2025-05-06T14:13:40-05:00 2024-06-30 420714325 RSM US LLP 227 W 1ST ST STE 700 DULUTH MN 558021926 990 2023-07-01 200360007 ESSENTIA HEALTH ESSE 2187868376 502 E 2ND ST DULUTH MN 55805 TRACI MORRIS CHIEF FINANCIAL OFFICER 2187868376 2025-05-06 1 0 JULIE BOYER P01278549 2187275025 2023 2025-03-06 01:10:19Z DAVID HERMAN MD 502 E 2ND ST DULUTH MN 55805 502152092 0 X WWW.ESSENTIAHEALTH.ORG X 2003 MN WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 12 9 3457 0 7959857 463847 557769 379975 326854490 339765124 12475106 20626715 8321740 9104446 348209105 369876260 0 5000 0 0 256341805 279765776 0 0 0 83824369 70606250 340166174 350377026 8042931 19499234 723173585 869746602 294668684 369547738 428504901 500198864 X WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 0 0 174214564 5000 339765124 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 ITS SUPPORTED ORGANIZATIONS AS LISTED ON SCHEDULE A OF FORM 990, ALL OF WHICH ARE ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986.ESSENTIA HEALTH IS THE PARENT ORGANIZATION OF AN INTEGRATED HEALTH SYSTEM THAT INCLUDES ALL ENTITIES THAT ARE OWNED OR CONTROLLED, DIRECTLY OR INDIRECTLY, BY ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"). THE SYSTEM SERVES PATIENTS IN MINNESOTA, WISCONSIN, AND NORTH DAKOTA. HEADQUARTERED IN DULUTH, MINNESOTA, THE SYSTEM COMBINES THE STRENGTHS AND TALENTS OF OVER 16,000 EMPLOYEES, INCLUDING MORE THAN 2,200 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. THE SYSTEM, WHICH INCLUDES MANY CATHOLIC FACILITIES, IS GUIDED BY THE VALUES OF QUALITY, HOSPITALITY, RESPECT, JOY, JUSTICE, STEWARDSHIP AND TEAMWORK. THE SYSTEM DELIVERS ON ITS MISSION BY HAVING PATIENT-CENTERED FOCUS AT 14 HOSPITALS, APPROXIMATELY 80 CLINICS, SIX LONG-TERM CARE FACILITIES, TWO ASSISTED LIVING FACILITIES, THREE INDEPENDENT LIVING FACILITIES, SEVERAL REHABILITATION CENTERS, SEVEN AMBULANCE SERVICES, 27 RETAIL PHARMACIES, HOME HEALTH SERVICES, AND ONE RESEARCH INSTITUTE. THE SYSTEM 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 THE SYSTEM FILE SEPARATE FORM 990S.AT FISCAL YEAR ENDED JUNE 30, 2024, THE SYSTEM'S CONSOLIDATED TOTAL OPERATING REVENUE WAS $2,983,758,000 AND CONSOLIDATED INCOME FROM OPERATIONS WAS $20,404,000.THE SYSTEM'S HOSPITALS HAVE A TOTAL OF 1,202 LICENSED BEDS WHICH PROVIDED NEARLY 207,000 HOSPITAL PATIENT DAYS AND OVER 772,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2024. THE CLINICS HAD 2.1 MILLION ENCOUNTERS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2024, THE SYSTEM PROVIDED TOTAL COMMUNITY BENEFITS OF $178 MILLION WHICH INCLUDED COSTS OF PROVIDING CHARITY CARE, COSTS IN EXCESS OF MEDICAID PAYMENTS, MEDICAID SURCHARGE, MINNESOTACARE TAX, COMMUNITY BUILDING ACTIVITIES AND SERVICES, HEALTH PROFESSIONALS EDUCATION, AND RESEARCH. 