GRAND ITASCA CLINIC AND HOSPITAL: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: GRAND ITASCA CLINIC AND HOSPITAL (EIN 41-1865874)
Tax period: 2021-01-01 to 2021-12-31
Filed: 2022-11-07
IRS object ID: 202203119349300020
Schema version: 2021v4.2
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 H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-11-07T09:01:27-06:00	ReturnTs
Tax Period End	2021-12-31	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	411865874	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Grand Itasca Clinic and Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	GRAN	BusinessNameControlTxt
Phone	2183265000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1601 Golf Course Road	AddressLine1Txt
City	Grand Rapids	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55744	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Jean MacDonell	PersonNm
Person Title	President & CEO	PersonTitleTxt
Signature	2022-11-07	SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	Jean	PersonFirstNm
Person Last	MacDonell	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Jean MacDonell	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1601 Golf Course Road	AddressLine1Txt
City	Grand Rapids	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55744	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$123,377,597	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.GRANDITASCA.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1997	FormationYr
Legal Domicile State	MN	LegalDomicileStateCd
Activity Or Mission	Provide quality, accessible, and valuable health care services via a hospital, home health agency, and clinic to the surrounding rural community.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	855	TotalEmployeeCnt
Total Volunteers	50	TotalVolunteersCnt
Total Gross UBI	$35,562	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$5,619,077	PYContributionsGrantsAmt
CY Contributions Grants	$8,413,522	CYContributionsGrantsAmt
PY Program Service Revenue	$96,504,009	PYProgramServiceRevenueAmt
CY Program Service Revenue	$113,265,452	CYProgramServiceRevenueAmt
PY Investment Income	$773,754	PYInvestmentIncomeAmt
CY Investment Income	$928,263	CYInvestmentIncomeAmt
PY Other Revenue	$221,940	PYOtherRevenueAmt
CY Other Revenue	$309,243	CYOtherRevenueAmt
PY Total Revenue	$103,118,780	PYTotalRevenueAmt
CY Total Revenue	$122,916,480	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$61,250,728	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$66,465,684	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$35,554,974	PYOtherExpensesAmt
CY Other Expenses	$41,274,769	CYOtherExpensesAmt
PY Total Expenses	$96,805,702	PYTotalExpensesAmt
CY Total Expenses	$107,740,453	CYTotalExpensesAmt
PY Revenues Less Expenses	$6,313,078	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$15,176,027	CYRevenuesLessExpensesAmt
Total Assets BOY	$71,663,098	TotalAssetsBOYAmt
Total Assets EOY	$77,773,462	TotalAssetsEOYAmt
Total Liabilities BOY	$29,235,604	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$20,473,388	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$42,427,494	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$57,300,074	NetAssetsOrFundBalancesEOYAmt
Mission	Provide quality, accessible, and valuable health care services via a hospital, home health agency, and clinic to the surrounding rural community.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$95,501,164	ExpenseAmt
Revenue	$113,539,133	RevenueAmt
Desc	Grand Itasca Clinic & Hospital is an integrated multi-specialty clinic and hospital. The facility is licensed for 45 beds. In addition to providing traditional hospital services, the facility has a surgery center, full complement of imaging services, a 24-hour emergency department, outpatient rehabilitation services, and outpatient clinic services. The facility employs over 700 people, including over 60 healthcare providers. The organization has over 250,000 patient encounters each year, including emergency visits, surgeries, births, home health and clinic visits. Grand Itasca serves the patient regardless of the person's ability to pay. During the calendar year, the system provided $1,082,756 of charity care, $962,712 of discounts to the uninsured and absorbed $8,279,962 of unpaid Medicare and Medicaid costs. Grand Itasca also paid $1,708,930 in payments for Minnesota Care Tax and Medicaid Surcharges, which were used to fund care for the indigent and underinsured. Grand Itasca Clinic and Hospital is part of Fairview Health Services which is an industry-leading, award-winning, nonprofit, integrated health system providing exceptional health care across the full spectrum of health care services. Founded in 1906, Fairview serves the twelve-county Minneapolis/St. Paul Metro Area, as well as communities throughout greater Minnesota and portions of Northern Iowa and Western Wisconsin and is one of the most comprehensive and geographically accessible systems in Minnesota. Fairview, the University of Minnesota and the University of Minnesota Physicians approved an agreement which became effective in late 2018 (the "M Health Fairview Agreement"). While the parties maintain their separate governance, the M Health Fairview Agreement further integrated operations across the clinical delivery system and enhances research and education by creating a joint clinical enterprise among the parties. The M Health Fairview Agreement brings together not only UMMC and its related service lines, but also Fairview's other hospitals, primary care clinics, and other services. All are part of a shared care delivery system that is led by a single structure that includes academic physician leadership. The goal of the joint clinical enterprise is to create a nationally-renowned academic health system. This care system was united under a single brand, M Health Fairview, which is inclusive of the Fairview Hospitals and Clinics In March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. The pandemic has had a significant negative effect on the healthcare industry. Fairview continues to follow guidance from the Center for Disease Control and Prevention and the Minnesota Department of Health and is coordinating its activities with state and local governments as well as other health systems in the state and region. First and foremost, Fairview's focus is on caring for its patients during this ongoing pandemic. Fairview continues to provide COVID-19 vaccines to all individuals ages 5 and older. Fairview is committed to educating the community and distributing vaccines. Fairview has administered the most vaccines in the State of Minnesota. As of December 31, 2021, Fairview has administered more than 540,000 doses to patients in the system. A remarkable program called the Minnesota Immunization Network Initiative (MINI), a collaboration led by Fairview and supported by over 120 community partners, works to reduce barriers to influenza vaccinations for communities experiencing disparities. MINI provides flu immunizations free of charge to community members six months and older. Since inception, more than 100,000 immunizations have been given to prevent influenza. MINI clinics are hosted at non-traditional locations such as churches, mosques, temples, schools, community centers, libraries, food pantries, and homeless shelters. The clinics are hosted by a local partner who provides the space, promotion, and serves as a trusted messenger for community members. Fairview provides the vaccine and clinical team, including interpreters, support staff and information about other local community resources. Influenza vaccinations are provided at no charge to participants, six months and older. MINI clinics have expanded their reach to include other vaccinations such as Hepatitis A, blood pressure screening and cardiovascular health education, free dental varnish treatments and oral health education. These services are often provided in conjunction with MINI flu shots clinics or on their own. During the COVID-19 pandemic, the MINI program leveraged over 15 years of experience providing mobile clinical services in diverse settings to respond to the urgent public health crisis. MINI launched a large scale, low barrier testing initiative in partnership with Saint Paul Ramsey County Public Health and the Minnesota Department of Health. This collaboration enabled thousands of community members to receive a free COVID-19 test in convenient, trusted community spaces. In total, MINI supported 47 testing events and administered almost 20,000 tests. To date, MINI has provided 800 community based COVID vaccination clinics and given over 49,800 vaccinations. MINI continued to provide influenza vaccinations throughout the pandemic and administered over 4,000 free flu shots in 2021. The Fairview system consists of 11 hospitals, it controls and operates University of Minnesota Medical Center, the adult and pediatric teaching hospital of the University of Minnesota Medical School, has 10 community based general acute care hospitals and 1 long-term acute care hospital; over 80 primary and specialty care clinics; offers over 100 specialty care services; urgent care clinics; occupational health clinics; 36 retail and specialty pharmacies; pharmacy benefit management services; rehabilitation centers; counseling; hospice services; 90+ owned and managed senior care facilities and long-term care housing facilities (through Ebenezer Society, a Fairview subsidiary); and emergency medical transportation. Fairview's 34,000+ employees and network of 5,000+ system providers embrace innovation and new thinking to drive a healthier future through healing, discovery and education. The health care and medical services which Fairview provides to the community include, but are not limited to: primary, specialty, tertiary, and quaternary care; hospital and physician services; senior services; assisted living; long-term care; urgent care and emergency services; pharmacy; care of mothers and children; physical therapy/sports medicine; rehabilitation services; and inpatient and outpatient behavioral health care and chemical dependency services. Fairview provides specialized care for the treatment of cancer, heart disease, diabetes, wound care, chronic conditions, solid organ transplant, blood and marrow transplant, and many other specialties. Fairview also offers social work services, health education and support groups and services for various health issues.	Desc
