2019-11-15T08:20:04-06:00 2018-12-31 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 225 S 6TH ST 2300 MINNEAPOLIS MN 55402 990 2018-01-01 208316475 MAPLE GROVE HOSPITAL CORPORATION MAPL 7635811000 9875 HOSPITAL DRIVE MAPLE GROVE MN 55369 AARON BLOOMQUIST TREASURER 7635205048 2019-11-08 1 LAWRENCE H MOHR CPA P00447603 6128764500 2019-11-08 38.88.188.75 2019-11-08 13:23:37 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 EDB264CAD7F9F6CD2E19D356927987B2A35A11B0 2018 2020-04-17 16:48:07Z ANDREW COCHRANE 9875 HOSPITAL DRIVE MAPLE GROVE MN 55369 209318217 0 X WWW.MAPLEGROVEHOSPITAL.ORG X 2007 MN TO EMPOWER OUR CUSTOMERS TO ACHIEVE THEIR BEST HEALTH. 7 2 1206 402 0 0 8910 6708 195925342 209059019 237307 252490 0 0 196171559 209318217 0 0 0 0 70305142 73660146 0 0 0 98963494 100709576 169268636 174369722 26902923 34948495 173527171 169219480 143321812 139342031 30205359 29877449 X TO EMPOWER OUR CUSTOMERS TO ACHIEVE THEIR BEST HEALTH. 0 0 147470441 207283916 MAPLE GROVE HOSPITAL IS A GENERAL, ACUTE CARE HOSPITAL PROVIDING EMERGENCY SERVICES, MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL-SURGICAL, OBSTETRICAL, AND PEDIATRIC SERVICES. MAPLE GROVE HOSPITAL'S MISSION IS EMPOWERING ITS CUSTOMERS TO ACHIEVE THEIR BEST HEALTH.IN ADDITION TO CHARITY AND UNCOMPENSATED CARE, MAPLE GROVE HOSPITAL ALSO PROVIDES NUMEROUS COMMUNITY BENEFITS (AT NO COST OR BELOW COST) IN FURTHERANCE OF ITS CHARITABLE PURPOSE INCLUDING HEALTH RELATED EDUCATIONAL PROGRAMS: SAFETY FAIRS, CAR SEAT CLINICS, MENTAL HEALTH AND FIRST AID CLASSES, AND ASTHMA EDUCATION IN ELEMENTARY SCHOOLS. MAPLE GROVE HOSPITAL PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED COSTS TO RESIDENTS OF ITS COMMUNITY PRIMARILY THROUGH (A) THE DIFFERENCE BETWEEN PUBLIC PROGRAM PAYMENTS (PRIMARILY MEDICARE AND MEDICAID) AND THE RELATED COSTS OF PROVIDING SUCH SERVICES, AND (B) SERVICES PROVIDED TO PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT WHO ARE DETERMINED UNABLE TO PAY BECAUSE OF ECONOMIC FACTORS. IN ADDITION, MAPLE GROVE HOSPITAL CONTRIBUTES TO FUNDING MEDICAL CARE FOR THE UNINSURED THROUGH PAYMENT OF PATIENT SERVICES TAXES, WHICH INCLUDE THE MEDICAID SURCHARGE AND THE MINNESOTA CARE TAX ON CERTAIN NET REVENUE. 147470441 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 91 0 1206 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 2 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X AARON BLOOMQUIST 7635205200 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 J KEVIN CROSTON MD BOARD CHAIR 10.00 43.00 X X 0 1020962 46962 AARON BLOOMQUIST TREASURER 10.00 42.00 X X 0 462955 37186 SAMANTHA HANSON DIRECTOR 2.00 50.00 X 0 495928 37546 JENNIFER CLOSE DIRECTOR 2.00 50.00 X 0 423118 36255 JEFF WICKLANDER DIRECTOR 2.00 50.00 X 0 507845 46424 JAMES HEREFORD DIRECTOR 2.00 0.00 X 0 0 0 DAN FROMM DIRECTOR 2.00 0.00 X 0 0 0 ANDREW COCHRANE PRESIDENT 50.00 1.00 X 0 462756 45392 PAMELA DOORENBOS MD VP MEDICAL AFFAIRS 50.00 1.00 X 346284 0 25501 WENDY ULFERTS VP PATIENT CARE/ CHIEF NURSING OFFICER 50.00 0.00 X 251213 0 31019 REBECCA THIESFELD RAUEN DIRECTOR, HUMAN RESOURCES 50.00 0.00 X 176019 0 27858 JANET ANGELL DIRECTOR, PROCEDURAL CARE 50.00 0.00 X 169310 0 19702 FAITH ZWIRCHITZ DIRECTOR, WOMENS & CHILDREN'S 50.00 0.00 X 190201 0 13563 KAREN HALL PHARMACIST 50.00 0.00 X 172387 0 26541 SHERYL VUGTEVEEN DIRECTOR OF ACUTE CARE 50.00 0.00 X 162839 0 26615 1468253 3373564 420564 68 0 1 0 UNIVERSITY OF MINNESOTA PHYSICIANS 720 WASHINGTON AVE STE 200 MINNEAPOLIS MN 55414 PHYSICIAN SERVICES 1475470 ARAMARK HEALTHCARE FOOD 25271 NETWORK PLACE CHICAGO IL 60673 DIETARY 1272940 FAIRVIEW HEALTH SERVICES 2450 RIVERSIDE AVENUE MINNEAPOLIS MN 55454 PHYSICIAN SERVICES 885445 CROTHALL LAUNDRY SERVICE INC 13028 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 LAUNDRY 650622 SPECIALISTS IN GENERAL SURGERY 9825 HOSPITAL DRIVE 105 MAPLE GROVE MN 55369 PHYSICIAN SERVICES 447715 19 6708 6708 6708 PATIENT REVENUE 621500 207283916 207283916 CMS/EHR PAYMENTS & OTH 900099 695742 695742 CONTRACT SERVICES 900099 666021 666021 GIFT SHOP 900099 246647 246647 ALL OTHER 621910 166693 166693 209059019 252490 252490 209318217 207283916 0 2027593 X 654016 654016 59167517 49483419 9684098 2494485 2086206 408279 7200086 6021630 1178456 4144042 3465776 678266 22324589 18670667 3653922 80736 67522 13214 60411 50523 9888 20272570 16954507 3318063 438117 366409 71708 1540489 1288353 252136 165314 138257 27057 2680358 2241657 438701 25551 21369 4182 4633950 3875500 758450 7702629 6441920 1260709 1213106 1014554 198552 SUPPLIES 22427891 18757061 3670830 BAD DEBT EXPENSE 7733561 7733561 GOVERNMENT TAXES 5629865 5629865 MAINTENANCE AND REPAIRS 2713869 2269683 444186 1066570 892002 174568 174369722 147470441 26899281 0 1450 1650 35642857 34628773 27266879 29296834 2347646 2263577 729627 753127 150050661 63122906 92282218 86927755 11359494 11160764 3607000 3607000 290000 580000 173527171 169219480 15792661 16042412 127529151 123299619 143321812 139342031 X 30205359 29877449 30205359 29877449 173527171 169219480 X 34948495 -476405 -34800000 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 110555863 34023423 76532440 39494798 29099483 10395315 86927755 X PART X, LINE 2: MAPLE GROVE HOSPITAL EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2018 OR 2017. 