2023-05-03T09:08:47-05:00 2022-06-30 420714325 RSM US LLP 227 W 1ST ST STE 700 DULUTH MN 558021926 990 2021-07-01 200360007 ESSENTIA HEALTH ESSE 2187868376 502 E 2ND ST DULUTH MN 55805 TRACI MORRIS CHIEF FINANCIAL OFFICER 2187868376 2023-05-03 1 TRACI MORRIS 999009999 JULIE BOYER P01278549 2187275025 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DAVID HERMAN MD 502 E 2ND ST DULUTH MN 55805 603548510 0 X WWW.ESSENTIAHEALTH.ORG X 2003 MN WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 15 13 2942 0 7562002 1920681 2442953 98433264 201958094 272757934 21870185 35598565 6383316 10121816 232654548 416911579 0 103 0 0 156833921 225215626 0 0 0 55151852 61742098 211985773 286957827 20668775 129953752 613077249 630123333 284681870 248867911 328395379 381255422 X WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 0 0 136994805 103 272757934 ESSENTIA HEALTH 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 CRITICAL ACCESS GROUP, A MINNESOTA NONPROFIT CORPORATION THROUGH ITS DISSOLUTION ON 11/5/21, BRAINERD LAKES INTEGRATED HEALTH SYSTEM, A MINNESOTA NONPROFIT CORPORATION, ST. MARY'S DULUTH CLINIC HEALTH SYSTEM DBA ESSENTIA HEALTH EAST, A MINNESOTA NONPROFIT CORPORATION, AND INNOVIS HEALTH, LLC DBA ESSENTIA HEALTH WEST, A DELAWARE LIMITED LIABILITY COMPANY AND IN SUPPORT OF CRITICAL ACCESS GROUP THROUGH 11/5/21, BRAINERD LAKES INTEGRATED HEALTH SYSTEM, ESSENTIA HEALTH EAST, AND ESSENTIA HEALTH WEST AND EACH OF THE TAX-EXEMPT ENTITIES IDENTIFIED AS SUPPORTED ORGANIZATIONS IN THEIR ARTICLES OF INCORPORATION, ALL OF WHICH ARE ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986.ESSENTIA HEALTH IS AN INTEGRATED HEALTH SYSTEM SERVING PATIENTS IN MINNESOTA, WISCONSIN, AND NORTH DAKOTA. HEADQUARTERED IN DULUTH, MINNESOTA, ESSENTIA HEALTH COMBINES THE STRENGTHS AND TALENTS OF 14,000 EMPLOYEES, INCLUDING MORE THAN 2,000 PHYSICIANS AND ADVANCED PRACTITIONERS, WHO SERVE OUR 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 DELIVERS ON ITS MISSION BY HAVING PATIENT-CENTERED FOCUS AT 14 HOSPITALS, APPROXIMATELY 70 CLINICS, SIX LONG-TERM CARE FACILITIES, TWO ASSISTED LIVING FACILITIES, FOUR INDEPENDENT LIVING FACILITIES, SEVERAL REHABILITATION CENTERS, SEVEN AMBULANCE SERVICES, 24 RETAIL PHARMACIES, HOME HEALTH SERVICES, AND ONE RESEARCH INSTITUTE. ESSENTIA HEALTH SERVES A PREDOMINANTLY RURAL POPULATION WHOSE MEDIAN INCOMES GENERALLY FALL BELOW AVERAGES OF THE STATES WHERE THEY LIVE. THE PRESENCE OF OUR CLINICS AND HOSPITALS ENSURES THAT PEOPLE WITH FEW ECONOMIC RESOURCES DO NOT HAVE TO DRIVE AN HOUR OR MORE TO RECEIVE BASIC (AND IN SOME CASES LIFESAVING) MEDICAL CARE. THE LEGAL ENTITIES COMPRISING ESSENTIA HEALTH FILE SEPARATE FORM 990'S.AT FISCAL YEAR ENDED JUNE 30, 2022, ESSENTIA HEALTH'S CONSOLIDATED TOTAL REVENUE WAS $2,616,554,000 AND CONSOLIDATED INCOME FROM OPERATIONS WAS $79,469,000.ESSENTIA HEALTH'S HOSPITALS HAVE A TOTAL OF 1,202 LICENSED BEDS WHICH PROVIDED OVER 201,000 HOSPITAL PATIENT DAYS AND NEARLY 791,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2022. THE CLINICS HAD NEARLY 1.8 MILLION ENCOUNTERS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2022, ESSENTIA HEALTH PROVIDED TOTAL COMMUNITY BENEFITS OF OVER $165 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. 136994805 1 1 0 1 0 0 0 0 0 0 1 1 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 614 0 1 2942 1 1 1 1 CJ 0 0 0 0 0 0 0 0 1 0 X 15 13 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X TRACI MORRIS 2187868376 502 E 2ND ST DULUTH MN 55805 DAVID HERMAN MD CHIEF EXECUTIVE OFFICER 60.00 0.00 X 2809815 0 313481 JODI MANSFIELD EXECUTIVE VICE PRESIDENT, COO 60.00 0.00 X 1494837 0 155953 JON PRYOR MD PRESIDENT - EAST 1.00 59.00 X 0 1094092 37651 WILLIAM HEEGAARD MD PRESIDENT - WEST 1.00 59.00 X 0 870563 131171 TRACI MORRIS CHIEF FINANCIAL OFFICER/BD TREASURER 60.00 0.00 X 865812 0 103913 BRADLEY BEARD CHIEF OPERATING OFFICER - EAST 1.00 59.00 X 0 827400 134968 PETER HENRY MD CHIEF MEDICAL OFFICER THRU 6/22 57.00 3.00 X 836884 0 118561 DANIEL NIKCEVICH MD FORMER PRESIDENT - EAST 0.00 60.00 X 0 827845 60685 GREGORY GLASNER MD FORMER PRESIDENT - WEST 0.00 10.00 X 0 881046 3603 DEBORAH WELLE-POWELL CHF POPULATION HEALTH OFF THRU 6/22 60.00 0.00 X 740071 0 93513 CHARLES WATSON CHIEF INFORMATION OFFICER 60.00 0.00 X 688672 0 118297 DIANE DAVIDSON CHIEF HUMAN RESOURCE OFFICER 60.00 0.00 X 695670 0 107346 ANNE STEPHEN MD CHIEF MEDICAL OFFICER - EAST 1.00 59.00 X 0 662630 106038 RICHARD VETTER MD CHIEF MEDICAL OFFICER - WEST 1.00 59.00 X 0 653960 108385 MICHAEL WATTERS CHIEF LEGAL OFFICER/BOARD SECRETARY 60.00 0.00 X 635849 0 115445 AL HURLEY CHIEF OPERATING OFFICER - WEST 1.00 59.00 X 0 580988 90599 SHEILA HART SENIOR VP-INTEGRATED CARE DELIVERY 60.00 0.00 X 555293 0 95764 SARAH MANNEY KURTH MD CHIEF MEDICAL INFORMATION OFFICER 60.00 0.00 X 490220 0 87260 PATRICK TWOMEY MD FORMER CHIEF MEDICAL OFFICER 0.00 60.00 X 0 