2022-05-09T17:27:48-05:00 2021-06-30 420714325 RSM US LLP 227 W 1ST ST STE 700 DULUTH MN 558021926 990 2020-07-01 200360007 ESSENTIA HEALTH ESSE 2187868376 502 E 2ND ST DULUTH MN 55805 TRACI MORRIS CHIEF FINANCIAL OFFICER 2187868376 2022-05-09 1 TRACI MORRIS 999009999 JULIE BOYER P01278549 2187275025 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z DAVID HERMAN MD 502 E 2ND ST DULUTH MN 55805 838675796 0 X WWW.ESSENTIAHEALTH.ORG X 2003 MN WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 16 13 2027 0 2886764 713281 397700 2442953 200055453 201958094 14850803 21870185 3764177 6383316 219068133 232654548 3350 0 0 0 160284048 156833921 0 0 0 44608567 55151852 204895965 211985773 14172168 20668775 549423564 613077249 334218110 284681870 215205454 328395379 X WE ARE CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. 0 0 82503309 201958094 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, 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, 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 OVER 14,000 EMPLOYEES, INCLUDING MORE THAN 2,000 PHYSICIANS AND ADVANCED PRACTITIONERS, WHO SERVE ITS PATIENTS AND COMMUNITIES THROUGH THE MISSION OF BEING CALLED TO MAKE A HEALTHY DIFFERENCE IN PEOPLE'S LIVES. ESSENTIA HEALTH, WHICH INCLUDES MANY CATHOLIC FACILITIES, IS GUIDED BY THE VALUES OF QUALITY, HOSPITALITY, RESPECT, JOY, JUSTICE, STEWARDSHIP AND TEAMWORK. THE ORGANIZATION LIVES OUT ITS MISSION BY HAVING PATIENT-CENTERED FOCUS AT 14 HOSPITALS, APPROXIMATELY 70 CLINICS, SIX LONG-TERM CARE FACILITIES, THREE ASSISTED LIVING FACILITIES, THREE INDEPENDENT LIVING FACILITIES, SIX AMBULANCE SERVICES, 20 RETAIL PHARMACIES, AND ONE RESEARCH INSTITUTE. ESSENTIA HEALTH PROVIDES SERVICES PREDOMINANTLY IN RURAL COMMUNITIES AND IS COMMITTED TO ELIMINATING GEOGRAPHIC BARRIERS TO CARE. MANY OF ESSENTIA HEALTH'S HOSPITALS AND CLINICS ARE LOCATED IN COMMUNITIES THAT ARE FEDERALLY RECOGNIZED AS BEING MEDICALLY UNDERSERVED.ESSENTIA HEALTH IS ACCREDITED AS AN ACCOUNTABLE CARE ORGANIZATION BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE. THE LEGAL ENTITIES COMPRISING ESSENTIA HEALTH FILE SEPARATE FORM 990'S.AT FISCAL YEAR ENDED JUNE 30, 2021, ESSENTIA HEALTH'S CONSOLIDATED TOTAL REVENUE WAS $2,452,310,000 AND CONSOLIDATED INCOME FROM OPERATIONS WAS $168,258,000.ESSENTIA HEALTH'S HOSPITALS HAVE A TOTAL OF 1,221 LICENSED BEDS WHICH PROVIDED OVER 192,000 HOSPITAL PATIENT DAYS AND OVER 832,000 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED JUNE 30, 2021. THE CLINICS HAD OVER 1.6 MILLION ENCOUNTERS DURING THE SAME TIME PERIOD.DURING THE FISCAL YEAR ENDED JUNE 30, 2021, ESSENTIA HEALTH PROVIDED TOTAL COMMUNITY BENEFITS OF OVER $134 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. 