SANFORD: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: SANFORD (EIN 45-3791176)
Tax period: 2022-01-01 to 2022-12-31
Filed: 2023-11-09
IRS object ID: 202323139349302342
Schema version: 2022v5.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-11-09T10:23:32-06:00	ReturnTs
Tax Period End	2022-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	346565596	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	155 N WACKER DRIVE	AddressLine1Txt
City	CHICAGO	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60606	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	453791176	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SANFORD GROUP RETURN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	SANF	BusinessNameControlTxt
Phone	6053331000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 5039 RTE 5218	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	571175039	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	BILL MARLETTE	PersonNm
Person Title	EVP, CFO & TREASURER	PersonTitleTxt
Phone	6053331000	PhoneNum
Signature	2023-11-09	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	BILL	PersonFirstNm
Person Last	MARLETTE	PersonLastNm

Field	Value	IRS element (for citing)
SSN	XXX-XX-XXXX	SSN

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	0	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JESS WAGENER	PreparerPersonNm
PTIN	P01622613	PTIN
Phone	3128792000	PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	BILL GASSEN	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2301 EAST 60TH ST	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57104	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$5,327,534,915	GrossReceiptsAmt
Group Return For Affiliates	Yes (1)	GroupReturnForAffiliatesInd
All Affiliates Included	Yes (1)	AllAffiliatesIncludedInd
Group Exemption	5851	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.SANFORDHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Activity Or Mission	"DEDICATED TO SHARING GOD'S LOVE THROUGH THE WORK OF HEALTH, HEALING AND COMFORT."	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	3121	TotalEmployeeCnt
Total Volunteers	1254	TotalVolunteersCnt
Total Gross UBI	$102,695,945	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$2,898,047	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$173,849,939	PYContributionsGrantsAmt
CY Contributions Grants	$100,939,514	CYContributionsGrantsAmt
PY Program Service Revenue	$5,046,555,124	PYProgramServiceRevenueAmt
CY Program Service Revenue	$5,209,223,752	CYProgramServiceRevenueAmt
PY Investment Income	$5,533,720	PYInvestmentIncomeAmt
CY Investment Income	$9,136,742	CYInvestmentIncomeAmt
PY Other Revenue	$2,635,171	PYOtherRevenueAmt
CY Other Revenue	$2,637,006	CYOtherRevenueAmt
PY Total Revenue	$5,228,573,954	PYTotalRevenueAmt
CY Total Revenue	$5,321,937,014	CYTotalRevenueAmt
PY Grants And Similar Paid	$47,416,673	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$44,519,605	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$2,822,078,981	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$2,907,712,001	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,964,536,735	PYOtherExpensesAmt
CY Other Expenses	$2,208,856,104	CYOtherExpensesAmt
PY Total Expenses	$4,834,032,389	PYTotalExpensesAmt
CY Total Expenses	$5,161,087,710	CYTotalExpensesAmt
PY Revenues Less Expenses	$394,541,565	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$160,849,304	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,485,607,781	TotalAssetsBOYAmt
Total Assets EOY	$3,581,478,897	TotalAssetsEOYAmt
Total Liabilities BOY	$1,207,557,219	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,069,495,687	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$2,278,050,562	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$2,511,983,210	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	PART OF THE SANFORD HEALTH SYSTEM, SANFORD IS COMMITTED TO THE HEALTHCARE NEEDS OF COMMUNITIES THROUGHOUT SOUTH DAKOTA, NORTH DAKOTA, MINNESOTA AND IOWA. SANFORD PROVIDES A FULL RANGE OF PRIMARY AND SPECIALTY HEALTH CARE SERVICES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$4,734,788,301	ExpenseAmt
Grant	$44,519,604	GrantAmt
Revenue	$5,064,394,241	RevenueAmt
Desc	SANFORD IS THE NATION'S LARGEST NOT-FOR-PROFIT INTEGRATED RURAL HEALTH SYSTEM PROVIDING MEDICAL SERVICES AT EVERY LEVEL FROM CRITICAL ACCESS HOSPITALS TO TERTIARY AND QUATERNARY CARE. THE SANFORD FOOTPRINT INCLUDES OVER 220,000 SQUARE MILES WITH A NINE STATE SERVICE AREA INCLUDING A NETWORK OF CHILDREN'S PRIMARY CARE CLINIC LOCATIONS ACROSS THE COUNTRY AND THE WORLD. SANFORD OPERATES FULL-TIME EMERGENCY CENTERS AND PROVIDES EMERGENCY CARE TO EVERYONE REGARDLESS OF THEIR ABILITY TO PAY. SANFORD FACILITIES AND CLINICS PROVIDE SERVICES TO REMOTE AND MEDICALLY UNDERSERVED AREAS THAT WOULD OTHERWISE NOT HAVE ACCESS TO EVEN PRIMARY CARE SERVICES. SANFORD FINANCIALLY SUPPORTS HEALTH AND WELLNESS, EDUCATION AND COMMUNITY DEVELOPMENT ACTIVITIES TO IMPROVE THE QUALITY OF LIFE AND STRENGTHEN COMMUNITIES THROUGHOUT THE REGION. EACH OF SANFORD'S FACILITIES PROMOTES HEALTH AND HEALING THAT RESPONDS TO THE UNIQUE NEEDS OF THE PATIENTS IN THE COMMUNITIES THAT SANFORD SERVES, ENSURING ACCESS TO COMPREHENSIVE AND SPECIALIZED SERVICES. THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT INDICATED THE IMPORTANT NEED FOR BEHAVIORAL HEALTH SERVICES FOR OUR COMMUNITY MEMBERS. SANFORD IS MEETING THIS NEED THROUGH AN INTEGRATED DELIVERY SYSTEM PROVIDING BEHAVIORAL HEALTH WITHIN THE MEDICAL HOME STRUCTURE.PLEASE SEE SCHEDULE H FOR A DESCRIPTION OF ADDITIONAL SERVICES, COMMUNITY BENEFIT ACTIVITIES, AND THE FULL SPECTRUM OF CHARITY CARE THAT SANFORD PROVIDES WITHIN THE COMMUNITY.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$41,001,593	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$5,322,741	RevenueAmt
Desc	MEDICAL EDUCATION IS AN IMPORTANT SERVICE FOR SANFORD. SANFORD PROVIDES THE MEDICAL COMMUNITY WITH HIGH QUALITY EDUCATIONAL AND PROFESSIONAL DEVELOPMENT THAT IS EVIDENCE AND RESEARCH BASED; ACCREDITED FOR PHYSICIANS, NURSES, PHARMACISTS, AND ALLIED HEALTH PROFESSIONALS AND SCIENTISTS; INCLUSIVE OF CULTURAL DIVERSITY AND ADDRESSES THE NEED FOR SPECIALTY TRAINING.SANFORD IS DEDICATED TO PREPARING HEALTH CARE PROFESSIONALS FOR THE FUTURE. THE SANFORD PROMISE PROGRAM CONNECTS STUDENTS, EDUCATORS AND COMMUNITIES WITH SCIENCE AND RESEARCH IN HEALTH CARE AT A SECONDARY EDUCATION AGE. SANFORD WORKS IN PARTNERSHIP WITH THE UNIVERSITY OF SOUTH DAKOTA - SANFORD SCHOOL OF MEDICINE, AND THE UNIVERSITY OF NORTH DAKOTA - SCHOOL OF MEDICINE TO PROVIDE ROTATIONS FOR MEDICAL STUDENTS, RESIDENCIES AND FELLOWSHIPS. SANFORD WORKS IN PARTNERSHIP WITH AN EXTENSIVE GROUP OF HIGHER LEARNING ORGANIZATIONS TO PROVIDE STUDENT TRAINING AND LEARNING OPPORTUNITIES IN MANY VENUES ACROSS OUR REGION.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$36,091,714	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$8,433,837	RevenueAmt
Desc	SANFORD RESEARCH AND SANFORD RESEARCH NORTH ARE BOTH NON-PROFIT HEALTH RESEARCH ORGANIZATIONS. COMBINED, BOTH ENTITIES HAVE MORE THAN 200 SCIENTISTS AND STAFF AS WELL AS CENTERS, INCLUDING: CHILDREN'S HEALTH, FOCUSED ON PEDIATRIC RARE DISEASES AND CANCER; THE SANFORD PROJECT, SEEKING A CURE FOR TYPE 1 DIABETES THROUGH THE BODY'S NATURAL ABILITY TO REGENERATE CELLS; HEALTH OUTCOMES AND PREVENTION FOCUSING ON SUDDEN INFANT DEATH SYNDROME AND BIRTH-RELATED DISORDERS AT STUDY SITES INCLUDING UNITED STATES NATIVE AMERICAN RESERVATIONS AND SOUTH AFRICA; GENOMIC AND MOLECULAR MEDICINE WITH AN EMPHASIS ON GENOMICS, MOLECULAR BIOLOGY, BIOBANKING AND IMMUNOTHERAPY; EDITH SANFORD BREAST CANCER FOCUSING ON ADVANCED MOLECULAR RESEARCH AND PERSONALIZED TREATMENT; NEUROSCIENCES, FOCUSED ON THE AREA OF EATING DISORDERS, OBESITY AND BARIATRIC SURGERY OUTCOMES AS WELL AS PHYSIOLOGICAL ASPECTS OF EATING AND ADDICTION AND CLINICAL RESEARCH INCLUDING PARTICIPATION IN DRUG AND DEVICE STUDIES, THE NATIONAL CANCER INSTITUTE COMMUNITY CLINICAL ONCOLOGY PROGRAM AND THE NATIONAL COMMUNITY CANCER CENTER PILOT PROJECT.SANFORD RESEARCH AND SANFORD RESEARCH NORTH OFFER EXCITING CHALLENGES FOR RESEARCHERS BOTH IN WELL-ESTABLISHED PROJECTS AND EVER EXPANDING RESEARCH OPPORTUNITIES. SANFORD OFFERS OPPORTUNITIES TO PARTICIPATE IN CLINICAL TRIALS AND TO BE A PART OF THE CHANGING FACE OF MEDICINE.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$4,811,881,608	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	Yes (1)	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	Yes (1)	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (1)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (1)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	Yes (1)	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	4396	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	3121	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	Yes (1)	ForeignFinancialAccountInd
Foreign Country	CH	ForeignCountryCd
Foreign Country	GH	ForeignCountryCd
Foreign Country	GM	ForeignCountryCd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	6	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	Yes (1)	LocalChaptersInd
Policies Reference Chapters	Yes (1)	PoliciesReferenceChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	MN	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	OR	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BILL MARLETTE EVP CFO & TREASURER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6053331000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2301 EAST 60TH STREET	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57104	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
WILLIAM BRUNNER MD
PHYSICIAN	60.00	0.00	Yes (X)	$3,406,075	$0	$39,142
BRYAN NERMOE
PRESIDENT & CEO, FARGO-END 3/22	55.00	5.00		$0	$457,274	$37,952	Yes (X)
BRYAN NERMOE
SEE SCH J, PART III, LINES 4A-4B	55.00	5.00		$0	$2,719,941	$0	Yes (X)
BILL GASSEN III
TRUSTEE, PRESIDENT & CEO	49.64	10.36		$0	$2,683,582	$379,583		Yes (X)	Yes (X)
TOMASZ STYS MD
PHYSICIAN	60.00	0.00	Yes (X)	$2,806,912	$0	$39,520
RANDY BURY
FORMER CHIEF ADMIN OFFICER	0.00	0.00		$0	$56,688	$0				Yes (X)
RANDY BURY
SEE SCH J, PART III, LINES 4A-4B	0.00	0.00		$0	$2,769,572	$0				Yes (X)
ADAM STYS MD
PHYSICIAN	60.00	0.00	Yes (X)	$2,750,489	$0	$42,510
ERIC BELANGER MD
PHYSICIAN	60.00	0.00	Yes (X)	$2,545,233	$0	$42,926
MARIAN PETRASKO MD
PHYSICIAN	60.00	0.00	Yes (X)	$2,427,171	$0	$34,932
MATT HOCKS
EVP, CHIEF OPERATING OFFICER	53.85	6.15		$0	$2,164,525	$248,300	Yes (X)
MICHELLE BRUHN
EVP, CFO & TREASURER	49.64	10.36		$0	$1,530,538	$186,998			Yes (X)
JENNIFER GRENNAN
EVP, CHIEF ADMIN OFFICER	55.00	5.00		$0	$1,476,061	$183,409	Yes (X)
MICHAEL LEBEAU MD
SVP, HEALTH SVC OPERATIONS	60.00	0.00		$0	$1,420,525	$182,111	Yes (X)
PAUL HANSON
PRESIDENT & CEO, SIOUX FALLS	60.00	0.00		$0	$1,254,502	$154,600	Yes (X)
MARIA BELL MD
TRUSTEE, PHYSICIAN	57.99	2.01		$1,143,694	$0	$43,942		Yes (X)
TODD SCHAFFER
PRESIDENT & CEO, BISMARCK	60.00	0.00		$0	$948,736	$110,906	Yes (X)
TIFFANY LAWRENCE
PRESIDENT & CEO, FARGO-BEG 3/22	55.00	5.00		$0	$924,767	$132,767	Yes (X)
SUSAN JARVIS
PRESIDENT & CEO, BEMIDJI	60.00	0.00		$0	$805,036	$122,025	Yes (X)
MICHELLE MICKA
SVP, FINANCE, HEALTH SERVICES	55.00	5.00		$0	$615,816	$80,707	Yes (X)
MARK LUNDEEN MD
TRUSTEE, PHYSICIAN	57.99	2.01		$343,914	$0	$13,962		Yes (X)
JOANN KUNKEL
FORMER CFO-SCH J, PART III, LINES 4A-4B	0.00	0.00		$0	$339,000	$0				Yes (X)
ANDY NORTH
TRUSTEE, SECRETARY, INDEP CONTRACTOR	9.10	2.01		$316,771	$0	$0		Yes (X)	Yes (X)
KIM PATRICK
FORMER CLO-SCH J, PART III, LINES 4A-4B	0.00	0.00		$0	$315,000	$0				Yes (X)
NATHAN WHITE
FORMER COO-SCH J, PART III, LINES 4A-4B	0.00	0.00		$0	$300,000	$0				Yes (X)
MARK PAULSON MD
TRUSTEE, PHYSICIAN	57.99	2.01		$239,394	$0	$38,669		Yes (X)
ALLISON WIERDA-SUTTLE MD
FORMER SVP, CMO-SCH J PT III, 4A-4B	0.00	0.00		$0	$264,600	$0				Yes (X)
NEIL GULSVIG
TRUSTEE, CHAIRPERSON	5.10	2.01		$75,772	$0	$0		Yes (X)	Yes (X)
LAURIS MOLBERT
TRUSTEE, VICE CHAIR	5.10	2.01		$35,500	$0	$0		Yes (X)	Yes (X)
MARNIE HERMANN
TRUSTEE	5.10	2.01		$35,500	$0	$0		Yes (X)
DON JACOBS
TRUSTEE	5.10	2.01		$34,500	$0	$0		Yes (X)
JAMES CAIN
TRUSTEE	5.10	2.01		$34,500	$0	$0		Yes (X)
ROBIN SMITH
TRUSTEE, TREASURER	5.10	2.01		$34,000	$0	$0		Yes (X)	Yes (X)
WESLEY ENGBRECHT
TRUSTEE	5.10	2.01		$34,000	$0	$0		Yes (X)
BRENT TEIKEN
TRUSTEE, PAST CHAIR	5.10	2.01		$33,000	$0	$0		Yes (X)	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$16,296,425	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$21,046,163	TotReportableCompRltdOrgAmt
Total Other Compensation	$2,114,961	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2308	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
FOCUSONE SOLUTIONS LLC
1010 N 102ND ST STE 300	OMAHA	NE	68114	STAFFING SERVICES	$300,145,941
MAYO CLINIC LABORATORIES
200 FIRST ST SOUTHWEST	ROCHESTER	MN	55905	LAB/MEDICAL SERVICES	$10,891,161
MCGOUGH CONSTRUCTION CO LLC
2737 FAIRVIEW AVE N	ST PAUL	MN	55113	CONSTRUCTION SERVICES	$7,396,303
LOCUMTENENSCOM LLC
2655 NORTHWINDS PKWY	ALPHARETTA	GA	30009	STAFFING SERVICES	$4,561,600
WAPITI MEDICAL STAFFING
107 FYNN DR SUITE 600	MILBANK	SD	57252	STAFFING SERVICES	$4,343,061

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	300	CntrctRcvdGreaterThan100KCnt
Related Organizations	$43,258,143	RelatedOrganizationsAmt
Government Grants	$42,975,576	GovernmentGrantsAmt
All Other Contributions	$14,705,795	AllOtherContributionsAmt
Total Contributions	$100,939,514	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
PATIENT SERVICES	621110	$2,359,607,636	$2,359,607,636
MEDICARE/MEDICAID	621400	$1,952,624,035	$1,952,624,035
PHARMACY	621300	$521,232,020	$513,313,609	$7,918,411
RETAIL SALES	456199	$187,530,621	$166,458,066	$21,072,555
SUPPORT SERVICES	561439	$52,033,841		$50,766,776	$1,267,065

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$136,195,599	TotalRevenueColumnAmt
Related Or Exempt Func Income	$86,147,473	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$22,938,203	UnrelatedBusinessRevenueAmt
Exclusion	$27,109,923	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$5,209,223,752	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,633,495	TotalRevenueColumnAmt
Exclusion	$5,633,495	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,650	TotalRevenueColumnAmt
Exclusion	$3,650	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$4,659,382	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$2,026,026	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$2,633,356	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,633,356	TotalRevenueColumnAmt
Exclusion	$2,633,356	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$1,067,175	SecuritiesAmt
Other	$6,007,947	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$1,165,159	SecuritiesAmt
Other	$2,406,716	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$97,984	SecuritiesAmt
Other	$3,601,231	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,503,247	TotalRevenueColumnAmt
Exclusion	$3,503,247	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,321,937,014	TotalRevenueColumnAmt
Related Or Exempt Func Income	$5,078,150,819	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$102,695,945	UnrelatedBusinessRevenueAmt
Exclusion	$40,150,736	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$44,383,028	TotalAmt
Program Services	$44,383,028	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$126,577	TotalAmt
Program Services	$126,577	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$10,000	TotalAmt
Program Services	$10,000	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$21,277,779	TotalAmt
Program Services	$19,663,681	ProgramServicesAmt
Management And General	$1,614,098	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$4,129,859	TotalAmt
Management And General	$4,129,859	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$2,358,340,963	TotalAmt
Program Services	$2,183,257,619	ProgramServicesAmt
Management And General	$175,083,344	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$96,623,894	TotalAmt
Program Services	$88,365,800	ProgramServicesAmt
Management And General	$8,258,094	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$274,888,369	TotalAmt
Program Services	$244,644,216	ProgramServicesAmt
Management And General	$30,244,153	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$152,451,137	TotalAmt
Program Services	$139,476,853	ProgramServicesAmt
Management And General	$12,974,284	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,998,111	TotalAmt
Program Services	$294,569	ProgramServicesAmt
Management And General	$2,703,542	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,196,513	TotalAmt
Program Services	$80,195	ProgramServicesAmt
Management And General	$1,116,318	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$1,680,186	TotalAmt
Management And General	$1,680,186	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$233,703	TotalAmt
Program Services	$233,703	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$439,234,857	TotalAmt
Program Services	$407,588,646	ProgramServicesAmt
Management And General	$31,646,211	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$20,963,774	TotalAmt
Program Services	$7,038,078	ProgramServicesAmt
Management And General	$13,925,696	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$57,854,805	TotalAmt
Program Services	$38,431,076	ProgramServicesAmt
Management And General	$19,423,729	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$120,195,962	TotalAmt
Program Services	$46,677,250	ProgramServicesAmt
Management And General	$73,518,712	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$109,632,057	TotalAmt
Program Services	$99,276,820	ProgramServicesAmt
Management And General	$10,355,237	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$20,974,164	TotalAmt
Program Services	$18,833,612	ProgramServicesAmt
Management And General	$2,140,552	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$5,490,097	TotalAmt
Program Services	$4,293,797	ProgramServicesAmt
Management And General	$1,196,300	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$24,916,005	TotalAmt
Program Services	$24,822,949	ProgramServicesAmt
Management And General	$93,056	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$171,958,121	TotalAmt
Program Services	$150,461,297	ProgramServicesAmt
Management And General	$21,496,824	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$20,230,385	TotalAmt
Program Services	$19,840,249	ProgramServicesAmt
Management And General	$390,136	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$1,213,605,821	$1,206,101,877	$7,503,944
CONTRACTED BIOMEDICAL S	$29,756,264	$29,754,082	$2,182
EMPLOYEE RECRUITMENT	$12,228,358	$8,133,417	$4,094,941
OTHER TAXES	$10,560,057	$10,340,928	$219,129

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	-$54,853,136	TotalAmt
Program Services	$19,751,289	ProgramServicesAmt
Management And General	-$74,604,425	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,161,087,710	TotalAmt
Program Services	$4,811,881,608	ProgramServicesAmt
Management And General	$349,206,102	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Field	Value	IRS element (for citing)
Joint Costs	Yes (X)	JointCostsInd

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$87,235,347	BOYAmt
EOY	$5,350,099	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$281,391,844	BOYAmt
EOY	$230,746,569	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
EOY	$220,673	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$653,343,333	BOYAmt
EOY	$747,066,864	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$50,879,932	BOYAmt
EOY	$69,083,286	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$125,839,955	BOYAmt
EOY	$124,928,258	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$65,070,623	BOYAmt
EOY	$78,225,069	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$3,815,138,177	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$2,025,007,992	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,751,741,875	BOYAmt
EOY	$1,790,130,185	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$735,389	BOYAmt
EOY	$433,579	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
EOY	$33,508,819	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$40,467,353	BOYAmt
EOY	$33,414,398	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$48,008,578	BOYAmt
EOY	$47,957,708	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$380,893,552	BOYAmt
EOY	$420,413,390	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,485,607,781	BOYAmt
EOY	$3,581,478,897	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$390,495,684	BOYAmt
EOY	$321,632,155	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$1,595,748	BOYAmt
EOY	$5,118,766	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$3,159,894	BOYAmt
EOY	$4,018,002	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$505,134,169	BOYAmt
EOY	$479,072,573	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$218,589	BOYAmt
EOY	$174,332	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$15,455,741	BOYAmt
EOY	$11,901,748	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$291,497,394	BOYAmt
EOY	$247,578,111	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,207,557,219	BOYAmt
EOY	$1,069,495,687	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,278,043,512	BOYAmt
EOY	$2,511,976,110	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,050	BOYAmt
EOY	$7,100	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,278,050,562	BOYAmt
EOY	$2,511,983,210	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,485,607,781	BOYAmt
EOY	$3,581,478,897	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$160,849,304	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$7,005,023	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$80,088,367	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd
Supported Organizations	19	SupportedOrganizationsCnt
Supported Organizations Total	19	SupportedOrganizationsTotalCnt

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
LIST OF ORGANIZATIONS AND PUBLIC CHARITY STATUS:	SANFORD HEALTH 509(A)(3) SANFORD MEDICAL CENTER 170(B)(1)(A)(III) SANFORD CLINIC 509(A)(2) SANFORD RESEARCH 170(B)(1)(A)(III) SANFORD RESEARCH NORTH 170(B)(1)(A)(III) SANFORD HOME HEALTH 509(A)(2) SANFORD HEALTH NETWORK 170(B)(1)(A)(III) SANFORD WORLD CLINICS 509(A)(2) SANFORD NORTH 509(A)(3) SANFORD MEDICAL CENTER FARGO 170(B)(1)(A)(III) SANFORD CLINIC NORTH 509(A)(2) SANFORD HEALTH NETWORK NORTH 170(B)(1)(A)(III) SANFORD HEALTH OF NORTHERN MINNESOTA 170(B)(1)(A)(III) BAKER PARK, INC. 509(A)(2) SANFORD WEST 509(A)(3) SANFORD BISMARCK 170(B)(1)(A)(III) SANFORD WORLD CLINICS-KLAMATH FALLS 509(A)(2) SANFORD VIRTUAL CARE 509(A)(2)
SCHEDULE A, PART I	PART I, LINE 12B - SANFORD HEALTH, SANFORD NORTH, AND SANFORD WEST ARE ALL TYPE II SUPPORTING ORGANIZATIONS. DETAIL FOR SCHEDULE A, PART I, LINE 12G LINE 12, COLUMN: (I) SANFORD MEDICAL CENTER; (II) 46-0227855; (III) 3; (IV) YES; (V) $37,525,246 LINE 12, COLUMN: (I) SANFORD CLINIC; (II) 46-0447693; (III) 10; (IV) YES; (V) $2,121,119 LINE 12, COLUMN: (I) SANFORD RESEARCH; (II) 46-0450378; (III) 4; (IV) YES; (V) $584,671 LINE 12, COLUMN: (I) SANFORD RESEARCH NORTH; (II) 45-0274828; (III) 4; (IV) YES; (V) $145,266 LINE 12, COLUMN: (I) SANFORD HOME HEALTH; (II) 46-0282134; (III) 10; (IV) YES; (V) $276,874 LINE 12, COLUMN: (I) SANFORD HEALTH NETWORK; (II) 46-0388596; (III) 3; (IV) YES; (V) $9,696,782 LINE 12, COLUMN: (I) SANFORD CLINIC NORTH; (II) 91-1770748; (III) 10; (IV) YES; (V) $4,364,111 LINE 12, COLUMN: (I) SANFORD MEDICAL CENTER FARGO; (II) 45-0226909; (III) 3; (IV) YES; (V) $46,504,965 LINE 12, COLUMN: (I) SANFORD WORLD CLINICS; (II) 26-2707628; (III) 10; (IV) YES; (V) $196,947 LINE 12, COLUMN: (I) SANFORD WORLD CLINICS-KLAMATH FALLS; (II) (92-0396212 (III) 10; (IV) YES; (V) $119,161 LINE 12, COLUMN: (I) SANFORD HEALTH OF NORTHERN MINNESOTA; (II) 41-1266009; (III) 3; (IV) YES; (V) $10,069,316 LINE 12, COLUMN: (I) BAKER PARK, INC.; (II) 41-1372480; (III) 10; (IV) YES; (V) $18,919 LINE 12, COLUMN: (I) SANFORD HEALTH FOUNDATION NORTH; (II) 45-0398104; (III) 7; (IV) YES; (V) $4,887,544 LINE 12, COLUMN: (I) SANFORD BISMARCK; (II) 45-0226700; (III) 3; (IV) YES; (V) $21,812,183 LINE 12, COLUMN: (I) SANFORD HEALTH FOUNDATION WEST; (II) 45-0397196; (III) 7; (IV) YES; (V) $80,201 LINE 12, COLUMN: (I) SANFORD VIRTUAL CARE; (II) 88-0976483; (III) 10; (IV) YES; (V) $7,634 LINE 12, COLUMN: (I) THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION; (II) 46-0422866; (III) 7; (IV) YES; (V) $214,007 LINE 12, COLUMN: (I) THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY; (II) 45-0228055; (III) 10; (IV) YES; (V) $27,607,528 LINE 12, COLUMN: (I) SANFORD HEALTH FOUNDATION OF NORTHERN MINNESOTA; (II) 41-1389317; (III) 7; (IV) YES; (V) $43,569
SCHEDULE A, PART I, LINE 12G, COLUMN (IV)	WE HAVE ANSWERED YES THAT THE ORGANIZATIONS ARE LISTED IN OUR GOVERNING DOCUMENTS BECAUSE THE ARTICLES DESCRIBE THE SPECIFIED SUPPORTED ORGANIZATIONS AND THE OTHER SUPPORTED ORGANIZATIONS BY CLASS (AFFILIATED WITH THE SPECIFIED SUPPORTED ORGANIZATIONS).
SCHEDULE A, PART III	LINE 1 - COLUMN: (A) 133,275; (B) 429,804; (C) 9,415,179; (D) (3,426,082); (E) 2,951,560 ; (F) 9,503,736 LINE 2 - COLUMN: (A) 81,522,328; (B) 172,939,530; (C) 177,631,632; (D) 204,250,348; (E) 252,665,915; (F) 889,009,753 LINE 6 - COLUMN: (A) 81,655,603; (B) 173,369,334; (C) 187,046,811; (D) 200,824,266; (E) 255,617,475; (F) 898,513,489 LINE 8 - COLUMN: (F) 898,513,489 LINE 9 - COLUMN: (A) 81,655,603; (B) 173,369,334; (C) 187,046,811; (D) 200,824,266; (E) 255,617,475; (F) 898,513,489 LINE 10A - COLUMN: (A) 1,127,888; (B) 1,216,540; (C) 1,544,624; (D) 1,377,220; (E) 1,111,018; (F) 6,377,290 LINE 10C - COLUMN: (A) 1,127,888; (B) 1,216,540; (C) 1,544,624; (D) 1,377,220; (E) 1,111,018; (F) 6,377,290 LINE 11 - COLUMN: (A) 718,178; (B) 1,230,289; (C) 673,203; (D) 151,437; (E) 789,277; (F) 3,562,384 LINE 13 - COLUMN: (A) 83,501,669; (B) 175,816,163; (C) 189,264,638; (D) 202,352,923; (E) 257,517,770; (F) 908,453,163 LINE 15: 98.91% LINE 16: 98.71% LINE 17: 0.70% LINE 18: 0.85% LINE 19A: X LINE 19B: X PART IV, SECTION A LINE 1: NO LINE 2: NO LINE 3A: NO LINE 4A: NO LINE 5A: YES LINE 5B: YES LINE 5C: NO LINE 6: YES LINE 7: NO LINE 8: NO LINE 9A: NO LINE 9B: NO LINE 9C: NO LINE 10A: NO LINE 11A: NO LINE 11B: NO LINE 11C: NO
SCHEDULE A, PART IV, SECTION A, LINE 1	THE ARTICLES OF INCORPORATION OF SANFORD HEALTH, SANFORD NORTH AND SANFORD BISMARCK PROVIDE THAT THEY SHALL PROVIDE OVERSIGHT, OPERATE FOR THE BENEFIT OF, TO SUPPORT THE FUNCTIONS OF, AND TO CARRY OUT SOME OR ALL OF THE CHARITABLE PURPOSES OF THE NAMED SUBSIDIARY ORGANIZATIONS WHICH ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ALL OTHER 501(C)(3) ORGANIZATIONS OPERATED, SUPERVISED OR CONTROLLED BY OR SUPERVISED OR CONTROLLED IN CONNECTION WITH, SUCH ORGANIZATIONS. FURTHER, PURSUANT TO THEIR BY-LAWS, THE GOVERNING BODY OF SANFORD (PARENT), SERVES AS THE GOVERNING BODY OF SANFORD HEALTH, SANFORD NORTH AND SANFORD BISMARCK AS WELL AS ALL OF THE NAMED TAX-EXEMPT SUBSIDIARY ORGANIZATIONS. THUS, SANFORD HEALTH, SANFORD NORTH AND SANFORD BISMARCK MEET THE RELATIONSHIP TEST AS A TYPE II ORGANIZATIONS BECAUSE THERE IS COMMON SUPERVISION AND CONTROL BETWEEN SANFORD HEALTH, SANFORD NORTH AND SANFORD BISMARCK AND THEIR NAMED SUPPORTED ORGANIZATIONS. SANFORD HEALTH, SANFORD NORTH, AND SANFORD BISMARCK ALSO SUPPORT ORGANIZATIONS WHICH ARE 501(C)(3) ORGANIZATIONS AFFILIATED WITH THE SUPPORTED ORGANIZATIONS OR ARE 501(C)(3) PUBLIC CHARITIES AFFILIATED WITH THESE AFFILIATED ENTITIES. THEY ARE DESCRIBED BY CLASS. IN ADDITION, THE ARTICLES PROVIDE THAT IN FURTHERANCE OF THEIR PURPOSES, THESE CORPORATIONS MAY ENGAGE IN, ADVANCE, PROMOTE, SUPPORT, AND ADMINISTER CHARITABLE, SCIENTIFIC, AND EDUCATIONAL ACTIVITIES AND PROJECTS OF EVERY KIND AND NATURE WHATSOEVER IN ITS OWN BEHALF OR AS THE AGENT, TRUSTEE, OR REPRESENTATIVE OF OTHERS. THIS INCLUDES TO AID OR ASSIST OTHER ORGANIZATIONS WHOSE ACTIVITIES ARE SUCH AS TO FURTHER, ACCOMPLISH, FOSTER, OR ATTAIN ANY SUCH PURPOSES. ALL POWERS OF THESE CORPORATIONS SHALL BE EXERCISED ONLY SO THAT THESE CORPORATIONS' OPERATIONS SHALL BE EXCLUSIVELY WITHIN THE CONTEMPLATION OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. TO QUALIFY AS A SECTION 509(A)(3) SUPPORTING ORGANIZATION, AN ORGANIZATION MUST SUPPORT ONE OR MORE SPECIFIED ORGANIZATIONS. FOR TYPE II SUPPORTING ORGANIZATION'S ARTICLES OF INCORPORATION, THE ARTICLES MUST DESIGNATE THE SUPPORTING ORGANIZATION(S) BY CLASS OR PURPOSE, AND WHICH INCLUDE PUBLICLY SUPPORTED ORGANIZATIONS WHICH ARE CLOSELY RELATED IN PURPOSE OR FUNCTION TO THE PUBLICLY SUPPORTED ORGANIZATION SPECIFIED IN THE ARTICLES. THEREFORE, THE LACK OF INCLUDING THE NAME OF THE AFFILIATED ORGANIZATIONS THAT SANFORD HEALTH, SANFORD NORTH, AND SANFORD WEST WILL SUPPORT IN THEIR ARTICLES OF INCORPORATION DOES NOT OTHERWISE DEFEAT THE ORGANIZATIONS STATUSES AS TYPE II SUPPORTING ORGANIZATIONS, BECAUSE THEIR ARTICLES DESCRIBE THESE SUPPORTED ORGANIZATIONS BY CLASS (AFFILIATED WITH THE SPECIFIED SUPPORTED ORGANIZATION) AND REQUIRE THAT THEY BE EXEMPT FROM TAX UNDER IRC SECTION 501(C)(3).
SCHEDULE A, PART IV, SECTION A, LINE 5A	(I) SANFORD WORLD CLINICS-KLAMATH FALLS, 92-0396212; (II) THE ORGANIZATION WAS ADDED BECAUSE IT WAS A NEW ORGANIZATION, AND IT WAS SUPPORTED BY THE SUPPORTING ORGANIZATIONS; (III) THE SUPPORTED ORGANIZATION WAS PART OF A CLASS ALREADY DESIGNATED IN THE ORGANIZATIONS ORGANIZING DOCUMENTS; (IV) NO ACTION NEEDED TO ACCOMPLISH (I) SANFORD VIRTUAL CARE, 88-0976483; (II) THE ORGANIZATION WAS ADDED BECAUSE IT WAS A NEW ORGANIZATION, AND IT WAS SUPPORTED BY THE SUPPORTING ORGANIZATIONS; (III) THE SUPPORTED ORGANIZATION WAS PART OF A CLASS ALREADY DESIGNATED IN THE ORGANIZATIONS ORGANIZING DOCUMENTS; (IV) NO ACTION NEEDED TO ACCOMPLISH (I) THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY, 45-0228055; (II) THE ORGANIZATION WAS ADDED BECAUSE IT WAS SUPPORTED BY THE SUPPORTING ORGANIZATIONS; (III) THE SUPPORTED ORGANIZATION WAS PART OF A CLASS ALREADY DESIGNATED IN THE ORGANIZATIONS ORGANIZING DOCUMENTS; (IV) NO ACTION NEEDED TO ACCOMPLISH (I) SANFORD HEALTH FOUNDATION OF NORTHERN MINNESOTA, 41-1389317; (II) THE ORGANIZATION WAS ADDED BECAUSE IT WAS SUPPORTED BY THE SUPPORTING ORGANIZATIONS; (III) THE SUPPORTED ORGANIZATION WAS PART OF A CLASS ALREADY DESIGNATED IN THE ORGANIZATIONS ORGANIZING DOCUMENTS; (IV) NO ACTION NEEDED TO ACCOMPLISH
SCHEDULE A, PART IV, SECTION A, LINE 6	THE ORGANIZATIONS GIVE GRANTS AND PROVIDE SUPPORT TO QUALIFIED 501(C)(3) PUBLIC CHARITIES, GOVERNMENTAL ENTITIES AND VARIOUS LOCAL NONPROFIT ORGANIZATIONS THAT SUPPORT THE MISSIONS OF SANFORD HEALTH, SANFORD NORTH, AND SANFORD WEST AND THE ORGANIZATIONS THAT THEY SUPPORT.
SCHEDULE A, PART IV, SECTION C, LINE 1	LINE 1: YES

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	Yes (1)	VolunteersInd
Paid Staff Or Management	Yes (1)	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (1)	GrantsOtherOrganizationsInd
Grants Other Organizations	$753,600	GrantsOtherOrganizationsAmt
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$527,817	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$398,769	OtherActivitiesAmt
Total Lobbying Expenditures	$1,680,186	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	THE FILING ORGANIZATION HAS MEMBERSHIPS IN THE FOLLOWING ORGANIZATIONS: 340B HEALTH, AMERICAN ACADEMY OF FAMILY PHYSICIANS, AMERICAN ACADEMY OF OPTHALMOLOGY, AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS, AMERICAN ACADEMY OF SLEEP MEDICINE, AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES, AMERICAN COLLEGE OF OB/GYN, AMERICAN COLLEGE OF OSTEOPATHIC SURGEONS, AMERICAN COLLEGE OF PHYSICIANS, AMERICAN COLLEGE OF SURGEONS PROFESSIONAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION, AMERICAN MEDICAL ASSOCIATION, AMERICAN MEDICAL GROUP ASSOCIATION, AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION, AMERICAN OSTEOPATHIC ASSOCIATION, AMERICAN PODIATRIC MEDICAL ASSOCIATION, AMERICAN SOCIETY FOR HEALTH CARE ENGINEERING, AIR MEDICAL OPERATORS ASSOCIATION, ASSOCIATION FOR ADVANCING PHYSICIAN & PROVIDER RECRUITMENT, ASSOCIATION OF COMMUNITY CANCER CENTERS, ASSOCIATION OF CRITICAL CARE TRANSPORT, CANTON ROTARY CLUB, CHAMBER OF COMMERCE GRAND FORKS, CHILDREN'S HOSPITAL ASSOCIATION, DOWNTOWN COMMUNITY PARTNERSHIP, FLORIDA PODIATRIC MEDICAL ASSOCIATION, GREATER ND CHAMBER, GREATER SF CHAMBER OF COMMERCE, HEALTHCARE INFORMATION AND MANAGEMENT SYSTEMS SOCIETY, HEALTH POLICY CONSORTIUM, IOWA HOSPITAL ASSOCIATION, IOWA MEDICAL SOCIETY, LEADINGAGE IA, MEDICAL GROUP MANAGEMENT ASSOCIATION, MIDWEST ASSOCIATION FOR MEDICAL EQUIPMENT & SUPPLIES, MINNESOTA HOSPITAL ASSOCIATION, NATIONAL ASSOCIATION FOR BIOMEDICAL RESEARCH, NATIONAL ASSOCIATION OF SOCIAL WORKERS, NATIONAL ASSOCIATION OF SPECIALTY PHARMACY, NATIONAL RURAL HEALTH ASSOCIATION, NORTH DAKOTA HOSPITAL ASSOCIATION, NORTH DAKOTA LONG TERM CARE ASSOCIATION, NORTH DAKOTA MOTOR CARRIERS ASSOCIATION, NORTH DAKOTA PETROLIUM COUNCIL, RENAL HEALTHCARE ASSOCIATION, SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATION, SD BIOTECH ASSOCIATION, SD CHAMBER OF COMMERCE & INDUSTRY, SD HEALTH CARE ASSOCIATION, SOCIETY OF DIAGNOSTIC MEDICAL SONOGRAPHY, SOUTH DAKOTANS DECIDE HEALTHCARE, SOUTH DAKOTANS FOR FAIR ELECTIONS, AND TRAUMA CENTER ASSOCIATION OF AMERICA. A PERCENTAGE OF MEMBERSHIP DUES PAID TO THESE ORGANIZATIONS RELATE TO LOBBYING EXPENSES. IN ADDITION, THE ORGANIZATION EMPLOYS CERTAIN INDIVIDUALS, AND CONTRACTS WITH VARIOUS LOBBYISTS, TO MONITOR LEGISLATIVE ACTS IMPORTANT TO ALL SANFORD ENTITIES ON BOTH STATE AND NATIONAL LEVELS. OCCASIONALLY, SANFORD EMPLOYEES SEND MAILINGS TO LEGISLATORS ON ISSUES THAT MAY AFFECT HEALTHCARE.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtcInd
Incl Escrow Custodial Acct Liab	Yes (1)	InclEscrowCustodialAcctLiabInd
Explanation Provided	Yes (X)	ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$95,588,573	BeginningYearBalanceAmt
Contributions	$3,297,480	ContributionsAmt
Investment Earnings Or Losses	-$419,011	InvestmentEarningsOrLossesAmt
Administrative Expenses	$180,536	AdministrativeExpensesAmt
End Year Balance	$98,286,506	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$92,002,112	BeginningYearBalanceAmt
Contributions	$3,586,461	ContributionsAmt
End Year Balance	$95,588,573	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$89,216,166	BeginningYearBalanceAmt
Contributions	$3,360,625	ContributionsAmt
Grants Or Scholarships	$574,611	GrantsOrScholarshipsAmt
Administrative Expenses	$67	AdministrativeExpensesAmt
End Year Balance	$92,002,112	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$84,843,272	BeginningYearBalanceAmt
Contributions	$4,372,894	ContributionsAmt
End Year Balance	$89,216,166	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$63,648,688	BeginningYearBalanceAmt
Contributions	$21,194,584	ContributionsAmt
End Year Balance	$84,843,272	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$130,555,153	OtherCostOrOtherBasisAmt
Book Value	$130,555,153	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,704,209,799	OtherCostOrOtherBasisAmt
Depreciation	$775,582,059	DepreciationAmt
Book Value	$928,627,740	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$93,048,174	OtherCostOrOtherBasisAmt
Depreciation	$57,956,978	DepreciationAmt
Book Value	$35,091,196	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,811,002,949	OtherCostOrOtherBasisAmt
Depreciation	$1,157,880,386	DepreciationAmt
Book Value	$653,122,563	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$76,322,102	OtherCostOrOtherBasisAmt
Depreciation	$33,588,569	DepreciationAmt
Book Value	$42,733,533	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,790,130,185	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
NON-OPERATING PROPERTY	$94,452,433
DEFERRED COMPENSATION ASSETS HELD FOR INVESTMENT	$160,807,939
OTHER ASSETS	$81,898,286
RIGHT OF USE ASSET	$83,254,732

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$420,413,390	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
DEFERRED COMPENSATION LIABILITY	$160,597,727
OTHER NON-CURRENT LIABILITIES	$20,196,146
LONG TERM OPERATING LEASE PAYABLE	$66,784,238

Field	Value	IRS element (for citing)
Total Liability	$247,578,111	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART IV, LINE 2B:	LONG TERM CARE FACILITIES HOLD SECURITY DEPOSITS FOR TENANTS.
PART V, LINE 4:	SANFORD HEALTH FOUNDATION, SANFORD HEALTH FOUNDATION NORTH, SANFORD HEALTH FOUNDATION OF NORTHERN MINNESOTA, AND SANFORD HEALTH FOUNDATION WEST HOLD ENDOWMENT FUNDS ON BEHALF OF THE FILING ORGANIZATION TO BE USED FOR ASSISTANCE IN ITS ACTIVITIES AND FOR PROVIDING HEALTH CARE, MEDICAL, OR EDUCATIONAL SERVICES.
PART X, LINE 2:	CERTAIN CONTROLLED ORGANIZATIONS ARE SUBJECT TO INCOME TAXES. DEFERRED INCOME TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE DIFFERENCES BETWEEN THE FINANCIAL AND INCOME TAX REPORTING BASIS OF ASSETS AND LIABILITIES BASED ON ENACTED TAX RATES AND LAWS. A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION. THE DEFERRED INCOME TAX PROVISION OR BENEFIT GENERALLY REFLECTS THE NET CHANGE IN DEFERRED INCOME TAX ASSETS AND LIABILITIES DURING THE YEAR. THE CURRENT INCOME TAX PROVISION REFLECTS THE TAX CONSEQUENCES OF REVENUES AND EXPENSES CURRENTLY TAXABLE OR DEDUCTIBLE ON VARIOUS INCOME TAX RETURNS FOR THE YEAR REPORTED. SANFORD GROUP DID NOT HAVE A MATERIAL INCOME TAX LIABILITY AT DECEMBER 31, 2022; SOME RELATED ORGANIZATIONS HAVE ESTABLISHED RESERVES.

Schedule F IRS990ScheduleF

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp (10 entries)

RegionRegionTxt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Specific Services ProvidedSpecificServicesProvidedTxt	Region Total ExpendituresRegionTotalExpendituresAmt
EAST ASIA AND THE PACIFIC	INVESTMENTS	CHINA INVESTMENTS, BEGINNING IN 2014	$523,000
EAST ASIA AND THE PACIFIC	PROGRAM SERVICES	ADMINISTRATIVE EXPENSES (NEW ZEALAND)	$106,000
EUROPE (INCLUDING ICELAND & GREENLAND)	PROGRAM SERVICES	ADMINISTRATIVE EXPENSES (GERMANY)	$3,000
SUB-SAHARAN AFRICA	PROGRAM SERVICES	ADMINISTRATIVE EXPENSES (GHANA), INVESTIGATION OF POTENTIAL RESEARCH PARTNER (SOUTH AFRICA)	$2,681,000
EUROPE (INCLUDING ICELAND & GREENLAND)	INVESTMENTS	GERMANY INVESTMENTS, BEGINNING IN 2015	$11,945,000
SUB-SAHARAN AFRICA	INVESTMENTS	GHANA INVESTMENTS, BEGINNING IN 2012	$2,337,000
CENTRAL AMERICA AND THE CARIBBEAN	PROGRAM SERVICES	ADMINISTRATIVE EXPENSES (COSTA RICA)	$2,317,000
MIDDLE EAST AND NORTH AFRICA	INVESTMENTS	ISRAEL INVESTMENTS, BEGINNING IN 2018	$1,300,000
EAST ASIA AND THE PACIFIC	INVESTMENTS	NEW ZEALAND INVESTMENTS, BEGINNING IN 2019	$1,600,000
CENTRAL AMERICA AND THE CARIBBEAN	INVESTMENT	COSTA RICA INVESTMENT, BEGINNING IN 2019	$8,000,000

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$21,212,000	SubtotalSpentAmt
Continuation Spent	$9,600,000	ContinuationSpentAmt
Total Spent	$30,812,000	TotalSpentAmt

Grants To Org Outside US GrantsToOrgOutsideUSGrp

Field	Value	IRS element (for citing)
Region	SUB-SAHARAN AFRICA	RegionTxt
Purpose Of Grant	GENERAL SUPPORT	PurposeOfGrantTxt
Cash Grant	$10,000	CashGrantAmt
Manner Of Cash Disbursement	BANK TRANSFER	MannerOfCashDisbursementTxt
Non Cash Assistance	$0	NonCashAssistanceAmt
Valuation Method Used	COST	ValuationMethodUsedDesc

Field	Value	IRS element (for citing)
Total501c3 Org	0	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt
Transfer To Foreign Corp	Yes (1)	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (1)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	0	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 2:	PRIOR TO DISBURSEMENT ALL GRANT FUND REQUESTS ARE REVIEWED TO ENSURE THE RECEIVING ORGANIZATION AND PROPOSED USE OF FUNDS ALIGN WITH SANFORD'S MISSION. GRANTS ARE DISBURSED BY THE ORGANIZATION ONLY AFTER THE EXPENDITURE HAS BEEN MADE AND PROPERLY AUTHORIZED BY THE ORGANIZATION ALONG WITH RELATED DOCUMENTATION TO ENSURE THE FUNDS ARE NOT DIVERTED FOR NON-CHARITABLE USE.
PART I, LINE 3:	EXPENDITURES ARE ACCOUNTED FOR ON THE ACCRUAL BASIS OF ACCOUNTING.
PART II, LINE 1 ACCOUNTING METHOD:	GRANTS AND OTHER ASSISTANCE TO ORGANIZATIONS OR ENTITIES OUTSIDE THE UNITED STATES ARE ACCOUNTED FOR ON THE ACCRUAL BASIS OF ACCOUNTING.
PART III ACCOUNTING METHOD:

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	225.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	375.000000000000	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$84,815,767	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$84,815,767	NetCommunityBenefitExpnsAmt
Total Expense	0.01640	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$656,748,729	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$530,138,370	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$126,610,359	NetCommunityBenefitExpnsAmt
Total Expense	0.02450	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$741,564,496	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$530,138,370	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$211,426,126	NetCommunityBenefitExpnsAmt
Total Expense	0.04090	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$42,943,092	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$575,297	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$42,367,795	NetCommunityBenefitExpnsAmt
Total Expense	0.00820	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$41,001,594	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,322,741	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$35,678,853	NetCommunityBenefitExpnsAmt
Total Expense	0.00690	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,535,999,172	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,303,001,747	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$232,997,425	NetCommunityBenefitExpnsAmt
Total Expense	0.04510	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$34,480,838	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,248,016	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,232,822	NetCommunityBenefitExpnsAmt
Total Expense	0.00310	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,141,891	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$24,141,891	NetCommunityBenefitExpnsAmt
Total Expense	0.00470	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,678,566,587	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,327,147,801	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$351,418,786	NetCommunityBenefitExpnsAmt
Total Expense	0.06800	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,420,131,083	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,857,286,171	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$562,844,912	NetCommunityBenefitExpnsAmt
Total Expense	0.10890	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,335,320	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,335,320	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$915,172	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$915,172	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,482,007	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,482,007	NetCommunityBenefitExpnsAmt
Total Expense	0.00300	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,250	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,250	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,789	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,789	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,098	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,098	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$296,695	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$296,695	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,673,493	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,673,493	NetCommunityBenefitExpnsAmt
Total Expense	0.00090	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$59,366	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$59,366	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$22,779,190	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$22,779,190	NetCommunityBenefitExpnsAmt
Total Expense	0.00450	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$73,533,536	BadDebtExpenseAmt
Reimbursed By Medicare	$572,478,356	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$566,666,820	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$5,811,536	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	25	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (25 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Business Name Line1SubordinateHospitalName/BusinessNameLine1Txt	Subordinate Hospital EINSubordinateHospitalEIN	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Childrens HospitalChildrensHospitalInd	Teaching HospitalTeachingHospitalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd	Critical Access HospitalCriticalAccessHospitalInd	OtherOtherDesc
SANFORD MEDICAL CENTER
1	1305 W 18TH STREET	SIOUX FALLS	SD	57117	WWW.SANFORDHEALTH.ORG	SD 10564	SANFORD MEDICAL CENTER	460227855	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
SANFORD MEDICAL CENTER FARGO
2	5225 23RD AVENUE S	FARGO	ND	58104	WWW.SANFORDHEALTH.ORG	ND 5070	SANFORD MEDICAL CENTER FARGO	450226909	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
SANFORD BROADWAY MEDICAL CENTER FARGO
3	801 BROADWAY NORTH	FARGO	ND	58122	WWW.SANFORDHEALTH.ORG	ND 5018A	SANFORD MEDICAL CENTER FARGO	450226909	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
SANFORD MEDICAL CENTER SOUTH UNIVERSITY
4	1720 SOUTH UNIVERSITY	FARGO	ND	58103	WWW.SANFORDHEALTH.ORG	ND 5068A	SANFORD MEDICAL CENTER FARGO	450226909	Yes (X)	Yes (X)		Yes (X)		A
SANFORD BISMARCK MEDICAL CENTER
5	300 N 7TH STREET	BISMARCK	ND	58501	WWW.SANFORDHEALTH.ORG	ND 5003A	SANFORD BISMARCK	450226700	Yes (X)	Yes (X)		Yes (X)	Yes (X)	A
SANFORD BEMIDJI MEDICAL CENTER
6	1300 ANNE STREET NW	BEMIDJI	MN	56601	WWW.SANFORDHEALTH.ORG	MN 371073	SANFORD HEALTH OF NORTHERN MINNESOTA	411266009	Yes (X)	Yes (X)			Yes (X)	A
SANFORD MEDICAL CENTER THIEF RIVER FALLS
7	3001 SANFORD PARKWAY	THIEF RIVER FALLS	MN	56701	WWW.SANFORDHEALTH.ORG	MN 371500	SANFORD HEALTH NETWORK NORTH	450409348	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)	INPATIENT MENTAL HEALTH
SANFORD ABERDEEN MEDICAL CENTER
8	2905 3RD AVENUE SE	ABERDEEN	SD	57401	WWW.SANFORDHEALTH.ORG	SD 65089	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A
SANFORD WORTHINGTON MEDICAL CENTER
9	1018 6TH AVENUE	WORTHINGTON	MN	56187	WWW.SANFORDHEALTH.ORG	MN 371449	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A
SANFORD SHELDON MEDICAL CENTER
10	118 N 7TH AVENUE	SHELDON	IA	51201	WWW.SANFORDHEALTH.ORG	IA 161381	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)	NURSING FACILITY
SANFORD VERMILLION MEDICAL CENTER
11	20 S PLUM STREET	VERMILLION	SD	57069	WWW.SANFORDHEALTH.ORG	SD 53082	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)	NURSING FACILITY
SANFORD CHAMBERLAIN MEDICAL CENTER
12	300 S BYRON BLVD	CHAMBERLAIN	SD	57325	WWW.SANFORDHEALTH.ORG	SD 50302	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)	NURSING FACILITY
SANFORD LUVERNE MEDICAL CENTER
13	1600 N KNISS AVENUE	LUVERNE	MN	56156	WWW.SANFORDHEALTH.ORG	MN 371352	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)
SANFORD CANBY MEDICAL CENTER
14	112 ST OLAF AVENUE S	CANBY	MN	56220	WWW.SANFORDHEALTH.ORG	MN 371019	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)	NURSING FACILITY
SANFORD JACKSON MEDICAL CENTER
15	1430 N HIGHWAY	JACKSON	MN	56143	WWW.SANFORDHEALTH.ORG	MN 371002	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)
SANFORD TRACY MEDICAL CENTER
16	251 5TH STREET E	TRACY	MN	56175	WWW.SANFORDHEALTH.ORG	MN 371440	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)
SANFORD HILLSBORO MEDICAL CENTER
17	12 3RD STREET SE	HILLSBORO	ND	58045	WWW.SANFORDHEALTH.ORG	ND 5026A	SANFORD HEALTH NETWORK NORTH	450409348	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)
SANFORD MEDICAL CENTER MAYVILLE
18	42 6TH AVENUE SE	MAYVILLE	ND	58257	WWW.SANFORDHEALTH.ORG	ND 5034A	SANFORD HEALTH NETWORK NORTH	450409348	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)
SANFORD WEBSTER MEDICAL CENTER
19	1401 W 1ST STREET	WEBSTER	SD	57274	WWW.SANFORDHEALTH.ORG	SD 10573	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)
SANFORD MEDICAL CENTER WHEATON
20	401 12TH STREET N	WHEATON	MN	56296	WWW.SANFORDHEALTH.ORG	MN 371390	SANFORD HEALTH NETWORK NORTH	450409348	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)
SANFORD BAGLEY MEDICAL CENTER
21	203 4TH STREET NW	BAGLEY	MN	56621	WWW.SANFORDHEALTH.ORG	MN 371484	SANFORD HEALTH OF NORTHERN MINNESOTA	411266009	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)
SANFORD CANTON-INWOOD MEDICAL CENTER
22	440 N HIAWATHA DRIVE	CANTON	SD	57013	WWW.SANFORDHEALTH.ORG	SD 51569	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)
SANFORD CLEAR LAKE MEDICAL CENTER
23	701 3RD AVENUE S	CLEAR LAKE	SD	57226	WWW.SANFORDHEALTH.ORG	SD 10533	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)
SANFORD WESTBROOK MEDICAL CENTER
24	920 BELL AVENUE	WESTBROOK	MN	56183	WWW.SANFORDHEALTH.ORG	MN 371439	SANFORD HEALTH NETWORK	460388596	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)
SANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTER
25	120 LA BREE AVENUE S	THIEF RIVER FALLS	MN	56701	WWW.SANFORDHEALTH.ORG	MN 410505	SANFORD HEALTH NETWORK NORTH	450409348	Yes (X)					A		BEHAVIORAL HEALTH CENTER-INPATIENT MENTAL HEALTH

