2020-04-15T15:53:14-05:00 2019-06-30 990 2018-07-01 271984704 ESSENTIA HEALTH FOUNDATION ESSE 2187868966 502 E 2ND ST DULUTH MN 55805 DEREK GROVES CHIEF DEVELOPMENT OFFICER 2187868966 2020-04-15 208.72.48.251 2020-04-15 15:53:09 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 2018 2020-09-23 17:36:50Z DEREK GROVES 502 E 2ND ST DULUTH MN 55805 32353303 0 X WWW.ESSENTIAHEALTH.ORG X 2009 MN WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES BY FOSTERING CHARITABLE SUPPORT FOR PATIENT CARE. ESSENTIA HEALTH FOUNDATION SERVES AS AN UMBRELLA FOR LOCAL FOUNDATIONS WITHIN ESSENTIA HEALTH SYSTEM, BUILDING ON COMMON STRENGTHS AND PROVIDING ECONOMIES OF SCALE. OUR GOALS INCLUDE BUILDING UPON OUR CULTURE OF PHILANTHROPY, INCREASING FUNDRAISING, ACTING AS A RESOURCE TO LOCAL FOUNDATIONS AND THE ESSENTIA SYSTEM, AND REDUCING COSTS TO LOCAL FOUNDATIONS. 7 5 13 309 0 0 3302378 5857997 0 0 1055537 1482907 -28169 -57188 4329746 7283716 1714271 3550723 0 0 832261 1200952 3310 50467 529024 666241 1058593 3216083 5860735 1113663 1422981 30571940 33030284 682914 1899979 29889026 31130305 X WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 0 0 3720243 3550723 ESSENTIA HEALTH FOUNDATION IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, SCIENTIFIC, AND RELIGIOUS PURPOSES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF CERTAIN ESSENTIA HEALTH SUPPORTED ORGANIZATIONS, AND OF THE TAX-EXEMPT ENTITIES IDENTIFIED AS SUPPORTED ORGANIZATIONS IN THEIR RESPECTIVE ARTICLES OF INCORPORATION.ESSENTIA HEALTH FOUNDATION FACILITATES CHARITABLE FUNDRAISING FOR AND ON BEHALF OF CERTAIN ESSENTIA HEALTH SUPPORTED ORGANIZATIONS. FUNDRAISING IS CONDUCTED BY DIRECT MAIL, SPECIAL EVENTS, GRANTS FROM FOUNDATIONS AND DONATIONS FROM INDIVIDUALS. COMPANIES, FOUNDATIONS, INDIVIDUALS, PHYSICIANS, AND STAFF PARTICIPATE BY GIVING TO THE FOUNDATION. DONATIONS ARE GIVEN FOR A WIDE RANGE OF CHARITABLE NEEDS OF EACH OF THE SUPPORTED ORGANIZATIONS INCLUDING PATIENT COMPASSIONATE CARE INITIATIVES, CAPITAL IMPROVEMENTS, EQUIPMENT AND SUPPLIES, COMMUNITY EDUCATION AND OUTREACH, RESEARCH, AND EMPLOYEE ASSISTANCE. ESSENTIA HEALTH FOUNDATION PROVIDES PROGRAMMATIC SUPPORT THROUGH DISBURSEMENT OF FOUNDATION FUNDS TO PROGRAMS ADMINISTERED BY ESSENTIA HEALTH RELATED ORGANIZATIONS TO BENEFIT PATIENTS, FAMILIES AND STAFF ADVANCING OUR MISSION.IN TOTAL, $4.8 MILLION WAS GIVEN TO THE FOUNDATION IN 2019 BY 5,835 DONORS, MOST OF WHOM RESIDE IN COMMUNITIES SERVED BY ESSENTIA HEALTH. THE FOUNDATION'S LOCAL ADVISORY BOARDS DISTRIBUTED $3.6 MILLION TO ITS SUPPORTED ORGANIZATIONS AND COMMUNITY PROGRAMS WHICH IMPROVE COMMUNITY HEALTH. THE ORGANIZATIONS ESSENTIA HEALTH FOUNDATION SUPPORTS PROVIDE HEALTH CARE SERVICES TO THE GENERAL PUBLIC AS PART OF ESSENTIA HEALTH.ESSENTIA HEALTH IS AN INTEGRATED HEALTH SYSTEM SERVING PATIENTS IN MINNESOTA, WISCONSIN, NORTH DAKOTA AND IDAHO. HEADQUARTERED IN DULUTH, MINNESOTA, ESSENTIA HEALTH COMBINES THE STRENGTHS AND TALENTS OF 14,500 EMPLOYEES, INCLUDING MORE THAN 2,000 PHYSICIANS AND ADVANCED PRACTITIONERS, WHO SERVE ITS PATIENTS AND COMMUNITIES THROUGH THE MISSION OF BEING CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. ESSENTIA HEALTH, WHICH INCLUDES MANY CATHOLIC FACILITIES, IS GUIDED BY THE VALUES OF QUALITY, HOSPITALITY, RESPECT, JOY, JUSTICE, STEWARDSHIP AND TEAMWORK. THE ORGANIZATION LIVES OUT ITS MISSION BY HAVING PATIENT-CENTERED FOCUS AT 15 HOSPITALS, OVER 70 CLINICS, SIX LONG-TERM CARE FACILITIES, THREE ASSISTED LIVING FACILITIES, THREE INDEPENDENT LIVING FACILITIES, SIX AMBULANCE SERVICES, AND ONE RESEARCH INSTITUTE. ESSENTIA HEALTH PROVIDES SERVICES PREDOMINANTLY IN RURAL COMMUNITIES AND IS COMMITTED TO ELIMINATING GEOGRAPHIC BARRIERS TO CARE. MANY OF ESSENTIA HEALTH'S HOSPITALS AND CLINICS ARE LOCATED IN COMMUNITIES THAT ARE FEDERALLY RECOGNIZED AS BEING MEDICALLY UNDERSERVED. ESSENTIA HEALTH IS ACCREDITED AS AN ACCOUNTABLE CARE ORGANIZATION BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE. THE LEGAL ENTITIES