCESS WITH GET FIT ITASCA, DEER RIVER FULL-SERVICE COMMUNITY SCHOOLS, LEECH LAKE BAND OF OJIBWE, ARROWHEAD ECONOMIC OPPORTUNITY AGENCY, SECOND HARVEST NORTH CENTRAL FOOD BANK, BOYS AND GIRLS CLUB, COMMUNITY AND ECONOMIC DEVELOPMENT ASSOCIATES, FORWARD HEALTH FOUNDATION, THE CITY OF DEER RIVER, ITASCA COUNTY PUBLIC HEALTH, ELDER CIRCLE, AND ITASCA COUNTY EXTENSION. ESSENTIA HEALTH DEER RIVER PART V, SECTION B, LINE 11: DURING FY 2024, ESSENTIA HEALTH DEER RIVER ADDRESSED SIGNIFICANT NEEDS IDENTIFIED IN THE FY 2022 ASSESSMENT: INTERNET ACCESS, FOOD ACCESS, AND MENTAL WELL-BEING. SOME ACTIVITIES WERE LED BY THE HOSPITAL WHILE OTHERS WERE PART OF LARGER COLLABORATIVE EFFORTS WITH LOCAL PARTNERS.ONE OTHER HEALTH NEED IDENTIFIED THROUGH THE CHNA PROCESS IS YOUTH VAPING, WHICH WILL NOT BE DIRECTLY ADDRESSED AS A PRIORITY DUE TO LIMITED CAPACITY. A LOCAL COALITION WILL CONTINUE TO ADDRESS IT IN THE SCHOOL.THE FOLLOWING DESCRIBES SIGNIFICANT ACCOMPLISHMENTS AND OUTCOMES.PRIORITY AREA #1: INTERNET ACCESSTO RESPOND TO DIGITAL INCLUSION NEEDS, THE HOSPITAL WORKED TO CONNECT PEOPLE TO PLACES WITH SAFE, RELIABLE INTERNET ACCESS. TO THIS END, THE HOSPITAL CONTINUED ITS PARTNERSHIP WITH SMART NORTH TO SUPPORT OPERATIONS OF THE DEER RIVER COMMUNITY TECH HUB WITHIN THE GOODALL RESOURCE CENTER ON THE ESSENTIA HEALTH DEER RIVER CAMPUS. OFFERING EQUIPMENT AND SOFTWARE TO HELP TEENAGERS BUILD AND DEVELOP SKILLS, THE TECH HUB SERVED 78 UNIQUE STUDENTS DURING THE YEAR, PROVIDING A PLACE FOR POSITIVE SOCIAL CONNECTION WITH PEERS AND FRESH FOOD ON-SITE FOR STUDENTS WHO FACE FOOD INSECURITY.PRIORITY AREA #2: FOOD ACCESSTO SUPPORT RELIABLE ACCESS TO HEALTHY FOOD, THE HOSPITAL PARTNERED WITH THE GRAND RAPIDS FARMERS MARKET TO ENCOURAGE CHILDREN AGES TWO THROUGH 12 TO CONSUME LOCAL PRODUCE UNDER THE POWER OF PRODUCE (POP) PROGRAM. PROVIDING $2 OF FREE PRODUCE TO CHILDREN AT EACH MARKET THEY ATTEND, THE POP PROGRAM ATTRACTED 766 UNIQUE PARTICIPANTS. IN ADDITION, THE HOSPITAL WORKED ALONGSIDE GET FIT ITASCA TO DEVELOP THE DEER RIVER COMMUNITY GARDEN. THROUGH CONTINUED IMPROVEMENTS TO THE SITE, INCLUDING FIVE NEW RAISED BEDS, SEVERAL NEW PERENNIAL PLANTS, AND THE PURCHASE OF A TILLER, THE COMMUNITY GARDEN WAS UTILIZED AT 100% CAPACITY BY 11 PARTICIPANTS AND INCREASED ONGOING PROJECT SUSTAINABILITY THROUGH COLLABORATION WITH THE CITY OF DEER RIVER. THE HOSPITAL ALSO PARTNERED WITH DEER RIVER SCHOOL DISTRICT TO DISTRIBUTE FOOD TO STUDENTS THROUGH SCHOOL FOOD PANTRIES AT DEER RIVER HIGH SCHOOL AND KING ELEMENTARY SCHOOL. DURING THE SCHOOL YEAR, 1,448 STUDENTS AT DEER RIVER HIGH SCHOOL AND 1,228 STUDENTS AT KING ELEMENTARY SCHOOL WERE REACHED WITH THE FOOD PROGRAM. THROUGH ITS COMMUNITY GRANTS PROGRAM, ESSENTIA HEALTH PROVIDED FUNDS TO THE FOLLOWING ORGANIZATIONS: SECOND HARVEST NORTHLAND TO PROVIDE FOOD TO LOW-INCOME STUDENTS THROUGH STOCKING LOCAL SCHOOL FOOD PANTRIES AND DISTRIBUTING SNACK PACKS, 6,560 PEOPLE BENEFITTED THIS YEAR; AND ITASCA COUNTY PUBLIC HEALTH TO EDUCATE ABOUT HEALTHY EATING AND COOKING BY PROVIDING SNAP PARTICIPANTS WITH RESOURCES LIKE RECIPES AND KITCHEN EQUIPMENT AT THE GRAND RAPIDS FARMERS MARKET, 50 PEOPLE SERVED IN THE PAST YEAR.PRIORITY AREA #3: MENTAL WELL-BEINGTO PROMOTE MENTAL WELL-BEING, THE HOSPITAL PARTNERED TO ENHANCE EQUAL ACCESS TO COMMUNITY EVENTS. MORE SPECIFICALLY, WE PARTNERED WITH MOBILITY MANIA AND SAMARITAN TRANSPORTATION TO LAUNCH A TRANSPORTATION VOUCHER PROGRAM FOR PEOPLE USING WHEELCHAIRS IN THE ESSENTIA HEALTH DEER RIVER SERVICE AREA. THE VOUCHER PROGRAM ALLOWS A WHEELCHAIR USER AND A COMPANION FREE ADA COMPLIANT TRANSPORTATION TO ATTEND ONE SOCIAL EVENT PER MONTH, WITH USE OF THE TRANSPORTATION SERVICE FOR UP TO FOUR