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	FACILITY REPORTING GROUP - A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	21	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	21	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	225.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	375.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE NARRATIVE FOR FULL URL	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE NARRATIVE FOR FULL URL	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE NARRATIVE FOR FULL URL	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (152 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: SANFORD MEDICAL CENTER, - FACILITY 3: SANFORD BROADWAY MEDICAL CENTER FARGO, - FACILITY 4: SANFORD MEDICAL CENTER SOUTH UNIVERSITY, - FACILITY 5: SANFORD BISMARCK MEDICAL CENTER, - FACILITY 6: SANFORD BEMIDJI MEDICAL CENTER, - FACILITY 7: SANFORD MEDICAL CENTER THIEF RIVER FALLS, - FACILITY 8: SANFORD ABERDEEN MEDICAL CENTER, - FACILITY 9: SANFORD WORTHINGTON MEDICAL CENTER, - FACILITY 10: SANFORD SHELDON MEDICAL CENTER, - FACILITY 11: SANFORD VERMILLION MEDICAL CENTER, - FACILITY 12: SANFORD CHAMBERLAIN MEDICAL CENTER, - FACILITY 13: SANFORD LUVERNE MEDICAL CENTER, - FACILITY 14: SANFORD CANBY MEDICAL CENTER, - FACILITY 15: SANFORD JACKSON MEDICAL CENTER, - FACILITY 16: SANFORD TRACY MEDICAL CENTER, - FACILITY 17: SANFORD HILLSBORO MEDICAL CENTER, - FACILITY 18: SANFORD MEDICAL CENTER MAYVILLE, - FACILITY 19: SANFORD WEBSTER MEDICAL CENTER, - FACILITY 20: SANFORD MEDICAL CENTER WHEATON, - FACILITY 21: SANFORD BAGLEY MEDICAL CENTER, - FACILITY 22: SANFORD CANTON-INWOOD MEDICAL CENTER, - FACILITY 23: SANFORD CLEAR LAKE MEDICAL CENTER, - FACILITY 24: SANFORD WESTBROOK MEDICAL CENTER, - FACILITY 2: SANFORD MEDICAL CENTER FARGO, - FACILITY 25: SANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH C
GROUP A-FACILITY 1 -- SANFORD MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 1 -- SANFORD MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 1 -- SANFORD MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 1 -- SANFORD MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO CAREACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE, LOCAL CARE OPTIONS, AND A USUAL SOURCE OF CARE HELP TO ENSURE ACCESS TO HEALTH CARE. HAVING ACCESS TO CARE ALLOWS INDIVIDUALS TO ENTER THE HEALTH CARE SYSTEM, FIND CARE EASILY AND LOCALLY, PAY FOR CARE, AND GET THEIR HEALTH NEEDS MET. SANFORD HAS MADE ACCESS TO CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE ACCESS TO AND AWARENESS OF AFFORDABLE CARE OPTIONS AND TO IMPROVE ACCESS THROUGH VIRTUAL CARE OPTIONS. IT IS SANFORD'S GOAL TO IMPROVE COMMUNITY ACCESS SO CARE IS AVAILABLE AND AFFORDABLE FOR ALL. PRIORITY 2: CHRONIC DISEASE PREVENTIONSANFORD MEDICAL CENTER TAKES AN INTEGRATED APPROACH TO DISEASE PREVENTION. SANFORD PROMOTES THE IMPORTANCE OF HAVING A PRIMARY CARE PROVIDER AND OFFERS SCREENING OPPORTUNITIES FOR EARLY DETECTION AND INTERVENTION OF CHRONIC DISEASE.SANFORD HAS MADE CHRONIC DISEASE PREVENTION A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO BROADEN COMMUNITY AWARENESS OF THE IMPORTANCE OF PRIMARY AND PREVENTIVE CARE AND IMPROVE CARE FOR CHILDREN AT RISK FOR OBESITY. IT IS SANFORD'S GOAL TO IMPROVE CHRONIC DISEASE MANAGEMENT AND REDUCTION OF OBESITY.PRIORITY 3: MENTAL HEALTH AND ADDICTIONMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH AND ADDICTION SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO EXPAND ACCESS TO TIMELY BEHAVIORAL HEALTH CARE AND REDUCE THE NEGATIVE IMPACT OF ADDICTION AND SUBSTANCE ABUSE ON THE COMMUNITY. IT IS SANFORD'S GOAL TO IMPROVE CARE MANAGEMENT FOR RESIDENTS SUFFERING FROM SUBSTANCE ABUSE AND MENTAL HEALTH ISSUES.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR:ACCESS TO CARESANFORD HEALTH WAS A MEMBER OF A COALITION OF PATIENT ADVOCATES, NURSES, HEALTH CARE PROVIDERS, FARMERS, FAITH LEADERS, AND EDUCATORS THAT WORKED TO PASS MEDICAID EXPANSION IN 2022, EXPANDING ELIGIBILITY TO 40,000 PEOPLE IN SD.HEALTH CARE LITERACY AND FINANCIAL ADVOCACY ARE ONGOING EFFORTS. WE COLLABORATE WITH SANFORD HEALTH PLAN TO HELP PATIENTS FIND AFFORDABLE COVERAGE. THE HOSPITAL ALSO HAS ONSITE FINANCIAL ADVOCATES WHO SPECIALIZE IN HEALTH CARE COVERAGE ENROLLMENT AND HELP PATIENTS NAVIGATE SANFORD'S FINANCIAL ASSISTANCE PROGRAM IF ELIGIBLE. WE CONTINUE TO ENHANCE ACCESS THROUGH VIDEO VISITS, TELEHEALTH, E-VISITS, REMOTE HOME MONITORING AND MY SANFORD NURSE. PCPS ARE ABLE TO REACH MORE PATIENTS TIMELY THROUGH VIRTUAL CARE OPTIONS. IN 2021, SANFORD HEALTH ANNOUNCED A VIRTUAL CARE INITIATIVE AS PART OF OUR COMMITMENT TO TRANSFORM HEALTH CARE FOR PATIENTS LIVING IN RURAL AND UNDERSERVED AREAS. VIRTUAL CARE SERVICES CONTINUED TO GROW IN 2022, BOTH AT THE MEDICAL CENTER AND THROUGHOUT THE REGION WITH 26 REGIONAL NETWORK FACILITIES WITH ACCESS TO VIRTUAL SERVICES FOR EMERGENCY SERVICES AS WELL AS TELE STROKE AND TELE BURN. GI, NEPHROLOGY, RHEUMATOLOGY AND PULMONARY WERE ADDED AS PEDIATRIC VIRTUAL OPTIONS IN 2022. CARESIGNAL HOME MONITORING EXPANDED WITH 7 PATIENTS ENROLLED IN 2022 FOR CONGESTIVE HEART FAILURE; 21 FOR DIABETES; AND 43 FOR DEPRESSION. TOTAL VIDEO VISITS IN THE SF REGION IN CY2022 WERE 24,000 AND E-VISITS WERE 12,800.OUR CALL CENTER, INCLUSIVE OF OUR ONE CALL SYSTEM, THE CLINICAL CALL CENTER, AND THE MY SANFORD NURSE LINE RESPONDS TO HUNDREDS OF THOUSANDS OF CALLS EACH YEAR. IN 2022, MY SANFORD NURSE HAD 47,743 CALLS AND THERE WERE 233,045 ONE CALL SYSTEM CALLS BRINGING THE 2022 TOTAL TO A QUARTER OF A MILLION CALLS.CHRONIC DISEASE PREVENTIONIN 2022, SANFORD MEDICAL CENTER (SMC) JOINED A NEW COLLABORATIVE INITIATED BY THE CITY OF SIOUX FALLS PUBLIC HEALTH DEPT. THIS COMMUNITY HEALTH IMPROVEMENT PLAN IS A COMPLEMENT TO THE CHNA BUT WITH A TARGETED FOCUS ON THE SIOUX FALLS METRO. THE CITY, SANFORD, AVERA, AND COMMUNITY PARTNERS DEVELOPED STRATEGIES TO ADDRESS GAPS IN PREVENTIVE CARE, SCREENINGS AND VACCINATIONS. IN 2022, WE LAUNCHED A MATCH WITH A DOCTOR QUIZ ON OUR WEBSITE TO HELP PEOPLE FIND THE RIGHT PROVIDER FOR THEIR NEEDS. WE ADDED COMMUNITY HEALTH WORKERS (CHWS) AT PRIMARY CARE CLINICS IN SIOUX FALLS. CHWS WORK WITH THE MEDICAID POPULATION TO ENSURE THEY RECEIVE APPROPRIATE CARE, INCLUDING PREVENTIVE CARE AND CONNECT THEM TO COMMUNITY RESOURCES AND SUPPORT SERVICES. IN 2022, CHWS LOGGED 658 ENCOUNTERS WITH THIS POPULATION.SMC DID MARKETING AND AWARENESS CAMPAIGNS IN FEBRUARY FOR HEART MONTH. OUR MOBILE HEART SCREENING TRUCK WAS OUT IN THE COMMUNITY FOR A TOTAL OF 31 DAYS IN 2022. OVERALL (IN CLINIC & MOBILE) WE DID 10,095 SCREENINGS IN 2022 (HEART: 5,509 WITH 1,599 POSITIVE SCREENS AND VASCULAR: 4,586 WITH 105 POSITIVE SCREENS).IN MARCH, WE PROMOTED COLORECTAL CANCER SCREENING AND HEALTHY LIFESTYLE HABITS TO DECREASE RISK. EDUCATIONAL INFORMATION WAS SHARED VIA DIRECT MAIL, SOCIAL MEDIA, OUR WEBSITE, AND OUR SANFORD HEALTH NEWS PODCAST SERIES. PRIMARY CARE STAFF ADVISED PATIENTS AS APPROPRIATE WHEN DUE FOR A SCREENING. SANFORD HEALTH ALSO ISSUED A GENERAL PRESS RELEASE NOTIFYING THE PUBLIC THAT THE SCREEN AGE WAS LOWERED FROM 50 TO 45. SMC SAW AN INCREASE IN COLORECTAL SCREENING RATE FROM 67.1% TO 68.2% IN 2022.LOCAL SCHOOLS HAVE ACCESS TO THE SANFORD FIT PROGRAM WHICH ENGAGES AND EMPOWERS CHILDREN AND FAMILIES TO MAKE HEALTHY LIFESTYLE CHOICES. STUDENTS LEARN ABOUT FOOD, PHYSICAL ACTIVITY, MOOD AND ENERGY NEEDS. IN 2022, OUR REGION HAD 3,700 FIT WEBSITE USERS AND 30,082 PAGE VIEWS. THE FIT TEAM CONDUCTED 35 EVENTS IN SIOUX FALLS TO 4,981 CHILDREN.MENTAL HEALTH AND ADDICTIONWE CONTINUE TO EXPAND BEHAVIORAL HEALTH SERVICES COMMENSURATE TO INCREASING DEMAND. EMBEDDING INTEGRATIVE HEALTH THERAPISTS WITHIN PRIMARY CARE CLINICS ENSURES BROADER ACCESS FOR OUR PATIENT POPULATION SEEKING OUTPATIENT CARE AND ENSURING REGULAR AND CONSISTENT SCREENING AND FOLLOW-UP. SMC HAS TWO PSYCHIATRY AND PSYCHOLOGY CLINIC LOCATIONS IN SIOUX FALLS. THE 49TH AND ELMWOOD LOCATION HAS TEN PROVIDERS. THE 84TH AND LOUISE LOCATION HOUSES PSYCHOLOGY AND NEUROPSYCHOLOGY PROVIDERS. WE CURRENTLY HAVE 5 PHYSICIANS, 5 PSYCHOLOGISTS, 2 NEUROPSYCHOLOGISTS, 7 APPS, 11 BEHAVIORAL HEALTH THERAPISTS. WE ARE ACTIVELY RECRUITING FOR ADDITIONAL PROVIDERS AT THE 49TH STREET LOCATION. WE ADDED 7 PROVIDERS IN 2022. WE HAD 36,505 TOTAL COMPLETED APPOINTMENTS INCLUDING OVER 5,000 NEW REFERRALS IN 2022. OF THE OVER 36,000 VISITS, 2,827 WERE MYCHART TELEMED HOME VISITS, 2,621 WERE TELEMED HOME VISITS (FACETIME), 13,301 WERE IN-CLINIC VISITS, AND OVER 11,000 WERE INDIVIDUAL THERAPY APPOINTMENTS. THE TOTAL ALSO INCLUDES A FEW OTHER VISIT TYPES OF LOWER VOLUMES INCLUDING GROUP THERAPY, MYCHART ADULT NURSE, AND NURSE VISITS FOR INJECTIONS OR BLOOD PRESSURE CHECKS.THE LINK, A COMMUNITY TRIAGE CENTER, IS THE RESULT OF A PARTNERSHIP BETWEEN SANFORD, THE CITY OF SIOUX FALLS, MINNEHAHA COUNTY, AND AVERA HEALTH TO CREATE A SAFE PLACE FOR PEOPLE EXPERIENCING NON-VIOLENT BEHAVIORAL HEALTH CRISIS OR NEEDING CARE FOR SUBSTANCE ABUSE. IT OFFERS ACCESS TO IMMEDIATE TREATMENT AND REFERRAL TO SUPPORT SERVICES FOR COMMUNITY RESIDENTS. SANFORD HEALTH ALSO HAS LICENSED ALCOHOL AND DRUG COUNSELORS AVAILABLE TO PROVIDE EVALUATION, RECOVERY SUPPORT, COUNSELING, AND OTHER RESOURCES. SMC STAFF AND PROVIDERS FOLLOW SANFORD ENTERPRISE BEST PRACTICES REGARDING OPIOID PRESCRIBING AND TREATMENT. THE EMR PROMPTS PROVIDERS TO CHECK PRESCRIPTION DRUG MONITORING PROGRAM BEFORE PRESCRIBING OPIOIDS, PERFORM ROUTINE YEARLY URINE DRUG SCREEN TESTS, PROVIDE EDUCATIONAL RESOURCES IN DEALING WITH PRESCRIBING OPIOIDS, AND GIVE CONTROLLED SUBSTANCE AGREEMENTS FOR PATIENTS USING OPIOIDS CHRONICALLY. THE ONECHART SYSTEM HAS AN OPIOID MANAGEMENT DASHBOARD WHERE PAIN AGREEMENTS, DRUG TESTS, AND NALOXONE COMPLIANCE ARE MONITORED. THERE IS ALSO A CHRONIC OPIOID USE REGISTRY TO SEE WHO HAS AN UPDATED OPIOID RISK TOOL ASSESSING RISK OF OPIOID ABUSE AND PAIN SCREENING TOOL. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE: LONG-TERM CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 1 -- SANFORD MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 1 -- SANFORD MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 3 -- SANFORD BROADWAY MEDICAL CENTER FARGO PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 3 -- SANFORD BROADWAY MEDICAL CENTER FARGO PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 3 -- SANFORD BROADWAY MEDICAL CENTER FARGO PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 3 -- SANFORD BROADWAY MEDICAL CENTER FARGO PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO AFFORDABLE HEALTH CAREACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE, LOCAL CARE OPTIONS, AND A USUAL SOURCE OF CARE HELP TO ENSURE ACCESS TO HEALTH CARE. HAVING ACCESS TO CARE ALLOWS INDIVIDUALS TO ENTER THE HEALTH CARE SYSTEM, FIND CARE EASILY AND LOCALLY, PAY FOR CARE, AND GET THEIR HEALTH NEEDS MET. NDSU REPORTED HEALTH CARE ACCESSIBILITY AND COST AS TWO SEPARATE HEALTH NEEDS. THE CASS-CLAY WORKING GROUP DETERMINED THAT THE TWO TOPICS ARE MOST APPROPRIATELY ADDRESSED AS A COMBINED TOPIC FOR PURPOSES OF THE LOCAL CHNA PROCESS.SANFORD HAS MADE HEALTHCARE ACCESS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND HEALTHCARE ACCESS AND ACCESS TO PRIMARY CARE SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD SEE THAT PATIENTS WILL HAVE GREATER EASE TO ACCESS PRIMARY CARE PROVIDERS FOR VIRTUAL OR IN-PERSON VISITS, HOME VISITS AND INCREASED EXPANDED HOURS. PATIENTS MAY EXPERIENCE LESS FREQUENT UTILIZATION OF EMERGENCY CARE, WHICH IS OFTEN MORE EXPENSIVE THAN PREVENTATIVE AND SCREENING SERVICES.PRIORITY 2: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSEMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO RECRUIT PROVIDERS, INCREASE ACCESS TO CARE AND MENTAL HEALTH PROMOTION. IT IS SANFORD'S GOAL TO HAVE BETTER ACCESS TO AND UTILIZATION OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES DUE TO SERVICES BEING PROVIDED AT THE RIGHT TIME AND RIGHT PLACE. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR: ACCESS TO AFFORDABLE HEALTH CARESANFORD FARGO ESTABLISHED TWO GOALS IN SUPPORT OF THE PRIORITY, ACCESS TO AFFORDABLE HEALTH CARE. THE FIRST IS TO EXPAND HEALTHCARE ACCESS AND SUPPORT RESOURCES FOR VULNERABLE AND UNDERSERVED POPULATIONS. THE SECOND IS TO EXPAND PLATFORM AND ACCESS TO PRIMARY CARE SERVICES.ONE STRATEGY IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROGRAM IS TO MAKE VIRTUAL VISITS AVAILABLE FOR ALL PRIMARY CARE PROVIDERS. AS OF THE END OF 2022, ACCESS TO TELEHEALTH IS AVAILABLE FOR ALL FAMILY MEDICINE PROVIDERS, WHICH ALLOWS PATIENTS TO RECEIVE CARE WITHIN THEIR HOMES IF THEY DO NOT HAVE ACCESS TO RELIABLE TRANSPORTATION OR CANNOT TRAVEL FOR APPOINTMENTS. TO INCREASE PRIMARY CARE AVAILABILITY, THE FAMILY MEDICINE RESIDENCY PROGRAM HAS BEGUN OUTREACH TO JEFFERSON ELEMENTARY (FARGO PUBLIC SCHOOLS) AND WILL BE EXPANDING TO YOUTHWORKS. JEFFERSON ELEMENTARY HAS APPROXIMATELY 288 STUDENTS, 231 OF WHICH ARE ELIGIBLE TO PARTICIPATE IN THE FREE LUNCH AND REDUCED-PRICE LUNCH PROGRAMS, ACCORDING TO THE NATIONAL CENTER FOR EDUCATION STATISTICS. YOUTHWORKS IS A "501C3 NON-PROFIT DEDICATED TO PROVIDING YOUTH AND FAMILY SERVICES THROUGHOUT NORTH DAKOTA. THEIR FOCUS AND EXPERTISE IS IN WORKING WITH TEENS, PARENTS, AND YOUNG ADULTS UNDER 22 YEARS OF AGE. OUR SERVICES INCLUDE PROGRAMS FOR RUNAWAY, HOMELESS AND STREET YOUTH; JUVENILE OFFENDERS; YOUTH FAILING IN SCHOOL; YOUTH SUSPENDED OR EXPELLED FROM SCHOOL; YOUNG PARENTS AND PREGNANT MOMS (UNDER 22); YOUTH ARRESTED AND UNABLE TO IMMEDIATELY RETURN HOME; YOUTH NEEDING EMERGENCY CARE; YOUTH NEEDING PEER SUPPORT OR CROSS-AGE MENTORING; AND YOUTH WITH ANGER ISSUES." THIS STRATEGY WILL HELP IMPROVE ACCESS FOR VULNERABLE AND UNDERSERVED RESIDENTS OF THE FARGO/MOORHEAD METRO AREA.A NEW PRIMARY CARE CLINIC IS UNDER CONSTRUCTION IN HORACE, ND AND IS SET TO OPEN IN 2023. THIS WILL SERVE THE NEEDS OF THE RAPIDLY GROWING TOWN OF HORACE AS WELL AS PORTIONS OF WEST FARGO TO ALLOW FOR INCREASED SPEED OF ACCESS TO INDIVIDUALS ACROSS ALL CLINICS. THREE NEW PROVIDERS WERE RECRUITED TO PRIMARY CARE. THE NEW PROVIDERS TOTALED 148 VISITS UPON STARTING IN THE FOURTH QUARTER OF 2022.MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE THREE GOALS SUPPORT THE MENTAL HEALTH AND SUBSTANCE ABUSE GOAL. THE FIRST IS RECRUITING PROVIDERS AND INCREASING ACCESS TO CARE. THE SECOND IS TO DEVELOP A COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION. THE THIRD IS TO DECREASE SUBSTANCE ABUSE.TO INCREASE ACCESS TO MENTAL HEALTH CARE, SANFORD FARGO EXPANDED ITS PARTNERSHIP WITH REGIONAL SCHOOLS TO PROVIDE STUDENT PLACEMENT FOR MASTER'S LEVEL THERAPISTS INTO THE INTERNAL MEDICINE DEPARTMENT. COORDINATION OF CARE WITH PRIMARY CARE, EMERGENCY DEPARTMENT, AND HOSPITAL CARE COORDINATION HAS RESULTED IN THE WAIT LIST FOR BEHAVIORAL HEALTH AND PSYCHIATRY APPOINTMENTS DECREASING FROM 2,000 PATIENTS TO 180 PATIENTS WAITING TO BE SCHEDULED. FURTHERMORE, ACCESS TO SUPPORTIVE BEHAVIORAL HEALTH SERVICES AND RESOURCES HAVE IMPROVED IN THE HOSPITAL WITH THE CREATION OF A DEDICATED UNIT AT THE SANFORD MEDICAL CENTER FARGO FOR PATIENTS ADMITTED FOR MEDICAL CARE WHO REQUIRE ADDITIONAL BEHAVIORAL HEALTH SUPPORT. IN 2022, SANFORD FARGO COMPLETED 10,083 COMPLETED VIDEO VISITS, 144 TRADITIONAL TELEMEDICINE AND 90 VERBAL VISITS.SANFORD FARGO CONDUCTED A DEPRESSION SCREENING INITIATIVE THROUGHOUT SANFORD-FARGO CLINICS TO SUPPORT COMMUNITY MENTAL HEALTH PROMOTION. THE PROMOTION RESULTED IN 40,000 DEPRESSION SCREENINGS COMPLETED BY INTERNAL MEDICINE, FAMILY MEDICINE, AND OB/GYN PROVIDERS AND RESIDENCY CLINICS. FOR ALL POSITIVE DEPRESSION SCREENINGS, THERE WAS A DOCUMENTED FOLLOW-UP PLAN WITHIN 14 DAYS OF THE SCREENING. SANFORD AMBULANCE REPORTED 1,200 PATIENTS RECEIVING CARE RELATED TO ALCOHOL USE, 1,350 RELATED TO BEHAVIORAL HEALTH/PSYCHIATRIC EPISODE. SANFORD FARGO IS ACTIVELY RECRUITING A NEW PROVIDER TO SUPPORT SUBOXONE CLINIC FOR PATIENTS WORKING ON ADDICTION AND RECOVERY TO DECREASE SUBSTANCE ABUSE. FURTHER SUPPORT IS PROVIDED THROUGH HOSPITAL PEER COACHING, WITH CONTINUED WORK WITH F5 AND THE LOTUS CENTER THROUGHOUT 2022 TO PROVIDE PEER COACHING IN THE HOSPITAL. SANFORD FARGO ALSO ENGAGES IN A PARTNERSHIP WITH CASS COUNTY'S WITHDRAWAL MANAGEMENT UNIT TO ENSURE COORDINATED UTILIZATION OF MEDICAL AND LAW ENFORCEMENT SUPPORT FOR INDIVIDUALS ACTIVELY IN DETOX.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:PHYSICAL ACTIVITY AND NUTRITIONSENIOR HOUSING AND LONG-TERM CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSING, EMPLOYMENT, ECONOMIC DEVELOPMENTDIVERSITY, INCLUSION, HEALTH EQUITYCHILDCAREHEALTH LITERACY AND NAVIGATIONSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 3 -- SANFORD BROADWAY MEDICAL CENTER FARGO PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 3 -- SANFORD BROADWAY MEDICAL CENTER FARGO PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 4 -- SANFORD MEDICAL CENTER SOUTH UNIVERSITY PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 4 -- SANFORD MEDICAL CENTER SOUTH UNIVERSITY PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 4 -- SANFORD MEDICAL CENTER SOUTH UNIVERSITY PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 4 -- SANFORD MEDICAL CENTER SOUTH UNIVERSITY PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO AFFORDABLE HEALTH CARE ACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE, LOCAL CARE OPTIONS, AND A USUAL SOURCE OF CARE HELP TO ENSURE ACCESS TO HEALTH CARE. HAVING ACCESS TO CARE ALLOWS INDIVIDUALS TO ENTER THE HEALTH CARE SYSTEM, FIND CARE EASILY AND LOCALLY, PAY FOR CARE, AND GET THEIR HEALTH NEEDS MET. NDSU REPORTED HEALTH CARE ACCESSIBILITY AND COST AS TWO SEPARATE HEALTH NEEDS. THE CASS-CLAY WORKING GROUP DETERMINED THAT THE TWO TOPICS ARE MOST APPROPRIATELY ADDRESSED AS A COMBINED TOPIC FOR PURPOSES OF THE LOCAL CHNA PROCESS.SANFORD HAS MADE HEALTHCARE ACCESS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND HEALTHCARE ACCESS AND ACCESS TO PRIMARY CARE SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD SEE THAT PATIENTS WILL HAVE GREATER EASE TO ACCESS PRIMARY CARE PROVIDERS FOR VIRTUAL OR IN-PERSON VISITS, HOME VISITS AND INCREASED EXPANDED HOURS. PATIENTS MAY EXPERIENCE LESS FREQUENT UTILIZATION OF EMERGENCY CARE, WHICH IS OFTEN MORE EXPENSIVE THAN PREVENTATIVE AND SCREENING SERVICES.PRIORITY 2: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSEMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO RECRUIT PROVIDERS, INCREASE ACCESS TO CARE AND MENTAL HEALTH PROMOTION. IT IS SANFORD'S GOAL TO HAVE BETTER ACCESS TO AND UTILIZATION OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES DUE TO SERVICES BEING PROVIDED AT THE RIGHT TIME AND RIGHT PLACE. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR: ACCESS TO AFFORDABLE HEALTH CARESANFORD FARGO ESTABLISHED TWO GOALS IN SUPPORT OF THE PRIORITY, ACCESS TO AFFORDABLE HEALTH CARE. THE FIRST IS TO EXPAND HEALTHCARE ACCESS AND SUPPORT RESOURCES FOR VULNERABLE AND UNDERSERVED POPULATIONS. THE SECOND IS TO EXPAND PLATFORM AND ACCESS TO PRIMARY CARE SERVICES.ONE STRATEGY IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROGRAM IS TO MAKE VIRTUAL VISITS AVAILABLE FOR ALL PRIMARY CARE PROVIDERS. AS OF THE END OF 2022, ACCESS TO TELEHEALTH IS AVAILABLE FOR ALL FAMILY MEDICINE PROVIDERS, WHICH ALLOWS PATIENTS TO RECEIVE CARE WITHIN THEIR HOMES IF THEY DO NOT HAVE ACCESS TO RELIABLE TRANSPORTATION OR CANNOT TRAVEL FOR APPOINTMENTS. TO INCREASE PRIMARY CARE AVAILABILITY, THE FAMILY MEDICINE RESIDENCY PROGRAM HAS BEGUN OUTREACH TO JEFFERSON ELEMENTARY (FARGO PUBLIC SCHOOLS) AND WILL BE EXPANDING TO YOUTHWORKS. JEFFERSON ELEMENTARY HAS APPROXIMATELY 288 STUDENTS, 231 OF WHICH ARE ELIGIBLE TO PARTICIPATE IN THE FREE LUNCH AND REDUCED-PRICE LUNCH PROGRAMS, ACCORDING TO THE NATIONAL CENTER FOR EDUCATION STATISTICS. YOUTHWORKS IS A "501C3 NON-PROFIT DEDICATED TO PROVIDING YOUTH AND FAMILY SERVICES THROUGHOUT NORTH DAKOTA. THEIR FOCUS AND EXPERTISE IS IN WORKING WITH TEENS, PARENTS, AND YOUNG ADULTS UNDER 22 YEARS OF AGE. OUR SERVICES INCLUDE PROGRAMS FOR RUNAWAY, HOMELESS AND STREET YOUTH; JUVENILE OFFENDERS; YOUTH FAILING IN SCHOOL; YOUTH SUSPENDED OR EXPELLED FROM SCHOOL; YOUNG PARENTS AND PREGNANT MOMS (UNDER 22); YOUTH ARRESTED AND UNABLE TO IMMEDIATELY RETURN HOME; YOUTH NEEDING EMERGENCY CARE; YOUTH NEEDING PEER SUPPORT OR CROSS-AGE MENTORING; AND YOUTH WITH ANGER ISSUES." THIS STRATEGY WILL HELP IMPROVE ACCESS FOR VULNERABLE AND UNDERSERVED RESIDENTS OF THE FARGO/MOORHEAD METRO AREA.A NEW PRIMARY CARE CLINIC IS UNDER CONSTRUCTION IN HORACE, ND AND IS SET TO OPEN IN 2023. THIS WILL SERVE THE NEEDS OF THE RAPIDLY GROWING TOWN OF HORACE AS WELL AS PORTIONS OF WEST FARGO TO ALLOW FOR INCREASED SPEED OF ACCESS TO INDIVIDUALS ACROSS ALL CLINICS. THREE NEW PROVIDERS WERE RECRUITED TO PRIMARY CARE. THE NEW PROVIDERS TOTALED 148 VISITS UPON STARTING IN THE FOURTH QUARTER OF 2022.MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSETHREE GOALS SUPPORT THE MENTAL HEALTH AND SUBSTANCE ABUSE GOAL. THE FIRST IS RECRUITING PROVIDERS AND INCREASING ACCESS TO CARE. THE SECOND IS TO DEVELOP A COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION. THE THIRD IS TO DECREASE SUBSTANCE ABUSE.TO INCREASE ACCESS TO MENTAL HEALTH CARE, SANFORD FARGO EXPANDED ITS PARTNERSHIP WITH REGIONAL SCHOOLS TO PROVIDE STUDENT PLACEMENT FOR MASTER'S LEVEL THERAPISTS INTO THE INTERNAL MEDICINE DEPARTMENT. COORDINATION OF CARE WITH PRIMARY CARE, EMERGENCY DEPARTMENT, AND HOSPITAL CARE COORDINATION HAS RESULTED IN THE WAIT LIST FOR BEHAVIORAL HEALTH AND PSYCHIATRY APPOINTMENTS DECREASING FROM 2,000 PATIENTS TO 180 PATIENTS WAITING TO BE SCHEDULED. FURTHERMORE, ACCESS TO SUPPORTIVE BEHAVIORAL HEALTH SERVICES AND RESOURCES HAVE IMPROVED IN THE HOSPITAL WITH THE CREATION OF A DEDICATED UNIT AT THE SANFORD MEDICAL CENTER FARGO FOR PATIENTS ADMITTED FOR MEDICAL CARE WHO REQUIRE ADDITIONAL BEHAVIORAL HEALTH SUPPORT. IN 2022, SANFORD FARGO COMPLETED 10,083 COMPLETED VIDEO VISITS, 144 TRADITIONAL TELEMEDICINE AND 90 VERBAL VISITS.SANFORD FARGO CONDUCTED A DEPRESSION SCREENING INITIATIVE THROUGHOUT SANFORD-FARGO CLINICS TO SUPPORT COMMUNITY MENTAL HEALTH PROMOTION. THE PROMOTION RESULTED IN 40,000 DEPRESSION SCREENINGS COMPLETED BY INTERNAL MEDICINE, FAMILY MEDICINE, AND OB/GYN PROVIDERS AND RESIDENCY CLINICS. FOR ALL POSITIVE DEPRESSION SCREENINGS, THERE WAS A DOCUMENTED FOLLOW-UP PLAN WITHIN 14 DAYS OF THE SCREENING. SANFORD AMBULANCE REPORTED 1,200 PATIENTS RECEIVING CARE RELATED TO ALCOHOL USE, 1,350 RELATED TO BEHAVIORAL HEALTH/PSYCHIATRIC EPISODE. SANFORD FARGO IS ACTIVELY RECRUITING A NEW PROVIDER TO SUPPORT SUBOXONE CLINIC FOR PATIENTS WORKING ON ADDICTION AND RECOVERY TO DECREASE SUBSTANCE ABUSE. FURTHER SUPPORT IS PROVIDED THROUGH HOSPITAL PEER COACHING, WITH CONTINUED WORK WITH F5 AND THE LOTUS CENTER THROUGHOUT 2022 TO PROVIDE PEER COACHING IN THE HOSPITAL. SANFORD FARGO ALSO ENGAGES IN A PARTNERSHIP WITH CASS COUNTY'S WITHDRAWAL MANAGEMENT UNIT TO ENSURE COORDINATED UTILIZATION OF MEDICAL AND LAW ENFORCEMENT SUPPORT FOR INDIVIDUALS ACTIVELY IN DETOX.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:PHYSICAL ACTIVITY AND NUTRITIONSENIOR HOUSING AND LONG-TERM CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSING, EMPLOYMENT, ECONOMIC DEVELOPMENTDIVERSITY, INCLUSION, HEALTH EQUITYCHILDCAREHEALTH LITERACY AND NAVIGATIONSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 4 -- SANFORD MEDICAL CENTER SOUTH UNIVERSITY PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 4 -- SANFORD MEDICAL CENTER SOUTH UNIVERSITY PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 5 -- SANFORD BISMARCK MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 5 -- SANFORD BISMARCK MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 5 -- SANFORD BISMARCK MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 5 -- SANFORD BISMARCK MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICESMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE ACCESS TO BEHAVIORAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN IMPROVED CONTINUUM OF CARE APPROACH TO ADDRESSING MENTAL AND BEHAVIORAL HEALTH NEEDS AND SUBSTANCE USE DISORDERS. PRIORITY 2: IMPROVE ACCESS TO AFFORDABLE CAREACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE, LOCAL CARE OPTIONS, AND A USUAL SOURCE OF CARE HELP TO ENSURE ACCESS TO HEALTH CARE. HAVING ACCESS TO CARE ALLOWS INDIVIDUALS TO ENTER THE HEALTH CARE SYSTEM, FIND CARE EASILY AND LOCALLY, PAY FOR CARE, AND GET THEIR HEALTH NEEDS MET. SANFORD HAS MADE HEALTHCARE ACCESS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE AND IMPROVE ACCESS TO SERVICES. IMPROVING ACCESS TO HEALTHCARE SERVICES HAS BOTH FINANCIAL AND QUALITY OF LIFE IMPLICATIONS ON THE COMMUNITY. BY HELPING COMMUNITY MEMBERS ACCESS THE RIGHT CARE AT THE RIGHT TIME IN THE RIGHT PLACE, THEY ARE BETTER ABLE TO PREVENT AND MANAGE CHRONIC DISEASE AND ENJOY A BETTER QUALITY OF LIFE. FROM A FINANCIAL PERSPECTIVE, BETTER ACCESS TO CARE CAN BE MEASURED IN REDUCED UNNECESSARY EMERGENCY VISITS AND HOSPITALIZATIONS. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICESTWO GOALS WERE IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS TO IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES, A VITAL NEED FOR THE COMMUNITIES SERVED BY SANFORD HEALTH. THE FIRST GOAL ADVANCES SCHOOL-BASED SERVICES FOR PEDIATRIC PATIENTS WHILE THE SECOND GOAL EXPANDS BEHAVIORAL HEALTH SERVICES AVAILABLE THROUGH THE EMERGENCY DEPARTMENT. SANFORD HEALTH HAS PARTNERED WITH NUMEROUS SCHOOLS IN THE BISMARCK PUBLIC SCHOOLS DISTRICT TO PROVIDE ONSITE BEHAVIORAL HEALTH SERVICES AS PART OF A COMPREHENSIVE TIERED-SYSTEM APPROACH TO PROVIDING RESILIENCY TRAINING AND INTERVENTIONS TO HELP STUDENTS BE SUCCESSFUL. FOR THOSE STUDENTS WHO MAY BENEFIT FROM SERVICES PROVIDED BY A LICENSED BEHAVIORAL HEALTH PROVIDER, SANFORD HEALTH'S ROLE IN THIS PARTNERSHIP IS TO PROVIDE ONSITE CARE. FURTHER, SANFORD'S THERAPIST MEETS WEEKLY WITH THE SCHOOLS' LEADERSHIP TEAMS TO BETTER COORDINATE SUPPORT SERVICES FOR HIGH-RISK STUDENTS. TO ENSURE ACCESS, SANFORD PROVIDED TELEHEALTH VISIT OPTIONS AND CONTINUED CARING FOR THE STUDENTS DURING THE SUMMER BREAK. THIS PROJECT BEGAN AS A PILOT PROGRAM WITH SIMLE MIDDLE SCHOOL. IN 2022, SANFORD PROVIDED 341 VISITS WITH SIMLE STUDENTS AND THEIR FAMILIES AND EXTENDED THE SERVICE EIGHT ADDITIONAL SCHOOLS, PROVIDING A TOTAL OF 989 VISITS IN 2022. SANFORD PARTNERS WITH HEARTVIEW FOUNDATION, A SUBSTANCE USE DISORDER TREATMENT CENTER, TO CO-LOCATE A COUNSELOR IN SANFORD'S EMERGENCY ROOM. THE COUNSELOR MET WITH 159 PATIENTS, 93 OF WHOM WERE REFERRED TO TREATMENT AT HEARTVIEW OR ELSEWHERE. HEARTVIEW OFFERS A 16-BED RESIDENTIAL FACILITY IN BISMARCK AMONG OTHER SERVICES. THE ORGANIZATION HAS ADDITIONAL RESIDENTIAL FACILITIES IN CANDO, ND, AND DICKINSON, ND.SANFORD EXPANDED ITS PARTNERSHIP WITH HEARTVIEW BY COLLABORATING WITH HEARTVIEW AND THE BISMARCK POLICE DEPARTMENT ON A GRANT APPLICATION TO PROVIDE TREATMENT FOR PATIENTS WITH CHRONIC SUD AND/OR OPIOID OVERDOSE. THE GRANT WAS APPROVED JANUARY 2022, AND THE PROGRAM BEGAN AUGUST 2022. SANFORD HAS REFERRED 13 PATIENTS TO HEARTVIEW FOR SUD MEDICATION-ASSISTED TREATMENT OPPORTUNITIES. AS PART OF THE PROGRAM TO HELP PATIENTS WHO EXPERIENCE AN OVERDOSE BE SUCCESSFUL IN SEEKING TREATMENT, SANFORD PHYSICIANS PRESCRIBE BUPRENORPHINE TO HELP PATIENTS SAFELY TRANSITION TO A MEDICATION-ASSISTED THERAPY PROGRAM. IMPROVE ACCESS TO AFFORDABLE CARESANFORD BISMARCK IS ADDRESSING THE PRIORITY THROUGH TWO GOALS: REDUCING HEALTHCARE COSTS BY REDUCING AVOIDABLE VISITS AND INCREASING HEALTHCARE COVERAGE IN THE COMMUNITY. RESIDENTS OF THE CHNA AREA CONDUCTED 3,378 SEARCHES ON THE FINDHELP PLATFORM IN 2022. A QUARTER OF THEM WERE HEALTH RELATED.COMMUNITY HEALTH WORKERS (CHWS) ARE ONE OF THE STRATEGIES DEPLOYED BY THE REGION TO REDUCE AVOIDABLE VISITS. CHWS ARE TRAINED PUBLIC HEALTH WORKERS WHO SERVE AS A BRIDGE BETWEEN COMMUNITIES AND THE HEALTHCARE SYSTEM. THEY ARE NON-LICENSED PROVIDERS WITH SPECIFIC TRAINING TO HELP PATIENTS ADDRESS THEIR SOCIAL DETERMINANTS OF HEALTH OUTSIDE THE CLINIC SETTING.SANFORD HEALTH BISMARCK ADDED A COMMUNITY HEALTH WORKER TO HELP ADDRESS PATIENT NEEDS OUTSIDE THE FOUR WALLS OF A CLINIC OR A HOSPITAL. THE CHW WORKS WITH PATIENTS TO IMPROVE HEALTH OUTCOMES BY HELPING THOSE WHO MIGHT OTHERWISE HAVE TROUBLE ACCESSING THE HEALTH SYSTEM AND BY CONNECTING PATIENTS TO COMMUNITY SERVICES SUCH AS HOUSING, TRANSPORTATION, AND FOOD. THE CHW PLAYS AN IMPORTANT ROLE WITH HEALTH SYSTEM CARE TEAMS AND HAS A UNIQUE KNOWLEDGE OF BARRIERS TO ACCESS AND ARE EXPERTS IN OVERCOMING THOSE BARRIERS.IN 2022, SANFORD BISMARCK'S CHW HELPED 164 PATIENTS. BY HELPING PATIENTS CONNECT TO NEEDED COMMUNITY SERVICES AND OTHER HEALTH-RELATED LIVING FACTORS, THE CHW HELPED REDUCE AVOIDABLE ER VISITS AND AVOIDABLE HOSPITALIZATIONS FOR THESE PATIENTS BY 56 PERCENT AND 68 PERCENT, RESPECTIVELY. BOTH THE HEALTH IMPROVEMENT AND COST SAVINGS FOR BOTH THE PATIENT AND THE HEALTHCARE SYSTEM ARE TREMENDOUS. TO INCREASE HEALTHCARE COVERAGE IN THE COMMUNITY, SANFORD HEALTH HAS INTEGRATED FULLTIME, ONSITE FINANCIAL ADVOCATES WHO SPECIALIZE IN HEALTHCARE COVERAGE ENROLLMENT TO HELP COMMUNITY MEMBERS WHO ARE UNINSURED AND UNDERINSURED SECURE ACCESS TO HEALTHCARE SERVICES. THEY HELP SANFORD PATIENTS AS WELL AS COMMUNITY REFERRALS.HEALTH INSURANCE COVERAGE: SANFORD BISMARCK'S FINANCIAL ADVOCATES HELPED 3,363 UNINSURED AND UNDERINSURED PATIENTS AND THEIR FAMILIES SECURE HEALTH CARE COVERAGE, HELPING PATIENTS PAY FOR MUCH-NEEDED HEALTHCARE SERVICES AND ONGOING CARE.THE SANFORD HEALTH FOUNDATION ALSO SUPPORTS PATIENTS THAT MAY BE TEMPORARILY UNABLE TO AFFORD THE MEDICATIONS THEY NEED DUE TO EXTENUATING CIRCUMSTANCES, E.G., SUDDEN LOSS OF EMPLOYMENT, SANFORD'S FOUNDATION ESTABLISHED A FUND TO HELP COMMUNITY MEMBERS. ESTABLISHED INTERNAL WORKFLOW PROCESSES TO HELP INDIVIDUALS UNABLE TO AFFORD PRESCRIPTIONS RECEIVE THE MEDICATION FREE OF CHARGE.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:HEALTHY LIVING ACCESS TO HEALTH CARE PROVIDERSLONG-TERM CARE PUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 5 -- SANFORD BISMARCK MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 5 -- SANFORD BISMARCK MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 6 -- SANFORD BEMIDJI MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 6 -- SANFORD BEMIDJI MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 6 -- SANFORD BEMIDJI MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 6 -- SANFORD BEMIDJI MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO HEALTH CARE: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ADD ADDITIONAL BEHAVIORAL HEALTH PROVIDERS, PROGRAMS, IMPROVED ACCESS, AND ALTERNATE WAYS TO ENGAGE WITH BEHAVIORAL HEALTH PROVIDERS. IT IS SANFORD'S GOAL TO PROVIDE ACCESS TO QUALITY AND TIMELY HEALTH CARE RELATED TO MENTAL HEALTH AND SUBSTANCE ABUSE. PRIORITY 2: HEALTHY LIVINGIN THE UNITED STATES, MANY OF THE LEADING CAUSES OF DEATH AND DISEASE ARE ATTRIBUTED TO UNHEALTHY BEHAVIORS. FOR EXAMPLE, POOR NUTRITION AND LOW LEVELS OF PHYSICAL ACTIVITY ARE ASSOCIATED WITH HIGHER RISK OF CARDIOVASCULAR DISEASE, TYPE 2 DIABETES, AND OBESITY. TOBACCO USE IS ASSOCIATED WITH HEART DISEASE, CANCER, AND POOR PREGNANCY OUTCOMES IF THE MOTHER SMOKES DURING PREGNANCY. EXCESSIVE ALCOHOL USE IS ASSOCIATED WITH INJURIES, CERTAIN TYPES OF CANCERS, AND CIRRHOSIS. SANFORD HAS MADE HEALTHY LIVING A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN OPTIONS AND ASSISTANCE FOR HEALTHY LIVING. IT IS SANFORD'S GOAL TO FOCUS ON HEALTHY LIVING TO INCLUDE ASSESSMENT AND TREATMENT OF CHRONIC HEALTH ISSUES, LEVELS OF PHYSICAL ACTIVITY AND FOOD INSECURITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO HEALTH CARE: MENTAL HEALTHWE IDENTIFIED FOUR GOALS TO ADDRESS MENTAL HEALTH ACCESS. THE FIRST IS TO DEVELOP A FULLY INTEGRATED BEHAVIORAL HEALTH SYSTEM, RESULTING IN INCREASED ACCESS AND QUALITY CARE AND BECOME A CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC (CCBHC). THE SECOND GOAL IS TO INCREASE ACCESS TO URGENT AND EMERGENT BEHAVIORAL HEALTH SERVICES FOR COMMUNITY MEMBERS IN BEHAVIORAL HEALTH CRISIS. SANFORD BEMIDJI ALSO SEEKS THE GOALS OF INCREASING ACCESS TO CULTURALLY SENSITIVE SUBSTANCE ABUSE PREVENTION AND TREATMENT AND INCREASING ACCESS TO CHILDREN'S BEHAVIORAL HEALTH SERVICES. WE ANTICIPATE BECOMING A CCBHC, CERTIFIED BY THE MINNESOTA DEPARTMENT OF HEALTH, IN MARCH 2023. A 2-YEAR FEDERAL GRANT FOR CCBHC IMPLEMENTATION WILL END IN FEBRUARY 2023 AND INCLUDED 1,360 PATIENT INTAKES. SANFORD IS RECRUITING FOR ADDITIONAL PROVIDERS, WHICH RESULTED IN SIGNING TWO PSYCHIATRISTS AND THREE APPS. ADDITIONAL NEEDS WERE SUPPORTED THROUGH FURTHER DEVELOPMENT OF SCHOLARSHIPS AND INTERNSHIPS PROGRAMMING WITH EIGHT INTERNS ADDED IN 2022. THIS SUPPORTS THE NEEDS OF BOTH THE SYSTEM AND THE STUDENTS SEEKING A CAREER IN THE MEDICAL FIELD.IN ADDITION TO THE NEEDS WITHIN THE CHNA COMMUNITY, SANFORD IS EXPLORING THE EXPANSION OF BEHAVIORAL HEALTH SERVICES INTO SECONDARY MARKETS IN MULTIPLE COMMUNITIES ADJACENT TO THE CURRENT SERVICE FOOTPRINT. BEHAVIORAL HEALTH SERVICES WERE EXPANDED INTO PARK RAPIDS THROUGH THE ACQUISITION OF A BETTER CONNECTION COMPLETED 12/2021. THE ADDITION TO THE SANFORD ORGANIZATION INCREASED SERVICES BY 20% WITH A 1.0 CARE COORDINATOR, AND 1.0 BHC.HEARTLAND LAKES DEVELOPMENT (HLD) HAS SECURED THE LAND TO BUILD A SUPPORTIVE HOUSING COMPLEX. NEXT STEPS IN THE PLANNING/CONSTRUCTION HAVE NOT STARTED. WE CONTINUE TO COMMUNICATE WITH HLD AS PLANS ARE DEVELOPED.CONSTRUCTION WAS COMPLETED ON THE BEHAVIORAL HEALTH CRISIS CENTER HOSPITAL AND EMPATH UNITS. A SOFT ROLL-OUT FOR EMPATH STARTED DECEMBER 2022 AND THE IP UNIT OPENED IN FEBRUARY 2023. ACCESS TO MOBILE CRISIS SERVICES WAS EXPANDED BY INCREASING FULL-TIME FTES.TO INCREASE ACCESS TO CULTURALLY SENSITIVE SUBSTANCE ABUSE PREVENTION AND TREATMENT, BEHAVIORAL HEALTH'S SUD PROGRAM BECAME A WELLBRIETY CERTIFIED TREATMENT CENTER IN 2022. MEETING THIS CRITERIA ENSURES ALL COUNSELORS ARE TRAINED IN AND INCORPORATE CULTURALLY BASED CURRICULUM, PROVIDES ACCESS TO A NATIVE AMERICAN ELDER WHO CONDUCTS CEREMONIES AND PROVIDES TEACHINGS, AND INCORPORATES TRADITIONAL NATIVE AMERICAN HEALING PRACTICES (SMUDGING, PIPE CEREMONY, SWEAT LODGE, ETC.) INTO THE PROGRAM.THE MEDICATION ASSISTED TREATMENT PROGRAM MOVED TO THE 1705 CLINIC AND TRANSITIONED TO THE BH UMBRELLA.EXPANDING BH SERVICES INTO SECONDARY IS BEING EXPLORED IN MULTIPLE COMMUNITIES ADJACENT TO THE CURRENT SERVICE FOOTPRINT TO INCREASE ACCESS TO CHILDREN'S BH SERVICES.CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS EXPANDED WITH CONTINUED PLANNING FOR MORE IN-HOME SERVICES. HOWEVER, IN-SCHOOL SERVICE NEEDS HAVE DRAMATICALLY INCREASED. THE SCHOOL LINKED MENTAL HEALTH GRANT REQUEST WAS INCREASED BY $300,000, TO SUPPORT AN INCREASE OF FIVE FTES TO SERVE ADDITIONAL SCHOOLS. WE WILL BE OFFERING CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS TO ALL BEMIDJI SCHOOLS.HEALTHY LIVINGWE ESTABLISHED FOUR GOALS WITHIN THE PRIORITY: ASSESSMENT AND TREATMENT OF CHRONIC HEALTH ISSUES, ASSESSMENT AND TREATMENT OF CHRONIC HEALTH ISSUES, FOOD INSECURITY, AND EXPAND SUPPORT OF HUBBARD COUNTY AND PARK RAPIDS THROUGH LOCAL COMMUNITY PARTNERS AND FOCUS ON THE ISSUES OF HEALTHY LIFESTYLES, BEHAVIORAL HEALTH, AFFORDABLE HOUSING, AND WORKFORCE DEVELOPMENT.WE STARTED 2022 COMMITTED TO IMPROVING DEPRESSION SCREENING IN PRIMARY CARE. DURING THE YEAR, WE ADDED DEPRESSION SCREENING TO SEVERAL SPECIALTY DEPARTMENTS AND THE WALK-IN CLINIC. THE RESULTS WERE EXCELLENT. IN A 1-MONTH PERIOD, FALL 2022, THE WALK-IN CLINIC ALONE SCREENED OVER 1,000 PATIENTS THAT LIKELY WOULD HAVE BEEN MISSED. AT YEAR END, THE PRIMARY CARE CLINICS SCREENED 65.7% OF ELIGIBLE PATIENTS, AN IMPROVEMENT FROM 48.3% IN 2021. THIS RATE PLACES OUR PRIMARY CARE IN THE TOP 30% OF ALL CLINICIANS NATIONWIDE. ADDING THE SPECIALTY AND WALK-IN CLINICS IMPROVED THE REGIONAL SCREENING FROM 42.9% TO 49.3% OF ELIGIBLE PATIENTS AND RANKS BETTER THAN 50% NATIONWIDE. DEPRESSION REMISSION RATES ALSO IMPROVED IN PRIMARY CARE AND THE REGION. PRIMARY CARE IMPROVED FROM 14% TO 16%, AND ALTHOUGH THESE NUMBERS SEEM LOW, THEY ARE ALSO IN THE TOP 30% NATIONWIDE. THE REGION IS IN TOP HALF.THE PRIMARY CARE GOAL OF REDUCING UNCONTROLLED DIABETES TO BETTER THAN 23.5% WAS REALIZED, MOVING FROM 24.6% OF PATIENTS UNCONTROLLED TO 22.1% (TOP 20% NATIONWIDE). REFERRALS TO SELF-CARE IMPROVED FROM 0-2 PER MONTH IN AUGUST 2021 TO 15 PATIENTS/MONTH BY AUGUST 2022 THROUGH PROMOTION EFFORTS. PATIENTS WHO ATTEND THE BETTER CHOICES/BETTER HEALTH CLASS HAVE A 12% IMPROVEMENT IN MEDICATION COMPLIANCE.THE PEDIATRIC CLINIC IMPLEMENTED THE FOOD PANTRY IN JUNE 2022. DUE TO STAFFING CONSTRAINTS THE CLINIC WAS UNABLE TO SCREEN EACH FAMILY AS ORIGINALLY PLANNED. STAFFING CONSTRAINTS ARE DECREASING, THE PANTRY HAD A RESET JAN. 2023. IN THE MONTH OF JANUARY IT WAS ESTIMATED THAT APPROXIMATELY 350-400 LBS OF FOOD WAS GIVEN OUT. THIS IMPACTED 6 FAMILIES, INCLUDING A FAMILY OF 12. THE GOAL MOVING FORWARD IS TO SCREEN EACH FAMILY AT WELL-CHILD CHECKS. STAFF WILL MONITOR THE NUMBER OF PATIENTS SCREENED COMPARED TO THE NUMBER OF WELL-CHILD CHECKS. OVER TIME WE WILL LOOK TO EXPAND THIS TO OTHER VISIT TYPES. SANFORD STAFF ATTEND QUARTERLY ACTION PARK RAPIDS NON-PROFIT AGENCY NETWORKING MEETINGS TO LISTEN TO THE NEEDS/CONCERNS OF THE NON-PROFIT COMMUNITY INCLUDING SOCIAL ISSUES, EDUCATION AND EXPANDED BEHAVIORAL HEALTH NEEDS. COLLABORATION WITH UNITED WAY TO FIND INITIATIVE IN HUBBARD COUNTY.SANFORD PARTICIPATED IN THE CHI ST. JOSEPH HEALTH CARE/HUBBARD CHNA SURVEY AND STAKEHOLDERS MEETING.WE SURVEYED OUR STAFF WHO HAVE DEPENDENTS ON THEIR CHILDCARE NEEDS. QUESTIONS INCLUDED THE TIMES THEY NEEDED CARE, AS WELL AS NUMBER OF KIDS AND NUMBER OF HOURS PER WEEK. THE RESPONSE RATE WAS APPROXIMATELY 40%. THE HIGHEST NEEDS OF OUR STAFF INCLUDE DROP IN AND BACKUP CHILD CARE (FOR THE TIMES THEIR REGULAR DAYCARE BECOMES SICK OR TAKES VACATION), AND INFANT SPOTS. CONVERSATIONS CONTINUE WITH COMMUNITY PARTNERS ON HOW ADDITIONAL CHILDCARE IN OUR COMMUNITY CAN BE SUPPORTED.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:EMPLOYMENT AND INCOMEACCESS TO AFFORDABLE HEALTH CAREAFFORDABLE HOUSINGPUBLIC TRANSPORTATIONCHILD CARE QUALITYCOMMUNITY SAFETYSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 6 -- SANFORD BEMIDJI MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 6 -- SANFORD BEMIDJI MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 7 -- SANFORD MEDICAL CENTER THIEF RIVER FALLS PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 7 -- SANFORD MEDICAL CENTER THIEF RIVER FALLS PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 7 -- SANFORD MEDICAL CENTER THIEF RIVER FALLS PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 7 -- SANFORD MEDICAL CENTER THIEF RIVER FALLS PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES FOR MENTAL HEALTH PROMOTION, SUICIDE PREVENTION AND EDUCATION FOR PARENTING RELATED SKILLS. IT IS SANFORD'S GOAL TO INCREASE ACCESS TO MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES, IN PARTICULAR FOR AT RISK YOUTH AND TO DECREASE THE NUMBER OF SUICIDES.PRIORITY 2: ACCESS TO HEALTHCARE PROVIDERSACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE, LOCAL CARE OPTIONS, AND A USUAL SOURCE OF CARE HELP TO ENSURE ACCESS TO HEALTH CARE. HAVING ACCESS TO CARE ALLOWS INDIVIDUALS TO ENTER THE HEALTH CARE SYSTEM, FIND CARE EASILY AND LOCALLY, PAY FOR CARE, AND GET THEIR HEALTH NEEDS MET. SANFORD HAS MADE ACCESS TO HEALTHCARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO DEVELOP A FULLTIME DERMATOLOGY CLINIC AND TO EXPAND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH. IT IS SANFORD'S GOAL TO INCREASE THE NUMBER OF LOCAL PROVIDERS SERVICING THIEF RIVER FALLS THROUGH LOCALLY BASED PROVIDERS, OUTREACH FROM OTHER SANFORD FACILITIES, OR TELEHEALTH/VIRTUAL CARE PLATFORMS. INCREASED PROVIDERS WILL EXPAND THE NUMBER OF AVAILABLE SERVICES AND APPOINTMENTS AVAILABLE TO THE LOCAL COMMUNITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTH SANFORD THIEF RIVER FALLS AND SANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTER ESTABLISHED TWO GOALS WITHIN THE MENTAL HEALTH PRIORITY. THE FIRST IS TO DEVELOP AND IMPLEMENT COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION. THE SECOND GOAL IS TO DEVELOP AND IMPLEMENT COMMUNITY EDUCATION FOR PARENTING RELATED SKILLS.IN LATE 2021, AS PART OF THE GOAL TO DEVELOP AND IMPLEMENT COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION, SANFORD BEHAVIORAL HEALTH IDENTIFIED A CORE TEAM OF STAFF AND DEVELOPED A STRATEGY TO GROW A COMMUNITY COALITION FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION IN OUR COMMUNITY. IN JANUARY OF 2022, SANFORD BEHAVIORAL HEALTH BEGAN MEETING MONTHLY WITH COMMUNITY PARTNERS FROM TEN PUBLIC AND PRIVATE ENTITIES INCLUDING PUBLIC HEALTH, LAW ENFORCEMENT, FAITH COMMUNITY, EDUCATION, EMPLOYERS, HEALTH CARE, AND YOUTH ACTIVITIES. OVER THE PAST YEAR, SIX ADDITIONAL PARTNERS WERE ADDED, INCLUDING SCHOOL COUNSELORS, VIP, ADDITIONAL SCHOOL DISTRICT, MENTAL HEALTH PROVIDER, HIGH SCHOOL STUDENT, AND A SUICIDE LOSS SURVIVOR. THROUGHOUT THE YEAR, THIS GROUP BECAME KNOWN AS "COMMUNITY STRONG," DEFINED OUR COMMUNITY AS PENNINGTON COUNTY, AND IDENTIFIED OUR FOCUS ON YOUTH AND FAMILY EDUCATION. COMMUNITY STRONG ESTABLISHED A VISION STATEMENT TO BE "A COMMUNITY THAT STRIVES, PROMOTES AND SEEKS OUT MENTAL AND EMOTIONAL WELLBEING AND A MISSION STATEMENT "TO EMPOWER A HEALTHY COMMUNITY IN PENNINGTON COUNTY THROUGH EDUCATION, OUTREACH AND SUPPORT THAT RESHAPES THINKING AND AWARENESS AROUND MENTAL WELL-BEING AND SUICIDE PREVENTION." IN 2022, IN PARTNERSHIP WITH COMMUNITY STRONG, SANFORD BEHAVIORAL HEALTH PROVIDED FOUR EDUCATIONAL EVENTS IN PENNINGTON COUNTY, WITH ADDITIONAL OUTREACH EVENTS.IN EARLY 2022, SANFORD BEHAVIORAL HEALTH IDENTIFIED KEY PERSONNEL TO DEVELOP A STRATEGY FOR IMPLEMENTING PARENTING RELATED SKILLS IN THE COMMUNITY AS PART OF THE GOAL TO DEVELOP AND IMPLEMENT COMMUNITY EDUCATION FOR PARENTING RELATED SKILLS. IN MAY OF 2022, SANFORD BEHAVIORAL HEALTH USED ESTABLISHED RELATIONSHIPS THROUGH THE JUVENILE DIVERSION PROGRAM TO IDENTIFY PARTNERS WHO COULD JOIN IN THE EFFORT TO IMPLEMENT AND PROMOTE THIS TYPE OF EDUCATIONAL GROUP FOR PARENTS. THROUGH WORK WITH THE TRF POLICE DEPARTMENT, PENNINGTON COUNTY SOCIAL SERVICES, PENNINGTON COUNTY COURT AND COUNTY ATTORNEY, AND TRF SCHOOL DISTRICT, IT WAS IDENTIFIED THAT THE INITIAL TARGETED POPULATION OF THIS PARENTING SKILLS EDUCATION WOULD BE PARENTS OF CHILDREN IN THE JUVENILE DIVERSION PROGRAM, OR THOSE THAT THE AGENCIES INVOLVED ARE IDENTIFYING AS ESCALATING IN CRIMINAL JUSTICE SYSTEM AND AT AN INCREASED NEED FOR SERVICES. IN LATE MAY, THE CURRICULUM TO BE USED WAS IDENTIFIED AS THE INCREDIBLE YEARS AND LOVE & LOGIC CURRICULUM. FACILITATORS WERE ALSO IDENTIFIED FROM SANFORD BEHAVIORAL HEALTH AND PENNINGTON COUNTY SOCIAL SERVICES. THE FIRST SIX-WEEK SESSION OF THE PARENTING SKILLS GROUP BEGAN IN OCTOBER OF 2022 WITH SIX FAMILIES COMPLETING THE TRAINING.ACCESS TO HEALTHCARE PROVIDERSTWO GOALS WERE ESTABLISHED TO SUPPORT THE PRIORITY, INCLUDING THE DEVELOPMENT OF A FULLTIME DERMATOLOGY CLINIC IN THIEF RIVER FALLS, AND EXPANDING THE PLATFORM AND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH.TO SUPPORT THE GOAL OF DEVELOPING A FULL-TIME DERMATOLOGY CLINIC IN THIEF RIVER FALLS, SANFORD HEALTH TRF HIRED A FULL-TIME DERMATOLOGY NURSE PRACTITIONER IN APRIL OF 2021. THE DERMATOLOGIST STARTED IN THIEF RIVER FALLS AFTER SIX MONTHS OF TRAINING WITH A DERMATOLOGIST IN GRAND FORKS, SO THE COMMUNITY NOW HAS A FULL-TIME DERMATOLOGY SERVICE. CY2022 FOCUSED ON BUILDING THE PRACTICE TO INCLUDE RESOURCES NEEDED FOR SKIN TESTING, SKIN CHECKS, BIOPSIES, AND PROCEDURES ALONG WITH STAFFING AND SCHEDULING RESOURCES TO BEST ACCOMMODATE PATIENT NEEDS. AVAILABLE LOCAL DERMATOLOGY APPOINTMENTS WENT FROM MONTHLY OUTREACH, ROUGHLY 40 APPOINTMENTS, TO FULL-TIME COMMUNITY CLINIC, ROUGHLY 140 APPOINTMENTS PER MONTH. PATIENT UTILIZATION OF DERMATOLOGY SERVICES WAS BUILT AND SUSTAINED EARLY IN 2022. HELPING WITH THE PRACTICE AWARENESS AND PATIENT EDUCATION INCLUDED MARKETING THE NEW NURSE PRACTITIONER TO THE PUBLIC VIA TRADITIONAL AND SOCIAL MEDIA SOURCES, HOSTING FREE PUBLIC SKIN CHECK EVENTS, COMMUNITY OUTREACH WITH EMPLOYERS AND THE SCHOOL DISTRICT, AND PRODUCING AND DISTRIBUTING SKIN PREVENTION EDUCATIONAL MATERIALS. THIEF RIVER FALLS DERMATOLOGY IS OFFERING ROBUST GEOGRAPHICAL OFFERINGS IN OUR PRIMARY SERVICE AREA BY SPENDING TWO DAYS OF OUTREACH DERMATOLOGY TIME IN COMMUNITIES HALLOCK AND CROOKSTON, GIVING THEM 16 PATIENT APPOINTMENTS OF DERMATOLOGY ACCESS NOT PREVIOUSLY HAD. IN CY2023, THE FOCUS WILL BE ON GROWING AVAILABLE ACCESS BY INCREASING APPOINTMENTS EACH CLINIC DAY.AS PART OF THE EXPANDED PLATFORM AND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH GOAL, SANFORD BEHAVIORAL HEALTH PROVIDES PATIENTS THE FLEXIBILITY OF SCHEDULING THEIR APPOINTMENT IN THE MANNER THAT BEST SUITS THEIR NEEDS, PROVIDED THAT WE ARE ABLE TO MEET REGULATORY REQUIREMENTS AND IT IS IN THE PATIENT'S BEST INTEREST CLINICALLY. AS A RESULT, MORE THAN 40% OF APPOINTMENTS ARE CURRENTLY SCHEDULED AS TELEHEALTH APPOINTMENTS. THIS DATA DOES NOT REFLECT ANY NEW PATIENT ASSESSMENTS WHO MAY BE SEEN VIA TELEHEALTH DUE TO THE INABILITY TO CAPTURE THE DATA WITHOUT A MANUAL PROCESS.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO QUALITY HEALTHCAREAFFORDABLE HOUSINGLONG-TERM CAREPUBLIC TRANSPORTATIONSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 7 -- SANFORD MEDICAL CENTER THIEF RIVER FALLS PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 7 -- SANFORD MEDICAL CENTER THIEF RIVER FALLS PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 8 -- SANFORD ABERDEEN MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 8 -- SANFORD ABERDEEN MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 8 -- SANFORD ABERDEEN MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 8 -- SANFORD ABERDEEN MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: PHYSICAL ACTIVITY AND NUTRITIONTHE ENVIRONMENTS WHERE PEOPLE LIVE, LEARN, WORK, AND PLAY AFFECT ACCESS TO HEALTHY FOOD AND OPPORTUNITIES FOR PHYSICAL ACTIVITY WHICH, ALONG WITH GENETIC FACTORS AND PERSONAL CHOICES, SHAPE HEALTH AND THE RISK OF BEING OVERWEIGHT AND OBESE. SANFORD HAS MADE PHYSICAL ACTIVITY AND NUTRITION A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE AND IMPROVE CARE OF PATIENTS WITH OBESITY DIAGNOSIS AND TO PROVIDE EDUCATION TO SCHOOLS REGARDING PHYSICAL ACTIVITY AND NUTRITION. IT IS SANFORD'S GOAL TO IMPROVE PHYSICAL ACTIVITY AND NUTRITION FOR THE COMMUNITY. PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSACCORDING TO THE COUNTY HEALTH RANKINGS FOR CLINICAL CARE, ACCESS TO HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE, LOCAL CARE OPTIONS, AND A USUAL SOURCE OF CARE HELP TO ENSURE ACCESS TO HEALTH CARE. HAVING ACCESS TO CARE ALLOWS INDIVIDUALS TO ENTER THE HEALTH CARE SYSTEM, FIND CARE EASILY AND LOCALLY, PAY FOR CARE, AND GET THEIR HEALTH NEEDS MET.SANFORD HAS MADE HEALTHCARE ACCESS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE AND IMPROVE ACCESS TO SERVICES AND EDUCATION. IT IS SANFORD'S GOAL THAT ALL PATIENTS REQUIRING ACCESS TO HEALTHCARE ARE SUCCESSFUL IN SECURING TIMELY APPOINTMENTS AND IMPROVING MENTAL HEALTH SERVICES IN THE COMMUNITY. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARPHYSICAL ACTIVITY AND NUTRITIONSANFORD ABERDEEN SUPPORTED THE PRIORITY THROUGH A COMBINATION OF VOLUNTEER SUPPORT AND OUTREACH BY ITS REGISTERED DIETICIAN. THE NEED FOR CONTINUED FOCUS ON THE GOAL IS VISIBLE WITHIN THE RESULTS OF THE FINDHELP SEARCH TOOL NOTED WITHIN THE SYSTEM SUMMARY IN THE PREVIOUS SECTION. RESIDENTS OF THE CHNA-DEFINED SANFORD ABERDEEN MEDICAL CENTER COMMUNITY CONDUCTED 783 SEARCHES IN 2022 ACROSS THE PLATFORM, 25% OF THE SEARCHES WERE RELATED TO FOOD ISSUES, SUCH AS PANTRIES, PAYING FOR FOOD, AND MEALS. COMMUNITY RESIDENTS ENGAGED WITH FOOD RESOURCES ON THE SANFORD FINDHELP TOOL 14 TIMES IN 2022. BY ONE MEASURE, BROWN COUNTY OBESITY RATES ARE 35.5% FOR FEMALES AND 35.1% FOR MALES PER DATA FROM THE INSTITUTE FOR HEALTH METRICS AND EVALUATION.VOLUNTEER EFFORTS FOCUSED ON GETTING HEALTHY FOOD IN THE HANDS OF THOSE THAT NEED IT. TO THAT END SANFORD VOLUNTEERED TEN HOURS TO MEALS ON WHEELS IN 2022, EXTENDING CARE BEYOND THE HOSPITAL WALLS TO PARTNER WITH A LOCAL COMMUNITY PARTNER TO DELIVER FOOD TO LOCAL SENIORS. SANFORD ABERDEEN PARTNERED WITH ANOTHER COMMUNITY PARTNER, THE SALVATION ARMY, TO DONATE ITEMS TO HOST A HEALTH FOOD DRIVE FOR YOUTH. IN TOTAL, 800 POUNDS OF FOOD AND $700 IN MONETARY DONATIONS WERE COLLECTED THROUGH THE EFFORT.SANFORD ABERDEEN EMPLOYS A REGISTERED DIETICIAN. IN ADDITION TO THEIR WORK WITHIN THE HEALTH SYSTEM, THE REGISTERED DIETICIAN COMPLETED A HEALTHY COOKING CLASS FOR AGING ADULTS AT THE ABERDEEN SENIOR CENTER. THE DIETITIAN ALSO ANALYZED LOCAL RESTAURANT MENUS TO PROVIDE INFORMATION TO CONSUMERS ON HEALTH OPTIONS AS PART OF PARTICIPATION IN HUB CITY HEALTHY EATS. ACCESS TO HEALTH CARE PROVIDERSSANFORD ABERDEEN IS SUPPORTING THE PRIORITY BY AUGMENTING LOCAL RESOURCES VIA TELEMEDICINE OUTREACH TO THE COMMUNITY FROM RESOURCES AVAILABLE THROUGH SANFORD HEALTH IN SIOUX FALLS, THROUGH INTEGRATED HEALTH THERAPISTS INTEGRATED INTO PRIMARY CARE SETTINGS, AND STANDARDIZING WORKFLOW TO ALL HEALTH COACHES AND PANEL SPECIALISTS WITHIN THE HOSPITAL AND CLINIC THROUGH EDUCATIONAL EFFORTS. SANFORD ABERDEEN HAD 180 REFERRALS FOR INTEGRATED HEALTH THERAPISTS (IHT) FROM VARIOUS SERVICE LINES, INCLUDING 139 FROM FAMILY PRACTICE, 11 FROM ORTHOPEDICS, 3 FROM ONCOLOGY, 9 FROM OBGYN, 7 FROM ENT, 3 FROM CHILDREN'S, AND 7 FROM CARDIOLOGY. IHT VISITS TOTALED 393 IN 2022 AND TOTAL 92 THROUGH THE FIRST TWO MONTHS OF 2023. REFERRALS TO BEHAVIORAL HEALTH/PSYCHOLOGY WERE 130 IN 2022 INCLUDING 123 FROM FAMILY PRACTICE, 3 FROM OBGYN, AND 4 FROM CHILDREN'S. BEHAVIORAL HEALTH THERAPISTS (BHT) BEGAN SEEING PATIENTS IN OCTOBER 2022 AND HAD 79 VISITS THROUGH THE END OF THE YEAR. BHT VISITS TOTALED 135 THROUGH THE FIRST TWO MONTHS OF 2023. COMMUNITY HEALTH WORKERS HAD 56 VISITS DURING THE PAST YEAR.SANFORD ABERDEEN COMPLETED WORKFLOW EDUCATION TO ALL PROVIDERS AND NURSING STAFF FOR REFERRALS. SANFORD ABERDEEN HAS HIRED A PMHNP, CNP WHO WILL BE ABLE TO COMPLETE LOCAL PSYCH REFERRALS AND MEDICATION MANAGEMENT.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 8 -- SANFORD ABERDEEN MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 8 -- SANFORD ABERDEEN MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 9 -- SANFORD WORTHINGTON MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 9 -- SANFORD WORTHINGTON MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTER
GROUP A-FACILITY 9 -- SANFORD WORTHINGTON MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 9 -- SANFORD WORTHINGTON MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO PROVIDERS (BILINGUAL MENTAL HEALTH AND PEDIATRIC DENTAL CARE)ACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE HELPS INDIVIDUALS AND FAMILIES ACCESS NEEDED PRIMARY CARE, SPECIALISTS, AND EMERGENCY CARE, BUT DOES NOT ENSURE ACCESS ON ITS OWNIT IS ALSO NECESSARY FOR PROVIDERS TO OFFER AFFORDABLE CARE, BE AVAILABLE TO TREAT PATIENTS, AND BE IN RELATIVELY CLOSE PROXIMITY TO PATIENTS.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE SCREENING OF MENTAL HEALTH AND REFERRAL SOURCES FOR MENTAL HEALTH SUPPORT AND TO INCREASE ACCESS TO PEDIATRIC DENTAL CARE FOR AT-RISK PATIENTS. IT IS SANFORD'S GOAL THAT MORE AREA RESIDENTS WILL HAVE ACCESS TO PROVIDERS OF BILINGUAL MENTAL HEALTH AND PEDIATRIC DENTAL CARE.PRIORITY 2: TEEN PREGNANCYTEEN PREGNANCY RESULTS IN SUBSTANTIAL SOCIAL, ECONOMIC, AND HEALTH COSTS THROUGH IMMEDIATE AND LONG-TERM IMPACTS ON TEEN PARENTS AND THEIR CHILDREN. STUDIES SHOW THAT THE CHILDREN OF TEENAGE MOTHERS ARE MORE LIKELY TO HAVE LOWER SCHOOL ACHIEVEMENT AND TO DROP OUT OF HIGH SCHOOL, HAVE MORE HEALTH PROBLEMS, BE INCARCERATED AT SOME TIME DURING ADOLESCENCE, AND FACE UNEMPLOYMENT AS A YOUNG ADULT, THAN CHILDREN BORN TO OLDER MOTHERS.SANFORD HAS MADE TEEN PREGNANCY A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE LINKAGES BETWEEN TEEN PREGNANCY PREVENTION PROGRAMS AND COMMUNITY-BASED CLINICAL SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WILL BENEFIT FROM STRONG LOCAL PARTNERSHIPS THROUGH SANFORD'S FOCUS ON THIS ISSUE. FAMILY PRACTICE AND PEDIATRIC PROVIDERS WILL PROVIDE PATIENT EDUCATION, RECOMMEND, AND SUPPORT SPECIALTY REFERRALS. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO PROVIDERS (BILINGUAL MENTAL HEALTH AND PEDIATRIC DENTAL CARE)SANFORD WORTHINGTON ESTABLISHED TWO GOALS FOR THE PRIORITY, INCLUDING INCREASING ACCESS TO PEDIATRIC DENTAL CARE FOR AT-RISK PATIENTS, IN ADDITION TO INCREASED SCREENING OF MENTAL HEALTH AND REFERRAL SOURCES FOR MENTAL HEALTH SUPPORT. DENTAL CARE WAS THE EIGHTH MOST SEARCHED TERM ON THE FINDHELP PLATFORM. IN TOTAL COMMUNITY MEMBERS CONDUCTED 434 SEARCHES IN 2022 WITH 28% BEING HEALTH-RELATED TOPICS.THE ORGANIZATION COMPLETED A PROFORMA FOR A DENTAL THERAPIST IN THE CLINIC SETTING. THE PROFORMA INDICATED THAT IT WAS NOT A FEASIBLE OPPORTUNITY. HOWEVER, SANFORD WORTHINGTON EDUCATED CLINICAL STAFF ON LOCAL DENTAL DISPARITIES AND IS SHARING LOCAL DATA. DATA IS SHARED BI-ANNUALLY WITH STAFF. STAFF ALSO EXPLORED THE OPPORTUNITY FOR PARTNERSHIP WITH HIGHER EDUCATION AND DENTAL PROGRAMS TO COMPLETE A ROTATION OF DENTAL SERVICE PRACTICE IN AMBULATORY SETTING. THIS WAS ALSO DETERMINED TO NOT BE FEASIBLE.THE ORGANIZATION IS COLLABORATING TO DETERMINE A LOCAL STRATEGY TO ASSIST PATIENTS IN GREATEST NEED. LAST YEAR, SANFORD SHARED OPPORTUNITIES FOR LOCAL PROJECTS AND SERVICES IN THE COMMUNITY SETTING FOR REFERRAL OF AT-RISK PATIENTS AND CONTINUES TO STRENGTHEN RELATIONSHIPS WITH LOCAL DENTAL PROVIDERS, PUBLIC HEALTH, AND OTHER COMMUNITY STAKEHOLDERS TO ENSURE THOSE IN GREATEST NEED GET CONNECTED TO THE RESOURCES NEEDED TO TREAT AND PREVENT PEDIATRIC DENTAL ISSUES.FOR MENTAL HEALTH, THE ORGANIZATION WAS ABLE TO SUCCESSFULLY RECRUIT AN INTEGRATED HEALTH THERAPIST (IHT) AFTER THE POSITION WAS POSTED FOR MORE THAN 600 DAYS. THE IHT JOINED THE ORGANIZATION IN OCTOBER 2022. TWO BILINGUAL SPANISH COMMUNITY HEALTH WORKERS (CHWS) COMPLETED APPROXIMATELY 50 SOCIAL DETERMINANTS OF HEALTH ASSESSMENTS (SDOH) ON TARGETED PATIENTS REFERRED TO CHWS AFTER THE SDOH ASSESSMENT WAS INTRODUCED AND IMPLEMENTED INTO CHW WORKFLOW IN JUNE OF 2022. THE SDOH SCREENING CONTAINS QUESTIONS REGARDING MENTAL HEALTH AND STRESS. IF PATIENTS RESPOND TO THOSE QUESTIONS WITH A CONCERN, THE CHWS FURTHER ASSESS AND REFER TO INTERNAL AND/OR EXTERNAL COMMUNITY MENTAL HEALTH RESOURCES AS NEEDED. IN NOVEMBER, A SHORTENED VERSION OF THE SDOH ASSESSMENT WAS DEPLOYED TO ALL PATIENTS CHECKING IN FOR THEIR APPOINTMENT AT REGISTRATION WHICH INCREASES LIKELIHOOD OF IDENTIFYING MENTAL HEALTH CONCERNS TO BE ADDRESSED WITH THE PROVIDER AND OPPORTUNITY FOR APPROPRIATE REFERRAL AND FOLLOW UP.SANFORD WORTHINGTON IS WORKING TO IMPROVE PATIENT COMPLETION RATE OF APPROPRIATE MENTAL HEALTH SCREENING IN AMBULATORY SETTINGS THROUGH STAFF WORKFLOW IMPROVEMENTS. THE CMS QUALITY GOAL FOR DEPRESSION SCREENING IS 95% AND WORTHINGTON WAS AT 26% IN JANUARY 2021. HOWEVER, THIS HAS IMPROVED TO 67.7% AS OF THE END OF 2022. THE SIGNIFICANT IMPROVEMENT WAS THE RESULT OF FOCUSED WORK BY STAFF. THE PANEL ASSISTANT RAN A REGISTRY OF PATIENTS THAT WERE MISSING THE DEPRESSION SCREEN OR HAD AN OUTDATED SCREENING TO COMPLETE. SOME OF THOSE WITH A MISSING SCREED WERE UPDATED VIA TELEPHONE OUTREACH WHILE OTHERS WERE FLAGGED AND COMPLETED DURING A SCHEDULED APPOINTMENT. WORTHINGTON WAS ABLE TO INCREASE ACCESS TO MENTAL HEALTH TELEMEDICINE SERVICES WITH THE ADDITION OF A CREDENTIALED LICENSED MENTAL HEALTH SERVICE PROVIDER TO COVER WORTHINGTON CLINIC PATIENTS IN MARCH 2022.TEEN PREGNANCYSANFORD WORTHINGTON WORKED TOGETHER WITH NOBLES COUNTY PUBLIC HEALTH AND SMOC FAMILY PLANNING TO ORGANIZE A BRAINSTORMING MEETING WITH COMMUNITY STAKEHOLDERS REGARDING TEEN PREGNANCY. SMOC FAMILY PLANNING IS THE LEAD FOR THIS PROJECT. ORGANIZATIONS AND COMMUNITY MEMBERS REPRESENTED AT THE INITIAL BRAINSTORM MEETING ON MARCH 22, 2022, INCLUDED LOCAL PUBLIC HEALTH, SMOC FAMILY PLANNING, SANFORD WORTHINGTON, WELLSHARE INTERNATIONAL, SMOC HEAD START, AND COMMUNITY HEALTH WORKERS. THE MEETING WAS HELD AT THE SANFORD WORTHINGTON HOSPITAL WITH DISCUSSION THAT COVERED CURRENT STATISTICS FOR NOBLES COUNTY, AN INFORMAL ASSESSMENT OF SERVICES OFFERED, A GAP ANALYSIS, AND A LIST OF COMMUNITY REPRESENTATIVES THAT SHOULD BE AT THE TABLE FOR AN OFFICIAL WORK GROUP. A SECOND BRAINSTORM MEETING WAS HELD ON APRIL 27TH WITH A FEW ADDITIONAL STAKEHOLDERS THAT WERE UNABLE TO ATTEND THE FIRST BRAINSTORM SESSION. NEW ATTENDEES INCLUDED COMMUNITY ADVOCATE/JBS, SOUTHWEST CRISIS CENTER, COUNSELOR, WORTHINGTON HIGH SCHOOL, AND CHILD PROTECTION NOBLES COUNTY COMMUNITY SERVICES. WITH THE ADDITIONAL FEEDBACK AND INPUT, IT WAS DECIDED TO OFFICIALLY EXTEND AN INVITE TO THOSE THE GROUP LISTED AND KICK OFF A TEEN PREGNANCY WORK GROUP WITH THE EXPANDED GROUP.IN MAY, SMOC FAMILY PLANNING PRESENTED TO THE SANFORD PATIENT AND FAMILY ADVISORY COUNCIL REGARDING THE NEW WORKGROUP AND PLANS TO MOVE FORWARD WITH REGULAR MEETINGS.OTHER FAMILY PLANNING PRIORITIES TOOK PRECEDENCE FOR THE REMAINDER OF 2022. THE WORKGROUP WILL RECONVENE IN 2023 TO DETERMINE THE NEXT STEPS FOR ADDRESSING TEEN PREGNANCY IN NOBLES COUNTY. SANFORD WORTHINGTON IS A WILLING AND ENGAGED PARTNER TO CONTINUE THIS IMPORTANT WORK. THERE IS MUCH ENTHUSIASM AMONG OTHER COMMUNITY PARTNERS TO CONTINUE MOMENTUM WITH TEEN PREGNANCY PREVENTION EFFORTS.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:INCOME AND POVERTYPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGACCESS TO AFFORDABLE HEALTH CAREPHYSICAL ACTIVITY AND NUTRITIONCHILDCARE QUALITYLONG-TERM CARESANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 9 -- SANFORD WORTHINGTON MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 9 -- SANFORD WORTHINGTON MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 10 -- SANFORD SHELDON MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 10 -- SANFORD SHELDON MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 10 -- SANFORD SHELDON MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 10 -- SANFORD SHELDON MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO AFFORDABLE HEALTH CARE ACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE, LOCAL CARE OPTIONS, AND A USUAL SOURCE OF CARE HELP TO ENSURE ACCESS TO HEALTH CARE. HAVING ACCESS TO CARE ALLOWS INDIVIDUALS TO ENTER THE HEALTH CARE SYSTEM, FIND CARE EASILY AND LOCALLY, PAY FOR CARE, AND GET THEIR HEALTH NEEDS MET. SANFORD HAS MADE ACCESS TO AFFORDABLE HEALTH CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EDUCATE THE COMMUNITY ON THE FULL SCOPE OF LOCALLY AVAILABLE SERVICES AND OFFER COMMUNITY EDUCATIONAL AND SCREENING EVENTS TO ENHANCE PREVENTATIVE CARE AND REDUCE OUT-OF-POCKET COSTS. IT IS SANFORD'S GOAL TO INCREASE THE PUBLIC EDUCATION ON THE PROMOTION OF SERVICES AVAILABLE IN SHELDON, REDUCING OUT-OF-POCKET COSTS DUE TO TRAVEL TIME AND TIME AWAY FROM THEIR EMPLOYMENT.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE HELPS INDIVIDUALS AND FAMILIES ACCESS NEEDED PRIMARY CARE, SPECIALISTS, AND EMERGENCY CARE, BUT DOES NOT ENSURE ACCESS ON ITS OWNIT IS ALSO NECESSARY FOR PROVIDERS TO OFFER AFFORDABLE CARE, BE AVAILABLE TO TREAT PATIENTS, AND BE IN RELATIVELY CLOSE PROXIMITY TO PATIENTS.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ENHANCE MARKETING AND PROMOTIONAL ACTIVITIES TO IMPROVE ACCESS AND TO PROMOTE VIRTUAL CARE TO AUGMENT ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE. IT IS SANFORD'S GOAL TO ENHANCE ACCESS TO CARE FOR RESIDENTS OF SHELDON AND THE SURROUNDING AREA.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO AFFORDABLE HEALTH CARESANFORD SET TWO GOALS IN AN EFFORT TO INCREASE ACCESS TO AFFORDABLE HEALTH CARE. THE FIRST IS TO EDUCATE THE COMMUNITY ON THE FULL SCOPE OF SERVICES AVAILABLE LOCALLY. THE SECOND GOAL IS TO OFFER COMMUNITY EDUCATIONAL AND SCREENING EVENTS TO ENHANCE PREVENTATIVE CARE AND REDUCE OUT-OF-POCKET COSTS.SANFORD HEALTH LAUNCHED TWO CAMPAIGNS FOCUSING ON PRIMARY CARE IN THE CALENDAR YEAR 2022. "CARE CLOSE TO HOME" ADVERTISEMENTS WERE CREATED FOR ALL SANFORD CLINIC LOCATIONS AND UTILIZED WITHIN THE SHELDON MARKET. THE BOYDEN, SHELDON, SANBORN, HARTLEY, AND LAKE PARK CLINICS LISTED THEIR SPECIFIC HOURS AND AVAILABLE PROVIDERS WITHIN THE CAMPAIGN. "HERE FOR ALL. HERE FOR GOOD" WAS THE SECOND CAMPAIGN THAT WAS DIGITALLY LAUNCHED WITHIN THE SHELDON MARKET. DUE TO COVID POSITIVITY RATES SANFORD SHELDON DID NOT HOLD ANY IN HOUSE COMMUNITY EDUCATION EVENTS IN 2022. THE ORGANIZATION CONTINUED TO ASSIST O'BRIEN COUNTY PUBLIC HEALTH WITH VACCINE ASSISTANCE. IN CALENDAR YEAR 2022 APPROXIMATELY 130 INDIVIDUALS RECEIVED A VACCINE AT EVENTS. ADDITIONALLY, SANFORD SHELDON STAFF TRAVELED TO SIOUX CITY IA TO ASSIST WITH NATIONAL GUARD COVID TESTING FOR APPROXIMATELY 110 TROOPS THAT WERE BEING DEPLOYED.SANFORD SHELDON DID HOST HEART AND VASCULAR SCREENS WHICH CORRELATED WITH HEART MONTH IN FEBRUARY 2022 AT REDUCED COSTS FOR THE PATIENT.ACCESS TO HEALTH CARE PROVIDERSSANFORD SHELDON EXPANDED MENTAL HEALTH SERVICES IN JULY 2022 WITH THE ADDITION OF CYNTHIA KANTOS, INTEGRATED HEALTH THERAPIST. KANTOS BRINGS THE TOTAL NUMBER OF MENTAL HEALTH PROVIDERS AVAILABLE AT SANFORD SHELDON TO FIVE. CYNTHIA KANTOS JOINS JASON CHESTER, LISW AND STACEY JUMBECK PMHNP, APRN, CNP AS IN HOUSE PROVIDERS. MATTHEW EGGERS, DO AND MARK DANIELS, PHD PROVIDE MENTAL HEALTH SERVICES VIA TELEMED.IN ORDER TO PROVIDE ADDITIONAL CLINIC SERVICES TO PATIENTS IN NORTHWEST IOWA, SANFORD SHELDON BEGAN A CLINIC EXPANSION PROJECT WHICH WILL INCLUDE EIGHT ADDITIONAL EXAM ROOMS PLUS FOUR PROCEDURE ROOMS. ESTIMATED COMPLETION DATE IS JULY 2023.AS NOTED IN THE PREVIOUS GOAL, SANFORD HEALTH LAUNCHED TWO CAMPAIGNS FOCUSING ON PRIMARY CARE IN THE CALENDAR YEAR 2022. "CARE CLOSE TO HOME" ADVERTISEMENTS WERE CREATED FOR ALL SANFORD CLINIC LOCATIONS AND UTILIZED WITHIN THE SHELDON MARKET. THE BOYDEN, SHELDON, SANBORN, HARTLEY, AND LAKE PARK CLINICS LISTED THEIR SPECIFIC HOURS AND AVAILABLE PROVIDERS WITHIN THE CAMPAIGN. "HERE FOR ALL. HERE FOR GOOD" WAS THE SECOND CAMPAIGN THAT WAS DIGITALLY LAUNCHED WITHIN THE SHELDON MARKET. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:PHYSICAL ACTIVITY AND NUTRITIONAFFORDABLE HOUSINGPUBLIC TRANSPORTATIONLONG-TERM CAREENVIRONMENTAL HEALTHSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 10 -- SANFORD SHELDON MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 10 -- SANFORD SHELDON MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 11 -- SANFORD VERMILLION MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 11 -- SANFORD VERMILLION MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 11 -- SANFORD VERMILLION MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 11 -- SANFORD VERMILLION MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO AFFORDABLE HEALTH CAREACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE, LOCAL CARE OPTIONS, AND A USUAL SOURCE OF CARE HELP TO ENSURE ACCESS TO HEALTH CARE. HAVING ACCESS TO CARE ALLOWS INDIVIDUALS TO ENTER THE HEALTH CARE SYSTEM, FIND CARE EASILY AND LOCALLY, PAY FOR CARE, AND GET THEIR HEALTH NEEDS MET.SANFORD VERMILLION HAS MADE ACCESS TO AFFORDABLE HEALTH CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ENSURE PATIENTS AND COMMUNITY PARTNERS ARE AWARE OF ITS FINANCIAL ASSISTANCE PROGRAM AND OTHER PROGRAMS AVAILABLE TO ELIGIBLE PATIENTS TO ASSIST WITH MEDICATIONS AND PREVENTATIVE CARE. IT IS SANFORD'S GOAL TO SEE LESS ACCOUNTS GOING TO COLLECTIONS OR WRITTEN OFF TO BAD DEBT AND A GREATER SHARE WRITTEN OFF TO OUR FINANCIAL ASSISTANCE PROGRAM. THERE ARE OTHER ASSISTANCE PROGRAMS FOR MEDICATIONS AND WOMEN'S PREVENTATIVE CARE THAT WE CAN HELP PATIENTS GET SIGNED UP FOR AS WELL.PRIORITY 2: HEALTH CARE ACCESS: MENTAL HEALTH/BEHAVIORAL HEALTHACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE HELPS INDIVIDUALS AND FAMILIES ACCESS NEEDED PRIMARY CARE, SPECIALISTS, AND EMERGENCY CARE, BUT DOES NOT ENSURE ACCESS ON ITS OWNIT IS ALSO NECESSARY FOR PROVIDERS TO OFFER AFFORDABLE CARE, BE AVAILABLE TO TREAT PATIENTS, AND BE IN RELATIVELY CLOSE PROXIMITY TO PATIENTS.SANFORD HAS MADE HEALTH CARE ACCESS: MENTAL HEALTH/BEHAVIORAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE ALTERNATIVE VISIT TYPES AND TO ALLOW OPEN SCHEDULING AND EXPANSION OF WEEKEND HOURS. IT IS SANFORD'S GOAL TO OFFER THE ALTERNATIVE VISITS, ADDING OPEN SCHEDULING AND EXPANSION OF OUR WEEKEND HOURS, THUS ALLOWING GREATER ACCESS TO OUR PROVIDERS FOR THE COMMUNITY AND WILL ADVERTISE THESE SO THE COMMUNITY IS AWARE.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO AFFORDABLE HEALTH CARESANFORD VERMILLION ESTABLISHED TWO GOALS TO SUPPORT IMPROVED ACCESS TO AFFORDABLE HEALTH CARE. THE FIRST GOAL CENTERED ON BUILDING UPON CURRENT EFFORTS TO PROMOTE THE ORGANIZATION'S FINANCIAL ASSISTANCE PROGRAM TO REDUCE BAD DEBT AND INCREASE UTILIZATION BY POPULATIONS THAT WOULD BENEFIT. THE SECOND GOAL IS TO PROMOTE AWARENESS OF OTHER ASSISTANCE PROGRAMS FOR MEDICATIONS AND PREVENTATIVE CARE. ONE ILLUSTRATION OF THE NEED IS THROUGH THE 436 SEARCHES CONDUCTED WITHIN THE COMMUNITY ON THE FINDHELP PLATFORM IN 2022. OVER A QUARTER OF SEARCHES (28%) WERE FOR HEALTH-RELATED TOPICS WITH SEVERAL RELATED TO COST APPEARING ON THE MOST-SEARCHED LIST, INCLUDING "DISCOUNTED HEALTHCARE," "HELP PAY FOR HEALTHCARE, AND "MEDICAL BILLS."THE HOSPITAL PROVIDED A FINANCIAL ASSISTANCE PROGRAM PATIENT BROCHURE TO ALL ADMITTED PATIENTS IN 2022. THE PLAN IS TO DISPLAY THIS BROCHURE AT THE CENTRAL REGISTRATION AREA, CLINIC AND OUTPATIENT WAITING ROOMS. THE CLINIC PROVIDED THE BILLING OFFICE'S BUSINESS CARDS WITH THEIR PHONE NUMBER TO PATIENTS WHO WISHED TO CALL ABOUT THE FINANCIAL ASSISTANCE PROGRAM OR HAD OTHER BILLING INQUIRIES. FINANCIAL ASSISTANCE PACKETS WERE ALSO PROVIDED TO PATIENTS AS REQUESTED AT THE CLINIC. THE CLINIC ALSO HAS THE MEDDATA PATIENT BROCHURE IN THEIR LOBBY FOR PATIENTS TO ACCESS ON THEIR PROGRAM TO ASSIST WITH MEDICAL BILLS FOR UNINSURED AND/OR GAPS IN COVERAGE.THE CLINIC DIRECTOR ENSURED EDUCATION WAS PROVIDED AT ORIENTATION FOR STAFF AND PROVIDERS ON PATIENT ASSISTANCE PROGRAMS FOR MEDICATIONS AND PREVENTATIVE CARE SUCH AS NEEDYMEDS.COM AND ALL WOMEN COUNT. THE CLINIC HEALTH COACH AND NEW COMMUNITY HEALTH CARE WORKER (OCTOBER 2022) ASSISTED PATIENTS WITH ACCESSING THESE RESOURCES FOR THOSE APPLICABLE. THE FINANCIAL ASSISTANCE PROGRAM APPLICATION FORM IS AVAILABLE AT THE CLINIC OR HOSPITAL AND ON THE SANFORD WEBSITE FOR PATIENTS TO ACCESS. THE OTHER ASSISTANCE PROGRAMS ARE ALSO ON THE WEBSITE AND BROCHURES FOR EACH ARE IN THE CLINIC LOBBY AND ARE PROVIDED TO APPLICABLE PATIENTS. THE HOSPITAL HAS A LIST OF RESOURCES CREATED BY THE SOCIAL WORKER THAT IS REVIEWED WITH AND GIVEN TO APPLICABLE PATIENTS AT DISCHARGE. THE WRITE OFFS FOR BAD DEBT (ACCOUNTS SENT TO COLLECTIONS) IN 2022 DECREASED FROM 2021 BY OVER $389,000 WHICH WAS ONE OF THE GOALS. TOTAL WRITTEN OFF TO THE FINANCIAL ASSISTANCE PROGRAM IN 2022 WAS DOWN APPROXIMATELY $15,000 FROM 2021.CLINIC STAFF AND PROVIDERS HAVE ALSO PROMOTED DIRECT ACCESS LABS TO PATIENTS WHO MAY BENEFIT FROM THEM, SUCH AS THOSE WITH HIGH DEDUCTIBLES. FOR THESE LABS, PATIENTS CAN COME IN AND GET LAB SERVICES WITHOUT SEEING A PROVIDER AND PAY A REDUCED COST AT TIME OF SERVICE; NO INSURANCE IS BILLED. SANFORD VERMILLION IS ALSO LISTED AS A SITE ON SANFORD HEALTH'S WEBSITE THAT OFFERS DIRECT ACCESS LABS. IN 2021 VERMILLION CONDUCTED 77 DIRECT ACCESS LABS AND IN 2022 IT INCREASED TO 219.HEALTH CARE ACCESS: MENTAL HEALTH/BEHAVIORAL HEALTH TWO GOALS WERE ESTABLISHED VIA THE CHNA TO INCREASE ACCESS TO MENTAL AND BEHAVIORAL HEALTH; PROMOTE ALTERNATIVE VISIT TYPES TO INCREASE ACCESS-VERBAL, VIDEO, TELEHEALTH, AND DIRECT ACCESS LABORATORY VISITS AND ALLOW OPEN SCHEDULING AND EXPANSION OF WEEKEND HOURS.ALL BEHAVIORAL HEALTH VISITS WERE OPENED UP TO VIRTUAL VISITS AT THE END OF 2022. THE INTEGRATED HEALTH THERAPIST (IHT) OFFERS ALL VISIT TYPES INCLUDING IN-PERSON, VIDEO, TELEHEALTH, AND PHONE VISITS. THE OUTREACH PSYCHOLOGY PROVIDER WHO COMES TO VERMILLION OFFERS TELEHEALTH WHEN THERE'S INCLEMENT WEATHER AND THE OTHER MENTAL HEALTH COUNSELOR ONLY OFFERS IN-PERSON VISITS. THE NUMBER OF BEHAVIORAL/MENTAL HEALTH VISITS INCREASED AT THE CLINIC FROM 2,149 TO 2,412 IN 2022 COMPARED TO 2021. HOWEVER, THE NUMBER AND % OF CANCELED VISITS AND NO-SHOW APPOINTMENTS DID NOT DECREASE BUT REMAINED ABOUT 5%, IN LINE WITH THE INDUSTRY AVERAGE.BEHAVIORAL/MENTAL HEALTH PROVIDERS EACH HAVE A PAGE DESCRIPTION ON THE SANFORD CLINIC VERMILLION WEBSITE FOR PATIENTS TO ACCESS INFORMATION ABOUT THEM. THEY WERE ALSO FEATURED AND PROMOTED AT THE 4/12/22 DHF EVENING FOR WOMEN, "MENTAL HEALTH AND EMOTIONAL RESILIENCY." THE ALTERNATE VISIT TYPES ARE PROMOTED BY CLINIC STAFF AND PROVIDERS, THROUGH THE SANFORD WEBSITE, WITH OUR OUTREACH PROVIDER ADS AND WITH OUR MYCHART APP WHERE THEY CAN SELF-SCHEDULE APPOINTMENTS. THE ACCESSIBILITY FOR PATIENTS TO COME IN AND GET LABS ON THEIR OWN WITHOUT SEEING A DOCTOR THROUGH THE DIRECT ACCESS LABS WAS UTILIZED BY MORE PATIENTS IN 2022 WITH 219 LABS COMPLETED COMPARED TO 77 IN 2021.OPEN SCHEDULING OF APPOINTMENTS WAS AVAILABLE TO PATIENTS IN 2022 VIA THE MYCHART APP. FOR 2022, 6% OF OUR CLINIC APPOINTMENTS WERE SCHEDULED ONLINE BY SANFORD VERMILLION PATIENTS. UNFORTUNATELY, WEEKEND BEHAVIORAL HEALTH APPOINTMENTS WERE UNABLE TO BE OFFERED IN 2022.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:AFFORDABLE HOUSINGPUBLIC TRANSPORTATIONSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 11 -- SANFORD VERMILLION MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 11 -- SANFORD VERMILLION MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 12 -- SANFORD CHAMBERLAIN MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 12 -- SANFORD CHAMBERLAIN MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 12 -- SANFORD CHAMBERLAIN MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 12 -- SANFORD CHAMBERLAIN MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTH AND SUBSTANCE ABUSEMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ADD ADDITIONAL MENTAL HEALTH RESOURCES IN THE COMMUNITY AND TO INCREASE ACCESSIBILITY TO MENTAL HEALTH CARE FOR YOUTH. IT IS SANFORD'S GOAL TO INCREASE MENTAL HEALTH COUNSELING AND SUBSTANCE ABUSE COUNSELING OPTIONS IN THE COMMUNITY. PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERS SPECIALTY CAREACCESS TO CARE REQUIRES NOT ONLY FINANCIAL COVERAGE, BUT ALSO ACCESS TO PROVIDERS. WHILE HIGH RATES OF SPECIALIST PHYSICIANS HAVE BEEN SHOWN TO BE ASSOCIATED WITH HIGHER (AND PERHAPS UNNECESSARY) UTILIZATION, SUFFICIENT AVAILABILITY OF PRIMARY CARE PHYSICIANS IS ESSENTIAL FOR PREVENTIVE AND PRIMARY CARE, AND, WHEN NEEDED, REFERRALS TO APPROPRIATE SPECIALTY CARE.SANFORD HAS MADE ACCESS TO SPECIALTY HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE NEW SPECIALTY CARE SERVICES INCLUDING OPHTHALMOLOGY AND ORTHOPEDICS AND CREATE AWARENESS OF VIRTUAL CARE OPTIONS FOR SPECIALTY SERVICES. IT IS SANFORD'S GOAL TO PROVIDE ENHANCED ACCESS TO A VARIETY OF SPECIALTY CARE SERVICES IN THE COMMUNITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTH AND SUBSTANCE ABUSETHE SANFORD CHAMBERLAIN MEDICAL CENTER IS SUPPORTING THE PRIORITY THROUGH ITS GOAL OF ADDING ADDITIONAL MENTAL HEALTH RESOURCES TO THE COMMUNITY AND INCREASING ACCESSIBILITY FOR MENTAL HEALTH CARE FOR YOUTH, SPECIFICALLY, THROUGH ITS PARTNERSHIP WITH THE CHAMBERLAIN SCHOOL DISTRICT. THE SANFORD CHAMBERLAIN MEDICAL CENTER PROVIDES MENTAL HEALTH SERVICES AND SUBSTANCE ABUSE PREVENTION EDUCATION TO STUDENTS IN THE CHAMBERLAIN SCHOOL DISTRICT. MENTAL HEALTH SERVICES INCLUDE AN EMBEDDED LICENSED MENTAL HEALTH COUNSELOR WITHIN THE MIDDLE SCHOOL AND HIGH SCHOOL. THE COUNSELOR ALSO PROVIDES SERVICES TO THE ELEMENTARY SCHOOL. THE COUNSELOR IS IN THE ELEMENTARY SCHOOL ONE HALF DAY PER WEEK AND THE MIDDLE SCHOOL/HIGH SCHOOL ONE HALF DAY PER WEEK.SANFORD CHAMBERLAIN MADE PLANS TO PROVIDE YOUTH MENTAL HEALTH FIRST AID TRAINING TO THE CHAMBERLAIN COMMUNITY FOR THE FIRST TIME. THIS PROGRAM IS SCHEDULED TO TAKE PLACE IN FEBRUARY 2023. PLANS WERE DEVELOPED IN 2022 FOR ADDITIONAL SERVICES, INCLUDING LIFE AFTER LOSS, A WHOLE FAMILY GRIEF COUNSELING PROGRAM, WERE ALSO DEVELOPED AND ARE SCHEDULED TO START AS AN ONGOING PROGRAM BEGINNING IN JANUARY 2023.ACCESS TO HEALTH CARE PROVIDERS SPECIALTY CARESANFORD CHAMBERLAIN PRIORITIZED OPHTHALMOLOGY AND ORTHOPEDICS AS TWO SPECIALTIES FOR ADDITIONAL PROMOTION LOCALLY AS PART OF THE PRIORITY IN ADDITION TO INCREASED PROMOTION OF VIRTUAL CARE OPTIONS FOR THOSE THAT QUALITY BASED UPON THEIR NEEDED TYPE OF CARE. RESIDENTS OF THE THREE COUNTIES INCLUDED IN THE CHNA-DEFINED COMMUNITY CONDUCTED 326 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 19% FOR HEALTH-RELATED TOPICS.UNFORTUNATELY, SANFORD HAD TO CANCEL OPHTHALMOLOGY OUTREACH TO CHAMBERLAIN DUE TO PROVIDER AVAILABILITY. THE LOCAL MEDICAL CENTER IS EXPLORING OPTIONS FOR THE SERVICE DUE TO THE IDENTIFIED NEED FOR LOCAL CATARACTS SURGERY SERVICES. ORTHOPEDIC PROCEDURES WERE RE-ESTABLISHED LOCALLY IN NOVEMBER 2022 WITH CLINT BENGE, MD PROVIDING OUTREACH SERVICES. DR. BENGE IS AN ORTHOPEDIC SURGEON BASED IN SIOUX FALLS, SD AND OFFERS ACL RECONSTRUCTION, CARTILAGE RESTORATION, HIP ARTHROSCOPY, KNEE ARTHROSCOPY, MENISCAL REPAIR AND TRANSPLANTATION, AND SHOULDER ARTHROSCOPY AND ARTHROPLASTY.SANFORD CHAMBERLAIN, AND THE SYSTEM GENERALLY, UTILIZES TELE/VIRTUAL HEALTH AS AN OPTION TO AUGMENT SOME SERVICES THAT ARE PROVIDED IN THE LOCAL COMMUNITY. SANFORD CHAMBERLAIN SET A GOAL OF INCREASING THE PROMOTION OF TELE/VIRTUAL HEALTH TO INCREASE AWARENESS OF THE OPTION WITHIN THE COMMUNITY. THE FIRST INSTALLMENT OF TELEHEALTH EDUCATION WAS PRESENTED TO THE LOCAL ADVISORY BOARD IN OCTOBER 2022.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREPHYSICAL ACTIVITY AND NUTRITIONSEXUAL ACTIVITYCOMMUNITY SAFETYCHILDCARE QUALITYAFFORDABLE HOUSINGPUBLIC TRANSPORTATION AND THE INTERNETSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD SHARED THE FINDINGS OF THE CHNA RESEARCH AND THESE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 12 -- SANFORD CHAMBERLAIN MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 12 -- SANFORD CHAMBERLAIN MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 13 -- SANFORD LUVERNE MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 13 -- SANFORD LUVERNE MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 13 -- SANFORD LUVERNE MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 13 -- SANFORD LUVERNE MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND MENTAL HEALTH OPPORTUNITIES AND DECREASE SUBSTANCE ABUSE IN THE COMMUNITY. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD SEE EXPANDED ACCESS TO MENTAL HEALTH SERVICES WITHIN THE COMMUNITY.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE HELPS INDIVIDUALS AND FAMILIES ACCESS NEEDED PRIMARY CARE, SPECIALISTS, AND EMERGENCY CARE, BUT DOES NOT ENSURE ACCESS ON ITS OWNIT IS ALSO NECESSARY FOR PROVIDERS TO OFFER AFFORDABLE CARE, BE AVAILABLE TO TREAT PATIENTS, AND BE IN RELATIVELY CLOSE PROXIMITY TO PATIENTS.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE ACCESS TO PRIMARY CARE AND EXPAND TELEHEALTH AND DENTAL ACCESS. IT IS SANFORD'S GOAL TO PROVIDE GREATER ACCESS TO CARE USING THE VISIT STYLE PREFERRED BY THE PATIENT. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTHSANFORD LUVERNE IS ADDRESSING THE PRIORITY WITH THE GOALS OF EXPANDING MENTAL HEALTH OPPORTUNITIES AND DECREASING SUBSTANCE ABUSE IN THE COMMUNITY. MENTAL HEALTH IS TOP OF MIND FOR AREA RESIDENTS AS COMMUNITY RESIDENTS CONDUCTED 289 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 19% ON HEALTH-RELATED TOPICS. "PSYCHIATRIC EMERGENCY SERVICES" APPEARED IN THE TOP FIVE MOST SEARCHED LIST.ROCK COUNTY VOTED AT END OF 2022 TO NOT RENEW THE CONTRACT WITH SW MENTAL HEALTH, THUS CREATING A NEED FOR MORE MENTAL HEALTH SERVICES IN ROCK COUNTY. THE LOCAL SANFORD TEAM MET WITH COUNTY LEADERSHIP TO DISCUSS TRANSITION AND SUBSEQUENTLY RECEIVED APPROVAL TO POST FOR A FULL TIME LICSW BEHAVIORAL HEALTH THERAPIST AND ARE CURRENTLY WAITING FOR APPLICATIONS.SANFORD'S CURRENT INTEGRATED HEALTH THERAPIST (IHT) HAS BEEN ACTIVELY ENGAGED WITHIN THE COMMUNITY THIS PAST YEAR. MENTAL HEALTH PROVIDERS ENGAGE THE 6TH GRADE CLASS OF 80-90 STUDENTS ON ISSUES SURROUNDING MENTAL HEALTH, INCLUDING MINDFULNESS, HEALTHY RELATIONSHIPS, SUBSTANCE USE, TAKING CARE OF YOUR BRAIN, BRAIN HEALTH BASICS, AND BULLYING. SANFORD'S IHT COORDINATES AND IS A PRESENTER. ALL LOCAL MENTAL HEALTH PROVIDERS MEET ONCE PER MONTH IN BRAIN HEALTH GROUP MEETINGS TO EXPLORE GAPS IN CARE, COMMUNITY ENGAGEMENT, AND AVAILABILITY. SANFORD'S IHT LEADS THESE MEETINGS OF APPROXIMATELY 20 INDIVIDUALS. THIS GROUP ORGANIZED AMERICAN FOUNDATION FOR SUICIDE PREVENTION CLASSES AND HAD APPROXIMATELY 20 PEOPLE BETWEEN THE TWO CLASSES.ORGANIZED BY SANFORD'S IHT, THE OUT OF THE DARKNESS SUICIDE PREVENTION WALK TOOK PLACE SEPT 2022 AND DREW 200-300 WALKERS.GOAL: SUBSTANCE ABUSESANFORD HEALTH HAS BEEN ACTIVELY INVOLVED IN THE COMMUNITY'S OPIOID GRANT WORK AS WELL AS WITH COMMUNITY EDUCATION. THROUGH THE OPIOID GRANT WORK, THERE HAVE BEEN TWO BILLBOARDS PUT UP WITHIN THE COMMUNITY FOR AWARENESS. IN ADDITION, ANGELA KENNECKE PRESENTED EMILY'S HOPE IN FEBRUARY 2022 AND THE 3RD GRADE HAD EMILY'S HOPE CURRICULUM PRESENTED. LOCAL SUBSTANCE USE COUNSELORS HAVE BEEN ACTIVELY INVOLVED WITH COMMUNITY EDUCATION EVENTS FOCUSING AROUND NARCAN TRAINING THROUGH THE STEVE RUMMLER HOPE FOUNDATION.ADDITIONAL EVENTS INCLUDE A JANUARY 6TH GRADE BRAIN HEALTH PRESENTATION ON SUBSTANCE USE AND ABUSE WITH 80 KIDS, A FEBRUARY OPIOID PANEL WITH 150 PEOPLE AT LUVERNE HIGH SCHOOL, SUBSTANCE USE AND ABUSE EDUCATION WITH 80 KIDS WITHIN LUVERNE HIGH SCHOOL HEALTH CLASSES, AN APRIL EDUCATION SESSION TO SANFORD LUVERNE LAB STAFF ON ADDICTION AND STIGMA WITH SEVEN PEOPLE, AND A WOMEN'S ECUMENICAL BRUNCH IN MAY WITH 100 PEOPLE COVERING EDUCATION, ADDICTION, AND FAITH.IN THE FALL, 100 PEOPLE ATTENDED AN OCTOBER PRESENTATION ON ADDICTION AND FAITH, 10 PEOPLE ATTENDED A SANFORD LUVERNE LUNCH AND LEARN ON ADDICTION AND STIGMA IN NOVEMBER, 15 LADIES ATTENDED ANOTHER NOVEMBER EVENT ON THE TOPIC WITH PINK LADIES SANFORD LUVERNE, AND 45 PEOPLE ATTENDED A COMMUNITY NALOXONE TRAINING IN DECEMBER.ACCESS TO HEALTH CARE PROVIDERSACCESS TO HEALTH CARE PROVIDERS IS ADDRESSED THROUGH INCREASING ACCESS TO FAMILY MEDICINE AND EXPANDING TELEHEALTH AND DENTAL ACCESS. DR. KAT DAHL JOINED THE LUVERNE FAMILY MEDICINE TEAM IN FEBRUARY 2022 TO EXPAND ACCESS AND HAS BUILT A FULL CASELOAD. IN THE FALL OF 2022, LUVERNE HAD A TRANSITION FROM ONE NURSE PRACTITIONER TO ANOTHER NURSE PRACTITIONER WHO ADDED AN ADDITIONAL DAY EVERY TWO WEEKS, PROVIDING GREATER ACCESS. ENCOUNTER NUMBERS CONTINUE TO INCREASE WITH THE EXPANDED ACCESS.AFTER HOURS CARE IS AVAILABLE THROUGH A VIRTUAL VISIT WITHIN THE MYCHART APP. AFTER HOURS ACUTE CARE IS NOT AVAILABLE AT LUVERNE, BUT PATIENTS CAN BE DIRECTED TO WORTHINGTON, ROCK RAPIDS, OR SIOUX FALLS. TELEHEALTH EXPANSION HAS BEEN MINIMAL THIS YEAR DUE TO LIMITED OFFERINGS. TELEPSYCH IS FREQUENTLY USED AND PRESENTLY HAS WAIT TIMES OF SEVERAL WEEKS. THIS AREA CONTINUES TO BE A FOCUS OF THE SYSTEM AND WILL EXPAND AS THE VIRTUAL HEALTH INITIATIVE GROWS.CLINIC PROVIDERS CONTINUE TO PARTNER WITH THE MOBILE DENTAL UNIT THAT COMES TO LUVERNE. THE MOBILE DENTAL UNIT COMES 1-2 DAYS PER MONTH. THE ORGANIZATION HAS ALSO PARTNERED WITH CARING HANDS CLINIC IN PIPESTONE FOR MEDICAID PATIENTS. HOWEVER, CARING HANDS NOW HAS A SEVERAL WEEK WAIT TIME.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREPHYSICAL ACTIVITY AND NUTRITIONAFFORDABLE HOUSINGCHILDCARE/DAYCARE SERVICESSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 13 -- SANFORD LUVERNE MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 13 -- SANFORD LUVERNE MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 14 -- SANFORD CANBY MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 14 -- SANFORD CANBY MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 14 -- SANFORD CANBY MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 14 -- SANFORD CANBY MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTH MENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO FOCUS ON TWO PRIMARY GOALS: EXPANDING AWARENESS OF THE SANFORD CANBY AMBULATORY CARE MANAGER'S ROLE IN MENTAL HEALTH AND PROVIDING AND/OR SUPPORTING MENTAL HEALTH RESOURCES TO AREA YOUTH. IT IS SANFORD'S GOAL TO MAKE THE COMMUNITY MORE AWARE OF MENTAL HEALTH RESOURCES THAT ARE AVAILABLE IN THEIR LOCAL COMMUNITY.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERS ACCESS TO CARE REQUIRES NOT ONLY FINANCIAL COVERAGE, BUT ALSO ACCESS TO PROVIDERS. WHILE HIGH RATES OF SPECIALIST PHYSICIANS HAVE BEEN SHOWN TO BE ASSOCIATED WITH HIGHER (AND PERHAPS UNNECESSARY) UTILIZATION, SUFFICIENT AVAILABILITY OF PRIMARY CARE PHYSICIANS IS ESSENTIAL FOR PREVENTIVE AND PRIMARY CARE, AND, WHEN NEEDED, REFERRALS TO APPROPRIATE SPECIALTY CARE.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO IMPROVE ACCESS TO PROVIDERS, SPECIFICALLY TO INCREASE ACCESS TO PRIMARY CARE PROVIDERS AND IMPROVE MARKETING AROUND SPECIALTY OUTREACH SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD FEEL EMPOWERED TO TAKE OWNERSHIP OF PREVENTATIVE HEALTH MAINTENANCE AND SEE PROGRESS TOWARDS AN OVERALL HEALTHIER POPULATION. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTHSANFORD CANBY SUPPORTS THIS PRIORITY THROUGH A DUAL FOCUS ON EXPANDING AWARENESS OF AMBULATORY CARE MANAGER'S ROLE IN MENTAL HEALTH WITHIN THE COMMUNITY AND PROVIDING MENTAL HEALTH RESOURCES TO AREA YOUTH. A TOTAL OF 91 MENTAL HEALTH APPOINTMENTS TOOK PLACE FOR THE 2022 YEAR.ONE OF THE TACTICS IDENTIFIED BY THE HOSPITAL ROLE TO INCREASE COMMUNITY AWARENESS LEVELS WAS TO PRESENT FOUR EDUCATION SESSIONS ANNUALLY ON THE ROLE OF THE AMBULATOR CARE MANAGER. THE AMBULATORY CARE MANAGER PRESENTED TO SEVERAL STAKEHOLDER GROUPS IN 2022 IN ORDER TO EXPAND AWARENESS OF HER ROLE IN MENTAL HEALTH. THE CANBY ROTARY CLUB (OCTOBER 13) DISCUSSED WHAT MENTAL HEALTH CONDITIONS ARE AND HOW TO RECOGNIZE THEM, IN ADDITION TO COMMUNITY RESOURCES AND LOCAL SERVICES. SANFORD CANBY'S PATIENT ADVISORY AND PATIENT AND FAMILY ENGAGEMENT COUNCIL RECEIVED A SIMILAR PRESENTATION ON APRIL 27. MENTAL HEALTH AMONG THE ELDERLY, INCLUDING SIGNS AND SYMPTOMS, WAS THE TOPIC FOR NOVEMBER 11 AND DECEMBER 6 PRESENTATIONS TO THE SYLVAN PLACE RESIDENT COUNCIL AND SYLVAN COURT FAMILY COUNCIL, RESPECTIVELY. THE DISCUSSION INCLUDED INFORMATION ON THE AVAILABILITY OF LOCAL RESOURCES. THE SEVEN MEMBERS OF THE SYLVAN COURT FAMILY COUNCIL ALSO REVIEWED A VIDEO ON DEPRESSION ON MARCH 7.MENTAL HEALTH EDUCATION WAS PROVIDED BY THE AMBULATORY CARE MANAGER TO SANFORD CANBY STAFF VIA AN ARTICLE IN THE AUGUST 2022 SANFORD CANBY EMPLOYEE NEWSLETTER ON THE 988 SUICIDE & CRISIS LIFELINE. THE SAME INFORMATION WAS ALSO POSTED ON SANFORD CANBY WELLNESS CENTER'S FACEBOOK PAGE ON OCTOBER 17, 2022. IN THE COMING YEAR, INFORMATION ON DEPRESSION/MENTAL HEALTH EDUCATION AND AWARENESS WILL BE PRESENTED TO THE EMR CANBY HIGH SCHOOL STUDENTS ON MAY 8, 2023. STAFF ALSO SUPPORTED THE NATIONAL NIGHT OUT FOR AREA YOUTH ON JULY 26, 2022. REHAB, WELLNESS CENTER, AND AMBULANCE STAFF MEMBERS FROM SANFORD CANBY PARTICIPATED IN THE EVENT.ACCESS TO HEALTH CARE PROVIDERSTO SUPPORT THE PRIORITY, THE HOSPITAL IS WORKING TO INCREASE PREVENTATIVE HEALTH AND WELLNESS VISITS AND EXPAND KNOWLEDGE AND AWARENESS OF SANFORD-PROVIDED SPECIALTY OUTREACH SERVICES AVAILABLE LOCALLY. YELLOW MEDICINE COUNTY RESIDENTS AND STAFF ENGAGED THE FINDHELP PLATFORM IN 2022 WITH 114 SEARCHES, 24% OF WHICH WERE FOR HEALTH-RELATED TERMS. SANFORD CANBY HAD A TOTAL OF 969 PREVENTATIVE CARE PROVIDER ENCOUNTERS IN 2022.SANFORD PROVIDERS CONDUCTED A NUMBER OF PUBLIC ENGAGEMENTS TO INTERACT WITH THE PUBLIC IN SUPPORT OF INCREASED PREVENTATIVE CARE VISITS. DR. AYBAR AND DR. LOPEZ WERE THE GRAND MARSHALLS OF THE CANBY HAT DAZE PARADE ON JUNE 18TH. A COMMUNITY RETIREMENT PARTY WAS HELD FOR DR. AYBAR AND DR. LOPEZ WITH SANFORD'S PA-C KAHLEY MEYER IN ATTENDANCE. DR. FUHRMAN, DR. AYBAR, DR. HANSON, AND MICHELLE DANIELSON, CNP PARTICIPATED IN ADDITIONAL COMMUNITY EVENTS THROUGHOUT THE YEAR. DR. FUHRMAN AND HANSON PARTICIPATED IN THE CANBY TRUNK OR TREAT ON OCTOBER 31, 2022, WHILE DRS. FUHRMAN AND DANIELSON PARTICIPATED IN THE CANBY HOMETOWN HOLIDAY PARADE IN DECEMBER. AYBAR AND HANSON PRESENTED A MATURATION CLASS AT CANBY ELEMENTARY SCHOOL ON APRIL 27. AYBAR PROVIDED WEIGHT CERTIFICATIONS FOR MINNESOTA HIGH SCHOOL WRESTLERS IN DECEMBER 2022.SANFORD CANBY IS EXPANDING ITS MARKETING OF DIRECT ACCESS LABORATORY TESTING. DIRECT ACCESS LABORATORY TESTING BROCHURES HAVE BEEN DISPLAYED AT THE SANFORD CANBY CLINIC FRONT DESK SINCE JANUARY 2022 AND WAS EXTENDED TO THE ELECTRONIC DISPLAY TV IN THE SANFORD CANBY CLINIC WAITING AREA IN FEBRUARY 2023. DIRECT ACCESS LABS RECEIVED $7,150 IN TESTING REVENUE IN 2022.A CAMPAIGN TO EXPAND AWARENESS OF SANFORD-PROVIDED SPECIALTY AND OUTREACH SERVICES STARTED IN 2023. EFFORTS INCLUDE POSTING ONE OUTREACH PROVIDER'S INFORMATION ON THE SANFORD CANBY WELLNESS CENTER FACEBOOK PAGE EACH MONTH BEGINNING MARCH 2023 AND THE SAME INFORMATION WILL BE DISPLAYED ON THE ELECTRONIC DISPLAY TV IN THE SANFORD CANBY CLINIC WAITING AREA. 2022 VOLUMES FOR SPECIALTY AND OUTREACH SERVICES INCLUDE UROLOGY 91, CARDIOLOGY 466, NEPHROLOGY 145, GASTROENTEROLOGY 177, PODIATRY 221, AND VASCULAR 49. ADDITIONAL EDUCATION TO SANFORD CANBY EMPLOYEES WILL TAKE PLACE VIA THE EMPLOYEE NEWSLETTER EACH MONTH BEGINNING IN APRIL 2023. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:AFFORDABLE HOUSINGEMPLOYMENT AND ECONOMIC OPPORTUNITIESSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 14 -- SANFORD CANBY MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 14 -- SANFORD CANBY MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 15 -- SANFORD JACKSON MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 15 -- SANFORD JACKSON MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 15 -- SANFORD JACKSON MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 15 -- SANFORD JACKSON MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTH MENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ADVANCE INTEGRATED HEALTHCARE IN THE COMMUNITY AND TO INCREASE AWARENESS AND EDUCATION ON SUICIDE PREVENTION. IT IS SANFORD'S GOAL TO INCREASE THE NUMBER OF PATIENTS THAT SANFORD PROVIDES INTEGRATED HEALTH THERAPIST SERVICES TO IN THE JACKSON AREA. PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSACCESS TO CARE REQUIRES NOT ONLY FINANCIAL COVERAGE, BUT ALSO ACCESS TO PROVIDERS. WHILE HIGH RATES OF SPECIALIST PHYSICIANS HAVE BEEN SHOWN TO BE ASSOCIATED WITH HIGHER (AND PERHAPS UNNECESSARY) UTILIZATION, SUFFICIENT AVAILABILITY OF PRIMARY CARE PHYSICIANS IS ESSENTIAL FOR PREVENTIVE AND PRIMARY CARE, AND, WHEN NEEDED, REFERRALS TO APPROPRIATE SPECIALTY CARE.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE COMMUNITY AWARENESS OF LOCAL PROVIDERS AND INCREASE ACCESS TO SPECIALTY CARE AT SANFORD JACKSON MEDICAL CENTER. IT IS SANFORD'S GOAL TO INCREASE AWARENESS OF PRIMARY CARE PROVIDERS AND SPECIALTY CARE.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTHSANFORD JACKSON IS WORKING ON THE GOALS OF ADVANCING INTEGRATED HEALTHCARE IN THE COMMUNITY AND INCREASING AWARENESS AND PROVIDING EDUCATION ON SUICIDE PREVENTION IN SUPPORT OF THE PRIORITY. SANFORD JACKSON MEDICAL CENTER'S INTEGRATED HEALTH THERAPIST (IHT) LEADS A COMMUNITY TASK FORCE COMPRISED OF REPRESENTATIVES FROM DES MOINES VALLEY HEALTH AND HUMAN SERVICES (PUBLIC HEALTH), LAW ENFORCEMENT OFFICIALS, EMS, INDUSTRY LEADERS, SOUTHWEST MENTAL HEALTH, AND FAMILY SERVICES NETWORK. THIS TASK FORCE MEETS MONTHLY TO DISCUSS BEHAVIORAL HEALTH ISSUES OF ALL AGES, AVAILABLE RESOURCES, AND THE IMPACT ON OUR COMMUNITY. THE IHT AND OTHER STAFF MEMBERS WERE ALSO INVOLVED IN A STRATEGIC PLANNING SUICIDE PREVENTION COHORT FACILITATED BY MINNESOTA DEPARTMENT OF PUBLIC HEALTH ALONGSIDE DES MOINES VALLEY HEALTH AND HUMAN SERVICES (PUBLIC HEALTH) AND VARIOUS OTHER LOCAL COMMUNITY STAKEHOLDERS. THIS SPECIFIC GROUP BEGAN MEETING MONTHLY IN SEPTEMBER 2021 AND CONTINUED TO DO SO THROUGH 2022 CALENDAR YEAR. THE GOAL OF THIS COHORT IS TO GAIN SKILLS TO DEVELOP A COMPREHENSIVE PLAN TO PRIORITIZE PREVENTION EFFORTS RELATED TO DEATH BY SUICIDE.IN MAY OF 2022 SANFORD JACKSON MEDICAL CENTER'S INTEGRATED HEALTH THERAPIST ALONG WITH A FAMILY NURSE PRACTITIONER COMPLETED A BEHAVIORAL HEALTH EDUCATION, AWARENESS AND RESPONSE DEVELOPMENT COURSE. THIS COURSE HELPS INCREASE KNOWLEDGE, SKILLS, AND CONFIDENCE TO SUPPORT PEOPLE WITH BEHAVIORAL HEALTH CONCERNS. ITS FOCUS IS TO ASSIST ATTENDEES TO SUPPORT PATIENTS STRUGGLING WITH A WIDE RANGE OF BEHAVIORAL HEALTH CONCERNS. IN 2022 SANFORD JACKSON MEDICAL CENTER SOUGHT TO MAINTAIN AND FILL OPEN INTEGRATED HEALTH THERAPIST POSITIONS. STAFF MEMBERS WORKED TIRELESSLY WITH SANFORD TALENT ADVISORS AND OTHER INTERNAL CONTACTS TO ATTRACT CANDIDATES AND MAINTAIN RELATIONSHIPS.SANFORD JACKSON MEDICAL CENTER STAFF IS A STRONG PRESENCE IN THE LOCAL POSITIVE COMMUNITY NORMS PROGRAM PATH, (POSITIVE ACTIONS TOWARDS HEALTH) BY ATTENDING MONTHLY AND OCCASIONAL BIMONTHLY MEETINGS. THE OVERALL GOAL IS TO CULTIVATE LASTING CULTURAL TRANSFORMATION BY INVOLVING THE STUDENTS, PARENTS, TEACHERS, AND THE ENTIRE COMMUNITY IN UNDERSTANDING NOT JUST WHAT IS CONCERNING, BUT ALSO WHAT IS HELPFUL. THEY ENCOURAGED ATTENDANCE TO MOTIVATIONAL SPEAKER, CORY GREENWOOD IN A FEBRUARY 18, 2022, PRESENTATION. THIS SPEAKER WAS BROUGHT TO OUR COMMUNITY AND SCHOOL SYSTEMS BY FUNDING PROVIDED BY PATH. ON DECEMBER 2, 2022, THE SANFORD JACKSON MEDICAL CENTER ADMINISTRATOR SIGNED THE STIGMA FREE RESOLUTION TO RECOGNIZE THE COMMUNITY NEEDS AND AGREE TO JOIN THE COLLABORATE CAMPAIGN AGAINST THE STIGMA OF MENTAL ILLNESS. SANFORD JACKSON MEDICAL CENTER WAS ESTABLISHED AS A STIGMA-FREE ZONE AND WILL CONTINUE TO HELP RAISE AWARENESS OF RESOURCES AND ENCOURAGE PATIENTS, RESIDENTS, AND FELLOW STAFF MEMBERS TO ENGAGE IN CARE AS SOON AS THE NEED IS IDENTIFIED SO RECOVERY CAN BEGIN.ACCESS TO HEALTH CARE PROVIDERSTO INCREASE ACCESS TO HEALTH CARE PROVIDERS, THE MEDICAL CENTER IS WORKING TO CREATE COMMUNITY AWARENESS OF PROVIDER OFFERING LOCAL CARE AND WORKING TO INCREASE SPECIALTY CARE ACCESS AT THE SANFORD JACKSON MEDICAL CENTER.TO INCREASE AWARENESS, SANFORD JACKSON MEDICAL CENTER PROVIDED BIOMETRIC SCREENINGS TO SIX AREA EMPLOYERS AND SCREENED 188 PEOPLE. THE RESULTS WERE GIVEN TO PATIENTS WITH INSTRUCTIONS TO FOLLOW UP WITH THEIR PRIMARY CARE PROVIDER (PCP) OR SEEK MEDICAL CARE IF ANY OF THE MEASURES FELL OUTSIDE OF THE NORMAL RANGE. ADDITIONALLY IN MARCH 2022 SANFORD JACKSON MEDICAL CENTER PARTICIPATED IN THE MARTIN COUNTY STAR HEALTH AND WELLNESS EDITION. THE MEDICAL CENTER PROVIDED A "HERE FOR YOUR HEALTH IN JACKSON" AD AND ARTICLE "WHEN SHOULD I FIND A PRIMARY CARE PROVIDER?" TO HELP GENERATE AWARENESS ABOUT THE IMPORTANCE OF HAVING A PCP. SANFORD JACKSON MEDICAL CENTER ALSO CONTINUED TO RECEIVE FEEDBACK AND COMMUNITY INPUT FROM BOTH OUR ADVISORY BOARD AND PATIENT ADVISORY BOARD. IN 2022 SANFORD JACKSON MEDICAL CENTER DESIGNED AND STARTED CONSTRUCTION ON A NEW STATE OF THE ART TELEHEALTH SUITE FOR AN IMPROVED TELEHEALTH EXPERIENCE. THE NEW TELEHEALTH SUITE IS EQUIPPED WITH A LARGE SCREEN TELEVISION, MICROPHONE, AND SPEAKERS TO ENHANCE OUR PATIENT'S TELEMEDICINE EXPERIENCE AT THE MEDICAL CENTER. THE ADDITION OF THE TELEHEALTH SUITE HAS IMPROVED THE QUALITY OF CARE FOR CURRENT TELEMEDICINE PATIENTS THAT WAS ALREADY TAKING PLACE WITH DR. EGGERS, A PEDIATRIC PSYCHIATRIST. IT ALSO PAVED THE WAY FOR EXPLORATION OF OTHER OPPORTUNITIES FOR TELEHEALTH PROVIDERS AND SPECIALTY SERVICES THAT ARE SCHEDULED TO BEGIN IN EARLY 2023. THOSE SERVICES CURRENTLY SCHEDULED TO BEGIN ARE VASCULAR HEALTH (MARCH) AND NEPHROLOGY (APRIL). IN 2022 WE ALSO SAW THE ADDITION OF AN UPGRADED ULTRASOUND MACHINE THAT IMPROVED THE ULTRASOUND OB/GYN CAPABILITIES LOCALLY, SO PATIENTS DID NOT HAVE TO TRAVEL TO RECEIVE THESE SCANS.SANFORD JACKSON MEDICAL CENTER WAS FORTUNATE TO ADD TWO TALENTED PROFESSIONALS TO ITS STAFF IN 2022. IN JANUARY OF 2022, KAITLIN JOHNSON ACCEPTED THE ROLE AS THE NEW SUPERVISOR OVER THERAPY AND REHABILITATION. KAITLIN BRINGS WITH HER A BACKGROUND THAT SPECIALIZES IN WOMEN'S HEALTH, PARKINSON'S, PEDIATRICS, GERIATRICS, CONTINENCE, POST-SURGERY, AS WELL AS SPORTS, AND ORTHOPEDIC INJURIES. SHE ALSO BRINGS WITH HER NEW THERAPIES THAT ARE NOW AVAILABLE LOCALLY SUCH AS DRY NEEDLING, CUPPING, TAPING, BALANCE THERAPY, MANUAL/HANDS ON THERAPY AND THE GRASTON TECHNIQUE. IN NOVEMBER OF 2022 SANFORD JACKSON MEDICAL CENTER INCREASED THEIR SURGICAL STAFF AND AVAILABLE SURGICAL SERVICES WITH THE ADDITION OF DR. RODNEY DYNES, MD. HE IS CURRENTLY PERFORMING COLONOSCOPIES, ENDOSCOPIES, VASECTOMIES, HEMORRHOIDECTOMY, AND LIPOMA REMOVALS, WITH PLANS TO EXPAND SERVICES IN 2023. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:PHYSICAL ACTIVITY AND NUTRITIONHUMAN IMMUNODEFICIENCY VIRUS (HIV)ALCOHOL-RELATED DRIVING DEATHSAFFORDABLE HOUSINGSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 15 -- SANFORD JACKSON MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 15 -- SANFORD JACKSON MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 16 -- SANFORD TRACY MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 16 -- SANFORD TRACY MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 16 -- SANFORD TRACY MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 16 -- SANFORD TRACY MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: PHYSICAL ACTIVITY AND NUTRITIONTHE ENVIRONMENTS WHERE PEOPLE LIVE, LEARN, WORK, AND PLAY AFFECT ACCESS TO HEALTHY FOOD AND OPPORTUNITIES FOR PHYSICAL ACTIVITY WHICH, ALONG WITH GENETIC FACTORS AND PERSONAL CHOICES, SHAPE THE HEALTH AND THE RISK OF BEING OVERWEIGHT AND OBESE.SANFORD HEALTH TRACY HAS MADE PHYSICAL ACTIVITY AND NUTRITION SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO CONTINUE THE RN HEALTH COACH PROGRAM AND TO BEGIN A DIABETIC EDUCATION PROGRAM. IN ADDITION, SANFORD HAS DEVELOPED A STRATEGY TO PROVIDE AN ALTERNATIVE OPTION FOR THOSE COMMUNITY MEMBERS WHO ARE HUNGRY AND/OR LACKING FOOD OPTIONS. IT IS SANFORD'S GOAL TO PROVIDE A POSITIVE IMPACT ON PHYSICAL WELLBEING SPECIFICALLY RELATED TO OBESITY AND CHRONIC ILLNESS LIKE HIGH BLOOD PRESSURE AND DIABETES, AS WELL AS A POSITIVE IMPACT ON THE LACK OF NUTRITIONAL FOOD ACCESS.PRIORITY 2: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE SCREENING FOR DEPRESSION AND TO PROMOTE AND IMPROVE ACCESS TO SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD SEE A LOWERED NUMBER OF MENTAL HEALTH DAYS FROM COMMUNITY MEMBERS AND A POSITIVE INCREASE IN AWARENESS OF MENTAL HEALTH SERVICES IN THE COMMUNITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARPHYSICAL ACTIVITY AND NUTRITIONSANFORD TRACY HAS THE GOAL OF USING THE RN HEALTH COACH AND DIABETIC EDUCATION PROGRAMS TO INCREASE AWARENESS OF DIABETES AND IMPROVE KEY MEASURES, SUCH AS A1C IN DIABETICS. SANFORD TRACY ALSO SEEKS TO SUPPORT COMMUNITY MEMBERS WHO ARE HUNGRY AND/OR LACK FOOD OPTIONS THROUGH A PANTRY LOCATION IN THE CLINIC.THE FOOD PANTRY PROGRAM BEGAN IN 2022 WITH SIX INDIVIDUALS/FAMILIES RECEIVING BOXES. DUE TO THE RESIGNATION OF BEHAVIORAL HEALTH ON-SITE STAFF IN 2022, THE PROGRAM SLOWED. IT IS MORE DIFFICULT FOR PCPS AND NURSES TO IDENTIFY THESE INDIVIDUALS AND FAMILIES IN NEED AT TIMES. THE ORGANIZATION IS EXPLORING OPTIONS TO RENEW THE PROGRAM IN 2023.REGARDING SANFORD'S RN HEALTH COACH, A1C IMPROVED QUARTERLY RATES FROM 16.6% IN Q1 2022 TO 14.4% IN Q4 OF 2022. HYPERTENSION CONTROL INCREASED FROM 84.3% IN Q1 2022 TO 87.5% IN Q4 2022. BMI DATA UNAVAILABLE DUE TO INACCURACIES IN DATA. PROVIDERS CONTINUE TO REVIEW BMI WITH PATIENTS, BUT DATA IS NO LONGER MONITORED OR MEASURED FOR QUALITY PURPOSES. THE DIABETIC EDUCATION PROGRAM STARTED 2022 SLOW DUE TO A MATERNITY LEAVE WITH STAFF. UPON RETURN IN APRIL, THE PROGRAM SAW 11 PATIENTS. COMMUNITY EDUCATION EVENTS WERE POSTPONED IN 2022 DUE TO THE MATERNITY LEAVE AND LIMITED AVAILABILITY OF STAFF. EDUCATION PROGRAMS ARE BEING CONSIDERED FOR 2023 BASED UPON STAFF AVAILABILITY.MENTAL HEALTHTHE PRIORITY WILL BE ADDRESSED BY SANFORD TRACY THROUGH TWO GOALS. THE FIRST GOAL IS TO INCREASE SCREENING FOR DEPRESSION AND REFERRALS TO BEHAVIORAL HEALTH SPECIALISTS. THE SECOND GOAL IS TO RAISE AWARENESS OF MENTAL HEALTH AND BEHAVIORAL HEALTH PROVIDERS AND SERVICES AT SANFORD TRACY.BEHAVIORAL HEALTH SCREENINGS AVERAGED APPROXIMATELY 68% FOR 2022. THE STRETCH GOAL IS TO ACHIEVE 100% SCREENING OF ALL PATIENTS TWELVE YEARS AND OLDER WITH A PRIOR HISTORY OF DEPRESSION OR ANXIETY. STAFF EDUCATION WILL CONTINUE TO HELP INCREASE THIS SCREENING NUMBER IN 2023. MENTAL HEALTH REFERRAL EFFORTS TO OUTSIDE PROVIDERS AND FACILITIES WERE PUT ON HOLD IN 2022 DUE TO THE RESIGNATION OF IN-HOUSE BEHAVIORAL HEALTH PROVIDERS AT SANFORD TRACY. THE STAFFING UPDATE ALSO PAUSED THE PROMOTION OF IN-HOUSE BEHAVIORAL HEALTH SERVICES FOR 2022. CURRENT UTILIZATION REMAINS LIMITED DUE TO AVAILABILITY CONSTRAINTS FROM HAVING ONE OUTREACH TELEMEDICINE PSYCHIATRIST. HOWEVER, THE PSYCHIATRIST SAW 197 PATIENTS VIA TELEMEDICINE VISITS IN 2022, AN INCREASE FROM 99 IN 2021.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO HEALTH CARE PROVIDERSACCESS TO AFFORDABLE HEALTH CAREEMPLOYMENT AND ECONOMIC OPPORTUNITIESPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 16 -- SANFORD TRACY MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 16 -- SANFORD TRACY MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 17 -- SANFORD HILLSBORO MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 17 -- SANFORD HILLSBORO MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 17 -- SANFORD HILLSBORO MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 17 -- SANFORD HILLSBORO MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTH SERVICESMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH SERVICES A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO IMPROVE ACCESS, USE OF INTEGRATED HEALTH THERAPISTS AND IMPROVE SCREENING PROCEDURES. IT IS SANFORD'S GOAL TO REDUCE THE SEVERITY OF DEPRESSION THROUGH SCREENING AND CARE DELIVERY EFFORTS. PRIORITY 2: TRANSPORTATIONTRANSPORTATION SYSTEMS HELP ENSURE THAT PEOPLE CAN REACH EVERYDAY DESTINATIONS, SUCH AS JOBS, SCHOOLS, HEALTHY FOOD OUTLETS, AND HEALTH CARE FACILITIES, SAFELY AND RELIABLY. PUBLIC TRANSPORTATION SERVICES PLAY AN IMPORTANT ROLE FOR PEOPLE WHO ARE UNABLE TO DRIVE, PEOPLE WITHOUT ACCESS TO PERSONAL VEHICLES, CHILDREN, INDIVIDUALS WITH DISABILITIES, AND OLDER ADULTS.SANFORD HEALTH HILLSBORO HAS MADE TRANSPORTATION A SIGNIFICANT PRIORITY AND HAS DEVELOPED A STRATEGY TO WORK IN COLLABORATION WITH CITY AND COUNTY LEADERSHIP TO EXPLORE OPTIONS FOR THE LOCAL COMMUNITY AND COUNTY MEMBERS. IT IS SANFORD'S GOAL TO IMPROVE THE AVAILABILITY OF PUBLIC TRANSPORTATION THROUGH BOTH THE PROMOTION OF CURRENT RESOURCES WITHIN THE HOSPITAL AND CLINIC SETTINGS, BUT ALSO IN WORKING TO ESTABLISH NEW RESOURCES THAT EXPAND OPPORTUNITIES.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTH SERVICES SANFORD HILLSBORO HAS ESTABLISHED TWO GOALS FOR THE MENTAL HEALTH SERVICES PRIORITY. THE FIRST IS IMPROVING PHQ-9 SCORES FOR PATIENTS WITH DEPRESSION. THE SECOND IS TO PROVIDE FOR IMPROVED ACCESS TO MENTAL HEALTH/BEHAVIORAL HEALTH SERVICES. ALTHOUGH THE FINDHELP TOOL IS NOT SPECIFIC TO MENTAL HEALTH, RESIDENTS OF THE CHNA COMMUNITY CONDUCTED 298 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 29% ON HEALTH-RELATED TOPICS.SANFORD HILLSBORO HAD IMPLEMENTED INTEGRATED HEALTH THERAPISTS (IHTS) INTO THE CLINICS, PRIMARILY VIA TELEHEALTH, BUT THE IHT RESIGNED, AND THE ORGANIZATION IS IN THE PROCESS OF RECRUITING A REPLACEMENT. PATIENTS AND PROVIDERS FELT THAT THE PROGRAM WAS GOING WELL, AND IT IS USED QUITE FREQUENTLY.HILLSBORO'S GO LIVE FOR SENIOR LIFE SOLUTIONS OUTPATIENT GROUP THERAPY PROGRAM RESTARTED EARLY 2023 AND WE HAVE 4-10 PATIENTS PER DAY PARTICIPATING IN THE PROGRAM. THE SERVICE PREVIOUSLY OPERATED VIRTUALLY BEGINNING IN JANUARY 2021.TRANSPORTATIONSANFORD SEEKS TO ADDRESS TRANSPORTATION PRIORITIES BY PROVIDING A COMPREHENSIVE DIRECTION OF OPTIONS AVAILABLE WITHIN THE COUNTY. COMMUNITY RESIDENTS CONDUCTED 298 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 11% ON TRANSIT-RELATED TOPICS. SEARCH TERMS INCLUDE "HELP PAY FOR TRANSIT," "TRANSPORTATION, AND "HELP PAY FOR GAS."A LIST OF TRANSPORTATION OPTIONS IS AVAILABLE ACROSS THE COUNTY BY SANFORD HILLSBORO IN COORDINATION WITH TRAILL COUNTY. THE COMMUNITY HAS A BUS/VAN AVAILABLE FOR USE AND INDICATIONS ARE IT IS WELL-RECEIVED IN THE COMMUNITY. A LIMITATION TO THE PROGRAM IS DRIVER AVAILABILITY.SANFORD SUPPORTS THE USE OF VIRTUAL CARE AS AN ALTERNATIVE TO IN PERSON VISITS FOR SEVERAL TYPES OF CARE. AS SUCH, SANFORD HILLSBORO PROMOTES VIRTUAL CARE INCLUDING VIDEO VISITS, TELEHEALTH, AND E-VISITS TO PATIENTS AS APPROPRIATE.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO HEALTH CAREPHYSICAL ACTIVITY AND NUTRITIONACCESS TO QUALITY CHILDCARE AND AFFORDABLE HOUSINGSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 17 -- SANFORD HILLSBORO MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 17 -- SANFORD HILLSBORO MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 18 -- SANFORD MEDICAL CENTER MAYVILLE PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 18 -- SANFORD MEDICAL CENTER MAYVILLE PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 18 -- SANFORD MEDICAL CENTER MAYVILLE PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 18 -- SANFORD MEDICAL CENTER MAYVILLE PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTH SERVICESMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES AND REDUCE THE SEVERITY OF DEPRESSION THROUGH USE OF INTEGRATED HEALTH THERAPISTS AND IMPROVE SCREENING PROCEDURES REDUCE MORTALITY AND MORBIDITY FROM MENTAL HEALTH AND BEHAVIORAL HEALTH AND SUBSTANCE ABUSE. IT IS SANFORD'S GOAL TO REDUCE THE SEVERITY OF DEPRESSION THROUGH SCREENING AND CARE DELIVERY EFFORTS.PRIORITY 2: TRANSPORTATIONTRANSPORTATION SYSTEMS HELP ENSURE THAT PEOPLE CAN REACH EVERYDAY DESTINATIONS, SUCH AS JOBS, SCHOOLS, HEALTHY FOOD OUTLETS, AND HEALTH CARE FACILITIES, SAFELY AND RELIABLY. PUBLIC TRANSPORTATION SERVICES PLAY AN IMPORTANT ROLE FOR PEOPLE WHO ARE UNABLE TO DRIVE, PEOPLE WITHOUT ACCESS TO PERSONAL VEHICLES, CHILDREN, INDIVIDUALS WITH DISABILITIES, AND OLDER ADULTS.SANFORD HEALTH MAYVILLE HAS MADE TRANSPORTATION A SIGNIFICANT PRIORITY AND HAS DEVELOPED A STRATEGY TO WORK IN COLLABORATION WITH CITY AND COUNTY LEADERSHIP TO EXPLORE OPTIONS FOR THE LOCAL COMMUNITY AND COUNTY MEMBERS. IT IS SANFORD'S GOAL TO IMPROVE AVAILABILITY OF PUBLIC TRANSPORTATION THROUGH BOTH THE PROMOTION OF CURRENT RESOURCES WITHIN THE HOSPITAL AND CLINIC SETTINGS, BUT ALSO IN WORKING TO ESTABLISH NEW RESOURCES THAT EXPAND OPPORTUNITIES.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTH SERVICESSANFORD MAYVILLE CHANGED TO USING THE PHQ2 FOR ALL PATIENT HEALTH QUESTIONNAIRE ON INITIAL APPOINTMENTS TO ENSURE THOSE IN NEED OF MENTAL HEALTH SERVICES ARE IDENTIFIED AND OFFERED TREATMENT. THE PANEL MANAGEMENT TEAM IS COMPLETING FOLLOW-UP FOR NEW DEPRESSION DIAGNOSIS. SANFORD HILLSBORO WILL START THE SAME PROCESS IN QUARTER TWO OF 2023.SANFORD MAYVILLE HAD IMPLEMENTED INTEGRATED HEALTH THERAPISTS (IHTS) INTO THE CLINICS, PRIMARILY VIA TELEHEALTH, BUT THE IHT RESIGNED, AND THE ORGANIZATION IS IN THE PROCESS OF RECRUITING A REPLACEMENT. PATIENTS AND PROVIDERS FELT THAT THE PROGRAM WAS GOING WELL, AND IT IS USED QUITE FREQUENTLY.TRANSPORTATIONSANFORD SEEKS TO ADDRESS TRANSPORTATION PRIORITIES BY PROVIDING A COMPREHENSIVE DIRECTION OF OPTIONS AVAILABLE WITHIN THE COUNTY. COMMUNITY RESIDENTS CONDUCTED 298 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 11% ON TRANSIT-RELATED TOPICS. SEARCH TERMS INCLUDE "HELP PAY FOR TRANSIT," "TRANSPORTATION, AND "HELP PAY FOR GAS."A LIST OF TRANSPORTATION OPTIONS IS AVAILABLE ACROSS THE COUNTY BY SANFORD MAYVILLE IN COORDINATION WITH TRAILL COUNTY. THE COMMUNITY HAS A BUS/VAN AVAILABLE FOR USE AND INDICATIONS ARE IT IS WELL-RECEIVED IN THE COMMUNITY. A LIMITATION TO THE PROGRAM IS DRIVER AVAILABILITY.SANFORD SUPPORTS THE USE OF VIRTUAL CARE AS AN ALTERNATIVE TO IN PERSON VISITS FOR SEVERAL TYPES OF CARE. AS SUCH, SANFORD HILLSBORO PROMOTES VIRTUAL CARE INCLUDING VIDEO VISITS, TELEHEALTH, AND E-VISITS TO PATIENTS AS APPROPRIATE.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO HEALTH CAREPHYSICAL ACTIVITY AND NUTRITIONACCESS TO QUALITY CHILDCARE AND AFFORDABLE HOUSINGSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 18 -- SANFORD MEDICAL CENTER MAYVILLE PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 18 -- SANFORD MEDICAL CENTER MAYVILLE PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 19 -- SANFORD WEBSTER MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 19 -- SANFORD WEBSTER MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 19 -- SANFORD WEBSTER MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 19 -- SANFORD WEBSTER MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: PHYSICAL ACTIVITY AND NUTRITIONTHE ENVIRONMENTS WHERE PEOPLE LIVE, LEARN, WORK, AND PLAY AFFECT ACCESS TO HEALTHY FOOD AND OPPORTUNITIES FOR PHYSICAL ACTIVITY WHICH, ALONG WITH GENETIC FACTORS AND PERSONAL CHOICES, SHAPE THE HEALTH AND THE RISK OF BEING OVERWEIGHT AND OBESE.SANFORD HAS MADE PHYSICAL ACTIVITY AND NUTRITION A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE THE NUMBER OF PATIENTS ENGAGING WITH DIETICIANS TO IMPROVE NUTRITION AND TO CREATE A COMPREHENSIVE APPROACH TO CARE MANAGEMENT. IT IS SANFORD'S GOAL TO SEE IMPROVED HEALTH AND WELLNESS AND BETTER OVERALL MANAGEMENT OF CHRONIC DISEASES.PRIORITY 2: COMMUNITY SAFETYACCIDENTS AND VIOLENCE AFFECT HEALTH AND QUALITY OF LIFE IN THE SHORT- AND LONG-TERM, FOR THOSE BOTH DIRECTLY AND INDIRECTLY AFFECTED, AND LIVING IN UNSAFE NEIGHBORHOODS CAN IMPACT HEALTH IN A MULTITUDE OF WAYS. SANFORD HAS MADE COMMUNITY SAFETY A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE AND LEVERAGE RESOURCES TO ADDRESS SUBSTANCE ABUSE ISSUES AND EXPAND ACCESS TO MENTAL HEALTH AND BEHAVIORAL HEALTH CARE. IT IS SANFORD'S GOAL TO INCREASE GREATER AWARENESS OF RESOURCES AVAILABLE TO MITIGATE COMMUNITY SAFETY ISSUES. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARPHYSICAL ACTIVITY AND NUTRITIONSANFORD WEBSTER IS ADDRESSING THE PRIORITY THROUGH THE GOALS OF CREATING A COMPREHENSIVE APPROACH TO CARE MANAGEMENT AND INCREASING THE NUMBER OF PATIENTS ENGAGING WITH DIETICIANS TO IMPROVE NUTRITION. THE NEED FOR PHYSICAL ACTIVITY AND NUTRITION GOAL IS SHOWN THROUGH THE FINDHELP TOOL. IN 2022, 37% OF THE LOCAL SEARCHES ON FINDHELP WERE FOR FOOD-RELATED TOPICS.THE SANFORD WEBSTER MEDICAL CENTER HAD 173 DIETICIAN REFERRALS IN 2022. SANFORD STAFF PROMOTED DISEASE MANAGEMENT AND NUTRITION PROGRAMS WITHIN THE COMMUNITY THROUGHOUT THE YEAR TO GENERATE THE REFERRALS. MEDICAL STAFF WERE INVOLVED IN THE REFERRALS OF THESE PATIENTS TO MAKE SURE ACCESS TO NUTRITION AND PATIENT/COMMUNITY ENGAGEMENT WERE A TOP PRIORITY. THE SANFORD WEBSTER MEDICAL CENTER ENGAGED WITH 18-28 PATIENTS A MONTH WITH THE ORGANIZATION'S CHRONIC CARE MANAGEMENT PROGRAM. PROVIDERS REVIEW THE PLAN OF CARE AND THE NURSES LEADING THE PROGRAMS CONNECT WITH THE PATIENTS TO HELP IMPROVE OVERALL HEALTHCARE. THE COLLABORATION BETWEEN THE PATIENT, MEDICAL STAFF, AND NURSES INCREASED THE OVERALL PARTICIPATION IN THE PROGRAM. STAFF WERE ALSO ABLE TO REFER TO THE DIETICIAN AND CARE TEAM, CREATING GREATER OVERALL COMMUNITY ENGAGEMENT AND BETTER HEALTH WITHIN THE COMMUNITY.COMMUNITY SAFETYSANFORD WEBSTER SET TWO GOALS TO PROMOTE AND LEVERAGE RESOURCES TO ADDRESS SUBSTANCE ABUSE ISSUES AND EXPANDED ACCESS TO MENTAL HEALTH AND BEHAVIORAL HEALTH CARE TO IMPROVE COMMUNITY SAFETY.THE SANFORD WEBSTER MEDICAL CENTER PROVIDES ACCESS TO PSYCHIATRY SERVICES THROUGH TELEMEDICINE. THE WEBSTER MEDICAL STAFF WORK CLOSELY WITH DR. NUSS AND DR. EGGERS ON A FULL RANGE OF SERVICES INCLUDING SUBSTANCE ABUSE. THE WEBSTER CLINIC ASSISTED WITH 183 VISITS IN 2022 TO HELP ADDRESS SUBSTANCE ABUSE ISSUES WITHIN THE COMMUNITY. THE SANFORD WEBSTER MEDICAL CENTER PROVIDES ACCESS TO AN INTEGRATED HEALTH THERAPIST. THE ENGAGEMENT AND ACCESS ARE DRIVEN BY THE MEDICAL STAFF TO PROVIDE REFERRALS AND ACCESS INTO THIS SERVICE LINE. INTEGRATED HEALTH PROVIDERS HAD 222 IHT APPOINTMENTS IN 2022. INTEGRATED HEALTH THERAPISTS ARE AVAILABLE DURING CLINIC HOURS FOR AVAILABLE APPOINTMENT WITH DR. DANIELS. THE UTILIZATION AND ACCESS WERE IDENTIFIED AND HAS BEEN UTILIZED BY THE COMMUNITY AND MEDICAL STAFF.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREEMPLOYMENT AND ECONOMIC OPPORTUNITIESSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 19 -- SANFORD WEBSTER MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 19 -- SANFORD WEBSTER MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 20 -- SANFORD MEDICAL CENTER WHEATON PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 20 -- SANFORD MEDICAL CENTER WHEATON PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 20 -- SANFORD MEDICAL CENTER WHEATON PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 20 -- SANFORD MEDICAL CENTER WHEATON PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTH AND SUBSTANCE ABUSE MENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH AND SUBSTANCE ABUSE SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO IMPROVE ACCESS TO SERVICES. IT IS SANFORD'S GOAL TO INCREASE ACCESS TO PSYCHOLOGY AND PSYCHIATRY AND TO EXPAND TELEHEALTH SERVICES. PRIORITY 2: PHYSICAL ACTIVITY AND NUTRITIONTHE ENVIRONMENTS WHERE PEOPLE LIVE, LEARN, WORK, AND PLAY AFFECT ACCESS TO HEALTHY FOOD AND OPPORTUNITIES FOR PHYSICAL ACTIVITY WHICH, ALONG WITH GENETIC FACTORS AND PERSONAL CHOICES, SHAPE THE HEALTH AND THE RISK OF BEING OVERWEIGHT AND OBESE.SANFORD HAS MADE PHYSICAL ACTIVITY AND NUTRITION SIGNIFICANT PRIORITIES HAS DEVELOPED STRATEGIES IMPROVE ACCESS TO NUTRITION AND TO PROMOTE AND SUPPORT OPPORTUNITIES FOR PHYSICAL ACTIVITY. IT IS SANFORD'S GOAL TO HAVE ADDITIONAL FOOD SOURCES AND AVAILABILITY FOR FOOD OPTIONS AND TO IMPROVE AND EXPAND COMMUNITY AREAS FOR PHYSICAL ACTIVITY.ADDRESSING OF SIGNIFICANT NEEDS DURING THE CURRENT YEARMENTAL HEALTH AND SUBSTANCE ABUSESANFORD MEDICAL CENTER WHEATON IS WORKING TO IMPROVE ACCESS TO SERVICES BY ADVANCING TELEHEALTH SERVICES, EXPANDING PSYCHOLOGY SERVICES, AND COORDINATING WITH GOVERNMENTAL ENTITIES TO EXPAND ACCESS WITHIN THEIR PROGRAMS AND FACILITIES. IN 2022, SANFORD WHEATON HAD 28 ADULT AND ONE PEDIATRIC BEHAVIORAL HEALTH REFERRALS FROM A PATIENT BASE OF 3,447. THE REFERRALS ALL OCCURRED VIA THE TELEHEALTH SERVICE. SANFORD WHEATON IS WORKING WORTH SANFORD HEALTH LEADERSHIP TO EXPLORE OPTIONS WITHIN THE ORGANIZATION FOR EXPANDED TELEHEALTH SERVICES WITH THIEF RIVER FALLS-BASED PROVIDERS AS PSYCHOLOGY CONTINUES TO BE A SERVICE WITH LIMITED LOCAL CAPACITY. SANFORD WHEATON CONTINUES TO WORK ON DEVELOPING PARTNERSHIP AND PLANNING WITH CURRENT PARTNERS TO FILL THE NEED WITHIN THE REGION AND COMMUNITY. FOR EXAMPLE, HORIZON PUBLIC HEALTH ALSO RECOGNIZES THE PRIORITY OF MENTAL CARE AND MENTAL ILLNESS AS A TOP PRIORITY IN THEIR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP).PHYSICAL ACTIVITY AND NUTRITIONSANFORD MEDICAL CENTER WHEATON SET TWO GOALS FOR THE PHYSICAL ACTIVITY AND NUTRITION PRIORITY. THE FIRST GOAL IS TO IMPROVE ACCESS TO NUTRITION THROUGH SUPPORT OF THE COMMUNITY BACKPACK PROGRAM. THE TOP FOUR SEARCHES FROM THE COMMUNITY ON FINDHELP WERE BASED UPON FOOD INSECURITY, INCLUDING "HELP PAY FOR FOOD," "FOOD DELIVERY," "FOOD PANTRY, AND "EMERGENCY FOOD." THE SECOND GOAL IS PROMOTING AND SUPPORTING OPPORTUNITIES FOR PHYSICAL ACTIVITY.SANFORD WHEATON PARTICIPATES IN THE LOCAL BACKPACK PROGRAM PROVIDING FOOD TO CHILDREN IN THE LOCAL SCHOOLS. THE PROGRAM PROVIDES FOOD FOR CHILDREN EVERY OTHER WEEKEND BY PLACING ENTREES, CEREAL, AND SNACKS IN THEIR LOCKER. THERE ARE 51 STUDENTS THAT PARTICIPATE IN GRADES K-12 OUT OF A TOTAL STUDENT BASE OF 359. SANFORD STAFF PACK AND DELIVER THE BAGS TO A VOLUNTEER AT THE SCHOOL.SANFORD WHEATON ALSO SUPPORTS DEVELOPMENT OF BALL PARKS IN THE COMMUNITY TO PROMOTE PHYSICAL ACTIVITY. IN SUPPORT, SANFORD HAS OFFERED $10,000 OVER THE NEXT 3 YEARS FOR THE BALLPARK IMPROVEMENT PROGRAM. THE HOSPITAL IS ALSO ACTIVELY PARTICIPATING IN AN ACTIVE TRANSPORTATION GRANT WITH THE MINNESOTA DEPARTMENT OF TRANSPORTATION, COLLABORATING WITH THE LOCAL CITY AND PARK BOARD. WE ARE ALSO EXPLORING HAVING AN OPEN TIME FOR THE HOSPITAL CARDIAC REHAB SPACE AND WORKING TOWARDS A HEALTHIER COMMUNITY.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN:ACCESS TO HEALTH CARE PROVIDERSEMPLOYMENT AND ECONOMIC OPPORTUNITIESSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 20 -- SANFORD MEDICAL CENTER WHEATON PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 20 -- SANFORD MEDICAL CENTER WHEATON PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 21 -- SANFORD BAGLEY MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 21 -- SANFORD BAGLEY MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 21 -- SANFORD BAGLEY MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 21 -- SANFORD BAGLEY MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO HEALTH CARE PROVIDERSACCESS TO CARE REQUIRES NOT ONLY FINANCIAL COVERAGE, BUT ALSO ACCESS TO PROVIDERS. WHILE HIGH RATES OF SPECIALIST PHYSICIANS HAVE BEEN SHOWN TO BE ASSOCIATED WITH HIGHER (AND PERHAPS UNNECESSARY) UTILIZATION, SUFFICIENT AVAILABILITY OF PRIMARY CARE PHYSICIANS IS ESSENTIAL FOR PREVENTIVE AND PRIMARY CARE, AND, WHEN NEEDED, REFERRALS TO APPROPRIATE SPECIALTY CARE. SANFORD HEALTH IS POSITIONED LOCALLY TO HAVE A POSITIVE IMPACT ON ACCESS TO AFFORDABLE, QUALITY HEALTHCARE WITHIN THE COMMUNITY. THIS EFFORT WILL FOCUS ON TWO PRIMARY GOALS. THE FIRST GOAL IS TO HAVE INCREASED ACCESS TO PRIMARY AND SPECIALTY CARE AND THE SECOND GOAL IS TO HAVE INCREASED UTILIZATION OF TELEMEDICINE SERVICES.PRIORITY 2: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HEALTH IS POSITIONED LOCALLY TO HAVE A POSITIVE IMPACT ON BEHAVIORAL HEALTH SERVICES WITHIN THE COMMUNITY. THIS EFFORT WILL FOCUS ON TWO PRIMARY GOALS. THE FIRST GOAL IS TO PROVIDE ADDITIONAL BEHAVIORAL HEALTH SERVICES WITHIN SANFORD BAGLEY. THE SECOND GOAL IS THE ASSESSMENT AND TREATMENT OF BEHAVIORAL HEALTH CONCERNS WITHIN PRIMARY CARE VISITS.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO HEALTH CARE PROVIDERSSANFORD BAGLEY HAS SET THE GOALS OF INCREASING ACCESS TO PRIMARY AND SPECIALTY CARE WITHIN THE COMMUNITY AND TO INCREASE UTILIZATION OF TELEMEDICINE SERVICES AS A CARE DELIVERY MECHANISM. RESIDENTS OF CLEARWATER COUNTY CONDUCTED 206 SEARCHES ON THE FINDHELP PLATFORM IN 2022. NEARLY 14% OF SEARCHES WERE FOR HEALTH-RELATED SUPPORT.EFFORTS PROGRESSED IN 2022 TO INCREASE PRIMARY AND SPECIALTY CARE WITHIN SANFORD BAGLEY CLINICS. DR. COLLEEN SWANK, MD BEGAN OFFERING PEDIATRIC CARE OUTREACH AT THE BAGLEY CLINIC ONE DAY A MONTH. DR. SWANK IS BASED IN BEMIDJI, MN. DR. SWANK HAD A TOTAL OF 18 PATIENTS SCHEDULED AND 13 VISITS COMPLETED. IN 2022, THE EPIC BUILD (PROGRAMMING NEEDED FOR SCHEDULING, DOCUMENTATION, AND BILLING) WAS COMPLETED FOR DERMATOLOGY SERVICES WITHIN THE BAGLEY CLINIC. IN DECEMBER 2022, DR. CHET MAINGI, EXPRESSED INTEREST IN PROVIDING OUTREACH DERMATOLOGY SERVICES AT THE BAGLEY CLINIC STARTING THE SPRING OF 2023. DR. MAINGI WILL BE AVAILABLE TO SEE PATIENTS APPROXIMATELY TWICE A MONTH.EFFORTS HAVE BEEN MADE TO PROMOTE UTILIZATION TELEHEALTH SERVICES FOR PRIMARY CARE APPOINTMENTS. SANFORD PROMOTED ON-DEMAND VISITS FOR PATIENTS IN 2022. THE SANFORD HEALTH PLAN PROMOTED ZERO DOLLAR ON-DEMAND URGENT CARE VIDEO VISITS 24 HOURS A DAY AND SEVEN DAYS A WEEK IN ADDITION PROMOTIONS CENTERED ON SCHEDULED VIRTUAL CARE APPOINTMENTS FOR PRIMARY CARE. THE PRIMARY CARE VIRTUAL VISITS ALLOWED EXISTING SANFORD PATIENTS TO VISIT WITH A PROVIDER IN THE PLACE OF A CLINIC VISIT. THIS OPTION WAS EXPANDED TO NOT ONLY SANFORD HEALTH PLAN PATIENTS, BUT TO ANYONE WHO WAS AN ESTABLISHED PATIENT. IN 2022, SANFORD BAGLEY CLINIC PROVIDERS HAVE BEEN TRAINED ON HOW TO CONDUCT TELEHEALTH VISITS AND EQUIPMENT WAS PROCURED (WEBCAMS-SPEAKERS). A TOTAL OF 212 TELEHEALTH VISITS WERE PERFORMED IN FAMILY MEDICINE, 17 TELEHEALTH VISITS FOR INTERNAL MEDICINE, AND 429 TELEHEALTH VISITS FOR BEHAVIORAL HEALTH.MENTAL HEALTHSIGNIFICANT WORK HAS BEEN PERFORMED IN 2022 TO INCREASE BEHAVIORAL HEALTH SERVICES AND SUPPORT IN THE SANFORD BAGLEY COMMUNITY. SANFORD CONTRACTED WITH A SENOR LIFE SOLUTIONS FOR BEHAVIORAL HEALTH SERVICES. SENIOR LIFE SOLUTIONS IS AN INTENSIVE OUTPATIENT GROUP THERAPY PROGRAM DESIGNED TO MEET THE NEEDS OF INDIVIDUALS TYPICALLY 65 AND OLDER, EXPERIENCING DEPRESSION OR ANXIETY RELATED TO LIFE CHANGES THAT ARE OFTEN ASSOCIATED WITH AGING. THE PARTICIPANTS MEET UP TO THREE TIMES PER WEEK IN A SUPPORTIVE, ENCOURAGING GROUP SETTING. THE SENIOR LIFE SOLUTION PROGRAM WAS ESTABLISHED IN 2022 AND BEGAN SEEING PATIENTS IN DECEMBER OF 2022. THE PROGRAM PERFORMED 27 THERAPY SESSIONS IN 2022.SANFORD BAGLEY CLINIC MADE DEPRESSION SCREENING AT ROUTINE PRIMARY CARE VISITS A FOCUS FOR 2022. DEPRESSION IS A SERIOUS MEDICAL ILLNESS ASSOCIATED WITH HIGHER RATES OF CHRONIC DISEASE, INCREASED HEALTH CARE UTILIZATION, AND IMPAIRED FUNCTIONING. SANFORD BAGLEY CLINIC DEPRESSION SCREENING RATE WAS AT 65.2% IN JANUARY 2022. A SCREENING RATE GOAL OF 87.4 % WAS ESTABLISHED AND STEADY PROGRESS WAS MADE THROUGHOUT THE YEAR TO MEET THIS TARGET. THE DEPARTMENT EXCEEDED THE GOAL IN NOVEMBER (87.7%) AND MET THE GOAL AGAIN IN DECEMBER (87.3%). THE DEPARTMENT WILL FOCUS ON MAINTAINING THIS AND THEIR STRETCH GOAL WILL CONTINUE TO BE 95%. DEPRESSION REMISSION AT 12 MONTHS WAS AT 17.56%. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:LONG-TERM CARE, NURSING HOMES, AND SENIOR HOUSINGAFFORDABLE HOUSINGCOMMUNITY SAFETY ACCESS TO AFFORDABLE HEALTH CAREPUBLIC TRANSPORTATIONACCESS TO QUALITY HEALTH CARESANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 21 -- SANFORD BAGLEY MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 21 -- SANFORD BAGLEY MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 22 -- SANFORD CANTON-INWOOD MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 22 -- SANFORD CANTON-INWOOD MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 22 -- SANFORD CANTON-INWOOD MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 22 -- SANFORD CANTON-INWOOD MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO AFFORDABLE HOUSINGTHERE IS A STRONG AND GROWING EVIDENCE BASE LINKING STABLE AND AFFORDABLE HOUSING TO HEALTH. AS HOUSING COSTS HAVE OUTPACED LOCAL INCOMES, HOUSEHOLDS NOT ONLY STRUGGLE TO ACQUIRE AND MAINTAIN ADEQUATE SHELTER, BUT ALSO FACE DIFFICULT TRADE-OFFS IN MEETING OTHER BASIC NEEDS. WHEN THE MAJORITY OF A PAYCHECK GOES TOWARD THE RENT OR MORTGAGE, IT CAN BE DIFFICULT TO AFFORD DOCTOR VISITS, HEALTHY FOODS, UTILITY BILLS, AND RELIABLE TRANSPORTATION TO WORK OR SCHOOL. THIS CAN, IN TURN, LEAD TO INCREASED STRESS LEVELS AND EMOTIONAL STRAIN. SANFORD HAS MADE ACCESS TO AFFORDABLE HOUSING A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE HOUSING OPTIONS WHICH WOULD SEE AN INCREASE IN POPULATION AND ABILITY FOR CITIZENS TO AGE IN PLACE VERSUS MOVING OUT OF TOWN DUE TO NO OPTIONS. THIS WORK WILL PROVIDE A MUCH NEEDED ECONOMIC STIMULUS TO THE COMMUNITY, AS WELL AS INCREASED ACCESS TO AFFORDABLE HOUSING OPTIONS. IT IS SANFORD'S GOAL TO WORK WITH THE CANTON ECONOMIC DEVELOPMENT CORPORATION (CEDC) TO RECRUIT A DEVELOPER TO CANTON TO BUILD AFFORDABLE MULTI-FAMILY AND SINGLE-FAMILY HOMES.PRIORITY 2: ACCESS TO SENIOR LIVINGLONG-TERM CARE REFERS TO A BROAD RANGE OF SERVICES AND SUPPORTS TO MEET THE NEEDS OF FRAIL OLDER ADULTS AND OTHER PEOPLE WHO ARE LIMITED IN THEIR ABILITIES FOR SELF-CARE BECAUSE OF CHRONIC ILLNESS, DISABILITY, AGE, OR OTHER HEALTH-RELATED CONDITIONS. THESE SERVICES HELP PEOPLE LIVE AS INDEPENDENTLY AND SAFELY AS POSSIBLE WHEN THEY CAN NO LONGER PERFORM EVERYDAY ACTIVITIES ON THEIR OWN. CARE CAN BE PROVIDED IN THE HOME, A NURSING HOME, OR IN A VARIETY OF OTHER SETTINGS.SANFORD HAS MADE ACCESS TO SENIOR LIVING A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPLORE ADDITIONAL OPTIONS FOR SENIOR CARE, INCLUDING HOME-BASED CARE AND HOUSING ALTERNATIVES. IT IS SANFORD'S GOAL TO DO A HOME HEALTH FEASIBILITY STUDY AND EXPAND SENIOR HOUSING OPTIONS IN THE COMMUNITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO AFFORDABLE HOUSINGSANFORD CANTON-INWOOD MEDICAL CENTER SEEKS TO INCREASE ACCESS TO AFFORDABLE HOUSING THROUGH ITS MEMBERSHIP IN AND SUPPORT OF THE CANTON ECONOMIC DEVELOPMENT CORPORATION (CEDC). THE CEDC IS WORKING TO INCREASE THE NUMBER OF AFFORDABLE HOUSING AND CUSTOM-BUILT HOMES AVAILABLE IN THE COMMUNITY. AN EXAMPLE OF THE NEED IS SHOWN THROUGH THE SANFORD FINDHELP TOOL. RESIDENTS OF THE CHNA AREA, EXCLUDING SIOUX FALLS, HARRISBURG, AND TEA CONDUCTED 326 SEARCHES IN 2022 WITH HALF ORIGINATING FROM THE CANTON, SD ZIP CODE. HOUSING-RELATED TERMS WERE ONE-FOURTH OF ALL SEARCHES, WITH TERMS SUCH AS "HELP PAY FOR HOUSING AND "HOUSING VOUCHERS" COMMONLY USED.THE CANTON ECONOMIC DEVELOPMENT CORPORATION (CEDC) PURCHASED THE 64.12-ACRE PARCEL FROM THE CANTON INWOOD AREA HEALTH FOUNDATION ON SEPTEMBER 1, 2022. AN AGREEMENT WAS LATER SIGNED WITH EXP GROUP TO CREATE A LIMITED LIABILITY COMPANY (LLC) CALLED MONARCH DEVELOPMENT PARTNERS ON OCTOBER 17, 2022. THIS AGREEMENT WILL BRING EXP GROUP AND CANTON ECONOMIC DEVELOPMENT CORPORATION TOGETHER TO DESIGN A LAYOUT OF THE HOUSING DEVELOPMENT TO COVER MULTI-FAMILY AND SINGLE-FAMILY HOUSING IN ADDITION TO GREEN SPACES AND A BIKE/WALKING TRAIL. ENGINEERS ARE CURRENTLY CONDUCTING THE NECESSARY SURVEYS SO THAT THE ARCHITECT AND DESIGNER CAN MAP THE DEVELOPMENT. ONCE MAPPED, THE PROJECT WILL SEEK APPROVAL FROM THE CITY OF CANTON.AN AREA OF INTEREST TO THE ORGANIZATION IS LEGISLATION RECENTLY PASSED BY THE SOUTH DAKOTA LEGISLATURE. SB41 WILL PROVIDE $200 MILLION DOLLARS TO INFRASTRUCTURE PROJECTS, LIKE THE ONE TAKING PLACE IN CANTON. THE BILL HAS THE POTENTIAL TO SPEED UP THE PROJECT, SHOULD IT BE SELECTED AS PART OF THE PROCESS. ACCESS TO SENIOR LIVING SANFORD IS WORKING TO EXPAND ACCESS TO SENIOR LIVING THROUGH A COMBINED EFFORT OF EXPANDED LOCAL SENIOR HOUSING OPTIONS AND VIA POTENTIAL DEVELOPMENT OF HOME HEALTH SERVICES IN THE COMMUNITY. SANFORD CANTON PROVIDES HOME HEALTH SERVICES TO THE COMMUNITY ON AN AS-NEEDED BASIS. ADDITIONALLY, SANFORD HOME HEALTH AND COMMUNITY SERVICES IN SIOUX FALLS SENDS SANFORD NURSES TO CANTON PATIENTS WHO QUALIFY FOR AND NEED HOME HEALTH SERVICES. SANFORD CANTON CLINIC STAFF AND PROVIDERS ARE AWARE THAT HOME HEALTH IS AN OPTION IN CANTON FOR THOSE THAT QUALIFY.THE LOCAL RN CARE MANAGER FOR THE CANTON AND BERESFORD CLINICS PROVIDES ASSISTANCE TO MANY OF OUR CHRONIC PATIENTS AND ELDERLY THAT LACK THE RESOURCES TO PROVIDE THE NECESSARY TREATMENTS ON THEIR OWN. THE CARE MANAGER HELPS THEM FIND HOUSING, FOOD, AND UTILITY ASSISTANCE. ADDITIONALLY, SHE WORKS WITH DRUG COMPANIES TO GET MEDICATION VOUCHERS FOR PATIENTS AND WILL HELP PATIENTS GET SET UP ON THEIR DIABETIC TREATMENTS. THE CARE MANAGER WILL HELP MONITOR DIABETIC PATIENTS AND WILL PROVIDE EDUCATION TO PATIENTS AS NEEDED. SHE HAS SUPPORTED PROVIDERS IN THE CLINIC BY TAKING PATIENTS THAT ARE NOT ALWAYS COMPLIANT AT HOME AND NEED ADDITIONAL HELP. SHE HELPS PROVIDE SUPPORT AND HELPS NURTURE THEM SO THAT THEY CAN, AT SOME POINT, SUPPORT THEMSELVES IN THEIR OWN HOME.SANFORD CANTON-INWOOD HAS WHAT SANFORD CALLS THE RURAL HEALTH COOP. THE RURAL HEALTH COOP COMES TO CANTON ON MONDAYS FROM 11-1 P.M. TO HELP THOSE 18 AND OVER WITH NO INSURANCE, MEDICAID, OR MEDICARE. THEY HAVE TWO RN'S AND A PHARMACIST THAT ASSIST WITH THESE PATIENTS. THEY ALSO HAVE ACCESS TO A NURSE PRACTITIONER AND A DIETICIAN.WE CONTINUE TO EVALUATE OPTIONS TO EXPAND SENIOR CARE SERVICES IN THE COMMUNITY AS RESOURCES ALLOW.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREMENTAL HEALTH AND SUBSTANCE ABUSEPUBLIC TRANSPORTATION SANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 22 -- SANFORD CANTON-INWOOD MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 22 -- SANFORD CANTON-INWOOD MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 23 -- SANFORD CLEAR LAKE MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 23 -- SANFORD CLEAR LAKE MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 23 -- SANFORD CLEAR LAKE MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 23 -- SANFORD CLEAR LAKE MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO HEALTH CARE PROVIDERS/AFFORDABLE HEALTH CAREACCESS TO CARE REQUIRES NOT ONLY FINANCIAL COVERAGE, BUT ALSO ACCESS TO PROVIDERS. WHILE HIGH RATES OF SPECIALIST PHYSICIANS HAVE BEEN SHOWN TO BE ASSOCIATED WITH HIGHER (AND PERHAPS UNNECESSARY) UTILIZATION, SUFFICIENT AVAILABILITY OF PRIMARY CARE PHYSICIANS IS ESSENTIAL FOR PREVENTIVE AND PRIMARY CARE, AND, WHEN NEEDED, REFERRALS TO APPROPRIATE SPECIALTY CARE.ACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE, LOCAL CARE OPTIONS, AND A USUAL SOURCE OF CARE HELP TO ENSURE ACCESS TO HEALTH CARE. HAVING ACCESS TO CARE ALLOWS INDIVIDUALS TO ENTER THE HEALTH CARE SYSTEM, FIND CARE EASILY AND LOCALLY, PAY FOR CARE, AND GET THEIR HEALTH NEEDS MET. SANFORD HEALTH CLEAR LAKE HAS MADE ACCESS TO HEALTH CARE PROVIDERS AND AFFORDABLE HEALTH CARE SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO RECRUIT AN ADDITIONAL PRIMARY CARE PROVIDER AND TO INCREASE ANNUAL WELLNESS VISITS. IT IS SANFORD'S GOAL TO INCREASE MEDICAL STAFF RESULTING IN INCREASED APPOINTMENT AVAILABILITY, AS WELL AS A GREATER PATIENT CHOICE IN PROVIDERS. PRIORITY 2: TRANSPORTATIONTRANSPORTATION SYSTEMS HELP ENSURE THAT PEOPLE CAN REACH EVERYDAY DESTINATIONS, SUCH AS JOBS, SCHOOLS, HEALTHY FOOD OUTLETS, AND HEALTHCARE FACILITIES, SAFELY AND RELIABLY. PUBLIC TRANSPORTATION SERVICES PLAY AN IMPORTANT ROLE FOR PEOPLE WHO ARE UNABLE TO DRIVE, PEOPLE WITHOUT ACCESS TO PERSONAL VEHICLES, CHILDREN, INDIVIDUALS WITH DISABILITIES, AND OLDER ADULTS.SANFORD HEALTH CLEAR LAKE HAS MADE TRANSPORTATION A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO DEVELOP A SUSTAINABLE PUBLIC TRANSPORTATION SERVICE IN THE CLEAR LAKE COMMUNITY AND TO ESTABLISH AN INFRASTRUCTURE IMPROVEMENT PLAN TO ALLOW FOR ENHANCED WALKABILITY IN THE CLEAR LAKE COMMUNITY. IT IS SANFORD'S GOAL TO IMPROVE THE AVAILABILITY OF TRANSPORTATION OPTIONS FOR COMMUNITY MEMBERS UNABLE TO KEEP APPOINTMENTS DUE TO LACK OF PERSONAL TRANSPORTATION OPTIONS. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO HEALTH CARE PROVIDERS/AFFORDABLE HEALTH CARESANFORD CLEAR LAKE MEDICAL CENTER IDENTIFIED A NEED FOR ADDITIONAL PRIMARY CARE AVAILABILITY AND INCREASED USE OF WELLNESS VISITS THROUGH ITS CHNA PROGRAM. TO ADDRESS THIS PRIORITY, SANFORD CLEAR LAKE SET THE GOALS OF RECRUITING TWO PRIMARY CARE PROVIDERS AND INCREASING WELLNESS VISITS BY 10% BY THE END OF 2024.SANFORD CLEAR LAKE WAS ABLE TO HIRE TWO NEW PRIMARY CARE ADVANCED PRACTICE PROVIDERS (APPS) IN THE LAST YEAR. AS A RESULT, THE CLINIC IS NOW STAFFED MONDAY THROUGH FRIDAY BY TWO PA-CS AND ONE CNP. ONE PROVIDER ALSO DOES OUTREACH SERVICES TO THE SANFORD CANBY CLINIC.TO INCREASE WELLNESS VISITS, SANFORD CLEAR LAKE IS WORKING INTERNALLY WITH THE ORGANIZATION'S MARKETING DEPARTMENT AND PHYSICIANS ON EXPANDED COMMUNITY CAMPAIGNS. DURING THE PAST YEAR, THE MARKETING DEPARTMENT COMPLETED VIDEOS ON ALL NEW PROVIDERS HIGHLIGHTING THEIR BIOGRAPHIES. THE VIDEOS ARE AVAILABLE ON SANFORDHEALTH.ORG. THE NEW PROVIDERS WERE INTRODUCED TO THE COMMUNITY THROUGH COORDINATED SOCIAL MEDIA AND NEWSPAPER CAMPAIGNS. THE NEW PROVIDER SOCIAL MEDIA POSTS SHOWED SIGNIFICANT ENGAGEMENT WITH OUR MARKET WITH HUNDREDS OF VIEWS AND SHARED VIDEOS. FOR REFERENCE, THE POPULATION OF DEUEL COUNTY, THE CHNA COMMUNITY, IS 1,220 AS PROVIDED IN THE CHNA REPORT. ADDITIONALLY, DEUEL COUNTY RESIDENTS CONDUCTED 67 SEARCHES ON THE FINDHELP PLATFORM IN 2022, WITH 13% FOR HEALTH-RELATED TOPICS.PROVIDER ENGAGEMENT WITH THE COMMUNITY INCLUDED OUTREACH TO THE CRYSTAL SPRINGS RODEO, THE ST PATRICK'S DAY PIE AUCTION, AND THE COMMUNITY'S THURSDAYS ON THIRD MUSIC NIGHT. TWO PROVIDERS ATTENDED THE DEUEL COUNTY COMMUNITY FOUNDATION'S TOUR OF TABLES IN OCTOBER 2022. ALL OF THESE ACTIVITIES PROMOTE PRIMARY CARE PROVIDERS ENGAGING WITH THE COMMUNITY.TRANSPORTATION SANFORD CLEAR LAKE ESTABLISHED TWO GOALS FOR THE PRIORITY, INCLUDING THE DEVELOPMENT OF A SUSTAINABLE PUBLIC TRANSPORTATION SERVICE FOR THE CLEAR LAKE COMMUNITY BY 2024 AND ESTABLISHING AN INFRASTRUCTURE IMPROVEMENT PLAN TO ALLOW FOR ENHANCED WALKABILITY IN THE CLEAR LAKE COMMUNITY. ONE IN TEN FINDHELP SEARCHES FROM THE COUNTY IN 2022 WERE TRANSIT-RELATED TOPICS. TRANSIT SEARCH TERMS INCLUDED "TRANSPORTATION FOR HEALTHCARE AND "HELP PAY FOR TRANSIT."UPON STUDY, THE DEUEL COUNTY COMMUNITY TRANSIT DETERMINED THAT RIDERSHIP WITHIN THE COMMUNITY OF CLEAR LAKE WAS LIMITED AND WOULD NOT SUPPORT A PUBLIC TRANSIT OPTION WITHIN THE CITY. AS SUCH, THE TRANSIT PROJECT WAS PUT ON HOLD AS NEXT STEPS ARE EVALUATED. SANFORD HEALTH DOES COORDINATE WITH A VOLUNTEER THAT CAN PROVIDE TRANSPORTATION TO COMMUNITY MEMBERS AND HOSPITALIZED PATIENTS BASED UPON THE VOLUNTEER'S SCHEDULE.THE MEDICAL CENTER PARTICIPATES IN THE HEALTHY HOMETOWN COMMITTEE. HEALTHY HOMETOWN IS A PROGRAM THAT ASSISTS COMMUNITIES IN IMPLEMENTING CHANGES THAT PROMOTE HEALTHY LIVING BY FOCUSING ON THREE AREAS; MOVE MORE, EAT WELL, AND FEEL BETTER. THE COMMITTEE IS WORKING WITH THE SOUTH DAKOTA DEPARTMENT OF TRANSPORTATION FOR A FLASHING CROSS WALK AND PAINTED BUMP OUTS AT HIGHWAY 15. THIS INTERSECTION IS A BUSY LOCATION WHERE MANY STUDENTS CROSS TO WALK TO AND FROM SCHOOL. INTERNALLY, SANFORD CLEAR LAKE HAD BUCKLED CONCRETE SIDEWALKS AROUND THE BUILDING THAT WERE REPAIRED IN THE SUMMER OF 2022 TO PROVIDE SAFER WALKING CONDITIONS FOR PATIENTS AND STAFF. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:MENTAL HEALTHAFFORDABLE HOUSING PHYSICAL ACTIVITY AND NUTRITIONSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 23 -- SANFORD CLEAR LAKE MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 23 -- SANFORD CLEAR LAKE MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 24 -- SANFORD WESTBROOK MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 24 -- SANFORD WESTBROOK MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 24 -- SANFORD WESTBROOK MEDICAL CENTER PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 24 -- SANFORD WESTBROOK MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HEALTH WESTBROOK HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND THE USE OF TELEMEDICINE AND IN-HOUSE MENTAL HEALTH SERVICES AND INCREASE THE NUMBER OF SCREENINGS AND REFERRALS TO BEHAVIORAL HEALTH PROVIDERS. IT IS SANFORD'S GOAL TO SEE A LOWERED NUMBER OF MENTAL HEALTH DAYS FROM COMMUNITY MEMBERS AND A POSITIVE INCREASE IN AWARENESS OF MENTAL HEALTH SERVICES IN THE COMMUNITY.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE HELPS INDIVIDUALS AND FAMILIES ACCESS NEEDED PRIMARY CARE, SPECIALISTS, AND EMERGENCY CARE, BUT DOES NOT ENSURE ACCESS ON ITS OWNIT IS ALSO NECESSARY FOR PROVIDERS TO OFFER AFFORDABLE CARE, BE AVAILABLE TO TREAT PATIENTS, AND BE IN RELATIVELY CLOSE PROXIMITY TO PATIENTS.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND OUTREACH SERVICES AND TO ADDRESS THE NEED FOR LIMITED ACCESS TO DENTAL CARE. REDUCE MORTALITY AND MORBIDITY FROM MENTAL HEALTH AND BEHAVIORAL HEALTH AND SUBSTANCE ABUSE. IT IS SANFORD'S GOAL TO INCREASE THE AVAILABILITY OF SPECIALTY SERVICES LOCALLY THROUGH OUTREACH AND/OR TELEHEALTH.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTHTHE MENTAL HEALTH PRIORITY IS BEING ADDRESSED THROUGH EXPANDED USE OF CURRENT TELEMEDICINE AND IN-HOUSE MENTAL HEALTH SERVICES AND THE ADDITIONAL GOAL OF INCREASING THE NUMBER OF SCREENINGS AND REFERRALS TO BEHAVIORAL HEALTH PROVIDERS. SANFORD WESTBROOK BEHAVIORAL HEALTH PROVIDERS RESIGNED IN 2022. AS SUCH, PROMOTION OF IN-HOUSE PROVIDERS WAS PLACED ON HOLD UNTIL A SOLUTION IS DEVELOPED TO ADDRESS THE CAPACITY NEED. UTILIZATION HAS BEEN LIMITED TO ACCESS TO ONE OUTREACH TELEMEDICINE PSYCHIATRIST. THIS PSYCHIATRIST SAW 158 PATIENTS VIA TELEMEDICINE VISITS IN 2022: UP FROM 134 IN 2021. SIMILARLY, REFERRAL EFFORTS TO OUTSIDE PROVIDERS AND FACILITIES HAVE BEEN PUT ON HOLD.BEHAVIORAL HEALTH SCREENINGS AVERAGED APPROXIMATELY 80.73% FOR 2022. THE STRETCH GOAL IS TO ACHIEVE 100% SCREENING OF ALL PATIENTS TWELVE YEARS AND OLDER WITH A PRIOR HISTORY OF DEPRESSION OR ANXIETY. STAFF EDUCATION WILL CONTINUE TO HELP INCREASE THIS SCREENING NUMBER IN 2023.ACCESS TO HEALTH CARE PROVIDERSSANFORD WESTBROOK SET A GOAL OF EXPANDED OUTREACH SERVICES TO ADDRESS THE ACCESS NEED. THE HOSPITAL CONTINUES TO RECRUIT AN ORTHOPEDIC OUTREACH SPECIALIST AND AN ADDITIONAL GENERAL SURGEON. SANFORD WORTHINGTON DOES HAVE A POSSIBLE ORTHOPEDIC AND GENERAL SURGEON THAT MAY BEGIN OUTREACH SERVICES AT SANFORD WESTBROOK IN 2023. OUTREACH TELEHEALTH APPOINTMENTS CONTINUE TO BE OFFERED WITH 2022 SEEING SEVEN ONCOLOGY TELEMED VISITS (UP FROM 0 IN 2021); 87 NEPHROLOGY TELEMED VISITS (UP FROM 79 IN 2021); FIVE INFECTIOUS DISEASE TELEMED VISITS (DOWN FROM 12 IN 2021) AND 158 PSYCH TELEMED VISITS (UP FROM 134 IN 2021). THE GOAL OF ADDRESSING THE NEED FOR LIMITED ACCESS TO DENTAL CARE, MEETINGS WITH SCHOOL PROGRAM DIRECTORS AND SCHOOL NURSE WAS COMPLETED IN 2022. THE APPLICATION AND A SUCCESSFUL RECEIPT OF A MDH COMMUNITY CLINIC GRANT TO FUND THE WESTBROOK WALNUT GROVE ELEMENTARY AND JUNIOR HIGH SCHOOLS DENTAL HEALTH PROGRAM WERE ALSO COMPLETED IN 2022. BY SEPTEMBER, THE SUPPLIES FOR THE PROGRAM WERE PURCHASED, WHICH INCLUDE TOOTHBRUSHES, TOOTHPASTE, FLOSSERS, AND FLUORIDE RINSES THAT STUDENTS RECEIVE EVERY MONTH. DENTAL EDUCATION INFORMATION FOR PROVIDERS WAS SHARED AT PROVIDER MEETINGS IN 2022. PROVIDERS AND CLINIC NURSES SHARE DENTAL INFORMATION WITH PARENTS AT ALL WELL CHILD VISITS, AS WELL AS OFFER FLUORIDE VARNISH IF APPROPRIATE AT WELL CHILD VISITS.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:COMMUNITY SAFETYENVIRONMENTAL HEALTHAFFORDABLE HOUSINGPUBLIC TRANSPORTATIONPHYSICAL ACTIVITY AND NUTRITIONEMPLOYMENT AND ECONOMIC OPPORTUNITIESSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 24 -- SANFORD WESTBROOK MEDICAL CENTER PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 24 -- SANFORD WESTBROOK MEDICAL CENTER PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 2 -- SANFORD MEDICAL CENTER FARGO PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 2 -- SANFORD MEDICAL CENTER FARGO PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 2 -- SANFORD MEDICAL CENTER FARGO PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCULDED.
GROUP A-FACILITY 2 -- SANFORD MEDICAL CENTER FARGO PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO AFFORDABLE HEALTH CAREACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE, LOCAL CARE OPTIONS, AND A USUAL SOURCE OF CARE HELP TO ENSURE ACCESS TO HEALTH CARE. HAVING ACCESS TO CARE ALLOWS INDIVIDUALS TO ENTER THE HEALTH CARE SYSTEM, FIND CARE EASILY AND LOCALLY, PAY FOR CARE, AND GET THEIR HEALTH NEEDS MET. NDSU REPORTED HEALTH CARE ACCESSIBILITY AND COST AS TWO SEPARATE HEALTH NEEDS. THE CASS-CLAY WORKING GROUP DETERMINED THAT THE TWO TOPICS ARE MOST APPROPRIATELY ADDRESSED AS A COMBINED TOPIC FOR PURPOSES OF THE LOCAL CHNA PROCESS.SANFORD HAS MADE HEALTHCARE ACCESS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND HEALTHCARE ACCESS AND ACCESS TO PRIMARY CARE SERVICES. IT IS SANFORD'S GOAL THAT THE COMMUNITY WOULD SEE THAT PATIENTS WILL HAVE GREATER EASE TO ACCESS PRIMARY CARE PROVIDERS FOR VIRTUAL OR IN-PERSON VISITS, HOME VISITS AND INCREASED EXPANDED HOURS. PATIENTS MAY EXPERIENCE LESS FREQUENT UTILIZATION OF EMERGENCY CARE, WHICH IS OFTEN MORE EXPENSIVE THAN PREVENTATIVE AND SCREENING SERVICES.PRIORITY 2: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSEMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SIGNIFICANT PRIORITIES AND HAS DEVELOPED STRATEGIES TO RECRUIT PROVIDERS, INCREASE ACCESS TO CARE AND MENTAL HEALTH PROMOTION. IT IS SANFORD'S GOAL TO HAVE BETTER ACCESS TO AND UTILIZATION OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES DUE TO SERVICES BEING PROVIDED AT THE RIGHT TIME AND RIGHT PLACE. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR: ACCESS TO AFFORDABLE HEALTH CARESANFORD FARGO ESTABLISHED TWO GOALS IN SUPPORT OF THE PRIORITY, ACCESS TO AFFORDABLE HEALTH CARE. THE FIRST IS TO EXPAND HEALTHCARE ACCESS AND SUPPORT RESOURCES FOR VULNERABLE AND UNDERSERVED POPULATIONS. THE SECOND IS TO EXPAND PLATFORM AND ACCESS TO PRIMARY CARE SERVICES.ONE STRATEGY IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROGRAM IS TO MAKE VIRTUAL VISITS AVAILABLE FOR ALL PRIMARY CARE PROVIDERS. AS OF THE END OF 2022, ACCESS TO TELEHEALTH IS AVAILABLE FOR ALL FAMILY MEDICINE PROVIDERS, WHICH ALLOWS PATIENTS TO RECEIVE CARE WITHIN THEIR HOMES IF THEY DO NOT HAVE ACCESS TO RELIABLE TRANSPORTATION OR CANNOT TRAVEL FOR APPOINTMENTS. TO INCREASE PRIMARY CARE AVAILABILITY, THE FAMILY MEDICINE RESIDENCY PROGRAM HAS BEGUN OUTREACH TO JEFFERSON ELEMENTARY (FARGO PUBLIC SCHOOLS) AND WILL BE EXPANDING TO YOUTHWORKS. JEFFERSON ELEMENTARY HAS APPROXIMATELY 288 STUDENTS, 231 OF WHICH ARE ELIGIBLE TO PARTICIPATE IN THE FREE LUNCH AND REDUCED-PRICE LUNCH PROGRAMS, ACCORDING TO THE NATIONAL CENTER FOR EDUCATION STATISTICS. YOUTHWORKS IS A "501C3 NON-PROFIT DEDICATED TO PROVIDING YOUTH AND FAMILY SERVICES THROUGHOUT NORTH DAKOTA. THEIR FOCUS AND EXPERTISE IS IN WORKING WITH TEENS, PARENTS, AND YOUNG ADULTS UNDER 22 YEARS OF AGE. OUR SERVICES INCLUDE PROGRAMS FOR RUNAWAY, HOMELESS AND STREET YOUTH; JUVENILE OFFENDERS; YOUTH FAILING IN SCHOOL; YOUTH SUSPENDED OR EXPELLED FROM SCHOOL; YOUNG PARENTS AND PREGNANT MOMS (UNDER 22); YOUTH ARRESTED AND UNABLE TO IMMEDIATELY RETURN HOME; YOUTH NEEDING EMERGENCY CARE; YOUTH NEEDING PEER SUPPORT OR CROSS-AGE MENTORING; AND YOUTH WITH ANGER ISSUES." THIS STRATEGY WILL HELP IMPROVE ACCESS FOR VULNERABLE AND UNDERSERVED RESIDENTS OF THE FARGO/MOORHEAD METRO AREA.A NEW PRIMARY CARE CLINIC IS UNDER CONSTRUCTION IN HORACE, ND AND IS SET TO OPEN IN 2023. THIS WILL SERVE THE NEEDS OF THE RAPIDLY GROWING TOWN OF HORACE AS WELL AS PORTIONS OF WEST FARGO TO ALLOW FOR INCREASED SPEED OF ACCESS TO INDIVIDUALS ACROSS ALL CLINICS. THREE NEW PROVIDERS WERE RECRUITED TO PRIMARY CARE. THE NEW PROVIDERS TOTALED 148 VISITS UPON STARTING IN THE FOURTH QUARTER OF 2022.MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE THREE GOALS SUPPORT THE MENTAL HEALTH AND SUBSTANCE ABUSE GOAL. THE FIRST IS RECRUITING PROVIDERS AND INCREASING ACCESS TO CARE. THE SECOND IS TO DEVELOP A COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION. THE THIRD IS TO DECREASE SUBSTANCE ABUSE.TO INCREASE ACCESS TO MENTAL HEALTH CARE, SANFORD FARGO EXPANDED ITS PARTNERSHIP WITH REGIONAL SCHOOLS TO PROVIDE STUDENT PLACEMENT FOR MASTER'S LEVEL THERAPISTS INTO THE INTERNAL MEDICINE DEPARTMENT. COORDINATION OF CARE WITH PRIMARY CARE, EMERGENCY DEPARTMENT, AND HOSPITAL CARE COORDINATION HAS RESULTED IN THE WAIT LIST FOR BEHAVIORAL HEALTH AND PSYCHIATRY APPOINTMENTS DECREASING FROM 2,000 PATIENTS TO 180 PATIENTS WAITING TO BE SCHEDULED. FURTHERMORE, ACCESS TO SUPPORTIVE BEHAVIORAL HEALTH SERVICES AND RESOURCES HAVE IMPROVED IN THE HOSPITAL WITH THE CREATION OF A DEDICATED UNIT AT THE SANFORD MEDICAL CENTER FARGO FOR PATIENTS ADMITTED FOR MEDICAL CARE WHO REQUIRE ADDITIONAL BEHAVIORAL HEALTH SUPPORT. IN 2022, SANFORD FARGO COMPLETED 10,083 COMPLETED VIDEO VISITS, 144 TRADITIONAL TELEMEDICINE AND 90 VERBAL VISITS.SANFORD FARGO CONDUCTED A DEPRESSION SCREENING INITIATIVE THROUGHOUT SANFORD-FARGO CLINICS TO SUPPORT COMMUNITY MENTAL HEALTH PROMOTION. THE PROMOTION RESULTED IN 40,000 DEPRESSION SCREENINGS COMPLETED BY INTERNAL MEDICINE, FAMILY MEDICINE, AND OB/GYN PROVIDERS AND RESIDENCY CLINICS. FOR ALL POSITIVE DEPRESSION SCREENINGS, THERE WAS A DOCUMENTED FOLLOW-UP PLAN WITHIN 14 DAYS OF THE SCREENING. SANFORD AMBULANCE REPORTED 1,200 PATIENTS RECEIVING CARE RELATED TO ALCOHOL USE, 1,350 RELATED TO BEHAVIORAL HEALTH/PSYCHIATRIC EPISODE. SANFORD FARGO IS ACTIVELY RECRUITING A NEW PROVIDER TO SUPPORT SUBOXONE CLINIC FOR PATIENTS WORKING ON ADDICTION AND RECOVERY TO DECREASE SUBSTANCE ABUSE. FURTHER SUPPORT IS PROVIDED THROUGH HOSPITAL PEER COACHING, WITH CONTINUED WORK WITH F5 AND THE LOTUS CENTER THROUGHOUT 2022 TO PROVIDE PEER COACHING IN THE HOSPITAL. SANFORD FARGO ALSO ENGAGES IN A PARTNERSHIP WITH CASS COUNTY'S WITHDRAWAL MANAGEMENT UNIT TO ENSURE COORDINATED UTILIZATION OF MEDICAL AND LAW ENFORCEMENT SUPPORT FOR INDIVIDUALS ACTIVELY IN DETOX.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:PHYSICAL ACTIVITY AND NUTRITIONSENIOR HOUSING AND LONG-TERM CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSING, EMPLOYMENT, ECONOMIC DEVELOPMENTDIVERSITY, INCLUSION, HEALTH EQUITYCHILDCAREHEALTH LITERACY AND NAVIGATIONSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 2 -- SANFORD MEDICAL CENTER FARGO PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 2 -- SANFORD MEDICAL CENTER FARGO PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2020 THROUGH DECEMBER 2021, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2022-2024. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.NORTHERN DENTAL ACCESS CENTER SOUTHWEST HEALTH AND HUMAN SERVICES BELTRAMI COUNTY PUBLIC HEALTH SIOUX FALLS DEPARTMENT OF HEALTH BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION MINNESOTA DEPARTMENT OF HEALTH SOUTHWEST HEALTH AND HUMAN SERVICES AVERA HEALTH OTTERTAIL PUBLIC HEALTH ESSENTIA HEALTH BELTRAMI COUNTY HEALTH AND HUMAN SERVICES CHI ST. ALEXIUS HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH LIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING THEM THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES; A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE. COMMUNITY AND STAKEHOLDER SURVEY MEMBERS OF THE COMMUNITY WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND THE NEEDS OF THE COMMUNITY BASED UPON THE UW POPULATION HEALTH MODEL. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW UP OPPORTUNITY TO COMMENT ON THE REASON. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR. TO FURTHER PROMOTE COMMUNITY INVOLVEMENT THE SURVEY WAS ALSO SENT TO COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS WITH MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE ASKED TO COMPLETE THE INSTRUMENT AS A RESIDENT OF THE COMMUNITY AND FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT. THE SURVEY WAS HIGHLIGHTED IN A SANFORD HEALTH NEWS ARTICLE (HTTPS://NEWS.SANFORDHEALTH.ORG/COMMUNITY/SANFORD-HEALTH-ADDRESSES-TOP-COMMUNITY-HEALTH-NEEDS/) AND PROMOTED THROUGH SOCIAL MEDIA VIA PAID COMMUNICATIONS. THE PAID COMMUNICATIONS YIELDED 344,300 IMPRESSIONS AND 1,150 COMPLETED SURVEYS ACROSS THE SYSTEM.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. NEARLY 7,000 RESPONDENTS FROM ACROSS THE ENTIRE SANFORD FOOTPRINT COMPLETED THE SURVEY.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY WHICH BUILDS UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. FOR EXAMPLE, IF THE COMPOSITE STRATIFIED SYSTEM-WIDE AVERAGE SCORE IS 4 AND AN INDIVIDUAL COMMUNITY'S AVERAGE RESPONSE WAS 2.5, THAT WOULD SUGGEST AN ISSUE OF CONCERN AND A POTENTIAL COMMUNITY HEALTH CARE NEED TO BE HIGHLIGHTED IN THE SUMMARY FINDINGS. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS (HTTPS://WWW.COUNTYHEALTHRANKINGS.ORG/) AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA BUT NOT BOTH WERE ALSO INCLUDED IN THE FINDINGS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO FIND THE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT RESOURCES WERE AVAILABLE TO ADDRESS THE NEEDS.COMMUNITY LISTENING SESSIONS AND INTERVIEWSCOMMUNITY STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION OF THE FINDINGS OF THE CHNA RESEARCH. FACILITATED DISCUSSION COMMENCED AFTER THE PRESENTATION, AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION. THE FACILITATED DISCUSSION SOUGHT TO INFORM ON SEVERAL ASPECTS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHERE CAN WE HAVE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ANY WORK CURRENTLY BEING DONE ON THESE NEEDS?ARE THERE UNDERUTILIZED COMMUNITY RESOURCES THAT COULD ADDRESS THIS TOPIC?WHICH FALL WITHIN THE PURVIEW OF HEALTHCARE SYSTEM AND WHICH DO NOT?CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2022-2024 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 6A:	SANFORD USD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD SOUTH UNIVERSITY MEDICAL CENTERSANFORD BISMARCK MEDICAL CENTERSANFORD BEMIDJI MEDICAL CENTERSANFORD ABERDEEN MEDICAL CENTERSANFORD BAGLEY MEDICAL CENTERSANFORD CANBY MEDICAL CENTERSANFORD CANTON-INWOOD MEDICAL CENTERSANFORD CHAMBERLAIN MEDICAL CENTERSANFORD CLEAR LAKE MEDICAL CENTERSANFORD HILLSBORO MEDICAL CENTERSANFORD JACKSON MEDICAL CENTERSANFORD LUVERNE MEDICAL CENTERSANFORD MAYVILLE MEDICAL CENTERSANFORD SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 7D:	SANFORD INVITED COMMUNITY PARTNERS TO ATTEND PRESENTATIONS AND DISCUSSIONS OF THE RESULTS. COMMUNITY STAKEHOLDERS AND COMMUNITY COUNCILS WERE INCLUDED.
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES FOR MENTAL HEALTH PROMOTION, SUICIDE PREVENTION AND EDUCATION FOR PARENTING RELATED SKILLS. IT IS SANFORD'S GOAL TO INCREASE ACCESS TO MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES, IN PARTICULAR FOR AT RISK YOUTH AND TO DECREASE THE NUMBER OF SUICIDES.PRIORITY 2: ACCESS TO HEALTHCARE PROVIDERSACCESS TO AFFORDABLE, QUALITY HEALTH CARE IS IMPORTANT TO PHYSICAL, SOCIAL, AND MENTAL HEALTH. HEALTH INSURANCE, LOCAL CARE OPTIONS, AND A USUAL SOURCE OF CARE HELP TO ENSURE ACCESS TO HEALTH CARE. HAVING ACCESS TO CARE ALLOWS INDIVIDUALS TO ENTER THE HEALTH CARE SYSTEM, FIND CARE EASILY AND LOCALLY, PAY FOR CARE, AND GET THEIR HEALTH NEEDS MET. SANFORD HAS MADE ACCESS TO HEALTHCARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO DEVELOP A FULLTIME DERMATOLOGY CLINIC AND TO EXPAND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH. IT IS SANFORD'S GOAL TO INCREASE THE NUMBER OF LOCAL PROVIDERS SERVICING THIEF RIVER FALLS THROUGH LOCALLY BASED PROVIDERS, OUTREACH FROM OTHER SANFORD FACILITIES, OR TELEHEALTH/VIRTUAL CARE PLATFORMS. INCREASED PROVIDERS WILL EXPAND THE NUMBER OF AVAILABLE SERVICES AND APPOINTMENTS AVAILABLE TO THE LOCAL COMMUNITY.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTH SANFORD THIEF RIVER FALLS AND SANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTER ESTABLISHED TWO GOALS WITHIN THE MENTAL HEALTH PRIORITY. THE FIRST IS TO DEVELOP AND IMPLEMENT COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION. THE SECOND GOAL IS TO DEVELOP AND IMPLEMENT COMMUNITY EDUCATION FOR PARENTING RELATED SKILLS.IN LATE 2021, AS PART OF THE GOAL TO DEVELOP AND IMPLEMENT COMMUNITY STRATEGY FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION, SANFORD BEHAVIORAL HEALTH IDENTIFIED A CORE TEAM OF STAFF AND DEVELOPED A STRATEGY TO GROW A COMMUNITY COALITION FOR MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION IN OUR COMMUNITY. IN JANUARY OF 2022, SANFORD BEHAVIORAL HEALTH BEGAN MEETING MONTHLY WITH COMMUNITY PARTNERS FROM TEN PUBLIC AND PRIVATE ENTITIES INCLUDING PUBLIC HEALTH, LAW ENFORCEMENT, FAITH COMMUNITY, EDUCATION, EMPLOYERS, HEALTH CARE, AND YOUTH ACTIVITIES. OVER THE PAST YEAR, SIX ADDITIONAL PARTNERS WERE ADDED, INCLUDING SCHOOL COUNSELORS, VIP, ADDITIONAL SCHOOL DISTRICT, MENTAL HEALTH PROVIDER, HIGH SCHOOL STUDENT, AND A SUICIDE LOSS SURVIVOR. THROUGHOUT THE YEAR, THIS GROUP BECAME KNOWN AS "COMMUNITY STRONG," DEFINED OUR COMMUNITY AS PENNINGTON COUNTY, AND IDENTIFIED OUR FOCUS ON YOUTH AND FAMILY EDUCATION. COMMUNITY STRONG ESTABLISHED A VISION STATEMENT TO BE "A COMMUNITY THAT STRIVES, PROMOTES AND SEEKS OUT MENTAL AND EMOTIONAL WELLBEING AND A MISSION STATEMENT "TO EMPOWER A HEALTHY COMMUNITY IN PENNINGTON COUNTY THROUGH EDUCATION, OUTREACH AND SUPPORT THAT RESHAPES THINKING AND AWARENESS AROUND MENTAL WELL-BEING AND SUICIDE PREVENTION." IN 2022, IN PARTNERSHIP WITH COMMUNITY STRONG, SANFORD BEHAVIORAL HEALTH PROVIDED FOUR EDUCATIONAL EVENTS IN PENNINGTON COUNTY, WITH ADDITIONAL OUTREACH EVENTS.IN EARLY 2022, SANFORD BEHAVIORAL HEALTH IDENTIFIED KEY PERSONNEL TO DEVELOP A STRATEGY FOR IMPLEMENTING PARENTING RELATED SKILLS IN THE COMMUNITY AS PART OF THE GOAL TO DEVELOP AND IMPLEMENT COMMUNITY EDUCATION FOR PARENTING RELATED SKILLS. IN MAY OF 2022, SANFORD BEHAVIORAL HEALTH USED ESTABLISHED RELATIONSHIPS THROUGH THE JUVENILE DIVERSION PROGRAM TO IDENTIFY PARTNERS WHO COULD JOIN IN THE EFFORT TO IMPLEMENT AND PROMOTE THIS TYPE OF EDUCATIONAL GROUP FOR PARENTS. THROUGH WORK WITH THE TRF POLICE DEPARTMENT, PENNINGTON COUNTY SOCIAL SERVICES, PENNINGTON COUNTY COURT AND COUNTY ATTORNEY, AND TRF SCHOOL DISTRICT, IT WAS IDENTIFIED THAT THE INITIAL TARGETED POPULATION OF THIS PARENTING SKILLS EDUCATION WOULD BE PARENTS OF CHILDREN IN THE JUVENILE DIVERSION PROGRAM, OR THOSE THAT THE AGENCIES INVOLVED ARE IDENTIFYING AS ESCALATING IN CRIMINAL JUSTICE SYSTEM AND AT AN INCREASED NEED FOR SERVICES. IN LATE MAY, THE CURRICULUM TO BE USED WAS IDENTIFIED AS THE INCREDIBLE YEARS AND LOVE & LOGIC CURRICULUM. FACILITATORS WERE ALSO IDENTIFIED FROM SANFORD BEHAVIORAL HEALTH AND PENNINGTON COUNTY SOCIAL SERVICES. THE FIRST SIX-WEEK SESSION OF THE PARENTING SKILLS GROUP BEGAN IN OCTOBER OF 2022 WITH SIX FAMILIES COMPLETING THE TRAINING.ACCESS TO HEALTHCARE PROVIDERSTWO GOALS WERE ESTABLISHED TO SUPPORT THE PRIORITY, INCLUDING THE DEVELOPMENT OF A FULLTIME DERMATOLOGY CLINIC IN THIEF RIVER FALLS, AND EXPANDING THE PLATFORM AND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH.TO SUPPORT THE GOAL OF DEVELOPING A FULL-TIME DERMATOLOGY CLINIC IN THIEF RIVER FALLS, SANFORD HEALTH TRF HIRED A FULL-TIME DERMATOLOGY NURSE PRACTITIONER IN APRIL OF 2021. THE DERMATOLOGIST STARTED IN THIEF RIVER FALLS AFTER SIX MONTHS OF TRAINING WITH A DERMATOLOGIST IN GRAND FORKS, SO THE COMMUNITY NOW HAS A FULL-TIME DERMATOLOGY SERVICE. CY2022 FOCUSED ON BUILDING THE PRACTICE TO INCLUDE RESOURCES NEEDED FOR SKIN TESTING, SKIN CHECKS, BIOPSIES, AND PROCEDURES ALONG WITH STAFFING AND SCHEDULING RESOURCES TO BEST ACCOMMODATE PATIENT NEEDS. AVAILABLE LOCAL DERMATOLOGY APPOINTMENTS WENT FROM MONTHLY OUTREACH, ROUGHLY 40 APPOINTMENTS, TO FULL-TIME COMMUNITY CLINIC, ROUGHLY 140 APPOINTMENTS PER MONTH. PATIENT UTILIZATION OF DERMATOLOGY SERVICES WAS BUILT AND SUSTAINED EARLY IN 2022. HELPING WITH THE PRACTICE AWARENESS AND PATIENT EDUCATION INCLUDED MARKETING THE NEW NURSE PRACTITIONER TO THE PUBLIC VIA TRADITIONAL AND SOCIAL MEDIA SOURCES, HOSTING FREE PUBLIC SKIN CHECK EVENTS, COMMUNITY OUTREACH WITH EMPLOYERS AND THE SCHOOL DISTRICT, AND PRODUCING AND DISTRIBUTING SKIN PREVENTION EDUCATIONAL MATERIALS. THIEF RIVER FALLS DERMATOLOGY IS OFFERING ROBUST GEOGRAPHICAL OFFERINGS IN OUR PRIMARY SERVICE AREA BY SPENDING TWO DAYS OF OUTREACH DERMATOLOGY TIME IN COMMUNITIES HALLOCK AND CROOKSTON, GIVING THEM 16 PATIENT APPOINTMENTS OF DERMATOLOGY ACCESS NOT PREVIOUSLY HAD. IN CY2023, THE FOCUS WILL BE ON GROWING AVAILABLE ACCESS BY INCREASING APPOINTMENTS EACH CLINIC DAY.AS PART OF THE EXPANDED PLATFORM AND ACCESS TO TELEHEALTH TECHNOLOGIES IN BEHAVIORAL HEALTH GOAL, SANFORD BEHAVIORAL HEALTH PROVIDES PATIENTS THE FLEXIBILITY OF SCHEDULING THEIR APPOINTMENT IN THE MANNER THAT BEST SUITS THEIR NEEDS, PROVIDED THAT WE ARE ABLE TO MEET REGULATORY REQUIREMENTS AND IT IS IN THE PATIENT'S BEST INTEREST CLINICALLY. AS A RESULT, MORE THAN 40% OF APPOINTMENTS ARE CURRENTLY SCHEDULED AS TELEHEALTH APPOINTMENTS. THIS DATA DOES NOT REFLECT ANY NEW PATIENT ASSESSMENTS WHO MAY BE SEEN VIA TELEHEALTH DUE TO THE INABILITY TO CAPTURE THE DATA WITHOUT A MANUAL PROCESS.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO QUALITY HEALTHCAREAFFORDABLE HOUSINGLONG-TERM CAREPUBLIC TRANSPORTATIONSANFORD SERVES AS A PARTNER IN MANY COMMUNITY GROUPS THAT HAVE THE EXPERTISE TO ADDRESS THESE UNMET NEEDS. SANFORD HAS SHARED THE RESULTS OF THE CHNA AND THE UNMET NEEDS WITH COMMUNITY LEADERS AND STAKEHOLDERS.
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 13H:	OTHER FACTORS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS INCLUDE BALANCE OWED, FAMILY SIZE, DEBT TO INCOME RATIO, SAVINGS AND INVESTMENTS, OTHER DEBT (BOTH MEDICAL AND NON-MEDICAL), PREVIOUS BANKRUPTCIES AND LIENS, PATIENT/GUARANTOR INVOLVEMENT IN OTHER STATE AND FEDERAL ASSISTANCE PROGRAMS, INDIVIDUAL CIRCUMSTANCES, CURRENT EMPLOYMENT STATUS, TOTAL MONTHLY EXPENSES AND THIRD PARTY ANALYTIC SCORE.
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 16J:	OTHER MEASURES TO PUBLICIZE THE POLICY WITHIN THE COMMUNITY SERVED BY THE HOSPITAL FACILITY INCLUDE PUBLISHING WITH LOCAL PUBLIC HEALTH AGENCIES, COLLECTION AGENCIES AND SUBMISSION TO LAW FIRMS THAT SERVE THE UNDERPRIVILEGED POPULATION.THE FINANCIAL ASSISTANCE PROGRAM SUMMARY, COMPLETE POLICY AND THE SANFORD FINANCIAL ASSISTANCE APPLICATION ARE ALL AVAILABLE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY

Field	Value	IRS element (for citing)
Facility	251	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (251 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - SANFORD CLINIC ABERDEEN
3015 3RD AVENUE SE	ABERDEEN	SD	57401	MEDICAL CLINIC
2 - SANFORD CLINIC ABERDEEN SURGICAL CENTER
3015 3RD AVENUE SE	ABERDEEN	SD	57401	AMBULATORY SURGERY CENTER
3 - SANFORD HEALTH ADRIAN CLINIC
201 MAINE AVE	ADRIAN	SD	56110	RURAL HEALTH CLINIC
4 - SANFORD HEALTH BROADWAY CLINIC
1527 BROADWAY STREET	ALEXANDRIA	MN	56308	MEDICAL CLINIC
5 - SANFORD HEALTH EASTON PLACE CLINIC
510 - 22ND AVENUE E SUITE 602	ALEXANDRIA	MN	56308	MEDICAL CLINIC
6 - SANFORD BAGLEY CLINIC
1656 CENTRAL ST W	BAGLEY	MN	56621	RURAL HEALTH CLINIC
7 - SANFORD BAGLEY EYE CENTER & OPTICAL
1656 CENTRAL ST W	BAGLEY	MN	56621	EYE CARE CENTER
8 - SANFORD TRACY BALATON CLINIC
551 HIGHWAY 14 E	BALATON	MN	56115	MEDICARE CERTIFIED RURAL HEALTH CLINIC
9 - SANFORD HEALTH BASSETT FAMILY CLINIC
103 CLARK ST	BASSETT	NE	68714	MEDICAL CLINIC
10 - SANFORD HEALTH BAUDETTE EYE CENTER
103 MAIN ST	BAUDETTE	MN	56623	EYE CARE CENTER
11 - BAKER PARK INC
803 DEWEY AVENUE	BEMIDJI	MN	56601	ASSISTED LIVING CENTER
12 - EDITH SANFORD BREAST CENTER BEMIDJI
1233 34TH ST NW	BEMIDJI	MN	56601	WOMEN'S HEALTH
13 - SANFORD BEMIDJI 1611 ANNE ST CLINIC
1611 ANNE ST NW	BEMIDJI	MN	56601	MEDICAL CLINIC
14 - SANFORD BEMIDJI 1705 ANN ST CLINIC
1705 ANNE ST NW	BEMIDJI	MN	56601	MEDICAL CLINIC
15 - SANFORD BEMIDJI EYE CENTER & OPTICAL
1611 ANNE ST NW	BEMIDJI	MN	56601	EYE CARE CENTER
16 - SANFORD BEMIDJI DOWNTOWN EYE CENTER & OP
506 BELTRAMI AVE NW	BEMIDJI	MN	56601	EYE CARE CENTER
17 - SANFORD BEMIDJI HOME CARE & HOSPICE
3201 PINE RIDGE AVE NW	BEMIDJI	MN	56601	HOME CARE AND HOSPICE
18 - SANFORD BEMIDJI MAIN CLINIC
1233 34TH ST NW	BEMIDJI	MN	56601	MEDICAL CLINIC
19 - SANFORD BEMIDJI OTHOPEDICS & SPORTS MEDI
1300 ANNE STREET NW	BEMIDJI	MN	56601	MEDICAL CLINIC
20 - SANFORD DIALYSIS BEMIDJI
1300 ANNE STREET NW	BEMIDJI	MN	56601	DIALYSIS
21 - SANFORD HEALTH NEILSON PLACE
1000 ANNE ST NW	BEMIDJI	MN	56601	SKILLED NURSING FACILITY
22 - SANFORD HEALTH TRILLIUM
930 ANNE STREET NW	BEMIDJI	MN	56601	ASSISTED LIVING CENTER
23 - SANFORD HEALTH WINDSONG
1000 ANNE ST NW	BEMIDJI	MN	56601	ASSISTED LIVING CENTER
24 - SANFORD JOE LUEKEN CANCER CENTER
1233 34TH ST NW	BEMIDJI	MN	56601	CANCER CENTER
25 - SANFORD BEHAVIORAL HEALTH HEADWATERS ACT
1705 ANNE ST NW	BEMIDJI	MN	56601	BEHAVIORAL HEALTH TREATMENT CENTER
26 - SANFORD HEALTH PRIMEWEST RESIDENTIAL
3124 HANNAH AVE NW	BEMIDJI	MN	56601	BEHAVIORAL HEALTH & ADDICTION CENTER
27 - SANFORD CLINIC BERESFORD
600 W CEDAR STREET	BERESFORD	SD	57004	RURAL HEALTH CLINIC
28 - BISMARCK CANCER CENTER
500 N 8TH STREET	BISMARCK	ND	58501	CANCER CENTER
29 - SANFORD BIRTH CENTER
300 N 7TH STREET	BISMARCK	ND	58501	BIRTH CENTER
30 - SANFORD CANCER CENTER BISMARCK
300 N 7TH STREET	BISMARCK	ND	58501	CANCER CENTER
31 - SANFORD CHILDREN'S NORTH CLINIC
765 W INTERSTATE AVE	BISMARCK	ND	58503	CHILDREN'S CLINIC
32 - SANFORD CLINIC
222 N 7TH STREET	BISMARCK	ND	58501	MEDICAL CLINIC
33 - SANFORD EAST INTERSTATE AVE CLINIC
1800 E INTERSTATE AVE	BISMARCK	ND	58503	MEDICAL CLINIC
34 - SANFORD FIFTH & BROADWAY CLINIC
515 E BROADWAY AVE	BISMARCK	ND	58501	MEDICAL CLINIC
35 - SANFORD HEALTH CHIROPRACTICOCC MED CLIN
2603 E BROADWAY AVE	BISMARCK	ND	58501	MEDICAL CLINIC
36 - SANFORD NORTH CLINIC
2830 N WASHINGTON STREET	BISMARCK	ND	58503	MEDICAL CLINIC
37 - SANFORD ORTHOPEDIC & SPORTS MEDICINE
225 N 7TH STREET	BISMARCK	ND	58501	MEDICAL CLINIC
38 - SANFORD SEVENTH & BROADWAY CLINIC
715 E BROADWAY AVE	BISMARCK	ND	58501	MEDICAL CLINIC
39 - SANFORD SEVENTH & ROSSER CLINIC
414 N 7TH STREET	BISMARCK	ND	58501	MEDICAL CLINIC
40 - SANFORD SEVENTH & THAYER CLINIC
209 N 7TH STREET	BISMARCK	ND	58501	MEDICAL CLINIC
41 - SANFORD SOUTH CLINIC
1040 TACOMA AVE	BISMARCK	ND	58504	MEDICAL CLINIC
42 - SANFORD STATE SREET CLINIC
3318 N 14TH STREET	BISMARCK	ND	58503	MEDICAL CLINIC
43 - SANFORD TOM & FRANCES LEACH BISMARCK DIA
209 N 7TH STREET	BISMARCK	ND	58501	DIALYSIS CENTER
44 - SANFORD BEMIDJI BLACKDUCK CLINIC
81 1ST ST NW	BLACKDUCK	MN	56630	MEDICAL CLINIC
45 - SANFORD BOYDEN CLINIC
3971 320TH ST	BOYDEN	IA	51234	MEDICAL CLINIC
46 - SANFORD BRANDON ACUTE CARE & ORTHO FAST
1105 E HOLLY BLVD	BRANDON	SD	57005	MEDICAL CLINIC
47 - SANFORD BRANDON FAMILY MEDICINE & CHILDR
1105 E HOLLY BLVD	BRANDON	SD	57005	MEDICAL CLINIC
48 - SANFORD HEALTH BROOKINGS CLINIC
922 - 22ND AVENUE S	BROOKINGS	SD	57006	MEDICAL CLINIC
49 - SANFORD CANBY CLINIC
112 ST OLAF AVENUE S	CANBY	MN	56220	MEDICARE CERTIFIED RURAL HEALTH CLINIC
50 - SANFORD CANBY DENTAL CLINIC
11 ST OLAF AVENUE S	CANBY	MN	56220	DENTAL CLINIC
51 - SANFORD CANBY DIALYSIS UNIT
112 ST OLAF AVENUE S	CANBY	MN	56220	MEDICARE CERTIFIED END STAGE RENAL DIALYSIS
52 - SANFORD CANBY HOME CARE
213 ST OLAF AVENUE N	CANBY	MN	56220	MEDICARE CERTIFIED HOME HEALTH AGENCY
53 - SANFORD CANBY MEDICAL CENTER
112 ST OLAF AVENUE S	CANBY	MN	56220	CLASS F HOME CARE PROVIDER
54 - SANFORD DIALYSIS CANBY
112 ST OLAF AVENUE S	CANBY	MN	56220	DIALYSIS
55 - SANFORD HEALTH CANBY SYLVAN PLACE
212 ST OLAF AVENUE S	CANBY	MN	56220	HOUSING WITH SERVICES
56 - SANFORD HEALTH CANISTOTAUSD CLINIC
320 W MAIN ST	CANISTOTA	SD	57012	RURAL HEALTH CLINIC
57 - SANFORD CANTON CLINIC
400 N HIAWATHA DRIVE	CANTON	SD	57013	RURAL HEALTH CLINIC
58 - SANFORD HEALTH CANTON HIAWATHA HEIGHTS
398 N HIAWATHA DRIVE	CANTON	SD	57013	ASSISTED LIVING CENTER
59 - SANFORD BEMIDJI CASS LAKE CLINIC
219 GRANT UTLEY AVE NW	CASS LAKE	MN	56633	MEDICAL CLINIC
60 - SANFORD CHAMBERLAIN CLINIC
300 S BYRON BLVD	CHAMBERLAIN	SD	57325	RURAL HEALTH CLINIC
61 - SANFORD DIALYSIS
300 S BYRON BLVD	CHAMBERLAIN	SD	57325	DIALYSIS
62 - SANFORD HEALTH CHAMBERLAIN CARE CENTER
300 S BYRON BLVD	CHAMBERLAIN	SD	57325	NURSING FACILITY
63 - SANFORD HOME HEALTH & HOSPICE CHAMBERLAI
110 W BEEBE AVE	CHAMBERLAIN	SD	57325	HOME HEALTH CARE & HOSPICE
64 - SANFORD HEALTH CLARK CLINIC
211 N COMMERCIAL STREET	CLARK	SD	57225	RURAL HEALTH CLINIC
65 - SANFORD CLEAR LAKE CLINIC
701 3RD AVENUE S	CLEAR LAKE	SD	57226	RURAL HEALTH CLINIC
66 - SANFORD CLEAR LAKE MEDICAL CENTER
701 3RD AVENUE S	CLEAR LAKE	SD	57226	HOME HEALTH CARE
67 - SANFORD BAGLEY CLEARBROOK CLINIC
22 ELM STREET	CLEARBROOK	MN	56634	RURAL HEALTH CLINIC
68 - SANFORD HEALTH DAKOTA DUNES CLINIC
350 OAK TREE LN	DAKOTA DUNES	SD	57049	MEDICAL CLINIC
69 - SANFORD HEALTH DELL RAPIDS ORCHARD HILLS
200 W 10TH STREET	DELL RAPIDS	SD	57022	ASSISTED LIVING CENTER
70 - SANFORD DIALYSIS
1234 WASHINGTON AVE SUITE B	DETROIT LAKES	MN	56501	DIALYSIS CENTER
71 - SANFORD HEALTH DETROIT LAKES CLINC & SAM
1245 WASHINGTON AVENUE	DETROIT LAKES	MN	56501	AMBULATORY SURGERY CENTER/CLINIC
72 - SANFORD HEALTH DETROIT LAKES EYE CENTER
1234 WASHINGTON AVE SUITE A	DETROIT LAKES	MN	56501	EYE CARE CENTER
73 - SANFORD HEALTH WEST DICKINSON CLINIC
2615 FAIRWAY STREET	DICKINSON	ND	58601	MEDICAL CLINIC
74 - SANFORD HEALTH EAST DICKINSON CLINIC
33 9TH ST W	DICKINSON	ND	58601	MEDICAL CLINIC
75 - SANFORD HEALTH HEARING CENTER DICKINSON
1531 W VILLARD ST	DICKINSON	ND	58601	HEARING CENTER
76 - SANFORD DERMATOLOGY CLINIC
625 DEMERS AVE NW	EAST GRAND FORKS	MN	56721	MEDICAL CLINIC
77 - SANFORD HEALTH 621 DEMERS AVE CLINIC
621 DEMERS AVE NW	EAST GRAND FORKS	MN	56721	MEDICAL CLINIC
78 - SANFORD HEALTH 929 CENTRAL AVE CLINIC
929 CENTRAL AVE	EAST GRAND FORKS	MN	56721	MEDICAL CLINIC
79 - SANFORD HEALTH 625 DEMERS AVE CLINIC
625 DEMERS AVE NW	EAST GRAND FORKS	MN	56721	MEDICAL CLINIC
80 - SANFORD HOME CARE EAST GRAND FORKS
404 DEMERS AVE	EAST GRAND FORKS	MN	56721	HOME HEALTH CARE
81 - SANFORD HEALTH EDGELEY CLINIC
506 2ND ST	EDGELEY	ND	58433	MEDICAL CLINIC
82 - SANFORD LUVERNE EDGERTON CLINIC
733 MAIN AVE	EDGERTON	MN	56128	RURAL HEALTH CLINIC
83 - SANFORD HEALTH ELLENDALE CLINIC
141 MAIN ST	ELLENDALE	ND	58436	RURAL HEALTH CLINIC
84 - SANFORD HEALTH ENDERLIN CLINIC
201 4TH AVENUE	ENDERLIN	ND	58027	RURAL HEALTH CLINIC
85 - SANFORD CLINIC ESTELLINE
305 HOSPITAL DRIVE	ESTELLINE	SD	57234	RURAL HEALTH CLINIC
86 - EDITH SANFORD BREAST CENTER FARGO
737 BROADWAY N	FARGO	ND	58102	WOMEN'S HEALTH
87 - SANFORD 1711 MEDICAL BUILDING
1711 UNIVERSITY DRIVE S	FARGO	ND	58103	MEDICAL CLINIC
88 - SANFORD 2801 MEDICAL BUILDING
2801 S UNIVERSITY DRIVE	FARGO	ND	58122	MEDICAL CLINIC
89 - SANFORD BRAIN & SPINE CENTER FARGO
2301 25TH ST S	FARGO	ND	58103	MEDICAL CLINIC
90 - SANFORD BROADWAY CLINIC
801 BROADWAY N	FARGO	ND	58102	MEDICAL CLINIC
91 - SANFORD BROADWAY MEDICAL BUILDING
736 BROADWAY N	FARGO	ND	58102	MEDICAL CLINIC
92 - SANFORD CHILDREN'S BROADWAY CLINIC
737 BROADWAY N	FARGO	ND	58102	CHILDREN'S CLINIC
93 - SANFORD CHILDREN'S CARE CLINIC
100 4TH STREET S	FARGO	ND	58103	CHILDREN'S CLINIC
94 - SANFORD CHILDREN'S SOUTHWEST CLINIC
2701 13TH AVE S	FARGO	ND	58103	CHILDREN'S CLINIC
95 - SANFORD DERMATOLOGY & LASER CLINIC
4656 40TH AVE S	FARGO	ND	58104	MEDICAL CLINIC
96 - SANFORD DIALYSIS FARGO
2801 S UNIVERSITY DRIVE	FARGO	ND	58122	DIALYSIS
97 - SANFORD FOOT AND ANKLE CLINIC
1720 S UNIVERSITY DR	FARGO	ND	58103	MEDICAL CLINIC
98 - SANFORD HOME CARE FARGO
100 4TH STREET S	FARGO	ND	58103	HOME HEALTH AGENCY
99 - SANFORD I-94 CLINIC
5225 23RD AVENUE SOUTH	FARGO	ND	58104	MEDICAL CLINIC
100 - SANFORD NEUROSCIENCE CLINIC
700 1ST AVE S	FARGO	ND	58103	MEDICAL CLINIC
101 - SANFORD NORTH FARGO CLINIC
2601 BROADWAY N	FARGO	ND	58102	MEDICAL CLINIC
102 - SANFORD ORTHOPEDIC WALK-IN CLINIC FARGO
1720 S UNIVERSITY DR	FARGO	ND	58103	MEDICAL CLINIC
103 - SANFORD PAIN CENTER FARGO
2301 25TH ST S	FARGO	ND	58103	MEDICAL CLINIC
104 - SANFORD REPRODUCTIVE MEDICINE CLINIC
1111 HARWOOD DRIVE S	FARGO	ND	58104	MEDICAL CLINIC
105 - SANFORD ROGER MARIS CANCER CENTER
820 4TH STREET N	FARGO	ND	58102	CANCER CENTER
106 - SANFORD SOUTH UNIVERSITY CLINIC
1717 S UNIVERSITY DR	FARGO	ND	58103	MEDICAL CLINIC
107 - SANFORD SOUTH UNIVERSITY EYE CENTER & OP
1717 S UNIVERSITY DR	FARGO	ND	58103	EYE CARE CENTER
108 - SANFORD SOUTHPOINTE CLINIC
2400 32ND AVE S	FARGO	ND	58103	MEDICAL CLINIC
109 - SANFORD SOUTHPOINTE EYE CENTER & OPTICAL
2400 32ND AVE S	FARGO	ND	58103	EYE CARE CENTER
110 - SANFORD VETERANS SQUARE CLINIC
3955 56TH ST S	FARGO	ND	58104	MEDICAL CLINIC
111 - SANFORD HEALTH FINLEY CLINIC
407 WASHINGTON AVE E	FINLEY	ND	58230	RURAL HEALTH CLINIC
112 - SANFORD HEALTH FORMAN CLINIC
336 MAIN ST	FORMAN	ND	58032	RURAL HEALTH CLINIC
113 - SANFORD DIALYSIS FORT YATES
10 N RIVER ROAD	FORT YATES	ND	58538	DIALYSIS CENTER
114 - SANFORD HEALTH FOSSTON EYE CENTER & OPTI
111 2ND ST NE	FOSSTON	MN	56542	EYE CARE CENTER
115 - SANFORD ROCK RAPIDS GEORGE CLINIC
101 N MAIN	GEORGE	IA	51237	RURAL HEALTH CLINIC
116 - SANFORD HEALTH GRAND FORKS CLINIC
1750 47TH AVE S	GRAND FORKS	ND	58201	MEDICAL CLINIC
117 - SANFORD HEALTH GWINNER CLINIC
69 HIGHWAY 13 W	GWINNER	ND	58040	MEDICAL CLINIC
118 - SANFORD HEALTH HALSTAD CLINIC
445 1ST STREET E	HALSTAD	MN	56548	RURAL HEALTH CLINIC
119 - SANFORD HEALTH HARTFORD CLINIC
905 N OAKS AVE	HARTFORD	SD	57033	MEDICAL CLINIC
120 - SANFORD SHELDON HARTLEY CLINIC
512 3RD ST NE	HARTLEY	IA	51346	MEDICAL CLINIC
121 - SANFORD HAWLEY CLINIC
1412 MAIN ST	HAWLEY	MN	56549	MEDICAL CLINIC
122 - SANFORD HEALTH COMSTOCK CORNER
12 3RD STREET SE	HILLSBORO	ND	58045	ASSISTED LIVING CENTER
123 - SANFORD HILLSBORO CARE CENTER
12 3RD STREET SE	HILLSBORO	ND	58045	HOSPITAL BASED-NURSING FACILITIES LTC
124 - SANFORD HEALTH HILLSBORO CLINIC
315 EAST CALEDONIA	HILLSBORO	ND	58045	RURAL HEALTH CLINIC
125 - SANFORD HEALTH DIALYSIS HOSPERS
112 SUNRISE DRIVE	HOSPERS	IA	51238	END STAGE RENAL DIALYSIS
126 - SANFORD HEALTH INTL FALLS EYE CENTER
1400 HIGHWAY 71	INTERNATIONAL FALLS	MN	56649	EYE CARE CENTER
127 - SANFORD HEALTH INWOOD CLINIC
303 E JEFFERSON ST	INWOOD	IA	51240	MEDICAL CLINIC
128 - SANFORD CLINIC IPSWICH
110 5TH AVENUE	IPSWICH	SD	57451	RURAL HEALTH CLINIC
129 - SANFORD JACKSON CLINIC
1430 NORTH HIGHWAY	JACKSON	MN	56143	MEDICARE CERTIFIED RURAL HEALTH CLINIC
130 - SANFORD DIALYSIS JAMESTOWN
300 2ND AVENUE NE	JAMESTOWN	ND	58401	DIALYSIS CENTER
131 - SANFORD HEALTH HEARING CENTER JAMESTOWN
904 5TH AVE NE	JAMESTOWN	ND	58401	HEARING CENTER
132 - SANFORD HEALTH JAMESTOWN 2ND AVE CLINIC
300 2ND AVENUE NE	JAMESTOWN	ND	58401	MEDICAL CLINIC
133 - SANFORD DIALYSIS JAMESTOWN
300 2ND AVENUE NE	JAMESTOWN	ND	58401	DIALYSIS
134 - SANFORD HEALTH JAMESTOWN CLINIC
904 5TH AVE NE	JAMESTOWN	ND	58401	MEDICAL CLINIC
135 - SANFORD HEALTH KELLIHER CLINIC
243 CLARK AVE N	KELLIHER	MN	56650	MEDICAL CLINIC
136 - SANFORD HEALTH KIMBALL CLINIC
101 S MAIN ST	KIMBALL	SD	57355	RURAL HEALTH CLINIC
137 - SANFORD CHILDREN'S CLINIC
3001 DAGGETT ST	KLAMATH FALLS	OR	97601	MEDICAL CLINIC
138 - SANFORD HEALTH LAKE NORDEN CLINIC
512 MAIN AVE	LAKE NORDEN	SD	57248	RURAL HEALTH CLINIC
139 - SANFORD JACKSON LAKEFIELD CLINIC
209 MAIN STREET	LAKEFIELD	MN	56150	MEDICARE CERTIFIED RURAL HEALTH CLINIC
140 - SANFORD HEALTH LAKE PARK CLINIC
215 N MARKET ST	LAKE PARK	IA	51347	MEDICAL CLINIC
141 - SANFORD HEALTH LAMOURE CLINIC
100 1ST AVE SW	LAMOURE	ND	58458	RURAL HEALTH CLINIC
142 - SANFORD HEALTH LENNOX CLINIC
108 S MAIN	LENNOX	SD	57039	RURAL HEALTH CLINIC
143 - SANFORD HEALTH LIDGERWOOD CLINIC
21 WILEY AVE S	LIDGERWOOD	ND	58053	MEDICAL CLINIC
144 - SANFORD HEALTH LISBON CLINIC
102 10TH AVE W	LISBON	ND	58054	MEDICAL CLINIC
145 - SANFORD HOME CARE LISBON
404 FOREST ST	LISBON	ND	58054	HOME HEALTH CARE
146 - SANFORD HOME HEALTH LUVERNE
304 N MCKENZIE ST	LUVERNE	MN	56156	HOME HEALTH CARE
147 - SANFORD LUVERNE CLINIC
1601 SIOUX VALLEY DR	LUVERNE	MN	56156	MEDICAL CLINIC
148 - SANFORD LUVERNE HOSPICE
217 N OAKLEY ST	LUVERNE	MN	56156	MEDICARE CERTIFIED HOSPICE
149 - SANFORD DIALYSIS
323 SW 10TH STREET	MADISON	SD	57042	END STAGE RENAL DIALYSIS
150 - SANFORD HOSPICE MADISON
900 2ND AVENUE	MADISON	MN	56256	HOSPICE (LICENSED IN SD)
151 - SANFORD HEALTH MAHNOMEN CLINIC
410 W 4TH ST	MAHNOMEN	MN	56557	RURAL HEALTH CLINIC
152 - SANFORD HOME CARE MAHNOMEN
414 W JEFFERSON AVE	MAHNOMEN	MN	56557	HOME HEALTH CARE
153 - SANFORD HOME CARE BISMARCK
910 18TH STREET NW	MANDAN	ND	58554	HOME HEALTH AGENCY
154 - SANFORD EAST MANDAN CLINIC
102 MANDAN AVE	MANDAN	ND	58554	MEDICAL CLINIC
155 - SANFORD NORTH MANDAN CLINIC
910 18TH STREET NW	MANDAN	ND	58554	MEDICAL CLINIC
156 - SANFORD HOME CARE MAYVILLE
49 7TH AVE SE	MAYVILLE	ND	58257	HOME HEALTH CARE
157 - SANFORD MAYVILLE CLINIC
600 1ST ST SE	MAYVILLE	ND	58257	MEDICAL CLINIC
158 - SANFORD HEALTH HIGHWAY 2 CLINIC
801 21ST AVE SE	MINOT	ND	58701	MEDICAL CLINIC
159 - SANFORD HEALTH NORTHWEST CLINIC
1500 21ST AVE NW	MINOT	ND	58701	MEDICA
160 - SANFORD HEALTH MINNEOTA CLINIC
700 N MONROE ST	MINNEOTA	MN	56264	RURAL HEALTH CLINIC
161 - SANFORD HEALTH MITCHELL CLINIC
2100 HIGHLAND WAY	MITCHELL	SD	57301	MEDICAL CLINIC
162 - SANFORD MOORHEAD CAMPUS
4000 28TH AVE S	MOORHEAD	MN	56560	MEDICAL CLINIC
163 - SANFORD DIALYSIS MORRIS
400 1ST STREET EAST	MORRIS	MN	56267	DIALYSIS
164 - SANFORD HEALTH MOUNTAIN LAKE CLINIC
308 N 8TH STREET	MOUNTAIN LAKE	MN	56159	MEDICARE CERTIFIED RURAL HEALTH CLINIC
165 - SANFORD HEALTH OAKES CLINIC
420 7TH ST S	OAKES	ND	58474	MEDICAL CLINIC
166 - SANFORD CHILDREN'S CLINIC
3605 VISTA WAY	OCEANSIDE	CA	92056	CHILDREN'S CLINIC
167 - SANFORD HEALTH PARK RAPIDS CLINIC
110 7TH ST W	PARK RAPIDS	MN	56470	MEDICAL CLINIC
168 - SANFORD HEALTH PARKERS PRAIRIE CLINIC
115 E SOO STREET	PARKERS PRAIRIE	MN	56361	MEDICAL CLINIC
169 - SANFORD HEALTH PELICAN RAPIDS CLINIC
211 EAST MILL STREET	PELICAN RAPIDS	MN	56572	RURAL HEALTH CLINIC
170 - SANFORD HOME CARE PELICAN RAPIDS
211 EAST MILL STREET	PELICAN RAPIDS	MN	56572	HOME HEALTH CARE
171 - SANFORD HEALTH PIERRE CLINIC
521 E SIOUX AVE	PIERRE	SD	57501	MEDICAL CLINIC
172 - SANFORD VERMILLION PONCA CLINIC
111 E 2ND STREET	PONCA	NE	68770	MEDICAL CLINIC
173 - SANFORD DIALYSIS RED LAKE
24760 HOSPITAL DRIVE	RED LAKE	MN	56671	DIALYSIS
174 - SANFORD ROCK RAPIDS CLINIC
104 BUNCOMBE DRIVE	ROCK RAPIDS	IA	51246	RURAL HEALTH CLINIC
175 - SANFORD SHELDON SANBORN CLINIC
321 MAIN STREET	SANBORN	IA	51248	MEDICAL CLINIC
176 - SANFORD HEALTH SHELDON CARE CENTER
118 NORTH SEVENTH AVENUE PO BOX 250	SHELDON	IA	51201	HOSPITAL BASED-NURSING FACILITIES
177 - SANFORD SHELDON CLINIC
800 OAK STREET	SHELDON	IA	51201	RURAL HEALTH CLINIC
178 - SANFORD SHELDON HOME HEALTH & HOSPICE
118 NORTH SEVENTH AVENUE PO BOX 250	SHELDON	IA	51201	HOME HEALTH AGENCY AND HOSPICE
179 - AVA'S HOUSE
1320 W 17TH STREET	SIOUX FALLS	SD	57104	HOSPICE
180 - SANFORD 10TH & PHILLIPS ACUTE CARE & ORT
136 S PHILLIPS AVE	SIOUX FALLS	SD	57104	MEDICAL CLINIC
181 - SANFORD 26TH & SYCAMORE FAMILY MEDICINE
4405 E 26TH ST	SIOUX FALLS	SD	57103	MEDICAL CLINIC
182 - SANFORD 32ND & ELLIS CLINIC
2601 S ELLIS ROAD	SIOUX FALLS	SD	57106	MEDICAL CLINIC
183 - SANFORD 49TH & OXBOW FAMILY MEDICINE
3401 W 49TH STREET	SIOUX FALLS	SD	57106	MEDICAL CLINIC
184 - SANFORD 4TH & SYCAMORE FAMILY MEDICINE
600 N SYCAMORE AVE	SIOUX FALLS	SD	57110	MEDICAL CLINIC
185 - SANFORD 69TH & LOUISE FAMILY MEDICINE
6101 S LOUISE AVE	SIOUX FALLS	SD	57108	MEDICAL CLINIC
186 - SANFORD 69TH & MINNESOTA FAMILY MEDICINE
6110 S MINNESOTA AVE	SIOUX FALLS	SD	57108	MEDICAL CLINIC
187 - SANFORD CANCER CENTER
1309 W 17TH ST	SIOUX FALLS	SD	57104	CANCER CENTER
188 - SANFORD CARDIOVASCULAR INSTITUTE
1301 W 18TH STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
189 - SANFORD CHILDREN'S MB2 CLINIC
1205 S GRANGE AVE	SIOUX FALLS	SD	57105	CHILDREN'S CLINIC
190 - SANFORD CHILDREN'S RESIDENCY CLINIC
6101 S LOUISE AVE	SIOUX FALLS	SD	57108	CHILDREN'S CLINIC
191 - SANFORD CHILDREN'S SPECIALTY CLINIC
1600 W 22ND STREET	SIOUX FALLS	SD	57117	CHILDREN'S CLINIC
192 - SANFORD DERMATOLOGY CLINIC
1310 W 22ND STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
193 - SANFORD DIABETES & THYROID CLINIC
1305 W 18TH STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
194 - SANFORD DIALYSIS SIOUX FALLS
1321 W 22ND STREET	SIOUX FALLS	SD	57117	DIALYSIS CENTER
195 - SANFORD EAR NOSE AND THROAT CLINIC
1310 W 22ND STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
196 - SANFORD EYE CENTER & OPTICAL
1621 S MINNESOTA AVE	SIOUX FALLS	SD	57105	EYE CARE CENTER
197 - SANFORD HEALTH EYE CLINIC
2310 S MARION RD 140	SIOUX FALLS	SD	57106	EYE CARE CENTER
198 - SANFORD HEALTH MB2 CLINIC
1205 S GRANGE AVE	SIOUX FALLS	SD	57105	MEDICAL CLINIC
199 - SANFORD HOME HEALTH SIOUX FALLS
2710 WEST 12TH STREET	SIOUX FALLS	SD	57104	HOME HEALTH CARE
200 - SANFORD HOSPICE SIOUX FALLS
2710 WEST 12TH STREET	SIOUX FALLS	SD	57104	HOSPICE (LICENSED IN MN AND SD)
201 - SANFORD IMAGENETICS
1321 W 22ND STREET	SIOUX FALLS	SD	57117	GENETICS
202 - SANFORD INTERNAL MEDICINE CLINIC
1321 W 22ND STREET	SIOUX FALLS	SD	57117	MEDICAL CLINIC
203 - SANFORD MATERNAL-FETAL MEDICINE
1500 W 22ND STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
204 - SANFORD OBSTETRICS & GYNECOLOGY CLINIC
1500 W 22ND STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
205 - SANFORD PSYCHIATRY & PSYCHOLOGY CLINIC
2400 W 49TH STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
206 - SANFORD SURGICAL ASSOCIATES
1508 W 22ND STREET	SIOUX FALLS	SD	57105	AMBULATORY SURGERY CENTER/CLINIC
207 - SANFORD USD 34TH & KIWANIS FAMILY MEDICI
2701 S KIWANIS AVE	SIOUX FALLS	SD	57105	MEDICAL CLINIC
208 - SANFORD VAN DEMARK CLINIC
1210 W 18TH STREET	SIOUX FALLS	SD	57104	MEDICAL CLINIC
209 - SANFORD VASCULAR ASSOCIATES
1305 W 18TH STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
210 - SANFORD WOMEN'S PRIMARY CARE CLINIC
5019 S WESTERN AVE	SIOUX FALLS	SD	57108	MEDICAL CLINIC
211 - THE BIRTH PLACE
1500 W 22ND STREET	SIOUX FALLS	SD	57105	BIRTH CENTER
212 - NORTHERN LIGHTS COMMUNITY RESIDENCE
921 ATLANTIC AVE N	THIEF RIVER FALLS	MN	56701	RESIDENTIAL BEHAVIORAL HEALTH
213 - SANFORD BEHAVIORAL HEALTH OUTPATIENT CLI
120 LABREE AVENUE S	THIEF RIVER FALLS	MN	56701	BEHAVIORAL HEALTH TREATMENT CENTER
214 - SANFORD DIALYSIS THIEF RIVER FALLS
120 LABREE AVENUE S	THIEF RIVER FALLS	MN	56701	DIALYSIS
215 - SANFORD HEALTH THIEF RIVER FALLS EYE CEN
1720 HIGHWAY 59 S	THIEF RIVER FALLS	MN	56701	EYE CARE CENTER
216 - SANFORD HEALTH THIEF RIVER FALLS SOUTHEA
1720 HIGHWAY 59 S	THIEF RIVER FALLS	MN	56701	MEDICAL CLINIC
217 - SANFORD THIEF RIVER FALLS CLINIC
3001 SANFORD PKWY	THIEF RIVER FALLS	MN	56701	MEDICAL CLINIC
218 - SANFORD HEALTH TRACY O'BRIEN COURT
410 STATE STREET	TRACY	MN	56175	HOUSING WITH SERVICES
219 - SANFORD TRACY CLINIC
249 FIFTH STREET E	TRACY	MN	56175	MEDICARE CERTIFIED RURAL HEALTH CLINIC
220 - SHETEK HOME CARE SERVICES
251 5TH ST E	TRACY	MN	56175	HOME HEALTH CARE
221 - SANFORD HEALTH TWIN VALLEY CLINIC
501 2ND ST NW	TWIN VALLEY	MN	56584	RURAL HEALTH CLINIC
222 - SANFORD HEALTH ULEN CLINIC
108 VIKING AVENUE W	ULEN	MN	56585	RURAL HEALTH CLINIC
223 - SANFORD HEALTH VALLEY CITY CLINIC
520 CHAUTAUQUA BLVD	VALLEY CITY	ND	58072	MEDICAL CLINIC
224 - SANFORD HEALTH VERMILLION CARE CENTER
125 WALKER STREET	VERMILLION	SD	57069	NURSING FACILITY
225 - SANFORD HEALTH VERMILLION DAKOTA GERDENS
126 S PLUM STREET	VERMILLION	SD	57069	RESIDENTIAL LIVING CENTER
226 - SANFORD HOSPICE VERMILLION
848 EAST CHERRY STREET	VERMILLION	SD	57069	HOSPICE
227 - SANFORD VERMILLION CLINIC
20 S PLUM STREET	VERMILLION	SD	56069	MEDICAL CLINIC
228 - SANFORD DIALYSIS
111 WASHINGTON AVE NW	WAGNER	SD	57380	DIALYSIS CENTER
229 - SANFORD HEALTH WAHPETON CLINIC
332 2ND AVE N	WAHPETON	ND	58075	MEDICAL CLINIC
230 - SANFORD HEALTH WAHPETON EYE CENTER & OPT
332 2ND AVE N	WAHPETON	ND	58075	EYE CARE CENTER
231 - SANFORD HEALTH WAHPETON PT & PSYCHOLOGY
123 2ND AVE N	WAHPETON	ND	58075	MEDICAL CLINIC
232 - SANFORD HEALTH WALKER CLINIC
614 MICHIGAN AVENUE	WALKER	MN	56484	RURAL HEALTH CLINIC
233 - SANFORD HEALTH WALKER REHAB
106 5TH ST S	WALKER	MN	56484	REHABILITATIVE SERVICES
234 - SANFORD TRACY WALNUT GROVE CLINIC
810 8TH ST	WALNUT GROVE	MN	56180	MEDICARE CERTIFIED RURAL HEALTH CLINIC
235 - SANFORD HEALTH WATERTOWN CLINIC
901 4TH STREET NW	WATERTOWN	SD	57201	MEDICAL CLINIC
236 - SANFORD HEALTH HEARING CENTER
116 8TH STREET NE	WATFORD CITY	ND	58854	HEARING CENTER
237 - SANFORD HEALTH WATFORD CITY CLINIC
709 4TH AVE NE	WATFORD CITY	ND	58854	MEDICAL CLINIC
238 - SANFORD WEBSTER CLINIC
101 PEABODY DRIVE	WEBSTER	SD	57274	RURAL HEALTH CLINIC
239 - SANFORD HEALTH WESTROOK PETERSON ESTATES
1012 9TH STREET	WESTBROOK	MN	56183	HOUSING WITH SERVICES
240 - SANFORD WESTBROOK CLINIC
920 BELL AVENUE	WESTBROOK	MN	56183	MEDICARE CERTIFIED RURAL HEALTH CLINIC
241 - SANFORD WEST FARGO CLINIC
1220 SHEYENNE STREET	WEST FARGO	ND	58078	MEDICAL CLINIC
242 - SANFORD HOME CARE WHEATON
405 12TH ST N	WHEATON	MN	56926	HOME HEALTH CARE
243 - SANFORD WHEATON CLINIC
401 12TH ST N	WHEATON	MN	56926	RURAL HEALTH CLINIC
244 - SANFORD CLINIC WINDOM
591 2ND AVENUE N	WINDOM	MN	56101	MEDICARE CERTIFIED RURAL HEALTH CLINIC
245 - SANFORD HOSPICE WINNER
745 E 8TH STREET	WINNER	SD	57580	HOSPICE
246 - SANFORD DIALYSIS
1018 SIXTH AVENUE	WORTHINGTON	MN	56187	DIALYSIS CENTER
247 - SANFORD HEALTH CANCER CENTER
1018 SIXTH AVENUE	WORTHINGTON	MN	56187	CANCER CENTER
248 - SANFORD HOSPICE WORTHINGTON
1935 WOODLAND CT	WORTHINGTON	MN	56187	HOSPICE (LICENSED IN SD)
249 - SANFORD WORTHINGTON CLINIC
1680 DIAGONAL ROAD	WORTHINGTON	MN	56187	MEDICAL CLINIC
250 - SANFORD WORTHINGTON MEDICAL CENTER
1018 SIXTH AVENUE	WORTHINGTON	MN	56187	MEDICARE CERTIFIED END STAGE RENAL DIALYSIS
251 - SANFORD WORTHINGTON OBGYN CLINIC
1018 SIXTH AVENUE	WORTHINGTON	MN	56187	MEDICAL CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	SANFORD HEALTH DOES NOT DENY CARE TO ANYONE BASED ON THE ABILITY TO PAY. SANFORD'S FINANCIAL ASSISTANCE (CHARITY CARE) POLICY PROVIDES DISCOUNTED AND FREE SERVICES TO PATIENTS WHO LACK THE RESOURCES TO BE FULLY RESPONSIBLE FOR THE HEALTHCARE THEY RECEIVE. THE FINANCIAL ASSISTANCE POLICY IS DESIGNED TO ENSURE THE ENTIRE COMMUNITY SERVED BY SANFORD HAS ACCESS TO NEEDED HEALTHCARE SERVICES. ELIGIBILITY FOR DISCOUNTED OR FREE SERVICES UNDER THE FINANCIAL ASSISTANCE POLICY IS BASED ON INCOME LEVELS AND FAMILY SIZE. GENERALLY, INDIVIDUALS EARNING INCOME OF UP TO 375% OF THE FEDERAL POVERTY INCOME GUIDELINES ARE ELIGIBLE FOR VARYING LEVELS OF DISCOUNTS, INCLUDING FULL DISCOUNTS FOR CERTAIN INCOME LEVELS. APPLICATIONS FOR COVERAGE UNDER THE PROGRAM MAY BE OBTAINED AT ANY SANFORD PATIENT REGISTRATION AREA.THE PRIMARY SCOPE OF SANFORD'S FINANCIAL ASSISTANCE MATRIX CONSIDERS FAMILY INCOME AND FAMILY SIZE TO OBJECTIVELY DETERMINE FINANCIAL NEED. THE FAMILY INCOME RANGE VARIES FROM 0-225% UP TO 375% OF THE FEDERAL POVERTY LEVEL (FPL). AN APPLICANT OVER 375% MAY BE ELIGIBLE FOR SOME LEVEL OF FINANCIAL ASSISTANCE BASED ON A REVIEW OF ADDITIONAL FACTORS SUCH AS: THE SIZE OF THE ACCOUNT BALANCE, DEBT-TO-INCOME RATIO, CURRENT ASSETS, CURRENT LIABILITIES, IRS FOOD EXPENSE ALLOWANCES, MONTHLY CASH FLOW, ETC.ADDITIONALLY, IT IS POSSIBLE FOR A FAMILY TO QUALIFY IN ONE SEGMENT (BASED ON INCOME AND FAMILY SIZE ALONE) BUT BE MOVED TO A MORE GENEROUS (FOR THE PATIENT) SEGMENT BASED ON THE OTHER FINANCIAL VARIABLES MENTIONED ABOVE. AN APPLICANT MAY BE DENIED IF THEY HAVE SUBSTANTIAL ASSETS AND APPLICANTS ARE CONSIDERED ON A CASE BY CASE BASIS.THE AMOUNT GENERALLY BILLED (AGB) DISCOUNT PERCENTAGE IS THE LEAST AMOUNT SANFORD CAN DISCOUNT FOR ANY PATIENT QUALIFYING UNDER THE SANFORD FINANCIAL ASSISTANCE POLICY. IT IS THE PERCENTAGE USED FOR THE LOWEST LEVEL OF ASSISTANCE GRANTED FOR THOSE QUALIFYING UNDER THE SANFORD FINANCIAL ASSISTANCE POLICY AS LISTED ON APPENDIX 1 - SLIDING DISCOUNT SCHEDULE FOR ASSISTANCE. ANYONE ELSE QUALIFYING FOR ASSISTANCE AT GREATER LEVELS WILL RECEIVE DISCOUNT AMOUNTS GREATER THAN THE SANFORD AGB DISCOUNT AMOUNT. PART I, LINE 5B: SANFORD AS A WHOLE DID NOT EXCEED ITS FINANCIAL ASSISTANCE BUDGET FOR CY 2022, HOWEVER, IF THEY WOULD HAVE EXCEEDED THEIR BUDGET IT WOULD NOT IMPACT THEIR ABILITY TO SERVE ANY PATIENTS AND NO PATIENTS WOULD BE DISALLOWED SERVICES. THE ORGANIZATION PROVIDED FREE OR DISCOUNTED SERVICES TO PATIENTS WHO WERE ELIGIBLE FOR FREE OR DISCOUNTED CARE.PART I, LINE 6: SANFORD HEALTH'S COMMUNITY BENEFIT ANNUAL REPORT IS POSTED ANNUALLY ON THE SANFORD WEBSITE AT:HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART I, LINE 7:	COST TO CHARGE RATIOS ARE USED TO CALCULATE THE AMOUNTS ON LINE 7A - 7C (FINANCIAL ASSISTANCE, MEDICAID SHORTFALL, AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) AND ALSO LINE 7G (SUBSIDIZED HEALTH SERVICES) FOR EACH OF THE SUBSIDIARIES INCLUDED IN THE RETURN. ALL OTHER AMOUNTS FOR LINES 7E, 7F, 7H AND 7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST TO CHARGE RATIO, OR SIMILAR COST ACCOUNTING METHODOLOGY. THESE COSTS STILL REPRESENT THE COSTS TO PROVIDE BENEFITS.
PART I, LINE 7G:	SUBSIDIZED HEALTH SERVICES ARE CLINICAL SERVICES PROVIDED TO BOTH INPATIENTS AND OUTPATIENTS DESPITE A FINANCIAL LOSS TO SANFORD. EACH LOSS HAS BEEN CALCULATED AFTER REMOVING LOSSES ASSOCIATED WITH BAD DEBTS, FINANCIAL ASSISTANCE AND MEDICAID. ALTHOUGH THESE SERVICES GENERATE OVERALL LOSSES TO SANFORD, THEY CONTINUE TO MEET THE NEEDS OF THE COMMUNITIES SERVED. VARIOUS SERVICES THAT GENERATE LOSSES ARE PROVIDED BY SANFORD THROUGH PHYSICIAN PRACTICES. FOR CY 2022, SUBSIDIZED HEALTH SERVICES PROVIDED THROUGH CLINIC PHYSICIAN PRACTICES GENERATED LOSSES OF $232,997,424.11.
PART II, COMMUNITY BUILDING ACTIVITIES:	SANFORD HEALTH IS A NOT-FOR-PROFIT ORGANIZATION DEDICATED TO THE WORK OF HEALTH AND HEALING FOR THE PUBLIC GOOD. SANFORD IS COMMITTED TO GIVING BACK TO THE COMMUNITIES IN WHICH ITS EMPLOYEES AND PATIENTS LIVE AND WORK. SANFORD INVESTS RESOURCES IN ORDER TO PRODUCE THE BEST OUTCOMES FOR PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY ENRICHMENT, AND PARTNERS WITH OTHERS TO ENSURE THAT THE COMMUNITY IS A WELCOMING, HEALTHY ENVIRONMENT AND ONE THAT ATTRACTS AND SUSTAINS A DIVERSE SANFORD WORKFORCE TO DELIVER THE BEST PATIENT CARE AND MUCH NEEDED MEDICAL RESEARCH. SANFORD CONSIDERS REQUESTS FOR FUNDING AND IN KIND SUPPORT FOR NEW AND ONGOING PROGRAMS WITH ALL AREAS SUPPORTING THE ABOVE GOALS, SUCH AS BASIC HUMAN SERVICES, EDUCATION AND WORKFORCE DEVELOPMENT BY RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO MEDICAL SHORTAGE OR UNDERSERVED AREAS AND COLLABORATING WITH EDUCATIONAL INSTITUTIONS TO TRAIN AND RECRUIT HEALTH PROFESSIONALS, ADVOCATING COMMUNITY HEALTH IMPROVEMENT THROUGH EFFORTS TO SUPPORT POLICIES AND PROGRAMS THAT SAFEGUARD OR IMPROVE PUBLIC HEALTH AND HELP TO ENSURE ACCESS TO HEALTH CARE SERVICES.
PART III, LINE 2:	BAD DEBT EXPENSE AT COST IS DETERMINED USING THE SAME COST TO CHARGE RATIOS THAT ARE USED TO CALCULATE FINANCIAL ASSISTANCE AND MEDICAID SHORTFALL. DISCOUNTS AND ALLOWANCES ARE ACCOUNTED FOR SEPARATELY FROM BAD DEBT EXPENSE.
PART III, LINE 3:	IT IS SANFORD'S POLICY TO MAKE FINANCIAL ASSISTANCE AVAILABLE TO PATIENTS WHO FIT THE FINANCIAL ASSISTANCE CRITERIA. IT IS THE ORGANIZATION'S GOAL TO MAKE CERTAIN THAT SANFORD IS PROACTIVE IN IDENTIFICATION OF THE PATIENTS WHO NEED HELP WITH FINANCIAL CONCERNS. FINANCIAL COUNSELORS MAKE EVERY EFFORT TO ENSURE THAT FINANCIAL ASSISTANCE ELIGIBLE PATIENTS DO NOT PROGRESS TO BAD DEBT. FOR THIS REASON, A DOLLAR AMOUNT FOR BAD DEBT IS NOT INCLUDED.
PART III, LINE 4:	THE AUDITED FINANCIAL STATEMENTS (AFS) OF SANFORD INCLUDE A BAD DEBT FOOTNOTE. SEE FOOTNOTE 3 ON PAGES 17 - 19 OF THE AFS. SANFORD REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP).
PART III, LINE 8:	PER IRS INSTRUCTIONS, SANFORD HAS IDENTIFIED THE COST ASSOCIATED WITH PROVIDING MEDICARE SERVICES FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT CALCULATIONS ARE TOTAL EXPENSE LESS EXPENSES DEEMED "UNALLOWABLE" PER MEDICARE REGULATIONS. THE NET EXPENSE IS THEN USED TO CALCULATE THE COST PER DAY AND COST TO CHARGE RATIOS WHICH ARE MULTIPLIED BY THE MEDICARE DAYS AND ANCILLARY CHARGES TO DETERMINE THE COST OF PROVIDING MEDICARE SERVICES. IF ALL EXPENSES THAT SANFORD INCURRED WERE INCLUDED ON THE MEDICARE COST REPORT; THIS WOULD SHOW A SHORTFALL OF APPROXIMATELY $585,268,604. SANFORD BELIEVES THIS SHORTFALL SHOULD BE CONSIDERED COMMUNITY BENEFIT BECAUSE THESE SERVICES WOULD NEED TO BE PROVIDED BY EITHER ANOTHER CHARITABLE ORGANIZATION OR THE GOVERNMENT IF IT WAS NOT PROVIDED BY SANFORD.
PART III, LINE 9B:	SANFORD WILL PROVIDE SERVICES AT NO COST OR REDUCED COST TO PATIENTS WHO QUALIFY FOR THE PROGRAM. PATIENTS WITH INCOMES AT OR BELOW 225% OF THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES POVERTY GUIDELINE WILL RECEIVE A 100% REDUCTION OF THEIR PAYMENT RESPONSIBILITY. PATIENTS WITH INCOME BETWEEN 225% - 375% OF THE POVERTY GUIDELINE WILL BE GIVEN A DISCOUNT BASED ON A SLIDING SCALE AND ASSETS ARE CONSIDERED IN THE CALCULATION OF THE INCOME OF THE PATIENT, WITH THE EXCEPTION OF THE PATIENT'S PRINCIPAL RESIDENCE. PATIENTS ABOVE 375% OF THE FPG WILL BE REVIEWED FOR ADDITIONAL FACTORS SUCH AS SIZE OF MEDICAL DEBT BEFORE A FINAL DETERMINATION. PATIENTS MUST MAKE THEIR FINANCIAL NEED KNOWN TO APPROPRIATE PERSONNEL AND BE ENGAGED IN FILING APPROPRIATE AND COMPLETE APPLICATIONS. THE PROGRAM IS AVAILABLE TO THOSE PATIENTS WITHOUT HEALTH CARE BENEFITS FROM ANY SOURCE AS WELL AS TO THOSE WHO HAVE COVERAGE FOR HEALTH CARE COSTS THROUGH A GOVERNMENT PROGRAM, COMMERCIAL INSURANCE, OR OTHER HEALTH BENEFIT PLAN BUT CONTINUE TO HAVE A REMAINING BALANCE AFTER BENEFITS HAVE BEEN APPLIED TO THE CHARGES. SANFORD WILL NOT DENY FINANCIAL ASSISTANCE BASED ON RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP OR AGE.EVERY EFFORT IS MADE TO IDENTIFY PATIENTS WITH FINANCIAL NEED AS EARLY AS POSSIBLE IN THE REVENUE CYCLE.SANFORD HAS ZERO TOLERANCE FOR ABUSIVE, HARASSING, OPPRESSIVE, FALSE, DECEPTIVE, OR MISLEADING LANGUAGE OF COLLECTIONS CONDUCT. THIS ZERO TOLERANCE APPLIES TO INTERNAL SANFORD STAFF AND THIRD PARTY COLLECTION VENDORS AND ATTORNEYS.NEITHER SANFORD NOR ANY OF ITS THIRD PARTY COLLECTION VENDORS WILL TAKE ANY EXTRAORDINARY COLLECTION EFFORTS UNTIL SANFORD AND THE THIRD PARTY COLLECTION VENDOR HAVE MADE REASONABLE EFFORTS TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY.
PART VI, LINE 2:	SANFORD HEALTH REGULARLY UTILIZES A BROAD ARRAY OF RESOURCES AND PARTNERS TO ASSESS AND DELIVER CARE TO THE COMMUNITIES SERVED BY THE SYSTEM. ASSESSMENT AND, BY EXTENSION, COMMUNITY ENGAGEMENT, IS A COMPOSITE, PARTNER-DRIVEN APPROACH.WITHIN THE CONTEXT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS, THE SYSTEM RELIES UPON A MULTI-STEP, MULTI-MODAL APPROACH THAT MINIMIZES THE INHERENT LIMITATIONS OF ANY GIVEN ASSESSMENT TOOL AND INCREASES THE POINTS OF CONTACT FOR COMMUNITY MEMBERS TO SHARE DIRECT INSIGHTS INTO THE PROCESS. STEP ONE OF THE CHNA IS ENGAGEMENT WITH OTHER HEALTH SYSTEMS IN THE COMMUNITIES IN WHICH SANFORD AND ANOTHER HEALTH SYSTEM BOTH OPERATE. ADDITIONALLY, SANFORD ENGAGES PUBLIC HEALTH ORGANIZATIONS AND OTHER CARE PROVIDERS IN THE DEVELOPMENT OF ASSESSMENT STRATEGIES AND TOOLS. THE COOPERATION BETWEEN THE ORGANIZATIONS ENSURES INFORMATION IS COLLECTED THAT WILL BENEFIT NOT ONLY THE CHNA PROGRAM, BUT ALSO THE STRATEGIES AND OPERATIONS OF THE RESPECTIVE ORGANIZATIONS. THE SYSTEMS ALSO COLLABORATE IN THE DEVELOPMENT OF THEIR RESPECTIVE IMPLEMENTATION PLANS TO FURTHER THE POSITIVE IMPACT TO THE COMMUNITY. AS NOTED ABOVE, THE CHNA ASSESSMENT INCLUDES A MULTI-MODAL PROCESS, WHICH BEGINS WITH A SURVEY TO COMMUNITY MEMBERS SENT VIA MULTIPLE PATHWAYS, WHICH INCLUDE THE PURCHASE OF A LOCAL SURVEY PANEL AND THE DEVELOPMENT OF A COMMUNITY STAKEHOLDER LIST. STAKEHOLDERS ARE ASKED TO COMPLETE THE SURVEY AND THEN FORWARD THE TOOL TO THEIR CONTACTS TO AMPLIFY THE COLLECTION OPPORTUNITIES. AN INDEPENDENT THIRD PARTY WITH SURVEY ANALYSIS EXPERTISE IS RETAINED TO EVALUATE THE RESULTS AND DEVELOP AN INITIAL LIST OF NEEDS WITH ADDITIONAL AUGMENTATION FROM COUNTYHEALTHRANKINGS.COM, CENSUS DATA, AND OTHER SECONDARY DATA SOURCES. LOCAL STAKEHOLDER MEETINGS THAT INCLUDE HEALTH CARE LEADERS, ELECTED OFFICIALS, REPRESENTATIVES OF UNDERSERVED COMMUNITIES, NONPROFIT LEADERS, AND OTHER COMMUNITY PARTNERS THEN REVIEW THE FINDINGS, PROVIDE INPUT, AND DEVELOP THE FINAL PRIORITIES FOR INCLUSION IN THE IMPLEMENTATION PLAN.DATA GATHERED FROM THE CHNA PROGRAM, PARTICULARLY SURVEY RESPONSES, IS MADE AVAILABLE TO LOCAL COMMUNITY ORGANIZATIONS THAT REQUEST THE INFORMATION. SANFORD VIEWS THE FINDINGS AS A COMMUNITY ASSET THAT CAN FURTHER THE POSITIVE IMPACT ON COMMUNITY HEALTH OUTSIDE THE WALLS OF THE SYSTEM.RECENTLY, SANFORD HAS ADDED MORE RESOURCES TO ADVANCE COMMUNITY HEALTH. FINDHELP IS AN ONLINE PLATFORM THAT CONNECTS LOCAL ORGANIZATIONS, FUNDING OPPORTUNITIES, AND OTHER RESOURCES CONNECTED TO SOCIAL DETERMINANTS OF HEALTH WITH INDIVIDUALS IN NEED. SANFORD INTEGRATED THE FINDHELP PLATFORM INTO THE ORGANIZATION'S WEBSITE, ELECTRONIC MEDICAL RECORD, AND POST-VISIT PAPERS. THE INTEGRATION NOT ONLY ALLOWS USERS TO SELF-SEARCH FOR LOCAL RESOURCES BASED UPON THEIR NEED, BUT ALSO ALLOWS SANFORD'S CARE MANAGEMENT TEAM TO DIRECTLY REFER PATIENTS TO LOCAL ORGANIZATIONS AND MONITOR ENGAGEMENT. FINDHELP IS PUBLIC TO ANY RESIDENT AND IS NOT RESERVED SPECIFICALLY FOR PATIENTS OF THE SYSTEM. THE SERVICES OFFERED ON THE NEW WEBSITE ARE EITHER FREE OR REDUCED COST AND COVER OPTIONS THAT MIGHT NOT BE INCLUDED WITH MEDICARE OR MEDICAID. THIS PARTNERSHIP ALLOWS SANFORD TO ADDRESS INEQUITY IN THE COMMUNITIES WE SERVE WITH EXISTING SERVICES THAT MEET THE NEEDS OF PATIENTS.ADDITIONAL EXTERNAL SOURCES ARE REGULARLY ENGAGED WITHIN THE STRATEGIC PLANNING, OPERATIONAL, AND CHNA PROCESS. THE ADVISORY BOARD IS REPRESENTATIVE OF THESE ASSESSMENT CAPABILITIES. THE ADVISORY BOARD (AB) OFFERS A WEALTH OF SECONDARY INFORMATION, SUCH AS INDUSTRY TRENDS, CONSUMER ASSESSMENTS, AND OTHER INFORMATION. AB ALSO INCLUDES DATA TOOLS, INCLUDING THE MARKET INNOVATION CENTER AND THE POST-ACUTE PATHWAYS EXPLORER THAT PROVIDES LINE OF SIGHT INTO DEMOGRAPHIC DATA, VOLUME PROJECTIONS, CARE COORDINATION PATTERNS, AND CARE DRIVERS BEYOND THE INTERNAL DATA SOURCES WITHIN SANFORD. OTHER ENGAGEMENTS AND ASSESSMENTS INCLUDE LEADERSHIP AND MEMBERSHIP IN STATE HEALTHCARE ASSOCIATIONS AND VIZIENT. THE DEVELOPMENT OF PATIENT FAMILY ADVISORY AND DIVERSITY, EQUITY AND INCLUSION COUNCILS WITHIN SYSTEM FACILITIES PROMOTES TWO-WAY COMMUNICATION WITH THE COMMUNITIES SERVED. THESE TOOLS ARE INCORPORATED THROUGHOUT THE PLANNING PROCESS AND ARE EMBEDDED WITHIN OPERATIONS. TO ENSURE CARE PROVIDED ENCOMPASSES THE WHOLE PERSON, SANFORD HEALTH EMPLOYS COMMUNITY HEALTH WORKERS (CHWS), FIRST ESTABLISHING THE ROLE IN 2014. THESE NON-CLINICAL STAFF PROVIDE FRONTLINE PUBLIC HEALTH SERVICES AND SERVE AS A LIAISON BETWEEN HEALTH CARE AND THE COMMUNITY TO FACILITATE ACCESS TO RESOURCES. THESE CARE TEAM MEMBERS PROVIDE A RANGE OF SERVICES AND ACTIVITIES FOR AT-RISK POPULATIONS INCLUDING OUTREACH, COMMUNITY EDUCATION, INFORMAL COUNSELING, SOCIAL SUPPORT, AND ADVOCACY.ANOTHER IMPORTANT SUPPORT/LIAISON ROLE IS THAT OF HEALTH GUIDES. THESE INDIVIDUALS IDENTIFY GAPS IN CARE PREVENTING RISING-RISK PATIENTS FROM ACHIEVING THEIR HEALTH GOALS. GUIDES ADDRESS BARRIERS PATIENTS ARE FACING IN ACCESSING THE RESOURCES THEY NEED TO BE SUCCESSFUL. HEALTH GUIDES HELP PATIENTS NAVIGATE THE HEALTH SYSTEM AND VARIOUS COMMUNITY RESOURCES, EMPOWERING PATIENTS TO TAKE MORE OWNERSHIP OF THEIR HEALTH AND BE AN ACTIVE PARTICIPANT IN THEIR CARE.MANY SANFORD HEALTH CLINIC FACILITIES OFFER A BROAD RANGE OF ROBUST, INTEGRATED CARE OPTIONS. FROM DIETICIANS TO PHARMACISTS TO SOCIAL WORKERS, AMBULATORY RN CARE MANAGERS AND INTEGRATED HEALTH THERAPISTS (IHTS), PATIENTS SEEN FOR PRIMARY CARE HAVE CLOSE PROXIMITY TO OTHER ANCILLARY SUPPORT SERVICES AND CARE OPTIONS. PATIENTS STRUGGLING WITH MENTAL HEALTH OR SUBSTANCE DEPENDENCY ISSUES, FOR EXAMPLE, CAN OFTEN IMMEDIATELY SEE A SUPPORT PROFESSIONAL ON-SITE VERSUS HAVING TO WAIT TO SEE A SPECIALIST VIA A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. SANFORD ALSO SCREENS FOR SOCIAL DETERMINANTS OF HEALTH AND HAVE "WELLNESS PANTRIES" EMBEDDED IN OUR PEDIATRIC CLINICS ACROSS MINNESOTA, NORTH DAKOTA AND SOUTH DAKOTA. WE ARE CURRENTLY COLLECTING DATA TO BETTER UNDERSTAND HOW ADDRESSING FOOD INSECURITY HELPS REDUCE ANXIETY AND DEPRESSION IN CHILDREN. THE TIMELINESS OF THESE KEY SERVICES HELPS TO ENSURE THAT PATIENT NEEDS ARE NOT FALLING THROUGH THE CRACKS OR THAT CARE IS DELAYED.
PART VI, LINE 3:	SANFORD EMPLOYS A VARIETY OF STRATEGIES TO MAKE CERTAIN THAT THE ORGANIZATION IS TRANSPARENT IN THE COMMUNICATION OF FINANCIAL ASSISTANCE GUIDELINES. THE STAFF AT SANFORD MAKES EVERY EFFORT TO IDENTIFY PATIENTS NEEDING FINANCIAL ASSISTANCE AS EARLY IN THE REVENUE CYCLE AS POSSIBLE. ALL SANFORD ENTITIES DISPLAY SIGNAGE IN REGISTRATION AREAS ADVISING PATIENTS OF THEIR ABILITY TO REQUEST FINANCIAL ASSISTANCE. THE SIGNAGE WAS MADE AVAILABLE IN ENGLISH AND SPANISH. ALTERNATE LANGUAGES WERE INCLUDED ON THE SIGNAGE THAT BASICALLY STATED, IF YOU NEED INTERPRETER SERVICES, PLEASE INQUIRE AT THE REGISTRATION DESK. FINANCIAL ASSISTANCE APPLICATIONS WERE AVAILABLE IN ENGLISH, SPANISH, CHINESE, GERMAN, HINDI, KOREAN, LAOTIAN AND VIETNAMESE UPON REQUEST OR ON THE SANFORD WEBSITE. ALL HEALTHCARE WORKERS WHO IDENTIFY PATIENTS WITH FINANCIAL NEED ARE ENCOURAGED TO PROVIDE PATIENTS OR THEIR DESIGNEES A FINANCIAL APPLICATION. THIS MAY INCLUDE, BUT NOT BE LIMITED TO THE FOLLOWING AREAS: ADMINISTRATION, ADMISSIONS, PATIENT FINANCIAL SERVICES, FINANCIAL COUNSELORS, SOCIAL SERVICES, PHYSICIANS, NURSING, CLINIC DIRECTOR, RECEPTION STAFF AND HUMAN RESOURCES.FINANCIAL COUNSELORS ARE TRAINED TO WORK INDIVIDUALLY WITH PATIENTS TO DETERMINE THE FINANCIAL NEED AND RECOMMEND APPROPRIATE ASSISTANCE IN APPLICATION FOR CHARITY CARE, GOVERNMENT PROGRAMS OR DISCOUNTED SERVICES.SANFORD'S FINANCIAL ASSISTANCE PROGRAM IS AVAILABLE TO ANYONE WHO QUALIFIES FOR ASSISTANCE. THIS PROGRAM ENSURES THAT ALL PEOPLE RECEIVE THE CARE THEY NEED, REGARDLESS OF THEIR FINANCIAL SITUATION. SANFORD MAKES FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO COMMUNITY AGENCIES AND REFERRAL ORGANIZATIONS. FINANCIAL ASSISTANCE INFORMATION IS ALSO AVAILABLE ON THE SANFORD WEBSITE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
PART VI, LINE 4:	SANFORD HEALTH IS AN INTEGRATED HEALTH SYSTEM HEADQUARTERED IN THE DAKOTAS. IT IS ONE OF THE LARGEST RURAL HEALTH SYSTEMS IN THE NATION WITH 46 MEDICAL CENTERS AND 222 CLINIC LOCATIONS IN NINE STATES AND THREE COUNTRIES. SANFORD HEALTH'S APPROXIMATELY 44,000 EMPLOYEES, INCLUDING 2,827 PHYSICIANS AND 7,944 REGISTERED NURSES DELIVERING CARE IN MORE THAN 80 SPECIALTY AREAS, MAKE IT THE LARGEST EMPLOYER IN THE DAKOTAS. SANFORD USD MEDICAL CENTER - SIOUX FALLS, SOUTH DAKOTASIOUX FALLS IS THE LARGEST CITY IN THE STATE OF SOUTH DAKOTA AND IS THE COUNTY SEAT OF MINNEHAHA COUNTY. SIOUX FALLS ALSO EXTENDS INTO LINCOLN COUNTY. THE 2022 U.S. CENSUS BUREAU ESTIMATES A TOTAL POPULATION OF 203,971 FOR SIOUX FALLS. ACCORDING TO THE 2022 COUNTY HEALTH RANKINGS, THE POPULATION OF MINNEHAHA COUNTY IS 81.1% WHITE, 6.4% AFRICAN AMERICAN, 2.9% AMERICAN INDIAN, 2.2% ASIAN AND 5.4% HISPANIC. SIOUX FALLS IS A SIGNIFICANT REGIONAL HEALTH CARE CENTER. ONLY 2% OF THE POPULATION IS REPORTED TO BE NOT PROFICIENT IN ENGLISH. THE MEDIAN HOUSEHOLD INCOME IN SIOUX FALLS IS $66,502.SANFORD MEDICAL CENTER FARGO - FARGO, NORTH DAKOTAFARGO IS THE LARGEST CITY IN NORTH DAKOTA, ACCOUNTING FOR 17% OF THE STATE'S POPULATION. FARGO IS ALSO THE COUNTY SEAT OF CASS COUNTY. THE 2022 UNITED STATES CENSUS ESTIMATES THE POPULATION OF FARGO WAS 131,444. ACCORDING TO THE 2022 COUNTY HEALTH RANKINGS, THE POPULATION OF CASS COUNTY IS 84.1% WHITE, 6.3% AFRICAN AMERICAN, 1.5% AMERICAN INDIAN, 3.3% ASIAN AND 2.9% HISPANIC. ONLY 1% OF THE POPULATION IS REPORTED TO BE NOT PROFICIENT IN ENGLISH. THE MEDIAN HOUSEHOLD INCOME IS $68,718. SANFORD BEMIDJI MEDICAL CENTER - BEMIDJI, MINNESOTABEMIDJI IS LOCATED IN BELTRAMI COUNTY, MINNESOTA. BEMIDJI HOUSES MANY NATIVE AMERICAN SERVICES, INCLUDING THE INDIAN HEALTH SERVICE. THE CITY IS THE CENTRAL HUB OF THE RED LAKE INDIAN RESERVATION, WHITE EARTH INDIAN RESERVATION, AND THE LEECH LAKE INDIAN RESERVATION. ACCORDING TO THE 2022 UNITED STATES CENSUS ESTIMATES, THE POPULATION OF BEMIDJI IS 15,424. ACCORDING TO THE 2022 COUNTY HEALTH RANKINGS, THE POPULATION OF BELTRAMI COUNTY IS 71.9% WHITE, 0.7% AFRICAN AMERICAN, 22% AMERICAN INDIAN, 0.8% ASIAN AND 2.5% HISPANIC. 0% OF THE POPULATION IS REPORTED TO BE NOT PROFICIENT IN ENGLISH. THE MEDIAN HOUSEHOLD INCOME IS $55,910.SANFORD BISMARCK MEDICAL CENTER - BISMARCK, NORTH DAKOTABISMARCK IS A CITY LOCATED IN BURLEIGH COUNTY IN CENTRAL NORTH DAKOTA. BISMARCK IS EXPERIENCING FAST-PACED GROWTH AS A DIRECT RESULT OF OIL DEVELOPMENT THROUGHOUT THE WESTERN PART OF THE STATE. BISMARCK IS THE STATE CAPITAL AND IS THE SECOND LARGEST CITY IN THE STATE OF NORTH DAKOTA WITH AN ESTIMATED POPULATION OF 74,445. ACCORDING TO THE 2022 COUNTY HEALTH RANKINGS, THE POPULATION OF BURLEIGH COUNTY IS 88.2% WHITE, 2.2 AFRICAN AMERICAN, 4.5% AMERICAN INDIAN, 0.9% ASIAN AND 2.7% HISPANIC. 0% OF THE POPULATION IS REPORTED TO BE NOT PROFICIENT IN ENGLISH. THE MEDIAN HOUSEHOLD INCOME IS $76,043.SANFORD NETWORK HOSPITALSSANFORD HEALTH NETWORK HOSPITALS IS A NETWORK OF RURAL HOSPITALS LOCATED THROUGHOUT SOUTH DAKOTA, NORTH DAKOTA, AND MINNESOTA.SANFORD CLINICSSANFORD CLINIC IS A MULTI-SPECIALTY CLINIC COMPRISED OF APPROXIMATELY 2,827 PHYSICIANS PROVIDING SERVICES IN THE US AS WELL AS INTERNATIONALLY.
PART VI, LINE 5:	SANFORD MAINTAINS AN OPEN MEDICAL STAFF. COMMUNITY BOARDS - THE SANFORD BOARD OF TRUSTEES WAS COMPRISED OF 13 MEMBERS AT THE END OF THE CALENDAR YEAR, INCLUDING 9 COMMUNITY MEMBERS, 3 PHYSICIANS AND THE CEO. SURPLUS FUNDS - SURPLUS FUNDS ARE INVESTED BACK INTO THE COMMUNITY, AS WELL AS TO RESOURCE DEVELOPMENT AND FACILITY DEVELOPMENT TO BETTER SERVE PATIENTS AND COMMUNITIES.
PART VI, LINE 6:	SANFORD HEALTH IS AN INTEGRATED HEALTH SYSTEM HEADQUARTERED IN THE DAKOTAS. IT IS ONE OF THE LARGEST RURAL HEALTH SYSTEMS IN THE NATION WITH 46 MEDICAL CENTERS AND 222 CLINIC LOCATIONS IN NINE STATES AND THREE COUNTRIES. SANFORD HEALTH'S APPROXIMATELY 44,000 EMPLOYEES, INCLUDING 2,827 PHYSICIANS AND 7,944 REGISTERED NURSES DELIVERING CARE IN MORE THAN 80 SPECIALTY AREAS, MAKE IT THE LARGEST EMPLOYER IN THE DAKOTAS.SANFORD HEALTH PROVIDES SERVICES AT EVERY LEVEL FROM CRITICAL ACCESS HOSPITALS TO TERTIARY AND QUATERNARY CARE. THE SANFORD FOOTPRINT INCLUDES OVER 220,000 SQUARE MILES WITH A NINE STATE SERVICE AREA AND A NETWORK OF CHILDREN'S PRIMARY CARE CLINIC LOCATIONS ACROSS THE COUNTRY AND WORLD. SANFORD HEALTH OPERATES FULL-TIME EMERGENCY CENTERS AND PROVIDES EMERGENCY CARE TO EVERYONE REGARDLESS OF THEIR ABILITY TO PAY. SANFORD FACILITIES AND CLINICS PROVIDE SERVICES TO REMOTE AND MEDICALLY UNDERSERVED AREAS THAT WOULD OTHERWISE NOT HAVE ACCESS TO EVEN PRIMARY CARE SERVICES. SANFORD HEALTH FINANCIALLY SUPPORTS HEALTH AND WELLNESS, EDUCATION AND COMMUNITY DEVELOPMENT ACTIVITIES TO IMPROVE THE QUALITY OF LIFE AND STRENGHTEN COMMUNITIES THROUGHOUT THE REGION. EACH FACILITY PROMOTES HEALTH AND HEALING THAT RESPONDS TO THE UNIQUE NEEDS OF THE PATIENTS IN THE COMMUNITY, ENSURING ACCESS TO COMPREHENSIVE AND SPECIALIZED SERVICES. PART VI, LINE 7: COMMUNITY BENEFIT REPORTING IS NOT REQUIRED AND THEREFORE NOT FILED IN NORTH DAKOTA, SOUTH DAKOTA, OR NEBRASKA. FILING IN MINNESOTA IS VOLUNTARY.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (190 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
ABERDEEN AREA CHAMBER OF COMM
PO BOX 1179	ABERDEEN	SD	574021179	460103710	501(C)(6)	$7,750	$0	ECONOMIC DEVELOPMENT
ABERDEEN DEVELOPMENT CORP
416 PRODUCTION ST N	ABERDEEN	SD	57401	466011831	501(C)(6)	$10,000	$0	ECONOMIC DEVELOPMENT,COMMUNITY HEALTH IMPROVEMENT
ABERDEEN FAMILY YMCA
5 S STATE ST	ABERDEEN	SD	57401	460255779	501(C)(3)	$25,000	$0	COMMUNITY HEALTH IMPROVEMENT
ABERDEEN PUBLIC SCHOOLS FOUNDA
1224 S 3RD ST	ABERDEEN	SD	57401	460423109	501(C)(3)	$40,000	$0	PROGRAM SUPPORT
ALZHEIMERS ASSOC
225 N MICHIGAN AVE FLOOR 17	CHICAGO	IL	60601	133039601	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT
AMER CANCER ACTION SOC NETWORK
555 11TH ST NW	WASHINGTON	DC	20004	522340031	501(C)(4)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT
AMERICAN CANCER SOCIETY
250 WILLIAMS ST 4TH FL	ATLANTA	GA	30303	131788491	501(C)(3)	$514,000	$0	RESEARCH
AMERICAN GOLD GYMNASTICS INC
2001 17TH AVE S	FARGO	ND	58103	450333196	501(C)(3)	$40,000	$0	PROGRAM SUPPORT
AMERICAN HEART ASSOCIATION INC
7272 GREENVILLE AVENUE	DALLAS	TX	75231	135613797	501(C)(3)	$34,500	$0	COMMUNITY HEALTH IMPROVEMENT
ARTS PARTNERSHIP
1104 2ND AVE S STE 315	FARGO	ND	58104	237108936	501(C)(3)	$15,000	$0	PROGRAM SUPPORT
AUGUSTANA UNIVERSITY
2001 S SUMMIT AVE	SIOUX FALLS	SD	57197	460224588	501(C)(3)	$5,058,150	$0	PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
BECKER COUNTY HISTORICAL SOC
714 SUMMIT AVE	DETROIT LAKES	MN	56501	410873609	501(C)(3)	$6,000	$0	ECONOMIC DEVELOPMENT
BEEF LOGIC INC
316 S COTEAU AVE	PIERRE	SD	57501	872043795	501(C)(3)	$75,000	$0	ECONOMIC DEVELOPMENT
BEMIDJI AREA SCHOOLS
502 MINNESOTA AVE	BEMIDJI	MN	56619	416000181	115	$98,000	$0	EDUCATION/WORKFORCE DEVELOPMENT
BEMIDJI BLUE OX MARATHON
PO BOX 633	BEMIDJI	MN	56619	461700357	501(C)(3)	$15,000	$0	ECONOMIC DEVELOPMENT
BEMIDJI COMMUNITY ARENA CORP
PO BOX 1726	BEMIDJI	MN	566191726	813622011	501(C)(3)	$69,060	$0	ECONOMIC DEVELOPMENT
BEMIDJI STATE UNIVERSITY
1500 BIRCHMONT DR NE	BEMIDJI	MN	56601	411687554	115	$112,200	$0	PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
BEMIDJI SYMPHONY ORCHESTRA
PO BOX 3136	BEMIDJI	MN	56619	392017074	501(C)(3)	$14,500	$0	PROGRAM SUPPORT
BEMIDJI YOUTH SOCCER
PO BOX 265	BEMIDJI	MN	56619	411870778	501(C)(3)	$6,500	$0	PROGRAM SUPPORT
BIO GIRLS INC
4151 38TH ST STE A	FARGO	ND	58104	810792142	501(C)(3)	$17,000	$0	COMMUNITY HEALTH IMPROVEMENT
BISHOP DUDLEY HOSPITALITY HOUS
101 N INDIANA AVE	SIOUX FALLS	SD	57103	911836526	501(C)(3)	$16,000	$0	COMMUNITY HEALTH IMPROVEMENT
BISMARCK CANCER CENTER FDTN
500 N 8TH ST	BISMARCK	ND	58501	260466647	501(C)(3)	$11,464	$0	COMMUNITY HEALTH IMPROVEMENT
BISMARCK MANDAN CHAMBER EDC
1640 BURNT BOAT DR	BISMARCK	ND	58503	450116753	501(C)(6)	$17,725	$0	ECONOMIC DEVELOPMENT
BISMARCK MANDAN CHAMBER FOUNDATION
1640 BURNT BOAT DR	BISMARCK	ND	58503	263807225	501(C)(3)	$25,000	$0	ECONOMIC DEVELOPMENT
BISMARCK PUBLIC SCHOOL DISTRICT #1
806 N WASHINGTON ST	BISMARCK	ND	58501	456000242	115	$67,004	$2,747	EDUCATION/WORKFORCE DEVELOPMENT,PROGRAM SUPPORT	FMV	T-SHIRTS
BISMARCK PUBLIC SCHOOLS FDTN
806 N WASHINGTON ST	BISMARCK	ND	58501	450442960	501(C)(3)	$70,000	$0	EDUCATION/WORKFORCE DEVELOPMENT,PROGRAM SUPPORT
BISMARCK STATE COLLEGE FOUND
PO BOX 5587	BISMARCK	ND	585065587	450358929	501(C)(3)	$104,842	$0	EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
BOY SCOUTS VOYAGEURS COUNCIL
3877 STEBNER ROAD	HERMANTOWN	MN	55811	410695583	501(C)(3)	$10,000	$0	EDUCATION/WORKFORCE DEVELOPMENT
BOYS & GIRLS CLUB ABERDEEN
1121 1ST AVE SE	ABERDEEN	SD	57401	237062273	501(C)(3)	$6,500	$0	COMMUNITY HEALTH IMPROVEMENT
BOYS & GIRLS CLUB BEMIDJI AREA
1600 MINNESOTA AVE NW	BEMIDJI	MN	56601	810599601	501(C)(3)	$11,540	$0	COMMUNITY HEALTH IMPROVEMENT
BOYS & GIRLS CLUBS OF THE RED RIVER VALLEY
2500 18TH ST S	FARGO	ND	58103	450316132	501(C)(3)	$20,000	$0	COMMUNITY HEALTH IMPROVEMENT
BRANDON VALLEY BOOSTER CLUB
PO BOX 572	BRANDON	SD	57005	460393971	501(C)(3)	$95,300	$0	PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
BRANDON VALLEY SCHOOL DISTRICT 49-2
300 S SPLITROCK BLVD	BRANDON	SD	57005	466002577	115	$10,000	$0	PROGRAM SUPPORT
BUTTERFLY HOUSE & AQUARIUM
4320 S OXBOW AVE	SIOUX FALLS	SD	57106	522370420	501(C)(3)	$16,000	$0	ECONOMIC DEVELOPMENT
CALL TO FREEDOM INC
1915 E 8TH ST STE 100	SIOUX FALLS	SD	57103	475469817	501(C)(3)	$22,500	$0	COMMUNITY HEALTH IMPROVEMENT
CANTON SCHOOLS
800 N MAIN ST	CANTON	SD	57013	466002143	115	$18,764	$0	PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT
CHAD GREENWAYS LEAD WAY FDTN
59 CAVALIER BLVD STE 310	FLORENCE	KY	41042	261782419	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT
CHAMBER OF COMMERCE FMWF
PO BOX 2443	FARGO	ND	581082443	450448041	501(C)(6)	$15,920	$0	ECONOMIC DEVELOPMENT
CHARIS MINISTRY PARTNERS
1300 E 10TH ST	SIOUX FALLS	SD	57103	383775128	501(C)(3)	$7,000	$0	COMMUNITY HEALTH IMPROVEMENT
CHRISTIAN YOUTH ACTIVITY LEAGUE
47644 273RD ST	HARRISBURG	SD	57032	464964311	501(C)(3)	$5,427	$0	PROGRAM SUPPORT
CITY OF WEBSTER
PO BOX 539	WEBSTER	SD	57274	466000530	115	$7,143	$0	COMMUNITY HEALTH IMPROVEMENT
CITY OF YANKTON
PO BOX 176	YANKTON	SD	57078	466000567	115	$10,000	$0	ECONOMIC DEVELOPMENT
COMMUNITY MEMORIAL HOSPITAL
814 JACKSON ST	BURKE	SD	57523	460219795	501(C)(3)	$25,000	$0	COMMUNITY HEALTH IMPROVEMENT
CONCORDIA COLLEGE
901 8TH STREET S	MOORHEAD	MN	565609981	410693977	501(C)(3)	$3,306,500	$369,883	EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT	APPRAISAL	LAND
CREIGHTON UNIVERSITY
2500 CALIFORNIA PLAZA	OMAHA	NE	68178	470376583	501(C)(3)	$250,000	$0	SCHOLARSHIP ENDOWMENT
CRIBS FOR KIDS INC
5450 SECOND AVE	PITTSBURGH	PA	15207	251442806	501(C)(3)	$5,036	$0	PROGRAM SUPPORT
DAKOTA ALLIANCE SOCCER CLUB
401 W 39TH ST	SIOUX FALLS	SD	57105	460359817	501(C)(3)	$74,250	$0	PROGRAM SUPPORT
DAKOTA MEDICAL FOUNDATION
4141 28TH AVE SOUTH	FARGO	ND	58104	456012318	501(C)(3)	$12,050	$0	COMMUNITY HEALTH IMPROVEMENT
DAKOTA STATE UNIVERSITY
820 N WASHINGTON AVE	MADISON	SD	57042	466000364	115	$617,500	$0	EDUCATION/WORKFORCE DEVELOPMENT,PROGRAM SUPPORT
DEADWOOD CHAMBER OF COMMERCE
501 MAIN ST	DEADWOOD	SD	57732	460118544	501(C)(6)	$20,000	$0	ECONOMIC DEVELOPMENT
DOWNTOWN COMMUNITY PARTNERSHIP
210 BROADWAY STE 202	FARGO	ND	58102	464472309	501(C)(6)	$5,500	$0	ECONOMIC DEVELOPMENT
DOWNTOWN SIOUX FALLS INC
230 S PHILIPS AVE STE 306	SIOUX FALLS	SD	57104	363627217	501(C)(4)	$29,104	$0	ECONOMIC DEVELOPMENT
DSU HERITAGE FDTN
230 8TH AVE W	DICKINSON	ND	58601	475378718	501(C)(3)	$144,000	$0	EDUCATION/WORKFORCE DEVELOPMENT
ELEVATE RAPID CITY
525 UNIVERSITY LOOP STE 102	RAPID CITY	SD	57701	460118545	501(C)(6)	$50,000	$0	ECONOMIC DEVELOPMENT
FAMILY ADVOCACY CNTR OF NORTH
800 BEMIDJI AVE N STE 4	BEMIDJI	MN	566013072	202102302	501(C)(3)	$18,000	$0	COMMUNITY HEALTH IMPROVEMENT
FAMILY FEST
PO BOX 90646	SIOUX FALLS	SD	57109	812254064	501(C)(3)	$7,500	$0	COMMUNITY HEALTH IMPROVEMENT
FARGO PARK DISTRICT
701 MAIN AVE	FARGO	ND	58103	456002070	501(C)(6)	$3,553,103	$0	COMMUNITY HEALTH IMPROVEMENT
FARGO PUBLIC SCHOOLS
415 4TH ST N	FARGO	ND	57192	456012318	501(C)(3)	$187,500	$0	PROGRAM SUPPORT
FARGO YOUTH BASEBALL
1892 17TH AVE S	FARGO	ND	58103	450370089	501(C)(3)	$17,700	$0	PROGRAM SUPPORT
FARGO YOUTH HOCKEY ASSOC
831 17TH AVE N	FARGO	ND	58102	363548649	501(C)(3)	$12,000	$0	PROGRAM SUPPORT
FIRST CITY OF LIGHTS FOUNDATION
PO BOX 1991	BEMIDJI	MN	56619	854069354	501(C)(3)	$6,500	$0	ECONOMIC DEVELOPMENT
FIRST TEE OF SOUTH DAKOTA
PO BOX 88938	SIOUX FALLS	SD	57109	460449824	501(C)(3)	$36,000	$0	PROGRAM SUPPORT
FIRSTLINK
4357 13TH AVE S STE 107L	FARGO	ND	58103	450419491	501(C)(3)	$25,000	$0	COMMUNITY HEALTH IMPROVEMENT
FITNESS ON MAIN
901 MAIN STREET	BURKE	SD	57523	264125455	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT
FOLDS OF HONOR SOUTH DAKOTA
5800 N PATRIOT DR	OWASSO	OK	74055	753240683	501(C)(3)	$60,800	$0	PROGRAM SUPPORT
FORWARD SIOUX FALLS
PO BOX 907	SIOUX FALLS	SD	57101	460396647	501(C)(6)	$250,000	$0	ECONOMIC DEVELOPMENT
FRESH START SURGICAL GIFTS
2011 PALOMAR AIRPORT RD STE 206	CARLSBAD	CA	92011	330460177	501(C)(3)	$75,000	$0	PROGRAM SUPPORT
GATEWAY TO SCIENCE
1810 SCHAFER STREET STE 1	BISMARCK	ND	58501	450443517	501(C)(3)	$10,000	$0	EDUCATION/WORKFORCE DEVELOPMENT
GLORY HOUSE OF SIOUX FALLS
4000 S WEST AVE	SIOUX FALLS	SD	57105	460308425	501(C)(3)	$15,000	$0	COMMUNITY HEALTH IMPROVEMENT
GREAT NORTH POLE
675 13TH AVE E STE 101	WEST FARGO	ND	58078	821969429	501(C)(3)	$20,000	$0	COMMUNITY HEALTH IMPROVEMENT
GREATER SF CHAMBER OF COMMERCE
200 N PHILLIPS AVE STE 200	SIOUX FALLS	SD	571046058	460189300	501(C)(6)	$6,200	$0	ECONOMIC DEVELOPMENT
GROUND WORKS
102 N KROHNS PL STE 116	SIOUX FALLS	SD	57103	475498537	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT		'
HARRISBURG HIGH SCHOOL
1300 E WILLOW ST	HARRISBURG	SD	57032	466002218	501(C)(3)	$8,050	$0	PROGRAM SERVICES
HARRISBURG SCHOOL DISTRICT
200 WILLOW ST	HARRISBURG	SD	57032	466002218	115	$229,800	$0	PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT
HARTFORD AREA DEVELOPMENT FDTN
125 N MAIN AVE	HARTFORD	SD	57033	460354618	501(C)(3)	$10,000	$0	ECONOMIC DEVELOPMENT
HELPLINE CENTER INC
1000 N WEST AVE STE 310	SIOUX FALLS	SD	571041314	237424387	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT
HOPE HAVEN INC
PO BOX 70	ROCK VALLEY	IA	51247	420890017	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT
HUETHER FAMILY MATCH POINTE
4210 N BOBHALLA DR	SIOUX FALLS	SD	57107	452784394	501(C)(3)	$12,000	$0	PROGRAM SUPPORT
INDEPENDENT SCHOOL DIST #2184
709 NORTH KNISS AVE	LUVERNE	MN	56156	411784004	115	$10,250	$6,147	EDUCATION/WORKFORCE DEVELOPMENT
INDEPENDENT SCHOOL DISTRICT518
1117 MARINE AVE	WORTHINGTON	MN	561871610	416008522	115	$112,000	$0	PROGRAM SUPPORT
JUNIOR ACHIEVEMENT OF SD
300 S PHILLIPS AVE STE L102	SIOUX FALLS	SD	57104	460306352	501(C)(3)	$15,200	$0	EDUCATION/WORKFORCE DEVELOPMENT
LAKOTA NATION INVITATIONAL
PO BOX 3140	RAPID CITY	SD	57709	461310975	501(C)(3)	$7,500	$0	ECONOMIC DEVELOPMENT
LEGENDS OF GOLD
PO BOX 287	BERESFORD	SD	57004	273794971	501(C)(3)	$20,000	$0	PROGRAM SUPPORT
LEVITT AT THE FALLS
524 N MAIN AVE 106	SIOUX FALLS	SD	57104	611699910	501(C)(3)	$75,000	$464	ECONOMIC DEVELOPMENT	COST	SIGNAGE
LIFESCAPE
2501 WEST 26TH ST	SIOUX FALLS	SD	57105	460233030	501(C)(3)	$41,898	$0	PROGRAM SUPPORT
LINK
132 N DAKOTA AVE	SIOUX FALLS	SD	57104	844806781	501(C)(3)	$400,000	$0	COMMUNITY HEALTH IMPROVEMENT
LUVERNE AREA COMMUNITY FOUND
102 E MAIN ST	LUVERNE	MN	56156	411512905	501(C)(3)	$6,000	$7	COMMUNITY HEALTH IMPROVEMENT	COST	AED ACCESSORIES
MAKE A WISH FOUNDATION OF SOUTH DAKOTA & MONTANA
1400 W 17TH ST	SIOUX FALLS	SD	57104	460375953	501(C)(3)	$12,400	$0	COMMUNITY HEALTH IMPROVEMENT
MANDAN PUBLIC SCHOOL DISTRICT1
901 DIVISION ST NW	MANDAN	ND	58554	456001098	115	$12,500	$0	PROGRAM SUPPORT
MAYVILLE STATE UNIVERSITY
330 THIRD ST NE	MAYVILLE	ND	58257	456002485	501(C)(3)	$30,000	$0	PROGRAM SUPPORT,SCHOLARSHIP ENDOWMENT
MCCROSSAN BOYS RANCH
47135 260TH STREET	SIOUX FALLS	SD	57107	460311913	501(C)(3)	$7,500	$0	PROGRAM SUPPORT
MCKENZIE COUNTY HEALTHCARE SYS
709 4TH AVE NE	WATFORD CITY	ND	58854	770637498	501(C)(3)	$100,000	$0	COMMUNITY HEALTH IMPROVEMENT
METRO AREA TOURNAMENT COMM
415 NORTH 4TH ST	FARGO	ND	58102	450458883	501(C)(3)	$20,000	$0	PROGRAM SUPPORT
MINNESOTA STATE UNIVERSITY MOORHEAD
1104 7TH AVE SOUTH	MOORHEAD	MN	56563	411687554	115	$102,250	$0	PROGRAM SUPPORT
MINNETONKA TOUCHDOWN CLUB
18301 HWY 7	MINNETONKA	MN	55435	460496128	501(C)(3)	$10,000	$0	PROGRAM SUPPORT
MITCHELL PARKS & RECREATION
612 NORTH MAIN STREET	MITCHELL	SD	57301	466000305	115	$17,000	$0	COMMUNITY HEALTH IMPROVEMENT
MN STATE UNIV MANKATO FDTN
236 WIGLEY ADMINISTRATION CTR	MANKOTA	MN	56001	416033423	501(C)(3)	$200,000	$0	SCHOLARSHIP ENDOWMENT
MN WEST FOUNDATION
1593 11TH AVENUE	GRANITE FALLS	MN	56241	363266500	501(C)(3)	$10,000	$0	SCHOLARSHIP ENDOWMENT
MO RIVER BASEBALL CLUB
540 CRESTLAND PLACE	BISMARCK	ND	58503	872686828	501(C)(3)	$7,500	$0	PROGRAM SUPPORT
MO SLOPE AREAWIDE UNITED WAY
515 N 4TH ST	BISMARCK	ND	58501	450387741	501(C)(3)	$18,500	$0	COMMUNITY HEALTH IMPROVEMENT, ECONOMIC DEVELOPMENT
MOORHEAD AREA PUBLIC SCHOOLS
2410 14TH ST S	MOORHEAD	MN	56560	812603701	115	$140,000	$0	EDUCATION/WORKFORCE DEVELOPMENT
MOORHEAD YOUTH HOCKEY ASSOC
707 SE MAIN AVE	MOORHEAD	MN	56560	237221429	501(C)(3)	$50,500	$0	PROGRAM SUPPORT
NAMELESS COALITION FOR THE HOMELESS
PO BOX 353	BEMIDJI	MN	566010353	472472053	501(C)(3)	$10,000	$0	ECONOMIC SUPPORT
NAMI SD
PO BOX 89213	SIOUX FALLS	SD	57109	363593641	501(C)(3)	$6,500	$0	COMMUNITY HEALTH IMPROVEMENT
NATIONAL KIDNEY FOUNDATION
30 EAST 33RD STREET	NEW YORK	NY	10016	131673104	501(C)(3)	$27,000	$0	COMMUNITY HEALTH IMPROVEMENT
NATL MULTIPLE SCLEROSIS SOC
733 THIRD AVENUE FLOOR 3	NEW YORK	NY	10017	135661935	501(C)(3)	$11,500	$0	COMMUNITY HEALTH IMPROVEMENT
ND ASSISTIVE
3240 15TH ST S SUITE B	FARGO	ND	58104	270260522	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT
ND SAFETY COUNCIL
1710 CANARY AVE SUITE A	BISMARCK	ND	58501	450353009	501(C)(3)	$0	$13,000	COMMUNITY HEALTH IMPROVEMENT	COST	WATER
ND STATE COLLEGE OF SCIENCE
800 N 6TH ST	WAHPETON	ND	580760002	450407617	501(C)(3)	$7,500	$0	COMMUNITY HEALTH IMPROVEMENT
NDSU
PO BOX 6050	FARGO	ND	581086050	456002439	501(C)(3)	$668,088	$0	PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT
NDSU FOUNDATION & ALUMNI ASSOC
1241 UNIVERSITY DR N	FARGO	ND	58102	237120898	501(C)(3)	$2,430,000	$0	PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
NICKLAUS CHILDRENS HOSP FDTN
3100 SW 62ND AVE	MIAMI	FL	33155	461784918	501(C)(3)	$3,000,000	$0	COMMUNITY HEALTH IMPROVEMENT
NORTHERN DENTAL ACCESS CENTER
1405 ANNE ST NW	BEMIDJI	MN	56601	841711812	501(C)(3)	$20,000	$0	COMMUNITY HEALTH IMPROVEMENT
NORTHERN LIGHTS COUNCIL
4200 19TH AVE S	FARGO	ND	581037207	450226415	501(C)(3)	$7,250	$0	COMMUNITY HEALTH IMPROVEMENT
NORTHERN STATE UNIVERSITY
1200 S JAY ST	ABERDEEN	SD	574017198	466000364	115	$792,000	$0	PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT
NORTHERN SUN INTERCOLLEGIATE
2999 COUNTY RD 42 W	BURNSVILLE	MN	55306	411783486	501(C)(3)	$100,000	$0	SCHOLARSHIP ENDOWMENT,PROGRAM SUPPORT
NORTHWEST INDIAN CMTY DEV CTR
520 4TH ST NW	BEMIDJI	MN	56601	363505641	501(C)(3)	$6,000	$0	COMMUNITY HEALTH IMPROVEMENT
NORTHWEST MN FOUNDATION
201 3RD ST NW	BEMIDJI	MN	56601	411556013	501(C)(3)	$28,550	$0	PROGRAM SUPPORT
OAK GROVE LUTHERAN SCHOOL
124 N TERRACE	FARGO	ND	58102	450226473	501(C)(3)	$24,000	$0	PROGRAM SUPPORT
OUTDOOR ADVENTURE FOUNDATION
415 38TH ST S STE E	FARGO	ND	58103	270192316	501(C)(3)	$7,500	$0	COMMUNITY HEALTH IMPROVEMENT
PERHAM AREA COMMUNITY CENTER
620 3RD AVE SE	PERHAM	MN	56573	411565457	115	$40,500	$0	COMMUNITY HEALTH IMPROVEMENT
PREMIERE PLAYHOUSE
315 N PHILLIPS AVE	SIOUX FALLS	SD	57104	800074622	501(C)(3)	$7,500	$0	EDUCATION/WORKFORCE DEVELOPMENT
PROFESSIONAL PATIENT ADVOCATES IN LIFE SCIENCES
94 HILLANDALE RD	DANBURY	CT	06811	472878879	501(C)(3)	$20,000	$0	COMMUNITY HEALTH IMPROVEMENT
RAPID CITY CLUB FOR BOYS INC
320 N 4TH ST	RAPID CITY	SD	57701	460277778	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT
REINBOWS INC OF WINDOM MN
43341 480TH AVE	WINDOM	MN	56101	208775427	501(C)(3)	$7,000	$0	COMMUNITY HEALTH IMPROVEMENT
RONALD MCDONALD HOUSE
4757 AGASSIZ XING S	FARGO	ND	58104	450365598	501(C)(3)	$105,000	$0	COMMUNITY HEALTH IMPROVEMENT
RONALD MCDONALD HOUSE CHARITY
825 S LAKE ROAD	SIOUX FALLS	SD	57104	460371152	501(C)(3)	$25,000	$0	COMMUNITY HEALTH IMPROVEMENT
SAMARITANS FEET
PO BOX 78992	CHARLOTTE	NC	282717045	141880905	501(C)(3)	$2,540,000	$0	COMMUNITY HEALTH IMPROVEMENT
SD BASKETBALL COACHES ASSOCIATION
1404 YOSEMITE LANE	BROOKINGS	SD	57006	811379554	501(C)(3)	$6,232	$0	PROGRAM SUPPORT
SD COMMUNITY FOUNDATION
1714 N LINCOLN AVE	PIERRE	SD	57501	460398115	501(C)(3)	$1,266,000	$0	SCHOLARSHIP ENDOWMENT
SD GOLF ASSOCIATION JUNIOR GOLF FOUNDATION
PO BOX 88938	SIOUX FALLS	SD	57109	460449824	501(C)(3)	$25,000	$0	PROGRAM SUPPORT
SD HALL OF FAME
1480 SOUTH MAIN	CHAMBERLAIN	SD	57325	460324210	501(C)(3)	$50,000	$0	ECONOMIC DEVELOPMENT
SD HIGH SCHOOL ACTIVITIES
PO BOX 1217	PIERRE	SD	575011217	460226882	501(C)(3)	$125,000	$0	PROGRAM SUPPORT
SD LAW ENFORCEMENT CHARITIES
101 SOUTH MAIN AVE STE 100	SIOUX FALLS	SD	57104	460440378	501(C)(3)	$10,000	$0	SCHOLARSHIP ENDOWMENT
SD MILITARY HERITAGE ALLIANCE
1600 W RUSSELL ST	SIOUX FALLS	SD	57104	832381925	501(C)(3)	$250,000	$0	MILITARY AND VETERANS SERVICES
SD SCHOOL OF MINES AND TECHN
501 EAST ST JOSEPH STREET	RAPID CITY	SD	577013995	466000364	115	$18,000	$0	PROGRAM SUPPORT
SD STATE UNIV FOUNDATION
815 MEDARY AVE	BROOKINGS	SD	57007	460273801	501(C)(3)	$1,167,000	$0	PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
SD SYMPHONY ORCHESTRA
300 NORTH DAKOTA AVE STE 116	SIOUX FALLS	SD	57104	466017026	501(C)(3)	$43,000	$0	ECONOMIC DEVELOPMENT
SD YOUTH SOCCER ASSOC
2127 S MINNESOTA AVE STE 201	SIOUX FALLS	SD	57105	237183054	501(C)(3)	$25,000	$0	PROGRAM SUPPORT
SF AREA COMMUNITY FOUNDATION
200 N CHERAPA PL	SIOUX FALLS	SD	57103	311748533	501(C)(3)	$50,000	$0	COMMUNITY HEALTH IMPROVEMENT,ECONOMIC DEVELOPMENT
SF CHRISTIAN HIGH SCHOOL
6120 S CHARGER CIRCE	SIOUX FALLS	SD	57108	460340024	501(C)(3)	$114,460	$0	SCHOLARSHIP ENDOWMENT,PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT
SF SWIM TEAM INC
PO BOX 758	SIOUX FALLS	SD	57101	460343732	501(C)(3)	$25,000	$0	PROGRAM SUPPORT
SF YOUTH HOCKEY ASSOC
5000 S MINNESOTA AVE	SIOUX FALLS	SD	57108	460427805	501(C)(3)	$65,000	$0	PROGRAM SUPPORT
SHELDON COMM SCHOOL DISTRICT
1700 E 4TH STREET	SHELDON	IA	51201	426038825	115	$30,000	$0	PROGRAM SUPPORT
SIGN FRACTURE CARE INTERNATIONAL
451 HILLS ST STE B	RICHLAND	WA	99354	911952283	501(C)(3)	$250,000	$0	COMMUNITY HEALTH IMPROVEMENT
SIOUX COUNCIL BOY SCOUTS
800 N WEST AVE	SIOUX FALLS	SD	57104	460224599	501(C)(3)	$25,000	$0	EDUCATION/WORKFORCE DEVELOPMENT
SIOUX EMPIRE UNITED WAY
1000 N W AVE 120	SIOUX FALLS	SD	571041314	460233701	501(C)(3)	$150,000	$0	COMMUNITY HEALTH IMPROVEMENT,ECONOMIC DEVELOPMENT
SIOUX FALLS AREA CASA PROGRAM
PO BOX 1901	SIOUX FALLS	SD	57101	460430647	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT
SIOUX FALLS LUTHERAN SCHOOL
308 W 37TH ST	SIOUX FALLS	SD	57105	460343381	501(C)(3)	$1,000,000	$0	EDUCATION/WORKFORCE DEVELOPMENT
SIOUX FALLS POWER HOCKEY
5808 S PRAIRIE VIEW CT	SIOUX FALLS	SD	57108	471795011	501(C)(3)	$40,000	$0	PROGRAM SUPPORT
SIOUX FALLS SCHOOL DISTRICT
201 E 38TH ST	SIOUX FALLS	SD	57105	466002586	501(C)(3)	$336,852	$0	PROGRAM SUPPORT, EDUCATION/WORKFORCE DEVELOPMENT
SIOUX FALLS SPORTS AUTHORITY
200 N PHILLIPS AVE SUITE 304	SIOUX FALLS	SD	57104	205850491	501(C)(3)	$7,500	$0	ECONOMIC DEVELOPMENT
SIOUX FALLS WOMEN RUN TRAINING
5235 S SWEETBRIAR CT	SIOUX FALLS	SD	57108	813518734	501(C)(6)	$15,000	$0	COMMUNITY HEALTH IMPROVEMENT
SIOUX FALLS YMCA
230 S MINNESOTA AVE	SIOUX FALLS	SD	57104	460225021	501(C)(3)	$61,090	$0	COMMUNITY HEALTH IMPROVEMENT
SMSU FOUNDATION
1501 STATE ST	MARSHALL	MN	56258	237108470	501(C)(3)	$100,000	$0	PROGRAM SUPPORT
SOUTH DAKOTA STATE UNIVERSITY
815 MEDARY AVE PO BOX 525	BROOKINGS	SD	57007	460273801	115	$1,121,500	$0	PROGRAM SUPPORT
SPECIAL OLYMPICS SOUTH DAKOTA
800 E I-90 LANE	SIOUX FALLS	SD	57104	460359776	501(C)(3)	$10,100	$0	COMMUNITY HEALTH IMPROVEMENT
ST JOHN PAUL II CATHOLIC SCHLS
5600 25TH ST S	FARGO	ND	581047123	450403317	501(C)(3)	$20,000	$0	PROGRAM SUPPORT
SUMMIT LEAGUE INC
4000 N HERCULES AVE STE 200	SIOUX FALLS	SD	571071401	391417116	501(C)(3)	$1,600,000	$0	PROGRAM SUPPORT
TEAM FOUNDATION
105 PARK AVE NW	BAGLEY	MN	56621	061696861	501(C)(3)	$7,500	$0	PROGRAM SUPPORT
TEAM MAKERS CLUB INC
3309 FLECHTNER DR S STE G	FARGO	ND	58103	456014085	501(C)(3)	$131,000	$0	PROGRAM SUPPORT
THIEF RIVER FALLS SCHOOLS
230 LABREE AVENUE SOUTH	THIEF RIVER FALLS	MN	56701	416003126	115	$21,500	$0	PROGRAM SUPPORT
UND ALUMNI ASSOC & FOUNDATION
3501 UNIVERSITY AVE STOP 8157	GRAND FORKS	ND	58202	450348296	501(C)(3)	$112,500	$0	SCHOLARSHIP ENDOWMENT
UNITED WAY OF BEMIDJI AREA
PO BOX 27	BEMIDJI	MN	56619	411567744	501(C)(3)	$93,760	$0	ECONOMIC DEVELOPMENT
UNITED WAY OF CASS-CLAY
PO BOX 1609	FARGO	ND	581071609	410810008	501(C)(3)	$126,900	$0	COMMUNITY HEALTH IMPROVEMENT,ECONOMIC DEVELOPMENT
UNITED WAY OF NORTHEASTERN SD
PO BOX 1065	ABERDEEN	SD	574021065	237086355	501(C)(3)	$10,450	$0	COMMUNITY HEALTH IMPROVEMENT,ECONOMIC DEVELOPMENT
UNIV OF MARY
7500 UNIVERSITY DR	BISMARCK	ND	58504	450273403	501(C)(3)	$210,000	$0	EDUCATION/WORKFORCE DEVELOPMENT
UNIV OF NE FOUNDATION
1010 LINCOLN MALL STE 300	LINCOLN	NE	68508	470379839	501(C)(3)	$250,000	$0	SCHOLARSHIP ENDOWMENT
UNIV OF SD FOUNDATION
1110 N DAKOTA ST	VERMILLION	SD	57069	466018891	501(C)(3)	$3,143,333	$0	PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
UNIV OF WI FOUNDATION
1848 UNIVERSITY AVE	MADISON	WI	537264090	390743975	501(C)(3)	$110,000	$0	PROGRAM SUPPORT
UNIVERSITY OF COLORAD
13001 E 17TH PLACE	AURORA	CO	80045	846000555	115	$250,000	$0	RESEARCH
UNIVERSITY OF JAMESTOWN
6085 COLLEGE LANE	JAMESTOWN	ND	58405	450231180	501(C)(3)	$70,300	$0	PROGRAM SUPPORT
UPPER MIDWEST ELITE LEAGUE
PO BOX 385970	BLOOMINGTON	MN	55438	043644163	501(C)(3)	$6,250	$0	PROGRAM SUPPORT
USD SCHOOL OF MEDICINE
414 EAST CLARK ST	VERMILLION	SD	57069	466000364	115	$52,004	$0	PROGRAM SUPPORT,EDUCATION/WORKFORCE DEVELOPMENT,SCHOLARSHIP ENDOWMENT
VALLEY CITY STATE UNIVERSITY
101 COLLEGE ST SW	VALLEY CITY	ND	58072	456002482	115	$5,500	$129	EDUCATION/WORKFORCE DEVELOPMENT	FMV	BIKE DONATION FOR AUCTION
VERMILLION CHAMBER OF COMMERCE
2 E MAIN ST STE 101	VERMILLION	SD	57069	460284795	501(C)(3)	$22,500	$0	ECONOMIC DEVELOPMENT
DEPARTMENT OF VETERAN AFFAIRS
2501 WEST 22ND ST	SIOUX FALLS	SD	57105	460227571	115	$0	$3,051,485	COMMUNITY HEALTH IMPROVEMENT	COST	PGX TESTING
VETERANS COMMUNITY PROJECT
88900 TROOST AVE	KANSAS CITY	MO	64131	474960735	501(C)(3)	$17,000	$0	MILITARY AND VETERANS SERVICES
VILLAGE FAMILY SERVICE CENTER
808 3RD AVE S STE 101	FARGO	ND	58103	450226423	501(C)(3)	$102,000	$0	COMMUNITY HEALTH IMPROVEMENT
VILLAGE NORTHWEST UNLIMITED
330 VILLAGE CIRCLE	SHELDON	IA	51201	421044017	501(C)(3)	$27,500	$0	COMMUNITY HEALTH IMPROVEMENT
VOLUNTEERS OF AMERICA DAKOTAS
PO BOX 89306	SIOUX FALLS	SD	57109	237353508	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT
WARNER SCHOOL DIST 6-5 FNDN
PO BOX 20	WARNER	SD	57479	204606639	501(C)(3)	$10,000	$0	ECONOMIC DEVELOPMENT
WATERTOWN COMMUNITY FOUNDATION
211 E KEMP AVE	WATERTOWN	SD	57201	460350319	501(C)(3)	$20,000	$0	ECONOMIC DEVELOPMENT
WATERTOWN DEVELOPMENT COMPANY
PO BOX 332	WATERTOWN	SD	57201	470813269	501(C)(3)	$15,000	$0	ECONOMIC DEVELOPMENT
WEST CENTRAL SCHOOL DISTRICT
PO BOX 252	HARTFORD	SD	57033	460284421	115	$25,050	$0	PROGRAM SUPPORT
WESTERN REGION ECONOMIC DEV
PO BOX 1306	WILLISTON	ND	58802	363803598	501(C)(6)	$10,000	$0	ECONOMIC DEVELOPMENT
WINGS OF VALOR INC
45618 278TH ST	PARKER	SD	57053	843711088	501(C)(3)	$51,942	$0	MILITARY AND VETERANS SERVICES
WINNER REGIONAL HEALTHCARE CTR
745 E 8TH ST	WINNER	SD	57580	460274380	501(C)(3)	$100,000	$0	COMMUNITY HEALTH IMPROVEMENT
YELLOW JACKET FOUNDATION
1200 UNIVERSITY ST UNIT 9506	BELLE FOURCHE	SD	57717	510151319	501(C)(3)	$110,000	$0	PROGRAM SUPPORT
YOUNG MENS CHRISTIAN ASSOC SF
606 E TAN TARA CIR	SIOUX FALLS	SD	57106	464887667	501(C)(3)	$30,000	$0	PROGRAM SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	174	Total501c3OrgCnt
Total Other Org	17	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	GENERAL SUPPORT FOR COMMUNITY PROGRAMS	GrantTypeTxt
Cash Grant	$25	CashGrantAmt
Non Cash Assistance	$30,577	NonCashAssistanceAmt
Valuation Method Used	COST	ValuationMethodUsedDesc
Non Cash Assistance	$25 GIFT CARDS SANFORD CARES CHRISTMAS PROGRAM; YOUTH SPORTS PROGRAM ASSISTANCE	NonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	PRIOR TO DISBURSEMENT ALL GRANT FUND REQUESTS ARE REVIEWED TO ENSURE THE RECEIVING ORGANIZATION AND PROPOSED USE OF FUNDS ALIGN WITH SANFORD'S MISSION.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	Yes (X)	FirstClassOrCharterTravelInd
Travel For Companions	Yes (X)	TravelForCompanionsInd
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	Yes (1)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (27 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
WILLIAM BRUNNER MD
PHYSICIAN	$3,264,442	$0	$0	$0	$141,633	$0	$15,250	$0	$23,892	$0	$3,445,217	$0	$0	$0
BRYAN NERMOE
PRESIDENT & CEO, FARGO-END 3/22	$0	$175,719	$0	$252,724	$0	$28,831	$0	$30,585	$0	$7,367	$0	$495,226	$0	$0
BRYAN NERMOE
SEE SCH J, PART III, LINES 4A-4B	$0	$0	$0	$0	$0	$2,719,941	$0	$0	$0	$0	$0	$2,719,941	$0	$688,398
BILL GASSEN III
TRUSTEE, PRESIDENT & CEO	$0	$1,818,239	$0	$582,757	$0	$282,586	$0	$378,828	$0	$755	$0	$3,063,165	$0	$0
TOMASZ STYS MD
PHYSICIAN	$2,655,388	$0	$0	$0	$151,524	$0	$15,250	$0	$24,270	$0	$2,846,432	$0	$0	$0
RANDY BURY
FORMER CHIEF ADMIN OFFICER	$0	$36,400	$0	$0	$0	$20,288	$0	$0	$0	$0	$0	$56,688	$0	$0
RANDY BURY
SEE SCH J, PART III, LINES 4A-4B	$0	$0	$0	$0	$0	$2,769,572	$0	$0	$0	$0	$0	$2,769,572	$0	$0
ADAM STYS MD
PHYSICIAN	$2,617,365	$0	$0	$0	$133,124	$0	$15,250	$0	$27,260	$0	$2,792,999	$0	$0	$0
ERIC BELANGER MD
PHYSICIAN	$2,543,991	$0	$0	$0	$1,242	$0	$15,250	$0	$27,676	$0	$2,588,159	$0	$0	$0
MARIAN PETRASKO MD
PHYSICIAN	$2,270,184	$0	$0	$0	$156,987	$0	$6,240	$0	$28,692	$0	$2,462,103	$0	$0	$0
MATT HOCKS
EVP, CHIEF OPERATING OFFICER	$0	$1,448,268	$0	$482,335	$0	$233,922	$0	$219,455	$0	$28,845	$0	$2,412,825	$0	$0
MICHELLE BRUHN
EVP, CFO & TREASURER	$0	$1,012,253	$0	$350,000	$0	$168,285	$0	$160,681	$0	$26,317	$0	$1,717,536	$0	$0
JENNIFER GRENNAN
EVP, CHIEF ADMIN OFFICER	$0	$989,176	$0	$330,001	$0	$156,884	$0	$157,092	$0	$26,317	$0	$1,659,470	$0	$0
MICHAEL LEBEAU MD
SVP, HEALTH SVC OPERATIONS	$0	$968,405	$0	$285,000	$0	$167,120	$0	$154,419	$0	$27,692	$0	$1,602,636	$0	$0
PAUL HANSON
PRESIDENT & CEO, SIOUX FALLS	$0	$835,062	$0	$277,997	$0	$141,443	$0	$134,455	$0	$20,145	$0	$1,409,102	$0	$0
MARIA BELL MD
TRUSTEE, PHYSICIAN	$1,020,094	$0	$54,000	$0	$69,600	$0	$15,250	$0	$28,692	$0	$1,187,636	$0	$0	$0
TODD SCHAFFER
PRESIDENT & CEO, BISMARCK	$0	$664,040	$0	$153,130	$0	$131,566	$0	$108,543	$0	$2,363	$0	$1,059,642	$0	$0
TIFFANY LAWRENCE
PRESIDENT & CEO, FARGO-BEG 3/22	$0	$729,385	$0	$68,796	$0	$126,586	$0	$105,250	$0	$27,517	$0	$1,057,534	$0	$0
SUSAN JARVIS
PRESIDENT & CEO, BEMIDJI	$0	$531,338	$0	$180,184	$0	$93,514	$0	$91,858	$0	$30,167	$0	$927,061	$0	$0
MICHELLE MICKA
SVP, FINANCE, HEALTH SERVICES	$0	$414,734	$0	$146,250	$0	$54,832	$0	$61,109	$0	$19,598	$0	$696,523	$0	$0
MARK LUNDEEN MD
TRUSTEE, PHYSICIAN	$332,590	$0	$0	$0	$11,324	$0	$11,832	$0	$2,130	$0	$357,876	$0	$0	$0
JOANN KUNKEL
FORMER CFO-SCH J, PART III, LINES 4A	$0	$0	$0	$0	$0	$339,000	$0	$0	$0	$0	$0	$339,000	$0	$0
ANDY NORTH
TRUSTEE, SECRETARY, INDEP CONTRACTOR	$316,771	$0	$0	$0	$0	$0	$0	$0	$0	$0	$316,771	$0	$0	$0
KIM PATRICK
FORMER CLO-SCH J, PART III, LINES 4A	$0	$0	$0	$0	$0	$315,000	$0	$0	$0	$0	$0	$315,000	$0	$0
NATHAN WHITE
FORMER COO-SCH J, PART III, LINES 4A	$0	$0	$0	$0	$0	$300,000	$0	$0	$0	$0	$0	$300,000	$0	$0
MARK PAULSON MD
TRUSTEE, PHYSICIAN	$221,637	$0	$13,500	$0	$4,257	$0	$10,612	$0	$28,057	$0	$278,063	$0	$0	$0
ALLISON WIERDA-SUTTLE MD
FORMER SVP, CMO-SCH J PT III, 4A-4B	$0	$0	$0	$0	$0	$264,600	$0	$0	$0	$0	$0	$264,600	$0	$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	ON PART I, QUESTIONS REGARDING COMPENSATION, SANFORD CHECKED SEVERAL OF THE ITEMS AS PROVIDED TO LISTED PERSONS: FIRST CLASS OR CHARTER TRAVEL - CHARTER TRAVEL FOR BUSINESS PURPOSES IS PROVIDED FOR INDIVIDUALS AS NEEDED AND AS COST APPROPRIATE, IN ACCORDANCE WITH WRITTEN POLICIES. THESE COSTS ARE NOT INCLUDED IN THE W-2'S OF THE INDIVIDUALS AS THEY ARE INCURRED FOR BUSINESS PURPOSES OF SANFORD. TRAVEL FOR COMPANIONS - LIMITED TRAVEL FOR COMPANIONS IS OFFERED FOR CERTAIN MEETINGS AND EVENTS. THESE COSTS ARE INCLUDED IN THE 1099'S OF THE INDIVIDUALS. SANFORD USED THE SIFL (STANDARD INDUSTRY FARE LEVEL) RATE METHOD TO IMPUTE THE FRINGE BENEFIT TO THE LISTED PERSON. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - CERTAIN COMPENSATION MAY BE GROSSED UP TO INCLUDE APPROPRIATE TAX AMOUNTS. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES - ALL SANFORD EMPLOYEES ARE ELIGIBLE FOR DISCOUNTED WELLNESS MEMBERSHIPS, A PORTION OF THESE DISCOUNTS AND OTHER CLUB DUES ARE INCLUDED AS FRINGE BENEFITS AND TAXED AS SUCH. PART I, LINE 3: THE EXECUTIVE COMPENSATION COMMITTEE OF THE SANFORD BOARD OF TRUSTEES DIRECTLY ENGAGES A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY TO REVIEW THE TOTAL COMPENSATION ARRANGEMENTS OF THE OFFICERS AND EXECUTIVES OF THE ORGANIZATION, INCLUDING THE CEO, AND TO REPORT THE FINDINGS TO THEM FOR DELIBERATION AND ACTION. THE DELIBERATIONS AND ACTIONS ARE RECORDED IN THE MINUTES OF THE SANFORD BOARD OF TRUSTEES. THE MOST RECENT STUDY WAS COMPLETED IN 2022.
PART I, LINES 4A-B	LINE 4A-SEVERANCE OR CHANGE OF CONTROL PAYMENT UPON HIRE OR PROMOTION, SELECT OFFICERS AND KEY EMPLOYEES SIGN AN EXECUTIVE SEVERANCE AGREEMENT (THE "AGREEMENT"). THE AGREEMENT PROVIDES THAT THE EXECUTIVE WILL RECEIVE A MULTIPLE OF HIS OR HER SALARY (BASED ON YEARS OF SERVICE OR POSITION) AS A PAYMENT IN THE EVENT OF A DEFINED SEPARATION EVENT, WHICH CAN INCLUDE AN INVOLUNTARY SEPARATION OR AN EMPLOYEE VOLUNTARILY LEAVING FOR A DEFINED CONTRACTUAL REASON. EXECUTIVES MAY ALSO QUALIFY FOR A PAYMENT FOR SATISFYING A NON-COMPETE. FINAL SEPARATION PAYMENTS MIGHT VARY FROM THE AMOUNT PROVIDED IN THE AGREEMENT AS A RESULT OF NEGOTIATIONS SURROUNDING POST-SEPARATION OBLIGATIONS AND INCENTIVES (THE "SEPARATION" PAYMENT). LINE 4B-SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS SANFORD SPONSORS NONQUALIFIED RETIREMENT PLANS FOR SELECT OFFICERS OR KEY EMPLOYEES. CERTAIN OF THE BELOW OFFICERS OR KEY EMPLOYEES WERE PAID AS A RESULT OF A VESTING EVENT. LINE 4A AND 4B-PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE OR CHANGE OF CONTROL PAYMENTS AND/OR SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS: BRYAN NERMOE: SEPARATION..................................$2,011,302 NONQUALIFIED RETIREMENT PLAN.................$708,639 TOTAL.......................................$2,719,941 RANDY BURY: SEPARATION..................................$2,769,572 JOANN KUNKEL: NON-COMPETE PAYMENT...........................$339,000 KIM PATRICK: NON-COMPETE PAYMENT...........................$315,000 NATHAN WHITE: NON-COMPETE PAYMENT...........................$300,000 ALLISON WIERDA-SUTTLE: NON-COMPETE PAYMENT...........................$264,600
PART I, LINE 6	SANFORD PHYSICIANS ARE COMPENSATED BASED ON THE PROFESSIONAL SERVICES THEY PERFORM WITHIN THE CLINIC IN WHICH THEY PROVIDE CARE. GENERALLY, THE MODEL IS BASED ON PRODUCTION.
PART I, LINE 7	CERTAIN EMPLOYEES ARE ELIGIBLE FOR A DISCRETIONARY INCENTIVE BONUS. BONUSES ARE PAID BASED ON THE ACHIEVEMENT OF FINANCIAL AND OTHER GOALS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
A	460315509	83755VHY3	2004-09-14	$70,073,989	2004: NEW CONSTRUCTION OF HEALTHCARE FACILITIES	0	0	0
CITY OF CHAMBERLAIN
B	460000094	000000000	2010-12-30	$4,000,000	2010 CHAMB: NEW CONSTRUCTION OF LONG-TERM CARE FACILITIES	0	0	0
SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
C	460315509	000000000	2012-03-29	$66,185,000	2012AB: REFUNDING BONDS ISSUED 9/12/2001 AND 10/15/2002	0	0	0
SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
D	460315509	000000000	2012-06-14	$45,000,000	2012D:REFINANCE TAXABLE INDEBTEDNESS USED TO CONSTRUCT HEALTHCARE FACILITY	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Other Spent ProceedsOtherSpentProceedsAmt
A	$57,490,000	$71,581,953	$74,550	$764,068	$70,817,885	2006	0	0	Yes (1)	Yes (1)
B	$2,959,679	$4,000,000			$4,000,000	2010	0	0	Yes (1)	Yes (1)
C	$35,040,000	$66,185,000		$24,356		2012	Yes (1)	Yes (1)	Yes (1)	Yes (1)	$66,160,644
D	$19,220,000	$45,000,000			$45,000,000	2012	0	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd
A	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd
A	0	Yes (1)	Yes (1)
B	Yes (1)	0	Yes (1)
C	0	Yes (1)	Yes (1)
D	Yes (1)	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	0
B	0
C	0
D	0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 09/14/2006 ISSUER NAME: SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 03/29/2013 ISSUER NAME: SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 10/30/2019 ISSUER NAME: SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 11/12/2020
SCHEDULE K, PART I, BOND ISSUES	BONDS ISSUED 10/28/2014, COLUMN(C) CUSIP #: 83755VXF6 AND 83755VXE9 BONDS ISSUED 9/14/2004, COLUMN(C) CUSIP #: 83755VHY3 AND 83755VHZ0
PART I, COLUMN E AND PART II, LINE 3	DIFFERENCES BETWEEN THE ISSUE PRICE (PART I, COLUMN E) AND TOTAL PROCEEDS (PART II, LINE 3) ARE DUE TO INVESTMENT EARNINGS.
PART II, LINE 4	THE AMOUNTS SHOWN HERE CONSIST OF DEBT SERVICE FUND DEPOSITS.
PART III	PART III HAS NOT BEEN COMPLETED FOR THE 3/29/2012 SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY BONDS. THESE BONDS REFUNDED PRE-2003 DEBT THAT DOES NOT HAVE TO BE REPORTED.
PART IV, LINE 6	WITH RESPECT TO THE 3/29/2012 AND 10/21/2015 SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY BONDS, THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW FINANCED WITH PROCEEDS OF BONDS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
A	460315509	83755VWA8	2014-08-05	$52,083,720	2014A: CURRENT REFUND 2004A ISSUED 9/14/2004	0	0	0
SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
B	460315509	83755VXE9	2014-10-28	$207,014,209	2014B: NEW CONSTRUCTION AND REMODELING OF HEALTHCARE FACILITIES	0	0	0
SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
C	460315509	83755VZW7	2015-10-21	$192,641,206	2015:NEW CONSTRUCTION & ADVANCED REFUNDING OF BONDS ISSUED 4/19/07, 5/22/07	0	0	0
SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
D	460315509	000000000	2016-10-28	$50,000,000	2016: NEW CONSTRUCTION, EQUIPMENT AND IMPROVEMENTS	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	RetiredRetiredAmt	Capitalized InterestCapitalizedInterestAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt
A	$52,083,720	$476	$52,083,720	2014	Yes (1)	0	Yes (1)	Yes (1)
B	$207,081,359	$3,605		2017	0	0	Yes (1)	Yes (1)	$24,890,000	$31,874	$1,906,127	$205,143,359
C	$192,707,024	$3,685	$80,746,163	2017	0	Yes (1)	Yes (1)	Yes (1)	$25,260,000		$1,431,628	$110,529,233
D	$50,000,000			2017	0	0	Yes (1)	Yes (1)	$30,000,000		$150,032	$49,849,968