1 1 1 X 1 X 275.000000000000 1 1 1 0 0 3460251 3460251 0.01980 30097870 20887295 9210575 0.05280 33558121 20887295 12670826 0.07260 371101 600 370501 0.00210 371101 600 370501 0.00210 33929222 20887895 13041327 0.07470 1 2731901 35303729 36142065 -838336 X 1 1 1 1 MAPLE GROVE HOSPITAL CORPORATION 9875 HOSPITAL DRIVE MAPLE GROVE MN 55369 X X X MAPLE GROVE HOSPITAL CORPORATION 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X WWW.MAPLEGROVEHOSPITAL.ORG X 1 16 1 WWW.MAPLEGROVEHOSPITAL.ORG 0 1 X 200.000000000000 275.000000000000 X X X X X 1 1 X X X 1 X WWW.MAPLEGROVEHOSPITAL.ORG X WWW.MAPLEGROVEHOSPITAL.ORG X WWW.MAPLEGROVEHOSPITAL.ORG X X X X X 1 X 0 X 1 0 0 MAPLE GROVE HOSPITAL CORPORATION PART V, SECTION B, LINE 5: ONE OF THE KEY OBJECTIVES IN CONDUCTING THE 2016 CHNA WAS TO IDENTIFY HEALTH ISSUES WHICH ARE MOST IMPORTANT TO OUR COMMUNITY MEMBERS AND ESTABLISH OR STRENGTHEN COMMUNITY RELATIONSHIPS TO HELP ADDRESS THESE HEALTH ISSUES. THIS WAS ACCOMPLISHED IN SEVERAL WAYS. A STEERING COMMITTEE COMPOSED OF COMMUNITY LEADERS, SOCIAL SERVICE PROVIDERS, HEALTH CARE PROVIDERS, SCHOOL DISTRICT EMPLOYEES, BUSINESS REPRESENTATIVES AND A PUBLIC HEALTH REPRESENTATIVE GUIDED THE ASSESSMENT PROCESS AND IDENTIFICATION OF HEALTH NEEDS. MAPLE GROVE HOSPITAL CONVENED 5 FOCUS GROUPS FROM TARGET POPULATIONS THROUGHOUT THE COMMUNITY. WE FURTHER INTERVIEWED KEY STAKEHOLDERS FROM LOCAL GOVERNMENT, LAW ENFORCEMENT, EDUCATION, RELIGIOUS AND COMMUNITY-BASED ORGANIZATIONS. LASTLY WE CONDUCTED AN ONLINE SURVEY FOR BUSINESS GROUPS, THE FAITH COMMUNITY AND COMMUNITY MEMBERS. THE ASSESSMENT WAS COMPLETED WORKING IN CONJUNCTION WITH FAIRVIEW AND MAPLE GROVE HOSPITAL. MAPLE GROVE HOSPITAL CORPORATION PART V, SECTION B, LINE 11: OUR MOST RECENT CHNA WAS CONDUCTED IN 2016. THE OVERALL CHNA WAS GUIDED BY THE COMMUNITY ENGAGEMENT ADVISORY TEAM WHICH IS COMPOSED OF COMMUNITY MEMBERS, MAPLE GROVE HOSPITAL EMPLOYEES, AND PUBLIC HEALTH REPRESENTATIVES. DATA USED TO IDENTIFY THE TOP PRIORITIES INCLUDED: DEMOGRAPHIC DATA; QUANTITATIVE DATA FROM THE MINNESOTA HOSPITAL ASSOCIATION, MINNESOTA DEPARTMENT OF HEALTH, HENNEPIN COUNTY SHAPE 2014, COMMUNITY NEED INDEX AND ATTRIBUTED PATIENT DATA; QUALITATIVE DATA FROM FOCUS GROUPS, KEY STAKEHOLDER INTERVIEWS, AND COMMUNITY ASSET MAPPING. THE FOLLOWING PRIORITIES WERE IDENTIFIED IN THE ASSESSMENT:-MENTAL HEALTH/SUBSTANCE ABUSE/USE-HEALTHY AGING/SENIOR SERVICES-CANCER - PREVENTION, SCREENING, HEALTHY SURVIVORS-INJURY PREVENTION ACROSS THE LIFESPAN-NUTRITION/HEALTHY LIFESTYLES-YOUTH ENGAGEMENT - EDUCATION ABOUT HEALTHCARE CAREERS, LEADERSHIP DEVELOPMENT-UNDERSTANDING OF IMMIGRANT CULTURES AND ISSUES RELATED TO HEALTH/DISPARITIES-TRANSPORTATION/HEALTHCARE ACCESSAFTER DISCUSSION OF THE HEALTH PRIORITIES, THE COMMUNITY ENGAGEMENT ADVISORY TEAM VOTED TO FOCUS ON TWO HEALTH PRIORITIES. PRIORITIZATION WAS BASED ON THE FOLLOWING CRITERION:-HOW WIDESPREAD IS THE HEALTH NEED?-HOW SERIOUS OR IMPORTANT DO YOU THINK THIS HEALTH NEED IS FOR INDIVIDUALS AND/OR THE COMMUNITY?-WHAT IS THE POTENTIAL FOR MAPLE GROVE HOSPITAL AND COMMUNITY PARTNERS TO HAVE A POSITIVE IMPACT ON THIS HEALTH NEED WITHIN 3 TO 4 YEARS?BASED ON THESE CRITERIA, THE TOP NEEDS WERE IDENTIFIED AS:-MENTAL HEALTH/SUBSTANCE ABUSE/USE - 207 VOTES-HEALTHY AGING/SENIOR SERVICES - 169 VOTES-CANCER - PREVENTION, SCREENING, HEALTHY SURVIVORS - 162 VOTES-NUTRITION/HEALTHY LIFESTYLES - 161 VOTES-INJURY PREVENTION ACROSS THE LIFESPAN - 159 VOTES-UNDERSTANDING OF IMMIGRANT CULTURES AND ISSUES RELATED TO HEALTH/DISPARITIES - 157 VOTES-YOUTH ENGAGEMENT - EDUCATION ABOUT HEALTHCARE CAREERS, LEADERSHIP DEVELOPMENT - 143 VOTES-TRANSPORTATION/HEALTHCARE ACCESS - 132 VOTESAFTER A REVIEW OF POTENTIAL IMPLEMENTATION PROJECTS TO ADDRESS THESE HEALTH PRIORITIES, A DECISION WAS MADE TO SEPARATE MENTAL HEALTH AND SUBSTANCE ABUSE/USE. THE FINAL HEALTH PRIORITIES FROM THE 2016 CHNA ARE:-MENTAL HEALTH-SUBSTANCE ABUSE/USE AND-HEALTHY AGING/SENIOR SERVICESTHESE HEALTH PRIORITIES ARE BEING ADDRESSED WITH COMMUNITY PARTNERSHIPS, COMMUNITY SUPPORT AND CULTURAL APPROPRIATENESS IN MIND.MAPLE GROVE HOSPITAL IS USING SEVERAL STRATEGIES TO ADDRESS THE IDENTIFIED HEALTH PRIORITIES. PRIORITY 1: MENTAL HEALTH (SYSTEM WIDE PRIORITY)GOAL - TO SUPPORT THE MENTAL HEALTH OF COMMUNITY MEMBERS ALONG THE MENTAL HEALTH CONTINUUM.OBJECTIVES:I. REDUCE THE STIGMA ASSOCIATED WITH MENTAL HEALTH CONDITIONS STRATEGIES:-INCORPORATED THE MAKE IT OKAY MESSAGE INTO ANNUAL EMPLOYEE TRAINING-ACTION - THE MAKE IT OKAY MESSAGE HAS BEEN INCLUDED IN THE ANNUAL ALL EMPLOYEE TRAINING.