HOURS AT EACH EVENT. BY THE END OF THE YEAR, THE PARTNERSHIP ALLOWED 100 PEOPLE DEPENDENT ON WHEELCHAIRS (AND THEIR COMPANIONS) TO PARTICIPATE IN 1,200 SOCIAL EVENTS, WITH DEDICATION OF 4,800 SERVICE HOURS TO THE PROGRAM BY THE TRANSPORTATION SERVICE. THROUGH ITS COMMUNITY GRANTS PROGRAM, ESSENTIA HEALTH ALSO PROVIDED FUNDS TO THE CITY OF NORTHOME TO REVITALIZE ITS CITY PLAYGROUND, WHICH SERVES AS AN IMPORTANT COMMUNITY GATHERING PLACE; THIS PROJECT SERVED 200 PEOPLE IN THE PAST YEAR. ADDITIONAL DISCLOSURES NOT REQUIRED FOR PART V, SECTION C: SCHEDULE H, PART V, SECTION B, LINE 3E:ESSENTIA HEALTH DEER RIVER CONDUCTED A NEW CHNA IN FY22 AND CHOSE TO ADDRESS THREE PRIORITY HEALTH NEEDS BASED ON THE FEEDBACK OF 156 COMMUNITY MEMBERS. THE SIGNIFICANT HEALTH NEEDS ARE INTERNET ACCESS, FOOD ACCESS, AND MENTAL WELLBEING. THE NEEDS ARE NOT RANKED IN ORDER; ALL THREE HEALTH NEEDS ARE CONSIDERED PRIORITIES. THE HOSPITAL WILL WORK ON ADDRESSING EACH NEED SIMULTANEOUSLY FROM FY23-FY25.FORM 990, SCH 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. 4 1 - ESSENTIA HEALTH DEER RIVER CLINIC 115 10TH AVE NE DEER RIVER MN 56636 MULTI-SPECIALTY CLINIC 2 - ESSENTIA HEALTH DEER RIVER HOME CARE 115 10TH AVE NE DEER RIVER MN 56636 HOME HEALTH 3 - ESSENTIA HEALTH HOMESTEAD 1053 COMSTOCK CT DEER RIVER MN 56636 SKILLED NURSING FACILITY 4 - ESSENTIA HEALTH COMSTOCK COURT 35 10TH AVE NE DEER RIVER MN 56636 SENIOR APARTMENTS 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 $1,518,736. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL IS LOCATED IN A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND AS SUCH INCLUDES PHYSICIAN RECRUITMENT AS A COMMUNITY BUILDING ACTIVITY PER THE RECOMMENDATION OF THE CATHOLIC HEALTH ASSOCIATION COMMUNITY BENEFIT GUIDE. 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 DEER RIVER 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: 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 DEER RIVER 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 HIS/HER PAYMENT AGREEMENTS. THE ORGANIZATION OFFERS EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS AND WILL NOT IMPOSE LIENS ON PRIMARY RESIDENCES NOR REPORT PATIENTS TO A CREDIT RATING AGENCY FOR OUTSTANDING PATIENT BILLS. THE ORGANIZATION WILL NOT CHARGE A PATIENT THE GROSS AMOUNT OF CHARGES FOR ANY UNINSURED TREATMENT. UNINSURED DISCOUNTS WILL BE APPLIED TO THE GROSS CHARGES PRIOR TO ANY FINANCIAL ASSISTANCE OR OTHER DISCOUNTS. IF AT ANY TIME THE ORGANIZATION RECOGNIZES THAT A PATIENT MAY BE ELIGIBLE FOR STATE OR FEDERAL PROGRAMS, A REPRESENTATIVE WILL ASSIST THE PATIENT IN OBTAINING INFORMATION ABOUT THESE PROGRAMS OR PROVIDE CONTACT INFORMATION FOR THESE PROGRAMS. THE ORGANIZATION CONTRACTS WITH AN OUTSIDE PATIENT ADVOCACY AGENCY, WHICH MAY PROVIDE ASSISTANCE TO THE UNINSURED PATIENT IN APPLYING TO CERTAIN STATE AND FEDERAL PROGRAMS.AT ANY STAGE OF THE PATIENT EXPERIENCE AND UP THROUGH THE COLLECTION PROCESS, THE PATIENT MAY EXPRESS A CONCERN THAT THEY ARE UNABLE TO PAY THEIR BILL IN FULL OR MEET THE PAYMENT PLAN REQUIREMENTS. AT THAT TIME, THE PATIENT WILL BE GIVEN EVERY OPPORTUNITY TO COMPLETE AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE ORGANIZATION TRAINS ITS OUTSIDE DEBT COLLECTION AGENCIES AND ATTORNEYS ABOUT THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION ABOUT THE FAP OR SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE ORGANIZATION REQUIRES ITS OUTSIDE COLLECTION AGENCIES AND ATTORNEYS TO REFER PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE TO ESSENTIA HEALTH. IF A PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, THE ORGANIZATION SUSPENDS ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND ESSENTIA HEALTH HAS NOTIFIED THE PATIENT OF ITS DECISION. PATIENTS ARE ADVISED AT THAT TIME TO NOTIFY THE COLLECTION AGENCY TO HOLD THEIR ACCOUNT. THE OUTSIDE DEBT COLLECTION AGENCIES ARE NOTIFIED BY ESSENTIA HEALTH ONCE AN ACCOUNT ADJUSTMENT HAS BEEN MADE. PART VI, LINE 2: NEEDS ASSESSMENT:WE ASSESS AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE 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 DEER RIVER IS LOCATED IN DEER RIVER, MN AND IS A PART OF ESSENTIA HEALTH, WHICH IS DEFINED IN PART VI, LINE 6. THE ORGANIZATION OPERATES 1 HOSPITAL, 1 CLINIC, 1 SKILLED NURSING FACILITY, SENIOR APARTMENTS, AND HOME HEALTH THAT SERVE PRIMARILY CASS AND ITASCA COUNTIES. THE OVERALL COMMUNITY IS CLASSIFIED AS RURAL.ESSENTIA HEALTH DEER RIVER COVERS A SERVICE AREA OF APPROXIMATELY 45,000 PEOPLE. THE SERVICE AREA AGE DISTRIBUTION IS 18% UNDER THE AGE OF 18; 55% BETWEEN THE AGES OF 18 AND 65; AND 27% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE AREA IS 92% CAUCASIAN; 1% AFRICAN AMERICAN; 1% HISPANIC; AND 6% OTHER. THE GENDER SPLIT RATIO IS 50% WOMEN AND 50% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY $53,000.ESSENTIA HEALTH DEER RIVER, AS PART OF ESSENTIA HEALTH, IS COMMITTED TO SERVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. APPROXIMATELY 1.5% GROSS REVENUE DOLLARS WERE FROM SELF-PAY PATIENTS AND 17.9% FROM MEDICAID RECIPIENTS. DEER RIVER AND REMER, MN ARE CURRENTLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS.AS MENTIONED ABOVE, ESSENTIA HEALTH DEER RIVER 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 IS 1 OTHER HOSPITAL OUTSIDE OF THE ESSENTIA HEALTH UMBRELLA THAT SERVICES 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 EAST 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 IMPROVE HOUSING, ACCESS TO HEALTHY FOODS 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 DEER RIVER 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 DEER RIVER 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, REPORTS FILED WITH STATES MN X X X 1 1 0 0 0 0 0 0 0 KRISTA SKORUPA MD BD DIRECT THRU 4/24/REL ORG PRESIDEN 0 389189 0 78395 0 1855 0 70901 0 15301 0 555641 0 0 TAMMY KRITZER BD DIRECT THRU 4/24/REL ORG SVP, OPS 0 335917 0 75563 0 35529 0 66370 0 16029 0 529408 0 32833 SARA LOKSTAD MD ASSOCIATE CHIEF MEDICAL OFFICER 0 319869 0 0 0 487 0 19234 0 1632 0 341222 0 0 MICHAEL LARSON FORMER INTERIM ADMINISTRATOR 0 162374 0 69751 0 31982 0 20329 0 13747 0 298183 0 25201 KEVIN BARSNESS CRNA 247375 0 0 0 1576 0 12476 0 14828 0 276255 0 0 0 LORI SUTHERLAND CRNA SUPERVISOR 257321 0 0 0 549 0 12866 0 1050 0 271786 0 0 0 JOSHUA SENGER FINANCE DIRECTOR 0 197802 0 0 0 177 0 9890 0 1022 0 208891 0 0 STEPHANIE ALEXANDER NURSE PRACTITIONER 191194 0 0 0 848 0 9560 0 999 0 202601 0 0 0 AMANDA REED ADMINISTRATOR 151151 0 0 0 122 0 8123 0 38531 0 197927 0 0 0 KRISTINE MOSHER NURSE PRACTITIONER 160397 0 0 0 729 0 8258 0 15915 0 185299 0 0 0 BERTIL LINDQUIST CRNA 120711 0 0 0 26742 0 6189 0 7107 0 160749 0 0 0 PART I, LINE 3 ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA HEALTH DEER RIVER'S ADMINISTRATOR'S COMPENSATION: A COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B SEVERANCE PAYMENT: HIGHEST-COMPENSATED EMPLOYEE BERTIL LINDQUIST RECEIVED PAYMENTS TOTALING $24,518 IN CALENDAR YEAR 2023 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, LINDQUIST RECEIVED ALL SEVERANCE PAYMENTS DURING CALENDAR YEAR 2023. 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. 