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd
A	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd
A	Yes (1)	0	0
B	0	Yes (1)	0
C	0	Yes (1)	0
D	Yes (1)	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	0
B	0
C	0
D	0

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (7 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
MELINDA ANDERSON
FAMILY RELATIONSHIP - MARK PAULSON	$169,960	EMPLOYMENT	0
KATHRYN NERMOE
FAMILY RELATIONSHIP - BRYAN NERMOE	$150,884	EMPLOYMENT	0
KACEY DOYLE
FAMILY RELATIONSHIP - MARNIE HERMANN	$65,433	EMPLOYMENT	0
KRISTI BENZ
FAMILY RELATIONSHIP - LAURIS MOLBERT	$60,298	EMPLOYMENT	0
NICHOLE HESTER
FAMILY RELATIONSHIP - ANDY NORTH	$58,844	INDEPENDENT CONTRACTOR ARRANGEMENT	0
MALLORY NERMOE
FAMILY RELATIONSHIP - BRYAN NERMOE	$54,485	EMPLOYMENT	0
MEGAN HEMMELGARN
FAMILY RELATIONSHIP - MARK PAULSON	$17,259	EMPLOYMENT	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 3A:	SANFORD HEALTH, SANFORD MEDICAL CENTER, SANFORD NORTH, SANFORD MEDICAL CENTER FARGO, SANFORD CLINIC NORTH, SANFORD CLINIC, SANFORD BISMARCK, SANFORD HEALTH NETWORK NORTH, AND SANFORD WORLD CLINICS HAVE UNRELATED BUSINESS GROSS INCOME OVER $1,000.
PART V, LINE 4A:	SANFORD WORLD CLINICS HAS AN INTEREST IN FINANCIAL ACCOUNTS IN THE FOREIGN COUNTRIES OF GHANA, CHINA AND GERMANY.
FORM 990, PART VI, SECTION A, LINE 2	THE FOLLOWING OFFICERS, BOARD MEMBERS, AND KEY EMPLOYEES ARE EMPLOYEES OF SANFORD OR ITS RELATED ORGANIZATIONS. MANY OF THESE EMPLOYEES ALSO SERVE ON OTHER RELATED SANFORD BOARDS, OR HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER THAT SPAN THE ORGANIZATION AS A WHOLE: BILL GASSEN, BRYAN NERMOE, JENNIFER GRENNAN, MARIA BELL, MARK LUNDEEN, MARK PAULSON, MICHAEL LEBEAU, MICHELLE BRUHN, MICHELLE MICKA, PAUL HANSON, MATT HOCKS, SUSAN JARVIS, TODD SCHAFFER, & TIFFANY LAWRENCE.
FORM 990, PART VI, SECTION A, LINE 6	SANFORD IS GOVERNED BY A BOARD OF TRUSTEES (BOT) THAT HAS ULTIMATE STRATEGIC AND DECISION MAKING AUTHORITY. THE BOT DELEGATES CERTAIN ACTIVITIES AND RESPONSIBILITIES TO BOARDS OF EACH OF SANFORD'S PRIMARY OPERATING SUBSIDIARIES. THE UNIQUE NATURE AND COMPLEXITY OF THE SUBSIDIARIES REQUIRES EACH TO HAVE A DELEGATED BOARD WITH A SINGULAR ENTITY FOCUS. SUCH BODIES, REFERRED TO AS BOARDS OF DIRECTORS AND BOARDS OF GOVERNORS, ADDRESS MATTERS SUCH AS CREDENTIALING, ACCREDITATION STANDARDS, DEVELOPING BUDGETS, PROGRAMS AND FACILITIES ON AN ENTITY-SPECIFIC BASIS, AND GENERALLY CONSIST OF INDIVIDUALS DISTINCT FROM THE BOT. THESE BOARDS FUNCTION MUCH LIKE COMMITTEES IN A TRADITIONAL CORPORATE STRUCTURE. THE BOT THEN ACTS AS A HOLDING COMPANY BOARD, SYNTHESIZING AND RECONCILING EACH ENTITY'S PROGRAMS AND BUDGETS INTO A SYSTEM-WIDE STRATEGIC PLAN. THIS STRUCTURE OF GOVERNANCE PRODUCES A SIGNIFICANT NUMBER OF TRUSTEES, GOVERNORS AND DIRECTORS. SUBSIDIARIES INCLUDED WITHIN THIS GROUP TAX RETURN CONSIST OF SANFORD HEALTH, SANFORD NORTH, SANFORD MEDICAL CENTER, SANFORD MEDICAL CENTER FARGO, SANFORD CLINIC, SANFORD CLINIC NORTH, SANFORD HEALTH NETWORK, SANFORD HEALTH NETWORK NORTH, SANFORD HOME HEALTH, SANFORD RESEARCH, SANFORD RESEARCH NORTH, SANFORD WORLD CLINICS, SANFORD HEALTH OF NORTHERN MINNESOTA, BAKER PARK, INC., SANFORD WEST, SANFORD BISMARCK, SANFORD VIRTUAL CARE, AND SANFORD WORLD CLINICS - KLAMATH FALLLS. THE BOARD OF TRUSTEES OF SANFORD IS ALSO THE BOARD OF TRUSTEES FOR SANFORD HEALTH, SANFORD NORTH, AND SANFORD WEST, AND SANFORD IS THE SOLE CORPORATE MEMBER OF THESE ENTITIES. THESE ENTITIES, IN TURN, ARE THE SOLE CORPORATE MEMBERS OF THEIR SUBSIDIARIES. THE ACTIONS APPROVED BY A SUBSIDIARY'S BOARD OF DIRECTORS ARE THEN APPROVED BY THE SANFORD BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7A	THE SANFORD BOARD OF TRUSTEES APPOINTS THE BOARD MEMBERS FOR THE BOARDS OF DIRECTORS AND BOARDS OF GOVERNORS OF THE SUBSIDIARY ENTITIES.
FORM 990, PART VI, SECTION A, LINE 7B	THE SANFORD BOARD OF TRUSTEES APPROVES THE ACTIONS APPROVED BY THE BOARDS OF DIRECTORS AND BOARDS OF GOVERNORS OF THE SUBSIDIARY ENTITIES. FORM 990, PART VI, SECTION B, LINE 10B: SANFORD NORTH, SANFORD CLINIC AND SANFORD HEALTH NETWORK HAVE LOCAL CHAPTERS, BRANCHES OR AFFILIATES OVER WHICH THE ORGANIZATION HAS THE LEGAL AUTHORITY TO EXERCISE DIRECT OR INDIRECT SUPERVISION AND CONTROL.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED INTERNALLY BY THE TAX DEPARTMENT AND REVIEWED BY EXECUTIVE MANAGEMENT. AN EXTERNAL ACCOUNTING FIRM REVIEWS THE RETURN. THE TAX DEPARTMENT PREPARES RETURN HIGHLIGHTS AND KEY DISCLOSURES FOR FINANCE SENIOR LEADERSHIP. BEFORE THE RETURN IS FILED, A COMPLETE COPY OF THE RETURN IS PROVIDED TO THE CURRENT BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 12C	THE ANNUAL CONFLICT OF INTEREST DISCLOSURE PROCESS IS MANAGED BY THE CHIEF COMPLIANCE OFFICER (CCO). THE CCO IS RESPONSIBLE FOR ASSURING THAT ALL COMPLETED FORMS ARE RETURNED IN A TIMELY AND COMPLETE MANNER. CONFLICT OF INTEREST QUESTIONNAIRES ARE SENT TO SYSTEM TRUSTEES, MEMBERS OF THE GOVERNING BOARDS OF SUBSIDIARY ENTITIES, OFFICERS, AND KEY EMPLOYEES FOR ALL ENTITIES SUBJECT TO THE IRS FORM 990 FILINGS. THE DISCLOSURES ARE SUMMARIZED FOR REVIEW BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES, PURSUANT TO POLICY. THIS REVIEW ALLOWS: 1) THE BOARD TO ACQUIRE AN AWARENESS OF FINANCIAL RELATIONSHIPS OF BOARD MEMBERS AND KEY MANAGEMENT EMPLOYEES AND CAN INVOKE THE RECUSAL PROCESS ON A CASE-BY-CASE BASIS IF POTENTIAL CONFLICTS ARE IMPLICATED IN BOARD DECISIONS AND DELIBERATIONS, AND, 2) GIVES THE BOARD THE OPPORTUNITY TO SEEK ADDITIONAL INFORMATION AND CLARIFICATION ABOUT DISCLOSURES TO DETERMINE POTENTIAL CONFLICTS OF INTEREST, AND HOW TO MANAGE THEM.
FORM 990, PART VI, SECTION B, LINE 15	THE EXECUTIVE COMPENSATION COMMITTEE OF THE SANFORD BOARD OF TRUSTEES DIRECTLY ENGAGES A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTING FIRM ANNUALLY TO REVIEW THE TOTAL COMPENSATION ARRANGEMENTS OF THE OFFICERS AND EXECUTIVES OF THE ORGANIZATION, INCLUDING THE CEO, AND TO REPORT THE FINDINGS TO THEM FOR DELIBERATION AND ACTION. THE DELIBERATIONS AND ACTIONS ARE RECORDED IN THE MINUTES OF THE SANFORD BOARD OF TRUSTEES. THE MOST RECENT STUDY WAS COMPLETED IN 2022. PART VI, LINE 16A: SANFORD MEDICAL CENTER, SANFORD CLINIC, SANFORD MEDICAL CENTER FARGO AND SANFORD CLINIC NORTH HAVE PARTICIPATED IN JOINT VENTURES WITH TAXABLE ENTITIES.
FORM 990, PART VI, SECTION C, LINE 19	ALTHOUGH THE ORGANIZATION DOES NOT MAINTAIN A WEBSITE WHERE THE PUBLIC CAN ACCESS THESE DOCUMENTS, IT WOULD RESPOND INDIVIDUALLY TO ANY REQUESTS OR INQUIRIES FROM THE PUBLIC FOR THESE DOCUMENTS.
FORM 990, PART VII, SECTION A	THE TABLE REPORTS THE COMPENSATION OF THE SANFORD OFFICERS, DIRECTORS/TRUSTEES, SYSTEM KEY EMPLOYEES, AND FIVE HIGHEST COMPENSATED EMPLOYEES AND INDEPENDENT CONTRACTORS. THE SANFORD BOARD OF TRUSTEES HAS ULTIMATE GOVERNANCE RESPONSIBILITIES FOR EACH SUBORDINATE ORGANIZATION.
FORM 990, PART VII, SECTION B	WE ARE REPORTING ONE GROUP OF TOP FIVE EMPLOYEES AND INDEPENDENT CONTRACTORS FOR THE ENTIRE GROUP. AMOUNTS LISTED AS COMPENSATION FOR THE FIVE HIGHEST COMPENSATED INDEPENDENT CONTRACTORS INCLUDE PAYMENTS FOR BOTH MATERIALS AND SERVICES.
FORM 990, PART XI, LINE 9:	NET PAYROLL PAID BY PARENT NET OF OTHER EXPENSES PAID FOR AFFILIATES 62,167,718. PENSION PLAN ACTURIAL GAIN/LOSS 18,822,320. CAPITAL CONTRIBUTIONS TO SUBSIDIARIES -901,671.
FORM 990 ELECTIONS	FORM 990, PAGE 1, LINE H(A) - LISTING OF SUBORDINATE ORGANIZATIONS: NAMES, ADDRESSES, AND EINS SANFORD HEALTH 1305 W 18TH STREET, PO BOX 5039 SIOUX FALLS, SD 57117-5039 EIN: 31-1527032 SANFORD MEDICAL CENTER 1305 W 18TH STREET, PO BOX 5039 SIOUX FALLS, SD 57117-5039 EIN: 46-0227855 SANFORD HOME HEALTH 1305 W 18TH STREET, PO BOX 5039 SIOUX FALLS, SD 57117-5039 EIN: 46-0282134 SANFORD HEALTH NETWORK 1305 W 18TH STREET SIOUX FALLS, SD 57105 EIN: 46-0388596 SANFORD CLINIC 1305 W 18TH STREET, PO BOX 5039 SIOUX FALLS, SD 57117-5039 EIN: 46-0447693 SANFORD RESEARCH 2301 E 60TH STREET N SIOUX FALLS, SD 57104 EIN: 46-0450378 SANFORD RESEARCH NORTH 120 8TH STREET SOUTH FARGO, ND 58103 EIN: 45-0274828 SANFORD WORLD CLINICS 1305 W 18TH STREET SIOUX FALLS, SD 57105 EIN: 26-2707628 SANFORD WORLD CLINICS - KLAMATH FALLS 3001 DAGGETT AVE KLAMATH FALLS, OR 97601 92-0396212 SANFORD NORTH 801 BROADWAY DRIVE, PO BOX 2010 FARGO, ND 58122 EIN: 45-0385890 SANFORD CLINIC NORTH 801 BROADWAY DRIVE, PO BOX 2010 FARGO, ND 58122 EIN: 91-1770748 SANFORD MEDICAL CENTER FARGO 801 BROADWAY DRIVE, PO BOX 2010 FARGO, ND 58122 EIN: 45-0226909 SANFORD HEALTH NETWORK NORTH 801 BROADWAY DRIVE, PO BOX 2010 FARGO, ND 58122 EIN: 45-0409348 SANFORD HEALTH OF NORTHERN MINNESOTA 1300 ANNE STREET NW BEMIDJI, MN 56601 EIN: 41-1266009 BAKER PARK, INC. 803 DEWEY AVENUE NW BEMIDJI, MN 56601 EIN: 41-1372480 SANFORD WEST 300 N 7TH STREET BISMARCK, ND 58501 EIN: 45-0397195 SANFORD BISMARCK 300 N 7TH STREET BISMARCK, ND 58501 EIN: 45-0226700 SANFORD VIRTUAL CARE 1305 W 18TH STREET, PO BOX 5039 SIOUX FALLS, SD 57117-5039 EIN: 88-0976483