82503309 1 0 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 701 0 1 2027 1 1 1 1 CJ 0 0 0 0 0 0 0 0 1 0 X 16 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 3333333 0 276875 JODI MANSFIELD EXECUTIVE VICE PRESIDENT, COO 60.00 0.00 X 1431098 0 146196 GREGORY GLASNER MD FORMER PRESIDENT - WEST 0.00 0.00 X 0 1068895 50879 JON PRYOR MD PRESIDENT - EAST & CENTRAL 1.00 59.00 X 0 1017145 33915 DEBORAH WELLE-POWELL CHIEF POPULATION HEALTH OFFICER 60.00 0.00 X 854631 0 86864 TRACI MORRIS CHIEF FINANCIAL OFFICER 60.00 0.00 X 829492 0 97388 PETER HENRY MD CHIEF MEDICAL OFFICER 1.00 59.00 X 808979 0 112833 BRADLEY BEARD CHIEF OPERATING OFFICER - EAST 1.00 59.00 X 0 791165 129415 DANIEL NIKCEVICH MD FORMER PRESIDENT - EAST 0.00 60.00 X 0 801821 59982 RICHARD VETTER MD INTERIM PRES THRU 4/20/CMO - WEST 1.00 59.00 X 0 680304 101735 DIANE DAVIDSON CHIEF HUMAN RESOURCE OFFICER 60.00 0.00 X 664176 0 101805 ANNE STEPHEN MD CHIEF MEDICAL OFFICER - EAST 1.00 59.00 X 0 635986 101367 MICHAEL WATTERS CHIEF LEGAL OFFICER 60.00 0.00 X 592392 0 125275 MARK HAYWARD FORMER SENIOR VP, OPERATIONS 0.00 60.00 X 0 588967 47648 AL HURLEY CHIEF OPERATING OFFICER - WEST 1.00 59.00 X 0 535880 81225 SHEILA HART SENIOR VP-INTEGRATED CARE DELIVERY 60.00 0.00 X 522367 0 86739 STEFANIE GEFROH ELLISON MD BOARD DIRECTOR 3.00 57.00 X 15000 525293 56104 PATRICK TWOMEY MD FORMER CHIEF MEDICAL OFFICER 0.00 60.00 X 0 528681 59635 CHARLES WATSON CHIEF INFORMATION OFFICER 60.00 0.00 X 495085 0 89970 ADAM REES PRESIDENT - CENTRAL THRU 4/20 1.00 59.00 X 0 506261 39361 WILLIAM HEEGAARD MD PRESIDENT - WEST 1.00 59.00 X 2165 504962 22397 DENNIS DASSENKO CHIEF INFORMATION OFFICER THRU 3/20 60.00 0.00 X 494956 0 31041 SARAH MANNEY KURTH MD CHIEF MEDICAL INFORMATION OFFICER 60.00 0.00 X 311135 85444 66058 MELANIE WILSON VICE PRESIDENT, REVENUE SERVICES 60.00 0.00 X 392523 0 47409 MICHAEL VAN SCOY MD PHYSICIAN 60.00 0.00 X 378214 0 56559 RAJESH PRABHU MD PHYSICIAN - SECTION CHAIR 60.00 0.00 X 349072 0 34136 JANE RUDD MD BOARD DIRECTOR 3.00 57.00 X 15000 289263 60756 TIMOTHY SAYLER FORMER CHIEF OPERATING OFFICER-WEST 0.00 0.00 X 0 335171 16256 PATRICIA DELONG CHIEF NURSING OFF-CENTRAL THRU 8/20 1.00 59.00 X 0 261420 21174 FRANK MODICH FORMER INTERIM CHIEF LEGAL OFFICER 60.00 0.00 X 251095 0 21525 THOMAS RUSS MD BOARD DIRECTOR 3.00 57.00 X 22500 171465 10288 JEFFREY KORSMO FORMER EVP, OPERATIONS & ADMIN 0.00 0.00 X 156580 0 0 DAVID GADDIE BOARD CHAIR 3.00 0.00 X X 45000 0 0 KEVIN MOUG BOARD DIRECTOR 3.00 0.00 X 33375 0 0 JAMES ANDERSON BOARD DIRECTOR 3.00 6.00 X 33250 0 0 DEAN AGER BOARD DIRECTOR 3.00 2.00 X 30000 0 0 LAURIE LEWANDOWSKI BOARD DIRECTOR 3.00 2.00 X 27125 0 0 CHARLES ALBRECHT BOARD DIRECTOR THRU 12/20 3.00 2.00 X 21500 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 0.00 X 20000 0 0 WALTER LEINO MD BOARD DIRECTOR 3.00 2.00 X 20000 0 0 MARK RONNEI BOARD DIRECTOR 3.00 6.00 X 1500 0 0 SISTER BEVERLY RAWAY BOARD DIRECTOR 3.00 4.00 X 0 0 0 SISTER CLARE MARIE TRETTEL BOARD DIRECTOR 