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: TAMMY KRITZER $32,833 MICHAEL LARSON $25,201 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: KRISTA SKORUPA, MD $44,501 TAMMY KRITZER $42,418 MICHAEL LARSON $6,975 A CITY OF DEER RIVER 416005091 000000000 2006-12-31 7575000 SERIES 2006 (SEE PART VI) 0 0 0 A 5464498 7575000 151500 7423500 2008 0 0 1 1 A 0 0 0 0 0.00700 0.00700 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 SCHEDULE K, PART 1, COLUMN (F): DESCRIPTION OF PURPOSE: SERIES 2006: FINANCE CONSTRUCTION AND EQUIPMENT PURCHASES IN DEER RIVER, MN. 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 6 MEMBERS OF ORGANIZATION: ESSENTIA HEALTH EAST IS THE SOLE MEMBER OF ESSENTIA HEALTH DEER RIVER. DEER RIVER AREA HEALTH CARE FOUNDATION AND ESSENTIA HEALTH EAST MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7A. ESSENTIA HEALTH AND ESSENTIA HEALTH EAST HAVE RESERVED POWERS WITH RESPECT TO ESSENTIA HEALTH DEER RIVER AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7B. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS WITH RIGHT TO ELECT GOVERNING BODY: DEER RIVER AREA HEALTH CARE FOUNDATION APPOINTS AND REMOVES TWO BOARD DIRECTORS; ESSENTIA HEALTH EAST APPOINTS AND REMOVES ESSENTIA HEALTH DEER RIVER'S REMAINING GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS WITH RIGHT TO APPROVE GOVERNING BODY DECISIONS: 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, AND TO APPROVE, THE SYSTEM'S STRATEGIC AND BUSINESS PLANS. (B) MISSION. AUTHORITY TO CREATE, AND TO APPROVE, THE MISSION, PURPOSE AND VISION STATEMENTS FOR ALL ENTITIES IN THE SYSTEM BY THE AFFIRMATIVE VOTE OF AT LEAST 67% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS. (C) DEBT. APPROVAL OF THE INCURRENCE OF DEBT AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE ASSETS OF, ALL ENTITIES IN THE SYSTEM IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS, AND THE AUTHORITY TO CAUSE ALL ENTITIES IN THE SYSTEM TO PARTICIPATE IN SYSTEM BORROWING. (D) GOVERNING INSTRUMENTS. AUTHORITY TO CAUSE, AND TO APPROVE, AMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS OF ALL ENTITIES IN THE SYSTEM. (E) MERGERS AND ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF ALL ENTITIES IN THE SYSTEM. (F) AFFILIATIONS AND JOINT VENTURES. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES WITH THIRD PARTIES OF ALL ENTITIES IN THE SYSTEM. (G) TRANSFER OF ASSETS WITHIN THE SYSTEM. AUTHORITY TO TRANSFER ASSETS, INCLUDING CASH, BETWEEN AND AMONG ENTITIES WITHIN THE SYSTEM; PROVIDED, HOWEVER, THAT ESSENTIA HEALTH SHALL NOT HAVE AUTHORITY TO REQUIRE ANY ENTITY IN THE SYSTEM TO TRANSFER ASSETS (I) THAT WOULD CAUSE SUCH ENTITY TO BE IN DEFAULT OF ITS COVENANTS OR OBLIGATIONS UNDER ANY BOND OR OTHER FINANCING DOCUMENTS; (II) FROM THE CATHOLIC ENTITIES TO THE SECULAR ENTITIES OR FROM THE SECULAR ENTITIES TO THE CATHOLIC ENTITIES IN A MANNER OR TO AN EXTENT THAT WOULD CAUSE THE CATHOLIC ENTITIES TO BE IN VIOLATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS) IN THE JUDGMENT OF THE LOCAL ORDINARY; OR (III) SUCH THAT MONEY GENERATED BY SERVICES AT SECULAR FACILITIES WITHIN THE SYSTEM BY PROCEDURES THAT ARE CONTRARY TO THE ERDS WOULD BE USED AT THE CATHOLIC ENTITIES OR MONEY GENERATED BY CATHOLIC ENTITIES WOULD BE USED IN THE PROVIDING OF SERVICES CONTRARY TO THE ERDS AT SECULAR FACILITIES WITHIN THE SYSTEM. (H) TRANSFER OF ASSETS OUTSIDE THE SYSTEM. AUTHORITY TO CAUSE, AND TO APPROVE, THE SALE, LEASE OR OTHER TRANSFER OF ASSETS OF ALL ENTITIES IN THE SYSTEM TO PARTIES OUTSIDE OF THE SYSTEM WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS. (I) SERVICES. AUTHORITY TO CAUSE, AND TO APPROVE, THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS WITHIN ALL ENTITIES IN THE SYSTEM. (J) BUDGETS. APPROVAL OF CAPITAL AND OPERATING BUDGETS OF ALL ENTITIES IN THE SYSTEM. (K) PROFESSIONAL SERVICES. SELECTION OF THE GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS OF ALL ENTITIES IN THE SYSTEM. (L) APPROVAL OF PARENT BOARDS. APPROVAL OF THE ELECTION AND REMOVAL, WITH OR WITHOUT CAUSE, OF 100% OF THE ESSENTIA HEALTH WEST (INNOVIS) BOARD OF MANAGERS AND THE ESSENTIA HEALTH CENTRAL (BLIHS), CRITICAL ACCESS GROUP (CAG) AND ESSENTIA HEALTH EAST (SMDC) BOARDS OF DIRECTORS (WHO SHALL BE ELECTED BY THE METHODS SET FORTH IN THE INNOVIS, BLIHS, CAG AND SMDC GOVERNING DOCUMENTS, RESPECTIVELY, SUBJECT TO ESSENTIA HEALTH'S APPROVAL); PROVIDED THAT AT LEAST ONE MEMBER OF ESSENTIA HEALTH'S BOARD OF DIRECTORS SHALL SERVE AS A DIRECTOR OF CAG, AT LEAST ONE MEMBER OF ESSENTIA HEALTH'S BOARD OF DIRECTORS SERVE AS A DIRECTOR OF SMDC, AT LEAST ONE MEMBER OF ESSENTIA HEALTH'S BOARD OF DIRECTORS SHALL SERVE AS A DIRECTOR OF BLIHS, AND AT LEAST ONE MEMBER OF ESSENTIA HEALTH'S BOARD OF DIRECTORS SERVE AS A MANAGER OF INNOVIS. (M) ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL ACQUISITIONS BY AND FORMATIONS OF ENTITIES IN THE SYSTEM. (N) MARKETING. AUTHORITY TO IMPLEMENT SYSTEM-WIDE MARKETING AND PROMOTIONAL ACTIVITIES. (O) COMPLIANCE PLANS. AUTHORITY TO CREATE, AND TO APPROVE, CORPORATE COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS FOR ENTITIES WITHIN THE SYSTEM. (P) QUALITY PLAN. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S QUALITY PLAN. (Q) NON-BUDGETED PURCHASES. APPROVAL OF NON-BUDGETED CAPITAL PURCHASES AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY ESSENTIA HEALTH FOR ENTITIES WITHIN THE SYSTEM. (R) HUMAN RESOURCES. AUTHORITY TO CREATE HUMAN RESOURCE POLICIES AND PROCEDURES WITHIN THE SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B ESSENTIA HEALTH EAST HAS THE FOLLOWING RESERVED POWERS OVER ALL ITS SUBSIDIARIES: (A) QUALITY, SAFETY AND SERVICE. AUTHORITY TO RECOMMEND QUALITY AND SAFETY INITIATIVES AND TO REVIEW AND EXECUTE APPROVED QUALITY AND SAFETY PLANS FOR THE EAST MARKET. (B) MISSION, VISION AND VALUES. AUTHORITY TO CREATE A MISSION AND A VISION FOR THE EAST MARKET THAT SUPPORTS THE MISSION AND VISION OF ESSENTIA HEALTH; RESPONSIBILITY TO OVERSEE THE MISSION PERFORMANCE, INCLUDING CHARITY CARE, OF ALL FACILITIES WITHIN THE EAST MARKET; RESPONSIBILITY TO ADOPT THE VALUES OF ESSENTIA HEALTH. (C) OPERATING AND FINANCIAL PERFORMANCE. RESPONSIBILITY TO OVERSEE THE OPERATING AND FINANCIAL PERFORMANCE OF THE EAST MARKET. (D) DEVELOPMENT OF BUDGETS, STRATEGIC PLANS AND STRATEGY MAP. AUTHORITY TO DEVELOP AND RECOMMEND, BASED ON ESSENTIA HEALTH TARGETS, CAPITAL AND OPERATING BUDGETS FOR THE EAST MARKET AND ITS FACILITIES; AUTHORITY TO RECOMMEND, WITHIN THE ESSENTIA HEALTH CONTEXT, MARKET AND LOCAL STRATEGIC PLANS FOR THE EAST MARKET; AUTHORITY TO DEVELOP EAST MARKET GOVERNANCE STRATEGY MAP AND BALANCED SCORECARD WITHIN ESSENTIA HEALTH'S SYSTEM STRATEGY TO MEET SYSTEM GOALS. (E) IMPLEMENTATION OF APPROVED BUDGETS AND STRATEGIC PLANS. RESPONSIBILITY TO IMPLEMENT THE APPROVED CAPITAL AND OPERATING BUDGETS AND STRATEGIC AND BUSINESS PLANS FOR THE EAST MARKET. (F) NON-BUDGETED EXPENDITURES. AUTHORITY TO APPROVE NON-BUDGETED CAPITAL PURCHASES AND LEASES FOR EAST MARKET FACILITIES WITHIN DOLLAR LIMITS DEFINED BY ESSENTIA HEALTH. (G) ACCREDITATION AND LICENSURE. RESPONSIBILITY TO OVERSEE ACCREDITATION AND LICENSURE COMPLIANCE FOR THE FACILITIES OF THE EAST MARKET. (H) AFFILIATIONS, ACQUISITIONS AND JOINT VENTURES. AUTHORITY TO RECOMMEND PROPOSED AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES; RESPONSIBILITY TO OVERSEE NEGOTIATION AND IMPLEMENTATION OF APPROVED ACQUISITIONS AND OPERATION OF ALL APPROVED AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES WITH THIRD PARTIES WITHIN THE EAST MARKET. (I) APPOINTMENT OF DIRECTORS. AUTHORITY TO APPOINT OR ELECT ESSENTIA