2024-05-08T14:59:28-05:00 2023-06-30 990 2022-07-01 410695602 ST JOSEPH'S MEDICAL CENTER STJO 2188292861 523 N 3RD ST BRAINERD MN 56401 KEVIN BOREN VICE PRESIDENT, FINANCE 2188292861 2024-05-08 KEVIN BOREN 999009999 1 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER KRISTA SKORUPA MD 523 N 3RD ST BRAINERD MN 56401 320428841 0 0928 X WWW.ESSENTIAHEALTH.ORG X 1985 MN THROUGHOUT ESSENTIA HEALTH, WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. AS A MEMBER OF THE ESSENTIA HEALTH FAMILY, ST. JOSEPH'S MEDICAL CENTER'S MISSION AS A CATHOLIC, BENEDICTINE SPONSORED FACILITY IS TO PROMOTE CHRIST'S MINISTRY OF HOLISTIC HEALING FOR ALL HUMAN LIFE WITH SPECIAL CONCERN FOR THE POOR AND POWERLESS. 11 7 1258 55 206778 85344 3946242 1397758 272775005 268084969 18761368 6089299 298437 383463 295781052 275955489 480737 324222 0 0 124481726 129185766 0 0 0 126468323 134237099 251430786 263747087 44350266 12208402 376719623 404572269 50045804 53519264 326673819 351053005 X THROUGHOUT ESSENTIA HEALTH, WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES.AS A MEMBER OF THE ESSENTIA HEALTH FAMILY, ST. JOSEPH'S MEDICAL CENTER'S MISSION AS A CATHOLIC, BENEDICTINE SPONSORED FACILITY IS TO PROMOTE CHRIST'S MINISTRY OF HOLISTIC HEALING FOR ALL HUMAN LIFE WITH SPECIAL CONCERN FOR THE POOR AND POWERLESS. 0 0 232413949 324222 268084969 ST. JOSEPH'S MEDICAL CENTER, DBA ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, IS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, RELIGIOUS, EDUCATIONAL, AND SCIENTIFIC PURPOSES. MORE SPECIFICALLY, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER IS ORGANIZED AND OPERATED TO OWN, MAINTAIN, OPERATE AND CONDUCT, DIRECTLY OR INDIRECTLY, AND TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, CARE FOR THE AGED AND SOCIAL SERVICES IN ACCORDANCE WITH THE CHARITABLE WORKS TRADITION OF THE ROMAN CATHOLIC CHURCH. IN KEEPING WITH THIS SPECIFIC PURPOSE, ALL WORKS SHALL BE CARRIED OUT IN ACCORDANCE WITH THE CHARISM OF THE BENEDICTINE SISTERS BENEVOLENT ASSOCIATION, A MINNESOTA NONPROFIT CORPORATION.ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER HAS A 162-BED HOSPITAL THAT SERVES THE BRAINERD LAKES AREA AND PRIMARY CARE CLINICS THAT SERVE A THREE-COUNTY REGION. ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER OFFERS 24-HOUR EMERGENCY CARE THROUGH ITS LEVEL 3 TRAUMA CENTER AS WELL AS OBSTETRICS AND BIRTHING SERVICES. ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER HAS BEEN DESIGNATED AS A PRIMARY STROKE CENTER.ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER EMPLOYS APPROXIMATELY 875 FULL TIME EQUIVALENTS. THE HOSPITAL PROVIDED ALMOST 20,000 HOSPITAL PATIENT DAYS AND 114,000 OUTPATIENT VISITS DURING FISCAL YEAR ENDED JUNE 30, 2023. THE CLINICS HAD OVER 239,000 ENCOUNTERS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2023, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER PROVIDED THE FOLLOWING COMMUNITY BENEFITS: $1.2 MILLION IN CHARITY CARE, $12.8 MILLION COSTS IN EXCESS OF MEDICAID PAYMENTS, $122,000 IN COMMUNITY SERVICES, AND $265,000 IN HEALTH PROFESSION EDUCATION. 232413949 1 1 0 1 0 0 0 0 0 0 1 1 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 0 1 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1258 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 7 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X KEVIN BOREN 2188292861 523 N 3RD ST BRAINERD MN 56401 JON PRYOR MD PRESIDENT THRU 1/23 1.00 59.00 X 0 1131335 37830 WILLIAM HEEGAARD PRESIDENT 1.00 59.00 X 0 902097 138409 KEVIN CASEY MD CHIEF MEDICAL OFFICER 1.00 59.00 X 0 816807 130502 PETER HENRY MD CHIEF MEDICAL OFFICER THRU 6/22 1.00 59.00 X 0 611303 60578 KEVIN BOREN VICE PRESIDENT, FINANCE 1.00 59.00 X 0 528452 89011 KRISTA SKORUPA MD INTERIM PRESIDENT 1.00 59.00 X 0 533408 69831 MICHAEL LARSON SENIOR VP, OPERATIONS THRU 6/23 1.00 59.00 X 471133 0 76360 NATHAN LAPOSKY MD BOARD DIRECTOR 1.00 59.00 X 0 472744 60793 JARED REESE MD BOARD DIRECTOR 1.00 59.00 X 0 319049 59832 JANELLE TEPPER CRNA MANAGER 60.00 0.00 X 255295 0 50205 JESSE LIND CRNA 60.00 0.00 X 242409 0 49649 SANDY ZUTZ-WICZEK VICE PRESIDENT, CLINIC OPERATIONS 60.00 0.00 X 0 252295 33152 SAMUEL BRANDL CRNA 60.00 0.00 X 266279 0 12662 MELISSA MCKAY REGIONAL NURSING DIRECTOR 1.00 59.00 X 227716 0 44277 KACIE WOTTRENG CRNA 60.00 0.00 X 236208 0 13279 DEAN COCHRANE CRNA 60.00 0.00 X 231555 0 13643 JESSICA TABATT MD BOARD DIRECTOR 1.00 59.00 X 0 219592 19128 JOHN SPERRAZZA SENIOR VP, OPERATIONS THRU 5/22 1.00 59.00 X 172122 35078 4572 MARK RONNEI BOARD CHAIR 2.00 7.00 X X 0 21500 0 GINNY KNUDSON BOARD SECRETARY 2.00 4.00 X X 0 1500 0 KRISTA SOUKUP BOARD VICE CHAIR 2.00 2.00 X X 0 1500 0 GEORGE LOBAN BOARD DIRECTOR 1.00 1.00 X 0 0 0 HARA CHARLIER BOARD DIRECTOR 1.00 5.00 X 0 0 0 MIKE PAULUS BOARD DIRECTOR 1.00 1.00 X 0 0 0 SISTER BEVERLY HORN BOARD TREASURER 2.00 3.00 X X 0 0 0 SISTER DANILE LYNCH BOARD DIRECTOR 1.00 1.00 X 0 0 0 2102717 5846660 963713 119 0 1 0 0 836925 540848 19985 1397758 INPATIENT AND OUTPATIENT REVENUES 621110 268084969 267878191 206778 268084969 4843130 4843130 59824 59907 -83 -83 -83 45659614 44145701 267744 1513913 -267744 1246169 1246169 CAFETERIA/VENDING REVENUE 722514 342522 342522 LINEN SERVICE 812300 29843 29843 CONSTRUCTION CREDITS 900099 9870 9870 1311 1311 383546 275955489 267878191 206778 6472762 X 324222 324222 2399701 1173814 1225887 103391 103391 103124625 100258460 2866165 4485002 4344863 140139 12787541 11964554 822987 6285506 6018485 267021 10 10 4348 4348 617796 617796 22222313 21170786 1051527 119874 95749 24125 7094853 5695937 1398916 410287 398884 11403 3255129 3164658 90471 595477 566125 29352 155644 86924 68720 709128 709128 7749853 7534460 215393 1139904 1123364 16540 UNRELATED BUSINESS INCO 121019 121019 MEDICAL SUPPLIES 41503107 41503107 AFFILIATE SUPPORT FEE 28605795 13718666 14887129 AFFILIATE EXP & REVENUE 6649355 29319 6620036 13283207 12429053 854154 263747087 232413949 31333138 0 66274 16782 84310587 82830793 25825884 27847316 1060197 1226566 5875727 5476089 803008 677126 186786060 134447343 51131258 52338717 201704435 230522710 2041507 0 386367 351767 3514379 3284403 376719623 404572269 21784762 16654598 17551927 26651612 7218267 6946599 3490848 3266455 50045804 53519264 X 326673819 351053005 326673819 351053005 376719623 404572269 X 12208402 13612634 -1441850 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 4348 4348 0 PART II-B, LINE 1: LOBBYING ACTIVITY EXPLANATION: ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER 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. 2413881 2413881 107824564 77281231 30543333 69531840 55017319 14514521 7015775 2148793 4866982 52338717 POOLED INVESTMENT FUNDS 222092958 F BOND CONSTRUCTION FUND 8429752 F 230522710 OPERATING LEASES 3203269 ASSET RETIREMENT OBLIGATION 63186 3266455 1 1 X 1 X 0 1 1 1 0 1 1 1203923 1203923 0.00470 41718255 28963043 12755212 0.04940 42922178 28963043 13959135 0.05410 121680 121680 0.00050 270957 6438 264519 0.00100 392637 6438 386199 0.00150 43314815 28969481 14345334 0.05560 1 5532985 39565127 52510208 -12945081 X 1 1 1 1 ESSENTIA HEALTH ST JOSEPH'S MEDICAL CENTER 523 N 3RD ST BRAINERD MN 56401 WWW.ESSENTIAHEALTH.ORG 410323 X X X X ESSENTIA HEALTH ST JOSEPH'S MEDICAL CEN 0 0 1 X X X X X X X X X 21 1 1 1 1 X WWW.ESSENTIAHEALTH.ORG/ABOUT/CHNA/ X 1 21 1 WWW.ESSENTIAHEALTH.ORG/ABOUT/CHNA/ 0 1 X 200.000000000000 X X X X X 1 1 X X X X 1 X ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X ESSENTIAHEALTH.ORG/PATIENTS-VISITORS/BILLING/FINANCIAL-ASSISTANCE/ X 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 ST. JOSEPH'S MEDICAL CENTER PART V, SECTION B, LINE 5: ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER SOLICITED BROAD FEEDBACK FROM THE COMMUNITY THROUGH A COMMUNITY SURVEY, WHICH COLLECTED 957 RESPONSES; THE SURVEY WAS ADMINISTERED 6/21/2021 TO 8/19/2021. THROUGHOUT THE PROCESS, A HEAVY EMPHASIS WAS PLACED ON CONSIDERING THE INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, SPECIFICALLY INDIVIDUALS FROM LOW-INCOME, MEDICALLY UNDERSERVED, OR MINORITY POPULATIONS AND THOSE WITH A SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH.THE CROW WING ENERGIZED STEERING COMMITTEE, WHICH GUIDED THE PROCESS, INCLUDED REPRESENTATION FROM CROW WING COUNTY PUBLIC HEALTH, NYSTROM & ASSOCIATES, ST. CROIX HOSPICE, ACR CONSULTING, CENTRAL LAKES COLLEGE, UNIVERSITY OF MINNESOTA EXTENSION, THE CITY OF BRAINERD, MID-MINNESOTA FEDERAL CREDIT UNION, BIG STONE THERAPIES, BRAINERD DISPATCH, LAKES AREA UNITED WAY, HEARTLAND HOSPICE, CROSSLAKE CHAMBER OF COMMERCE, AND PEQUOT LAKES PUBLIC SCHOOLS. OTHER PARTICIPANTS INCLUDED CUYUNA REGIONAL MEDICAL CENTER, BRAINERD FAMILY YMCA, BRAINERD LAKES AREA ECONOMIC DEVELOPMENT, AND CENTRAL MINNESOTA COUNCIL ON AGING.ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER 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 ST. JOSEPH'S MEDICAL CENTER PART V, SECTION B, LINE 6A: TO ALIGN RESOURCES AND STRENGTHS TO BETTER SERVE OUR COMMUNITY, THE CHNA WAS CONDUCTED IN COLLABORATION WITH CUYUNA REGIONAL MEDICAL CENTER AND ST. CLOUD VETERANS ADMINISTRATION MEDICAL CENTER, UNRELATED HOSPITAL FACILITIES. ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER PART V, SECTION B, LINE 6B: ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER WORKED COLLABORATIVELY ON THE ASSESSMENT PROCESS WITH ACR CONSULTING, BIG STONE THERAPIES, BLUE CROSS BLUE SHIELD OF MN, BRAINERD DISPATCH, BRAINERD FAMILY YMCA, BRAINERD HRA, BRAINERD LAKES AREA ECONOMIC DEVELOPMENT, CENTRAL LAKES COLLEGE, CENTRAL MINNESOTA COUNCIL ON AGING, THE CITY OF BRAINERD, CROSSLAKE CHAMBER OF COMMERCE, CROW WING COUNTY, HEARTLAND HOSPICE CARE, ISD 186 SCHOOL BOARD, LAKES AREA RESTORATIVE JUSTICE, MID-MINNESOTA FEDERAL CREDIT UNION, MINNESOTA DEPARTMENT OF HEALTH, NORTHERN PINES MENTAL HEALTH, NYSTROM & ASSOCIATES, LAKES AREA UNITED WAY, AND UNIVERSITY OF MINNESOTA EXTENSION. ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER PART V, SECTION B, LINE 11: DURING FY 2023, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ADDRESSED SIGNIFICANT NEEDS IDENTIFIED IN THE FY 2022 ASSESSMENT: MENTAL HEALTH, TOBACCO USE, AND HEALTHY EATING/ACTIVE LIVING. IT HAS APPROACHED THESE NEEDS AS A MEMBER OF CROW WING ENERGIZED (CWE), A COALITION CO-LED BY ESSENTIA HEALTH AND CROW WING COUNTY THAT SEEKS TO "IMPROVE HEALTH AND WELLNESS BY MAKING THE HEALTHY CHOICE THE EASY CHOICE" IN CROW WING COUNTY, MINNESOTA.OTHER HEALTH NEEDS IDENTIFIED THROUGH THE CHNA PROCESS ARE HOUSING AND SUBSTANCE/ALCOHOL USE, WHICH WILL NOT BE DIRECTLY ADDRESSED AS PRIORITIES DUE TO LIMITED RESOURCES. THERE ARE OTHER LOCAL ORGANIZATIONS AS WELL AS THE MOVEMENT AT THE COUNTY LEVEL TO ADDRESS HOUSING IN CROW WING COUNTY.THE FOLLOWING DESCRIBES SIGNIFICANT ACCOMPLISHMENTS AND OUTCOMES.PRIORITY AREA #1: MENTAL HEALTHTO PROMOTE MENTAL HEALTH, ESSENTIA HEALTH PROVIDED NUMEROUS OPPORTUNITIES FOR THE PUBLIC TO LEARN ABOUT PRACTICING MENTAL WELLNESS ON AN EVERYDAY BASIS. ON SEPTEMBER 16, 2022, ESSENTIA HEALTH AND CROW WING COUNTY CO-HOSTED THE CROW WING ENERGIZED ANNUAL SUMMIT AT LAKEWOOD CHURCH IN BAXTER. ATTRACTING 154 CROW WING COUNTY RESIDENTS, THE DAY-LONG EVENT FOCUSED ON THE TOPIC, "ROOTED IN HAPPINESS." 88% OF ATTENDEES SAID THEY WERE "VERY SATISFIED" WITH THE EVENT, WHICH FEATURED A KEYNOTE ADDRESS, THREE BREAKOUT SESSIONS, AND RESOURCE TABLES. 47% OF ATTENDEES ALSO REPORTED AGREEMENT WITH THE STATEMENT, "I CAN IDENTIFY HOW TO INCLUDE POSITIVE PSYCHOLOGY AT MY HOME OR WORK." ON OCTOBER 29, 2022, CWE HELD ITS MENTAL HEALTH RESOURCE FAIR. WITH 71 PEOPLE IN ATTENDANCE, THE EVENT TRAINED PARTICIPANTS IN NUMEROUS MENTAL WELL-BEING PROGRAMS, INCLUDING MAKE IT OK, QPR (QUESTION, PERSUADE, REFER), ADVERSE CHILDHOOD EXPERIENCES (ACES), SAVE (SUICIDE PREVENTION), AND COUNSELING ON ACCESS TO LETHAL MEANS (CALM). ON NOVEMBER 14, 2022, CWE HOSTED A LOCAL PREMIERE OF THE FILM "ANGST: RAISING AWARENESS ABOUT ANXIETY," WHICH ATTRACTED 32 PEOPLE. ON JANUARY 25-26, 2023, CWE ALSO HOSTED A FACILITATOR TRAINING LED BY FAMILYWISE FOR ACES; 27 LOCAL RESIDENTS WERE TRAINED TO PROVIDE THIS PROGRAM'S IMPORTANT INFORMATION TO AUDIENCES ACROSS CROW WING COUNTY. ON APRIL 27, 2023, CWE HOSTED A MAKE IT OK AMBASSADOR TRAINING; 25 PEOPLE WERE TRAINED AS AMBASSADORS. AND ON SATURDAY, MAY 6, 2023, CWE PARTNERED WITH CENTRAL LAKES COLLEGE TO HOST THE SECOND ANNUAL 5K FOR MENTAL HEALTH AWARENESS; 182 PEOPLE PARTICIPATED.PRIORITY AREA #2: TOBACCO USETO DISCOURAGE TOBACCO USE, ESSENTIA HEALTH CONTINUED ITS PARTNERSHIP WITH CROW WING COUNTY TO PROMOTE CESSATION RESOURCES AND ENCOURAGE CESSATION. SINCE TOBACCO USE HAS TIES TO MENTAL WELL-BEING ISSUES, ESSENTIA HEALTH HOSTED AN EVENT, "MAKE IT OK TO TALK ABOUT MENTAL ILLNESS AND SUBSTANCE USE DISORDER." 36 PEOPLE ATTENDED THE EVENT, WHICH AIMED TO INCREASE UNDERSTANDING ABOUT SUBSTANCE USE, DECREASE STIGMA AROUND ADDRESSING USE OF SUBSTANCES, AND PROMOTE HELP SEEKING ACTIVITIES.PRIORITY AREA #3: HEALTHY EATING/ACTIVE LIVINGTO ENCOURAGE CONSUMPTION OF FRUITS AND VEGETABLES, ESSENTIA HEALTH ENGAGED IN NUMEROUS PARTNERSHIPS. PARTNERING WITH CROW WING COUNTY, ESSENTIA HEALTH PROMOTED HEALTHY EATING WITH ITS ANNUAL "ONE VEGETABLE, ONE COMMUNITY" PROGRAM, WHICH PROMOTES A SPECIFIC VEGETABLE TO CELEBRATE AND CONSUME IN THE CALENDAR YEAR. IN SUMMER 2022, 1,650 VOTES WERE CAST TO ELECT THE 2023 VEGETABLE OF THE YEAR. WHEN THE GREEN BEAN WAS SELECTED, ESSENTIA HEALTH VISITED ALL FIRST-GRADE CLASSROOMS IN CROW WING COUNTY WITH A LESSON ABOUT THE BENEFITS OF HEALTHY EATING; 926 STUDENTS RECEIVED EDUCATION AND GREEN BEAN SEEDS AS PART OF THE PROGRAM. ALONGSIDE ITS CWE PARTNERS, ESSENTIA HEALTH ALSO SUPPORTED THE "RETHINK YOUR DRINK" CAMPAIGN TO DISCOURAGE CONSUMPTION OF SUGARY BEVERAGES AND ENCOURAGE WATER CONSUMPTION. 25 BUSINESSES/ORGANIZATIONS, WHICH EMPLOY MORE THAN 905 PEOPLE, PARTICIPATED IN THE CAMPAIGN DURING 2022.TO PROMOTE EVERYDAY ACTIVITY, ESSENTIA HEALTH PROVIDED COMMUNITY PROGRAMS THAT ENCOURAGE AND FACILITATE MOVEMENT. THROUGH PARTNERSHIP WITH TRELLIS/JUNIPER, ESSENTIA HEALTH HOSTED A NUMBER OF EVIDENCE-BASED CLASSES AIMED AT THE PHYSICAL ACTIVITY NEEDS OF OLDER ADULTS. THEY HOSTED FOUR MATTER OF BALANCE CLASSES (41 PEOPLE), FIVE NATIONAL DIABETES PREVENTION PROGRAM (NDPP) COHORTS (35 PEOPLE), AND 10 STAY ACTIVE AND INDEPENDENT FOR LIFE (SAIL) CLASSES (578 PEOPLE). ESSENTIA HEALTH VISITED GARFIELD ELEMENTARY AND BAXTER ELEMENTARY SCHOOLS TO SUPPORT BIKE RODEOS IN CROW WING COUNTY, REACHING 270 ELEMENTARY SCHOOL STUDENTS WITH LESSONS ABOUT BIKE AND HELMET SAFETY. THROUGH PARTNERSHIP WITH NATURE NETWORK, CWE ALSO DESIGNED AN INVENTORY OF RECREATION FACILITIES THROUGHOUT CROW WING COUNTY TO SUPPORT PHYSICAL ACTIVITY. ESSENTIA HEALTH SUPPORTED THE PRODUCTION AND DISTRIBUTION OF 1,500 COPIES OF THE "PARKS INVENTORY" PAMPHLET AT THE BEGINNING OF SUMMER 2023. ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER PART V, SECTION B, LINE 23: OCCASIONALLY CERTAIN FAP-ELIGIBLE PATIENTS ARE CHARGED MORE THAN AMOUNTS GENERALLY BILLED ON SERVICES. THIS COULD OCCUR IF THE PATIENT PAYMENTS ARE APPLIED ON PATIENT BILLS BEFORE AND/OR AFTER THE FINANCIAL ASSISTANCE POLICY (FAP) ADJUSTMENTS WERE APPLIED. THE HOSPITAL PROVIDES THOSE PATIENTS WITH A $5 OR MORE OVERPAYMENT WITH A REFUND CHECK, EXPLANATION LETTER, AND DETAILED SUMMARY OF SERVICES IMPACTED.THE NUMBER OF PATIENTS AFFECTED AND THE TOTAL DOLLAR AMOUNT INVOLVED FOR FY23 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, LINE 3E:ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER CONDUCTED A NEW CHNA IN FY22 AND CHOSE TO ADDRESS THREE PRIORITY HEALTH NEEDS BASED ON THE FEEDBACK OF 957 COMMUNITY MEMBERS. THE SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY ARE MENTAL HEALTH, TOBACCO USE, AND HEALTHY EATING/ACTIVE LIVING. THE NEEDS ARE NOT RANKED IN ORDER; ALL THREE HEALTH NEEDS ARE CONSIDERED PRIORITIES. THE HOSPITAL WILL WORK ON ADDRESSING EACH NEED SIMULTANEOUSLY FROM FY23 - FY25.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. 16 1 - ESSENTIA HEALTH ST JOSEPH'S-BRAINERD CL 2024 S 6TH ST BRAINERD MN 56401 MULTI-SPECIALTY CLINIC 2 - ESSENTIA HEALTH ST JOSEPH'S-BAXTER CLIN 13060 ISLE DR BAXTER MN 56425 MULTI-SPECIALTY CLINIC 3 - ESSENTIA HEALTH ST JOSEPH'S-ORTHOPEDICS 2014 S 6TH ST BRAINERD MN 56401 ORTHOPEDIC CLINIC 4 - ESSENTIA HEALTH ST JOSEPH'S-PINE RIVER 280 BARCLAY AVE PINE RIVER MN 56474 MULTI-SPECIALTY CLINIC 5 - ESSENTIA HEALTH ST JOSEPH'S-PEQUOT LAKE 4317 W WOODMAN ST PEQUOT LAKES MN 56472 PRIMARY CARE CLINIC 6 - ESSENTIA HEALTH ST JOSEPH'S-PILLAGER CL 680 PILLSBURY ST N PILLAGER MN 56473 PRIMARY CARE CLINIC 7 - ESSENTIA HEALTH ST JOSEPH'S-CROSSLAKE C 35205 COUNTY RD 3 CROSS LAKE MN 56442 PRIMARY CARE CLINIC 8 - ESSENTIA HEALTH ST JOSEPH'S-PIERZ CLINI 138 NORTH MAIN ST S PIERZ MN 56364 PRIMARY CARE CLINIC 9 - ESSENTIA HEALTH LAKELAND PSYCHIATRY CLIN 523 3RD ST N BRAINERD MN 56401 PSYCHIATRY CLINIC 10 - ESSENTIA HEALTH ST JOSEPH'S-EMILY CLINI 20918 COUNTY RD 1 EMILY MN 56447 PRIMARY CARE CLINIC 11 - ESSENTIA HEALTH ST JOSEPH'S-HACKENSACK 110 3RD ST S HACKENSACK MN 56452 PRIMARY CARE CLINIC 12 - ESSENTIA HEALTH ST JOSEPH'S-DEERWOOD CL 24087 CUYUNA ST DEERWOOD MN 56444 PRIMARY CARE CLINIC 13 - ESSENTIA HEALTH ST JOSEPH'S-GOOD BEGINN 523 3RD ST BRAINERD MN 56401 OB CLINIC 14 - ESSENTIA HEALTH ST JOSEPH'S-REHABILITAT 2016 S 6TH ST BRAINERD MN 56401 REHABILITATION CENTER 15 - ESSENTIA HEALTH LAKES IMAGING 2019 S 6TH ST BRAINERD MN 56401 RADIOLOGY CLINIC 16 - ESSENTIA HEALTH ST JOSEPH'S-BAXTER URGE 13060 ISLE DR BAXTER MN 56425 URGENT CARE CLINIC PART I, LINE 3C: ASSETS WILL BE CONSIDERED ALONG WITH THE PATIENT'S INCOME TO DETERMINE ELIGIBILITY FOR THE FINANCIAL ASSISTANCE PROGRAM. TO BE ELIGIBLE, REPORTABLE ASSETS MAY NOT EXCEED $75,000 FOR A HOUSEHOLD OF ONE (1), OR $150,000 FOR A HOUSEHOLD OF TWO (2) OR MORE. ASSETS MAY INCLUDE, BUT ARE NOT LIMITED TO, SUCH ITEMS AS CHECKING AND SAVINGS ACCOUNTS, IRAS, 401(K)S, PENSIONS, HEALTH SAVINGS ACCOUNTS, ADDITIONAL PROPERTY, AND ANY OTHER RETIREMENT FUNDING. PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT INFORMATION IS