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      <Form990PartVIISectionAGrp>
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        <FAPAppAvailableOnWebsiteURLTxt>ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE</FAPAppAvailableOnWebsiteURLTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>ESSENTIA HEALTH ADA</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 5: ESSENTIA HEALTH ADA SOLICITED BROAD FEEDBACK FROM THE COMMUNITY THROUGH A COMMUNITY SURVEY WHICH COLLECTED 86 RESPONSES, AND THREE LISTENING SESSIONS WITH 16 PARTICIPANTS; THE SURVEY WAS ADMINISTERED FROM MARCH TO NOVEMBER 2021 AND LISTENING SESSIONS WERE HELD IN NOVEMBER 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 STATEWIDE HEALTH IMPROVEMENT PARTNERSHIP, POLK-NORMAN-MAHNOMEN PUBLIC HEALTH, NORMAN COUNTY SOCIAL SERVICES, THE CITY OF ADA, ADA ALIVE, IMPACT COALITION, AND THE SUICIDE PREVENTION PROJECT.ESSENTIA HEALTH ADA DID NOT RECEIVE ANY COMMENTS ON THE PREVIOUS CHNA. IF RECEIVED, ANY COMMENTS WOULD HAVE BEEN TAKEN INTO CONSIDERATION IN THE CHNA UPDATE PROCESS.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>ESSENTIA HEALTH ADA</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 6B: ESSENTIA HEALTH ADA WORKED COLLABORATIVELY ON THE ASSESSMENT PROCESS WITH STATEWIDE HEALTH IMPROVEMENT PARTNERSHIP, POLK-NORMAN-MAHNOMEN PUBLIC HEALTH, NORMAN COUNTY SOCIAL SERVICES, TRI-VALLEY OPPORTUNITY COUNCIL, AREA AGENCY ON AGING, NORMAN COUNTY SHERIFF'S DEPARTMENT, THE CITY OF ADA, ADA ALIVE, IMPACT COALITION, NORTHWEST MINNESOTA FOUNDATION, NORMAN COUNTY EAST SCHOOL DISTRICT, ADA-BORUP WEST SCHOOL DISTRICT, UNIVERSITY OF MINNESOTA EXTENSION, DEKKO COMMUNITY CENTER, COUNTY 4H, HOPE PROJECT, AND SUICIDE PREVENTION PROJECT.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>ESSENTIA HEALTH ADA</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 11: DURING FY 2024, ESSENTIA HEALTH ADA ADDRESSED SIGNIFICANT NEEDS IDENTIFIED IN THE FY 2022 ASSESSMENT: YOUTH MENTAL WELL-BEING AND ACCESS TO EMPLOYMENT OPPORTUNITIES. 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 HEALTHY EATING/ACTIVE LIVING, WHICH WILL NOT BE DIRECTLY ADDRESSED AS PRIORITIES BECAUSE THE FEASIBILITY FOR HOUSING WAS RANKED LOW, AND THERE ARE OTHER COMMUNITY PARTNERS CURRENTLY DOING WORK AROUND HEALTHY EATING/ACTIVE LIVING.THE FOLLOWING DESCRIBES SIGNIFICANT ACCOMPLISHMENTS AND OUTCOMES.PRIORITY AREA #1: YOUTH MENTAL WELL-BEINGTO PROMOTE YOUTH MENTAL WELL-BEING, ESSENTIA HEALTH ADA PARTNERED WITH THE DEKKO COMMUNITY CENTER AND NORMAN COUNTY PUBLIC HEALTH TO HOST A BIKE RODEO FOR LOCAL YOUTH. AT THIS EVENT, 95 YOUTH RECEIVED BIKE HELMETS AND 100% OF PRE-K THROUGH 5TH GRADE STUDENTS IN ADA-BORUP-WEST ELEMENTARY AND LITTLE LEARNERS EARLY CHILDHOOD EDUCATION CENTER RECEIVED BIKE SAFETY EDUCATION. THROUGH THIS INITIATIVE, CHILDREN AND FAMILIES RECEIVED EDUCATION ON LEADING AN ACTIVE LIFESTYLE AND THE IMPORTANCE OF PHYSICAL ACTIVITY FOR MENTAL WELL-BEING. ADDITIONALLY, YOUTH WHO PARTICIPATED IN THE EVENT ENGAGED WITH LOCAL PUBLIC HEALTH AND FIRST RESPONDER PERSONNEL, WHICH FOSTERED COMMUNITY ENGAGEMENT AND HEALTHY RELATIONSHIP BUILDING AMONG CHILDREN AND TRUSTED ADULTS. IN ADDITION TO THIS PARTNERSHIP, THE HOSPITAL PARTNERED WITH THE RURAL ENRICHMENT AND COUNSELING HEADQUARTERS (REACH) TO SUPPORT THE BACKPACK PROGRAM. THE BACKPACK PROGRAM IS A COLLABORATION BETWEEN GREAT PLAINS FOOD BANK, NORTH COUNTRY FOOD BANK, AND FEEDING AMERICA TO PROVIDE NUTRITIOUS FOOD FOR CHILDREN IN THE NORMAN COUNTY EAST AND ADA-BORUP-WEST SCHOOL DISTRICTS TO TAKE HOME EACH FRIDAY DURING THE SCHOOL YEAR. THROUGH THIS INITIATIVE, LOCAL CHILDREN RECEIVE NUTRITIOUS, KID-FRIENDLY, AND SHELF-STABLE SNACKS AND EASY TO PREPARE INDIVIDUAL MEALS. PROVIDING ACCESS TO FOOD FOR CHILDREN EXPERIENCING FOOD INSECURITY HELPS PROMOTE MENTAL WELL-BEING BY ALLEVIATING STRESS AND ANXIETY RELATED TO HUNGER AND UNCERTAINTY ABOUT WHERE THEIR NEXT MEAL WILL COME FROM. WHEN CHILDREN HAVE CONSISTENT ACCESS TO NUTRITIOUS MEALS, THEY CAN FOCUS BETTER IN SCHOOL, FEEL MORE SECURE, AND DEVELOP HEALTHIER RELATIONSHIPS, ALL OF WHICH CONTRIBUTE TO IMPROVED MENTAL AND EMOTIONAL WELL-BEING. ALTHOUGH THESE EFFORTS ARE ONGOING, THIS INITIATIVE IS ANTICIPATED TO SERVE OVER 190 CHILDREN THROUGHOUT REACH'S SERVICE AREA DURING