2026-05-11T10:12:42-05:00 2025-06-30 990 2024-07-01 410844574 DEER RIVER HEALTHCARE CENTER INC DEER 2182462900 115 10TH AVE NE DEER RIVER MN 56636 JOSHUA SENGER FINANCE DIRECTOR 2182462900 2026-05-11 0 2024 2025-03-06 01:10:19Z ESSENTIA HEALTH DEER RIVER AMANDA REED 115 10TH AVE NE DEER RIVER MN 56636 64976751 0 X WWW.ESSENTIAHEALTH.ORG X 1956 MN WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 12 10 253 14 205 0 113717 14266 46124623 46356674 781542 1314221 72781 59101 47092663 47744262 0 0 0 0 19043684 19430000 0 0 0 22803175 24707199 41846859 44137199 5245804 3607063 53655611 57953550 8625016 7002315 45030595 50951235 X WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 0 0 35597487 46356674 DEER RIVER HEALTHCARE CENTER, INC., DBA ESSENTIA HEALTH DEER RIVER, IS CREATED AND ORGANIZED EXCLUSIVELY FOR CHARITABLE, RELIGIOUS, EDUCATIONAL, AND SCIENTIFIC PURPOSES. MORE SPECIFICALLY, ESSENTIA HEALTH DEER RIVER SHALL OWN, MAINTAIN, OPERATE AND CONDUCT HEALTH CARE AND RELATED ACTIVITIES AND FACILITIES FOR THE PROMOTION OF HEALTH WITHIN ITS COMMUNITY, INCLUDING CHARITABLE CARE TO PERSONS UNABLE TO PAY.ESSENTIA HEALTH DEER RIVER HAS A CRITICAL ACCESS HOSPITAL WITH 20 LICENSED BEDS AND MULTI-SPECIALTY CLINIC SERVING ITASCA AND CASS COUNTIES. THE HOSPITAL IS A LEVEL IV TRAUMA CENTER AND OFFERS EMERGENCY CARE 24 HOURS A DAY. ESSENTIA HEALTH DEER RIVER OFFERS INPATIENT AND OUTPATIENT SERVICES INCLUDING IMAGING/RADIOLOGY, LAB, SURGERY, AND REHABILITATION.ESSENTIA HEALTH DEER RIVER HAS A SKILLED NURSING FACILITY CONNECTED TO THE HOSPITAL THAT PROVIDES 24 HOUR SKILLED NURSING AND PERSONAL CARE. RESIDENTS HAVE ACCESS TO PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES. IN ADDITION, ESSENTIA HEALTH DEER RIVER'S SENIOR LIVING APARTMENTS PROVIDE A FULL SPECTRUM OF SENIOR LIVING OPPORTUNITIES.ESSENTIA HEALTH DEER RIVER EMPLOYS APPROXIMATELY 140 FULL TIME EQUIVALENTS. THE HOSPITAL PROVIDED NEARLY 1,500 HOSPITAL PATIENT DAYS AND 25,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2025. THE CLINIC HAD OVER 15,000 ENCOUNTERS AND THE SKILLED NURSING FACILITY PROVIDED NEARLY 8,000 RESIDENT DAYS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2025, ESSENTIA HEALTH DEER RIVER PROVIDED THE FOLLOWING COMMUNITY BENEFITS: $425,000 IN CHARITY CARE, $1,000 COSTS IN EXCESS OF MEDICAID PAYMENTS, $63,000 IN COMMUNITY SERVICES, AND $63,000 IN HEALTH PROFESSION EDUCATION.ESSENTIA HEALTH IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTH SYSTEM THAT INCLUDES THIS ORGANIZATION AND ALL ENTITIES THAT ARE OWNED OR CONTROLLED, DIRECTLY OR INDIRECTLY, BY ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM OR "ESSENTIA HEALTH"). 35597487 1 1 0 1 0 0 0 0 1 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 253 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 10 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X JOSHUA SENGER 2182462900 115 10TH AVE NE DEER RIVER MN 56636 TRACI MORRIS TREASURER/REL ORG CHIEF FINCL OFF 1.00 59.00 X 0 1054730 144686 MICHAEL WATTERS SECRETARY/REL ORG CHIEF LEGAL OFF 1.00 59.00 X 0 773128 151399 TROY DUININCK MD BD DIRECTOR/REL ORG PHYS & DIV CHAIR 0.10 59.90 X 0 547906 69761 TODD DEFREECE BD DIRECT THRU 2/25/SVP, OPS 1.00 59.00 X 0 412659 117001 SARA LOKSTAD MD BD DIRECT THRU 2/25/ASSOCIATE CMO 1.00 59.00 X 0 337545 22951 JACOB STAY CNRA 60.00 0.00 X 240724 18834 51034 JAN BALDWIN MD BOARD DIRECTOR/RELATED ORG PHYSICIAN 0.10 59.90 X 0 258062 50172 KEVIN BARSNESS CRNA 60.00 0.00 X 275202 0 29137 LORI SUTHERLAND CRNA SUPERVISOR 60.00 0.00 X 285123 0 16241 JOSHUA SENGER FINANCE DIRECTOR 1.00 59.00 X 0 223978 11578 STEPHANIE ALEXANDER NURSE PRACTITIONER 60.00 0.00 X 216793 0 11796 AMANDA REED ADMINISTRATOR 60.00 0.00 X 172465 0 49515 KRISTINE MOSHER NURSE PRACTITIONER 60.00 0.00 X 170567 0 25496 ANGELA SMITH NURSING DIRECTOR 60.00 0.00 X 61342 99786 9034 MICHAEL LARSON FORMER INTERIM ADMINISTRATOR 0.00 0.00 X 0 163836 0 THOMAS JAMAR BOARD VICE CHAIR 0.10 1.10 X X 0 6600 0 GEORGE LOBAN BOARD DIRECTOR 0.10 1.10 X 0 5600 0 ANTHONY SERTICH BOARD CHAIR 0.10 2.10 X X 0 5400 0 AMY BERGSTROM BOARD DIRECTOR 0.10 1.10 X 0 5000 0 ANTHONY YUNG BOARD DIRECTOR 0.10 1.10 X 0 3600 0 ADAM BACHAND BOARD DIRECTOR 0.10 1.10 X 0 0 0 APRIL JESPERSON BOARD DIRECTOR THRU 2/25 0.70 0.00 X 0 0 0 ARA ANDERSON BOARD VICE CHAIR THRU 2/25 0.70 0.00 X X 0 0 0 BECKY URBANSKI BOARD DIRECTOR 0.10 1.10 X 0 0 0 DAVID DELAWYER BOARD DIRECTOR THRU 2/25 0.70 0.00 X 0 0 0 KYLE FAIRBANKS BOARD DIRECTOR THRU 2/25 0.70 0.00 X 0 0 0 LYNETTE HOW BOARD SECRETARY/TREASURER THRU 2/25 0.70 0.00 X X 0 0 0 NANCY ARONSON NORR BOARD DIRECTOR 0.10 1.10 X 0 0 0 NEAL WALKER BOARD CHAIR THRU 2/25 0.70 0.00 X X 0 0 0 PAM THOMPSON BOARD DIRECTOR THRU 2/25 0.70 0.00 X 0 0 0 SISTER BEVERLY RAWAY BOARD DIRECTOR 0.10 3.10 X 0 0 0 SISTER JEANNE ANN WEBER BOARD DIRECTOR 0.10 1.10 X 0 0 0 1422216 3916664 759801 22 1 1 0 0 14266 14266 INPATIENT AND OUTPATIENT REVENUES 621110 42590590 42590385 205 SKILLED NURSING FACILITY REVENUE 623000 3307688 3307688 ASSISTED & INDEPENDENT LIVING REV 623000 283315 283315 EQUITY SHARE IN CENTRAL MN DIAGNO 900099 175081 175081 46356674 755450 755450 100 0 100 100 100 17791260 17232489 558771 558771 558771 CAFETERIA & VENDING REVENUE 722514 56761 56761 MISCELLANEOUS REVENUE 900099 2240 2240 59001 47744262 46356469 205 1373322 X 376257 142958 233299 84653 84653 15117615 13886977 1230638 602476 555332 47144 2263159 1984940 278219 985840 876843 108997 -229 -229 556 556 90191 90191 1740233 1421589 318644 12087 1159 10928 2071298 1599958 471340 81047 74449 6598 794117 729473 64644 142630 101551 41079 19848 8537 11311 93498 93498 1550652 1424422 126230 179580 169545 10035 MEDICAL SUPPLIES 7775741 7775741 AFFILIATE SUPPORT FEE 5146752 2506983 2639769 AFFILIATE EXP & REV ALL 2879324 287932 2591392 BAD DEBT EXPENSE 1115799 1115799 1014075 839801 174274 44137199 35597487 8539712 0 178352 5662642 4781583 4778494 5615269 5953953 488156 507073 1400290 1008180 82948 84236 23276918 14699624 10301814 8577294 25982883 28950705 4824316 2430973 53655611 57953550 2937008 2354338 184649 363136 2108100 1626178 2420 2420 800460 701 2592379 2655542 8625016 7002315 X 44728688 50649328 301907 301907 45030595 50951235 53655611 57953550 X 3607063 1953877 359700 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 556 556 0 SCHEDULE C, PART II-B, LINE 1, LOBBYING ACTIVITIES: LOBBYING ACTIVITY EXPLANATION: ESSENTIA HEALTH DEER RIVER PAYS DUES TO A CERTAIN ORGANIZATION RELATED TO THE INDUSTRY WHICH HAS LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. 0 1 X 301907 301907 301907 301907 301907 301907 301907 301907 301907 301907 0.00000 0.00000 1.00000 0 0 383772 383772 18223078 12829908 5393170 484806 347445 137361 3804931 1846553 1958378 380331 -324282 704613 8577294 POOLED INVESTMENT FUND 28950705 F 28950705 OPERATING LEASES 2472886 ASSET RETIREMENT OBLIGATION (FIN47) 182656 2655542 PART IV, LINE 2B: ESCROW AND CUSTODIAL ARRANGEMENTS: ESSENTIA HEALTH DEER RIVER ACTS AS CUSTODIAN FOR THE FUNDS OF THE SKILLED NURSING FACILITY RESIDENTS. RESIDENT TRUST FUNDS TOTALED $2,420 AT JUNE 30, 2025. PART V, LINE 4: ENDOWMENT FUND INTENDED USES: ESSENTIA HEALTH DEER RIVER'S INTENDED USE OF ITS ENDOWMENT FUNDS IS FOR CAPITAL AND OTHER IMPROVEMENTS THAT FURTHER ESSENTIA HEALTH DEER RIVER'S MISSION. 