COMPRISING ESSENTIA HEALTH FILE SEPARATE FORM 990'S.ESSENTIA HEALTH'S HOSPITALS HAVE A TOTAL OF 1,198 LICENSED BEDS WHICH PROVIDED OVER 189,000 HOSPITAL PATIENT DAYS AND OVER 679,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2019. THE CLINICS HAD OVER 1.7 MILLION ENCOUNTERS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2019, ESSENTIA HEALTH PROVIDED TOTAL COMMUNITY BENEFITS OF OVER $128 MILLION WHICH INCLUDED COSTS OF PROVIDING CHARITY CARE, COSTS IN EXCESS OF MEDICAID PAYMENTS, MEDICAID SURCHARGE, MINNESOTACARE TAX, COMMUNITY SERVICES, HEALTH PROFESSION EDUCATION, RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS. 3720243 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 X 0 0 1 13 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 7 5 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 0 MN AK AR CA FL GA IL KS KY MD MI MS NH NJ NM NC OR PA SC TN WV X SARAH GUSTAFSON 2187868966 502 E 2ND ST DULUTH MN 55805 RICHARD BROWN BOARD CHAIR 1.00 0.00 X X 0 0 0 ROBERT BENNETT BOARD DIRECTOR 1.00 0.00 X 0 0 0 CARRIE EDBLAD BOARD DIRECTOR 1.00 0.00 X 0 0 0 ROBERT ERICKSON MD BOARD DIRECTOR 1.00 39.00 X 0 535181 46830 VAL KNUDSEN BOARD DIRECTOR 1.00 0.00 X 0 0 0 JIM SINCLAIR BOARD DIRECTOR 1.00 0.00 X 0 0 0 FAYE WITT BOARD DIRECTOR 1.00 0.00 X 0 64770 0 CRAIG NATHAN BOARD DIRECTOR THRU 7/18 1.00 0.00 X 0 0 0 JIM REHDER BOARD DIRECTOR THRU 7/18 1.00 0.00 X 0 0 0 MIKE SEYFER BOARD DIRECTOR THRU 7/18 1.00 0.00 X 0 0 0 DEREK GROVES CHIEF DEVELOPMENT OFFICER 60.00 0.00 X 226483 0 15014 SUSAN OMDALEN DIRECTOR OF DEVELOPMENT 60.00 0.00 X 117378 0 30316 JAMES GARVEY FORMER INTERIM EXECUTIVE DIRECTOR 0.00 60.00 X 0 553229 95486 343861 1153180 187646 2 1 1 0 0 46976 1330146 4480875 181199 5857997 652400 652400 25640847 24810340 830507 830507 830507 186119 46976 242175 -56056 -56056 15940 17072 -1132 -1132 7283716 0 0 1425719 3205677 3205677 345046 345046 336445 285978 50467 687421 320385 367036 25955 14659 11296 136851 76280 60571 64747 38046 26701 420 420 151169 151169 512257 510897 1360 8229 6526 1703 95047 90990 4057 20304 9463 10841 30980 30390 590 45224 55133 -9909 7513 3502 4011 CHARITABLE GIFT ANNUITY 169520 169520 DUES 12274 12274 MISCELLANEOUS 2330 2030 300 PUBLICATIONS & SUBSCRIP 2198 2198 1128 1128 5860735 3720243 1611468 529024 1103117 1939798 2270646 1121352 869605 2473305 15120 57872 96112 69242 34383 26870 298907 313260 25918318 27036388 61844 61439 30571940 33030284 377129 335461 111202 6000 194583 1558518 682914 1899979 X 18861689 18767153 9538303 10822484 1489034 1540668 29889026 31130305 30571940 33030284 X 1422981 -184640 2938 X 0 1 X 1 0 X 4606755 4302877 2643491 3133279 5857997 20544399 4606755 4302877 2643491 3133279 5857997 20544399 5545430 14998969 469137 419341 538345 590190 652400 2669413 23213812 0.64610 0.62960 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 11027337 3987418 47153 1611621 1087135 12363152 10522043 2322323 107924 1338837 586116 11027337 10601362 1688872 -149890 1539028 79273 10522043 11015293 2315209 -11496 1384201 1333443 10601362 9854601 2610802 10806 1018530 442386 11015293 0.00000 0.12460 0.87540 0 0 96112 69242 26870 26870 POOLED INVESTMENT FUND 27036388 F 27036388 PAYABLES TO RELATED TAX-EXEMPT ORGANIZATIONS 1386032 DISCOUNTED CHARITABLE GIFT ANNUITY CONTRACTS 172486 1558518 PART V, LINE 4: USES OF ORGANIZATION'S ENDOWMENT FUNDS: ESSENTIA HEALTH FOUNDATION'S ENDOWMENT FUNDS ARE ESTABLISHED BY DONOR DESIGNATED CONTRIBUTIONS AND SPENT IN ACCORDANCE TO DONOR WISHES. THESE FUNDS ARE USED TO FURTHER THE MISSION OF ESSENTIA HEALTH BY SUPPORTING ESSENTIA HEALTH ENTITIES, PATIENTS, AND COMMUNITIES ESSENTIA HEALTH SERVES. DINNER/AUCTION 68509 2916 65593 36268 879 14593 500 3881 GOLF EVENT 42000 15120 26880 5449 8836 7328 6950 8 112723 26980 85743 96157 4816 24148 1350 18557 223232 45016 178216 137874 5695 47577 9178 29388 229712 -51496 15940 14924 2148 0 15940 14924 2148 17072 -1132 MN ID 0 ESSENTIA HEALTH FOUNDATION IS LICENSED IN THE STATE OF MN. ESSENTIA HEALTH FOUNDATION IS NOT LICENSED IN IDAHO BECAUSE THE GAMING ACTIVITY FOR FY19 WAS BELOW THE LIMIT IDAHO REQUIRES FOR LICENSURE. 