2014-05-09T10:03:28-05:00 2013-06-30 861065772 Deloitte Tax LLP 50 South Sixth Street Suite 2800 Minneapolis MN 55402 990 2012-07-01 272042143 Sanford Medical Center Wheaton SANF 7012342000 401 12th Street N Wheaton MN 56296 JoAnn Kunkel 6053331000 2014-05-09 1 Kristina Rasmussen P00143920 6123974000 2012 2015-11-30 17:44:51Z Kelby Krabbenhoft 1305 W 18th St PO Box 5039 Sioux Falls SD 57117 7598332 0 X www.sanfordhealth.org X 2009 MN "Dedicated to the Work of Health and Healing" 15 7 80 5 0 0 26567 11825 6734836 7463251 36588 116207 12700 7049 6810691 7598332 2150 650 0 0 3374409 3579384 0 0 0 3173500 4263362 6550059 7843396 260632 -245064 10021960 6677469 297088 458164 9724872 6219305 Our mission "Dedicated to the Work of Health and Healing" and our vision "Improving the Human Condition through Exceptional Care, Innovation and Discover", is the constant force that drives our plans, decisions and actions. 0 0 6211334 650 7463251 Sanford Medical Center Wheaton is a 15-bed acute care hospital and attached clinic that provides inpatient and outpatient services to individuals residing in the Wheaton, Minnesota area. Services are provided regardless of an individual's ability to pay. The hospital conducts and provides space for community health education and various support groups, as well as contributes to other non-profits in the community. 6211334 1 0 0 1 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 80 1 0 0 0 0 0 0 0 0 0 0 X 15 7 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X JoAnn Kunkel CFO 6053331000 1305 West 18th Street Sioux Falls SD 57117 X Barb Everist 0.10 5.30 X 0 0 0 Barbara Stork 0.10 5.30 X 0 0 0 Barry Martin thru Nov 12 0.10 5.30 X 0 0 0 Brent Teiken 0.10 5.30 X 0 0 0 Christopher Meeker MD 0.10 59.90 X 0 213821 31035 David Beito 0.10 5.30 X 0 0 0 Don Morton 0.10 5.30 X 0 0 0 Jerome Feder 0.10 5.30 X 0 0 0 Jim Entenman 0.10 5.30 X 0 0 0 Lauris Molbert 0.10 5.30 X 0 0 0 Mark Paulson MD 0.10 59.90 X 0 248496 32936 Mikal Claar thru Nov 12 0.10 5.30 X 0 0 0 Patrick Durick 0.10 5.30 X 0 0 0 Richard Hardie MD 0.10 59.90 X 0 747423 33818 Ronald Moquist 0.10 5.30 X 0 0 0 Thomas Hruby 0.10 5.30 X 0 0 0 Kelby K Krabbenhoft 0.10 59.90 X X 0 1539421 22054 Kelby K Krabbenhoft Deferred Comp 0.10 59.90 X X 0 0 589623 JoAnn L Kunkel 0.10 59.90 X 0 438048 33700 Lisa Carlson thru Oct 12 0.10 59.90 X 0 644186 31847 Bruce D Viessman 5.00 55.00 X 0 221109 34070 Leslie Wietstock 10.00 50.00 X 0 189051 21182 Edmond L Weiland 5.00 55.00 X 0 464084 34678 Richard Giesel 5.00 55.00 X 0 426574 27104 JoAnn Foltz 60.00 0.00 X 129070 0 7505 Michelle Rinke 40.00 0.00 X 137880 0 26476 266950 5132213 926028 2 0 1 0 0 11825 11825 Medicare/Medicaid 621400 4054377 4054377 Patient services 621400 3226207 3226207 Other Program Revenue 900099 170251 170251 Cafeteria Revenue 722514 12416 12416 7463251 116207 116207 7049 0 7049 7049 7049 7598332 7450835 0 135672 X 650 650 2731923 2532408 199515 123143 113926 9217 477093 424076 53017 247225 180907 66318 861 861 897789 868764 29025 2656 2656 158386 142848 15538 253937 253937 26011 20794 5217 12100 11113 987 529575 480926 48649 15612 15612 Intercompany Purchases 1381372 366427 1014945 Medical Supplies 716075 716075 Bad Debt 138611 75822 62789 Miscellaneous 130377 22661 107716 7843396 6211334 1632062 0 188017 318883 2517829 1325511 3176837 1210345 185957 141005 35245 25278 9338123 5909794 3664674 3428329 253401 228118 10021960 6677469 297088 458164 297088 458164 X 9724872 6219305 9724872 6219305 10021960 6677469 X -245064 -3260503 X 0 1 X 1 1 1 X 0 0 0 0 0 0 0 0 1 861 861 0 Explanation of Lobbying Activities: Part II-B, Line 1: The filing organization has a membership in the American Hospital Association and Minnesota Hospital Association. A percentage of membership dues paid to these organizations relate to lobbying expenses. 71330 71330 7294894 4325978 2968916 1711777 1379349 332428 260122 204467 55655 3428329 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: Certain controlled organizations are subject to income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. A tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination. The deferred income tax provision or benefit generally reflects the net change in deferred income tax assets and liabilities during the year. The current income tax provision reflects the tax consequences of revenue and expenses currently taxable or deductible on various income tax returns for the year reported. Sanford Medical Center Wheaton did not have a material income tax liability at June 30, 2013; some related organizations have established reserves. 