2026-05-11T09:50:35-05:00 2025-06-30 990 2024-07-01 261175213 INNOVIS HEALTH LLC INNO 7013648000 3000 32ND AVE S FARGO ND 58103 DOUG ARVIN VICE PRESIDENT, FINANCE 7013648000 2026-05-11 0 2024 2025-03-06 01:10:19Z ESSENTIA HEALTH WEST STEFANIE GEFROH ELLISON 3000 32ND AVE S FARGO ND 58103 684544304 0 X WWW.ESSENTIAHEALTH.ORG X LLC 2007 DE WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 8 4 3244 75 846850 399838 436465 2806034 622015231 677826212 -372647 -300765 3326795 3166378 625405844 683497859 921506 1089951 0 0 308564344 341545857 0 0 0 316622063 336887122 626107913 679522930 -702069 3974929 320704145 326410429 351947823 353881294 -31243678 -27470865 X WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 0 0 616056224 1089951 677826212 INNOVIS HEALTH, LLC, DBA ESSENTIA HEALTH WEST, IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE, SCIENTIFIC, AND EDUCATIONAL PURPOSES. IN FURTHERANCE OF ITS PURPOSES, ESSENTIA HEALTH WEST PROVIDES HEALTH CARE SERVICES IN MINNESOTA AND NORTH DAKOTA THROUGH ITS HOSPITAL AND 21 CLINICS, INCLUDING CHARITABLE CARE TO PERSONS UNABLE TO PAY.THE MULTI-SPECIALTY HOSPITAL WITH 142 LICENSED BEDS IS ACCREDITED BY THE JOINT COMMISSION AND IS DESIGNED AS A LEVEL II TRAUMA CENTER AND COMPREHENSIVE STROKE CENTER. THE EMERGENCY DEPARTMENT IS OPEN 24 HOURS PER DAY. ESSENTIA HEALTH WEST OFFERS A BROAD RANGE OF INPATIENT AND OUTPATIENT SERVICES FOR ITS PATIENTS, INCLUDING CRITICAL CARE, PEDIATRIC SERVICES, NEONATAL INTENSIVE CARE, MATERNITY CARE, IMAGING/RADIOLOGY, LAB, SURGERY, HEART AND VASCULAR, AND CANCER SERVICES.ESSENTIA HEALTH WEST EMPLOYS APPROXIMATELY 1,980 FULL TIME EQUIVALENTS. THE HOSPITAL PROVIDED MORE THAN 41,000 HOSPITAL PATIENT DAYS AND 255,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2025. THE CLINICS HAD APPROXIMATELY 662,000 ENCOUNTERS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2025, ESSENTIA HEALTH WEST PROVIDED THE FOLLOWING COMMUNITY BENEFITS: $5.8 MILLION IN CHARITY CARE, $19.3 MILLION COSTS IN EXCESS OF MEDICAID PAYMENTS, $968,000 IN COMMUNITY SERVICES, AND $1.4 MILLION IN HEALTH PROFESSION EDUCATION.ESSENTIA HEALTH IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTH SYSTEM THAT INCLUDES THIS ORGANIZATION AND ALL ENTITIES THAT ARE OWNED OR CONTROLLED, DIRECTLY OR INDIRECTLY, BY ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM OR "ESSENTIA HEALTH"). 616056224 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 3244 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 8 4 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MN X DOUG ARVIN 7013648000 3000 32ND AVE S FARGO ND 58103 ADAM STIBBE MD PHYSICIAN & SECTION CHAIR 60.00 0.00 X 1784680 0 70470 BENJAMIN SMITH MD BOARD DIRECTOR & PHYSICIAN 59.20 0.80 X 1709392 3375 76023 JEROME SAMPSON MD PHYSICIAN 60.00 0.00 X 1613917 0 51857 SCOTT REARDON MD PHYSICIAN 60.00 0.00 X 1352487 0 76564 MICKEY SYRQUIN MD PHYSICIAN 60.00 0.00 X 1303324 0 66896 KIMBERLY KOLKHORST MD PHYSICIAN & SECTION CHAIR 60.00 0.00 X 1260253 0 66946 TRACI MORRIS TREASURER/REL ORG CHIEF FINCL OFF 1.00 59.00 X 0 1054730 144686 WILLIAM HEEGAARD MD FORMER PRESIDENT 1.00 22.00 X 527729 448218 122346 ROBERT GREEN FORMER VICE PRESIDENT, FINANCE 0.00 60.00 X 0 782582 151254 RICHARD VETTER MD CHIEF MEDICAL OFFICER THRU 12/24 58.00 2.00 X 775719 0 150321 MICHAEL WATTERS SECRETARY/REL ORG CHIEF LEGAL OFF 1.00 59.00 X 0 773128 151399 ALAN BRUNS MD FORMER KE/PHYSICIAN & DIVISON CHAIR 60.00 0.00 X 891122 0 33137 AL HURLEY CHIEF OPERATING OFFICER 56.00 4.00 X 706163 0 129814 JOSHUA GEBUR MD FORMER KE/PHYSICIAN & DIVISION CHAIR 60.00 0.00 X 709763 0 69074 MARK THOMPSON MD PRESIDENT THRU 7/24 57.00 3.00 X 702130 0 40293 STEFANIE GEFROH ELLISON MD PRESIDENT 57.00 3.00 X 532220 30000 66878 TANYA DIEGEL DO FORMER KE/PHYSICIAN & DIVISION CHAIR 59.00 1.00 X 543585 0 66608 TANNER GOODRICH SENIOR VICE PRESIDENT, OPERATIONS 57.00 3.00 X 464920 0 113980 DOUG ARVIN VICE PRESIDENT, FINANCE 60.00 0.00 X 445233 0 34888 TAYLOR MERTZ MD BD DIRECTOR/PHYSICIAN & SEC CHAIR 58.20 1.80 X 371362 4500 67780 ANDREW MOEN MD FORMER KE/PHYSICIAN & DIVISION CHAIR 60.00 0.00 X 372780 0 69550 RAE SALUS FORMER SENIOR VP OPERATIONS 0.00 0.00 X 351547 0 3359 JOSEPH WENDT FORMER KE/VP, ADMINISTRATOR 60.00 0.00 X 280871 0 58507 MICHELLE STENBECK CHIEF NURSING OFFICER THRU 1/24 60.00 0.00 X 294844 0 24013 KERRY CARLSON FORMER KE/VP, OPERATIONS 60.00 0.00 X 257429 0 52424 SUZANNE ZELTINGER CHIEF NURSING OFFICER 60.00 0.00 X 252448 0 18546 DAN BEAUCHAMP FORMER KE/FACILITIES SNR DIRECTOR 1.00 59.00 X 96740 103311 50972 WALTER JOHNSON MD FORMER PHYSICIAN & SECTION CHAIR 0.00 0.00 X 250000 0 0 CHRISTY BRINKMAN FORMER KE/OPERATIONS SNR DIRECTOR 1.00 59.00 X 0 218377 13846 JAMES CHRISTENSEN MD BOARD DIRECTOR & PHYSICIAN 59.20 0.80 X 145864 2250 26779 JOEL HAUGEN MD BOARD CHAIR/RETIRED PHYSICIAN 0.20 0.80 X X 108155 8000 0 LAURIE LEWANDOWSKI BOARD DIRECTOR 0.20 3.80 X 0 23375 0 ARRICK JACKSON BOARD DIRECTOR THRU 5/25 0.20 0.80 X 0 4500 0 TIMOTHY HEILMAN BOARD VICE CHAIR 0.20 0.80 X X 0 4500 0 ANDERSON ST GEORGE BOARD DIRECTOR 0.20 0.80 X 0 0 0 JENNY OLSON BOARD DIRECTOR THRU 2/25 0.20 0.80 X 0 0 0 KIM PLADSON BOARD DIRECTOR 0.20 0.80 X 0 0 0 SISTER BEVERLY HORN BOARD DIRECTOR THRU 4/25 0.20 0.80 X 0 0 0 18104677 3460846 2069210 651 1 1 0 0 193745 603864 2008425 2806034 INPATIENT AND OUTPATIENT REVENUES 621110 677063397 676576814 486583 DAKOTA CLINIC PHARMACY INVESTMENT 900099 631125 631125 PARK RAPIDS AREA INVESTMENT 900099 131690 131690 677826212 10916 10916 924275 341739 0 134685 924275 207054 1131329 207054 924275 76297 303066 73901 617143 2396 -314077 -311681 -311681 368573 220716 147857 153213 -5356 CAFETERIA & VENDING SALES 722514 1846716 1846716 RELEASE OF INFORMATION 900099 39876 39876 MISCELLANEOUS REVENUE 900099 600 600 1887192 683497859 677339629 846850 2505346 X 1089951 1089951 5218703 1314739 3903964 279669 276102 3567 279169491 269430052 9739439 11553267 11161085 392182 28648642 26384437 2264205 16676085 15909129 766956 15010 15010 1492 1492 17259 17259 1047 1047 34630306 28083513 6546793 651260 24784 626476 20613216 16918590 3694626 14983169 14460448 522721 8001136 7721999 279137 1760888 1419012 341876 620794 319960 300834 8381392 8381392 22268396 21491514 776882 6944166 6883338 60828 MEDICAL SUPPLIES 115739175 115739175 UNRELATED BUSINESS TAX 205847 205847 AFFILIATE SUPPORT FEE 70026024 33827061 36198963 BAD DEBT EXPENSE 31050726 31050726 975819 4169217 -3193398 679522930 616056224 63466706 0 4183220 205336 72668 27114 14344 69001265 75187246 4090419 4694598 12412089 12434362 5495749 6183966 460758917 254735379 204099251 206023538 516652 215369 2384667 2666181 7800897 9288991 10647268 9469384 320704145 326410429 61987147 75826479 38523 123177388 119732440 120812051 119605918 45932714 38716457 351947823 353881294 X -31243678 -27470865 -31243678 -27470865 320704145 326410429 X 3974929 17931 -220047 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 17259 17259 0 SCHEDULE C, PART II-B, LINE 1, LOBBYING ACTIVITIES: LOBBYING ACTIVITY EXPLANATION: ESSENTIA HEALTH WEST PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. 