491873 62666 RHONDA KAZIK CHIEF NURSING OFFICER 54.00 6.00 X 0 467377 82235 STEFANIE GEFROH ELLISON MD BOARD DIRECTOR 3.00 57.00 X 20000 434340 60733 MELANIE WILSON SENIOR VP-REVENUE SERVICES 60.00 0.00 X 413742 0 49391 MICHAEL VAN SCOY MD PHYSICIAN 60.00 0.00 X 381613 0 57344 MARIA BEAVER MD PHYSICIAN LEADER 60.00 0.00 X 401334 0 22643 JANE RUDD MD BOARD DIRECTOR 3.00 57.00 X 20000 293294 63563 ADAM REES FORMER PRESIDENT - CENTRAL 0.00 0.00 X 0 280136 22241 FRANK MODICH FORMER INTERIM CHIEF LEGAL OFFICER 60.00 0.00 X 257754 0 26343 ROBERT NORMAN FORMER CHIEF FINANCIAL OFFICER 0.00 0.00 X 198000 0 0 THOMAS RUSS MD BOARD DIRECTOR THRU 12/21 3.00 57.00 X 30000 144469 8668 TIMOTHY SAYLER FRMR CHIEF OPERATING OFFICER - WEST 0.00 0.00 X 0 162970 0 MARK HAYWARD FORMER SENIOR VP, OPERATIONS 0.00 0.00 X 0 118589 8661 DAVID GADDIE BOARD CHAIR 3.00 0.00 X X 45000 0 0 JAMES ANDERSON BOARD DIRECTOR 3.00 6.00 X 30750 0 0 DEAN AGER BOARD DIRECTOR 3.00 0.00 X 30000 0 0 KEVIN MOUG BOARD DIRECTOR 3.00 0.00 X 30000 0 0 LAURIE LEWANDOWSKI BOARD DIRECTOR 3.00 1.00 X 28000 0 0 MARK RONNEI BOARD DIRECTOR 3.00 6.00 X 21200 0 0 ALAN HODNIK BOARD VICE CHAIR 3.00 0.00 X X 20000 0 0 GEORGE GOLDFARB BOARD DIRECTOR 3.00 0.00 X 20000 0 0 KIMBERLEY STOKES BOARD DIRECTOR 3.00 1.00 X 20000 0 0 WALTER LEINO MD BOARD DIRECTOR 3.00 2.00 X 20000 0 0 SISTER BEVERLY RAWAY BOARD DIRECTOR 3.00 4.00 X 0 0 0 SISTER CLARE MARIE TRETTEL BOARD DIRECTOR 3.00 0.00 X 0 0 0 SISTER KATHLEEN HOFER BOARD DIRECTOR 3.00 0.00 X 0 0 0 11800516 8791572 2447121 177 1 1 0 HEALTHTRUST INC PO BOX 742697 ATLANTA GA 30374 MEDICAL STAFFING 26558153 MAYO COLLABORATIVE SERVICES PO BOX 4100 ROCHESTER MN 55903 LAB SERVICES 15734898 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 MEDICAL BILLING SOFTWARE SUPPORT SERVICE 10392191 PHILIPS HEALTHCARE PO BOX 100355 ATLANTA GA 30384 MEDICAL EQUIPMENT SUPPORT SERVICES 8936585 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 MEDICAL STAFFING 6492253 252 97463789 969475 98433264 SUPPORT REVENUE 541610 272757934 272757934 272757934 6129753 622 6129131 216105743 186542714 94217 29563029 -94217 29468812 29468812 SYSTEM ACCESS/USE REVENUE 541519 10106954 7556720 2550234 EDUCATIONAL CONSULTING 611710 4660 4660 GARNISHMENT FEES 900099 4140 4140 6062 6062 10121816 416911579 272757934 7562002 38158379 X 103 103 10261617 1535362 8726255 165028346 88351789 76676557 7316865 3993120 3323745 30848979 17564265 13284714 11759819 6416531 5343288 3003244 3003244 399268 399268 515830 515830 946875 946875 30270883 7285311 22985572 6411427 6054654 356773 9204991 715019 8489972 3975655 2128460 1847195 65155 34882 30273 906305 422681 483624 460376 281626 178750 840409 840409 1313475 703200 610275 UNRELATED BUSINESS TAX 932355 932355 DUES 835638 369486 466152 LICENSES 496171 89230 406941 FEDERAL EXCISE TAX 477471 477471 686570 208677 477893 286957827 136994805 149963022 0 6647549 5821766 52189969 79351663 11244383 9620888 7041357 5914856 12979812 9046992 1981970 3932820 10 355702716 334254994 53227022 57570317 7107232 6650732 117935051 127005287 613077249 630123333 143488836 124752482 449161 250000 15216400 14318000 11282470 11177704 114245003 98369725 284681870 248867911 X 328395379 381255422 328395379 381255422 613077249 630123333 X 129953752 -84153325 7059616 X X 0 1 X 1 1 1 X X 4 INNOVIS HEALTH LLC 261175213 3 1 76821592 0 4 76821592 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 SCHEDULE A, PART I, LINE 12G: SUPPORTED ORGANIZATIONS: ESSENTIA HEALTH ALSO SUPPORTS THREE 509(A)(3) ENTITIES WHO ARE LISTED IN ESSENTIA HEALTH'S GOVERNING DOCUMENTS: BRAINERD LAKES INTEGRATED HEALTH SYSTEM (EIN: 37-1532145), CRITICAL ACCESS GROUP (EIN: 26-1219624) THROUGH ITS DISSOLUTION ON 11/5/2021, AND ST. MARY'S DULUTH CLINIC HEALTH SYSTEM (EIN: 41-1836633). ESSENTIA HEALTH PROVIDED MONETARY SUPPORT IN THE AMOUNTS OF $33,049,615 TO BRAINERD LAKES INTEGRATED HEALTH SYSTEM, $0 TO CRITICAL ACCESS GROUP, $177,086,620 TO ST. MARY'S DULUTH CLINIC HEALTH SYSTEM, AND $76,821,592 TO INNOVIS HEALTH, LLC (AS SHOWN ON LINE 12G) FOR AN OVERALL TOTAL OF $286,957,827 IN MONETARY SUPPORT. ESSENTIA HEALTH ALSO SUPPORTS THE TAX-EXEMPT SUBSIDIARIES OF ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS, SUBSTANTIALLY ALL OF WHICH ARE PUBLICLY SUPPORTED ENTITIES UNDER IRC SECTION 509(A). SCHEDULE A, PART I, LINE 12G, COLUMN V: AMOUNT OF SUPPORT: THE AMOUNT OF SUPPORT INCLUDES ESSENTIA HEALTH'S FUNCTIONAL EXPENSES WHICH ARE INCURRED FOR THE BENEFIT OF ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS. SCHEDULE A, PART IV, SECTION A, LINE 2: DETERMINATION OF STATUS OF SUPPORTED ORGANIZATIONS: TWO OF ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS (BRAINERD LAKES INTEGRATED HEALTH SYSTEM AND ST. MARY'S DULUTH CLINIC HEALTH SYSTEM) ARE TYPE II SUPPORTING ORGANIZATIONS UNDER IRC SECTION 509(A)(3). BRAINERD LAKES INTEGRATED HEALTH SYSTEM AND ST. MARY'S DULUTH CLINIC