3.00 2.00 X 0 0 0 SISTER KATHLEEN HOFER BOARD DIRECTOR 3.00 0.00 X 0 0 0 12191543 9328123 2272810 145 1 1 0 MAYO COLLABORATIVE SERVICES PO BOX 4100 ROCHESTER MN 55903 LAB SERVICES 14829181 CONSTRUCTION ENGINEERS INC 200 NORTH 69TH STREET GRAND FORKS ND 58203 CONSTRUCTION SERVICES 7579037 EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 53593 MEDICAL BILLING SOFTWARE SUPPORT SERVICE 7470006 OLAF ANDERSON CONSTRUCTION PO BOX 2766 FARGO ND 58108 CONSTRUCTION SERVICES 7335115 PHILIPS HEALTHCARE PO BOX 100355 ATLANTA GA 30384 MEDICAL EQUIPMENT SUPPORT SERVICES 5518317 179 2442953 2442953 SUPPORT REVENUE 541610 201958094 201958094 201958094 4606473 591 4605882 623284960 605879627 141621 17405333 -141621 17263712 17263712 SYSTEM ACCESS/USE REVENUE 541519 5334116 2875702 2458414 INSURANCE CLAIMS 900099 1000000 1000000 SETTLEMENTS 900099 33072 33072 16128 10471 5657 6383316 232654548 201958094 2886764 25366737 X 10603926 1570416 9033510 115361876 52400876 62961000 5279509 2473677 2805832 20586788 9092899 11493889 5001822 2292066 2709756 7101785 7101785 429605 429605 529101 529101 1018312 1018312 24621385 6173260 18448125 5344131 4084575 1259556 7520603 230465 7290138 3372936 1532090 1840846 214174 97284 116890 277805 133000 144805 171529 73194 98335 1334450 1334450 1262162 573312 688850 UNRELATED BUSINESS TAX 94703 94703 DUES 657455 142974 514481 FEDERAL EXCISE TAX 586090 586090 PUBLICATIONS AND SUBSCR 175823 145278 30545 439803 153493 286310 211985773 82503309 129482464 0 6639384 6647549 147290731 52189969 11062062 11244383 5467244 7041357 8126185 6144215 3619537 1981970 47721 0 221046398 355702716 53227022 53227022 5725000 7107232 95298465 117935051 549423564 613077249 122432533 143488836 2479287 449161 16105045 15216400 101736654 11282470 91464591 114245003 334218110 284681870 X 215205454 328395379 215205454 328395379 549423564 613077249 X 20668775 24116803 68404347 X X 0 1 X 1 1 1 X X 4 INNOVIS HEALTH LLC 261175213 3 1 55255423 0 4 55255423 0 1 1 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: 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), AND ST. MARY'S DULUTH CLINIC HEALTH SYSTEM (EIN: 41-1836633). ESSENTIA HEALTH PROVIDED MONETARY SUPPORT IN THE AMOUNTS OF $23,594,583 TO BRAINERD LAKES INTEGRATED HEALTH SYSTEM, $0 TO CRITICAL ACCESS GROUP, $133,135,767 TO ST. MARY'S DULUTH CLINIC HEALTH SYSTEM, AND $55,255,423 TO INNOVIS HEALTH, LLC (AS SHOWN ON LINE 12G) FOR AN OVERALL TOTAL OF $211,985,773 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: THREE OF ESSENTIA HEALTH'S SUPPORTED ORGANIZATIONS (BRAINERD LAKES INTEGRATED HEALTH SYSTEM, CRITICAL ACCESS GROUP, AND ST. MARY'S DULUTH CLINIC HEALTH SYSTEM) ARE TYPE II SUPPORTING ORGANIZATIONS UNDER IRC SECTION 509(A)(3). BRAINERD LAKES INTEGRATED HEALTH SYSTEM, CRITICAL ACCESS GROUP, AND ST. MARY'S DULUTH CLINIC HEALTH SYSTEM SUPPORT TAX-EXEMPT ORGANIZATIONS ORGANIZED UNDER IRC SECTION 509(A)(1) OR 509(A)(2). SCHEDULE A, PART IV, SECTION A, LINE 6: SUPPORT TO OTHER ORGANIZATIONS: ESSENTIA HEALTH 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. 