HEALTH EAST (SMDC) DESIGNATED DIRECTOR POSITIONS TO SERVE ON THE BOARDS OF THE DIRECT SUBSIDIARIES AND TO REMOVE SUCH DIRECTORS WITH OR WITHOUT CAUSE. (J) PRESIDENT. AUTHORITY TO ADVISE THE CEO OF ESSENTIA HEALTH REGARDING THE APPOINTMENT, REMOVAL AND PERIODIC EVALUATION OF THE PRESIDENT OF SMDC. (K) SATISFACTION. RESPONSIBILITY TO EXECUTE, EVALUATE AND OVERSEE PATIENT, FAMILY AND CUSTOMER SATISFACTION WITH RESPECT TO THE SERVICES PROVIDED WITHIN THE EAST MARKET AND TO ENSURE ESTABLISHED GOALS ARE MET. (L) JOB SATISFACTION. RESPONSIBILITY TO OVERSEE JOB SATISFACTION AND STAFF MORALE WITHIN THE EAST MARKET FACILITIES. (M) HUMAN RESOURCES. RESPONSIBILITY TO OVERSEE IMPLEMENTATION OF ESSENTIA HEALTH HUMAN RESOURCE POLICIES AND PROCEDURES THROUGHOUT THE EAST MARKET. (N) COMPLIANCE. RESPONSIBILITY TO EXECUTE THE APPROVED ESSENTIA HEALTH CORPORATE COMPLIANCE AND RISK MANAGEMENT PLANS FOR THE EAST MARKET. (O) CREDENTIALING. RESPONSIBILITY TO PERFORM MEDICAL STAFF CREDENTIALING FOR THE EAST MARKET FACILITIES. (P) NOMINATIONS. AUTHORITY TO NOMINATE PERSONS FOR APPOINTMENT TO THE SMDC BOARD OF DIRECTORS BY THE BENEDICTINE SISTERS BENEVOLENT ASSOCIATION AND ESSENTIA HEALTH. (Q) AMENDMENTS. AUTHORITY TO SUGGEST PROPOSED AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF SMDC, THE DIRECT SUBSIDIARIES, AND ANY SUBSIDIARIES THEREOF. (R) COMPENSATION PLANS. RESPONSIBILITY TO REVIEW AND APPROVE COMPENSATION OF EAST MARKET EXECUTIVES AND PHYSICIANS FOR REASONABLENESS AND CONSISTENCY WITH THE LAW AND ESSENTIA HEALTH'S COMPENSATION PHILOSOPHY. (S) PRESIDENT/CHIEF MEDICAL OFFICER. BY ACTION OF THE SMDC PRESIDENT, AUTHORITY TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CHIEF MEDICAL OFFICER OF ANY OF THE GOVERNING OR PARENT BOARDS OF THE DIRECT SUBSIDIARIES. (T) PUBLIC POLICY. RESPONSIBILITY TO SUPPORT ESSENTIA HEALTH PUBLIC POLICY AND ADVOCACY PLANS. (U) MARKETING. RESPONSIBILITY TO COORDINATE LOCAL MARKETING AND PROMOTIONAL ACTIVITIES CONSISTENT WITH ESSENTIA HEALTH MARKETING PLANS. (V) PHILANTHROPY. RESPONSIBILITY TO COORDINATE PHILANTHROPY WITHIN THE EAST MARKET CONSISTENT WITH ESSENTIA HEALTH FOUNDATION POLICIES. (W) PROFESSIONAL SERVICES. RESPONSIBILITY TO OVERSEE EAST MARKET MANAGEMENT'S COOPERATION WITH EXTERNAL AUDITORS AND GENERAL LEGAL COUNSEL SELECTED BY ESSENTIA HEALTH AND COORDINATION OF LEGAL SERVICES THROUGH THE ESSENTIA HEALTH OFFICE OF GENERAL COUNSEL. (X) CATHOLIC FACILITIES. RESPONSIBILITY TO OVERSEE IMPLEMENTATION OF BSBA APPROVED METHODS, POLICIES AND PROCEDURES PERTAINING TO ADHERENCE BY THE EAST MARKET CATHOLIC FACILITIES WITH THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES AND USE OF RELIGIOUS SYMBOLS, DISTINGUISHING ELEMENTS AND PRAYERS. (Y) PROJECTS INVOLVING REAL ESTATE. AUTHORITY TO RECOMMEND FACILITY DEVELOPMENT PROJECTS, SUBJECT TO THE APPROVAL OF ESSENTIA HEALTH; RESPONSIBILITY TO OVERSEE EXECUTION OF APPROVED DEVELOPMENT PROJECTS ACCORDING TO ESSENTIA HEALTH POLICIES. FORM 990, PART VI, SECTION A, LINE 8B COMMITTEES: THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. 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 HIS/HER MOST RECENTLY COMPLETED QUESTIONNAIRE EACH TIME THE FIDUCIARY BECOMES AWARE OF A FINANCIAL INTEREST, A POTENTIAL CONFLICT, OR CHANGE TO ANY INFORMATION THAT THE FIDUCIARY PREVIOUSLY REPORTED. ESSENTIA HEALTH'S CHIEF COMPLIANCE OFFICER WILL COLLECT THE QUESTIONNAIRES AND EVALUATE THE DISCLOSURES. IF A FIDUCIARY HAS A POTENTIAL CONFLICT OF INTEREST, THE CHIEF COMPLIANCE OFFICER OR DESIGNEE MAY REQUEST ADDITIONAL INFORMATION FROM THE FIDUCIARY, THE MANAGEMENT TEAM, AND OTHERS. DURING THE EVALUATION PROCESS, THE CHIEF COMPLIANCE OFFICER MAY ALSO CONSULT WITH ESSENTIA