0 0 0 0.16670 0.83330 MARLENE FERUSGON 502 EAST 2ND STREET DULUTH MN 55805 0 SEE SCHEDULE G PART IV X 0 SCHEDULE G, PART III, LINE 11: GAMING ACTIVITIES WITH NONMEMBERS: ESSENTIA HEALTH FOUNDATION DOES NOT HAVE ANY MEMBERS. SCHEDULE G, PART III, LINE 16: GAMING MANAGER INFORMATION: ESSENTIA HEALTH FOUNDATION CONDUCTED RAFFLES DURING THE YEAR AS PART OF FUNDRAISING EVENTS. BECAUSE THESE EVENTS WERE CONDUCTED IN VARIOUS LOCATIONS THROUGHOUT THE ESSENTIA HEALTH FOUNDATION NETWORK, SEVERAL EMPLOYEES SUPERVISED THE GAMING EVENTS. THESE EMPLOYEES PROVIDED THE FOLLOWING SERVICES: RECORDKEEPING, MONEY COUNTING, AND GENERAL OVERSIGHT OF THE GAMING OPERATION. THE NAMES AND GAMING-RELATED COMPENSATION, INCLUDING COMPENSATION FROM RELATED ORGANIZATIONS, ARE LISTED BELOW: PAMELA PERLEBERG $1,503 DAVID JEREMAISON $100 MARY COURNEYA $41 KIMBERLY JOHNSON $39 1 COMMUNITY CARE N SHARE CAFE PO BOX 354 EMILY MN 56447 464436799 501(C)(3) 8000 PROGRAM SUPPORT ESSENTIA HEALTH 502 E 2ND ST DULUTH MN 55805 200360007 501(C)(3) 8665 PROGRAM SUPPORT ESSENTIA INSTITUTE OF RURAL HEALTH 502 E 2ND ST DULUTH MN 55805 271291124 501(C)(3) 280160 PROGRAM SUPPORT GRACEVILLE HEALTH CENTER 115 W 2ND ST GRACEVILLE MN 56240 410726173 501(C)(3) 347573 PROGRAM SUPPORT HORIZON HEALTH INC PO BOX 220 PIERZ MN 56364 411699160 501(C)(3) 9571 PROGRAM SUPPORT INNOVIS HEALTH LLC 3000 32ND AVE S FARGO ND 58103 261175213 501(C)(3) 189938 PROGRAM SUPPORT JUNIOR ACHIEVEMENT OF THE UPPER MIDWEST 1745 UNIVERSITY AVENUE WEST ST PAUL MN 55104 411424988 501(C)(3) 7000 PROGRAM SUPPORT LAKES AREA RESTORATIVE JUSTICE PROJECT 424 NW THIRD STREET BRAINERD MN 56401 550903543 501(C)(3) 10000 PROGRAM SUPPORT MOUNTED EAGLES INC PO BOX 566 NISSWA MN 56468 411685725 501(A)(3) 19905 SCHOLARSHIPS SMDC MEDICAL CENTER 502 E 2ND ST DULUTH MN 55805 411878730 501(C)(3) 318565 PROGRAM SUPPORT ST JOSEPH'S MEDICAL CENTER 523 N 3RD ST BRAINERD MN 56401 410695602 501(C)(3) 90953 PROGRAM SUPPORT ST MARY'S HOSPITAL OF SUPERIOR 3500 TOWER AVE SUPERIOR WI 54880 411811073 501(C)(3) 50698 PROGRAM SUPPORT ST MARY'S MEDICAL CENTER 407 E 3RD ST DULUTH MN 55805 410695604 501(C)(3) 1374029 PROGRAM SUPPORT ST MARY'S REGIONAL HEALTH CENTER 1027 WASHINGTON AVE DETROIT LAKES MN 56501 411620386 501(C)(3) 413546 PROGRAM SUPPORT 13 1 ASSIST ESSENTIA HEALTH PATIENTS & COMMUNITY 3626 136414 134281 FMV VARIOUS ITEMS (MEDICAL SUPPLIES, GAS GIFT CARDS, CLOTHING, GROCERIES, ETC.) REACH OUT & READ, BOOKS FOR PATIENTS 590 2576 FMV BOOKS ASSIST ESSENTIA HEALTH EMPLOYEES IN FINANCIAL NEED 48 35569 4456 FMV GIFT CARDS, HOUSING SCHOLARSHIPS 14 15070 GRIEF SUPPORT GROUP 10 250 FMV GAS GIFT CARDS BREAST CANCER AWARENESS, EDUCATION & TREATMENT 84 16430 FMV GAS AND GROCERY GIFT CARDS PART I, LINE 2: PROCEDURE FOR MONITORING THE USE OF GRANTS: ESSENTIA HEALTH FOUNDATION'S MANAGEMENT REVIEWS THE GRANT ACTIVITY BY REVIEWING AND DOCUMENTING EACH EXPENDITURE REQUEST AND APPROVING THE EXPENSE. ALL DISBURSEMENTS ARE MADE IN ACCORDANCE WITH FUND DESIGNATION AND PURPOSE. GRANTS ARE MADE TO GOVERNMENT & NOT-FOR-PROFIT INSTITUTIONS OR ORGANIZATIONS, PRIMARILY TO MEMBERS OF ESSENTIA HEALTH AND AFFILIATED ORGANIZATIONS. DISBURSEMENTS MUST BE CONSISTENT WITH THE MISSION STATEMENT AND PURPOSE OF THE ESSENTIA HEALTH FOUNDATION AS STATED IN ITS ORGANIZATIONAL DOCUMENTS. GRANT PROPOSALS ARE REVIEWED AT VARIOUS ASSOCIATED FOUNDATION COMMITTEES PRIOR TO DISBURSEMENT AND IN ACCORDANCE WITH THE FUND DISBURSEMENT PROCESS. GRANTS AND OTHER ASSISTANCE TO INDIVIDUALS IS USED TO ASSIST ESSENTIA HEALTH PATIENTS AND COMMUNITY MEMBERS IN FINANCIAL NEED; TO ASSIST WITH COMMUNITY BASED PROGRAMS TO INCLUDE SUPPLIES, PREVENTION, AWARENESS, SUPPORT GROUPS OR EDUCATIONAL ACTIVITIES; OR TO PROVIDE SCHOLARSHIPS FOR THOSE IN THE MEDICAL FIELD. GRANT MONITORING OF SUCH ACTIVITIES ARE IN ACCORDANCE WITH PROCEDURES DEFINED ABOVE. X 1 1 X X X X 0 1 0 0 0 0 0 0 1 1 ROBERT ERICKSON MD BOARD DIRECTOR 0 531154 0 0 0 4027 0 22000 0 24830 0 582011 0 0 DEREK GROVES CHIEF DEVELOPMENT OFFICER 213270 0 4720 0 8493 0 0 0 15014 0 241497 0 0 0 JAMES GARVEY FORMER INTERIM EXECUTIVE DIRECTOR 0 424864 0 66742 0 61623 0 72069 0 23417 0 648715 0 40997 PART I, LINE 1A BENEFITS PROVIDED: DURING TAX YEAR 2018, AS A NEW EMPLOYEE RELOCATING FROM ANOTHER AREA, CHIEF DEVELOPMENT OFFICER DEREK GROVES RECEIVED A HOUSING ALLOWANCE. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION. PART I, LINE 3 ESTABLISHING CEO'S COMPENSATION: ESSENTIA HEALTH, AS A RELATED ORGANIZATION, USED THE FOLLOWING METHODS TO ESTABLISH ESSENTIA HEALTH FOUNDATION'S CHIEF DEVELOPMENT OFFICER'S COMPENSATION: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: ESSENTIA HEALTH'S NONQUALIFIED RETIREMENT PLAN IS OFFERED TO DESIGNATED ESSENTIA HEALTH EXECUTIVES. THERE IS A MINIMUM FOUR YEAR VESTING DATE, OR VESTING IS AUTOMATIC UPON REACHING RETIREMENT AGE, DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. BENEFITS ARE SUBJECT TO INCOME TAXES UPON VESTING AND PAYABLE FROM ESSENTIA HEALTH'S GENERAL ASSETS. REPORTED AS OTHER REPORTABLE COMPENSATION IN SCHEDULE J, PART II, COLUMN B (III), THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A RECEIVED PAYMENT OF THE VESTED BENEFIT FROM THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN DURING THE YEAR: JAMES GARVEY $51,644 REPORTED AS RETIREMENT AND OTHER DEFERRED COMPENSATION IN SCHEDULE J, PART II, COLUMN C, ESSENTIA HEALTH MADE CONTRIBUTIONS, SUBJECT TO THE VESTING TERMS, DURING THE YEAR INTO THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ON BEHALF OF THE FOLLOWING INDIVIDUALS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A: JAMES GARVEY $49,539 PART I, LINE 8 INITIAL CONTRACT EXCEPTION: ESSENTIA HEALTH FOUNDATION'S CHIEF DEVELOPMENT OFFICER, DEREK GROVES, RECEIVED COMPENSATION DURING THE YEAR UNDER AN INITIAL EMPLOYMENT AGREEMENT SUBJECT TO THE INITIAL CONTRACT EXCEPTION. THROUGH THE ESSENTIA HEALTH EXECUTIVE COMPENSATION COMMITTEE, THIS COMPENSATION ARRANGEMENT WAS REVIEWED AND APPROVED BY INDEPENDENT PERSONS USING COMPARABILITY DATA AND DELIBERATIONS AND DECISIONS WERE DOCUMENTED. X 18 5729 COST OR SELLING X 94709 COST OR SELLING X 6 8410 COST OR SELLING X 122 16880 COST OR SELLING X 1 100 COST OR SELLING X 6 1830 COST OR SELLING X AUCTION ITEMS 159 53541 COST OR SELLING 0 0 1 0 PART I, COLUMN (B): ESSENTIA HEALTH FOUNDATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. SCHEDULE M, PART I, COLUMN (D): METHOD: ESSENTIA HEALTH FOUNDATION USED THE COST OR SELLING PRICE OF DONATED PROPERTY TO DETERMINE AMOUNT REPORTED ON FORM 990, PART VIII, LINE 1G. FORM 990, PART I, LINE 16A: PROFESSIONAL FUNDRAISING EXPENSES: THE AMOUNT LISTED REPRESENTS THE INTERNAL PROFESSIONAL FUNDRAISING COSTS AS REPORTED ON PART IX, COLUMN (D), LINE 5. IT DOES NOT REPRESENT FEES PAID TO EXTERNAL PROFESSIONAL FUNDRAISERS. FORM 990, PART V, LINE 1A: 1099 REPORTING: CERTAIN VENDOR PAYMENTS AND FORM 1099'S WERE PROCESSED THROUGH ESSENTIA HEALTH ON BEHALF OF CERTAIN LEGAL ENTITIES COMPRISING ESSENTIA HEALTH. FORM 990, PART V, LINE 1C: NO GAMING (GAMBLING) WINNINGS. FORM 990, PART VI, SECTION A, LINE 6 MEMBER OF ORGANIZATION: ESSENTIA HEALTH IS THE SOLE MEMBER OF ESSENTIA HEALTH FOUNDATION AND MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7A. ESSENTIA HEALTH ALSO HAS RESERVED POWERS WITH RESPECT TO ESSENTIA HEALTH FOUNDATION AS DESCRIBED IN SCHEDULE O, PART VI, LINE 7B. FORM 990, PART VI, SECTION A, LINE 7A MEMBER WITH RIGHT TO ELECT GOVERNING BODY: ESSENTIA HEALTH APPOINTS AND REMOVES ESSENTIA HEALTH FOUNDATION'S GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B MEMBER WITH RIGHT TO APPROVE GOVERNING BODY DECISION: ESSENTIA HEALTH FOUNDATION IS A SUBSIDIARY OF ESSENTIA HEALTH, WHOSE BOARD OF DIRECTORS HAS RESERVED POWERS WITH RESPECT TO THIS CORPORATION AND ITS SUBSIDIARIES, AND ALL OF THE OTHER DIRECT AND INDIRECT SUBSIDIARIES OF ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"). ESSENTIA HEALTH'S RESERVED POWERS ARE AS FOLLOWS: STRATEGIC AND BUSINESS PLANS. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S STRATEGIC AND BUSINESS PLANS. MISSION. AUTHORITY TO CREATE, AND TO APPROVE, THE MISSION, PURPOSE AND VISION STATEMENTS FOR ALL ENTITIES IN THE SYSTEM BY THE AFFIRMATIVE VOTE OF AT LEAST 67% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS. DEBT. APPROVAL OF THE INCURRENCE OF DEBT BY, AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE ASSETS OF, ALL ENTITIES IN THE SYSTEM IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS, AND THE AUTHORITY TO CAUSE ALL ENTITIES IN THE SYSTEM TO PARTICIPATE IN SYSTEM BORROWING. GOVERNING INSTRUMENTS. AUTHORITY TO CAUSE, AND TO APPROVE, AMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS AND/OR CERTIFICATES OF FORMATION AND OPERATING AGREEMENTS OF ALL ENTITIES IN THE SYSTEM. MERGERS AND ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF ALL ENTITIES IN THE SYSTEM. AFFILIATIONS AND JOINT VENTURES. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES WITH THIRD PARTIES OF ALL ENTITIES IN THE SYSTEM. TRANSFER OF ASSETS WITHIN THE SYSTEM. AUTHORITY TO TRANSFER ASSETS, INCLUDING CASH, BETWEEN AND AMONG ENTITIES WITHIN THE SYSTEM; PROVIDED, HOWEVER, THAT ESSENTIA HEALTH SHALL NOT HAVE AUTHORITY TO REQUIRE ANY ENTITY IN THE SYSTEM TO TRANSFER ASSETS (A) THAT WOULD CAUSE SUCH ENTITY TO BE IN DEFAULT OF ITS COVENANTS OR OBLIGATIONS UNDER ANY BOND OR OTHER FINANCING DOCUMENTS; (B) FROM THE CATHOLIC ENTITIES TO THE SECULAR ENTITIES OR FROM THE SECULAR ENTITIES TO THE CATHOLIC ENTITIES IN A MANNER OR TO AN EXTENT THAT WOULD CAUSE THE CATHOLIC ENTITIES TO BE IN VIOLATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS) IN THE JUDGMENT OF THE LOCAL ORDINARY; OR (C) SUCH THAT MONEY GENERATED BY SERVICES AT SECULAR FACILITIES WITHIN THE SYSTEM BY PROCEDURES THAT ARE CONTRARY TO THE ERDS WOULD BE USED AT THE CATHOLIC ENTITIES OR MONEY GENERATED BY CATHOLIC ENTITIES WOULD BE USED IN THE PROVIDING OF SERVICES CONTRARY TO THE ERDS AT SECULAR FACILITIES WITHIN THE SYSTEM. TRANSFER OF ASSETS OUTSIDE THE SYSTEM. AUTHORITY TO CAUSE, AND TO APPROVE, THE SALE, LEASE OR OTHER TRANSFER OF ASSETS OF ALL ENTITIES IN THE SYSTEM TO PARTIES OUTSIDE OF THE SYSTEM WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS. SERVICES. AUTHORITY TO CAUSE, AND TO APPROVE, THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS WITHIN ALL ENTITIES IN THE SYSTEM. BUDGETS. APPROVAL OF CAPITAL AND OPERATING BUDGETS OF ALL ENTITIES IN THE SYSTEM. PROFESSIONAL SERVICES. SELECTION OF THE GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS OF ALL ENTITIES IN THE SYSTEM. ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL ACQUISITIONS BY AND FORMATIONS OF ENTITIES IN THE SYSTEM. MARKETING. AUTHORITY TO IMPLEMENT SYSTEM-WIDE MARKETING AND PROMOTIONAL ACTIVITIES. COMPLIANCE PLANS. AUTHORITY TO CREATE, AND TO APPROVE, CORPORATE COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS FOR ENTITIES WITHIN THE SYSTEM. QUALITY PLAN. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S QUALITY PLAN. NON-BUDGETED PURCHASES. APPROVAL OF NON-BUDGETED CAPITAL PURCHASES AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY ESSENTIA HEALTH FOR ENTITIES WITHIN THE SYSTEM. HUMAN RESOURCES. AUTHORITY TO CREATE HUMAN RESOURCE POLICIES AND PROCEDURES WITHIN THE SYSTEM. RESERVED POWERS. AUTHORITY TO CREATE ADDITIONAL ESSENTIA HEALTH RESERVED POWERS BY THE AFFIRMATIVE VOTE OF AT LEAST 80% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS (EXCLUDING THE ESSENTIA HEALTH CEO); PROVIDED, HOWEVER, THAT ANY ADDITIONAL ESSENTIA HEALTH RESERVED POWERS SHALL NOT CONTRAVENE OR HINDER THE RESERVED POWERS OF BENEDICTINE SISTERS BENEVOLENT ASSOCIATION. FORM 990, PART VI, SECTION A, LINE 8B COMMITTEES: THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE 2018 FORM 990, INCLUDING ALL SCHEDULES, WAS REVIEWED BY ESSENTIA HEALTH FOUNDATION'S MANAGEMENT AND GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. EACH CURRENT DIRECTOR OF THE GOVERNING BODY RECEIVED A FINAL COPY OF THE 2018 FORM 990. ESSENTIA HEALTH FOUNDATION'S FINANCE LEADER REVIEWED THE FORM AND SCHEDULES AND ANY QUESTIONS WERE DISCUSSED. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCING CONFLICT OF INTEREST POLICY: ESSENTIA HEALTH'S COMPREHENSIVE CONFLICT OF INTEREST PROGRAM PREVENTS, DETECTS AND RESOLVES ACTUAL CONFLICTS OF INTERESTS OR THE ACTUAL OR POTENTIAL APPEARANCE OF SUCH. FIDUCIARIES, DEFINED AS AN ESSENTIA HEALTH BOARD MEMBER/TRUSTEE, OFFICER, BOARD COMMITTEE MEMBER, SENIOR MANAGEMENT EMPLOYEE, OR ANY OTHERS CONSIDERED TO BE IN A POSITION OF INFLUENCE, ARE COVERED UNDER ESSENTIA HEALTH'S CONFLICT OF INTEREST PROGRAM. UPON INITIAL APPOINTMENT, EACH FIDUCIARY MUST COMPLETE AN INITIAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AT THE CONCLUSION OF EACH CALENDAR YEAR, EACH FIDUCIARY MUST COMPLETE AN ANNUAL CONFLICT OF INTEREST STATEMENT AND DISCLOSURE QUESTIONNAIRE. AS NEEDED, A FIDUCIARY WILL UPDATE HIS/HER MOST RECENTLY COMPLETED QUESTIONNAIRE EACH TIME THE FIDUCIARY BECOMES AWARE OF A FINANCIAL INTEREST, A POTENTIAL CONFLICT, OR CHANGE TO ANY INFORMATION THAT THE FIDUCIARY PREVIOUSLY REPORTED. ESSENTIA HEALTH'S CHIEF COMPLIANCE OFFICER WILL COLLECT THE QUESTIONNAIRES AND EVALUATE THE DISCLOSURES. IF A FIDUCIARY HAS A POTENTIAL CONFLICT OF INTEREST, THE CHIEF COMPLIANCE OFFICER OR DESIGNEE MAY REQUEST ADDITIONAL INFORMATION FROM THE FIDUCIARY, THE MANAGEMENT TEAM, AND OTHERS. DURING THE EVALUATION PROCESS, THE CHIEF COMPLIANCE OFFICER MAY ALSO CONSULT WITH ESSENTIA HEALTH'S BOARD AND AUDIT COMMITTEE CHAIRS, SENIOR MANAGEMENT, LEGAL DEPARTMENT, OR APPROPRIATE REPRESENTATIVES FROM ESSENTIA HEALTH. THE CHIEF COMPLIANCE OFFICER REPORTS TO THE ESSENTIA HEALTH AUDIT COMMITTEE AND THE ESSENTIA HEALTH BOARD OF DIRECTORS ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST DISCLOSED BY THE FIDUCIARY, ALONG WITH RECOMMENDED ACTIONS. THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) WILL THEN DETERMINE WHETHER TO APPROVE THE SITUATION OR TO IMPLEMENT SPECIAL CONTROLS TO MANAGE THE POTENTIAL CONFLICT OF INTEREST. THE CHIEF COMPLIANCE OFFICER WILL THEN OFFICIALLY NOTIFY THE FIDUCIARY IN WRITING OF THE BOARD'S DECISION. THE DECISION OF WHETHER OR NOT THE DISCLOSURE CONSTITUTES A CONFLICT WILL BE AT THE ESSENTIA HEALTH BOARD OF DIRECTOR'S (OR DESIGNEE) SOLE DISCRETION, AND ITS CONCERN MUST BE THE WELFARE OF ESSENTIA HEALTH AND ITS AFFILIATE(S) AND THE ADVANCEMENT OF ITS PURPOSES. WHEN THE ESSENTIA HEALTH BOARD OF DIRECTORS (OR DESIGNEE) CONSIDERS A FIDUCIARY'S DISCLOSURE AS A CONFLICT OF INTEREST, SPECIAL CONTROLS WILL BE IDENTIFIED TO MANAGE, ELIMINATE OR REDUCE THE LIKELIHOOD AND/OR APPEARANCE OF A CONFLICT ARISING. CONTROLS MAY INCLUDE, BUT ARE NOT LIMITED TO: A. IF THE CONFLICT INVOLVES AN ON-GOING MATTER OR RELATIONSHIP, THE FIDUCIARY MUST NOT PARTICIPATE IN BOARD, BOARD COMMITTEE OR MANAGEMENT DISCUSSIONS RELATED TO THE CONFLICT AND MUST RECUSE THEMSELVES AND IF APPROPRIATE, WITHDRAW, FROM ANY BOARD MEETING OR PORTION THEREOF WHERE THE MATTER IS BEING DISCUSSED AND DURING THE VOTE ON THE POTENTIAL CONFLICT OF INTEREST. THE FIDUCIARY MAY ANSWER QUESTIONS AT THE BOARD'S OR THE BOARD COMMITTEE'S REQUEST. B. IF THE CONFLICT INVOLVES A SPECIFIC TRANSACTION OR DECISION, THE FIDUCIARY WILL FULLY DISCLOSE THEIR INTEREST AND ALL RELATED MATERIAL FACTS. THE BOARD OR COMMITTEE OF THE BOARD WILL DETERMINE WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO ESSENTIA HEALTH OR ITS AFFILIATE(S). IF THE BOARD DETERMINES A CONFLICT DOES NOT EXIST, THE FIDUCIARY MAY PROCEED WITH THE TRANSACTION; HOWEVER, HE OR SHE WILL NOT BE ELIGIBLE TO VOTE ON RELATED ISSUES SHOULD THEY ARISE. IF THE BOARD DETERMINES A CONFLICT DOES EXIST, THE FIDUCIARY WILL BE NOTIFIED OF THE DECISION REGARDING WHETHER THE CONTEMPLATED TRANSACTION WILL BE AUTHORIZED AS JUST, FAIR, AND REASONABLE. FORM 990, PART VI, SECTION B, LINE 15A PROCESS FOR DETERMINING