-INCORPORATE THE MAKE IT OKAY MESSAGE ON THE MAPLE GROVE HOSPITAL WEBSITE AND IN OUR PUBLIC COMMUNICATIONS DURING MAY - MENTAL HEALTH AWARENESS MONTH-ACTION - USED OUR WEB SITE TO GET INFORMATION ABOUT A MAY 11, 2018 YOUTH MENTAL HEALTH FIRST AID CLASS AND A MAY 18 ADULT FOCUSED MENTAL HEALTH FIRST AID CLASS OUT TO THE COMMUNITY.-ACTION - PUBLISHED AN ARTICLE IN THE SPRING 2018 MAPLE GROVE HOSPITAL MAGAZINE TITLED "TAKING STEPS TO PROVIDE YOUTH MENTAL HEALTH SERVICE." II. INCREASE EDUCATION ABOUT MENTAL HEALTH STRATEGIES:-OFFER A MINIMUM OF FOUR EVIDENCE BASED MENTAL HEALTH FIRST AID (MHFA) CLASSES ACROSS THE SYSTEM ANNUALLY-ACTION - 7 MENTAL HEALTH FIRST AID CLASSES WERE OFFERED TO THE COMMUNITY IN 2018. THESE INCLUDE:-MARCH 9, 2018 - TWO YOUTH FOCUSED MHFA CLASSES IN PARTNERSHIP WITH THE OSSEO SCHOOL DISTRICT AND MDH. ONE AT MAPLE GROVE HOSPITAL AND ONE AT THE OSSEO SCHOOL DISTRICT EDUCATION SERVICE CENTER - 49 NURSES ATTENDED. -MARCH 23, 2018 - YOUTH FOCUSED MENTAL HEALTH FIRST AID CLASS AT MAPLE GROVE HOSPITAL IN PARTNERSHIP WITH MDH - 23 PERSONS ATTENDED.-MAY 11, 2018 - YOUTH FOCUSED MHFA CLASS AT NORTH MEMORIAL HEALTH SPECIALTY CENTER IN PARTNERSHIP WITH MDH - 23 PERSONS ATTENDED. -MAY 18, 2018 ADULT FOCUSED MHFA CLASS AT NORTH MARKET IN PARTNERSHIP WITH FAIRVIEW 16 PERSONS ATTENDED.-SEPTEMBER 25, 2018 - YOUTH FOCUSED MHFA CLASS AT NEW HOPE YMCA IN PARTNERSHIP WITH MDH AND THE NEW HOPE YMCA - 21 PERSONS ATTENDED.-OCTOBER 12, 2018 - YOUTH FOCUSED MHFA CLASS AT NORTH MEMORIAL HEALTH SPECIALTY CENTER IN PARTNERSHIP WITH MDH - 17 PERSONS ATTENDED.-ACTION - IN 2018 BEGAN OFFERING SAFETALK SUICIDE AWARENESS CLASSES. 2 SAFETALK CLASSES WERE OFFERED TO THE COMMUNITY IN 2018.-JULY 25, 2018 - SAFETALK CLASS AT MAPLE GROVE HOSPITAL IN PARTNERSHIP WITH MDH - 13 PERSONS ATTENDED.-SEPTEMBER 28, 2018 - SAFETALK CLASS AT MAPLE GROVE HOSPITAL IN PARTNERSHIP WITH MDH - 20 PERSONS ATTENDED. III. IMPROVE ACCESS TO MENTAL HEALTH SERVICES STRATEGIES:-OPENED THE NORTH MEMORIAL MENTAL HEALTH & ADDICTION CARE CLINIC -ACTION - THE CLINIC LOCATED IN ROBBINSDALE OPENED IN DECEMBER OF 2016 IN RESPONSE TO AN IDENTIFIED COMMUNITY NEED. THE CLINIC HAS 10,300 SQ. FT. AND FOCUSES ON GENERAL MENTAL HEALTH PROBLEMS WITH A SPECIFIC FOCUS ON SERIOUS AND PERSISTENT MENTAL ILLNESS AND POST-TRAUMATIC STRESS DISORDER.-CONTINUED ASSESSMENT OF COMMUNITY NEED AND DEVELOPMENT OF PROGRAMS AS NEED IS IDENTIFIED-ACTION - IN 2018, IN ASSESSING THE NEEDS OF THE PRESENTING PATIENT COMMUNITY, WE ADDED ADDITIONAL PROGRAMMING TO INCLUDE A PARTIAL HOSPITALIZATION PROGRAM FOCUSED ON SPMI POPULATIONS. WE ALSO ADDED AN INTENSIVE OUTPATIENT PROGRAM FOCUSED ON PTSD, THE FIRST OF ITS KIND IN THE STATE AND IN THE METRO AREA. IN EARLY 2018, WE HIRED TWO MORE PSYCHOLOGISTS. IN LATE 2018, WE BEGAN A HIRING PROCESS TO EXPAND ACCESS BY INCREASING THE NUMBER OF OUTPATIENT THERAPISTS BY 4 AND PRESCRIBERS BY 4 AS WELL. ALL FOUR THERAPISTS STARTED IN 2019. -WE ALSO EXPANDED ACCESS TO BEHAVIORAL HEALTH THROUGH THE HIRING OF AN ADDITIONAL BEHAVIORAL HEALTH PROVIDER LOCATED IN THE PRIMARY CARE SETTING, A SERVICE LINE KNOWN AS INTEGRATIVE BEHAVIORAL HEALTH. -WE HAVE NOT BEEN ABLE TO FORMALLY EXPAND OUR ADDICTION SERVICES OFFERING IN 2018. IN 2019, TWO OF THE NEWLY HIRED OUTPATIENT PSYCHOLOGISTS CAME TO NORTH WITH A SIGNIFICANT PROFESSIONAL BACKGROUND IN WORKING WITH POPULATIONS STRUGGLING WITH ADDICTION. DEVELOPING CO-OCCURRING MH/SUD PROGRAMMING REMAINS A POSSIBLE PLAN FOR EXPANSION, BUT WE HAVE BEEN LIMITED BY NOT HAVING ADDICTION SPECIALISTS AMONGST OUR OUTPATIENT PRESCRIBERS. IV. SUPPORT NORTH MEMORIAL HEALTH'S DOMESTIC VIOLENCE ADVOCACY PROGRAM SAFEJOURNEYSTRATEGIES:-ENSURE 24-HOUR ADVOCACY IS PROVIDED BY TRAINED VOLUNTEERS-ACTION - 24-HOUR ADVOCACY IS IN PLACE.-TRAINED NEW VOLUNTEERS IN 2018-ACTION - FOUR SYSTEM WIDE VOLUNTEER TRAINING WERE HELD IN 2018. VOLUNTEERS SERVE BOTH MAPLE GROVE HOSPITAL AND NORTH MEMORIAL HEALTH HOSPITAL. 31 VOLUNTEER ADVOCATES WERE TRAINED. -INCREASE THE NUMBER OF PARTICIPANTS -ACTION - THE MAPLE GROVE SUPPORT GROUP HAD 68 ENCOUNTERS - THIS IS NOT NUMBER OF PEOPLE, IT INCLUDES DUPLICATES. THERE WERE 10 INDIVIDUAL CLIENTS THAT ATTENDED THROUGHOUT THE YEAR. 60 WALK IN ENCOUNTERS WERE HAD WITH CLIENTS - THIS IS A SYSTEM WIDE NUMBER AS THEY ALL MET AT NORTH MEMORIAL HEALTH REGARDLESS OF WHERE THEY CAME FROM. 9 INDIVIDUAL CLIENTS WERE SERVED IN THIS WAY. SAFEJOURNEY HAD 217 PHONE CALLS (SYSTEM WIDE) AND FIVE CLINIC ENCOUNTERS.-TRAIN NEW FACILITATORS FOR SUPPORT GROUPS-ACTION - TRAINED 31 NEW VOLUNTEERS IN 2018.