HEALTH'S BOARD AND AUDIT COMMITTEE CHAIRS, SENIOR MANAGEMENT, LEGAL DEPARTMENT, OR APPROPRIATE REPRESENTATIVES FROM ESSENTIA HEALTH. THE CHIEF COMPLIANCE OFFICER REPORTS TO THE ESSENTIA HEALTH AUDIT COMMITTEE AND THE ESSENTIA HEALTH BOARD OF DIRECTORS ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY THE FIDUCIARY, ALONG WITH RECOMMENDED ACTIONS. THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) WILL THEN DETERMINE WHETHER TO APPROVE THE SITUATION OR TO IMPLEMENT SPECIAL CONTROLS TO MANAGE THE POTENTIAL CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER WILL THEN OFFICIALLY NOTIFY THE FIDUCIARY IN WRITING OF THE BOARD'S DECISION. THE DECISION OF WHETHER OR NOT THE DISCLOSURE CONSTITUTES A CONFLICT WILL BE AT THE ESSENTIA HEALTH BOARD OF DIRECTOR'S (OR DESIGNEE) SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF ESSENTIA HEALTH AND ITS AFFILIATE(S) AND THE ADVANCEMENT OF ITS PURPOSES. WHEN THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) CONSIDERS A FIDUCIARY'S DISCLOSURE AS A CONFLICT OF INTEREST, SPECIAL CONTROLS WILL BE IDENTIFIED TO MANAGE, ELIMINATE OR REDUCE THE LIKELIHOOD AND/OR APPEARANCE OF A CONFLICT ARISING. CONTROLS MAY INCLUDE, BUT ARE NOT LIMITED TO: A. IF THE CONFLICT INVOLVES AN ON-GOING MATTER OR RELATIONSHIP, THE FIDUCIARY MUST NOT PARTICIPATE IN BOARD, BOARD COMMITTEE, OR MANAGEMENT DISCUSSIONS RELATED TO THE CONFLICT AND MUST RECUSE THEMSELVES AND IF APPROPRIATE, WITHDRAW, FROM ANY BOARD MEETING OR PORTION THEREOF WHERE THE MATTER IS BEING DISCUSSED AND DURING THE VOTE ON THE POTENTIAL CONFLICT OF INTEREST. THE FIDUCIARY MAY ANSWER QUESTIONS AT THE BOARD'S OR THE BOARD COMMITTEE'S REQUEST. B. IF THE CONFLICT INVOLVES A SPECIFIC TRANSACTION OR DECISION, THE FIDUCIARY WILL FULLY DISCLOSE THEIR INTEREST AND ALL RELATED MATERIAL FACTS. THE BOARD OR COMMITTEE OF THE BOARD WILL DETERMINE WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO ESSENTIA HEALTH OR ITS AFFILIATE(S). IF THE BOARD DETERMINES A CONFLICT DOES NOT EXIST, THE FIDUCIARY MAY PROCEED WITH THE TRANSACTION; HOWEVER, HE OR SHE WILL NOT BE ELIGIBLE TO VOTE ON RELATED ISSUES SHOULD THEY ARISE. IF THE BOARD DETERMINES A CONFLICT DOES EXIST, THE FIDUCIARY WILL BE NOTIFIED OF THE DECISION REGARDING WHETHER THE CONTEMPLATED TRANSACTION WILL BE AUTHORIZED AS JUST, FAIR, AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION: THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF ESSENTIA HEALTH'S BOARD OF DIRECTORS IS AUTHORIZED TO FULFILL THE BOARD'S RESPONSIBILITIES REGARDING EXECUTIVE COMPENSATION CONSISTENT WITH ESSENTIA'S MISSION, VALUES AND TAX-EXEMPT STATUS, AND THE EXECUTIVE COMPENSATION COMMITTEE'S CHARTER. THE EXECUTIVE COMPENSATION COMMITTEE MEETS AT LEAST TWICE ANNUALLY TO CARRY OUT ITS RESPONSIBILITIES, WHICH INCLUDE, BUT ARE NOT LIMITED TO, ESTABLISHING, REVIEWING AND MODIFYING, AS APPROPRIATE, REASONABLE COMPENSATION AND BENEFITS FOR DESIGNATED ESSENTIA EXECUTIVES WHO ARE OFFICERS OR KEY EMPLOYEES OF ESSENTIA OR ANY OF ITS AFFILIATES WHICH MAY BE PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINIONS ON TOTAL COMPENSATION REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE MAY REQUEST ITS INDEPENDENT ADVISORS TO: MONITOR COMPARABILITY DATA AND MARKETPLACE TRENDS; MAKE APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES; AND PERIODICALLY REVIEW THE MARKET COMPETITIVENESS OF ESSENTIA EXECUTIVE COMPENSATION PACKAGES. PRIOR TO ESTABLISHING OR ADJUSTING EXECUTIVE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE WILL OBTAIN AND RELY UPON APPROPRIATE DATA AS TO COMPARABILITY OF THE PROPOSED COMPENSATION OR ADJUSTMENTS. THE EXECUTIVE COMPENSATION COMMITTEE WILL ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THOSE DETERMINATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MINUTES WILL INCLUDE: THE TERMS OF THE APPROVED COMPENSATION AND THE DATE APPROVED; THE EXECUTIVE COMPENSATION COMMITTEE MEMBERS PRESENT DURING THE REVIEW, DISCUSSION AND APPROVAL OF THE PROPOSED COMPENSATION AND THOSE WHO VOTED ON THE PROPOSED COMPENSATION; IDENTIFICATION OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE EXECUTIVE COMPENSATION COMMITTEE AND HOW THE DATA WAS OBTAINED; ANY ACTIONS BY A MEMBER OF THE EXECUTIVE COMPENSATION COMMITTEE HAVING A CONFLICT OF INTEREST; AND DOCUMENTATION OF THE BASIS FOR THE DETERMINATION. THIS PROCESS WAS LAST UNDERTAKEN IN 2023 FOR ESSENTIA HEALTH DEER RIVER'S FINANCE DIRECTOR AND ADMINISTRATOR. THE ESSENTIA HEALTH PHYSICIAN AND PROVIDER COMPENSATION COMMITTEE HAS AN ANNUAL COMPENSATION PROCESS THAT INCLUDES A REVIEW AND RECOMMENDATION OF THE UPCOMING FISCAL YEAR'S PHYSICIAN AND PROVIDER COMPENSATION PLAN RATES AND THE COMPENSATION PLAN METHODOLOGY. COMPENSATION RATES FOR THE ESSENTIA HEALTH PHYSICIAN LEADERSHIP ARE RECOMMENDED BY THE ESSENTIA HEALTH SYSTEM EXECUTIVE LEADERSHIP TEAM BASED ON ITS REVIEW OF MARKET SURVEYS, REGIONAL COMPETITIVE FACTORS, AND THE ANNUAL BUDGET PROCESS. THE COMPENSATION OF ESSENTIA HEALTH PHYSICIAN, PROVIDER AND PHYSICIAN LEADERSHIP, INCLUDING APPOINTED CHIEF AND CHAIR POSITIONS, IS REVIEWED AND APPROVED BY THE ESSENTIA HEALTH BOARD OF DIRECTORS. THIS PROCESS WAS LAST UNDERTAKEN IN 2024 FOR ESSENTIA HEALTH DEER RIVER'S ASSOCIATE CHIEF MEDICAL OFFICER. 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 24D: AFFILIATE REVENUE AND EXPENSE ALLOCATION: ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, AND THE DULUTH CLINIC, LTD. ALLOCATE CERTAIN REVENUES AND EXPENSES DIRECTLY TO ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH SANDSTONE, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, ESSENTIA HEALTH NORTHERN PINES, ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER, ESSENTIA HEALTH DEER RIVER, ESSENTIA HEALTH VIRGINIA, ESSENTIA HEALTH SURGERY CENTERS, ESSENTIA HEALTH MOOSE LAKE, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, AND ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, ALL RELATED ORGANIZATIONS. NET AFFILIATE REVENUE AND EXPENSE ALLOCATIONS OF $2,793,038 INCLUDE THE FOLLOWING TYPES OF REVENUE AND EXPENSES: PATIENT REVENUE; NONPATIENT REVENUE; AMORTIZATION AND DEPRECIATION; INTEREST; PROFESSIONAL FEES; PURCHASED SERVICES; REPAIRS AND MAINTENANCE; SALARIES, WAGES, AND RELATED BENEFITS; SUPPLIES; UTILITIES; AGENCY FEES; PROVIDER AND OTHER TAXES; AND OTHER EXPENSES. FORM 990, PART XI, LINE 9: NET ASSET TRANSFER WITH RELATED ORGANIZATION -359,700. FORM 990, PART XII, LINE 3: CONSOLIDATED UNIFORM GUIDANCE AUDIT: ESSENTIA HEALTH DEER RIVER, AS PART OF ESSENTIA HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS, WAS REQUIRED AND UNDERWENT A CONSOLIDATED AUDIT SET FORTH IN THE UNIFORM GUIDANCE, 2 C.F.R. PART 200, SUBPART F. THE CONSOLIDATED AUDIT IS REVIEWED BY THE ESSENTIA HEALTH AUDIT COMMITTEE. 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 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 INNOVIS HEALTH LLC 3000 32ND AVE S FARGO ND 58103 261175213 HOSPITAL/CLINIC DE 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 N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 ESSENTIA HEALTH M 4904544 ACTUAL COSTS ESSENTIA HEALTH P 2133043 ACTUAL COSTS ESSENTIA HEALTH S 11600000 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION S 500000 ACTUAL COSTS MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC S 5500000 ACTUAL COSTS ST JOSEPH'S MEDICAL CENTER P 55200 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