SANFORD: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization: SANFORD (EIN 45-3791176)
Tax period: 2024-01-01 to 2024-12-31
Filed: 2025-11-13
IRS object ID: 202523179349302617
Schema version: 2024v5.2
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 L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2025-11-13T08:49:29-06:00	ReturnTs
Tax Period End	2024-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	346565596	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	155 N WACKER DRIVE	AddressLine1Txt
City	CHICAGO	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60606	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2024-01-01	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	PO BOX 5039 RTE 5218	AddressLine1Txt
City	SIOUX FALLS	CityNm
State Abbreviation	SD	StateAbbreviationCd
ZIP	571175039	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	NICHOLAS OLSON	PersonNm
Person Title	EVP, CFO	PersonTitleTxt
Phone	6053331000	PhoneNum
Signature	2025-11-13	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	0	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JESS WAGENER	PreparerPersonNm
PTIN	P01622613	PTIN
Phone	3128792000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2024	TaxYr
Build TS	2025-03-06 01:10:19Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	BILL GASSEN	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	$6,128,553,345	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	TO CARE, COMFORT AND CURE	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	3271	TotalEmployeeCnt
Total Volunteers	1302	TotalVolunteersCnt
Total Gross UBI	$129,413,179	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$8,490,549	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$100,653,729	PYContributionsGrantsAmt
CY Contributions Grants	$106,770,013	CYContributionsGrantsAmt
PY Program Service Revenue	$5,616,529,846	PYProgramServiceRevenueAmt
CY Program Service Revenue	$5,979,938,305	CYProgramServiceRevenueAmt
PY Investment Income	$19,460,626	PYInvestmentIncomeAmt
CY Investment Income	$21,264,847	CYInvestmentIncomeAmt
PY Other Revenue	$2,011,713	PYOtherRevenueAmt
CY Other Revenue	$2,607,388	CYOtherRevenueAmt
PY Total Revenue	$5,738,655,914	PYTotalRevenueAmt
CY Total Revenue	$6,110,580,553	CYTotalRevenueAmt
PY Grants And Similar Paid	$46,276,954	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$47,489,473	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$3,036,308,464	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$3,288,698,827	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$2,290,939,774	PYOtherExpensesAmt
CY Other Expenses	$2,492,950,369	CYOtherExpensesAmt
PY Total Expenses	$5,373,525,192	PYTotalExpensesAmt
CY Total Expenses	$5,829,138,669	CYTotalExpensesAmt
PY Revenues Less Expenses	$365,130,722	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$281,441,884	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,759,919,108	TotalAssetsBOYAmt
Total Assets EOY	$4,274,026,030	TotalAssetsEOYAmt
Total Liabilities BOY	$1,129,335,603	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,142,418,868	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$2,630,583,505	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$3,131,607,162	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SANFORD HEALTH IS COMMITTED TO THE HEALTHCARE NEEDS OF COMMUNITIES THROUGHOUT THE UPPER MIDWEST. SANFORD HEALTH PROVIDES A FULL RANGE OF PRIMARY AND SPECIALTY HEALTHCARE SERVICES AND STRIVES TO BE THE PREMIER RURAL HEALTH SYSTEM IN THE UNITED STATES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$5,293,466,097	ExpenseAmt
Grant	$47,489,473	GrantAmt
Revenue	$5,949,015,399	RevenueAmt