17137377 17137377 245564210 118347345 127216865 20197770 8440079 11757691 159155984 123901119 35254865 18703576 4046836 14656740 206023538 PAYABLES TO RELATED TAX-EXEMPT ORGANIZATIONS 29000000 OPERATING LEASES 9709457 TENANT DEPOSITS 7000 38716457 1 1 X 1 X 0 1 1 1 0 1 1 5795470 5795470 0.00890 76790097 57447716 19342381 0.02980 82585567 57447716 25137851 0.03870 967707 967707 0.00150 1415871 1415871 0.00220 2383578 2383578 0.00370 84969145 57447716 27521429 0.04240 2543 2543 0.00000 40000 40000 0.00010 42543 42543 0.00010 1 31050726 96078696 116298757 -20220061 X 1 1 1 1 ESSENTIA HEALTH WEST 3000 32ND AVE S FARGO ND 58103 WWW.ESSENTIAHEALTH.ORG 5067 X X X X ESSENTIA HEALTH WEST 0 0 1 X X X X X X X X X 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 WEST PART V, SECTION B, LINE 5: ESSENTIA HEALTH WEST SOLICITED BROAD FEEDBACK FROM THE COMMUNITY THROUGH A COMMUNITY SURVEY, WHICH COLLECTED 1,865 RESPONSES; THE SURVEY WAS ADMINISTERED FROM 10/2/2023 TO 12/31/2023.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 THE MOORHEAD PUBLIC LIBRARY, BLUE CROSS BLUE SHIELD OF NORTH DAKOTA, ARKOS HEALTH, CITY OF MOORHEAD, SOUL SOLUTIONS RECOVERY CENTER, MOORHEAD AREA PUBLIC SCHOOLS, CITY OF BARNESVILLE, FOUNDATIONS FOR A HEALTHY NORTH DAKOTA, YMCA OF THE NORTHERN SKY, CITY OF DILWORTH, CITY OF FARGO, GLOBAL REFUGE, LAKES & PRAIRIES COMMUNITY ACTION PARTNERSHIP, SOUTHEAST HUMAN SERVICES CENTER, UNITED WAY OF CASS CLAY, NORTH DAKOTA HEALTH AND HUMAN SERVICES, SANFORD HEALTH, FAMILY HEALTHCARE, CULTURAL DIVERSITY RESOURCES, RED RIVER MARKET, FARGO CASS PUBLIC HEALTH, CLAY COUNTY PUBLIC HEALTH, FARGO NATIVE AMERICAN COMMISSION, NORTH DAKOTA STATE UNIVERSITY EXTENSION, GROWING TOGETHER COMMUNITY GARDENS, CASS CLAY COMMUNITY LAND TRUST, HIGH PLAINS FAIR HOUSING CENTER, LEGAL SERVICES OF NORTHWEST MINNESOTA, HEART N' SOUL COMMUNITY CAFE, FARGO-MOORHEAD COALITION TO END HOMELESSNESS, CASS CLAY HUNGER COALITION, GREAT PLAINS FOOD BANK, MINNESOTA STATE COMMUNITY AND TECHNICAL COLLEGE, MINNESOTA STATE UNIVERSITY MOORHEAD, NEW ROOTS MIDWEST, IMMIGRANT DEVELOPMENT CENTER, NEW AMERICAN CONSORTIUM FOR WELLNESS AND EMPOWERMENT, INDIGENOUS ASSOCIATION, AND INDIGENOUS LEGACY DURING THE SURVEY TIMEFRAME ABOVE.ESSENTIA HEALTH WEST 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 WEST PART V, SECTION B, LINE 6A: TO ALIGN RESOURCES AND STRENGTHS TO BETTER SERVE OUR COMMUNITY, THE CHNA WAS CONDUCTED IN COLLABORATION WITH SANFORD HEALTH, AN UNRELATED HOSPITAL FACILITY. ESSENTIA HEALTH WEST PART V, SECTION B, LINE 6B: ESSENTIA HEALTH WEST WORKED COLLABORATIVELY ON THE ASSESSMENT PROCESS WITH THE MOORHEAD PUBLIC LIBRARY, BLUE CROSS BLUE SHIELD OF NORTH DAKOTA, ARKOS HEALTH, CITY OF MOORHEAD, SOUL SOLUTIONS RECOVERY CENTER, MOORHEAD AREA PUBLIC SCHOOLS, CITY OF BARNESVILLE, FOUNDATIONS FOR A HEALTHY NORTH DAKOTA, YMCA OF THE NORTHERN SKY, CITY OF DILWORTH, CITY OF FARGO, GLOBAL REFUGE, LAKES & PRAIRIES COMMUNITY ACTION PARTNERSHIP, SOUTHEAST HUMAN SERVICE CENTER, UNITED WAY OF CASS CLAY, NORTH DAKOTA HEALTH AND HUMAN SERVICES, FAMILY HEALTHCARE, CULTURAL DIVERSITY RESOURCES, RED RIVER MARKET, FARGO CASS PUBLIC HEALTH, CLAY COUNTY PUBLIC HEALTH, FARGO NATIVE AMERICAN COMMISSION, NORTH DAKOTA STATE UNIVERSITY EXTENSION, GROWING TOGETHER COMMUNITY GARDENS, CASS CLAY COMMUNITY LAND TRUST, HIGH PLAINS FAIR HOUSING CENTER, LEGAL SERVICES OF NORTHWEST MINNESOTA, HEART N' SOUL COMMUNITY CAFE, FARGO-MOORHEAD COALITION TO END HOMELESSNESS, CASS CLAY HUNGER COALITION, GREAT PLAINS FOOD BANK, MINNESOTA STATE COMMUNITY AND TECHNICAL COLLEGE, MINNESOTA STATE UNIVERSITY MOORHEAD, NEW ROOTS MIDWEST, IMMIGRANT DEVELOPMENT CENTER, NEW AMERICAN CONSORTIUM FOR WELLNESS AND EMPOWERMENT, INDIGENOUS ASSOCIATION, AND INDIGENOUS LEGACY. ESSENTIA HEALTH WEST PART V, SECTION B, LINE 11: DURING FY 2025, ESSENTIA HEALTH WEST ADDRESSED SIGNIFICANT NEEDS IDENTIFIED IN THE FY 2022 ASSESSMENT: HEALTH EQUITY AND YOUTH MENTAL HEALTH. SOME ACTIVITIES WERE LED BY THE HOSPITAL, WHILE OTHERS WERE PART OF LARGER COLLABORATIVE EFFORTS WITH LOCAL PARTNERS.OTHER HEALTH NEEDS IDENTIFIED THROUGH THE CHNA PROCESS ARE HOUSING AND TRANSPORTATION, WHICH WILL NOT BE DIRECTLY ADDRESSED AS PRIORITIES BECAUSE FEASIBILITY WAS RANKED LOW. THESE NEEDS WILL BE ADDRESSED AS POSSIBLE THROUGH OTHER COMMUNITY INITIATIVES.THE FOLLOWING DESCRIBES SIGNIFICANT ACCOMPLISHMENTS AND OUTCOMES.PRIORITY AREA #1: HEALTH EQUITYTO PROMOTE HEALTH EQUITY, THE HOSPITAL ENGAGED IN SEVERAL COMMUNITY PARTNERSHIPS. IN FY 2025, THE HOSPITAL PARTNERED WITH THE IMMIGRANT DEVELOPMENT CENTER TO SPONSOR DRIVING TO SUCCESS, A PROGRAM AIMED AT ASSISTING NEW AMERICANS IN OBTAINING THEIR DRIVER'S LICENSE. SINCE 2023, THE PROGRAM HAS SUCCESSFULLY PROVIDED CUSTOMIZED DRIVING EDUCATION AND BEHIND-THE-WHEEL INSTRUCTION TO NEW AMERICANS IN THE FARGO-MOORHEAD COMMUNITY. BUILDING ON THE SUCCESS OF THE FIRST DRIVING TO SUCCESS STUDENT COHORT IN 2023, THE HOSPITAL RENEWED THEIR PARTNERSHIP WITH THE IMMIGRANT DEVELOPMENT CENTER TO SPONSOR ANOTHER COHORT OF STUDENTS THROUGH THE DRIVING TO SUCCESS PROGRAM. THE FY25 COHORT INCLUDED 27 NEW AMERICAN PARTICIPANTS, WITH 10 PROGRAM PARTICIPANTS SUCCESSFULLY OBTAINING THEIR CLASS D DRIVER'S LICENSE, FOSTERING GREATER INDEPENDENCE AND OPPORTUNITY FOR THESE COMMUNITY MEMBERS AND THEIR FAMILIES.SINCE 2016, THE HOSPITAL HAS PARTNERED WITH LOCAL HIGHER EDUCATION INSTITUTIONS TO SPONSOR SCRUBS CAMP, A SUMMER OUTREACH PROGRAM THAT GIVES LOCAL HIGH SCHOOL STUDENTS AN OPPORTUNITY TO EXPLORE HEALTH SCIENCE PROFESSIONS THROUGH ENGAGING, HANDS-ON ACTIVITIES. IN FY 2025, THE HOSPITAL PARTNERED WITH MINNESOTA