-DISTRIBUTE CLIENT EMERGENCY FUNDS TO QUALIFIED CLIENTS-ACTION - SYSTEM WIDE WE SERVED 7 CLIENTS AND DISTRIBUTED $1,772.88. -PROVIDE COMMUNITY OUTREACH AND EDUCATION ON SAFEJOURNEY-ACTION - NO COMMUNITY OUTREACH AND EDUCATION WERE PROVIDED IN THE MAPLE GROVE HOSPITAL SERVICE AREA. V. WORK WITH COMMUNITY PARTNERS TO COLLECTIVELY IDENTIFY OPPORTUNITIES TO ADDRESS MENTAL HEALTH ISSUES AND SOCIAL CONDITIONS THAT AFFECT MENTAL HEALTH CONDITIONS - CHIP, CCH, WEST METRO HOSPITAL GROUP, LOCAL PUBLIC HEALTH, GOVERNMENT AND OTHERSSTRATEGIES:-CONTINUE ACTIVE INVOLVEMENT IN HENNEPIN COUNTY CHIP AND SOCIAL ISOLATION WORKGROUP-ACTION - CHIP 1.0 ENDED IN 2017. 5 SOCIAL ISOLATION EVENTS WERE HELD IN 2017. -CONTINUE ACTIVE INVOLVEMENT WITH THE CENTER FOR COMMUNITY HEALTH COLLECTIVE ACTION GROUP-ACTION - GROUP CONTINUES TO WORK ON INCREASING AWARENESS OF MENTAL HEALTH FIRST AID CLASSES IN THE METRO COMMUNITY. MAY MENTAL HEALTH AWARENESS MONTH IS A FOCUS FOR GETTING THE WORD OUT ON MAKE IT OKAY AND CLASSES FOCUSED ON MENTAL HEALTH. COMMUNITY HEALTH OUTREACH MANAGER CONTINUES TO REPRESENT THE SYSTEM AT MONTHLY MEETINGS.-EXPLORE COMMUNITY PARTNERSHIP OPPORTUNITIES THAT ADDRESS MENTAL HEALTH AND VIOLENCE PART V, SECTION B, LINE 11 CONTINUED: -ACTION - STARTED IN PARTNERSHIP WITH MDH AND OTHER COMMUNITY PARTNERS A YOUTH SUICIDE PREVENTION COALITION TO EXPLORE HOW WE CAN BETTER WORK TOGETHER TO ADDRESS THE ISSUE OF YOUTH SUICIDE IN OUR COMMUNITY. PRIORITY 2: SUBSTANCE ABUSE/USE (SYSTEM WIDE PRIORITY)GOAL TO CREATE AN ENVIRONMENT WHERE SUBSTANCE ABUSE/USE AMONG THE GENERAL POPULATION AND SUBSTANCE ABUSE/USE AMONG YOUTH IS REDUCED. OBJECTIVES:I. INCREASE AWARENESS OF SUBSTANCE ABUSE/USE ISSUES AMONG YOUTH AND YOUNG ADULTS AND ACTIVITIES TO ADDRESS THESE ISSUES STRATEGIES:-CONTINUE WORKING WITH AND SUPPORTING COMMUNITY COLLABORATIVES SUCH AS PARTNERSHIP FOR CHANGE AND PARTNERS IN PREVENTION-ACTION - STAFF ATTENDED PARTNERSHIP FOR CHANGE AND PARTNERS IN PREVENTION MEETINGS.-ACTION - FINANCIALLY SUPPORT PARTNERS IN PREVENTION'S UNCOVER THE TRUTH CAMPAIGN WHICH EDUCATES WAYZATA HIGH SCHOOL STUDENTS ABOUT DRUG AND ALCOHOL ISSUES AND THE BEHAVIOR OF THEIR PEERS.-ACTION - PARTNERSHIP FOR CHANGE, HOUSED AT NORTH MEMORIAL HEALTH HOSPITAL'S TRAUMA DEPARTMENT, LEVERAGES COMMUNITY PARTNERSHIPS TO PREVENT AND REDUCE SUBSTANCE USE/ABUSE IN THE COMMUNITY THROUGH STRATEGIES SUCH AS:-POLD (PLACE OF LAST DRINK) AND RAVE (RESPONSIBLE VENDOR EDUCATION & ENFORCEMENT)-EXPANDED SOCIAL HOST ORDINANCE-MEDICINE ABUSE PREVENTION WORKGROUP WHICH INCLUDES MEDICATION DROP BOXES - 1 BOX OPENED IN 2018 AT BROOKLYN CENTER POLICE DEPARTMENT-MARIJUANA PERCEPTION OF HARM - HELD A MARIJUANA SYMPOSIUM ON APRIL 2018. HAZELDEN, PARTNERSHIP FOR CHANGE, NORTH MEMORIAL HEALTH, AND PARTNERS IN PREVENTION SPONSORED A SOLD-OUT MARIJUANA SYMPOSIUM TO EDUCATE POLICY MAKERS, COMMUNITY LEADERS AND HEALTH CARE EXPERTS ABOUT THE IMPACT MARIJUANA CAN HAVE ON COMMUNITIES. NATIONAL SPEAKERS DISCUSSED THE INSIGHTS AND LEARNINGS FROM OTHER STATES WHO HAVE ALREADY LEGALIZED MARIJUANA FOR RECREATIONAL USE. EXPERTS COVERED A RANGE OF TOPICS, INCLUDING COMMON MARIJUANA MYTHS, WAYS LEGALIZATION HAS IMPACTED COLORADO AND THE CURRENT STATE OF MARIJUANA LEGALIZATION. THERE WERE ABOUT 100 ATTENDEES AT THE MARIJUANA SYMPOSIUM. POSITIVE EVALUATION WAS RECEIVED.-ACTION - STARTED IN PARTNERSHIP WITH MDH AND OTHER COMMUNITY PARTNERS A YOUTH SUICIDE PREVENTION COALITION TO EXPLORE HOW WE CAN BETTER WORK TOGETHER TO ADDRESS THE ISSUE OF YOUTH SUICIDE IN OUR COMMUNITY II. IMPROVE ACCESS TO ADDICTION MEDICINE SERVICES STRATEGIES:-OPENED THE NORTH MEMORIAL HEALTH MENTAL HEALTH & ADDICTION CARE CLINIC -ACTION - THE CLINIC LOCATED IN ROBBINSDALE OPENED IN DECEMBER OF 2016 IN RESPONSE TO AN IDENTIFIED COMMUNITY NEED. ORIGINALLY THE CLINIC INCLUDED ADDICTION MEDICINE, HOWEVER WHEN OUR ONLY ADDICTION MEDICINE PROVIDER LEFT IN EARLY 2017 A REPLACEMENT WAS NOT OBTAINED. SUBSTANCE USE DISORDERS ARE ADDRESSED WITHIN THE CONTEXT OF MENTAL HEALTH CARE. -CONTINUED ASSESSMENT OF COMMUNITY NEED AND DEVELOPMENT OF PROGRAMS AS NEED IS IDENTIFIED-ACTION - IN 2018, IN ASSESSING THE NEEDS OF THE PRESENTING PATIENT COMMUNITY, WE ADDED ADDITIONAL PROGRAMMING TO INCLUDE A PARTIAL HOSPITALIZATION PROGRAM FOCUSED ON SPMI POPULATIONS. WE ALSO ADDED AN INTENSIVE OUTPATIENT PROGRAM FOCUSED ON PTSD, THE FIRST OF ITS KIND IN THE STATE AND IN THE METRO AREA. IN EARLY 2018, WE HIRED TWO MORE PSYCHOLOGISTS. IN LATE 2018, WE BEGAN A HIRING PROCESS TO EXPAND ACCESS BY INCREASING THE NUMBER OF OUTPATIENT THERAPISTS BY 4 AND PRESCRIBERS BY 4 AS WELL. ALL FOUR THERAPISTS STARTED IN 2019. -WE ALSO EXPANDED ACCESS TO BEHAVIORAL HEALTH THROUGH THE HIRING OF AN ADDITIONAL BEHAVIORAL HEALTH PROVIDER LOCATED IN THE PRIMARY CARE SETTING, A SERVICE LINE KNOWN AS INTEGRATIVE BEHAVIORAL HEALTH. -WE HAVE NOT BEEN ABLE TO FORMALLY EXPAND OUR ADDICTION