Desc	SANFORD HEALTH, THE LARGEST RURAL HEALTH SYSTEM IN THE UNITED STATES, IS DEDICATED TO TRANSFORMING THE HEALTH CARE EXPERIENCE AND PROVIDING ACCESS TO WORLD-CLASS HEALTH CARE IN AMERICA'S HEARTLAND. SANFORD PROVIDES MEDICAL SERVICES AT EVERY LEVEL FROM CRITICAL ACCESS HOSPITALS TO TERTIARY AND QUATERNARY CARE. THE SANFORD FOOTPRINT OF OWNED, LEASED AND MANAGED SITES INCLUDES OVER 250,000 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.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$51,679,766	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$6,642,227	RevenueAmt
Desc	SANFORD HEALTH PROVIDES HIGH QUALITY MEDICAL EDUCATIONAL AND PROFESSIONAL DEVELOPMENT THAT IS EVIDENCE AND RESEARCH BASED; ACCREDITED FOR PHYSICIANS, NURSES, PHARMACISTS, AND ALLIED HEALTH PROFESSIONALS AND SCIENTISTS; INCLUSIVE OF CULTURAL DIFFERENCES AND ADDRESSES THE NEED FOR SPECIALTY TRAINING. SANFORD HEALTH 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 UNIVERSITIES 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	$38,934,194	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$19,511,850	RevenueAmt
Desc	RESEARCH ENDEAVORS SPAN CHILDREN'S HEALTH, FOCUSED ON PEDIATRIC RARE DISEASES AND CANCER; THE SANFORD PROJECT, SEEKING TO REDUCE THE BURDEN OF TYPE 1 DIABETES THROUGH DISCOVERY AND CLINICAL APPLICATION; GENOMIC AND MOLECULAR MEDICINE INCLUDING GENOMICS, BIOBANKING AND IMMUNOTHERAPY; EDITH SANFORD BREAST CANCER FOR ADVANCED MOLECULAR RESEARCH AND PERSONALIZED TREATMENT; NEUROBEHAVIORAL SCIENCES, STUDYING EATING DISORDERS, OBESITY AND BARIATRIC SURGERY OUTCOMES AS WELL AS PHYSIOLOGICAL ASPECTS OF EATING AND ADDICTION AND CLINICAL RESEARCH HOSTING DRUG AND DEVICE STUDIES, THE NCI COMMUNITY ONCOLOGY RESEARCH PROGRAM AND THE NEONATAL RESEARCH NETWORK. RESEARCH ALSO LEADS EDUCATIONAL PROGRAMS SUPPORTING SCIENCE IN LOCAL K-12 SCHOOL DISTRICTS, UNDERGRADUATE, GRADUATE AND POST-DOCTORAL PROGRAMS.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$5,384,080,057	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
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	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	Yes (1)	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 With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
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	0	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	4348	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	3271	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	CH	ForeignCountryCd
Foreign Country	GH	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
Form1098 C Filed	Yes (1)	Form1098CFiledInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	8	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	NICHOLAS OLSON EVP 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 (31 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
BILL GASSEN
TRUSTEE, PRESIDENT & CEO	23.70	36.30	Yes (X)	Yes (X)	$0	$4,414,119	$585,241
ANDY NORTH
TRUSTEE, SECRETARY, INDEP CONTRACTOR	1.91	2.99	Yes (X)	Yes (X)	$379,383	$0	$0
LAURIS MOLBERT
TRUSTEE, CHAIRPERSON	1.91	2.99	Yes (X)	Yes (X)	$107,199	$0	$0
BRENT TEIKEN
TRUSTEE	1.91	2.99	Yes (X)		$84,246	$0	$0
JAMES CAIN
TRUSTEE, TREASURER	1.91	2.99	Yes (X)	Yes (X)	$81,651	$0	$0
MARNIE HERMANN
TRUSTEE, VICE CHAIR	1.91	2.99	Yes (X)	Yes (X)	$80,382	$0	$0
NEIL GULSVIG
TRUSTEE, PAST CHAIR	1.91	2.99	Yes (X)	Yes (X)	$80,055	$0	$0
MARK LUNDEEN MD
TRUSTEE	1.91	2.99	Yes (X)		$80,000	$0	$0
DAVID SHULKIN
TRUSTEE (START 1/24)	1.91	2.99	Yes (X)		$79,826	$0	$0
STEPHANIE HERSETH SANDLIN
TRUSTEE (START 1/24)	1.91	2.99	Yes (X)		$78,750	$0	$0
WESLEY ENGBRECHT
TRUSTEE	1.91	2.99	Yes (X)		$77,594	$0	$0
DANA DYKHOUSE
TRUSTEE (START 1/24)	1.91	2.99	Yes (X)		$76,727	$0	$0
SCOTT WOOTEN