1 1 X 1 X 225.000000000000 1 X 375.000000000000 1 1 0 1 1 35092 0 35092 0.00460 792913 330956 461957 0.06000 0 0 0.00000 828005 330956 497049 0.06460 13466 0 13466 0.00170 1609 0 1609 0.00020 31680 0 31680 0.00410 0 0 0.00000 14966 0 14966 0.00190 61721 61721 0.00790 889726 330956 558770 0.07250 0 0 0.00000 165 0 165 0.00000 0 0 0.00000 0 0 0.00000 0 0 0.00000 0 0 0.00000 5310 0 5310 0.00070 0 0 0.00000 0 0 0.00000 5475 5475 0.00070 1 125736 0 3723421 3636511 86910 X 1 1 1 1 Sanford Medical Center Wheaton

401 12th Street N Wheaton MN 56296

X X X X Sanford Medical Center Wheaton 1 1 X X X X X X X X X 12 1 1 1 X X X X X X 0 0 1 1 225.000000000000 1 375.000000000000 1 X X X X X X X X 1 1 X X X X X X X 1 0 1 X 0 0 Part I, Line 3c: Sanford's charity care policy provides discounted and free services to patients who lack the resources to be fully responsible for the healthcare they receive. The Community Care Policy is designed to ensure the entire community served by Sanford has access to needed healthcare services.Eligibility for discounted or free services under the Community Care Policy is based on income levels and family size. Generally, individuals earning income of up to 375% of the Federal Poverty Income Guidelines are eligible for varying levels of discounts, including full discounts for certain income levels. In addition, an automatic discount is provided to any patient who is determined to not have insurance of any type. Applications for coverage under the program may be obtained at any Sanford patient registration area.The primary scope of Sanford's financial assistance matrix considers family income and family size to objectively determine financial need. The family income range varies from 225% to 375% of the Federal Poverty Level (FPL).An applicant over 375% may be eligible for some level of financial assistance based on a review of additional factors such as: the size of the account balance, debt-to-income ratio, current assets, current liabilities, IRS food expense allowances, monthly cash flow, etc.Additionally, it is possible for a family to qualify in one segment (based on income and family size alone) but be moved to a more generous (for the patient) segment based on the other financial variables mentioned above. Part I, Line 6a: Community benefit reporting is voluntary in Minnesota. Part I, Line 7: A cost-to-charge ratio is used to calculate the amounts on Line 7a - 7c (Charity Care, Medicaid Shortfall and Other Means-Tested Government Programs). The amounts for Lines 7e - 7i would come from the books and records of specific segments of the organization and would not be based on a cost-to-charge ratio. Part I, L7 Col(f): Total expenses reported on Form 990, Part IX, Line 25, Column (A) include bad debt expense. This expense has been removed from the denominator when calculating the percent of total expense considered the net community benefit expense and reported in Part I, Line 7, Column (f). The amount of bad debt expense excluded from this percentage calculation is $138,611.Part III, Line 3: Bad debt expense at cost is determined using the same methodology that is used to calculate Charity Care and Medicaid Shortfall. Discounts and allowances are accounted for separately from Bad Debt Expense. Part III, Line 4: The audited financial statements of Sanford do not include a bad debt footnote. Sanford reports bad debt in accordance with generally accepted accounting principles (GAAP). Bad debt expense at cost is determined using the same methodology that is used to calculate Charity Care and Medicaid Shortfall. Discounts and allowances are accounted for separately from Bad debt expense.It is Sanford's policy to make charity care available to patients who fit the charity care criteria. It is the organization's goal to make certain that Sanford is proactive in identification of the patients who need help with financial concerns. Financial counselors make every effort to ensure that charity care patients do not progress to bad debt. For this reason, a dollar amount for bad debt is not included. Part III, Line 8: Per IRS instructions, Sanford has identified the cost associated with providing Medicare services from the Medicare cost report. The Medicare cost report calculations are total expense less