STATE UNIVERSITY MOORHEAD (MSUM) AND THE NORTH DAKOTA STATE COLLEGE OF SCIENCE (NDSCS) TO HOST SCRUBS CAMP. THE HOSPITAL'S INVOLVEMENT IN THE PROGRAM ALLOWS PARTICIPANTS TO EXPLORE DIFFERENT PATHWAYS IN HEALTHCARE AND EXPERIENCE THE ROLE THAT HEALTHCARE PROFESSIONALS PLAY IN IMPROVING THE HEALTH OF THOSE IN THEIR CARE. FURTHERMORE, THE HOSPITAL'S INVESTMENT IN THE PROGRAM PROMOTES EQUITY BY DRIVING DOWN THE OVERALL COST OF THE CAMP FOR PARTICIPANTS AND HELPING TO REMOVE FINANCIAL BARRIERS OF ATTENDANCE. IN FY 2025, THE HOSPITAL'S INVESTMENT IN SCRUBS CAMP RESULTED IN AN ANTICIPATED 50 YOUTH RECEIVING EXPERIENCE IN A HEALTHCARE SETTING THROUGH HANDS-ON ACTIVITIES. IN ADDITION, THE HOSPITAL'S INVESTMENT IN THE PROGRAM RESULTED IN AN ADDITIONAL 20 STUDENTS BEING ABLE TO PARTICIPATE IN THE CAMP DURING 2025 COMPARED TO 2024.TO PROMOTE HEALTH EQUITY, THE HOSPITAL INCREASED OUTREACH AND SUPPORT EFFORTS IN NEW AMERICAN COMMUNITIES. THE HOSPITAL SPONSORED A SWIMMING LESSON SCHOLARSHIP FUND FOR NEW AMERICAN YOUTH AT THE YMCA OF THE NORTHERN SKY. THROUGH THIS PARTNERSHIP, 80 YOUTHS FROM THE NEW AMERICAN COMMUNITY RECEIVED INSTRUCTION ON SWIMMING SKILLS AND WATER SAFETY, WITH 100% OF YOUTHS MASTERING AT LEAST TWO WATER SAFETY SKILLS BY THE END OF THE LESSONS. TO INCREASE OUTREACH EFFORTS AND RECRUIT SWIMMING LESSON PARTICIPANTS, THE HOSPITAL PARTNERED WITH NEW ROOTS MIDWEST, A LOCAL NONPROFIT ORGANIZATION THAT SERVES NEW AMERICAN COMMUNITY MEMBERS. THIS PARTNERSHIP WITH NEW ROOTS MIDWEST RESULTED IN A MORE DIVERSE GROUP OF SWIMMING LESSON PARTICIPANTS, WITH 50% OF PARTICIPANTS BEING FEMALE AND PARTICIPANTS REPORTING THEIR COUNTRY OF ORIGIN PRIOR TO IMMIGRATING AS ONE OF FOUR EAST AFRICAN OR MIDDLE EASTERN COUNTRIES.THE HOSPITAL SUPPORTED THE NAVIGATION OF EMPLOYMENT OPPORTUNITIES AND WORKFORCE DEVELOPMENT AMONG ADULT RESIDENTS THROUGH THEIR SPONSORSHIP OF CAREER READINESS AND TRAINING PROGRAMS AT LAKES AND PRAIRIES COMMUNITY ACTION PARTNERSHIP (CAPLP) AND SOUTHEASTERN NORTH DAKOTA COMMUNITY ACTION AGENCY (SENDCAA). THROUGH THE HOSPITAL'S SPONSORSHIP OF THE CAREER CONNECT PROGRAM, CAPLP WILL ASSIST AN ANTICIPATED 15 INDIVIDUALS IN COMPLETING TRAINING AND BECOMING EMPLOYED LOCALLY IN A HIGH DEMAND CAREER FIELD SUCH AS HEALTHCARE OR MANUFACTURING. SIMILARLY, THROUGH THE HOSPITAL'S SPONSORSHIP OF THE CAREER COACH PROGRAM, SENDCAA WILL ASSIST AN ANTICIPATED 25 INDIVIDUALS IN RECEIVING EDUCATION AND TRAINING AS A CERTIFIED NURSING ASSISTANT (CNA), POSITIONING THESE INDIVIDUALS ON A PATH TO LONG-TERM EMPLOYMENT IN HEALTHCARE.PRIORITY AREA #2: YOUTH MENTAL HEALTHTHE HOSPITAL PARTNERED WITH CLAY COUNTY PUBLIC HEALTH AND THE MOORHEAD ALTERNATIVE LEARNING CENTER (ALC) TO ADDRESS YOUTH MENTAL HEALTH DURING FY 2025. STUDENTS AT THE ALC PREVIOUSLY REPORTED HIGH RATES OF ANXIETY, DEPRESSION, AND EMOTIONAL DYSREGULATION, WHICH NEGATIVELY IMPACTED STUDENTS' ABILITY TO STAY IN CLASS AND SUCCESSFULLY COMPLETE HIGH SCHOOL. TO POSITIVELY SUPPORT STUDENT MENTAL HEALTH, THE HOSPITAL AND CLAY COUNTY PUBLIC HEALTH PARTNERED TO SUPPORT THE IMPLEMENTATION OF SOURCES OF STRENGTH CURRICULUM ON THE ALC CAMPUS. THE CURRICULUM, WHICH IS A BEST PRACTICE YOUTH MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION PROGRAM, WAS INTRODUCED TO ALC TEACHERS AND STAFF DURING THE SPRING OF 2023 AND WAS UTILIZED WITH ALC STUDENTS DURING FY 2024-2025. TO SUPPORT THE SOURCES OF STRENGTH CURRICULUM, THE HOSPITAL SPONSORED TWO COMMUNITY VOLUNTEERING EVENTS FOR STUDENTS. THESE EVENTS DIRECTLY RELATED TO THE SOURCES OF STRENGTH CURRICULUM BY BOLSTERING STUDENTS' INVOLVEMENT IN HEALTHY ACTIVITIES AND GENEROSITY, BOTH OF WHICH ARE ASPECTS OF THE CURRICULUM. THE HOSPITAL'S INVOLVEMENT IN THESE ACTIVITIES RESULTED IN 15 STUDENTS ATTENDING TWO COMMUNITY VOLUNTEERING ACTIVITIES AND 75% OF STUDENTS REPORTING THAT THEY FELT POSITIVELY CONNECTED TO PEERS AND TRUSTED ADULTS AND THAT THE EVENTS HELPED IMPROVE THEIR HELP-SEEKING BEHAVIORS. ESSENTIA HEALTH WEST PART V, SECTION B, LINE 23: OCCASIONALLY CERTAIN FAP-ELIGIBLE PATIENTS ARE CHARGED MORE THAN AMOUNTS GENERALLY BILLED ON SERVICES. THIS COULD OCCUR IF THE PATIENT PAYMENTS ARE APPLIED 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 12 INDIVIDUALS & $1,599.ESSENTIA HEALTH'S REVENUE CYCLE DEPARTMENT CONFIRMS IF ANY PATIENT PAYMENTS ARE MADE AFTER THE FAP APPLICATION HAS BEEN RECEIVED. IF SO, THE PATIENT PAYMENT IS UNAPPLIED AND THEN THE FAP ADJUSTMENT IS APPLIED. THE PATIENT PAYMENT IS THEN POSTED, AND IF THE PATIENT PAYMENT IS GREATER THAN THE REMAINING BALANCE ON THE BILL, A REFUND TO THE PATIENT IS PROVIDED. THERE COULD BE A FAP-ELIGIBLE PATIENT OVERPAYMENT DEPENDING ON THE TIMING OF THE PATIENT PAYMENT OR IF THE PATIENT IS STILL PAYING THEIR CO-PAYMENT AT THE TIME OF SERVICE. WE CONTACT THESE PATIENTS TO REMIND THEM THAT THEY HAVE CHARITY CARE AND DO NOT NEED TO PAY THEIR CHARGES UNTIL THEIR FAP ADJUSTMENTS HAVE BEEN MADE. WE REQUEST THE REFUND AT THE TIME OF PROCESSING THE FAP APPLICATION IF APPLICABLE. WE ALSO PERFORM AUDITS FOR ANY FAP OVERPAYMENTS DUE TO THE TIMING OF PATIENT PAYMENTS. ADDITIONAL DISCLOSURES NOT REQUIRED FOR PART V, SECTION C: SCHEDULE H, PART V, SECTION B, LINE 3E:ESSENTIA HEALTH WEST CONDUCTED A NEW CHNA IN FY25 AND CHOSE THREE PRIORITY HEALTH NEEDS TO ADDRESS. THE SIGNIFICANT HEALTH NEEDS ARE SOCIAL DRIVERS OF HEALTH, NUTRITION AND PHYSICAL ACTIVITY, AND HOUSING. 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.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. 