THE NEXT YEAR.THE HOSPITAL ALSO SUPPORTED YOUTH MENTAL WELL-BEING THROUGH ANOTHER PARTNERSHIP WITH THE DEKKO COMMUNITY CENTER THAT FORMED A SCHOLARSHIP FUND FOR LOCAL YOUTH TO ACCESS SWIMMING LESSONS. PHYSICAL ACTIVITY IS VITAL FOR MENTAL HEALTH, AIDS IN REGULATING STRESS AND ANXIETY, AND CAN BOOST SELF-ESTEEM, ALL OF WHICH PROMOTE POSITIVE MENTAL WELL-BEING. ADDITIONALLY, ENGAGING IN PHYSICAL ACTIVITY IN GROUP SETTINGS CAN FOSTER SOCIAL CONNECTIONS, PROVIDING A SENSE OF COMMUNITY AND SUPPORT THAT FURTHER ENHANCES EMOTIONAL RESILIENCE. THROUGH THIS PARTNERSHIP WITH THE DEKKO COMMUNITY CENTER, 28 YOUTH WERE ABLE TO ACCESS SWIMMING LESSONS FREE OF CHARGE, WHICH SUPPORTED THE EQUITABLE ACCESS OF PHYSICAL ACTIVITY, COMMUNITY ENGAGEMENT, AND MENTAL WELL-BEING FOR YOUTH AND FAMILIES IN ADA. OF THE 28 STUDENTS WHO ACCESSED SWIMMING LESSONS ON A SCHOLARSHIP, 75% WERE PARTICIPATING IN SWIMMING LESSONS FOR THE FIRST TIME AND 68% SUCCESSFULLY PASSED THE SWIMMING LEVEL THAT THEY WERE ENROLLED IN.PRIORITY AREA #2: ACCESS TO EMPLOYMENT OPPORTUNITIESESSENTIA HEALTH ADA COLLABORATED WITH COMMUNITY PARTNERS TO PROMOTE ACCESS TO ECONOMIC OPPORTUNITIES IN THE COMMUNITY. IN FY 2024, THE HOSPITAL PARTNERED WITH ADA-BORUP-WEST HIGH SCHOOL AND LOCAL BUSINESSES IN ADA TO HOST A JOB SHADOWING DAY FOR 10TH GRADE STUDENTS AT THE ADA-BORUP-WEST HIGH SCHOOL. THE PURPOSE OF THIS EVENT WAS TO SHOWCASE DIFFERENT JOBS AT LOCAL BUSINESSES WITH THE GOAL OF INTRODUCING YOUTH TO DIFFERENT CAREER FIELDS AVAILABLE IN ADA AND EMPOWERING THEM TO MAKE POSITIVE EDUCATION AND CAREER CHOICES FOR THEMSELVES. AT THIS EVENT, 100% OF ADA-BORUP-WEST 10TH GRADE STUDENTS ENGAGED WITH BUSINESSES AND TRUSTED ADULTS IN THE COMMUNITY, GIVING STUDENTS AN UNDERSTANDING OF THE EDUCATION AND EXPERIENCE REQUIRED FOR DIFFERENT CAREERS. FURTHERMORE, AS A RESULT OF THIS EVENT, 70% OF STUDENTS REPORTED FEELING HOPEFUL OR IN CONTROL OF THEIR FUTURE AND 60% OF STUDENTS REPORTED FEELING THAT THERE WERE CAREER OPPORTUNITIES AVAILABLE FOR THEM IN NORMAN COUNTY. IN ADDITION TO THIS PARTNERSHIP, THE HOSPITAL PARTNERED WITH TRI-VALLEY TRANSPORTATION TO SPONSOR A PUBLIC TRANSPORTATION SERVICE FOR RESIDENTS OF TWIN VALLEY, MINNESOTA. THROUGH THIS PARTNERSHIP, PUBLIC TRANSPORTATION IS AVAILABLE FREE OF CHARGE TO ALL COMMUNITY MEMBERS. THIS PARTNERSHIP IS ANTICIPATED TO ENHANCE ACCESS TO HEALTHCARE, NUTRITIOUS FOOD, SOCIAL SERVICES, EDUCATION, AND EMPLOYMENT OPPORTUNITIES TO 100 RURAL RESIDENTS IN FY 2024.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>ADDITIONAL DISCLOSURES NOT REQUIRED FOR PART V, SECTION C:</FormAndLineReferenceDesc>
        <ExplanationTxt>SCHEDULE H, PART V, SECTION B, LINE 3E:ESSENTIA HEALTH ADA CONDUCTED A NEW CHNA IN FY22 AND CHOSE TO ADDRESS TWO PRIORITY HEALTH NEEDS BASED ON THE FEEDBACK OF 86 COMMUNITY MEMBERS. THE SIGNIFICANT HEALTH NEEDS ARE YOUTH MENTAL WELLBEING AND ACCESS TO EMPLOYMENT OPPORTUNITIES. 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.</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>1</FacilityNum>
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        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - ESSENTIA HEALTH ADA CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>201 9TH ST W</AddressLine1Txt>
            <CityNm>ADA</CityNm>
            <StateAbbreviationCd>MN</StateAbbreviationCd>
            <ZIPCd>56510</ZIPCd>
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          <FacilityTxt>MULTI-SPECIALTY CLINIC</FacilityTxt>
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      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3C:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 6A:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LN 7 COL(F):</FormAndLineReferenceDesc>