Total Program Service Expenses	$95,501,164	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	855	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Form1098 C Filed	false	Form1098CFiledInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	MN	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Todd Christenson	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	2189991703	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1601 Golf Course Road	AddressLine1Txt
City	Grand Rapids	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55744	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Laura Reed RN
Officer	1.0	40.0	Yes (X)	Yes (X)	$0	$1,085,509	$157,567
Brian Armdahl MD
Director	1.0	40.0	Yes (X)		$0	$442,388	$45,061
Cory Jackson
Director	1.0	1.0	Yes (X)		$0	$0	$0
Dale Adams
Chair	1.0	1.0	Yes (X)		$0	$0	$0
Dale Fruhman
Director	1.0	0	Yes (X)		$0	$0	$0
Dennis Roy
Secretary	1.0	0	Yes (X)		$0	$0	$0
Josh Skelton
Finance Comm Chair	1.0	0	Yes (X)		$0	$0	$0
Keith Murphy MD
Director	40.0	0.0	Yes (X)		$334,341	$0	$50,543
Kent Koerbitz
Director	1.0	0	Yes (X)		$0	$0	$0
Kevin Nelson MD
Director	1.0	40.0	Yes (X)		$0	$488,180	$13,107
Kimberley DeRoche MD
Director	1.0	40.0	Yes (X)		$0	$481,052	$94,058
Mike Ives
Vice Chair	1.0	0	Yes (X)		$0	$0	$0
Mike Miskovich DDS
Director	1.0	0	Yes (X)		$0	$0	$0
Simon Lick MD
Director	40.0	0.0	Yes (X)		$303,998	$0	$46,992
Steve Burggraf
Director	1.0	0	Yes (X)		$0	$0	$0
James Hereford
Officer	2.0	40.0		Yes (X)	$0	$2,262,435	$512,663
Jean MacDonell
President & CEO	20.0	20.0		Yes (X)	$0	$372,775	$75,151
Jon Pederson
VP Operations	40.0	0.0		Yes (X)	$178,140	$0	$30,186
Todd Christensen
VP Finance	20.0	20.0		Yes (X)	$161,308	$0	$23,592
Daniel Soular
CMO	40.0	0.0			$376,053	$0	$39,422	Yes (X)
Darin Skaudis MD
Physician	40.0	0			$0	$0	$0		Yes (X)
John Kole MD
Physician	40.0	0.0			$408,875	$0	$55,951		Yes (X)
Jonathan Germscheid MD
Physician	40.0	0.0			$412,367	$0	$49,361		Yes (X)
Ryan Novak MD
Physician	40.0	0.0			$572,710	$0	$65,757		Yes (X)
Shawn Olson MD
Physician	40.0	0.0			$419,776	$0	$37,085		Yes (X)
Wilfred Gould MD
Physician	40.0	0.0			$444,401	$0	$51,442		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,611,969	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$5,132,339	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,347,938	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	90	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Related Organizations	$33,839	RelatedOrganizationsAmt
Government Grants	$8,379,683	GovernmentGrantsAmt
Total Contributions	$8,413,522	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient services	621110	$107,862,460	$107,862,460
Pharmacy	446110	$3,849,285	$3,849,285
Joint Venture- Surgery Center	621400	$1,553,707	$1,553,707

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$113,265,452	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$229,373	TotalRevenueColumnAmt
Exclusion	$229,373	ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$698,390	SecuritiesAmt
Other	$500	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$698,390	SecuritiesAmt
Other	$500	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$698,890	TotalRevenueColumnAmt
Exclusion	$698,890	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$496,679	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$461,117	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$35,562	TotalRevenueColumnAmt
Unrelated Business Revenue	$35,562	UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	Cafeteria & Other Revenue	Desc
Business	722514	BusinessCd
Total Revenue Column	$273,681	TotalRevenueColumnAmt
Related Or Exempt Func Income	$273,681	RelatedOrExemptFuncIncomeAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$273,681	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$122,916,480	TotalRevenueColumnAmt
Related Or Exempt Func Income	$113,539,133	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$35,562	UnrelatedBusinessRevenueAmt
Exclusion	$928,263	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,544,573	TotalAmt
Program Services	$735,874	ProgramServicesAmt
Management And General	$808,699	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$52,989,881	TotalAmt
Program Services	$47,996,126	ProgramServicesAmt
Management And General	$4,993,755	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,334,534	TotalAmt
Program Services	$2,026,295	ProgramServicesAmt
Management And General	$308,239	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$6,128,839	TotalAmt
Program Services	$4,828,444	ProgramServicesAmt
Management And General	$1,300,395	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,467,857	TotalAmt
Program Services	$2,963,102	ProgramServicesAmt
Management And General	$504,755	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$784,539	TotalAmt
Program Services	$679,653	ProgramServicesAmt
Management And General	$104,886	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$3,105	TotalAmt
Management And General	$3,105	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$13,559	TotalAmt
Management And General	$13,559	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$5,154	TotalAmt
Management And General	$5,154	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$8,511,739	TotalAmt
Program Services	$6,522,877	ProgramServicesAmt
Management And General	$1,988,862	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$293,782	TotalAmt
Program Services	$35,687	ProgramServicesAmt
Management And General	$258,095	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,248,936	TotalAmt
Program Services	$2,013,972	ProgramServicesAmt
Management And General	$234,964	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,902,614	TotalAmt
Program Services	$1,899,771	ProgramServicesAmt
Management And General	$2,843	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$72,212	TotalAmt
Program Services	$60,975	ProgramServicesAmt
Management And General	$11,237	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$203,228	TotalAmt
Program Services	$184,561	ProgramServicesAmt
Management And General	$18,667	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,107,838	TotalAmt
Program Services	$1,107,838	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,507,099	TotalAmt
Program Services	$1,266,438	ProgramServicesAmt
Management And General	$1,240,661	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$52,701	TotalAmt
Program Services	$52,701	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$19,663,621	$19,585,533	$78,088
Taxes	$1,698,908	$1,713,865	-$14,957
Supplies - Other	$934,736	$643,738	$290,998
Repair & Maintenance	$911,320	$906,844	$4,476

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$359,678	TotalAmt
Program Services	$276,870	ProgramServicesAmt
Management And General	$82,808	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$107,740,453	TotalAmt
Program Services	$95,501,164	ProgramServicesAmt
Management And General	$12,239,289	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$23,182,881	BOYAmt
EOY	$17,561,948	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$10,581,169	BOYAmt
EOY	$11,422,539	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$36,708	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,785,838	BOYAmt
EOY	$1,693,938	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$327,928	BOYAmt
EOY	$380,139	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$42,336,399	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$10,694,366	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$32,231,963	BOYAmt
EOY	$31,642,033	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$3,516,611	BOYAmt
EOY	$15,072,865	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$71,663,098	BOYAmt
EOY	$77,773,462	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$9,136,680	BOYAmt
EOY	$9,352,424	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$10,519,822	BOYAmt
EOY	$5,587,299	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$9,579,102	BOYAmt
EOY	$5,533,665	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$29,235,604	BOYAmt
EOY	$20,473,388	EOYAmt

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$39,800,492	BOYAmt
EOY	$54,222,084	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,627,002	BOYAmt
EOY	$3,077,990	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$42,427,494	BOYAmt
EOY	$57,300,074	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$71,663,098	BOYAmt
EOY	$77,773,462	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$15,176,027	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$303,447	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	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 (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

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	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$5,154	OtherActivitiesAmt
Total Lobbying Expenditures	$5,154	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	Grand Itasca Clinic and Hospital pays dues to American Hospital Association and Minnesota Hospital Association (MHA). A portion of these annual dues are determined to be used for lobbying purposes.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,194,000	OtherCostOrOtherBasisAmt
Book Value	$1,194,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$29,938,538	OtherCostOrOtherBasisAmt
Depreciation	$4,560,098	DepreciationAmt
Book Value	$25,378,440	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$10,543,117	OtherCostOrOtherBasisAmt