EVP, CFO (END 4/24)	23.70	36.30		Yes (X)	$0	$2,525,208	$51,220
NICK OLSON
EVP, CFO (BEG 4/24)	23.70	36.30		Yes (X)	$0	$1,047,876	$123,386
BILL MARLETTE
INTERIM, EVP, CFO (END 1/24)	23.70	36.30		Yes (X)	$0	$894,301	$275
MATT HOCKS
EVP, CHIEF OPERATING OFFICER	54.00	6.00			$0	$2,798,445	$276,533	Yes (X)
JENNIFER GRENNAN
EVP, CHIEF ADMIN OFFICER	51.00	9.00			$0	$1,991,610	$207,852	Yes (X)
MICHAEL LEBEAU MD
SVP, HEALTH SVC OPERATIONS	50.00	10.00			$0	$1,824,864	$209,688	Yes (X)
PAUL HANSON
PRESIDENT & CEO, SIOUX FALLS	60.00	0.00			$0	$1,471,880	$172,935	Yes (X)
TIFFANY LAWRENCE
PRESIDENT & CEO, FARGO	55.00	5.00			$0	$1,426,252	$179,445	Yes (X)
TODD SCHAFFER
PRESIDENT & CEO, BISMARCK	60.00	0.00			$0	$1,224,459	$127,517	Yes (X)
KARLA EISCHENS
PRESIDENT & CEO, BEMIDJI	60.00	0.00			$0	$729,610	$107,668	Yes (X)
WILLIAM BRUNNER MD
PHYSICIAN	60.00	0.00			$3,286,993	$0	$46,564		Yes (X)
ADAM STYS MD
PHYSICIAN	60.00	0.00			$3,250,190	$0	$53,103		Yes (X)
TOMASZ STYS MD
PHYSICIAN	60.00	0.00			$2,911,937	$0	$48,065		Yes (X)
ERIC BELANGER MD
PHYSICIAN	60.00	0.00			$2,885,080	$0	$41,962		Yes (X)
ALEXANDER DROFA MD
PHYSICIAN	60.00	0.00			$2,835,917	$0	$48,215		Yes (X)
DON JACOBS
FORMER TRUSTEE	0.00	0.00			$13,502	$0	$0			Yes (X)
MICHELLE BRUHN
FORMER EVP, CFO & TREASURER	0.00	0.00			$0	$293,725	$0			Yes (X)
SUSAN JARVIS
FORMER PRESIDENT & CEO, BEMIDJI	60.00	0.00			$0	$920,606	$146,335			Yes (X)
BRYAN NERMOE
FORMER PRESIDENT & CEO, FARGO	0.00	0.00			$0	$252,724	$0			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$16,389,432	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$21,815,679	TotReportableCompRltdOrgAmt
Total Other Compensation	$2,426,004	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2543	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
FOCUSONE SOLUTIONS LLC
1010 N 102ND ST STE 300	OMAHA	NE	68114	STAFFING SERVICES	$82,249,583
HENRY CARLSON CONSTRUCTION LLC
1205 RUSSELL ST	SIOUX FALLS	SD	57104	CONSTRUCTION SERVICES	$48,201,317
SIRIUS COMPUTER SOLUTIONS LLC
PO BOX 405547	ATLANTA	GA	30384	SOFTWARE MAINTENANCE & SUPPORT	$40,889,798
FIEGEN CONSTRUCTION COMPANY
3712 S WESTERN AVE SUITE 200	SIOUX FALLS	SD	57105	CONSTRUCTION SERVICES	$19,562,363
EPIC SYSTEMS GROUP
1979 MILKY WAY	VERONA	WI	53593	SOFTWARE MAINTENANCE & SUPPORT	$14,086,173

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	409	CntrctRcvdGreaterThan100KCnt
Related Organizations	$72,319,564	RelatedOrganizationsAmt
Government Grants	$31,547,938	GovernmentGrantsAmt
All Other Contributions	$2,902,511	AllOtherContributionsAmt
Noncash Contributions	$495,000	NoncashContributionsAmt
Total Contributions	$106,770,013	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICES	621110	$2,606,060,516	$2,606,060,516
MEDICARE / MEDICAID	621400	$2,231,956,275	$2,231,956,275
PHARMACY REVENUE	456110	$618,161,606	$603,322,453	$14,839,153
RETAIL SALES	446199	$392,976,809	$372,171,388	$20,805,421
REFERENCE LAB	621500	$20,095,023	$49,759	$20,045,264

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$110,688,076	TotalRevenueColumnAmt
Related Or Exempt Func Income	$36,652,003	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$72,992,546	UnrelatedBusinessRevenueAmt
Exclusion	$1,043,527	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$5,979,938,305	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,394,451	TotalRevenueColumnAmt
Exclusion	$14,394,451	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$24,178	TotalRevenueColumnAmt
Exclusion	$24,178	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$4,008,915	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,425,705	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$2,583,210	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,583,210	TotalRevenueColumnAmt
