2020-11-10T17:33:08-06:00 2019-12-31 390859910 BAKER TILLY US LLP 225 S 6TH ST 2300 MINNEAPOLIS MN 55402 990 2019-01-01 208316475 MAPLE GROVE HOSPITAL CORPORATION MAPL 7635811000 9875 HOSPITAL DRIVE MAPLE GROVE MN 55369 DAN FROMM TREASURER 7635205048 2020-10-30 1 LAWRENCE H MOHR CPA P00447603 6128764500 2020-10-30 45.62.178.239 2020-10-30 12:47:03 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 EDB264CAD7F9F6CD2E19D356927987B2A35A11B0 2019 2021-01-29 14:40:06Z ANDREW COCHRANE 9875 HOSPITAL DRIVE MAPLE GROVE MN 55369 210277624 0 X WWW.MAPLEGROVEHOSPITAL.ORG X 2007 MN TO EMPOWER OUR CUSTOMERS TO ACHIEVE THEIR BEST HEALTH. 7 2 1238 600 0 0 6708 88695 209059019 209917998 252490 270931 0 0 209318217 210277624 0 0 0 0 73660146 79131877 0 0 0 100709576 97588624 174369722 176720501 34948495 33557123 169219480 174471313 139342031 135808035 29877449 38663278 X TO EMPOWER OUR CUSTOMERS TO ACHIEVE THEIR BEST HEALTH. 0 0 149494127 208322748 MAPLE GROVE HOSPITAL IS A GENERAL, ACUTE CARE HOSPITAL PROVIDING EMERGENCY SERVICES, MATERNITY AND NEONATAL CARE, AND GENERAL MEDICAL-SURGICAL, OBSTETRICAL, AND PEDIATRIC SERVICES. MAPLE GROVE HOSPITAL'S MISSION IS EMPOWERING ITS CUSTOMERS TO ACHIEVE THEIR BEST HEALTH.IN ADDITION TO CHARITY AND UNCOMPENSATED CARE, MAPLE GROVE HOSPITAL ALSO PROVIDES NUMEROUS COMMUNITY BENEFITS (AT NO COST OR BELOW COST) IN FURTHERANCE OF ITS CHARITABLE PURPOSE INCLUDING HEALTH RELATED EDUCATIONAL PROGRAMS: SAFETY FAIRS, CAR SEAT CLINICS, MENTAL HEALTH AND FIRST AID CLASSES, AND ASTHMA EDUCATION IN ELEMENTARY SCHOOLS. MAPLE GROVE HOSPITAL PROVIDES MEDICAL CARE WITHOUT CHARGE OR AT REDUCED COSTS TO RESIDENTS OF ITS COMMUNITY PRIMARILY THROUGH (A) THE DIFFERENCE BETWEEN PUBLIC PROGRAM PAYMENTS (PRIMARILY MEDICARE AND MEDICAID) AND THE RELATED COSTS OF PROVIDING SUCH SERVICES, AND (B) SERVICES PROVIDED TO PATIENTS EXPRESSING A WILLINGNESS TO PAY BUT WHO ARE DETERMINED UNABLE TO PAY BECAUSE OF ECONOMIC FACTORS. IN ADDITION, MAPLE GROVE HOSPITAL CONTRIBUTES TO FUNDING MEDICAL CARE FOR THE UNINSURED THROUGH PAYMENT OF PATIENT SERVICES TAXES, WHICH INCLUDE THE MEDICAID SURCHARGE AND THE MINNESOTA CARE TAX ON CERTAIN NET REVENUE. 149494127 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 160 0 1238 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 2 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X DAN FROMM 7635205200 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 J KEVIN CROSTON MD BOARD CHAIR 2.00 42.00 X X 0 1274710 47162 JEFF WICKLANDER DIRECTOR 2.00 50.00 X 0 562019 123234 CAROLYN OGLAND VUKICH CHIEF MEDICAL OFFICER 2.00 50.00 X 0 570714 39490 JENNIFER CLOSE DIRECTOR - OUTGOING 2.00 50.00 X 0 567968 36254 ANDREW COCHRANE PRESIDENT 2.00 50.00 X 0 537106 45592 SAMANTHA HANSON DIRECTOR 2.00 50.00 X 0 539999 42699 AARON BLOOMQUIST TREASURER 2.00 42.00 X X 0 462955 37186 PAMELA DOORENBOS MD VP MEDICAL AFFAIRS 50.00 1.00 X 434293 0 17102 WENDY ULFERTS VP PATIENT CARE/ CHIEF NUR 50.00 0.00 X 341271 0 29822 SARAH JOHNSON MGR, PHARMACY 50.00 0.00 X 181088 0 23483 KELLY HADSALL PHARMACIST 50.00 0.00 X 156624 0 23319 LETTY TAM PHARMACIST 50.00 0.00 X 162233 0 13782 JOAN YOST REGISTERED NURSE 50.00 0.00 X 155996 0 18283 SHERRY COLUCCI MULTI-SPECIALTY TECH 50.00 0.00 X 165569 0 7150 JAMES HEREFORD DIRECTOR 2.00 0.00 X 0 0 0 DAN FROMM DIRECTOR - OUTGOING 2.00 0.00 X 0 0 0 ROBERT BEACHER DIRECTOR 2.00 0.00 X 0 0 0 1597074 4515471 504558 85 0 1 0 OWENS & MINOR INCORPORATED 9120 LOCKWOOD BOULEVARD MECHANICSVILLE VA 23116 MEDICAL SUPPLIES 5826104 CARDINAL HEALTH 7000 CARDINAL PLACE DUBLIN OH 43017 MEDICAL SUPPLIES 3457929 RYAN COMPANIES US 533 SOUTH THIRD STREET SUITE 100 MINNEAPOLIS MN 55415 CONSTRUCTION 3023435 DEPUY 325 PARAMOUNT DRIVE RAYNHAM MA 02767 MEDICAL DEVICES 2649591 MEDTRONIC 710 MEDTRONIC PARKWAY NE MINNEAPOLIS MN 55432 MEDICAL SUPPLIES AND DEVICES 2313314 65 77385 11310 88695 PATIENT REVENUE 621500 208322748 208322748 CONTRACT SERVICES 900099 666021 666021 CMS/EHR PAYMENTS & OTH 900099 659196 659196 GIFT SHOP 900099 238230 238230 ALL OTHER 621910 31803 31803 209917998 270931 270931 210277624 208322748 0 1866181 822488 822488 62247658 52059426 10188232 3115595 2605658 509937 8498232 7107305 1390927 4447904 3719904 728000 22072940 18460206 3612734 54750 45789 8961 160399 134146 26253 14420755 12060473 2360282 308113 257683 50430 1759647 1471641 288006 416424 348267 68157 2584881 2161807 423074 46407 38811 7596 4516981 3777675 739306 7634838 6385225 1249613 1086357 908550 177807 SUPPLIES 23824254 19924878 3899376 BAD DEBT EXPENSE 9387167 9387167 GOVERNMENT TAXES 5189430 5189430 MAINTENANCE AND REPAIRS 2776110 2321737 454373 1349171 1128349 220822 176720501 149494127 27226374 0 1650 3700 34628773 35704768 29296834 33561089 42008 2263577 2354247 753127 656522 155479762 70757745 86927755 84722017 11160764 13231438 3607000 3607000 580000 588524 169219480 174471313 16042412 16568128 123299619 118950087 0 289820 139342031 135808035 X 29877449 38663278 29877449 38663278 169219480 174471313 X 33557123 1728706 -26500000 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 109415902 42123312 67292590 41762117 28634433 13127684 4301743 4301743 84722017 THIRD PARTY PAYOR SETTLEMENT 289820 289820 X PART X, LINE 2: MAPLE GROVE HOSPITAL EVALUATES ITS UNCERTAIN TAX POSITIONS ON AN ANNUAL BASIS, AND THERE HAVE BEEN NO UNCERTAIN TAX POSITIONS RECORDED IN 2019 OR 2018. 