Depreciation	$5,881,827	DepreciationAmt
Book Value	$4,661,290	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$660,744	OtherCostOrOtherBasisAmt
Depreciation	$252,441	DepreciationAmt
Book Value	$408,303	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$31,642,033	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
Assets Limited to Use	$194,912
Other Long-Term Assets	$2,932,187
Investment in Joint Venture	-$11,120
Intercompany Receivable	$11,956,886

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$15,072,865	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Deferred Compensation Obligations	$2,921,320
Work Comp Reserve	$740,858
Intercompany Payable
Other Long-Term Debt	$1,871,487

Field	Value	IRS element (for citing)
Total Liability	$5,533,665	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	FormAndLineReferenceDesc
Explanation	Grand Itasca Clinic and Hospital is part of Fairview Health Services. Fairview recognizes all tax positions, including those positions in a previously filed tax return or a position expected to be taken in a future tax filing that is reflected in measuring current or deferred income tax assets and liabilities, when it is more likely than not (likelihood of greater than 50%) that, based on technical merits, the position will be sustained upon examination. There are $14,540 and $0 uncertain tax positions recorded on the consolidated balance sheets as of December 31, 2021 and 2020, respectively. Fairview has made reasonable estimates of the provision for income taxes and on existing deferred tax balances based on accounting guidance included in ASC 740, Income Taxes. Fairview does not expect that there will be a significant change in the total amount of unrecognized tax benefits within the next 12 months.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$974,752	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$688,324	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$286,428	NetCommunityBenefitExpnsAmt
Total Expense	0.0027	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,501,700	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$11,073,363	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,428,337	NetCommunityBenefitExpnsAmt
Total Expense	0.0411	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$16,476,452	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$11,761,687	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,714,765	NetCommunityBenefitExpnsAmt
Total Expense	0.0438	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$311,937	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$311,937	NetCommunityBenefitExpnsAmt
Total Expense	0.0029	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$722,557	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$237,455	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$485,102	NetCommunityBenefitExpnsAmt
Total Expense	0.0045	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,545	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,042	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,503	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$27,395	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$27,395	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$1,078,434	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$250,497	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$827,937	NetCommunityBenefitExpnsAmt
Total Expense	0.0077	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$17,554,886	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,012,184	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,542,702	NetCommunityBenefitExpnsAmt
Total Expense	0.0514	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,115,480	BadDebtExpenseAmt
Bad Debt Expense Attributable	$22,310	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$31,201,796	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$35,295,390	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$4,093,594	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	CDI Grand Rapids LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	Provide MRI, Diagnostic Injection and Pa	PrimaryActivitiesTxt
Org Profit Or Ownership	0.55	OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership	0.0	OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership	0.0	PhysiciansProfitOrOwnershipPct

Field	Value	IRS element (for citing)
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Grand Itasca Clinic and Hospital	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1601 Golf Course Road	AddressLine1Txt
City	Grand Rapids	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55744	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.GRANDITASCA.ORG	WebsiteAddressTxt
State License	406125	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Grand Itasca Clinic and Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	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 (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	See Section C, Line 7d	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	22	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	See Section C, Line 7d	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.0	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
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
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	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 (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	https://www.fairview.org/billing/financial-assistance	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	http://www.fvfiles.com/2266.pdf	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://www.fairview.org/billing/financial-assistance	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 (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	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 (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 3E	Fairview is committed to transparency and accountability in all we do, including our efforts to assess - and respond to - our community's most pressing health needs. The community benefit work that we do across Fairview must reflect our community's actual needs, not our assumptions about what those needs might or should be. Because we understand that change cannot happen when we work in silos, and it cannot happen in a single year, we grounded our 2021 CHNA process in alignment with our 2018 CHNA needs, existing data, and the voices of community members and community partners. Once we had collected, analyzed, and synthesized the information we received from both primary and secondary data sources, we established a prioritization process through which we could identify the community health needs that, if effectively addressed, would have the greatest positive impact on our communities and particularly on our priority populations. Having a consistent, defined process helps reduce the skewing effect of conscious and unconscious biases and enables us to define priority need areas that reflect our community's top health needs rather than our perception of those needs. We evaluated areas of need based on four broad criteria: -Has this need been voiced by the community? Has this need been vetted by the community? -Does this need align with Fairview's strategies and priorities? -Does this need align with existing public health strategies and community health assessments? -Does this need build upon Fairview's 2018 CHNA priority needs? Our process resulted in the identification of three priority need areas. They are: -Navigating and accessing care and resources -Healing, connectedness, and mental health -Addressing structural racism and barriers to achieving health equity.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Grand Itasca Clinic and hospital. The assessment process and data collection methods we used during this CHNA cycle were different than ever before due to the COVID-19 pandemic. COVID- 19 caused delays in data collection among local, state, and national organizations. As a result of these delays, the U.S. Census Bureau had not yet released finalized data from the 2020 U.S. Census by the time we began the CHNA process. As a result, we used 2015-2019 American Community Survey data. Local public health agencies also were not able to provide updated data as they have in the past. We acknowledge that, due to these setbacks, the data we used is less recent than desired. Additionally, COVID-19 required us to add new safety precautions to our method of gathering community voice data. For example, all conversations and interviews, which had previously been in-person meetings, took place in a virtual format instead. We collected additional community voice data by convening a broad array of stakeholders, with special focus on the priority populations. The process included discussions with community benefit and assessment committees, our community advisory council, the HOPE Commission listening and learning sessions, and key stakeholder interviews. Throughout this process, community members, local business leaders, government representatives, nonprofit and community organizations, and content experts shared their voices and perspectives about their community's health needs. Each hospital within Fairview has a community committee that is involved in the CHNA process throughout the three-year cycle. Each committee is comprised of local community and organizational leaders and is staffed by the Grand Itasca Community Relations department and the Fairview Community Advancement department. Community health steering committees met four times between April and October in 2021, three of which were individual committee meetings and one of which was a system-wide Community Impact Summit that brought all the committees together. Each committee meeting consisted of facilitated discussions through which our team gathered input about top community