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (11 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
1527 BROADWAY LLC
1527 BROADWAY	ALEXANDRIA	MN	56308	411336392	REAL ESTATE	MN	$0	$151,829	SANFORD CLINIC NORTH
B&K PROPERTIES LLC
PO BOX 5039 RTE 5218	SIOUX FALLS	SD	571175030	830614887	REAL ESTATE	SD	$0	$0	SANFORD HEALTH
HEALTHCARE ENVIRONMENTAL SERVICES LLC
PO BOX 2010	FARGO	ND	58122	205236701	RETAIL ENTERPRISES	ND	$1,143,510	$3,806,618	SANFORD NORTH
LINCOLN COUNTY REAL ESTATE TRUST
100 S PHILLIPS AVE	SIOUX FALLS	SD	57104	466126929	REAL ESTATE	SD			SANFORD HEALTH
LYNX TRUST
PO BOX 5186	SIOUX FALLS	SD	57117	266167201	INVESTMENT	SD			SANFORD HEALTH
NATIONAL STUDENT HOUSING TRUST-SD
PO BOX 5186	SIOUX FALLS	SD	57117	206831968	INVESTMENT	SD	$0	$0	SANFORD HEALTH
NORTH COUNTRY SENIOR LIVING LLC
1000 ANNE ST NW	BEMIDJI	MN	56601	263862586	SENIOR HOUSING	CO	$3,839,877	$5,143,010	SANFORD HEALTH OF NORTHERN MINNESOTA
PPK FAMILY TRUST
100 S PHILLIPS AVE	SIOUX FALLS	SD	57104	207317570	RENTAL REAL ESTATE	SD	$34,580	$2,247,575	SANFORD HEALTH
SANFORD HEALTHCARE ACCESSORIES LLC
3223 32ND AVE SW	FARGO	ND	58103	202404179	SALES OF DURABLE MEDICAL EQUIP	ND	$0	$0	SANFORD HEALTH
SHETEK MEDICAL SERVICES LLC
251 5TH STREET E	TRACY	MN	56175	412004685	HOME HEALTH SERVICES	MN	$166,282	$246	SANFORD HEALTH NETWORK
SOUTHWEST MN RADIATION CENTER LLC
1018 6TH AVENUE	WORTHINGTON	MN	56187	460447693	RADIATION SERVICES	MN			SANFORD HEALTH NETWORK