174214564 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 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 X 695 0 1 3457 1 1 1 1 CJ 0 0 0 0 0 0 0 0 1 0 X 12 9 0 0 0 0 0 1 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 3045950 0 361993 JODI MANSFIELD EXECUTIVE VICE PRESIDENT, COO 60.00 0.00 X 1450081 0 181697 LLOYD KETCHUM MD BD DIRECTOR/REL ORG PHYS & DIV CHAIR 3.00 57.00 X 0 1188768 68263 BRADLEY BEARD CHIEF OPERATING OFFICER - EAST 1.00 59.00 X 0 1073967 159414 WILLIAM HEEGAARD MD PRES-EAST THRU 4/24/FRMR PRES-WEST 1.00 59.00 X 0 879244 182878 TRACI MORRIS CHIEF FINANCIAL OFFICER/TREASURER 42.00 18.00 X 900190 0 125852 KARYN BAUM MD CHIEF TRANSFORMATION OFF THRU 1/24 60.00 0.00 X 827055 0 151032 KEVIN CASEY MD CHIEF MEDICAL OFFICER THRU 10/23 57.00 3.00 X 828826 0 141717 DANIEL NIKCEVICH MD FORMER PRESIDENT - EAST 0.00 60.00 X 0 838948 60230 RICHARD VETTER MD INTERIM PRES-WEST THRU 8/23/CMO-WEST 1.00 59.00 X 0 725972 131548 AL HURLEY CHIEF OPERATING OFFICER - WEST 1.00 59.00 X 0 741059 111212 DIANE DAVIDSON CHIEF HUMAN RESOURCES OFF THRU 4/24 60.00 0.00 X 685804 0 134402 ROBERT GREEN SNR VICE PRES, FINANCIAL OPERATIONS 60.00 0.00 X 645032 0 140047 CHARLES WATSON CHIEF INFORMATION OFFICER 60.00 0.00 X 645626 0 134073 MICHAEL WATTERS CHIEF LEGAL OFFICER/SECRETARY 42.00 18.00 X 645998 0 132655 ANNE STEPHEN MD CHIEF MEDICAL OFF - EAST THRU 5/24 1.00 59.00 X 0 644847 124684 RHONDA KAZIK CHIEF NURSE EXECUTIVE 54.00 6.00 X 0 555556 115867 MELANIE WILSON SENIOR VICE PRES, REVENUE SERVICES 60.00 0.00 X 539144 0 123370 SARAH MANNEY KURTH MD CHIEF MEDICAL INFORMATION OFFICER 60.00 0.00 X 507408 0 120626 JON PRYOR MD PRESIDENT - EAST THRU 1/23 0.00 5.00 X 0 591355 9781 STEFANIE GEFROH ELLISON MD BD DIRECT/REL ORG INTERIM CMO & PHYS 3.00 57.00 X 0 488999 68680 KRISTA SKORUPA MD PRESIDENT - EAST 1.00 59.00 X 0 469439 86202 GRATIA PITCHER MD CHIEF MEDICAL OFFICER 60.00 0.00 X 472648 0 58675 JANE RUDD MD BD DIRECTOR/REL ORG PHYS & DIV CHAIR 3.00 57.00 X 20000 304188 64683 MARK THOMPSON MD PRESIDENT - WEST 1.00 59.00 X 0 258393 47471 FRANK MODICH FORMER INTERIM CHIEF LEGAL OFFICER 60.00 0.00 X 260107 0 26520 SHEILA HART SNR VP-INT CARE DELIVERY THRU 3/23 60.00 0.00 X 222155 0 14938 ROBERT NORMAN FORMER CHIEF FINANCIAL OFFICER 0.00 0.00 X 216000 0 0 PETER HENRY MD FORMER CHIEF MEDICAL OFFICER 0.00 60.00 X 0 118625 8098 JOHN SMYLIE FORMER CHIEF OPERATING OFFICER 0.00 0.00 X 120000 0 0 TIMOTHY SAYLER FRMR CHIEF OPERATING OFFICER - WEST 0.00 0.00 X 0 116149 0 ALAN HODNIK BOARD CHAIR 3.00 0.00 X X 45000 0 0 GEORGE GOLDFARB BOARD VICE CHAIR 3.00 0.00 X X 30000 0 0 KEVIN MOUG BOARD DIRECTOR 3.00 0.00 X 30000 0 0 KIMBERLY STOKES BOARD DIRECTOR 3.00 1.00 X 30000 0 0 LAURIE LEWANDOWSKI BOARD DIRECTOR 3.00 6.00 X 24500 0 0 DAVID GADDIE BOARD DIRECTOR THRU 12/23 3.00 0.00 X 20000 0 0 DEAN AGER BOARD DIRECTOR THRU 12/23 3.00 0.00 X 20000 0 0 JAMES ANDERSON BOARD DIRECTOR THRU 12/23 3.00 0.00 X 20000 0 0 MARK RONNEI BOARD DIRECTOR 3.00 0.00 X 20000 0 0 WALTER LEINO MD BOARD DIRECTOR THRU 12/23 3.00 0.00 X 20000 0 0 SISTER BEVERLY RAWAY BOARD DIRECTOR 3.00 12.00 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 12291524 8995509 3086608 271 1 1 0 MCGOUGH CONSTRUCTION 2737 FAIRVIEW AVE N ST PAUL MN 55113 CONSTRUCTION SERVICES 74004176 AMN HEALTHCARE INC 12400 HIGH