needs. The Fairview Community Advisory Council, composed of key community leaders and staffed by Community Advancement, reviews the CHNA report and written implementation strategy and recommends it to the Patient Care and Experience Committee of the Fairview Board of Directors for review and adoption. Each member represents the member's respective community, and members represent a broad range of sectors, among them community organizations serving cultural communities, higher education organizations, banks, and a nonprofit electric company. The Community Advisory Council met from May through November 2021 to participate in the CHNA process, give feedback, and ultimately recommend the CHNA and implementation strategy for adoption. The HOPE Commission is a multi-year transformational change effort of M Health Fairview to drive more equitable outcomes and inclusive environments and experiences for our patients, employees, and communities. The Commission conducted a series of listening and learning sessions in 2020 and 2021. The objective was to hold a mirror to Fairview to assess where we are now and how we can make lasting change. Part of being an anti-racist health system is developing a candid understanding of our shortcomings. We particularly sought to hear perspectives and ideas from the most impacted populations: BIPOC employees and patients, front-line workers who care for underserved and marginalized patients, and those patients themselves. A survey was also made available each year to gather insights and suggestions from employees and patients who could not directly participate in a listening and learning session. In 2020, the commission convened 32 virtual listening and learning sessions and two town halls involving more than 1,500 participants across Fairview sites. The sessions focused on employees but included patients and community members as well. In September 2021, the HOPE Commission continued the listening and learning sessions following the same model. In this iteration, however, the focus was primarily on gathering input from patients (and employees as patients). In both 2020 and 2021's listening and learning sessions, the facilitators and note takers reflected the community represented by the session's group to the greatest degree possible. In August and September 2021, Fairview's Community Advancement team conducted a series of interviews with staff members who work with communities. Each conversation followed a consistent interview protocol developed for this purpose, and each interview was captured by means of detailed notes. The goal of these interviews was to draw on staff expertise to gain a deeper understanding of our priority needs and to determine whether there are any emerging needs that we should be considering. Between Aug. 31 and Sept.17, 2021, we conducted 17 interviews. In August 2021, we held two focus groups in partnership with other organizations. We convened the first focus group in partnership with HealthPartners and Allina Health, and the participants were faith community nurses. We convened the second focus group in partnership with the organizations that are a part of the East Side Health and Well-being Collaborative. This meeting's focus was on accessing care and resources for different cultural communities. Fairview also participated in two large surveys. KRC Research conducted a survey around health and health care needs in St. Paul between June 8 and July 7, 2021, and administered it to community members, Fairview employees, patients, and community partners. Responses were received from 294 residents, more than 1,000 employees, 221 patients, and 20 partners. The survey was offered online and by phone and in five languages: English, Spanish, Hmong, Somali, and Karen. Fairview also supported and was a partner organization in Bridge to Health, a survey that assesses the health needs of northern Minnesota residents. The Bridge to Health survey was administered between Aug. 28 and Oct. 23, 2020. The geographic areas that were sampled included Aitkin, Carlton, Cook, Itasca, Koochiching, Lake, St. Louis, and Pine counties in Minnesota, as well as Douglas County in Wisconsin. As a foundational part of program planning and evaluation, Community Advancement staff are continuously soliciting feedback from community partners and program participants. We capture this information on an ongoing basis and use it to provide valuable context and drive insights into the needs of the communities we serve. Fairview staff developed standardized tools, processes, instructions, and facilitator, interviewer, and note-taker protocols and training. All primary data was compiled, cleaned, and analyzed. Community conversations lasted various lengths from 30-120 minutes. All community input was captured by a note-taker. The Fairview team contracted with the following groups to support our assessment process: -Loren Blinde, PhD of Writing Power, a copywriter and content strategist, on the writing of the report. -Kristi Fordyce, an independent contractor, for analysis support. -Weber Shandwick, for data collection and analysis of focus groups and stakeholder interviews focused on St. Paul. -KRC Research for the administration and analysis of the St. Paul Community Survey
Schedule H, Part V, Section B, Line 7 Facility , 1	Facility , 1 - Grand Itasca Clinic and hospital. The Community Health Needs Assessment Report for Grand Itasca Clinic and Hospital are located at: https://stcr-prd-cd.fairview.org/-/media/Files/Local-Health-Needs/Read-full-reports/2021-CHNA-Report-Grand-Itasca-Clinic-and-Hospital2125.pdf?_ga=2.XXX-XX-XXXX.1916792193.1654267916-XXX-XX-XXXX.1594916074 The Community Health Needs Assessment Implementation Strategy Report for Grand Itasca Clinic and Hospital are located at: https://stcr-prd-cd.fairview.org/-/media/Files/Local-Health-Needs/CHNA-Implementation-Strategy-Report-20222024-GICH-1.pdf?_ga=2.XXX-XX-XXXX.1916792193.1654267916-XXX-XX-XXXX.1594916074
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Grand Itasca Clinic and hospital. Over the course of 2021, Fairview's hospitals and medical centers, including Grand Itasca Clinic & Hospital, conducted our Community Health Needs Assessment (CHNA) process to determine our priority needs and our response. As part of this process, we listened and learned much about our community's most pressing needs. Through those conversations, and supported by community data, we prioritized the following needs: Navigating and accessing care and resources, Healing, connectedness, and mental health, and Addressing structural racism and barriers to equity. The CHNA Implementation Strategy Report outlines the major strategies and actions we will deploy throughout the 2022-2024 assessment cycle. The current generation will be the first generation in American history to experience shorter life expectancy than their parents did.1 Over the past decade, rates of poverty, food insecurity, isolation, mental illness, addiction, and other determinants of poor health have continued to rise and these do not impact everyone equally - Minnesota has some of the nation's largest racial, ethnic, and geographic health inequities. To impact these devastating trends, we must respond in ways that align with the factors that research has shown to have a significant effect on an individual's health and wellbeing. Studies estimate that eighty percent of a person's health outcomes are influenced by factors outside a healthcare setting,2 and a person's zip code matters more than their genetic code when it comes to long-term health.3 Given these realities, our response must reach outside the health system's walls and must focus on those experiencing health inequities to be most effective. Since the 2010 passage of the Affordable Care Act, our health system has engaged in four CHNA cycles. During each cycle, we have found the same or similar needs have existed for our communities. This means that our communities have largely faced the same challenges for more than a decade - and that despite our efforts to address these issues, these problems are not relenting. In fact, in many cases, these conditions have worsened over the past decade. Over the past 10 years of responding to our communities' biggest needs we have learned important lessons which have guided us in the development of our Fairview Health Services 2022-2024 implementation strategies. An essential part of the 2018 CHNA process was the identification of priority needs in the local community. The hospitals and/or medical centers identified the following priority needs for Grand Itasca Clinic & Hospital: Mental health and well-being, Healthy lifestyles, Access to care and services. Each hospital and/or medical center developed a hospital specific implementation plan around its priority health issues along with a system focus on policy, system, and environmental (PSE) change to address the identified priority needs. Each program is evaluated on an annual basis against program specific anticipated impacts. As part of the evaluation process each program indicator is assigned a value of "green", "yellow" or "red" based upon the following criteria. A rating of "green" means that the program (a) met, or exceeded, 2021 hospital goal/s as written in hospital implementation plan (b) it has count data tied to both goal/s and anticipated impact/s (c) there is an evaluation tool with measure tied to anticipated impact/s. A rating of "yellow" means that the program (a) had partial completion of 2021 hospital goal/s as written in hospital implementation plan (b) it has count data tied to either goal/s or anticipated impact/s but not both (c) there is an evaluation tool without measure tied to anticipated impact/s. A rating of "red" means that the program (a) did not complete the 2021 hospital goal/s written in hospital implementation plan (b) there was no count data (c) there was no evaluation tool/s. Policy, System, and