expenses deemed "unallowable" per Medicare regulations. The net expense is then used to calculate the cost per day and cost to charge ratios which are multiplied by the Medicare days and ancillary charges to determine the cost of providing Medicare services. If all expenses that Sanford Medical Center Wheaton incurred were included on the Medicare cost report; this would show a shortfall of approximately $140,521. Sanford believes this shortfall should be considered community benefit because these services would need to be provided by either another charitable organization or the government if they were not provided by Sanford. Part III, Line 9b: Sanford will provide services at no cost or reduced cost to patients who qualify for the program. Patients with incomes at or below 225% of the United States Department of Health and Human Services poverty guidelines will receive a 100% reduction of their payment responsibility. Patients with income between 225% - 375% of the poverty guideline will be given a discount based on a sliding scale and assets are considered in the calculation of the income of the patient, with the exception of the patient's principal residence. Patients above 375% of the FPG will be reviewed for additional factors such as size of medical debt before a final determination. Patients must make their financial need known to appropriate personnel and be engaged in filing appropriate and complete applications. The program is available to those patients without health care benefits from any source as well as to those who have coverage for health care costs through a government program, commerical insurance or other health benefit plan but continue to have a remaining balance after benefits have been applied to the charges.Sanford will not deny financial assistance based on race, creed, sex, national origin, handicap or age.Every effort is made to identify patients with financial need as early as possible in the revenue cycle. Sanford Medical Center Wheaton Part V, Section B, Line 1j: The community health needs assessment was conducted during FY 2013. The main model used was the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the varioius surveys and data sets. The process implemented was based on the McKnight Foundation model - Mapping Community Capacity by John L. McKnight and John P. Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies. Sanford Medical Center Wheaton Part V, Section B, Line 3: Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all of the Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be our secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities include listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA Sanford Medical Center Wheaton Part V, Section B, Line 4: Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Worthington Medical Center Sanford Medical Center Wheaton Part V, Section B, Line 5c: Sanford Medical Center Wheaton invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included. Sanford Medical Center Wheaton Part V, Section B, Line 7: The following unmet needs will not be addressed directly by Sanford Medical Center Wheaton, but may be addressed by the Sanford enterprise system or by working with community leaders:Aging - Sanford provides medical care for the elderly and additional support for driver evaluation and rehabilitation. Sanford will share the results of the CHNA with community leaders.Children and Youth - The main concerns expressed related to childhood obesity and also bullying in the schools. Sanford is addressing mental health through an enterprise mental health implementation strategy and has also developed an enterprise strategy to address obesity. Sanford will share the results of the CHNA with community leaders.Economic Situation/Business Community - Although Sanford is one of the biggest employers in the area and contributes substantially to the economic growth of the region and provides medical care to those who qualify for charity care through the Community Care program and a discounted fee for those who qualify, there remain unmet needs beyond Sanford's scope of work. Sanford will share the survey results and unmet needs with community/city leaders.Pollution/Environment - The County Health Rankings did not indicate that pollution was an issue for this area. Sanford will address this perceived need by sharing these concerns with county leadership and public health.Safety - The safety