1 1 X 1 X 0 1 1 1 0 1 1 425107 425107 0.00990 7650858 7650047 811 0.00000 8075965 7650047 425918 0.00990 62608 62608 0.00150 84298 21790 62508 0.00150 146906 21790 125116 0.00300 8222871 7671837 551034 0.01290 14363 14363 0.00030 14363 14363 0.00030 1 1115799 12630562 12691823 -61261 X 1 1 1 1 ESSENTIA HEALTH DEER RIVER 115 10TH AVE NE DEER RIVER MN 56636 WWW.ESSENTIAHEALTH.ORG 419715 X X X X X ESSENTIA HEALTH DEER RIVER 0 0 1 X X X X X X X X X 24 1 1 1 1 X WWW.ESSENTIAHEALTH.ORG/ABOUT/CHNA/ X 1 24 1 WWW.ESSENTIAHEALTH.ORG/ABOUT/CHNA/ 0 1 X 200.000000000000 X X X X X 1 1 X X X X 1 X WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X WWW.ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X X X X X 1 X 0 X X X X 1 X 0 0 ESSENTIA HEALTH DEER RIVER PART V, SECTION B, LINE 5: ESSENTIA HEALTH DEER RIVER SOLICITED BROAD FEEDBACK FROM THE COMMUNITY THROUGH A COMMUNITY SURVEY, WHICH COLLECTED 184 RESPONSES; THE SURVEY WAS ADMINISTERED FROM 7/18/2024 TO 9/30/2024.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. TO EMPHASIZE THESE INTERESTS, THE HOSPITAL STRATEGICALLY ENGAGED WITH AITKIN-ITASCA-KOOCHICHING COMMUNITY HEALTH BOARD, BOYS AND GIRLS CLUB DEER RIVER, BOYS AND GIRLS CLUB OF GRAND RAPIDS GREENWAY, BOYS AND GIRLS CLUB OF THE LEECH LAKE AREA, DEER RIVER SCHOOL DISTRICT FULL-SERVICE COMMUNITY SCHOOL, ELDERCIRCLE, FIRST CALL FOR HELP OF ITASCA COUNTY, FORWARD HEALTH FOUNDATION, FREE RANGE FOOD CO-OP, GRAND ITASCA HOSPITAL-FAIRVIEW, GRAND RAPIDS AREA COMMUNITY FOUNDATION, GRAND RAPIDS FARMERS MARKET, GRAND RAPIDS SCHOOL DISTRICT, ITASCA AREA SCHOOLS COLLABORATIVE, ITASCA COUNTY LOCAL ADVISORY COUNCIL ON MENTAL HEALTH, ITASCA COUNTY NAMI, ITASCA COUNTY PUBLIC HEALTH, ITASCA PRIDE, KOOTASCA COMMUNITY ACTION HEAD START, LEECH LAKE BAND, MISSION RESTART, MOBILITY MANIA, OPEN DOOR COAT RACK, PROJECT CARE FREE CLINIC - GRAND RAPIDS, SECOND HARVEST NORTHLAND, SMART NORTH-TECH HUB, U OF M EXTENSION SNAP-ED, AND UNITED WAY OF 1,000 LAKES DURING THE SURVEY TIMEFRAME ABOVE.ESSENTIA HEALTH DEER RIVER DID NOT RECEIVE ANY COMMENTS ON ITS PREVIOUS CHNA. IF RECEIVED, ANY COMMENTS WOULD HAVE BEEN TAKEN INTO CONSIDERATION IN THE CHNA UPDATE PROCESS. ESSENTIA HEALTH DEER RIVER PART V, SECTION B, LINE 6A: TO ALIGN RESOURCES AND STRENGTHS TO BETTER SERVE OUR COMMUNITY, THE CHNA WAS CONDUCTED IN COLLABORATION WITH GRAND ITASCA HOSPITAL - FAIRVIEW, AN UNRELATED HOSPITAL. ESSENTIA HEALTH DEER RIVER PART V, SECTION B, LINE 6B: ESSENTIA HEALTH DEER RIVER WORKED COLLABORATIVELY ON THE ASSESSMENT PROCESS WITH AITKIN-ITASCA-KOOCHICHING COMMUNITY HEALTH BOARD, BOYS AND GIRLS CLUB DEER RIVER, BOYS AND GIRLS CLUB OF GRAND RAPIDS GREENWAY, BOYS AND GIRLS CLUB OF THE LEECH LAKE AREA, DEER RIVER SCHOOL DISTRICT FULL-SERVICE COMMUNITY SCHOOL, ELDERCIRCLE, FIRST CALL FOR HELP OF ITASCA COUNTY, FORWARD HEALTH FOUNDATION, FREE RANGE FOOD CO-OP, GRAND RAPIDS AREA COMMUNITY FOUNDATION, GRAND RAPIDS FARMERS MARKET, GRAND RAPIDS SCHOOL DISTRICT, ITASCA AREA SCHOOLS COLLABORATIVE, ITASCA COUNTY LOCAL ADVISORY COUNCIL ON MENTAL HEALTH, ITASCA COUNTY NAMI, ITASCA COUNTY PUBLIC HEALTH, ITASCA PRIDE, KOOTASCA COMMUNITY ACTION HEAD START, LEECH LAKE BAND, MISSION RESTART, MOBILITY MANIA, OPEN DOOR COAT RACK, PROJECT CARE FREE CLINIC - GRAND RAPIDS, SECOND HARVEST NORTHLAND, SMART NORTH - TECH HUB, U OF M EXTENSION SNAP-ED, AND UNITED WAY OF 1,000 LAKES. ESSENTIA HEALTH DEER RIVER PART V, SECTION B, LINE 11: DURING FY 2025, ESSENTIA HEALTH DEER RIVER ADDRESSED SIGNIFICANT NEEDS IDENTIFIED IN THE FY 2022 ASSESSMENT: INTERNET ACCESS, FOOD ACCESS, AND MENTAL WELL-BEING. SOME ACTIVITIES WERE LED BY THE HOSPITAL WHILE OTHERS WERE PART OF LARGER COLLABORATIVE EFFORTS WITH LOCAL PARTNERS.ONE OTHER HEALTH NEED IDENTIFIED THROUGH THE CHNA PROCESS IS YOUTH VAPING, WHICH WILL NOT BE DIRECTLY ADDRESSED AS A PRIORITY DUE TO LIMITED CAPACITY. A LOCAL COALITION WILL CONTINUE TO ADDRESS IT IN THE SCHOOL.THE FOLLOWING DESCRIBES SIGNIFICANT ACCOMPLISHMENTS AND OUTCOMES.PRIORITY AREA #1: INTERNET ACCESSTO RESPOND TO DIGITAL INCLUSION NEEDS, THE HOSPITAL WORKED TO CONNECT PEOPLE TO PLACES WITH SAFE, RELIABLE INTERNET ACCESS. TO THIS END, THE HOSPITAL CONTINUED ITS PARTNERSHIP WITH SMART NORTH TO SUPPORT OPERATION OF THE DEER RIVER COMMUNITY TECH HUB WITHIN THE GOODALL RESOURCE CENTER ON THE HOSPITAL CAMPUS AND THE OPENING OF THE GRAND RAPIDS TECH HUB AT THE GRAND RAPIDS AREA LEARNING CENTER IN GRAND RAPIDS. OFFERING EQUIPMENT AND SOFTWARE TO HELP TEENAGERS BUILD AND DEVELOP SKILLS, THE TECH HUBS SERVED 146 UNIQUE STUDENTS DURING THE YEAR, PROVIDING A PLACE FOR POSITIVE SOCIAL CONNECTION WITH PEERS AND FRESH FOOD ON-SITE FOR STUDENTS WHO FACE FOOD INSECURITY.PRIORITY AREA #2: FOOD ACCESSTO SUPPORT RELIABLE ACCESS TO HEALTHY FOOD, THE HOSPITAL WORKED ALONGSIDE SEVERAL ORGANIZATIONS. THE HOSPITAL PARTNERED WITH THE GRAND RAPIDS FARMERS MARKET TO ENCOURAGE CHILDREN AGES 2 THROUGH 12 TO CONSUME LOCAL PRODUCE UNDER THE POWER OF PRODUCE (POP) PROGRAM. PROVIDING $3 OF FREE PRODUCE TO CHILDREN AT EACH MARKET THEY ATTEND, THE POP PROGRAM ATTRACTED 1,195 UNIQUE PARTICIPANTS. IN ADDITION, THE HOSPITAL WORKED ALONGSIDE THE CITY OF DEER RIVER TO CONTINUE DEVELOPMENT OF THE DEER RIVER COMMUNITY GARDEN, WHICH ATTRACTED 32 PARTICIPANTS DURING THE 2024 GROWING SEASON. THE HOSPITAL ALSO PARTNERED WITH DEER RIVER SCHOOL DISTRICT TO CONNECT FOOD TO STUDENTS IN NEED THROUGH SCHOOL FOOD PANTRIES AT DEER RIVER HIGH SCHOOL AND KING ELEMENTARY SCHOOL, WHICH SERVED 347 STUDENTS DURING THE YEAR. THROUGH ITS COMMUNITY GRANTS PROGRAM, ESSENTIA HEALTH ALSO PROVIDED FUNDING TO ITASCA COUNTY PUBLIC HEALTH AND UNIVERSITY OF MINNESOTA EXTENSION SNAP-ED TO ENHANCE THE AFFORDABILITY AND USE OF LOCAL PRODUCE FOR 20 LOW-INCOME CUSTOMERS AT THE GRAND RAPIDS FARMERS MARKET.PRIORITY AREA #3: MENTAL WELL-BEINGTO PROMOTE MENTAL WELL-BEING, THE HOSPITAL PARTNERED TO ENHANCE EQUAL ACCESS TO COMMUNITY EVENTS. MORE SPECIFICALLY, THE HOSPITAL PARTNERED WITH MOBILITY MANIA AND SAMARITAN TRANSPORTATION TO LAUNCH A TRANSPORTATION VOUCHER PROGRAM FOR PEOPLE USING WHEELCHAIRS IN THE HOSPITAL SERVICE AREA. THE VOUCHER PROGRAM ALLOWS A WHEELCHAIR USER AND A COMPANION FREE ADA COMPLIANT TRANSPORTATION TO ATTEND ONE SOCIAL EVENT PER MONTH, WITH USE OF THE TRANSPORTATION SERVICE FOR UP TO FOUR HOURS AT EACH EVENT. BY THE END OF THE YEAR, THE PARTNERSHIP ALLOWED PEOPLE DEPENDENT ON WHEELCHAIRS (AND THEIR COMPANIONS) TO PARTICIPATE IN 80 SOCIAL EVENTS, WITH DEDICATION OF 400 SERVICE HOURS TO THE PROGRAM BY THE TRANSPORTATION SERVICE. ESSENTIA HEALTH DEER RIVER PART V, SECTION B, LINE 23: OCCASIONALLY CERTAIN FAP-ELIGIBLE PATIENTS ARE CHARGED MORE THAN AMOUNTS GENERALLY BILLED ON SERVICES. THIS COULD OCCUR IF THE PATIENT PAYMENTS ARE APPLIED TO PATIENT BILLS BEFORE AND/OR AFTER THE FINANCIAL ASSISTANCE POLICY (FAP) ADJUSTMENTS WERE APPLIED. THE HOSPITAL PROVIDES THOSE PATIENTS WITH A $5 OR MORE OVERPAYMENT WITH A REFUND CHECK, EXPLANATION LETTER, AND DETAILED SUMMARY OF SERVICES IMPACTED.THE NUMBER OF PATIENTS AFFECTED AND THE TOTAL DOLLAR AMOUNT INVOLVED FOR FY25 WAS 1 INDIVIDUAL & $34.ESSENTIA HEALTH'S REVENUE CYCLE DEPARTMENT CONFIRMS IF ANY PATIENT PAYMENTS ARE MADE AFTER THE FAP APPLICATION HAS BEEN RECEIVED. IF SO, THE PATIENT PAYMENT IS UNAPPLIED AND THEN THE FAP ADJUSTMENT IS APPLIED. THE PATIENT PAYMENT IS THEN POSTED, AND IF THE PATIENT PAYMENT IS GREATER THAN THE REMAINING BALANCE ON THE BILL, A REFUND TO THE PATIENT IS PROVIDED. THERE COULD BE A FAP-ELIGIBLE PATIENT OVERPAYMENT DEPENDING ON THE TIMING OF THE PATIENT PAYMENT OR IF THE PATIENT IS STILL PAYING THEIR CO-PAYMENT AT THE TIME OF SERVICE. WE CONTACT THESE PATIENTS TO REMIND THEM THAT THEY HAVE CHARITY CARE AND DO NOT NEED TO PAY THEIR CHARGES UNTIL THEIR FAP ADJUSTMENTS HAVE BEEN MADE. WE REQUEST THE REFUND AT THE TIME OF PROCESSING THE FAP APPLICATION IF APPLICABLE. WE ALSO PERFORM AUDITS FOR ANY FAP OVERPAYMENTS DUE TO THE TIMING OF PATIENT PAYMENTS. ADDITIONAL DISCLOSURES NOT REQUIRED FOR PART V, SECTION C: SCHEDULE H, PART V, SECTION B, LINE 3E:ESSENTIA HEALTH DEER RIVER CONDUCTED A NEW CHNA IN FY25 AND CHOSE THREE PRIORITY HEALTH NEEDS TO ADDRESS. THE SIGNIFICANT HEALTH NEEDS ARE SOCIAL DRIVERS OF HEALTH, NUTRITION AND MOVEMENT, AND INJURY PREVENTION. THE NEEDS ARE NOT RANKED IN ORDER; ALL THREE HEALTH NEEDS ARE CONSIDERED PRIORITIES. THE HOSPITAL WILL WORK ON ADDRESSING EACH NEED SIMULTANEOUSLY FROM FY26 - FY28.FORM 990, SCH H, PART V, SECTION B, LINE 16I:DUE TO THE SMALL SIZES OF THE LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS OF THE COMMUNITIES SERVED BY THE ORGANIZATION, THE ORGANIZATION WAS NOT REQUIRED TO TRANSLATE THE FINANCIAL ASSISTANCE POLICY (FAP), THE FAP APPLICATION FORM, OR THE PLAIN LANGUAGE SUMMARY OF THE FAP TO OTHER LANGUAGES. ALTHOUGH IT WAS NOT REQUIRED, THE ORGANIZATION TRANSLATED THE FAP APPLICATION FORM INTO SPANISH. 