Environmental (PSE) change initiatives often take multiple years to plan and implement. Using a CDC evaluation framework each PSE initiative is monitored and evaluated annually against anticipated activities and milestones linked to the six connected PSE evaluation steps. The six connected steps of PSE change we tracked for monitoring and evaluation purposes are (1) engage stakeholders, (2) describe the program, (3) focus the evaluation design, (4) gather credible evidence, (5) justify conclusions, and (6) ensure use and share lessons learned. In 2021 COVID-19 impacted many of our Community Health Improvement Plan (CHIP) programs and other offerings with impacts such as transitioning in person classes and services to virtual, adjusting participant surveys, and pivoting some programs to broaden their scope and more directly respond to COVID-19 related needs in the community. Priority: Mental health and wellbeing Grand Itasca Clinic & Hospital offered the evidence-based Mental Health First Aid program. The program introduces risk factors and warning signs of common mental health and substance use disorders, builds understanding of their impact, and reviews support options. The interactive course teaches participants how to offer initial help to an individual who may be experiencing a mental health concern or crisis and connect them to the appropriate resources. Youth Mental Health First Aid is the second core program which focuses on mental health concerns among youth ages 12-18. The 2021 anticipated impact for the Mental Health First Aid programs was an increase in participants' ability to recognize and correct misconceptions about mental health and mental illness. The anticipated impact was assigned a value of "green". 2021 Impact: Green - Outcome: 50% increase from pre-survey (50%) to postsurvey (100%) in response to the following: I strongly agree or agree that I can recognize when an individual should be referred to a mental health professional. In 2021, the Psychological First Aid program was implemented in place of Mental Health First Aid. Wording of question asked was adjusted slightly to better fit with the program curriculum. Priority: Healthy lifestyles: Grand Itasca Clinic & Hospital offered the evidence-based Living Well Suite which included three programs that were developed by Stanford University's Patient Education Research Center. (1) Chronic Disease Self-Management is a workshop given 2.5 hours once a week, for six weeks offered to individuals and their caregivers who are living with chronic conditions. Subjects addressed include medication use, communication with doctors and caregivers, nutrition, and fitness- with practical exercises and advice designed to meet participants' needs. (2) Chronic Pain Self-Management is a workshop given 2 hours once a week, for six weeks, in community settings. The workshop helps participants, and their support person, deal with the ongoing issues associated with chronic pain. (3) Diabetes Self-Management is a 6 week once a week program developed to helps those living with diabetes or pre-diabetes to improve their general health. The 2021 anticipated impact for the Living Well Suite was an increase participants' perception of positive lifestyle changes. The anticipated impact was assigned a value of "green". 2021 Impact: Green - Outcome: 90% of participants that responded to the post program survey indicated that they strongly agree or agree with the following statement: The program has helped them manage chronic condition(s). Priority: Access to care and resources Grand Itasca Clinic & Hospital offered the evidence-based Living Well Suite which included three programs that were developed by Stanford University's Patient Education Research Center. (1) Chronic Disease Self-Management is a workshop given 2.5 hours once a week, for six weeks offered to individuals and their caregivers who are living with chronic conditions. Subjects addressed include medication use, communication with doctors and caregivers, nutrition, and fitness- with practical exercises and advice designed to meet participants' needs. (2) Chronic Pain Self-Management is a workshop given 2 hours once a week, for six weeks, in community settings. The workshop helps participants, and their support person, deal with the ongoing issues associated with chronic pain. (3) Diabetes Self-Management is a 6 week once a week program developed to helps those living with diabetes or pre-diabetes to improve their general health. The 2021 anticipated impact for the Living Well Suite was an increase in participants who agree that the program helps them work with their health care providers. The anticipated impact was assigned a value of "green".
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - Grand Itasca Clinic and hospital. 2021 Impact: Green - Outcome: 100% of participants that responded to the post program survey indicated that they strongly agree or agree with the following statement: The program has helped them work with healthcare professionals. Grand Itasca Clinic & Hospital offered the evidence-based Mental Health First Aid program. The program introduces risk factors and warning signs of common mental health and substance use disorders, builds understanding of their impact, and reviews support options. The interactive course teaches participants how to offer initial help to an individual who may be experiencing a mental health concern or crisis and connect them to the appropriate resources. Youth Mental Health First Aid is the second core program which focuses on mental health concerns among youth ages 12-18. The 2021 anticipated impact for the Mental Health First Aid programs was increase participants' confidence in assisting someone to connect with professional resources. The anticipated impact was assigned a value of "green". 2021 Impact: Green - Outcome: 0% increase from pre-survey (100%) to postsurvey (100%) in response to the following: I strongly agree or agree that I understand the impact that traumatic events and experiences can have on individuals. In 2021, the Psychological First Aid program was implemented in place of Mental Health First Aid. Wording of question asked was adjusted slightly to better fit with the program curriculum. Needs identified but not addressed: Prioritizing needs that are the root causes of almost all health disparities allows us to develop upstream strategies that will have a large and lasting impact in our communities. All of the significant needs we have identified will ultimately be positively impacted by addressing the root causes we have identified as our priority needs. Although the following health needs were not selected as priority needs, Grand Itasca Clinic & Hospital will continue to support work aligned with addressing these needs as appropriate particularly when doing so would address the social determinants of health and/or the leading causes of premature death. Affordable, healthy, and safe housing: This issue is beyond what Grand Itasca Clinic & Hospital resources can support at this time. Asthma: This issue will be addressed as part of patient care but falls outside the scope of the community-based CHNA Implementation Strategy. Chronic lower respiratory disease: This issue will be addressed as part of patient care but falls outside the scope of the community-based CHNA Implementation Strategy. Clinic hours: This issue will be addressed as part of patient care but falls outside the scope of the community-based CHNA Implementation Strategy. Cost associated with care: This issue will be addressed as part of patient care but falls outside the scope of the community-based CHNA Implementation Strategy. Patient advocate/navigator: This issue will be addressed as part of patient care but falls outside the scope of the community-based CHNA Implementation Strategy. Stroke: This issue will be addressed as part of patient care but falls outside the scope of the community-based CHNA Implementation Strategy. Transportation: This issue is beyond what Grand Itasca Clinic & Hospital resources can support at this time. Wait times to appointment date: This issue will be addressed as part of patient care but falls outside the scope of the community-based CHNA Implementation Strategy.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - Grand Itasca Clinic and Hospital. The Minnesota Attorney General agreement was used in the determination of the eligibility for financial assistance.
Schedule H, Part V, Section B, Line 16 Facility , 1	Facility , 1 - Grand Itasca Clinic and hospital. A summary of the Financial Assistance Policy is posted in various locations in the hospital.

Field	Value	IRS element (for citing)
Facility	3	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Grand Itasca Professional Building
111 SE 3rd Street	Grand Rapids	MN	55744	Outpatient Clinic
Grand Itasca Clinic and Hospital Home Care
111 Southeast 3rd Street	Grand Rapids	MN	557443663	Outpatient Clinic
Grand Itasca YMCA Clinic
400 River Road	Grand Rapids	MN	557443663	Outpatient Clinic

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c Other Income Based Criteria for Free or Discounted Care	Patients that are eligible for the organization's Community Care Program or other Charity Care Plans may receive a reduction on amounts owed or up to 100% of total charges. The organization informs patients about the Community Care Program prior to delivery of services if feasible and as appropriate and during the billing process. Uninsured patients with household income up to 200% of the federal poverty level qualify for a 100% discount of the total charges. Uninsured patients who are residents of Minnesota or Wisconsin with a household income greater than 300% of the federal poverty level and equal to or below $125,000 AND RECEIVE MEDICALLY NECESSARY HOSPITAL OR HOSPITAL BASED SERVICES are charged a discount rate equal to the rate from the hospital's highest volume private payor contract.