SERVICES OFFERING IN 2018. IN 2019, TWO OF THE NEWLY HIRED OUTPATIENT PSYCHOLOGISTS CAME TO NORTH WITH A SIGNIFICANT PROFESSIONAL BACKGROUND IN WORKING WITH POPULATIONS STRUGGLING WITH ADDICTION. DEVELOPING CO-OCCURRING MH/SUD PROGRAMMING REMAINS A POSSIBLE PLAN FOR EXPANSION, BUT WE HAVE BEEN LIMITED BY NOT HAVING ADDICTION SPECIALISTS AMONGST OUR OUTPATIENT PRESCRIBERS. III. INCREASE AWARENESS OF OPIOID MISUSE AND WORK TO PUT SYSTEMS IN PLACE TO REDUCE THIS MISUSESTRATEGIES:-WORK WITH ICSI (INSTITUTE FOR CLINICAL IMPROVEMENT) ON PROGRAM DEVELOPMENT-ACTION - WORKGROUPS HAVE BEEN FORMED AROUND:-ACUTE PRESCRIBING-IMPLEMENTED ACUTE OPIOID PRESCRIBING GUIDELINES FOR SURGICAL AND NON-SURGICAL PRESCRIBING-SURGICAL PRESCRIBING AT OR BELOW THE PRESCRIBING THRESHOLDS FOR INITIAL 9 PROCEDURES NEARLY DOUBLED, RESULTING IN 40,000 FEWER PILLS PRESCRIBED. THE EMERGENCY DEPARTMENT PRESCRIBED IN LINE WITH GUIDELINES 93% OF THE TIME RESULTING IN 50,000 FEWER OPIOID PILLS PRESCRIBED. AMBULATORY AND URGENT CARE SETTINGS DECREASED PRESCRIBING OPIOIDS TO OPIOID NAVE CUSTOMERS.-HIGH RISK POPULATIONS-EFFORTS IN PROGRESS TO SUPPORT PATIENTS IN THE EMERGENCY DEPARTMENT TO BEGIN MEDICATION ASSISTED THERAPY.-PROPER DISPOSAL OF UNUSED OPIOIDS -IN 2018, MEDICATION DISPOSAL KIOSKS AT NORTH MEMORIAL HEALTH HOSPITAL AND MAPLE GROVE HOSPITAL COLLECTED OVER 500 POUNDS OF POTENTIALLY DANGEROUS UNUSED OR EXPIRED PRESCRIPTION AND OVER-THE-COUNTER MEDICATIONS FROM OUR COMMUNITY. THE DISPOSAL KIOSKS ARE INSTALLED AT BOTH NORTH MEMORIAL HEALTH PHARMACY - ROBBINSDALE ON THE FIRST FLOOR OF NORTH MEMORIAL HEALTH HOSPITAL AND NORTH MEMORIAL HEALTH PHARMACY - MAPLE GROVE AT MAPLE GROVE MEDICAL CENTER. STRATEGIES: -GROW INTERNAL TEAM TO MANAGE OPIOID PROGRAM DEVELOPMENT AND DEPLOY ICSI CONTENT-ACTION - A WORKGROUP HAS BEEN FORMED AROUND:-CHRONIC PRESCRIBING FOR CHRONIC PAIN-A CHRONIC CONTROLLED SUBSTANCES GUIDELINE WAS DESIGNED TO SAFELY AND EFFECTIVELY SUPPORT THE PRESCRIBING OF OPIOIDS TO CHRONIC USE CUSTOMERS. CUSTOMERS WHO RECEIVED AN ANNUAL URINE TOXICOLOGY SCREEN INCREASED BY 10%. MORE CHRONIC OPIOID CUSTOMERS COMPLETED A PRESCRIPTION CONTROLLED SUBSTANCE AGREEMENT WITH THEIR PROVIDER. -CONTINUE INVOLVEMENT WITH PARTNERSHIP FOR CHANGE AND MINNESOTA'S PRESCRIPTION MONITORING PROGRAM (PMP)-ACTION - PARTNERSHIP FOR CHANGE WORKING IN PARTNERSHIP WITH THE PHARMACY DEPARTMENT ON INTEGRATING PMP INTO EPIC, PATIENT PORTAL AND EDUCATION.-PROVIDER FORUM: PANEL DISCUSSION ON OPIOIDS, APRIL 2018-THE MEDICINE ABUSE PREVENTION WORKGROUP COLLABORATED WITH NORTH MEMORIAL HEALTH ED AND GRAND ROUNDS STAFF TO PLAN A PROVIDER EDUCATION EVENT SURROUNDING THE OPIOID EPIDEMIC. ABOUT 65 PROVIDERS ATTENDED THE EVENT IN APRIL. NEXT STEPS INCLUDE CONTINUING TO PROMOTING DISPOSAL OPTIONS TO RESIDENTS AND APPLY FOR FUNDING TO CONTINUE PROVIDER EDUCATION OPPORTUNITIES.-RESEARCH COMMUNITY BASED OPIOID ABUSE PREVENTION PROGRAMS-ACTION - BEING ADDRESSED BY WORK WITH ICSI AND PARTNERSHIP FOR CHANGEPRIORITY 3: HEALTHY AGING/SENIOR SERVICESGOAL - TO WORK TOGETHER WITH LOCAL GOVERNMENT, OTHER HEALTHCARE SYSTEMS, SOCIAL SERVICE PROVIDERS AND COMMUNITY MEMBERS TO CREATE AN ENVIRONMENT WHERE OUR AGING POPULATION CAN HAVE ACCESS TO THE PROGRAMS AND SERVICES NEEDED TO AGE IN PLACE.OBJECTIVES:I. ADDRESS COMMUNITY-BASED INFRASTRUCTURAL CHALLENGES THAT CREATE BARRIERS TO HEALTHY AGING IN MAPLE GROVESTRATEGIES:-CONTINUE WORKING WITH THE CITY OF MAPLE GROVE'S AGE-FRIENDLY MAPLE GROVE INITIATIVE -ACTION - ACTIVE PARTICIPATION ON THE CITY OF MAPLE GROVE'S AGE-FRIENDLY MAPLE GROVE LEADERSHIP TEAM. CO-CHAIR OF THE COMMUNITY SUPPORT AND HEALTH SERVICES TEAM.II. IMPROVE EDUCATION ABOUT ADVANCE CARE PLANNING STRATEGIES:-OFFER A MINIMUM OF FOUR EVIDENCE BASED RESPECTING CHOICES PRESENTATION IN THE MAPLE GROVE COMMUNITY ASSESSMENT AREA-ACTION - CLASSES WERE CHANGED FROM RESPECTING CHOICES TO ADVANCE CARE PLANNING. FOUR CLASSES WERE OFFERED IN THE MAPLE GROVE ASSESSMENT AREA IN 2018:-FEBRUARY 28, 2018 -ADVANCED CARE PLANNING CLASS AT THE MAPLE GROVE COMMUNITY CENTER - 10 PARTICIPANTS. -MAY 17, 2018 -ADVANCED CARE PLANNING CLASS AT MAPLE GROVE HOSPITAL - 8 PARTICIPANTS -SEPTEMBER 20, 2018 -ADVANCED CARE PLANNING CLASS AT MAPLE GROVE HOSPITAL - 5 PARTICIPANTS -NOVEMBER 8, 2018 -ADVANCED CARE PLANNING CLASS AT THE MAPLE GROVE COMMUNITY CENTER - 12 PARTICIPANTS -EXPLORE OFFERING A RESPECTING CHOICES TRAIN-THE-PRESENTER SESSION TO COMMUNITY PARTNERS THAT WOULD OFFER THE RESPECTING CHOICES CLASS TO THE WIDER COMMUNITY-ACTION - ADVANCE CARE PLANNING TRAINING WAS OFFERED TO A SOCIAL WORKER AT MAPLE GROVE HOSPITAL IN ORDER TO CONTINUE OFFERING ADVANCE CARE PLANNING CLASSES TO THE COMMUNITY. PART V, SECTION B, LINE 11 CONTINUED: III. EXPLORE IMPLEMENTING A COMMUNITY-BASED FALLS PREVENTION EDUCATION PROGRAM STRATEGIES:-STEPPING ON PROGRAMS IMPLEMENTED AT BOTH MAPLE GROVE HOSPITAL AND NORTH MEMORIAL HEALTH HOSPITAL-ACTION - A STEPPING ON CLASS WAS OFFERED FIRST QUARTER OF 2018 AT THE ST. THERESE LOCATION IN BROOKLYN PARK. 13 PERSONS COMPLETED THE COURSE. -A STEPPING ON CLASS WAS OFFERED SECOND QUARTER OF 2018 AT THE MAPLE GROVE COMMUNITY CENTER. 