HEALTH SYSTEM SUPPORT TAX-EXEMPT ORGANIZATIONS ORGANIZED UNDER IRC SECTION 509(A)(1) OR 509(A)(2). SUPPORTED ORGANIZATION CRITICAL ACCESS GROUP WAS DISSOLVED DURING THE FISCAL YEAR. SCHEDULE A, PART IV, SECTION A, LINE 5: REMOVAL OF SUPPORTED ORGANIZATION: DURING FY 2022, SUPPORTED ORGANIZATION CRITICAL ACCESS GROUP (EIN 26-1219624) WAS DISSOLVED. IN 2020, CRITICAL ACCESS GROUP (CAG) REMOVED ITS TWO SUPPORTED ORGANIZATIONS OF WHICH IT WAS THE SOLE CORPORATE MEMBER. WITH THE TRANSFER OF CAG'S REMAINING SUPPORTED ORGANIZATIONS, THE CAG BOARD OF DIRECTORS DETERMINED IT WAS BEST TO DISSOLVE CAG. AS IDENTIFIED IN THE CAG BYLAWS, ESSENTIA HEALTH, THROUGH ITS RESERVED POWERS, HAS THE POWER AND RIGHT "TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF ALL ENTITIES IN THE SYSTEM." THE CAG BOARD AUTHORIZED THE DISSOLUTION AND APPROVED THE PLAN OF DISSOLUTION. THE ESSENTIA HEALTH BOARD OF DIRECTORS ALSO APPROVED THE DISSOLUTION. CAG TRANSFERRED ITS REMAINING ASSETS TO ESSENTIA HEALTH AND WAS LEGALLY DISSOLVED ON NOVEMBER 5, 2021. SCHEDULE A, PART IV, SECTION A, LINE 6: SUPPORT TO OTHER ORGANIZATIONS: ESSENTIA HEALTH MADE CONTRIBUTIONS TO UNRELATED ORGANIZATIONS THAT ALIGN WITH ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS' MISSIONS. THESE CONTRIBUTIONS CREATED A HEALTHY DIFFERENCE IN PEOPLES' LIVES BY PROVIDING RESOURCES TO FAMILIES IN NEED. ESSENTIA HEALTH ALSO SUPPORTS THE TAX-EXEMPT SUBSIDIARIES OF ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS BY PROVIDING VARIOUS SERVICES AND MONETARY SUPPORT. SCHEDULE A, PART IV, SECTION D, LINE 3: SUPPORTED ORGANIZATIONS' VOICE AND DIRECTION: THERE ARE MULTIPLE DIRECTORS THAT SERVE ON ESSENTIA HEALTH'S BOARD OF DIRECTORS AS WELL AS ON ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS' BOARD OF DIRECTORS. IN ADDITION, THE OFFICERS AND OTHER KEY EMPLOYEES OF ESSENTIA HEALTH AND ITS SUPPORTED ORGANIZATIONS MAINTAIN CLOSE AND CONTINUOUS WORKING RELATIONSHIPS BY SITTING ON THE SAME LEADERSHIP COMMITTEES AND TEAMS. FIRST AT THE SUPPORTED ORGANIZATION LEVEL AND THEN AT THE SUPPORTING ORGANIZATION LEVEL, ESSENTIA HEALTH'S INVESTMENTS AND USE OF INCOME AND ASSETS ARE DISCUSSED AND APPROVED RESULTING IN ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS HAVING A SIGNIFICANT VOICE IN DIRECTING THE ACTIVITIES OF ESSENTIA HEALTH. SCHEDULE A, PART IV, SECTION E, LINE 3A: POWER TO APPOINT OR ELECT DIRECTORS: ESSENTIA HEALTH APPROVES THE ELECTION OF ITS SUPPORTED ORGANIZATIONS' BOARD OF DIRECTORS AND MAY REMOVE, WITH OR WITHOUT CAUSE, THESE SAME DIRECTORS AT ANY TIME. SCHEDULE A, PART IV, SECTION E, LINE 3B: DIRECTION OVER THE POLICIES, PROGRAMS, AND ACTIVITIES OF THE SUPPORTED ORGANIZATIONS: AS THE PARENT OF ITS SUPPORTED ORGANIZATIONS, ESSENTIA HEALTH HAS VARIOUS FINANCIAL, OPERATIONAL, AND ADVISORY POWERS, KNOWN AS RESERVED POWERS, WITH RESPECT TO ITS SUPPORTED ORGANIZATIONS AND THEIR SUBSIDIARIES CREATING A SUBSTANTIAL DEGREE OF DIRECTION OVER THE POLICIES, PROGRAMS, AND ACTIVITIES OF ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS. ESSENTIA HEALTH ESTABLISHES AND OVERSEES VARIOUS POLICIES AND PROGRAMS INCLUDING POLICIES RELATED TO BUT NOT LIMITED TO ADMINISTRATION, HUMAN RESOURCES, FINANCE, COMPLIANCE, INFORMATION SERVICES, PATIENT RELATIONS/RISK MANAGEMENT, SAFETY, EMERGENCY PREPAREDNESS & SERVICES, REVENUE SERVICES, ESSENTIA HEALTH MEDICAL GROUP, PHYSICIAN/PROVIDER SERVICES, RESEARCH AND EDUCATION, AND THE ESSENTIA HEALTH FOUNDATION. ESSENTIA HEALTH HAS THE FOLLOWING AUTHORITY OVER ITS SUPPORTED ORGANIZATIONS AND THEIR SUBSIDIARIES: CREATE AND APPROVE STRATEGIC BUSINESS PLANS; CREATE AND APPROVE THE MISSION, PURPOSE AND VISION STATEMENTS; CREATE AND APPROVE AMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS AND/OR CERTIFICATES OF FORMATION AND OPERATING AGREEMENTS; AND CAUSE AND APPROVE THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 0 0 1 122270 0 1 509830 632100 0 PART II-B, LINE 1: ESSENTIA HEALTH EMPLOYS ONE FULL-TIME IN-HOUSE PUBLIC POLICY INDIVIDUAL AND DURING FY 2022 CONTRACTED WITH VARIOUS CONSULTANT FIRMS TO MONITOR FEDERAL AND STATE LEGISLATIVE ACTIVITIES OF INTEREST RELATED TO HEALTH AND HUMAN SERVICES ISSUES. ESSENTIA HEALTH'S PUBLIC POLICY ACTIVITIES OCCUR ON A MULTI-STATE AND NATIONAL LEVEL. ESSENTIA HEALTH PUBLIC POLICY ACTIVITIES INCLUDED IN-PERSON, TELEPHONIC, ELECTRONIC COMMUNICATION AND INFORMATION RELAY WITH LEGISLATORS AND STAFF, ADMINISTRATIVE OFFICIALS, GOVERNMENT AGENCIES AND DEPARTMENTS ON BOTH THE STATE AND FEDERAL LEVELS. THE PRIMARY ISSUES OF INTEREST AND CONCERN INCLUDE: CRITICAL ACCESS HOSPITAL DESIGNATION, STATUS AND REIMBURSEMENT PHYSICIAN AND HOSPITAL SERVICES REIMBURSEMENT MEDICARE AND MEDICAID REIMBURSEMENT POLICIES DISPROPORTIONATE SHARE HOSPITAL FUNDING SOLE COMMUNITY HOSPITAL STATUS AND FUNDING GRADUATE MEDICAL EDUCATION/INDIRECT MEDICAL EDUCATION FUNDING HEALTH INFORMATION TECHNOLOGY FUNDING AND