Exclusion	$2,583,210	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$23,417,483	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$432,661	SecuritiesAmt
Other	$16,114,426	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$432,661	SecuritiesAmt
Other	$7,303,057	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,870,396	TotalRevenueColumnAmt
Related Or Exempt Func Income	-$4,768,829	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$730,795	UnrelatedBusinessRevenueAmt
Exclusion	$10,908,430	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,110,580,553	TotalRevenueColumnAmt
Related Or Exempt Func Income	$5,845,443,565	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$129,413,179	UnrelatedBusinessRevenueAmt
Exclusion	$28,953,796	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$47,295,864	TotalAmt
Program Services	$47,295,864	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$193,609	TotalAmt
Program Services	$193,609	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$25,637,961	TotalAmt
Program Services	$23,526,842	ProgramServicesAmt
Management And General	$2,111,119	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$1,626,893	TotalAmt
Management And General	$1,626,893	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$2,661,473,477	TotalAmt
Program Services	$2,443,811,412	ProgramServicesAmt
Management And General	$217,662,065	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$153,437,024	TotalAmt
Program Services	$143,520,974	ProgramServicesAmt
Management And General	$9,916,050	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$277,328,969	TotalAmt
Program Services	$245,679,776	ProgramServicesAmt
Management And General	$31,649,193	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$169,194,503	TotalAmt
Program Services	$155,782,890	ProgramServicesAmt
Management And General	$13,411,613	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$3,503,714	TotalAmt
Program Services	$650,966	ProgramServicesAmt
Management And General	$2,852,748	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,380,826	TotalAmt
Program Services	$103,959	ProgramServicesAmt
Management And General	$1,276,867	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$823,506	TotalAmt
Management And General	$823,506	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$711,706	TotalAmt
Management And General	$711,706	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$376,585,985	TotalAmt
Program Services	$336,255,426	ProgramServicesAmt
Management And General	$40,330,559	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$19,644,933	TotalAmt
Program Services	$5,997,774	ProgramServicesAmt
Management And General	$13,647,159	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$62,842,849	TotalAmt
Program Services	$42,907,221	ProgramServicesAmt
Management And General	$19,935,628	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$140,847,720	TotalAmt
Program Services	$12,101,124	ProgramServicesAmt
Management And General	$128,746,596	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$121,162,468	TotalAmt
Program Services	$112,360,071	ProgramServicesAmt
Management And General	$8,802,397	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$22,214,217	TotalAmt
Program Services	$20,079,245	ProgramServicesAmt
Management And General	$2,134,972	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$7,049,054	TotalAmt
Program Services	$5,524,046	ProgramServicesAmt
Management And General	$1,525,008	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$26,244,908	TotalAmt
Program Services	$18,345,602	ProgramServicesAmt
Management And General	$7,899,306	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$136,664,535	TotalAmt