INCLUDED ON ESSENTIA HEALTH'S (EMPLOYER IDENTIFICATION NUMBER 20-0360007) WEBSITE AT WWW.ESSENTIAHEALTH.ORG. ESSENTIA HEALTH, HEADQUARTERED IN DULUTH, MINNESOTA, IS THE PARENT OF A FULLY INTEGRATED HEALTH SYSTEM SERVING PATIENTS IN MINNESOTA, WISCONSIN, AND NORTH DAKOTA. PART I, LINE 7: THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES WAS USED TO CALCULATE THE COSTS FOR THE FOLLOWING COMMUNITY BENEFITS: CHARITY CARE AND UNREIMBURSED MEDICAID. ACTUAL COSTS WERE USED FOR THE REMAINDER OF THE COMMUNITY BENEFITS REPORTED. PART I, LN 7 COL(F): BAD DEBT EXPENSE THAT WAS SUBTRACTED FROM TOTAL EXPENSE TO OBTAIN THE % OF COMMUNITY BENEFIT TO TOTAL EXPENSE AMOUNTED TO $5,532,985. PART III, LINE 2: DISCOUNTS, CHARITY CARE, AND BAD DEBT EXPENSE ARE ACCOUNTED FOR AS REDUCTIONS TO REVENUE. BAD DEBT EXPENSE IS CALCULATED AFTER ALL ESTIMATED DISCOUNTS AND APPLICABLE PAYMENTS ARE APPLIED TO A PATIENT ACCOUNT. BAD DEBT EXPENSE IS A COMBINATION OF THE ACTUAL ACCOUNT WRITE-OFFS TO A COLLECTION AGENCY FOR ACCOUNTS DEEMED UNCOLLECTIBLE, ALONG WITH ESTIMATED EXPENSE FOR ACCOUNTS WITH A REMAINING BALANCE IN ACCOUNTS RECEIVABLE. IF, DURING THE COLLECTION PROCESS, IT BECOMES KNOWN THAT THE PATIENT QUALIFIES FOR CHARITY CARE, THE AMOUNTS INCLUDED WITHIN BAD DEBT EXPENSE WOULD BE RECLASSIFIED TO CHARITY CARE. PART III, LINE 3: ESSENTIA HEALTH PROVIDES FULL CHARITY CARE THROUGH ITS TRADITIONAL APPLICATION PROCESS. FULL CHARITY CARE IS A COMPLETE WRITE-OFF OF ELIGIBLE GROSS HOSPITAL AND CLINIC CHARGES. THIS IS BASED ON THE PATIENT'S INCOME IN RELATION TO THE FEDERAL POVERTY GUIDELINES. CATASTROPHIC CHARITY CARE IS FINANCIAL ASSISTANCE THAT PROVIDES A ONE-TIME DISCOUNT BASED ON AN APPLICATION FOR TRADITIONAL CHARITY CARE AND DOES NOT QUALIFY BUT HAS A BALANCE GREATER THAN $5,000. PATIENT, OR THEIR GUARANTOR, MAY BE GRANTED CATASTROPHIC CHARITY CARE ASSISTANCE FOR ELIGIBLE SERVICES IF THEY COMPLETE A FINANCIAL ASSISTANCE APPLICATION AND PROVIDE REQUIRED DOCUMENTATION. THE PATIENT AND/OR GUARANTOR WILL NOT PAY MORE THAN 20% OF ANNUAL INCOME BASED ON ELIGIBLE CHARGES. ESSENTIA HEALTH ALSO RECOGNIZES THAT IT IS NOT FEASIBLE, OR SOMETIMES NECESSARY, FOR ALL PATIENTS TO COMPLETE FINANCIAL ASSISTANCE APPLICATIONS AND PROVIDE DOCUMENTATION REQUIRED THROUGH THE TRADITIONAL PROCESS. ESSENTIA HEALTH IMPLEMENTED AN ALTERNATIVE DOCUMENTATION AND PRESUMPTIVE PROCESS USING A TOOL THAT IDENTIFIES ACCOUNTS THAT AUTOMATICALLY QUALIFY FOR CHARITY CARE AND RECLASSIFIED THOSE ACCOUNTS TO CHARITY CARE ALLOWANCE. AS A RESULT, WE ESTIMATE $0 OF PATIENT ACCOUNTS WRITTEN OFF TO BAD DEBT WOULD QUALIFY FOR CHARITY CARE.ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER IS A PART OF A LARGER ORGANIZATION, ESSENTIA HEALTH. ESSENTIA HEALTH AND ITS MEMBER ORGANIZATIONS INCORPORATE 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, ESSENTIA HEALTH MAKES 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 FACILITY'S TOTAL MEDICARE SHORTFALL IS $25,126,656, OF WHICH A SHORTFALL OF $12,945,081 (CONSISTING OF $39,565,127 REVENUE AND $52,510,208 COST) IS INCLUDED IN PART III, SECTION B, LINES 5-7, AND A SHORTFALL OF $12,181,575 (CONSISTING OF $64,634,214 REVENUE AND $76,815,789 COST) REPRESENT ALL OTHER MEDICARE SERVICES NOT INCLUDED IN THE ANNUAL COST REPORT.THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6:THE METHODOLOGY USED IN DETERMINING THE REPORTED MEDICARE ALLOWABLE COST BEGINS WITH THE HOSPITAL'S GENERAL LEDGER SYSTEM. THE COSTS ARE OBTAINED FROM THE GENERAL LEDGER AND THEN ADJUSTED AND REPORTED IN ACCORDANCE WITH CENTERS FOR MEDICARE SERVICES (CMS) "COST FINDING" GUIDELINES AS PUBLISHED IN THEIR PROVIDER REIMBURSEMENT MANUAL. ONCE THE MEDICARE ALLOWABLE COSTS ARE DETERMINED FROM THE HOSPITAL'S COST REPORT, ANY COSTS ATTRIBUTED TO SUBSIDIZED HEALTH SERVICES, AND MEDICAL EDUCATION, ARE REMOVED AND REPORTED SEPARATELY.EXPLANATION FOR ANY PRIOR YEAR SETTLEMENTS FOR MEDICARE-RELATED SERVICES IN THE CURRENT TAX YEAR:EACH ESSENTIA HEALTH HOSPITAL IS REQUIRED TO FILE A MEDICARE COST REPORT 5 MONTHS AFTER THE CLOSE OF THEIR FISCAL YEAR. THE COST REPORT PROVIDES MEDICARE WITH INFORMATION THAT IS USED TO DETERMINE UTILIZATION AND SPENDING TRENDS BUT ALSO IS USED TO SET FUTURE PAYMENT RATES FOR MOST MEDICARE SERVICES. IF THE INTERIM PAYMENTS PAID TO A HOSPITAL ARE HIGHER OR LOWER THAN THE FILED COST REPORT ALLOWABLE REIMBURSEMENT, THERE WILL BE A SETTLEMENT FOR THAT FISCAL YEAR. THIS CAN BE DUE TO CHANGES IN UTILIZATION OR COST OF PROVIDING SERVICES FOR CRITICAL ACCESS HOSPITALS (CAH) OR DIFFERENCES BETWEEN INTERIM AND FINAL PAYMENT FACTORS FOR DISPROPORTIONATE SHARE, BAD DEBTS, OR INDIRECT MEDICAL EDUCATION FOR NON-CAH HOSPITALS. AN ESTIMATE FOR THESE SETTLEMENTS IS RECORDED AT THE CLOSE OF THE FISCAL YEAR. IF THE ESTIMATE VARIES FROM THE FINAL SETTLEMENT RECEIVED 6-7 MONTHS AFTER THE FISCAL YEAR ENDS, THEN THESE AMOUNTS ARE RECORDED AS PRIOR YEAR MEDICARE REVENUE.THE EXTENT TO WHICH ANY SHORTFALL REPORTED IN PART III, LINE 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT AND THE RATIONALE FOR THE ORGANIZATION'S OPINION:ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER IS A PART OF A LARGER ORGANIZATION, ESSENTIA HEALTH. 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 AND IT IS LIKELY TO GET WORSE. MANY MEDICARE BENEFICIARIES ARE POOR AND ARE ELIGIBLE FOR MEDICAID IN ADDITION TO MEDICARE. MEDICARE UNDERPAYMENT MUST BE SHOULDERED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE COMMUNITY'S ELDERLY AND POOR. THESE UNDERPAYMENTS REPRESENT A REAL COST OF SERVING THE COMMUNITY. PART III, LINE 9B: THE POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR ESSENTIA HEALTH'S FINANCIAL ASSISTANCE POLICY (FAP) AND FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR A GOVERNMENTAL PROGRAM OR FOR FINANCIAL ASSISTANCE FROM ESSENTIA HEALTH, AND THE PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS/HER PAYMENT AGREEMENTS. THE ORGANIZATION OFFERS EXTENDED PAYMENT PLANS TO ELIGIBLE PATIENTS AND WILL NOT IMPOSE LIENS ON PRIMARY RESIDENCES NOR REPORT PATIENTS TO A CREDIT RATING AGENCY FOR OUTSTANDING PATIENT BILLS. THE ORGANIZATION WILL NOT CHARGE A PATIENT THE GROSS AMOUNT OF CHARGES FOR ANY UNINSURED TREATMENT. UNINSURED DISCOUNTS WILL BE APPLIED TO THE GROSS CHARGES PRIOR TO ANY FINANCIAL ASSISTANCE OR OTHER DISCOUNTS. IF AT ANY TIME THE ORGANIZATION RECOGNIZES THAT A PATIENT MAY BE ELIGIBLE FOR STATE OR FEDERAL PROGRAMS, A REPRESENTATIVE WILL ASSIST THE PATIENT IN OBTAINING INFORMATION ABOUT THESE PROGRAMS OR PROVIDE CONTACT INFORMATION FOR THESE PROGRAMS. THE ORGANIZATION CONTRACTS WITH AN OUTSIDE PATIENT ADVOCACY AGENCY, WHICH MAY PROVIDE ASSISTANCE TO THE UNINSURED PATIENT IN APPLYING TO CERTAIN STATE AND FEDERAL PROGRAMS. AT ANY STAGE OF THE PATIENT EXPERIENCE AND UP THROUGH THE COLLECTION PROCESS, THE PATIENT MAY EXPRESS A CONCERN THAT THEY ARE UNABLE TO PAY THEIR BILL IN FULL OR MEET THE PAYMENT PLAN REQUIREMENTS. AT THAT TIME, THE PATIENT WILL BE GIVEN EVERY OPPORTUNITY TO COMPLETE AND SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE ORGANIZATION TRAINS ITS OUTSIDE DEBT COLLECTION AGENCIES AND ATTORNEYS ABOUT THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION ABOUT THE FAP OR SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. THE ORGANIZATION REQUIRES ITS OUTSIDE COLLECTION AGENCIES AND ATTORNEYS TO REFER PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE TO ESSENTIA HEALTH. IF A PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED FOR COLLECTION ACTIVITY, THE ORGANIZATION SUSPENDS ALL COLLECTION ACTIVITY UNTIL THE PATIENT'S FINANCIAL ASSISTANCE APPLICATION HAS BEEN PROCESSED AND ESSENTIA HEALTH HAS NOTIFIED THE PATIENT OF ITS DECISION. PATIENTS ARE ADVISED AT THAT TIME TO NOTIFY THE COLLECTION AGENCY TO HOLD THEIR ACCOUNT. THE OUTSIDE DEBT COLLECTION AGENCIES ARE NOTIFIED BY ESSENTIA HEALTH ONCE AN ACCOUNT ADJUSTMENT HAS BEEN MADE. PART VI, LINE 2: NEEDS ASSESSMENT:WE ASSESS AND RESPOND TO THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE THROUGH MANY WAYS INCLUDING THE FOLLOWING:MARKETING RESEARCH - THE ESSENTIA HEALTH MARKETING RESEARCH DEPARTMENT CONDUCTS SURVEYS AND 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 BOTH IN STAFFING AND PROCESSES.INTERNAL QUALITY INDICATORS - WE TRACK DATA THAT LEAD TO THE IMPROVED CARE AND TREATMENT OF PATIENTS WITH CHRONIC DISEASES, TOBACCO USE, AND MENTAL HEALTH CONDITIONS. THIS INCLUDES PATIENT ACTIVITY AND OUTCOMES, ALLOWING FOR OUR ESSENTIA HEALTH TO BETTER IDENTIFY THE NEEDS OF THE PATIENTS, WHICH 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 - THEIR ANALYSIS OF CURRENT STAFFING TRENDS AIDS IN PROVIDING HEALTHCARE ACCESS APPROPRIATELY TO THE COMMUNITIES WE SERVE. ESSENTIA INSTITUTE OF RURAL HEALTH (EIRH) - EIRH PROVIDES RESEARCH OF PATIENT DATA, COMMUNITY DATA, AND THE OUTCOMES ASSOCIATED WITH CURRENT CLINICAL PRACTICES, INTERVENTIONS, AND PREVENTION STRATEGIES (E.G., OPIOID USE DISORDER, SOCIAL DETERMINANTS OF HEALTH). PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:THE ORGANIZATION MAKES