PRIVACY ISSUES CYBERSECURITY STATE AND FEDERAL SHARED SAVINGS DEMONSTRATION PROJECTS MEDICARE REIMBURSEMENT FOR REHAB FACILITIES MEDICARE 340B PRESCRIPTION DRUG DISCOUNT PROGRAM MULTI-STATE NURSE LICENSURE COMPACT MULTI-STATE ADVANCED PRACTICE REGISTERED NURSE LICENSURE COMPACT MULTI-STATE PHYSICIAN LICENSURE COMPACT MULTI-STATE PHYSICAL THERAPY COMPACT MANDATED NURSE STAFFING QUOTAS ELECTRONIC MEDICAL RECORD INTEROPERABILITY/HEALTH INFORMATION TECHNOLOGY MEDICARE RECOVERY AUDIT CONTRACTOR AUDITS (RAC) HEALTH INFORMATION EXCHANGE MEDICAL EDUCATION AND RESEARCH COSTS (MERC) STATE CHILDREN'S HEALTH INSURANCE PROGRAM WORKFORCE DEVELOPMENT ISSUES PUBLIC HEALTH INITIATIVES COMMUNITY BENEFITS WORKERS COMPENSATION SYSTEM TAX EXEMPT STATUS ENVIRONMENTAL PROTECTION & SOLID WASTE ADVANCED CARE PLANNING PANDEMIC PREPAREDNESS AND READINESS EXPANSION OF TELEHEALTH SERVICES MENTAL HEALTH/BEHAVIORAL HEALTH ISSUES COVID-19 RELIEF ESSENTIA HEALTH WAS AN ADVOCATE SPONSOR THROUGH THE DULUTH AREA CHAMBER OF COMMERCE FOR THE 2022 "DULUTH & ST. LOUIS COUNTY AT THE CAPITAL DAYS" EVENT. ESSENTIA HEALTH MET WITH MINNESOTA LEGISLATORS TO DISCUSS ISSUES AFFECTING OUR COMMUNITIES AND HEALTHCARE. ESSENTIA HEALTH ALSO PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT INCLUDED IN THE TOTAL IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. 16950 13988 2962 14581 6562 8019 12948281 9026442 3921839 3932820 337420 F POOLED INVESTMENT FUNDS 333917574 F 334254994 INVESTMENT IN BENEDICTINE HEALTH SYSTEM 53227022 C INVESTMENT IN ST FRANCIS REGIONAL MEDICAL CENTER 4343295 C 57570317 DEFERRED DEBT FINANCING COSTS - LINE OF CREDIT 23043 DEFERRED COMPENSATION FUND 98193653 REINSURANCE RECEIVABLE 3579833 DEFERRED TAX ASSET 2109713 DEFERRED TAX ALLOWANCE -1939573 OPERATING LEASE ASSET 95187 RECEIVABLES FROM RELATED ORGS 24943431 127005287 BENEFIT PLAN LIABILITY 98193652 UNCLAIMED PROPERTY 80886 OPERATING LEASES 95187 98369725 CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 161555839 CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 PROGRAM SERVICES SELF INDEMNITY 17531657 0 0 0 0 0 0 179087496 0 179087496 1 0 1 1 1 0 PART III ACCOUNTING METHOD: X X 1 1 X X X X 1 1 0 0 0 0 0 0 0 DAVID HERMAN MD CHIEF EXECUTIVE OFFICER 1491535 0 1040413 0 277867 0 309238 0 4243 0 3123296 0 249892 0 JODI MANSFIELD EXECUTIVE VICE PRESIDENT, COO 933596 0 382305 0 178936 0 153601 0 2352 0 1650790 0 121044 0 JON PRYOR MD PRESIDENT - EAST 0 758337 0 313657 0 22098 0 23200 0 14451 0 1131743 0 0 WILLIAM HEEGAARD MD PRESIDENT - WEST 0 602073 0 252007 0 16483 0 96049 0 35122 0 1001734 0 0 TRACI MORRIS CHIEF FINANCIAL OFFICER/BD TREASURER 614101 0 243007 0 8704 0 100805 0 3108 0 969725 0 4501 0 BRADLEY BEARD CHIEF OPERATING OFFICER - EAST 0 574846 0 240965 0 11589 0 96003 0 38965 0 962368 0 0 PETER HENRY MD CHIEF MEDICAL OFFICER THRU 6/22 534939 0 224952 0 76993 0 89603 0 28958 0 955445 0 62496 0 DANIEL NIKCEVICH MD FORMER PRESIDENT - EAST 0 702819 0 0 0 125026 0 23200 0 37485 0 888530 0 89270 GREGORY GLASNER MD FORMER PRESIDENT - WEST 0 58616 0 0 0 822430 0 3603 0 0 0 884649 0 0 DEBORAH WELLE-POWELL CHF POPULATION HEALTH OFF THRU 6/22 475501 0 192891 0 71679 0 79523 0 13990 0 833584 0 50279 0 CHARLES WATSON CHIEF INFORMATION OFFICER 481395 0 203330 0 3947 0 80201 0 38096 0 806969 0 0 0 DIANE DAVIDSON CHIEF HUMAN RESOURCE OFFICER 445466 0 188226 0 61978 0 75293 0 32053 0 803016 0 48504 0 ANNE STEPHEN MD CHIEF MEDICAL OFFICER - EAST 0 440280 0 187274 0 35076 0 73912 0 32126 0 768668 0 18214 RICHARD VETTER MD CHIEF MEDICAL OFFICER - WEST 0 462575 0 183596 0 7789 0 72041 0 36344 0 762345 0 0 MICHAEL WATTERS CHIEF LEGAL OFFICER/BOARD SECRETARY 456301 0 172505 0 7043 0 76006 0 39439 0 751294 0 0 0 AL HURLEY CHIEF OPERATING OFFICER - WEST 0 403561 0 168002 0 9425 0 67202 0 23397 0 671587 0 0 SHEILA HART SENIOR VP-INTEGRATED CARE DELIVERY 362761 0 148486 0 44046 0 64091 0 31673 0 651057 0 33763 0 SARAH MANNEY KURTH MD CHIEF MEDICAL INFORMATION OFFICER 340579 0 144930 0 4711 0 48134 0 39126 0 577480 0 0 0 PATRICK TWOMEY MD FORMER CHIEF MEDICAL OFFICER 0 489551 0 0 0 2322 0 23200 0 39466 0 554539 0 0 RHONDA KAZIK CHIEF NURSING OFFICER 0 334302 0 105527 0 27548 0 55520 0 26715 0 549612 0 0 STEFANIE GEFROH ELLISON MD BOARD DIRECTOR 20000 421931 0 0 0 12409 0 23182 0 37551 20000 495073 0 0 MELANIE WILSON SENIOR VP-REVENUE SERVICES 362713 0 50730 0 299 0 14500 0 34891 0 463133 0 0 0 MICHAEL VAN SCOY MD PHYSICIAN 379858 0 0 0 1755 0 20954 0 36390 0 438957 0 0 0 MARIA BEAVER MD PHYSICIAN LEADER 400945 0 0 0 389 0 21360 0 1283 0 423977 0 0 0 JANE RUDD MD BOARD DIRECTOR 20000 291962 0 0 0 1332 0 23200 0 40363 20000 356857 0 0 ADAM REES FORMER PRESIDENT - CENTRAL 0 0 0 0 0 280136 0 0 0 22241 0 302377 0 0 FRANK MODICH FORMER INTERIM CHIEF LEGAL OFFICER 225750 0 31787 0 217 0 12053 0 14290 0 284097 0 0 0 ROBERT NORMAN FORMER CHIEF FINANCIAL OFFICER 0 0 0 0 198000 0 0 0 0 0 198000 0 0 0 THOMAS RUSS MD BOARD DIRECTOR THRU 12/21 30000 144469 0 0 0 0 0 8668 0 0 30000 153137 0 0 TIMOTHY SAYLER FRMR CHIEF OPERATING OFFICER - WEST 0 0 0 0 0 162970 0 0 0 0 0 162970 0 9520 MARK HAYWARD FORMER SENIOR VP, OPERATIONS 0 0 0 0 0 118589 0 0 0 8661 0 127250 0 0 PART I, LINE 1A BENEFITS PROVIDED: DURING CALENDAR YEAR 2021, CHARTER TRAVEL WAS USED BY TWO BOARD DIRECTORS, TWO OFFICERS, FIVE KEY EMPLOYEES, AND TWO HIGHEST-COMPENSATED EMPLOYEES FOR TRAVEL BETWEEN ESSENTIA HEALTH AND OTHER ORGANIZATIONS. THE USE OF CHARTER TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION TO THESE INDIVIDUALS AS ALL TRAVEL WAS BUSINESS RELATED. DURING CALENDAR YEAR 2021, KEY EMPLOYEE JODI MANSFIELD RECEIVED A HOUSING ALLOWANCE. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION. PART I, LINES 4A-B SEVERANCE PAYMENT: FORMER KEY EMPLOYEE GREGORY GLASNER, MD RECEIVED PAYMENT TOTALING $271,874 IN CALENDAR YEAR 2021 RELATED TO HIS TERMINATION. THE TERMINATION TERMS ARE FROM DECEMBER 31, 2019 TO JUNE 30, 2021. MR. GLASNER WILL RECEIVE PAY TOTALING $773,947 & BENEFITS TOTALING $32,883 RELATED TO HIS TERMINATION. FORMER KEY EMPLOYEE ADAM REES RECEIVED PAYMENT TOTALING $285,796 IN CALENDAR YEAR 2021 RELATED TO HIS TERMINATION. THE TERMINATION TERMS ARE FROM APRIL 6, 2020 TO OCTOBER 6, 2021. MR. REES WILL RECEIVE PAY TOTALING $541,070 & BENEFITS TOTALING $29,839 RELATED TO HIS TERMINATION. FORMER KEY EMPLOYEE MARK HAYWARD RECEIVED PAYMENT TOTALING $120,899 IN CALENDAR YEAR 2021 RELATED TO HIS TERMINATION. THE TERMINATION TERMS ARE FROM APRIL 30, 2020 TO APRIL 30, 2021. MR. HAYWARD WILL RECEIVE PAY TOTALING $334,402 & BENEFITS TOTALING $26,206 RELATED TO HIS TERMINATION. ALL OTHER INDIVIDUALS LISTED AS FORMERS IN FORM 990, PART VII, SECTION A, LINE 1A DID NOT RECEIVE A SEVERANCE PAYMENT DURING CALENDAR YEAR 2021. SOME OF THESE INDIVIDUALS REMAIN EMPLOYED WITHIN ESSENTIA HEALTH AND ITS SUBSIDIARIES. 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: DAVID HERMAN, MD $266,204 JODI MANSFIELD $122,840 TRACI MORRIS $6,094 PETER HENRY, MD $62,896 DANIEL NIKCEVICH, MD $120,872 GREGORY GLASNER, MD $6,214 DEBORAH WELLE-POWELL $50,682 DIANE DAVIDSON $48,905 ANNE STEPHEN, MD $24,662 SHEILA HART $33,766 TIMOTHY SAYLER $35,567 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: DAVID HERMAN, MD $286,038 JODI MANSFIELD $130,401 WILLIAM HEEGAARD, MD $76,803 TRACI MORRIS $77,605 BRADLEY BEARD $72,803 PETER HENRY, MD $66,403 DEBORAH WELLE-POWELL $56,323 CHARLES WATSON $57,001 DIANE DAVIDSON $52,093 ANNE STEPHEN, MD $50,712 RICHARD VETTER, MD $48,841 MICHAEL WATTERS $53,281 AL HURLEY $44,002 SHEILA HART $40,891 SARAH MANNEY KURTH, MD $24,934 RHONDA KAZIK $40,645 A DULUTH ECONOMIC DEVELOPMENT AUTHORITY 900848286 26444CHF2 2018-11-01 704253406 SERIES 2018A (SEE PART VI) 0 0 0 B CASS COUNTY ND 456002205 000000000 2020-02-18 61320000 SERIES 2020A (SEE PART VI) 0 0 0 C WI HEALTH & EDU FAC AUTH 391337855 000000000 2020-02-18 13095000 SERIES 2020B (SEE PART VI) 0 0 0 D DULUTH ECONOMIC DEVELOPMENT AUTHORITY 900848286 000000000 2020-02-18 116955000 SERIES 2020C (SEE PART VI) 0 0 0 A 3776805 32652 3744153 1 0 0 1 B 3985800 14300 3971500 2020 1 0 1 1 C 851175 7800 843375 2020 1 0 1 1 D 1792050 7602074 46800 7555274 2020 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 1 0 0 0 0 1 A 0 0 0 1 0 0 1 SEE PART VI 3.400000000000 1 0 1 B 0 0 1 0 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: DULUTH ECONOMIC DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2022 SCHEDULE K: ADDITIONAL INFORMATION/COMMENTS RELATING TO THE REPORTING OF LIABILITIES BY RELATED ORGANIZATIONS: ESSENTIA HEALTH HAS AN OBLIGATED GROUP CREATED UNDER THE MASTER TRUST INDENTURE WHICH IS COMPOSED OF THE FOLLOWING MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, BRAINERD LAKES INTEGRATED HEALTH SYSTEM, ST. MARY'S INNOVIS HEALTH, THE DULUTH CLINIC, LTD. AND ESSENTIA HEALTH WEST (THE "OBLIGATED GROUP MEMBERS"). THE OBLIGATED GROUP MEMBERS ARE JOINTLY AND SEVERALLY OBLIGATED ON ALL INDEBTEDNESS EVIDENCED OR SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. SERIES 2018A: THE SERIES 2018A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH EAST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, BRAINERD LAKES INTEGRATED HEALTH SYSTEM, ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, AND ESSENTIA HEALTH WEST ARE THE CONDUIT BORROWERS OF THE SERIES 2018A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH DULUTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020A: THE SERIES 2020A BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020A BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020B: THE SERIES 2020B BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020B BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SERIES 2020C: THE SERIES 2020C BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH, ESSENTIA HEALTH