BLUFF DR STE 100 SAN DIEGO CA 92130 MEDICAL STAFFING 36262488 PHILIPS HEALTHCARE 3000 MINUTEMAN ROAD ANDOVER MA 01810 MEDICAL EQUIPMENT SUPPORT SERVICES 16420751 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 MEDICAL STAFFING 13627908 RJ RYAN CONSTRUCTION INC 1100 MENDOTA HEIGHTS RD MENDOTA HEIGHTS MN 55120 CONSTRUCTION SERVICES 11984152 293 2412 372563 5000 379975 SUPPORT REVENUE 541610 339765124 339765124 339765124 14396515 -613696 15010211 134772261 3733771 132254095 21737 2518166 3712034 6230200 6230200 SYSTEM ACCESS/USE REVENUE 541519 8573553 8573553 SETTLEMENTS 900099 523786 523786 MISCELLANEOUS 900099 5075 5075 2032 2032 9104446 369876260 339765124 7959857 21771304 5000 5000 9864513 61819 9802694 75522 75522 209886189 114242952 95643237 8146321 5179370 2966951 37091184 20708352 16382832 14702047 8144148 6557899 3917850 3917850 518188 518188 518833 518833 1178227 1178227 31035132 10458202 20576930 6793499 6093569 699930 11701625 973152 10728473 6896264 3753699 3142565 135676 73850 61826 1899758 836847 1062911 450868 293860 157008 745801 745801 1847727 1005735 841992 UNRELATED BUSINESS TAX -270622 -270622 DUES 831825 419372 412453 PUBLICATIONS & SUBSCRIP 797728 808039 -10311 FEDERAL EXCISE TAX 652470 652470 955401 335275 620126 350377026 174214564 176162462 0 4339962 1339619 59902579 118276666 10600363 16095265 7290211 7326617 49339896 13470678 5302652 35869218 33033 2280 451201985 486821935 57570317 57570317 7202430 6301014 119730053 140143671 723173585 869746602 115769932 132186930 1448996 261257 48480431 47583206 10684747 10237396 118284578 179278949 294668684 369547738 X 428504901 500198864 428504901 500198864 723173585 869746602 X 19499234 32372314 19822415 X X 0 1 X 1 1 1 X X 21 BRAINERD MEDICAL CENTER INC 371532148 3 1 3657167 0 BRIDGES MEDICAL CENTER 200479568 3 1 1313518 0 DEER RIVER HEALTHCARE CENTER INC 410844574 3 1 5206030 0 ESSENTIA HEALTH FOUNDATION 271984704 7 1 143379 0 ESSENTIA HEALTH MOOSE LAKE 845099016 3 1 4903266 0 ESSENTIA HEALTH SURGERY CENTERS 881577422 3 1 1176151 0 ESSENTIA INSTITUTE OF RURAL HEALTH 271291124 4 1 990355 0 FIRST CARE MEDICAL SERVICES 410706143 3 1 3753811 0 GRACEVILLE HEALTH CENTER 410726173 3 1 1348214 0 INNOVIS HEALTH LLC 261175213 3 1 69063428 0 NORTHERN PINES MEDICAL CENTER 410841441 3 1 2753137 0 PINE MEDICAL CENTER 411884597 3 1 2774919 0 POLINSKY MEDICAL REHABILITATION CENTER 410691275 3 1 789764 0 SMDC MEDICAL CENTER 411878730 3 1 88066993 0 ST JOSEPH'S MEDICAL CENTER 410695602 3 1 32151608 0 ST MARY'S EMS 411805811 10 1 1377635 0 ST MARY'S HOSPITAL OF SUPERIOR 411811073 3 1 12344705 0 ST MARY'S INNOVIS HEALTH 262861321 3 1 1101984 0 ST MARY'S MEDICAL CENTER 410695604 3 1 62809315 0 ST MARY'S REGIONAL HEALTH CENTER 411620386 3 1 19927118 0 THE DULUTH CLINIC LTD 410883623 3 1 34495993 0 21 350148490 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 X 1 1 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 6: SUPPORT TO OTHER ORGANIZATIONS: ESSENTIA HEALTH MADE A CONTRIBUTION TO AN UNRELATED ORGANIZATION THAT ALIGNS WITH ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS' MISSIONS. 