4 1 - ESSENTIA HEALTH DEER RIVER CLINIC 115 10TH AVE NE DEER RIVER MN 56636 MULTI-SPECIALTY CLINIC 2 - ESSENTIA HEALTH DEER RIVER HOME CARE 115 10TH AVE NE DEER RIVER MN 56636 HOME HEALTH 3 - ESSENTIA HEALTH HOMESTEAD 1053 COMSTOCK CT DEER RIVER MN 56636 SKILLED NURSING FACILITY 4 - ESSENTIA HEALTH COMSTOCK COURT 35 10TH AVE NE DEER RIVER MN 56636 SENIOR APARTMENTS PART I, LINE 3C: ASSETS WILL BE CONSIDERED ALONG WITH THE PATIENT'S INCOME TO DETERMINE ELIGIBILITY FOR THE FINANCIAL ASSISTANCE PROGRAM. TO BE ELIGIBLE, REPORTABLE ASSETS MAY NOT EXCEED $75,000 FOR A HOUSEHOLD OF ONE (1), OR $150,000 FOR A HOUSEHOLD OF TWO (2) OR MORE. ASSETS MAY INCLUDE, BUT ARE NOT LIMITED TO, SUCH ITEMS AS CHECKING AND SAVINGS ACCOUNTS, IRAS, 401(K)S, PENSIONS, HEALTH SAVINGS ACCOUNTS, ADDITIONAL PROPERTY, AND ANY OTHER RETIREMENT FUNDING. PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT INFORMATION IS INCLUDED ON ESSENTIA HEALTH'S (EMPLOYER IDENTIFICATION NUMBER 20-0360007) WEBSITE AT WWW.ESSENTIAHEALTH.ORG. ESSENTIA HEALTH, HEADQUARTERED IN DULUTH, MINNESOTA, IS THE PARENT OF AN INTEGRATED HEALTH SYSTEM SERVING PATIENTS IN MINNESOTA, NORTH DAKOTA, AND WISCONSIN. PART I, LINE 7: THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES WAS USED TO CALCULATE THE COSTS FOR THE FOLLOWING COMMUNITY BENEFITS: CHARITY CARE AND UNREIMBURSED MEDICAID. ACTUAL COSTS WERE USED FOR THE REMAINDER OF THE COMMUNITY BENEFITS REPORTED. PART I, LN 7 COL(F): BAD DEBT EXPENSE THAT WAS SUBTRACTED FROM TOTAL EXPENSE TO OBTAIN THE % OF COMMUNITY BENEFIT TO TOTAL EXPENSE AMOUNTED TO $1,115,799. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL IS LOCATED IN A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA AND AS SUCH INCLUDES PHYSICIAN RECRUITMENT AS A COMMUNITY BUILDING ACTIVITY PER THE RECOMMENDATION OF THE CATHOLIC HEALTH ASSOCIATION COMMUNITY BENEFIT GUIDE. PART III, LINE 2: DISCOUNTS, CHARITY CARE, AND BAD DEBT EXPENSE ARE ACCOUNTED FOR AS REDUCTIONS TO REVENUE. BAD DEBT EXPENSE IS CALCULATED AFTER ALL ESTIMATED DISCOUNTS AND APPLICABLE PAYMENTS ARE APPLIED TO A PATIENT ACCOUNT. BAD DEBT EXPENSE IS A COMBINATION OF THE ACTUAL ACCOUNT WRITE-OFFS TO A COLLECTION AGENCY FOR ACCOUNTS DEEMED UNCOLLECTIBLE, ALONG WITH ESTIMATED EXPENSE FOR ACCOUNTS WITH A REMAINING BALANCE IN ACCOUNTS RECEIVABLE. IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE. PART III, LINE 3: ESSENTIA HEALTH PROVIDES FULL CHARITY CARE THROUGH ITS TRADITIONAL APPLICATION PROCESS. FULL CHARITY CARE IS A COMPLETE WRITE-OFF OF ELIGIBLE GROSS HOSPITAL AND CLINIC CHARGES. THIS IS BASED ON THE PATIENT'S INCOME IN RELATION TO THE FEDERAL POVERTY GUIDELINES. CATASTROPHIC CHARITY CARE IS FINANCIAL ASSISTANCE THAT PROVIDES A ONE-TIME DISCOUNT BASED ON AN APPLICATION FOR TRADITIONAL CHARITY CARE AND DOES NOT QUALIFY BUT HAS A BALANCE GREATER THAN $5,000. PATIENT, OR THEIR GUARANTOR, MAY BE GRANTED CATASTROPHIC CHARITY CARE ASSISTANCE FOR ELIGIBLE SERVICES IF THEY COMPLETE A FINANCIAL ASSISTANCE APPLICATION AND PROVIDE THE REQUIRED DOCUMENTATION. THE PATIENT AND/OR GUARANTOR WILL NOT PAY MORE THAN 20% OF ANNUAL INCOME BASED ON ELIGIBLE CHARGES.ESSENTIA HEALTH ALSO RECOGNIZES THAT IT IS NOT FEASIBLE, OR SOMETIMES NECESSARY, FOR ALL PATIENTS TO COMPLETE FINANCIAL ASSISTANCE APPLICATIONS AND PROVIDE DOCUMENTATION REQUIRED THROUGH THE TRADITIONAL PROCESS. ESSENTIA HEALTH IMPLEMENTED AN ALTERNATIVE DOCUMENTATION AND PRESUMPTIVE PROCESS USING A TOOL THAT IDENTIFIES ACCOUNTS THAT AUTOMATICALLY QUALIFY FOR CHARITY CARE AND RECLASSIFIED THOSE ACCOUNTS TO CHARITY CARE ALLOWANCE. AS A RESULT, WE ESTIMATE $0 OF PATIENT ACCOUNTS WRITTEN OFF TO BAD DEBT WOULD QUALIFY FOR CHARITY CARE.ESSENTIA HEALTH DEER RIVER INCORPORATES THE COST OF BAD DEBT AS A COMMUNITY BENEFIT. AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE THE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THAT CARE. IN DOING SO, WE MAKE QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS. PART III, LINE 4: PAGES 16-18 OF ESSENTIA HEALTH'S CONSOLIDATED AUDIT REPORT CONTAIN THE FOOTNOTE DESCRIBING THE ORGANIZATION'S BAD DEBT EXPENSE. PART III, LINE 8: RECONCILIATION FOR MEDICARE SHORTFALL BETWEEN TOTAL MEDICARE PROGRAM AND WHAT IS ALLOWED ON THE COST REPORT:THE HOSPITAL'S TOTAL MEDICARE SHORTFALL IS $1,404,248, OF WHICH A SHORTFALL OF $61,261 (CONSISTING OF $12,630,562 REVENUE AND $12,691,823 COST) IS INCLUDED IN PART III, SECTION B, LINES 5-7, AND A SHORTFALL OF $1,342,987 (CONSISTING OF $8,104,111 REVENUE AND $9,447,098 COST) REPRESENT ALL OTHER MEDICARE SERVICES NOT INCLUDED IN THE ANNUAL COST REPORT.THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6:THE METHODOLOGY USED IN DETERMINING THE REPORTED MEDICARE ALLOWABLE COST BEGINS WITH THE HOSPITAL'S GENERAL LEDGER SYSTEM. THE COSTS ARE OBTAINED FROM THE GENERAL LEDGER AND THEN ADJUSTED AND REPORTED IN ACCORDANCE WITH CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) "COST FINDING" GUIDELINES AS PUBLISHED IN THEIR PROVIDER REIMBURSEMENT MANUAL. ONCE THE MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE HOSPITAL'S COST REPORT, ANY COSTS ATTRIBUTED TO SUBSIDIZED HEALTH SERVICES, AND MEDICAL EDUCATION, ARE REMOVED AND REPORTED SEPARATELY.EXPLANATION FOR ANY PRIOR YEAR SETTLEMENTS FOR MEDICARE-RELATED SERVICES IN THE CURRENT TAX YEAR:EACH ESSENTIA HEALTH HOSPITAL IS REQUIRED TO FILE A MEDICARE COST REPORT 5 MONTHS AFTER THE CLOSE OF THEIR FISCAL YEAR. THE COST REPORT PROVIDES MEDICARE WITH INFORMATION THAT IS USED TO DETERMINE UTILIZATION AND SPENDING TRENDS BUT ALSO IS USED TO SET FUTURE PAYMENT RATES FOR MOST MEDICARE SERVICES. IF THE INTERIM PAYMENTS PAID TO A HOSPITAL ARE HIGHER OR LOWER THAN THE FILED COST REPORT ALLOWABLE REIMBURSEMENT, THERE WILL BE A SETTLEMENT FOR THAT FISCAL YEAR. THIS CAN BE DUE TO CHANGES IN UTILIZATION OR COST OF PROVIDING SERVICES FOR CRITICAL ACCESS HOSPITALS (CAH) OR DIFFERENCES BETWEEN INTERIM AND FINAL PAYMENT FACTORS FOR DISPROPORTIONATE SHARE, BAD DEBTS, OR INDIRECT MEDICAL EDUCATION FOR NON-CAH HOSPITALS. AN ESTIMATE FOR THESE SETTLEMENTS IS RECORDED AT THE CLOSE OF THE FISCAL YEAR. IF THE ESTIMATE VARIES FROM THE FINAL SETTLEMENT RECEIVED 6-7 MONTHS AFTER THE FISCAL YEAR ENDS, THEN THESE AMOUNTS ARE RECORDED AS PRIOR YEAR MEDICARE REVENUE.THE EXTENT TO WHICH ANY SHORTFALL REPORTED IN PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT AND THE RATIONALE FOR THE ORGANIZATION'S OPINION:ESSENTIA HEALTH DEER RIVER IS A PART OF ESSENTIA HEALTH, AN INTEGRATED HEALTH SYSTEM. ESSENTIA HEALTH AND ITS MEMBER ORGANIZATIONS INCORPORATE THE FULL VALUE OF THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. THE RATIONALE FOR THE ORGANIZATION'S OPINION IS PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. MANY MEDICARE BENEFICIARIES ARE POOR AND ARE ELIGIBLE FOR MEDICAID IN ADDITION TO MEDICARE. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY. PART III, LINE 9B: THE POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR ESSENTIA HEALTH'S FINANCIAL ASSISTANCE POLICY (FAP) AND FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR FINANCIAL ASSISTANCE FROM ESSENTIA HEALTH, AND THE PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH THEIR PAYMENT AGREEMENTS. THE ORGANIZATION OFFERS EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS AND WILL NOT IMPOSE LIENS ON PRIMARY RESIDENCES NOR REPORT PATIENTS TO A CREDIT RATING AGENCY FOR OUTSTANDING PATIENT BILLS.THE ORGANIZATION WILL NOT CHARGE A PATIENT THE GROSS AMOUNT OF CHARGES FOR ANY UNINSURED TREATMENT. UNINSURED DISCOUNTS WILL BE APPLIED TO THE GROSS CHARGES PRIOR TO ANY FINANCIAL ASSISTANCE OR OTHER DISCOUNTS.IF AT ANY TIME THE ORGANIZATION RECOGNIZES THAT A PATIENT MAY BE ELIGIBLE FOR STATE OR FEDERAL PROGRAMS, A REPRESENTATIVE WILL ASSIST THE PATIENT IN OBTAINING INFORMATION ABOUT THESE PROGRAMS OR PROVIDE CONTACT INFORMATION FOR THESE PROGRAMS. THE ORGANIZATION CONTRACTS WITH AN OUTSIDE PATIENT ADVOCACY AGENCY, WHICH MAY PROVIDE ASSISTANCE TO THE UNINSURED PATIENT IN APPLYING TO CERTAIN STATE AND FEDERAL PROGRAMS.AT ANY STAGE OF THE PATIENT EXPERIENCE AND UP THROUGH THE COLLECTION PROCESS, THE PATIENT MAY EXPRESS A CONCERN THAT THEY ARE UNABLE TO PAY THEIR BILL IN FULL OR MEET THE PAYMENT PLAN REQUIREMENTS. AT THAT TIME, THE PATIENT WILL BE GIVEN EVERY OPPORTUNITY TO COMPLETE AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE.THE ORGANIZATION TRAINS ITS OUTSIDE DEBT COLLECTION AGENCIES AND ATTORNEYS ABOUT THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION ABOUT THE FAP OR SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE ORGANIZATION REQUIRES ITS OUTSIDE COLLECTION AGENCIES AND ATTORNEYS TO REFER PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE TO ESSENTIA HEALTH.IF A PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, THE ORGANIZATION SUSPENDS ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND ESSENTIA HEALTH HAS NOTIFIED THE PATIENT OF ITS DECISION. PATIENTS ARE ADVISED AT THAT TIME TO NOTIFY THE COLLECTION AGENCY TO HOLD THEIR ACCOUNT. THE OUTSIDE DEBT COLLECTION AGENCIES ARE NOTIFIED BY ESSENTIA HEALTH ONCE AN ACCOUNT ADJUSTMENT HAS BEEN MADE. PART VI, LINE 2: NEEDS ASSESSMENT:WE ASSESS AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE IN MANY WAYS, INCLUDING THE FOLLOWING:MARKETING RESEARCH - THE ESSENTIA HEALTH MARKETING RESEARCH DEPARTMENT CONDUCTS SURVEYS, FOCUS GROUPS, AND REVIEWS INTERNAL DATA TO BETTER UNDERSTAND THE NEEDS AND USE(S) OF OUR SERVICES. THIS INCLUDES ACCESS TO SERVICE AREAS (E.G., PRIMARY CARE), PAYOR INFORMATION (E.G., ESSENTIA CARE), AND OVERALL GAPS IN SERVICES. ASSESSMENTS HAVE RESULTED IN INTERNAL CHANGES IN BOTH STAFFING AND PROCESSES.ESSENTIA HEALTH POPULATION CARE MANAGEMENT - WE USE AN ANALYSIS OF MULTIPLE POPULATIONS; ONE SUCH GROUP IS "ACCOUNTABLE CARE ORGANIZATION (ACO) POPULATIONS." THE ANALYSES DONE INCLUDE THE IDENTIFICATION OF PATIENTS WHO HAVE UNCONTROLLED ASTHMA, UNCONTROLLED DIABETES, ARE PRE-DIABETIC, OR WHO HAVE DEPRESSION; THE RESULTS ARE USED IN TARGETED OUTREACH BY THE POPULATION CARE TEAM. TARGETED OUTREACH HAS PROVEN TO LEAD TO BETTER OUTCOMES FOR THESE POPULATIONS.COMMUNITY GIVING - THROUGH OUR COMMUNITY GIVING PROCESS WE ENGAGE TO UNDERSTAND COMMUNITY NEEDS ACROSS A BROAD SPECTRUM OF COMMUNITY ORGANIZATIONS. WE REVIEW REQUESTS FOR FINANCIAL SUPPORT GENERATED BY COMMUNITY NON-PROFITS AND EVALUATE FUNDING BASED ON POTENTIAL OF PROGRAMS AND PROJECTS TO HAVE A POSITIVE AND SUSTAINABLE IMPACT ON THE HEALTH AND VITALITY OF OUR COMMUNITIES. THIS INCLUDES COMPLEMENTING OUR COMMUNITY FUNDING BY GATHERING PERSPECTIVES ON COMMUNITY EFFORTS AND THE ROLE ESSENTIA HEALTH CAN PLAY IN ADDRESSING COMMUNITY NEEDS AS A COLLABORATIVE PARTNER.INTERNAL QUALITY INDICATORS - WE TRACK DATA THAT LEADS TO THE IMPROVED CARE AND TREATMENT OF PATIENTS WITH CHRONIC DISEASES, TOBACCO USE, AND MENTAL HEALTH CONDITIONS. THIS DATA INCLUDES PATIENT ACTIVITY AND OUTCOMES, WHICH ALLOWS ESSENTIA HEALTH TO BETTER IDENTIFY THE NEEDS OF THE PATIENTS AND CAN BE UTILIZED TO ASSESS THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE.HEALTH DATA PROVIDED BY PAYOR ORGANIZATIONS, NAMELY GOVERNMENT AND COMMERCIAL HEALTH INSURERS - THIS HEALTH DATA TYPICALLY INVOLVES MEDICAL TREATMENT AND OUTCOMES THAT REFLECT TRENDS OF UNHEALTHY LIFESTYLES AND BEHAVIORS. OUR OBJECTIVE IS TO UNDERSTAND THESE RELATIONSHIPS AND TO DEVELOP ACTION STEPS TO INTERVENE ON THE FRONT END TO PREVENT SUCH MEDICAL SITUATIONS FROM OCCURRING.ESSENTIA HEALTH HUMAN RESOURCES DEPARTMENT - THE ANALYSIS OF CURRENT STAFFING TRENDS AIDS IN PROVIDING HEALTHCARE ACCESS APPROPRIATELY TO THE COMMUNITIES WE SERVE.ESSENTIA INSTITUTE OF RURAL HEALTH (EIRH) - EIRH PROVIDES RESEARCH OF PATIENT DATA, COMMUNITY DATA, AND THE OUTCOMES ASSOCIATED WITH CURRENT CLINICAL PRACTICES, INTERVENTIONS, AND PREVENTION STRATEGIES (E.G., OPIOID USE DISORDER, SOCIAL DETERMINANTS OF HEALTH). PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE ORGANIZATION MAKES INFORMATION ON ITS FINANCIAL ASSISTANCE POLICY (FAP) READILY AVAILABLE TO PATIENTS. INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS IS AVAILABLE ON THE ESSENTIA HEALTH WEBSITE (WWW.ESSENTIAHEALTH.ORG, SELECT PATIENTS & VISITORS, SELECT BILLING & FINANCIAL ASSISTANCE) WHERE THE INFORMATION AND APPLICATION IS EASILY ACCESSIBLE TO BE VIEWED, DOWNLOADED, AND PRINTED AT NO CHARGE TO THE PATIENT. PATIENTS CAN ALSO APPLY FOR FAP VIA MYCHART. NOTICES ON THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE CONSPICUOUSLY POSTED IN EMERGENCY ROOM DEPARTMENTS. FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE DURING THE PRE-ADMISSION FINANCIAL SCREENING, AT THE TIME OF REGISTRATION, AND PRIOR TO A HOSPITAL DISCHARGE. INFORMATION ABOUT THE FAP IS IN ALL COLLECTION LETTERS AND PATIENT STATEMENTS.FAP INFORMATION AND/OR APPLICATIONS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. THE ORGANIZATION EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS PROVIDING DIRECT PATIENT TREATMENT AND WHO WORK IN ADMISSIONS, BILLING, AND COLLECTIONS, ABOUT THE EXISTENCE OF THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION. ANNUAL EDUCATION/AWARENESS OF THE FAP IS PROVIDED TO ENSURE ALL EMPLOYEES WITH PATIENT CONTACT ARE AWARE OF THE PROGRAM AND HOW PATIENTS CAN OBTAIN ADDITIONAL INFORMATION. CLINICAL AND HOSPITAL STAFF WHO PROVIDE DIRECT PATIENT CARE HAVE KNOWLEDGE OF THE FAP AND KNOW TO DIRECT PATIENTS TO A REGISTRATION INTERVIEWER OR BUSINESS OFFICE REPRESENTATIVE. REGISTRATION STAFF HAVE AN UNDERSTANDING OF THE POLICY, KNOWLEDGE OF WHERE THE RELATED DOCUMENTS ARE LOCATED, AND WHERE TO DIRECT THE PATIENT FOR MORE INFORMATION ON THE FAP. DESIGNATED EMPLOYEES (PATIENT FINANCIAL SERVICES COUNSELORS & PATIENT FINANCIAL SERVICES REPRESENTATIVES) HAVE A THOROUGH UNDERSTANDING OF THE FAP AND OFFER THE INFORMATION ON THE FAP TO THOSE PATIENTS WHO MAKE AN INQUIRY ABOUT THE PROGRAM OR ARE DETERMINED THROUGH A FINANCIAL SCREENING TO BE ELIGIBLE FOR THIS PROGRAM. PATIENT ADVOCACY SERVICES ALSO INFORM THE PATIENT ABOUT THE AVAILABILITY OF ASSISTANCE. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT, A PATIENT'S GUARANTOR, A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. THE ORGANIZATION RESPONDS TO ANY ORAL OR WRITTEN REQUESTS FOR MORE GENERAL INFORMATION ON THE FAP MADE BY A PATIENT OR ANY INTERESTED PARTY. PART VI, LINE 4: COMMUNITY INFORMATION:ESSENTIA HEALTH DEER RIVER IS LOCATED IN DEER RIVER, MN, AND IS A PART OF ESSENTIA HEALTH, WHICH IS DEFINED IN PART VI, LINE 6. THE ORGANIZATION OPERATES ONE HOSPITAL, ONE CLINIC, ONE SKILLED NURSING FACILITY, SENIOR APARTMENTS, AND HOME HEALTH THAT PRIMARILY SERVE CASS AND ITASCA COUNTIES. THE OVERALL COMMUNITY IS CLASSIFIED AS RURAL.ESSENTIA HEALTH DEER RIVER COVERS A SERVICE AREA OF APPROXIMATELY 44,000 PEOPLE. THE SERVICE AREA AGE DISTRIBUTION IS 20% UNDER THE AGE OF 18, 53% BETWEEN THE AGES OF 18 AND 65, AND 27% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE AREA IS 88% CAUCASIAN, 4% AMERICAN INDIAN, AND 8% OTHER. THE GENDER SPLIT RATIO IS 49% WOMEN AND 51% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY $68,000.ESSENTIA HEALTH DEER RIVER, AS PART OF ESSENTIA HEALTH, IS COMMITTED TO SERVING PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. APPROXIMATELY 1.5% GROSS REVENUE DOLLARS WERE FROM SELF-PAY PATIENTS AND 16.7% FROM MEDICAID RECIPIENTS. CASS COUNTY AND PORTIONS OF ITASCA COUNTY ARE CURRENTLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS.AS MENTIONED ABOVE, ESSENTIA HEALTH DEER RIVER IS PART OF ESSENTIA HEALTH. ESSENTIA HEALTH STAFFS HOSPITALS AND CLINICS IN FEDERALLY RECOGNIZED UNDERSERVED AREAS AND SUPPORTS THE HEALTH OF ITS COMMUNITIES THROUGH ACTIVE OUTREACH PROGRAMS THAT BRING ONCOLOGISTS, CARDIOLOGISTS, AND OTHERS INTO ITS SMALLER COMMUNITIES. THIS ELIMINATES BARRIERS TO CARE FOR MANY PATIENTS, PARTICULARLY THOSE WHO ARE ELDERLY, LIVING ON LOW INCOMES, OR ARE FACED WITH OTHER CHALLENGES THAT MAKE IT DIFFICULT TO TRAVEL LONG DISTANCES FOR CARE.THERE IS ONE OTHER HOSPITAL OUTSIDE OF THE ESSENTIA HEALTH UMBRELLA THAT SERVICES THE COMMUNITY. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:THE ORGANIZATION'S BOARD OF DIRECTORS IS COMPOSED MAINLY OF VOLUNTEER REPRESENTATIVES FROM THE COMMUNITIES IT SERVES. THE ORGANIZATION HAS AN OPEN MEDICAL STAFF, SO ANY QUALIFIED PHYSICIAN OF THE COMMUNITY IS ALLOWED TO APPLY. ALL APPLICANTS WHO APPLY MUST MEET THE CREDENTIALING STANDARDS AND BE APPROVED BY THE ESSENTIA HEALTH EAST GOVERNING BOARD IN ORDER TO PROVIDE SERVICES AT ESSENTIA HEALTH. IN ADDITION, THE HOSPITAL PROVIDES ON-SITE CLINICAL EXPERIENCES FOR MEDICAL STUDENTS AND RESIDENTS, ADVANCED PRACTICE AND PRE-LICENSURE NURSES, PHARMACISTS, THERAPISTS, TECHNICIANS, AND THOSE IN OTHER HEALTH CARE VOCATIONS.WE REINVEST IN THE ORGANIZATION BY ACQUIRING THE LATEST STATE-OF-THE-ART EQUIPMENT AND BY INVESTING IN PROGRAMS THAT ARE NEEDED IN OUR COMMUNITY.IN ADDITION TO THE ACTIVITIES LISTED IN PART I, LINE 7 AS WELL AS PART V, SECTION B, LINE 11, THE ORGANIZATION SUPPORTS THE HEALTH AND VITALITY OF OUR COMMUNITIES THROUGH A SPECIAL DEDICATION TO MAKING A DIFFERENCE IN AREAS THAT POSITIVELY IMPACT THE SOCIAL DETERMINANTS OF HEALTH. WE MAKE SIGNIFICANT CONTRIBUTIONS TO COMMUNITY NON-PROFITS WORKING TO IMPROVE HOUSING, ACCESS TO HEALTHY FOODS AND HEALTHY YOUTH DEVELOPMENT. ADDITIONALLY, WE ENCOURAGE OUR COLLEAGUES TO CONTRIBUTE THEIR TIME IN MEANINGFUL WAYS THROUGH A FORMAL EMPLOYEE VOLUNTEER PROGRAM THAT INCENTIVIZES COMMUNITY VOLUNTEERING BY PROVIDING A $100 DONATION TO A NON-PROFIT OF THE EMPLOYEE'S CHOICE AFTER VOLUNTEERING AT LEAST 20 HOURS. IN FY25, MORE THAN 29,000 IMPACTFUL VOLUNTEER HOURS WERE REPORTED BY ESSENTIA HEALTH COLLEAGUES. OUR LEADERS ARE ACTIVELY ENGAGED IN LENDING THEIR EXPERTISE ON COMMUNITY BOARDS, INCLUDING WORKFORCE DEVELOPMENT EFFORTS THAT CONTRIBUTE TO THE ECONOMIC VITALITY OF OUR REGION. LASTLY, THE HOSPITAL ENGAGES COMMUNITIES IN COMING TOGETHER AND CREATING SOCIAL CONNECTIVITY THROUGH SUPPORT OF VARIOUS LOCAL EVENTS, FUNDRAISERS, AND OUTINGS, MANY OF WHICH INVOLVE PHYSICAL ACTIVITY AND SUPPORT ORGANIZATIONS THAT ENHANCE THE VIABILITY OF OUR COMMUNITIES.ESSENTIA HEALTH DEER RIVER IS A PART OF ESSENTIA HEALTH, AN INTEGRATED HEALTH SYSTEM WITH FACILITIES IN MINNESOTA, NORTH DAKOTA, AND WISCONSIN. 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 IMPROVE 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 240,000 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 19,000 PEOPLE USED THE WEBSITE, RESULTING IN 6,700 REFERRALS TO COMMUNITY-BASED ORGANIZATIONS. ADDITIONALLY, THROUGH VARIOUS COMMUNITY ENGAGEMENT ACTIVITIES, WE ADDED OVER 400 NEW PROGRAMS TO THE DIRECTORY THIS YEAR.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 15 SITES ACROSS MINNESOTA, NORTH DAKOTA, AND WISCONSIN. 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 $2.6 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 MEDICINE RESIDENCY PROGRAM. THIS PROGRAM IS VITAL IN ADDRESSING THE GROWING SHORTAGE OF PRIMARY CARE PHYSICIANS IN RURAL COMMUNITIES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:ESSENTIA HEALTH DEER RIVER IS PART OF ESSENTIA HEALTH, AN INTEGRATED HEALTH SYSTEM WITH 14 HOSPITALS, APPROXIMATELY 80 CLINICS, SIX LONG-TERM CARE FACILITIES, TWO ASSISTED LIVING FACILITIES, THREE INDEPENDENT LIVING FACILITIES, SEVERAL REHABILITATION CENTERS, SEVEN AMBULANCE SERVICES, 29 RETAIL PHARMACIES, ONE RESEARCH INSTITUTE, AND HOME HEALTH SERVICES IN THREE STATES: MINNESOTA, NORTH DAKOTA, AND WISCONSIN. 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 THE PATIENT PORTAL, MYCHART, WHICH OFFERS PATIENTS SECURE, 24/7 ONLINE ACCESS TO THEIR MEDICAL RECORD. MYCHART ALSO ALLOWS PATIENTS TO CONTACT THEIR PHYSICIAN OR CLINIC THROUGH DIRECT MESSAGING, SCHEDULE APPOINTMENTS, PARTICIPATE IN VIRTUAL CARE AND ORDER MEDICATION REFILLS. THESE SERVICES ARE OFFERED AT NO COST TO PATIENTS AND THEIR AUTHORIZED FAMILY, FRIENDS, AND CAREGIVERS.ESSENTIA HEALTH ALSO PROMOTES THE HEALTH OF ALL 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.VIRTUAL CARE ALLOWS PATIENTS TO RECEIVE CARE FROM A PROVIDER WHO IS NOT AVAILABLE IN THEIR HOME COMMUNITY OR FOR THE PATIENT'S CONVENIENCE. THESE APPOINTMENTS TAKE PLACE IN A PATIENT'S HOME, LOCAL CLINICS OR HOSPITALS THROUGH SECURE INTERACTIVE VIDEOCONFERENCING. THIS EXPERIENCE OFFERS THE SAME HIGH-QUALITY CARE THAT PATIENTS EXPECT DURING AN IN-PERSON VISIT. VIRTUAL CARE IS AVAILABLE WITH CARE TEAMS FROM PRIMARY CARE, BEHAVIORAL HEALTH AND MULTIPLE OTHER SPECIALTIES. IN ADDITION, ESSENTIA HEALTH OFFERS VIDEO VISITS ON DEMAND FOR SAME DAY CARE, ONLINE E-VISITS FOR COMMON CONDITIONS AND FREE MEDICAL ADVICE FROM OUR REGISTERED NURSES THROUGH OUR NURSE CARE LINE ANY TIME OF DAY OR NIGHT.