WEST, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, ESSENTIA HEALTH EAST, ESSENTIA HEALTH DULUTH, ESSENTIA HEALTH ST. MARY'S MEDICAL CENTER, ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, ESSENTIA HEALTH ST. MARY'S HOSPITAL-SUPERIOR, AND ESSENTIA HEALTH POLINSKY MEDICAL REHABILITATION CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2020C BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH, THE DULUTH CLINIC, LTD., ESSENTIA HEALTH WEST, ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES, AND ST. MARY'S INNOVIS HEALTH HAVE RECORDED A PORTION OF THE BOND LIABILITY ON THEIR BALANCE SHEETS WHICH ARE CONSOLIDATED WITH ESSENTIA HEALTH. SCHEDULE K, PART I, COLUMN (F): DESCRIPTION OF PURPOSE: SERIES 2018A: ACQUIRE, CONSTRUCT, BUILD, AND EQUIP MEDICAL CAMPUS PROJECT IN DULUTH, MN; REFUND SERIES 2008E BONDS ISSUED MAY 2, 2008 TO REFINANCE SERIES 1997 BONDS ISSUED DECEMBER 18, 1997 TO FINANCE EQUIPMENT PURCHASES IN DULUTH, MN AND FINANCE PROPERTY ACQUISITIONS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN NORTHERN MINNESOTA; AND REFUND SERIES 2014 BONDS ISSUED JULY 29, 2014 TO REFINANCE PRIOR NOTE USED FOR CAPITAL IMPROVEMENTS TO SKILLED NURSING FACILITY LOCATED IN DETROIT LAKES, MN AND VARIOUS CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN BAXTER, FRAZEE, AND PELICAN RAPIDS, MN AND FINANCE CAPITAL EXPENDITURES TO REPLACE THE CHILLER UNIT FOR ESSENTIA HEALTH VIRGINIA, RENOVATE APPROXIMATELY 118,000 SQUARE FEET OF CLINIC SPACE FOR ESSENTIA HEALTH BRAINERD SPECIALTY CLINIC, REMODEL AND EQUIP EXISTING CLINIC SPACE IN EMILY, MN FOR ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER, AND EXPAND AND REMODEL THE IMAGING AREA IN THE EMERGENCY ROOM OF ESSENTIA HEALTH ST. MARY'S-DETROIT LAKES' HOSPITAL. SERIES 2020A: REFUND SERIES 2008A BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFINANCE A PORTION OF THE ACQUISITION OF CERTAIN ASSETS OF ESSENTIA HEALTH WEST IN CONNECTION WITH THE AFFILIATION OF ESSENTIA HEALTH WITH ESSENTIA HEALTH WEST. SERIES 2020B: REFUND SERIES 2008B BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 1999B BONDS ISSUED MAY 18, 1999 FOR CONSTRUCTION PROJECTS AND EQUIPMENT PURCHASES IN SUPERIOR, WI AND VARIOUS DULUTH CLINIC LOCATIONS IN NORTHWESTERN WISCONSIN. SERIES 2020C: REFUND SERIES 2008C BONDS ISSUED FEBRUARY 25, 2010 TO REOFFER BONDS ORIGINALLY ISSUED MARCH 4, 2008 TO REFUND SERIES 2004 BONDS ISSUED MARCH 19, 2004 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN DULUTH, BRAINERD, AND DETROIT LAKES, MN AND REFUND SERIES 1999A BONDS ISSUED MAY 18, 1999 FOR VARIOUS ACQUISITIONS, CONSTRUCTION PROJECTS, CAPITAL IMPROVEMENTS AND EQUIPMENT PURCHASES IN BRAINERD, DETROIT LAKES AND DULUTH, MN AND VARIOUS DULUTH CLINIC SITES IN NORTHERN MINNESOTA. SCHEDULE K, PART II, LINE 3: ISSUE PRICE: THE SERIES 2018A, SERIES 2020A, SERIES 2020B AND SERIES 2020C BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. THE ISSUE PRICE LISTED IN ESSENTIA HEALTH'S SCHEDULE K, PART I, COLUMN (E) REPRESENTS THE ESSENTIA HEALTH OBLIGATED GROUP'S TOTAL BORROWING. SCHEDULE K, PART II, LINES 3 THROUGH 12: PROCEEDS: THE SERIES 2018A, SERIES 2020A, SERIES 2020B, AND SERIES 2020C BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. A PORTION OF THE SERIES 2018A, SERIES 2020A, SERIES 2020B, AND SERIES 2020C BORROWINGS WERE ALLOCATED TO ESSENTIA HEALTH, AN ESSENTIA HEALTH OBLIGATED GROUP MEMBER. THE PROCEEDS LISTED IN ESSENTIA HEALTH'S SCHEDULE K, PART II, LINES 3 THROUGH 12 REPRESENT ESSENTIA HEALTH'S ALLOCATED PORTION OF THE PROCEEDS. SCHEDULE K, PART IV, LINE 5B: NAME OF PROVIDER OF GIC: NATIXIS FUNDING CORP & THE TORONTO-DOMINION BANK 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 7B MEMBER WITH RIGHT TO APPROVE GOVERNING BODY DECISIONS: THE BENEDICTINE SISTERS BENEVOLENT ASSOCIATION ("BSBA") HAS CERTAIN RESERVED POWERS OVER ESSENTIA HEALTH'S CATHOLIC FACILITIES. BSBA'S RESERVED POWERS ARE AS FOLLOWS: MISSION. AUTHORITY TO APPROVE THE MISSION AND PURPOSE STATEMENTS FOR CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM. *ADHERENCE TO ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS). AUTHORITY TO APPROVE THE METHODS, POLICIES AND PROCEDURES PERTAINING TO THE ADHERENCE OF CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM TO THE ERDS. *OFFICIAL CATHOLIC DIRECTORY. AUTHORITY TO OVERSEE THE LISTING OF QUALIFIED ENTITIES AND FACILITIES WITHIN THE SYSTEM IN THE OFFICIAL CATHOLIC DIRECTORY, SUBJECT TO THE APPROVAL OF APPLICABLE CATHOLIC AUTHORITIES. *CATHOLIC HEALTH ASSOCIATION. AUTHORITY TO REQUIRE CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM TO JOIN THE MEMBERSHIP OF THE CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES. ALIENATION OF STABLE PATRIMONY OR ECCLESIASTICAL GOODS. AUTHORITY TO APPROVE ALIENATION OF EITHER STABLE PATRIMONY OR OTHER ECCLESIASTICAL GOODS WITHIN THE SYSTEM IF SUCH GOODS INVOLVED IN A SPECIFIC TRANSACTION APPROVED BY