1 1 1 X 1 X 275.000000000000 1 1 1 0 0 4321670 4321670 0.02450 33163066 23894758 9268308 0.05240 37484736 23894758 13589978 0.07690 211779 600 211179 0.00120 211779 600 211179 0.00120 37696515 23895358 13801157 0.07810 1 3165798 37417614 38226087 -808473 X 1 1 1 1 MAPLE GROVE HOSPITAL CORPORATION 9875 HOSPITAL DRIVE MAPLE GROVE MN 55369 X X X MAPLE GROVE HOSPITAL CORPORATION 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X SEE PART V FOR FULL URL X 1 19 1 SEE PART V FOR FULL URL 0 1 X 200.000000000000 275.000000000000 X X X X X 1 1 X X X 1 X SEE PART V FOR FULL URL X SEE PART V FOR FULL URL X SEE PART V FOR FULL URL X X X X X 1 X 0 X 1 0 0 MAPLE GROVE HOSPITAL CORPORATION PART V, SECTION B, LINE 5: ONE OF THE KEY OBJECTIVES IN CONDUCTING THE CHNA WAS TO IDENTIFY HEALTH ISSUES WHICH ARE MOST IMPORTANT TO OUR COMMUNITY MEMBERS AND ESTABLISH OR STRENGTHEN COMMUNITY RELATIONSHIPS TO HELP ADDRESS THESE HEALTH ISSUES. THIS WAS ACCOMPLISHED IN SEVERAL WAYS. A STEERING COMMITTEE COMPOSED OF COMMUNITY LEADERS, SOCIAL SERVICE PROVIDERS, HEALTH CARE PROVIDERS, SCHOOL DISTRICT EMPLOYEES, BUSINESS REPRESENTATIVES AND A PUBLIC HEALTH REPRESENTATIVE GUIDED THE ASSESSMENT PROCESS AND IDENTIFICATION OF HEALTH NEEDS. MAPLE GROVE HOSPITAL CONVENED 5 FOCUS GROUPS FROM TARGET POPULATIONS THROUGHOUT THE COMMUNITY. WE FURTHER INTERVIEWED KEY STAKEHOLDERS FROM LOCAL GOVERNMENT, LAW ENFORCEMENT, EDUCATION, RELIGIOUS AND COMMUNITY-BASED ORGANIZATIONS. LASTLY WE CONDUCTED AN ONLINE SURVEY FOR BUSINESS GROUPS, THE FAITH COMMUNITY AND COMMUNITY MEMBERS. THE ASSESSMENT WAS COMPLETED WORKING IN CONJUNCTION WITH FAIRVIEW AND MAPLE GROVE HOSPITAL. MAPLE GROVE HOSPITAL CORPORATION PART V, SECTION B, LINE 11: IN 2019 MGH CONDUCTED OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), BASED ON THE THREE YEAR CYCLE. THE 2019 CHNA WAS APPROVED BY THE MGH COMMUNITY ENGAGEMENT ADVISORY TEAM (CEAT) ON OCTOBER 31, 2019 AND BY THE MAPLE GROVE HOSPITAL BOARD OF DIRECTORS ON NOVEMBER 7, 2019. IT WAS POSTED TO OUR WEBSITE ON DECEMBER 30, 2019. THE COMMUNITY HEALTH WORK CARRIED OUT DURING 2019, WHILE THE 2019 CHNA WAS BEING CONDUCTED, WAS BASED ON THE 2016 CHNA FINDINGS. THE OVERALL CHNA WAS GUIDED BY THE COMMUNITY ENGAGEMENT ADVISORY TEAM (CEAT) WHICH IS COMPOSED OF COMMUNITY MEMBERS, MAPLE GROVE HOSPITAL EMPLOYEES AND PUBLIC HEALTH REPRESENTATIVES. DATA USED TO IDENTIFY THE TOP PRIORITIES INCLUDE: DEMOGRAPHIC DATA; QUANTITATIVE DATA FROM THE MINNESOTA HOSPITAL ASSOCIATION, MINNESOTA DEPARTMENT OF HEALTH, HENNEPIN COUNTY SHAPE 2014, COMMUNITY NEED INDEX AND ATTRIBUTED PATIENT DATA; QUALITATIVE DATA FROM FOCUS GROUPS, KEY STAKEHOLDER INTERVIEWS AND COMMUNITY ASSET MAPPING. THE FOLLOWING PRIORITIES WERE IDENTIFIED IN THE ASSESSMENT:-MENTAL HEALTH/SUBSTANCE ABUSE/USE-HEALTHY AGING/SENIOR SERVICES-CANCER PREVENTION, SCREENING, HEALTHY SURVIVORS-INJURY PREVENTION ACROSS THE LIFESPAN-NUTRITION/HEALTHY LIFESTYLES-YOUTH ENGAGEMENT EDUCATION ABOUT HEALTHCARE CAREERS, LEADERSHIP DEVELOPMENT-UNDERSTANDING OF IMMIGRANT CULTURES AND ISSUES RELATED TO HEALTH/DISPARITIES-TRANSPORTATION/HEALTHCARE ACCESSAFTER DISCUSSION OF THE HEALTH PRIORITIES, (CEAT) VOTED TO FOCUS ON TWO HEALTH PRIORITIES. PRIORITIZATION WAS BASED ON THE FOLLOWING CRITERION:-HOW WIDESPREAD IS THE HEALTH NEED?-HOW SERIOUS OR IMPORTANT DO YOU THINK THIS HEALTH NEED IS FOR INDIVIDUALS AND/OR THE COMMUNITY?-WHAT IS THE POTENTIAL FOR MAPLE GROVE HOSPITAL AND COMMUNITY PARTNERS TO HAVE A POSITIVE IMPACT ON THIS HEALTH NEED WITHIN THREE TO FOUR YEARS?BASED ON THESE CRITERIA, THE TOP NEEDS WERE IDENTIFIED AS:-MENTAL HEALTH/SUBSTANCE ABUSE/USE 207 VOTES-HEALTHY AGING/SENIOR SERVICES -169 VOTES-CANCER PREVENTION, SCREENING, HEALTHY SURVIVORS 162 VOTES-NUTRITION/HEALTHY LIFESTYLES 161 VOTES-INJURY PREVENTION ACROSS THE LIFESPAN 159 VOTES-UNDERSTANDING OF IMMIGRANT CULTURES AND ISSUES RELATED TO HEALTH/DISPARITIES 157 VOTES-YOUTH ENGAGEMENT EDUCATION ABOUT HEALTHCARE CAREERS, LEADERSHIP DEVELOPMENT 143 VOTES-TRANSPORTATION/HEALTHCARE ACCESS 132 VOTESAFTER A REVIEW OF POTENTIAL IMPLEMENTATION PROJECTS TO ADDRESS THESE HEALTH PRIORITIES, A DECISION WAS MADE TO SEPARATE MENTAL HEALTH AND SUBSTANCE ABUSE/USE. THE FINAL HEALTH PRIORITIES FROM THE 2016 CHNA ARE:-MENTAL HEALTH-SUBSTANCE ABUSE/USE AND-HEALTHY AGING/SENIOR SERVICESTHESE HEALTH PRIORITIES ARE BEING ADDRESSED WITH COMMUNITY PARTNERSHIPS, COMMUNITY SUPPORT AND CULTURAL APPROPRIATENESS IN MIND. MENTAL HEALTH AND SUBSTANCE ABUSE/USE ARE BEING ADDRESSED SYSTEM WIDE.MAPLE GROVE HOSPITAL IS USING SEVERAL