        <ExplanationTxt>BAD DEBT EXPENSE THAT WAS SUBTRACTED FROM TOTAL EXPENSE TO OBTAIN THE % OF COMMUNITY BENEFIT TO TOTAL EXPENSE AMOUNTED TO $372,150.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II, COMMUNITY BUILDING ACTIVITIES:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>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 ADA 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>PAGES 16-18 OF ESSENTIA HEALTH'S CONSOLIDATED AUDIT REPORT CONTAIN THE FOOTNOTE DESCRIBING THE ORGANIZATION'S BAD DEBT EXPENSE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>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 ADA 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>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).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>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 &amp; 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 &amp; 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>COMMUNITY INFORMATION:ESSENTIA HEALTH ADA IS LOCATED IN ADA, MN AND IS A PART OF ESSENTIA HEALTH, WHICH IS DEFINED IN PART VI, LINE 6. THE ORGANIZATION OPERATES 1 HOSPITAL AND 1 CLINIC THAT SERVE THE COMMUNITIES OF NORMAN, CASS, POLK AND MAHNOMEN COUNTIES. THE OVERALL COMMUNITY IS CLASSIFIED AS RURAL.ESSENTIA HEALTH ADA COVERS A SERVICE AREA OF APPROXIMATELY 2,400 PEOPLE. THE SERVICE AREA AGE DISTRIBUTION IS 21% UNDER THE AGE OF 18; 57% BETWEEN THE AGES OF 18 AND 65; AND 23% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE AREA IS 90% CAUCASIAN; 1% ASIAN; 6% HISPANIC; AND 3% OTHER. THE GENDER SPLIT RATIO IS 52% WOMEN AND 48% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY $53,000.ESSENTIA HEALTH ADA, AS PART OF ESSENTIA HEALTH, IS COMMITTED TO SERVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. APPROXIMATELY 2.8% GROSS REVENUE DOLLARS WERE FROM SELF-PAY PATIENTS AND 20.1% FROM MEDICAID RECIPIENTS. NORMAN COUNTY IS CURRENTLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA.AS MENTIONED ABOVE, ESSENTIA HEALTH ADA 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 NO OTHER HOSPITALS OUTSIDE OF THE ESSENTIA HEALTH UMBRELLA THAT SERVICE THE COMMUNITY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>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 ADA 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 6:</FormAndLineReferenceDesc>
        <ExplanationTxt>AFFILIATED HEALTH CARE SYSTEM:ESSENTIA HEALTH ADA 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 7, REPORTS FILED WITH STATES</FormAndLineReferenceDesc>
        <ExplanationTxt>MN</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>502 E 2ND ST</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55805</ZIPCd>
        </USAddress>
        <RecipientEIN>271984704</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>23314</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>PROGRAM SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>1</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>PROCEDURES FOR MONITORING USE OF GRANT FUNDS: CONTRIBUTIONS TO THE ESSENTIA HEALTH FOUNDATION, A RELATED ORGANIZATION, ARE MADE TO COVER THEIR OPERATING EXPENSES. ESSENTIA HEALTH ADA MAY ALSO MAKE DESIGNATED DONATIONS TO THE ESSENTIA HEALTH FOUNDATION'S UNRESTRICTED FUND.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BENJAMIN SMITH MD</PersonNm>
        <TitleTxt>BOARD DIRECTOR/RELATED ORG PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>1625910</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>1140</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>26400</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>46148</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1699598</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TRACI MORRIS</PersonNm>
        <TitleTxt>TREASURER/REL ORG CHIEF FINCL OFF</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>669563</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>146723</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>83904</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>123590</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>2262</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1026042</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>63527</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL WATTERS</PersonNm>
        <TitleTxt>SECRETARY/REL ORG CHIEF LEGAL OFF</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>489927</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>111318</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>44753</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>93066</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>39589</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>778653</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>28999</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SREEJITH GOPI MD</PersonNm>