concerns are related to child abuse, substance abuse and domestic violence. Sanford has developed an enterprise wide strategy to address mental health.Substance Abuse - Sanford is addressing substance abuse through the mental health implementation strategy. Sanford Medical Center Wheaton Part V, Section B, Line 12h: Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score. Sanford Medical Center Wheaton Part V, Section B, Line 14g: Other methods to publicize the financial assistance policy within the community served include publishing with collection agencies and submission to law firms that serve the underprivileged population. The plain language policy description is available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance Part VI, Line 2: Sanford has a well-established connection with their communities and as a result is a committed community partner that can mobilize its resources to improve community health. For decades, an ongoing informal community health care needs assessment occurs through participation in and/or leadership roles with community task forces, schools, government entities, social service agencies, churches and other community organizations. It is through these interactions and participation that Sanford identifies or is apprised of health care needs. The response to these needs includes but is not limited to, financial support, educational efforts to reduce or avoid risky behaviors, screenings and health risk assessments, vaccination programs, loaned management expertise, as well as wellness programs and initiatives. These activities servce to improve the health of the communities and fulfills Sanford's mission. Part VI, Line 3: Sanford employs a variety of strategies to make certain that the organization is transparent in the communication of financial assistance guidelines. The staff at Sanford makes every effort to identify patients needing financial assistance as early in the revenue cycle as possible. All Sanford entities display signage in registration areas advising patients of their ability to request financial assistance upon request. The signage is made available in English and Spanish. Financial Assistance application is available in English or Spanish upon request.All healthcare workers who identify patients with financial need are encourage to provide patients or their designees a financial application. This may include, but not be limited to the following areas:Administration, Admissions, Patient Financial Services, Financial Counselors, Social Services, Physicians, Nursing, Clinic Director, Reception staff and Human Resources.Financial counselors are trained to work individually with patients to determine the financial need and recommend appropriate assistance in application for charity care, government programs or discounted services. Part VI, Line 4: Sanford Medical Center Wheaton - Wheaton, MinnesotaWheaton is located in Traverse County, Minnesota on the border where Minnesota, North Dakota and South Dakota all meet. Based on 2010 US Census data, Wheaton has a population of 1,424. The median age in the city was 49.5 years old. 20.4% of residents were under the age of 18; 5.3% were between the ages of 18 and 24; 18.5% were from 25 to 44; 24.3% were from 45 to 64; and 31.5% were 65 years of age or older. The average household income is $40,806. Part VI, Line 5: Sanford maintains an open medical staff.Community Boards - The Sanford Board of Trustees was comprised of 15 members at the end of the fiscal year, including 11 volunteer community members, three physicians and the CEO.Surplus Funds - Surplus funds are invested back into the community, as well as to resource development and facility development to better serve patients and communities. Part VI, Line 6: Sanford is the nation's largest not-for-profit integrated rural health system providing medical services at every level from critical access hospitals to tertiary and quaternary care. The Sanford footprint includes over 220,000 square miles with a nine state service area including a network of children's primary care clinic locations across the country and world. Sanford operates full-time emergency centers and provides emergency care to everyone regardless of their ability to pay. Sanford facilities and clinics provide services to remote and medically underserved areas that would otherwise not have access to even primary care services.Sanford financially supports health and wellness, education and community development activities to improve the quality of life and strengthen communities throughout the region. Each of Sanford's facilities promotes health and healing that responds to the unique needs of the patients in the communities that Sanford serves, ensuring access to comprehensive and specialized services. A recently completed and published community health needs assessment indicated the important need for behavioral health services for our community members. Sanford is meeting this need through an integrated delivery system providing behavioral health within the medical home structure. 