COMPENSATION: THE INDEPENDENT EXECUTIVE COMPENSATION COMMITTEE OF ESSENTIA HEALTH'S BOARD OF DIRECTORS IS AUTHORIZED TO FULFILL THE BOARD'S RESPONSIBILITIES REGARDING EXECUTIVE COMPENSATION CONSISTENT WITH ESSENTIA'S MISSION, VALUES AND TAX-EXEMPT STATUS, AND THE EXECUTIVE COMPENSATION COMMITTEE'S CHARTER. THE EXECUTIVE COMPENSATION COMMITTEE MEETS AT LEAST TWICE ANNUALLY TO CARRY OUT ITS RESPONSIBILITIES, WHICH INCLUDE, BUT ARE NOT LIMITED TO, ESTABLISHING, REVIEWING AND MODIFYING, AS APPROPRIATE, REASONABLE COMPENSATION AND BENEFITS FOR DESIGNATED ESSENTIA EXECUTIVES WHO ARE OFFICERS OR KEY EMPLOYEES OF ESSENTIA OR ANY OF ITS AFFILIATES WHICH MAY BE PAID BY RELATED ORGANIZATIONS. THE EXECUTIVE COMPENSATION COMMITTEE ENGAGES QUALIFIED INDEPENDENT COMPENSATION ADVISORS TO PROVIDE OBJECTIVE AND IMPARTIAL COMPARATIVE DATA AND TO EXPRESS OPINIONS ON TOTAL COMPENSATION REASONABLENESS. THE EXECUTIVE COMPENSATION COMMITTEE MAY REQUEST ITS INDEPENDENT ADVISORS TO: MONITOR COMPARABILITY DATA AND MARKETPLACE TRENDS; MAKE APPROPRIATE RECOMMENDATIONS REGARDING SALARY RANGES; AND PERIODICALLY REVIEW THE MARKET COMPETITIVENESS OF ESSENTIA EXECUTIVE COMPENSATION PACKAGES. PRIOR TO ESTABLISHING OR ADJUSTING EXECUTIVE COMPENSATION, THE EXECUTIVE COMPENSATION COMMITTEE WILL OBTAIN AND RELY UPON APPROPRIATE DATA AS TO COMPARABILITY OF THE PROPOSED COMPENSATION OR ADJUSTMENTS. THE EXECUTIVE COMPENSATION COMMITTEE WILL ADEQUATELY DOCUMENT THE BASIS FOR ITS DETERMINATION CONCURRENTLY WITH MAKING THOSE DETERMINATIONS. THE EXECUTIVE COMPENSATION COMMITTEE MINUTES WILL INCLUDE: THE TERMS OF THE APPROVED COMPENSATION AND THE DATE APPROVED; THE EXECUTIVE COMPENSATION COMMITTEE MEMBERS PRESENT DURING THE REVIEW, DISCUSSION AND APPROVAL OF THE PROPOSED COMPENSATION AND THOSE WHO VOTED ON THE PROPOSED COMPENSATION; IDENTIFICATION OF THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE EXECUTIVE COMPENSATION COMMITTEE AND HOW THE DATA WAS OBTAINED; ANY ACTIONS BY A MEMBER OF THE EXECUTIVE COMPENSATION COMMITTEE HAVING A CONFLICT OF INTEREST; AND DOCUMENTATION OF THE BASIS FOR THE DETERMINATION. THE YEAR THIS PROCESS WAS LAST UNDERTAKEN FOR ESSENTIA HEALTH FOUNDATION'S CHIEF DEVELOPMENT OFFICER WAS 2019. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART XI, LINE 9: ADJUSTMENT FOR CHANGE IN VALUE OF CHARITABLE GIFT ANNUITY 2,938. BRAINERD LAKES INTEGRATED HEALTH SYSTEM 2024 S 6TH ST BRAINERD MN 56401 371532145 SUPPORTING ORG MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 1 BRAINERD MEDICAL CENTER INC 2024 S 6TH ST BRAINERD MN 56401 371532148 CLINIC MN 501(C)(3) LINE 3 BRAINERD LAKES INTEGRATED HEALTH SYSTEM 1 BRIDGES MEDICAL CENTER 201 9TH ST W ADA MN 56510 200479568 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 CLEARWATER VALLEY HOSPITAL AND CLINICS INC 301 CEDAR OROFINO ID 83544 820497771 HOSPITAL/CLINIC ID 501(C)(3) LINE 3 CRITICAL ACCESS GROUP 1 CRITICAL ACCESS GROUP 503 E 3RD ST STE 400 DULUTH MN 55805 261219624 SUPPORTING ORG MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 1 DEER RIVER HEALTHCARE CENTER INC 115 10TH AVE NE DEER RIVER MN 56636 410844574 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ESSENTIA HEALTH 502 E 2ND ST DULUTH MN 55805 200360007 SUPPORTING ORG MN 501(C)(3) LINE 12C, III-FI N/A 0 ESSENTIA INSTITUTE OF RURAL HEALTH 502 E 2ND ST DULUTH MN 55805 271291124 RESEARCH MN 501(C)(3) LINE 4 THE DULUTH CLINIC LTD 1 FIRST CARE MEDICAL SERVICES 900 HILLIGOSS BLVD SE FOSSTON MN 56542 410706143 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 GRACEVILLE HEALTH CENTER 115 W 2ND ST GRACEVILLE MN 56240 410726173 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 INNOVIS HEALTH LLC 3000 32ND AVE S FARGO ND 58103 261175213 HOSPITAL/CLINIC DE 501(C)(3) LINE 3 ESSENTIA HEALTH 1 MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC 4418 HAINES RD DULUTH MN 55811 411674021 MEDICAL EQUIPMENT MN 501(C)(3) LINE 10 ST MARY'S MEDICAL CENTER 1 NORTHERN PINES MEDICAL CENTER 5211 HWY 110 AURORA MN 55705 410841441 