Program Services	$110,002,562	ProgramServicesAmt
Management And General	$26,661,973	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$26,097,031	TotalAmt
Program Services	$23,280,540	ProgramServicesAmt
Management And General	$2,816,491	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$1,540,145,054	$1,543,546,010	-$3,400,956
BIOMEDICAL SERVICES	$30,272,277	$30,272,277
OTHER TAXES	$20,733,970	$20,287,513	$446,457
CERT/LICENSES/SUBSCRIPT	$11,538,834	$10,410,799	$1,128,035

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	-$55,513,218	TotalAmt
Program Services	$32,143,555	ProgramServicesAmt
Management And General	-$87,656,773	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,829,138,669	TotalAmt
Program Services	$5,384,080,057	ProgramServicesAmt
Management And General	$445,058,612	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$59,316,362	BOYAmt
EOY	$140,911,773	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$183,735,153	BOYAmt
EOY	$254,828,846	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$836,469,834	BOYAmt
EOY	$809,694,586	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$21,449	BOYAmt
EOY	$17,989	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$74,098,691	BOYAmt
EOY	$76,107,318	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$131,499,348	BOYAmt
EOY	$136,859,819	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$93,247,192	BOYAmt
EOY	$101,889,548	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$4,192,108,718	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$2,108,709,461	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,864,744,233	BOYAmt
EOY	$2,083,399,257	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$192,795	BOYAmt
EOY	$210,450	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$57,598,283	BOYAmt
EOY	$17,127,027	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$33,679,559	BOYAmt
EOY	$33,758,470	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$44,839,780	BOYAmt
EOY	$186,355,134	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$380,476,429	BOYAmt
EOY	$432,865,813	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,759,919,108	BOYAmt
EOY	$4,274,026,030	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$322,769,972	BOYAmt
EOY	$330,107,354	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$6,139,321	BOYAmt
EOY	$1,597,851	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$20,072,536	BOYAmt
EOY	$15,468,583	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$451,201,775	BOYAmt
EOY	$425,371,043	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$349,593	BOYAmt
EOY	$425,450	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$7,847,503	BOYAmt
EOY	$8,970,172	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$320,954,903	BOYAmt
EOY	$360,478,415	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,129,335,603	BOYAmt
EOY	$1,142,418,868	EOYAmt

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

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,630,576,405	BOYAmt
EOY	$3,131,607,162	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,100	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,630,583,505	BOYAmt
EOY	$3,131,607,162	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,759,919,108	BOYAmt
EOY	$4,274,026,030	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$281,441,884	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$42,153,731	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$261,735,504	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