0 1 0 1 0 0 1 121906 0 1 523101 645007 0 PART II-B, LINE 1: ESSENTIA HEALTH EMPLOYS ONE FULL-TIME IN-HOUSE PUBLIC POLICY INDIVIDUAL AND DURING 2021 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 2021 "DULUTH & ST. LOUIS COUNTY AT THE CAPITAL DAYS" EVENT. WHILE ESSENTIA HEALTH PLANNED TO MEET FACE-TO-FACE WITH MINNESOTA LEGISLATORS TO DISCUSS ISSUES AFFECTING OUR COMMUNITIES AND HEALTHCARE, THE EVENT WAS HELD VIRTUALLY DUE TO COVID-19. 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. 10880 7193 3687 8115305 6137022 1978283 1981970 528865 F POOLED INVESTMENT FUNDS 355173851 F 355702716 INVESTMENT IN BENEDICTINE HEALTH SYSTEM 53227022 C 53227022 DEFERRED DEBT FINANCING COSTS - LINE OF CREDIT 59931 DEFERRED COMPENSATION FUND 113680063 REINSURANCE RECEIVABLE 3162478 DEFERRED TAX ASSET 1580222 DEFERRED TAX ALLOWANCE -582659 OPERATING LEASE ASSET 35016 117935051 SWAP LIABILITY 420534 BENEFIT PLAN LIABILITY 113680063 UNCLAIMED PROPERTY 113890 OPERATING LEASES 30516 114245003 CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 154696643 CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 PROGRAM SERVICES SELF INDEMNITY 18073503 0 0 0 0 0 0 172770146 0 172770146 1 0 1 1 0 0 PART III ACCOUNTING METHOD: X X 1 1 X X X X 1 1 0 0 0 0 0 0 1 1 DAVID HERMAN MD CHIEF EXECUTIVE OFFICER 1381185 0 894842 0 1057306 0 272692 0 4183 0 3610208 0 854084 0 JODI MANSFIELD EXECUTIVE VICE PRESIDENT, COO 891815 0 354482 0 184801 0 143844 0 2352 0 1577294 0 115602 0 GREGORY GLASNER MD FORMER PRESIDENT - WEST 0 85991 0 98232 0 884672 0 24882 0 25997 0 1119774 0 224829 JON PRYOR MD PRESIDENT - EAST & CENTRAL 0 733769 0 271892 0 11484 0 20340 0 13575 0 1051060 0 0 DEBORAH WELLE-POWELL CHIEF POPULATION HEALTH OFFICER 449452 0 180577 0 224602 0 73079 0 13785 0 941495 0 185514 0 TRACI MORRIS CHIEF FINANCIAL OFFICER 586581 0 232679 0 10232 0 94280 0 3108 0 926880 0 5714 0 PETER HENRY MD CHIEF MEDICAL OFFICER 515481 0 210600 0 82898 0 85296 0 27537 0 921812 0 56831 0 BRADLEY BEARD CHIEF OPERATING OFFICER - EAST 0 553975 0 225586 0 11604 0 91394 0 38021 0 920580 0 0 DANIEL NIKCEVICH MD FORMER PRESIDENT - EAST 0 677509 0 0 0 124312 0 24024 0 35958 0 861803 0 87496 RICHARD VETTER MD INTERIM PRES THRU 4/20/CMO - WEST 0 501301 0 171875 0 7128 0 69608 0 32127 0 782039 0 0 DIANE DAVIDSON CHIEF HUMAN RESOURCE OFFICER 428354 0 176213 0 59609 0 71304 0 30501 0 765981 0 46635 0 ANNE STEPHEN MD CHIEF MEDICAL OFFICER - EAST 0 426386 0 175320 0 34280 0 70940 0 30427 0 737353 0 18214 MICHAEL WATTERS CHIEF LEGAL OFFICER 435609 0 148699 0 8084 0 88390 0 36885 0 717667 0 0 0 MARK HAYWARD FORMER SENIOR VP, OPERATIONS 0 114915 0 125401 0 348651 0 14674 0 32974 