STRATEGIES TO ADDRESS THE IDENTIFIED HEALTH PRIORITIES. PRIORITY 1: MENTAL HEALTH (SYSTEM WIDE PRIORITY)GOAL - TO SUPPORT THE MENTAL HEALTH OF COMMUNITY MEMBERS ALONG THE MENTAL HEALTH CONTINUUM.OBJECTIVES:I. REDUCE THE STIGMA ASSOCIATED WITH MENTAL HEALTH CONDITIONS STRATEGIES:-INCORPORATED THE MAKE IT OKAY MESSAGE INTO ANNUAL EMPLOYEE TRAINING-ACTION - MAPLE GROVE HOSPITAL INCORPORATED THE MAKE IT OKAY MESSAGE INTO THE ANNUAL EMPLOYEE TRAINING. MAKE IT OKAY IS DESIGNED TO REDUCE STIGMA SURROUNDING MENTAL HEALTH. THIS EDUCATION IS DESIGNED TO EMPOWER OUR EMPLOYEES TO FEEL COMFORTABLE ADDRESSING MENTAL HEALTH ISSUES WITH THEIR CLIENTS, FAMILY, FRIENDS AND COMMUNITY MEMBERS. -TO REDUCE THE STIGMA AROUND SUICIDE A SAFETALK CLASS WAS OFFERED TO THE COMMUNITY ON MAY 16, 2019 AT THE NEW HOPE YMCA.-STAFF AT MAPLE GROVE HOSPITAL HELD A MENTAL HEALTH/MAKE IT OKAY RESISTANCE EVENT FOR STAFF AND HOSPITAL VISITORS.-STAFF AT NORTH MEMORIAL HEALTH HOSPITAL EXPRESSED AN INTEREST IN BEING TRAINED IN MAKE IT OKAY, AFTER LEARNING ABOUT THE MAKE IT OKAY PROGRAM IN THE ANNUAL EMPLOYEE TRAINING, IN ORDER TO PROVIDE COMMUNITY TRAINING IN THE FUTURE. II. INCREASE EDUCATION ABOUT MENTAL HEALTH STRATEGIES:-OFFER A MINIMUM OF FOUR EVIDENCE BASED MENTAL HEALTH FIRST AID (MHFA) CLASSES ACROSS THE SYSTEM ANNUALLY-ACTION - 4 MENTAL HEALTH FIRST AID CLASSES WERE OFFERED TO THE COMMUNITY IN 2019. -THESE INCLUDE: -JANUARY 24, 2019 YOUTH MENTAL HEALTH FIRST AID CLASS AT MAPLE GROVE HOSPITAL 14 PEOPLE ATTENDED. -MARCH 1, 2019 ADULT FOCUSED MENTAL HEALTH FIRST AID CLASS AT MAPLE GROVE HOSPITAL 22 PERSONS ATTENDED. -APRIL 19, 2019 - ADULT FOCUSED MENTAL HEALTH FIRST AID CLASS AT NORTH MARKET 16 PERSONS ATTENDED. -NOVEMBER 15, 2019 YOUTH MENTAL HEALTH FIRST AID CLASS AT NORTH SPECIALTY CENTER 6 PERSONS ATTENDED.-ACTION - IN 2018 BEGAN OFFERING SAFETALK SUICIDE AWARENESS CLASSES AFTER THE COMMUNITY REQUESTED SUICIDE PREVENTION EDUCATION AND SHORTER CLASSES. 5 SAFETALK CLASSES WERE OFFERED TO THE COMMUNITY IN 2019. -THESE INCLUDE: -FEBRUARY 27, 2019 SAFETALK CLASS AT NORTH MARKET 17 PERSONS ATTENDED. -MAY 16, 2019 SAFETALK CLASS AT NEW HOPE YMCA 10 PEOPLE ATTENDED. -JULY 19, 2019 SAFETALK CLASS AT MAPLE GROVE HOSPITAL 19 PERSONS ATTENDED. -SEPTEMBER 19, 2019 SAFETALK CLASS AT MAPLE GROVE HOSPITAL - 10 PERSONS ATTENDED. -NOVEMBER 8, 2019 SAFETALK CLASS AT THE CRYSTAL COMMUNITY CENTER 15 PERSONS ATTENDED.III. IMPROVE ACCESS TO MENTAL HEALTH SERVICESSTRATEGIES:-OPENED THE NORTH MEMORIAL MENTAL HEALTH & ADDICTION CARE CLINIC -ACTION - THE CLINIC LOCATED IN ROBBINSDALE OPENED IN DECEMBER OF 2016 IN RESPONSE TO AN IDENTIFIED COMMUNITY NEED. THE CLINIC HAS 10,300 SQ. FT. AND FOCUSES ON GENERAL MENTAL HEALTH PROBLEMS WITH A SPECIFIC FOCUS ON SERIOUS AND PERSISTENT MENTAL ILLNESS AND POST-TRAUMATIC STRESS DISORDER.-CONTINUED ASSESSMENT OF COMMUNITY NEEDS AND DEVELOPMENT OF PROGRAMS AS NEED IS IDENTIFIED-ACTION - IN 2019, TO MEET THE NEEDS OF THE PRESENTING PATIENT COMMUNITY, WE CONTINUED OUR PARTIAL HOSPITALIZATION PROGRAM FOCUSED ON SEVERE AND PERSISTENT MENTAL ILLNESS (SPMI) POPULATIONS ALONG WITH OUR INTENSIVE OUTPATIENT PROGRAM FOCUSED ON POST-TRAUMATIC STRESS DISORDER (PTSD), THE FIRST OF ITS KIND IN THE STATE AND IN THE METRO AREA. IN 2019, WE HIRED AND ON-BOARDED TWO ADDITIONAL PRESCRIBERS, FOUR PSYCHOLOGISTS, AND ONE INTEGRATIVE BEHAVIORAL HEALTH PROVIDER WHO IS LOCATED OUT OF THE CAMDEN PRIMARY CARE CLINIC. WE CONTINUED TO OFFER MENTAL HEALTH PROGRAMMING WITH A FOCUS ON HOLISTIC CARE, TRAUMA/PSTD AND SPMI. WE HIRED TWO ADDITIONAL PSYCHIATRISTS IN 2019, WHO WILL START IN SUMMER/FALL 2020.-AT MAPLE GROVE HOSPITAL BEHAVIORAL HEALTH PROVIDERS WERE CONTACTED WITH TO INCREASE BEHAVIORAL HEALTH COVERAGE FOR THE ECC STARTING IN JULY OF 2019. IV. SUPPORT NORTH MEMORIAL HEALTH'S DOMESTIC VIOLENCE ADVOCACY PROGRAM SAFEJOURNEY. THIS PROGRAM TRANSITIONED FROM COMMUNITY VOLUNTEERS TO HOSPITAL BASED SOCIAL WORKERS DECEMBER OF 2019. STRATEGIES:-ENSURE 24-HOUR ADVOCACY IS PROVIDED BY TRAINED VOLUNTEERS-ACTION - 24-HOUR ADVOCACY IS IN PLACE.-TRAINED NEW VOLUNTEERS IN 2019-ACTION - FIVE NEW SYSTEM WIDE ADVOCATES WERE TRAINED IN 2019. VOLUNTEERS SERVE BOTH MAPLE GROVE HOSPITAL AND NORTH MEMORIAL HEALTH HOSPITAL. -CLIENTS SERVED-ACTION - 58 CLIENTS WERE SERVED BY WALK IN ADVOCACY IN 2019. -ACTION - 70 CLIENTS ATTENDED SUPPORT GROUPS AT MAPLE GROVE HOSPITAL AND 39 CLIENTS ATTENDED SUPPORT GROUPS AT NORTH MEMORIAL HEALTH HOSPITAL IN 2019. -DISTRIBUTE CLIENT EMERGENCY FUNDS TO QUALIFIED CLIENTS-ACTION - SYSTEM WIDE WE SERVED 61 INDIVIDUAL CLIENTS AND DISTRIBUTED $8,349 IN EMERGENCY SUPPORT.-PROVIDE COMMUNITY OUTREACH AND EDUCATION ON SAFEJOURNEY-ACTION - PARTICIPATED IN COMMUNITY OUTREACH AT GOLDEN VALLEY LUTHERAN CHURCH ON SEPTEMBER 22, 2019. 75 PEOPLE ATTENDED. CONTINUED... PART V, SECTION B, LINE 11 CONTINUED: V. WORK WITH COMMUNITY PARTNERS TO COLLECTIVELY IDENTIFY OPPORTUNITIES TO ADDRESS MENTAL HEALTH ISSUES AND SOCIAL CONDITIONS THAT AFFECT MENTAL HEALTH CONDITIONS - CHIP, CCH, WEST METRO HOSPITAL GROUP, LOCAL PUBLIC HEALTH, GOVERNMENT AND OTHERS.STRATEGIES:-CONTINUE ACTIVE INVOLVEMENT IN HENNEPIN COUNTY CHIP AND SOCIAL ISOLATION WORKGROUP-ACTION - CHIP 1.0 ENDED IN 2017 AND REGULAR INVOLVEMENT STOPPED. CONTINUED PARTICIPATION WITH CHIP COLLABORATIVE BY ATTENDING MEETINGS ON COMMUNITY MENTAL HEALTH AND HOUSING STABILITY WHEN APPROPRIATE. COMMUNITY HEALTH OUTREACH MANAGER ATTENDED CHIP COLLABORATIVE MEETING APRIL 25, 2019.-CONTINUE ACTIVE INVOLVEMENT WITH THE CENTER FOR COMMUNITY HEALTH COLLECTIVE ACTION GROUP.-ACTION - GROUP CONTINUES TO WORK ON INCREASING AWARENESS OF MENTAL HEALTH FIRST AID CLASSES IN THE METRO COMMUNITY. MAY MENTAL HEALTH AWARENESS MONTH IS A FOCUS FOR GETTING THE WORD OUT ON MAKE IT OKAY AND CLASSES FOCUSED ON MENTAL HEALTH. COMMUNITY HEALTH OUTREACH MANAGER CONTINUES TO REPRESENT THE SYSTEM AT MONTHLY MEETINGS AND IS NOW A MEMBER OF THE CENTER FOR COMMUNITY HEALTH BOARD.-EXPLORE COMMUNITY PARTNERSHIP OPPORTUNITIES THAT ADDRESS MENTAL HEALTH AND VIOLENCE-ACTION - YOUTH SUICIDE PREVENTION COALITION CONTINUED TO MEET IN 2019. MANY GROUPS SUCH AS PARTNERS IN PREVENTION, THE NORTHWEST HENNEPIN FAMILY SERVICE COLLABORATIVE AND THE ROBBINSDALE REDESIGN FAMILY SERVICE COLLABORATIVE ARE WORKING WITH LOCAL SCHOOLS TO ADDRESS SUICIDE PREVENTION. DECISION WAS MADE TO TABLE THIS COALITION UNTIL 2020 AFTER THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT ARE COMPLETED. -NORTH MEMORIAL HEALTH HOSPITAL CONTINUES TO WORK WITH THE CITY OF MINNEAPOLIS ON THE VIOLENCE INTERVENTION PROGRAM - NEXT STEP. IN 2019 112 CLIENTS WERE ENROLLED. PRIORITY 2: SUBSTANCE ABUSE/USE (SYSTEM WIDE PRIORITY)GOAL - TO CREATE AN ENVIRONMENT WHERE SUBSTANCE ABUSE/USE AMONG THE GENERAL POPULATION AND SUBSTANCE ABUSE/USE AMONG YOUTH IS REDUCED. OBJECTIVES:I. INCREASE AWARENESS OF SUBSTANCE ABUSE/USE ISSUES AMONG YOUTH AND YOUNG ADULTS AND ACTIVITIES TO ADDRESS THESE ISSUES.STRATEGIES:-CONTINUE WORKING WITH AND SUPPORTING COMMUNITY COLLABORATIVE SUCH AS PARTNERSHIP FOR CHANGE AND PARTNERS IN PREVENTION-ACTION - STAFF ATTENDED PARTNERSHIP FOR CHANGE AND PARTNERS IN PREVENTION MEETINGS.-ACTION - FINANCIALLY SUPPORTED PARTNERS IN PREVENTION'S UNCOVER THE TRUTH CAMPAIGN WHICH EDUCATES WAYZATA HIGH SCHOOL STUDENTS ABOUT DRUG AND ALCOHOL ISSUES WITH REGARD TO THEIR PEERS.-ACTION - PARTNERSHIP FOR CHANGE, HOUSED OUT OF NORTH MEMORIAL HEALTH HOSPITAL'S TRAUMA DEPARTMENT, LEVERAGES COMMUNITY PARTNERSHIPS TO PREVENT AND REDUCE SUBSTANCE USE/ABUSE IN THE COMMUNITY THROUGH STRATEGIES SUCH AS: -POLD (PLACE OF LAST DRINK) AND RAVE (RESPONSIBLE VENDOR EDUCATION & ENFORCEMENT) -EXPANDED SOCIAL HOST ORDINANCE. -MEDICINE ABUSE PREVENTION WORKGROUP WHICH INCLUDES MEDICATION DROP BOXES - 2 BOXES OPENED IN 2019 AT BROOKLYN PARK AND CRYSTAL POLICE DEPARTMENTS. -MARIJUANA PERCEPTION OF HARM PARTICIPATED ON THE EXECUTIVE COMMITTEE OF SMART APPROACHES TO MARIJUANA MINNESOTA TO HELP EDUCATE COMMUNITY MEMBERS ABOUT POTENTIAL HEALTH IMPACTS OF MARIJUANA USE AND EXPANDED ACCESS.II. IMPROVE ACCESS TO ADDICTION MEDICINE SERVICES STRATEGIES:-OPENED THE NORTH MEMORIAL MENTAL HEALTH & ADDICTION CARE CLINIC -ACTION - THE CLINIC LOCATED IN ROBBINSDALE OPENED IN DECEMBER OF 2016 IN RESPONSE TO AN IDENTIFIED COMMUNITY NEED. ORIGINALLY THE CLINIC INCLUDED ADDITION MEDICINE, HOWEVER WHEN OUR ONLY ADDITION MEDICINE PROVIDER LEFT IN EARLY 2017 A REPLACEMENT WAS NOT OBTAINED. SUBSTANCE USE DISORDERS ARE ADDRESSED WITHIN THE CONTEXT OF MENTAL HEALTH CARE. -CONTINUED ASSESSMENT OF COMMUNITY NEEDS AND DEVELOPMENT OF PROGRAMS AS NEED IS IDENTIFIED-ACTION - IN 2019, WE CONTINUED TO ADDRESS, WHEN APPROPRIATE, SUBSTANCE USE ISSUES IN INDIVIDUAL APPOINTMENTS AND PROGRAMMING, HOWEVER, NONE OF OUR PROGRAMMING IS SUBSTANCE USE DISORDER SPECIFIC. WE HAVE SEVERAL PROVIDERS WHO HAVE SPECIALIZATION IN SUBSTANCE USE TREATMENT AND TWO OF OUR OUTPATIENT PROVIDERS ARE DUALLY LICENSED AS LADC AND LPCC. -IN 2019, WE HIRED AND ON-BOARDED TWO ADDITIONAL PRESCRIBERS, FOUR PSYCHOLOGISTS, AND ONE INTEGRATIVE BEHAVIORAL HEALTH PROVIDER WHO IS LOCATED OUT OF THE CAMDEN PRIMARY CARE CLINIC. WE CONTINUED TO OFFER MENTAL HEALTH PROGRAMMING WITH A FOCUS ON HOLISTIC CARE, TRAUMA/POST-TRAUMATIC STRESS DISORDER, AND SEVERE AND PERSISTENT MENTAL ILLNESS. WE HIRED TWO ADDITIONAL PSYCHIATRISTS IN 2019, WHO WILL START IN SUMMER/FALL 2020.-IN 2019, TWO OF THE NEWLY HIRED OUTPATIENT PSYCHOLOGISTS CAME TO NORTH WITH A SIGNIFICANT PROFESSIONAL BACKGROUND IN WORKING WITH POPULATIONS STRUGGLING WITH ADDICTION. DEVELOPING CO-OCCURRING MH/SUD PROGRAMMING REMAINS A POSSIBLE PLAN FOR EXPANSION, BUT WE HAVE BEEN LIMITED BY NOT HAVING ADDICTION SPECIALISTS AMONGST OUR OUTPATIENT PRESCRIBERS. III. INCREASE AWARENESS OF OPIOID MISUSE AND WORK TO PUT SYSTEMS IN PLACE TO REDUCE THIS MISUSE.STRATEGIES:-GROW OPIOIDS CLINICAL PRACTICE COUNCIL TO MANAGE OPIOID PROGRAM DEVELOPMENT AND DEPLOY INSTITUTE FOR CLINICAL IMPROVEMENT (ICSI) OPIOID GUIDELINES.-ACTION - WORKGROUPS HAVE BEEN FORMED AROUND: -BEST PRACTICE PRESCRIBING -IMPLEMENTED ENHANCED FUNCTIONALITY TO INTEGRATE THE MINNESOTA PRESCRIPTION MONITORING PROGRAM (PMP) WITHIN THE ELECTRONIC MEDICAL RECORD TO ENHANCE USE AND FUNCTIONALITY. -DEPLOYED A POST-OPERATIVE PAIN MANAGEMENT PATIENT GUIDE TO ENHANCE PATIENT ENGAGEMENT IN CARE AND REDUCE SOLE RELIANCE ON OPIOIDS. -ACTIVE ENGAGEMENT WITHIN THE MN HEALTH COLLABORATIVE ACTIVATED BY THE INSTITUTE FOR CLINICAL IMPROVEMENT TO DRIVE EFFORTS STATEWIDE. -IMPLEMENTED DEFAULT OPIOID PRESCRIBING SETTINGS AND ALERTS IN THE ELECTRONIC MEDICAL RECORD TO SUPPORT BEST PRACTICE PRESCRIBING. -SURGICAL PRESCRIBING AT OR BELOW THE PRESCRIBING BENCHMARKS CONTINUED ROLLOUT TO PROCEDURES IN 3 ADDITIONAL SPECIALTIES, RESULTING IN A 24% INCREASE IN PROCEDURES PRESCRIBED AT OR BELOW BENCHMARK AND 100,000 FEWER PILLS PRESCRIBED FROM BASELINE. -IN 2019, THE EMERGENCY DEPARTMENT PRESCRIPTIONS WERE IN LINE WITH GUIDELINES 95% OF THE TIME RESULTING IN 42,000 FEWER OPIOID PILLS PRESCRIBED. -THE AMBULATORY SETTING DECREASED PRESCRIBING OPIOIDS TO OPIOID NAVE CUSTOMERS AND INCREASED THE VOLUME OF SCRIPTS AT OR BELOW BASELINE FOR ACUTE PRESCRIBING.-HIGH RISK POPULATIONS -MEDICATION ASSISTED THERAPY GUIDELINE AND WORKFLOW WITHIN THE EMERGENCY DEPARTMENT INITIATED TO SUPPORT RAPID TREATMENT INITIATION AND COMMUNITY-BASED ADDICTION CARE FOLLOW-UP. -IMPLEMENTED OUTPATIENT MEDICATION ASSISTED THERAPY BEST PRACTICE GUIDELINE AND ELECTRONIC MEDICAL RECORD TOOLS.-PROPER DISPOSAL OF UNUSED OPIOIDS -NORTH MEMORIAL HEALTH HOSPITAL AND MAPLE GROVE HOSPITAL CONTINUED TO PROTECT OUR COMMUNITIES BY PROVIDING ACCESS TO SAFE DISPOSAL OPTIONS FOR UNWANTED MEDICATIONS. THE DISPOSAL KIOSKS ARE INSTALLED AT BOTH NORTH MEMORIAL HEALTH PHARMACY ROBBINSDALE ON THE FIRST FLOOR OF NORTH MEMORIAL HEALTH HOSPITAL AND NORTH MEMORIAL HEALTH PHARMACY MAPLE GROVE AT MAPLE GROVE MEDICAL CENTER. -LANGUAGE ADDED TO ALL AFTER VISIT SUMMARIES INSTRUCTING PATIENTS OF HOW TO DISPOSE OF MEDICATIONS PROPERLY.STRATEGIES: -GROW INTERNAL TEAM TO MANAGE OPIOID PROGRAM DEVELOPMENT AND DEPLOY ICSI CONTENT.-ACTION - A WORKGROUP HAS BEEN FORMED AROUND: -CHRONIC PRESCRIBING FOR CHRONIC PAIN. -PUBLISHED OPIOID USE DISORDER ALGORITHM AND TAPERING GUIDELINE -IMPLEMENTED ENHANCED FUNCTIONALITY TO INTEGRATE THE MINNESOTA PRESCRIPTION MONITORING PROGRAM (PMP) WITHIN THE ELECTRONIC MEDICAL RECORD TO ENHANCE USE AND FUNCTIONALITY. IMPLEMENTED ALERTS IN THE ELECTRONIC MEDICAL RECORD TO SUPPORT BEST PRACTICE PRESCRIBING.-CONTINUE INVOLVEMENT WITH PARTNERSHIP FOR CHANGE AND MINNESOTA'S PRESCRIPTION MONITORING PROGRAM (PMP)-ACTION - PARTNERSHIP FOR CHANGE WORKING IN PARTNERSHIP WITH THE PHARMACY DEPARTMENT ON INTEGRATING PMP INTO EPIC, PATIENT PORTAL AND EDUCATION. -PROVIDER FORUM: PANEL DISCUSSION ON OPIOIDS, OCTOBER 2019 -THE MEDICINE ABUSE PREVENTION WORKGROUP COLLABORATED WITH NORTH MEMORIAL ED AND GRAND ROUNDS STAFF TO PLAN A PROVIDER EDUCATION EVENT SURROUNDING THE OPIOID EPIDEMIC. MORE THAN 50 PROVIDERS ATTENDED THE EVENT IN OCTOBER, WHICH UPDATED ON OPIOID PRESCRIBING TRENDS, HOW THE PRESCRIPTION DRUG MONITORING PROGRAM IS NOW ACCESSIBLE DIRECTLY THROUGH EPIC, AND TRIPS FOR HAVING CONVERSATIONS WITH PATIENTS ABOUT LIMITING AND TAPERING OPIOID PRESCRIPTIONS.-RESEARCH COMMUNITY BASED OPIOID ABUSE PREVENTION PROGRAMS.-ACTION - BEING ADDRESSED BY WORK WITH ICSI AND PARTNERSHIP FOR CHANGE.CONTINUED... PART V, SECTION B, LINE 11 CONTINUED: PRIORITY 3: HEALTHY AGING/SENIOR SERVICESGOAL - TO WORK TOGETHER WITH LOCAL GOVERNMENT, OTHER HEALTHCARE SYSTEMS, SOCIAL SERVICE PROVIDERS AND COMMUNITY MEMBERS TO CREATE AN ENVIRONMENT WHERE OUR AGING POPULATION CAN HAVE ACCESS TO THE PROGRAMS AND SERVICES NEEDED TO AGE IN PLACE.OBJECTIVES:I. ADDRESS COMMUNITY-BASED INFRASTRUCTURAL CHALLENGES THAT CREATE BARRIERS TO HEALTHY AGING IN MAPLE GROVESTRATEGIES:-CONTINUE WORKING WITH THE CITY OF MAPLE GROVE'S AGE-FRIENDLY MAPLE GROVE INITIATIVE.-ACTION - ACTIVE PARTICIPATION ON THE CITY OF MAPLE GROVE'S AGE-FRIENDLY MAPLE GROVE LEADERSHIP TEAM. CO-CHAIR OF THE COMMUNITY SUPPORT AND HEALTH SERVICES TEAM.II. IMPROVE EDUCATION ABOUT ADVANCE CARE PLANNING STRATEGIES:-OFFER A MINIMAL OF FOUR EVIDENCE BASED RESPECTING CHOICES PRESENTATION IN THE MAPLE GROVE COMMUNITY ASSESSMENT AREA.-ACTION - CLASSES WERE CHANGED FROM RESPECTING CHOICES TO ADVANCE CARE PLANNING IN 2019 FOUR CLASSES WERE OFFERED IN THE MAPLE GROVE ASSESSMENT AREA IN 2019: -MARCH 14, 2019 - ADVANCE CARE PLANNING CLASS AT THE MAPLE GROVE COMMUNITY CENTER 9 PARTICIPANTS. -MAY 8, 2019 -ADVANCE CARE PLANNING CLASS AT MAPLE GROVE HOSPITAL 8 PARTICIPANTS -SEPTEMBER 18, 2019 ADVANCE CARE PLANNING CLASS AT THE MAPLE GROVE COMMUNITY CENTER 13 PARTICIPANTS. -NOVEMBER 5, 2019 ADVANCE CARE PLANNING AT MAPLE GROVE HOSPITAL 7 PARTICIPANTS -IN ADDITION TO THE CLASSES OFFERED ABOVE, A NATIONAL HEALTH CARE DECISION DAY EVENT WAS HELD AT MAPLE GROVE HOSPITAL ON APRIL 16, 2019 22 PARTICIPANTS.-EXPLORE OFFERING A RESPECTING CHOICES TRAIN THE PRESENTER SESSION TO COMMUNITY PARTNERS THAT WOULD OFFER THE RESPECTING CHOICES CLASS TO THE WIDER COMMUNITY.-ACTION - ADVANCE CARE PLANNING CLASSES OFFERED INSTEAD OF RESPECTING CHOICES CLASSES. A SOCIAL WORKER AT MAPLE GROVE HOSPITAL WAS TRAINED IN 2018 TO OFFER ADVANCE CARE PLANNING CLASSES. THAT SOCIAL WORKER NOW OFFERS ADVANCE CARE PLANNING CLASSES IN THE MAPLE GROVE COMMUNITY. III. EXPLORE IMPLEMENTING A COMMUNITY-BASED FALLS PREVENTION EDUCATION PROGRAM STRATEGIES:-STEPPING ON, A FALLS PREVENTION PROGRAMS, IMPLEMENTED AT BOTH MAPLE GROVE HOSPITAL AND NORTH MEMORIAL HEALTH HOSPITAL-ACTION- THREE STEPPING ON CLASSES WERE OFFERED TO THE COMMUNITY IN 2019. -JANUARY 14, 2019 TO FEBRUARY 25, 2019. CLASS HELD MAPLE GROVE HOSPITAL. 11 PERSONS REGISTERED FOR THE CLASS. -APRIL 1, 2019 TO MAY 13, 2019. CLASS HELD AT MAPLE GROVE HOSPITAL. 8 PERSONS REGISTERED FOR THE CLASS. -OCTOBER 1, 2019 TO NOVEMBER 12, 2019. CLASS HELD MAPLE GROVE HOSPITAL. 6 PERSONS REGISTERED FOR THE CLASS.-FALLS PREVENTION EDUCATION WAS PROVIDED TO COMMUNITY MEMBERS AT THE MAPLE GROVE FARMERS MARKET ON SEPTEMBER 19, 2019.IV. COMMIT MAPLE GROVE HOSPITAL SUPPORT AND RESOURCES TO WORK WITH COMMUNITY PARTNERS TO COLLECTIVELY IDENTIFY OPPORTUNITIES TO ADDRESS ISSUES AND CONDITIONS THAT AFFECT HEALTH AGINGSTRATEGIES:-OFFER FINANCIAL SUPPORT FOR THE CITY OF MAPLE GROVE'S AGE-FRIENDLY MAPLE GROVE INITIATIVE-ACTION - FINANCIAL SUPPORT WAS PROVIDED IN 2019 TO THE CITY OF MAPLE GOVE'S AGE-FRIENDLY INITIATIVE TO SUPPORT THE CONSULTANT HIRED TO ADVANCE THIS WORK.V. WORK WITH COMMUNITY PARTNERS TO REDUCE CONDITIONS THAT NEGATIVELY AFFECT THE MENTAL HEALTH OF SENIORS SUCH AS SOCIAL ISOLATIONSTRATEGIES:-CONTINUE WORKING WITH HENNEPIN COUNTY CHIP SOCIAL ISOLATION COMMITTEE-ACTION - CHIP 1.0 ENDED IN 2017. -EXPLORE POTENTIAL PARTNERSHIPS WITH SOCIAL SERVICE GROUPS THAT ADDRESS SOCIAL ISOLATION-ACTION - NORTH MEMORIAL COMMUNITY PARAMEDICS MAKE HOME VISITS AND ASSESS SOCIAL ISOLATION AND FOOD INSECURITY. AGE-FRIENDLY MAPLE GROVE PARTNERSHIP INVOLVES OFFERING CLASSES TO SENIORS IN THE COMMUNITY AND DEVELOPMENT OF A WEB-SITE THAT OFFERS INFORMATION FOR SENIORS.THE HEALTH PRIORITIES NOT BEING ADDRESSED DIRECTLY INCLUDE:-CANCER PREVENTION, SCREENING, HEALTHY SURVIVORS -NUTRITION/HEALTHY LIFESTYLES -INJURY PREVENTION ACROSS THE LIFESPAN -UNDERSTANDING OF IMMIGRANT CULTURES AND ISSUES RELATED TO HEALTH/DISPARITIES-YOUTH ENGAGEMENT EDUCATION ABOUT HEALTHCARE CAREERS, LEADERSHIP DEVELOPMENT-TRANSPORTATION/HEALTHCARE ACCESS THE COMMUNITY ENGAGEMENT ADVISORY TEAM FELT THAT TO MAKE A MEANINGFUL DIFFERENCE IN THE TOP THREE IDENTIFIED HEALTH PRIORITIES RESOURCES SHOULD BE FOCUSED ON THESE PRIORITIES AND NOT SPREAD ACROSS A MULTITUDE OF PRIORITIES. CANCER PREVENTION, SCREENING AND HEALTHY SURVIVORS IS BEING ADDRESSED IN THE AMERICAN CANCER SOCIETY AND THE CANCER CENTER AT NORTH MEMORIAL. NUTRITION AND HEALTHY LIFESTYLES IS BEING ADDRESSED BY MANY GROUPS SUCH AS THE AMERICAN CANCER SOCIETY, THE AMERICAN HEART ASSOCIATION, THE YMCA AND LOCAL PARK AND RECREATION ASSOCIATIONS. INJURY PREVENTION IS BEING ADDRESSED BY SAFE KIDS OUT OF NORTH MEMORIAL AND SENIOR INJURY PREVENTION IS BEING ADDRESSED THROUGH THE HEALTHY AGING/SENIOR SERVICES HEALTH PRIORITY. CULTURAL DIVERSITY IS BEING WOVEN INTO THE TOP THREE PRIORITIES. YOUTH HAVE ACCESS TO VOLUNTEER OPPORTUNITIES THROUGH MAPLE GROVE HOSPITAL'S VOLUNTEER DEPARTMENT. TRANSPORTATION IS BEING DISCUSSED AT THE COUNTY AND LOCAL LEVEL ALONG WITH THE HEALTHY AGING/SENIOR SERVICES PRIORITY. PART V, SECTION B, LINE 7A & 10A: THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT HAS BEEN POSTED ONLINE AT:HTTPS://NORTHMEMORIAL.COM/WP-CONTENT/UPLOADS/2016/10/MGH-COMMUNITY-HEALTH-NEEDS-ASSESSMENTV2.PDFTHE IMPLEMENTATION PLAN HAS BEEN POSTED ONLINE AT: HTTPS://NORTHMEMORIAL.COM/WP-CONTENT/UPLOADS/2020/05/MGH-IMPLEMENTATION-PLAN_2020.PDF PART V, SECTION B, LINE 16: FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY IS AVAILABLE AT:HTTPS://NORTHMEMORIAL.COM/FINANCIAL-ASSISTANCE/ PART III, LINE 2: AMOUNT REPRESENTS THE HOSPITAL'S BAD DEBT PROVISION REDUCED BY THE HOSPITAL'S COST TO CHARGE RATIO WHICH REPRESENTS THE BEST ESTIMATE OF COST FOR THE BAD DEBT PROVISION. PART III, LINE 4: MAPLE GROVE HOSPITAL'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DESCRIPTION ABOUT BAD DEBT EXPENSE. THE COST TO CHARGE RATIO WAS USED TO DETERMINE THE AMOUNT ON PART III, SECTION A, LINE 2. WE DO NOT HAVE THE INFORMATION NECESSARY TO DETERMINE WHICH PORTION OF THE AMOUNT REPORTED ON LINE 2 IS COMMUNITY BENEFIT. PART III, LINE 8: THE SHORTFALL REPORTED REPRESENTS THE AMOUNT THE MEDICARE REIMBURSEMENT IS LESS THAN THE ESTIMATED COST OF PROVIDING SERVICES TO THOSE PATIENTS. THE METHOD USED TO ESTIMATE THOSE COSTS IS THE COST TO CHARGE RATIO APPROACH WHICH CALCULATES THE RATIO OF TOTAL HOSPITAL COSTS / TOTAL HOSPITAL GROSS REVENUE AND THEM APPLIES THAT RATIO TO TOTAL MEDICARE GROSS REVENUE. PART III, LINE 9B: MAPLE GROVE HOSPITAL CORPORATION HAS POLICIES AND PROCEDURES IN PLACE FOR COLLECTION PRACTICES THAT INCLUDE IDENTIFICATION AND SCREENING FOR CHARITY CARE AND FINANCIAL ASSISTANCE. THE POLICIES ARE AVAILABLE ON THE ORGANIZATION'S INTRANET AND EACH PATIENT IS GIVEN A BROCHURE UPON ADMISSION. PART VI, LINE 2: MAPLE GROVE HOSPITAL WORKS CLOSELY WITH COMMUNITY MEMBERS TO DETERMINE AREAS OF INTEREST AND NEED IN HEALTHCARE SERVICES. (A NEW COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN 2019. WE ARE CURRENTLY ADDRESSING THE NEEDS IDENTIFIED IN OUR 2019 COMMUNITY HEALTH NEEDS ASSESSMENT.) PART VI, LINE 3: MAPLE GROVE HOSPITAL HAS A VERY PROACTIVE PROGRAM TO ASSIST UNINSURED AND UNDERINSURED PATIENTS WITH THEIR MEDICAL BILLS. WE COMPLY WITH THE ATTORNEY GENERAL'S REQUIREMENT TO PROVIDE A DISCOUNT TO UNINSURED MINNESOTA RESIDENTS AS WELL AS A FINANCIAL ASSISTANCE PROGRAM FOR FINANCIALLY QUALIFIED PATIENTS. WE HAVE PATIENT FINANCIAL ADVOCATES AS WELL AS A CONTRACTED VENDOR THAT MEETS WITH ALL OF OUR UNINSURED INPATIENTS AND SPECIFIC OUTPATIENTS TO ASSIST THEM IN MEDICAL ASSISTANCE ELIGIBILITY AND APPLICATIONS. THIS COULD INCLUDE A VISIT TO THEIR RESIDENCE IF THEY NEED HELP IN COMPLETING ASSISTANCE APPLICATIONS. SHOULD THEY NOT QUALIFY FOR STATE OR FEDERAL ASSISTANCE PROGRAMS, WE OFFER AND ASSIST THEM IN APPLYING FOR THE HOSPITAL'S FINANCIAL ASSISTANCE (CHARITY CARE) PROGRAM.IN ADDITION, OUR INTERNAL COLLECTIONS DEPARTMENT AND OUR COLLECTION AGENCIES ARE WELL VERSED IN OUR ASSISTANCE PROGRAMS AND WILL ASSESS DURING THEIR CONVERSATIONS WITH PATIENTS IF REFERRAL TO EITHER A STATE OR FEDERAL PROGRAM OR OUR CHARITY CARE PROGRAM WOULD BE APPROPRIATE. PART VI, LINE 4: WE SERVE A 27 ZIP-CODE AREA IN THE NORTHWEST SIDE OF THE TWIN CITIES METRO. THIS IS BASED ON THE HOME ZIP CODES FOR 75% OF OUR INPATIENT POPULATION, EXCLUDING NEWBORNS AND NEONATES. WE WORK WITH THE COMMUNITY TO ADDRESS COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. PART VI, LINE 5: MAPLE GROVE HOSPITAL PROVIDES EDUCATIONAL RESOURCES FOR COMMUNITY MEMBERS SUCH AS CLASSES ON HEALTH CARE DIRECTIVES, KIDS SAFETY FAIRS AND SEMINARS ON HEALTH TOPICS. PART VI, LINE 6: MAPLE GROVE HOSPITAL IS A PART OF NORTH MEMORIAL HEALTH SYSTEM, WHICH IS COMMITTED TO IMPROVING THE HEALTH OF THE COMMUNITIES WE SERVE. THROUGH TARGETED OUTREACH, EDUCATION AND PARTNERSHIPS, WE IMPROVE THE HEALTH OF OUR COMMUNITIES BY LISTENING TO THEIR NEEDS AND RESPONDING WITH APPROPRIATE PROGRAMS AND SERVICES. OUR PROGRAMS, MANY OF WHICH HAVE BEEN NATIONALLY RECOGNIZED, RANGE FROM HEALTH EDUCATION AND FREE SCREENING TO TRAINING HEALTH PROFESSIONALS. PART VI, LINE 7: MAPLE GROVE HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE STATE OF MINNESOTA. X X X 0 0 0 0 0 1 1 0 0 J KEVIN CROSTON MD BOARD CHAIR 0 954231 0 310489 0 9990 0 19450 0 27712 0 1321872 0 0 JEFF WICKLANDER DIRECTOR 0 449615 0 109996 0 2408 0 95200 0 28034 0 685253 0 0 CAROLYN OGLAND VUKICH CHIEF MEDICAL OFFICER 0 465000 0 98813 0 6901 0 16029 0 23461 0 610204 0 0 JENNIFER CLOSE DIRECTOR - OUTGOING 0 444038 0 41996 0 81934 0 19250 0 17004 0 604222 0 0 ANDREW COCHRANE PRESIDENT 0 433654 0 99996 0 3456 0 19450 0 26142 0 582698 0 0 SAMANTHA HANSON DIRECTOR 0 431538 0 104996 0 3465 0 19600 0 23099 0 582698 0 0 AARON BLOOMQUIST TREASURER 0 399657 0 60000 0 3298 0 19250 0 17936 0 500141 0 0 PAMELA DOORENBOS MD VP MEDICAL AFFAIRS 305606 0 127997 0 690 0 11200 0 5902 0 451395 0 0 0 WENDY ULFERTS VP PATIENT CARE/ CHIEF NUR 247424 0 93847 0 0 0 11200 0 18622 0 371093 0 0 0 SARAH JOHNSON MGR, PHARMACY 155623 0 25174 0 291 0 7232 0 16251 0 204571 0 0 0 KELLY HADSALL PHARMACIST 138812 0 17649 0 163 0 6258 0 17061 0 179943 0 0 0 LETTY TAM PHARMACIST 158951 0 3184 0 98 0 6485 0 7297 0 176015 0 0 0 JOAN YOST REGISTERED NURSE 147204 0 8547 0 245 0 6230 0 12053 0 174279 0 0 0 SHERRY COLUCCI MULTI-SPECIALTY TECH 163366 0 2011 0 192 0 0 0 7150 0 172719 0 0 0 PART I, LINE 3 THE CHIEF EXECUTIVE OFFICER IS AN EMPLOYEE OF NORTH MEMORIAL HEALTH CARE. OTHER BOARD MEMBERS LISTED WITH COMPENSATION FROM A RELATED ORGANIZATION ARE OFFICERS AND KEY EMPLOYEES OF NORTH MEMORIAL HEALTH CARE WHO PROVIDE SERVICES TO MAPLE GROVE HOSPITAL AS WELL AS TO ALL OR SOME RELATED ENTITIES AS IDENTIFIED ON SCHEDULE R. AS SUCH, THEIR COMPENSATION LEVELS INCORPORATE SERVICES PROVIDED TO MULTIPLE NORTH MEMORIAL ENTITIES. PART I, LINE 6 NORTH MEMORIAL HEALTH CARE'S ANNUAL INCENTIVE PLAN REQUIRES ACHIEVEMENT OF STATED PERFORMANCE METRICS, WHICH INCLUDE OPERATING CASH FLOW MARGIN. A CITY OF MAPLE GROVE 410873250 56516TBU8 2017-05-25 128801633 REFUNDING OF 2007 BOND SERIES 0 1 0 A 7740000 128801633 1020988 127780645 2017 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 3 NORTH MEMORIAL HEALTH CARE, A RELATED PARTY, PERFORMS MANAGEMENT DUTIES ON BEHALF OF MAPLE GROVE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 6 MAPLE GROVE HOSPITAL HAS ONE CLASS OF MEMBERS. NORTH MEMORIAL HEALTH CARE ("NORTH MEMORIAL") AND FAIRVIEW HEALTH SERVICES ("FAIRVIEW") ARE THE ONLY MEMBERS OF THE CORPORATION AND BOTH MEMBERS ARE NONPROFIT, TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS IS COMPRISED OF SEVEN VOTING DIRECTORS AND ONE NON-VOTING DIRECTOR, AS FOLLOWS: (A) THE CHIEF EXECUTIVE OFFICER OF NORTH MEMORIAL AND FOUR OTHER DIRECTORS APPOINTED ANNUALLY BY NORTH MEMORIAL, (B) THE CHIEF EXECUTIVE OFFICER OF FAIRVIEW AND ONE OTHER DIRECTOR APPOINTED ANNUALLY BY FAIRVIEW AND (C) THE MAPLE GROVE HOSPITAL CHIEF EXECUTIVE OFFICER. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS, AND ONLY THE MEMBERS, MAY TAKE DIRECT ACTION ON THE FOLLOWING MATTERS BY UNANIMOUS MEMBER APPROVAL: (A) AMENDMENTS TO THE ARTICLES OF INCORPORATION; (B) AMENDMENTS TO THE BYLAWS; (C) MERGER OR CONSOLIDATION OF THE CORPORATION (D) SALE, LEASE OR TRANSFER OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (E) JOINT VENTURES AFFECTING SUBSTANTIALLY ALL OF THE ASSETS OR OPERATIONS OF THE CORPORATION; (F) DETERMINATION OF THE NAME UNDER WHICH THE HOSPITAL CONDUCTS BUSINESS; (G) CERTAIN MORTGAGES OR OTHER SECURITY INTERESTS; (H) ISSUANCE OF CAPITAL CALLS; AND (I) DISSOLUTION AND LIQUIDATION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE MANAGEMENT COMPANY AND THE BOARD OF DIRECTORS REVIEW THE FORM 990 BEFORE IT IS FILED. REPRESENTATIVES FROM THE HOSPITAL'S INDEPENDENT ACCOUNTING FIRM REVIEW THE FORM 990 WITH THE MANAGEMENT COMPANY IN DETAIL AND NOTES FOR THE COMMITTEE ANY CHANGES IN THE FORM 990 FROM PRIOR YEARS. AFTER THOROUGH DISCUSSION, THE MANAGEMENT COMPANY APPROVES THE FORM 990 AND FORWARDS IT TO THE BOARD FOR ITS REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS AND ALL EMPLOYEES RECEIVE A COPY OF THE CONFLICT OF INTEREST POLICY EACH YEAR. EACH BOARD MEMBER AND STAFF MEMBER FILLS OUT A CONFLICT OF INTEREST QUESTIONNAIRE IN WHICH THEY ARE ASKED TO IDENTIFY ANY RELATIONSHIP THAT WOULD CREATE A CONFLICT OF INTEREST. THE RESULTS ARE SUMMARIZED AND REVIEWED TO DETERMINE ANY ACTUAL OR POTENTIAL CONFLICT AND ARE REPORTED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR KEY POSITIONS ARE REVIEWED BY THE EXECUTIVE COMMITTEE OF NORTH MEMORIAL WORKING IN CONJUNCTION WITH AN OUTSIDE CONSULTANT. THE EXECUTIVE COMMITTEE OF NORTH MEMORIAL INSURES THAT THE SALARY AND BENEFIT ADMINISTRATION REVIEW PROCESS IS BEING FOLLOWED, WHICH INCLUDES SALARY AND BENEFIT SURVEYS AND COMPARISONS OF ALL POSITIONS. THE CEO'S COMPENSATION IS SENT TO THE FULL BOARD FOR APPROVAL. THE COMPENSATION OF ALL OTHER KEY POSITIONS IS APPROVED BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST. FINANCIAL STATEMENTS ARE AVAILABLE ONLINE THROUGH THE OFFICE OF THE ATTORNEY GENERAL VIA THE CHARITY REPORT FILED WITH THE STATE OF MINNESOTA. FORM 990, PART XI, LINE 9: RETURN OF CAPITAL TO NORTH MEMORIAL HEALTH CARE -19,875,000. RETURN OF CAPITAL TO FAIRVIEW -6,625,000. FORM 990, PART XII, LINE 2C: NEITHER THE OVERSIGHT PROCESS OF THE AUDIT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT CHANGED DURING THE CURRENT TAX YEAR. FORM 990, PART XI, LINE 9: RETURN OF CAPITAL TO MEMBERS: A RETURN OF CAPITAL IN THE AMOUNT OF $26,500,000 WAS MADE TO THE MEMBERS OF THE ORGANIZATION. THE MEMBERS CONSIST OF NORTH MEMORIAL HEATH CARE AND FAIRVIEW HEALTH SERVICES. ALL MEMBERS ARE REQUIRED TO BE NON-PROFIT, TAX EXEMPT ORGANIZATIONS UNDER IRC SECTION 501(C)(3) PER THE BYLAWS OF THE ORGANIZATION. NORTH MEMORIAL HEALTH CARE 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 410729979 ACUTE CARE MN 501(C)(3) LINE 3 NORTH MEMORIAL 0 NORTH MEMORIAL FOUNDATION 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 411777966 FUNDRAISING MN 501(C)(3) LINE 7 NORTH MEMORIAL 0 ASSOCIATED HEALTH ASSURANCE 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 980343815 INSURANCE BD 501(C)(3) LINE 12B, II NORTH MEMORIAL 0 NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE LLC 9855 HOSPITAL DRIVE MAPLE GROVE MN 55369 260393039 OUTPATIENT SURGERY MN N/A MINNESOTA DIAGNOSTIC IMAGING PARTNERS LLC 2955 XENIUM LANE SUITE 40 PLYMOUTH MN 55441 352162215 RADIOLOGY MN N/A NORTH RADIATION THERAPY CENTER 6950 FRANCE AVE S SUITE 200 EDINA MN 55435 743069974 RADIOLOGY MN N/A MINNETONKA AMBULATORY SURGERY CENTER 3300 OAKDALE AVE NORTH ROBBINSDALE MN 55422 465653486 OUTPATIENT SURGERY MN N/A OAKDALE HEALTH ENTERPRISES INC 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 411546422 AMBULANCE MN N/A C 0 NORTH COLLABORATIVE CARE 3300 OAKDALE AVENUE NORTH ROBBINSDALE MN 55422 461680666 PRIMARY CARE MN N/A C 0 0 1 0 0 1 0 0 0 0 0 1 0 1 0 0 1 0 1 0 NORTH MEMORIAL HEALTH CARE (RETURN OF CAPITAL) B 19875000 CASH NORTH MEMORIAL HEALTH CARE (DEBT GUARANTEE) E 89895436 AMOUNT GUARANTEE NORTH MEMORIAL HEALTH CARE (LEASE PAYMENTS) K 3711487 AMOUNT PAID NORTH MEMORIAL HEALTH CARE (MANAGEMENT FEE) M 19660714 AMOUNT PAID NORTH MEMORIAL HEALTH CARE (SALARY REIMBURSEMENT) P 10777608 AMOUNT PAID