0 1 0 0 0 0 1 1 0 Christopher Meeker MD 0 213821 0 0 0 0 0 8842 0 22193 0 244856 0 0 Mark Paulson MD 0 200747 0 0 0 47749 0 12500 0 20436 0 281432 0 0 Richard Hardie MD 0 743706 0 0 0 3717 0 15000 0 18818 0 781241 0 0 Kelby K Krabbenhoft 0 941885 0 332500 0 265036 0 0 0 22054 0 1561475 0 0 Kelby K Krabbenhoft Deferred Comp 0 0 0 0 0 0 0 589623 0 0 0 589623 0 0 JoAnn L Kunkel 0 321232 0 80000 0 36816 0 14146 0 19554 0 471748 0 0 Lisa Carlson thru Oct 12 0 434253 0 129600 0 80333 0 12500 0 19347 0 676033 0 0 Bruce D Viessman 0 200971 0 300 0 19838 0 12076 0 21994 0 255179 0 0 Leslie Wietstock 0 168431 0 300 0 20320 0 8455 0 12727 0 210233 0 0 Edmond L Weiland 0 327462 0 82500 0 54122 0 15000 0 19678 0 498762 0 0 Richard Giesel 0 299790 0 74688 0 52096 0 12500 0 14604 0 453678 0 0 Michelle Rinke 101888 0 300 0 35692 0 5370 0 21106 0 164356 0 0 0 Part I, Line 1a On Part I, Questions Regarding Compensation, Sanford, a related organization, checked several of the items as provided to listed persons. Part I, Line 3 The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm to annually review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2013. Part I, Line 4b In addition to employer contributions to pension plans, amounts representing increases and decreases in actuarial value (actuarial value factors include age, tenure and salary) of defined contribution and defined benefit SERP Plans are included in Column C. Participants and changes in values include: Kelby Krabbenhoft $433,820 Part I, Line 6: Sanford physicians are compensated based on professional services they perform within the clinic in which they provide care. Generally, the model is based on production. Part I, Line 7 Certain employees are eligible for a discretionary incentive bonus, based on financial targets and other goals. Supplemental Information Part III Compensation reported on Schedule J, Part II includes: (B)(i) Base Compensation - salaries are based on the experience and performance of each executive and bench-marked using independent compensation survey information. (B)(ii) Bonus & Incentive Compensation - as part of executive compensation, individuals may be eligible for incentive performance compensation, however if the organization does not make its financial targets, incentive payments are not paid regardless of performance. (B)(iii) Other Reportable Compensation - generally includes taxable executive benefits. (C) Deferred Compensation - includes employer contributions to pension plans and the increase (or decrease) in the actuarial value (actuarial value factors include age, tenure and salary) of the benefit plans. (D) Nontaxable Benefits - generally includes health insurance premiums. A memo regarding executive compensation, written by the Chairman of the Sanford Board of Trustees, is on file and available upon request. Compensation paid to trustees is for full-time professional responsibilities as physicians, administrators or employees of the organization. The total compensation paid to Kelby Krabbenhoft of $1,539,421 is comprised of Base Salary of $941,885, Incentive Compensation of $332,500 and Other Taxable Earnings of $265,036. In addition, an amount of $589,623 has been reported for the estimated amount of ratable increase in value of the defined benefit pension plan, defined benefit SERP and a Gift Agreement Management Continuity Retention plan. Form 990, Part VI, Section A, line 2 The following officers, board members and key employees are employees of Sanford or its related organizations. Many of these employees also serve on other related Sanford boards, or have business relationships with each other that span the organization as a whole: Christopher Meeker Mark Paulson Richard Hardie Kelby Krabbenhoft JoAnn Kunkel Lisa Carlson Leslie Wietstock Bruce