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 HAS THE AUTHORITY TO APPOINT AND REMOVE ALL DIRECTORS, WITH OR WITHOUT CAUSE, ON THE BOARDS OF DIRECTORS OF ITS SUPPORTED ORGANIZATIONS. SCHEDULE A, PART IV, SECTION E, LINE 3B: DIRECTION OVER THE POLICIES, PROGRAMS, AND ACTIVITIES OF THE SUPPORTED ORGANIZATIONS: ESSENTIA HEALTH HAS COMPREHENSIVE AUTHORITY, AS THE PARENT OF THE SYSTEM, TO MANAGE ALL CHARITABLE ORGANIZATIONS WITHIN THE SYSTEM. THE ARTICLES OF INCORPORATION OF EACH SUPPORTED ORGANIZATION DELEGATES RESERVED POWERS TO ESSENTIA HEALTH OVER THE FOLLOWING FUNCTIONS OF THE SUPPORTED ORGANIZATION: (A) STRATEGIC AND BUSINESS PLANS; (B) MISSION; (C) DEBT ISSUANCE; (D) INITIATING AND APPROVING CHANGES TO GOVERNANCE DOCUMENTS; (E) APPOINTMENT AND REMOVAL OF DIRECTORS; (F) MERGERS, AFFILIATIONS AND DISSOLUTION; (G) TRANSFER OF ASSETS WITHIN THE SYSTEM; (H) TRANSFER OF ASSETS OUTSIDE THE SYSTEM; (I) OFFER OR DISCONTINUING ANY SERVICES OR SERVICE LOCATIONS; (J) BUDGETS; (K) SELECTION OF GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS; (L) CORPORATE ACQUISITIONS; (M) MARKETING; (N) COMPLIANCE; (O) QUALITY PLAN; (P) NON-BUDGETED PURCHASES; (Q) HUMAN RESOURCES; AND (R) SYSTEM COMPENSATION. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 0 0 1 45271 0 1 518833 564104 0 PART II-B, LINE 1: DURING FY 2024, ESSENTIA HEALTH EMPLOYED THREE FULL-TIME IN-HOUSE PUBLIC POLICY INDIVIDUALS AND CONTRACTED WITH VARIOUS CONSULTANT FIRMS TO MONITOR FEDERAL AND STATE LEGISLATIVE ACTIVITIES OF INTEREST RELATED TO HEALTH AND HUMAN SERVICES ISSUES AND RURAL HEALTH CARE. ESSENTIA HEALTH'S PUBLIC POLICY ACTIVITIES OCCUR ON THE LOCAL, STATE, AND FEDERAL LEVEL IN MINNESOTA, NORTH DAKOTA, AND WISCONSIN. 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 THE LOCAL, STATE, AND FEDERAL LEVELS. THIS ALSO INCLUDED EMPLOYEE-LED ADVOCACY EFFORTS THROUGH OUR ESSENTIA HEALTH ADVOCACY NETWORK. THE PRIMARY ISSUES OF INTEREST AND CONCERN INCLUDE: VALUE-BASED CARE 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 PRIOR AUTHORIZATION REFORM 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 15438 1512 15304801 13455240 1849561 34018145 34018145 35869218 POOLED INVESTMENT FUNDS 480219165 F BOND CONSTRUCTION FUND 6602770 F 486821935 INVESTMENT IN BENEDICTINE HEALTH SYSTEM 53227022 C INVESTMENT IN ST FRANCIS REGIONAL MEDICAL CENTER 4343295 C 57570317 DEFERRED COMPENSATION FUND 133441949 REINSURANCE RECEIVABLE 3504710 RECEIVABLES FROM RELATED ORGS 3121262 DEFERRED TAX ASSET 2467488 DEFERRED TAX ALLOWANCE -2391738 140143671 BENEFIT PLAN LIABILITY 133441949 PAYABLES TO RELATED ORGS 45807463 UNCLAIMED PROPERTY 29537 179278949 CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 187572058 CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 PROGRAM SERVICES SELF INDEMNITY 17706194 NORTH AMERICA 0 0 SEND AGENTS TO SEMINAR 2113 0 0 0 0 0 0 205280365 0 205280365 1 0 1 1 1 0 X X 1 1 X X X X 1 1 0 0 0 0 0 0 1 1 DAVID HERMAN MD CHIEF EXECUTIVE OFFICER 1695888 0 1026207 