ESSENTIA HEALTH PURSUANT TO THE AFFILIATION AGREEMENT, HAVE A DOLLAR VALUE EQUAL TO OR GREATER THAN 70% OF THE AMOUNT ESTABLISHED FROM TIME TO TIME THAT REQUIRES APPROVAL FROM THE HOLY SEE; PROVIDED, HOWEVER, THAT IT IS THE INTENT OF THE PARTIES THAT THIS PROVISION NOT BE APPLIED TO RESTRICT OR TO IMPEDE ESSENTIA HEALTH FROM ACTING AND MAKING DECISIONS ON BEHALF OF THE SYSTEM IN THE ORDINARY COURSE OF BUSINESS BUT BE APPLIED TO PREVENT THE TRANSFER OF SUBSTANTIAL ASSETS OF CATHOLIC ENTITIES WITHIN THE SYSTEM TO SUPPORT THE SECULAR ENTITIES WITHIN THE SYSTEM WITHOUT THE PRIOR APPROVAL OF BSBA. *MISSION EFFECTIVENESS. AUTHORITY TO APPROVE ANNUAL PLANS AND EVALUATIONS RELATING TO MISSION EFFECTIVENESS AND CHAPLAINCY FOR CATHOLIC FACILITIES AND ENTITIES WITHIN THE SYSTEM, INCLUDING THE USE OF RELIGIOUS SYMBOLS AND PRAYERS. AMENDMENTS. AUTHORITY TO APPROVE ANY AMENDMENTS TO THE GOVERNING DOCUMENTS OF ESSENTIA HEALTH, ESSENTIA HEALTH EAST (SMDC), ESSENTIA HEALTH CENTRAL (BLIHS), ESSENTIA HEALTH WEST (INNOVIS) OR CRITICAL ACCESS GROUP (CAG) THAT WOULD ALTER THE NUMBER OF DULUTH BENEDICTINES OR BSBA BOARD OF DIRECTOR MEMBERS OR OTHER APPOINTEES OF THE DULUTH BENEDICTINES SERVING AS MEMBERS OF SUCH ENTITY'S BOARD OF DIRECTORS; AUTHORITY TO APPROVE ANY AMENDMENTS TO THE GOVERNING DOCUMENTS OF THE CATHOLIC CAG SUBSIDIARIES, THE CATHOLIC SMDC SUBSIDIARIES, THE CATHOLIC BLIHS SUBSIDIARIES OR THE CATHOLIC SUBSIDIARIES OF INNOVIS, WHICH COULD MATERIALLY AFFECT SUCH ENTITY'S IDENTITY AS A CATHOLIC INSTITUTION, INCLUDING WITHOUT LIMITATION ANY AMENDMENT THAT WOULD ALTER THE NUMBER OF DULUTH BENEDICTINES OR BSBA BOARD OF DIRECTOR MEMBERS OR OTHER APPOINTEES OF THE DULUTH BENEDICTINES SERVING AS MEMBERS OF SUCH ENTITY'S BOARD OF DIRECTORS; AND AUTHORITY TO CAUSE ESSENTIA HEALTH TO MAKE AMENDMENTS TO THE GOVERNING DOCUMENTS OF THE CATHOLIC SUBSIDIARIES OF ESSENTIA HEALTH'S DIRECT SUBSIDIARIES, WHICH AMENDMENTS BSBA DETERMINES IN GOOD FAITH ARE NECESSARY TO PRESERVE SUCH ENTITY'S IDENTITY AS A CATHOLIC INSTITUTION. MERGERS AND DISSOLUTION. SUBJECT TO THE APPROVAL OF THE DULUTH BENEDICTINES, AUTHORITY TO APPROVE A PROPOSED MERGER, CONSOLIDATION, LIQUIDATION, OR DISSOLUTION OF ST. MARY'S MEDICAL CENTER (SMMC) AND ST. JOSEPH'S MEDICAL CENTER (SJMC) OR THE DISPOSITION OF ALL OR SUBSTANTIALLY ALL THE ASSETS OF SMMC AND SJMC. BSBA SPONSORSHIP. AUTHORITY TO ESTABLISH, ACCEPT, TRANSFER OR TERMINATE BSBA SPONSORSHIP OR CO-SPONSORSHIP OF A HEALTHCARE FACILITY. *RESERVED POWER CURRENTLY DELEGATED TO THE SPONSORSHIP COUNCIL. NOTE: SOME OF THE RESERVED POWERS OF THE BSBA BOARD LISTED ABOVE MAY ALSO BE RESERVED TO THE BENEDICTINE SISTERS OF ST. SCHOLASTICA MONASTERY OF DULUTH (THE "CHAPTER OR "DULUTH BENEDICTINES"). PRIOR TO THESE MATTERS GOING TO THE CHAPTER, ORDINARILY THEY WILL BE CONSIDERED AND ACTED UPON BY THE BSBA BOARD. THE FOLLOWING ACTIONS OF THE BSBA BOARD ARE SUBJECT TO APPROVAL BY THE CHAPTER: 1. APPROVE MERGERS, CONSOLIDATIONS, LIQUIDATIONS, OR DISSOLUTIONS INVOLVING SMMC OR SJMC. 2. APPROVE THE ACQUISITION OR DISPOSITION OF REAL ESTATE OWNED BY BSBA. 3. APPROVE DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, ASSETS OF SMMC OR SJMC. 4. APPROVE INDEBTEDNESS THAT WILL BE GUARANTEED BY BSBA. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE 2021 FORM 990, INCLUDING ALL SCHEDULES, WAS REVIEWED BY MANAGEMENT AND THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. THE FINANCE LEADER REVIEWED THE FORM AND SCHEDULES AND ANY QUESTIONS WERE DISCUSSED. EACH CURRENT DIRECTOR OF THE GOVERNING BODY RECEIVED A FINAL COPY OF THE 2021 FORM 990. 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 15 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'S CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, EXECUTIVE VICE PRESIDENT, COO, CHIEF MEDICAL OFFICER, CHIEF POPULATION HEALTH OFFICER, CHIEF HUMAN RESOURCE OFFICER, CHIEF LEGAL OFFICER, SENIOR VICE PRESIDENT OF INTEGRATED CARE DELIVERY, AND CHIEF NURSING OFFICER; ESSENTIA HEALTH EAST'S PRESIDENT, CHIEF OPERATING OFFICER AND CHIEF MEDICAL OFFICER; AND ESSENTIA HEALTH WEST'S PRESIDENT, CHIEF OPERATING OFFICER, AND CHIEF MEDICAL OFFICER WAS 2022. 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 IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,232,148. MANAGEMENT AND GENERAL EXPENSES 16,573,034. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,805,182. CONSULTANT FEES: PROGRAM SERVICE EXPENSES 964,748. MANAGEMENT AND GENERAL EXPENSES 1,061,640. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,026,388. TEMP AGENCY FEES: PROGRAM SERVICE EXPENSES 86,304. MANAGEMENT AND GENERAL EXPENSES 1,905,499. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,991,803. COLLECTION AGENCY FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,940,063. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,940,063. PATIENT LOAN PROGRAM FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,491,379. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,491,379. CONTRACT SERVICE MAINTENANCE: PROGRAM SERVICE EXPENSES 2,111. MANAGEMENT AND GENERAL EXPENSES 13,957. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,068. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS WITH RELATED ORGS 7,059,616. PART XII LINE 3: CONSOLIDATED A-133: ESSENTIA HEALTH, AS PART OF ESSENTIA HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS, WAS REQUIRED AND UNDERWENT A CONSOLIDATED AUDIT SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. THE CONSOLIDATED AUDIT IS REVIEWED BY THE ESSENTIA HEALTH AUDIT COMMITTEE. 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 CRITICAL ACCESS GROUP THRU 1152021 502 E 2ND ST DULUTH MN 55805 261219624 SUPPORTING ORG MN 501(C)(3) PF 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 FOUNDATION 502 E 2ND ST DULUTH MN 55805 271984704 FOUNDATION MN 501(C)(3) LINE 7 ESSENTIA HEALTH 1 ESSENTIA HEALTH MOOSE LAKE 4572 COUNTY ROAD 61 MOOSE LAKE MN 55767 845099016 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 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 WEST 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 407 E 3RD ST DULUTH MN 55805 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 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 THRU 1132022 705 LUNDORFF DR S SANDSTONE MN 55072 261634764 IMAGING SERVICES MN N/A N/A 0 0 HORSESHOE SURGERY CENTER LLC 1542 GOLF COURSE ROAD GRAND RAPIDS MN 55744 202137172 SURGERY CENTER MN N/A N/A 0 0 ESSENTIA HEALTH INSURANCE SERVICES SPC LTD PO BOX 1159 GRAND CAYMAN CJ K71-1102 000000000 SELF INSURANCE CJ N/A C 13738863 59869602 1.00000 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 BRAINERD MEDICAL CENTER INC L 3552742 ACTUAL COSTS BRAINERD MEDICAL CENTER INC Q 708662 ACTUAL COSTS BRIDGES MEDICAL CENTER L 993450 ACTUAL COSTS BRIDGES MEDICAL CENTER Q 672333 ACTUAL COSTS BRIDGES MEDICAL CENTER S 1500000 ACTUAL COSTS CRITICAL ACCESS GROUP C 97424840 ACTUAL COSTS CRITICAL ACCESS GROUP P 3329984 ACTUAL COSTS DEER RIVER HEALTHCARE CENTER INC L 3683962 ACTUAL COSTS DEER RIVER HEALTHCARE CENTER INC Q 2191868 ACTUAL COSTS DEER RIVER HEALTHCARE CENTER INC S 9500000 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION Q 163017 ACTUAL COSTS ESSENTIA HEALTH INSURANCE SERVICES SPC Q 14251755 ACTUAL COSTS ESSENTIA HEALTH INSURANCE SERVICES SPC R 14166709 ACTUAL COSTS ESSENTIA HEALTH MOOSE LAKE L 4564692 ACTUAL COSTS ESSENTIA HEALTH MOOSE LAKE Q 2266663 ACTUAL COSTS ESSENTIA HEALTH MOOSE LAKE S 2500000 ACTUAL COSTS ESSENTIA INSTITUTE OF RURAL HEALTH L 600000 ACTUAL COSTS ESSENTIA INSTITUTE OF RURAL HEALTH Q 1036580 ACTUAL COSTS ESSENTIA INSTITUTE OF RURAL HEALTH S 500000 ACTUAL COSTS FIRST CARE MEDICAL SERVICES L 3463981 ACTUAL COSTS FIRST CARE MEDICAL SERVICES Q 1629978 ACTUAL COSTS FIRST CARE MEDICAL SERVICES S 3000000 ACTUAL COSTS GRACEVILLE HEALTH CENTER L 978520 ACTUAL COSTS GRACEVILLE HEALTH CENTER Q 979095 ACTUAL COSTS INNOVIS HEALTH LLC L 43299387 ACTUAL COSTS INNOVIS HEALTH LLC Q 25345402 ACTUAL COSTS INNOVIS HEALTH LLC S 13000000 ACTUAL COSTS MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC L 1301915 ACTUAL COSTS MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC Q 852912 ACTUAL COSTS MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC S 15100000 ACTUAL COSTS NORTHERN PINES MEDICAL CENTER L 2038439 ACTUAL COSTS NORTHERN PINES MEDICAL CENTER Q 1051242 ACTUAL COSTS PINE MEDICAL CENTER L 2085461 ACTUAL COSTS PINE MEDICAL CENTER Q 1022858 ACTUAL COSTS POLINSKY MEDICAL REHABILITATION CENTER L 1165438 ACTUAL COSTS POLINSKY MEDICAL REHABILITATION CENTER Q 1314661 ACTUAL COSTS SMDC MEDICAL CENTER L 66488059 ACTUAL COSTS SMDC MEDICAL CENTER Q 41487401 ACTUAL COSTS SMDC MEDICAL CENTER S 13250000 ACTUAL COSTS ST JOSEPH'S MEDICAL CENTER L 23534542 ACTUAL COSTS ST JOSEPH'S MEDICAL CENTER Q 12825255 ACTUAL COSTS ST JOSEPH'S MEDICAL CENTER R 3300000 ACTUAL COSTS ST MARY'S EMS L 953697 ACTUAL COSTS ST MARY'S EMS Q 677263 ACTUAL COSTS ST MARY'S EMS S 500000 ACTUAL COSTS ST MARY'S HOSPITAL OF SUPERIOR L 7934341 ACTUAL COSTS ST MARY'S HOSPITAL OF SUPERIOR Q 4814585 ACTUAL COSTS ST MARY'S INNOVIS HEALTH L 344265 ACTUAL COSTS ST MARY'S INNOVIS HEALTH Q 120258 ACTUAL COSTS ST MARY'S MEDICAL CENTER L 44131911 ACTUAL COSTS ST MARY'S MEDICAL CENTER Q 30321496 ACTUAL COSTS ST MARY'S MEDICAL CENTER S 31800000 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER L 15343842 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER Q 9926921 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER S 9000000 ACTUAL COSTS THE DULUTH CLINIC LTD D 151363 ACTUAL COSTS THE DULUTH CLINIC LTD L 13485585 ACTUAL COSTS THE DULUTH CLINIC LTD Q 6021670 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 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 EMS 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