Schedule H, Part I, Line 7f Exclusions from Percent of Total Expense	There is no bad debt expense included in Form 990 Part IX as an expense. Due to the adoption of new GAAP reporting, the bad debt expense has been included with "discounts" netted against patient service revenue on Part VIII of Form 990.
Schedule H, Part I, Line 7g Subsidized Health Services	There are no costs associated with physician clinics included in line 7g.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	The amounts reported on Form 990, Schedule H, Part I, Line 7a through 7c were determined using the cost to charge ratio derived from Worksheet 2 in the Schedule H, Form 990 Instructions. Form 990, Schedule H, Part I, Lines 7e through 7j are reported at charges as recorded by the organization.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	The provision for bad debts is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in healthcare coverage, and other collection indicators. There is no bad debt expense included in Form 990 Part IX as an expense. Due to the adoption of new GAAP reporting, the bad debt expense has been included with "discounts" netted against patient service revenue on Part VIII of Form 990.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	The bad debt expense attributable to patients that may be eligible for financial assistance is based upon management's assessment of historical and expected net collections considering historical business and economic conditions, trends in healthcare coverage, and other collection indicators.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Subsequent changes that are determined to be the result of an adverse change in the patient's ability to pay (determined on a portfolio basis when applicable) are recorded as bad debt expense. Bad expense for the years ended December 31, 2021 and 2020, was not significant. See page 23 of the audited financial statements for additional information.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	It is part of the organization's mission that community benefit activity is carried out by staff/leadership at each facility based on the health care needs in that service area. The Medicare cost to charge ratio reporting is calculated service line by service line. Other expenses are calculated using the overall cost to charge ratio. Uncompensated costs resulting from Medicare, Medicaid and state and local indigent care programs are considered a community benefit because of the significant differences between actual costs and reimbursement.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	After our patients have received services, it is the policy of the organization to bill patients and their applicable payors on a timely and accurate basis. During this billing and collection process, staff is committed to providing quality customer service and timely follow up on all outstanding accounts. Billing: It is the goal of the organization to bill all claims accurately and on a timely basis. Although dependent on information and communications from patients and payors, the organization will provide sufficient follow up service to ensure that patients receive accurate account and billing information and have the opportunity to make payment and/or apply for community care. The organization has agreed to certain billing and collection practices by an agreement with the Minnesota Attorney General's office. There are financial counselors at every entity Monday through Friday who interact with the patients in person and over the phone to inform of programs available to them as well as assist them in applying for the programs. The information about needing assistance with paying the bill is posted on signs in the hospitals and materials are distributed to self-pay patients by registration staff. The statements sent out after the visit provide this information as well. If a patient/family member calls the Central Business Office customer service staff to ask for assistance with paying their bill, they are informed about options at that time. The organization provides an interpreter service that interprets conversations over the phone. This service can be used either as a three-way phone call or the Financial Counselor, in a room with the patient or family can place the call together to the interpreter phone service. The interpreter services line accommodates close to 200 languages. The billing process will be assisted by the following guidelines: 1) For all insured patients, the organization will bill all third party payor information (as provided by or verified by the patient) on a timely and accurate basis. 2) For all uninsured patients with Minnesota residency receiving hospital based services deemed medically necessary. The organization will apply an uninsured discount equal to the discount provider to our largest contracted non-government payor, any remaining balance will be billed to the patient in a timely and manner. 3) All billed patients have the opportunity to contact the organization regarding financial assistance for their accounts. Financial assistance may include Community Care, payment arrangements, medical assistance or other applicable programs. 4) If a patient contacts the organization regarding Community Care before the account is referred to a collection agency or attorney, an application and required documentation is requested (income verification etc.), the account will then be processed based on the outcome of the Community Care determination. 5) The organization takes reasonable measures to avoid referring an account to collection unless there are no responses from the patient. If a patient contacts the organization regarding Community Care after their account has been referred to a collection agency or attorney, the organization will send an application to the patient provided the account meets the Community Care requirements. If the completed application along with required documentation (income verification, etc.) is submitted, all collection action will be suspended until the patient is notified of the organization's determination.
Schedule H, Part V, Section B, Line 16a FAP website	- Grand Itasca Clinic and Hospital: Line 16a URL: https://www.fairview.org/billing/financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Grand Itasca Clinic and Hospital: Line 16b URL: http://www.fvfiles.com/2266.pdf;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- Grand Itasca Clinic and Hospital: Line 16c URL: https://www.fairview.org/billing/financial-assistance;
Schedule H, Part VI, Line 2 Needs assessment	Our triennial community health needs assessment process provides an important opportunity to engage with and understand our community, analyze what has changed-for better or worse-since the last assessment, and prioritize together with the community the issues we must urgently address in order to improve wellbeing and resilience. Fairview's 2021 Community Health Needs Assessment (CHNA) builds upon previous assessments and was developed in partnership with community members and organizations, local public health agencies, and other hospitals and health systems. It serves as a tool for guiding policy, advocacy, and program planning. It also fulfills Internal Revenue Service (IRS) requirements for CHNA pursuant to the Affordable Care Act of 2010, which requires 501(c)(3) nonprofit hospitals to conduct an assessment at least every three years and provide an annual evaluation of the previous implementation strategy's impact. Through this process, we aim to: -Intentionally engage with community members and organizations, public health agencies, and other hospitals and health systems to identify and understand significant health needs in the community. -Understand the needs of the community it serves by analyzing current demographics and social determinants of health indicators, as well as by collecting direct input from community members and organizations. -Inform the CHNA implementation strategy and action plan development. As part of the 2021 CHNA process, we reexamined and built upon the extensive community insights shared during our 2018 CHNA, while also surveying the community for current and emerging needs. We have identified three system-wide priority need areas, and we will collaborate with our hospitals and shared services to address these priorities. Our specific response will vary by hospital based on the ways in which the priority needs manifest across a given community as well as the partnerships, both ongoing and new, that we have developed to address those needs. Our community commitment - creating a healthier future and Improving the health and wellbeing of our communities. The healthcare people receive in a hospital or clinic is only a small part of a person's overall health. That's why our commitment to advancing health equity goes beyond the walls of our facilities and reaches out into the community. We collaborate with community partners to improve health and wellbeing and advance health equity. Our priorities include: * Bringing clinical services into neighborhoods to expand access * Advancing our anchor mission initiatives - local hiring, local purchasing, local investing, and leading and serving locally * Addressing social risk factors through food access and housing programs and community education and outreach. Why is this a priority for our healthcare system? Nearly 80 percent of health is influenced by factors outside of clinical care. These factors, called the social determinants of health, are our health behaviors and the economic and social conditions in which we live. To help address the social determinants of health, we are creating a health and wellness hub in downtown St. Paul that will focus on health, housing, and supportive services for the community. All this work is closely tied to our HOPE Commission's health equity and anti-racism efforts. It's designed to be culturally appropriate and to meet the specific needs of the community. We seek to do "with" and not "to" the communities we belong to and are proud to contribute to our community in so many ways. Fairview Health Services is committed to the health and wellbeing of our communities. For generations we have served the people of Minnesota, cared for our patients, and invested in the people and partnerships that make us stronger, together. As a nonprofit health system and an anchor institution-an organization rooted in our communities-we have a commitment to intentionally apply our long-term, place-based economic power and human capital in partnership with community to mutually benefit the long-term wellbeing of both. We recognize that this commitment begins in and with our communities. This work cannot be done alone, we must collaborate with community-based organizations, local public health departments, and other health systems. Our efforts, resources, and commitments are investments in the health and wellbeing of our communities where we live, work, learn, play, and worship. Our community benefit programs and activities focus on our mission to heal, discover, and educate for longer, healthier lives and must meet at least one of these objectives: * Improve access to health care services. * Enhance the health of the community. * Advance medical or health care knowledge. * Relieve the burden of government to improve health. Fairview Health Services, is committed to providing exceptional care, delivering breakthrough research and innovation to healthcare, improving health and wellbeing, and promoting health equity. As anchor institutions rooted in the hearts of the communities we serve, this commitment goes beyond our walls and into the community. THERE ARE DIFFERENT WAYS OUR HEALTH SYSTEM FULFILLS THIS PROMISE INCLUDING: * Allocating resources to benefit the community. The process is guided by our community health needs assessments, developed collaboratively with the communities we serve, and implemented in partnership with local organizations and leaders. - The priority needs identified in our 2021 assessment are: healing, connectedness, and mental health; addressing structural racism and barriers to achieving health equity; and navigating and accessing care and resources. Our efforts will center on people experiencing poverty as well as racial or ethnic populations experiencing health disparities. * Bringing clinical services into neighborhoods to expand access. These free healthcare services are offered in diverse and/or under-resourced neighborhoods. * Addressing social risk factors, known as the social determinants of health, through food access and housing programs, and community education and outreach. The goal is to improve community health and wellbeing. * Advancing our HOPE (Healing, Opportunity, People, and Equity) Commission's - health equity and anti-racism efforts to drive more equitable outcomes and inclusive environments and experiences for our patients, employees, and communities. Success stories include: improving patient sociodemographic data to better understand the populations we serve and more accurately assess for disparities, and increasing the representation of diverse populations in clinical trials.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Grand Itasca has financial advocates working with uninsured patients to assist them in completing application for various programs that may provide them coverage for medical services.
Schedule H, Part VI, Line 4 Community information	The CHNA community of each hospital and medical center is defined as a subset of zip codes within the Fairview service area, where 90 percent of its patients live. Each of the hospitals and medical centers were attributed unique zip codes and geographies. The Grand Itasca Clinic and Hospital is comprised of 11 zip codes. Our definition of communities includes all community members, including those who are patients and employees who live, work, and play in our service areas.
Schedule H, Part VI, Line 5 Promotion of community health	Grand Itasca promotes health in the community by supporting the local free clinic, through the provision of medical supplies, basic lab test and basic x-rays to the patients of this clinic at no charge. Grand Itasca also works with a community coalition to determine the health needs of the community served by Grand Itasca Clinic & Hospital.
Schedule H, Part VI, Line 6 Affiliated health care system	Grand Itasca Clinic and Hospital is a community-focused, non-profit health care organization that is part of Fairview Health Services. Grand Itasca Clinic and Hospital provides innovative technology, compassionate care, and a full spectrum of family health services. Fairview Health Services is a Minneapolis-based nonprofit health system driven to heal, discover, and educate for longer, healthier lives. Founded in 1906, Fairview provides exceptional care to patients and communities as one of the most comprehensive and geographically accessible systems in Minnesota, serving the greater Twin Cities metro area and north-central Minnesota. Through a close relationship with the University of Minnesota, Fairview offers access to breakthrough medical research and specialty expertise as part of a continuum of care that reaches all ages and health needs. Our mission: Fairview is driven to heal, discover, and educate for longer, healthier lives. The Fairview system consists of 11 hospitals, it controls and operates University of Minnesota Medical Center, the adult and pediatric teaching hospital of the University of Minnesota Medical School, has 10 community based general acute care hospitals and 1 long-term acute care hospital; over 80 primary and specialty care clinics; offers over 100 specialty care services; urgent care clinics; occupational health clinics; 36 retail and specialty pharmacies; pharmacy benefit management services; rehabilitation centers; counseling; hospice services; 90+ owned and managed senior care facilities and long-term care housing facilities (through Ebenezer Society, a Fairview subsidiary); and emergency medical transportation. Fairview's 34,000+ employees and network of 5,000+ system providers embrace innovation and new thinking to drive a healthier future through healing, discovery and education. Fairview hospitals and medical centers included: Bethesda Hospital (St. Paul) Fairview Lakes Medical Center (Wyoming) Fairview Northland Medical Center (Princeton) Fairview Range Medical Center (Hibbing) Fairview Ridges Hospital (Burnsville) Fairview Southdale Hospital (Edina) Grand Itasca Clinic & Hospital (Grand Rapids) St. John's Hospital (Maplewood) St. Joseph's Hospital (St. Paul) University of Minnesota Medical Center and University of Minnesota Masonic Children's Hospital (Minneapolis) Woodwinds Health Campus (Woodbury)
Schedule H, Part VI, Line 7 State filing of community benefit report	MN

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 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
Laura Reed RN
Officer	$0	$975,974	$0	$100,000	$0	$9,535	$0	$124,997	$0	$32,569	$0	$1,243,076	$0	$0
Brian Armdahl MD
Director	$0	$422,388	$0	$20,000	$0	$0	$0	$17,400	$0	$27,661	$0	$487,449	$0	$0
Simon Lick MD
Director	$284,848	$0	$10,000	$0	$9,150	$0	$19,500	$0	$27,492	$0	$350,990	$0	$0	$0
Keith Murphy MD
Director	$262,082	$0	$12,500	$0	$59,759	$0	$39,000	$0	$11,543	$0	$384,884	$0	$0	$0
Kevin Nelson MD
Director	$0	$68,179	$0	$0	$0	$420,000	$0	$8,863	$0	$4,244	$0	$501,287	$0	$0
Kimberley DeRoche MD
Director	$0	$432,052	$0	$49,000	$0	$0	$0	$66,386	$0	$27,672	$0	$575,110	$0	$0
James Hereford
Officer	$0	$1,729,577	$0	$400,000	$0	$132,858	$0	$443,315	$0	$69,348	$0	$2,775,098	$0	$0
Jean MacDonell
President & CEO	$0	$342,270	$0	$30,000	$0	$506	$0	$54,627	$0	$20,524	$0	$447,926	$0	$0
Todd Christensen
VP Finance	$156,308	$0	$5,000	$0	$0	$0	$5,072	$0	$18,520	$0	$184,899	$0	$0	$0
Jon Pederson
VP Operations	$168,140	$0	$10,000	$0	$0	$0	$3,814	$0	$26,372	$0	$208,326	$0	$0	$0
Daniel Soular
CMO	$300,471	$0	$26,000	$0	$49,582	$0	$19,500	$0	$19,922	$0	$415,475	$0	$0	$0
Jonathan Germscheid MD
Physician	$406,867	$0	$0	$0	$5,500	$0	$19,500	$0	$29,861	$0	$461,728	$0	$0	$0
John Kole MD
Physician	$401,375	$0	$0	$0	$7,500	$0	$26,000	$0	$29,951	$0	$464,826	$0	$0	$0
Ryan Novak MD
Physician	$542,710	$0	$10,000	$0	$20,000	$0	$35,800	$0	$29,957	$0	$638,467	$0	$0	$0
Shawn Olson MD
Physician	$409,276	$0	$0	$0	$10,500	$0	$14,830	$0	$22,255	$0	$456,861	$0	$0	$0
Wilfred Gould MD
Physician	$439,401	$0	$5,000	$0	$0	$0	$26,000	$0	$25,442	$0	$495,843	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 4a Severance or change-of-control payment	Severance payments made to individuals in 2021: Kevin Nelson $229,985
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	Participants in a nonqualified retirement plan who received an accrued contribution: James Hereford $425,915 Laura Reed $107,597 Jean MacDonell $37,227 Kevin Nelson $6,818 Kimberly DeRoche, MD $48,986 Payments from nonqualified retirement plan to individuals were: Kevin Nelson $59,900
Schedule J, Part I, Line 7 Non-fixed payments	Fairview Health Services provides lump sum financial awards based on system-wide, business unit and/or departments financial and quality measures. Annual goals, specifically tied to productivity and quality indicators, are set for the year and an incentive paid out annually if key goals and measures are achieved.