22 1 - ESSENTIA HEALTH SOUTH UNIVERSITY CLINIC 1702 S UNIVERSITY DR FARGO ND 58103 MULTI-SPECIALTY CLINIC 2 - ESSENTIA HEALTH 32ND AVENUE CLINIC 3000 32ND AVE S FARGO ND 58103 MULTI-SPECIALTY CLINIC 3 - ESSENTIA HEALTH-MID DAKOTA BISMARCK 9TH 401 N 9TH ST BISMARCK ND 58501 MULTI-SPECIALTY CLINIC 4 - ESSENTIA HEALTH-MID DAKOTA BISMARCK GATE 2700 STATE ST BISMARCK ND 58503 PRIMARY CARE CLINIC 5 - ESSENTIA HEALTH 52ND AVENUE CLINIC 4110 51ST AVE S FARGO ND 58103 MULTI-SPECIALTY CLINIC 6 - ESSENTIA HEALTH WAHPETON CLINIC 275 11TH ST S WAHPETON ND 58075 MULTI-SPECIALTY CLINIC 7 - ESSENTIA HEALTH WEST FARGO CLINIC 1401 13TH AVE E WEST FARGO ND 58078 MULTI-SPECIALTY CLINIC 8 - ESSENTIA HEALTH-WEST FARGO THE LIGHTS CL 3150 SHEYENNE ST STE 240 WEST FARGO ND 58078 MULTI-SPECIALTY CLINIC 9 - ESSENTIA HEALTH JAMESTOWN CLINIC 2430 20TH ST SW JAMESTOWN ND 58401 MULTI-SPECIALTY CLINIC 10 - ESSENTIA HEALTH WEST ACRES CLINIC 3902 13TH AVE S STE 3704 FARGO ND 58103 PRIMARY CARE CLINIC 11 - ESSENTIA HEALTH-MID DAKOTA BISMARCK KIRK 727 KIRKWOOD MALL BISMARCK ND 58504 PRIMARY CARE CLINIC 12 - ESSENTIA HEALTH MOORHEAD CLINIC 801 BELSLY BLVD MOORHEAD MN 56560 PRIMARY CARE CLINIC 13 - ESSENTIA HEALTH MID DAKOTA WOMEN'S CENTE 1000 E ROSSER AVE BISMARCK ND 58501 MULTI-SPECIALTY CLINIC 14 - ESSENTIA HEALTH 45TH STREET CLINIC 4476 31ST AVE S STE 101 FARGO ND 58104 PRIMARY CARE CLINIC 15 - ESSENTIA HEALTH VALLEY CITY CLINIC 132 4TH AVE NE VALLEY CITY ND 58072 MULTI-SPECIALTY CLINIC 16 - ESSENTIA HEALTH DOWNTOWN MOORHEAD CLINIC 720 MAIN AVE MOORHEAD MN 56560 PRIMARY CARE CLINIC 17 - ESSENTIA HEALTH OSGOOD CLINIC 4622 40TH AVE S FARGO ND 58104 MULTI-SPECIALTY CLINIC 18 - ESSENTIA HEALTH LISBON CLINIC 819 MAIN ST LISBON ND 58054 MULTI-SPECIALTY CLINIC 19 - ESSENTIA HEALTH NORTH FARGO 1100 19TH AVE N STE L-M FARGO ND 58102 MULTI-SPECIALTY CLINIC 20 - ESSENTIA HEALTH CASSELTON CLINIC 5 9TH AVE N CASSELTON ND 58102 PRIMARY CARE CLINIC 21 - ESSENTIA HEALTH HANKINSON CLINIC 501 MAIN AVE S HANKINSON ND 58041 PRIMARY CARE CLINIC 22 - ESSENTIA HEALTH WAHPETON ASC 275 11TH ST S WAHPETON ND 58075 SURGERY CENTER 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 $31,050,726. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY HEALTH IMPROVEMENT ADVOCACY INCLUDES COMMUNITY SAFETY AND DISASTER PREPAREDNESS WORK. WORKFORCE DEVELOPMENT COSTS ARE ASSOCIATED WITH COLLABORATION WITH THE INNOVATE28 PROGRAM IN FARGO/MOORHEAD AND THE SOUTHEASTERN NORTH DAKOTA COMMUNITY ACTION AGENCY'S WORKFORCE DEVELOPMENT INITIATIVE. 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 WEST INCORPORATES THE COST OF BAD DEBT AS A COMMUNITY BENEFIT. AS A TAX-EXEMPT HOSPITAL, WE MUST PROVIDE THE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THAT CARE. IN DOING SO, WE MAKE QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS. PART III, LINE 4: PAGES 16-18 OF ESSENTIA HEALTH'S CONSOLIDATED AUDIT REPORT CONTAIN THE FOOTNOTE DESCRIBING THE ORGANIZATION'S BAD DEBT EXPENSE. PART III, LINE 8: RECONCILIATION FOR MEDICARE SHORTFALL BETWEEN TOTAL MEDICARE PROGRAM AND WHAT IS ALLOWED ON THE COST REPORT:THE HOSPITAL'S TOTAL MEDICARE SHORTFALL IS $66,720,536, OF WHICH A SHORTFALL OF $20,220,061 (CONSISTING OF $96,078,696 REVENUE AND $116,298,757 COST) IS INCLUDED IN PART III, SECTION B, LINES 5-7, AND A SHORTFALL OF $46,500,475 (CONSISTING OF $115,143,446 REVENUE AND $161,643,922 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 WEST IS A PART OF ESSENTIA HEALTH, AN INTEGRATED HEALTH SYSTEM. ESSENTIA HEALTH AND ITS MEMBER ORGANIZATIONS INCORPORATE THE FULL VALUE OF THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. THE RATIONALE FOR THE ORGANIZATION'S OPINION IS PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS IS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. MANY MEDICARE BENEFICIARIES ARE POOR AND ARE ELIGIBLE FOR MEDICAID IN ADDITION TO MEDICARE. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY. PART III, LINE 9B: THE POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR ESSENTIA HEALTH'S FINANCIAL ASSISTANCE POLICY (FAP) AND FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR FINANCIAL ASSISTANCE FROM ESSENTIA HEALTH, AND THE PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH THEIR PAYMENT AGREEMENTS. THE ORGANIZATION OFFERS EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS AND WILL NOT IMPOSE LIENS ON PRIMARY RESIDENCES NOR REPORT PATIENTS TO A CREDIT RATING AGENCY FOR OUTSTANDING PATIENT BILLS.THE ORGANIZATION WILL NOT CHARGE A PATIENT THE GROSS AMOUNT OF CHARGES FOR ANY UNINSURED TREATMENT. UNINSURED DISCOUNTS WILL BE APPLIED TO THE GROSS CHARGES PRIOR TO ANY FINANCIAL ASSISTANCE OR OTHER DISCOUNTS.IF AT ANY TIME THE ORGANIZATION RECOGNIZES THAT A PATIENT MAY BE ELIGIBLE FOR STATE OR FEDERAL PROGRAMS, A REPRESENTATIVE WILL ASSIST THE PATIENT IN OBTAINING INFORMATION ABOUT THESE PROGRAMS OR PROVIDE CONTACT INFORMATION FOR THESE PROGRAMS. THE ORGANIZATION CONTRACTS WITH AN OUTSIDE PATIENT ADVOCACY AGENCY, WHICH MAY PROVIDE ASSISTANCE TO THE UNINSURED PATIENT IN APPLYING TO CERTAIN STATE AND FEDERAL PROGRAMS.AT ANY STAGE OF THE PATIENT EXPERIENCE AND UP THROUGH THE COLLECTION PROCESS, THE PATIENT MAY EXPRESS A CONCERN THAT THEY ARE UNABLE TO PAY THEIR BILL IN FULL OR MEET THE PAYMENT PLAN REQUIREMENTS. AT THAT TIME, THE PATIENT WILL BE GIVEN EVERY OPPORTUNITY TO COMPLETE AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE.THE ORGANIZATION TRAINS ITS OUTSIDE DEBT COLLECTION AGENCIES AND ATTORNEYS ABOUT THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION ABOUT THE FAP OR SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE ORGANIZATION REQUIRES ITS OUTSIDE COLLECTION AGENCIES AND ATTORNEYS TO REFER PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE TO ESSENTIA HEALTH.IF A PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, THE ORGANIZATION SUSPENDS ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND ESSENTIA HEALTH HAS NOTIFIED THE PATIENT OF ITS DECISION. PATIENTS ARE ADVISED AT THAT TIME TO NOTIFY THE COLLECTION AGENCY TO HOLD THEIR ACCOUNT. THE OUTSIDE DEBT COLLECTION AGENCIES ARE NOTIFIED BY ESSENTIA HEALTH ONCE AN ACCOUNT ADJUSTMENT HAS BEEN MADE. PART VI, LINE 2: NEEDS ASSESSMENT:WE ASSESS AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE IN MANY WAYS, INCLUDING THE FOLLOWING:MARKETING RESEARCH - THE ESSENTIA HEALTH MARKETING RESEARCH DEPARTMENT CONDUCTS SURVEYS, FOCUS GROUPS, AND REVIEWS INTERNAL DATA TO BETTER UNDERSTAND THE NEEDS AND USE(S) OF OUR SERVICES. THIS INCLUDES ACCESS TO SERVICE AREAS (E.G., PRIMARY CARE), PAYOR INFORMATION (E.G., ESSENTIA CARE), AND OVERALL GAPS IN SERVICES. ASSESSMENTS HAVE RESULTED IN INTERNAL CHANGES IN BOTH STAFFING AND PROCESSES.ESSENTIA HEALTH POPULATION CARE MANAGEMENT - WE USE AN ANALYSIS OF MULTIPLE POPULATIONS; ONE SUCH GROUP IS "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 WEST IS LOCATED IN FARGO, ND, AND IS A PART OF ESSENTIA HEALTH, WHICH IS DEFINED IN PART VI, LINE 6. THE ORGANIZATION OPERATES ONE HOSPITAL, 21 CLINICS, AND A SURGERY CENTER THAT PRIMARILY SERVE CASS AND BURLEIGH COUNTIES IN NORTH DAKOTA AND CLAY COUNTY, MINNESOTA, BUT RECEIVES REFERRALS FROM ACROSS THE REGION. THE OVERALL COMMUNITY IS CLASSIFIED AS A