        <TitleTxt>PHYSICIAN &amp; SECTION CHAIR</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>481368</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>9305</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>36987</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>40800</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>568460</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TAYLOR MERTZ MD</PersonNm>
        <TitleTxt>BD DIRECTOR/REL ORG PHYS &amp; SEC CHAIR</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>350856</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>363</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>26308</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>39539</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>417066</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAMES CHRISTENSEN MD</PersonNm>
        <TitleTxt>BOARD DIRECTOR/RELATED ORG PHYSICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>277114</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>2033</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>22434</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>25133</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>326714</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RYAN HILL</PersonNm>
        <TitleTxt>FORMER SENIOR FINANCE ADVISOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>227920</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>575</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>11454</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>39399</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>279348</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHENTEL DANGERUD</PersonNm>
        <TitleTxt>PHYSICIAN ASSISTANT</TitleTxt>
        <BaseCompensationFilingOrgAmt>208983</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>118</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10978</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>37601</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>257680</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>EMILY STUENESS</PersonNm>
        <TitleTxt>PHYSICIAN ASSISTANT</TitleTxt>
        <BaseCompensationFilingOrgAmt>191373</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>54</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>9129</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>38278</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>238834</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KARI BERGMAN</PersonNm>
        <TitleTxt>REGIONAL NURSING DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>183693</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>80</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10069</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>42372</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>236214</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KIMBERLY BODENSTEINER</PersonNm>
        <TitleTxt>FINANCE DIRECTOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>203664</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>788</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>10411</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>15892</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>230755</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JEAN CHISHOLM</PersonNm>
        <TitleTxt>REGISTERED NURSE</TitleTxt>
        <BaseCompensationFilingOrgAmt>196462</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>155</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10041</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>21853</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>228511</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ERIN STOLTMAN</PersonNm>
        <TitleTxt>ADMINISTRATOR</TitleTxt>
        <BaseCompensationFilingOrgAmt>146492</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>177</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7392</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>2646</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>156707</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DANIELLE ALDRICH</PersonNm>