Schedule J, Part I, Line 4a	Severance benefit payments will commence on the first regularly scheduled pay date that occurs at least five (5) days after the expiration of the rescission period. Payment of severance benefits is contingent upon (i) my having first signed and not rescinded my Service Agreement and Release Agreement and (ii) the return of Fairview's property.
Schedule J, Part I, Line 4b	The nonqualified plan (the Plan) is only open to a select group of highly compensated employees. The plan contributes the difference of what 403(b) employer contributions were missed for participants who earn more than the IRS limit on eligible compensation for qualified retirement plans. Participants may not elect to defer compensation. Contributions will be made in the form of a credit to the participant's account. Within 60 days after a participant becomes vested in a contribution, the Plan shall pay to the participant an amount equal to the amount the Participant is required to pay Federal, state, local, and foreign income taxes and employment taxes due to the vesting. The remaining amount in the participant's account shall not be paid until the separation from service payment date. A participant's account shall be distributed in cash. The plan complies with section 457(f) of the Code.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part V, Line 1a Line 1a, Section B: Independent Contractors	All Form 1099's were filed by a related organization Fairview Health Services, a 501(c)(3) non-profit, tax-exempt organization.
Form 990, Part VI, Line 11b Review of form 990 by governing body	The Tax Department conducts a detailed review of the completed return. The Form 990 is then reviewed by the Grand Itasca Director of Finance and a copy is provided to the finance committee and board of directors for approval prior to filing the return with the IRS.
Form 990, Part VI, Line 12c Conflict of interest policy	Board members sign the conflict of interest policy annually.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	Compensation is determined by assessing the market through the use of surveys and studies and determining pay rates and ranges from the results of the assessment. The CEO compensation package is summarized in an employment agreement that is approved by the board. The compensation package is based upon market for the position.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	Compensation is determined by assessing the market through the use of surveys and studies and determining pay rates and ranges from the results of the assessment. The CEO compensation package is summarized in an employment agreement that is approved by the board. The compensation package is based upon market for the position.
Form 990, Part VI, Line 19 Required documents available to the public	Financial statements, conflict of interest policy and governing documents are available upon request for the same period of disclosure as set forth in Section 6104(D).

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (15 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	Address Line2USAddress/AddressLine2Txt
D&T Facility Management Company
PO Box 64624	St Paul	MN	551640624	411928275	Management	MN	501(c)(3)	Type II	Fairview	false
Ebenezer Society
7505 Metro Blvd	Edina	MN	55439	410706141	Nursing	MN	501(c)(3)	10	Fairview	false	Suite 100
Fairview Foundation
2450 Riverside Avenue South	Minneapolis	MN	55454	411573810	Fundraising	MN	501(c)(3)	1	Fairview	false
Fairview Health Services
2450 Riverside Avenue	Minneapolis	MN	55454	410991680	Hospital	MN	501(c)(3)	3	NA	false
Fairview Home Care and Hospice
2450 26th Avenue South	Minneapolis	MN	55454	411434246	Home Health	MN	501(c)(3)	10	Fairview	false
Fairview Physician Associates Netwo
3400 West 66th Street	Minneapolis	MN	55435	411753325	Clinical	MN	501(c)(3)	10	Fairview	false
Grand Itasca Clinic and Hosptial
1601 Golf Course Road	Grand Rapids	MN	55744	411865874	Hospital	MN	501(c)(3)	3	Fairview	false
HealthEast Care System
2450 Riverside Avenue South	Minneapolis	MN	55454	363517697	Hospital	MN	501(c)(3)	3	Fairview	false
HealthEast Medical Research Institute
2450 Riverside Avenue South	Minneapolis	MN	55454	411765832	Med Resear	MN	501(c)(3)	4	Fairview	false
HealthEast Professional Services
2450 Riverside Avenue South	Minneapolis	MN	55454	261226617	Physician	MN	501(c)(3)	11	Fairview	false
HealthEast St John's Hospital
2450 Riverside Avenue South	Minneapolis	MN	55454	411456897	Hospital	MN	501(c)(3)	3	Fairview	false
HealthEast St Joseph's Hospital
2450 Riverside Avenue South	Minneapolis	MN	55454	410693880	Hospital	MN	501(c)(3)	3	Fairview	false
HealthEast Woodwinds Hospital
2450 Riverside Avenue South	Minneapolis	MN	55454	411592761	Hospital	MN	501(c)(3)	3	Fairview	false
PreferredOne Community Health Plan
6105 Golden Hills Drive	Golden Valley	MN	55416	411796007	Insurance	MN	501(c)(4)		Fairview	false
Range Regional Health Services
750 East 34th Street	Hibbing	MN	55746	411293970	Hospital	MN	501(c)(3)	3	Fairview	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
CDI Grand Rapids LLC
1601 Golf Course Road	Grand Itasca	MN	55744	453783014	Imaging Services	MN	NA	Related	$1,553,707	$334,354	false	false	0.55
Ridges Surgery Center LLC
14101 Fairview Drive Ste 400	Burnsville	MN	55337	462441825	Surg Cntr	MN	NA	N/A
Crosstown Surgery Center LLC
4200 Dahlberg Drive Suite 300	Golden Valley	MN	55422	272552748	Surgery Center	MN	NA	N/A
SouthHealth ASC LLC
4200 Dahlberg Drive Suite 300	Golden Valley	MN	55422	822364607	Surgery Center	MN	NA	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
Fairview Clinics
2450 Riverside Avenue South	Minneapolis	MN	55454	411761760	Physician	MN	NA	C Corporation	false
Fairview Physician and Clinic Services
2450 Riverside Avenue South	Minneapolis	MN	55454	411544996	Physician	MN	NA	C Corporation	false
Fairview Development Company
2450 Riverside Avenue South	Minneapolis	MN	55454	411568579	Leasehold	MN	NA	C Corporation	false
Fairview Express Care
2450 Riverside Avenue South	Minneapolis	MN	55454	205996177	Physician	MN	NA	C Corporation	false
FHS Assurance Limited
2450 Riverside Avenue South	Minneapolis	MN	55454	980417513	Self insur	MN	NA	C Corporation	false
HealthEast Diversified Services Inc
2450 Riverside Avenue South	Minneapolis	MN	55454	411388583	Reference	MN	NA	C Corporation	false

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

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	Grand Itasca Foundation	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	C	TransactionTypeTxt
Involved	$33,839	InvolvedAmt
Method Of Amount Determination	Cost	MethodOfAmountDeterminationTxt