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (23 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
ADAMS COUNTY GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	461495572	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
ARLINGTON GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	371805492	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	10	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
BOISE GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	363370371	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	PF	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
COLLISTER DRIVE HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	300872973	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	PF	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
F-M AMBULANCE SERVICE INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	450344371	EMT	ND	501(C)(4)		SANFORD NORTH	Yes (1)
GOOD SAMARITAN SOCIETY INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	460349951	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	271212446	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
HOWARD LAKE GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	364885253	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	10	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
LEA COUNTY GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	453946645	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	10	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
LILAC WAY GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	465740381	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
MILLARD GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	460396332	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
OLATHE GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	460396398	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
PRESCOTT GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	275114421	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
PROPHETSTOWN GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	460392943	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	10	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
RAPID CITY GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	461579750	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
SANFORD
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	271218956	SUPPORTING ORGANIZATION	ND	501(C)(3)	12-II		0
SANFORD HEALTH FOUNDATION
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	363297853	FOUNDATION	SD	501(C)(3)	12-II	SANFORD HEALTH	Yes (1)
SANFORD HEALTH FOUNDATION NORTH
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	450398104	FOUNDATION	ND	501(C)(3)	7	SANFORD NORTH	Yes (1)
SANFORD HEALTH FOUNDATION OF NORTHERN MINNESOTA
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	411389317	FOUNDATION	MN	501(C)(3)	7	SANFORD HEALTH OF NORTHERN MINNESOTA	Yes (1)
SANFORD HEALTH FOUNDATION WEST
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	450397196	FOUNDATION	ND	501(C)(3)	7	SANFORD BISMARCK	Yes (1)
SIOUX FALLS DOWNTOWN GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	452473519	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	Yes (1)
THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	460422866	FOUNDATION	MN	501(C)(3)	12-I	SANFORD HEALTH	Yes (1)
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	450228055	LONG-TERM CARE, SENIOR HOUSING & HOME AND COMMUNITY BASED SERVICES	ND	501(C)(3)	10	SANFORD	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (15 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
ADA COUNTY GOOD SAMARITAN HOUSING LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	364799439	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
ADAMS COUNTY GOOD SAMARITAN HOUSING LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	383896526	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
COLLISTER DRIVE HOUSING LLC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	611752929	LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	N/A	0	0
HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	271212511	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
LILAC WAY GOOD SAMARITAN HOUSING LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	364786577	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
MILLARD GOOD SAMARITAN HOUSING LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	271212324	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
NATIONAL STUDENT HOUSING-SOUTH DAKOTA LLC
100 S PHILLIPS AVE	SIOUX FALLS	SD	57104	202129839	INVESTMENT	SD	N/A	0	0
OLATHE GOOD SAMARITAN HOUSING LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	205297369	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
PENNINGTON COUNTY GOOD SAMARITAN HOUSING LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	384060178	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
PRESCOTT GOOD SAMARITAN HOUSING LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	275115281	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
RAC RENTALS LLC
100 S PHILLIPS AVE	SIOUX FALLS	SD	57104	261961077	INVESTMENT	SD	N/A	0	0
RAPID CITY GOOD SAMARITAN HOUSING LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	352466169	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
RUTH STREET GOOD SAMARITAN HOUSING LLC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	611748321	LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	N/A	0	0
SIOUX FALLS DOWNTOWN GOOD SAMARITAN LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	320377442	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
TEXAS GOOD SAMARITAN HOUSING LLC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	371774574	LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	N/A	0	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (15 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd
GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	815037667	INSURANCE	NE	N/A	C	0
GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	815020633	INSURANCE	ND	N/A	C	0
GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	814989242	INSURANCE	SD	N/A	C	0
GOOD SAMARITAN SOCIETY INSURANCE LTD
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	980379099	INSURANCE		N/A	C	0	CJ
HERITAGE HEALTHCARE OF NORTHERN NEW MEXICO INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	900491537	PROVIDE HOME AND COMMUNITY BASED SERVICES	NM	N/A	S	0
HERITAGE HEALTHCARE SERVICES INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	850418562	PROVIDE HOME AND COMMUNITY BASED SERVICES	NM	N/A	S	0
HERITAGE HOME HEALTHCARE & HOSPICE INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	850463468	PROVIDE HOME AND COMMUNITY BASED SERVICES	NM	N/A	S	0
HERITAGE HOME HEALTHCARE OF ARIZONA INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	204243949	PROVIDE HOME AND COMMUNITY BASED SERVICES	NM	N/A	S	0
HERITAGE HOME HEALTHCARE SERVICES INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	850463469	PROVIDE HOME AND COMMUNITY BASED SERVICES	NM	N/A	S	0
SANFORD FRONTIERS
1305 W 18TH STREET PO BOX 5039	SIOUX FALLS	SD	571175039	455436599	WEIGHT LOSS/FITNESS	SD	N/A	C	0
SANFORD HEALTH PLAN
300 CHERAPA PLACE	SIOUX FALLS	SD	57103	911842494	INSURANCE	SD	N/A	C	0
SANFORD HEALTH PLAN OF MN
300 CHERAPA PLACE	SIOUX FALLS	SD	57103	460445852	INSURANCE	MN	N/A	C	0
SANFORD INTERNATIONAL - MUNICH GMBH
					HEALTHCARE		N/A	C	0	GM	NYMPHENBURGER STRASSE 3	MUNICH	GM
SANFORD WORLD CLINICS - GHANA
					HEALTHCARE		N/A	C	0	GH	SARBAH ROAD TANTRI LORRY STATION	CAPE COAST	GH
SHANGHAI SANFORD HEALTHCARE MANAGEMENT CONSULTING CO LTD
					HEALTHCARE		N/A	C	0	CH	188 YESHENG ROAD ROOM A-862 GUOMA	SHANGHAI	CH