        <TitleTxt>REGISTERED NURSE</TitleTxt>
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        <CompensationBasedOnRltdOrgsAmt>1672</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>253</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>6313</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>84</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>30426</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>150318</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1756</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA HEALTH ADA'S ADMINISTRATOR'S COMPENSATION: A COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>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 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: TRACI MORRIS $97,190 MICHAEL WATTERS $68,732</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART V, LINE 1A:</FormAndLineReferenceDesc>
        <ExplanationTxt>1099 REPORTING: VENDOR PAYMENTS AND FORM 1099S WERE PROCESSED THROUGH ESSENTIA HEALTH ON BEHALF OF THE LEGAL ENTITIES COMPRISING ESSENTIA HEALTH.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>BUSINESS RELATIONSHIP: OFFICER KIM BODENSTEINER AND BOARD DIRECTOR MARK FINSTAD HAVE A BUSINESS RELATIONSHIP IN ULTIMA BANK MINNESOTA.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: DURING THE FISCAL YEAR ENDED JUNE 30, 2024, THE ARTICLES OF INCORPORATION AND BYLAWS OF ESSENTIA HEALTH ADA WERE AMENDED TO UPDATE THE SOLE MEMBER TO ESSENTIA HEALTH AND CLARIFY AND UPDATE THE RESERVED POWERS OF ESSENTIA HEALTH. THE BYLAWS WERE AMENDED TO MODIFY THE COMPOSITION OF THE BOARD OF DIRECTORS TO CONSIST OF THE SAME INDIVIDUALS WHO SERVE ON THE ESSENTIA HEALTH WEST BOARD OF MANAGERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS OF ORGANIZATION: ESSENTIA HEALTH IS THE SOLE MEMBER OF ESSENTIA HEALTH ADA. ESSENTIA HEALTH HAS RESERVED POWERS WITH RESPECT TO ESSENTIA HEALTH ADA AS DESCRIBED IN SCHEDULE O, PART VI, LINES 7A &amp; 7B.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBER WITH RIGHT TO ELECT GOVERNING BODY: ESSENTIA HEALTH ADA'S GOVERNING BODY CONSISTS OF THE SAME INDIVIDUALS SERVING ON ESSENTIA HEALTH WEST'S BOARD OF MANAGERS. ESSENTIA HEALTH, AS THE SOLE MEMBER OF ESSENTIA HEALTH WEST, HAS THE POWER TO APPOINT AND REMOVE ESSENTIA HEALTH WEST'S GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBER 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 CORPORATION'S STRATEGIC AND BUSINESS PLANS. (B) MISSION. AUTHORITY TO CREATE, APPROVE AND AMEND THE CORPORATION'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 CORPORATION'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 CORPORATION TO PARTICIPATE IN SYSTEM BORROWING. (D) GOVERNING INSTRUMENTS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS. (E) APPOINTMENT AND REMOVAL OF DIRECTORS. AUTHORITY TO APPOINT AND REMOVE ALL DIRECTORS ON THE CORPORATION'S BOARD OF DIRECTORS, WITH OR WITHOUT CAUSE. (F) MERGERS AND ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF THE CORPORATION. (G) AFFILIATIONS AND JOINT VENTURES. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AFFILIATIONS, JOINT VENTURES, AND OTHER ALLIANCES WITH THIRD PARTIES BY THE CORPORATION. (H) TRANSFER OF ASSETS WITHIN THE SYSTEM. AUTHORITY TO TRANSFER THE CORPORATION'S ASSETS, INCLUDING CASH, BETWEEN AND AMONG ENTITIES WITHIN THE SYSTEM; PROVIDED, HOWEVER, THAT THE MEMBER SHALL NOT HAVE AUTHORITY TO REQUIRE THE CORPORATION TO TRANSFER ASSETS (I) THAT WOULD CAUSE IT 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 THE CATHOLIC ENTITIES WOULD BE USED IN THE PROVIDING OF SERVICES CONTRARY TO THE ERDS AT SECULAR FACILITIES WITHIN THE SYSTEM. (I) TRANSFER OF ASSETS OUTSIDE THE SYSTEM. AUTHORITY TO CAUSE, AND TO APPROVE, THE SALE, LEASE OR OTHER TRANSFER OF THE CORPORATION'S ASSETS TO PARTIES OUTSIDE OF THE SYSTEM WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR AGGREGATE LIMITS PRESCRIBED IN WRITING BY THE MEMBER'S BOARD OF DIRECTORS. (J) SERVICES. AUTHORITY TO CAUSE, AND TO APPROVE, THE OFFERING OR DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS BY THE CORPORATION. (K) BUDGETS. APPROVAL OF THE CORPORATION'S CAPITAL AND OPERATING BUDGETS. (L) PROFESSIONAL SERVICES. SELECTION OF THE CORPORATION'S GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS. (M) CORPORATE ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL CORPORATE ACQUISITIONS BY THE CORPORATION. (N) MARKETING. THE CORPORATION'S PARTICIPATION IN SYSTEM-WIDE MARKETING AND PROMOTIONAL ACTIVITIES. (O) COMPLIANCE PLANS. AUTHORITY TO CREATE, APPROVE AND AMEND THE CORPORATION'S COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS. (P) QUALITY PLAN. AUTHORITY TO CREATE, APPROVE AND AMEND THE CORPORATION'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 THE MEMBER'S BOARD OF DIRECTORS. (R) HUMAN RESOURCES. AUTHORITY TO CREATE, APPROVE AND AMEND THE CORPORATION'S HUMAN RESOURCE POLICIES AND PROCEDURES. (S) SYSTEM COMPENSATION. AUTHORITY, ON BEHALF OF THE CORPORATION, TO DEVELOP AND IMPLEMENT COMPENSATION STRATEGIES, POLICIES, AND PROCEDURES ON A SYSTEM-WIDE BASIS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>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 ADA'S REGIONAL NURSING DIRECTOR, 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 ADA'S PHYSICIAN &amp; SECTION CHAIR.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, &amp; 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).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 24E:</FormAndLineReferenceDesc>
        <ExplanationTxt>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 $278,209 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART XII LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>CONSOLIDATED UNIFORM GUIDANCE AUDIT: ESSENTIA HEALTH ADA, 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.</ExplanationTxt>
      </SupplementalInformationDetail>
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          <BusinessNameLine1Txt>ESSENTIA HEALTH MOOSE LAKE</BusinessNameLine1Txt>
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          <AddressLine1Txt>4572 COUNTY ROAD 61</AddressLine1Txt>
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          <AddressLine1Txt>502 E 2ND ST</AddressLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>GRACEVILLE HEALTH CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>115 WEST 2ND ST</AddressLine1Txt>
          <CityNm>GRACEVILLE</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>56240</ZIPCd>
        </USAddress>
        <EIN>410726173</EIN>
        <PrimaryActivitiesTxt>HOSPITAL/CLINIC/SKILLED NURSING FACILITY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>INNOVIS HEALTH LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3000 32ND AVE S</AddressLine1Txt>
          <CityNm>FARGO</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58103</ZIPCd>
        </USAddress>
        <EIN>261175213</EIN>
        <PrimaryActivitiesTxt>HOSPITAL/CLINIC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DE</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>502 E 2ND ST</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55805</ZIPCd>
        </USAddress>
        <EIN>411674021</EIN>
        <PrimaryActivitiesTxt>MEDICAL EQUIPMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ST MARY'S MEDICAL CENTER</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>NORTHERN PINES MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>5211 HWY 110</AddressLine1Txt>
          <CityNm>AURORA</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55705</ZIPCd>
        </USAddress>
        <EIN>410841441</EIN>
        <PrimaryActivitiesTxt>HOSPITAL/CLINIC/SKILLED NURSING FACILITY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PINE MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>705 LUNDORFF DR S</AddressLine1Txt>
          <CityNm>SANDSTONE</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55072</ZIPCd>
        </USAddress>
        <EIN>411884597</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>POLINSKY MEDICAL REHABILITATION CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>530 E 2ND ST</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55805</ZIPCd>
        </USAddress>
        <EIN>410691275</EIN>
        <PrimaryActivitiesTxt>REHABILITATION SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SMDC MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>502 E 2ND ST</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55805</ZIPCd>
        </USAddress>
        <EIN>411878730</EIN>