0 323855 0 358867 0 3126 0 3407943 0 309577 0 JODI MANSFIELD EXECUTIVE VICE PRESIDENT, COO 1024301 0 226802 0 198978 0 180129 0 1568 0 1631778 0 136882 0 LLOYD KETCHUM MD BD DIRECTOR/REL ORG PHYS & DIV CHAIR 0 1183975 0 0 0 4793 0 26400 0 41863 0 1257031 0 0 BRADLEY BEARD CHIEF OPERATING OFFICER - EAST 0 623960 0 141083 0 308924 0 117040 0 42374 0 1233381 0 282744 WILLIAM HEEGAARD MD PRES-EAST THRU 4/24/FRMR PRES-WEST 0 692531 0 175228 0 11485 0 140520 0 42358 0 1062122 0 0 TRACI MORRIS CHIEF FINANCIAL OFFICER/TREASURER 669563 0 146723 0 83904 0 123590 0 2262 0 1026042 0 63527 0 KARYN BAUM MD CHIEF TRANSFORMATION OFF THRU 1/24 671183 0 151870 0 4002 0 122994 0 28038 0 978087 0 0 0 KEVIN CASEY MD CHIEF MEDICAL OFFICER THRU 10/23 544746 0 151370 0 132710 0 111701 0 30016 0 970543 0 0 0 DANIEL NIKCEVICH MD FORMER PRESIDENT - EAST 0 782526 0 0 0 56422 0 22699 0 37531 0 899178 0 47365 RICHARD VETTER MD INTERIM PRES-WEST THRU 8/23/CMO-WEST 0 557980 0 104855 0 63137 0 90376 0 41172 0 857520 0 44511 AL HURLEY CHIEF OPERATING OFFICER - WEST 0 437036 0 98285 0 205738 0 85036 0 26176 0 852271 0 184950 DIANE DAVIDSON CHIEF HUMAN RESOURCES OFF THRU 4/24 505512 0 111333 0 68959 0 101036 0 33366 0 820206 0 54770 0 ROBERT GREEN SNR VICE PRES, FINANCIAL OPERATIONS 528350 0 105198 0 11484 0 100969 0 39078 0 785079 0 0 0 CHARLES WATSON CHIEF INFORMATION OFFICER 520804 0 117295 0 7527 0 99948 0 34125 0 779699 0 0 0 MICHAEL WATTERS CHIEF LEGAL OFFICER/SECRETARY 489927 0 111318 0 44753 0 93066 0 39589 0 778653 0 28999 0 ANNE STEPHEN MD CHIEF MEDICAL OFF - EAST THRU 5/24 0 471933 0 107579 0 65335 0 92380 0 32304 0 769531 0 52101 RHONDA KAZIK CHIEF NURSE EXECUTIVE 0 450726 0 97962 0 6868 0 88083 0 27784 0 671423 0 0 MELANIE WILSON SENIOR VICE PRES, REVENUE SERVICES 437809 0 99001 0 2334 0 86067 0 37303 0 662514 0 0 0 SARAH MANNEY KURTH MD CHIEF MEDICAL INFORMATION OFFICER 393596 0 90001 0 23811 0 79444 0 41182 0 628034 0 0 0 JON PRYOR MD PRESIDENT - EAST THRU 1/23 0 107717 0 120323 0 363315 0 7713 0 2068 0 601136 0 0 STEFANIE GEFROH ELLISON MD BD DIRECT/REL ORG INTERIM CMO & PHYS 0 484549 0 0 0 4450 0 26400 0 42280 0 557679 0 0 KRISTA SKORUPA MD PRESIDENT - EAST 0 389189 0 78395 0 1855 0 70901 0 15301 0 555641 0 0 GRATIA PITCHER MD CHIEF MEDICAL OFFICER 445417 0 0 0 27231 0 33631 0 25044 0 531323 0 0 0 JANE RUDD MD BD DIRECTOR/REL ORG PHYS & DIV CHAIR 20000 302823 0 0 0 1365 0 25200 0 39483 20000 368871 0 0 MARK THOMPSON MD PRESIDENT - WEST 0 184312 0 50000 0 24081 0 37334 0 10137 0 305864 0 0 FRANK MODICH FORMER INTERIM CHIEF LEGAL OFFICER 241598 0 18155 0 354 0 12436 0 14084 0 286627 0 0 0 SHEILA HART SNR VP-INT CARE DELIVERY THRU 3/23 80001 0 67596 0 74558 0 8069 0 6869 0 237093 0 39691 0 ROBERT NORMAN FORMER CHIEF FINANCIAL OFFICER 0 0 0 0 216000 0 0 0 0 0 216000 0 0 0 PETER HENRY MD FORMER CHIEF MEDICAL OFFICER 0 98223 0 0 0 20402 0 7876 0 222 0 126723 0 20402 JOHN SMYLIE FORMER CHIEF OPERATING OFFICER 0 0 0 0 120000 0 0 0 0 0 120000 0 0 0 TIMOTHY SAYLER FRMR CHIEF OPERATING OFFICER - WEST 0 0 0 0 0 116149 0 0 0 0 0 116149 0 0 PART I, LINE 1A BENEFITS PROVIDED: DURING CALENDAR YEAR 2023, CHARTER TRAVEL WAS USED BY TWO OFFICERS, ONE KEY EMPLOYEE, AND ONE FORMER KEY EMPLOYEE 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 2023, KEY EMPLOYEE JODI MANSFIELD RECEIVED A HOUSING ALLOWANCE. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION. PART I, LINES 4A-B KEY EMPLOYEE KEVIN CASEY, MD RECEIVED PAYMENTS TOTALING $129,325 IN CALENDAR YEAR 2023 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, CASEY WILL RECEIVE PAY TOTALING $1,029,319 & BENEFITS TOTALING $33,928 FROM OCTOBER 9, 2023 TO APRIL 8, 2025. ALL OTHER INDIVIDUALS LISTED AS FORMERS IN FORM 990, PART VII, SECTION A, LINE 1A DID NOT RECEIVE A SEVERANCE PAYMENT DURING CALENDAR YEAR 2023. SOME OF THESE INDIVIDUALS REMAIN EMPLOYED WITHIN ESSENTIA HEALTH AND ITS SUBSIDIARIES. 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 $309,577 JODI MANSFIELD $136,882 BRADLEY BEARD $297,439 TRACI MORRIS $79,902 DANIEL NIKCEVICH, MD $50,786 RICHARD VETTER, MD $52,278 AL HURLEY $195,546 DIANE DAVIDSON $54,770 MICHAEL WATTERS $33,314 ANNE STEPHEN, MD $54,159 JON PRYOR, MD $361,146 SHEILA HART $39,691 PETER HENRY, MD $20,402 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 $332,467 JODI MANSFIELD $153,729 BRADLEY BEARD $90,640 WILLIAM HEEGAARD, MD $103,603 TRACI MORRIS $97,190 KARYN BAUM, MD $96,594 KEVIN CASEY, MD $85,301 RICHARD VETTER, MD $63,976 AL HURLEY $59,141 DIANE DAVIDSON $74,636 ROBERT GREEN $74,569 CHARLES WATSON $73,548 MICHAEL WATTERS $68,732 ANNE STEPHEN, MD $65,980 RHONDA KAZIK $61,683 MELANIE WILSON $59,667 SARAH MANNEY KURTH, MD $53,044 KRISTA SKORUPA, MD $44,501 GRATIA PITCHER, MD $7,680 MARK THOMPSON, MD $37,334 PART I, LINE 8 INITIAL CONTRACT EXCEPTION: ESSENTIA HEALTH'S CHIEF MEDICAL OFFICER, GRATIA PITCHER, MD, RECEIVED COMPENSATION DURING THE YEAR UNDER AN INITIAL EMPLOYMENT AGREEMENT SUBJECT TO THE INITIAL CONTRACT EXCEPTION. THROUGH THE ESSENTIA HEALTH EXECUTIVE COMPENSATION COMMITTEE, THIS COMPENSATION ARRANGEMENT WAS REVIEWED AND APPROVED BY INDEPENDENT PERSONS USING COMPARABILITY DATA; DELIBERATIONS AND DECISIONS WERE DOCUMENTED. 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 2023 1 0 1 1 B 3985800 14300 3971500 2020 1 0 1 1 C 851175 7800 843375 2020 1 0 1 1 D 3598400 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 1 1 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: 06/30/2023 ISSUER NAME: MN AGRICULTURAL AND ECONOMIC DEVELOPMENT BRD DATE THE REBATE COMPUTATION WAS PERFORMED: 06/30/2024 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, 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, 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. SERIES 2023C: THE SERIES 2023C BONDS ARE SECURED BY NOTES ISSUED UNDER THE MASTER TRUST INDENTURE. THE OBLIGATED GROUP MEMBERS: ESSENTIA HEALTH AND ESSENTIA HEALTH ST. JOSEPH'S MEDICAL CENTER ARE THE CONDUIT BORROWERS OF THE SERIES 2023C BONDS. THE CONDUIT BORROWERS ESSENTIA HEALTH 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. 