COMBINATION OF SUBURBAN AND RURAL.ESSENTIA HEALTH WEST COVERS A SERVICE AREA OF APPROXIMATELY 516,000 PEOPLE. THE SERVICE AREA AGE DISTRIBUTION IS 22% UNDER THE AGE OF 18, 58% BETWEEN THE AGES OF 18 AND 65, AND 20% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE AREA IS 84% CAUCASIAN, 4% AFRICAN AMERICAN, 2% ASIAN, 3% AMERICAN INDIAN, AND 7% OTHER. THE GENDER SPLIT RATIO IS 49% WOMEN AND 51% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY $75,000.ESSENTIA HEALTH WEST, AS PART OF ESSENTIA HEALTH, IS COMMITTED TO SERVING PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. APPROXIMATELY 2.2% GROSS REVENUE DOLLARS WERE FROM SELF-PAY PATIENTS AND 12.2% FROM MEDICAID RECIPIENTS. RANSOM COUNTY, ND, PORTIONS OF CLAY COUNTY, MN, AND THE BROADER SERVICE AREA ARE CURRENTLY DESIGNATED AS MEDICALLY UNDERSERVED AREAS.AS MENTIONED ABOVE, ESSENTIA HEALTH WEST IS PART OF ESSENTIA HEALTH. ESSENTIA HEALTH STAFFS HOSPITALS AND CLINICS IN FEDERALLY RECOGNIZED UNDERSERVED AREAS AND SUPPORTS THE HEALTH OF ITS COMMUNITIES THROUGH 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 ARE 18 OTHER HOSPITALS OUTSIDE OF THE ESSENTIA HEALTH UMBRELLA THAT SERVICE THE COMMUNITY. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:THE ORGANIZATION'S BOARD OF DIRECTORS IS COMPOSED MAINLY OF VOLUNTEER REPRESENTATIVES FROM THE COMMUNITIES IT SERVES. THE ORGANIZATION HAS AN OPEN MEDICAL STAFF, SO ANY QUALIFIED PHYSICIAN OF THE COMMUNITY IS ALLOWED TO APPLY. ALL APPLICANTS WHO APPLY MUST MEET THE CREDENTIALING STANDARDS AND BE APPROVED BY THE ESSENTIA HEALTH WEST GOVERNING BOARD IN ORDER TO PROVIDE SERVICES AT ESSENTIA HEALTH. IN ADDITION, THE HOSPITAL PROVIDES ON-SITE CLINICAL EXPERIENCES FOR MEDICAL STUDENTS AND RESIDENTS, ADVANCED PRACTICE AND PRE-LICENSURE NURSES, PHARMACISTS, THERAPISTS, TECHNICIANS, AND THOSE IN OTHER HEALTH CARE VOCATIONS.WE REINVEST IN THE ORGANIZATION BY ACQUIRING THE LATEST STATE-OF-THE-ART EQUIPMENT AND BY INVESTING IN PROGRAMS THAT ARE NEEDED IN OUR COMMUNITY.IN ADDITION TO THE ACTIVITIES LISTED IN PART I, LINE 7 AS WELL AS PART V, SECTION B, LINE 11, THE ORGANIZATION SUPPORTS THE HEALTH AND VITALITY OF OUR COMMUNITIES THROUGH A SPECIAL DEDICATION TO MAKING A DIFFERENCE IN AREAS THAT POSITIVELY IMPACT THE SOCIAL DETERMINANTS OF HEALTH. WE MAKE SIGNIFICANT CONTRIBUTIONS TO COMMUNITY NON-PROFITS WORKING TO ENCOURAGE ACCESS TO HEALTHY FOODS, MENTAL WELL-BEING, AND HEALTHY YOUTH DEVELOPMENT. ADDITIONALLY, WE ENCOURAGE OUR COLLEAGUES TO CONTRIBUTE THEIR TIME IN MEANINGFUL WAYS THROUGH A FORMAL EMPLOYEE VOLUNTEER PROGRAM THAT INCENTIVIZES COMMUNITY VOLUNTEERING BY PROVIDING A $100 DONATION TO A 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 WEST 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 WEST IS PART OF ESSENTIA HEALTH, AN INTEGRATED HEALTH SYSTEM WITH 14 HOSPITALS, APPROXIMATELY 80 CLINICS, SIX LONG-TERM CARE FACILITIES, TWO ASSISTED LIVING FACILITIES, THREE INDEPENDENT LIVING FACILITIES, SEVERAL REHABILITATION CENTERS, SEVEN AMBULANCE SERVICES, 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: LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT:N/A 1 BIO GIRLS 4225 38TH ST S STE 111 FARGO ND 58104 810792142 501(C)3 20500 0 PROGRAM SUPPORT CASS CLAY COMMUNITY LAND TRUST 109 1/2 BROADWAY NORTH 203 FARGO ND 58102 834077611 501(C)3 10000 0 PROGRAM SUPPORT CHURCHES UNITED FOR THE HOMELESS 1901 1ST AVE N MOORHEAD MN 56560 411594892 501(C)3 10100 0 PROGRAM SUPPORT CULTURAL DIVERSITY RESOURCES 112 N UNIVERSITY DR STE 306 FARGO ND 58102 411896836 501(C)3 7000 0 PROGRAM SUPPORT ESSENTIA HEALTH FOUNDATION 502 E 2ND ST DULUTH MN 55805 271984704 501(C)3 700957 0 PROGRAM SUPPORT GATEWAY TO SCIENCE CENTER INC 1600 CANARY AVE 1 BISMARCK ND 58501 450443517 501(C)3 10000 0 PROGRAM SUPPORT GREATER FARGO MOORHEAD ECONOMIC DEVELOPMENT CORPORATION 51 BROADWAY SUITE 500 FARGO ND 58102 456011769 501(C)3 10000 0 PROGRAM SUPPORT IMMIGRANT DEVELOPMENT CENTER 810 4TH AVE S STE 100 MOORHEAD MN 56560 203368647 501(C)3 13700 0 PROGRAM SUPPORT JEREMIAH PROGRAM 615 1ST AVE NE STE 210 MINNEAPOLIS MN 55413 411801834 501(C)3 15000 0 PROGRAM SUPPORT LAKES AND PRAIRIES COMMUNITY ACTION PARTNERSHIP INC 891 BELSLY BLVD MOORHEAD MN 56560 410905871 501(C)3 7500 0 PROGRAM SUPPORT LUTHERAN CHURCH OF THE CROSS 1402 16TH ST E WEST FARGO ND 58078 450360370 501(C)3 10000 0 PROGRAM SUPPORT MINNESOTA FLYERS GYMNASTICS INC 1306 ROSSMAN AVE DETROIT LAKES MN 56501 411825524 501(C)3 25000 0 PROGRAM SUPPORT MINNESOTA STATE UNIVERSITY MOORHEAD 1104 7TH AVE S MOORHEAD MN 56563 411687554 STATE UNIVERSITY 7500 0 PROGRAM SUPPORT MOUNTAIN-PLAINS YOUTH WORKS 217 W ROSSER AVE BISMARCK ND 58501 460345922 501(C)3 55000 0 PROGRAM SUPPORT PRESENTATION PARTNERS IN HOUSING 219 7TH ST S FARGO ND 58103 203697395 501(C)3 20386 0 PROGRAM SUPPORT SACRED PIPE RESOURCE CENTER 424 ASHWOOD AVE BISMARCK ND 58504 261088259 501(C)3 7200 0 PROGRAM SUPPORT SOUL SOLUTIONS RECOVERY CENTER INC 1801 38TH ST S FARGO ND 58103 843025490 501(C)3 25000 0 PROGRAM SUPPORT SOUTHEASTERN NORTH DAKOTA COMMUNITY ACTION AGENCY 3233 SOUTH UNIVERSITY DR FARGO ND 58104 456014870 501(C)3 15000 0 PROGRAM SUPPORT STEPPING STONES MINISTRIES PO BOX 1492 BISMARCK ND 58502 931845283 501(C)3 12150 0 PROGRAM SUPPORT THE CHAMBER FARGO MOORHEAD WEST FARGO 3312 42ND ST FARGO ND 58104 450448041 501(C)6 25000 0 PROGRAM SUPPORT UNITED WAY OF CASS CLAY PO BOX 1609 FARGO ND 58107 410810008 501(C)3 22600 0 PROGRAM SUPPORT VALLEY LAKE BOY'S HOME INC 3850 200TH AVE BRECKENRIDGE MN 56520 510137932 501(C)3 7500 0 PROGRAM SUPPORT 21 1 PART I, LINE 2: PROCEDURES FOR MONITORING GRANTS: ESSENTIA HEALTH WEST PROVIDES GRANT MONIES TO NON-PROFIT ORGANIZATIONS, SCHOOLS, CIVIC ORGANIZATIONS, GOVERNMENT ENTITIES AND FAITH-BASED ORGANIZATIONS THAT DEMONSTRATE THE MISSION OR VALUES OF ESSENTIA HEALTH. A COMMUNITY CONTRIBUTIONS COMMITTEE IS RESPONSIBLE FOR REVIEWING AND DISTRIBUTING A POOL OF FUNDS DEDICATED TO COMMUNITY BENEFITS. GRANT RECIPIENTS ARE REQUIRED TO SUBMIT A FINAL REPORT WITHIN ONE YEAR OF RECEIVING FUNDS. CONTRIBUTIONS TO THE ESSENTIA HEALTH FOUNDATION, A RELATED ORGANIZATION, ARE MADE TO COVER THEIR OPERATING EXPENSES. ESSENTIA HEALTH WEST MAY ALSO MAKE DESIGNATED DONATIONS TO THE ESSENTIA HEALTH FOUNDATION. ADDITIONALLY, ESSENTIA HEALTH WEST'S COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP PROGRAM PROVIDES FUNDING TO EXTERNAL