0 636615 0 121271 AL HURLEY CHIEF OPERATING OFFICER - WEST 0 378133 0 149139 0 8608 0 60686 0 20539 0 617105 0 0 SHEILA HART SENIOR VP-INTEGRATED CARE DELIVERY 335747 0 139004 0 47616 0 56563 0 30176 0 609106 0 32235 0 STEFANIE GEFROH ELLISON MD BOARD DIRECTOR 15000 524681 0 0 0 612 0 22746 0 33358 15000 581397 0 0 PATRICK TWOMEY MD FORMER CHIEF MEDICAL OFFICER 0 490684 0 0 0 37997 0 22800 0 36835 0 588316 0 26745 CHARLES WATSON CHIEF INFORMATION OFFICER 370998 0 95589 0 28498 0 64148 0 25822 0 585055 0 0 0 ADAM REES PRESIDENT - CENTRAL THRU 4/20 0 101861 0 0 0 404400 0 13928 0 25433 0 545622 0 133971 WILLIAM HEEGAARD MD PRESIDENT - WEST 2165 424904 0 53655 0 26403 0 0 0 22397 2165 527359 0 0 DENNIS DASSENKO CHIEF INFORMATION OFFICER THRU 3/20 137823 0 165555 0 191578 0 23385 0 7656 0 525997 0 47319 0 SARAH MANNEY KURTH MD CHIEF MEDICAL INFORMATION OFFICER 262989 85308 46868 0 1278 136 21031 7075 27886 10066 360052 102585 0 0 MELANIE WILSON VICE PRESIDENT, REVENUE SERVICES 348249 0 43974 0 300 0 14250 0 33159 0 439932 0 0 0 MICHAEL VAN SCOY MD PHYSICIAN 376460 0 0 0 1754 0 22800 0 33759 0 434773 0 0 0 RAJESH PRABHU MD PHYSICIAN - SECTION CHAIR 348430 0 0 0 642 0 21667 0 12469 0 383208 0 0 0 JANE RUDD MD BOARD DIRECTOR 15000 287922 0 0 0 1341 0 22800 0 37956 15000 350019 0 0 TIMOTHY SAYLER FORMER CHIEF OPERATING OFFICER-WEST 0 0 0 0 0 335171 0 0 0 16256 0 351427 0 0 PATRICIA DELONG CHIEF NURSING OFF-CENTRAL THRU 8/20 0 169876 0 33362 0 58182 0 10761 0 10413 0 282594 0 0 FRANK MODICH FORMER INTERIM CHIEF LEGAL OFFICER 221129 0 29759 0 207 0 11618 0 9907 0 272620 0 0 0 THOMAS RUSS MD BOARD DIRECTOR 22500 171465 0 0 0 0 0 10288 0 0 22500 181753 0 0 JEFFREY KORSMO FORMER EVP, OPERATIONS & ADMIN 0 0 0 0 156580 0 0 0 0 0 156580 0 0 0 PART I, LINE 1A BENEFITS PROVIDED: DURING CALENDAR YEAR 2020, CHARTER TRAVEL WAS USED BY ONE OFFICER AND ONE KEY EMPLOYEE FOR TRAVEL BETWEEN ESSENTIA HEALTH'S OFFICE IN DULUTH, MN 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 2020, KEY EMPLOYEE JODI MANSFIELD AND HIGHEST-COMPENSATED EMPLOYEE CHARLES WATSON RECEIVED HOUSING ALLOWANCES. THESE BENEFITS WERE TREATED AS TAXABLE COMPENSATION TO BOTH INDIVIDUALS. PART I, LINES 4A-B SEVERANCE PAYMENT: FORMER KEY EMPLOYEE GREGORY GLASNER, MD RECEIVED PAYMENT TOTALING $502,073 IN CALENDAR YEAR 2020 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 MARK HAYWARD RECEIVED PAYMENT TOTALING $213,503 IN CALENDAR YEAR 2020 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. KEY EMPLOYEE ADAM REES RECEIVED PAYMENT TOTALING $255,274 IN CALENDAR YEAR 2020 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 TIMOTHY SAYLER RECEIVED PAYMENT TOTALING $335,171 IN CALENDAR YEAR 2020 RELATED TO HIS TERMINATION. THE TERMINATION TERMS ARE FROM APRIL 15, 2019 TO OCTOBER 14, 2020. MR. SAYLER WILL RECEIVE PAY TOTALING $630,396 & BENEFITS TOTALING $30,477 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 2020. 