ALTRU HEALTH SYSTEM: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: ALTRU HEALTH SYSTEM (EIN 45-0310462)
Tax period: 2020-01-01 to 2020-12-31
Filed: 2021-11-15
IRS object ID: 202133199349325093
Schema version: 2020v4.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-11-15T17:26:26-06:00	ReturnTs
Tax Period End	2020-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	450310328	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	BRADY MARTZ & ASSOCIATES PC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 14296	AddressLine1Txt
City	GRAND FORKS	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	582084296	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	450310462	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ALTRU HEALTH SYSTEM	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	ALTR	BusinessNameControlTxt
Phone	7017805200	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1200 S COLUMBIA RD	AddressLine1Txt
City	GRAND FORKS	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	582014036	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DOUGLAS ARVIN	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	7017805200	PhoneNum
Signature	2021-11-15	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	DOUGLAS	PersonFirstNm
Person Last	ARVIN	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	NICOLE HELDSTAB	PreparerPersonNm
PTIN	P01220683	PTIN
Phone	7017754685	PhoneNum
Preparation	2021-11-15	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	ALTRU HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	DOUGLAS ARVIN	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1200 S COLUMBIA RD	AddressLine1Txt
City	GRAND FORKS	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	582014036	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$676,328,795	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	ALTRU.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1970	FormationYr
Legal Domicile State	ND	LegalDomicileStateCd
Activity Or Mission	HEALTHCARE DELIVERY	ActivityOrMissionDesc
Voting Members Governing Body	10	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	4638	TotalEmployeeCnt
Total Volunteers	161	TotalVolunteersCnt
Total Gross UBI	$5,928,964	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$1,167,921	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$6,523,415	PYContributionsGrantsAmt
CY Contributions Grants	$31,563,667	CYContributionsGrantsAmt
PY Program Service Revenue	$586,994,537	PYProgramServiceRevenueAmt
CY Program Service Revenue	$567,894,421	CYProgramServiceRevenueAmt
PY Investment Income	$21,652,292	PYInvestmentIncomeAmt
CY Investment Income	$4,857,235	CYInvestmentIncomeAmt
PY Other Revenue	$160,745	PYOtherRevenueAmt
CY Other Revenue	$150,119	CYOtherRevenueAmt
PY Total Revenue	$615,330,989	PYTotalRevenueAmt
CY Total Revenue	$604,465,442	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,231,281	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,251,903	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$357,173,657	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$320,085,870	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$50,000	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$50,000	CYTotalFundraisingExpenseAmt
PY Other Expenses	$264,877,829	PYOtherExpensesAmt
CY Other Expenses	$252,770,704	CYOtherExpensesAmt
PY Total Expenses	$623,282,767	PYTotalExpensesAmt
CY Total Expenses	$574,158,477	CYTotalExpensesAmt
PY Revenues Less Expenses	-$7,951,778	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$30,306,965	CYRevenuesLessExpensesAmt
Total Assets BOY	$610,029,430	TotalAssetsBOYAmt
Total Assets EOY	$713,951,165	TotalAssetsEOYAmt
Total Liabilities BOY	$346,941,347	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$401,155,788	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$263,088,083	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$312,795,377	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	IMPROVING HEALTH, ENRICHING LIFE.WHY WE SERVE: TO ACHIEVE OPTIMUM HEALTH FOR ALL RESIDENTS IN OUR REGION.HOW WE SERVE: BY PROVIDING HEALTH EDUCATION, PREVENTIVE SERVICES, EARLY INTERVENTION, AND APPROPRIATE CARE.WHOM WE SERVE: THE MORE THAN 235,000 RESIDENTS OF NORTHEAST NORTH DAKOTA AND NORTHWEST MINNESOTA.WHO WE ARE: A COMMUNITY OF OVER 4,000 HEALTH PROFESSIONALS AND SUPPORT STAFF COMMITTED TO SERVING THE REGION FOR MORE THAN 100 YEARS.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$30,086,414	ExpenseAmt
Revenue	$31,208,669	RevenueAmt
Desc	ONCOLOGY - ALTRU'S TEAM OF ONCOLOGISTS PROVIDE INPATIENT AND OUTPATIENT CANCER TREATMENT SERVICES TO PATIENTS WITHIN OUR SERVICE REGION AND ALSO PROVIDE OUTREACH CLINIC SERVICES TO COMMUNITIES THROUGHOUT OUR SERVICE AREA. IN 2020, THERE WERE 215 HOSPITAL DISCHARGES.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$9,948,215	ExpenseAmt
Revenue	$28,291,518	RevenueAmt
Desc	CARDIOLOGY - ALTRU OFFERS COMPREHENSIVE SERVICES INCLUDING INTERVENTIONAL AND MEDICAL CARDIOLOGY. ADDITIONAL SERVICES INCLUDE ECHOCARDIOGRAPHY, CARDIAC STRESS TESTS, AND CARDIAC REHAB. ALTRU HAS BEEN RECOGNIZED THREE TIMES AS A "100 TOP HOSPITALS" FOR CARDIOVASCULAR CARE. OUR CARDIOLOGY TEAM ALSO PROVIDES OUTREACH CLINIC SERVICES TO COMMUNITIES THROUGHOUT OUR SERVICE AREA. IN 2020, THERE WERE 928 HOSPITAL DISCHARGES.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$21,377,901	ExpenseAmt
Revenue	$40,527,739	RevenueAmt
Desc	GENERAL SURGERY - ALTRU'S TEAM OF GENERAL SURGEONS PERFORM INPATIENT AND OUTPATIENT SURGERY AND SEE PATIENTS AT ALTRU HOSPITAL, ALTRU CLINICS, AND SOME OF ALTRU'S REGIONAL CLINICS. IN 2020, THERE WERE 663 GENERAL SURGERY HOSPITAL DISCHARGES.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$457,034,743	ExpenseAmt
Grant	$1,251,903	GrantAmt
Revenue	$461,220,394	RevenueAmt
Desc	OTHER PROGRAM SERVICES INCLUDE OTHER PATIENT CARE PROGRAMS.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$457,034,743	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$1,251,903	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$461,220,394	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$518,447,273	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	Yes (1)	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	Yes (1)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (1)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	99	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	4638	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	10	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	Yes (1)	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THE ORGANIZATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7017805203	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1200 SOUTH COLUMBIA ROAD	AddressLine1Txt
City	GRAND FORKS	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58201	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (37 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
JODY TREUER
BOARD MEMBER/PHYSICIAN	40.00	Yes (X)	$1,088,690	$0	$54,069
STEVEN WEISER
BOARD MEMBER/PRESIDENT	40.00	Yes (X)	$582,360	$0	$270,661	Yes (X)
BRADLEY WEHE
BOARD MEMBER/CEO (THROUGH FEB 2020)	40.00	Yes (X)	$862,120	$0	$12,402	Yes (X)
WILLIAM MCKINNON MD
BOARD MEMBER/PHYSICIAN	40.00	Yes (X)	$335,521	$0	$122,688
DAVID MOLMEN
BOARD MEMBER/CEO (INTERIM)	40.00	Yes (X)	$738,676	$0	$78,153	Yes (X)
KRIS COMPTON
BOARD CHAIR/VICE CHAIR	1.00	Yes (X)	$0	$0	$0	Yes (X)
LONNIE LAFFEN
VICE CHAIR/CHAIR (THROUGH DEC 2020)	1.00	Yes (X)	$0	$0	$0	Yes (X)
PHILIP GISI
SECRETARY (THROUGH MAY 2020)	1.00	Yes (X)	$0	$0	$0	Yes (X)
DANIEL ROLINE
SECRETARY	1.00	Yes (X)	$0	$0	$0	Yes (X)
KEITH OKESON
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
KAREN THINGLESTAD
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
LAURA BLOCK
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
ERIC HALVERSON
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
SARA LUSIGNAN
CFO/TREASURER (THROUGH FEB 2020)	40.00		$448,340	$0	$4,281	Yes (X)
CRAIG FAERBER
INTERIM CFO - CONTRACTED	40.00		$0	$0	$0	Yes (X)
DOUGLAS ARVIN
CFO/TREASURER (STARTING DEC 2020)	40.00		$66,569	$0	$0	Yes (X)
REED REYMAN
EVP - REGION	40.00		$271,779	$0	$125,925		Yes (X)
JEREMY GARDNER
MEDICAL DIRECTOR	40.00		$935,666	$0	$107,097		Yes (X)
JONATHAN HAUG
MEDICAL DIRECTOR	40.00		$601,852	$0	$124,785		Yes (X)
YVONNE GOMEZ
MEDICAL DIRECTOR	40.00		$444,794	$0	$95,953		Yes (X)
JOSHUA DEERE
MEDICAL DIRECTOR	40.00		$494,543	$0	$80,182		Yes (X)
KELLEE FISK
CHIEF PEOPLE OFFICER	40.00		$450,022	$0	$185,507		Yes (X)
JANICE HAMSCHER
CHIEF NURSE OFFICER	40.00		$381,935	$0	$175,528		Yes (X)
MARK WAIND
CHIEF INFORMATION OFFICER	40.00		$313,213	$0	$161,572		Yes (X)
MEGHAN COMPTON
CHIEF LEGAL COUNSEL	40.00		$309,614	$0	$138,680		Yes (X)
KRISTI HALL-JIRAN
CHIEF PHILANTHROPY OFFICER	40.00		$211,212	$0	$87,888		Yes (X)
SUNIL KARTHAM
MEDICAL DIRECTOR	40.00		$641,266	$0	$63,693		Yes (X)
HEATHER STRANDELL
DIRECTOR PRIMARY CARE OPS	40.00		$218,173	$0	$63,764		Yes (X)
ALEXSANDER TODOROVIC
DIRECTOR INFO SYSTEMS APPLICATIONS	40.00		$191,522	$0	$71,528		Yes (X)
JODI SORUM
DIRECTOR PRIMARY CARE & POP. HEALTH	40.00		$172,217	$0	$56,178		Yes (X)
ERIN NAVARRO
DIRECTOR PHARMACY SVCS	40.00		$171,633	$0	$74,318		Yes (X)
MATTHEW SCHUMACHER
DIRECTOR TECH & SUPPORT SVCS	40.00		$168,223	$0	$83,283		Yes (X)
MEVAN WIJETUNGA
PHYSICIAN	40.00		$1,279,367	$0	$59,015			Yes (X)
GRANT SEEGER
PHYSICIAN	40.00		$1,201,604	$0	$59,931			Yes (X)
IKECHUKWU ONYEKA
PHYSICIAN	40.00		$1,154,689	$0	$60,961			Yes (X)
BARRY BJORGAARD
PHYSICIAN	40.00		$1,162,597	$0	$52,305			Yes (X)
BRANDON SPEIDEL
PHYSICIAN	40.00		$1,114,819	$0	$59,240			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$16,013,016	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$2,529,587	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	422	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
HURON CONSULTING SERVICES LLC
3005 MOMENTUM PLACE	CHICAGO	IL	606895330	SERVICES	$19,859,752
SODEXO INC AND AFFILIATES
9801 WASHINGTON BLVD	GAITHERSBURG	MD	20878	SERVICES	$3,934,398
MAYO COLLABORATIVE SERVICES INC
PO BOX 9146	MINNEAPOLIS	MN	554809146	SERVICES	$3,926,112
WEATHERBY LOCUMS INC
PO BOX 75397	DALLAS	TX	753972633	SERVICES	$1,860,056
COMPHEALTH MEDICAL STAFFING
PO BOX 713100	SALT LAKE CITY	UT	841713100	SERVICES	$1,541,608

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	62	CntrctRcvdGreaterThan100KCnt
Related Organizations	$1,656,679	RelatedOrganizationsAmt
Government Grants	$29,906,988	GovernmentGrantsAmt
Total Contributions	$31,563,667	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
NET SERVICE TO PATIENTS	621110	$522,239,063	$518,015,697	$4,223,366
PROGRAM SERVICE REVENUE	621110	$45,568,071	$43,232,623	$1,555,479	$779,969
BIOMED SERVICES/SITE SERVICES FEE	900099	$87,287			$87,287

Field	Value	IRS element (for citing)
Total Program Service Revenue	$567,894,421	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,805,970	TotalRevenueColumnAmt
Exclusion	$6,805,970	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$69,914,618	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$69,461,798	SecuritiesAmt
Other	$2,401,555	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$452,820	SecuritiesAmt
Other	-$2,401,555	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$1,948,735	TotalRevenueColumnAmt
Exclusion	-$1,948,735	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
RENTAL OFFICE SPACE/PARKING LOT	531120	$136,478	$136,478
SNOW REMOVAL	812900	$8,082	$8,082
TELECOMMUNICATIONS	517000	$5,559	$5,559

Field	Value	IRS element (for citing)
Other Revenue Total	$150,119	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$604,465,442	TotalRevenueColumnAmt
Related Or Exempt Func Income	$561,248,320	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$5,928,964	UnrelatedBusinessRevenueAmt
Exclusion	$5,724,491	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$1,249,118	TotalAmt
Program Services	$1,249,118	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$2,785	TotalAmt
Program Services	$2,785	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$13,199,839	TotalAmt
Program Services	$3,796,873	ProgramServicesAmt
Management And General	$9,402,966	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$255,571,653	TotalAmt
Program Services	$246,822,104	ProgramServicesAmt
Management And General	$8,749,549	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$12,736,829	TotalAmt
Program Services	$12,288,201	ProgramServicesAmt
Management And General	$448,628	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$20,228,862	TotalAmt
Program Services	$19,516,343	ProgramServicesAmt
Management And General	$712,519	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$18,348,687	TotalAmt
Program Services	$17,131,399	ProgramServicesAmt
Management And General	$1,217,288	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$50,000	TotalAmt
Fundraising	$50,000	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$978,364	TotalAmt
Management And General	$978,364	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$435,555	TotalAmt
Program Services	$335,377	ProgramServicesAmt
Management And General	$100,178	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$9,806,165	TotalAmt
Program Services	$7,162,535	ProgramServicesAmt
Management And General	$2,643,630	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,769,579	TotalAmt
Program Services	$1,362,575	ProgramServicesAmt
Management And General	$407,004	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$8,351,662	TotalAmt
Program Services	$5,846,163	ProgramServicesAmt
Management And General	$2,505,499	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$30,287,519	TotalAmt
Program Services	$21,201,264	ProgramServicesAmt
Management And General	$9,086,255	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,740,621	TotalAmt
Program Services	$2,110,278	ProgramServicesAmt
Management And General	$630,343	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
SUPPLIES	$110,968,879	$110,047,440	$921,439
UNRELATED BUSINESS TAX	-$201,323	-$201,323
PURCHASED SERVICES	$50,031,800	$38,524,486	$11,507,314
CONSULTING AND PROFESSI	$31,796,704	$26,390,121	$5,406,583

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,805,179	TotalAmt
Program Services	$4,861,534	ProgramServicesAmt
Management And General	$943,645	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$574,158,477	TotalAmt
Program Services	$518,447,273	ProgramServicesAmt
Management And General	$55,661,204	ManagementAndGeneralAmt
Fundraising	$50,000	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$381,604	BOYAmt
EOY	$60,207,102	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$60,406,731	BOYAmt
EOY	$86,018,355	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$72,283,695	BOYAmt
EOY	$68,049,949	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$581,035	BOYAmt
EOY	$558,774	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$8,177,489	BOYAmt
EOY	$8,818,747	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$5,745,124	BOYAmt
EOY	$7,069,210	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$638,288,748	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$409,953,438	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$237,708,445	BOYAmt
EOY	$228,335,310	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$149,056,628	BOYAmt
EOY	$178,500,957	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$26,987,118	BOYAmt
EOY	$30,836,534	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$48,701,561	BOYAmt
EOY	$45,556,227	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$610,029,430	BOYAmt
EOY	$713,951,165	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$53,466,010	BOYAmt
EOY	$112,059,842	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$733,391	BOYAmt
EOY	$734,039	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$252,194,430	BOYAmt
EOY	$245,179,639	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$40,547,516	BOYAmt
EOY	$43,182,268	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$346,941,347	BOYAmt
EOY	$401,155,788	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$263,088,083	BOYAmt
EOY	$312,795,377	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$263,088,083	BOYAmt
EOY	$312,795,377	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$610,029,430	BOYAmt
EOY	$713,951,165	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$30,306,965	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$15,466,870	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$17,549	DonatedServicesAndUseFcltsAmt
Other Changes In Net Assets	$3,915,910	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,118,416	OtherCostOrOtherBasisAmt
Book Value	$9,118,416	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$292,122,570	OtherCostOrOtherBasisAmt
Depreciation	$183,548,777	DepreciationAmt
Book Value	$108,573,793	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$23,538,441	OtherCostOrOtherBasisAmt
Depreciation	$10,226,080	DepreciationAmt
Book Value	$13,312,361	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$253,995,257	OtherCostOrOtherBasisAmt
Depreciation	$216,178,581	DepreciationAmt
Book Value	$37,816,676	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$59,514,064	OtherCostOrOtherBasisAmt
Book Value	$59,514,064	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$228,335,310	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDesc	Book ValueBookValueAmt
ASSETS HELD BY TRUSTEE	$797,315
UNAMORTIZED BOND ISSUE AND OTHER COSTS	$7,516,187
ASSETS HELD UNDER TRUST AGREEMENTS	$18,850,480
DUE FROM AFFILIATES	$50,762
OTHER ASSETS	$18,341,483

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$45,556,227	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
DUE TO AFFILIATES	$77,336
OTHER	$21,255,256
ESTIMATED THIRD PARTY LIABILITY	$4,200,275
SPECIAL ASSESSMENTS PAYABLE	$535,213
ASSET RETIREMENT OBLIGATION	$3,000,000
LEASE LIABILITY	$14,114,188

Field	Value	IRS element (for citing)
Total Liability	$43,182,268	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES THE ORGANIZATION'S POLICY IS TO EVALUATE THE LIKELIHOOD THAT ITS UNCERTAIN TAX POSITIONS WILL PREVAIL UPON EXAMINATION BASED ON THE EXTENT TO WHICH THOSE POSITIONS HAVE SUBSTANTIAL SUPPORT WITHIN THE INTERNAL REVENUE CODE AND REGULATIONS, REVENUE RULINGS, COURT DECISIONS AND OTHER EVIDENCE. IT IS THE OPINION OF MANAGEMENT THAT THE ORGANIZATION HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT WOULD BE SUBJECT TO CHANGE UPON EXAMINATION. THE FEDERAL INCOME TAX RETURNS OF THE ORGANIZATION ARE SUBJECT TO EXAMINATION BY INTERNAL REVENUE SERVICE GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. ALL FILINGS ARE CURRENT.	ExplanationTxt

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Special Fundraising Events	Yes (X)	SpecialFundraisingEventsInd
Agrmt Prof Fundraising Acty	Yes (1)	AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

Organization Business Name OrganizationBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY COUNSELLING SERVICE CO LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	527 MADISON AVENUE 5TH FLOOR	AddressLine1Txt
City	NEW YORK	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	10022	ZIPCd

Field	Value	IRS element (for citing)
Activity	FEASIBILITY STUDY FOR CAPITAL CAMPAIGN	ActivityTxt
Fundraiser Control Of Funds	0	FundraiserControlOfFundsInd
Gross Receipts	$0	GrossReceiptsAmt
Retained By Contractor	$50,000	RetainedByContractorAmt
Net To Organization	-$50,000	NetToOrganizationAmt

Field	Value	IRS element (for citing)
Total Retained By Contractors	$50,000	TotalRetainedByContractorsAmt
Total Net To Organization	-$50,000	TotalNetToOrganizationAmt
Licensed States	ND	LicensedStatesCd

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent150	Yes (X)	Percent150Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent250	Yes (X)	Percent250Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,079,333	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,079,333	NetCommunityBenefitExpnsAmt
Total Expense	0.00540	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$19,203,101	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$19,203,101	NetCommunityBenefitExpnsAmt
Total Expense	0.03340	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,176,835	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,176,835	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$23,459,269	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$23,459,269	NetCommunityBenefitExpnsAmt
Total Expense	0.04080	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$713,219	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$713,219	NetCommunityBenefitExpnsAmt
Total Expense	0.00120	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$776,644	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$776,644	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,441	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$21,441	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$66,397	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$66,397	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,577,701	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,577,701	NetCommunityBenefitExpnsAmt
Total Expense	0.00270	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,036,970	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$25,036,970	NetCommunityBenefitExpnsAmt
Total Expense	0.04350	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$3,056,369	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$132,295,518	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$397,390,197	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$265,094,679	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	3	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (3 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd
ALTRU HOSPITAL
1	1200 S COLUMBIA RD	GRAND FORKS	ND	582066002	Yes (X)	Yes (X)	Yes (X)	A
ALTRU REHABILITATION CENTER
2	4500 S WASHINGTON ST	GRAND FORKS	ND	582066002	Yes (X)			A
ALTRU SPECIALTY CENTER
3	4500 S WASHINGTON ST	GRAND FORKS	ND	58201	Yes (X)	Yes (X)		A

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ALTRU HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	19	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.ALTRU.ORG	OwnWebsiteURLTxt
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	20	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.ALTRU.ORG	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	150.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	250.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.ALTRU.ORG	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.ALTRU.ORG	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.ALTRU.ORG	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit Report To Credit Agency	Yes (X)	PermitReportToCreditAgencyInd
Permit Legal Judicial Process	Yes (X)	PermitLegalJudicialProcessInd
Collection Activities	Yes (1)	CollectionActivitiesInd
Reporting To Credit Agency	Yes (X)	ReportingToCreditAgencyInd
Engaged Legal Judicial Process	Yes (X)	EngagedLegalJudicialProcessInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	Yes (1)	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: ALTRU HOSPITAL, - FACILITY 2: ALTRU REHABILITATION CENTER, - FACILITY 3: ALTRU SPECIALTY CENTER
ALTRU HOSPITAL PART V, SECTION B, LINE 5:	ALTRU HEALTH SYSTEM AND THE GRAND FORKS PUBLIC HEALTH DEPARTMENT ENGAGED MULTIPLE PARTNERS TO CONDUCT SURVEYS AND FOCUS GROUPS WITH COMMUNITY LEADERS AND SPECIAL POPULATIONS TO GET THEIR INSIGHT ABOUT THE HEALTH OF THE COMMUNITY AND HOW IT CAN BE IMPROVED. IT WAS AGREED TO USE THE PROCESS FROM THE ASSOCIATION FOR COMMUNITY HEALTH IMPROVEMENT (SIX STEP COMMUNITY HEALTH ASSESSMENT PROCESS).A COMMUNITY-BASED ADVISORY COMMITTEE WAS FORMED TO WORK WITH ALTRU AND GRAND FORKS PUBLIC HEALTH ON THE ASSESSMENT. LEADERSHIP FROM ALTRU AND GRAND FORKS PUBLIC HEALTH SERVED ON THE ADVISORY COMMITTEE, ALONG WITH INDIVIDUALS REPRESENTING THE FOLLOWING AGENCIES/ORGANIZATIONS:ALTRU FAMILY YMCAGRAND FORKS CITY COUNCILCOMMUNITY VIOLENCE INTERVENTION CENTERGRAND FORKS PARK DISTRICTGRAND FORKS PUBLIC SCHOOLSGRAND FORKS AIR FORCE BASEGRAND FORKS FIRE DEPARTMENTGRAND FORKS POLICE DEPARTMENTGRAND FORKS SENIOR CENTERGLOBAL FRIENDS COALITIONNORTHEAST HUMAN SERVICE CENTERNORTHLANDS RESCUE MISSIONNORTHWESTERN MENTAL HEALTH CENTERPOLK COUNTY PUBLIC HEALTHQUALITY HEALTH ASSOCIATESSIMPLOTSPECTRA HEALTHTHE CHAMBERTURTLE RIVER STATE PARKUNIVERSITY OF NORTH DAKOTAUNITED WAYCITIES AREA TRANSITGRAND FORKS HERALDGRAND FORKS HOUSING AUTHORITYGRAND FORKS ECONOMIC DEVELOPMENT CORPINSPIRE PHARMACYTHE ADVISORY COMMITTEE ENGAGED STACY SCHWIMMER, A STUDENT FROM THE UNIVERSITY OF NORTH DAKOTA'S MASTER OF PUBLIC HEALTH PROGRAM WITH THE ASSISTANCE OF DR. DONALD WARNE, MD, MPH, PROFESSOR AND DIRECTOR OF THE DEPARTMENT OF POPULATION HEALTH. THE STUDENT AND FACULTY TEAM, MELANIE NADEAU, MPH, PHD, PROFESSOR AND ASSISTANT DIRECTOR OF THE DEPARTMENT OF POPULATION HEALTH, AND ASHLEE NELSON AND ZACHARY HOGGARATH, GRADUATE RESEARCH ASSISTANTS, CONDUCTED A COMMUNITY SURVEY ALONG WITH FOCUS GROUPS WITH COMMUNITY LEADERS AND SPECIAL POPULATIONS TO GET THEIR INSIGHT ABOUT THE HEALTH OF GRAND FORKS AND POLK COUNTY COMMUNITIES AND HOW IT CAN BE IMPROVED.
ALTRU HOSPITAL PART V, SECTION B, LINE 6A:	ALTRU 1300 COLUMBIA
ALTRU HOSPITAL PART V, SECTION B, LINE 6B:	GRAND FORKS PUBLIC HEALTH
ALTRU HOSPITAL PART V, SECTION B, LINE 11:	ALTRU HEALTH SYSTEM DEVELOPED A LIST OF APPROXIMATELY SEVENTEEN SIGNIFICANT ISSUES/NEEDS WITH THE INPUT OF THE ADVISORY COMMITTEE. FROM THIS LIST, THE HEALTH ISSUES WERE RANKED BY PRIORITY, AND THE TOP 6 AREAS WERE IDENTIFIED FOR AREAS OF IMPROVEMENT. THE ADVISORY COMMITTEE AND A SMALLER COMMITTEE COMPRISED OF INDIVIDUALS FROM ALTRU HEALTH SYSTEM, GRAND FORKS PUBLIC HEALTH DEPARTMENT, GRAND FORKS SUBSTANCE ABUSE PREVENTION COALITION, POLK COUNTY PUBLIC HEALTH, AND QUALITY HEALTH ASSOCIATES OF NORTH DAKOTA ARE WORKING ON THE ONGOING IMPROVEMENT PLANNING / IMPLEMENTATION STRATEGY DEVELOPMENT. THE COMMITTEE WILL BE CONDUCTING IMPLEMENTATION ACTIVITIES AND PROVIDING UPDATES ANNUALLY TO KEY STAKEHOLDERS TO DOCUMENT PROGRESS. LIMITED FINANCIAL, COMMUNITY, AND PERSONNEL RESOURCES DID NOT ALLOW ALTRU HEALTH SYSTEM TO ADDRESS ALL OF THE IDENTIFIED NEEDS FOR THE 2019 CHNA. THE IMPLEMENTATION STRATEGY ADDRESSING THE NEEDS IDENTIFIED IN THE 2019 CHNA WAS ADOPTED IN 2020. DUE TO COVID RELATED DEMANDS, ALTRU'S RESOURCES WERE NOT ABLE TO BE FOCUSED ON THE CHNA GOALS IN 2020. RESOURCES WERE DEDICATED TO A BLUE ZONE ASSESSMENT WEEK WITH THE PUBLIC HEALTH TEAM, WHICH COULD ULTIMATELY IMPACT THE OBESITY, SUBSTANCE ABUSE AND MENTAL HEALTH PRIORITIES ACROSS OUR COMMUNITIES.
ALTRU HOSPITAL PART V, SECTION B, LINE 24:	ALL PATIENTS ARE CHARGED THE GROSS CHARGE REGARDLESS OF INSURANCE STATUS. ADJUSTMENTS MAY BE APPLIED PROVIDING THE PATIENTS APPLY FOR AND QUALIFY FOR CHARITY CARE.

Field	Value	IRS element (for citing)
Facility	55	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (55 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - ALTRU CANCER CENTER
960 S COLUMBIA RD	GRAND FORKS	ND	582066003	OUTPATIENT DEPT OF ALTRU HOSP - CLINIC
2 - TRUYU AESTHETIC CENTER
3165 DEMERS AVE	GRAND FORKS	ND	582066003	OUTPATIENT DEPT OF ALTRU HOSP - CLINIC
3 - ALTRU FAMILY MEDICINE CENTER
1380 S COLUMBIA RD	GRAND FORKS	ND	582066003	OUTPATIENT DEPT OF ALTRU HOSP - CLINIC
4 - ALTRU FAMILY MEDICINE RESIDENCY
725 HAMLINE STREET	GRAND FORKS	ND	58203	OUTPATIENT CLINIC
5 - ALTRU FAMILY MEDICINE RESIDENCY PHARMACY
725 HAMLINE STREET	GRAND FORKS	ND	58203	OUTPATIENT PHARMACY
6 - ALTRU CLINIC - DRAYTON
1003 N MAIN	DRAYTON	ND	582254650	OUTPATIENT CLINIC/THERAPY
7 - ALTRU 860 COLUMBIA
860 S COLUMBIA RD	GRAND FORKS	ND	582066002	OUTPATIENT DEPARTMENT - PSYCH SERVICES
8 - ALTRU OUTPATIENT CENTER
411 2ND ST NW	EAST GRAND FORKS	MN	56721	OUTPATIENT THERAPY
9 - ALTRU CLINIC - CAVALIER
201 E 3RD AVE S	CAVALIER	ND	582200040	OUTPATIENT CLINIC
10 - ALTRU CLINIC - DEVILS LAKE
1001 7TH STREET NE	DEVILS LAKE	ND	583012719	OUTPATIENT CLINIC
11 - ALTRU CLINIC - CROOKSTON
400 SOUTH MINNESOTA	CROOKSTON	MN	567160606	OUTPATIENT DEPT OF ALTRU HOSP - CLINIC
12 - ALTRU CLINIC - RED LAKE FALLS
312 INTERNATIONAL DRIVE	RED LAKE FALLS	MN	567504662	OUTPATIENT DEPT OF ALTRU HOSP - CLINIC
13 - ALTRU CLINIC - ERSKINE
113 VANCE AVE N	ERSKINE	MN	565354201	OUTPATIENT DEPT OF ALTRU HOSP - CLINIC
14 - ALTRU CLINIC - FERTILE
101 S MILL ST	FERTILE	MN	565404215	OUTPATIENT DEPT OF ALTRU HOSP - CLINIC
15 - ALTRU CLINIC - ROSEAU
711 DELMORE DRIVE	ROSEAU	MN	567511534	OUTPATIENT CLINIC
16 - ALTRU CLINIC - WARROAD
412 MAIN AVE NE	WARROAD	MN	567632342	OUTPATIENT CLINIC
17 - ALTRU CLINIC - GREENBUSH
19120 200TH ST	GREENBUSH	MN	567269280	OUTPATIENT CLINIC
18 - UNITY MEDICAL CENTER
164 WEST 13TH STREET	GRAFTON	ND	58237	HOME HEALTH/HOSPICE
19 - FIRST CARE HEALTH CENTER
PO BOX I	PARK RIVER	ND	58270	HOME HEALTH/HOSPICE/THERAPY
20 - NELSON COUNTY HEALTH SYSTEM
BOX 367	MCVILLE	ND	58254	HOME HEALTH/HOSPICE
21 - CO ALTRU CLINIC - CAVALIER
201 E 3RD AVE S	CAVALIER	ND	58220	HOME HEALTH/HOSPICE
22 - ALTRU HOME SVCS-NORTH VALLEY HOME HEALTH
109 S MINNESOTA ST	WARREN	MN	56762	HOME HEALTH/HOSPICE
23 - ANETA PARKVIEW HEALTH CENTER
BOX 287	ANETA	ND	58212	OUTREACH CLINIC
24 - CAVALIER COUNTY MEMORIAL
909 2ND ST	LANGDON	ND	58249	OUTREACH CLINIC
25 - CENTRAL BOILER
20502 160TH ST	GREENBUSH	MN	56726	OUTREACH CLINIC
26 - COOPERSTOWN MEDICAL CENTER
1200 ROBERTS ST	COOPERSTOWN	ND	58425	OUTREACH CLINIC
27 - DEVILS LAKE GOOD SAMARITAN
302 7TH AVE	DEVILS LAKE	ND	58301	OUTREACH CLINIC
28 - FIRST CARE HEALTH CENTER
115 VIVIAN ST	PARK RIVER	ND	58270	OUTREACH CLINIC
29 - FRIENDSHIP
554 W 12TH ST	GRAFTON	ND	58327	OUTREACH CLINIC
30 - 4TH CORP
120 11TH ST	NEW ROCKFORD	ND	58356	OUTREACH CLINIC
31 - GRIGGS COUNTY HOSPITAL
1200 ROBERTS AVE NE	COOPERSTOWN	ND	58425	OUTREACH CLINIC
32 - HATTON PRAIRIE VILLAGE
930 DAKOTA AVE	HATTON	ND	58240	OUTREACH CLINIC
33 - HEARTLAND CARE CENTER
620 14TH AVE NE	DEVILS LAKE	ND	58301	OUTREACH CLINIC
34 - KARLSTAD HEALTH CARE
304 WASHINGTON AVE W	KARLSTAD	MN	56732	OUTREACH CLINIC
35 - KITTSON MEMORIAL HEALTH CARE CENTER
1010 S BIRCH	HALLOCK	MN	56728	OUTREACH CLINIC
36 - KITTSON MEMORIAL CLINIC OF KARLSTAD
1ST AND ROOSEVELT	KARLSTAD	MN	56732	OUTREACH CLINIC
37 - LAKE REGION CORP
224 3TH ST NW	DEVILS LAKE	ND	583012908	OUTREACH CLINIC
38 - LAKOTA GOOD SAMARITAN
608 4TH AVE SW HWY 2	LAKOTA	ND	583447500	OUTREACH CLINIC
39 - MAPLE MANOR CARE CENTER
1116 9TH AVE	LANGDON	ND	58249	OUTREACH CLINIC
40 - MCINTOSH MANOR NURSING HOME
600 RIVERSIDE AVE NE	MCINTOSH	MN	56556	OUTREACH CLINIC
41 - NELSON COUNTY CARE CENTER
108 E NYHUS AVE	MCVILLE	ND	58254	OUTREACH CLINIC
42 - NELSON COUNTY HEALTH SYSTEM
200 NORTH MAIN	MCVILLE	ND	58254	OUTREACH CLINIC
43 - NORTHWOOD DEACONESS
4 N PARK ST	NORTHWOOD	ND	58267	OUTREACH CLINIC
44 - OAKLAND PARK COMMUNITIES INC
123 BAKEN STREET	THIEF RIVER FALLS	MN	56701	OUTREACH CLINIC
45 - PEMBILIER NURSING CENTER
500 DELANO AVE	WALHALLA	ND	58282	OUTREACH CLINIC
46 - PEMBINA COUNTY MEMORIAL HOSPITAL
301 MOUNTAIN STREET E	CAVALIER	ND	58220	OUTREACH CLINIC
47 - PIONEER MEMORIAL CARE CENTER
23028 347TH ST SE	ERSKINE	MN	565359466	OUTREACH CLINIC
48 - REM-GRAFTON
817 HILL AVE	GRAFTON	ND	58327	OUTREACH CLINIC
49 - VALLEY 4000
4004 24TH AVE SOUTH	GRAND FORKS	ND	58201	OUTREACH CLINIC
50 - VALLEY MEMORIAL HOMES
2900 14TH AVE SOUTH	GRAND FORKS	ND	58201	OUTREACH CLINIC
51 - WEDGEWOOD MANOR
804 MAIN STREET WEST	CAVALIER	ND	58220	OUTREACH CLINIC
52 - CENTER FOR PREVENTION & GENETICS
4401 S 11TH ST	GRAND FORKS	ND	58201	OUTREACH CLINIC
53 - ALTRU CLINIC - EAST GRAND FORKS
607 DEMERS AVE	EAST GRAND FORKS	MN	56721	OUTPATIENT DEPT OF ALTRU HOSP - CLINIC
54 - ALTRU PROFESSIONAL CENTER
4440 S WASHINGTON ST	GRAND FORKS	ND	58201	OUTPATIENT CLINIC
55 - ALTRU CLINIC - THIEF RIVER FALLS
1845 HWY 59 S STE 800	THIEF RIVER FALLS	MN	56701	OUTPATIENT CLINIC

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A:	PREPARATION OF ANNUAL COMMUNITY BENEFIT REPORT: ALTRU HEALTH SYSTEM PREPARES ANNUALLY A COMMUNITY BENEFIT REPORT BASED ON FORMS DESIGNED BY THE CATHOLIC HEALTH ORGANIZATION. ONCE ALL REPORTING FORMS HAVE BEEN COMPILED FOR THE YEAR, THE CATHOLIC HEALTH ORGANIZATION'S REFERENCE GUIDE FROM "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT" IS USED TO DETERMINE WHAT ITEMS SHOULD BE REPORTED INTO WHAT CATEGORY. THE COMMUNITY BENEFIT REPORT IS PUBLISHED AS A PART OF THE CORPORATION'S ANNUAL REPORT, WHICH IS PLACED ON OUR WEB SITE FOR PUBLIC ACCESS.
PART I, LINE 7:	COLUMN (F) - PERCENT OF TOTAL EXPENSES: IN DETERMINING THE DENOMINATOR FOR THE PERCENT OF TOTAL EXPENSE CALCULATION, THE AMOUNT REPORTED ON FORM 990, PART IX, LINE 25, COLUMN (A) WAS REDUCED BY BAD DEBTS EXPENSE OF $3,056,369.CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST: THE METHODOLOGY USED TO DETERMINE THE REPORTED AMOUNTS FOR THE CHARITY CARE IS A COST-TO-CHARGE RATIO BASED ON GROSS CHARGES WRITTEN OFF PURSUANT TO OUR CHARITY CARE AND MEANS-TESTED PROGRAMS ELIGIBILITY CRITERIA. OTHER COMMUNITY BENEFIT IS DETERMINED FROM INFORMATION THAT WAS COMPILED ON FORMS DESIGNED BY THE CATHOLIC HEALTH ORGANIZATION AND USING THEIR REFERENCE GUIDE, "A GUIDE FOR PLANNING AND REPORTING COMMUNITY BENEFIT," TO DETERMINE WHICH CATEGORY THE AMOUNTS ARE PROPERLY REPORTED UNDER.
PART II, COMMUNITY BUILDING ACTIVITIES:	NONE DOCUMENTED ON FORM 990.
PART III, LINE 4:	FOOTNOTE DISCLOSURE REGARDING BAD DEBTS EXPENSE: NOTE 1 ON PAGE 10, 16 ON PAGES 33-34 AND 18 ON PAGES 34-36 TO THE AUDITED FINANCIAL STATEMENTS REPORT ON BAD DEBT EXPENSE.
PART III, LINE 8:	NONE OF THE SHORTFALL SHOWN ON PART III, LINE 7 OF $265,094,679 HAS BEEN TREATED AS COMMUNITY BENEFIT AS REPORTED ON SCHEDULE H. THE SOURCE OF THE AMOUNT SHOWN ON PART III, LINE 6 COMES FROM THE MEDICARE ALLOWABLE COSTS REPORTED IN ALTRU'S MEDICARE COST REPORT SUBMITTED FOR THE FISCAL YEAR ENDING DECEMBER 31, 2020, UTILIZING THE FOLLOWING WORKSHEETS: WORKSHEETS B PART I, H-7 PARTS 1&2, I-4, AND K-6.
PART III, LINE 9B:	PROVISION FOR COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE FOUND IN ALTRU'S POLICIES 2611 "DEDUCTIONS FROM REVENUES AND 2614 "CHARITY CARE." ALTRU'S COMMUNITY CARE PROGRAM IS DESIGNED TO PROVIDE FINANCIAL ASSISTANCE TO THOSE WHO HAVE NO INSURANCE AND/OR LIMITED MEANS TO PAY FOR THEIR MEDICAL SERVICES AND DO NOT QUALIFY FOR OTHER PROGRAMS. IN ADDITION TO QUALITY HEALTHCARE, PATIENTS OF ALTRU HEALTH SYSTEM ARE PROVIDED FINANCIAL COUNSELING REGARDING THEIR MEDICAL BILLS, BY SOMEONE WHO CAN UNDERSTAND AND OFFER POSSIBLE SOLUTIONS FOR THOSE WHO CANNOT PAY IN FULL. PROGRAMS ARE ALSO AVAILABLE FOR UNINSURED PATIENTS, AND FOR THOSE FOUND TO BE IN MEDICAL HARDSHIP.
PART VI, LINE 2:	NEEDS ASSESSMENT: ALTRU HEALTH SYSTEM'S MISSION - IMPROVING HEALTH, ENRICHING LIFE - CONFIRMS THAT OUR RESPONSIBILITY TO THE REGION GOES BEYOND PROVIDING QUALITY HEALTHCARE SERVICES. ALL OF OUR RESOURCES ARE DEVOTED TO IMPROVING HEALTH IN THE COMMUNITIES WE SERVE. AT ALTRU, GOOD HEALTH MEANS THAT EVERY INDIVIDUAL SHOULD ENJOY THE BEST ACHIEVABLE AND SO SHOULD OUR COMMUNITIES. ALTRU'S THIRD CYCLE OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN 2019; THE ASSESSMENT WAS APPROVED BY OUR BOARD OF DIRECTORS ON DECEMBER 16, 2019. AS A RESULT OF THE ASSESSMENT, ALTRU PRIORITIZED AND IS FOCUSING ON THE FOLLOWING SIX ISSUES: 1) SUBSTANCE USE - REDUCE THE PREVALENCE OF SUBSTANCE USE INCLUDING ALCOHOL, TOBACCO, AND OTHER DRUGS; 2) MENTAL HEALTH - PROMOTE MENTAL HEALTH AND BUILDING RESILIENCE; 3) OBESITY - REDUCE THE PREVALENCE OF OBESITY IN OUR POPULATION; 4) TRANSPORTATION - IMPROVE THE QUALITY OF AND ACCESS TO TRANSPORTATION; 5) COST OF HEALTH CARE - REDUCE THE BURDEN OF THE COST OF HEALTH CARE; 6) HOUSING - INCREASE THE AVAILABILITY OF AFFORDABLE HOUSING, INCLUDING PERMANENT SUPPORTIVE OPTIONS.
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:ALTRU HAS SEVERAL AVENUES IN WHICH INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS IS COMMUNICATED TO PATIENTS. UNINSURED AND SELF-PAY PATIENTS IN THE HOSPITAL RECEIVE A VISIT FROM PATIENT REPRESENTATIVES AFTER INTAKE. DURING THIS MEETING, THEY ARE INFORMED OF VARIOUS FEDERAL, STATE AND COMMUNITY-BASED PROGRAMS THAT MAY PROVIDE ASSISTANCE. UNINSURED OR SELF-PAY PATIENTS FROM OUTPATIENTS RECEIVE CONTACT FROM PATIENT REPRESENTATIVES BY PHONE OR EMAIL INFORMING THEM OF POTENTIAL SOURCES OF FINANCIAL ASSISTANCE. BOTH SETS OF PATIENTS ARE ALSO PROVIDED INFORMATION ON HOW TO MOVE FORWARD IN APPLYING FOR THE PROGRAMS. IF PATIENTS ARE FOUND TO BE STRUGGLING WITH MEDICAL EXPENSES, OUR CREDIT AND COLLECTIONS REPRESENTATIVES UTILIZE LETTERS AND PHONE CALLS TO INFORM THEM OF VARIOUS RESOURCES THAT MAY PROVIDE ASSISTANCE.FINANCIAL ASSISTANCE INFORMATION IS ALSO AVAILABLE TO THE PUBLIC AS A WHOLE. ALTRU'S WEBSITE, ALTRU.ORG, INCLUDES FINANCIAL ASSISTANCE CONTACT INFORMATION AND ELIGIBILITY GUIDELINES. PATIENTS MAY REVIEW THIS ON THEIR OWN AND CONTACT AGENCIES THAT MAY PROVIDE ASSISTANCE BASED ON THEIR CIRCUMSTANCES. ALSO, ALTRU DISTRIBUTES BROCHURES FEATURING OUR COMMUNITY CARE PROGRAM AND OTHER FEDERAL AND STATE PROGRAMS. THESE BROCHURES ARE AVAILABLE TO BOTH PATIENTS AND VISITORS IN WAITING ROOMS OF OUR INPATIENT AND OUTPATIENT FACILITIES AS WELL AS IN ALL BUSINESS OFFICE LOCATIONS.
PART VI, LINE 4:	COMMUNITY INFORMATION:ALTRU HEALTH SYSTEM SERVES A 24-COUNTY AREA THAT IS DIVIDED INTO SEVEN DISTINCT SUB-SERVICE AREAS AND HAS A POPULATION OF APPROXIMATELY 235,000 PERSONS (SOURCE: OPTUM POPULATION AGE SEGMENTATION ANALYSIS) WHO RESIDE IN A DIVERSE AREA OF AGRICULTURE AND INDUSTRY. THE SERVICE AREA STRETCHES 265 MILES EAST AND WEST AND 120 MILES NORTH AND SOUTH. GRAND FORKS SITS IN THE CENTRAL SERVICE AREA IN THE MIDDLE OF THE RED RIVER VALLEY, ONE OF THE WORLD'S RICHEST AGRICULTURAL AREAS. PRINCIPAL CROPS INCLUDE SUGAR BEETS, POTATOES, EDIBLE BEANS, AND SMALL GRAINS SUCH AS WHEAT AND BARLEY. MUCH OF THE INDUSTRY IN THE AREA IS RELATED TO AGRICULTURE AND FOOD PROCESSING.THE CENTRAL SERVICE AREA, COMPRISED OF GRAND FORKS AND SURROUNDING COMMUNITIES WITHIN GRAND FORKS COUNTY, IS HOME TO APPROXIMATELY 71,825 PEOPLE (SOURCE: OPTUM POPULATION AGE SEGMENTATION ANALYSIS). LOCATED IN THIS SUB-SERVICE AREA ARE ALTRU HOSPITAL, ALTRU SPECIALTY CENTER, ALTRU REHABILITATION CENTER, ALTRU CANCER CENTER, AND 13 OTHER LOCATIONS THAT ARE HOME TO OUR PROVIDERS' CLINIC PRACTICES AND OTHER SERVICES OFFERED BY ALTRU. ALTRU HOSPITAL SERVES AS THE MAJOR REFERRAL CENTER FOR THE PEOPLE OF THE REGION. AS SUCH, IT PROVIDES A BROAD SPECTRUM OF PROGRAMS AND SERVICES. A FULL RANGE OF SERVICES ARE AVAILABLE FOR PATIENTS SUFFERING FROM CANCER, HEART DISEASE, END-STAGE RENAL DISEASE, NEUROLOGICAL DISORDERS, ALCOHOL OR CHEMICAL DEPENDENCY, HIGH RISK OBSTETRICAL COMPLICATIONS, AND PSYCHIATRIC DISORDERS. ALTRU HOSPITAL'S INPATIENT MARKET SHARE IN 2020 FOR OUR ENTIRE SERVICE AREA WAS 42 PERCENT BASED ON CLAIMS DATA. 84 PERCENT OF ALTRU HOSPITAL'S MEDICAL STAFF IS COMPRISED OF PROVIDERS WHO ARE EMPLOYED BY ALTRU HEALTH SYSTEM. ALSO LOCATED IN GRAND FORKS COUNTY IS NORTHWOOD COMMUNITY HEALTH CENTER (IN NORTHWOOD, ND). A COUPLE NOTABLE POPULATIONS ALTRU SERVES THAT ARE WITHIN OUR CENTRAL SERVICE AREA INCLUDE THE UNIVERSITY OF NORTH DAKOTA AND GRAND FORKS AIR FORCE BASE. THE UNIVERSITY OF NORTH DAKOTA IS THE STATE'S OLDEST INSTITUTION OF HIGHER LEARNING WITH AN ENROLLMENT OF 13,615 (FALL 2020). THE NUMBER OF RESIDENTS AT GRAND FORKS AIR FORCE BASE WAS COUNTED AT 2,002 (2020 CENSUS).THE EAST, NORTH, NORTHEAST, NORTHWEST, SOUTH AND WEST SERVICE AREAS INCLUDE 23 COUNTIES THAT HAVE A POPULATION OF 163,447 PEOPLE (SOURCE: OPTUM POPULATION AGE SEGMENTATION ANALYSIS); THIS AREA IS LARGELY RURAL AND AGRICULTURAL. WITHIN THIS AREA, ALTRU HAS ELEVEN REGIONAL CLINIC LOCATIONS. BEYOND THE CENTRAL SERVICE AREA, THERE ARE SEVERAL SMALL HOSPITALS LISTED BELOW. CAVALIER COUNTY MEMORIAL HOSPITAL: LANGDON, ND PEMBINA COUNTY HOSPITAL: CAVALIER, ND UNITY MEDICAL CENTER: GRAFTON, ND FIRST CARE HEALTH CENTER: PARK RIVER, ND NELSON COUNTY HEALTH SYSTEM: MCVILLE, ND KITTSON MEMORIAL HOSPITAL: HALLOCK, MN NORTH VALLEY HEALTH CENTER: WARREN, MN LAKEWOOD HEALTH CENTER: BAUDETTE, MN MERCY HOSPITAL: DEVILS LAKE, ND SANFORD-THIEF RIVER FALLS MEDICAL CENTER: THIEF RIVER FALLS, MN PRESENTATION MEDICAL CENTER: ROLLA, ND TOWNER COUNTY MEDICAL CENTER: CANDO, ND SANFORD MAYVILLE MEDICAL CENTER: MAYVILLE, ND LIFECARE MEDICAL CENTER: ROSEAU, MN QUENTIN N. BURDICK MEMORIAL HOSPITAL: BELCOURT, NDALTRU HEALTH SYSTEM EMPLOYS MANY PROVIDERS WITHIN THE SUB-SERVICE AREAS. ALL OF THESE PROVIDERS ARE ON MEDICAL STAFFS OF COMMUNITY HOSPITALS THROUGHOUT THE REGION AND REFER PATIENTS TO ALTRU HOSPITAL AND ELSEWHERE FOR SPECIALITY CARE.AS PREVIOUSLY MENTIONED, ALTRU'S 24-COUNTY SERVICE AREA HAS A POPULATION OF APPROXIMATELY 235,000. USING DATA FROM OPTUM (A VENDOR SPECIALIZING IN HEALTH CARE PLANNING INFORMATION), THE INSURANCE COVERAGE FOR COMMUNITIES IN OUR SERVICE AREA IS ESTIMATED TO BE AS FOLLOWS: COVERAGE AS A PERCENT COMMERCIAL 51% MEDICARE - TYPE OF POLICY 25%MEDICAID - TYPE OF POLICY 10%SELF-PAY 6%OTHER 8%TOTAL 100%ALSO, FROM OPTUM, OUR TOTAL SERVICE AREA'S INCOME BY HOUSEHOLD IS AS FOLLOWS:INCOME RANGE 2020 PERCENTAGES$ < $ 5,000 3% $ 5,000 - $ 9,999 4%$ 10,000 - $ 14,999 5%$ 15,000 - $ 19,999 4%$ 20,000 - $ 24,999 5%$ 25,000 - $ 29,999 5%$ 30,000 - $ 34,999 4%$ 35,000 - $ 39,999 4%$ 40,000 - $ 44,999 4%$ 45,000 - $ 49,999 4%$ 50,000 - $ 54,999 4%$ 55,000 - $ 59,999 5%$ 60,000 - $ 64,999 4%$ 65,000 - $ 69,999 3%$ 70,000 - $ 74,999 4%$ 75,000 - $ 79,999 3%$ 80,000 - $ 84,999 3%$ 85,000 - $ 89,999 3%$ 90,000 - $ 94,999 3%$ 95,000 - $ 99,999 3%$100,000 - $124,999 10%$125,000 - $149,999 6%$150,000 - $199,999 5%$ > $200,000 5%ACCORDING TO THE WEBSITE FOR HEALTH RESOURCES AND SERVICES ADMINISTRATION, THE FOLLOWING AREAS IN OUR SERVICE AREA ARE MUA'S:NORTH DAKOTA:BENSON COUNTY: WEST/NORTHWEST SERVICE AREACAVALIER COUNTY: NORTH SERVICE AREAGRAND FORKS COUNTY: CENTRAL SERVICE AREANELSON COUNTY: WEST SERVICE AREAPEMBINA COUNTY: NORTH SERVICE AREAROLETTE COUNTY: NORTHWEST SERVICE AREATOWNER COUNTY: WEST/NORTHWEST SERVICE AREATRAILL COUNTY: SOUTH SERVICE AREAWALSH COUNTY: NORTH SERVICE AREAMINNESOTA:KITTSON COUNTY: NORTHEAST SERVICE AREAMARSHALL COUNTY: NORTHEAST SERVICE AREAPOLK COUNTY: EAST SERVICE AREAROSEAU COUNTY: NORTHEAST SERVICE AREA
PART VI, LINE 5:	ALL OF ALTRU'S RESOURCES ARE DEVOTED TO IMPROVING HEALTH IN THE COMMUNITIES WE SERVE. TO DO SO, WE KNOW THAT NOT ALL MEDICAL SERVICES WILL COME FROM STAFF EMPLOYED BY ALTRU HEALTH SYSTEM. ALTRU EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN OUR COMMUNITY FOR NEARLY ALL DEPARTMENTS. ALSO, OUR BOARD OF DIRECTORS IS MADE UP OF INDIVIDUALS FROM OUTSIDE ALTRU HEALTH SYSTEM. THESE PEOPLE ARE VOLUNTEERS WHO HAVE THE SAME DEDICATION AND FOCUS ON ALTRU'S MISSION AS OUR OWN STAFF.
PART VI, LINE 6:	ALTRU HEALTH SYSTEM IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. IN SEPTEMBER 2011, ALTRU HEALTH SYSTEM BECAME THE FIRST MEMBER OF THE MAYO CLINIC CARE NETWORK. THIS IS A NON-OWNERSHIP RELATIONSHIP THAT BENFITS THE ORGANIZATION'S PHYSICIANS AND PATIENTS FROM ENHANCED ACCESS TO MAYO PHYSICIANS AND CLINICAL RESOURCES. MORE SPECIFICALLY, PHYSICIANS HAVE ACCESS TO MAYO CLINIC'S EVIDENCE-BASED DISEASE MANAGEMENT PROTOCOLS, CLINIC CARE GUIDELINES, AND TREATMENT RECOMMENDATIONS AND REFERENCE MATERIALS FOR COMPLEX MEDICAL CONDITIONS.PART VI, LINE 7: ALTRU HEALTH SYSTEM IS NOT REQUIRED TO FILE OUR COMMUNITY BENEFIT REPORT WITH ANY OUTSIDE ORGANIZATIONS BUT HAS MADE OUR REPORT AVAILABLE TO ANYONE ON OUR WEB SITE.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (16 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Address Line2USAddress/AddressLine2Txt
ALTRU FAMILY YMCA
215 N 7TH ST	GRAND FORKS	ND	58203	450226434	501(C)(3)	$52,000	YMCA PROJECT; FIRECRACKER ROAD RACE
CHAMBER OF GRAND FORKS EAST GRAND FORKS
202 N 3RD ST	GRAND FORKS	ND	58203	202924979	501(C)(6)	$10,699	2020 SUPPORT
CITY OF GRAND FORKS
255 N 4TH ST	GRAND FORKS	ND	58203	456002085	GRAND FORKS, ND	$121,438	SOCIAL DETOX FACILITY
DAKOTA MEDICAL FOUNDATION
4141 28TH AVE S	FARGO	ND	58104	456012318	501(C)(3)	$5,000	ZAZULA SPONSORSHIP
GRAND FORKS DOWNTOWN DEVELOPMENT ASSOCIATION
23 N 3RD ST STE 2	GRAND FORKS	ND	58203	464711617	501(C)(6)	$5,000	GREENWAY TAKEOVER FESTIVAL, VISIONARY PARTNERSHIP
GRAND FORKS PARK DISTRICT FOUNDATION
1060 47TH AVE S	GRAND FORKS	ND	58201	260625504	501(C)(3)	$185,500	WELLNESS CENTER AND HEROES AND LEGENDS
GREATER GRAND FORKS YOUNG PROFESSIONALS
202 NORTH 3RD ST	GRAND FORKS	ND	58203	320134204	501(C)(6)	$10,000	GGFYP VISIONARY SPONSORSHIP
MAYVILLE STATE UNIVERSITY FOUNDATION
330 3RD ST NE	MAYVILLE	ND	58257	456013477	501(C)(3)	$8,333	ARTIFICIAL TURF
RE ARENA INC
ONE RALPH ENGLESTAD DR	GRAND FORKS	ND	58203	113666663	501(C)(3)	$98,500	GAME DAY SPONSORSHIPS
UND FOUNDATION
3100 UNIVERSITY AVE STOP 8157	GRAND FORKS	ND	58202	450348296	501(C)(3)	$481,871	UND ATHLETICS HIGH PERFORMANCE CENTER; ALTRU TURF FUND
UND GRANTS AND CONTRACT ADMIN
TWAMLEY HALL 100 264 CENTENNIAL DR	GRAND FORKS	ND	58202	456002491	501(C)(3)	$60,000	SIM-ND PROJECT	STOP 7306
UNITED WAY - GF EGF
1407 24TH AVE S STE 400	GRAND FORKS	ND	58201	450255772	501(C)(3)	$20,000	CORPORATE GIFT 2020
CITY OF EAST GRAND FORKS
600 DEMERS AVE NW	EAST GRAND FORKS	MN	56721	416005112	EAST GRAND FORKS, MN	$90,000	WELLNESS PROGRAM
GRAND FORKS MARATHON INC
PO BOX 14867	GRAND FORKS	ND	58203	273739718	501(C)(3)	$17,280	PRESENTING SPONSOR
GRAND FORKS FOUNDATION FOR EDUCATION