10 PERSONS COMPLETED THE COURSE.-A STEPPING ON FACILITATOR TRAINING CLASS WAS OFFERED TO COMMUNITY AND STAFF MEMBERS IN JUNE OF 2018. ONE OF THE TRAINERS WAS A MAPLE GROVE HOSPITAL STAFF MEMBER AND ONE WAS A NORTH MEMORIAL HEALTH HOSPITAL STAFF MEMBER. A TOTAL OF 12 PERSONS WERE TRAINED TO BE STEPPING ON FACILITATORS. THIS TRAINING WAS CONDUCTED IN ORDER TO INCREASE THE REACH OF STEPPING ON CLASSES IN THE COMMUNITY. IN THE FALL OF 2018 4 STEPPING ON CLASSES WERE OFFERED IN THE COMMUNITY. 30 PERSONS COMPLETED THE COURSES.IV. COMMIT MAPLE GROVE HOSPITAL SUPPORT AND RESOURCES TO WORK WITH COMMUNITY PARTNERS TO COLLECTIVELY IDENTIFY OPPORTUNITIES TO ADDRESS ISSUES AND CONDITIONS THAT AFFECT HEALTH AGINGSTRATEGIES:-OFFER FINANCIAL SUPPORT FOR THE CITY OF MAPLE GROVE'S AGE-FRIENDLY MAPLE GROVE INITIATIVE-ACTION - FINANCIAL SUPPORT WAS PROVIDED IN 2018 TO THE CITY OF MAPLE GOVE'S AGE-FRIENDLY INITIATIVE TO SUPPORT THE CONSULTANT HIRED TO ADVANCE THIS WORK.V. WORK WITH COMMUNITY PARTNERS TO REDUCE CONDITIONS THAT NEGATIVELY AFFECT THE MENTAL HEALTH OF SENIORS SUCH AS SOCIAL ISOLATIONSTRATEGIES:-CONTINUE WORKING WITH HENNEPIN COUNTY CHIP SOCIAL ISOLATION COMMITTEE-ACTION - CHIP 1.0 ENDED IN 2017. 5 SOCIAL ISOLATION EVENTS WERE HELD IN 2017.-EXPLORE POTENTIAL PARTNERSHIPS WITH SOCIAL SERVICE GROUPS THAT ADDRESS SOCIAL ISOLATION-ACTION - NORTH MEMORIAL HEALTH COMMUNITY PARAMEDICS MAKE HOME VISITS AND ASSESS SOCIAL ISOLATION AND FOOD INSECURITY. 13THE HEALTH PRIORITIES NOT BEING ADDRESSED DIRECTLY INCLUDE:-CANCER - PREVENTION, SCREENING, HEALTHY SURVIVORS -NUTRITION/HEALTHY LIFESTYLES -INJURY PREVENTION ACROSS THE LIFESPAN -UNDERSTANDING OF IMMIGRANT CULTURES AND ISSUES RELATED TO HEALTH/DISPARITIES-YOUTH ENGAGEMENT- EDUCATION ABOUT HEALTHCARE CAREERS, LEADERSHIP DEVELOPMENT-TRANSPORTATION/HEALTHCARE ACCESS THE COMMUNITY ENGAGEMENT ADVISORY TEAM FELT THAT TO MAKE A MEANINGFUL DIFFERENCE IN THE TOP THREE IDENTIFIED HEALTH PRIORITIES RESOURCES SHOULD BE FOCUSED ON THESE PRIORITIES AND NOT SPREAD ACROSS A MULTITUDE OF PRIORITIES. CANCER PREVENTION, SCREENING AND HEALTHY SURVIVORS IS BEING ADDRESSED IN THE AMERICAN CANCER SOCIETY AND THE CANCER CENTER AT NORTH MEMORIAL HEALTH. NUTRITION AND HEALTHY LIFESTYLES IS BEING ADDRESSED BY MANY GROUPS SUCH AS THE AMERICAN CANCER SOCIETY, THE AMERICAN HEART ASSOCIATION, THE YMCA AND LOCAL PARK AND RECREATION ASSOCIATIONS. INJURY PREVENTION IS BEING ADDRESSED BY SAFE KIDS OUT OF NORTH MEMORIAL HEALTH AND SENIOR INJURY PREVENTION IS BEING ADDRESSED THROUGH THE HEALTHY AGING/SENIOR SERVICES HEALTH PRIORITY. CULTURAL DIVERSITY IS BEING WOVEN INTO THE TOP THREE PRIORITIES. YOUTH HAVE ACCESS TO VOLUNTEER OPPORTUNITIES THROUGH MAPLE GROVE HOSPITAL'S VOLUNTEER DEPARTMENT. TRANSPORTATION IS BEING DISCUSSED AT THE COUNTY AND LOCAL LEVEL ALONG WITH THE HEALTHY AGING/SENIOR SERVICES PRIORITY. PART III, LINE 2: AMOUNT REPRESENTS THE HOSPITAL'S BAD DEBT PROVISION REDUCED BY THE HOSPITAL'S COST TO CHARGE RATIO WHICH REPRESENTS THE BEST ESTIMATE OF COST FOR THE BAD DEBT PROVISION. PART III, LINE 4: MAPLE GROVE HOSPITAL'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DESCRIPTION ABOUT BAD DEBT EXPENSE. THE COST TO CHARGE RATIO WAS USED TO DETERMINE THE AMOUNT ON PART III, SECTION A, LINE 2. WE DO NOT HAVE THE INFORMATION NECESSARY TO DETERMINE WHICH PORTION OF THE AMOUNT REPORTED ON LINE 2 IS COMMUNITY BENEFIT. PART III, LINE 8: THE SHORTFALL REPORTED REPRESENTS THE AMOUNT THE MEDICARE REIMBURSEMENT IS LESS THAN THE ESTIMATED COST OF PROVIDING SERVICES TO THOSE PATIENTS. THE METHOD USED TO ESTIMATE THOSE COSTS IS THE COST TO CHARGE RATIO APPROACH WHICH CALCULATES THE RATIO OF TOTAL HOSPITAL COSTS / TOTAL HOSPITAL GROSS REVENUE AND THEM APPLIES THAT RATIO TO TOTAL MEDICARE GROSS REVENUE. PART III, LINE 9B: MAPLE GROVE HOSPITAL CORPORATION HAS POLICIES AND PROCEDURES IN PLACE FOR COLLECTION PRACTICES THAT INCLUDE IDENTIFICATION AND SCREENING FOR CHARITY CARE AND FINANCIAL ASSISTANCE. THE POLICIES ARE AVAILABLE ON THE ORGANIZATION'S INTRANET AND EACH PATIENT IS GIVEN A BROCHURE UPON ADMISSION. PART VI, LINE 2: MAPLE GROVE HOSPITAL WORKS CLOSELY WITH COMMUNITY MEMBERS TO DETERMINE AREAS OF INTEREST AND NEED IN HEALTHCARE SERVICES. (A NEW COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN 2016. WE ARE CURRENTLY ADDRESSING THE NEEDS IDENTIFIED IN OUR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT.) PART VI, LINE 3: MAPLE GROVE HOSPITAL HAS A VERY PROACTIVE PROGRAM TO ASSIST UNINSURED AND UNDERINSURED PATIENTS