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 $1,045,702 JODI MANSFIELD $117,642 GREGORY GLASNER, MD $219,413 DEBORAH WELLE-POWELL $214,301 TRACI MORRIS $7,622 PETER HENRY, MD $60,800 DANIEL NIKCEVICH, MD $116,709 DIANE DAVIDSON $47,215 ANNE STEPHEN, MD $24,295 MARK HAYWARD $133,434 SHEILA HART $32,515 PATRICK TWOMEY, MD $35,675 ADAM REES $146,591 DENNIS DASSENKO $185,575 JEFFREY KORSMO $3,222 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 $249,892 JODI MANSFIELD $121,044 DEBORAH WELLE-POWELL $50,279 TRACI MORRIS $71,480 PETER HENRY, MD $62,496 BRADLEY BEARD $68,594 RICHARD VETTER, MD $46,808 DIANE DAVIDSON $48,504 ANNE STEPHEN, MD $48,140 MICHAEL WATTERS $71,290 MARK HAYWARD $4,822 AL HURLEY $37,886 SHEILA HART $33,763 CHARLES WATSON $64,148 ADAM REES $5,201 DENNIS DASSENKO $12,518 PART I, LINE 8 INITIAL CONTRACT EXCEPTION: ESSENTIA HEALTH'S CHIEF INFORMATION OFFICER, CHARLES WATSON, AND ESSENTIA HEALTH'S CHIEF MEDICAL INFORMATION OFFICER, SARAH MANNEY KURTH, MD, RECEIVED COMPENSATION DURING THE YEAR UNDER INITIAL EMPLOYMENT AGREEMENTS SUBJECT TO THE INITIAL CONTRACT EXCEPTION. THROUGH THE ESSENTIA HEALTH EXECUTIVE COMPENSATION COMMITTEE, THESE COMPENSATION ARRANGEMENTS WERE REVIEWED AND APPROVED BY INDEPENDENT PERSONS USING COMPARABILITY DATA AND 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 1 0 0 1 B 3985800 14300 3971500 2020 1 0 1 1 C 851175 7800 843375 2020 1 0 1 1 D 893425 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: 06/30/2021 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, CRITICAL ACCESS GROUP, 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 2020 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 2020 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 INFORMATION 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 2021. THE YEAR THIS PROCESS WAS LAST UNDERTAKEN FOR ESSENTIA HEALTH CENTRAL'S CHIEF NURSING OFFICER WAS 2020. 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 5,666,088. MANAGEMENT AND GENERAL EXPENSES 13,463,219. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,129,307. COLLECTION AGENCY FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,975,824. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,975,824. PATIENT LOAN PROGRAM FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,669,299. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,669,299. CONSULTANT FEES: PROGRAM SERVICE EXPENSES 388,826. MANAGEMENT AND GENERAL EXPENSES 390,266. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 779,092. TEMP AGENCY FEES: PROGRAM SERVICE EXPENSES 118,346. MANAGEMENT AND GENERAL EXPENSES 948,102. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,066,448. CONTRACT SERVICE MAINTENANCE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,415. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,415. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS WITH RELATED ORGS 28,404,347. EHIS DIVIDEND 40,000,000. 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 503 E 3RD ST STE 400 DULUTH MN 55805 261219624 SUPPORTING ORG MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 1 DEER RIVER HEALTHCARE CENTER INC 115 10TH AVE NE DEER RIVER MN 56636 410844574 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ESSENTIA HEALTH 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 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 4418 HAINES RD DULUTH MN 55811 411674021 MEDICAL EQUIPMENT MN 501(C)(3) LINE 10 ST MARY'S MEDICAL CENTER 1 NORTHERN PINES MEDICAL CENTER 5211 HWY 110 AURORA MN 55705 410841441 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 PINE MEDICAL CENTER 705 LUNDORFF DR S SANDSTONE MN 55072 411884597 HOSPITAL MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 POLINSKY MEDICAL REHABILITATION CENTER 530 E 2ND ST DULUTH MN 55805 410691275 REHABILITATION SERVICES MN 501(C)(3) LINE 3 ST MARY'S MEDICAL CENTER 1 SMDC MEDICAL CENTER 502 E 2ND ST DULUTH MN 55805 411878730 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ST JOSEPH'S MEDICAL CENTER 523 N 3RD ST BRAINERD MN 56401 410695602 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 BRAINERD LAKES INTEGRATED HEALTH SYSTEM 1 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 407 E 3RD ST DULUTH MN 55805 411836633 SUPPORTING ORG MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 1 ST MARY'S EMS 1027 WASHINGTON AVE DETROIT LAKES MN 56501 411805811 EMERGENCY SERVICES MN 501(C)(3) LINE 10 INNOVIS HEALTH LLC 1 ST MARY'S HOSPITAL OF SUPERIOR 3500 TOWER AVE SUPERIOR WI 54880 411811073 HOSPITAL/CLINIC MN 501(C)(3) LINE 3 ST MARY'S MEDICAL CENTER 1 ST MARY'S INNOVIS HEALTH 1027 WASHINGTON AVE DETROIT LAKES MN 56501 262861321 PHARMACY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 ST MARY'S MEDICAL CENTER 407 E 3RD ST DULUTH MN 55805 410695604 HOSPITAL MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 ST MARY'S REGIONAL HEALTH CENTER 1027 WASHINGTON AVE DETROIT LAKES MN 56501 411620386 HOSPITAL/CLINIC/SKILLED NURSING FACILITY MN 501(C)(3) LINE 3 INNOVIS HEALTH LLC 1 THE DULUTH CLINIC LTD 400 E 3RD ST DULUTH MN 55805 410883623 CLINIC MN 501(C)(3) LINE 3 ST MARY'S DULUTH CLINIC HEALTH SYSTEM 1 PMC-GATEWAY IMAGING LLC 705 LUNDORFF DR S SANDSTONE MN 55072 261634764 IMAGING SERVICES MN N/A N/A 0 0 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 28922973 57108607 1.00000 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 1 1 1 BRAINERD MEDICAL CENTER INC L 1411501 ACTUAL COSTS BRAINERD MEDICAL CENTER INC Q 916029 ACTUAL COSTS BRIDGES MEDICAL CENTER L 738812 ACTUAL COSTS BRIDGES MEDICAL CENTER Q 638850 ACTUAL COSTS BRIDGES MEDICAL CENTER R 120000 ACTUAL COSTS DEER RIVER HEALTHCARE CENTER INC L 2780719 ACTUAL