        <PrimaryActivitiesTxt>HOSPITAL/CLINIC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST JOSEPH'S MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>523 N 3RD ST</AddressLine1Txt>
          <CityNm>BRAINERD</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>56401</ZIPCd>
        </USAddress>
        <EIN>410695602</EIN>
        <PrimaryActivitiesTxt>HOSPITAL/CLINIC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S DULUTH CLINIC HEALTH SYSTEM</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>502 E 2ND ST</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55805</ZIPCd>
        </USAddress>
        <EIN>411836633</EIN>
        <PrimaryActivitiesTxt>SUPPORTING ORG</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12B, II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S EMS</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1027 WASHINGTON AVE</AddressLine1Txt>
          <CityNm>DETROIT LAKES</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>56501</ZIPCd>
        </USAddress>
        <EIN>411805811</EIN>
        <PrimaryActivitiesTxt>EMERGENCY SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S HOSPITAL OF SUPERIOR</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3500 TOWER AVE</AddressLine1Txt>
          <CityNm>SUPERIOR</CityNm>
          <StateAbbreviationCd>WI</StateAbbreviationCd>
          <ZIPCd>54880</ZIPCd>
        </USAddress>
        <EIN>411811073</EIN>
        <PrimaryActivitiesTxt>HOSPITAL/CLINIC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S INNOVIS HEALTH</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1027 WASHINGTON AVE</AddressLine1Txt>
          <CityNm>DETROIT LAKES</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>56501</ZIPCd>
        </USAddress>
        <EIN>262861321</EIN>
        <PrimaryActivitiesTxt>PHARMACY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>402 E 3RD ST</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55805</ZIPCd>
        </USAddress>
        <EIN>410695604</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S REGIONAL HEALTH CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1027 WASHINGTON AVE</AddressLine1Txt>
          <CityNm>DETROIT LAKES</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>56501</ZIPCd>
        </USAddress>
        <EIN>411620386</EIN>
        <PrimaryActivitiesTxt>HOSPITAL/CLINIC/SKILLED NURSING FACILITY</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE DULUTH CLINIC LTD</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>400 E 3RD ST</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55805</ZIPCd>
        </USAddress>
        <EIN>410883623</EIN>
        <PrimaryActivitiesTxt>CLINIC</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DE</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH INSURANCE SERVICES SPC LTD</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>PO BOX 1159</AddressLine1Txt>
          <CityNm>GRAND CAYMAN</CityNm>
          <CountryCd>CJ</CountryCd>
          <ForeignPostalCd>K71-1102</ForeignPostalCd>
        </ForeignAddress>
        <EIN>000000000</EIN>
        <PrimaryActivitiesTxt>SELF INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>MID DAKOTA CLINIC INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>502 E 2ND ST</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55805</ZIPCd>
        </USAddress>
        <EIN>450311334</EIN>
        <PrimaryActivitiesTxt>CLINIC OPERATIONS CEASED 9/30/22</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>ND</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>1</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>1156018</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COSTS</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>721722</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COSTS</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ST MARY'S REGIONAL HEALTH CENTER</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>3600</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COSTS</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE R, PART II, COLUMN (A):</FormAndLineReferenceDesc>
        <ExplanationTxt>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 &amp; 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</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>