INFORMATION ON ITS FINANCIAL ASSISTANCE POLICY (FAP) READILY AVAILABLE TO PATIENTS. INFORMATION ABOUT FINANCIAL ASSISTANCE PROGRAMS IS AVAILABLE ON THE ESSENTIA HEALTH WEBSITE (WWW.ESSENTIAHEALTH.ORG, SELECT PATIENTS & VISITORS) WHERE THE INFORMATION AND APPLICATION IS EASILY ACCESSIBLE TO BE VIEWED, DOWNLOADED, AND PRINTED AT NO CHARGE TO THE PATIENT. PATIENTS CAN ALSO APPLY FOR FAP VIA MYCHART. NOTICES ON THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE CONSPICUOUSLY POSTED IN EMERGENCY ROOM DEPARTMENTS. FINANCIAL ASSISTANCE INFORMATION IS AVAILABLE DURING THE PRE-ADMISSION FINANCIAL SCREENING, AT THE TIME OF REGISTRATION, AND PRIOR TO A HOSPITAL DISCHARGE. INFORMATION ABOUT THE FAP IS IN ALL COLLECTION LETTERS AND PATIENT STATEMENTS.FAP INFORMATION AND/OR APPLICATIONS ARE MADE AVAILABLE TO APPROPRIATE COMMUNITY HEALTH SERVICES AGENCIES AND OTHER ORGANIZATIONS THAT ASSIST PEOPLE IN NEED. THE ORGANIZATION EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS PROVIDING DIRECT PATIENT TREATMENT AND WHO WORK IN ADMISSIONS, BILLING, AND COLLECTIONS, ABOUT THE EXISTENCE OF THE FAP AND HOW A PATIENT MAY OBTAIN MORE INFORMATION. ANNUAL EDUCATION/AWARENESS OF THE FAP IS PROVIDED TO ENSURE ALL EMPLOYEES WITH PATIENT CONTACT ARE AWARE OF THE PROGRAM AND HOW PATIENTS CAN OBTAIN ADDITIONAL INFORMATION. CLINICAL AND HOSPITAL STAFF WHO PROVIDE DIRECT PATIENT CARE HAVE KNOWLEDGE OF THE FAP AND KNOW TO DIRECT PATIENTS TO A REGISTRATION INTERVIEWER OR BUSINESS OFFICE REPRESENTATIVE. REGISTRATION STAFF HAVE AN UNDERSTANDING OF THE POLICY, KNOWLEDGE OF WHERE THE RELATED DOCUMENTS ARE LOCATED, AND WHERE TO DIRECT THE PATIENT FOR MORE INFORMATION ON THE FAP. DESIGNATED EMPLOYEES (PATIENT FINANCIAL SERVICES COUNSELORS & PATIENT FINANCIAL SERVICES REPRESENTATIVES) HAVE A THOROUGH UNDERSTANDING OF THE FAP AND OFFER THE INFORMATION ON THE FAP TO THOSE PATIENTS WHO MAKE AN INQUIRY ABOUT THE PROGRAM OR ARE DETERMINED THROUGH A FINANCIAL SCREENING TO BE ELIGIBLE FOR THIS PROGRAM. PATIENT ADVOCACY SERVICES ALSO INFORM THE PATIENT ABOUT THE AVAILABILITY OF ASSISTANCE. A REQUEST FOR FINANCIAL ASSISTANCE MAY BE MADE BY THE PATIENT, A PATIENT'S GUARANTOR, A FAMILY MEMBER, CLOSE FRIEND, OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS. THE ORGANIZATION RESPONDS TO ANY ORAL OR WRITTEN REQUESTS FOR MORE GENERAL INFORMATION ON THE FAP MADE BY A PATIENT OR ANY INTERESTED PARTY. PART VI, LINE 4: COMMUNITY INFORMATION:ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER IS LOCATED IN BRAINERD, MN. ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER IS A PART OF ESSENTIA HEALTH, WHICH IS DEFINED IN PART VI, LINE 6. ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER OPERATES 1 HOSPITAL, 14 CLINICS, 1 URGENT CARE CLINIC, AND A REHABILITATION CENTER THAT PRIMARILY SERVE CROW WING, CASS, AND MORRISON COUNTIES. THE OVERALL COMMUNITY IS CLASSIFIED AS A COMBINATION OF SUBURBAN AND RURAL. ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER COVERS A SERVICE AREA OF APPROXIMATELY 118,000 PEOPLE. THE SERVICE AREA AGE DISTRIBUTION IS 20% UNDER THE AGE OF 18; 55% BETWEEN THE AGES OF 18 AND 65; AND 25% OVER THE AGE OF 65. THE RACIAL MAKEUP OF THE SERVICE AREA IS 94% CAUCASIAN; 1% HISPANIC; AND 5% OTHER. THE GENDER SPLIT RATIO IS 50% WOMEN AND 50% MEN. THE AVERAGE INCOME FOR THE SERVICE AREA IS APPROXIMATELY $53,000. ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, AS PART OF ESSENTIA HEALTH, IS COMMITTED TO SERVE PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. APPROXIMATELY 1.3% GROSS REVENUE DOLLARS WERE FROM SELF-PAY PATIENTS AND 15.2% FROM MEDICAID RECIPIENTS. CASS COUNTY IS CURRENTLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA. AS MENTIONED ABOVE, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER IS PART OF ESSENTIA HEALTH. ESSENTIA HEALTH STAFFS HOSPITALS AND CLINICS IN FEDERALLY-RECOGNIZED UNDERSERVED AREAS AND SUPPORTS THE HEALTH OF ITS COMMUNITIES THROUGH AN ACTIVE OUTREACH PROGRAM THAT BRINGS SPECIALISTS LIKE ONCOLOGISTS, CARDIOLOGISTS, NEUROLOGISTS, AND OTHERS INTO ITS SMALLER COMMUNITIES. THIS ELIMINATES BARRIERS TO CARE FOR MANY PATIENTS, PARTICULARLY THOSE WHO ARE ELDERLY, LIVING ON LOW INCOMES, OR ARE FACED WITH OTHER CHALLENGES THAT MAKE IT DIFFICULT TO TRAVEL LONG DISTANCES FOR CARE. THERE ARE 3 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 BRAINERD LAKES INTEGRATED HEALTH SYSTEM GOVERNING BOARD, IN ACCORDANCE WITH THE RESERVED POWERS, 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 HEALTHCARE VOCATIONS.WE REINVEST IN THE ORGANIZATION BY ACQUIRING THE LATEST STATE-OF-THE-ART EQUIPMENT AND BY INVESTING IN PROGRAMS THAT ARE NEEDED IN OUR COMMUNITY.IN ADDITION TO THE ACTIVITIES LISTED IN PART I, LINE 7 AS WELL AS PART V, SECTION B, LINE 11, THE ORGANIZATION SUPPORTS THE HEALTH AND VITALITY OF OUR COMMUNITIES THROUGH A SPECIAL DEDICATION TO MAKING A DIFFERENCE IN AREAS THAT POSITIVELY IMPACT THE SOCIAL DETERMINANTS OF HEALTH. WE MAKE SIGNIFICANT CONTRIBUTIONS TO COMMUNITY NON-PROFITS WORKING TO IMPROVE HOUSING, ACCESS TO HEALTHY FOODS AND HEALTHY YOUTH DEVELOPMENT. ADDITIONALLY, WE ENCOURAGE OUR COLLEAGUES TO CONTRIBUTE THEIR TIME IN MEANINGFUL WAYS THROUGH A FORMAL EMPLOYEE VOLUNTEER PROGRAM THAT INCENTIVIZES COMMUNITY VOLUNTEERING BY PROVIDING A $100 DONATION TO A NONPROFIT OF THE EMPLOYEE'S CHOICE AFTER VOLUNTEERING AT LEAST 20 HOURS. IN FY23, MORE THAN 18,000 IMPACTFUL VOLUNTEER HOURS WERE REPORTED FOR ESSENTIA HEALTH COLLEAGUES. OUR LEADERS ARE ACTIVELY ENGAGED IN LENDING THEIR EXPERTISE ON COMMUNITY BOARDS, INCLUDING WORKFORCE DEVELOPMENT EFFORTS THAT CONTRIBUTE TO THE ECONOMIC VITALITY OF OUR REGION. LASTLY, THE HOSPITAL ENGAGES COMMUNITIES IN COMING TOGETHER AND CREATING SOCIAL CONNECTIVITY THROUGH SUPPORT OF VARIOUS LOCAL EVENTS, FUNDRAISERS, AND OUTINGS, MANY OF WHICH INVOLVE PHYSICAL ACTIVITY AND SUPPORT BUSINESSES THAT ENHANCE THE VIABILITY OF OUR COMMUNITIES.ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER IS A PART OF ESSENTIA HEALTH, A FULLY INTEGRATED HEALTH SYSTEM WITH FACILITIES IN MINNESOTA, WISCONSIN, AND NORTH DAKOTA. AS A NON-PROFIT ORGANIZATION, ESSENTIA HEALTH REINVESTS SURPLUS REVENUES INTO MEDICAL TRAINING, PROGRAMS, AND TECHNOLOGY DESIGNED TO REDUCE THE RISK OF PREVENTABLE HARM TO OUR PATIENTS AND INCREASE THE HEALTH AND VITALITY OF THE COMMUNITIES WE SERVE.ESSENTIA HEALTH PROVIDES SERVICES PREDOMINANTLY IN RURAL COMMUNITIES AND IS COMMITTED TO ELIMINATING GEOGRAPHIC BARRIERS TO CARE. MANY OF ESSENTIA HEALTH'S CLINICS AND COMMUNITY HOSPITALS ARE LOCATED IN COMMUNITIES THAT ARE FEDERALLY RECOGNIZED AS BEING MEDICALLY UNDERSERVED. WE INVEST IN FACILITY UPGRADES, TECHNOLOGY, AND STAFFING THAT ENHANCE CARE IN THESE COMMUNITIES TO ENSURE PATIENTS CAN RECEIVE AS MUCH CARE AS POSSIBLE CLOSE TO HOME. THIS IS A VITAL COMPONENT OF COMMUNITY HEALTH IN AREAS WHERE RESIDENTS ARE OFTEN ELDERLY, LIVING ON LIMITED INCOMES, AND RESTRICTED IN THEIR TRANSPORTATION OPTIONS.RESIDENTS OF GEOGRAPHICALLY ISOLATED COMMUNITIES SERVED BY ESSENTIA HEALTH ALSO BENEFIT FROM TELEHEALTH SERVICES THAT PROVIDE LOCAL ACCESS TO SPECIALISTS AND SPECIALTY SERVICES USUALLY AVAILABLE ONLY IN LARGER URBAN AREAS. SERVICES ARE AVAILABLE IN MORE THAN 30 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 20 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.SINCE MOST HEALTH CARE COSTS ARE DIRECTLY RELATED TO CARING FOR PATIENTS WHO HAVE CHRONIC CONDITIONS, ESSENTIA HEALTH IS COMMITTED TO IMPROVING HEALTH OUTCOMES FOR PATIENTS, ESPECIALLY THOSE WITH CHRONIC DISEASES. FOR EXAMPLE, ESSENTIA HEALTH OFFERS ONE-ON-ONE TOBACCO CESSATION COUNSELING AT NEARLY 30 SITES ACROSS MINNESOTA, WISCONSIN, AND NORTH DAKOTA. THESE SITES COVER A WIDE GEOGRAPHY, FROM SMALL RURAL COMMUNITIES TO LARGER URBAN AREAS, AND OFTEN SERVE 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.ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND IMPROVING HEALTH EQUITY IS A KEY FOCUS FOR ESSENTIA HEALTH AS WELL. ACROSS OUR SERVICE AREA, FOOD INSECURITY REMAINS A PROBLEM WITH SOME COUNTIES SEEING AS HIGH AS 18% OF THE POPULATION WITH FOOD INSECURITY COMPARED TO THE MINNESOTA STATE AVERAGE OF 10%. A FIVE-QUESTION "SOCIAL NEEDS" QUESTIONNAIRE IS SENT TO ALL PRIMARY CARE AND PEDIATRIC PATIENTS THROUGH MYCHART, WHICH OFFERS PATIENTS SECURE, 24/7 ONLINE ACCESS TO THEIR MEDICAL RECORD. PATIENTS WHO ANSWER THAT THEY HAVE A SOCIAL-DETERMINANT NEED AND WOULD LIKE SUPPORT ARE CONNECTED WITH OUR COMMUNITY CARE ASSOCIATES AND COMMUNITY HEALTH WORKERS. THESE ESSENTIA HEALTH COLLEAGUES DEVELOP A TRUSTING RELATIONSHIP WITH PATIENTS, MAKE REFERRALS TO CONNECT THEM WITH SERVICES, AND FOLLOW UP WITH THEM TO ENSURE NEW RESOURCES AND REFERRALS ARE HELPFUL.IN 2021, ESSENTIA HEALTH PARTNERED WITH FIND HELP TO PROVIDE A FREE ONLINE RESOURCE GUIDE (WEARERESOURCEFUL.ORG) TO HELP OUR COMMUNITY MEMBERS FIND FREE AND REDUCED COST SERVICES. RESOURCEFUL HELPS PEOPLE CONNECT TO SOCIAL SERVICE PROGRAMS, INCLUDING FOOD, SHELTER, HEALTH CARE, WORK, TRANSPORTATION, FINANCIAL ASSISTANCE AND OTHER RESOURCES. RESOURCEFUL IS USED BY OUR CARE TEAM MEMBERS TO PLACE AND TRACK REFERRALS TO COMMUNITY RESOURCES. IT'S ALSO USED BEYOND THE WALLS OF OUR HOSPITALS AND CLINICS BY COMMUNITY ORGANIZATIONS, HELPERS AND NAVIGATORS, FAMILIES, AND INDIVIDUALS FOR FREE. AS OF SPRING 2023, MORE THAN 13,000 REFERRALS TO COMMUNITY RESOURCES HAD BEEN PLACED THROUGH THE PLATFORM.ADDITIONALLY, ESSENTIA HEALTH SUPPORTS THE HEALTH OF OUR COMMUNITIES THROUGH ACTIVE RESEARCH AND CLINICAL TRIALS THROUGH THE ESSENTIA INSTITUTE OF RURAL HEALTH (INSTITUTE). THE INSTITUTE CONDUCTS CLINICAL, TRANSLATIONAL, AND HEALTH SERVICES RESEARCH WITH A PRIMARY FOCUS ON THE NEEDS OF RURAL AMERICANS. VARIOUS ESSENTIA HEALTH ORGANIZATIONS CONTRIBUTED APPROXIMATELY $3.8 MILLION IN SUPPORT TO THE INSTITUTE DURING THE PAST YEAR. ESSENTIA HEALTH IS ALSO A PRIMARY SUPPORTER OF MEDICAL EDUCATION, PARTICULARLY IN THE AREA OF RURAL PRIMARY CARE. ESSENTIA HEALTH PHYSICIANS SERVE AS FACULTY AND PRECEPTORS FOR THE UNIVERSITY OF MINNESOTA SCHOOL OF MEDICINE IN DULUTH, MN. ESSENTIA HEALTH ALSO PROVIDES FUNDING, ADMINISTRATIVE SUPPORT, AND RESIDENCY OPPORTUNITIES FOR THE DULUTH FAMILY PRACTICE RESIDENCY PROGRAM. THIS PROGRAM IS VITAL IN ADDRESSING THE GROWING SHORTAGE OF PRIMARY CARE PHYSICIANS IN RURAL COMMUNITIES. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER IS PART OF ESSENTIA HEALTH, A FULLY INTEGRATED HEALTH SYSTEM WITH 14 HOSPITALS, APPROXIMATELY 78 CLINICS, SIX LONG-TERM CARE FACILITIES, TWO ASSISTED LIVING FACILITIES, THREE INDEPENDENT LIVING FACILITIES, SEVERAL REHABILITATION CENTERS, SEVEN AMBULANCE SERVICES, 27 RETAIL PHARMACIES, ONE RESEARCH INSTITUTE, AND HOME HEALTH SERVICES IN THREE STATES: MINNESOTA, WISCONSIN, AND NORTH DAKOTA. ESSENTIA HEALTH SERVES A PREDOMINANTLY RURAL POPULATION WHOSE MEDIAN INCOMES GENERALLY FALL BELOW THE AVERAGES OF THE STATES WHERE THEY LIVE. THE PRESENCE OF OUR CLINICS AND HOSPITALS ENSURES THAT PEOPLE WITH FEW ECONOMIC RESOURCES DO NOT HAVE TO DRIVE AN HOUR OR MORE TO RECEIVE BASIC (AND IN SOME CASES LIFESAVING) MEDICAL CARE.IN ADDITION TO STAFFING HOSPITALS AND CLINICS IN FEDERALLY RECOGNIZED UNDERSERVED AREAS, ESSENTIA HEALTH SUPPORTS THE HEALTH OF COMMUNITIES THROUGH ACTIVE OUTREACH PROGRAMS THAT BRING ONCOLOGISTS, CARDIOLOGISTS, AND OTHERS INTO SMALL HOSPITALS AND CLINICS. ESSENTIA HEALTH'S SIZE AND INTEGRATED STRUCTURE ALSO ALLOW THE ORGANIZATION TO EXTEND SERVICES LIKE CHEMOTHERAPY, WOUND CARE, AND HOSPICE CARE TO SMALLER COMMUNITIES.PATIENTS ARE ABLE TO TRAVEL SEAMLESSLY BETWEEN ESSENTIA HEALTH'S SMALLER COMMUNITY CLINICS AND ITS LARGER SPECIALTY CARE CENTERS THANKS TO SIGNIFICANT INVESTMENTS IN ELECTRONIC HEALTH RECORDS (EHRS). ALMOST EVERY ESSENTIA HEALTH HOSPITAL AND CLINIC IS LINKED TO THIS SYSTEM, ALLOWING CLINICIANS TO SHARE EVERYTHING FROM LAB RESULTS AND RADIOLOGY IMAGES TO NOTES ON CLINIC VISITS, HOSPITAL STAYS, AND SERVICES LIKE PHYSICAL REHABILITATION.THE EHR IS ALSO AN INCREASINGLY VALUABLE TOOL FOR PATIENTS AND THEIR FAMILIES, THANKS TO MYCHART, WHICH OFFERS PATIENTS SECURE, 24/7 ONLINE ACCESS TO THEIR MEDICAL RECORD. MYCHART ALSO ALLOWS PATIENTS TO CONTACT THEIR PHYSICIAN OR CLINIC, SCHEDULE APPOINTMENTS, AND ORDER MEDICATION REFILLS. THESE SERVICES ARE ALL OFFERED AT NO COST TO PATIENTS AND THEIR AUTHORIZED FAMILY, FRIENDS, AND CAREGIVERS.ESSENTIA HEALTH ALSO PROMOTES THE HEALTH OF ALL OF ITS COMMUNITIES THROUGH ADHERENCE TO EVIDENCE-BASED BEST PRACTICE STANDARDS AND CLINICAL QUALITY GOALS DESIGNED TO ENSURE THAT PATIENTS RECEIVE THE SAME HIGH STANDARD OF CARE AT ANY ESSENTIA HEALTH HOSPITAL OR CLINIC.THE ESSENTIA INSTITUTE OF RURAL HEALTH (INSTITUTE) ACTIVELY SUPPORTS COMMUNITY HEALTH THROUGH ITS TRANSLATIONAL AND HEALTH SERVICES RESEARCH WITH A PRIMARY FOCUS ON THE NEEDS OF RURAL AMERICANS. THE INSTITUTE ALSO SPONSORS A NUMBER OF CONFERENCES AND OTHER EDUCATIONAL EVENTS, OPEN TO ALL MEDICAL PROFESSIONALS IN THE REGION, TO ENSURE THAT RURAL CLINICIANS HAVE ACCESS TO CURRENT MEDICAL EDUCATION AND TRAINING CLOSE TO HOME.TELEHEALTH ALLOWS PATIENTS TO RECEIVE CARE FROM A SPECIALIST WHO IS NOT AVAILABLE IN THEIR HOME COMMUNITY. TELEHEALTH APPOINTMENTS TAKE PLACE IN LOCAL CLINICS OR HOSPITALS THROUGH SECURE INTERACTIVE VIDEOCONFERENCING. PATIENTS FEEL LIKE THEY ARE IN THE SAME ROOM AS THEIR DOCTOR. THIS EXPERIENCE OFFERS THE SAME HIGH-QUALITY CARE THAT PATIENTS EXPECT DURING AN IN-PERSON VISIT. TELEHEALTH CAN BE USED FOR SERVICES SUCH AS BEHAVIORAL HEALTH, CARDIOLOGY, STROKE CARE, PRIMARY CARE, AND ENDOCRINOLOGY/DIABETES CARE. IN ADDITION, PATIENTS CAN RECEIVE THE CARE THEY NEED WHERE AND WHEN THEY WANT IT. ESSENTIA OFFERS 24/7 VIDEO VISITS ON DEMAND FOR URGENT NEEDS ANY TIME, ONLINE E-VISITS FOR MORE THAN 20 COMMON CONDITIONS AND FREE MEDICAL ADVICE FROM OUR REGISTERED NURSES ANY TIME OF THE DAY OR NIGHT THROUGH OUR NURSE CARE LINE.ESSENTIA HEALTH'S HOSPITALS AND CLINICS PLAY ADDITIONAL ROLES IN PROMOTING HEALTH WITHIN THEIR COMMUNITIES. EACH ESSENTIA HEALTH HOSPITAL CONDUCTS A COMMUNITY HEALTH ASSESSMENT TO DETERMINE THE UNIQUE HEALTH NEEDS OF COMMUNITY RESIDENTS. THESE ASSESSMENTS, WHICH ARE BASED ON INPUT FROM A BROAD RANGE OF COMMUNITY RESIDENTS AND STAKEHOLDERS, ARE THE BASIS FOR ACTION PLANS AIMED AT ADDRESSING THE COMMUNITY'S MOST PRESSING HEALTH NEEDS. MOST RECENTLY, TOPICS OF CONCERN HAVE INCLUDED ELIMINATING SOCIAL AND ECONOMIC BARRIERS TO HEALTH AND WELLNESS, IMPROVING MENTAL HEALTH SERVICES AND AWARENESS, ADDRESSING YOUTH SUBSTANCE ABUSE, FOOD INSECURITY, AND OBESITY. THESE ISSUES ARE THEN ADDRESSED THROUGH COLLABORATION WITH PRIVATE BUSINESSES, GOVERNMENT AGENCIES, AND OTHER NON-PROFITS.CURRENTLY, TWO OF THE MOST PROMINENT COLLABORATIONS ARE WITH CROW WING ENERGIZED AND BRIDGING HEALTH DULUTH, JOINT PUBLIC-PRIVATE PARTNERSHIPS AIMED AT IMPROVING THE OVERALL HEALTH STATUS OF THESE COMMUNITIES THROUGH COORDINATED PROGRAMMING AIMED AT LIFESTYLE ISSUES RANGING FROM EXERCISE TO HEALTHY EATING TO ADDRESS SOCIAL DETERMINANTS OF HEALTH.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, AND DULUTH, 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 1 ESSENTIA HEALTH FOUNDATION 502 E 2ND ST DULUTH MN 55805 271984704 501(C)(3) 295564 0 PROGRAM SUPPORT WONDERTREK CHILDREN'S MUSEUM FRANKLIN ARTS CENTER 1001 KINGWOOD ST BRAINERD MN 56401 832715287 501(C)(3) 25000 0 PROGRAM SUPPORT 2 0 PART I, LINE 2: PROCEDURES FOR MONITORING USE OF GRANT FUNDS: ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER'S MANAGEMENT REVIEWS THE GRANT ACTIVITY BY REVIEWING AND DOCUMENTING EACH EXPENDITURE REQUEST AND APPROVING THE EXPENSE. X 1 1 X X X X 1 1 0 0 0 0 0 0 0 JON PRYOR MD PRESIDENT THRU 1/23 0 785922 0 331316 0 14097 0 24400 0 13430 0 1169165 0 0 WILLIAM HEEGAARD PRESIDENT 0 623417 0 267196 0 11484 0 101311 0 37098 0 1040506 0 0 KEVIN CASEY MD CHIEF MEDICAL OFFICER 0 633232 0 168938 0 14637 0 107120 0 23382 0 947309 0 0 PETER HENRY MD CHIEF MEDICAL OFFICER THRU 6/22 0 297901 0 239408 0 73994 0 46852 0 13726 0 671881 0 66403 KEVIN BOREN VICE PRESIDENT, FINANCE 0 394711 0 85550 0 48191 0 49069 0 39942 0 617463 0 32212 KRISTA SKORUPA MD INTERIM PRESIDENT 0 336583 0 143215 0 53610 0 54798 0 15033 0 603239 0 0 MICHAEL LARSON SENIOR VP, OPERATIONS THRU 6/23 311357 0 132526 0 27250 0 50689 0 25671 0 547493 0 20200 0 NATHAN LAPOSKY MD BOARD DIRECTOR 0 472180 0 0 0 564 0 24400 0 36393 0 533537 0 0 JARED REESE MD BOARD DIRECTOR 0 318749 0 0 0 300 0 24210 0 35622 0 378881 0 0 JANELLE TEPPER CRNA MANAGER 254918 0 0 0 377 0 13458 0 36747 0 305500 0 0 0 JESSE LIND CRNA 242099 0 0 0 310 0 12817 0 36832 0 292058 0 0 0 SANDY ZUTZ-WICZEK VICE PRESIDENT, CLINIC OPERATIONS 0 219816 0 23803 0 8676 0 0 0 33152 0 285447 0 0 SAMUEL BRANDL CRNA 266072 0 0 0 207 0 11588 0 1074 0 278941 0 0 0 MELISSA MCKAY REGIONAL NURSING DIRECTOR 217511 0 10000 0 205 0 11773 0 32504 0 271993 0 0 0 KACIE WOTTRENG CRNA 236022 0 0 0 186 0 11801 0 1478 0 249487 0 0 0 DEAN COCHRANE CRNA 231079 0 0 0 476 0 0 0 13643 0 245198 0 0 0 JESSICA TABATT MD BOARD DIRECTOR 0 219419 0 0 0 173 0 17610 0 1518 0 238720 0 0 JOHN SPERRAZZA SENIOR VP, OPERATIONS THRU 5/22 94812 33463 0 0 77310 1615 4016 0 404 152 176542 35230 0 0 PART I, LINE 1A BENEFITS PROVIDED: DURING CALENDAR YEAR 2022, KEY EMPLOYEE JOHN SPERRAZZA RECEIVED A HOUSING ALLOWANCE. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION. PART I, LINE 3 METHODS USED TO ESTABLISH CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER'S PRESIDENT'S COMPENSATION: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B SEVERANCE PAYMENT: KEY EMPLOYEE JOHN SPERRAZZA RECEIVED PAYMENTS TOTALING $72,504 IN CALENDAR YEAR 2022 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, SPERRAZZA RECEIVED ALL SEVERANCE PAYMENTS DURING CALENDAR YEAR 2022. 