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. SERIES 2023C: ACQUIRE, CONSTRUCT, RENOVATE, AND EQUIP CERTAIN HEALTH FACILITIES IN ESKO AND STAPLES, MN. SCHEDULE K, PART II, LINE 3: ISSUE PRICE: THE SERIES 2018A, 2020A, 2020B, 2020C, AND 2023C 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. IN ADDITION, THE SERIES 2023C TOTAL PROCEEDS ARE NOT IDENTICAL TO THE ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. SCHEDULE K, PART II, LINES 3 THROUGH 12: PROCEEDS: THE SERIES 2018A, 2020A, 2020B, 2020C, AND 2023C BONDS WERE ISSUED BY THE ESSENTIA HEALTH OBLIGATED GROUP. A PORTION OF THE SERIES 2018A, 2020A, 2020B, 2020C, AND 2023C 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 A MN AGRICULTURAL AND ECONOMIC DEVELOPMENT BRD 416007162 000000000 2023-06-22 44585000 SERIES 2023C (SEE PART VI) 0 0 0 A 36366724 222523 29541431 6602770 0 0 0 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 KATHERINE NIKCEVICH RELATED TO DANIEL NIKCEVICH, MD 75522 COMPENSATION OF FAMILY MEMBER OF FORMER KEY EMPLOYEE 0 FORM 990, PART V, LINE 1A: 1099 REPORTING: VENDOR PAYMENTS AND FORM 1099S WERE PROCESSED THROUGH ESSENTIA HEALTH ON BEHALF OF THE LEGAL ENTITIES COMPRISING ESSENTIA HEALTH. FORM 990, PART V, LINE 1C: NO GAMING (GAMBLING) WINNINGS. FORM 990, PART VI, SECTION A, LINE 7A MEMBER WITH RIGHT TO ELECT GOVERNING BODY: THE PRIORESS OF THE BENEDICTINE SISTERS OF ST. SCHOLASTICA MONASTERY OF DULUTH OR ITS CANONICALLY AUTHORIZED SUCCESSOR (COLLECTIVELY, "SSMD") (OR HER DESIGNEE WHO SHALL BE A BENEDICTINE SISTER OF SSMD) SHALL SERVE AS A DIRECTOR FOR SO LONG AS SHE HOLDS SUCH OFFICE (OR DESIGNATION). FORM 990, PART VI, SECTION A, LINE 7B MEMBER WITH RIGHT TO APPROVE GOVERNING BODY DECISIONS: THE BENEDICTINE SISTERS OF ST. SCHOLASTICA MONASTERY OF DULUTH OR ITS CANONICALLY AUTHORIZED SUCCESSOR (COLLECTIVELY, "SSMD") HOLD CERTAIN RESERVED POWERS OVER ESSENTIA HEALTH AND ITS CATHOLIC ENTITIES ("SSMD SPONSORED ENTITY"). SSMD HAS THE RESERVED POWER TO APPROVE ANY AMENDMENTS TO ESSENTIA HEALTH'S GOVERNING DOCUMENTS THAT WOULD ALTER THE NUMBER OF SSMD REPRESENTATIVES SERVING ON THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE 2023 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 2023 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. THIS PROCESS WAS LAST UNDERTAKEN IN 2024 FOR ESSENTIA HEALTH'S CHIEF EXECUTIVE OFFICER, EXECUTIVE VICE PRESIDENT, COO, CHIEF FINANCIAL OFFICER, CHIEF HUMAN RESOURCE OFFICER, CHIEF LEGAL OFFICER, CHIEF NURSE EXECUTIVE, AND CHIEF MEDICAL OFFICER; ESSENTIA HEALTH EAST'S CHIEF OPERATING OFFICER, CHIEF MEDICAL OFFICER, AND PRESIDENT; AND ESSENTIA HEALTH WEST'S CHIEF MEDICAL OFFICER, CHIEF OPERATING OFFICER, AND PRESIDENT. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, & FINANCIAL STATEMENTS TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART XI, LINE 9: EHIS DIVIDEND 20,000,000. NET ASSET TRANSFERS WITH RELATED ORGS -177,585. FORM 990, PART XII, LINE 3: CONSOLIDATED UNIFORM GUIDANCE AUDIT: ESSENTIA HEALTH, AS PART OF ESSENTIA HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS, WAS REQUIRED AND UNDERWENT A CONSOLIDATED AUDIT SET FORTH IN THE UNIFORM GUIDANCE, 2 C.F.R. PART 200, SUBPART F. 