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 NUTRITION AND PHYSICAL ACTIVITY, AND ADDRESSING HOUSING, CHILD CARE, AND MENTAL WELL-BEING. THESE ISSUES ARE THEN ADDRESSED THROUGH COLLABORATION WITH GOVERNMENT AGENCIES, AND OTHER NON-PROFITS.IN AN EFFORT TO HELP SOME OF OUR COMMUNITIES' AT-RISK POPULATIONS REMAIN AT HOME AND OUT OF THE HOSPITAL OR NURSING HOME, ESSENTIA HEALTH HAS COMMUNITY PARAMEDIC PROGRAMS IN FARGO, ND, AS WELL AS BRAINERD, DETROIT LAKES, DEER RIVER, VIRGINA AND ADA, MN. PARAMEDICS MAKE HOUSE CALLS TO PATIENTS WHO HAVE BEEN IDENTIFIED AS AT RISK FOR EMERGENCY DEPARTMENT VISITS. DURING THE CALLS, THEY TAKE VITAL SIGNS, ASSESS POSSIBLE HEALTH AND SAFETY RISKS, AND DETERMINE IF PATIENTS MAY BENEFIT FROM ADDITIONAL COMMUNITY RESOURCES.ESSENTIA HEALTH EMPLOYEES CONTRIBUTE DIRECTLY TO THE HEALTH AND WELLNESS OF THEIR COMMUNITIES BY VOLUNTEERING IN PROGRAMS RANGING FROM HABITAT FOR HUMANITY TO UNITED WAY TO FOOD AND CLOTHING DRIVES. THEY ARE ACTIVE FUNDRAISERS FOR HEALTH-RELATED ORGANIZATIONS IN THEIR COMMUNITIES, LIKE LOCAL CHAPTERS OF THE AMERICAN HEART ASSOCIATION. ESSENTIA HEALTH ENCOURAGES AND SUPPORTS THESE VOLUNTEER EFFORTS IN A VARIETY OF WAYS, INCLUDING SPONSORSHIPS, FINANCIAL CONTRIBUTIONS, AND VOLUNTEER RECOGNITION.WE ALSO SUPPORT COMMUNITY HEALTH THROUGH CONTRIBUTIONS THAT FOCUS ON PROGRAMS AND SERVICES THAT BENEFIT THE OVERALL HEALTH OF THE COMMUNITIES WE SERVE. SOME EXAMPLES OF THESE PROGRAMS ARE FARMERS MARKETS, COMMUNITY GARDENS, WORKFORCE DEVELOPMENT PROGRAMS, AND TRANSPORTATION ACCESS PROGRAMS. PART VI, LINE 7, REPORTS FILED WITH STATES MN X X X 0 1 0 0 0 0 0 0 1 1 TRACI MORRIS TREASURER/REL ORG CHIEF FINCL OFF 0 702675 0 269075 0 82980 0 142406 0 2280 0 1199416 0 71480 MICHAEL WATTERS SECRETARY/REL ORG CHIEF LEGAL OFF 0 506819 0 192028 0 74281 0 109834 0 41565 0 924527 0 62797 TROY DUININCK MD BD DIRECTOR/REL ORG PHYS & DIV CHAIR 0 546405 0 0 0 1501 0 27600 0 42161 0 617667 0 0 TODD DEFREECE BD DIRECT THRU 2/25/SVP, OPS 0 294079 0 117008 0 1572 0 77284 0 39717 0 529660 0 0 SARA LOKSTAD MD BD DIRECT THRU 2/25/ASSOCIATE CMO 0 337041 0 0 0 504 0 21266 0 1685 0 360496 0 0 JACOB STAY CNRA 190538 18815 50000 0 186 19 12514 606 34459 3455 287697 22895 0 0 JAN BALDWIN MD BOARD DIRECTOR/RELATED ORG PHYSICIAN 0 256218 0 0 0 1844 0 20737 0 29435 0 308234 0 0 KEVIN BARSNESS CRNA 258530 0 15000 0 1672 0 13495 0 15642 0 304339 0 0 0 LORI SUTHERLAND CRNA SUPERVISOR 267398 0 15000 0 2725 0 13885 0 2356 0 301364 0 0 0 JOSHUA SENGER FINANCE DIRECTOR 0 204756 0 19037 0 185 0 10553 0 1025 0 235556 0 0 STEPHANIE ALEXANDER NURSE PRACTITIONER 215922 0 0 0 871 0 10796 0 1000 0 228589 0 0 0 AMANDA REED ADMINISTRATOR 156689 0 15634 0 142 0 9190 0 40325 0 221980 0 0 0 KRISTINE MOSHER NURSE PRACTITIONER 169680 0 0 0 887 0 8739 0 16757 0 196063 0 0 0 ANGELA SMITH NURSING DIRECTOR 47410 99554 13822 0 110 232 3062 4978 306 688 64710 105452 0 0 MICHAEL LARSON FORMER INTERIM ADMINISTRATOR 0 0 0 0 0 163836 0 0 0 0 0 163836 0 6975 PART I, LINE 3 ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA HEALTH DEER RIVER'S ADMINISTRATOR'S COMPENSATION: A COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B 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 $78,928 MICHAEL WATTERS $62,797 MICHAEL LARSON $6,975 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 $114,806 MICHAEL WATTERS $84,801 TODD DEFREECE $49,684 PART I, LINE 8 INITIAL CONTRACT EXCEPTION: ESSENTIA HEALTH DEER RIVER'S NURSING DIRECTOR, ANGELA SMITH, RECEIVED COMPENSATION DURING THE YEAR UNDER AN INITIAL EMPLOYMENT AGREEMENT SUBJECT TO THE INITIAL CONTRACT EXCEPTION. THROUGH THE ESSENTIA HEALTH EXECUTIVE COMPENSATION COMMITTEE, THIS COMPENSATION ARRANGEMENT WAS REVIEWED AND APPROVED BY INDEPENDENT PERSONS USING COMPARABILITY DATA; DELIBERATIONS AND DECISIONS WERE DOCUMENTED. A CITY OF DEER RIVER 416005091 000000000 2006-12-31 7575000 SERIES 2006 (SEE PART VI) 0 0 0 A 5947422 7575000 151500 7423500 2008 0 0 1 1 A 0 0 0 0 0.00700 0.00700 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 SCHEDULE K, PART 1, COLUMN (F): DESCRIPTION OF PURPOSE: SERIES 2006: FINANCE CONSTRUCTION AND EQUIPMENT PURCHASES IN DEER RIVER, MN. SCOTT SCHJENKEN RELATED TO KYLE FAIRBANKS 84653 COMPENSATION OF FAMILY MEMBER OF BOARD DIRECTOR 0 FORM 990, PART V, LINE 1A: 1099 REPORTING: VENDOR PAYMENTS AND FORM 1099S WERE PROCESSED THROUGH ESSENTIA HEALTH ON BEHALF OF THE LEGAL ENTITIES COMPRISING ESSENTIA HEALTH. FORM 990, PART VI, SECTION A, LINE 4 SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS: DURING THE FISCAL YEAR ENDED JUNE 30, 2025, THE ARTICLES OF INCORPORATION AND BYLAWS OF ESSENTIA HEALTH DEER RIVER 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 EAST BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF ORGANIZATION: THROUGH FEBRUARY 2025, ESSENTIA HEALTH EAST WAS THE SOLE MEMBER OF ESSENTIA HEALTH DEER RIVER AND HAD RESERVED POWERS WITH RESPECT TO ESSENTIA HEALTH DEER RIVER AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7B. THROUGH FEBRUARY 2025, DEER RIVER AREA HEALTH CARE FOUNDATION AND ESSENTIA HEALTH EAST MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7A. BEGINNING MARCH 1, 2025, ESSENTIA HEALTH IS THE SOLE MEMBER OF ESSENTIA HEALTH DEER RIVER. ESSENTIA HEALTH HAS RESERVED POWERS WITH RESPECT TO ESSENTIA HEALTH DEER RIVER AS DESCRIBED IN SCHEDULE O, PART VI, LINES 7A & 7B. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS WITH RIGHT TO ELECT GOVERNING BODY: THROUGH FEBRUARY 2025, DEER RIVER AREA HEALTH CARE FOUNDATION APPOINTED AND REMOVED TWO BOARD DIRECTORS; ESSENTIA HEALTH EAST APPOINTED AND REMOVED ESSENTIA HEALTH DEER RIVER'S REMAINING GOVERNING BODY. BEGINNING MARCH 1, 2025, ESSENTIA HEALTH DEER RIVER'S GOVERNING BODY CONSISTS OF THE SAME INDIVIDUALS SERVING ON ESSENTIA HEALTH EAST'S BOARD OF DIRECTORS. ESSENTIA HEALTH, AS THE SOLE MEMBER OF ESSENTIA HEALTH EAST, HAS THE POWER TO APPOINT AND REMOVE ESSENTIA HEALTH EAST'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS WITH RIGHT TO APPROVE GOVERNING BODY DECISIONS: ESSENTIA HEALTH SHALL HAVE THE FOLLOWING RESERVED POWERS, FOR THE PURPOSES OF SERVING AS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTH CARE NETWORK THAT INCLUDES ALL ENTITIES THAT ARE OWNED OR CONTROLLED, DIRECTLY OR INDIRECTLY, BY ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"): (A) STRATEGIC AND BUSINESS PLANS. AUTHORITY TO CREATE, 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 ASSETS' 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. FORM 990, PART VI, SECTION A, LINE 7B FORM 990, PART VI, LINE 7B CONT THROUGH FEBRUARY 2025, ESSENTIA HEALTH EAST ALSO HAD THE FOLLOWING RESERVED POWERS OVER ALL ITS SUBSIDIARIES: (A) QUALITY, SAFETY AND SERVICE. AUTHORITY TO RECOMMEND QUALITY AND SAFETY INITIATIVES AND TO REVIEW AND EXECUTE APPROVED QUALITY AND SAFETY PLANS FOR THE EAST MARKET. (B) MISSION, VISION AND VALUES. AUTHORITY TO CREATE A MISSION AND A VISION FOR THE EAST MARKET THAT SUPPORTS THE MISSION AND VISION OF ESSENTIA HEALTH; RESPONSIBILITY TO OVERSEE THE MISSION PERFORMANCE, INCLUDING CHARITY CARE, OF ALL FACILITIES WITHIN THE EAST MARKET; RESPONSIBILITY TO ADOPT THE VALUES OF ESSENTIA HEALTH. (C) OPERATING AND FINANCIAL PERFORMANCE. RESPONSIBILITY TO OVERSEE THE OPERATING AND FINANCIAL PERFORMANCE OF THE EAST MARKET. (D) DEVELOPMENT OF BUDGETS, STRATEGIC PLANS AND STRATEGY MAP. AUTHORITY TO DEVELOP AND RECOMMEND, BASED ON ESSENTIA HEALTH TARGETS, CAPITAL AND OPERATING BUDGETS FOR THE EAST MARKET AND ITS FACILITIES; AUTHORITY TO RECOMMEND, WITHIN THE ESSENTIA HEALTH CONTEXT, MARKET AND LOCAL STRATEGIC PLANS FOR THE EAST MARKET; AUTHORITY TO DEVELOP EAST MARKET GOVERNANCE STRATEGY MAP AND BALANCED SCORECARD WITHIN ESSENTIA HEALTH'S SYSTEM STRATEGY TO MEET SYSTEM GOALS. (E) IMPLEMENTATION OF APPROVED BUDGETS AND STRATEGIC PLANS. RESPONSIBILITY TO IMPLEMENT THE APPROVED CAPITAL AND OPERATING BUDGETS AND STRATEGIC AND BUSINESS PLANS FOR THE EAST MARKET. (F) NON-BUDGETED EXPENDITURES. AUTHORITY TO APPROVE NON-BUDGETED CAPITAL PURCHASES AND LEASES FOR EAST MARKET FACILITIES WITHIN DOLLAR LIMITS DEFINED BY ESSENTIA HEALTH. (G) ACCREDITATION AND LICENSURE. RESPONSIBILITY TO OVERSEE ACCREDITATION AND LICENSURE COMPLIANCE FOR THE FACILITIES OF THE EAST MARKET. (H) AFFILIATIONS, ACQUISITIONS AND JOINT VENTURES. AUTHORITY TO RECOMMEND PROPOSED AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES; RESPONSIBILITY TO OVERSEE NEGOTIATION AND IMPLEMENTATION OF APPROVED ACQUISITIONS AND OPERATION OF ALL APPROVED AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES WITH THIRD PARTIES WITHIN THE EAST MARKET. (I) APPOINTMENT OF DIRECTORS. AUTHORITY TO APPOINT OR ELECT ESSENTIA HEALTH EAST (SMDC) DESIGNATED DIRECTOR POSITIONS TO SERVE ON THE BOARDS OF THE DIRECT SUBSIDIARIES AND TO REMOVE SUCH DIRECTORS WITH OR WITHOUT CAUSE. (J) PRESIDENT. AUTHORITY TO ADVISE THE CEO OF ESSENTIA HEALTH REGARDING THE APPOINTMENT, REMOVAL AND PERIODIC EVALUATION OF THE PRESIDENT OF SMDC. (K) SATISFACTION. RESPONSIBILITY TO EXECUTE, EVALUATE AND OVERSEE PATIENT, FAMILY AND CUSTOMER SATISFACTION WITH RESPECT TO THE SERVICES PROVIDED WITHIN THE EAST MARKET AND TO ENSURE ESTABLISHED GOALS ARE MET. (L) JOB SATISFACTION. RESPONSIBILITY TO OVERSEE JOB SATISFACTION AND STAFF MORALE WITHIN THE EAST MARKET FACILITIES. (M) HUMAN RESOURCES. RESPONSIBILITY TO OVERSEE IMPLEMENTATION OF ESSENTIA HEALTH HUMAN RESOURCE POLICIES AND PROCEDURES THROUGHOUT THE EAST MARKET. (N) COMPLIANCE. RESPONSIBILITY TO EXECUTE THE APPROVED ESSENTIA HEALTH CORPORATE COMPLIANCE AND RISK MANAGEMENT PLANS FOR THE EAST MARKET. (O) CREDENTIALING. RESPONSIBILITY TO PERFORM MEDICAL STAFF CREDENTIALING FOR THE EAST MARKET FACILITIES. (P) NOMINATIONS. AUTHORITY TO NOMINATE PERSONS FOR APPOINTMENT TO THE SMDC BOARD OF DIRECTORS BY THE BENEDICTINE SISTERS BENEVOLENT ASSOCIATION AND ESSENTIA HEALTH. (Q) AMENDMENTS. AUTHORITY TO SUGGEST PROPOSED AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF SMDC, THE DIRECT SUBSIDIARIES, AND ANY SUBSIDIARIES THEREOF. (R) COMPENSATION PLANS. RESPONSIBILITY TO REVIEW AND APPROVE COMPENSATION OF EAST MARKET EXECUTIVES AND PHYSICIANS FOR REASONABLENESS AND CONSISTENCY WITH THE LAW AND ESSENTIA HEALTH'S COMPENSATION PHILOSOPHY. (S) PRESIDENT/CHIEF MEDICAL OFFICER. BY ACTION OF THE SMDC PRESIDENT, AUTHORITY TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CHIEF MEDICAL OFFICER OF ANY OF THE GOVERNING OR PARENT BOARDS OF THE DIRECT SUBSIDIARIES. (T) PUBLIC POLICY. RESPONSIBILITY TO SUPPORT ESSENTIA HEALTH PUBLIC POLICY AND ADVOCACY PLANS. (U) MARKETING. RESPONSIBILITY TO COORDINATE LOCAL MARKETING AND PROMOTIONAL ACTIVITIES CONSISTENT WITH ESSENTIA HEALTH MARKETING PLANS. (V) PHILANTHROPY. RESPONSIBILITY TO COORDINATE PHILANTHROPY WITHIN THE EAST MARKET CONSISTENT WITH ESSENTIA HEALTH FOUNDATION POLICIES. (W) PROFESSIONAL SERVICES. RESPONSIBILITY TO OVERSEE EAST MARKET MANAGEMENT'S COOPERATION WITH EXTERNAL AUDITORS AND GENERAL LEGAL COUNSEL SELECTED BY ESSENTIA HEALTH AND COORDINATION OF LEGAL SERVICES THROUGH THE ESSENTIA HEALTH OFFICE OF GENERAL COUNSEL. (X) CATHOLIC FACILITIES. RESPONSIBILITY TO OVERSEE IMPLEMENTATION OF BSBA APPROVED METHODS, POLICIES AND PROCEDURES PERTAINING TO ADHERENCE BY THE EAST MARKET CATHOLIC FACILITIES WITH THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES AND USE OF RELIGIOUS SYMBOLS, DISTINGUISHING ELEMENTS AND PRAYERS. (Y) PROJECTS INVOLVING REAL ESTATE. AUTHORITY TO RECOMMEND FACILITY DEVELOPMENT PROJECTS, SUBJECT TO THE APPROVAL OF ESSENTIA HEALTH; RESPONSIBILITY TO OVERSEE EXECUTION OF APPROVED DEVELOPMENT PROJECTS ACCORDING TO ESSENTIA HEALTH POLICIES. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE CURRENT 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 FORM 990. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCING CONFLICT OF INTEREST POLICY: ESSENTIA HEALTH'S COMPREHENSIVE CONFLICT OF INTEREST PROGRAM PREVENTS, DETECTS, AND RESOLVES ACTUAL CONFLICTS OF INTERESTS OR THE ACTUAL OR POTENTIAL APPEARANCE OF SUCH. FIDUCIARIES, DEFINED AS AN ESSENTIA HEALTH BOARD MEMBER/TRUSTEE, OFFICER, BOARD COMMITTEE MEMBER, SENIOR MANAGEMENT EMPLOYEE, OR ANY OTHERS CONSIDERED TO BE IN A POSITION OF INFLUENCE, ARE COVERED UNDER ESSENTIA HEALTH'S CONFLICT OF INTEREST PROGRAM. UPON INITIAL APPOINTMENT, EACH FIDUCIARY MUST COMPLETE AN INITIAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AT THE CONCLUSION OF EACH CALENDAR YEAR, EACH FIDUCIARY MUST COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AS NEEDED, A FIDUCIARY WILL UPDATE THEIR MOST RECENTLY COMPLETED QUESTIONNAIRE EACH TIME THE FIDUCIARY BECOMES AWARE OF A FINANCIAL INTEREST, A POTENTIAL CONFLICT, OR CHANGE TO ANY INFORMATION THAT THE FIDUCIARY PREVIOUSLY REPORTED. ESSENTIA HEALTH'S CHIEF COMPLIANCE OFFICER WILL COLLECT THE QUESTIONNAIRES AND EVALUATE THE DISCLOSURES. IF A FIDUCIARY HAS A POTENTIAL CONFLICT OF INTEREST, THE CHIEF COMPLIANCE OFFICER OR THEIR DESIGNEE MAY REQUEST ADDITIONAL INFORMATION FROM THE FIDUCIARY, THE MANAGEMENT TEAM, AND OTHERS. DURING THE EVALUATION PROCESS, THE CHIEF COMPLIANCE OFFICER MAY ALSO CONSULT WITH ESSENTIA HEALTH'S BOARD AND AUDIT COMMITTEE CHAIRS, SENIOR MANAGEMENT, LEGAL DEPARTMENT, OR APPROPRIATE REPRESENTATIVES FROM ESSENTIA HEALTH. THE CHIEF COMPLIANCE OFFICER REPORTS TO THE ESSENTIA HEALTH AUDIT COMMITTEE AND THE ESSENTIA HEALTH BOARD OF DIRECTORS ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY THE FIDUCIARY, ALONG WITH RECOMMENDED ACTIONS. THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) WILL THEN DETERMINE WHETHER TO APPROVE THE SITUATION OR TO IMPLEMENT SPECIAL CONTROLS TO MANAGE THE POTENTIAL CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER WILL THEN OFFICIALLY NOTIFY THE FIDUCIARY IN WRITING OF THE BOARD'S DECISION. THE DECISION OF WHETHER OR NOT THE DISCLOSURE CONSTITUTES A CONFLICT WILL BE AT THE ESSENTIA HEALTH BOARD OF DIRECTOR'S (OR DESIGNEE) SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF ESSENTIA HEALTH AND ITS AFFILIATE(S) AND THE ADVANCEMENT OF ITS PURPOSES. WHEN THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) CONSIDERS A FIDUCIARY'S DISCLOSURE AS A CONFLICT OF INTEREST, SPECIAL CONTROLS WILL BE IDENTIFIED TO MANAGE, ELIMINATE OR REDUCE THE LIKELIHOOD AND/OR APPEARANCE OF A CONFLICT ARISING. CONTROLS MAY INCLUDE, BUT ARE NOT LIMITED TO: A. IF THE CONFLICT INVOLVES AN ON-GOING MATTER OR RELATIONSHIP, THE FIDUCIARY MUST NOT PARTICIPATE IN BOARD, BOARD COMMITTEE, OR MANAGEMENT DISCUSSIONS RELATED TO THE CONFLICT AND MUST RECUSE THEMSELVES AND, IF APPROPRIATE, WITHDRAW FROM ANY BOARD MEETING OR PORTION THEREOF WHERE THE MATTER IS BEING DISCUSSED AND DURING THE VOTE ON THE POTENTIAL CONFLICT OF INTEREST. THE FIDUCIARY MAY ANSWER QUESTIONS AT THE BOARD'S OR THE BOARD COMMITTEE'S REQUEST. B. IF THE CONFLICT INVOLVES A SPECIFIC TRANSACTION OR DECISION, THE FIDUCIARY WILL FULLY DISCLOSE THEIR INTEREST AND ALL RELATED MATERIAL FACTS. THE BOARD OR COMMITTEE OF THE BOARD WILL DETERMINE WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO ESSENTIA HEALTH OR ITS AFFILIATE(S). IF THE BOARD DETERMINES A CONFLICT DOES NOT EXIST, THE FIDUCIARY MAY PROCEED WITH THE TRANSACTION; HOWEVER, THEY WILL NOT BE ELIGIBLE TO VOTE ON RELATED ISSUES SHOULD THEY ARISE. IF THE BOARD DETERMINES A CONFLICT DOES EXIST, THE FIDUCIARY WILL BE NOTIFIED OF THE DECISION REGARDING WHETHER THE CONTEMPLATED TRANSACTION WILL BE AUTHORIZED AS JUST, FAIR, AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION: THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF ESSENTIA HEALTH'S BOARD OF DIRECTORS IS AUTHORIZED TO FULFILL THE BOARD'S RESPONSIBILITIES REGARDING EXECUTIVE COMPENSATION CONSISTENT WITH ESSENTIA'S MISSION, VALUES AND TAX-EXEMPT STATUS, AND THE EXECUTIVE COMPENSATION COMMITTEE'S CHARTER. THE EXECUTIVE COMPENSATION COMMITTEE MEETS AT LEAST TWICE ANNUALLY TO CARRY OUT ITS RESPONSIBILITIES, WHICH INCLUDE, BUT ARE NOT LIMITED TO, ESTABLISHING, REVIEWING AND MODIFYING, AS APPROPRIATE, REASONABLE COMPENSATION AND BENEFITS FOR DESIGNATED ESSENTIA EXECUTIVES WHO ARE OFFICERS OR KEY EMPLOYEES OF ESSENTIA OR ANY OF ITS AFFILIATES WHICH