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	Yes (1)	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (20 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
FM AMBULANCE
R	$133,088	CASH METHOD
SANFORD (PARENT)
R	$146,935,197	CASH METHOD
SANFORD FRONTIERS
B	$36,733,574	CASH METHOD
SANFORD HEALTH FOUNDATION
S	$476,075	CASH METHOD
SANFORD HEALTH FOUNDATION
P	$4,682,184	CASH METHOD
SANFORD HEALTH FOUNDATION
C	$35,269,345	CASH METHOD
SANFORD HEALTH FOUNDATION NORTH
S	$525,796	CASH METHOD
SANFORD HEALTH FOUNDATION NORTH
P	$2,249,273	CASH METHOD
SANFORD HEALTH FOUNDATION NORTH
C	$5,107,410	CASH METHOD
SANFORD HEALTH FOUNDATION NORTHERN MN
P	$623,005	CASH METHOD
SANFORD HEALTH FOUNDATION NORTHERN MN
C	$1,515,432	CASH METHOD
SANFORD HEALTH FOUNDATION NORTHERN MN
S	$3,109,854	CASH METHOD
SANFORD HEALTH FOUNDATION WEST
P	$943,446	CASH METHOD
SANFORD HEALTH FOUNDATION WEST
C	$1,191,151	CASH METHOD
SANFORD HEALTH FOUNDATION WEST
S	$1,441,680	CASH METHOD
SANFORD WORLD CLINICS - GHANA
B	$876,672	CASH METHOD
THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION
R	$696,358	CASH METHOD
THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION
P	$1,361,596	CASH METHOD
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
S	$6,391,581	CASH METHOD
SANFORD HEALTH PLAN
B	$15,000,000	CASH METHOD