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: PETER HENRY, MD $66,403 KEVIN BOREN $32,212 MICHAEL LARSON $20,200 REPORTED AS RETIREMENT AND OTHER DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C, ESSENTIA HEALTH MADE CONTRIBUTIONS, SUBJECT TO THE VESTING TERMS, DURING THE YEAR INTO THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A: WILLIAM HEEGAARD, MD $78,203 KEVIN CASEY, MD $107,120 PETER HENRY, MD $22,946 KEVIN BOREN $24,669 KRISTA SKORUPA, MD $30,398 MICHAEL LARSON $26,289 A DULUTH ECONOMIC DEVELOPMENT AUTHORITY 900848286 26444CHF2 2018-11-01 704253406 SRS 2018A BONDS (SEE PART VI) 0 0 0 B DULUTH ECONOMIC DEVELOPMENT AUTHORITY 900848286 000000000 2020-05-15 65000000 SRS 2020D BONDS (SEE PART VI) 0 0 0 C MN AGRICULTURAL AND ECONOMIC DEVELOPMENT BRD 416007162 000000000 2023-06-22 44585000 SERIES 2023C (SEE PART VI) 0 0 0 A 12027408 103982 11923425 1 0 1 1 B 389538 6000000 39888 5599030 361082 0 0 0 1 C 9319336 58721 830863 8429752 0 0 0 1 A 0 1 0 0 0.00500 0.00000 0.00500 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 1 SEE PART IV 1 1 1 B 0 1 0 0 0 0 0 1 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: DULUTH ECONOMIC DEVELOPMENT AUTHORITY 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, BRAINERD LAKES INTEGRATED HEALTH SYSTEM, 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, BRAINERD LAKES INTEGRATED HEALTH SYSTEM, 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 2020D: THE SERIES 2020D BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, ESSENTIA HEALTH EAST, AND BRAINERD LAKES INTEGRATED HEALTH SYSTEM ARE THE CONDUIT BORROWERS OF THE SERIES 2020D BONDS. THE OBLIGATED GROUP MEMBERS ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ARE INDIRECT BENEFICIARIES OF THE SERIES 2020D BORROWING AND HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2023C: THE SERIES 2023C BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2023C BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH 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. 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 2020D: ACQUIRE, CONSTRUCT, RENOVATE, AND EQUIP CERTAIN HEALTH FACILITIES IN DULUTH, CLOQUET, PARK RAPIDS, AND PINE RIVER, MN. SERIES 2023C: ACQUIRE, CONSTRUCT, RENOVATE, AND EQUIP CERTAIN HEALTH FACILITIES IN ESKO AND STAPLES, MN. SCHEDULE K, PART II, LINE 3: ISSUE PRICE: SERIES 2018A, SERIES 2020D, AND SERIES 2023C BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. THE ISSUE PRICE LISTED IN ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER'S SCHEDULE K, PART I, COLUMN (E) REPRESENTS THE ESSENTIA HEALTH OBLIGATED GROUP'S TOTAL BORROWING. IN ADDITION, THE SERIES 2023C TOTAL PROCEEDS ARE NOT IDENTICAL TO THE ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. SCHEDULE K, PART II, LINES 3 THROUGH 12: PROCEEDS: SERIES 2018A, SERIES 2020D, AND SERIES 2023C BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. A PORTION OF THE SERIES 2018A, SERIES 2020D, AND SERIES 2023C BORROWINGS WERE ALLOCATED TO ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, AN ESSENTIA HEALTH OBLIGATED GROUP MEMBER. THE PROCEEDS LISTED IN ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER'S SCHEDULE K, PART II, LINES 3 THROUGH 12 REPRESENT ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER'S ALLOCATED PORTION OF THE PROCEEDS. SCHEDULE K, PART IV, LINE 5B: NAME OF PROVIDER OF GIC: NATIXIS FUNDING CORP & THE TORONTO-DOMINION BANK MISSY LAPOSKY RELATED TO NATHAN LAPOSKY 91146 COMPENSATION OF FAMILY MEMBER OF BOARD DIRECTOR 0 MATTHEW SOUKUP RELATED TO KRISTA SOUKUP 12245 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 6 MEMBERS OF ORGANIZATION: BRAINERD LAKES INTEGRATED HEALTH SYSTEM IS THE SOLE MEMBER OF ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER. ESSENTIA HEALTH HAS RESERVED POWERS WITH RESPECT TO ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER AS DESCRIBED IN SCHEDULE O, PART VI, LINES 7A & 7B. BENEDICTINE SISTERS BENEVOLENT ASSOCIATION AND BRAINERD LAKES INTEGRATED HEALTH SYSTEM ALSO HAVE RESERVED POWERS WITH RESPECT TO ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7B. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS WITH RIGHT TO ELECT GOVERNING BODY: ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER'S GOVERNING BODY CONSISTS OF THE SAME INDIVIDUALS SERVING ON BRAINERD LAKES INTEGRATED HEALTH SYSTEM'S BOARD OF DIRECTORS. ESSENTIA HEALTH, AS THE SOLE MEMBER OF BRAINERD LAKES INTEGRATED HEALTH SYSTEM, APPOINTS AND REMOVES BRAINERD LAKES INTEGRATED HEALTH SYSTEM'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS WITH RIGHT TO APPROVE GOVERNING BODY DECISION: ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER IS A SUBSIDIARY OF ESSENTIA HEALTH, WHOSE BOARD OF DIRECTORS HAS RESERVED POWERS WITH RESPECT TO THIS CORPORATION AND ITS SUBSIDIARIES, AND ALL OF THE OTHER DIRECT AND INDIRECT SUBSIDIARIES OF ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"). ESSENTIA HEALTH'S RESERVED POWERS ARE AS FOLLOWS: STRATEGIC AND BUSINESS PLANS. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S STRATEGIC AND BUSINESS PLANS. MISSION. AUTHORITY TO CREATE, AND TO APPROVE, THE MISSION, PURPOSE AND VISION STATEMENTS FOR ALL ENTITIES IN THE SYSTEM BY THE AFFIRMATIVE VOTE OF AT LEAST 67% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS. DEBT. APPROVAL OF THE INCURRENCE OF DEBT BY, AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE ASSETS OF, ALL ENTITIES IN THE SYSTEM IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS, AND THE AUTHORITY TO CAUSE ALL ENTITIES IN THE SYSTEM TO PARTICIPATE IN SYSTEM BORROWING. GOVERNING INSTRUMENTS. AUTHORITY TO CAUSE, AND TO APPROVE, AMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS AND/OR CERTIFICATES OF FORMATION AND OPERATING AGREEMENTS OF ALL ENTITIES IN THE SYSTEM. MERGERS AND ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF ALL ENTITIES IN THE SYSTEM. AFFILIATIONS AND JOINT VENTURES. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES WITH THIRD PARTIES OF ALL ENTITIES IN THE SYSTEM. TRANSFER OF ASSETS WITHIN THE SYSTEM. AUTHORITY TO TRANSFER ASSETS, INCLUDING CASH, BETWEEN AND AMONG ENTITIES WITHIN THE SYSTEM; PROVIDED, HOWEVER, THAT ESSENTIA HEALTH SHALL NOT HAVE AUTHORITY TO REQUIRE ANY ENTITY IN THE SYSTEM TO TRANSFER ASSETS (A) THAT WOULD CAUSE SUCH ENTITY TO BE IN DEFAULT OF ITS COVENANTS OR OBLIGATIONS UNDER ANY BOND OR OTHER FINANCING DOCUMENTS; (B) 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 (C) SUCH THAT MONEY GENERATED BY SERVICES AT SECULAR FACILITIES WITHIN THE SYSTEM BY PROCEDURES THAT ARE CONTRARY TO THE ERDS WOULD BE USED AT THE CATHOLIC ENTITIES OR MONEY GENERATED BY CATHOLIC ENTITIES WOULD BE USED IN THE PROVIDING OF SERVICES CONTRARY TO THE ERDS AT SECULAR FACILITIES WITHIN THE SYSTEM. TRANSFER OF ASSETS OUTSIDE THE SYSTEM. AUTHORITY TO CAUSE, AND TO APPROVE, THE SALE, LEASE OR OTHER TRANSFER OF ASSETS OF ALL ENTITIES IN THE SYSTEM TO PARTIES OUTSIDE OF THE SYSTEM WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS. SERVICES. AUTHORITY TO CAUSE, AND TO APPROVE, THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS WITHIN ALL ENTITIES IN THE SYSTEM. BUDGETS. APPROVAL OF CAPITAL AND OPERATING BUDGETS OF ALL ENTITIES IN THE SYSTEM. PROFESSIONAL SERVICES. SELECTION OF THE GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS OF ALL ENTITIES IN THE SYSTEM. ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL ACQUISITIONS BY AND FORMATIONS OF ENTITIES IN THE SYSTEM. MARKETING. AUTHORITY TO IMPLEMENT SYSTEM-WIDE MARKETING AND PROMOTIONAL ACTIVITIES. COMPLIANCE PLANS. AUTHORITY TO CREATE, AND TO APPROVE, CORPORATE COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS FOR ENTITIES WITHIN THE SYSTEM. QUALITY PLAN. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S QUALITY PLAN. NON-BUDGETED PURCHASES. APPROVAL OF NON-BUDGETED CAPITAL PURCHASES AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY ESSENTIA HEALTH FOR ENTITIES WITHIN THE SYSTEM. HUMAN RESOURCES. AUTHORITY TO CREATE HUMAN RESOURCE POLICIES AND PROCEDURES WITHIN THE SYSTEM. RESERVED POWERS. AUTHORITY TO CREATE ADDITIONAL ESSENTIA HEALTH RESERVED POWERS BY THE AFFIRMATIVE VOTE OF AT LEAST 80% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS (EXCLUDING THE ESSENTIA HEALTH CEO); PROVIDED, HOWEVER, THAT ANY ADDITIONAL ESSENTIA HEALTH RESERVED POWERS SHALL NOT CONTRAVENE OR HINDER THE RESERVED POWERS OF BENEDICTINE SISTERS BENEVOLENT ASSOCIATION. THE BENEDICTINE SISTERS BENEVOLENT ASSOCIATION ("BSBA") ALSO HAS CERTAIN RESERVED POWERS OVER ESSENTIA HEALTH'S CATHOLIC FACILITIES. BSBA'S RESERVED POWERS ARE AS FOLLOWS: MISSION. AUTHORITY TO APPROVE THE MISSION AND PURPOSE STATEMENTS FOR CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM. *ADHERENCE TO ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS). AUTHORITY TO APPROVE THE METHODS, POLICIES AND PROCEDURES PERTAINING TO THE ADHERENCE OF CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM, TO THE ERDS. *OFFICIAL CATHOLIC DIRECTORY. AUTHORITY TO OVERSEE THE LISTING OF QUALIFIED ENTITIES AND FACILITIES WITHIN THE SYSTEM IN THE OFFICIAL CATHOLIC DIRECTORY, SUBJECT TO THE APPROVAL OF APPLICABLE CATHOLIC AUTHORITIES. *CATHOLIC HEALTH ASSOCIATION. AUTHORITY TO REQUIRE CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM TO JOIN THE MEMBERSHIP OF THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES. ALIENATION OF STABLE PATRIMONY OR ECCLESIASTICAL GOODS. AUTHORITY TO APPROVE ALIENATION OF EITHER STABLE PATRIMONY OR OTHER ECCLESIASTICAL GOODS WITHIN THE SYSTEM IF SUCH GOODS INVOLVED IN A SPECIFIC TRANSACTION APPROVED BY ESSENTIA HEALTH PURSUANT TO THE AFFILIATION AGREEMENT HAVE A DOLLAR VALUE EQUAL TO OR GREATER THAN 70% OF THE AMOUNT ESTABLISHED FROM TIME TO TIME THAT REQUIRES APPROVAL FROM THE HOLY SEE; PROVIDED, HOWEVER, THAT IT IS THE INTENT OF THE PARTIES THAT THIS PROVISION NOT BE APPLIED TO RESTRICT OR TO IMPEDE ESSENTIA HEALTH FROM ACTING AND MAKING DECISIONS ON BEHALF OF THE SYSTEM IN THE ORDINARY COURSE OF BUSINESS BUT BE APPLIED TO PREVENT THE TRANSFER OF SUBSTANTIAL ASSETS OF CATHOLIC ENTITIES WITHIN THE SYSTEM TO SUPPORT THE SECULAR ENTITIES WITHIN THE SYSTEM WITHOUT THE PRIOR APPROVAL OF BSBA. *MISSION EFFECTIVENESS. AUTHORITY TO APPROVE ANNUAL PLANS AND EVALUATIONS RELATING TO MISSION EFFECTIVENESS AND CHAPLAINCY FOR CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM, INCLUDING THE USE OF RELIGIOUS SYMBOLS AND PRAYERS. AMENDMENTS. AUTHORITY TO APPROVE ANY AMENDMENTS TO THE GOVERNING DOCUMENTS OF ESSENTIA HEALTH, ESSENTIA HEALTH EAST (SMDC), ESSENTIA HEALTH CENTRAL (BLIHS), ESSENTIA HEALTH WEST (INNOVIS) OR CRITICAL ACCESS GROUP (CAG), THAT WOULD ALTER THE NUMBER OF DULUTH BENEDICTINES OR BSBA BOARD OF DIRECTOR MEMBERS OR OTHER APPOINTEES OF THE DULUTH BENEDICTINES SERVING AS MEMBERS OF SUCH ENTITY'S BOARD OF DIRECTORS; AUTHORITY TO APPROVE ANY AMENDMENTS TO THE GOVERNING DOCUMENTS OF THE CATHOLIC CAG SUBSIDIARIES, THE CATHOLIC SMDC SUBSIDIARIES, THE CATHOLIC BLIHS SUBSIDIARIES OR THE CATHOLIC SUBSIDIARIES OF INNOVIS, WHICH COULD MATERIALLY AFFECT SUCH ENTITY'S IDENTITY AS A CATHOLIC INSTITUTION, INCLUDING WITHOUT LIMITATION ANY AMENDMENT THAT WOULD ALTER THE NUMBER OF DULUTH BENEDICTINES OR BSBA BOARD OF DIRECTOR MEMBERS OR OTHER APPOINTEES OF THE DULUTH BENEDICTINES SERVING AS MEMBERS OF SUCH ENTITY'S BOARD OF DIRECTORS, AND AUTHORITY TO CAUSE ESSENTIA HEALTH TO MAKE AMENDMENTS TO THE GOVERNING DOCUMENTS OF THE CATHOLIC SUBSIDIARIES OF ESSENTIA HEALTH'S DIRECT SUBSIDIARIES, WHICH AMENDMENTS BSBA DETERMINES IN GOOD FAITH ARE NECESSARY TO PRESERVE SUCH ENTITY'S IDENTITY AS A CATHOLIC INSTITUTION. MERGERS AND DISSOLUTION. SUBJECT TO THE APPROVAL OF THE DULUTH BENEDICTINES, AUTHORITY TO APPROVE A PROPOSED MERGER, CONSOLIDATION, LIQUIDATION, OR DISSOLUTION OF ST. MARY'S MEDICAL CENTER (SMMC) AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER (SJMC) OR THE DISPOSITION OF ALL OR SUBSTANTIALLY ALL THE ASSETS OF SMMC AND SJMC. BSBA SPONSORSHIP. AUTHORITY TO ESTABLISH, ACCEPT, TRANSFER OR TERMINATE BSBA SPONSORSHIP OR CO-SPONSORSHIP OF A HEALTHCARE FACILITY. *RESERVED POWER CURRENTLY DELEGATED TO THE SPONSORSHIP COUNCIL. NOTE: SOME OF THE RESERVED POWERS OF THE BSBA BOARD LISTED ABOVE MAY ALSO BE RESERVED TO THE CHAPTER OF THE BSBA. PRIOR TO THESE MATTERS GOING TO THE BSBA CHAPTER, ORDINARILY THEY WILL BE CONSIDERED AND ACTED UPON BY THE BSBA BOARD. THE FOLLOWING ACTIONS OF THE BSBA BOARD ARE SUBJECT TO APPROVAL BY THE BSBA CHAPTER: 1. APPROVE MERGERS, CONSOLIDATIONS, LIQUIDATIONS, OR DISSOLUTIONS INVOLVING SMMC OR SJMC. 2. APPROVE THE ACQUISITION OR DISPOSITION OF REAL ESTATE OWNED BY BSBA. 3. APPROVE DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, ASSETS OF SMMC OR SJMC. 4. APPROVE INDEBTEDNESS THAT WILL BE GUARANTEED BY BSBA. FORM 990, PART VI, SECTION A, LINE 7B BRAINERD LAKES INTEGRATED HEALTH SYSTEM HAS THE FOLLOWING RESERVED POWERS OVER ALL ITS SUBSIDIARIES: QUALITY, SAFETY, AND SERVICE. AUTHORITY TO RECOMMEND QUALITY AND SAFETY INITIATIVES AND TO REVIEW AND EXECUTE APPROVED QUALITY AND SAFETY PLANS FOR THE CENTRAL MARKET. MISSION, VISION AND VALUES. AUTHORITY TO CREATE A MISSION AND A VISION THAT SUPPORT THE MISSION AND VISION OF ESSENTIA HEALTH; RESPONSIBILITY TO OVERSEE THE MISSION PERFORMANCE, INCLUDING CHARITY CARE, OF ALL FACILITIES WITHIN THE CENTRAL MARKET; RESPONSIBILITY TO ADOPT THE VALUES OF ESSENTIA HEALTH. OPERATING AND FINANCIAL PERFORMANCE. RESPONSIBILITY TO OVERSEE THE OPERATING AND FINANCIAL PERFORMANCE OF THE CENTRAL MARKET. DEVELOPMENT OF BUDGETS, STRATEGIC PLANS AND STRATEGY MAP. AUTHORITY TO DEVELOP AND RECOMMEND, BASED ON ESSENTIA HEALTH TARGETS, CAPITAL AND OPERATING BUDGETS FOR THE CENTRAL MARKET AND ITS FACILITIES; AUTHORITY TO RECOMMEND, WITHIN THE ESSENTIA HEALTH CONTEXT, MARKET AND LOCAL STRATEGIC PLANS FOR THE CENTRAL MARKET; AUTHORITY TO DEVELOP CENTRAL MARKET GOVERNANCE STRATEGY MAP AND BALANCED SCORECARD WITHIN ESSENTIA HEALTH'S SYSTEM STRATEGY TO MEET SYSTEM GOALS. NON-BUDGETED EXPENDITURES. AUTHORITY TO APPROVE NON-BUDGETED CAPITAL PURCHASES AND LEASES FOR CENTRAL MARKET FACILITIES WITHIN DOLLAR LIMITS DEFINED BY ESSENTIA HEALTH. ACCREDITATION AND LICENSURE. RESPONSIBILITY TO OVERSEE ACCREDITATION AND LICENSURE COMPLIANCE FOR THE FACILITIES OF THE CENTRAL MARKET. AFFILIATIONS, ACQUISITIONS AND JOINT VENTURES. AUTHORITY TO RECOMMEND PROPOSED AFFILIATIONS, ACQUISITIONS, 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 CENTRAL MARKET. APPOINTMENT OF DIRECTORS. AUTHORITY TO APPOINT OR ELECT DIRECTORS OF THE DIRECT SUBSIDIARIES SUBJECT TO THEIR BYLAWS, AND TO REMOVE DIRECTORS, WITH OR WITHOUT CAUSE. SATISFACTION. RESPONSIBILITY TO EXECUTE, EVALUATE AND OVERSEE PATIENT, FAMILY AND CUSTOMER SATISFACTION WITH RESPECT TO SERVICES PROVIDED WITHIN THE CENTRAL MARKET AND TO ENSURE ESTABLISHED GOALS ARE MET. JOB SATISFACTION. RESPONSIBILITY TO OVERSEE JOB SATISFACTION AND STAFF MORALE WITHIN THE CENTRAL MARKET FACILITIES. HUMAN RESOURCES. RESPONSIBILITY TO OVERSEE IMPLEMENTATION OF ESSENTIA HEALTH HUMAN RESOURCE POLICIES AND PROCEDURES THROUGHOUT THE CENTRAL MARKET. COMPLIANCE. RESPONSIBILITY TO EXECUTE THE APPROVED ESSENTIA HEALTH CORPORATE COMPLIANCE AND RISK MANAGEMENT PLANS FOR THE CENTRAL MARKET. CREDENTIALING. RESPONSIBILITY TO PERFORM MEDICAL STAFF CREDENTIALING FOR THE CENTRAL MARKET FACILITIES. AMENDMENTS. AUTHORITY TO SUGGEST PROPOSED AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS OF THIS CORPORATION, THE DIRECT SUBSIDIARIES, AND ANY SUBSIDIARIES THEREOF. COMPENSATION PLANS. RESPONSIBILITY TO REVIEW AND APPROVE COMPENSATION OF CENTRAL MARKET EXECUTIVES AND PHYSICIANS FOR REASONABLENESS AND CONSISTENCY WITH THE LAW AND ESSENTIA HEALTH'S COMPENSATION PHILOSOPHY. PRESIDENT/CHIEF MEDICAL OFFICER. BY ACTION OF THE PRESIDENT OF BLIHS, AUTHORITY TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CHIEF MEDICAL OFFICER OF ANY OF THE DIRECT SUBSIDIARIES. PUBLIC POLICY. RESPONSIBILITY TO SUPPORT ESSENTIA HEALTH PUBLIC POLICY AND ADVOCACY PLANS. MARKETING. RESPONSIBILITY TO COORDINATE LOCAL MARKETING AND PROMOTIONAL ACTIVITIES CONSISTENT WITH ESSENTIA HEALTH MARKETING PLANS. PHILANTHROPY. RESPONSIBILITY TO COORDINATE PHILANTHROPY CONSISTENT WITH ESSENTIA HEALTH FOUNDATION POLICIES. PROFESSIONAL SERVICES. RESPONSIBILITY TO OVERSEE CENTRAL 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. CATHOLIC FACILITIES. RESPONSIBILITY TO OVERSEE IMPLEMENTATION OF BSBA-APPROVED METHODS, POLICIES AND PROCEDURES PERTAINING TO ADHERENCE BY THE CENTRAL MARKET CATHOLIC FACILITIES WITH THE ERDS AND USE OF RELIGIOUS SYMBOLS, DISTINGUISHING ELEMENTS AND PRAYERS. 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 2022 FORM 990, INCLUDING ALL SCHEDULES, WAS REVIEWED BY MANAGEMENT AND THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. THE FINANCE LEADER REVIEWED THE FORM AND SCHEDULES AND ANY QUESTIONS WERE DISCUSSED. EACH CURRENT DIRECTOR OF THE GOVERNING BODY RECEIVED A FINAL COPY OF THE 2022 FORM 990. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCING CONFLICT OF INTEREST POLICY: ESSENTIA HEALTH'S COMPREHENSIVE CONFLICT OF INTEREST PROGRAM PREVENTS, DETECTS, AND RESOLVES ACTUAL CONFLICTS OF INTERESTS OR THE ACTUAL OR POTENTIAL APPEARANCE OF SUCH. FIDUCIARIES, DEFINED AS AN ESSENTIA HEALTH BOARD MEMBER/TRUSTEE, OFFICER, BOARD COMMITTEE MEMBER, SENIOR MANAGEMENT EMPLOYEE, OR ANY OTHERS CONSIDERED TO BE IN A POSITION OF INFLUENCE, ARE COVERED UNDER ESSENTIA HEALTH'S CONFLICT OF INTEREST PROGRAM. UPON INITIAL APPOINTMENT, EACH FIDUCIARY MUST COMPLETE AN INITIAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AT THE CONCLUSION OF EACH CALENDAR YEAR, EACH FIDUCIARY MUST COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AS NEEDED, A FIDUCIARY WILL UPDATE HIS/HER MOST RECENTLY COMPLETED QUESTIONNAIRE EACH TIME THE FIDUCIARY BECOMES AWARE OF A FINANCIAL INTEREST, A POTENTIAL CONFLICT, OR CHANGE TO ANY INFORMATION THAT THE FIDUCIARY PREVIOUSLY REPORTED. ESSENTIA HEALTH'S CHIEF COMPLIANCE OFFICER WILL COLLECT THE QUESTIONNAIRES AND EVALUATE THE DISCLOSURES. IF A FIDUCIARY HAS A POTENTIAL CONFLICT OF INTEREST, THE CHIEF COMPLIANCE OFFICER OR DESIGNEE MAY REQUEST ADDITIONAL INFORMATION FROM THE FIDUCIARY, THE MANAGEMENT TEAM, AND OTHERS. DURING THE EVALUATION PROCESS, THE CHIEF COMPLIANCE OFFICER MAY ALSO CONSULT WITH ESSENTIA HEALTH'S BOARD AND AUDIT COMMITTEE CHAIRS, SENIOR MANAGEMENT, LEGAL