NON-PROFIT PARTNERS RESPONDING TO NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). EACH ORGANIZATION SIGNS A GRANT AGREEMENT AND IS HELD ACCOUNTABLE FOR PROGRESS ON THEIR PROJECT, WITH REQUIRED PERFORMANCE TRACKING REPORTS DUE EVERY SIX MONTHS. X 1 1 X X X X 1 1 0 0 0 0 0 0 1 1 ADAM STIBBE MD PHYSICIAN & SECTION CHAIR 1783540 0 0 0 1140 0 27600 0 42870 0 1855150 0 0 0 BENJAMIN SMITH MD BOARD DIRECTOR & PHYSICIAN 1708252 3375 0 0 1140 0 27600 0 48423 0 1785415 3375 0 0 JEROME SAMPSON MD PHYSICIAN 1604029 0 0 0 9888 0 25060 0 26797 0 1665774 0 0 0 SCOTT REARDON MD PHYSICIAN 1351347 0 0 0 1140 0 27600 0 48964 0 1429051 0 0 0 MICKEY SYRQUIN MD PHYSICIAN 1296337 0 0 0 6987 0 27600 0 39296 0 1370220 0 0 0 KIMBERLY KOLKHORST MD PHYSICIAN & SECTION CHAIR 1259063 0 0 0 1190 0 24245 0 42701 0 1327199 0 0 0 TRACI MORRIS TREASURER/REL ORG CHIEF FINCL OFF 0 702675 0 269075 0 82980 0 142406 0 2280 0 1199416 0 71480 WILLIAM HEEGAARD MD FORMER PRESIDENT 0 330418 136878 0 390851 117800 8380 72253 21251 20462 557360 540933 0 0 ROBERT GREEN FORMER VICE PRESIDENT, FINANCE 0 548932 0 222166 0 11484 0 118444 0 32810 0 933836 0 0 RICHARD VETTER MD CHIEF MEDICAL OFFICER THRU 12/24 514300 0 195353 0 66066 0 107093 0 43228 0 926040 0 46808 0 MICHAEL WATTERS SECRETARY/REL ORG CHIEF LEGAL OFF 0 506819 0 192028 0 74281 0 109834 0 41565 0 924527 0 62797 ALAN BRUNS MD FORMER KE/PHYSICIAN & DIVISON CHAIR 885792 0 0 0 5330 0 27600 0 5537 0 924259 0 0 0 AL HURLEY CHIEF OPERATING OFFICER 453221 0 183113 0 69829 0 102252 0 27562 0 835977 0 59141 0 JOSHUA GEBUR MD FORMER KE/PHYSICIAN & DIVISION CHAIR 708691 0 0 0 1072 0 27600 0 41474 0 778837 0 0 0 MARK THOMPSON MD PRESIDENT THRU 7/24 417961 0 0 0 284169 0 0 0 40293 0 742423 0 0 0 STEFANIE GEFROH ELLISON MD PRESIDENT 530965 30000 0 0 1255 0 27600 0 39278 0 599098 30000 0 0 TANYA DIEGEL DO FORMER KE/PHYSICIAN & DIVISION CHAIR 542631 0 0 0 954 0 26450 0 40158 0 610193 0 0 0 TANNER GOODRICH SENIOR VICE PRESIDENT, OPERATIONS 329260 0 134498 0 1162 0 82444 0 31536 0 578900 0 0 0 DOUG ARVIN VICE PRESIDENT, FINANCE 390604 0 52650 0 1979 0 17250 0 17638 0 480121 0 0 0 TAYLOR MERTZ MD BD DIRECTOR/PHYSICIAN & SEC CHAIR 371004 4500 0 0 358 0 27307 0 40473 0 439142 4500 0 0 ANDREW MOEN MD FORMER KE/PHYSICIAN & DIVISION CHAIR 372053 0 0 0 727 0 27368 0 42182 0 442330 0 0 0 RAE SALUS FORMER SENIOR VP OPERATIONS 0 0 0 0 351547 0 0 0 3359 0 354906 0 29564 0 JOSEPH WENDT FORMER KE/VP, ADMINISTRATOR 240069 0 30940 0 9862 0 14690 0 43817 0 339378 0 0 0 MICHELLE STENBECK CHIEF NURSING OFFICER THRU 1/24 26939 0 0 0 267905 0 0 0 24013 0 318857 0 0 0 KERRY CARLSON FORMER KE/VP, OPERATIONS 233148 0 23315 0 966 0 13419 0 39005 0 309853 0 0 0 SUZANNE ZELTINGER CHIEF NURSING OFFICER 223881 0 17309 0 11258 0 11934 0 6612 0 270994 0 0 0 DAN BEAUCHAMP FORMER KE/FACILITIES SNR DIRECTOR 90025 86033 0 16930 6715 348 5119 5447 20203 20203 122062 128961 0 0 WALTER JOHNSON MD FORMER PHYSICIAN & SECTION CHAIR 0 0 0 0 250000 0 0 0 0 0 250000 0 0 0 CHRISTY BRINKMAN FORMER KE/OPERATIONS SNR DIRECTOR 0 197221 0 20888 0 268 0 10982 0 2864 0 232223 0 0 JAMES CHRISTENSEN MD BOARD DIRECTOR & PHYSICIAN 144640 2250 0 0 1224 0 11531 0 15248 0 172643 2250 0 0 PART I, LINE 1A BENEFITS PROVIDED: DURING CALENDAR YEAR 2024, CHARTER TRAVEL WAS USED BY ONE OFFICER AND ONE KEY EMPLOYEE FOR TRAVEL BETWEEN ESSENTIA HEALTH WEST AND OTHER ORGANIZATIONS. THE USE OF CHARTER TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION TO THESE INDIVIDUALS AS ALL TRAVEL WAS BUSINESS RELATED. PART I, LINE 3 ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA HEALTH WEST'S PRESIDENT'S COMPENSATION: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B SEVERANCE PAYMENT: FORMER OFFICER WILLIAM HEEGAARD, MD RECEIVED PAYMENTS TOTALING $393,086 IN CALENDAR YEAR 2024 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, HEEGAARD WILL RECEIVE PAY TOTALING $1,095,026 AND BENEFITS TOTALING $45,337 FROM JUNE 2, 2024 TO DECEMBER 2, 2025. OFFICER MARK THOMPSON, MD RECEIVED PAYMENTS TOTALING $278,656 IN CALENDAR YEAR 2024 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, THOMPSON WILL RECEIVE PAY TOTALING $1,086,758 AND BENEFITS TOTALING $39,075 FROM JULY 26, 2024 TO JANUARY 31, 2026. FORMER KEY EMPLOYEE RAE SALUS RECEIVED PAYMENTS TOTALING $322,470 IN CALENDAR YEAR 2024 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, SALUS WILL RECEIVE PAY TOTALING $480,012 AND BENEFITS TOTALING $17,362 FROM JUNE 20, 2023 TO DECEMBER 20, 2024. KEY EMPLOYEE MICHELLE STENBECK RECEIVED PAYMENTS TOTALING $241,169 IN CALENDAR YEAR 2024 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, STENBECK WILL RECEIVE PAY TOTALING $275,018 AND BENEFITS TOTALING $17,590 FROM JANUARY 30, 2024 TO JANUARY 30, 2025. ALL OTHER INDIVIDUALS LISTED AS FORMERS IN FORM 990, PART VII, SECTION A, LINE 1A DID NOT RECEIVE A SEVERANCE PAYMENT DURING CALENDAR YEAR 2024. SOME OF THESE INDIVIDUALS REMAIN EMPLOYED WITHIN ESSENTIA HEALTH AND ITS SUBSIDIARIES. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ESSENTIA HEALTH'S NONQUALIFIED RETIREMENT PLAN IS OFFERED TO DESIGNATED ESSENTIA HEALTH EXECUTIVES. THERE IS A MINIMUM FOUR YEAR VESTING DATE, OR VESTING IS AUTOMATIC UPON REACHING RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. BENEFITS ARE SUBJECT TO INCOME TAXES UPON VESTING AND PAYABLE FROM ESSENTIA HEALTH'S GENERAL ASSETS. REPORTED AS OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B (III), THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A RECEIVED PAYMENT OF THE VESTED BENEFIT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: TRACI MORRIS $78,928 WILLIAM HEEGAARD, MD $112,499 RICHARD VETTER, MD $54,695 MICHAEL WATTERS $62,797 AL HURLEY $59,235 RAE SALUS $29,564 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 WILLIAM HEEGAARD, MD $48,668 ROBERT GREEN $90,844 RICHARD VETTER, MD $79,493 MICHAEL WATTERS $84,801 AL HURLEY $75,236 TANNER GOODRICH $54,995 PART I, LINE 8 INITIAL CONTRACT EXCEPTION: ESSENTIA HEALTH WEST'S CHIEF NURSING OFFICER, SUZANNE ZELTINGER, 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 DULUTH ECONOMIC DEVELOPMENT AUTHORITY 900848286 26444CHF2 2018-11-01 704253406 SRS 2018A (SEE PART VI) 0 0 0 B CASS COUNTY NORTH DAKOTA 456002205 148047BF9 2018-11-01 42050194 SRS 2018B (SEE PART VI) 0 0 0 C CASS COUNTY NORTH DAKOTA 456002205 000000000 2020-02-18 61320000 SRS 2020A (SEE