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 PINE MEDICAL CENTER 705 LUNDORFF DR S SANDSTONE MN 55072 411884597 HOSPITAL MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 POLINSKY MEDICAL REHABILITATION CENTER 530 E 2ND ST DULUTH MN 55805 410691275 REHABILITATION SERVICES MN 501(C)(3) LINE 3 ST MARY'S MEDICAL CENTER 1 SMDC MEDICAL CENTER 502 E 2ND ST DULUTH MN 55805 411878730 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ST JOSEPH'S MEDICAL CENTER 523 N 3RD ST BRAINERD MN 56401 410695602 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 BRAINERD LAKES INTEGRATED HEALTH SYSTEM 1 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 407 E 3RD ST DULUTH MN 55805 411836633 SUPPORTING ORG MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 1 ST MARY'S EMS 1027 WASHINGTON AVE DETROIT LAKES MN 56501 411805811 EMERGENCY SERVICES MN 501(C)(3) LINE 10 INNOVIS HEALTH LLC 1 ST MARY'S HOSPITAL OF SUPERIOR 3500 TOWER AVE SUPERIOR WI 54880 411811073 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ST MARY'S MEDICAL CENTER 1 ST MARY'S HOSPITAL INC PO BOX 137 COTTONWOOD ID 83522 820226453 HOSPITAL/CLINIC ID 501(C)(3) LINE 3 CRITICAL ACCESS GROUP 1 ST MARY'S INNOVIS HEALTH 1027 WASHINGTON AVE DETROIT LAKES MN 56501 262861321 PHARMACY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 ST MARY'S MEDICAL CENTER 407 E 3RD ST DULUTH MN 55805 410695604 HOSPITAL MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ST MARY'S REGIONAL HEALTH CENTER 1027 WASHINGTON AVE DETROIT LAKES MN 56501 411620386 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 THE DULUTH CLINIC LTD 400 E 3RD ST DULUTH MN 55805 410883623 CLINIC MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 PMC-GATEWAY IMAGING LLC 705 LUNDORFF DR S SANDSTONE MN 55072 261634764 IMAGING SERVICES MN N/A N/A 0 0 ESSENTIA HEALTH INSURANCE SERVICES SPC LTD PO BOX 1159 GRAND CAYMAN CJ 000000000 SELF INSURANCE CJ N/A C 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 ESSENTIA HEALTH P 119269 ACTUAL COSTS ESSENTIA INSTITUTE OF RURAL HEALTH B 280160 ACTUAL COSTS GRACEVILLE HEALTH CENTER B 347573 ACTUAL COSTS INNOVIS HEALTH LLC B 189938 ACTUAL COSTS INNOVIS HEALTH LLC C 256705 ACTUAL COSTS SMDC MEDICAL CENTER B 318565 ACTUAL COSTS ST JOSEPH'S MEDICAL CENTER B 90953 ACTUAL COSTS ST JOSEPH'S MEDICAL CENTER C 124756 ACTUAL COSTS ST MARY'S HOSPITAL OF SUPERIOR B 50698 ACTUAL COSTS ST MARY'S MEDICAL CENTER B 1374029 ACTUAL COSTS ST MARY'S MEDICAL CENTER C 715065 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER B 413546 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER C 211825 ACTUAL COSTS SCHEDULE R, PART II, COLUMN (A) THE FOLLOWING ESSENTIA HEALTH ENTITIES HAVE A DOING BUSINESS AS NAME: LEGAL NAME; DOING BUSINESS AS NAME BRAINERD LAKES INTEGRATED HEALTH SYSTEM; ESSENTIA HEALTH CENTRAL BRAINERD MEDICAL CENTER, INC.; ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC BRIDGES MEDICAL CENTER; ESSENTIA HEALTH ADA DEER RIVER HEALTHCARE CENTER, INC.; ESSENTIA HEALTH DEER RIVER FIRST CARE MEDICAL SERVICES; ESSENTIA HEALTH FOSSTON GRACEVILLE HEALTH CENTER; ESSENTIA HEALTH HOLY TRINITY HOSPITAL INNOVIS HEALTH, LLC; ESSENTIA HEALTH WEST MIDWEST MEDICAL EQUIPMENT AND SUPPLIES, INC.; ESSENTIA HEALTH MEDICAL EQUIPMENT & SUPPLIES NORTHERN PINES MEDICAL CENTER; ESSENTIA HEALTH NORTHERN PINES PINE MEDICAL CENTER; ESSENTIA HEALTH SANDSTONE POLINSKY MEDICAL REHABILITATION CENTER; ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER SMDC MEDICAL CENTER; ESSENTIA HEALTH DULUTH ST. JOSEPH'S MEDICAL CENTER; ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ST. MARY'S DULUTH CLINIC HEALTH SYSTEM; ESSENTIA HEALTH EAST ST. MARY'S EMS; ESSENTIA HEALTH ST. MARY'S EMERGENCY MEDICAL SERVICES-DETROIT LAKES ST. MARY'S HOSPITAL OF SUPERIOR; ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR ST. MARY'S MEDICAL CENTER; ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER ST. MARY'S REGIONAL HEALTH CENTER; ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES