2021-11-10T12:29:09-06:00 2020-12-31 990 2020-01-01 410907986 ST FRANCIS REGIONAL MEDICAL CENTER STFR 6122620660 PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 AMY JERDEE PRESIDENT 6122620660 2021-11-10 AMY JERDEE 999009999 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z AMY JERDEE PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 203338644 0 0928 X WWW.STFRANCIS-SHAKOPEE.COM X 1966 MN PROVIDE QUALITY HEALTH CARE FOR THE PEOPLE IN SCOTT, CARVER AND WESTERN DAKOTA COUNTIES, MINNESOTA. 16 12 0 181 0 0 293281 1141094 171374833 168212074 2484011 6526193 560874 593080 174712999 176472441 294952 146087 0 0 82678452 84472538 0 0 172901 78995845 79359292 161969249 163977917 12743750 12494524 196443242 215100940 58179247 65278465 138263995 149822475 X ST. FRANCIS REGIONAL MEDICAL CENTER (ST. FRANCIS) HAS A RICH TRADITION OF PROVIDING QUALITY HEALTH CARE FOR THE PEOPLE LIVING IN SCOTT, CARVER AND WESTERN DAKOTA COUNTIES OF MINNESOTA. FOUNDED BY A SMALL GROUP OF FRANCISCAN SISTERS IN 1938, ST. FRANCIS HAS GROWN FROM A SMALL COMMUNITY HOSPITAL TO A COMPREHENSIVE, HIGH-QUALITY REGIONAL MEDICAL CENTER RAPIDLY EXPANDING TO MEET THE NEEDS OF THIS FAST-GROWING AREA. LOCAL ACCESS TO HIGH-QUALITY HEALTH CARE MAKES ST. FRANCIS A VALUABLE COMMUNITY ASSET, BOTH TO THE INDIVIDUALS AND BUSINESSES IT SERVES. ST. FRANCIS CONTINUES TO PROVIDE EXCELLENT, COMPASSIONATE HEALTH CARE SERVICES WITH AN EMPHASIS ON INDIVIDUAL DIGNITY IN THE HEALING OF BODY, MIND, AND SPIRIT. THIS COMMITTMENT IS REFLECTED IN OUR MISSION STATEMENT "AT ST. FRANCIS,WE WORK TOGETHER TO PROVIDE ALL PEOPLE THE HEALING EXPERIENCE WE WOULD EXPECT FOR OURSELVES AND OUR FAMILIES." 0 0 133634178 176062714 HOSPITAL, MEDICAL AND OTHER HEALTH CARE SERVICESST.FRANCIS, LOCATED IN THE TWIN CITIES SOUTHWEST METRO IN THE CITY OF SHAKOPEE, MINNESOTA, DELIVERS HIGH QUALITY, RESPECTFUL HOSPITAL, MEDICAL AND OTHER HEALTH CARE SERVICES TO PATIENTS. AS A CATHOLIC, MISSION-DRIVEN ORGANIZATION, ST.FRANCIS IS COMMITTED TO IMPROVING THE LIFELONG HEALTH OF THE COMMUNITIES IT SERVES. ST. FRANCIS SHARES ITS CAMPUS WITH ST.GERTRUDE'S HEALTH AND REHABITLITION CENTER, ALLINA HEALTH CLINIC, PARK NICOLLET CLINIC, CANCER CENTER, DIALYSIS CENTER, EMERGENCY AND URGENT CARE, MEDICAL AND DENTISTRY, AND MANY OTHER SERVICES AND SPECIALTY CLINICS HOUSED IN ADJOINING MEDICAL OFFICE BUILDINGS. ST. FRANCIS IS JOINTLY OWNED BY ALLINA HEALTH SYSTEM, HPI-RAMSEY, CONTROLLED BY HEALTH PARTNERS,INC. AND CRITICAL ACCESS GROUP, CONTROLLED BY ESSENTIA HEALTH.IN 2020 ST. FRANCIS EXPENDED $ 133.6 MILLION TO PROVIDE MEDICAL SERVICES TO PATIENTS THAT INCLUDED OVER 5,000 INPATIENT ADMISSIONS, NEARLY 98,000 OUTPATIENT VISITS AND OVER 1,000 BIRTHS. 12254159 COSTS OF PARTICIPATING IN GOVERNMENT PROGRAMSTO PROMOTE ACCESS TO CARE FOR ALL INDIVIDUALS, ST. FRANCIS PARTICIPATES IN THE FOLLOWING PUBLIC HEALTH CARE PROGRAMS: MEDICARE, MEDICAID, MINNESOTACARE, AND GENERAL ASSISTANCE. PAYMENTS FROM THESE PROGRAMS FREQUENTLY DO NOT COVER THE COSTS ST. FRANCIS INCURS TO SERVE PROGRAM BENEFICIARIES. THE FOLLOWING IS A BREAKDOWN ON COSTS RELATED TO THESE PROGRAMS, SERVICES AND ADDITIONAL TAXES AND FEES.COSTS IN EXCESS OF MEDICARE AND MEDICAID PAYMENTSST. FRANCIS PROVIDES SERVICES TO PUBLIC PROGRAM ENROLLEES. SUCH PUBLIC PROGRAMS HAVE HISTORICALLY BEEN REIMBURSED AT AMOUNTS LESS THAN COST. IN 2020, ST. FRANCIS EXPENDED $7.3 MILLION BEYOND REIMBURSEMENTS TO PROVIDE CARE FOR MEDICARE PATIENTS AND AN ADDITIONAL $1.1 MILLION BEYOND REIMBURSEMENTS FOR MEDICAID PATIENTS.MEDICAID SURCHARGEST. FRANCIS IS A PARTICIPANT IN THE MEDICAID SURCHARGE PROGRAM. THE CURRENT PROGRAM INCLUDES A 1.56% SURCHARGE ON A HOSPITAL'S NET PATIENT REVENUE (EXCLUDING MEDICARE REVENUE). REPORTED AMOUNTS ARE NET OF ANY DISPROPORTIONATE SHARE ADJUSTMENTS. IN 2020, ST. FRANCIS PAID $1.8 MILLION FOR THE MEDICAID SURCHARGE.MINNESOTACARE TAXST. FRANCIS ALSO PARTICIPATES IN THE FUNDING OF MEDICAL CARE FOR PEOPLE WHO ARE UNINSURED THROUGH A MINNESOTACARE TAX OF 2% ON CERTAIN NET REVENUE. PATIENTS WHO ARE UNABLE TO GET INSURANCE THROUGH THEIR EMPLOYER ARE ELIGIBLE TO PARTICIPATE IN MINNESOTACARE. ST. FRANCIS PAID $2.1 MILLION FOR MINNESOTACARE TAX IN 2020. 3405468 -7850640 UNCOMPENSATED CARECHARITY CAREST. FRANCIS PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED COST TO RESIDENTS OF THE COMMUNITIES THAT IT SERVES THROUGH THE PROVISION OF CHARITY CARE. OUR CHARITY CARE PROGRAM KNOWN AS ALLINA HEALTH PARTNERS CARE PROGRAM WAS ESTABLISHED TO ASSIST PATIENTS WHO DO NOT QUALIFY FOR MEDICAL ASSISTANCE SUCH AS MEDICAID AND WHOSE ANNUAL INCOMES ARE AT OR BELOW 275% OF THE FEDERAL POVERTY LEVEL. CHARITY CARE DOES NOT INCLUDE BAD DEBT (CHARGES WRITTEN OFF FOR PROVIDING SERVICES TO PERSONS ABLE, BUT UNWILLING, TO PAY FOR THESE SERVICES). THROUGH THIS PROGRAM, ST. FRANCIS STRIVES TO ENSURE THAT ALL MEMBERS OF THE COMMUNITY RECEIVE QUALITY MEDICAL CARE; REGARDLESS OF ABILITY TO PAY. IN 2020, ST. FRANCIS PROVIDED $0.8 MILLION IN CHARITY CARE.UNINSURED DISCOUNT PROGRAMFOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR MEDICAID OR MEET THE FINANCIAL THRESHOLD FOR CHARITY CARE, BUT REQUIRE SOME FINANCIAL ASSISTANCE, ST. FRANCIS PROVIDES A SLIDING SCALE DISCOUNT. ALL UNINSURED PATIENTS ARE ELIGIBLE FOR A MINIMUM OF A 25 PERCENT DISCOUNT ON BILLED CHARGES AND MAY QUALIFY FOR DISCOUNTS UP TO 44 PERCENT BASED ON ELIGIBILITY CRITERIA. IN 2020, ST. FRANCIS PROVIDED $2.6 MILLION IN SUCH DISCOUNTS TO LOW-INCOME, UNINSURED INDIVIDUALS. BAD DEBTST. FRANCIS PROVIDES MEDICAL CARE TO ALL IN NEED. THERE ARE TIMES WHEN PATIENT ACCOUNT BALANCES GO UNPAID, KNOWN AS BAD DEBT. THESE BAD DEBT CHARGES IN 2020 TOTALED $7.9 MILLION. BAD DEBT EXPENSE HAS NOT BEEN INCLUDED IN FORM 990, PART IX, LINE 25 BUT HAS BEEN REPORTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON FORM 990, PART VIII LINE 2B. 969146 146087 COMMUNITY SERVICESST. FRANCIS IS COMMITTED TO SUPPORTING PROGRAMS AND SERVICES THAT ADDRESS COMMUNITY NEEDS. IN 2020, ST. FRANCIS CONTRIBUTED $0.8 MILLION TO COMMUNITY PROGRAMS AND SERVICES TO ADVANCE THE HEALTH OF THE BROADER COMMUNITY. BELOW ARE EXAMPLES OF PROGRAMS AND SERVICES ST. FRANCIS SUPPORTS WITHIN THE COMMUNITIES WE SERVE UNDER THE CATEGORIES PROVIDED BY THE CATHOLIC HEALTHCARE ASSOCIATION (CHA) AND VHA, INC. THE ACTIVITIES IMPROVE COMMUNITY HEALTH AND DO NOT GENERATE INPATIENT OR OUTPATIENT BILLS. ST. FRANCIS SUPPORTS MANY PROGRAMS THAT FALL UNDER THIS CATEGORY. A FEW EXAMPLES INCLUDE:RIVER VALLEY HEALTH SERVICES:ST. FRANCIS PROVIDES FINANCIAL SUPPORT TO RIVER VALLEY HEALTH SERVICES (RIVER VALLEY). RIVER VALLEY PROVIDES SAFE, HIGH-QUALITY PUBLIC HEALTH NURSING AND BI-LINGUAL COMMUNITY RESOURCE REFERRALS AND CASE MANAGEMENT AT SITES IN SCOTT AND CARVER COUNTIES TO PEOPLE WHO ARE UNINSURED AND UNDERINSURED. IN 2020 RIVER VALLEY HAD 1,403 CLIENT VISITS, INCLUDING COVID-19 AND TELEHEALTH SCREENINGS. THIS PREVENTATIVE MODEL HAS PROVEN EFFECTIVE IN PROVIDING ACCESS TO CARE AS 100% OF THE CLIENTS ARE UNINSURED OR UNDERINSURED. RIVER VALLEY HELPS PEOPLE WITH COMPLEX PROBLEMS NAVIGATE THROUGH THE COMMUNITY AGENCIES AND PROGRAMS AVAILABLE TO THEM. IN 2020, RIVER VALLEY TOOK ON MANY NEW ACTIVITIES INCLUDING PPE DISTRIBUTIONS TO VETERANS AND OTHERS, CONTACT TRACING, COVID-19 TRACING AND SUPPORTING CLIENTS WITH UNMET COVID-19 INDUCED NEEDS AND SUPPORT DURING ISOLATION AND QUARANTINE.ESPERANZA: UNABLE TO HOLD ITS TRADITIONAL SUMMER PROGRAMMING IN 2020, ESPERANZA TURNED ITS ATTENTION TO SUPPORTING COMMUNITY MEMBERS IN CARVER, SCOTT AND DAKOTA COUNTIES WITH COVID-19 ACCESSIBLE FOOD DISTRIBUTIONS. ESPERANZA TAPPED INTO ITS MANY COMMUNITY VOLUNTEERS AND WAS OUT IN EVERY KIND OF WEATHER TO ENSURE HUNGRY PEOPLE IN OUR COMMUNITY HAD FOOD TO EAT. OF NOTE, ESPERANZA OFFICALLY CAME UNDER THE CARVER-SCOTT-DAKOTA COMMUNITY ACTION PROGRAM IN 2020, PROVIDING ALL BACK OFFICE FUNCTIONS AND CREATING STABILITY FOR FUTURE GROWTH AS WELL AS SUSTAINABILITY. ST. MARY'S HEALTH CLINICST. MARY'S HEALTH CLINIC PROVIDES QUALITY, FREE HEALTH SERVICES TO PEOPLE WHO ARE UNINSURED AND UNDERINSURED. FOR MANY YEARS, ST. FRANCIS HAS PROVIDED FINANCIAL SUPPORT,CLINIC SPACE AND SUPPLIES TO ALLOW ST. MARY'S HEALTH CLINIC TO OPERATE IN SHAKOPEE. ST. MARY'S HEALTH CLINICS PROVIDES LABORATORY TESTING, RADIOLOGY, OUTPATIENT CARE AND MEDICAL SUPPLIES. THE ST. MARY'S CLINIC IN SHAKOPEE PROVIDES A CONTINUUM OF FREE HEALTH CARE SERVICES TO LOW-INCOME, UNINSURED PEOPLE IN SCOTT, CARVER AND WESTERN DAKOTA COUNTIES. VOLUNTEER DOCTORS AND NURSES PROVIDE CARE INCLUDING PRIMARY CARE VISITS, LAB TESTS, DIAGNOSTIC SERVICES, HEALTH SCREENING, RADIOLOGY SERVICES, PRESCRIPTION MEDICATIONS AND ANY OTHER MEDICALLY NECESSARY OUTPATIENT MEDICAL SERVICES. INTERPRETING SERVICES ARE PROVIDE, AND THE DIABETES EDUCATION ENHANCEMENT PROGRAM (DEEP) PROVIDES ONE-TO-ONE DIABETES SCREENING AND CARE MANAGEMENT TO PATIENTS. OVER 99% OF THE PATIENTS SEEN AT SMHC IN SHAKOPEE ARE LATINX AND 100% OF THE PATIENTS ARE AT OR BELOW THE 275% OF FEDERAL POVERTY GUIDELINES. ALL SERVICES ARE PROVIDED FREE OF CHARGE TO THE PATIENTS. IN 2020, SMHC RESPONDED TO COMMUNITY COVID-19 CONCERNS INCLUDING DIRECT PATIENT FOLLOW UP WITH 800 LATINX PARTICIPANTS.HEALTH PROFESSIONS EDUCATION ST. FRANCIS ACTIVELY SUPPORTS NUMEROUS MEDICAL EDUCATION ACTIVITIES FOR PROVIDERS, HEALTH CARE STUDENTS AND OTHER HEALTH PROFESSIONALS. IN 2020, ST. FRANCIS INVESTED $26,732 IN INTERNSHIP OPPORTUNITIES, MENTORING PARTNERSHIPS, AND GRADUATE MEDICAL EDUCATION PROGRAMMING. ST. FRANCIS IS COMMITTED TO THE EDUCATION, TRAINING AND DEVELOPMENT OF FUTURE HEALTH CARE PROFESSIONALS AND ENSURES THE AVAILABILITY OF A HIGHLY TRAINED WORKFORCE TO MEET THE COMMUNITY'S HEALTH CARE NEEDS. FINANCIAL AND IN-KIND CONTRIBUTIONSST. FRANCIS PROVIDES NUMEROUS IN-KIND AND MONETARY CONTRIBUTIONS TO NOT-FOR-PROFIT ORGANIZATIONS TO SUPPORT COMMUNITY NEEDS. IN 2020, ST. FRANCIS FUNDED $122 THOUSAND FOR DONATIONS TO COMMUNITY PROGRAMS, EQUIPMENT, SUPPLIES, AND STAFF TIME, ST. FRANCIS PARTNERS WITH LOCAL ORGANIZATIONS POSSESSING EXPERTISE, VOLUNTEERS AND STAFF NEEDED TO IMPROVE THE HEALTH OF PEOPLE IN NEED. COMMUNITY-BUILDING ACTIVITIESST. FRANCIS AND ITS EMPLOYEES ARE ACTIVE PARTICIPANTS IN VARIOUS COMMUNITY ACTIVITIES THAT TARGET THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS AND HUNGER. EXAMPLES INCLUDE COMMUNITY HEALTH IMPROVEMENT ADVOCACY, WORKFORCE DEVELOPMENT, PARTICIPATING IN VARIOUS COMMUNITY COALITIONS AND DISASTER PREPAREDNESS PLANNING. IN 2020, THE VALUE ST. FRANCIS PROVIDED IS VALUED AT $9,600.RELATED ORGANIZATIONS - ST. FRANCIS ALSO INDIRECTLY SUPPORTS THE NUMEROUS CHARITABLE PURPOSES SUPPORTED BY ITS RESPECTIVE JOINT MEMBER ORGANIZATIONS OF CRITICAL ACCESS GROUP, ALLINA HEALTH SYSTEM AND HPI-RAMSEY. 969146 146087 150262951 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 X 88 0 1 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 X 16 12 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 MN X TAX SERVICES MAIL ROUTE 10890 6122620660 2925 CHICAGO AVENUE MINNEAPOLIS MN 554071321 KEITH OLSON DO DIRECTOR 2.00 40.00 X 0 461040 38432 AMY JERDEE DIRECTOR/PRESIDENT 40.00 0.00 X X 306077 0 57349 JENNIFER HUNT MD DIRECTOR 2.00 40.00 X 0 330183 45569 MARK DANAHY MD DIRECTOR 2.00 0.00 X 0 0 0 SR KATHLEEN DEL MONTE DIRECTOR 2.00 0.00 X 484 0 0 JENNIFER DESCHAINE DIRECTOR/SECRETARY 2.00 0.00 X 390 0 0 AYESHA DOWNS DDS DIRECTOR/VICE CHAIR 2.00 0.00 X 290 0 0 DEBORAH PAULY DIRECTOR/CHAIRMAN 2.00 0.00 X 290 0 0 ROBERT BERNIER DIRECTOR/TREASURER 2.00 0.00 X 194 0 0 REV DANIEL POFFENBERGER DIRECTOR 2.00 0.00 X 171 0 0 SHARI DUGSTAD DIRECTOR 2.00 0.00 X 144 0 0 YANNICK MIAFFO DIRECTOR 2.00 0.00 X 96 0 0 MICHAEL WEBB DIRECTOR 2.00 0.00 X 73 0 0 JOANNA BRYANT DIRECTOR 2.00 0.00 X 0 0 0 AMY DEWANE DIRECTOR 2.00 0.00 X 0 0 0 SR KATHLEEN HOFER DIRECTOR 2.00 0.00 X 0 0 0 MARK SANNES MD DIRECTOR 2.00 0.00 X 0 0 0 CYNTHIA VINCENT VP FINANCE 40.00 0.00 X 244841 0 70857 SUE MILLER VP PATIENT CARE SVCS. 40.00 0.00 X 241222 0 58700 JAMES GRUENWALD CRNA 40.00 0.00 X 211032 0 28577 CHRISTY MCGUFFEE CRNA 40.00 0.00 X 204304 0 31238 DEAN TEBRAKE CRNA 40.00 0.00 X 213277 0 18970 GREGORY SPINDLER CRNA 40.00 0.00 X 213343 0 18664 FARAH PIEPER CRNA 40.00 0.00 X 216363 0 487 MONTE JOHNSON MD FORMER DIRECTOR/VP MEDICAL AFFAIRS 24.00 16.00 X 258110 172074 90283 BRIAN PROKOSCH MD FORMER VP MEDICAL AFFAIRS 0.00 40.00 X 0 353530 23055 2110701 1316827 482181 109 1 1 0 PARK NICOLLET METHODIST HOSPITAL 6500 EXCELSIOR BLVD ST LOUIS PARK MN 55440 PROFESSIONAL SERVICES - PHYSICIAN 1420928 PREMIER STAFFING INC 243 WINKLER TRAIL COLOGNE MN 55322 PROFESSIONAL SERVICES - PHYSICIAN 1255966 CHILDREN'S HEALTH CARE INC 2525 CHICAGO AVENUE SOUTH MINNEAPOLIS MN 55404 PROFESSIONAL SERVICES - MEDICAL 1044513 MA MORTENSON COMPANY 700 MEADOW LANE NORTH MINNEAPOLIS MN 55422 CONSTRUCTION 555655 HEALTH SYSTEMS COOPERATIVE LAUNDRIES 55 5TH STREET EAST 960 ST PAUL MN 55101 OTHER SERVICES - DRY CLEANING/LAUNDRY 421030 13 63471 1077623 1543 1141094 NET PATIENT REVENUE 621110 176062714 176062714 BAD DEBT 621110 -7850640 -7850640 168212074 959505 959505 196 196 583355 0 583355 583355 583355 32341379 56736 26823200 8423 5518179 48313 5566492 5566492 44305 63471 34580 9725 9725 176472441 168212074 0 7119273 114936 114936 31151 31151 1669209 612202 1057007 62163037 58828875 3250631 83531 4358300 4058483 294114 5703 11202850 10432180 756010 14660 5079142 4729735 342760 6647 15000 15000 100000 100000 11478858 10484516 958349 35993 276804 276804 23126758 23066023 45200 15535 121277 47162 74115 5856080 3165131 2690949 10832 5262 5570 17643 12951 4692 1682756 1682756 8378552 6282601 2094200 1751 1491200 1043840 447360 PURCHASED SERVICES 22830023 21770636 1057899 1488 MINNESOTACARE TAX 2068997 2068997 MEDICAID SURCHARGE 1771252 1771252 133260 54262 71405 7593 163977917 150262951 13542065 172901 450413 272632 92528 569434 26867280 24023845 66331 103831 2141857 2411321 49003 38816 165636951 100423199 64863180 65213752 89524349 113382117 12388301 9085192 196443242 215100940 9679595 14069190 123789 37686 36111372 34215029 12264491 16956560 58179247 65278465 X 136719559 147173426 1544436 2649049 138263995 149822475 196443242 215100940 X 12494524 -1040899 104855 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 220940 220940 105122140 54178829 50943311 5752629 5112149 640480 48397816 38511689 9886127 6143426 2620532 3522894 65213752 TRUST MONEY MARKET 34844042 F TRUST CORE FIXED INCOME 29698036 F TRUST EQUITY SECURITIES 22676027 F TRUST GLOBAL BOND FUNDS 5360185 F COMMODITIES & OTHER 5370959 F TRUST GLOBAL EQUITY FUND 1652259 F TRUST EMERGE MARKET FUND 3766337 F EMERGING MARKETS DEBT FUND 3284123 F EQUITY LONG/SHORT HEDGE FUNDS 4530397 F DONOR RESTRICTED INVESTMENTS 2199746 F FUNDS RESTRICTED BY TRUSTEE 6 F 113382117 OTHER LONG-TERM LIABILITIES 6796830 CURRENT PORTION OTHER LT DEBT & CAPITAL LEASE 3263313 OPERATING LEASE LIABILITIES 6896417 16956560 X PART X, LINE 2: THE FOLLOWING IS FROM NOTE 2(L) TO THE AUDITED FINANCIAL STATEMENTS: "THE MEDICAL CENTER ANALYZES INCOME TAX POSITIONS TAKEN FOR FILING WITH THE INTERNAL REVENUE SERVICE AND THE STATE OF MINNESOTA. THE MEDICAL CENTER BELIEVES THAT INCOME TAX FILING POSITIONS WILL BE SUSTAINED UPON EXAMINATION AND DOES NOT ANTICIPATE ANY ADJUSTMENTS THAT WOULD RESULT IN A MATERIAL ADVERSE EFFECT ON THE MEDICAL CENTER'S CONSOLIDATED FINANCIAL STATEMENTS. AS OF DECEMBER 31, 2020 AND 2019, THE MEDICAL CENTER DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. ACCORDINGLY, THE MEDICAL CENTER HAS NOT RECORDED ANY RESERVES OR RELATED ACCRUALS FOR INTEREST AND PENALTIES FOR UNCERTAIN INCOME TAX POSITIONS. THE FILINGS FOR THE YEARS 2016 TO 2019 ARE OPEN TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES." CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 7587028 EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM 1233972 0 0 0 0 0 0 8821000 0 8821000 0 0 1 0 0 0 PART III ACCOUNTING METHOD: FORM 990 SCHEDULE F PART IV 3 ST. FRANCIS REGIONAL MEDICAL CENTER'S INVESTMENTS, INCLUDING THOSE OUTSIDE THE U.S., ARE POOLED WITH THOSE OF OTHER ALLINA HEALTH ENTITIES UNDER A TRUST AGREEMENT, WITH THE CUSTODIAN /TRUSTEE BANK HANDLING THE INVESTMENT ACCOUNTING. INVESTMENTS ARE STATED AT FAIR VALUE. THE MEDICAL CENTER HAS CLASSIFIED INVESTMENTS, OTHER THAN THOSE LIMITED AS TO USE, AS TRADING AND RECORDS ADJUSTMENTS TO MARKET VALUE AS A COMPONENT OF NONOPERATING GAINS(LOSSES). THE DETAILS OF THE SALES AND PURCHASES ARE MAINTAINED BY THE CUSTODIAN/TRUSTEE BANK. DUE TO THE UNITIZED STRUCTURE OF THE INVESTMENTS AT ALLINA HEALTH, THE MEDICAL CENTER IS ALLOCATED AN EQUITABLE PORTION OF SALES AND PURCHASES OF INVESTMENTS EXECUTED FOR ALLINA HEALTH. THE MEDICAL CENTER'S EQUITABLE PORTION IS INCLUDED IN SCHEDULE F PART I LINE 3 AND ALLINA HEALTH SYSTEM MASTER TRUST, EIN 36-3261413, FILES THE FORM 5471 ON BEHALF OF THE OTHER ALLINA HEALTH ENTITIES, INCLUDING THE MEDICAL CENTER. FOUNDATION GALA 107776 63471 44305 4150 30430 107776 63471 44305 4150 30430 34580 9725 1 1 X 1 X 275.000000000000 0 1 1 0 1 1 768694 768694 0.00470 2858357 2858357 0.01740 2068997 2068997 0.01260 5696048 5696048 0.03470 6 2199 454739 454739 0.00280 1 4 26732 26732 0.00020 1 57 9191 9191 0.00010 1 0 121399 121399 0.00070 4 0 122503 122503 0.00070 13 2260 734564 734564 0.00450 13 2260 6430612 6430612 0.03920 1 94231 94231 0.00060 2 20 1411 1411 0.00000 3 20 95642 95642 0.00060 1 2595776 22743805 29378301 -6634496 X 1 1 1 1 ST FRANCIS REGIONAL MEDICAL CENTER 1455 ST FRANCIS AVENUE SHAKOPEE MN 55379 WWW.STFRANCIS-SHAKOPEE.COM 380437 X X X X ST FRANCIS REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 19 1 0 1 1 X SEE WEBSITE PART V, SECTION C, LINE 7D X SEE WEBSITE PART V,SECTION C, LINE 7D X X 1 19 1 SEE WEBSITE PART V,SECTION C, LINE 7D 0 1 X 275.000000000000 0.000000000000 X X X X X X 1 1 X X X 1 X WWW.STFRANCIS-SHAKOPEE.COM X WWW.STFRANCIS-SHAKOPEE.COM X WWW.STFRANCIS-SHAKOPEE.COM X X X X X X 1 X 0 X X X 1 X 0 1 ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: IN 2019, EACH ALLINA HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. EACH HOSPITAL WORKED CLOSELY WITH LOCAL PUBLIC HEALTH TO COMPLETE ITS CHNA. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PIERCE COUNTY. AT A MINIMUM, LOCAL PUBLIC HEALTH WORKED WITH ALLINA HEALTH TO REVIEW HOSPITAL, STATE AND LOCAL DATA AND HELP DEFINE 2020-2022 CHNA PRIORITIES. ADDITIONALLY, TO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. COMMUNITY INPUT CAME FROM DIVERSE GROUPS IN TERMS OF AGE, RACE/ETHNICITY, CULTURAL GROUP, AND OTHER DEMOGRAPHICS. A SPECIAL EFFORT WAS MADE TO REACH HISTORICALLY UNDERSERVED COMMUNITIES INCLUDING, BUT NOT LIMITED TO: WEST AFRICAN, SOMALI, LATINX, LGBTQ, FARMING, AFRICAN AMERICAN, PEOPLE EXPERIENCING MENTAL HEALTH CONDITIONS, PEOPLE LIVING ON LESS AND LOW-INCOME HOUSING RESIDENTS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT.THE ST. FRANCIS MEDICAL CENTER APPROACH:ST. FRANCIS DEVELOPED ITS CHNA IN PARTNERSHIP WITH SCOTT COUNTY PUBLIC HEALTH, WHICH WAS SIMULTANEOUSLY LEADING ITS COMMUNITY HEALTH IMPROVEMENT PLANNING (CHIP) PROCESS. THE PROCESS WAS ALSO INFLUENCED BY STAFF'S PARTICIPATION IN THE SCOTT COUNTY HEALTH CARE SYSTEM COLLABORATIVE, SCOTT COUNTY HEALTH IMPROVEMENT PARTNERSHIP'S COMMUNITY LEADERSHIP TEAM, THE CARVER COUNTY PUBLIC HEALTH CHIP PROCESS AND OTHER COMMUNITY EFFORTS. THESE GROUPS INCLUDED COMMUNITY MEMBERS AND REPRESENTATIVES FROM 19 AGENCIES AND ORGANIZATIONS. AS PART OF THIS PROCESS, THE SCOTT COUNTY HEALTH CARE COLLABORATIVE HOSTED A PRIMARY DATA COLLECTION EVENT IN OCTOBER 2017 THAT WAS HEAVILY PROMOTED TO ENSURE ATTENDANCE BY A BROAD CROSS-SECTION OF COMMUNITY. APPROXIMATELY 140 RESIDENTS PARTICIPATED. HALF OF PARTICIPANTS IDENTIFIED AS INDIGENOUS OR PEOPLE OF COLOR. A WIDE RANGE OF AGES WERE REPRESENTED: ALMOST 25 PERCENT OF PARTICIPANTS WERE YOUTH UNDER AGE 24 YEARS, AND 39 PERCENT OF PARTICIPANTS IDENTIFIED AND GENERATION X. THE EVENT INCLUDED AN ENGAGEMENT PROCESS CALLED INTENTIONAL SOCIAL INTERACTION, WHICH CONSISTS OF FOCUSED CONVERSATIONS ABOUT SCOTT COUNTY ASSETS, CULTURAL WELLNESS TRADITIONS AND GAPS IN CARE. AS PART OF THE PRIORITIZATION PROCESS CONDUCTED BY SCOTT COUNTY PUBLIC HEALTH CARE SYSTEM COLLABORATIVE AND SCOTT COUNTY HEALTH IMPROVEMENT PARTNERSHIP'S COMMUNITY LEADERSHIP TEAM TO REVIEW STATE AND LOCAL SECONDARY DATA RESOURCES, SUCH AS HEALTH ISSUE BROCHURES PREPARED BY SCOTT COUNTY PUBLIC HEALTH, SCOTT COUNTY RESPONSES ON THE MINNESOTA STUDENT SURVEY, SCOTT COUNTY CHRONIC DISEASE DASHBOARD AND SCOTT COUNTY 10-YEAR DEATH DATA. ADDITIONALLY, THE SCOTT COUNTY PRIORITIZATION GROUP REVIEWED SELECT ALLINA HEALTH PATIENT DATA, CHOSEN BASED ON PRIORITIES DEFINED BY THE CENTER FOR COMMUNITY HEALTH AND ALLINA HEALTH EQUITY PRIORITIES. ADDITIONALLY, SCOTT COUNTY PUBLIC HEALTH CONDUCTED A COMMUNITY INPUT SURVEY, CREATED IN PARTNERSHIP WITH ST. FRANCIS AND HEALTH PARTNERS/PARK NICOLLET FOUNDATION. IN THE SUMMER OF 2018, STAFF DISTRIBUTED ENGLISH AND SPANISH VERSIONS OF THE SURVEY AT EVENTS, SUCH AS THE SHAKOPEE INTERNATIONAL FESTIVAL, SCOTT COUNTY FAIR, VISION 2040 POP-UPS AND COMMUNITY AREAS LIKE LAUNDRY MATS, ETHNIC GROCERY STORES AND THE DEPARTMENT OF MOTOR VEHICLES. THE SURVEY ASKED COMMUNITY RESIDENTS TO LIST THEIR TOP THREE COMMUNITY HEALTH CONCERNS FROM A LIST THAT INCLUDED EXPERIENCES WITH TRAUMA AND HEALTH CONDITIONS, BEHAVIORS AND PERCEPTIONS. A TOTAL OF 1,125 COMMUNITY MEMBERS COMPLETED THE SURVEY. STAFF ANALYZED THE SURVEY RESULTS BY COMMUNITY AND DEMOGRAPHIC INDICATORS, INCLUDING GENDER, RACE, ETHNICITY, AGE AND INCOME.BASED ON THE DATA REVIEW AND COMMUNITY FEEDBACK, SCOTT COUNTY PUBLIC HEALTH CHIP PARTICIPANTS GENERATED A LIST OF 16 HEALTH ISSUES FOR FINAL REVIEW. IN NOVEMBER 2018, SCOTT COUNTY PUBLIC HEALTH HOSTED A PRIORITIZATION MEETING IN WHICH PARTICIPANTS VOTED ON THEIR TOP THREE LOCAL HEALTH PRIORITIES. THIS VOTING PROCESS RESULTED IN THE FOLLOWING NEEDS BEING IDENTIFIED FOR SCOTT COUNTY: - ALCOHOL AND DRUG USE BY YOUTH- OBESITY- MENTAL HEALTH CONCERNSTO BUILD ON PREVIOUS WORK AND DUE TO THE OVERLAP IN PRIORITIES IDENTIFIED THROUGH THE SCOTT COUNTY PUBLIC HEALTH ASSESSMENT PROCESS WITH THOSE IDENTIFIED FOR ST. FRANCIS' 2016 CHNA, ST. FRANCIS CHOSE TO CONTINUE ITS EXISTING PRIORITIES FOR ACTION IN 2020-2022: - MENTAL WELLNESS AND SUBSTANCE ABUSE - HEALTHY WEIGHT- ACCESS TO CARE ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: PUBLIC HEALTH AGENCY STAFF WERE VERY INVOLVED IN MEETING TO REVIEW DATA AND PLAN THE FOCUS GROUP AND COMMUNITY DIALOGUE. COUNTIES INVOLVED IN THE ST. FRANCIS CHNA INCLUDE: CARVER COUNTY, DAKOTA COUNTY, AND SCOTT COUNTY. ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 7D: UPON REQUESTSCHEDULE H PART V, LINE 7A AND 10A: WWW.STFRANCIS-SHAKOPEE.COM/MEDIA/14831/STFRANCIS-CHNA.PDFSCHEDULE H PART V, LINE 7B: HTTP://WWW.ALLINAHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: AT THE END OF 2019, ALLINA HEALTH COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT. THE 2019 ASSESSMENT IDENTIFIED HEALTHY EATING/ACTIVE LIVING, MENTAL HEALTH AND SUBSTANCE USE AND SOCIAL DETERMINANTS OF HEALTH AS PRIORITY NEEDS FOR 2020-2022 ACROSS ALL ALLINA HEALTH GEOGRAPHIES. MANY PLANNED ACTIVITIES AND EVENTS WERE PUT ON HOLD DUE TO COVID-19 PANDEMIC, AFFECTING THE SCOPE AND FOCUS OF WORK IN 2020 FOR THE ALLINA HEALTH SYSTEM AND INDIVIDUAL HOSPITALS. HOWEVER, MANY EFFORTS WERE MADE TO CONTINUE IMPROVING THE HEALTH OF THE COMMUNITIES BY ADVANCING ADVOCACY WORK AND DEEPENING HOSPITALS' RELATIONSHIP AND COLLABORATION WITH THE COMMUNITIES ALLINA HEALTH SERVES.EXAMPLES OF SYSTEM-WIDE INITIATIVES IN THESE AREAS INCLUDE:CHANGE TO CHILL - CHANGE TO CHILL (CTC) IS A FREE, ONLINE RESOURCE THAT PROVIDES STRESS REDUCTION TIPS, LIFE BALANCE TECHNIQUES AND HEALTH EDUCATION SERVICES FOR TEENS. SINCE 2018, THE PROGRAM HAS ALSO INCLUDED AN IN-PERSON COMPONENT-THE CHANGE TO CHILL SCHOOL PARTNERSHIP (CTCSP). COMPONENTS OF CTCSP INCLUDE STAFF TRAINING ON CTC, CTC MESSAGING FOR PARENTS, A PAID STUDENT INTERNSHIP AND FUNDING FOR A "CHILL ZONE"-A DESIGNATED SPACE FOR STUDENTS AND STAFF TO PRACTICE SELF-CARE. INITIAL EVALUATIONS OF CTCSP HAVE SHOWN INCREASES IN CONFIDENCE IN ABILITY TO COPE WITH STRESS AMONG STUDENTS WHO PARTICIPATE IN PROGRAM COMPONENTS. IN 2020, COVID-19 CAUSED FEAR, ANXIETY, UNCERTAINTY AND STRESS IN POPULATIONS ACROSS MINNESOTA AND SCHOOLS TRANSITIONED TO DISTANCE LEARNING. CTC MET THE CHANGING NEEDS OF THE COMMUNITY BY TRANSFORMING IN-PERSON TRAININGS AND CTCSP TO A VIRTUAL MODEL, OFFERING A VIRTUAL CARE PACKAGES TO FAMILIES, CREATING NEW ONLINE RESOURCES LIKE A VIRTUAL CHILL ZONE, AND ENHANCING EXISTING PROGRAM CONTENT RELATED TO COPING WITH GRIEF, LOSS AND CHANGE. IN 2020, MORE THAN 55,000 USERS VISITED THE CTC WEBSITE-A 81% INCREASE FROM THE PREVIOUS YEAR. AN ADDITIONAL 2,500 PARTICIPATED IN VIRTUAL TRAININGS AND WELL-BEING SESSIONS, AND 30 STUDENTS FROM 15 HIGH SCHOOLS AND MIDDLE SCHOOLS PARTICIPATED IN A VIRTUAL CTCSP INTERNSHIP PROGRAM. BE THE CHANGE - ALLINA HEALTH HAS BEEN A LEADER IN ELIMINATING STIGMA AROUND MENTAL HEALTH AND ADDICTION CONDITIONS WITHIN THE HEALTHCARE INDUSTRY. BE THE CHANGE, WAS A CAMPAIGN TO ELIMINATE STIGMA AROUND MENTAL HEALTH AND ADDICTION CONDITIONS AT ALLINA HEALTH AND ENSURE ALL PATIENTS RECEIVE THE SAME CONSISTENT, EXCEPTIONAL CARE. AT THE CAMPAIGN'S LAUNCH, 500 ALLINA HEALTH EMPLOYEES VOLUNTEERED TO LEAD THE EFFORT AS TRAINED BE THE CHANGE CHAMPIONS AND HELP EDUCATE AND GENERATE AWARENESS AMONG THEIR COLLEAGUES ABOUT MENTAL HEALTH AND ADDICTION CONDITIONS THROUGH PRESENTATIONS AND EDUCATION EVENTS. IN 2020, BE THE CHANGE TRANSITIONED FROM A CAMPAIGN TO AN EMPLOYEE RESOURCE GROUP. THE PURPOSE OF THIS GROUP IS TO CREATE AN INCLUSIVE, WELCOMING AND SUPPORTIVE ENVIRONMENT FOR PEOPLE LIVING WITH DISABILITIES, MENTAL HEALTH CONDITIONS AND/OR ADDICTION AND CONTINUE TO WORK TO ELIMINATE STIGMA AROUND MENTAL HEALTH, ADDICTION AND DISABILITY CONDITIONS.IN ADDITION, ST FRANCIS IS ADDRESSING NEEDS IDENTIFIED THROUGH THE CHNA; GOAL 1: MENTAL HEALTH AND SUBSTANCE USE. ST. FRANCIS CONTINUES TO PROMOTE THE MENTAL HEALTH AND WELLNESS OF TEENS THROUGH LOCAL PROMOTION OF THE CHANGE TO CHILL PROGRAM AND SUPPORTING LOCAL SCHOOLS VIA THE CHANGE TO CHILL SCHOOL PARTNERSHIP. DURING THE 2019-2020 SCHOOL YEAR, ST. FRANCIS PARTNERED WITH BURNSVILLE HIGH SCHOOL AND JORDAN HIGH SCHOOL TO IMPLEMENT CTC PROGRAMMING, REACHING APPROXIMATELY 3,056 STUDENTS, CONTINUED 2018-2019 PARTNERSHIP WITH SHAKOPEE HIGH SCHOOL, REACHING APPROXIMATELY 2,711 STUDENTS AND PARTNERED WITH HIDDEN OAKS MIDDLE SCHOOL AND TWIN OAKS MIDDLE SCHOOL IN 2020-2021 SCHOOL YEAR, REACHING APPROXIMATELY 2,170 STUDENTS. IN AN EFFORT TO ELIMINATE STIGMA ASSOCIATED WITH MENTAL HEALTH AND ADDICTION CONDITIONS, ST. FRANCIS REGIONAL MEDICAL CENTER STAFF CONTINUE TO PROMOTE AND PARTICIPATE IN ALLINA HEALTH'S BE THE CHANGE INITIATIVE WHICH TRANSITIONED TO THE CARES EMPLOYEE RESOURCE GROUP IN 2020. ADDITIONALLY, MEDICAL STAFF WORKED CLOSELY WITH NUMEROUS COMMUNITY PARTNERS TO IMPROVE MENTAL WELLNESS AND SUPPORT IN SCOTT COUNTY. THESE PARTNERSHIPS INCLUDED SUPPORTING SCOTT COUNTY DRUG FREE COMMUNITY THROUGH THE SCOTT COUNTY PREVENTION COALITION AND PROVIDING CHARITABLE SUPPORT TO CHOOSE NOT TO USE. ADDITIONALLY, TO SUPPORT OPPORTUNITIES TO EDUCATE AND BUILD THE REFUSAL SKILLS OF ADOLESCENTS WITH RESPECT TO SUBSTANCE USE, ST. FRANCIS CONTRIBUTED $2,500 TO TREEHOUSE'S TEEN MENTORING PROGRAM. TREEHOUSE WORKS TO MEET THE NEEDS OF AT-RISK YOUTH TO HELP THEM OVERCOME THE CHALLENGES RELATED TO POVERTY, PARENTAL ADDICTION, NEGLECT AND ABUSE. AN EVALUATION OF THE MENTORING PROGRAM, SPECIFICALLY, INDICATES THE PROGRAM REDUCES TEENS LIKELIHOOD OF UTILIZING NEGATIVE COPING STRATEGIES SUCH AS SELF-HARM, SUICIDE, AND SUBSTANCE USE.TO IMPROVE MENTAL HEALTH SERVICES OFFERED TO ITS PATIENTS, THE ST. FRANCIS MENTAL HEALTH COMMITTEE CONTINUED TO PARTNER WITH LOCAL ORGANIZATIONS, SUCH AS GUILD INC., TO CREATE EFFECTIVE COMMUNICATIONS AND INFORMATION SHARING ACROSS SECTORS. THE MEDICAL CENTER ALSO BRINGS LICENSED ALCOHOL AND DRUG COUNSELORS TO THE CAMPUS TO SCREEN PATIENTS FOR MENTAL HEALTH AND SUBSTANCE USE NEEDS. ST. FRANCIS ALSO IMPLEMENTED TELEHEALTH IN THE MENTAL HEALTH EMERGENCY DEPARTMENT AND INPATIENT SETTINGS, CONTRIBUTING TO ST. FRANCIS' DESIGNATION OF HAVING THE HIGHEST PSYCHIATRIC TELEHEALTH UTILIZATION WITHIN THE ALLINA HEALTH SYSTEM. ST. FRANCIS CONVENES THE SOUTH METRO MENTAL HEALTH ROUNDTABLE AND IS ACTIVELY ENGAGED ON ALL SUBCOMMITTEE WORK.GOAL 2: IMPROVE THE HEALTH OF PEOPLE LIVING IN OUR COMMUNITY BY ENCOURAGING PHYSICAL ACTIVITY, PROMOTING NUTRITION AND REDUCING BARRIERS TO HEALTHY LIVING. ST. FRANCIS PARTICIPATES ON THE SCOTT COUNTY OBESITY ACTION TEAM AND ALSO WORKED TO SUPPORT LOCAL FOOD SHELVES IN PROVIDING HEALTHY FOOD TO SCOTT, CARVER AND DAKOTA COUNTY RESIDENTS WHO EXPERIENCE FOOD INSECURITY VIA A HEALTHY FOOD DRIVE AND $4,000 IN CHARITABLE CONTRIBUTIONS TO LOCAL FOOD SHELVES.TO INCREASE OPPORTUNITIES FOR COMMUNITY MEMBERS TO INCREASE PHYSICAL ACTIVITY AND IMPROVE NUTRITION, ST. FRANCIS PROMOTED HEALTH POWERED KIDS TO LOCAL SCHOOLS - A FREE COMMUNITY EDUCATION PROGRAM DESIGNED TO EMPOWER CHILDREN AGES 3 TO 14 YEARS TO MAKE HEALTHIER CHOICES ABOUT EATING, EXERCISE, KEEPING CLEAN AND MANAGING STRESS. GOAL 3: MEETING COMMUNITY HEALTH CARE NEEDS BY INCREASING CAPACITY AND IMPROVING COLLABORATION AMONG COMMUNITY SAFETY NET PROVIDERS. THE MEDICAL CENTER HAS BEEN A LONG TIME PARTNER AND MAJOR FUNDER OF ST. MARY'S HEALTH CLINIC IN SHAKOPEE AND THE RIVER VALLEY HEALTH SERVICE (RIVER VALLEY), WHICH TOGETHER SERVE OVER 1,000 UNINSURED OR UNDERINSURED PEOPLE EACH YEAR. ST. FRANCIS PROVIDED CLINIC SPACE, SUPPLIES AND EMPLOYEE VOLUNTEERS (VALUED AT $43,000 WEEKLY), AND MADE A $25,000 CHARITABLE CONTRIBUTION TO ST. MARY'S HEALTH CLINIC. ST. FRANCIS MEDICAL CENTER'S CFO, CINDY VINCENT, ALSO SERVES ON THE ST. MARY'S HEALTH CENTER'S BOARD OF DIRECTORS. A $40,000 CHARITABLE CONTRIBUTION WAS PROVIDED TO RIVER VALLEY NURSING CENTER AND THE MEDICAL CENTER'S DIRECTOR OF PATIENT CARE, SARAH AMENDOLA, SERVES ON THE RIVER VALLEY NURSING CENTER BOARD OF DIRECTORS. ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 13B: SEE RESPONSE TO FORM 990, SCHEDULE H, PART I, LINE 3C INCLUDED IN FORM 990, SCHEDULE H , PART VI FOR EXPLANATION OF CRITERIA. ST FRANCIS REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 24: NON-MEDICAL NECESSARY OR RETAIL/COSMETIC PROCEDURES WOULD NOT QUALIFY FOR THE UNINSURED DISCOUNT. PART I, LINE 3C: CHARITY CARE PROGRAM - ALLINA PARTNER'S CARE PROGRAM:A KEY COMPONENT OF ST. FRANCIS REGIONAL MEDICAL CENTER'S (ST. FRANCIS) MISSION IS TO DELIVER COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE SERVICES AND TO ADVOCATE FOR THOSE WITH LIMITED FINANCIAL MEANS. ST FRANCIS STRIVES TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING MEDICAL CARE. THEREFORE, ST. FRANCIS HAS SEVERAL FINANCIAL ASSISTANCE PROGRAMS INCLUDING A ROBUST CHARITY CARE PROGRAM KNOWN AS ALLINA PARTNER'S CARE PROGRAM, WHICH PROVIDES FREE CARE TO ALL PERSONS AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY IN THE FEDERAL REGISTRAR.THE CHARITY CARE PROGRAM ALSO PROVIDES FOR THE CONSIDERATION OF SPECIAL CIRCUMSTANCES FOR THE "MEDICALLY INDIGENT". ST. FRANCIS EXTENDS THE CHARITY CARE PROGRAM IN INSTANCES THAT ST. FRANCIS DETERMINES THE PATIENT IS UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS DUE TO CATASTROPHIC CIRCUMSTANCES EVEN THOUGH THEY HAVE INCOME OR ASSETS THAT OTHERWISE EXCEED THE GENERALLY APPLICABLE ELIGIBILITY CRITERIA FOR THE FREE CARE PROGRAM OR THE DISCOUNTED CARE PROGRAM (DESCRIBED BELOW) UNDER ST. FRANCIS' FINANCIAL ASSISTANCE PROGRAM GUIDELINES. DISCOUNTED CARE PROGRAM - UNINSURED DISCOUNT PROGRAM ST. FRANCIS ALSO HAS A FINANCIAL ASSISTANCE PROGRAM KNOWN AS THE UNINSURED DISCOUNT PROGRAM THAT PROVIDES A DISCOUNT ON BILLED CHARGES TO UNINSURED PATIENTS, AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT, FOR MEDICALLY NECESSARY CARE RECEIVED. THE UNINSURED DISCOUNT PROGRAM DOES NOT USE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY. INSTEAD, UNINSURED PATIENTS AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT ARE ELIGIBLE FOR A DISCOUNT BASED UPON THEIR INCOME LEVEL. ALL PATIENTS WITH AN ANNUAL INCOME AT OR BELOW $125,000 ARE ELIGIBLE FOR A DISCOUNT. THE DISCOUNT IS ALSO GENERALLY EXTENDED TO PATIENTS WITH AN ANNUAL INCOME ABOVE $125,000. ST. FRANCIS' UNINSURED DISCOUNT PROGRAM PROVIDES A SUBSTANTIAL DISCOUNT TO BILLED CHARGES FOR UNINSURED PATIENTS. THE DISCOUNT IS UPDATED ANNUALLY AND IS BASED ON THE REIMBURSEMENT RATE OF THE NON-GOVERNMENTAL THIRD PARTY PAYER WHICH PROVIDED ST. FRANCIS THE MOST REVENUE DURING THE PREVIOUS YEAR. PART I, LINE 6A: ST. FRANCIS' ANNUAL COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST. SEE CONTACT INFORMATION CONTAINED IN SCHEDULE O TO OBTAIN A COPY. PART I, LINE 7: WHERE APPROPRIATE, ST. FRANCIS USES A RATIO OF PATIENT CARE COSTS TO CHARGES (COST TO CHARGE RATIO) TO CALCULATE THE AMOUNTS REPORTED FOR PART I, LINE 7 (THE TABLE). PART I, LINE 7G: THE AMOUNT REPORTED AS SUBSIDIZED HEALTH SERVICES DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. PART I, LN 7 COL(F): BAD DEBT EXPENSE HAS NOT BEEN INCLUDED IN FORM 990, PART IX, LINE 25 AND HAS NOT BEEN USED FOR THE PURPOSE OF CALCULATING THE AMOUNTS REPORTED IN COLUMN 7F. IT HAS BEEN REPORTED AS A REDUCTION TO PATIENT SERVICE REVENUE ON FORM 990, PART VIII LINE 2B. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY-BUILDING ACTIVITIESUNDERSTANDING THAT GOOD HEALTH IS DEPENDENT ON SOCIETAL, COMMUNITY, AND FAMILY ENVIRONMENTS AS WELL AS INDIVIDUAL CHOICES, AND IS BIGGER THAN THE PROVISION OF HEALTH CARE, ST. FRANCIS ENGAGES IN COMMUNITY ACTIVITIES THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS SUCH AS POVERTY AND HOMELESSNESS. RESEARCH SHOWS THAT MANY OF THESE ROOT CAUSES ARE DIRECTLY TIED TO POOR HEALTH IF IGNORED, PARTICULARLY AMONG LOW-INCOME, MINORITY POPULATIONS. BELOW ARE A FEW EXAMPLES OF WAYS THAT ST. FRANCIS PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES IN 2020:COMMUNITY COALITIONSST. FRANCIS PARTICIPATES ON LOCAL COMMUNITY COALITIONS, SUCH AS THE SCOTT COUNTY COMMUNITY HEALTH IMPROVEMENT COMMITTEE AND COMMUNITY ADVISORY TEAMS IN ORDER TO RESPOND TO COMMUNITY NEEDS THROUGH COLLABORATION AND PARTNERSHIP. THESE COALITIONS PROVIDE ST. FRANCIS THE OPPORTUNITY TO BUILD RELATIONSHIPS TO DETERMINE HOW BEST TO LEVERAGE LOCAL RESOURCES TO ADDRESS COMMUNITY NEEDS THAT EXIST OUTSIDE THE TRADITIONAL REALM OF HEALTH CARE. IN ADDITION, ST. FRANCIS PARTICIPATES ON THE SCOTT-DAKOTA COUNTY WORKFORCE INVESTMENT BOARD, THE SCOTT COUNTY LOCAL ADVISORY COMMITTEE FOR MENTAL HEALTH AND TOGETHER WE CAN, A LOCAL COALITION TO PREVENT CHILDHOOD ABUSE AND NEGLECT IN SCOTT COUNTY. DISASTER PREPAREDNESSIN ADDITION TO COMMUNITY-BUILDING ACTIVITIES THAT RELATED TO ROOT CAUSES OF HEALTH, ST. FRANCIS ENGAGED IN AND LED DISASTER PREPAREDNESS PLANNING TO ENSURE SAFETY, EFFICIENCY AND EXCELLENT HEALTH CARE DURING TIMES OF TRAGEDY AND/OR UPSET. THIS INCLUDED PLANNING MEETINGS AND COMMUNITY MEETINGS/TRAININGS, AMONG OTHER THINGS. THESE PROGRAMS AND SERVICES, AMONG OTHERS, GIVE ST. FRANCIS THE OPPORTUNITY TO IMPACT COMMUNITY HEALTH BEFORE IT BECOMES PROBLEMATIC AND EXPENSIVE. IN ADDITION, THIS IMPORTANT WORK IS SUPPORTED BY THE MISSION OF OUR ORGANIZATION AND IS OUR RESPONSIBILITY AS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION. ST. FRANCIS WILL CONTINUE TO CONTRIBUTE TO IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH PROMOTION OF COMMUNITY HEALTH. PART III, LINE 2: SCH H, PART III, SECTION A, LINES 2 & 3SEE SCHEDULE H, PART III, SECTION A, LINE 3 NARRATIVE BELOW. PART III, LINE 4: SEE ATTACHED AUDIT, PAGE 10, 2(O). PART III, LINE 8: ST. FRANCIS USED THE AMOUNT REPORTED IN THE MEDICARE COST REPORT AS THE SOURCE FOR THE AMOUNTS REPORTED ON PART III, LINES 5 & 6 AS OUTLINED IN THE FORM 990, SCHEDULE H INSTRUCTIONS. FOR MEDICARE COST REPORTS, ST. FRANCIS USES A RATIO OF PATIENT CARE COSTS TO CHARGES (COST TO CHARGE RATIO) TO DETERMINE MEDICARE ALLOWABLE COSTS. GENERALLY, THE RATIO IS CALCULATED AS THE TOTAL MEDICARE ALLOWABLE PATIENT COSTS OVER THE TOTAL PATIENT CHARGES. MEDICARE CHARGES MULTIPLIED BY THIS RATIO EQUALS THE MEDICARE ALLOWABLE COSTS REPORTED IN THE MEDICARE COST REPORTS. ST. FRANCIS BELIEVES THAT AT LEAST SOME PORTION OF THE COSTS IT INCURS IN EXCESS OF PAYMENTS RECEIVED FROM THE FEDERAL GOVERNMENT FOR PROVIDING MEDICAL SERVICES TO MEDICARE ENROLLEES AND BENEFICIARIES UNDER THE FEDERAL MEDICARE PROGRAM (SHORTFALL OR MEDICARE SHORTFALL) CONSTITUTES A COMMUNITY BENEFIT. ST. FRANCIS' PROVIDING OF THESE SERVICES CLEARLY LESSENS THE BURDENS OF GOVERNMENT BY ALLEVIATING THE FEDERAL GOVERNMENT FROM HAVING TO DIRECTLY PROVIDE THESE MEDICAL SERVICES. AS DEMONSTRATED AND CALCULATED ON FORM 990, SCHEDULE H, PART III, LINE 7, ST. FRANCIS' MEDICARE "ALLOWABLE COSTS" CLEARLY EXCEED THE PAYMENTS IT RECEIVES FOR PROVIDING THESE MEDICAL SERVICES UNDER THE MEDICARE PROGRAM. THE TRUE COMMUNITY BENEFIT FOR ST. FRANCIS' PARTICIPATION IN THE CURRENT MEDICARE PROGRAM IS DEPENDENT ON HOW EFFICIENTLY AND COST EFFECTIVELY THE FEDERAL GOVERNMENT COULD OPERATE A DIRECT MEDICAL CARE MEDICARE PROGRAM OR ALTERNATIVELY THE COST TO THE GOVERNMENT TO CONTRACT OUT SUCH SERVICES THROUGH A COMPETITIVE BIDDING PROCESS IN THE OPEN MARKETS FOR THE SAME OR SIMILAR SERVICES FACTORING IN ITEMS SUCH AS QUALITY OF CARE, OUTCOMES AND SIMILAR IMPORTANT FACTORS AS COMPARED TO ST. FRANCIS' ACTUAL COSTS OF PROVIDING THE MEDICAL CARE. THE MEDICARE SHORTFALL CALCULATION ON THE FORM 990, SCHEDULE H, LINE 7 SIGNIFICANTLY UNDERSTATES ST. FRANCIS' ACTUAL MEDICARE SHORTFALL FOR TWO REASONS. FIRST, ST. FRANCIS INCURS SIGNIFICANT COSTS IN EXCESS OF PAYMENTS UNDER THE MEDICARE PROGRAM FOR PROVIDING CERTAIN SERVICES THAT ARE NOT SUBJECT TO MEDICARE COST REPORTING AND THEREFORE NOT REFLECTED IN ST. FRANCIS' COST AMOUNTS ON LINE 6. SECOND, LINE 6 LIMITS ST. FRANCIS' REPORTED COSTS TO ONLY MEDICARE "ALLOWABLE COSTS" AS SOLELY DETERMINED BY THE FEDERAL GOVERNMENT MEDICARE PROGRAM. FOR THESE TWO REASONS, THE MEDICARE SHORTFALL REPORTED ON LINE 7 SIGNIFICANTLY UNDERSTATES THE ACTUAL MEDICARE SHORTFALL AND THE ACTUAL COST OF PROVIDING MEDICAL CARE TO MEDICARE PROGRAM PARTICIPANTS.ST. FRANCIS BELIEVES A DIRECT MEDICAL SERVICE MEDICARE PROGRAM OPERATED BY THE FEDERAL GOVERNMENT AND THE COST TO THE GOVERNMENT TO CONTRACT OUT THE SERVICES UNDER A COMPETITIVE BIDDING PROCESS MAY PROVE TO BE EVEN MORE EXPENSIVE TO THE FEDERAL GOVERNMENT THAN ST. FRANCIS' REPORTED MEDICARE "ALLOWABLE COSTS" ON LINE 6 GIVEN ST. FRANCIS' QUALITY OF CARE, SUCCESSFUL OUTCOMES AND THE SIGNIFICANT DIFFERENCE BETWEEN ACTUAL COSTS ST. FRANCIS INCURS AND MEDICARE "ALLOWABLE COSTS" IN PROVIDING CARE UNDER THE MEDICARE PROGRAM. THEREFORE, ST. FRANCIS FIRMLY BELIEVES THAT THERE IS A TRUE COMMUNITY BENEFIT COMPONENT TO ITS PARTICIPATION IN THE FEDERAL MEDICARE PROGRAM. PART III, LINE 9B: ST. FRANCIS' WRITTEN DEBT COLLECTION POLICY AND COLLECTION PRACTICES APPLY UNIFORMLY TO ALL PATIENTS AND INCLUDE PROVISIONS RELATED TO ITS CHARITY CARE PROGRAM AND OTHER FINANCIAL ASSISTANCE PROGRAMS. IF A PATIENT IS KNOWN TO QUALIFY FOR A FINANCIAL ASSISTANCE PROGRAM, THEY ARE AUTOMATICALLY AFFORDED THE PROGRAM BENEFITS FOR UP TO ONE YEAR AS THEY WOULD HAVE ALREADY PROVIDED INFORMATION NECESSARY FOR ST. FRANCIS TO MAKE SUCH A DETERMINATION. FOR EXAMPLE, A PATIENT THAT QUALIFIED FOR ST. FRANCIS' CHARITY CARE PROGRAM BEFORE RECEIVING SERVICES WOULD NOT RECEIVE A BILLING STATEMENT FOR THE MEDICAL SERVICES PROVIDED. IN THE CASE OF A PATIENT QUALIFYING FOR THE CHARITY CARE PROGRAM AFTER RECEIVING SERVICES AND THE COMMENCEMENT OF CERTAIN COLLECTION ACTIVITIES, THE AMOUNTS ARE DISCHARGED AS CHARITY CARE AND ALL COLLECTION ACTIVITIES CEASE. AS DISCUSSED IN THE RESPONSE TO PART VI, LINE 3, PATIENTS ARE INFORMED AND EDUCATED ON ST. FRANCIS' FINANCIAL ASSISTANCE PROGRAMS INCLUDING ITS CHARITY CARE PROGRAM AS PART OF THE ROUTINE REGISTRATION, ADMISSION, INTAKE, BILLING AND COLLECTION PROCESSES. IF A PATIENT DESIRES TO APPLY FOR THE CHARITY CARE PROGRAM, PERSONNEL WILL SEND AN APPLICATION TO THE PATIENT. IF COLLECTION ACTIVITIES HAVE COMMENCED, THOSE ACTIVITIES WILL BE SUSPENDED FOR THIRTY (30) DAYS TO ALLOW TIME FOR THE APPLICATION PROCESS. COLLECTION ACTIVITY MAY RESUME IF, AFTER 30 DAYS, A COMPLETED APPLICATION HAS NOT BEEN RECEIVED. IN THE CASE OF AN INCOMPLETE APPLICATION, ST. FRANCIS MAY RESUME COLLECTION ACTIVITIES IF REQUESTS FOR ADDITIONAL INFORMATION ARE NOT MET WITH A TIMELY RESPONSE. IF AN APPLICANT DOES NOT MEET THE ELIGIBILITY CRITERIA AND THE APPLICATION IS DENIED, COLLECTION ACTIVITY MAY RESUME UPON DENIAL. HOWEVER, THE PATIENT MAY STILL BE ELIGIBLE FOR OTHER FINANCIAL ASSISTANCE PROGRAMS THAT ARE APPLIED AS WARRANTED BASED UPON THE INFORMATION PROVIDED. SUCH ACTIVITIES ARE FULLY EXPLAINED TO THE PATIENT DURING THE COLLECTION PROCESS. SCH H , PART III, SECTION A, LINE 3 ST. FRANCIS HAS ADOPTED HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION [HFMA] STATEMENT NO. 15, VALUATION AND FINANCIAL STATEMENT PRESENTATION OF CHARITY CARE, IMPLICIT PRICE CONCESSIONS AND BAD DEBTS BY INSTITUTIONAL HEALTHCARE PROVIDERS (STATEMENT 15). AS DISCLOSED IN THE FOOTNOTES TO ST. FRANCIS' AUDITED FINANCIAL STATEMENTS (SEE RESPONSE TO PART III, LINE 4), THE PROVISIONS FOR BAD DEBT AND CHARITY CARE ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THEREFORE, THE BAD DEBT AMOUNT STATED FOR FINANCIAL REPORTING PURPOSES IS REPORTED "NET" OF ANY ANTICIPATED PATIENT DISCOUNTS OR IMPLICIT PRICE CONCESSIONS TO WHICH THE PATIENT MAY BE ELIGIBLE INCLUDING, BUT NOT LIMITED TO, THE UNINSURED DISCOUNT PROGRAM (DISCUSSED ABOVE) AND REFLECTS THE ESTIMATED AMOUNT REPORTED AS "NET PATIENT SERVICE REVENUE" DURING THE CURRENT PERIOD OR ANY PREVIOUS PERIOD. THIS DOES NOT NECESSARILY EQUAL THE "COST" TO PROVIDE THE MEDICAL SERVICES. ALSO, NOTE THAT AMOUNTS RELATED TO PATIENTS WHO HAVE QUALIFIED UNDER THE CHARITY CARE PROGRAM ARE NOT INCLUDED IN EITHER NET PATIENT REVENUE OR IN BAD DEBT EXPENSE. IN OTHER WORDS, THE BAD DEBT EXPENSE AS REPORTED IN THE REVENUE SECTION OF THE FINANCIAL STATEMENTS OF THE FORM 990 DOES NOT INCLUDE AMOUNTS RELATED TO QUALIFIED CHARITY CARE PATIENTS AND IS STATED AT THE "NET" EXPECTED OR ANTICIPATED COLLECTION AMOUNT, WHICH MAY BE SIGNIFICANTLY DIFFERENT THAN PATIENT CHARGES DUE TO THE APPLICATION OF DISCOUNTS SUCH AS THOSE PROVIDED UNDER THE UNINSURED DISCOUNT PROGRAM. THIS AMOUNT ALSO CONSTITUTES A DIFFERENT AMOUNT THAN ST. FRANCIS' ACTUAL COST TO PROVIDE THE MEDICAL SERVICES. TO ARRIVE AT THE BAD DEBT "AT COST" AS REPORTED IN FORM 990, SCHEDULE H, PART III, LINE 2, ST. FRANCIS HAS APPLIED A RATIO OF PATIENT CARE COST TO CHARGES (COST-TO-CHARGE RATIO) TO THE ESTIMATED PATIENT CHARGE AMOUNT INCLUDED IN BAD DEBT AFTER REMOVING THE ANTICIPATED DISCOUNTS. THIS PROCESS PROVIDES A VERY CONSERVATIVE ESTIMATE OF ST. FRANCIS' BAD DEBT (AT COST) REPORTED ON LINE 2.ST. FRANCIS HAS A ROBUST PROCESS FOR ADMINISTERING ITS FINANCIAL ASSISTANCE PROGRAMS INCLUDING THE CHARITY CARE AND UNINSURED DISCOUNT PROGRAM DESCRIBED IN FURTHER DETAIL IN PART VI, LINE 3. EACH PATIENT IS PROVIDED NUMEROUS OPPORTUNITIES TO APPLY TO ALLINA PARTNER'S CARE PROGRAM AND TO PARTICIPATE, IF QUALIFIED, TO RECEIVE FREE OR DISCOUNTED MEDICAL CARE OR BE ENROLLED IN A GOVERNMENT SPONSORED MEDICAL CARE PROGRAM UNDER ST. FRANCIS'S VARIOUS FINANCIAL ASSISTANCE PROGRAMS. THE ADMINISTRATIVE PROCESS INCLUDES IDENTIFYING ANY PATIENT WITH A FINANCIAL CONCERN, AS WELL AS INFORMING, COUNSELING, QUALIFYING AND ASSISTING PATIENTS TO APPLY FOR THE ST. FRANCIS' CHARITY CARE AND OTHER FINANCIAL ASSISTANCE PROGRAMS. ALTHOUGH EACH PATIENT IS PROVIDED NUMEROUS OPPORTUNITIES TO RECEIVE FINANCIAL ASSISTANCE AND INFORMED MULTIPLE TIMES OF THE CHARITY CARE PROGRAM PRIOR TO ST. FRANCIS CLASSIFYING THE AMOUNTS AS BAD DEBT, IT IS POSSIBLE THAT PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE DO NOT COMPLETE THE APPLICATION. THIS AMOUNT IS NOT REASONABLY ESTIMABLE.AS A TAX-EXEMPT HOSPITAL, ST. FRANCIS IS REQUIRED TO PROVIDE NECESSARY MEDICAL CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES PROVIDED. DUE TO CIRCUMSTANCES BEYOND ST. FRANCIS' CONTROL, A PERSON WHO WOULD OTHERWISE QUALIFY UNDER THE CHARITY CARE PROGRAM MAY NOT PROVIDE ST. FRANCIS THE NECESSARY INFORMATION, FAIL TO QUALIFY FOR THE PROGRAM, AND FAIL TO RECEIVE FREE CARE. ULTIMATELY, THOSE AMOUNTS ARE WRITTEN-OFF AND REPORTED AS BAD DEBT EXPENSE. ANY METHODOLOGY ST. FRANCIS COULD USE TO QUANTIFY AND PROVIDE AN ESTIMATE OF HOW MUCH BAD DEBT (AT COST AND IF ANY) REPORTED ON LINE 2 REASONABLY COULD BE ATTRIBUTABLE TO PERSONS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER ST. FRANCIS' CHARITY CARE POLICY AND FOR ST. FRANCIS TO PROVIDE AN ESTIMATE OF WHAT PORTION OF BAD DEBT, IF ANY, ST. FRANCIS BELIEVES SHOULD CONSTITUTE COMMUNITY BENEFIT WOULD BE PURELY SPECULATIVE, IMPRECISE AND SUBJECT TO INHERENT METHODOLOGY FLAWS. WHILE ST. FRANCIS FIRMLY BELIEVES, FOR THE REASONS STATED ABOVE, THAT SOME COMPONENT OF ITS REPORTED BAD DEBT EXPENSE (AT COST) ON LINE 2 CONSTITUTES AMOUNTS RELATED TO PERSONS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER ST FRANCIS' CHARITY CARE PROGRAM, ST. FRANCIS CANNOT REASONABLY QUANTIFY THE AMOUNT AND RESPECTFULLY DECLINES THE OPPORTUNITY TO PROVIDE AN AMOUNT. THEREFORE, ST. FRANCIS HAS REPORTED ZERO OR NONE FOR FORM 990, SCHEDULE H, PART III, LINE 3. PART VI, LINE 2: IN 2019, ALLINA HEALTH CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT FOR EACH OF THE HOSPITALS IN THE SYSTEM. THE PURPOSE WAS TO IDENTIFY LOCAL PRIORITIES FOR EACH HOSPITAL AS WELL AS OVER-ARCHING THEMES FOR THE HEALTH SYSTEM TO ADDRESS FOR FY 2020-2022.TO RESPOND TO LOCAL NEEDS AND RESOURCES, EACH ALLINA HEALTH HOSPITAL CONDUCTED ITS 2020-2022 CHNA INDEPENDENTLY. THE HOSPITALS WORKED CLOSELY WITH LOCAL PUBLIC HEALTH. THESE INCLUDE REPRESENTATIVES FROM THESE COUNTIES: ANOKA COUNTY, BROWN COUNTY, CARVER COUNTY, DAKOTA COUNTY, HENNEPIN COUNTY, ISANTI COUNTY, RAMSEY COUNTY, STEELE COUNTY, SCOTT COUNTY, WASHINGTON COUNTY, WRIGHT COUNTY, AND PIERCE COUNTY. SOME ALSO COLLABORATED WITH OTHER HEALTH SYSTEMS AND COMMUNITY ORGANIZATIONS. WHERE POSSIBLE, THE HOSPITAL ALIGNED THEIR PROCESS WITH ASSESSMENTS BEING CONDUCTED BY LOCAL PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES. IN MANY CASES, THE HOSPITALS CONDUCTED THE CHNA JOINTLY WITH PARTNERS, WITH SHARED LEADERSHIP THROUGHOUT. THE CHNA PROCESS OCCURRED IN THREE STEPS: DATA REVIEW AND PRIORITIZATION, COMMUNITY INPUT AND THE DEVELOPMENT OF A THREE-YEAR IMPLEMENTATION PLAN. MOST HOSPITALS USED THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) COMMUNITY-DRIVEN STRATEGIC PLANNING PROCESS FOR IMPROVING COMMUNITY HEALTH. THE OFFICIAL CHNA PROCESS BEGAN IN JUNE 2018 AND WAS COMPLETED IN AUGUST 2019. EACH HOSPITAL'S CHNA TEAM REVIEWED COUNTY-SPECIFIC DATA RELATED TO DEMOGRAPHICS, SOCIAL AND ECONOMIC FACOTRS, HEALTH BEHAVIORS, PREVALENCE OF HEALTH CONDITIONS AND HEALTH CARE ACCESS. SOURCES VARIED, BUT INCLUDED THE MINNESOTA STUDENT SURVEY, HEALTH SURVEYS CONDUCTED BY LOCAL PUBLIC HEALTH DEPARTMENTS, LOCAL RESEARCH STUDIES ON TOPICS SUCH AS HOUSING AND SECONDARY PUBLIC HEALTH DATA AVAILABLE THROUGH THE MINNESOTA DEPARTMENT OF HEALTH. ADDITIONALLY, TEAMS REVIEWED SELECT COUNTY-SPECIFIC ALLINA HEALTH PATIENT DATA. MANY HOSPITALS ALSO COLLECTED FEEDBACK ON PERCEIVED COMMUNITY HEALTH NEEDS FROM LOCAL STAKEHOLDERS THROUGH COMMUNITY DIALOGUES, INTERVIEWS AND SURVEYS. BASED ON THE DATA REVIEW AND COMMUNITY FEEDBACK, LOCAL CHNA TEAMS CHOSE CHNA PRIORITIES FOR THE 2020-2022 CYCLE. SPECIFIC PRIORITIZATION CRITERIA WAS DETERMINED LOCALLY, BUT SIZE AND SERIOUSNESS OF THE PROBLEM, IMPORTANCE TO THE COMMUNITY AND ORGANIZATIONAL CAPACITY TO ADDRESS THE NEED WERE ALL CONSIDERED. HOSPITAL PRIORITIES INCLUDE:- MENTAL HEALTH AND WELLNESS, INCLUDING SUBSTANCE ABUSE- OBESITY, PHYSICAL ACTIVITY AND NUTRITION- ACCESS TO CARE- SOCIAL DETERMINANTS OF HEALTH- SOCIAL ISOLATION- VIOLENCE- DENTAL CAREST. FRANCIS SPECIFIC PRIORITIES INCLUDE:- MENTAL HEALTH AND WELLNESS, INCLUDING SUBSTANCE ABUSE- HEALTHY WEIGHT- ACCESS TO CARETO INCREASE THEIR UNDERSTANDING OF COMMUNITY MEMBERS' PERSPECTIVES ON IDENTIFIED HEALTH ISSUES AND IDEAS FOR ADDRESSING THEM, STAFF SOLICITED INPUT FROM INDIVIDUALS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY SUCH AS STAFF FROM SOCIAL SERVICE AND PUBLIC HEALTH ORGANIZATIONS AND RESIDENTS. STAFF COLLECTED FEEDBACK THROUGH A RANGE OF METHODS, INCLUDING FOCUS GROUPS AND INTERVIEWS. FOCUSED OUTREACH OCCURRED TO HISTORICALLY UNDERSERVED COMMUNITIES WHO EXPERIENCE HEALTH DISPARITIES. IN FEBRUARY AND APRIL 2019, COMMUNITY ENGAGEMENT LEADERS FROM EACH OF ALLINA HEALTH'S HOSPITALS DISCUSSED THE RESULTS OF EACH HOSPITAL'S DATA REVIEW, PRIORITIZATION AND COMMUNITY INPUT PROCESSES. PRIORITIES AND COMMON THEMES FOR ACTION WERE IDENTIFIED ACROSS ALL GEOGRAPHIES. TOGETHER, THEY IDENTIFIED MENTAL HEALTH (INCLUDING SUBSTANCE ABUSE) AND OBESITY CAUSED BY PHYSICAL INACTIVITY AND POOR NUTRITION AS PRIORITY NEEDS IN ALL ALLINA HEALTH GEOGRAPHIES. THEY ALSO IDENTIFIED SOCIAL DETERMINANTS OF HEALTH, PARTICULARLY ACCESS TO HEALTHY FOOD AND STABLE HOUSING, AS KEY FACTORS CONTRIBUTING TO HEALTH. ALL ALLINA HEALTH ASSESSMENTS AND ACTION PLANS WERE APPROVED BY LOCAL FACILITIES AND THE ALLINA HEALTH BOARD OF DIRECTORS BY DECEMBER 2019. COPIES OF EACH FACILITY'S NEEDS ASSESSMENT REPORT AND ACTION PLAN, INCLUDING THE REPORT AND ACTION PLAN FOR ST. FRANCIS, CAN BE FOUND AT: HTTPS://WWW.ALLINAHEALTH.ORG/ABOUT-US/COMMUNITY-INVOLVEMENT/NEED-ASSESSMENTS/2020-2022-NEEDS-ASSESSMENTS-AND-IMPLEMENTATIONS-PLANS. ONCE IMPLEMENTATION PLANS ARE CREATED, MORE DETAILED PLANNING CONTINUES WITH STAKEHOLDER TO DEVELOP AND DELIVER SPECIFIC PROGRAMS, SERVICES AND ACTIVITIES EITHER LOCALLY OR SYSTEM-WIDE. PART VI, LINE 3: AS A FAITH-BASED, NOT-FOR-PROFIT HOSPITAL, ST. FRANCIS DELIVERS COMPASSIONATE, HIGH QUALITY, AFFORDABLE HEALTH CARE SERVICES AND ADVOCATES FOR PEOPLE WITH LIMITED FINANCIAL MEANS. ST. FRANCIS WORKS TO ENSURE THAT THE FINANCIAL CAPACITY OF PEOPLE WHO NEED HEALTH CARE SERVICES DOES NOT PREVENT THEM FROM SEEKING OR RECEIVING CARE AT ST. FRANCIS. PROVIDING CONVENIENT ACCESS TO NECESSARY MEDICAL CARE REGARDLESS OF ONE'S ABILITY TO PAY FOR THOSE SERVICES IS IMPORTANT TO ST. FRANCIS. THROUGH ALLINA HEALTH SYSTEM, ST. FRANCIS HAS ESTABLISHED THE FOLLOWING FINANCIAL ASSISTANCE PROGRAMS: - ALLINA PARTNER'S CARE PROGRAM, PROVIDING CHARITY CARE - UNINSURED DISCOUNTS PROGRAM- SPECIAL CIRCUMSTANCES ASSISTANCE (INDIVIDUAL, CASE-BY-CASE BASIS)- MEDELIGIBLE SERVICES- MEDCREDIT FINANCIAL SERVICES ST. FRANCIS EMPLOYS FINANCIAL COUNSELORS TO ASSIST PEOPLE WHO WILL BE RECEIVING CARE IN BOTH THE INPATIENT AND OUTPATIENT SETTING. THE FINANCIAL COUNSELOR WORKS WITH INDIVIDUALS ON A CASE-BY-CASE BASIS. ST. FRANCIS ALSO EMPLOYS A FINANCIAL COUNSELOR FOR ITS EMERGENCY DEPARTMENT. THIS ALLOWS ST. FRANCIS TO ENROLL UNINSURED PATIENTS INTO PROGRAMS THE PATIENT MAY NOT OTHERWISE KNOW THEY ARE ENTITLED TO PARTICIPATE IN. IT ALSO ALLOWS ST. FRANCIS TO CONNECT THE PATIENTS WITH COMMUNITY RESOURCES LIKE THE RIVER VALLEY NURSING CENTER AND ST. MARY'S HEALTH CLINICS, BOTH OF THESE COMMUNITY PROGRAMS RECEIVE CHARITABLE CONTRIBUTIONS FROM ST. FRANCIS. ST. FRANCIS' CHARITY CARE POLICY AND UNINSURED DISCOUNT POLICY ARE AVAILABLE IN MULTIPLE LANGUAGES.FOR MORE INFORMATION ON ANY OF THE ST. FRANCIS FINANCIAL ASSISTANCE PROGRAMS, YOU MAY VISIT WWW.STFRANCIS-SHAKOPEE.COM OR WWW.ALLINAHEALTH.ORG AND CLICK ON THE FINANCIAL ASSISTANCE LINK.ST. FRANCIS PARTICIPATES IN ALL ALLINA HEALTH SYSTEM PROGRAMMING WITH RESPECT TO FINANCIAL ASSISTANCE, INCLUDING THE FOLLOWING:CHARITY CARE PROGRAM - ALLINA PARTNER'S CARE PROGRAM PROVIDES FREE MEDICALLY NECESSARY CARE TO ALL PERSONS AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY GUIDELINES AS PUBLISHED ANNUALLY IN THE FEDERAL REGISTER. THE PROGRAM WAS ESTABLISHED TO ASSIST PATIENTS WHO DO NOT QUALIFY FOR MEDICAL ASSISTANCE OR MINNESOTA CARE AND WHOSE ANNUAL INCOMES ARE AT OR BELOW 275 PERCENT OF THE FEDERAL POVERTY LEVEL. THE APPLICATION IS BRIEF AND ASKS FOR INFORMATION ON FAMILY SIZE, EMPLOYMENT, INCOME, BANKING AND INSURANCE. IF A PATIENT MEETS THE ELIGIBILITY GUIDELINES, THEIR TOTAL BALANCE WILL BE ZERO. THEY WILL RECEIVE FREE MEDICAL CARE. AN ELIGIBLE INDIVIDUAL WILL BE COVERED BY THE PROGRAM FOR UP TO ONE YEAR BARRING ANY SIGNIFICANT CHANGE IN INCOME. PATIENTS MAY BE ASKED TO APPLY FOR MEDICAL ASSISTANCE AND MINNESOTA CARE AND BE FOUND INELIGIBLE FOR THOSE PROGRAMS BEFORE THEY QUALIFY FOR ST FRANCIS' PARTNER'S CARE PROGRAM.THE UNINSURED DISCOUNT PROGRAM PROVIDES A DISCOUNT ON BILLED CHARGES TO UNINSURED PATIENTS, AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT, FOR MEDICALLY NECESSARY CARE RECEIVED FROM ANY ALLINA HOSPITAL, HOSPITAL BASED CLINIC AND WHOLLY-OWNED AMBULATORY SURGERY CENTERS. UNINSURED PATIENTS AND INSURED PATIENTS WHO RECEIVE UNINSURED TREATMENT ARE ELIGIBLE FOR A DISCOUNT BASED UPON THEIR INCOME LEVEL AND THE LOCATION OF THE SERVICES PROVIDED. ALL PATIENTS WITH AN ANNUAL INCOME AT OR BELOW $125,000 ARE ELIGIBLE FOR A DISCOUNT. THE DISCOUNT IS ALSO GENERALLY EXTENDED TO PATIENTS WITH AN ANNUAL INCOME ABOVE $125,000. THERE ARE THREE DISCOUNTS LEVELS ESTABLISHED, ONE FOR METRO HOSPITALS, ONE FOR REGIONAL HOSPITALS, AND ONE FOR HOSPITAL BASED CLINICS WITHIN THE ALLINA SYSTEM. SPECIAL CIRCUMSTANCES ASSISTANCE (ON INDIVIDUAL CASE BY CASE BASIS) - ST. FRANCIS PROVIDES FOR THE CONSIDERATION OF SPECIAL CIRCUMSTANCES FOR THE "MEDICALLY INDIGENT." ST. FRANCIS EXTENDS THE CHARITY CARE PROGRAM IN INSTANCES IT DETERMINES THE PATIENT IS UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS DUE TO CATASTROPHIC CIRCUMSTANCES EVEN THOUGH THEY HAVE INCOME OR ASSETS THAT OTHERWISE EXCEED THE GENERALLY APPLICABLE ELIGIBILITY CRITERIA FOR THE FREE CARE PROGRAM OR THE DISCOUNTED CARE PROGRAM (DESCRIBED BELOW) UNDER ST. FRANCIS' FINANCIAL ASSISTANCE PROGRAM GUIDELINES. FINANCIAL ASSISTANCE SERVICES WILL PROVIDE AN EVALUATION OF PATIENTS WITH SPECIAL CIRCUMSTANCES. THERE MAY BE A CIRCUMSTANCE WHERE PATIENTS EXPERIENCE A CATASTROPHIC EVENT THAT PUTS THEM IN A DEVASTATING FINANCIAL POSITION WHEREBY THE PROGRAM REPRESENTATIVES WILL DETERMINE HOW TO BEST SUPPORT THEM FINANCIALLY. MEDELIGIBLE SERVICES PROVIDE ADVOCACY SUPPORT TO PATIENTS WHO HAVE DIFFICULTY PAYING THEIR MEDICAL BILLS. THEY CAN ASSIST PATIENTS WITH APPLYING FOR FEDERAL, STATE AND COUNTY BENEFIT PROGRAMS. THE MEDELIGIBLE SERVICES PERSONNEL ARE ADVOCATES WHO EDUCATE PATIENTS AND FAMILIES ABOUT THE ADVANTAGES OF PROGRAMS AND ASSIST THEM WITH GETTING HELP. PERSONNEL CAN PROVIDE ASSISTANCE WITH MEDICAID AND MEDICARE, SOCIAL SECURITY, VETERAN'S ADMINISTRATION, FOOD STAMPS, EMERGENCY FOOD, AND SHELTER. MEDCREDIT FINANCIAL SERVICES PROVIDES FINANCIAL LOANS TO PATIENTS WHO CANNOT AFFORD TO PAY THEIR MEDICAL BILLS. THE PATIENT CAN CONSOLIDATE ALL MEDICAL EXPENSES FROM PARTICIPATING PROVIDERS SUCH THAT THE PATIENT HAS ONLY ONE MONTHLY PAYMENT. THERE IS NO CREDIT APPLICATION REQUIRED AND NO ANNUAL FEES OR DUES. THE ANNUAL PERCENTAGE INTEREST RATE IS 8 PERCENT. ONCE A PATIENT HAS ESTABLISHED A MEDCREDIT ACCOUNT, AMOUNTS CAN BE ADDED ON ANY ADDITIONAL MEDICAL EXPENSES FOR THEMSELVES AND THEIR FAMILY. PAYMENT PLANS-IF A PATIENT INDICATES THEY ARE UNABLE OR UNWILLING TO PAY THE BALANCE IN FULL, ST. FRANCIS OFFERS A PAYMENT PLAN WHICH CANNOT EXCEED TWELVE MONTHS AND CANNOT BE LESS THAN THIRTY DOLLARS PER MONTH. IF THE PATIENT IS UNABLE TO MEET THESE PARAMETERS, MEDCREDIT IS OFFERED TO THEM. THE FINANCIAL ASSISTANCE SERVICES INFORMATION AND EDUCATION METHODS - ALLINA HAS ROBUST METHODS TO INFORM AND EDUCATE PATIENTS AND PERSONS WHO ARE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING ITS CHARITY CARE PROGRAM, AND ALSO ABOUT GOVERNMENT PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE TO RECEIVE BENEFITS. EACH PATIENT BILLING STATEMENT CONTAINS INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAMS AND INCLUDES CONTACT INFORMATION. THE ST. FRANCIS WEBSITE HOMEPAGE AT WWW.STFRANCIS-SHAKOPEE.COM PROMINENTLY CONTAINS A LINK TO THE FINANCIAL ASSISTANCE SERVICES PAGE WHICH DESCRIBES ST FRANCIS' FINANCIAL ASSISTANCE PROGRAMS AND INCLUDES CONTACT INFORMATION. ST. FRANCIS POSTS SUMMARIES OF ITS FINANCIAL ASSISTANCE PROGRAMS IN BROCHURES IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS ST. FRANCIS' FACILITIES WHERE ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT.THE BROCHURES CONTAIN SUMMARIES OF THE FINANCIAL ASSISTANCE PROGRAMS AND INCLUDE CONTACT INFORMATION FOR THE PROGRAMS. THIS INFORMATION IS ALSO AVAILABLE IN SOMALI AND SPANISH. REGISTRATION, ADMISSIONS AND INTAKE PERSONNEL ARE TRAINED TO PROVIDE FINANCIAL ASSISTANCE PROGRAM INFORMATION TO ANYONE EXPRESSING A CONCERN ABOUT THEIR ABILITY TO PAY FOR SERVICES. ALL "SELF-PAY" PATIENTS (THE PATIENT IS NOT COVERED BY INSURANCE OR A GOVERNMENT PROGRAM) THAT COMES TO ST. FRANCIS' EMERGENCY ROOM RECEIVES A PACKET OF INFORMATION CONTAINING EVERYTHING NECESSARY TO APPLY FOR ST. FRANCIS' FINANCIAL ASSISTANCE PROGRAMS AND CERTAIN GOVERNMENT PROGRAMS. THERE IS CONTACT INFORMATION AND TELEPHONE NUMBERS THEY CAN CALL WITH ANY QUESTIONS OR TO RECEIVE ASSISTANCE IN COMPLETING APPLICATIONS. FINANCIAL ASSISTANCE PROGRAM PERSONNEL ALSO MEET DIRECTLY WITH ANY SELF-PAY PATIENT ADMITTED TO THE HOSPITAL. PERSONNEL WILL MEET WITH PATIENTS WHEREVER IT IS MOST CONVENIENT FOR THE PATIENT SUCH AS THE HOSPITAL, A CLINIC, ST. FRANCIS' OFFICES OR THE PATIENT'S HOME. ST. FRANCIS HAS AN INTERPRETER SERVICES TEAM THAT PROVIDES INTERPRETERS TO PATIENTS, COMPANIONS AND FAMILIES WHO HAVE LIMITED ENGLISH PROFICIENCY (LEP) OR ARE DEAF OR HARD OF HEARING (DHH). THIS SERVICE IS PROVIDED AT NO COST TO THE PATIENT. LEP AND DHH PERSONNEL ARE TRAINED TO INFORM AND EDUCATE PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAMS. ALL PERSONNEL RESPONSIBLE FOR ST. FRANCIS' COLLECTION ACTIVITIES ARE EXTENSIVELY TRAINED ON ST. FRANCIS' FINANCIAL ASSISTANCE PROGRAMS. ANY TIME A PATIENT EXPRESSES A CONCERN REGARDING THEIR ABILITY TO PAY FOR SERVICES, THE PERSONNEL EXPLAIN THE FINANCIAL ASSISTANCE PROGRAMS, ASK CERTAIN QUESTIONS TO OBTAIN INFORMATION AND TO DETERMINE WHICH FINANCIAL ASSISTANCE PROGRAMS THE PATIENT MAY QUALIFY AND BEST FITS THE PATIENTS' NEEDS. PART VI, LINE 4: ALLINA HEALTH SYSTEM (ALLINA HEALTH) IS A NOT-FOR-PROFIT SYSTEM OF CLINICS, HOSPITALS AND OTHER HEALTH CARE SERVICES. ALLINA HEALTH OWNS AND OPERATES 11 HOSPITALS, MORE THAN 90 CLINICS AND HEALTH CARE SERVICES, INCLUDING HOME CARE, HOSPICE CARE, PALLIATIVE CARE, OXYGEN AND MEDICAL EQUIPMENT, PHARMACIES AND EMERGENCY MEDICAL TRANSPORTATION IN OPERATION WITHIN MINNESOTA AND WESTERN WISCONSIN. NEARLY ALL ALLINA HOSPITAL PATIENTS COME FROM MINNESOTA AND WISCONSIN, THE MAJORITY OF WHICH COME FROM THE COUNTIES SURROUNDING ITS HOSPITALS AND CLINICS, INCLUDING THE SEVEN-COUNTY TWIN CITIES METRO AND SUBURBAN AND RURAL COMMUNITIES IN WESTERN WISCONSIN, SOUTHERN MINNESOTA AND CENTRAL MINNESOTA. COMMUNITIES SERVED BY ALLINA HEALTH ARE ASSIGNED INTO ONE OF NINE REGIONS AND EACH REGION INCLUDES AT LEAST ONE HOSPITAL WITHIN OUR SYSTEM. COMMUNITY ENGAGEMENT LEADS ARE ASSIGNED TO EACH REGION TO ENGAGE COMMUNITY IN COMMUNITY BENEFIT ACTIVITIES. ST. FRANCIS REPRESENTS THE SOUTH METRO.WEST METRO THE WEST METRO REGION INCLUDES ABBOTT NORTHWESTERN HOSPITAL AND PHILLIPS EYE INSTITUTE AND SERVES MOST COMMUNITIES WITHIN HENNEPIN COUNTY, THE LARGEST COUNTY IN MINNESOTA. THE CITY OF MINNEAPOLIS IS ITS LARGEST CITY AND THE COUNTY SEAT. THE WEST METRO REGION SERVES BOTH URBAN AND SUBURBAN COMMUNITIES AND INCLUDES A RANGE OF SOCIOECONOMIC STATUSES AS WELL AS A BROAD REPRESENTATION OF RACES AND ETHNICITIES. EAST METRO THE EAST METRO REGION INCLUDES UNITED HOSPITAL AND SERVES RAMSEY, WASHINGTON AND DAKOTA COUNTIES. THIS REGION SPANS THE EASTERN EDGE OF THE TWIN CITIES METRO, INCLUDING THE CITY OF ST. PAUL AND ITS SURROUNDING COMMUNITIES. ST. PAUL IS THE CAPITAL AND SECOND-MOST POPULOUS CITY IN THE STATE. THE EAST METRO REGION IS HIGHLY DIVERSE; GEOGRAPHICALLY, SOCIOECONOMICALLY AND RACIALLY. NORTHWEST METRO THE NORTHWEST METRO REGION INCLUDES MERCY HOSPITAL AND ITS UNITY CAMPUS AND PRIMARILY SERVES COMMUNITIES WITHIN ANOKA COUNTY, BUT ALSO INCLUDES AREAS WITHIN RAMSEY, SHERBURNE AND HENNEPIN COUNTIES. ANOKA COUNTY IS THE FOURTH-MOST POPULOUS COUNTY IN THE STATE OF MINNESOTA AND INCLUDES THE NORTHWEST METROPOLITAN AREA THAT IS PREDOMINANTLY SUBURBAN IN NATURE. SOUTH METRO THE SOUTH METRO REGION INCLUDES ST. FRANCIS REGIONAL MEDICAL CENTER, A PARTIALLY-OWNED HOSPITAL WITHIN THE ALLINA SYSTEM, AND PRIMARILY SERVES SCOTT AND EASTERN CARVER COUNTIES, BUT ALSO INCLUDES COMMUNITIES IN SIBLEY, LE SUEUR, DAKOTA AND HENNEPIN COUNTIES. THIS REGION INCLUDES BOTH SUBURBAN AND SMALL COMMUNITIES IN THE SOUTHWEST AREA OF THE MINNEAPOLIS-ST. PAUL METROPOLITAN AREA. NORTHWEST REGIONAL THE NORTHWEST REGIONAL AREA INCLUDES BUFFALO HOSPITAL AND IS LOCATED WEST OF THE METROPOLITAN AREA OF MINNEAPOLIS AND ST. PAUL. THIS REGION PRIMARILY SERVES WRIGHT COUNTY, BUT ALSO SERVES COMMUNITIES WITHIN STEARNS, MEEKER AND HENNEPIN COUNTIES. THIS REGION IS MADE UP OF BOTH SMALL AND RURAL COMMUNITIES. NORTH REGIONALTHE NORTH REGIONAL AREA INCLUDES CAMBRIDGE MEDICAL CENTER AND SERVES SMALL AND RURAL COMMUNITIES WITHIN ISANTI, CHISAGO, KANABEC AND PINE COUNTIES NORTH OF THE METROPOLITAN AREA OF MINNEAPOLIS AND ST. PAUL. SOUTHWEST REGIONALTHE SOUTHWEST REGIONAL AREA IS LOCATED IN SOUTH CENTRAL MINNESOTA AND INCLUDES NEW ULM MEDICAL CENTER. THE REGION SERVES COMMUNITIES AND RURAL AREAS IN AND AROUND BROWN COUNTY AND COMMUNITIES WITHIN SIBLEY AND NICOLLET COUNTIESSOUTH REGIONALLOCATED SOUTH OF THE TWIN CITIES METROPOLITAN AREA, THE SOUTH REGIONAL REGION PRIMARILY SERVES MID-SIZED SUBURBAN CITIES AND RICE, STEELE AND SOUTHERN DAKOTA COUNTIES AS WELL AS COMMUNITIES AND RURAL AREAS ACROSS DODGE, WASECA, AND GOODHUE COUNTIES. OWATONNA HOSPITAL AND DISTRICT ONE HOSPITALS SERVE THESE AREAS.EAST REGIONALTHE EAST REGIONAL REGION IS LOCATED IN EASTERN MINNESOTA AND WESTERN WISCONSIN. IT INCLUDES REGINA HOSPITAL AND RIVER FALLS AREA HOSPITALS, SERVING COMMUNITIES IN DAKOTA COUNTY IN MINNESOTA, AND PIERCE AND ST. CROIX COUNTIES IN WISCONSIN. PART VI, LINE 5: GOVERNING BODY A MAJORITY OF ST. FRANCIS' GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION NOR FAMILY MEMBERS THEREOF. OPEN MEDICAL STAFFTHE MEDICAL STAFF AT ST. FRANCIS IS OPEN, WITH THE EXCEPTION OF CERTAIN DEPARTMENTS (SUCH AS RADIOLOGY, PATHOLOGY, EMERGENCY MEDICINE) WITH WHICH ST. FRANCIS HAS ENTERED INTO EXCLUSIVE CONTRACTS WITH PARTICULAR MEDICAL GROUPS. THE HOSPITAL ENTERS INTO THESE CONTRACTS WHEN IT DETERMINES SUCH ARRANGEMENTS WILL IMPROVE CARE AND OPERATIONS IN THE HOSPITAL BY, FOR EXAMPLE, IMPROVING THE QUALITY OF PATIENT CARE, ASSURING THE AVAILABILITY OF SPECIFIC SERVICES, REDUCING THE COSTS OF PROVIDING HEALTH CARE, ALLOCATING HOSPITAL RESOURCES MORE EFFICIENTLY, SECURING GREATER PATIENT SATISFACTION, OR FACILITATING THE ORDERLY OPERATIONS OF THE HOSPITAL. IT DOES NOT ENTER INTO THESE ARRANGEMENTS SOLELY TO BENEFIT OR EXCLUDE SPECIFIC PROVIDERS OR TO RESTRAIN COMPETITION.ST. FRANCIS ENGAGES IN A BROAD ARRAY OF ACTIVITIES THAT PROMOTE GOOD HEALTH IN OUR COMMUNITY. SEVERAL DEPARTMENTS ENGAGE IN COMMUNITY OUTREACH ACTIVITIES INCLUDING SUPPORT GROUPS (DIABETES, CANCER, GRIEF AND LOSS), EDUCATIONAL CLASSES (CPR ANYTIME, NUTRITION), AND FREE SCREENINGS (SKIN CANCER, CERVICAL CANCER, AND DIABETES). ST. FRANCIS PARTNERS WITH SEVERAL LOCAL ORGANIZATIONS IN STRENGTHENING THE CONTINUUM OF CARE FOR PEOPLE WHO ARE UNINSURED AND UNDERINSURED. ST. FRANCIS PROVIDED FINANCIAL SUPPORT FOR RIVER VALLEY HEALTH SERVICES WHICH OFFERS FREE PUBLIC HEALTH NURSING AND SOCIAL SERVICES REFERRALS FOR THE UNINSURED AND UNDERINSURED IN SCOTT AND EASTERN CARVER COUNTY. RIVER VALLEY HEALTH SERVICES COORDINATES CARE FOR THE UNINSURED POPULATION, HELPING PEOPLE NAVIGATE THE HEALTH AND SOCIAL SERVICES SYSTEM AND CONNECT WITH THE MOST APPROPRIATE CARE PROVIDER FOR THE CLIENT'S PARTICULAR NEED. IN 2020, THEY HAD OVER 1,400 CLIENT VISITS. ST. FRANCIS PROVIDES FINANCIAL SUPPORT AND IN-KIND CLINIC SPACE ON THE ST. FRANCIS CAMPUS FOR ST. MARY'S HEALTH CLINICS TO ENSURE FREE MEDICAL CARE FOR UNINSURED AT ST. MARY'S SHAKOPEE LOCATION. PART VI, LINE 6: PURSUANT TO A JOINT MEMBERSHIP AGREEMENT, ALLINA HEALTH SYSTEM, HPI-RAMSEY, AND CRITICAL ACCESS GROUP ARE JOINT MEMBERS OF ST. FRANCIS REGIONAL MEDICAL CENTER (ST. FRANCIS).UNDER THE MEMBERSHIP AGREEMENT, ALLINA HEALTH HAS THE AUTHORITY AND RESPONSIBILITY FOR THE OPERATION AND MAINTENANCE OF ST. FRANCIS, INCLUDING PROMOTING THE HEALTH OF THE COMMUNITIES SERVED BY ST. FRANCIS. THE JOINT MEMBERS HAVE CERTAIN JOINT RESERVE POWERS. ALLINA HEALTH AND CRITICAL ACCESS GROUP HAVE CERTAIN EXCLUSIVE RESERVE POWERS RELATING TO GOVERNANCE OF ST. FRANCIS. PART VI, LINE 7, REPORTS FILED WITH STATES MN 1 SHAKOPEE SOCCER ASSOCIATION 1160 VIERLING DRIVE EAST SUITE 124 SHAKOPEE MN 55379 411972181 501 ( C )(3) 10000 2020 SHAKOPEE SOCCER ASSOCIATION SPONSORSHIP RIVER VALLEY COMMUNITY PARTNERSHIP (DBA THE RIVER VALLEY HEALTH SERVICES) 303 EAST 6TH STREET CHASKA MN 55318 202886410 501 ( C )(3) 47000 TO SUPPORT GENERAL OPERATING EXPENSES AND TELEHEALTH NEEDS IN RESPONSE TO THE COVID-19 OUTBREAK AND EMERGENCY ESPERANZA 1053 JEFFERSON STREET SOUTH SHAKOPEE MN 55379 842756523 501 ( C )(3) 6000 TO SUPPORT ESPERANZA WITH FOOD DISTRIBUTION ST MARY'S HEALTH CLINIC 1884 RANDOLPH AVENUE ST PAUL MN 55105 411760632 509 (A)(2) 25000 TO SUPPORT THE CLINIC THAT PROVIDES HEALTH SERVICES FOR UNINSURED AND LOW-INCOME FAMILIES. HOUSING AND LIVING 19 31151 PART I, LINE 2: ST. FRANCIS REGIONAL MEDICAL CENTER STRICTLY MONITORS GRANT FUNDS TO ENSURE THAT SUCH GRANTS ARE USED FOR PROPER AND INTENDED PURPOSES AND ARE NOT OTHERWISE DIVERTED FROM THE INTENDED USE. THE ORGANIZATION HAS PROCESS WHICH INCLUDES A WRITTEN APPLICATION WHICH REQUIRES SUPPORTING DOCUMENTATION AND SUBSTANTIATION PRIOR TO A GRANT BEING APPROVED AND DISBURSED. IN ADDITION AND DEPENDING ON THE FACTS AND CIRCUMSTANCE OF THE GRANT, THE ORGANIZATION EMPLOYS VARIOUS METHODS TO ENSURE PROPER AND INTENDED USE SUCH AS PERIODIC REPORTING TO THE ORGANIZATION, FIELD INVESTIGATIONS, CONTRACTS WITH REPAYMENT CLAUSES, REQUIRING ADDITIONAL SUBSTANTIATION AND DOCUMENTATION NOT AVAILABLE AT THE TIME OF THE GRANT, PAYING THIRD PARTIES DIRECTLY ON BEHALF OF THE GRANTEE ORGANIZATION, AND OTHER METHODS AS APPROPRIATE AND WARRANTED. 1 0 1 0 0 0 1 1 0 1 1 MONTE JOHNSON MD FORMER DIRECTOR/VP MEDICAL AFFAIRS 205700 137134 28178 18785 24232 16155 35759 23841 18410 12273 312279 208188 20306 13537 KEITH OLSON DO DIRECTOR 0 356628 0 7718 0 96694 0 13547 0 24885 0 499472 0 21660 BRIAN PROKOSCH MD FORMER VP MEDICAL AFFAIRS 0 174506 0 0 0 179024 0 23055 0 0 0 376585 0 0 JENNIFER HUNT MD DIRECTOR 0 259461 0 0 0 70722 0 27264 0 18305 0 375752 0 0 AMY JERDEE DIRECTOR/PRESIDENT 282482 0 19594 0 4001 0 28493 0 28856 0 363426 0 0 0 CYNTHIA VINCENT VP FINANCE 167226 0 29600 0 48015 0 38137 0 32720 0 315698 0 22992 0 SUE MILLER VP PATIENT CARE SVCS. 194292 0 28194 0 18736 0 34115 0 24585 0 299922 0 9721 0 JAMES GRUENWALD CRNA 203839 0 0 0 7193 0 0 0 28577 0 239609 0 0 0 CHRISTY MCGUFFEE CRNA 199914 0 0 0 4390 0 0 0 31238 0 235542 0 0 0 DEAN TEBRAKE CRNA 207512 0 0 0 5765 0 0 0 18970 0 232247 0 0 0 GREGORY SPINDLER CRNA 209471 0 0 0 3872 0 0 0 18664 0 232007 0 0 0 FARAH PIEPER CRNA 212555 0 0 0 3808 0 0 0 487 0 216850 0 0 0 PART I, LINE 4B 4(B): JENNIFER HUNT, MD - $48,626; KEITH OLSON, DO - $48,483; CYNTHIA VINCENT - $23,663; SUE MILLER - $10,922; MONTE JOHNSON, MD - $37,414; BRIAN PROKOSCH, MD - $156,138. PART I, LINE 6 DEFERRED COMPENSATION PLANS TERMS AND CONDITIONS: SEE SCHEDULE O RELATED TO FORM 990, PART VI, SECTION B, LINE 15 FOR A STATEMENT ON ALLINA HEALTH SYSTEM (ALLINA) PROVIDING ST. FRANCIS REGIONAL MEDICAL CENTER (ST. FRANCIS) STAFFING. ALLINA INCENTIVE PLAN ALLINA PROVIDES AN ANNUAL INCENTIVE COMPENSATION OPPORTUNITY FOR EXECUTIVES, MANAGEMENT AND KEY INDIVIDUAL CONTRIBUTOR STAFF. UNDER THIS PLAN, THE TARGET AWARD IS EXPRESSED AS A FUNCTION OF THE PARTICIPANT'S SALARY PAID DURING THE CALENDAR YEAR AND REQUIRES AT LEAST FOUR MONTHS OF SERVICE IN AN ELIGIBLE POSITION DURING THE YEAR. ACTUAL AWARDS CAN RANGE FROM 0% TO 150% OF THE TARGET AWARD, BASED ON ALLINA'S FINANCIAL AND NON-FINANCIAL PERFORMANCE OVER THE CALENDAR YEAR. NON-FINANCIAL PERFORMANCE MEASURES INCLUDE PATIENT & EMPLOYEE SAFETY, QUALITY, PATIENT EXPERIENCE AND FINANCIAL HEALTH. NO AWARDS ARE PROVIDED UNLESS THRESHOLD FINANCIAL PERFORMANCE IS ACHIEVED. PARTICIPANTS WHO HAVE LEFT EMPLOYMENT PRIOR TO THE END OF THE YEAR AS THE RESULT OF VOLUNTARY TERMINATION OR TERMINATION FOR POOR PERFORMANCE ARE NOT ELIGIBLE FOR AN AWARD. PART I, LINE 8 CERTAIN AMOUNTS REPORTED ON FORM 990, PART VII WERE PAID OR ACCRUED PURSUANT TO A CONTRACT THAT WAS SUBJECT TO THE INITIAL CONTRACT EXCEPTION DESCRIBED IN REGULATION SECTION 53.4958-4(A)(3). FROM TIME TO TIME, ST. FRANCIS REGIONAL MEDICAL CENTER ENTERS INTO CONTRACTUAL ARRANGEMENTS THAT MAY QUALIFY FOR THE INITIAL CONTRACT EXCEPTION BASED ON THE TERMS AND UNDERSTANDINGS OF THE CONTRACTUAL AGREEMENTS. SCHEDULE J, LINE 4(A) & (B) ADDITIONAL COMPENSATION DISCLOSURE: DEFERRED COMPENSATION PLANS TERMS AND CONDITIONS: EXECUTIVE MUTUAL FUND ACCOUNT PLAN PHYSICIAN MUTUAL FUND ACCOUNT PLAN THESE ACCOUNTS GIVE THE PARTICIPANT THE OPPORTUNITY FOR CAPITAL ACCUMULATION NOT FULLY AVAILABLE TO THEM THROUGH SOCIAL SECURITY OR THE GENERAL EMPLOYEE RETIREMENT PLANS BECAUSE OF MAXIMUMS PLACED ON COMPENSATION THAT CAN BE RECOGNIZED UNDER FEDERAL LAW FOR PURPOSES OF CONTRIBUTIONS. THEY ALSO SERVE AS AN IMPORTANT NON-COMPETE INCENTIVE TO PARTICIPANTS. PRIOR TO THE YEAR IN WHICH CONTRIBUTIONS ARE MADE, THE PARTICIPANT MUST DESIGNATE A VESTING/PAYOUT DATE CONSISTENT WITH THE CONSTRAINTS OF THE PLANS AND FEDERAL DEFERRED COMPENSATION REGULATIONS. AFTER THE CONTRIBUTIONS ARE MADE, THE PARTICIPANT HAS A ONE-TIME LIMITED OPPORTUNITY TO EXTEND THE ELECTED PAYMENT DATE FOR AT LEAST FIVE YEARS. ONCE THE VESTING/PAYOUT DATE HAS BEEN REACHED, ALLINA WILL WITHHOLD THE APPROPRIATE TAXES AND THE BALANCE WILL BE PAID TO THE PARTICIPANT ON THEIR PAYCHECK AS SOON AS ADMINISTRATIVELY FEASIBLE. IF THE PARTICIPANT TERMINATES EMPLOYMENT VOLUNTARILY BEFORE AN AMOUNT IS PAID, PAYMENT WILL BE SUBJECT TO THE PARTICIPANT'S COMPLIANCE WITH A NON-COMPETE AGREEMENT WITH ALLINA FOR TWO YEARS AFTER TERMINATION. THE PARTICIPANT MAY ELECT FROM AMONG INVESTMENT ALTERNATIVES THAT ARE SIMILAR TO THOSE AVAILABLE IN THE RETIREMENT SAVINGS PLAN. UNLIKE THE RETIREMENT SAVINGS PLAN, THE PARTICIPANT HAS THE STATUS OF AN UNSECURED CREDITOR OF ALLINA AND WILL NOT HAVE A PRIORITY CLAIM TO PAYMENT IN THE CASE OF THE COMPANY'S INABILITY TO PAY. HOWEVER, THE COMPANY DOES SET ASIDE ASSETS FOR ITS OBLIGATIONS BY ACTUALLY INVESTING THE PROMISED ASSETS CONSISTENT WITH PARTICIPANT ELECTIONS. THE MUTUAL FUND PLANS TERMINATED EFFECTIVE DECEMBER 31, 2018. ALL MUTUAL FUND ACCOUNTS SHALL BE DISTRIBUTED IN A LUMP SUM NO LATER THAN JANUARY 2021, OR IF ELECTED BY THE PARTICIPANT IN DECEMBER 2018, IN THREE ANNUAL INSTALLMENTS WITH THE FIRST HAVING BEEN MADE FEBRUARY 2019 (33.33 PERCENT OF ACCOUNT BALANCE), THE SECOND MADE FEBRUARY 2020 (50 PERCENT OF REMAINING BALANCE), AND THE THIRD MADE JANUARY 2021 (REMAINING BALANCE). ALLINA DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN THIS PLAN WAS AMENDED AND FROZEN EFFECTIVE DECEMBER 31, 2008, SUCH THAT NO FUTURE BENEFITS ACCRUE FOR SERVICE AFTER THAT DATE. THIS PLAN WAS REPLACED WITH THE EXECUTIVE RETIREMENT BENEFIT RESTORATION PLAN (ERBRP) EFFECTIVE JANUARY 1, 2009, AND IS NOW FROZEN AS OF DECEMBER 31, 2018. ELIGIBLE ALLINA EXECUTIVES PARTICIPATED IN A DEFINED CONTRIBUTION SERP. EMPLOYER CREDITS WERE MADE EACH YEAR TO THEIR DC SERP BALANCE ACCORDING TO THE FOLLOWING SCHEDULE: EXEC YRS OF SERVICE CONTRIBUTION % OF PENSIONABLE EARNINGS 0-5 2.75% 6-10 3.50% 11+ 4.75% EXECUTIVES WERE ALSO CREDITED AN AMOUNT EQUAL TO THE EXCESS AMOUNT THAT WOULD HAVE BEEN CREDITED TO THE PENSION ACCOUNT PLAN WERE IT NOT FOR THE QUALIFIED PLAN COMPENSATION LIMITS. DEPOSITS EARN THE INVESTMENT RATE OF RETURN EQUAL TO THE PENSION ACCOUNT PLAN CREDITING RATE AS DECLARED BY ALLINA. THE CURRENT RATE IS 4%. THE PARTICIPANT VESTS AFTER THREE YEARS OF EXECUTIVE SERVICE PROVIDED THAT IF THE PARTICIPANT TERMINATES EMPLOYMENT WITH ALLINA PRIOR TO AGE 65 FOR ANY REASON OTHER THAN ELIMINATION OF POSITION, THE PARTICIPANT MUST FULFILL THE TERMS OF A COVENANT NOT TO COMPETE, BENEFITS ARE PAID AS A SINGLE LUMP-SUM AMOUNT UPON AGE 65, RETIREMENT OR JOB POSITION ELIMINATION. IN THE CASE OF OTHER VOLUNTARY TERMINATIONS, PAYMENT IS DELAYED UNTIL COMPLETION OF THE TWO-YEAR NON-COMPETE PERIOD. THE DC SERP IS PAYABLE FROM ALLINA'S GENERAL ASSETS. IF ALLINA BECOMES INSOLVENT, THE PARTICIPANT WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PRIORITY CLAIM TO ANY ASSETS. ALLINA EXECUTIVE RETIREMENT BENEFIT RESTORATION PLAN (ERBRP) ELIGIBLE ALLINA EXECUTIVES PARTICIPATE IN A DEFERRED COMPENSATION RETIREMENT PLAN. EXECUTIVES ARE CREDITED AN AMOUNT EQUAL TO THE EXCESS AMOUNT THAT WOULD HAVE BEEN CREDITED TO THE ALLINA RETIREMENT SAVINGS PLAN WERE IT NOT FOR THE QUALIFIED PLAN COMPENSATION LIMITS. EMPLOYER CREDITS ARE MADE EACH YEAR TO THEIR ACCOUNT BALANCE ACCORDING TO THE FOLLOWING SCHEDULE AS OF THE END OF THE PLAN YEAR: PARTICIPANT'S YEARS OF VESTING SERVICE APPLICABLE PERCENTAGE LESS THAN 1 0% 1-5 5.0% 6-10 5.5% 11-15 6.0% 16 OR MORE 6.5% DEPOSITS EARN THE INVESTMENT RATE OF RETURN EQUAL TO THE INVESTMENT OPTIONS SELECTED BY THE PARTICIPANT WHICH ARE THE SAME OPTIONS AVAILABLE UNDER THE QUALIFIED PLAN. A PARTICIPANT WHO HAS COMPLETED AT LEAST TWO YEARS OF SERVICE BECOMES VESTED IN THE PORTION OF HIS OR HER ACCOUNT ATTRIBUTABLE TO THE ANNUAL CREDIT FOR A PARTICULAR YEAR AS OF JANUARY 15 OF THE YEAR FOLLOWING THE CALENDAR YEAR IN WHICH THE ANNUAL CREDIT IS EARNED. IN THE EVENT OF TERMINATION (OTHER THAN BECAUSE OF DEATH) PRIOR TO AGE 67, THE DISTRIBUTION DATE SHALL BE AS SOON AS ADMINISTRATIVELY POSSIBLE AFTER TERMINATION IN THE FORM OF A LUMP SUM PAYMENT. THE PLAN IS PAYABLE FROM ALLINA'S GENERAL ASSETS. IF ALLINA BECOMES INSOLVENT, THE PARTICIPANT WILL BE AN UNSECURED CREDITOR AND WILL HAVE NO PRIORITY CLAIM TO ANY ASSETS. THIS PLAN WAS EFFECTIVE JANUARY 1, 2009 AND IS NOW FROZEN AS OF DECEMBER 31, 2018. EXECUTIVE SEVERANCE PLAN ALLINA PROVIDES SALARY CONTINUATION FOR EXECUTIVES WHOSE EMPLOYMENT HAS BEEN INVOLUNTARILY TERMINATED FOR REASONS OTHER THAN CAUSE OR POOR PERFORMANCE. THE LENGTH OF THE SEVERANCE PAY PERIOD IS DEFINED BY THE PLAN AND DEPENDS ON THE LEVEL OF THE EXECUTIVE POSITION. UNDER THE PLAN THE SEVERED EXECUTIVE ALSO COULD CONTINUE CERTAIN BENEFITS FOR A LIMITED PERIOD OF TIME. IN 2009 THE PLAN WAS AMENDED TO FURTHER RESTRICT SEVERANCE BENEFITS IN THE CASE THAT THE EXECUTIVE OBTAINS OTHER EMPLOYMENT DURING THE SEVERANCE PERIOD. SUPPLEMENTAL PHYSICIAN AND EXECUTIVE SAVINGS PLAN THIS PLAN'S PURPOSE IS TO PROVIDE A SELECT GROUP OF PHYSICIANS AND EXECUTIVES WITH ADDITIONAL DEFERRED COMPENSATION. AMOUNTS DEFERRED UNDER THE PLAN ARE INTENDED TO BE EXEMPT FROM CODE SECTION 409A AND 457(F). ANNUAL CONTRIBUTIONS ARE MADE EACH FEBRUARY AND ARE BASED ON PREVIOUS YEAR'S ELIGIBLE COMPENSATION. PARTICIPANT'S APPLICABLE CONTRIBUTION PERCENTAGE FOLLOWS: PARTICIPANT APPLICABLE PERCENTAGE PHYSICIANS 5% VP'S 12% SVP | EVP 15% CEO 20% OF BASE SALARY + 10% OF BASE SALARY OVER IRS PAY LIMIT IF PARTICIPANT IS FULLY VESTED, THE CONTRIBUTION IS PAID DIRECTLY TO PARTICIPANT, LESS TAXES IN LATE JANUARY. IF PARTICIPANT IS UNVESTED, THE CONTRIBUTION IS DEPOSITED WITH FIDELITY. THE VESTING SCHEDULE FOR THIS PLAN FOLLOWS: FOR 2019 CONTRIBUTION, ONLY - IT WAS DEPOSITED IN FEBRUARY 2020, 50% VESTING AFTER 2 YEARS - I.E. 2021, PAID OUT 01/2021; AND, 50% VESTING IN 2022, PAID OUT 01/2022. FOR 2020 CONTRIBUTIONS AND AFTER - VESTING OCCURS AFTER 3 YEARS - I.E. 2020 CONTRIBUTION VESTS IN 2023, THE 2021 CONTRIBUTION VESTS IN 2024, ETC. PARTICIPANTS ARE 100% VESTED AT THE EARLIER OF AT LEAST AGE 60 WITH 7 YEARS OF SERVICE OR AGE 65. GRANDFATHERED PROVISION - FOR THOSE AGE 54 OR OLDER AND EMPLOYED AS OF 12/31/2018: EARLIER OF AT LEAST AGE 60 WITH 3 YEARS OF SERVICE OR AGE 65. THIS PLAN WAS EFFECTIVE JANUARY 1, 2019. A NON-COMPETE CLAUSE DOES NOT APPLY TO THIS PLAN. ALLINA HEALTH PHYSICIAN DEFERRED AWARD PLAN ALLINA HEALTH ESTABLISHED THIS EMPLOYEE BENEFIT PLAN TO PROVIDE DESIGNATED PHYSICIANS WITH ADDITIONAL DEFERRED COMPENSATION TO PROVIDE LONG TERM INCENTIVES TO REMAIN WITH THE COMPANY AND CONTRIBUTE TO ITS' SUCCESSFUL PERFORMANCE. SELECT PHYSICIANS ARE ELIGIBLE TO PARTICIPATE AFTER ONE FULL CALENDAR YEAR OF EMPLOYMENT AND BE WORKING A .5 FTE OR GREATER AS OF THE DECEMBER 31ST OF THE PLAN YEAR FOR WHICH THE CONTRIBUTION IS PROVIDED. THE PLAN ANNUAL FUNDING AWARD POOL IS DISCRETIONARY AND WILL BE DETERMINED AT THE END OF THE PLAN YEAR AND MUST BE APPROVED BY THE ALLINA HEALTH BOARD COMPENSATION COMMITTEE. ONCE THE AWARD POOL IS DETERMINED, THE AMOUNTS WILL BE ALLOCATED EQUALLY WITH ADJUSTMENTS MADE BASED ON THE PARTICIPANT'S FTE STATUS. A PARTICIPANT'S ACCOUNT SHALL BECOME VESTED AND NON-FORFEITABLE UPON THE EARLIEST OF THE FOLLOWING: THE DATE THE PARTICIPANT HAS ATTAINED AGE 65 THE DATE A TERMINATED PARTICIPANT HAS REACHED AGE 55, COMPLETED TEN YEARS OF VESTING SERVICE AND SATISFIED A TWO-YEAR NON-COMPETE RESTRICTION THE DATE OF THE PARTICIPANT'S DEATH. A CITY OF SHAKOPEE 416005539 819175BJ8 2014-06-18 46172827 SEE PART VI 0 0 0 A 8340000 46172827 750150 45422677 2014 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 A 1 SCHEDULE K SUPPLENTAL INFORMATION IN JUNE 2014, THE CITY OF SHAKOPEE , ON BEHALF OF ST. FRANCIS REGIONAL MEDICAL CENTER, ISSUED FIXED RATE HEALTH CARE FACILITIES REVENUE REFUNDING BONDS, SERIES 2014. THE 2014 BONDS, WHICH ARE SECURED BY PLEDGED REVENUE , WERE USED TO REDEEM THE CITY OF SHAKOPEE, MINNESOTA HEALTH CARE FACILITIES FIXED RATE REVENUE BONDS, SERIES 2004 ON SEPTEMBER 1, 2014. USED FOR THE PURPOSE OF REFUNDING OF THE 2004 DEBT WHICH INCLUDED THE REFUNDING OF THE SERIES 1998 NOTES, CONSTRUCTION OF IMPATIENT BED TOWER AND RENOVATION OF MULTIPLE EXISTING FACILITIES, ACQUISITION OF MEDICAL EQUIPMENT, INFORMATION TECHNOLOGY, AND FURNISHINGS. FORM 990, PART V, LINE 1A: ST. FRANCIS REGIONAL MEDICAL CENTER DOES NOT ISSUE PAYMENTS TO VENDORS AND SUPPLIERS BUT RATHER ALLINA HEALTH SYSTEM, A JOINT MEMBER ORGANIZATION, PROVIDES PAYMENTS TO VENDORS AND SUPPLIERS. THE NUMBER REPORTED ON FORM 990, PART V, LINE 1A IS THE NUMBER REPORTED ON ALLINA HEALTH SYSTEM'S FORM 1096 BOX 3 RELATED TO PAYMENTS MADE ON BEHALF OF ST. FRANCIS REGIONAL MEDICAL CENTER BY ALLINA. FORM 990, PART VI MARK DANAHY, M.D. IS A PHYSICIAN COMPENSATED BY AN UNRELATED ORGANIZATION WHICH PROVIDES SERVICES TO ST. FRANCIS OR A RELATED ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 ST. FRANCIS REGIONAL MEDICAL CENTER (ST. FRANCIS) HAS THREE MEMBERS, EACH OF WHICH IS A MINNESOTA NONPROFIT CORPORATION AND 501(C)(3) ORGANIZATION. PURSUANT TO A JOINT MEMBERSHIP AGREEMENT, CRITICAL ACCESS GROUP ("CAG"), ALLINA HEALTH SYSTEM, AND HPI-RAMSEY ARE JOINT MEMBERS OF ST. FRANCIS. ALLINA HEALTH SYSTEM HAS THE AUTHORITY AND RESPONSIBILITY FOR THE OPERATIONS AND MAINTENANCE OF ST. FRANCIS. THE JOINT MEMBERS HAVE CERTAIN JOINT RESERVED POWERS. ALLINA HEALTH SYSTEM AND CAG HAVE CERTAIN EXCLUSIVE RESERVED POWERS RELATING TO THE GOVERNANCE OF ST. FRANCIS. THE RESERVED AND JOINT POWERS ARE FULLY DESCRIBED IN ST. FRANCIS' GOVERNING DOCUMENTS. FORM 990, PART VI, SECTION A, LINE 6 SEE DESCRIPTION FOR LINE 3 ABOVE. FORM 990, PART VI, SECTION A, LINE 7A SEE DESCRIPTION FOR LINE 3 ABOVE. FORM 990, PART VI, SECTION A, LINE 7B SEE DESCRIPTION FOR LINE 3 ABOVE. FORM 990, PART VI, SECTION B, LINE 11B THE ST. FRANCIS REGIONAL MEDICAL CENTER ("ST. FRANCIS") FORM 990 WAS PREPARED BY THE TAX SERVICES FUNCTION OF ALLINA HEALTH SYSTEM ("ALLINA"), A JOINT MEMBER ORGANIZATION. THE FORM 990 FILING WAS SUBJECTED TO A RIGOROUS REVIEW PROCESS BY ALLINA'S TAX MANAGER AND TAX DIRECTOR. ALLINA'S CHIEF FINANCIAL OFFICER ALSO PERFORMED AN EXECUTIVE REVIEW OF THE FORM 990. AFTER THE MANAGEMENT REVIEW PROCESS DESCRIBED ABOVE WAS COMPLETED, THE FINAL FORM 990, AS ULTIMATELY FILED WITH THE INTERNAL REVENUE SERVICE ["IRS"],WAS PROVIDED TO EACH VOTING MEMBER OF ST. FRANCIS' BOARD OF DIRECTORS. THE ST. FRANCIS BOARD OF DIRECTORS REVIEWED THE FORM 990 AND AUTHORIZED AND APPROVED THE FILING OF THE FORM 990 AND THE MINNESOTA CHARITABLE TRUST ANNUAL REPORT. THE BOARD OF DIRECTORS RESOLUTION ALSO DIRECTED OFFICERS TO FILE THE FORM 990 WITH THE IRS AND THE CHARITABLE TRUST ANNUAL REPORT WITH THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. THE ABOVE STATED REVIEW AND APPROVAL PROCESS OCCURRED PRIOR TO FILING THE ST. FRANCIS FORM 990 WITH THE IRS AND MINNESOTA CHARITABLE TRUST ANNUAL REPORT WITH THE MINNESOTA ATTORNEY GENERAL. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS SEVERAL METHODS OF MONITORING AND ENFORCING COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. FIRST, THE ORGANIZATION REGULARLY DISTRIBUTES CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRES TO ITS OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES. THESE INDIVIDUALS ARE REQUIRED TO DISCLOSE ANNUALLY ANY INTEREST THAT COULD GIVE RISE TO CONFLICTS, INCLUDING ANY FAMILY OR BUSINESS RELATIONSHIP. SECOND, THE GENERAL COUNSEL'S OFFICE ANNUALLY DELIVERS A REPORT TO ALLINA'S BOARD OF DIRECTORS WHICH INCLUDES, AMONG OTHER THINGS, THE RESULTS OF THE CONFLICT OF INTEREST QUESTIONNAIRE, AN ANALYSIS OF POTENTIAL CONFLICTS, AND GUIDANCE FOR SATISFACTORILY RESOLVING CONFLICTS. THIRD, THE ORGANIZATION UNDERTAKES MANDATORY COMPLIANCE TRAINING OF ALL ITS EMPLOYEES WHICH INCLUDES TRAINING ON CONFLICTS OF INTEREST. FOURTH, ALL EMPLOYEES RECEIVE, AND ARE EXPECTED TO CONDUCT THEMSELVES IN ACCORDANCE WITH, ALLINA'S CODE OF CONDUCT. THE CODE OF CONDUCT CONTAINS EDUCATIONAL MATERIALS AND GUIDANCE TO RESOLVE POTENTIAL CONFLICTS OF INTEREST. FIFTH, ALLINA MAINTAINS A CORPORATE INTEGRITY HOTLINE, A CONFIDENTIAL 24 HOUR EXTERNAL RESOURCE TO HELP ANSWER QUESTIONS RELATED TO ETHICAL BUSINESS CONDUCT. ALL CALLS TO THE INTEGRITY LINE ARE KEPT CONFIDENTIAL. FORM 990, PART VI, SECTION B, LINE 15 ST. FRANCIS REGIONAL MEDICAL CENTER (ST. FRANCIS) HAS NO EMPLOYEES OF ITS OWN BUT RATHER ALLINA HEALTH SYSTEM, A JOINT MEMBER ORGANIZATION, PROVIDES THE STAFFING. THEREFORE, ST.FRANCIS' COMPENSATION AND BENEFITS PROGRAMS ARE VESTED IN AND ADMINISTERED IN CONJUNCTION WITH ALLINA HEALTH SYSTEM. THE COMPENSATION COMMITTEE OF THE ALLINA HEALTH SYSTEM BOARD OF DIRECTORS IS RESPONSIBLE FOR ALL COMPENSATION AND BENEFITS PROGRAM ELEMENTS FOR NON-COLLECTIVELY BARGAINED ALLINA HEALTH SYSTEM EXECUTIVE EMPLOYEES INCLUDING THOSE AT ST. FRANCIS. ALLINA HEALTH SYSTEM USES A PROCESS FOR DETERMINING COMPENSATION FOR THE ALLINA HEALTH SYSTEM CHIEF EXECUTIVE OFFICER, AND CERTAIN OTHER OFFICERS AND KEY EMPLOYEES THAT INCLUDED ALL OF THE FOLLOWING ELEMENTS: - REVIEW AND APPROVAL BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, THE MEMBERS OF WHICH ARE INDEPENDENT AND WITHOUT A CONFLICT OF INTEREST AS DEFINED IN REGULATION SECTION 53.4958-6(C)(1)(III). - ENGAGEMENT OF AN INDEPENDENT COMPENSATION CONSULTANT SPECIALIZING IN EXECUTIVE COMPENSATION. - USE OF DATA AS TO COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. - CONTEMPORANEOUS DOCUMENTATION, SUBSTANTIATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENT. THE ABOVE DESCRIBED PROCESS AND AN ASSESSMENT IS PERFORMED AT LEAST ANNUALLY FOR THE FOLLOWING POSITIONS: CHIEF EXECUTIVE OFFICER, PRESIDENT AND CHIEF OPERATING OFFICER; EVP CHIEF FINANCIAL OFFICER, EVP CHIEF HUMAN RESOURCES AND ADMINISTRATIVE OFFICER; SVP OPERATIONS/PRESIDENT III; SVP CHIEF MARKETING OFFICER; SVP CHIEF COMPLIANCE OFFICER; SVP CHIEF STRATEGY AND GROWTH OFFICER; SVP CHIEF MEDICAL OFFICER; SVP GENERAL COUNSEL; SVP CHIEF INFORMATION AND IMPROVEMENT OFFICER. IN ADDITION, THE COMPENSATION COMMITTEE REVIEWS AND RECOMMENDS CHANGES TO THE BOARD OF DIRECTORS FOR THE ALLINA HEALTH SYSTEM CHIEF EXECUTIVE OFFICER AND REVIEWS AND APPROVES ALL COMPENSATION CHANGES OF THE OTHER FORE MENTIONED POSITIONS LISTED IN ADVANCE OF THE CHANGE. FORM 990, PART VI, SECTION C, LINE 19 ST. FRANCIS REGIONAL MEDICAL CENTER MAKES ITS FORM 990, FORM 1023, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. TO ARRANGE AN INSPECTION OR RECEIVE A COPY, PLEASE CONTACT THE FOLLOWING: ST. FRANCIS REGIONAL MEDICAL CENTER TAX SERVICES MAIL ROUTE 10890 P.O. BOX 43 MINNEAPOLIS, MN 55407-0043 TELEPHONE: 612-262-0660 PHYSICAL ADDRESS: 2925 CHICAGO AVENUE MINNEAPOLIS, MN 55407-1321 THE FORM 990 AND FORM 1023 ARE ALSO AVAILABLE DIRECTLY FROM THE INTERNAL REVENUE SERVICE. THE FORM 990 IS ALSO AVAILABLE FROM THE CHARITIES DIVISION OF THE OFFICE OF THE MINNESOTA ATTORNEY GENERAL. THE FINANCIAL STATEMENTS ARE ALSO AVAILABLE FROM ELECTRONIC MUNICIPAL MARKET ACCESS AND ON THEIR WEBSITE AT HTTP://EMMA.MSRB.ORG. FORM 990, PART XI, LINE 9: CONTRIBUTION, EXPENSE AND GRANT FOUNDATION TRANSFER 1,104,855. CONTRIBUTION RELEASED FROM TEMPORARILY RESTRICTED NET ASSETS -1,000,000. FORM 990, PART XII, LINE 2C: THIS PROCESS REMAINS UNCHANGED FROM PRIOR YEAR. VALLEY REHABILITATION SERVICES LLC 1455 ST FRANCIS AVENUE SHAKOPEE MN 55379 411752857 MEDICAL SERVICES MN -514423 243041 ST FRANCIS REGIONAL MEDICAL CENTER ALLINA HEALTH SYSTEM PO BOX 43 MAIL ROUTE 10890 MINNEAPOLIS MN 554400043 363261413 HEALTHCARE SERVICES MN 501(C)(3) LINE 3 N/A 0 CRITICAL ACCESS GROUP 503 E 3RD STREET SUITE 400 DULUTH MN 55805 261219624 SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12B, II ESSENTIA HEALTH 0 HPI-RAMSEY 8170 33RD AVENUE S PO BOX 1309 MINNEAPOLIS MN 554401309 411793333 SUPPORTING ORGANIZATION MN 501(C)(3) LINE 12A, I HEALTHPARTNERSINC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0