DEPARTMENT, OR APPROPRIATE REPRESENTATIVES FROM ESSENTIA HEALTH. THE CHIEF COMPLIANCE OFFICER REPORTS TO THE ESSENTIA HEALTH AUDIT COMMITTEE AND THE ESSENTIA HEALTH BOARD OF DIRECTORS ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY THE FIDUCIARY, ALONG WITH RECOMMENDED ACTIONS. THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) WILL THEN DETERMINE WHETHER TO APPROVE THE SITUATION OR TO IMPLEMENT SPECIAL CONTROLS TO MANAGE THE POTENTIAL CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER WILL THEN OFFICIALLY NOTIFY THE FIDUCIARY IN WRITING OF THE BOARD'S DECISION. THE DECISION OF WHETHER OR NOT THE DISCLOSURE CONSTITUTES A CONFLICT WILL BE AT THE ESSENTIA HEALTH BOARD OF DIRECTOR'S (OR DESIGNEE) SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF ESSENTIA HEALTH AND ITS AFFILIATE(S) AND THE ADVANCEMENT OF ITS PURPOSES. WHEN THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) CONSIDERS A FIDUCIARY'S DISCLOSURE AS A CONFLICT OF INTEREST, SPECIAL CONTROLS WILL BE IDENTIFIED TO MANAGE, ELIMINATE OR REDUCE THE LIKELIHOOD AND/OR APPEARANCE OF A CONFLICT ARISING. CONTROLS MAY INCLUDE, BUT ARE NOT LIMITED TO: A. IF THE CONFLICT INVOLVES AN ON-GOING MATTER OR RELATIONSHIP, THE FIDUCIARY MUST NOT PARTICIPATE IN BOARD, BOARD COMMITTEE, OR MANAGEMENT DISCUSSIONS RELATED TO THE CONFLICT AND MUST RECUSE THEMSELVES AND IF APPROPRIATE, WITHDRAW, FROM ANY BOARD MEETING OR PORTION THEREOF WHERE THE MATTER IS BEING DISCUSSED AND DURING THE VOTE ON THE POTENTIAL CONFLICT OF INTEREST. THE FIDUCIARY MAY ANSWER QUESTIONS AT THE BOARD'S OR THE BOARD COMMITTEE'S REQUEST. B. IF THE CONFLICT INVOLVES A SPECIFIC TRANSACTION OR DECISION, THE FIDUCIARY WILL FULLY DISCLOSE THEIR INTEREST AND ALL RELATED MATERIAL FACTS. THE BOARD OR COMMITTEE OF THE BOARD WILL DETERMINE WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO ESSENTIA HEALTH OR ITS AFFILIATE(S). IF THE BOARD DETERMINES A CONFLICT DOES NOT EXIST, THE FIDUCIARY MAY PROCEED WITH THE TRANSACTION; HOWEVER, HE OR SHE WILL NOT BE ELIGIBLE TO VOTE ON RELATED ISSUES SHOULD THEY ARISE. IF THE BOARD DETERMINES A CONFLICT DOES EXIST, THE FIDUCIARY WILL BE NOTIFIED OF THE DECISION REGARDING WHETHER THE CONTEMPLATED TRANSACTION WILL BE AUTHORIZED AS JUST, FAIR, AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION: THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF ESSENTIA HEALTH'S BOARD OF DIRECTORS IS AUTHORIZED TO FULFILL THE BOARD'S RESPONSIBILITIES REGARDING EXECUTIVE COMPENSATION CONSISTENT WITH ESSENTIA'S MISSION, VALUES AND TAX-EXEMPT STATUS, AND THE EXECUTIVE COMPENSATION COMMITTEE'S CHARTER. THE EXECUTIVE COMPENSATION COMMITTEE MEETS AT LEAST TWICE ANNUALLY TO CARRY OUT ITS RESPONSIBILITIES, WHICH INCLUDE, BUT ARE NOT LIMITED TO, ESTABLISHING, REVIEWING AND MODIFYING, AS APPROPRIATE, REASONABLE COMPENSATION AND BENEFITS FOR DESIGNATED ESSENTIA EXECUTIVES WHO ARE OFFICERS OR KEY EMPLOYEES OF ESSENTIA OR ANY OF ITS AFFILIATES WHICH MAY BE PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINIONS ON TOTAL COMPENSATION REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE MAY REQUEST ITS INDEPENDENT ADVISORS TO: MONITOR COMPARABILITY DATA AND MARKETPLACE TRENDS; MAKE APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES; AND PERIODICALLY REVIEW THE MARKET COMPETITIVENESS OF ESSENTIA EXECUTIVE COMPENSATION PACKAGES. PRIOR TO ESTABLISHING OR ADJUSTING EXECUTIVE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE WILL OBTAIN AND RELY UPON APPROPRIATE DATA AS TO COMPARABILITY OF THE PROPOSED COMPENSATION OR ADJUSTMENTS. THE EXECUTIVE COMPENSATION COMMITTEE WILL ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THOSE DETERMINATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MINUTES WILL INCLUDE: THE TERMS OF THE APPROVED COMPENSATION AND THE DATE APPROVED; THE EXECUTIVE COMPENSATION COMMITTEE MEMBERS PRESENT DURING THE REVIEW, DISCUSSION AND APPROVAL OF THE PROPOSED COMPENSATION AND THOSE WHO VOTED ON THE PROPOSED COMPENSATION; IDENTIFICATION OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE EXECUTIVE COMPENSATION COMMITTEE AND HOW THE DATA WAS OBTAINED; ANY ACTIONS BY A MEMBER OF THE EXECUTIVE COMPENSATION COMMITTEE HAVING A CONFLICT OF INTEREST; AND DOCUMENTATION OF THE BASIS FOR THE DETERMINATION. THE YEAR THIS PROCESS WAS LAST UNDERTAKEN FOR ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER'S PRESIDENT, CHIEF MEDICAL OFFICER, VICE PRESIDENT OF FINANCE, SENIOR VICE PRESIDENT OF OPERATIONS, AND VICE PRESIDENT OF OPERATIONS WAS 2023, AND 2022 FOR ITS REGIONAL NURSING DIRECTOR. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART IX, LINE 24D: AFFILIATE REVENUE AND EXPENSE ALLOCATION: ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, AND THE DULUTH CLINIC, LTD. ALLOCATE CERTAIN REVENUES AND EXPENSES DIRECTLY TO ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH SANDSTONE, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, ESSENTIA HEALTH NORTHERN PINES, ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER, ESSENTIA HEALTH DEER RIVER, ESSENTIA HEALTH VIRGINIA, ESSENTIA HEALTH 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 $6,649,355 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: GRANT REALLOCATION ADJUSTMENT -479. NET ASSET TRANSFER WITH RELATED ORGANIZATION -1,441,371. FORM 990, PART XII, LINE 3: CONSOLIDATED UNIFORM GUIDANCE AUDIT: ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, AS PART OF ESSENTIA HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS, WAS REQUIRED AND UNDERWENT A CONSOLIDATED AUDIT SET FORTH IN THE UNIFORM GUIDANCE, 2 C.F.R. PART 200, SUBPART F. THE CONSOLIDATED AUDIT IS REVIEWED BY THE ESSENTIA HEALTH AUDIT COMMITTEE. BRAINERD LAKES INTEGRATED HEALTH SYSTEM 2024 S 6TH ST BRAINERD MN 56401 371532145 SUPPORTING ORG MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 1 BRAINERD MEDICAL CENTER INC 2024 S 6TH ST BRAINERD MN 56401 371532148 CLINIC MN 501(C)(3) LINE 3 BRAINERD LAKES INTEGRATED HEALTH SYSTEM 1 BRIDGES MEDICAL CENTER 201 9TH ST W ADA MN 56510 200479568 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 DEER RIVER HEALTHCARE CENTER INC 115 10TH AVE NE DEER RIVER MN 56636 410844574 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ESSENTIA HEALTH 502 E 2ND ST DULUTH MN 55805 200360007 SUPPORTING ORG MN 501(C)(3) LINE 12C, III-FI N/A 0 ESSENTIA HEALTH FOUNDATION 502 E 2ND ST DULUTH MN 55805 271984704 FOUNDATION MN 501(C)(3) LINE 7 ESSENTIA HEALTH 1 ESSENTIA HEALTH MOOSE LAKE 4572 COUNTY ROAD 61 MOOSE LAKE MN 55767 845099016 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 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 INNOVIS HEALTH LLC 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 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 PINE MEDICAL CENTER 705 LUNDORFF DR S SANDSTONE MN 55072 411884597 HOSPITAL MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 POLINSKY MEDICAL REHABILITATION CENTER 530 E 2ND ST DULUTH MN 55805 410691275 REHABILITATION SERVICES MN 501(C)(3) LINE 3 ST MARY'S MEDICAL CENTER 1 SMDC MEDICAL CENTER 502 E 2ND ST DULUTH MN 55805 411878730 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 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 INNOVIS HEALTH LLC 1 ST MARY'S HOSPITAL OF SUPERIOR 3500 TOWER AVE SUPERIOR WI 54880 411811073 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ST MARY'S MEDICAL CENTER 1 ST MARY'S INNOVIS HEALTH 1027 WASHINGTON AVE DETROIT LAKES MN 56501 262861321 PHARMACY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 ST MARY'S MEDICAL CENTER 402 E 2ND ST DULUTH MN 55805 410695604 HOSPITAL MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 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 INNOVIS HEALTH LLC 1 THE DULUTH CLINIC LTD 400 E 3RD ST DULUTH MN 55805 410883623 CLINIC MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 PMC-GATEWAY IMAGING LLC THRU 1132022 705 LUNDORFF DR S SANDSTONE MN 55072 261634764 IMAGING SERVICES MN N/A N/A 0 0 HORSESHOE SURGERY CENTER LLC 1542 GOLF COURSE ROAD GRAND RAPIDS MN 55744 202137172 SURGERY CENTER MN N/A N/A 0 0 ESSENTIA HEALTH INSURANCE SERVICES SPC LTD PO BOX 1159 GRAND CAYMAN CJ 000000000 SELF INSURANCE CJ N/A C 1 MID DAKOTA CLINIC INC 502 E 2ND ST DULUTH MN 55805 450311334 CLINIC OPERATIONS CEASED 9/30/22 ND N/A C 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 DEER RIVER HEALTHCARE CENTER Q 55200 ACTUAL COSTS ESSENTIA HEALTH M 28268424 ACTUAL COSTS ESSENTIA HEALTH P 14222889 ACTUAL COSTS ESSENTIA HEALTH R 1550000 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION B 295564 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION C 836925 ACTUAL COSTS ESSENTIA HEALTH MOOSE LAKE Q 54000 ACTUAL COSTS ESSENTIA INSTITUTE OF RURAL HEALTH R 337371 ACTUAL COSTS FIRST CARE MEDICAL SERVICES Q 50400 ACTUAL COSTS PINE MEDICAL CENTER Q 52200 ACTUAL COSTS SMDC MEDICAL CENTER Q 72600 ACTUAL COSTS ST MARY'S EMS P 119030 ACTUAL COSTS ST MARY'S MEDICAL CENTER A 7200 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER Q 92400 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