2400 47TH AVE S	GRAND FORKS	ND	58201	450404011	501(C)(3)	$10,425	TEARS DONATION
COMMUNITY VIOLENCE INTERVENTION CENTER
211 SOUTH 4TH ST	GRAND FORKS	ND	58201	450359167	501(C)(3)	$50,000	SPONSORSHIP/SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	13	Total501c3OrgCnt
Total Other Org	3	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	COMMUNITY VIOLENCE INTERVENTION CENTER - FUNDS WERE GRANTED WITH THE DIRECTION THAT CVIC WAS ABLE TO USE FUNDS AS NEEDED. CVIC DETERMINES THE RECIPIENTS OF THE ASSISTANCE PROVIDED THROUGH THOSE FUNDS. RE ARENA, INC. - ALTRU REVIEWS THE SPONSORSHIPS WITH RE ARENA/UNIVERSITY OF NORTH DAKOTA OFFICIALS PRIOR TO THE EVENTS AND HAS REPRESENTATIVES ATTEND THE EVENTS TO ACKNOWLEDGE THE PROPRIETY OF THE ANNOUNCEMENTS MADE REGARDING THE SPONSORSHIP OF THE DAY'S EVENT. UND FOUNDATION - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED TOWARDS THE UND ATHLECTICS HIGH PERFORMANCE CENTER AND THE ALTRU TURF FUND. ALTRU RECEIVED NAMING RIGHTS AND SIGNAGE. GREATER GRAND FORKS YOUNG PROFESSIONALS - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED. GRAND FORKS PARK DISTRICT FOUNDATION - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED TOWARDS THE WELLNESS CENTER FACILITY PROJECT. ALTRU FAMILY YMCA - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED TOWARDS THE YMCA PROJECT. ALTRU RECEIVED NAMING RIGHTS AND SIGNAGE. CITY OF GRAND FORKS - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED TOWARDS A SOCIAL DETOX FACILITY. GRAND FORKS DOWNTOWN DEVELOPMENT ASSOCIATION - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED. UNITED WAY - GF EGF - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED. CHAMBER OF GRAND FORKS EAST GRAND FORKS - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED. MAYVILLE STATE UNIVERSITY FOUNDATION - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED TOWARDS ARTIFICIAL TURF. DAKOTA MEDICAL FOUNDATION - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED TOWARDS RECOVERY REINVENTED. UND GRANTS AND CONTRACT ADMIN - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED FOR THE SIM-ND PROJECT. CITY OF EAST GRAND FORKS, MN - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED FOR THE WELLNESS PROGRAM. GRAND FORKS MARATHON INC - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED FOR A PRESENTING SPONSOR. GRAND FORKS FOUNDATION FOR EDUCATION - FUNDS GRANTED WITH THE DIRECTION THAT THEY WERE ABLE TO USE THE FUNDS AS NEEDED FOR TEARS.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (27 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MEVAN WIJETUNGA
PHYSICIAN	$1,243,794	$0	$0	$0	$35,573	$0	$25,554	$0	$36,684	$0	$1,341,605	$0	$0	$0
GRANT SEEGER
PHYSICIAN	$1,181,856	$0	$0	$0	$19,748	$0	$24,720	$0	$38,434	$0	$1,264,758	$0	$0	$0
IKECHUKWU ONYEKA
PHYSICIAN	$1,120,043	$0	$0	$0	$34,646	$0	$26,500	$0	$37,684	$0	$1,218,873	$0	$0	$0
BARRY BJORGAARD
PHYSICIAN	$1,116,943	$0	$0	$0	$45,654	$0	$25,100	$0	$30,428	$0	$1,218,125	$0	$0	$0
BRANDON SPEIDEL
PHYSICIAN	$1,075,572	$0	$0	$0	$39,247	$0	$26,279	$0	$36,184	$0	$1,177,282	$0	$0	$0
JODY TREUER
BOARD MEMBER/PHYSICIAN	$1,042,621	$0	$0	$0	$46,069	$0	$28,864	$0	$28,428	$0	$1,145,982	$0	$0	$0
JEREMY GARDNER
MEDICAL DIRECTOR	$908,295	$0	$7,500	$0	$19,871	$0	$72,637	$0	$37,684	$0	$1,045,987	$0	$0	$0
BRADLEY WEHE
BOARD MEMBER/CEO (THROUGH FEB 2020)	$57,095	$0	$0	$0	$805,025	$0	$7,929	$0	$5,072	$0	$875,121	$0	$0	$0
STEVEN WEISER
BOARD MEMBER/PRESIDENT	$495,791	$0	$60,000	$0	$26,569	$0	$238,200	$0	$35,684	$0	$856,244	$0	$0	$0
DAVID MOLMEN
BOARD MEMBER/CEO (INTERIM)	$103,698	$0	$0	$0	$634,978	$0	$50,198	$0	$30,178	$0	$819,052	$0	$0	$0
JONATHAN HAUG
MEDICAL DIRECTOR	$574,481	$0	$7,500	$0	$19,871	$0	$92,325	$0	$35,684	$0	$729,861	$0	$0	$0
SUNIL KARTHAM
MEDICAL DIRECTOR	$602,018	$0	$0	$0	$39,248	$0	$30,232	$0	$36,684	$0	$708,182	$0	$0	$0
KELLEE FISK
CHIEF PEOPLE OFFICER	$332,758	$0	$25,000	$0	$92,264	$0	$157,737	$0	$30,899	$0	$638,658	$0	$0	$0
JOSHUA DEERE
MEDICAL DIRECTOR	$447,827	$0	$7,500	$0	$39,216	$0	$54,977	$0	$28,379	$0	$577,899	$0	$0	$0
JANICE HAMSCHER
CHIEF NURSE OFFICER	$340,347	$0	$0	$0	$41,588	$0	$155,854	$0	$22,807	$0	$560,596	$0	$0	$0
YVONNE GOMEZ
MEDICAL DIRECTOR	$417,340	$0	$0	$0	$27,454	$0	$87,138	$0	$11,995	$0	$543,927	$0	$0	$0
MARK WAIND
CHIEF INFORMATION OFFICER	$272,568	$0	$0	$0	$40,645	$0	$139,432	$0	$25,141	$0	$477,786	$0	$0	$0
WILLIAM MCKINNON MD
BOARD MEMBER/PHYSICIAN	$281,059	$0	$7,500	$0	$46,962	$0	$103,063	$0	$22,577	$0	$461,161	$0	$0	$0
SARA LUSIGNAN
CFO/TREASURER (THROUGH FEB 2020)	$48,313	$0	$0	$0	$400,027	$0	$1,477	$0	$3,388	$0	$453,205	$0	$400,000	$0
MEGHAN COMPTON
CHIEF LEGAL COUNSEL	$305,777	$0	$0	$0	$3,837	$0	$100,450	$0	$41,308	$0	$451,372	$0	$0	$0
REED REYMAN
EVP - REGION	$250,250	$0	$0	$0	$21,529	$0	$108,950	$0	$19,831	$0	$400,560	$0	$0	$0
KRISTI HALL-JIRAN
CHIEF PHILANTHROPY OFFICER	$168,049	$0	$0	$0	$43,163	$0	$85,476	$0	$4,773	$0	$301,461	$0	$0	$0
HEATHER STRANDELL
DIRECTOR PRIMARY CARE OPS	$192,357	$0	$15,000	$0	$10,816	$0	$61,264	$0	$4,776	$0	$284,213	$0	$0	$0
ALEXSANDER TODOROVIC
DIRECTOR INFO SYSTEMS APPLICATIONS	$169,488	$0	$8,100	$0	$13,934	$0	$54,909	$0	$18,745	$0	$265,176	$0	$0	$0
MATTHEW SCHUMACHER
DIRECTOR TECH & SUPPORT SVCS	$149,706	$0	$7,500	$0	$11,017	$0	$50,823	$0	$34,445	$0	$253,491	$0	$0	$0
ERIN NAVARRO
DIRECTOR PHARMACY SVCS	$159,018	$0	$7,400	$0	$5,215	$0	$48,067	$0	$28,213	$0	$247,913	$0	$0	$0
JODI SORUM
DIRECTOR PRIMARY CARE & POP. HEALTH	$145,421	$0	$7,200	$0	$19,596	$0	$48,215	$0	$9,868	$0	$230,300	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINES 4A-B	FormAndLineReferenceDesc
Explanation	SARA LUSIGNAN, $400,000, SEVERANCE BRAD WEHE, $798,000, SEVERENCE DAVE MOLMEN, $608,185, 457(F)	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
CITY OF GRAND FORKS
A	456002085	38546WCC2	2012-05-01	$117,025,978	REFUND BONDS ISSUED IN 1997, AND 2010A/2010B; INFRASTRUCTURE, EQUIPMENT	0	0	0
CITY OF GRAND FORKS
B	456002085	38546WCR9	2017-07-12	$65,233,846	REFUND BONDS ISSUED IN 2005; FINANCE FACILITIES, INFRASTRUCTURE, EQUIPMENT	0	0	0
CITY OF GRAND FORKS
C	456002085	000000000	2017-09-06	$21,720,835	REFUND BONDS ISSUED IN 2007	0	0	0
CITY OF GRAND FORKS
D	456002085	000000000	2019-08-01	$13,520,000	REFUND BONDS ISSUED IN 2011 AND 1996	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Capitalized InterestCapitalizedInterestAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	In Reserve FundInReserveFundAmt	UnspentUnspentAmt
A	$2,615,000	$117,042,920	$83,269	$1,295,167	$66,185,853	$49,461,776	2012	Yes (1)	0	Yes (1)	Yes (1)
B	$3,770,000	$65,583,211	$19,519	$708,177	$40,209,015		2018	0	Yes (1)	0	Yes (1)	$381,082	$436,286
C	$9,320,702	$21,775,310		$82,447			2017	Yes (1)	0	Yes (1)	Yes (1)
D	$3,840,000	$13,520,000		$56,736			2019	Yes (1)	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0	0	0	0	0	0	0
B	0	0	0	0	0	0	0
C	0	0	0	0	0	0	0
D	0	0	0	0	0	0	0

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Rebate Not Due YetRebateNotDueYetInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd
A	0	Yes (1)	Yes (1)
B	Yes (1)	0	0
C	Yes (1)	0	0
D	Yes (1)	0	0

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	0
B	0
C	0
D	0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: CITY OF GRAND FORKS DATE THE REBATE COMPUTATION WAS PERFORMED: 01/23/2017
SCHEDULE K, PART II, PROCEEDS, LINE 3:	(A) TOTAL PROCEEDS OF ISSUE CONSIST OF SALES PROCEEDS OF $117,025,978 PLUS $16,941 OF INVESTMENT PROCEEDS. (B) TOTAL PROCEEDS OF ISSUE CONSIST OF SALES PROCEEDS OF $65,233,846 PLUS $349,365 OF INVESTMENT PROCEEDS. (C) TOTAL PROCEEDS OF ISSUE CONSIST OF SALES PROCEEDS OF $21,720,835 PLUS $54,475.04 OF INVESTMENT PROCEEDS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
CITY OF GRAND FORKS
A	456002085	000000000	2020-11-27	$19,000,000	REFINANCE LOAN UNSED TO FUND CONSTRUCTION COSTS OF REPLACEMENT HOSPITAL	0	0	0
CITY OF GRAND FORKS
B	456002085	000000000	2020-11-27	$10,000,000	REFINANCE LOAN UNSED TO FUND CONSTRUCTION COSTS OF REPLACEMENT HOSPITAL	0	0	0
CITY OF GRAND FORKS
C	456002085	000000000	2020-11-27	$11,000,000	REFINANCE LOAN UNSED TO FUND CONSTRUCTION COSTS OF REPLACEMENT HOSPITAL	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Substantial CompletionSubstantialCompletionYr	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$19,000,000	$123,826	2020	Yes (1)	Yes (1)
B	$10,000,000	$65,172	2020	Yes (1)	Yes (1)
C	$11,000,000	$71,689	2020	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Rebate Not Due YetRebateNotDueYetInd	Variable Rate IssueVariableRateIssueInd
A	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
MEGHAN COMPTON
FAMILY MEMBER OF KRIS COMPTON, OFFICER	$451,372	COMPENSATION	0
JLG ARCHITECTS
LONNIE LAFFEN, DIRECTOR, IS PRESIDENT OF JLG	$844,321	ARCHITECTURAL FEES FOR THE NEW HOSPITAL DESIGN	0
EDGEWOOD OPCO LLC
PHILIP GISI, DIRECTOR, IS PARTNER AND CEO	$20,000,000	INVESTMENT IN EDGEWOOD OPCO, LLC BY WHOLLY OWNED SUBSIDIARY OF ALTRU	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2	BOARD MEMBER, KRIS COMPTON, IS THE MOTHER OF KEY EMPLOYEE, MEGHAN COMPTON.
FORM 990, PART VI, SECTION A, LINE 3	ALTRU HEALTH SYSTEMS CONTRACTED WITH CMF HEALTHCARE CONSULTING, LLC, TO PROVIDE LEADERSHIP AND GUIDANCE TO THE FINANCE TEAM AS INTERIM CFO. CRAIG FAERBER SERVED IN THIS POSITION FROM FEBRUARY TO NOVEMBER 2020.
FORM 990, PART VI, SECTION B, LINE 11B	AN ELECTRONIC COPY OF THE RETURN WAS SENT TO THE BOARD MEMBERS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY IS REVIEWED AND SIGNED OFF ANNUALLY BY ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES. THESE FORMS ARE COLLECTED AND REVIEWED BY THE SECRETARY AND INTERNAL LEGAL COUNSEL. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE ALSO ADVISED TO REPORT SHOULD ANY CHANGES HAPPEN DURING THE YEAR.
FORM 990, PART VI, SECTION B, LINE 15	LINE 15A: ALTRU DETERMINES THE TOP MANAGEMENT OFFICIALS' COMPENSATION BY REVIEW AND APPROVAL BY A GOVERNING BODY WITHOUT CONFLICTS OF INTEREST, USING COMPARABLE COMPENSATION DATA FOR FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS (WITH RELEVANT COMPARABLES DOCUMENTED IN AN ANNUAL STATEMENT OF REASONABLENESS LETTER FROM ALTRU'S COMPENSATION CONSULTANT), AND MADE CONTEMPORANEOUS DOCUMENTATION OF THE DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. ALTRU HAS A COMPENSATION COMMITTEE MADE UP OF COMMUNITY BOARD MEMBERS ALONG WITH THE PRESIDENT AND CEO. WE ALSO WORK WITH AN OUTSIDE CONSULTANT WHICH PROVIDES US WITH DATA ON FAIR MARKET COMPENSATION FOR THE ENTIRE EXECUTIVE STAFF. FOR DETERMINING THE COMPENSATION OF THE PRESIDENT AND CEO, THE COMMUNITY BOARD MEMBERS OBTAIN THE DATA FROM THE CONSULTANT, HAVE AN OPPORTUNITY TO DISCUSS WITH THE CONSULTANT AND HAVE ANY QUESTIONS ANSWERED AND THEN THEIR DECISION IS SHARED WITH THE NON-CONFLICTED BOARD MEMBERS FOR FINAL APPROVAL. THIS PROCESS WAS USED TO DETERMINE THE COMPENSATION FOR BOTH POSITIONS OF PRESIDENT AND CEO IN 2020. LINE 15B: FOR SCHEDULE O: ALTRU USES SIMILAR CRITERIA TO THE PROCESS DESCRIBED IN 15(A) ABOVE. THE PRESIDENT AND CEO DETERMINE THE SALARIES FOR EACH OF THE EXECUTIVES THAT REPORT TO THEM. ALTRU USES AN OUTSIDE COMPENSATION CONSULTANT WHICH PROVIDES DATA ON FAIR MARKET COMPENSATION FOR FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. THE PRESIDENT AND CEO PRESENT THEIR DECISIONS ON THE EXECUTIVE COMPENSATION TO THE BOARD, WHICH IS A GOVERNING BODY WITHOUT CONFLICTS OF INTEREST AS TO THE SUBJECT MATTER. THE BOARD DOES NOT RATIFY THE BASE COMPENSATION FOR THE EXECUTIVES THAT REPORT TO THE PRESIDENT AND CEO (THE PRESIDENT AND CEO HAVE FINAL SAY IN SETTING BASE COMPENSATION FOR THEIR EXECUTIVE TEAM BASED ON THE COMPENSATION DATA REFERENCED ABOVE), BUT THE BOARD DOES DETERMINE THE ANNUAL GOALS FOR THE ALTRU SYSTEM THAT ARE USED TO DETERMINE (BY FORMULA) POTENTIAL BONUS PAYOUTS FOR THE EXECUTIVE TEAM. AS SHOWN IN SCHEDULE L, BOARD MEMBER KRIS COMPTON IS THE MOTHER OF MEGHAN COMPTON, A MEMBER OF THE EXECUTIVE TEAM (BUT NOT THE PRESIDENT OR CEO). AS SUCH, KRIS COMPTON PARTICIPATES AS A BOARD MEMBER TO APPROVE ANNUAL GOALS AT BEGINNING OF YEAR AND THEREAFTER RECUSES HERSELF FROM THE DECISION TO APPROVE THE BONUS BASED ON THE SYSTEM GOAL OUTCOMES AT END OF YEAR, DUE TO HER IDENTIFIED CONFLICT. RHE PROCESS DESCRIBED ABOVE WAS FOLLOWED FOR ALL EXECUTIVES IN 2020.
FORM 990, PART VI, SECTION C, LINE 18	THE ORGANIZATIONS 990 AND 990-T PUBLIC INSPECTION COPIES ARE AVAILABLE UPON REQUEST. FORM 1023 IS AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC THROUGH PUBLISHED ANNUAL REPORTS. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC	CRAIG FAERBER - C/O CMF HEALTHCARE CONSULTING, LLC; 4174 NAVAJO TRAIL NE, BROOKHAVEN, GA 30319.
FORM 990, PART XI, LINE 9:	APPLICATION OF FASB ASC TOPIC 715 3,915,914. ROUNDING -4.
990, PAGE 1, HEADING ITEM C	ALTRU 1300 COLUMBIA, ALTRU CANCER CENTER, ALTRU FAMILY MEDICINE CENTER, ALTRU FAMILY MEDICINE RESIDENCY, TRUYU AESTHETIC CENTER, ALTRU CLINIC-LAKE REGION, ALTRU CLINIC-CAVALIER, ALTRU CLINIC-DRAYTON, ALTRU CLINIC-CROOKSTON, ALTRU CLINIC-RED LAKE FALLS, ALTRU CLINIC-FERTILE, ALTRU CLINIC-ERSKINE, ALTRU CLINIC-ROSEAU, ALTRU CLINIC-WARROAD, ALTRU CLINIC-GREENBUSH, ALTRU CLINIC-KARLSTAD
FORM 990, PART VIII, LINE 2B & 2D	EXCLUSION AMOUNT BIOMED SERVICES $79,810 SITE SERVICE FEES $7,477 SUBTOTAL $87,287 PHARMACY SALES TO EMPLOYEES $81,223 HOUSING/SPACE RENTALS $652,528 VENDING MACHINE INCOME $44,501 SALE OF SCRAP/OTHER $1,717 SUBTOTAL $779,969 TOTAL EXCLUSION AMOUNT $867,256 RELATED OR EXEMPT FUNCTION INCOME HEARING CENTER $1,054,425 OCCUPATIONAL HEALTH $563,588 PURCHASE DISCOUNTS $125,913 REBATES $376,589 CONTRACT SERVICES, OUTREACH, EDUCATION $3,125,776 MEDICAL RECORDS TRANSCRIPT FEES $139,145 AFFILIATED OTHER REVENUE $621,078 340B PHARMACY REVENUE $26,285,960 DL HOSPITALIST CONTRACT REVENUE $762,400 SPORTS ADVANTAGE $202,814 EPIC RELATED FEES- CRITICAL ACCESS $1,771,553 MISCELLANEOUS REVENUE $8,203,383 TOTAL RELATED/EXEMPT INCOME $43,232,623
FORM 990, PART VIII, LINE 2B & 2D	1. BIOMED SERVICES: REVENUE EARNED THROUGH THE PROVISION OF SERVICES TO AREA HEALTH CARE FACILITIES NEEDING TO KEEP THEIR EQUIPMENT IN OPERATION IN ORDER TO PROVIDE THEIR PATIENTS WITH THEIR SERVICE. THE BIOMED PROGRAM PROVIDES SMALL REGIONAL HOSPITALS WITH A SERVICE OTHERWISE UNOBTAINABLE FROM ANYONE IN THE LOCAL AREA; IT IS OFTEN ON A PRIORITY BASIS. 2. SITE SERVICE FEES: FEES CHARGED FOR PROVIDING GROUNDS AND MAINTENANCE FOR THE AREA SURROUNDING THE HOSPITAL, INCLUDING FEES FOR SUCH SERVICES AS MAINTENANCE OF HOSPITAL PARKING LOT, SNOW SHOVELING, AND SNOW REMOVAL. 3. PHARMACY SALES TO EMPLOYEES: REVENUE INCURRED IN SALES STRICTLY FOR THE CONVENIENCE OF EMPLOYEES. 4. HOUSING/SPACE RENTALS: INCOME INCURRED THROUGH THE RENTAL OF SPACE TO THE AREA HEALTH EDUCATION CENTER WHICH IS REQUIRED TO BE ON-SITE TO WORK WITH OUR PHYSICIANS PROVIDING HEALTH CARE TO PATIENTS. 5. VENDING MACHINE INCOME: INCOME EARNED THROUGH THE OPERATION OF VENDING MACHINES IN THE BUILDINGS. 6. SALE OF SCRAP: INCOME EARNED THROUGH THE SALE OF ITEMS THAT ARE NOT FIXED ASSETS AND ARE OF DIMINISHED USE TO THE ORGANIZATION. 7. HEARING CENTER: REVENUE FROM THE PROVISION OF AUDIOLOGICAL SERVICES AND HEARING AIDS TO PATIENTS. 8. OCCUPATIONAL HEALTH: FEES FOR PROVIDING DRUG SCREENINGS FOR REGIONAL EMPLOYERS. 9. PURCHASE DISCOUNTS: THIS FIGURE REPRESENTS COST SAVINGS ON PURCHASES FROM SUPPLIERS FOR GOODS USED IN THE PROVISION OF HEALTH CARE SERVICES. 10. REBATES: REBATES RECEIVED BASED ON VOLUME OF PHARMACY PURCHASES. 11. CONTRACT SERVICES, OUTREACH, EDUCATION: REVENUES EARNED IN THE PROVISION OF COMMUNITY EDUCATION/WELLNESS PROGRAMS, PASTORAL COUNSELING SERVICES, AND CONTRACTED SERVICES WITH REGIONAL HEALTHCARE SYSTEMS TO BRING OUTREACH SERVICES INTO THEIR COMMUNITIES. 12. MEDICAL RECORD TRANSCRIPTION FEES: INCOME EARNED THROUGH THE CHARGING OF VARIOUS THIRD PARTY PAYERS FOR THE PHOTOCOPYING OF PATIENT RECORDS. INSURANCE COMPANIES AND PAYERS ARE CHARGED TO OFFSET THE COST OF COPYING. 13. OTHER REVENUE CHARGED TO AFFILIATED CORPORATIONS: REVENUE FROM THE PROVISION OF PATIENT SERVICES, SUCH AS PSYCH OR LABORATORY, TO THE PATIENTS OF OTHER CORPORATIONS, WHICH ARE AFFILIATED TO ALTRU HEALTH SYSTEM. 14. 340B PHARMACY REVENUE: INCOME EARNED FROM AREA PHARMACIES USING THE 340(B) BUYING CONTRACT TO PURCHASE PHARMACEUTICALS AT DISCOUNTED RATES. 15. DL HOSPITALIST CONTRACT REVENUE: INCOME FROM ALTRU PHYSICIANS PROVIDING HOSPITALIST SERVICES AT MERCY HOSPITAL, DEVILS LAKE. 16. SPORTS ADVANTAGE: EXOS PROGRAM FEES; PERFORMANCE TRAINING PROVIDED TO AREA ATHLETES AND COACHES 17. EPIC RELATED FEES FROM CRITICAL ACCESS HOSPITALS:ANNUAL FEES, INCLUDING ONE-TIME IMPLEMENTATION, OF AREA CRITICAL ACCESS HOSPITALS USING OUR EPIC VENDOR SOFTWARE FOR PATIENT BILLING 18. MISCELLANEOUS INCOME: INCLUDES A RETURN OF EXPENSES FROM AN INSURANCE POOL. ALSO INCLUDES INCOME EARNED THROUGH THE PROVISION OF SERVICES THAT ARE OPERATING IN THE HOSPITAL IN NATURE, BUT HAVE NO SPECIFIC COST CENTER IDENTIFICATIONS. AN EXAMPLE OF THIS WOULD BE IF THE DIRECTOR OF THE COMMUNICATIONS DEPARTMENT RECEIVED A SMALL TOKEN AMOUNT FOR FILLING OUT A SURVEY FROM SOME HEALTH CARE ORGANIZATION.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
ALTRU HEALTH FOUNDATION
2501 DEMERS AVE	GRAND FORKS	ND	58201	450368330	FUNDRAISING	ND	501(C)(3)	LINE 12B, II	ALTRU HEALTH SYSTEM	Yes (1)
DAK-MINN BLOOD BANK
1200 S COLUMBIA RD	GRAND FORKS	ND	58201	363453164	BLOOD BANK	ND	501(C)(3)	LINE 12D, III-O		0	N/A
ALTRU ALLIANCE
1200 S COLUMBIA RD	GRAND FORKS	ND	58201	237389089	SUPPORT HOSPITAL AND AFFILIATES	ND	501(C)(3)	LINE 12C, III-FI		0	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	ALTRU SPECIALTY SERVICES INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1200 S COLUMBIA RD	AddressLine1Txt
City	GRAND FORKS	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58201	ZIPCd

Field	Value	IRS element (for citing)
EIN	450395652	EIN
Primary Activities	DME SALES, RETAIL PHARMACY	PrimaryActivitiesTxt
Legal Domicile State	ND	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	ALTRU HEALTH SYSTEM	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	C	EntityTypeTxt
Share Of Total Income	$11,859,946	ShareOfTotalIncomeAmt
Share Of EOY Assets	$40,073,649	ShareOfEOYAssetsAmt
Ownership	1.00000	OwnershipPct
Controlled Organization	Yes (1)	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (1)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
ALTRU HEALTH FOUNDATION
C	$1,656,679	CASH DONATED
ALTRU HEALTH FOUNDATION
O	$122,685	COMPENSATION TO RELATED ORG
ALTRU SPECIALTY SERVICES
A	$136,478	RENT PAYMENT RECEIVED