PART VI) 0 0 0 D WI HEALTH & EDUCATION FACILITIES AUTHORITY 391337855 000000000 2020-02-18 13095000 SRS 2020B (SEE PART VI) 0 0 0 A 27710387 239569 27470818 2023 1 0 1 1 B 42050194 380994 41669200 2018 1 0 1 1 C 15103729 54188 15049541 2020 1 0 1 1 D 3225430 29557 3195873 2020 1 0 1 1 A 0 0 1 0 0 0 0 1 B 0 0 1 0 0 0 0 1 C 0 0 1 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 0 0 1 0 0 1 SEE PART VI 1 1 1 B 0 0 0 1 0 0 0 0 1 C 0 0 1 0 1 0 0 0 1 D 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: DULUTH ECONOMIC DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2023 ISSUER NAME: CASS COUNTY, NORTH DAKOTA DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2023 SCHEDULE K: ADDITIONAL INFORMATION/COMMENTS RELATING TO THE REPORTING OF LIABILITIES BY RELATED ORGANIZATIONS: ESSENTIA HEALTH HAS AN OBLIGATED GROUP CREATED UNDER THE MASTER TRUST INDENTURE WHICH IS COMPOSED OF THE FOLLOWING MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, ST. MARY'S INNOVIS HEALTH, THE DULUTH CLINIC, LTD. AND ESSENTIA HEALTH WEST (THE "OBLIGATED GROUP MEMBERS"). THE OBLIGATED GROUP MEMBERS ARE JOINTLY AND SEVERALLY OBLIGATED ON ALL INDEBTEDNESS EVIDENCED OR SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. SERIES 2018A: THE SERIES 2018A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2018A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH DULUTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2018B: THE SERIES 2018B BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH EAST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH DULUTH, AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2018B BONDS. THE CONDUIT BORROWER ESSENTIA HEALTH WEST HAS RECORDED THE BOND LIABILITY ON ITS BALANCE SHEET WHICH IS CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020A: THE SERIES 2020A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020B: THE SERIES 2020B BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020B BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020C: THE SERIES 2020C BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020C BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2023A: THE SERIES 2023A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2023A BONDS. THE CONDUIT BORROWER ESSENTIA HEALTH WEST HAS RECORDED THE BOND LIABILITY ON ITS BALANCE SHEET WHICH IS CONSOLIDATED WITH ESSENTIA HEALTH. SCHEDULE K, PART 1, COLUMN (F): DESCRIPTION OF PURPOSE: SERIES 2018A: ACQUIRE, CONSTRUCT, BUILD, AND EQUIP MEDICAL CAMPUS PROJECT IN DULUTH, MN; REFUND SERIES 2008E BONDS ISSUED MAY 2, 2008 TO REFINANCE SERIES 1997 BONDS ISSUED DECEMBER 18, 1997 TO FINANCE EQUIPMENT PURCHASES IN DULUTH, MN AND FINANCE PROPERTY ACQUISITIONS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN NORTHERN MINNESOTA; AND REFUND SERIES 2014 BONDS ISSUED JULY 29, 2014 TO REFINANCE PRIOR NOTE USED FOR CAPITAL IMPROVEMENTS TO SKILLED NURSING FACILITY LOCATED IN DETROIT LAKES, MN AND VARIOUS CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN BAXTER, FRAZEE, AND PELICAN RAPIDS, MN AND FINANCE CAPITAL EXPENDITURES TO REPLACE THE CHILLER UNIT FOR ESSENTIA HEALTH VIRGINIA, RENOVATE APPROXIMATELY 118,000 SQUARE FEET OF CLINIC SPACE FOR ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, REMODEL AND EQUIP EXISTING CLINIC SPACE IN EMILY, MN FOR ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, AND EXPAND AND REMODEL THE IMAGING AREA IN THE EMERGENCY ROOM OF ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES' HOSPITAL. SERIES 2018B: REFUND SERIES 2014 BONDS ISSUED JUNE 30, 2014 TO FINANCE CONSTRUCTING AND EQUIPPING 125,000 SQUARE FOOT EXPANSION TO IN-PATIENT HOSPITAL FACILITIES LOCATED IN FARGO, ND AND RELATED REMODELING. SERIES 2020A: REFUND SERIES 2008A BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFINANCE A PORTION OF THE ACQUISITION OF CERTAIN ASSETS OF ESSENTIA HEALTH WEST IN CONNECTION WITH THE AFFILIATION OF ESSENTIA HEALTH WITH ESSENTIA HEALTH WEST. SERIES 2020B: REFUND SERIES 2008B BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 1999B BONDS ISSUED MAY 18, 1999 FOR CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN SUPERIOR, WI AND VARIOUS DULUTH CLINIC LOCATIONS IN NORTHWESTERN WISCONSIN. SERIES 2020C: REFUND SERIES 2008C BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 2004 BONDS ISSUED MARCH 19, 2004 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN DULUTH, BRAINERD, AND DETROIT LAKES, MN AND REFUND SERIES 1999A BONDS ISSUED MAY 18, 1999 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN BRAINERD, DETROIT LAKES AND DULUTH, MN AND VARIOUS DULUTH CLINIC SITES IN NORTHERN MINNESOTA. SERIES 2023A: ACQUIRE CERTAIN HEALTH FACILITIES IN BISMARCK, ND. SCHEDULE K, PART II, LINE 3: ISSUE PRICE: THE SERIES 2018A, 2018B, 2020A, 2020B, 2020C, AND 2023A BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. THE ISSUE PRICE LISTED IN ESSENTIA HEALTH WEST'S SCHEDULE K, PART I, COLUMN (E) REPRESENTS THE ESSENTIA HEALTH OBLIGATED GROUP'S TOTAL BORROWING. SCHEDULE K, PART II, LINES 3 THROUGH 12: PROCEEDS: THE SERIES 2018A, 2018B, 2020A, 2020B, 2020C, AND 2023A BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. A PORTION OF THE SERIES 2018A, 2018B, 2020A, 2020B, 2020C, AND 2023A BORROWINGS WERE ALLOCATED TO ESSENTIA HEALTH WEST, AN ESSENTIA HEALTH OBLIGATED GROUP MEMBER. THE PROCEEDS LISTED IN ESSENTIA HEALTH WEST'S SCHEDULE K, PART II, LINES 3 THROUGH 12 REPRESENT ESSENTIA HEALTH WEST'S ALLOCATED PORTION OF THE PROCEEDS. SCHEDULE K, PART IV, LINE 5B: NAME OF PROVIDER OF GIC: NATIXIS FUNDING CORP & THE TORONTO-DOMINION BANK A DULUTH ECONOMIC DEVELOPMENT AUTHORITY 900848286 000000000 2020-02-18 116955000 SRS 2020C (SEE PART VI) 0 0 0 B BURLEIGH COUNTY NORTH DAKOTA 456002204 000000000 2023-06-22 21265000 SRS 2023A (SEE PART VI) 0 0 0 A 17056968 28807187 177343 28629844 2020 1 0 1 1 B 21265000 291616 20973384 2023 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 1 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 A 1 B 1 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 6466439 INDEPENDENT CONTRACTOR ARRANGEMENT 0 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 3580610 INDEPENDENT CONTRACTOR ARRANGEMENT 0 DANICA JOHNSON RELATED TO TANYA DIEGEL, DO 113601 COMPENSATION OF FAMILY MEMBER OF FORMER KEY EMPLOYEE 0 FORM 990, PART V, LINE 1A: 1099 REPORTING: VENDOR PAYMENTS AND FORM 1099S WERE PROCESSED THROUGH ESSENTIA HEALTH ON BEHALF OF THE LEGAL ENTITIES COMPRISING ESSENTIA HEALTH. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OF ORGANIZATION: ESSENTIA HEALTH IS THE SOLE MEMBER OF ESSENTIA HEALTH WEST AND MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7A. ESSENTIA HEALTH AND THE DULUTH BENEDICTINE MINISTRIES HAVE RESERVED POWERS WITH RESPECT TO ESSENTIA HEALTH WEST AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7B. FORM 990, PART VI, SECTION A, LINE 7A MEMBER WITH RIGHT TO ELECT GOVERNING BODY: ESSENTIA HEALTH HAS THE POWER TO APPOINT AND REMOVE ESSENTIA HEALTH WEST'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS WITH RIGHT TO APPROVE GOVERNING BODY DECISION: ESSENTIA HEALTH SHALL HAVE THE FOLLOWING RESERVED POWERS, FOR THE PURPOSES OF SERVING AS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTH CARE NETWORK THAT INCLUDES ALL ENTITIES THAT ARE OWNED OR CONTROLLED, DIRECTLY OR INDIRECTLY, BY ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"): (A) STRATEGIC AND BUSINESS PLANS. AUTHORITY TO CREATE, APPROVE AND AMEND THE COMPANY'S STRATEGIC AND BUSINESS PLANS. (B) MISSION. AUTHORITY TO CREATE, APPROVE AND AMEND THE COMPANY'S MISSION, PURPOSE AND VISION STATEMENTS. (C) DEBT. APPROVAL OF THE INCURRENCE OF DEBT AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE COMPANY'S ASSETS IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE MEMBER'S BOARD OF DIRECTORS, AND THE AUTHORITY TO CAUSE THE COMPANY TO PARTICIPATE IN SYSTEM BORROWING. (D) GOVERNING INSTRUMENTS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AMENDMENTS TO THE COMPANY'S CERTIFICATE OF FORMATION AND OPERATING AGREEMENT. (E) APPOINTMENT AND REMOVAL OF DIRECTORS. AUTHORITY TO APPOINT AND REMOVE ALL MANAGERS ON THE COMPANY'S BOARD, WITH OR WITHOUT CAUSE. (F) MERGERS, AFFILIATIONS, AND DISSOLUTION. AUTHORITY TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AFFILIATIONS, JOINT VENTURES, OTHER ALLIANCES WITH THIRD PARTIES, AND DISSOLUTION OF THE COMPANY. (G) TRANSFER OF ASSETS WITHIN THE SYSTEM. AUTHORITY TO TRANSFER THE COMPANY'S ASSETS, INCLUDING CASH, BETWEEN AND AMONG ENTITIES WITHIN THE SYSTEM; PROVIDED, HOWEVER, THAT THE MEMBER SHALL NOT HAVE AUTHORITY TO REQUIRE THE COMPANY TO TRANSFER ASSETS THAT WOULD CAUSE IT TO BE IN DEFAULT OF ITS COVENANTS OR OBLIGATIONS UNDER ANY BOND OR OTHER FINANCING DOCUMENTS. (H) TRANSFER OF ASSETS OUTSIDE THE SYSTEM. AUTHORITY TO CAUSE, AND TO APPROVE, THE SALE, LEASE OR OTHER TRANSFER OF THE COMPANY'S ASSETS TO PARTIES OUTSIDE OF THE SYSTEM WHEN THE ASSETS' VALUE EXCEEDS THE SINGLE OR AGGREGATE LIMITS PRESCRIBED IN WRITING BY THE MEMBER'S BOARD OF DIRECTORS. (I) SERVICES. AUTHORITY TO CAUSE, AND TO APPROVE, THE OFFERING OR DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS BY THE COMPANY. (J) BUDGETS. APPROVAL OF THE COMPANY'S CAPITAL AND OPERATING BUDGETS. (K) PROFESSIONAL SERVICES. SELECTION OF THE COMPANY'S GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS. (L) CORPORATE ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL CORPORATE ACQUISITIONS BY THE COMPANY. (M) MARKETING. THE COMPANY'S PARTICIPATION IN SYSTEM-WIDE MARKETING AND PROMOTIONAL ACTIVITIES. (N) COMPLIANCE PLANS. AUTHORITY TO CREATE, APPROVE AND AMEND THE COMPANY'S COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS. (O) QUALITY PLAN. AUTHORITY TO CREATE, APPROVE AND AMEND THE COMPANY'S QUALITY PLAN. (P) NON-BUDGETED PURCHASES. APPROVAL OF NON-BUDGETED CAPITAL PURCHASES AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE MEMBER'S BOARD OF DIRECTORS. (Q) HUMAN RESOURCES. AUTHORITY TO CREATE, APPROVE AND AMEND THE COMPANY'S HUMAN RESOURCE POLICIES AND PROCEDURES. (R) SYSTEM COMPENSATION. AUTHORITY, ON BEHALF OF THE COMPANY, TO DEVELOP AND IMPLEMENT COMPENSATION STRATEGIES, POLICIES AND PROCEDURES ON A SYSTEM-WIDE BASIS. DULUTH BENEDICTINE MINISTRIES ("DBM") HOLDS CERTAIN RESERVED POWERS OVER ESSENTIA HEALTH WEST. DBM HAS THE RESERVED POWER TO APPROVE ANY AMENDMENTS TO ESSENTIA HEALTH WEST'S GOVERNING DOCUMENTS THAT WOULD ALTER THE NUMBER OF DBM REPRESENTATIVES SERVING ON THE BOARD. 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 2025 FOR ESSENTIA HEALTH WEST'S CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER, PRESIDENT, AND SENIOR VICE PRESIDENT OF OPERATIONS, AND IN 2024 FOR ITS VICE PRESIDENT OF FINANCE AND CHIEF NURSING OFFICER. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART IX, LINE 24E: AFFILIATE REVENUE AND EXPENSE ALLOCATION: ESSENTIA HEALTH WEST, ESSENTIA HEALTH ADA, ESSENTIA HEALTH FOSSTON, ESSENTIA HEALTH HOLY TRINITY HOSPITAL, AND ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES ALLOCATE CERTAIN REVENUES AND EXPENSES DIRECTLY TO ESSENTIA HEALTH ADA, ESSENTIA HEALTH FOSSTON, ESSENTIA HEALTH HOLY TRINITY HOSPITAL, AND ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ALL RELATED ORGANIZATIONS. NET AFFILIATE REVENUE AND EXPENSE ALLOCATIONS OF ($7,233,639) INCLUDE THE FOLLOWING TYPES OF REVENUE AND EXPENSES: NONPATIENT REVENUE; AMORTIZATION AND DEPRECIATION; PURCHASED SERVICES; PROFESSIONAL FEES; AGENCY FEES; REPAIRS AND MAINTENANCE; SALARIES, WAGES, AND RELATED BENEFITS; SUPPLIES; UTILITIES; PROVIDER AND OTHER TAXES; AND OTHER EXPENSES. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS WITH RELATED ORGANIZATIONS -220,047. BRAINERD MEDICAL CENTER INC 2024 S 6TH ST BRAINERD MN 56401 371532148 CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 BRIDGES MEDICAL CENTER 201 9TH ST W ADA MN 56510 200479568 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 DEER RIVER HEALTHCARE CENTER INC 115 10TH AVE NE DEER RIVER MN 56636 410844574 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 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 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 INNOVIS HEALTH LLC C 121270 1.00000 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 BRIGHTSIDE SURGICAL LLC A 365050 ACTUAL COSTS ESSENTIA HEALTH M 69445824 ACTUAL COSTS ESSENTIA HEALTH P 36654838 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION B 700957 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION C 193745 ACTUAL COSTS ESSENTIA INSTITUTE OF RURAL HEALTH R 580200 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER A 789988 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER S 6400000 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