Viessman Richard Giesel Form 990, Part VI, Section A, line 6 Sanford Health Network North is the sole member of the organization. Form 990, Part VI, Section A, line 7a Board members are members of the Board of Governors of Sanford Health Network North. Form 990, Part VI, Section A, line 7b Sanford Health Network North, as sole member, reviews the actions of Sanford Medical Center Wheaton. Form 990, Part VI, Section B, line 11 The Form 990 is prepared internally by the finance department and reviewed by executive management. An external accounting firm reviews the return and prepares return highlights and key disclosures for the Board of Trustees meeting prior to the return filing date. Before the return is filed, a complete copy is provided to the current Board of Trustees. Form 990, Part VI, Section B, line 12c The annual Conflict of Interest disclosure process is managed by the Chief Compliance Officer (CCO). The CCO is responsible for assuring that all completed forms are returned in a timely and complete manner. Conflict of Interest questionnaires are sent to System Trustees, members of the governing boards of subsidiary entities, officers and key employees for all the entities subject to the IRS Form 990 filings. The disclosures are summarized for review by the executive committee of the Board of Trustees, pursuant to policy. This review allows: 1) The Board to acquire an awareness of financial relationships of board members and key management employees and can invoke the recusal process on a case-by-case basis when potential conflicts are implicated in Board decisions and deliberations, and 2) Gives the Board the opportunity to seek additional information and clarification about disclosures to determine potential conflicts of interest and how to manage them. Form 990, Part VI, Section B, line 15 The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm to annually review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2013. Additionally, Sanford periodically engages an independent compensation consultant to review and issue a report regarding the reasonableness of the total compensation arrangements of all physicians employed by the organization. The most recent study of the physician total compensation was completed in 2009. Form 990, Part VI, Section C, line 19 Although the organization does not maintain a website where the public can access these documents, it would respond individually to any requests or inquiries from the public for these documents. Form 990, Part VII Sanford Board of Trustees has ultimate governance responsibilities for each entity within the Sanford system. In addition, a Board of Directors is established for each entity, which has specific delegated responsibilities from the Board of Trustees related to the oversight of day to day operations of that entity. Other Fees Form 990, Part IX, line 11g Consulting Services: Program service expenses 0. Management and general expenses 26,268. Fundraising expenses 0. Total expenses 26,268. Service Contracts: Program service expenses 708,275. Management and general expenses 550. Fundraising expenses 0. Total expenses 708,825. Outside Medical Services: Program service expenses 130,066. Management and general expenses 0. Fundraising expenses 0. Total expenses 130,066. Collection Agency: Program service expenses 2,327. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,327. Other Purchased Services: Program service expenses 28,096. Management and general expenses 2,207. Fundraising expenses 0. Total expenses 30,303. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Transfer from related tax-exempt org for payroll and operating expenses -3,260,503. Sanford 801 Broadway Drive Fargo ND 58122 271218956 Supporting Organization ND 501(c)(3) 11-II 0 Sanford Health 1305 West 18th Street Sioux Falls SD 57117 311527032 Supporting Organization SD 501(c)(3) 11-II Sanford 1 Sanford USD Medical Center 1305 West 18th Street PO Box 5039 Sioux Falls SD 571175039 460227855 Hospital SD 501(c)(3) 3 Sanford Health 1 Sanford Health Foundation 1305 West 18th Street Sioux Falls SD 57117 363297853 Supporting Organization SD 501(c)(3) 11-II Sanford Health 1 Edith Sanford Breast Cancer Foundation 2301 60th Street N Sioux Falls SD 57104 450404126 Foundation ND 501(c)(3) 11-II Sanford Health 1 Sanford Clinic 1305 West 18th Street PO Box 5039 Sioux Falls SD 571175039 460447693 Clinical Services SD 501(c)(3) 3 Sanford Health 