COSTS DEER RIVER HEALTHCARE CENTER INC Q 2002168 ACTUAL COSTS DEER RIVER HEALTHCARE CENTER INC R 340000 ACTUAL COSTS ESSENTIA HEALTH FOUNDATION Q 150188 ACTUAL COSTS ESSENTIA HEALTH INSURANCE SERVICES SPC F 40000000 ACTUAL COSTS ESSENTIA HEALTH INSURANCE SERVICES SPC Q 9207132 ACTUAL COSTS ESSENTIA HEALTH INSURANCE SERVICES SPC R 15134543 ACTUAL COSTS ESSENTIA HEALTH MOOSE LAKE L 871720 ACTUAL COSTS ESSENTIA HEALTH MOOSE LAKE Q 1927023 ACTUAL COSTS ESSENTIA HEALTH MOOSE LAKE R 130000 ACTUAL COSTS ESSENTIA INSTITUTE OF RURAL HEALTH L 600000 ACTUAL COSTS ESSENTIA INSTITUTE OF RURAL HEALTH Q 958332 ACTUAL COSTS ESSENTIA INSTITUTE OF RURAL HEALTH R 140000 ACTUAL COSTS FIRST CARE MEDICAL SERVICES L 2282518 ACTUAL COSTS FIRST CARE MEDICAL SERVICES Q 1721181 ACTUAL COSTS FIRST CARE MEDICAL SERVICES S 680000 ACTUAL COSTS GRACEVILLE HEALTH CENTER L 863308 ACTUAL COSTS GRACEVILLE HEALTH CENTER Q 919700 ACTUAL COSTS GRACEVILLE HEALTH CENTER R 130000 ACTUAL COSTS INNOVIS HEALTH LLC L 29369435 ACTUAL COSTS INNOVIS HEALTH LLC Q 24111244 ACTUAL COSTS INNOVIS HEALTH LLC S 3603014 ACTUAL COSTS MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC L 1134558 ACTUAL COSTS MIDWEST MEDICAL EQUIPMENT AND SUPPLIES INC Q 704215 ACTUAL COSTS NORTHERN PINES MEDICAL CENTER L 1377969 ACTUAL COSTS NORTHERN PINES MEDICAL CENTER Q 1108661 ACTUAL COSTS NORTHERN PINES MEDICAL CENTER R 250000 ACTUAL COSTS PINE MEDICAL CENTER L 1339301 ACTUAL COSTS PINE MEDICAL CENTER Q 1052932 ACTUAL COSTS PINE MEDICAL CENTER R 1140000 ACTUAL COSTS POLINSKY MEDICAL REHABILITATION CENTER L 884010 ACTUAL COSTS POLINSKY MEDICAL REHABILITATION CENTER Q 1221666 ACTUAL COSTS POLINSKY MEDICAL REHABILITATION CENTER R 140000 ACTUAL COSTS SMDC MEDICAL CENTER L 41930793 ACTUAL COSTS SMDC MEDICAL CENTER Q 41748769 ACTUAL COSTS SMDC MEDICAL CENTER R 8450000 ACTUAL COSTS ST JOSEPH'S MEDICAL CENTER L 17017917 ACTUAL COSTS ST JOSEPH'S MEDICAL CENTER Q 12479261 ACTUAL COSTS ST JOSEPH'S MEDICAL CENTER R 3095470 ACTUAL COSTS ST MARY'S EMS L 852252 ACTUAL COSTS ST MARY'S EMS Q 679178 ACTUAL COSTS ST MARY'S EMS R 80000 ACTUAL COSTS ST MARY'S HOSPITAL OF SUPERIOR L 5108784 ACTUAL COSTS ST MARY'S HOSPITAL OF SUPERIOR Q 4711796 ACTUAL COSTS ST MARY'S HOSPITAL OF SUPERIOR S 9129161 ACTUAL COSTS ST MARY'S INNOVIS HEALTH L 297376 ACTUAL COSTS ST MARY'S INNOVIS HEALTH Q 107260 ACTUAL COSTS ST MARY'S MEDICAL CENTER L 34504057 ACTUAL COSTS ST MARY'S MEDICAL CENTER Q 30466271 ACTUAL COSTS ST MARY'S MEDICAL CENTER R 5394387 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER L 10696412 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER Q 9712065 ACTUAL COSTS ST MARY'S REGIONAL HEALTH CENTER R 1730000 ACTUAL COSTS THE DULUTH CLINIC LTD L 10331085 ACTUAL COSTS THE DULUTH CLINIC LTD Q 5698788 ACTUAL COSTS THE DULUTH CLINIC LTD R 1210000 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