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 ESSENTIA HEALTH 1 BRIDGES MEDICAL CENTER 201 9TH ST W ADA MN 56510 200479568 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 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 ESSENTIA HEALTH 1 ESSENTIA HEALTH SURGERY CENTERS 502 E 2ND ST DULUTH MN 55805 881577422 SURGERY CENTER MN 501(C)(3) LINE 3 ESSENTIA HEALTH 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 ESSENTIA HEALTH 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 502 E 2ND 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 ESSENTIA HEALTH 1 PINE MEDICAL CENTER 705 LUNDORFF DR S SANDSTONE MN 55072 411884597 HOSPITAL MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 POLINSKY MEDICAL REHABILITATION CENTER 530 E 2ND ST DULUTH MN 55805 410691275 REHABILITATION SERVICES MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 SMDC MEDICAL CENTER 502 E 2ND ST DULUTH MN 55805 411878730 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST JOSEPH'S MEDICAL CENTER 523 N 3RD ST BRAINERD MN 56401 410695602 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 502 E 2ND 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 ESSENTIA HEALTH 1 ST MARY'S HOSPITAL OF SUPERIOR 3500 TOWER AVE SUPERIOR WI 54880 411811073 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST MARY'S INNOVIS HEALTH 1027 WASHINGTON AVE DETROIT LAKES MN 56501 262861321 PHARMACY MN 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ST MARY'S MEDICAL CENTER 402 E 2ND ST DULUTH MN 55805 410695604 HOSPITAL MN 501(C)(3) LINE 3 ESSENTIA HEALTH 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 ESSENTIA HEALTH 1 THE DULUTH CLINIC LTD 400 E 3RD ST DULUTH MN 55805 410883623 CLINIC DE 501(C)(3) LINE 3 ESSENTIA HEALTH 1 ESSENTIA HEALTH INSURANCE SERVICES SPC LTD PO BOX 1159 GRAND CAYMAN CJ K71-1102 000000000 SELF INSURANCE CJ ESSENTIA HEALTH C 24547821 50911142 1.00000 1 MID DAKOTA CLINIC INC 502 E 2ND ST DULUTH MN 55805 450311334 CLINIC OPERATIONS CEASED 9/30/22 ND N/A C 1 0 0 1 1 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 BRAINERD MEDICAL CENTER INC L 2667315 ACTUAL COSTS BRAINERD MEDICAL CENTER INC Q 898000 ACTUAL COSTS BRIDGES MEDICAL CENTER L 1156018 ACTUAL COSTS BRIDGES MEDICAL CENTER Q 721722 ACTUAL COSTS DEER RIVER HEALTHCARE CENTER INC L 4904544 ACTUAL COSTS DEER RIVER HEALTHCARE CENTER INC Q 2133043 ACTUAL COSTS DEER RIVER HEALTHCARE CENTER INC R 11600000 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION Q 231491 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION S 1750000 ACTUAL COSTS ESSENTIA HEALTH INSURANCE SERVICES SPC F 20000000 ACTUAL COSTS ESSENTIA HEALTH 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MARY'S REGIONAL HEALTH CENTER R 59250000 ACTUAL COSTS THE DULUTH CLINIC LTD D 151363 ACTUAL COSTS THE DULUTH CLINIC LTD L 22966346 ACTUAL COSTS THE DULUTH CLINIC LTD Q 6045658 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