1 Sanford Home Health 1305 West 18th Street PO Box 5039 Sioux Falls SD 571175039 460282134 Home Health Services SD 501(c)(3) 9 Sanford Health 1 Sanford Health Network 1305 West 18th Street PO Box 5039 Sioux Falls SD 571175039 460388596 Hospitals/Clinics SD 501(c)(3) 3 Sanford Health 1 Sanford ResearchUSD 1305 West 18th Street PO Box 5039 Sioux Falls SD 571175039 460450378 Research SD 501(c)(3) 3 Sanford Health 1 Sanford World Clinics 1305 West 18th Street Sioux Falls SD 57117 262707628 Healthcare SD 501(c)(3) 3 Sanford Health 1 Sanford North PO Box 2010 Fargo ND 58122 450385890 Supporting Organization ND 501(c)(3) 11-II Sanford 1 Sanford Medical Center Fargo PO Box 2010 Fargo ND 58122 450226909 Hospital ND 501(c)(3) 3 Sanford North 1 FM Ambulance Service Inc 2215 18th St South Fargo ND 58103 450344371 EMT ND 501(c)(4) Sanford North 1 Sanford Health Foundation North PO Box 2010 Fargo ND 58122 450398104 Fundraising ND 501(c)(3) 7 Sanford North 1 Sanford Clinic North PO Box 2010 Fargo ND 58122 911770748 Clinics ND 501(c)(3) 9 Sanford North 1 Sanford Health Network North PO Box 2010 Fargo ND 58122 450409348 Hospitals/Clinics ND 501(c)(3) 11-II Sanford North 1 Sanford Hillsboro PO Box 609 Hillsboro ND 58045 450230400 Hospital ND 501(c)(3) 3 Sanford Health Network North 1 Sanford Health Foundation Hillsboro PO Box 609 Hillsboro ND 58045 363542187 Fundraising ND 501(c)(3) 7 Sanford Hillsboro 1 Sanford Medical Center Mayville 42 6th Ave SE Mayville ND 58257 450228899 Hospital ND 501(c)(3) 3 Sanford Health Network North 1 Sanford Medical Center Thief River Falls 120 Labree Ave S Thief River Falls MN 56701 410709579 Hospital MN 501(c)(3) 3 Sanford Health Network North 1 MeritCare Minnesota 1720 South Highway 59 Thief River Falls MN 56701 261530302 Promotion of health MN 501(c)(3) 3 Sanford North 1 Sanford Health of Northern Minnesota 1300 Anne St NW Bemidji MN 56601 411266009 Hospital MN 501(c)(3) 3 Sanford North 1 Sanford Health Foundation of Northern Minnesota 1300 Anne St NW Bemidji MN 56601 411389317 Fundraising - Support MN 501(c)(3) 11-II Sanford Health of Northern Minnesota 1 Baker Park Inc 803 Dewey Ave NW Bemidji MN 56601 411372480 Low Income Senior Housing MN 501(c)(3) 9 Sanford Health of Northern Minnesota 1 North Country Medical Clinic 1300 Anne St NW Bemidji MN 56601 411753855 Family Practice Medical Clinic MN 501(c)(3) 3 Sanford Health of Northern Minnesota 1 Sanford West 300 North 7th Street Bismarck ND 58501 450397195 Supporting Organization ND 501(c)(3) 11-II Sanford 1 Sanford Bismarck 300 North 7th Street Bismarck ND 58501 450226700 Hospital ND 501(c)(3) 3 Sanford West 1 Sanford Living Centers 1000 18th Street NW Suite 1 Bismarck ND 58554 450416454 Long-term Care Facility ND 501(c)(3) 9 Sanford Bismarck 1 Sanford West Foundation 300 North 7th Street Bismarck ND 58501 450397196 Fundraising ND 501(c)(3) 7 Sanford Bismarck 1 Medcenter One Inc Auxiliary 300 North 7th Street Bismarck ND 58501 237293043 Supporting Organization ND 501(c)(3) 11-I Sanford Bismarck 1 National Student Housing-South Dakota LLC 100 S Phillips Ave Sioux Falls SD 57104 202129839 Investment SD N/A RAC Rentals LLC 100 S Phillips Ave Sioux Falls SD 57104 261961077 Investment SD N/A Shetek Medical Services LLC 251 5th Street East Tracy MN 56175 412004685 Home Health Services MN N/A Southwest MN Radiation Center LLC 1018 6th Avenue Worthington MN 56187 460447693 Radiation Services MN N/A Sanford Home Medical Equipment Inc 2710 W 12th Street Sioux Falls SD 57105 460388597 Healthcare Equipment SD N/A C 1 Sanford Health Plan 300 Cherapa Place Sioux Falls SD 57103 911842494 Insurance SD N/A C 1 Sanford Health Plan of MN 300 Cherapa Place Sioux Falls SD 57103 460445852 Insurance MN N/A C 1 Bemidji Medical Equipment Inc 1300 Anne Street NW Bemidji MN 56601 411551725 Retail Sales of DME MN N/A C 1 North Country Management Inc 1300 Anne Street NW Bemidji MN 56601 411820025 Management Services MN N/A C 1 Sanford Frontiers 1305 W 18th Street PO Box 5039 Sioux Falls SD 571175039 455436599 Weight Loss Management SD N/A C 1 SOB Inc 2701 S Minnesota Avenue Suite 2 Sioux Falls SD 57105 460442628 Air Transportation SD N/A C 1 Sanford Affiliated Services Inc 300 N 7th Street Bismarck ND 58501 450403146 Investment Activity ND N/A C 1 Sanford World Clinics - Ghana Sarbah Road Tantri Lorry Station Cape Coast GH Healthcare GH N/A C 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 Sanford Clinic North O 301145 Cost