MAY BE PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINIONS ON TOTAL COMPENSATION REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE MAY REQUEST ITS INDEPENDENT ADVISORS TO: MONITOR COMPARABILITY DATA AND MARKETPLACE TRENDS; MAKE APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES; AND PERIODICALLY REVIEW THE MARKET COMPETITIVENESS OF ESSENTIA EXECUTIVE COMPENSATION PACKAGES. PRIOR TO ESTABLISHING OR ADJUSTING EXECUTIVE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE WILL OBTAIN AND RELY UPON APPROPRIATE DATA AS TO COMPARABILITY OF THE PROPOSED COMPENSATION OR ADJUSTMENTS. THE EXECUTIVE COMPENSATION COMMITTEE WILL ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THOSE DETERMINATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MINUTES WILL INCLUDE: THE TERMS OF THE APPROVED COMPENSATION AND THE DATE APPROVED; THE EXECUTIVE COMPENSATION COMMITTEE MEMBERS PRESENT DURING THE REVIEW, DISCUSSION AND APPROVAL OF THE PROPOSED COMPENSATION AND THOSE WHO VOTED ON THE PROPOSED COMPENSATION; IDENTIFICATION OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE EXECUTIVE COMPENSATION COMMITTEE AND HOW THE DATA WAS OBTAINED; ANY ACTIONS BY A MEMBER OF THE EXECUTIVE COMPENSATION COMMITTEE HAVING A CONFLICT OF INTEREST; AND DOCUMENTATION OF THE BASIS FOR THE DETERMINATION. THIS PROCESS WAS LAST UNDERTAKEN IN 2024 FOR ESSENTIA HEALTH DEER RIVER'S FINANCE DIRECTOR AND ADMINISTRATOR. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART IX, LINE 24C: AFFILIATE REVENUE AND EXPENSE ALLOCATION: ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, THE DULUTH CLINIC, LTD., AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ALLOCATE CERTAIN REVENUES AND EXPENSES DIRECTLY TO ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH SANDSTONE, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, ESSENTIA HEALTH NORTHERN PINES, ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER, ESSENTIA HEALTH DEER RIVER, ESSENTIA HEALTH VIRGINIA, ESSENTIA HEALTH SURGERY CENTERS, ESSENTIA HEALTH MOOSE LAKE, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, AND ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, ALL RELATED ORGANIZATIONS. NET AFFILIATE REVENUE AND EXPENSE ALLOCATIONS OF $2,879,324 INCLUDE THE FOLLOWING TYPES OF REVENUE AND EXPENSES: PATIENT REVENUE; NONPATIENT REVENUE; AMORTIZATION AND DEPRECIATION; INTEREST; PROFESSIONAL FEES; PURCHASED SERVICES; REPAIRS AND MAINTENANCE; SALARIES, WAGES, AND RELATED BENEFITS; SUPPLIES; UTILITIES; AGENCY FEES; PROVIDER AND OTHER TAXES; AND OTHER EXPENSES. FORM 990, PART XI, LINE 9: NET ASSET TRANSFER WITH RELATED ORGANIZATION 359,700. BRAINERD MEDICAL CENTER INC 2024 S 6TH ST BRAINERD MN 56401 371532148 CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 BRIDGES MEDICAL CENTER 201 9TH ST W ADA MN 56510 200479568 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ESSENTIA HEALTH 502 E 2ND ST DULUTH MN 55805 200360007 SUPPORTING ORG MN 501(C)(3) LINE 12C, III-FI N/A 0 ESSENTIA HEALTH ACO INC 502 E 2ND ST DULUTH MN 55805 993256474 SUPPORTING ORG DE 501(C)(3) LINE 12A, I ESSENTIA HEALTH 1 ESSENTIA HEALTH FOUNDATION 502 E 2ND ST DULUTH MN 55805 271984704 FOUNDATION MN 501(C)(3) LINE 7 ESSENTIA HEALTH 1 ESSENTIA HEALTH MOOSE LAKE 4572 COUNTY ROAD 61 MOOSE LAKE MN 55767 845099016 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ESSENTIA HEALTH SURGERY CENTERS 502 E 2ND ST DULUTH MN 55805 881577422 SURGERY CENTER MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ESSENTIA INSTITUTE OF RURAL HEALTH 502 E 2ND ST DULUTH MN 55805 271291124 RESEARCH MN 501(C)(3) LINE 4 THE DULUTH CLINIC LTD 1 FIRST CARE MEDICAL SERVICES 900 HILLIGOSS BLVD SE FOSSTON MN 56542 410706143 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 GRACEVILLE HEALTH CENTER 115 WEST 2ND ST GRACEVILLE MN 56240 410726173 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 INNOVIS HEALTH LLC 3000 32ND AVE S FARGO ND 58103 261175213 HOSPITAL/CLINIC DE 501(C)(3) LINE 3 ESSENTIA HEALTH 1 MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC 502 E 2ND ST DULUTH MN 55805 411674021 MEDICAL EQUIPMENT MN 501(C)(3) LINE 10 ST MARY'S MEDICAL CENTER 1 NORTHERN PINES MEDICAL CENTER 5211 HWY 110 AURORA MN 55705 410841441 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 PINE MEDICAL CENTER 705 LUNDORFF DR S SANDSTONE MN 55072 411884597 HOSPITAL MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 POLINSKY MEDICAL REHABILITATION CENTER 1600 MILLER TRUNK HWY BLDG C DULUTH MN 55811 410691275 REHABILITATION SERVICES MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 SMDC MEDICAL CENTER 502 E 2ND ST DULUTH MN 55805 411878730 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST JOSEPH'S MEDICAL CENTER 523 N 3RD ST BRAINERD MN 56401 410695602 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 502 E 2ND ST DULUTH MN 55805 411836633 SUPPORTING ORG MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 1 ST MARY'S EMS 1027 WASHINGTON AVE DETROIT LAKES MN 56501 411805811 EMERGENCY SERVICES MN 501(C)(3) LINE 10 ESSENTIA HEALTH 1 ST MARY'S HOSPITAL OF SUPERIOR 3500 TOWER AVE SUPERIOR WI 54880 411811073 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST MARY'S INNOVIS HEALTH 1027 WASHINGTON AVE DETROIT LAKES MN 56501 262861321 PHARMACY MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST MARY'S MEDICAL CENTER 402 E 2ND ST DULUTH MN 55805 410695604 HOSPITAL MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST MARY'S REGIONAL HEALTH CENTER 1027 WASHINGTON AVE DETROIT LAKES MN 56501 411620386 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 THE DULUTH CLINIC LTD 400 E 3RD ST DULUTH MN 55805 410883623 CLINIC DE 501(C)(3) LINE 3 ESSENTIA HEALTH 1 BRIGHTSIDE SURGICAL LLC 401 N 9TH ST BISMARCK ND 58501 831888619 AMBULATORY SURGERY CENTER ND N/A N/A 0 0 ESSENTIA HEALTH INSURANCE SERVICES SPC LTD PO BOX 1159 GRAND CAYMAN CJ K71-1102 981829514 SELF INSURANCE CJ N/A C 1 MID DAKOTA CLINIC INC 502 E 2ND ST DULUTH MN 55805 450311334 CLINIC OPERATIONS CEASED 9/30/22 ND N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 ESSENTIA HEALTH M 5146752 ACTUAL COSTS ESSENTIA HEALTH P 2099485 ACTUAL COSTS MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC S 3000000 ACTUAL COSTS ST JOSEPH'S MEDICAL CENTER P 55200 ACTUAL COSTS ST MARY'S EMS S 200000 ACTUAL COSTS SCHEDULE R, PART II, COLUMN (A): THE FOLLOWING ESSENTIA HEALTH ENTITIES HAVE A DOING BUSINESS AS NAME: LEGAL NAME; DOING BUSINESS AS NAME BRAINERD MEDICAL CENTER, INC.; ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC BRIDGES MEDICAL CENTER; ESSENTIA HEALTH ADA DEER RIVER HEALTHCARE CENTER, INC.; ESSENTIA HEALTH DEER RIVER FIRST CARE MEDICAL SERVICES; ESSENTIA HEALTH FOSSTON GRACEVILLE HEALTH CENTER; ESSENTIA HEALTH HOLY TRINITY HOSPITAL INNOVIS HEALTH, LLC; ESSENTIA HEALTH WEST MIDWEST MEDICAL EQUIPMENT AND SUPPLIES, INC.; ESSENTIA HEALTH MEDICAL EQUIPMENT & SUPPLIES NORTHERN PINES MEDICAL CENTER; ESSENTIA HEALTH NORTHERN PINES PINE MEDICAL CENTER; ESSENTIA HEALTH SANDSTONE POLINSKY MEDICAL REHABILITATION CENTER; ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER SMDC MEDICAL CENTER; ESSENTIA HEALTH DULUTH ST. JOSEPH'S MEDICAL CENTER; ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ST. MARY'S DULUTH CLINIC HEALTH SYSTEM; ESSENTIA HEALTH EAST ST. MARY'S EMS; ESSENTIA HEALTH EMS ST. MARY'S HOSPITAL OF SUPERIOR; ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR ST. MARY'S MEDICAL CENTER; ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER ST. MARY'S REGIONAL HEALTH CENTER; ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES