SANFORD: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: SANFORD (EIN 45-3791176)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-11
IRS object ID: 201711319349305151
Schema version: 2015v3.0
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-11T15:54:43-05:00	ReturnTs
Tax Period End	2016-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	861065772	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Deloitte Tax LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	50 South Sixth Street Suite 2800	AddressLine1Txt
City	Minneapolis	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55402	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	453791176	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Sanford Group Return	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	SANF	BusinessNameControlTxt
Phone	6053331000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	801 Broadway N	AddressLine1Txt
City	Fargo	CityNm
State Abbreviation	ND	StateAbbreviationCd
ZIP	58122	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JoAnn Kunkel	PersonNm
Person Title	Chief Financial Officer	PersonTitleTxt
Phone	6053331000	PhoneNum
Signature	2017-05-11	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Anne Fulton	PreparerPersonNm
PTIN	P00941863	PTIN
Phone	6123974000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Kelby Krabbenhoft	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2301 East 60th St	AddressLine1Txt
City	Sioux Falls	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57104	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$3,624,376,050	GrossReceiptsAmt
Group Return For Affiliates	Yes (1)	GroupReturnForAffiliatesInd
All Affiliates Included	Yes (1)	AllAffiliatesIncludedInd
Group Exemption	5851	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.sanfordhealth.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Activity Or Mission	"Dedicated to the Work of Health and Healing"	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	33087	TotalEmployeeCnt
Total Volunteers	3000	TotalVolunteersCnt
Total Gross UBI	$37,261,399	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$1,228,905	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$59,401,173	PYContributionsGrantsAmt
CY Contributions Grants	$55,386,334	CYContributionsGrantsAmt
PY Program Service Revenue	$3,338,667,965	PYProgramServiceRevenueAmt
CY Program Service Revenue	$3,553,249,301	CYProgramServiceRevenueAmt
PY Investment Income	$8,788,377	PYInvestmentIncomeAmt
CY Investment Income	$8,700,289	CYInvestmentIncomeAmt
PY Other Revenue	$4,159,380	PYOtherRevenueAmt
CY Other Revenue	$4,325,206	CYOtherRevenueAmt
PY Total Revenue	$3,411,016,895	PYTotalRevenueAmt
CY Total Revenue	$3,621,661,130	CYTotalRevenueAmt
PY Grants And Similar Paid	$11,403,756	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$14,409,710	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$1,981,169,107	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$2,090,504,437	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,214,937,187	PYOtherExpensesAmt
CY Other Expenses	$1,304,233,969	CYOtherExpensesAmt
PY Total Expenses	$3,207,510,050	PYTotalExpensesAmt
CY Total Expenses	$3,409,148,116	CYTotalExpensesAmt
PY Revenues Less Expenses	$203,506,845	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$212,513,014	CYRevenuesLessExpensesAmt
Total Assets BOY	$2,518,921,978	TotalAssetsBOYAmt
Total Assets EOY	$2,666,510,312	TotalAssetsEOYAmt
Total Liabilities BOY	$1,456,837,768	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,574,793,011	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,062,084,210	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,091,717,301	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Part of the Sanford Health System, Sanford is committed to the healthcare needs of communities throughout South Dakota, North Dakota, Minnesota and Iowa. Sanford provides a full range of primary and specialty health care services.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$2,904,255,181	ExpenseAmt
Grant	$14,400,810	GrantAmt
Revenue	$3,548,886,392	RevenueAmt
Desc	Sanford is the nation's largest not-for-profit integrated rural health system providing medical services at every level from critical access hospitals to tertiary and quaternary care. The Sanford footprint includes over 220,000 square miles with a nine state service area including a network of children's primary care clinic locations across the country and the world. Sanford operates full-time emergency centers and provides emergency care to everyone regardless of their ability to pay. Sanford facilities and clinics provide services to remote and medically underserved areas that would otherwise not have access to even primary care services. Sanford financially supports health and wellness, education and community development activities to improve the quality of life and strengthen communities throughout the region. Each of Sanford's facilities promotes health and healing that responds to the unique needs of the patients in the communities that Sanford serves, ensuring access to comprehensive and specialized services. A recently completed and published community health needs assessment indicated the important need for behavioral health services for our community members. Sanford is meeting this need through an integrated delivery system providing behavioral health within the medical home structure.Please see Schedule H for a description of additional services, community benefit activities, and the full spectrum of charity care that Sanford provides within the community.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$8,684,420	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$0	RevenueAmt
Desc	Medical education is an important service for Sanford. Sanford provides the medical community with high quality educational and professional development that is evidence and research based; accredited for physicians, nurses, pharmacists, and Allied Health Professionals and scientists; inclusive of cultural diversity and addresses the need for specialty training.Sanford is dedicated to preparing health care professionals for the future. The Sanford PROMISE program connects students, educators and communities with science and research in health care at a secondary education age. Sanford works in partnership with the University of South Dakota - Sanford School of Medicine, and the University of North Dakota - School of Medicine to provide rotations for medical students, residencies and fellowships. Sanford works in partnership with an extensive group of higher learning organizations to provide student training and learning opportunities in many venues across our region.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$27,694,832	ExpenseAmt
Grant	$8,900	GrantAmt
Revenue	$4,362,909	RevenueAmt
Desc	Sanford Research is a non-profit health research organization with more than 200 scientists and staff as well as centers, including: Children's Health, focused on pediatric rare diseases and cancer; The Sanford Project, seeking a cure for type 1 diabetes through the body's natural ability to regenerate cells; Health Outcomes and Prevention focusing on sudden infant death syndrome and birth-related disorders at study sites including United States Native American Reservations and South Africa; Genomic and Molecular Medicine with an emphasis on genomics, molecular biology, biobanking and immunotherapy; Edith Sanford Breast Cancer focusing on advanced molecular research and personalized treatment; and Clinical Research including participation in drug and device studies, the National Cancer Institute Community Clinical Oncology Program and the National Community Cancer Center Pilot Project.Sanford Research offers exciting challenges for researchers both in well-established projects and ever expanding research opportunities. Sanford offers opportunities to participate in clinical trials and to be a part of the changing face of medicine.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$2,940,634,433	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	Yes (1)	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	Yes (1)	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	Yes (1)	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	3195	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	33087	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	Yes (1)	ForeignFinancialAccountInd
Foreign Country	GH	ForeignCountryCd
Foreign Country	CH	ForeignCountryCd
Foreign Country	GM	ForeignCountryCd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	Yes (1)	LocalChaptersInd
Policies Reference Chapters	Yes (1)	PoliciesReferenceChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	MN	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	OR	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JoAnn Kunkel CFO	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	6053331000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2301 East 60th Street	AddressLine1Txt
City	Sioux Falls	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	57104	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (63 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Barb Everist
Trustee	2.00	3.40	Yes (X)	$0	$0	$0
Brent Teiken
Trustee	2.00	3.40	Yes (X)	$0	$0	$0	Yes (X)
David Beito
Trustee	2.00	3.40	Yes (X)	$0	$0	$0	Yes (X)
Don Jacobs
Trustee	2.00	3.40	Yes (X)	$0	$0	$0
Don Morton
Trustee	2.00	3.40	Yes (X)	$0	$0	$0
James Cain
Trustee	2.00	3.40	Yes (X)	$0	$0	$0
Jim Entenman
Trustee (thru Nov 15)	2.00	3.40	Yes (X)	$0	$0	$0
Lauris Molbert
Trustee	2.00	3.40	Yes (X)	$0	$0	$0
Maria Bell MD
Trustee/Sanford Physician	56.60	3.40	Yes (X)	$821,799	$0	$37,764
Mark Lundeen MD
Trustee/Sanford Physician	56.60	3.40	Yes (X)	$948,187	$0	$27,126
Mark Paulson MD
Trustee/Sanford Physician	56.60	3.40	Yes (X)	$234,209	$0	$32,587	Yes (X)
Melissa Hinton
Trustee	2.00	3.40	Yes (X)	$0	$0	$0
Michael LeBeau MD
Trustee/Sanford Physician	56.60	3.40	Yes (X)	$1,287,761	$0	$30,916
Patrick Durick
Trustee	2.00	3.40	Yes (X)	$0	$0	$0
Richard Hardie MD
Trustee/Sanford Physician (thru Nov 15)	56.60	3.40	Yes (X)	$624,505	$0	$34,022
Thomas Hruby
Trustee	2.00	3.40	Yes (X)	$0	$0	$0
Kelby K Krabbenhoft
Sanford President & CEO	5.00	55.00	Yes (X)	$3,896,486	$0	$21,654	Yes (X)
Kelby K Krabbenhoft Deferred Comp
Sanford President & CEO	5.00	55.00	Yes (X)	$0	$0	$717,699	Yes (X)
JoAnn L Kunkel
Chief Financial Officer	23.00	37.00		$826,615	$0	$33,636	Yes (X)
Nate White
Chief Operating Officer	60.00	0.00		$1,118,905	$0	$38,116	Yes (X)
Richard G Adcock
Chief Innovation Officer	60.00	0.00		$820,979	$0	$37,534	Yes (X)
Kim Patrick
Chief Legal Officer	60.00	0.00		$690,644	$0	$36,602	Yes (X)
Bill Marlette
Treasurer	60.00	0.00		$848,897	$0	$1,680	Yes (X)
Bill Marlette Deferred Comp
Treasurer	60.00	0.00		$0	$0	$161,277	Yes (X)
David Link
Chief Strategy Officer (thru Jan 16)	60.00	0.00		$1,053,253	$0	$24,172	Yes (X)
David Link Deferred Comp
Chief Strategy Officer (thru Jan 16)	60.00	0.00		$0	$0	$110,259	Yes (X)
Al Hurley
VP Operations Bismarck	60.00	0.00		$346,988	$0	$23,622		Yes (X)
Allison Suttle MD
Senior VP Chief Medical Officer	60.00	0.00		$502,365	$0	$37,788		Yes (X)
Bradley J Schipper
VP Operations Sioux Falls	60.00	0.00		$494,943	$0	$37,534		Yes (X)
Brenda Larsen
VP Operations Bismarck (thru Dec 15)	60.00	0.00		$332,230	$0	$34,209		Yes (X)
Bruce D Viessman
VP Finance Health Network	50.00	10.00		$313,004	$0	$34,374		Yes (X)
Bryan Nermoe
Exec VP Bemidji	55.00	5.00		$399,669	$0	$34,310		Yes (X)
Cole Turner
VP Finance Sioux Falls	60.00	0.00		$179,511	$0	$36,829		Yes (X)
Craig Boyer
VP Finance Bemidji	55.00	5.00		$261,023	$0	$104,752		Yes (X)
Craig Lambrecht
Exec VP Bismarck	55.00	5.00		$885,399	$0	$33,416		Yes (X)
Daniel Olson
Exec VP Bemidji (thru Dec 15)	55.00	5.00		$461,289	$0	$35,175		Yes (X)
Daniel W Blue
Exec VP Clinic	60.00	0.00		$929,444	$0	$37,676		Yes (X)
Douglas Okland
VP Clinic Finance	60.00	0.00		$309,608	$0	$16,930		Yes (X)
Ellen Cooke
VP Operations Fargo	60.00	0.00		$450,515	$0	$23,709		Yes (X)
Eric Hilmoe
VP Operations Health Network	60.00	0.00		$290,639	$0	$13,852		Yes (X)
Jeff D Sandene
Chief Integration Officer (thru Dec 15)	60.00	0.00		$595,715	$0	$34,920		Yes (X)
Jesse Tischer
Exec VP Health Network	50.00	10.00		$476,297	$0	$33,465		Yes (X)
Joy Johnson
VP Operations Bemidji	60.00	0.00		$348,090	$0	$139,398		Yes (X)
Karen Tobin
VP Operations SMC Fargo (thru July 15)	55.00	5.00		$901,777	$0	$15,199		Yes (X)
Kirk Cristy
VP Finance Bismarck	55.00	5.00		$310,877	$0	$18,798		Yes (X)
Matthew Hocks
Senior VP Clinic	60.00	0.00		$445,938	$0	$37,472		Yes (X)
Michael E Farritor
VP Clinic Sioux Falls	60.00	0.00		$525,688	$0	$38,432		Yes (X)
Michelle A Bruhn
Senior VP Finance Health Services	60.00	0.00		$495,273	$0	$16,574		Yes (X)
Michelle M Micka
Senior VP Finance Corp Controller	60.00	0.00		$357,064	$0	$34,722		Yes (X)
Paul Hanson
Exec VP Sioux Falls	60.00	0.00		$835,866	$0	$35,534		Yes (X)
Paul Richard
Exec VP Fargo	55.00	5.00		$753,169	$0	$36,414		Yes (X)
Randy Bury
Senior VP Operations	60.00	0.00		$791,959	$0	$8,856		Yes (X)
Randy Bury Deferred Comp
Senior VP Operations	60.00	0.00		$0	$0	$16,674		Yes (X)
Richard Marsden MD
VP Operations Fargo Clinic (thru Dec 15)	60.00	0.00		$633,774	$0	$28,846		Yes (X)
Steve W Goetsch
VP Finance Sioux Falls (thru Mar 16)	60.00	0.00		$355,114	$0	$39,068		Yes (X)
Tiffany Lawrence
VP Finance Fargo	55.00	5.00		$355,943	$0	$31,754		Yes (X)
Scott Pham
Physician	60.00	0.00		$2,882,267	$0	$37,238			Yes (X)
Tomasz P Stys
Physician	60.00	0.00		$2,657,677	$0	$35,238			Yes (X)
Adam T Stys
Physician	60.00	0.00		$2,461,585	$0	$35,238			Yes (X)
William C Brunner
Physician	60.00	0.00		$2,403,090	$0	$35,238			Yes (X)
Wilson T Asfora
Physician	60.00	0.00		$2,161,642	$0	$35,238			Yes (X)
Richard Giesel
Former Exec VP Health Network	60.00	0.00		$590,139	$0	$28,272				Yes (X)
Cecily Tucker
Former VP Finance	0.00	60.00		$0	$294,975	$16,000				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$40,667,811	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$294,975	TotReportableCompRltdOrgAmt
Total Other Compensation	$2,637,808	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2540	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Cardinal Health
7000 Cardinal Place	Dublin	OH	43017	Medical Services	$280,287,994
MA Mortenson Company
700 Meadow Lane N	Minneapolis	MN	55422	Construction	$123,756,052
Owens & Minor Inc
12199 Collection Ctr Dr	Chicago	IL	60693	Medical Services	$65,969,610
Medtronic USA
4642 Collection Ctr Dr	Chicago	IL	60693	Medical Services	$38,459,619
Henry Carlson Construction
1205 Russell Street	Sioux Falls	SD	57104	Construction	$21,482,842

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	981	CntrctRcvdGreaterThan100KCnt
Related Organizations	$33,005,269	RelatedOrganizationsAmt
Government Grants	$18,759,225	GovernmentGrantsAmt
All Other Contributions	$3,621,840	AllOtherContributionsAmt
Noncash Contributions	$41,449	NoncashContributionsAmt
Total Contributions	$55,386,334	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient Services	621400	$2,156,138,565	$2,156,138,565
Medicare/Medicaid	621400	$1,082,255,643	$1,082,255,643
Retail Sales	446199	$199,754,922	$183,024,762	$16,730,160
Reference Lab Revenue	900099	$19,678,901	$3,197,946	$16,480,955
Meaningful Use	900099	$6,356,400	$6,356,400

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$89,064,870	TotalRevenueColumnAmt
Related Or Exempt Func Income	$75,457,879	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$4,050,284	UnrelatedBusinessRevenueAmt
Exclusion	$9,556,707	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$3,553,249,301	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,914,432	TotalRevenueColumnAmt
Exclusion	$8,914,432	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,571,500	TotalRevenueColumnAmt
Exclusion	$2,571,500	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$3,757,791	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$2,004,085	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$1,753,706	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,753,706	TotalRevenueColumnAmt
Exclusion	$1,753,706	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$496,692	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$710,835	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$214,143	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$214,143	TotalRevenueColumnAmt
Exclusion	-$214,143	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,621,661,130	TotalRevenueColumnAmt
Related Or Exempt Func Income	$3,506,431,195	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$37,261,399	UnrelatedBusinessRevenueAmt
Exclusion	$22,582,202	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$14,409,710	TotalAmt
Program Services	$14,409,710	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$30,879,836	TotalAmt
Management And General	$30,879,836	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$1,570,910	TotalAmt
Management And General	$1,570,910	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$1,692,865,266	TotalAmt
Program Services	$1,509,096,468	ProgramServicesAmt
Management And General	$183,768,798	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$74,398,050	TotalAmt
Program Services	$57,749,733	ProgramServicesAmt
Management And General	$16,648,317	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$182,105,842	TotalAmt
Program Services	$147,085,759	ProgramServicesAmt
Management And General	$35,020,083	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$108,684,533	TotalAmt
Program Services	$91,573,556	ProgramServicesAmt
Management And General	$17,110,977	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$3,584,384	TotalAmt
Management And General	$3,584,384	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,167,311	TotalAmt
Management And General	$1,167,311	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$806,489	TotalAmt
Management And General	$806,489	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$183,205,738	TotalAmt
Program Services	$140,921,017	ProgramServicesAmt
Management And General	$42,284,721	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$17,835,612	TotalAmt
Program Services	$1,127,499	ProgramServicesAmt
Management And General	$16,708,113	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$39,476,709	TotalAmt
Program Services	$28,675,125	ProgramServicesAmt
Management And General	$10,801,584	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$31,170,543	TotalAmt
Program Services	$26,137,811	ProgramServicesAmt
Management And General	$5,032,732	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$1,285,750	TotalAmt
Program Services	$1,285,750	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$78,003,260	TotalAmt
Program Services	$59,480,297	ProgramServicesAmt
Management And General	$18,522,963	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$17,485,819	TotalAmt
Program Services	$14,306,501	ProgramServicesAmt
Management And General	$3,179,318	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$4,271,806	TotalAmt
Program Services	$3,226,596	ProgramServicesAmt
Management And General	$1,045,210	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$27,762,715	TotalAmt
Program Services	$27,511,507	ProgramServicesAmt
Management And General	$251,208	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$149,580,627	TotalAmt
Program Services	$118,981,611	ProgramServicesAmt
Management And General	$30,599,016	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$15,161,840	TotalAmt
Program Services	$12,941,975	ProgramServicesAmt
Management And General	$2,219,865	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$696,491,381	$663,295,194	$33,196,187
Intercompany Purchases	$7,154,778		$7,154,778
MinnesotaCare Tax	$5,729,323	$5,729,323
CME	$5,371,024	$5,371,024

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$18,688,860	TotalAmt
Program Services	$11,727,977	ProgramServicesAmt
Management And General	$6,960,883	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,409,148,116	TotalAmt
Program Services	$2,940,634,433	ProgramServicesAmt
Management And General	$468,513,683	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Field	Value	IRS element (for citing)
Joint Costs	Yes (X)	JointCostsInd

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$72,344,016	BOYAmt
EOY	$140,266,525	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$74,321,362	BOYAmt
EOY	$12,146,539	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$529,770,930	BOYAmt
EOY	$520,545,199	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$112,475	BOYAmt
EOY	$21,047	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$39,925,043	BOYAmt
EOY	$39,516,483	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$59,944,756	BOYAmt
EOY	$64,849,835	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$31,188,012	BOYAmt
EOY	$36,983,077	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$3,115,047,521	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,506,749,360	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,473,112,396	BOYAmt
EOY	$1,608,298,161	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$1,815,449	BOYAmt
EOY	$1,815,449	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$27,763,559	BOYAmt
EOY	$18,858,207	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$44,715,963	BOYAmt
EOY	$42,622,902	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$60,477,684	BOYAmt
EOY	$58,202,717	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$103,430,333	BOYAmt
EOY	$122,384,171	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,518,921,978	BOYAmt
EOY	$2,666,510,312	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$438,294,821	BOYAmt
EOY	$448,983,122	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$2,518,919	BOYAmt
EOY	$2,768,497	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,697,633	BOYAmt
EOY	$2,528,337	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$806,230,299	BOYAmt
EOY	$885,526,843	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$298,296	BOYAmt
EOY	$267,646	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$53,827,620	BOYAmt
EOY	$43,182,309	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$153,970,180	BOYAmt
EOY	$191,536,257	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,456,837,768	BOYAmt
EOY	$1,574,793,011	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,061,609,414	BOYAmt
EOY	$1,091,710,111	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$46,988	BOYAmt
EOY	$7,190	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$427,808	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,062,084,210	BOYAmt
EOY	$1,091,717,301	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,518,921,978	BOYAmt
EOY	$2,666,510,312	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$212,513,014	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$546,492	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$183,426,415	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd
Supported Organizations	18	SupportedOrganizationsCnt
Supported Organizations Total	18	SupportedOrganizationsTotalCnt

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
List of organizations and public charity status:	Sanford Health 509(a)(3) Sanford Medical Center 170(b)(1)(A)(iii) Sanford Clinic 170(b)(1)(A)(iii) Sanford Research 170(b)(1)(A)(iii) Sanford Home Health 509(a)(2) Sanford Health Network 170(b)(1)(A)(iii) Sanford World Clinics 170(b)(1)(A)(iii) Sanford North 509(a)(3) Sanford Medical Center Fargo 170(b)(1)(A)(iii) Sanford Clinic North 509(a)(2) Sanford Health Network North 509(a)(3) Sanford Medical Center Thief River Falls 170(b)(1)(A)(iii) Sanford Medical Center Mayville 170(b)(1)(A)(iii) Sanford Medical Center Wheaton 170(b)(1)(A)(iii) Sanford Hillsboro 170(b)(1)(A)(iii) Sanford Health of Northern Minnesota 170(b)(1)(A)(iii) Baker Park, Inc. 509(a)(2) Sanford West 509(a)(3) Sanford Bismarck 170(b)(1)(A)(iii) Sanford Living Centers 509(a)(2)
Schedule A, Part I	Part I, Line 11b - Sanford Health, Sanford North, Sanford West and Sanford Health Network North are Type II supporting organizations. Detail for Schedule A, Part I Line 11, Column: (i) Sanford Medical Center; (ii) 46-0227855; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 33,994,924 Line 11, Column: (i) Sanford Clinic; (ii) 46-0447693; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 5,706,574 Line 11, Column: (i) Sanford Research; (ii) 46-0450378; (iii) 170(b)(1)(A)(iii)l (iv) Yes; (v) 733,158 Line 11, Column: (i) Sanford Home Health; (ii) 46-0282134; (iii) 509(a)(2); (iv) Yes; (v) 210,473 Line 11, Column: (i) Sanford Health Network; (ii) 46-0388596; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 10,180,181 Line 11, Column: (i) Sanford Clinic North; (ii) 91-1770748; (iii) 509(a)(2); (iv) Yes; (v) 7,005,503 Line 11, Column: (i) Sanford Medical Center Fargo; (ii) 45-0226909; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 38,709,556 Line 11, Column: (i) Sanford Medical Center Thief River Falls; (ii) 41-0709579; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 2,947,247 Line 11, Column: (i) Sanford Medical Center Mayville; (ii) 45-0228899; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 327,831 Line 11, Column: (i) Sanford Medical Center Wheaton; (ii) 27-2042143; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 279,334 Line 11, Column: (i) Sanford Hillsboro; (ii) 45-0230400; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 324,368 Line 11, Column: (i) Sanford World Clinics; (ii) 26-2707628; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 274,979 Line 11, Column: (i) Sanford Health of Northern Minnesota; (ii) 41-1266009; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 9,066,080 Line 11, Column: (i) Baker Park, Inc.; (ii) 41-1372480; (iii) 509(a)(2); (iv) Yes; (v) 24,130 Line 11, Column: (i) Sanford Health Foundation North; (ii) 45-0398104; (iii) 170(b)(1)(A)(vi); (iv) Yes; (v) 191,722 Line 11, Column: (i) Sanford Bismarck; (ii) 45-0226700; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 16,993,739 Line 11, Column: (i) Sanford Living Centers; (ii) 45-0416454; (iii) 509(a)(2); (iv) Yes; (v) 1,151,899 Line 11, Column: (i) Sanford Health Foundation West; (ii) 45-0397196; (iii) 170(b)(1)(A)(vi); (iv) Yes; (v) 79,545
Schedule A, Part III	Detail for Schedule A, Part III Line 1 - column: (a) 719,019; (b) 653,960; (c) 625,251; (d) 232,693; (e) 221,829; (f) 2,452,752 Line 2 - column: (a) 380,393,691; (b) 353,433,077; (c) 195,263,418; (d) 214,359,949; (e) 229,728,673; (f) 1,373,178,808 Line 6 - column: (a) 381,112,710; (b) 354,087,037; (c) 195,888,669; (d) 214,592,642; (e) 229,950,502; (f) 1,375,631,560 Line 8 - column: (f) 1,375,631,560 Line 9 - column: (a) 381,112,710; (b) 354,087,037; (c) 195,888,669; (d) 214,592,642; (e) 229,950,502; (f) 1,375,631,560 Line 10a - column: (a) 994,862; (b) 1,011,110; (c) 970,589; (d) 671,284; (e) 718,153; (f) 4,365,998 Line 10c - column: (a) 994,862; (b) 1,011,110; (c) 970,589; (d) 671,284; (e) 718,153; (f) 4,365,998 Line 11 - column: (a) 358,969; (b) 197,834; (c) 279,896; (d) 400,943; (e) 274,195; (f) 1,511,837 Line 13 - column: (a) 382,466,541; (b) 355,295,981; (c) 197,139,154; (d) 215,664,869; (e) 230,942,850; (f) 1,381,509,395 Line 15: 99.57% Line 16: 99.61% Line 17: 0.32% Line 18: 0.29% Line 19a: X Line 19b: X Part IV, Section A Line 1: Yes Line 2: No Line 3a: No Line 4a: No Line 5a: No Line 6: No Line 7: No Line 8: No Line 9a: No Line 9b: No Line 9c: No Line 10a: No Line 11a: No Line 11b: No Line 11c: No Part IV, Section C Line 1: Yes

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	Yes (1)	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	Yes (1)	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$87,172	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$1,301,052	OtherActivitiesAmt
Total Lobbying Expenditures	$1,388,224	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1:	FormAndLineReferenceDesc
Explanation	The filing organization has memberships in the South Dakota Association of Healthcare Organizations, North Dakota Hospital Association, Minnesota Hospital Association, Iowa Hospital Association, American Hospital Association, North Dakota Long Term Care Association, North Dakota Medical Group Management Association, Iowa Alliance in Home Care and Health Policy Consortium. A percentage of membership dues paid to these organizations relate to lobbying expenses. In addition, the organization employs certain individuals, and contracts with various lobbyists, to monitor legislative acts important to all Sanford entities on both state and national levels. Occasionally, Sanford employees send mailings to legislators on issues that may affect healthcare.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtcInd
Incl Escrow Custodial Acct Liab	Yes (1)	InclEscrowCustodialAcctLiabInd
Explanation Provided	Yes (X)	ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$58,142,005	BeginningYearBalanceAmt
Contributions	$4,442,491	ContributionsAmt
End Year Balance	$62,584,497	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$54,120,507	BeginningYearBalanceAmt
Contributions	$4,007,618	ContributionsAmt
Investment Earnings Or Losses	$25,086	InvestmentEarningsOrLossesAmt
Other Expenditures	$6,372	OtherExpendituresAmt
Administrative Expenses	$4,834	AdministrativeExpensesAmt
End Year Balance	$58,142,005	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$48,229,852	BeginningYearBalanceAmt
Contributions	$5,316,297	ContributionsAmt
Investment Earnings Or Losses	$654,694	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$54,813	GrantsOrScholarshipsAmt
Other Expenditures	$6,949	OtherExpendituresAmt
Administrative Expenses	$18,574	AdministrativeExpensesAmt
End Year Balance	$54,120,507	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$43,654,039	BeginningYearBalanceAmt
Contributions	$4,275,810	ContributionsAmt
Investment Earnings Or Losses	$312,076	InvestmentEarningsOrLossesAmt
Other Expenditures	$7,305	OtherExpendituresAmt
Administrative Expenses	$4,768	AdministrativeExpensesAmt
End Year Balance	$48,229,852	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$38,601,256	BeginningYearBalanceAmt
Contributions	$5,033,151	ContributionsAmt
Investment Earnings Or Losses	$33,855	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$3,144	GrantsOrScholarshipsAmt
Other Expenditures	$6,341	OtherExpendituresAmt
Administrative Expenses	$4,738	AdministrativeExpensesAmt
End Year Balance	$43,654,039	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$112,323,009	OtherCostOrOtherBasisAmt
Book Value	$112,323,009	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,213,461,999	OtherCostOrOtherBasisAmt
Depreciation	$542,389,224	DepreciationAmt
Book Value	$671,072,775	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$74,774,254	OtherCostOrOtherBasisAmt
Depreciation	$39,805,722	DepreciationAmt
Book Value	$34,968,532	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,677,180,861	OtherCostOrOtherBasisAmt
Depreciation	$901,318,623	DepreciationAmt
Book Value	$775,862,238	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$37,307,398	OtherCostOrOtherBasisAmt
Depreciation	$23,235,791	DepreciationAmt
Book Value	$14,071,607	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,608,298,161	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
Deferred compensation	$84,075,533
Defined benefit pension liability	$98,355,049
Other non-current liabilities	$9,105,675

Field	Value	IRS element (for citing)
Total Liability	$191,536,257	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part IV, Line 2b:	Long term care facilities hold security deposits for tenants.
Part V, Line 4:	Edith Sanford Breast Cancer Foundation, Sanford Health Foundation, Sanford Health Foundation North, Sanford Health Foundation Hillsboro, Sanford Health Foundation of Northern Minnesota and Sanford Health Foundation West hold endowment funds on behalf of the filing organization to be used for assistance in its activities and for providing health care, medical, or educational services.
Part X, Line 2:	Certain controlled organizations are subject to income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. A tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination. The deferred income tax provision or benefit generally reflects the net change in deferred income tax assets and liabilities during the year. The current income tax provision reflects the tax consequences of revenues and expenses currently taxable or deductible on various income tax returns for the year reported. Sanford Group did not have a material income tax liability at June 30, 2016; some related organizations have established reserves.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp (9 entries)

RegionRegionTxt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Specific Services ProvidedSpecificServicesProvidedTxt	Region Total ExpendituresRegionTotalExpendituresAmt
East Asia and the Pacific	Program Services	Travel, conferences and purchased goods & services	$6,828
Europe (Including Iceland & Greenland)	Program Services	Investigation of potential clinic sites, travel and purchased goods & services	$33,229
North America	Program Services	Travel, conferences and purchased goods & services	$48,625
South Asia	Program Services	Purchased services	$550
Sub-Saharan Africa	Program Services	Legal services	$5,088
Sub-Saharan Africa	Investment	Investment in Ghana clinic operations	$5,536,344
East Asia and the Pacific	Investment	Investment in China clinic operations	$143,478
Russia and Neighboring States	Program Services	Travel and purchased goods & services	$3,669
Europe (Including Iceland & Greenland)	Investment	Investment in Germany clinic operations	$20,632

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continutation Total Office	0	ContinutationTotalOfficeCnt
Continutation Total Employee	0	ContinutationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$5,777,811	SubtotalSpentAmt
Continuation Spent	$20,632	ContinuationSpentAmt
Total Spent	$5,798,443	TotalSpentAmt
Transfer To Foreign Corp	Yes (1)	TransferToForeignCorpInd
Interest In Foreign Trust	0	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (1)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	0	PassiveForeignInvestmestCoInd
Foreign Partnership	0	ForeignPartnershipInd
Boycott Countries	0	BoycottCountriesInd

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	225.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	375.000000000000	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$67,179,952	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$67,179,952	NetCommunityBenefitExpnsAmt
Total Expense	0.01970	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$446,717,867	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$321,268,287	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$125,449,580	NetCommunityBenefitExpnsAmt
Total Expense	0.03680	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Total Expense	0.00000	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$513,897,819	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$321,268,287	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$192,629,532	NetCommunityBenefitExpnsAmt
Total Expense	0.05650	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,939,206	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,003,581	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,935,625	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,215,578	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,895,994	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,319,584	NetCommunityBenefitExpnsAmt
Total Expense	0.00330	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$468,135,503	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$419,572,511	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$48,562,992	NetCommunityBenefitExpnsAmt
Total Expense	0.01420	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$23,623,400	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,075,744	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,547,656	NetCommunityBenefitExpnsAmt
Total Expense	0.00490	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,724,280	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,724,280	NetCommunityBenefitExpnsAmt
Total Expense	0.00310	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$526,637,967	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$432,547,830	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$94,090,137	NetCommunityBenefitExpnsAmt
Total Expense	0.02750	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,040,535,786	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$753,816,117	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$286,719,669	NetCommunityBenefitExpnsAmt
Total Expense	0.08400	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,216	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,216	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$19,580	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$19,580	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,977	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,977	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$545,951	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$545,951	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$35,979	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$35,979	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$98,774	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$98,774	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$710,477	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$710,477	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$36,726,460	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$760,987,356	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$774,759,500	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$13,772,144	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	24	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (24 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Business Name Line1SubordinateHospitalName/BusinessNameLine1Txt	Subordinate Hospital EINSubordinateHospitalEIN	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Childrens HospitalChildrensHospitalInd	Teaching HospitalTeachingHospitalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd	Research FacilityResearchFacilityInd	Critical Access HospitalCriticalAccessHospitalInd	OtherOtherDesc
Sanford USD Medical Center
1	1305 W 18th Street	Sioux Falls	SD	57117	www.sanfordhealth.org	SD 10564	Sanford Medical Center	460227855	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
Sanford Medical Center Fargo
2	801 Broadway North	Fargo	ND	58122	www.sanfordhealth.org	ND 5018A	Sanford Medical Center Fargo	450226909	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
Sanford Medical Center South University
3	1720 South University	Fargo	ND	58103	www.sanfordhealth.org	ND 5068A	Sanford Medical Center Fargo	450226909	Yes (X)	Yes (X)		Yes (X)		A
Sanford Bismarck Medical Center
4	300 N 7th Street	Bismarck	ND	58501	www.sanfordhealth.org	ND 5003A	Sanford Bismarck	450226700	Yes (X)	Yes (X)		Yes (X)	Yes (X)	A	Yes (X)
Sanford Bemidji Medical Center
5	1300 Anne Street NW	Bemidji	MN	56601	www.sanfordhealth.org	MN 371073	Sanford Health of Northern Minnesota	411266009	Yes (X)	Yes (X)			Yes (X)	A
Sanford Medical Center Thief River Falls
6	3001 Sanford Parkway	Thief River Falls	MN	56701	www.sanfordhealth.org	MN 371500	Sanford Medical Center Thief River Falls	410709579	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)	Inpatient Mental Health
Sanford Aberdeen Medical Center
7	2905 3rd Avenue SE	Aberdeen	SD	57401	www.sanfordhealth.org	SD 65089	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A
Sanford Worthington Medical Center
8	1018 6th Avenue	Worthington	MN	56187	www.sanfordhealth.org	MN 371449	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A
Sanford Sheldon Medical Center
9	118 N 7th Avenue	Sheldon	IA	51201	www.sanfordhealth.org	IA 161381	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)	Nursing Facility
Sanford Vermillion Medical Center
10	20 S Plum Street	Vermillion	SD	57069	www.sanfordhealth.org	SD 53082	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)	Nursing Facility
Sanford Chamberlain Medical Center
11	300 S Byron Blvd	Chamberlain	SD	57325	www.sanfordhealth.org	SD 50302	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)	Nursing Facility
Sanford Luverne Medical Center
12	1600 N Kniss Avenue	Luverne	MN	56156	www.sanfordhealth.org	MN 371352	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)
Sanford Canby Medical Center
13	112 St Olaf Avenue S	Canby	MN	56220	www.sanfordhealth.org	MN 371019	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)	Nursing Facility
Sanford Jackson Medical Center
14	1430 N Highway	Jackson	MN	56143	www.sanfordhealth.org	MN 371002	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)
Sanford Tracy Medical Center
15	251 5th Street E	Tracy	MN	56175	www.sanfordhealth.org	MN 371440	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)
Sanford Rock Rapids Medical Center
16	801 S Greene Street	Rock Rapids	IA	51246	www.sanfordhealth.org	IA 161321	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)
Sanford Hillsboro Medical Center
17	12 3rd Street SE	Hillsboro	ND	58045	www.sanfordhealth.org	ND 5026A	Sanford Hillsboro	450230400	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)
Sanford Medical Center Mayville
18	42 6th Avenue SE	Mayville	ND	58257	www.sanfordhealth.org	ND 5034A	Sanford Medical Center Mayville	450228899	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)
Sanford Webster Medical Center
19	1401 W 1st Street	Webster	SD	57274	www.sanfordhealth.org	SD 10573	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)
Sanford Medical Center Wheaton
20	401 12th Street N	Wheaton	MN	56296	www.sanfordhealth.org	MN 371390	Sanford Medical Center Wheaton	272042143	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)
Sanford Bagley Medical Center
21	203 4th Street NW	Bagley	MN	56621	www.sanfordhealth.org	MN 371484	Sanford Health of Northern Minnesota	411266009	Yes (X)	Yes (X)				A		Yes (X)
Sanford Canton-Inwood Medical Center
22	440 N Hiawatha Drive	Canton	SD	57013	www.sanfordhealth.org	SD 51569	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)
Sanford Clear Lake Medical Center
23	701 3rd Avenue S	Clear Lake	SD	57226	www.sanfordhealth.org	SD 10533	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)
Sanford Westbrook Medical Center
24	920 Bell Avenue	Westbrook	MN	56183	www.sanfordhealth.org	MN 371439	Sanford Health Network	460388596	Yes (X)	Yes (X)			Yes (X)	A		Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Facility Reporting Group - A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	http://www.sanfordhealth.org/About/CHNA	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	http://www.sanfordhealth.org/About/CHNA	StrategyWebsiteURLTxt
Strategy Attached	0	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	225.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	375.000000000000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	See narrative for full url	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See narrative for full url	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See narrative for full url	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Average Negotiated Rates	Yes (X)	AverageNegotiatedRatesInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (146 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part V, Section B	Facility Reporting Group A
Facility Reporting Group A consists of:	- Facility 1: Sanford USD Medical Center, - Facility 2: Sanford Medical Center Fargo, - Facility 3: Sanford Medical Center South University, - Facility 4: Sanford Bismarck Medical Center, - Facility 5: Sanford Bemidji Medical Center, - Facility 6: Sanford Medical Center Thief River Falls, - Facility 7: Sanford Aberdeen Medical Center, - Facility 8: Sanford Worthington Medical Center, - Facility 9: Sanford Sheldon Medical Center, - Facility 10: Sanford Vermillion Medical Center, - Facility 11: Sanford Chamberlain Medical Center, - Facility 12: Sanford Luverne Medical Center, - Facility 13: Sanford Canby Medical Center, - Facility 14: Sanford Jackson Medical Center, - Facility 15: Sanford Tracy Medical Center, - Facility 16: Sanford Rock Rapids Medical Center, - Facility 17: Sanford Hillsboro Medical Center, - Facility 18: Sanford Medical Center Mayville, - Facility 19: Sanford Webster Medical Center, - Facility 20: Sanford Medical Center Wheaton, - Facility 21: Sanford Bagley Medical Center, - Facility 22: Sanford Canton-Inwood Medical Center, - Facility 23: Sanford Clear Lake Medical Center, - Facility 24: Sanford Westbrook Medical Center
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 6a:	Sanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Crime/Safety - Pharmaceutical Narcotics in the CommunitySanford USD Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Chronic DiseaseSanford is dedicated to improving health outcomes by monitoring BMI through quality metrics and referring to internal/external services to improve the care of patients with overweight or obesity diagnosis. The Sanford fit Program will be available to all local schools, students and families in the area through the classroom modules and the fit website. Sanford will address diabetes by adopting optimal diabetes care for patients ages 18-75 with diabetes. Sanford will standardize hypertension protocols in all primary care settings, and will adopt standardized protocols for optimal vascular care.Identified needs not directly addressed by this facility include: Aging - Cost of long term care Child and Youth - Bullying Access to Health Care - Access to affordable health insurance, Access to affordable health, Access to affordable prescription drugs Mental Health - Underage drug use and abuse, Alcohol abuse
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: HypertensionSanford Fargo Medical Center will reduce the number of patients with uncontrolled hypertension. Standardized nursing protocol for blood pressure checks and rechecks is a strategy that has been implemented throughout the medical center.Priority 2: DepressionSanford has prioritized depression as a top priority and has implemented strategy to perform assessments for depression and to improve PHQ-9 scores and the severity for patients with depression.Priority 3: Flu Vaccines Sanford has prioritized flu vaccines and has implemented strategy to increase the number of flu vaccines provided to community members. Sanford will develop consumer education materials, and conduct flu blitz clinics at various locations in the community. All assessed needs that are healthcare related are being addressed at Sanford. Sanford is not developing strategies to address the cost of long term care and the availability of long term care and memory care in the Fargo-Moorhead area. Long-term care cost and access is an area of care that Sanford is not directly addressing because there are organizations in the community that are working on these needs. Additional concerns that will not be addressed directly by strategy include bullying among children and youth, the cost of quality child care and the cost of quality infant care. The results of the CHNA have been shared with community leaders, and those who have expertise in the areas that are not being addressed directly by Sanford. Sanford Medical Center Fargo will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing, Hunger Aging - Cost of long term care, Availability of memory care, Availability of LTC Children and Youth - Bullying, Cost of quality child care, Cost of quality infant care, Availability of quality child care, Availability of quality infant care, Cost of services for at risk youth Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community, Crime, Child abuse and neglect, Domestic violence, Presence of gang activity in the community, Sex trafficking Health care - Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs, Timely access to substance abuse providers, Cost of affordable dental insurance coverage, Use of emergency room for primary care, Cost of affordable vision insurance
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: HypertensionSanford Fargo Medical Center will reduce the number of patients with uncontrolled hypertension. Standardized nursing protocol for blood pressure checks and rechecks is a strategy that has been implemented throughout the medical center.Priority 2: DepressionSanford has prioritized depression as a top priority and has implemented strategy to perform assessments for depression and to improve PHQ-9 scores and the severity for patients with depression.Priority 3: Flu Vaccines Sanford has prioritized flu vaccines and has implemented strategy to increase the number of flu vaccines provided to community members. Sanford will develop consumer education materials, and conduct flu blitz clinics at various locations in the community. All assessed needs that are healthcare related are being addressed at Sanford. Sanford is not developing strategies to address the cost of long term care and the availability of long term care and memory care in the Fargo-Moorhead area. Long-term care cost and access is an area of care that Sanford is not directly addressing because there are organizations in the community that are working on these needs. Additional concerns that will not be addressed directly by strategy include bullying among children and youth, the cost of quality child care and the cost of quality infant care. The results of the CHNA have been shared with community leaders, and those who have expertise in the areas that are not being addressed directly by Sanford. Sanford Medical Center Fargo will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing, Hunger Aging - Cost of long term care, Availability of memory care, Availability of LTC Children and Youth - Bullying, Cost of quality child care, Cost of quality infant care, Availability of quality child care, Availability of quality infant care, Cost of services for at risk youth Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community, Crime, Child abuse and neglect, Domestic violence, Presence of gang activity in the community, Sex trafficking Health care - Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs, Timely access to substance abuse providers, Cost of affordable dental insurance coverage, Use of emergency room for primary care, Cost of affordable vision insurance
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Access to affordable careSanford Bismarck Medical Center will increase the percentage of community members accessing preventive and acute care in appropriate settings. Sanford is establishing a Family Wellness Center to provide year-round health and wellness opportunities for community members and is also providing education to make patients aware of the best coverage options through a "no wrong door" policy to help community members secure health coverage and/or financial assistance through the Sanford financial assistance (Community Care) program.Priority 2: Substance abuseSanford will work with community stakeholders to identify gaps in the community's substance abuse continuum of care and to improve access to care. Sanford Bismarck Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Aging Population - Cost of long term care, Availability of memory care, Availability of long term care, Availability of resources to help elderly stay in their homes, Availability of resources for family/friends caring/making decisions for elders Children and Youth - Cost of quality child care, Availability of quality child care, Cost of quality infant care, Availability of quality infant care, Bullying, Youth crime Crime/Safety - Presence of street drugs, prescription drugs and alcohol, Crime, Presence of drug dealers in the community, Child abuse and neglect, Sex trafficking, Domestic violence, Presence of gang activity, Elder abuse Economics - Availability of affordable housing, Homelessness, Hunger Physical Health - Chronic disease, Inactivity/lack of exercise, Poor nutrition, Obesity Diversity - Access to translators/bilingual providers Mental Health - Depression, Stress, Suicide, Other psychiatric diagnosis, Dementia and Alzheimer's disease Transportation - Driving habits, Availability of good walking or biking options Environment - Hazardous water, Water quality, Air quality, Home septic systems
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Behavioral healthSanford Bemidji Medical Center has set strategy to reduce mortality and morbidity from chemical addiction and mental health disease by participating in a community partnership to develop a continuum of care for behavioral health services and to offer psychiatry and psychology services in the ambulatory setting. Sanford will also enhance the level of behavioral health services available in the inpatient setting. Sanford Bemidji Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Children and YouthSanford has set strategy to reduce the number of infants born to mothers who are opioid users by developing a case management system to work with pregnant women and to also coordinate medical assisted therapy options for pregnant women at risk of opioid use. Additionally, Sanford will enhance the level of care available to high risk infants born in Sanford Bemidji Medical Center.Sanford will also provide the Sanford fit program to the local schools and make the program available to families in the area through the fit website.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Transportation - Availability of public transportation Aging - Cost of long term care, Availability of long term care, Availability of resources for caregivers making decisions, Availability of memory care, Availability of resources to help the elderly stay in their homes, Availability of resources for grandparent caregivers for grandchildren, Understanding of advanced care directives Safety - Child abuse and neglect, Crime, Presence of street drugs, prescription drugs and alcohol, Presence of drug dealers, Domestic violence, Presence of gang activity, Elder abuse, Safe places for outdoor youth activities, Sex trafficking Health care - Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs, Cost of affordable dental insurance, Use of emergency services for primary care, Cost of affordable vision insurance, Timely access to mental health/behavioral health providers, Availability of non-traditional hours, Timely access to physician specialists, Coordination of care between providers and services Physical Health - Cancer, Inactivity, Obesity Chronic disease, Poor nutrition Preventive Health - Flu shots
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral HealthSanford Thief River Falls Medical Center has set strategy for the Behavioral Health Center to become CMS certified as a free-standing psychiatric hospital. Sanford will also develop a partial hospitalizations program and work to develop partnerships with regional behavioral health organizations.Priority 2: Physical HealthSanford will expand the wellness center and focus on a Kids Unite wellness center. Sanford will Partner with community organizations to plan and develop a self-sustaining community center. Additionally, Sanford will provide Sanford fit to local schools and child care organizations and will continue to enroll patients into the Medical Home. Sanford will not directly develop strategy to address the availability of affordable housing, walking and biking paths, the availability and cost of quality infant and child care, the availability and cost of activities for children and youth (except for the Sanford fit Program), bullying, teen pregnancy, services for at-risk youth, the presence of street drugs, drug dealers in the community, and domestic violence. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the findings of the CHNA and the needs with community leaders and public health agencies in the area. Sanford Medical Center Thief River Falls will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Transportation - Availability of good walking or biking paths Aging - Cost of long term care, Availability of memory care, Availability of resources to help the elderly stay safe in their homes Children and Youth - Availability of quality infant care, Availability of quality child care, Availability of activities for children and youth, Cost of activities for children and youth, Cost of quality infant care, Bullying, Cost of quality child care, Teen pregnancy, Availability of services for at-risk youth Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community, Domestic violence Health care - Access to affordable health insurance, Access to affordable prescription drugs, Access to affordable health care, Availability of non-traditional hours, Cost of affordable dental insurance coverage, Use of emergency services for primary care Preventive health - Flu shots, Immunizations, Not seeing a health care provider or dentist within the past year
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical Health/ObesitySanford Aberdeen Medical Center will provide the Sanford fit Program to all students and families through classroom modules and the fit website.Priority 2: Mental Health/DepressionSanford is committed to improving the care of patients with depression diagnosis and will perform depression assessments, and implement health coaches and primary care staff into the care process.Sanford will not directly develop strategy to address the availability of affordable housing, good water quality, the cost of long term care and the availability of memory care, the cost of quality infant care, and the presence of street drugs and alcohol in the community. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the results of the CHNA and the unmet needs with community leaders. Sanford Aberdeen Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Environment - Good water quality Aging - Cost of long term care, Availability of memory care Children and Youth - Bullying, Cost of quality infant care Safety - Presence of street drugs and alcohol in the community, Domestic violence, Child abuse Health care - Access to affordable health insurance
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical Center
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: AccessSanford Worthington Medical Center has implemented strategy to improve access by helping community members understand the resources and financial assistance that is available through Sanford Health. Sanford will also partner with community entities to increase4 holistic care and with an employer group to increase education relative to health career services and insurance.Priority 2: Physical HealthSanford will fully implement the Medical Home model, increase provider education of registered dietitian services, improve the availability of exercise and nutrition education across the community, and increase the implementation of preventive health care. Sanford will not develop strategy to address the availability of affordable housing, the availability of public transportation, water quality, the cost and availability of long-term care, memory care, resources for care givers and the elderly, the presence of street drugs, drug dealers, domestic violence, child abuse, and violent crime. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has shared the assessed needs with community leaders that have expertise in the various needs of the community. Sanford Worthington Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Transportation - Availability of public transportation Environment - Water quality Aging - Cost of long term care, Availability of memory care, Availability of long term care, Availability of resources for family friends/ caring for and making decisions for elders, Availability of resources to help the elderly stay safe in their homes Children and Youth - Availability of quality infant care, Availability of quality child care, Bullying, Cost of quality child care, Cost of quality infant care, Availability of activities for children and youth, Teen pregnancy, Cost of activities for children and youth, Availability of services for at risk youth, Teen births Safety - Presence of street drugs and alcohol in the community, Domestic violence, Presence of drug dealers in the community, Child abuse and neglect, Violent crime Mental Health - Depression, Stress, Dementia and Alzheimer's disease, Other psychiatric diagnosis, Drug use and abuse, Underage drug use and abuse, Alcohol use and abuse, Underage drinking, Smoking and tobacco use Preventive Health - Flu shots, Immunizations, Not seeing a healthcare provider or dentist in the past year
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral HealthSanford Sheldon Medical Center has developed strategy to reduce mortality and morbidity from chemical addiction and mental health diseases by recruiting a triage therapist, and working to reduce drug and alcohol abuse in the community. Sanford will work with the high school counselor to enhance curriculum to include abuse issues. Sanford Sheldon Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Children and YouthSanford has developed strategy to support the youth in the community by enhancing the community environment through structured after school programming, day care expansion, and education sessions for youth and parents.Identified needs not directly addressed by this facility include: Aging - Cost of long term care Safety - Presence of street drugs, prescription drugs and alcohol in the community, Child abuse and neglect, Domestic violence Health Care - Use of emergency services for primary health care, Access to affordable health insurance, Timely access to physician specialists, Availability of non-traditional hours, Timely access to doctors, PAs or NPs, Timely access to mental health providers Physical Health - Cancer, Chronic disease, Obesity, Poor nutrition, Inactivity Preventive Health - Flu shots, Immunizations
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental HealthSanford Vermillion Medical Center has developed strategy to increase mental health services in the Vermillion community through additional mental health counselors and providers as well as offering psychiatry telemedicine services. Sanford Vermillion Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Physical Health Sanford Vermillion has set strategies to reduce obesity, hypertension and high cholesterol and realize an overall improvement in physical health by offering a variety of classes, fitness programs and screenings.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Aging - Cost of long term care, Availability of memory care Children and Youth - Bullying Safety - Presence of street drugs and alcohol in the community, Child abuse and neglect Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Access to affordable health care, Cost of affordable dental insurance coverage
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical HealthSanford Chamberlain Medical Center has developed strategy to help the community improve their physical health and chronic health conditions. The Medial Home model will be fully integrated into the clinic setting, and quality measures for patients with diabetes, elevated lipids and asthma will be monitored. A patient advisory council will convene to improve patient and clinic communications. Sanford fit will be offered to the local school districts, and resources will be available to students, families, and leaders. Priority 2: Mental Health/Behavioral HealthSanford will integrate the Medical Home model into the clinic primary care setting and will utilize PHQ-9 assessments to evaluate for depression. Health coaches and a Master's prepared social worker will be dedicated to mental health/behavioral health services. The facilitated support group will be a focus for additional patient engagement.Sanford will not develop strategy to address the presence of street drugs and alcohol in the community, the presence of drug dealers, and child abuse. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford shared the findings of the CHNA research and these unmet needs with community leaders and community stakeholders. Sanford Chamberlain Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community, Child abuse and neglect Substance Use and Abuse - Drug use and abuse, Underage drug use and abuse, Alcohol use and abuse, Underage drinking, Smoking and tobacco use Children and Youth - Bullying, Youth crime, Availability of quality child care, Availability of quality infant care, High rates of teen births Health Care - Access to affordable health care, Need for medical care, Need for prescription mediciations, Unmet mental health needs
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical HealthSanford Luverne Medical Center will address chronic disease management and monitor MN community measure scores for improvement. Sanford will engage the community around wellness, healthy eating and dental health.Priority 2: Mental HealthSanford has developed strategy to improve access to mental health and substance abuse resources. PHQ-9 scores will be monitored and referrals to behavioral health triage therapists, care coordinators and chemical dependency staff with be made as determined by assessment.Sanford will not develop strategy to address the cost of long term care, the availability of memory care, the availability of quality infant and child care and the presence of street drugs in the community. However, Sanford shared the results of the CHNA research with community leaders and agencies with expertise to the identified needs. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford Luverne Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care Children and Youth - Availability of quality infant care, Availability of quality child care Safety - Presence of street drugs and alcohol in the community Health Care - Access to affordable health insurance Preventive Health - Flu shots, Immunizations
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical Health Sanford Canby Medical Center will implement the Together Canby Can initiative to promote healthy lifestyles, and will work with the public schools and parochial schools to bring Sanford fit to school age youth. Sanford will also implement the MN Community Measurement application for blood pressure screening and follow-up.Priority 2: Mental HealthSanford will implement an education program for awareness and prevention and will determine the availability of resources for mental health within the geographical area in partnership with public health. Sanford Canby Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care Children and Youth - Bullying, Availability of activities for children and youth, Cost of activities for children and youth Safety - Presence of street drugs and alcohol in the community Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Access to affordable prescription drugs, Cost of affordable dental insurance coverage
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Children and YouthSanford Jackson Medical Center will utilize Sanford fit tools at the Family Fun nights and will bring the curriculum to the area schools. Priority 2: Mental Health Sanford has developed strategy to reduce drug abuse by educating the public on the take back program in the community. Additionally, Sanford will consider the availability of the mobile mental health unit in Jackson County as a collaborative partnership for mental health services.Sanford Jackson Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Aging - Cost of long term care, Availability of memory care, Availability of resources for family/friends caring for and making decisions for elders Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community, Child abuse and neglect, Domestic violence, Violent crime Health Care - Availability of no-traditional hours, Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs, Cost of affordable dental insurance coverage Physical Health - Cancer, Inactivity or lack of exercise, Poor nutrition, Obesity, Chronic disease Preventive Health - Flu shots, Not seeing a health care provider or dentist in the past year
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental HealthSanford Tracy Medical Center has developed strategy to improve the access time for patients waiting to be placed for mental health services from the ER. Sanford will also work with community partners to create new recovery program options for community members, and will work with the MN DOH on a pilot project for integrating behavioral health into critical access hospitals.Sanford Tracy Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Physical HealthSanford will address chronic disease through utilization of Medical Home, health coaches, and the Sanford fit Program.Identified needs not directly addressed by this facility include: Aging - Cost of long term care Safety - Presence of drug dealers in the community, Presence of street drugs and alcohol in the community Health Care - Cost of affordable dental insurance coverage, Access to affordable health insurance Preventive Health - Flu shots, Immunizations, STDs
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral HealthSanford Rock Rapids Medical Center will enhance access to mental health and substance abuse resources, and access to resources to help the elderly stay in their homes. Behavioral health triage therapists and mental health providers will be added to improve access for mental health and behavioral health. Additionally, Sanford will work with local facilities and pharmacists on discharge to home and home options to ensure independence and safety at home. Sanford Rock Rapids Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Priority 2: Physical Health/Chronic DiseaseSanford will focus on the MN Community Measures Scores, continue the disease registry, and expand beyond diabetes to target evolving needs. Medication management, community education, and the promotion of physical activity in the community will be addressed. Sanford will also work with local dentists and mobile dental services to seek options to increase the availability of dental services that accept Medicaid.Sanford will not directly develop strategy to address the availability of affordable housing, bullying among children and youth, and the cost and availability of infant and child care. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford will share the concerns and the results of the CHNA with community leaders who do have expertise in their areas.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Aging - Cost of long term care, Availability of memory care, Availability of resources to help the elderly stay safe in their homes Children and Youth - Bullying, Availability of quality infant care, Cost of quality infant care, Availability of quality child care Safety - Presence of street drugs, prescription drugs and alcohol in the community Health Care - Access to affordable health insurance, Access to affordable prescription drugs, Cost of affordable dental insurance, Access to affordable health care, Cost of affordable vision insurance Preventive Health - Flu shots, Immunizations
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical HealthSanford Hillsboro Medical Center will focus on exercise programs for community members, including walking clubs, biking clubs and fitness challenges in partnership with the local wellness center and the medical center's therapy department. Sanford will also provide the Sanford fit program to the local schools and childcare providers.Priority 2: Mental Health ServicesSanford will implement the PHQ-9 assessment to identify patients with depression and develop plans to reduce the severity of depression. Sanford will also distribute a directory of available resources to patients, local groups and entities to create awareness in the community. Sanford will not develop strategy to address the cost of long term care and the availability of memory care because the state of North Dakota through the Department of Human Services controls the cost. Memory care cannot be added to the LTC facility. Safety issues such as seat belt usage and the presence of street drugs are issues that the city council and the sheriff's office are issues that the community stakeholders are addressing. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford Hillsboro Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care Children and Youth - Bullying, Availability of activities for children and youth, Cost of activities for children and youth Safety - Seat belt usage, Presence of street drugs and alcohol in the community Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Access to affordable prescription drugs, Cost of affordable dental insurance coverage Preventive Health - Flu shots, Immunizations
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Physical Health Sanford Mayville Medical Center will improve the availability of nutrition and exercise programs for community members. Additionally, the Sanford fit Program will be available to all students and families through classroom curriculum and through the fit website.Priority 2: Mental Health ServicesSanford will implement the PHQ-9 assessment to identify patients with depression and develop plans to reduce the severity of depression. Sanford will also distribute a directory of available resources to patients, local groups and entities to create awareness in the community. Sanford will not directly develop strategy to address the cost of long term care and the availability of memory care because the state of North Dakota through the Department of Human Services controls the cost. Sanford has deferred to the local nursing home which does have an Alzheimer's unit. Safety issues such as seat belt usage and the presence of street drugs are issues that the city council and the sheriff's office are addressing. Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford Medical Center Mayville will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care Children and Youth - Bullying, Availability of activities for children and youth, Cost of activities for children and youth Safety - Seat belt usage, Presence of street drugs and alcohol in the community Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Access to affordable prescription drugs, Cost of affordable dental insurance coverage Preventive Health - Flu shots, Immunizations
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: SafetySanford Webster Medical Center will address safety by offering MOAB (management of aggressive behavior) training for employees and to local schools, businesses and the public. Sanford will present a DUI drama program to high school juniors and seniors to reduce the number of alcohol and drug related accidents among teens. Sanford will conduct an annual sports power program to discourage drug and alcohol abuse.Priority 2: Physical Health Sanford will offer the use of PT equipment for the public to increase physical health. Sanford will also increase the number of nutrition consults and provide American Cancer Society referral cards for clinic and hospital visitors and patients.Sanford Webster Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Aging - Cost of long term care Children and Youth - Bullying, Availability of activities for children and youth Health Care - Access to affordable health insurance, Cost of affordable dental insurance, Cost of affordable vision insurance, Access to affordable health care, Access to affordable prescription drugs Mental Health - Underage drug use and abuse, Alcohol use and abuse, Drug use and abuse, Underage drinking, Smoking and tobacco use, Stress, Depression
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Worthington Medical Center
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental HealthSanford Medical Center Wheaton will expand Medical Home patients who have a PHQ-9 assessment indicating depression. Evidence-based guidelines for mental health will be implemented, and Sanford will work with the TRF psychiatry team and the Traverse County mental health providers to increase the number of available appointments for services. Sanford will also promote the early identification of mental health needs through early childhood wellness exams. Sanford will support parents with healthy social and emotional development tools.Priority 2: SafetySanford will work with law enforcement to provide safe collection sites for unused drugs.Priority 3: Children and YouthSanford will increase access to healthy food options to decrease hunger among children in the community, and support the development of local 4-H groups.Sanford Medical Center Wheaton will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care Physical Health - Cancer, Inactivity or lack of exercise, Obesity Preventive Health - Flu shots
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Children and YouthSanford Bagley Medical Center has made children and youth a significant priority and has developed strategies to improve the health of newborns and young children, and to enhance the level of care that is available for high risk infants. Sanford clinic nurses will communicate with providers and other staff members about the services that are available to at-risk youth in the community. Sanford Ambassadors will provide educational materials and Text 4 Life bracelets at community events. Additionally, Sanford fit is an on-line community health activation initiative created by Sanford Health that provides engaging programs and resources to kids, families, leaders and role models across numerous settings to promote and activate healthy choices.Priority 2: Mental Health Sanford has developed strategies to reduce mortality and morbidity from tobacco use, and has set strategies for suicide prevention.Sanford will not directly develop strategy to address the availability of affordable housing and public transportation. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford will share the formally assessed issues with community leaders who have expertise in these areas.Sanford Bagley Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Transportation - Availability of public transportation Aging - Cost of long term care, Availability of long term care, Availability of resources for caregivers making decisions, Availability of memory care, Availability of resources to help the elderly stay in their homes, Availability of resources for grandparent caregivers for grandchildren, Understanding of advanced care directives Safety - Child abuse and neglect, Crime, Presence of street drugs, prescription drugs and alcohol, Presence of drug dealers, Domestic violence, Presence of gang activity, Elder abuse, Safe places for outdoor youth activities, Sex trafficking Health Care - Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs, Cost of affordable dental insurance, Use of emergency services for primary care, Cost of affordable vision insurance, Timely access to mental health/behavioral health providers, Availability of non-traditional hours, Timely access to physician specialists, Coordination of care between providers and services Physical Health - Cancer, Inactivity, Obesity Chronic disease, Poor nutrition Preventive Health - Flu shots
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Children and YouthSanford Canton-Inwood Medical Center will implement the Sanford fit Program curriculum in the local schools and childcare facilities, and will make the program available for families through the website.Priority 2: Physical Health Sanford will develop a wellness challenge, create a community health fair and bike rodeo to increase opportunities to improve physical health in the community.Sanford will not develop strategy to address the need for affordable housing or the availability of good walking and biking option. However, Sanford serves as a partner in many community groups that have the expertise to address these unmet needs. Sanford has convened community leaders to learn of the findings of the formalized assessment and the unmet needs in the community. Sanford Canton-Inwood Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Economics - Availability of affordable housing Transportation - Availability of good walking or biking options Aging - Cost of long term care, Availability of memory care, Availability of long term care, Availability of resources to help the elderly stay safe in their homes, Availability of activities for seniors, Availability of resources for family/friends caring for and making decisions for elders, Cost of activities for seniors Safety - Presence of street drugs and alcohol in the community, Presence of drug dealers in the community Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Use of the emergency room services for primary health care Mental Health/Behavioral Health - Underage drug use and abuse, Underage drinking, Depression, Smoking and tobacco use, Stress, Dementia and Alzheimer's disease, Binge drinking
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral HealthSanford Clear Lake Medical Center will establish mental health services through telemedicine. Sanford will develop a directory of mental health services that are available to community members and will distribute it widely to groups and organizations in the community.Priority 2: Physical HealthSanford will provide education on preventive services that are available in order to increase compliance with preventive screenings recommendations. The focus will be on colorectal screenings, mammography, vaccinations and diabetic foot care.Sanford Clear Lake Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of resources for family/friends caring for and making decisions for elders, Availability of memory care Children and Youth - Bullying, Availability of activities for children and youth, Cost of activities for children and youth, Children living in poverty, Children in single parent households Health Care - Access to affordable health insurance, Cost of affordable vision insurance, Cost of affordable dental insurance coverage, Access to affordable prescription drugs, Access to affordable health care, Unmet medical needs, Unmet mental health needs, Need prescription medications Safety - Presence of street drugs and alcohol in the community Substance Use and Abuse - Underage drinking, Underage drug use and abuse, Smoking and tobacco use, Alcohol use and abuse Preventive Health - Flu shots, Immunizations, Not seeing a health care provider or dentist in the past year
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 5:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area (Cass County, North Dakota and Clay County, Minnesota), the Bemidji area (Beltrami County in MN), the Bismarck area (Burleigh and Morton counties in ND), and the Sioux Falls area (Minnehaha, Lincoln, Turner and McCook counties in SD). A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included.A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity. Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University-Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the priority needs. In cases where identified needs have not been directly addressed it is because those needs fall outside of Sanford's expertise, or because Sanford is working with community partners to address the needs. The needs not addressed directly by Sanford are listed for each facility. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/about/community-health-needs-assessmentPriority 1: Mental Health/Behavioral HealthSanford Westbrook Medical Center has set strategy to decrease the time for patients who seek mental health services to be in the ER before placement, and to work with community partners to create new recovery program options. Sanford will also work with the Minnesota Department of Health on a pilot for integrating behavioral health into critical access hospitals.Priority 2: Physical Health Sanford has set strategy to improve the care of patients with chronic disease, overweight and obesity diagnosis. Patients will work with registered dietitians, exercise specialists, and Health Coaches. Additionally, Sanford will work with the local school leadership to implement Sanford fit into the schools and community.Sanford Westbrook Medical Center will standardize narcotic prescribing protocols across the enterprise to reduce usage. Narcotic prescriptions will be tracked internally and areas for improvement will be identified.Identified needs not directly addressed by this facility include: Aging - Cost of long term care, Availability of memory care, Availability of resources for family/friends caring for and making decisions for elders Children and Youth - Bullying Safety - Presence of street drugs and alcohol in the community Health Care - Access to affordable health insurance, Access to affordable health care, Access to affordable prescription drugs
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individual circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population.The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy

Field	Value	IRS element (for citing)
Facility	95	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (95 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - Sanford USD Medical Center Dialysis
1305 W 18th Street	Sioux Falls	SD	57117	End Stage Renal Dialysis
2 - Sanford Dialysis Detroit Lakes
114 East Frazee Street	Detroit Lakes	MN	56501	Dialysis
3 - Sanford Clinic Sheldon
800 Oak Street	Sheldon	IA	51201	Rural Health Clinic
4 - Sanford Health Neilson Place
803 Dewey Avenue	Bemidji	MN	56601	Skilled Nursing Facility
5 - Sylvan Place
212 St Olaf Avenue S	Canby	MN	56220	Housing with Services
6 - Sanford Dialysis Fargo
2801 S University Drive	Fargo	ND	58122	Dialysis
7 - Sanford Home Care Fargo
100 4th Street S	Fargo	ND	58103	Home Health Agency
8 - Sanford Dialysis Thief River Falls
120 Labree Avenue S	Thief River Falls	MN	56701	Dialysis
9 - Sanford Mid-Dakota Dialysis
300 S Byron Blvd	Chamberlain	SD	57325	End Stage Renal Dialysis
10 - Sanford Care Center Vermillion
20 S Plum Street	Vermillion	SD	57069	Nursing Facility
11 - Sanford Dialysis Red Lake
24760 Hospital Drive Box 249	Red Lake	MN	56671	Dialysis
12 - Sanford Tom & Frances Leach Bismarck Dia
300 N 7th Street	Bismarck	ND	58501	Kidney Dialysis
13 - Sanford Dialysis Morris
400 East 1st Street	Morris	MN	56267	Dialysis
14 - Sanford Senior Care Sheldon
118 North Seventh Avenue PO Box 250	Sheldon	IA	51201	Hospital Based-Nursing Facilities
15 - Sanford Clinic Rock Rapids
803 South Green Street	Rock Rapids	IA	51246	Rural Health Clinic
16 - Sanford Hillsboro Care Center
12 3rd Street SE	Hillsboro	ND	58045	Hospital Based-Nursing Facilities
17 - Sanford Clinic Watertown Surgical Center
901 4th Street NW	Watertown	SD	57201	Ambulatory Surgery Center
18 - Sanford Chamberlain Care Center
300 S Byron Blvd	Chamberlain	SD	57325	Nursing Facility
19 - Sanford Clinic Canby
112 St Olaf Avenue	Canby	MN	56220	Medicare Certified Rural Health Clinic
20 - Sanford Worthington Medical Center
1018 Sixth Avenue	Worthington	MN	56187	Medicare Certified End Stage Renal Dialysis
21 - Sanford Clinic Tracy
251 Fifth Street East	Tracy	MN	56175	Medicare Certified Rural Health Clinic
22 - Sanford Clinic Webster
101 Peabody Drive	Webster	SD	57274	Rural Health Clinic
23 - Sanford Health Dickinson Ambulatory Surg
2615 Fairway Street	Dickinson	ND	58601	Ambulatory Surgery Center
24 - Sanford Bemidji Home Care
3807 Greenleaf NW Avenue	Bemidji	MN	56601	Home Health Agency
25 - Sanford Dialysis Bemidji
1300 Anne Street NW	Bemidji	MN	56601	Dialysis
26 - Sanford Health Dialysis Hospers
112 Sunrise Drive	Hospers	IA	51239	End Stage Renal Dialysis
27 - Sanford Health Windsong
1010 Anne Street N	Bemidji	MN	56601	Assisted Living Center
28 - Sanford Clinic Jackson
1430 North Highway	Jackson	MN	56143	Medicare Certified Rural Health Clinic
29 - Sanford Visiting Nurses Association
2710 West 12th Street	Sioux Falls	SD	57104	Professional Home Care Agency (licensed in MN and SD)
30 - Sanford Clinic Mt Lake
308 8th Street	Mountain Lake	MN	56159	Medicare Certified Rural Health Clinic
31 - Sanford Bagley Clinic
123 4th Street NW	Bagley	MN	56621	Rural Health Clinic
32 - Sanford Health Walker Clinic
614 Michigan Avenue	Walker	MN	56484	Rural Health Clinic
33 - Sanford Health Hillsboro Clinic
315 East Caledonia	Hillsboro	ND	58045	Rural Health Clinic
34 - Sanford Bemidji Hospice
3525 Pine Ridge Avenue NW	Bemidji	MN	56601	Hospice
35 - Sanford Home Care Home Health
910 18th Street NW	Mandan	ND	58554	Home Health Agency
36 - Sanford Hospice
2710 West 12th Street	Sioux Falls	SD	57104	Hospice (licensed in MN and SD)
37 - Sanford Health Detroit Lakes ASC
1245 Washington Avenue	Detroit Lakes	MN	56501	Ambulatory Surgery Center
38 - Sanford Health Mahnomen Clinic
414 West Jefferson PO Box 396	Mahnomen	MN	56557	Rural Health Clinic
39 - Sanford Clinic Aberdeen Surgical Center
3015 3rd Avenue SE	Aberdeen	SD	57401	Ambulatory Surgery Center
40 - Sanford Home Health and Hospice
118 North Seventh Avenue PO Box 250	Sheldon	IA	51201	Home Health Agency
41 - Sanford Health Pelican Rapids Clinic
211 East Mill Street	Pelican Rapids	MN	56572	Rural Health Clinic
42 - Sanford Clinic Westbrook
920 Bell Avenue	Westbrook	MN	56183	Medicare Certified Rural Health Clinic
43 - Sanford Hospice
1151 Ryans Road Suite 100	Worthington	MN	56187	Hospice (licensed in SD)
44 - Sanford Health Trillium
930 Anne Street N	Bemidji	MN	56601	Assisted Living Center
45 - Sanford Clinic Windom
591 2nd Avenue N	Windom	MN	56101	Medicare Certified Rural Health Clinic
46 - Sanford Behavioral Health Center
120 Labree Avenue S	Thief River Falls	MN	56701	Behavioral Health Treatment Center
47 - Orchard Hills
200 W 10th Street	Dell Rapids	SD	57022	Assisted Living Center
48 - Sanford Fort Yates Dialysis
Box J	Fort Yates	ND	58538	Kidney Dialysis
49 - Sanford Jamestown Dialysis
300 2nd Avenue NE	Jamestown	ND	58401	Kidney Dialysis
50 - Sanford Clear Lake Clinic
701 3rd Avenue S	Clear Lake	SD	57226	Rural Health Clinic
51 - Sanford Clinic Ipswich
110 5th Avenue	Ipswich	SD	57451	Rural Health Clinic
52 - Sanford Clinic Beresford
600 W Cedar Street	Beresford	SD	57004	Rural Health Clinic
53 - Sanford Clinic Clark
117 W 1st Avenue	Clark	SD	57225	Rural Health Clinic
54 - Sanford Transplant Center
736 Broadway	Fargo	ND	58122	Transplant Center
55 - Sanford Madison Dialysis
323 SW 10th Street	Madison	SD	57042	End Stage Renal Dialysis
56 - Sanford Home Care Hospice
910 18th Street NW	Mandan	ND	58554	Hospice
57 - Sanford Worthington Home Care
1018 Sixth Avenue	Worthington	MN	56187	Medicare Certified Home Health Agency
58 - Sanford Luverne Hospice
211 East Main Street Suite 101	Luverne	MN	56156	Medicare Certified Hospice
59 - Shetek Home Care
251 Fifth Street E	Tracy	MN	56175	Medicare Certified Home Health Agency
60 - Baker Park Inc
803 Dewey Avenue	Bemidji	MN	56601	Assisted Living Center
61 - Sanford Canby Dialysis Unit
112 St Olaf Avenue	Canby	MN	56220	Medicare Certified End Stage Renal Dialysis
62 - Sanford Canby Med Center
213 St Olat Avenue N Ste B	Canby	MN	56220	Medicare Certified Home Health Agency
63 - Sanford Clinic Lakefield
209 Main Street PO Box 546	Lakefield	MN	56150	Medicare Certified Rural Health Clinic
64 - Sanford Home Health and Hospice Sheldon
118 North Seventh Avenue	Sheldon	IA	51201	Hospice
65 - Sanford Transplant Center
300 N 7th Street	Bismarck	ND	58501	Transplant Center
66 - Sanford Rock Rapids George Clinic
101 N Main	George	IA	51237	Rural Health Clinic
67 - Sanford Clinic Lennox
108 S Main	Lennox	SD	57039	Rural Health Clinic
68 - Sanford Health LaMoure Clinic
Omega City Plaza	Lamoure	ND	58458	Rural Health Clinic
69 - Sanford Health Enderlin Clinic
201 4th Avenue Suite 1	Enderlin	ND	58027	Rural Health Clinic
70 - O'Brien Court
410 State Street	Tracy	MN	56175	Housing with Services
71 - Sanford Visiting Nurses Assoc-Luverne
211 East Main Street Suite 101	Luverne	MN	56156	Home Health Care
72 - Dakota Gardens Senior Living
126 S Plum Street	Vermillion	SD	57069	Residential Living Center
73 - Sanford Hiawatha Heights
398 N Hiawatha Drive	Canton	SD	57013	Assisted Living Center
74 - Sanford Clinic Sanborn
321 Main Street	Sanborn	IA	51201	Rural Health Clinic
75 - Sanford Clinic Estelline
305 Hospital Drive	Estelline	SD	57234	Rural Health Clinic
76 - Sanford Clinic Lake Norden
Main Street	Lake Norden	SD	57248	Rural Health Clinic
77 - Sanford Health Ellendale Clinic
PO Box 306	Ellendale	ND	58436	Rural Health Clinic
78 - Peterson Estates
1012 9th Street	Westbrook	MN	16183	Housing with Services
79 - Sanford Health Halstad Clinic
445 1st Street E	Halstad	MN	56548	Rural Health Clinic
80 - Sanford Hospice
20 S Plum Street	Vermillion	SD	57069	Hospice
81 - Sanford Visiting Nurses Assoc-Vermillion
20 S Plum Street	Vermillion	SD	57069	Home Health Care
82 - Sanford Health Twin Valley Clinic
212 Main Avenue W	Twin Valley	MN	56584	Rural Health Clinic
83 - Sanford Health Forman Clinic
PO Box 184	Forman	ND	58032	Rural Health Clinic
84 - Sanford Health Ulen Clinic
108 Viking Avenue W	Ulen	MN	56585	Rural Health Clinic
85 - Sanford Canby Medical Center
112 St Olaf Avenue S	Canby	MN	56220	Class F Home Care Provider
86 - Sanford Clear Lake Medical Center
701 3rd Avenue S	Clear Lake	SD	57226	Home Health Care
87 - Sanford Hospice Centennial Cottage
6301 W 43rd Street	Sioux Falls	SD	57106	Residential Hospice
88 - Sanford Hospice Foundation Cottage
6309 W 43rd Street	Sioux Falls	SD	57106	Residential Hospice
89 - Sanford Bagley Clearbrook Clinic
22 Elm Street	Clearbrook	MN	56634	Rural Health Clinic
90 - Sanford Hospice
900 2nd Avenue	Madison	MN	56256	Hospice (licensed in SD)
91 - Sanford Hospice
745 E 8th Street	Winner	SD	57580	Hospice
92 - Sanford Clinic Balaton
Highway 14E	Balaton	MN	56115	Medicare Certified Rural Health Clinic
93 - Sanford Visiting Nurses Assoc-Chamberlai
110 W Beede Ste 1	Chamberlain	SD	57325	Home Health Care
94 - Sanford Tracy Walnut Grove Clinic
830 Eighth Street	Walnut Grove	MN	56180	Medicare Certified Rural Health Clinic
95 - Sanford Hospice
300 S Byran Blvd	Chamberlain	SD	57325	Hospice

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 3c:	Sanford Health does not deny care to anyone based on the ability to pay. Sanford's Financial Assistance (charity care) policy provides discounted and free services to patients who lack the resources to be fully responsible for the healthcare they receive. The Financial Assistance Policy is designed to ensure the entire community served by Sanford has access to needed healthcare services. Eligibility for discounted or free services under the Financial Assistance Policy is based on income levels and family size. Generally, individuals earning income of up to 375% of the Federal Poverty Income Guidelines are eligible for varying levels of discounts, including full discounts for certain income levels. Applications for coverage under the program may be obtained at any Sanford patient registration area.The primary scope of Sanford's financial assistance matrix considers family income and family size to objectively determine financial need. The family income range varies from 0-225% up to 375% of the Federal Poverty Level (FPL). An applicant over 375% may be eligible for some level of financial assistance based on a review of additional factors such as: the size of the account balance, debt-to-income ratio, current assets, current liabilities, IRS food expense allowances, monthly cash flow, etc.Additionally, it is possible for a family to qualify in one segment (based on income and family size alone) but be moved to a more generous (for the patient) segment based on the other financial variables mentioned above. An applicant may be denied if they have substantial assets and applicants are considered on a case by case basis.Part I, Line 5b: Sanford as a whole did exceed its financial assistance budget for FY16, however, exceeding that budget did not impact the ability to serve any patients and no patients were disallowed services. The organization provided free or discounted services to patients who were eligible for free or discounted care.Part I, Line 6: Sanford Health prepared a Community Benefit Annual Report for FY 2016. This report is posted annually on the Sanford website at:http://www.sanfordhealth.org/About/CommunityBenefit
Part I, Line 7:	Cost to Charge Ratios are used to calculate the amounts on Line 7a - 7c (Financial Assistance, Medicaid Shortfall, and Other Means-Tested Government Programs) and also Line 7g (Subsidized Health Services) for each of the subsidiaries included in the return. All other amounts for Lines 7e, 7f, 7h and 7i would come from the books and records of specific segments of the organization and would not be based on a Cost to Charge Ratio, or similar cost accounting methodology.
Part I, Line 7g:	Subsidized health services are clinical services provided to both inpatients and outpatients despite a financial loss to Sanford. Each loss has been calculated after removing losses associated with bad debts, financial assistance and Medicaid. Although these services generate overall losses to Sanford, they continue to meet the needs of the communities served. Various services that generate losses are provided by Sanford through physician practices. For FY 2016, subsidized health services provided through these physician practices generated losses of $36,563,971.
Part II, Community Building Activities:	Sanford Health is a not-for-profit organization dedicated to the work of health and healing for the public good. Sanford is committed to giving back to the communities in which its employees and patients live and work. Sanford invests resources in order to produce the best outcomes for patient care, education, research, and community enrichment, and partners with others to ensure that the community is a welcoming, healthy environment and one that attracts and sustains a diverse Sanford workforce to deliver the best patient care and much needed medical research. Sanford considers requests for funding and in kind support for new and ongoing programs with all areas supporting the above goals, such as basic human services, education and workforce development by recruiting physicians and other health professionals to medical shortage or underserved areas and collaborating with educational institutions to train and recruit health professionals, advocating community health improvement through efforts to support policies and programs that safeguard or improve public health and help to ensure access to health care services.
Part III, Line 2:	Bad debt expense at cost is determined using the same cost to charge ratios that are used to calculate Financial Assistance and Medicaid Shortfall. Discounts and allowances are accounted for separately from Bad Debt Expense.
Part III, Line 3:	It is Sanford's policy to make financial assistance available to patients who fit the financial assistance criteria. It is the organization's goal to make certain that Sanford is proactive in identification of the patients who need help with financial concerns. Financial counselors make every effort to ensure that financial assistance eligible patients do not progress to bad debt. For this reason, a dollar amount for bad debt is not included.
Part III, Line 4:	The audited financial statements of Sanford do not include a bad debt footnote. Sanford reports bad debt in accordance with generally accepted accounting principles (GAAP).
Part III, Line 8:	Per IRS instructions, Sanford has identified the cost associated with providing Medicare services from the Medicare cost report. The Medicare cost report calculations are total expense less expenses deemed "unallowable" per Medicare regulations. The net expense is then used to calculate the cost per day and cost to charge ratios which are multiplied by the Medicare days and ancillary charges to determine the cost of providing Medicare services. If all expenses that Sanford incurred were included on the Medicare cost report; this would show a shortfall of approximately $179,909,572. Sanford believes this shortfall should be considered community benefit because these services would need to be provided by either another charitable organization or the government if it was not provided by Sanford.
Part III, Line 9b:	Sanford will provide services at no cost or reduced cost to patients who qualify for the program. Patients with incomes at or below 225% of the United States Department of Health and Human Services poverty guideline will receive a 100% reduction of their payment responsibility. Patients with income between 225% - 375% of the poverty guideline will be given a discount based on a sliding scale and assets are considered in the calculation of the income of the patient, with the exception of the patient's principal residence. Patients above 375% of the FPG will be reviewed for additional factors such as size of medical debt before a final determination. Patients must make their financial need known to appropriate personnel and be engaged in filing appropriate and complete applications. The program is available to those patients without health care benefits from any source as well as to those who have coverage for health care costs through a government program, commercial insurance, or other health benefit plan but continue to have a remaining balance after benefits have been applied to the charges. Sanford will not deny financial assistance based on race, creed, sex, national origin, handicap or age.Every effort is made to identify patients with financial need as early as possible in the revenue cycle.Sanford has zero tolerance for abusive, harassing, oppressive, false, deceptive, or misleading language of collections conduct. This zero tolerance applies to internal Sanford staff and third party collection vendors and attorneys.Neither Sanford nor any of its third party collection vendors will take any extraordinary collection efforts until Sanford and the third party collection vendor have made reasonable efforts to determine if a patient is eligible for financial assistance under the Financial Assistance Policy.
Part VI, Line 2:	Sanford conducted a community health needs assessment during FY 2016 in 24 communities throughout the enterprise. Sanford Health worked in partnership with Public Health Units across the organization's footprint to develop the methodology for the 2016 CHNA. Sanford requested input from community and county leaders, public health administration, physicians, nurses, representatives from the community and representatives of diverse populations through a series of community stakeholder meetings. Sanford extended a good faith effort to engage all of the aforementioned community representatives in the CHNA process. The names of community stakeholders who participated in the CHNA process are listed in the acknowledgement section for each medical center's CHNA report.A generalizable survey was conducted of residents in the Fargo area -Cass County, North Dakota and Clay County, Minnesota, the Bemidji area - Beltrami County in MN, the Bismarck area - Burleigh and Morton counties in ND, and the Sioux Falls area - Minnehaha, Lincoln, Turner and McCook counties in SD. A stratified random sample was obtained through a qualified vendor, to ensure that appropriate proportions from each of the counties were included. A non-generalizable on-line survey was conducted for all of the Sanford Medical Centers through a partnership between Sanford and the Center for Social Research (CSR) at North Dakota State University. The purpose of this non-generalizable survey of community leaders was to learn about the perceptions of area community leaders regarding community health, their personal health, preventive health, and the prevalence of disease. This group included community leaders, legislators, and agency leaders representing chronic disease and disparity.A Likert scale was developed to determine the respondent's highest concerns. Needs ranking 3.5 and above were included in the needs to be addressed and prioritized. Many of the identified needs that ranked below 3.5 are being addressed by Sanford. However, 3.5 and above was used as a focus for the purpose of the required prioritization. Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity. Each identified need was researched to determine what resources are available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were researched through asset mapping. Each Sanford Health Medical Center invited community stakeholders to meet, review the findings of the research, develop the asset/resources map, and determine the key priorities to address by implementation strategies during FY 2017-2019. Individuals who were invited to attend included county commissions, city council members, school board members, and agencies representing the chronic disease groups and disparity.Community stakeholders helped to determine key priorities for their respective communities.A listing of the community stakeholders can be found in each published CHNA at: http://www.sanfordhealth.org/about/community-health-needs-assessment Public comments and response to the community health needs assessment and the implementations strategies are welcome on the Sanford website under "About Sanford" in the Community Health Needs Assessment section. The only comment received since the publications on the Sanford website was a question asking if a CHNA was conducted in a rural area where Sanford does not have a medical center. The following community leadership members contributed their expertise with the planning, development and analysis of the community health needs assessment. Each member met multiple times during the CHNA process to guide and advise the team.-Sioux Falls Public Health-Pennington County Public Health-Beltrami Public Health-Traill County Public Health-Steele County Public Health-City of Halstad-South Dakota Department of Health-Clay County Public Health-South Dakota State University-Center for Social Research, North Dakota State University -Center for Rural Health -Burleigh County Public Health-Fargo Cass Public Health-South Dakota Department of Health-North Dakota Department of Health-North Dakota Public Health Association, in partnership with the American Indian CHNA
Part VI, Line 3:	Sanford employs a variety of strategies to make certain that the organization is transparent in the communication of financial assistance guidelines. The staff at Sanford makes every effort to identify patients needing financial assistance as early in the revenue cycle as possible. All Sanford entities display signage in registration areas advising patients of their ability to request financial assistance. The signage is made available in English and Spanish. Financial Assistance applications are available in English or Spanish upon request.All healthcare workers who identify patients with financial need are encouraged to provide patients or their designees a financial application. This may include, but not be limited to the following areas: Administration, Admissions, Patient Financial Services, Financial Counselors, Social Services, Physicians, Nursing, Clinic Director, Reception staff and Human Resources.Financial Counselors are trained to work individually with patients to determine the financial need and recommend appropriate assistance in application for charity care, government programs or discounted services.Sanford's Financial Assistance Program is available to anyone who qualifies for assistance. This program ensures that all people receive the care they need, regardless of their financial situation. Sanford makes Financial Assistance information available to community agencies and referral organizations. Financial Assistance information is also available on the Sanford website at:http://www.sanfordhealth.org/patients-visitors/patient-information/financial-assistance-policy
Part VI, Line 4:	Sanford Health is an integrated health system headquartered in the Dakotas. It is one of the largest health systems in the nation with 43 hospitals and nearly 250 clinics in nine states and three countries. Sanford Health's 27,000 employees, including 1,400 physicians, make it the largest employer in the Dakotas. Sanford USD Medical Center - Sioux Falls, South DakotaSioux Falls is the largest city in the state of South Dakota and is the County seat of Minnehaha County. Sioux Falls also extends into Lincoln County. The 2015 U.S. Census Bureau estimates a total population of 171,544 for Sioux Falls. According to the 2016 County Health Rankings, the population of Minnehaha County is 84.2% white, 4.5% African American, 2.7% American Indian, 1.9% Asian and 4.9% Hispanic. Sioux Falls is a significant regional health care center. Only 2% of the population is reported to be not proficient in English. The median household income in Sioux Falls is $52,494.Sanford Medical Center Fargo - Fargo, North DakotaFargo is the largest city in North Dakota, accounting for 15% of the state's population. Fargo is also the county seat of Cass County. The 2015 United States Census estimates the population of Fargo was 118,523. According to the 2016 County Health Rankings, the population of Cass County is 88.5% white, 3.6% African American, 1.3% American Indian, 2.6% Asian and 2.4% Hispanic. Only 1% of the population is reported to be not proficient in English. The median household income is $46,175. Sanford Bemidji Medical Center - Bemidji, MinnesotaBemidji is located in Beltrami County, Minnesota. Bemidji houses many Native American Services, including the Indian Health Service. The city is the central hub of the Red Lake Indian Reservation, White Earth Indian Reservation, and the Leech Lake Indian Reservation. According to the 2015 United States Census estimates, the population of Bemidji is 14,594. According to the 2016 County Health Rankings, the population of Beltrami County is 73.3% white, 0.7% African American, 21% American Indian, 0.7% Asian and 2.0% Hispanic. 0% of the population is reported to be not proficient in English. The median household Income is $35,610.Sanford Bismarck Medical Center - Bismarck, North DakotaBismarck is a city located in Burleigh County in central North Dakota. Bismarck is experiencing fast-paced growth as a direct result of oil development throughout the western part of the state. Bismarck is the state capital and is the second largest city on the state of North Dakota with a population 71,167. According to the 2016 County Health Rankings, the population of Burleigh County is 90.8% white, 1.1% African American, 4.1% American Indian, 0.7% Asian and 1.9% Hispanic. 0% of the population is reported to be not proficient in English. The median household income is $58,901.Sanford Network HospitalsSanford Health Network Hospitals is a network of rural hospitals located throughout South Dakota, North Dakota, Minnesota, and Iowa.Sanford ClinicsSanford Clinic is a multi-specialty clinic comprised of 1,400 physicians providing services in the US as well as internationally.
Part VI, Line 5:	Sanford maintains an open medical staff. Community Boards - The Sanford Board of Trustees was comprised of 15 members at the end of the fiscal year, including 10 volunteer community members, 4 physicians and the CEO. Surplus Funds - Surplus funds are invested back into the community, as well as to resource development and facility development to better serve patients and communities.
Part VI, Line 6:	Sanford Health is an integrated health system headquartered in the Dakotas. It is one of the largest health systems in the nation with 43 hospitals and nearly 250 clinics in nine states and three countries. Sanford Health's 27,000 employees, including 1,400 physicians, make it the largest employer in the Dakotas.Sanford Health provides services at every level from critical access hospitals to tertiary and quaternary care. The Sanford footprint includes over 220,000 square miles with a nine state service area and a network of children's primary care clinic locations across the country and world. Sanford Health operates full-time emergency centers and provides emergency care to everyone regardless of their ability to pay. Sanford facilities and clinics provide services to remote and medically underserved areas that would otherwise not have access to even primary care services. Sanford Health financially supports health and wellness, education and community development activities to improve the quality of life and strenghten communities throughout the region. Each facility promotes health and healing that responds to the unique needs of the patients in the community, ensuring access to comprehensive and specialized services. Part VI, Line 7: Community benefit reporting is not required and therefore not filed in North Dakota, South Dakota, Nebraska or Iowa. Filing in Minnesota is voluntary.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (109 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
Aberdeen Catholic School System
1400 N Dakota Street	Aberdeen	SD	57401	460334005	501(c)(3)	$32,700	Roncalli Revitalizing project
Aberdeen Development Corporation
416 Production St N	Aberdeen	SD	57401	466011831	501(c)(6)	$7,500	General support
Aberdeen Family YMCA
5 South State Street	Aberdeen	SD	57401	460255779	501(c)(3)	$6,500	General support
American Academy of Pediatrics (Reach Out and Read)
PO Box 22212	San Diego	CA	92192	330782521	501(c)(3)	$7,500	General support
American Cancer Society
4904 S Technopolis Dr	Sioux Falls	SD	57106	410724036	501(c)(3)	$52,658	General support
American Heart Association Inc
7272 Greenville Ave	Dallas	TX	75231	135613797	501(c)(3)	$110,291	General support
Arthritis Foundation - Upper Midwest Region
PO Box 1208	Fargo	ND	58107	390860526	501(c)(3)	$28,000	General support
Augsburg College
2211 Riverside Avenue	Minneapolis	MN	55454	410694721	501(c)(3)	$7,500	General support
Augustana College
2001 S Summit Ave	Sioux Falls	SD	57197	460224588	501(c)(3)	$1,393,751	AD Leadership fund, Support athletic club
Bemidji State University
1500 Birchmont Dr NE	Bemidji	MN	56601	237044156	501(c)(3)	$51,750	General support
Big Brothers Big Sisters of the Sioux Empire
1108 N West Ave Suite B	Sioux Falls	SD	57104	050593016	501(c)(3)	$7,500	General support
Boys and Girls Club of Sioux Empire
824 E 14th St	Sioux Falls	SD	57104	460399482	501(c)(3)	$28,000	General support
Brandon Valley Booster Club
PO Box 572	Brandon	SD	57005	466002577	501(c)(6)	$19,301	General support
Charis Ministry Partners
1300 E 10th Street	Sioux Falls	SD	57103	383775128	501(c)(3)	$7,000	General support
Childrens Home Society Foundation
801 N Sycamore Ave PO Box 1749	Sioux Falls	SD	57101	460224542	501(c)(3)	$24,500	General support
Children's Ark Inc
112 W 16th Avenue	Chamberlain	SD	57325	204089044	501(c)(3)		General support	$40,370	Book	Land
Children's World Care
1221 E 6th Street PO Box 235	Sheldon	IA	51201	421036015	501(c)(3)	$6,000	General support
City of Kimball
PO Box 16	Kimball	SD	57355	466000248	115	$50,000	Health Clinic project
Concordia College Corporation
901 S 8th St	Moorhead	MN	56562	410693977	501(c)(3)	$1,102,750	General support
Cullen Children's Foundation
PO Box 594	West Fargo	ND	58078	770636521	501(c)(3)	$20,000	General support
Cystic Fibrosis Foundation
8011 34th Ave S Ste 116	Bloomington	MN	55425	131930701	501(c)(3)	$36,000	General support
Dakota Alliance Soccer Club
401 W 39th Street	Sioux Falls	SD	57105	460359817	501(c)(3)	$63,175	General support
Dakota Hospital Foundation
20 S Plum Street	Vermillion	SD	57069	460226067	501(c)(3)	$100,500	Becky and David Nelson endowment
Dakota Schoolers
1809 W Oak Street	Sioux Falls	SD	57105	203452350	501(c)(3)	$37,500	Scholarships
Dakotabilities Inc
3600 S Duluth Avenue	Sioux Falls	SD	57105	460306216	501(c)(3)	$41,000	General support
Downtown Community Partnership
210 Broadway N Suite 202	Fargo	ND	58102	464472309	501(c)(6)	$20,000	General support
Downtown Sioux Falls Inc
230 S Phillips Avenue 102	Sioux Falls	SD	57104	363627217	501(c)(4)	$7,000	General support
Face It Together Inc
231 S Phillips Avenue 201	Sioux Falls	SD	57104	272501220	501(c)(3)	$295,000	Addiction recovery coaching, Community addiction services
Family HealthCare Center
301 NP Avenue	Fargo	ND	58102	450430628	501(c)(3)	$10,000	General support
Fargo Youth Hockey Association
831 17th Avenue N	Fargo	ND	58102	363548649	501(c)(3)	$10,250	General support
Feeding South Dakota
3511 N 1st Avenue	Sioux Falls	SD	57104	363293534	501(c)(3)	$10,000	General support
First Tee of SD
2604 West Russell St	Sioux Falls	SD	57104	460449824	501(c)(3)	$44,000	General support
Forward Sioux Falls
PO Box 907	Sioux Falls	SD	57101	460396647	501(c)(6)	$300,000	General support
Friends of the North Dakota Governor's Residence Council
PO Box 1914	Bismarck	ND	58502	363646958	501(c)(3)	$100,000	North Dakota Governor's Residence
Great Plains Zoo
805 S Kiwanis Ave	Sioux Falls	SD	57104	466015015	501(c)(3)	$77,667	General support
Greater Fargo Moorhead Economic Development Corporation
51 Broadway Suite 500	Fargo	ND	58102	456011769	501(c)(3)	$40,000	General support
Habitat for Humanity Greater Sioux Falls
721 E Amidon St	Sioux Falls	SD	57104	460407140	501(c)(3)	$10,500	General support
Health Occupations Students of America (ND Chapter)
PO Box 615	Hettinger	ND	58639	510249380	501(c)(3)	$12,000	General support
Horatio Alger Association of Distinguished Americans Inc
99 Canal Center Plaza Suite 320	Alexandria	VA	22314	131669975	501(c)(3)	$21,750	General support
Ice Sports Association
108 S Dakota Ave	Sioux Falls	SD	57104	271234271	501(c)(3)	$155,000	General support
Junior Achievement of South Dakota
1000 N West Ave 110	Sioux Falls	SD	57104	460306352	501(c)(3)	$26,250	General support
Juvenile Diabetes Research Foundation (JDRF) South Dakota
1301 W 18th Street	Sioux Falls	SD	57117	231907729	501(c)(3)	$25,000	General support
Leadership South Dakota
PO Box 675	Platte	SD	57369	460398115	501(c)(3)	$30,000	General support
Legends of Gold Inc
Box 287	Beresford	SD	57004	273794971	501(c)(3)	$25,000	General support
Lifescape (SD Achieve & Children's Care Foundation)
2501 W 26th St	Sioux Falls	SD	57105	460233030	501(c)(3)	$37,000	General support
Lifesource
2225 West River Road N	Minneapolis	MN	55411	363584029	501(c)(3)	$10,000	General support
Lincoln High School
201 E 38th Street	Sioux Falls	SD	57105	466002586	501(c)(3)	$14,991	General support
Luverne Hockey Club
905 N Kniss Ave	Luverne	MN	56156	411685848	501(c)(3)	$10,000	General support
Make-A-Wish Foundation of North Dakota
1102 43rd St SW Suite E	Fargo	ND	58103	450393770	501(c)(3)	$5,000	General support
Make-A-Wish Foundation of South Dakota
1400 West 17th Street	Sioux Falls	SD	57104	460375953	501(c)(3)	$15,000	General support
Matson Halverson Christiansen Hamilton Foundation
201 South Main Street	Kimball	SD	57355	460461691	501(c)(3)	$25,000	General support
Mayville State University Foundation
330 3rd St NE	Mayville	ND	58257	456013477	501(c)(3)	$24,500	General support
McCrossan Boys Ranch
47135 260th Street	Sioux Falls	SD	57107	460311913	501(c)(3)	$16,933	General support
McKenzie County Healthcare Systems Inc
516 N Main	Watford City	ND	58854	770637498	501(c)(3)	$100,000	Medical facility
Mike Miller Foundation
2107 Quiett Lane	Mitchell	SD	57301	300015773	501(c)(3)	$10,000	General support
Minnesota State University Moorhead Alumni Foundation
1104 7th Avenue S	Moorhead	MN	56563	237106061	501(c)(3)	$210,250	Scholarships
Moorhead Technical College Foundation Inc
1900 28th Avenue S	Moorhead	MN	56560	363366589	501(c)(3)	$33,711	Scholarships
National Audubon Society Inc (Audubon Dakota)
118 Broadway N Suite 716	Fargo	ND	58102	131624102	501(c)(3)	$7,500	General support
National Kidney Foundation
1970 Oakcrest Ave Suite 208	St Paul	MN	55113	131673104	501(c)(3)	$20,300	General support
National Multiple Sclerosis Society Upper Midwest Chapter
200 12th Ave S	Minneapolis	MN	55415	410790658	501(c)(3)	$25,000	General support
NDSCS Foundation
800 6th Street North	Wahpeton	ND	58067	450407617	501(c)(3)	$18,750	Scholarships
North Dakota American Legion Foundation
PO Box 5057	West Fargo	ND	58078	450368212	501(c)(3)	$11,250	General support
Northern State University Foundation
620 15th Ave SE	Aberdeen	SD	57401	237002314	501(c)(3)	$406,060	General support
Northern Sun Intercollegiate Conference
2999 County Road 42 West Suite 136	Burnsville	MN	55306	411783486	501(c)(3)	$240,000	Scholarships
Philanthropy Promotions Inc
2601 W 60th Street North	Sioux Falls	SD	57107	870695596	501(c)(3)	$7,500	General support
Red River Zoological Society
4255 23rd Avenue S	Fargo	ND	58104	363938878	501(c)(3)	$45,000	General support
Ronald McDonald House
825 S Lake Ave	Sioux Falls	SD	57104	460371152	501(c)(3)	$40,000	General support
Roosevelt High School
201 E 38th Street	Sioux Falls	SD	57105	466002586	501(c)(3)	$20,793	General support
Samaritan's Feet International
PO Box 78992	Charlotte	NC	28271	141880905	501(c)(3)	$150,000	Champions of Hope
Sanford Health Foundation Hillsboro
PO Box 609	Hillsboro	ND	58045	363542187	501(c)(3)	$50,000	General support
Sanford Health Foundation North
PO Box 2010	Fargo	ND	58122	450398104	501(c)(3)	$122,621	NICU, General support
SculptureWalk Inc
300 S Phillips Avenue	Sioux Falls	SD	57104	208535871	501(c)(3)	$202,500	Arc of Dreams
SD Basketball Coaches Association
1404 Yosemite Lane	Brookings	SD	57006	811379554	501(c)(3)	$7,500	Scholarships
SD Law Enforcement Charities
5214 Sweetbriar Court	Sioux Falls	SD	57108	460440378	501(c)(3)	$10,000	General support
SD Parks and Wildlife Foundation
523 E Capitol Ave	Pierre	SD	57501	460387968	501(c)(3)	$10,000	General support
SD Synod
2001 S Summit Ave	Sioux Falls	SD	57197	363512774	501(c)(3)	$10,000	General support
SDSU Foundation
815 Medary Ave PO Box 525	Brookings	SD	57007	460273801	501(c)(3)	$1,683,740	Sanford/SDSU SEED grants, Sports Medicine, General support
SF Cyclones
7605 Loganberry St	Sioux Falls	SD	57106	274705069	501(c)(3)	$27,500	General support
SF Diversity Council
1000 N West Ave Suite 400	Sioux Falls	SD	57104	273111451	501(c)(3)	$6,500	Youth initiative
Shiloh Christian School
1915 Shiloh Dr	Bismarck	ND	58503	450348120	501(c)(3)	$72,000	General support
Sioux Council Boy Scouts of America Inc
800 N West Avenue	Sioux Falls	SD	57104	460224599	501(c)(3)	$11,600	General support
Sioux Empire United Way
1000 North West Ave 120	Sioux Falls	SD	57104	460233701	501(c)(3)	$223,465	General support
Sioux Empire Baseball Association
1601 W 44th Place	Sioux Falls	SD	57105	411903475	501(c)(3)	$6,000	General support
Sioux Falls Area Community Foundation Inc
200 N Cherapa Place	Sioux Falls	SD	57103	311748533	501(c)(3)	$30,000	General support
Sioux Falls Catholic Schools
3100 W 41st St	Sioux Falls	SD	57105	460413591	501(c)(3)	$253,000	Teacher endowment, General support
Sioux Falls Christian
6120 Charger Circle	Sioux Falls	SD	57109	460340024	501(c)(3)	$17,500	General support
Sioux Falls Schools
201 E 38th Street	Sioux Falls	SD	57105	466002586	501(c)(3)	$78,200	General support, Scoreboard
Sioux Falls Sports Authority Summit League
200 N Phillips Ave Ste 304	Sioux Falls	SD	57104	205850491	501(c)(3)	$55,000	General support
Sioux Falls Swim Team Inc
PO Box 758	Sioux Falls	SD	57101	460343732	501(c)(3)	$25,500	General support
Southeast Technical Institute
2320 N Career Ave	Sioux Falls	SD	57107	364112897	501(c)(3)	$90,000	General support
South Dakota Voices for Children
PO Box 2196	Sioux Falls	SD	57101	460425502	501(c)(3)	$9,000	General support
Special Olympics North Dakota
2616 S 26th St	Grand Forks	ND	58201	450355704	501(c)(3)	$7,550	General support
Special Olympics South Dakota
305 W 39th St	Sioux Falls	SD	57105	460359776	501(c)(3)	$14,000	General support
Sunshine Memorial Foundation
4200 James Ray Drive	Grand Forks	ND	58202	460731709	501(c)(3)	$10,000	General support
Susan G Komen for the Cure
101 N Main Ave	Sioux Falls	SD	57104	331114233	501(c)(3)	$31,683	General support
The Arts Partnership of the Red River Valley
1104 2nd Avenue South Suite 315	Fargo	ND	58103	237108936	501(c)(3)	$20,000	General support
The Evangelical Lutheran Good Samaritan Society
4800 W 57th Street	Sioux Falls	SD	57117	450228055	501(c)(3)	$12,500	General support
TNT Kid's Fitness
2800 Main Avenue	Fargo	ND	58103	203459549	501(c)(3)	$30,750	General support
University of South Dakota Foundation
1110 N Dakota Street PO Box 5555	Vermillion	SD	57069	466018891	501(c)(3)	$2,348,729	Research, Sports complex, Clinical skills & simulation center
University of Wisconsin Foundation
600 Highland Ave	Madison	WI	53792	390743975	501(c)(3)	$17,000	Carbone Cancer Center
UP Aquatics Inc
3740 Aspyn Lane N	Fargo	ND	58102	271181382	501(c)(3)	$30,000	Swim facility
USD School of Medicine
1400 W 22nd Street	Sioux Falls	SD	57105	460418678	501(c)(3)	$71,004	Medical education
Valley City State University Foundation
101 College St	Valley City	ND	58072	237178785	501(c)(3)	$18,000	General support
Village Family Service Center
PO Box 9859	Fargo	ND	58106	450226423	501(c)(3)	$100,800	General support
Volunteers of America
1309 West 51st St PO Box 89306	Sioux Falls	SD	57109	237353508	501(c)(3)	$20,500	General support
Washington Pavilion
301 S Main Ave PO Box 984	Sioux Falls	SD	57101	460435791	501(c)(3)	$66,973	General support
Worthington Public Schools
1117 Marine Ave	Worthington	MN	56187	416008522	115	$10,000	General support
YMCA of Cass and Clay Counties
400 1st Avenue S	Fargo	ND	58103	450232096	501(c)(3)	$7,500	General support
YWCA Sioux Falls (EmBe)
300 W 11th Street	Sioux Falls	SD	57104	460234998	501(c)(3)	$13,860	Local support

Field	Value	IRS element (for citing)
Total501c3 Org	102	Total501c3OrgCnt
Total Other Org	7	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 2:	FormAndLineReferenceDesc
Explanation	Prior to disbursement all grant fund requests are reviewed to ensure the receiving organization and proposed use of funds align with Sanford's mission.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	Yes (X)	FirstClassOrCharterTravelInd
Travel For Companions	Yes (X)	TravelForCompanionsInd
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	Yes (1)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (52 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Maria Bell MD
Trustee/Sanford Physician	$767,249	$0	$0	$0	$54,550	$0	$13,250	$0	$24,514	$0	$859,563	$0	$0	$0
Mark Lundeen MD
Trustee/Sanford Physician	$849,011	$0	$0	$0	$99,176	$0	$13,250	$0	$13,876	$0	$975,313	$0	$0	$0
Mark Paulson MD
Trustee/Sanford Physician	$234,209	$0	$0	$0	$0	$0	$11,917	$0	$20,670	$0	$266,796	$0	$0	$0
Michael LeBeau MD
Trustee/Sanford Physician	$1,287,761	$0	$0	$0	$0	$0	$10,600	$0	$20,316	$0	$1,318,677	$0	$0	$0
Richard Hardie MD
Trustee/Sanford Physician (thru Nov	$618,653	$0	$0	$0	$5,852	$0	$13,250	$0	$20,772	$0	$658,527	$0	$0	$0
Kelby K Krabbenhoft
Sanford President & CEO	$1,468,928	$0	$2,352,758	$0	$74,800	$0	$0	$0	$21,654	$0	$3,918,140	$0	$0	$0
Kelby K Krabbenhoft Deferred Comp
Sanford President & CEO	$0	$0	$0	$0	$0	$0	$717,699	$0	$0	$0	$717,699	$0	$0	$0
JoAnn L Kunkel
Chief Financial Officer	$584,610	$0	$165,000	$0	$77,005	$0	$11,852	$0	$21,784	$0	$860,251	$0	$0	$0
Nate White
Chief Operating Officer	$786,928	$0	$225,000	$0	$106,977	$0	$13,250	$0	$24,866	$0	$1,157,021	$0	$0	$0
Richard G Adcock
Chief Innovation Officer	$579,228	$0	$165,000	$0	$76,751	$0	$13,250	$0	$24,284	$0	$858,513	$0	$0	$0
Kim Patrick
Chief Legal Officer	$474,182	$0	$135,000	$0	$81,462	$0	$13,250	$0	$23,352	$0	$727,246	$0	$0	$0
Bill Marlette
Treasurer	$532,683	$0	$200,000	$0	$116,214	$0	$0	$0	$1,680	$0	$850,577	$0	$0	$0
Bill Marlette Deferred Comp
Treasurer	$0	$0	$0	$0	$0	$0	$161,277	$0	$0	$0	$161,277	$0	$0	$0
David Link
Chief Strategy Officer (thru Jan 16)	$791,762	$0	$180,000	$0	$81,491	$0	$0	$0	$24,172	$0	$1,077,425	$0	$0	$0
David Link Deferred Comp
Chief Strategy Officer (thru Jan 16)	$0	$0	$0	$0	$0	$0	$110,259	$0	$0	$0	$110,259	$0	$0	$0
Al Hurley
VP Operations Bismarck	$288,536	$0	$20,600	$0	$37,852	$0	$10,600	$0	$13,022	$0	$370,610	$0	$0	$0
Allison Suttle MD
Senior VP Chief Medical Officer	$400,191	$0	$65,000	$0	$37,174	$0	$13,250	$0	$24,538	$0	$540,153	$0	$0	$0
Bradley J Schipper
VP Operations Sioux Falls	$387,373	$0	$73,250	$0	$34,320	$0	$13,250	$0	$24,284	$0	$532,477	$0	$0	$0
Brenda Larsen
VP Operations Bismarck (thru Dec 15)	$286,719	$0	$20,600	$0	$24,911	$0	$10,600	$0	$23,609	$0	$366,439	$0	$0	$0
Bruce D Viessman
VP Finance Health Network	$274,838	$0	$10,600	$0	$27,566	$0	$13,250	$0	$21,124	$0	$347,378	$0	$0	$0
Bryan Nermoe
Exec VP Bemidji	$336,566	$0	$31,000	$0	$32,103	$0	$13,250	$0	$21,060	$0	$433,979	$0	$0	$0
Cole Turner
VP Finance Sioux Falls	$173,911	$0	$5,600	$0	$0	$0	$9,641	$0	$27,188	$0	$216,340	$0	$0	$0
Craig Boyer
VP Finance Bemidji	$238,146	$0	$0	$0	$22,877	$0	$83,528	$0	$21,224	$0	$365,775	$0	$0	$0
Craig Lambrecht
Exec VP Bismarck	$632,327	$0	$150,000	$0	$103,072	$0	$10,600	$0	$22,816	$0	$918,815	$0	$0	$0
Daniel Olson
Exec VP Bemidji (thru Dec 15)	$367,232	$0	$43,750	$0	$50,307	$0	$13,250	$0	$21,925	$0	$496,464	$0	$0	$0
Daniel W Blue
Exec VP Clinic	$655,768	$0	$156,250	$0	$117,426	$0	$13,250	$0	$24,426	$0	$967,120	$0	$0	$0
Douglas Okland
VP Clinic Finance	$255,151	$0	$25,600	$0	$28,857	$0	$13,250	$0	$3,680	$0	$326,538	$0	$0	$0
Ellen Cooke
VP Operations Fargo	$348,430	$0	$62,350	$0	$39,735	$0	$13,250	$0	$10,459	$0	$474,224	$0	$0	$0
Eric Hilmoe
VP Operations Health Network	$220,354	$0	$41,600	$0	$28,685	$0	$13,098	$0	$754	$0	$304,491	$0	$0	$0
Jeff D Sandene
Chief Integration Officer (thru Dec	$441,353	$0	$104,688	$0	$49,674	$0	$13,250	$0	$21,670	$0	$630,635	$0	$0	$0
Jesse Tischer
Exec VP Health Network	$333,017	$0	$113,000	$0	$30,280	$0	$13,250	$0	$20,215	$0	$509,762	$0	$0	$0
Joy Johnson
VP Operations Bemidji	$311,630	$0	$0	$0	$36,460	$0	$126,494	$0	$12,904	$0	$487,488	$0	$0	$0
Karen Tobin
VP Operations SMC Fargo (thru July 1	$181,528	$0	$10,000	$0	$710,249	$0	$9,576	$0	$5,623	$0	$916,976	$0	$0	$0
Kirk Cristy
VP Finance Bismarck	$254,453	$0	$17,100	$0	$39,324	$0	$10,600	$0	$8,198	$0	$329,675	$0	$0	$0
Matthew Hocks
Senior VP Clinic	$382,470	$0	$30,000	$0	$33,468	$0	$13,250	$0	$24,222	$0	$483,410	$0	$0	$0
Michael E Farritor
VP Clinic Sioux Falls	$442,560	$0	$30,600	$0	$52,528	$0	$13,250	$0	$25,182	$0	$564,120	$0	$0	$0
Michelle A Bruhn
Senior VP Finance Health Services	$368,691	$0	$83,075	$0	$43,507	$0	$13,250	$0	$3,324	$0	$511,847	$0	$0	$0
Michelle M Micka
Senior VP Finance Corp Controller	$267,889	$0	$61,250	$0	$27,925	$0	$13,250	$0	$21,472	$0	$391,786	$0	$0	$0
Paul Hanson
Exec VP Sioux Falls	$637,096	$0	$125,000	$0	$73,770	$0	$13,250	$0	$22,284	$0	$871,400	$0	$0	$0
Paul Richard
Exec VP Fargo	$546,146	$0	$125,000	$0	$82,023	$0	$13,250	$0	$23,164	$0	$789,583	$0	$0	$0
Randy Bury
Senior VP Operations	$584,610	$0	$137,500	$0	$69,849	$0	$0	$0	$8,856	$0	$800,815	$0	$0	$0
Randy Bury Deferred Comp
Senior VP Operations	$0	$0	$0	$0	$0	$0	$16,674	$0	$0	$0	$16,674	$0	$0	$0
Richard Marsden MD
VP Operations Fargo Clinic (thru Dec	$542,980	$0	$10,600	$0	$80,194	$0	$13,250	$0	$15,596	$0	$662,620	$0	$0	$0
Steve W Goetsch
VP Finance Sioux Falls (thru Mar 16)	$317,964	$0	$10,600	$0	$26,550	$0	$13,250	$0	$25,818	$0	$394,182	$0	$0	$0
Tiffany Lawrence
VP Finance Fargo	$302,108	$0	$22,100	$0	$31,735	$0	$13,250	$0	$18,504	$0	$387,697	$0	$0	$0
Scott Pham
Physician	$2,882,267	$0	$0	$0	$0	$0	$13,250	$0	$23,988	$0	$2,919,505	$0	$0	$0
Tomasz P Stys
Physician	$2,657,458	$0	$0	$0	$219	$0	$13,250	$0	$21,988	$0	$2,692,915	$0	$0	$0
Adam T Stys
Physician	$2,459,876	$0	$0	$0	$1,709	$0	$13,250	$0	$21,988	$0	$2,496,823	$0	$0	$0
William C Brunner
Physician	$2,403,090	$0	$0	$0	$0	$0	$13,250	$0	$21,988	$0	$2,438,328	$0	$0	$0
Wilson T Asfora
Physician	$2,135,734	$0	$0	$0	$25,908	$0	$13,250	$0	$21,988	$0	$2,196,880	$0	$0	$0
Richard Giesel
Former Exec VP Health Network	$441,353	$0	$79,688	$0	$69,098	$0	$13,250	$0	$15,022	$0	$618,411	$0	$0	$0
Cecily Tucker
Former VP Finance	$0	$254,295	$0	$13,100	$0	$27,580	$0	$13,250	$0	$2,750	$0	$310,975	$0	$0

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 1a	On Part I, Questions Regarding Compensation, Sanford checked several of the items as provided to listed persons: First Class or Charter Travel - Charter travel for business purposes is provided for individuals as needed and as cost appropriate, in accordance with written policies. These costs are not included in the W-2's of the individuals as they are incurred for business purposes of Sanford. Travel for Companions - Limited travel for companions is required for certain annual meetings. These costs are not included in the W-2's of the individuals as they are incurred for business purposes of Sanford. Tax Indemnification and gross-up payments - Certain compensation may be grossed up to include appropriate tax amounts. Health or social club dues or initiation fees - All Sanford employees are eligible for discounted wellness memberships, a portion of these discounts and other club dues are included as fringe benefits, and taxed as such. Part I, Line 3: The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm annually to review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2016.
Part I, Lines 4a-b	Part I, Line 4a: The following individuals participated in a severance arrangement and received payments during the year: Karen Tobin $689,284 Part I, Line 4b: Certain executives participate in a defined contribution SERP Plan. There were no individuals who received payments during the year.
Part I, Line 6	Sanford physicians are compensated based on the professional services they perform within the clinic in which they provide care. Generally, the model is based on production.
Part I, Line 7	Certain employees are eligible for a discretionary incentive bonus. Bonuses are paid based on the achievement of financial and other goals.
Form 990, Schedule J, Supplemental:	Compensation reported on Schedule J includes: (B)(i) Base compensation - salaries are based on the experience and performance of each executive and bench-marked using independent compensation survey information. (B)(ii) Bonus & incentive compensation - as part of executive compensation, individuals may be eligible for incentive performance compensation, however if the organization does not meet its financial targets, incentive payments are not paid, regardless of performance. (B)(iii) Other reportable compensation - generally includes taxable executive benefits. (C) Deferred compensation - includes employer contributions to pension plans and the increase (or decrease) in the actuarial value (actuarial value factors include age, tenure and salary) of the defined benefit plans. (D) Nontaxable benefits - generally includes health insurance premiums. A memo regarding executive compensation, written by the Chairman of the Sanford Board of Trustees, is on file and available upon request. Compensation paid to trustees is for full-time professional responsibilities as physicians, administrators or employees of the organization. The total compensation paid to Kelby Krabbenhoft is comprised of base salary, incentive compensation and other taxable earnings. In addition, an amount has been reported for the estimated amount of ratable increase in value of the defined benefit pension plan, defined benefit SERP and a Gift Agreement Management Continuity Retention plan.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
South Dakota Health and Educational Facilities Authority
A	460315509	83755VHY3	2004-09-14	$70,073,989	New construction of healthcare facilities	0	0	0
South Dakota Health and Educational Facilities Authority
B	460315509	83755VME1	2007-04-19	$75,002,140	New construction and remodeling of healthcare facilities	Yes (1)	0	0
South Dakota Health and Educational Facilities Authority
C	460315509	83755VNZ3	2009-09-29	$71,015,042	New construction and remodeling of healthcare facilities	0	0	0
City of Fargo
D	456002069	307479CK9	2011-02-09	$134,069,821	Refunding bonds issued 12/5/1996, 11/8/2000, and 6/18/2002	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Bond DefeasedBondDefeasedAmt	Other Spent ProceedsOtherSpentProceedsAmt
A	$54,890,000	$71,581,953	$213,583	$764,068	$70,817,885	2006	0	0	Yes (1)	Yes (1)
B	$6,995,000	$78,207,775		$732,655	$77,475,119	2009	0	0	Yes (1)	Yes (1)	$64,380,000	$1
C	$3,755,000	$71,393,241		$997,167	$70,396,074	2012	0	0	Yes (1)	Yes (1)
D	$24,730,000	$134,069,821				2012	Yes (1)	Yes (1)	Yes (1)	Yes (1)		$134,069,821

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd
A	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd
A	0	Yes (1)	Yes (1)
B	0	Yes (1)	0
C	0	Yes (1)	0
D	Yes (1)	Yes (1)	0

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

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

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Date Rebate Computation Performed	Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 09/14/2006 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 04/19/2010 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 09/29/2012 Issuer Name: City of Fargo Date the Rebate Computation was Performed: 02/09/2016
Part I, Column e and Part II, Line 3	Differences between the issue price (Part I, column e) and total proceeds (Part II, line 3) are due to investment earnings.
Part II, Line 4	The amounts shown here consist of debt service fund deposits, except for the 10/28/14 South Dakota Health and Educational Facilities Authority bonds, for which the amount shown is a debt service reserve fund.
Part III	Part III has not been completed for the 2011 City of fargo bonds or 3/29/2012 South Dakota Health and Educational Facilities Authority bonds. These bonds refunded pre-2003 debt that does not have to be reported.
Part IV, Line 6	With respect to the 2011 City of Fargo bonds and the 3/29/2012 and 10/21/2015 South Dakota Health and Educational Facilities Authority bonds, this question is being answered without regard to a yield-restricted advance refunding escrow financed with proceeds of bonds.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
South Dakota Health and Educational Facilities Authority
A	460315509	83755VVM3	2012-11-01	$128,733,641	New construction and remodeling of healthcare facilities	0	0	0
City of Chamberlain
B	460000094	000000000	2010-12-30	$4,000,000	New construction of long-term care facilities	0	0	0
South Dakota Health and Educational Facilities Authority
C	460315509	000000000	2012-03-29	$66,185,000	Refunding bonds issued 9/12/2001 and 10/15/2002	0	0	0
South Dakota Health and Educational Facilities Authority
D	460315509	000000000	2012-06-14	$45,000,000	Refinance taxable indebtedness used to construct a healthcare facility	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	RetiredRetiredAmt	Other Spent ProceedsOtherSpentProceedsAmt
A	$129,135,779	$1,470,647	$127,665,132	2013	0	0	Yes (1)	Yes (1)
B	$4,000,000		$4,000,000	2010	0	0	Yes (1)	Yes (1)	$1,158,898
C	$66,185,000	$24,356		2012	Yes (1)	Yes (1)	Yes (1)	Yes (1)	$8,565,000	$66,160,644
D	$45,000,000		$45,000,000	2012	0	0	Yes (1)	Yes (1)	$5,200,000

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd
A	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	Variable Rate IssueVariableRateIssueInd
A	Yes (1)	0	0
B	0	Yes (1)	Yes (1)
C	Yes (1)	0	Yes (1)
D	Yes (1)	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

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

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
South Dakota Health and Educational Facilities Authority
A	460315509	83755VWA8	2014-08-05	$52,083,720	Current refund 2004A issued 9/14/2004	0	0	0
South Dakota Health and Educational Facilities Authority
B	460315509	83755VXE9	2014-10-28	$207,014,209	New construction and remodeling of healthcare facilities	0	0	0
South Dakota Health and Educational Facilities Authority
C	460315509	83755VZW7	2015-10-21	$192,641,206	New construction and advanced refunding of bonds issued 4/19/07 and 5/22/07	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceedsAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Capitalized InterestCapitalizedInterestAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	UnspentUnspentAmt	Refunding EscrowRefundingEscrowAmt
A	$52,083,720	$52,083,720	2014	Yes (1)	0	Yes (1)	Yes (1)
B	$207,081,359			0	0	0	Yes (1)	$31,874	$1,906,127	$205,080,460	$62,899
C	$192,662,449	$2,050,117		0	Yes (1)	0	Yes (1)		$1,431,628	$91,713,227	$18,771,431	$79,055,323

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd
A	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	0	Yes (1)	0	0	0	0	0	0	0
B	0	Yes (1)	0	0	0	0	0	0	0
C	0	Yes (1)	0	0	0	0	0	0	0

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	0
B	0
C	0

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxt	Loan PurposeLoanPurposeTxt	Loan From OrganizationLoanFromOrganizationInd	Original PrincipalOriginalPrincipalAmt	Balance DueBalanceDueAmt	DefaultDefaultInd	Board Or Committee ApprovalBoardOrCommitteeApprovalInd	Written AgreementWrittenAgreementInd
Maria Bell
Physician/Trustee	Retention Loan	Yes (X)	$100,000	$12,775	0	0	Yes (1)
Maria Bell
Physician/Trustee	Retention Loan	Yes (X)	$150,000	$8,272	0	0	Yes (1)

Field	Value	IRS element (for citing)
Total Balance Due	$21,047	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (10 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Amy Entenman
J Entenman - family relationship	$59,461	Compensation	0
Kim Goetsch
S Goetsch - family relationship	$44,440	Compensation	0
Kathryn Nermoe
B Nermoe - family relationship	$93,934	Compensation	0
Annette White
N White - family relationship	$223,596	Compensation	0
Paige Campbell
P Richard - family relationship	$54,212	Compensation	0
Katie Lundeen
M Lundeen - family relationship	$56,805	Compensation	0
Melinda Anderson
M Paulson - family relationship	$66,828	Compensation	0
Donna Cristy
K Cristy - family relationship	$104,672	Compensation	0
Michael Kunkel
J Kunkel - family relationship	$136,184	Compensation	0
John Durick
P Durick - family relationship	$119,449	Compensation	0

Schedule M IRS990ScheduleM

Cars And Other Vehicles CarsAndOtherVehiclesGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$39,800	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Desc	Medical equipment	Desc
Contribution	2	ContributionCnt
Noncash Contributions Rpt F990	$1,649	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Form8283 Received	0	Form8283ReceivedCnt
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (1)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Column (b):	FormAndLineReferenceDesc
Explanation	The organization used the number of contributors method.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part V, Line 3a:	Sanford Health, Sanford Medical Center, Sanford Clinic, Sanford North, Sanford Medical Center Fargo, Sanford Clinic North, Sanford Bismarck and Sanford Living Centers have unrelated business gross income over $1,000.
Part V, Line 4a:	Sanford World Clinics has an interest in financial accounts in the foreign countries of Ghana, China and Germany.
Form 990, Part VI, Section A, line 2	The following officers, board members, and key employees are employees of Sanford or its related organizations. Many of these employees also serve on other related Sanford boards, or have business relationships with each other that span the organization as a whole: Al Hurley, Allison Suttle, Bill Marlette, Bradley Schipper, Brenda Larsen, Bruce Viessman, Cole Turner, Craig Boyer, Craig Lambrecht, Daniel Olson, Daniel Blue, David Link, Douglas Okland, Ellen Cooke, Eric Hilmoe, Jeff Sandene, Jesse Tischer, JoAnn Kunkel, Joy Johnson, Karen Tobin, Kelby Krabbenhoft, Kim Patrick, Kirk Cristy, Maria Bell, Mark Lundeen, Mark Paulson, Matthew Hocks, Michael Farritor, Michael LeBeau, Michelle Bruhn, Michelle Micka, Nate White, Paul Hanson, Paul Richard, Randy Bury, Richard Hardie, Richard Marsden, Steve Goetsch, Tiffany Lawrence.
Form 990, Part VI, Section A, line 6	Sanford is governed by a Board of Trustees (BOT) that has ultimate strategic and decision making authority. The BOT delegates certain activities and responsibilities to Boards of each of Sanford's primary operating subsidiaries. The unique nature and complexity of the subsidiaries requires each to have a delegated Board with a singular entity focus. Such bodies, referred to as Boards of Directors and Boards of Governors, address matters such as credentialing, accreditation standards, developing budgets, programs and facilities on an entity-specific basis, and generally consist of individuals distinct from the BOT. These Boards function much like committees in a traditional corporate structure. The BOT then acts as a holding company Board, synthesizing and reconciling each entity's programs and budgets into a system-wide strategic plan. This structure of governance produces a significant number of trustees, governors and directors. Subsidiaries included within this group tax return consist of Sanford Health, Sanford North, Sanford Medical Center, Sanford Medical Center Fargo, Sanford Clinic, Sanford Clinic North, Sanford Health Network, Sanford Health Network North, Sanford Medical Center Thief River Falls, Sanford Medical Center Mayville, Sanford Medical Center Wheaton, Sanford Home Health, Sanford Research, Sanford World Clinics, Sanford Hillsboro, Sanford Health of Northern Minnesota, Baker Park, Inc., Sanford West, Sanford Bismarck and Sanford Living Centers. The Board of Trustees of Sanford is also the Board of Trustees for Sanford Health, Sanford North and Sanford West, and Sanford is the sole corporate member of these entities. These entities, in turn, are the sole corporate members of the subsidiaries. The actions approved by a subsidiary's Board of Directors are then approved by the Sanford Board of Trustees.
Form 990, Part VI, Section A, line 7a	The Sanford Board of Trustees appoints the board members for the Boards of Directors and Boards of Governors of the subsidiary entities.
Form 990, Part VI, Section A, line 7b	The Sanford Board of Trustees approves the actions approved by the Boards of Directors and Boards of Governors of the subsidiary entities. Form 990, Part VI, Section B, line 10b: Sanford North, Sanford Clinic and Sanford Health Network have local chapters, branches or affiliates over which the organization has the legal authority to exercise direct or indirect supervision and control.
Form 990, Part VI, Section B, line 11	The Form 990 is prepared internally by Finance and reviewed by executive management. An external accounting firm reviews the return and prepares return highlights and key disclosures for the Board of Trustees meeting prior to the return filing date. Before the return is filed, a complete copy is provided to the current Board of Trustees.
Form 990, Part VI, Section B, line 12c	The annual Conflict of Interest disclosure process is managed by the Chief Compliance Officer (CCO). The CCO is responsible for assuring that all completed forms are returned in a timely and complete manner. Conflict of Interest questionnaires are sent to System Trustees, members of the governing boards of subsidiary entities, officers, and key employees for all entities subject to the IRS Form 990 filings. The disclosures are summarized for review by the executive committee of the Board of Trustees, pursuant to policy. This review allows: 1) The Board to acquire an awareness of financial relationships of board members and key management employees and can invoke the recusal process on a case-by-case basis if potential conflicts are implicated in Board decisions and deliberations, and, 2) Gives the Board the opportunity to seek additional information and clarification about disclosures to determine potential conflicts of interest, and how to manage them.
Form 990, Part VI, Section B, line 15	The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm annually to review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2016. Part VI, Line 16a: Sanford Health, Sanford Medical Center, Sanford Clinic and Sanford Clinic North have participated in joint ventures with taxable entities.
Form 990, Part VI, Section C, line 19	Although the organization does not maintain a website where the public can access these documents, it would respond individually to any requests or inquiries from the public for these documents.
Form 990, Part VII, Section B	Amounts listed as compensation for the five highest compensated independent contractors include payments for both materials and services.
Form 990, Part VII	The Sanford Board of Trustees has ultimate governance responsibilities for each major operating entity within Sanford. In addition, a Board of Directors is established for each major operating entity. This Board has specific responsibilities delegated from the Board of Trustees. Generally these responsibilities are related to the oversight of the day to day operations of that entity.
Form 990, Part XI, line 9:	Net payroll and other expenses paid on behalf of parent/affiliates -164,188,394. Pension FAS 158 26,861,979. Transfer reserve cash to Sanford the parent -46,100,000.
Form 990 Elections	Form 990, Page 1, Line H(a) - Listing of Subordinate Organizations: Names, Addresses, and EINs Sanford Health 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 31-1527032 Sanford USD Medical Center 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0227855 Sanford Home Health 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0282134 Sanford Health Network 1305 W 18th Street Sioux Falls, SD 57105 EIN: 46-0388596 Sanford Clinic 1305 W 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0447693 Sanford Research 2301 E 60th Street N Sioux Falls, SD 57104 EIN: 46-0450378 Sanford World Clinics 1305 W 18th Street Sioux Falls, SD 57105 EIN: 26-2707628 Sanford North 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 45-0385890 Sanford Clinic North 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 91-1770748 Sanford Medical Center Fargo 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 45-0226909 Sanford Health Network North 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 45-0409348 Sanford Medical Center Thief River Falls 3001 Sanford Parkway Thief River Falls, MN 56701 EIN: 41-0709579 Sanford Medical Center Mayville 801 Broadway Drive, PO Box 2010 Fargo, ND 58122 EIN: 45-0228899 Sanford Medical Center Wheaton 401 12th Street N Wheaton, MN 56296 EIN: 27-2042143 Sanford Hillsboro 12 3rd Street SE, PO Box 609 Hillsboro, ND 58045 EIN: 45-0230400 Sanford Health of Northern Minnesota 1300 Anne Street NW Bemidji, MN 56601 EIN: 41-1266009 Baker Park, Inc. 803 Dewey Avenue NW Bemidji, MN 56601 EIN: 41-1372480 Sanford West 300 N 7th Street Bismarck, ND 58501 EIN: 45-0397195 Sanford Bismarck 300 N 7th Street Bismarck, ND 58501 EIN: 45-0226700 Sanford Living Centers 1000 18th Street NW, Suite 1 Mandan, ND 58554 EIN: 45-0416454

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (12 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Lincoln County Real Estate Trust
100 S Phillips Ave	Sioux Falls	SD	57104	466126929	Real Estate	SD	$0	$586,467	Sanford Health
PPK Family Trust
100 S Phillips Ave	Sioux Falls	SD	57104	207317570	Rental Real Estate	SD	$54,670	$95	Sanford Health
Lynx Trust
PO Box 5186	Sioux Falls	SD	57117	266167201	Investment	SD	-$5	$1	Sanford Health
National Student Housing Trust-SD
PO Box 5186	Sioux Falls	SD	57117	206831968	Investment	SD	-$14	$441	Sanford Health
Sanford HealthCare Accessories LLC
3223 32nd Ave SW	Fargo	ND	58103	202404179	Sales of Durable Medical Equip	ND	$36,381,932	$15,825,214	Sanford North
Healthcare Environmental Services LLC
PO Box 2010	Fargo	ND	58122	205236701	Retail Enterprises	ND	$3,035,700	$6,764,445	Sanford North
North Country Senior Living LLC
1000 Anne St NW	Bemidji	MN	56601	263862586	Senior Housing	CO	$3,318,431	$9,023,092	Sanford Health of Northern Minnesota
1527 Broadway LLC
1527 Broadway	Alexandria	MN	56308	411336392	Real Estate	MN	$707,234	$6,971,841	Sanford Clinic North
Medequip One LLC
626 N 6th Street	Bismarck	ND	58501	450452639	Durable medical equipment, products, and services	ND	$0	$0	Sanford West
Shetek Medical Services LLC
251 5th Street E	Tracy	MN	56175	412004685	Home Health Services	MN	$487,304	$452,198	Sanford Health Network
Sanford Health Mobile Med LLC
2603 E Broadway Avenue	Bismarck	ND	58501	471209528	Mobile Healthcare	ND	$289,437	$1,100,484	Sanford Health
Southwest MN Radiation Center LLC
1018 6th Avenue	Worthington	MN	56187	460447693	Radiation Services	MN	$1,031,772	$389,168	Sanford Health Network

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Sanford
801 Broadway Drive	Fargo	ND	58122	271218956	Supporting Organization	ND	501(c)(3)	11-II	0
Sanford Health Foundation
101 S Reid Street	Sioux Falls	SD	57103	363297853	Foundation	SD	501(c)(3)	11-II	Yes (1)	Sanford Health
Edith Sanford Breast Cancer Foundation
101 S Reid Street	Sioux Falls	SD	57103	450404126	Foundation	ND	501(c)(3)	11-II	Yes (1)	Sanford Health
F-M Ambulance Service Inc
2215 18th Street S	Fargo	ND	58103	450344371	EMT	ND	501(c)(4)		Yes (1)	Sanford North
Sanford Health Foundation North
PO Box 2010	Fargo	ND	58122	450398104	Foundation	ND	501(c)(3)	7	Yes (1)	Sanford North
Sanford Health Foundation Hillsboro
PO Box 609	Hillsboro	ND	58045	363542187	Foundation	ND	501(c)(3)	7	Yes (1)	Sanford Hillsboro
Sanford Health Foundation of Northern Minnesota
1300 Anne Street NW	Bemidji	MN	56601	411389317	Foundation	MN	501(c)(3)	11-II	Yes (1)	Sanford Health of Northern Minnesota
Sanford Health Foundation West
300 North 7th Street	Bismarck	ND	58501	450397196	Foundation	ND	501(c)(3)	7	Yes (1)	Sanford Bismarck
Medcenter One Inc Auxiliary
300 North 7th Street	Bismarck	ND	58501	237293043	Supporting Organization	ND	501(c)(3)	11-I	Yes (1)	Sanford Bismarck
Sanford Heart of America Health Plan
810 South Main	Rugby	ND	58368	450346132	Insurance	ND	501(c)(4)		Yes (1)	Sanford Health Plan
Sanford Health Foundation Thief River Falls
120 LaBree Ave S	Thief River Falls	MN	56701	411761135	Foundation	MN	501(c)(3)	7	Yes (1)	Sanford Medical Center Thief River Falls

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
National Student Housing-South Dakota LLC
100 S Phillips Ave	Sioux Falls	SD	57104	202129839	Investment	SD	Sanford Health	Related	$4,688	$4,087,902	0	0	0.99990
RAC Rentals LLC
100 S Phillips Ave	Sioux Falls	SD	57104	261961077	Investment	SD	Sanford Health	Related	$95,079	$4,214,732	0	0	0.99990

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
Sanford Home Medical Equipment Inc
2710 W 12th Street	Sioux Falls	SD	57105	460388597	Healthcare Equipment	SD	Sanford Health	C	$4,299,547	$13,862,578	1.00000	Yes (1)
Sanford Health Plan
300 Cherapa Place	Sioux Falls	SD	57103	911842494	Insurance	SD	Sanford Health	C	-$30,408,246	$223,021,570	1.00000	Yes (1)
Sanford Health Plan of MN
300 Cherapa Place	Sioux Falls	SD	57103	460445852	Insurance	MN	Sanford Health	C	-$404,328	$2,492,680	1.00000	Yes (1)
Sanford Frontiers
1305 W 18th Street PO Box 5039	Sioux Falls	SD	571175039	455436599	Weight Loss Management	SD	Sanford Health	C	$33,404,077	$53,964,950	1.00000	Yes (1)
SOB Inc
2701 S Minnesota Avenue Suite 2	Sioux Falls	SD	57105	460442628	Air Transportation	SD		C				Yes (1)	N/A
Sanford Affiliated Services Inc
300 N 7th Street	Bismarck	ND	58501	450403146	Investment Activity	ND	Sanford West	C	$1,007,331	$1,913,872	1.00000	Yes (1)
Sanford World Clinics - Ghana
					Healthcare		Sanford World Clinics	C	$1,007,664	$5,536,344	1.00000	Yes (1)		Sarbah Road Tantri Lorry Station	Cape Coast	GH	GH
Shanghai Sanford Healthcare Management Consulting Co Ltd
					Healthcare		Sanford World Clinics	C	$305,272	$143,478	1.00000	Yes (1)		188 Yesheng Road Room A-862 Guoma	Shanghai	CH	CH
Sanford International - Munich GmbH
					Healthcare		Sanford World Clinics	C		$20,387	1.00000	Yes (1)		Nymphenburger Strasse 3	Munich	GM	GM

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

Transactions Related Org TransactionsRelatedOrgGrp (13 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Sanford Health Foundation
C	$32,402,653	Cost
Sanford Health Foundation North
C	$1,514,983	Cost
Sanford Health Foundation West
C	$135,290	Cost
Sanford Health Foundation Hillsboro
B	$50,000	Cost
Sanford Health Foundation of Northern Minnesota
C	$203,719	Cost
Edith Sanford Breast Cancer Foundation
C	$325,419	Cost
Sanford
R	$46,100,000	Cost
Sanford Health Foundation Hillsboro
C	$199,923	Cost
F-M Ambulance Service Inc
R	$4,775,517	Cost
F-M Ambulance Service Inc
S	$816,659	Cost
Sanford Health Foundation North
R	$1,326,048	Cost
Sanford Health Foundation Thief River Falls
R	$70,692	Cost
Sanford Health Foundation West
R	$694,762	Cost

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Form 990, Schedule R Part V	FormAndLineReferenceDesc
Explanation	Expenditures are reported based on the accrual method which is the method used in the organization's financial statements.	ExplanationTxt