WITH THEIR MEDICAL BILLS. WE COMPLY WITH THE ATTORNEY GENERAL'S REQUIREMENT TO PROVIDE A DISCOUNT TO UNINSURED MINNESOTA RESIDENTS AS WELL AS A FINANCIAL ASSISTANCE PROGRAM FOR FINANCIALLY QUALIFIED PATIENTS. WE HAVE PATIENT FINANCIAL ADVOCATES AS WELL AS A CONTRACTED VENDOR THAT MEETS WITH ALL OF OUR UNINSURED INPATIENTS AND SPECIFIC OUTPATIENTS TO ASSIST THEM IN MEDICAL ASSISTANCE ELIGIBILITY AND APPLICATIONS. THIS COULD INCLUDE A VISIT TO THEIR RESIDENCE IF THEY NEED HELP IN COMPLETING ASSISTANCE APPLICATIONS. SHOULD THEY NOT QUALIFY FOR STATE OR FEDERAL ASSISTANCE PROGRAMS, WE OFFER AND ASSIST THEM IN APPLYING FOR THE HOSPITAL'S FINANCIAL ASSISTANCE (CHARITY CARE) PROGRAM.IN ADDITION, OUR INTERNAL COLLECTIONS DEPARTMENT AND OUR COLLECTION AGENCIES ARE WELL VERSED IN OUR ASSISTANCE PROGRAMS AND WILL ASSESS DURING THEIR CONVERSATIONS WITH PATIENTS IF REFERRAL TO EITHER A STATE OR FEDERAL PROGRAM OR OUR CHARITY CARE PROGRAM WOULD BE APPROPRIATE. PART VI, LINE 4: WE SERVE A 27 ZIP-CODE AREA IN THE NORTHWEST SIDE OF THE TWIN CITIES METRO. THIS IS BASED ON THE HOME ZIP CODES FOR 75% OF OUR INPATIENT POPULATION, EXCLUDING NEWBORNS AND NEONATES. WE WORK WITH THE COMMUNITY TO ADDRESS COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. PART VI, LINE 5: MAPLE GROVE HOSPITAL PROVIDES EDUCATIONAL RESOURCES FOR COMMUNITY MEMBERS SUCH AS CLASSES ON HEALTH CARE DIRECTIVES, KIDS SAFETY FAIRS AND SEMINARS ON HEALTH TOPICS. PART VI, LINE 6: MAPLE GROVE HOSPITAL IS A PART OF NORTH MEMORIAL HEALTH SYSTEM, WHICH IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. THROUGH TARGETED OUTREACH, EDUCATION AND PARTNERSHIPS, WE IMPROVE THE HEALTH OF OUR COMMUNITIES BY LISTENING TO THEIR NEEDS AND RESPONDING WITH APPROPRIATE PROGRAMS AND SERVICES. OUR PROGRAMS, MANY OF WHICH HAVE BEEN NATIONALLY RECOGNIZED, RANGE FROM HEALTH EDUCATION AND FREE SCREENING TO TRAINING HEALTH PROFESSIONALS. PART VI, LINE 7: MAPLE GROVE HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE STATE OF MINNESOTA. X X X 0 0 0 0 0 1 1 0 0 J KEVIN CROSTON MD BOARD CHAIR 0 809165 0 202500 0 9297 0 19250 0 27712 0 1067924 0 0 AARON BLOOMQUIST TREASURER 0 399657 0 60000 0 3298 0 19250 0 17936 0 500141 0 0 SAMANTHA HANSON DIRECTOR 0 420000 0 73500 0 2428 0 11969 0 25577 0 533474 0 0 JENNIFER CLOSE DIRECTOR 0 420000 0 0 0 3118 0 19250 0 17005 0 459373 0 0 JEFF WICKLANDER DIRECTOR 0 439621 0 66000 0 2224 0 19250 0 27174 0 554269 0 0 ANDREW COCHRANE PRESIDENT 0 399039 0 60000 0 3717 0 19250 0 26142 0 508148 0 0 PAMELA DOORENBOS MD VP MEDICAL AFFAIRS 300769 0 45115 0 400 0 16500 0 9001 0 371785 0 0 0 WENDY ULFERTS VP PATIENT CARE/ CHIEF NURSING OFFIC 219310 0 31503 0 400 0 12868 0 18151 0 282232 0 0 0 REBECCA THIESFELD RAUEN DIRECTOR, HUMAN RESOURCES 161091 0 14327 0 601 0 10525 0 17333 0 203877 0 0 0 JANET ANGELL DIRECTOR, PROCEDURAL CARE 153675 0 15100 0 535 0 6751 0 12951 0 189012 0 0 0 FAITH ZWIRCHITZ DIRECTOR, WOMENS & CHILDREN'S 160137 0 29945 0 119 0 11405 0 2158 0 203764 0 0 0 KAREN HALL PHARMACIST 153865 0 18257 0 265 0 10327 0 16214 0 198928 0 0 0 SHERYL VUGTEVEEN DIRECTOR OF ACUTE CARE 148070 0 14500 0 269 0 9754 0 16861 0 189454 0 0 0 PART I, LINE 3 THE CHIEF EXECUTIVE OFFICER IS AN EMPLOYEE OF NORTH MEMORIAL HEALTH CARE. OTHER BOARD MEMBERS LISTED WITH COMPENSATION FROM A RELATED ORGANIZATION ARE OFFICERS AND KEY EMPLOYEES OF NORTH MEMORIAL HEALTH CARE WHO PROVIDE SERVICES TO MAPLE GROVE HOSPITAL AS WELL AS TO ALL OR SOME RELATED ENTITIES AS IDENTIFIED ON SCHEDULE R. AS SUCH, THEIR COMPENSATION LEVELS INCORPORATE SERVICES PROVIDED TO MULTIPLE NORTH MEMORIAL ENTITIES. PART I, LINE 6 NORTH MEMORIAL HEALTH CARE'S ANNUAL INCENTIVE PLAN REQUIRES ACHIEVEMENT OF STATED PERFORMANCE METRICS, WHICH INCLUDE OPERATING CASH FLOW MARGIN. A CITY OF MAPLE GROVE 410873250 56516TBU8 2017-05-25 128801633 REFUNDING OF 2007 BOND SERIES 0 1 0 A 3810000 128801633 1020988 127780645 2017 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 3 NORTH MEMORIAL HEALTH CARE, A RELATED PARTY, PERFORMS MANAGEMENT DUTIES ON BEHALF OF MAPLE GROVE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 6 MAPLE GROVE HOSPITAL HAS ONE CLASS OF MEMBERS. NORTH MEMORIAL HEALTH CARE ("NORTH MEMORIAL") AND FAIRVIEW HEALTH SERVICES ("FAIRVIEW") ARE THE ONLY MEMBERS OF THE CORPORATION AND BOTH MEMBERS ARE NONPROFIT, TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS IS COMPRISED OF SEVEN VOTING DIRECTORS AND ONE NON-VOTING DIRECTOR, AS FOLLOWS: (A) THE CHIEF EXECUTIVE OFFICER OF NORTH MEMORIAL AND FOUR OTHER DIRECTORS APPOINTED ANNUALLY BY NORTH MEMORIAL (B) THE CHIEF EXECUTIVE OFFICER OF FAIRVIEW AND ONE OTHER DIRECTOR APPOINTED ANNUALLY BY FAIRVIEW AND (C) THE MAPLE GROVE HOSPITAL CHIEF EXECUTIVE OFFICER. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS, AND ONLY THE MEMBERS, MAY TAKE DIRECT ACTION ON THE FOLLOWING MATTERS BY UNANIMOUS MEMBER APPROVAL: (A) AMENDMENTS TO THE ARTICLES OF INCORPORATION; (B) AMENDMENTS TO THE BYLAWS; (C) MERGER OR CONSOLIDATION OF THE CORPORATION (D) SALE, LEASE OR TRANSFER OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (E) JOINT VENTURES AFFECTING SUBSTANTIALLY ALL OF THE ASSETS OR OPERATIONS OF THE CORPORATION; (F) DETERMINATION OF THE NAME UNDER WHICH THE HOSPITAL CONDUCTS BUSINESS; (G) CERTAIN MORTGAGES OR OTHER SECURITY INTERESTS; (H) ISSUANCE OF CAPITAL CALLS; AND (I) DISSOLUTION AND LIQUIDATION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE MANAGEMENT COMPANY AND THE BOARD OF DIRECTORS REVIEW THE FORM 990 BEFORE IT IS FILED. REPRESENTATIVES FROM THE HOSPITAL'S INDEPENDENT ACCOUNTING FIRM REVIEW THE FORM 990 WITH THE MANAGEMENT COMPANY IN DETAIL AND NOTES FOR THE COMMITTEE ANY CHANGES IN THE FORM 990 FROM PRIOR YEARS. AFTER THOROUGH DISCUSSION, THE MANAGEMENT COMPANY APPROVES THE FORM 990 AND FORWARDS IT TO THE BOARD FOR ITS REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS AND ALL EMPLOYEES RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY EACH YEAR. EACH BOARD MEMBER AND STAFF MEMBER FILLS OUT A CONFLICT OF INTEREST QUESTIONNAIRE IN WHICH THEY ARE ASKED TO IDENTIFY ANY RELATIONSHIP THAT WOULD CREATE A CONFLICT OF INTEREST. THE RESULTS ARE SUMMARIZED AND REVIEWED TO DETERMINE ANY ACTUAL OR POTENTIAL CONFLICT AND ARE REPORTED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR KEY POSITIONS ARE REVIEWED BY THE EXECUTIVE COMMITTEE OF NORTH MEMORIAL WORKING IN CONJUNCTION WITH AN OUTSIDE CONSULTANT. THE EXECUTIVE COMMITTEE OF NORTH MEMORIAL INSURES THAT THE SALARY AND BENEFIT ADMINISTRATION REVIEW PROCESS IS BEING FOLLOWED, WHICH INCLUDES SALARY AND BENEFIT SURVEYS AND COMPARISONS OF ALL POSITIONS. THE CEO'S COMPENSATION IS SENT TO THE FULL BOARD FOR APPROVAL. THE COMPENSATION OF ALL OTHER KEY POSITIONS IS APPROVED BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FINANCIAL STATEMENTS ARE AVAILABLE ONLINE THROUGH THE OFFICE OF THE ATTORNEY GENERAL VIA THE CHARITY REPORT FILED WITH THE STATE OF MINNESOTA. FORM 990, PART IX, LINE 11G MEDICAL FEES: PROGRAM SERVICE EXPENSES 14,331,416. MANAGEMENT AND GENERAL EXPENSES 2,804,714. TOTAL EXPENSES 17,136,130. COLLECTION AGENCY FEES: PROGRAM SERVICE EXPENSES 616,819. MANAGEMENT AND GENERAL EXPENSES 120,714. TOTAL EXPENSES 737,533. LAUNDRY FEES: PROGRAM SERVICE EXPENSES 555,801. MANAGEMENT AND GENERAL EXPENSES 108,773. TOTAL EXPENSES 664,574. MISCELLANEOUS PURCHASED FEES: PROGRAM SERVICE EXPENSES 1,450,471. MANAGEMENT AND GENERAL EXPENSES 283,862. TOTAL EXPENSES 1,734,333. FORM 990, PART XI, LINE 9: RETURN OF CAPITAL TO MEMBERS -34,800,000. FORM 990, PART XII, LINE 2C: NEITHER THE OVERSIGHT PROCESS OF THE AUDIT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT CHANGED DURING THE CURRENT TAX YEAR. FORM 990, PART XI, LINE 9: RETURN OF CAPITAL TO MEMBERS: A RETURN OF CAPITAL IN THE AMOUNT OF $34,800,000 WAS MADE TO THE MEMBERS OF THE ORGANIZATION. THE MEMBERS CONSIST OF NORTH MEMORIAL HEATH CARE AND FAIRVIEW HEALTH SERVICES. ALL MEMBERS ARE REQUIRED TO BE NON-PROFIT, TAX EXEMPT ORGANIZATIONS UNDER IRC SECTION 501(C)(3) PER THE BYLAWS OF THE ORGANIZATION. NORTH MEMORIAL HEALTH CARE 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 410729979 ACUTE CARE MN 501(C)(3) LINE 3 NORTH MEMORIAL 0 NORTH MEMORIAL FOUNDATION 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 411777966 FUNDRAISING MN 501(C)(3) LINE 7 NORTH MEMORIAL 0 ASSOCIATED HEALTH ASSURANCE 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 980343815 INSURANCE BD 501(C)(3) LINE 12B, II NORTH MEMORIAL 0 NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE LLC 9855 HOSPITAL DRIVE MAPLE GROVE MN 55369 260393039 OUTPATIENT SURGERY MN N/A MINNESOTA DIAGNOSTIC IMAGING PARTNERS LLC 2955 XENIUM LANE SUITE 40 PLYMOUTH MN 55441 352162215 RADIOLOGY MN N/A NORTH RADIATION THERAPY CENTER 6950 FRANCE AVE S SUITE 200 EDINA MN 55435 743069974 RADIOLOGY MN N/A MINNETONKA AMBULATORY SURGERY CENTER 3300 OAKDALE AVE NORTH ROBBINSDALE MN 55422 465653486 OUTPATIENT SURGERY MN N/A MULTICARE SLEEP CENTER LLC 10600 OLD COUNTY ROAD 15 PLYMOUTH MN 55441 274833673 OUTPATIENT SLEEP CENTER MN N/A OAKDALE HEALTH ENTERPRISES INC 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 411546422 AMBULANCE MN N/A C 0 NORTH COLLABORATIVE CARE 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 461680666 PRIMARY CARE MN N/A C 0 0 1 0 0 1 0 0 0 0 0 1 0 1 0 0 1 0 1 0 NORTH MEMORIAL HEALTH CARE (CASH TRANSFER) B 26100000 CASH NORTH MEMORIAL HEALTH CARE (DEBT GUARANTEE) E 89895436 AMOUNT GUARANTEE NORTH MEMORIAL HEALTH CARE (LEASE PAYMENTS) K 14771272 AMOUNT PAID NORTH MEMORIAL HEALTH CARE (MANAGEMENT FEE) M 19733631 AMOUNT PAID NORTH MEMORIAL HEALTH CARE (SALARY REIMBURSEMENT) P 9792138 AMOUNT PAID