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (8 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 509(A)(2) SANFORD RESEARCH 170(B)(1)(A)(III) SANFORD RESEARCH NORTH 170(B)(1)(A)(III) SANFORD HOME HEALTH 509(A)(2) SANFORD HEALTH NETWORK 170(B)(1)(A)(III) SANFORD WORLD CLINICS 509(A)(2) SANFORD NORTH 509(A)(3) SANFORD MEDICAL CENTER FARGO 170(B)(1)(A)(III) SANFORD CLINIC NORTH 509(A)(2) SANFORD HEALTH NETWORK NORTH 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 WORLD CLINICS-KLAMATH FALLS 509(A)(2) SANFORD VIRTUAL CARE 509(A)(2) SANFORD HEALTH OF SOUTH DAKOTA 170(B)(1)(A)(III)
SCHEDULE A, PART I	PART I, LINE 12B - SANFORD HEALTH, SANFORD NORTH, AND SANFORD WEST ARE ALL TYPE II SUPPORTING ORGANIZATIONS. PART I, LINE 12F - TOTAL NUMBER OF SUPPORTED ORGANIZATIONS - 21 DETAIL FOR SCHEDULE A, PART I, LINE 12G LINE 12, COLUMN: (I) SANFORD MEDICAL CENTER; (II) 46-0227855; (III) 3; (IV) YES; (V) $47,862,238 LINE 12, COLUMN: (I) SANFORD CLINIC; (II) 46-0447693; (III) 10; (IV) YES; (V) $3,593,622 LINE 12, COLUMN: (I) SANFORD RESEARCH; (II) 46-0450378; (III) 4; (IV) YES; (V) $1,202,755 LINE 12, COLUMN: (I) SANFORD RESEARCH NORTH; (II) 45-0274828; (III) 4; (IV) YES; (V) $181,436 LINE 12, COLUMN: (I) SANFORD HOME HEALTH; (II) 46-0282134; (III) 10; (IV) YES; (V) $493,751 LINE 12, COLUMN: (I) SANFORD HEALTH NETWORK; (II) 46-0388596; (III) 3; (IV) YES; (V) $12,403,116 LINE 12, COLUMN: (I) SANFORD CLINIC NORTH; (II) 91-1770748; (III) 10; (IV) YES; (V) $1,936,538 LINE 12, COLUMN: (I) SANFORD HEALTH NETWORK NORTH; (II) 45-0409348; (III) 3; (IV) YES; (V) $4,745,936 LINE 12, COLUMN: (I) SANFORD MEDICAL CENTER FARGO; (II) 45-0226909; (III) 3; (IV) YES; (V) $60,510,131 LINE 12, COLUMN: (I) SANFORD WORLD CLINICS; (II) 26-2707628; (III) 10; (IV) YES; (V) $430,079 LINE 12, COLUMN: (I) SANFORD WORLD CLINICS-KLAMATH FALLS; (II) 92-0396212 (III) 10; (IV) YES; (V) $99,977 LINE 12, COLUMN: (I) SANFORD HEALTH OF NORTHERN MINNESOTA; (II) 41-1266009; (III) 3; (IV) YES; (V) $14,102,329 LINE 12, COLUMN: (I) BAKER PARK, INC.; (II) 41-1372480; (III) 10; (IV) YES; (V) $29,048 LINE 12, COLUMN: (I) SANFORD HEALTH FOUNDATION NORTH; (II) 45-0398104; (III) 7; (IV) YES; (V) $142,347 LINE 12, COLUMN: (I) SANFORD BISMARCK; (II) 45-0226700; (III) 3; (IV) YES; (V) $26,745,913 LINE 12, COLUMN: (I) SANFORD HEALTH FOUNDATION WEST; (II) 45-0397196; (III) 7; (IV) YES; (V) $47,721 LINE 12, COLUMN: (I) SANFORD VIRTUAL CARE; (II) 88-0976483; (III) 10; (IV) YES; (V) $25,016 LINE 12, COLUMN: (I) THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION; (II) 46-0422866; (III) 7; (IV) YES; (V) $29,454,572 LINE 12, COLUMN: (I) THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY; (II) 45-0228055; (III) 10; (IV) YES; (V) $403,745 LINE 12, COLUMN: (I) SANFORD HEALTH FOUNDATION OF NORTHERN MINNESOTA; (II) 41-1389317; (III) 7; (IV) YES; (V) $14,102,329 LINE 12, COLUMN: (I) SANFORD HEALTH OF SOUTH DAKOTA; (II) 33-1259188; (III) 3; (IV) YES; (V) $403,745
SCHEDULE A, PART I, LINE 12G, COLUMN (IV)	WE HAVE ANSWERED YES THAT THE ORGANIZATIONS ARE LISTED IN OUR GOVERNING DOCUMENTS BECAUSE THE ARTICLES DESCRIBE THE SPECIFIED SUPPORTED ORGANIZATIONS AND THE OTHER SUPPORTED ORGANIZATIONS BY CLASS (AFFILIATED WITH THE SPECIFIED SUPPORTED ORGANIZATIONS).
SCHEDULE A, PART III	LINE 1 - COLUMN: (A) 9,415,179; (B) (3,426,082); (C) 3,504,069; (D) 2,528,926; (E) 3,897,496; (F) 15,919,589 LINE 2 - COLUMN: (A) 177,631,632; (B) 204,250,348; (C) 261,882,016; (D) 205,463,244; (E) 207,778,397; (F) 1,057,005,637 LINE 6 - COLUMN: (A) 187,046,811; (B) 200,824,266; (C) 265,386,085; (D) 246,599,928; (E) 211,675,894; (F) 1,111,532,984 LINE 7C - COLUMN: (A) 718,178; (B) 0; (C) 0; (D) 0; (E) 0; (F) 718,178 LINE 8 - COLUMN: (F) 1,110,814,806 LINE 9 - COLUMN: (A) 187,046,811; (B) 200,824,266; (C) 265,386,085; (D) 246,883,076; (E) 211,675,894; (F) 1,111,816,132 LINE 10A - COLUMN: (A) 1,544,624; (B) 1,377,220; (C) 1,495,086; (D) 163,641; (E) 335,549; (F) 4,916,120 LINE 10C - COLUMN: (A) 1,544,624; (B) 1,377,220; (C) 1,495,086; (D) 163,641; (E) 335,549; (F) 4,916,120 LINE 11 - COLUMN: (A) 673,203; (B) 151,437; (C) 789,277; (D) 508,990; (E) 67,393; (F) 2,122,907 LINE 13 - COLUMN: (A) 189,264,638; (B) 202,352,923; (C) 267,670,448; (D) 247,555,707; (E) 212,011,443; (F) 1,118,855,159 LINE 15: 99.28% LINE 16: 99.05% LINE 17: 0.44% LINE 18: 0.56% LINE 19A: X LINE 19B: X PART IV, SECTION A LINE 1: NO LINE 2: NO LINE 3A: NO LINE 4A: NO LINE 5A: YES LINE 5B: YES LINE 5C: NO LINE 6: YES 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
SCHEDULE A, PART IV, SECTION A, LINE 1	THE ARTICLES OF INCORPORATION OF SANFORD HEALTH, SANFORD NORTH AND SANFORD WEST PROVIDE THAT THEY SHALL PROVIDE OVERSIGHT, OPERATE FOR THE BENEFIT OF, TO SUPPORT THE FUNCTIONS OF, AND TO CARRY OUT SOME OR ALL OF THE CHARITABLE PURPOSES OF THE NAMED SUBSIDIARY ORGANIZATIONS WHICH ARE EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ALL OTHER 501(C)(3) ORGANIZATIONS OPERATED, SUPERVISED OR CONTROLLED BY OR SUPERVISED OR CONTROLLED IN CONNECTION WITH, SUCH ORGANIZATIONS. FURTHER, PURSUANT TO THEIR BY-LAWS, THE GOVERNING BODY OF SANFORD (PARENT), SERVES AS THE GOVERNING BODY OF SANFORD HEALTH, SANFORD NORTH AND SANFORD WEST AS WELL AS ALL OF THE NAMED TAX-EXEMPT SUBSIDIARY ORGANIZATIONS. THUS, SANFORD HEALTH, SANFORD NORTH AND SANFORD WEST MEET THE RELATIONSHIP TEST AS A TYPE II ORGANIZATIONS BECAUSE THERE IS COMMON SUPERVISION AND CONTROL BETWEEN SANFORD HEALTH, SANFORD NORTH AND SANFORD WEST AND THEIR NAMED SUPPORTED ORGANIZATIONS. SANFORD HEALTH, SANFORD NORTH, AND SANFORD WEST ALSO SUPPORT ORGANIZATIONS WHICH ARE 501(C)(3) ORGANIZATIONS AFFILIATED WITH THE SUPPORTED ORGANIZATIONS OR ARE 501(C)(3) PUBLIC CHARITIES AFFILIATED WITH THESE AFFILIATED ENTITIES. THEY ARE DESCRIBED BY CLASS. IN ADDITION, THE ARTICLES PROVIDE THAT IN FURTHERANCE OF THEIR PURPOSES, THESE CORPORATIONS MAY ENGAGE IN, ADVANCE, PROMOTE, SUPPORT, AND ADMINISTER CHARITABLE, SCIENTIFIC, AND EDUCATIONAL ACTIVITIES AND PROJECTS OF EVERY KIND AND NATURE WHATSOEVER IN ITS OWN BEHALF OR AS THE AGENT, TRUSTEE, OR REPRESENTATIVE OF OTHERS. THIS INCLUDES TO AID OR ASSIST OTHER ORGANIZATIONS WHOSE ACTIVITIES ARE SUCH AS TO FURTHER, ACCOMPLISH, FOSTER, OR ATTAIN ANY SUCH PURPOSES. ALL POWERS OF THESE CORPORATIONS SHALL BE EXERCISED ONLY SO THAT THESE CORPORATIONS' OPERATIONS SHALL BE EXCLUSIVELY WITHIN THE CONTEMPLATION OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. TO QUALIFY AS A SECTION 509(A)(3) SUPPORTING ORGANIZATION, AN ORGANIZATION MUST SUPPORT ONE OR MORE SPECIFIED ORGANIZATIONS. FOR TYPE II SUPPORTING ORGANIZATION'S ARTICLES OF INCORPORATION, THE ARTICLES MUST DESIGNATE THE SUPPORTING ORGANIZATION(S) BY CLASS OR PURPOSE, AND WHICH INCLUDE PUBLICLY SUPPORTED ORGANIZATIONS WHICH ARE CLOSELY RELATED IN PURPOSE OR FUNCTION TO THE PUBLICLY SUPPORTED ORGANIZATION SPECIFIED IN THE ARTICLES. THEREFORE, THE LACK OF INCLUDING THE NAME OF THE AFFILIATED ORGANIZATIONS THAT SANFORD HEALTH, SANFORD NORTH, AND SANFORD WEST WILL SUPPORT IN THEIR ARTICLES OF INCORPORATION DOES NOT OTHERWISE DEFEAT THE ORGANIZATIONS STATUSES AS TYPE II SUPPORTING ORGANIZATIONS, BECAUSE THEIR ARTICLES DESCRIBE THESE SUPPORTED ORGANIZATIONS BY CLASS (AFFILIATED WITH THE SPECIFIED SUPPORTED ORGANIZATION) AND REQUIRE THAT THEY BE EXEMPT FROM TAX UNDER IRC SECTION 501(C)(3).
SCHEDULE A, PART IV, SECTION A, LINE 5A	(1) SANFORD HEALTH OF SOUTH DAKOTA, 33-1259188; (II) THE ORGANIZATION WAS FORMED ON SEPTEMBER, 27TH, 2024 AND ADDED TO SANFORD GROUP RULING UPON ACQUISITION OF A HOSPITAL, URGENT CARE CENTER, AND SURGERY CENTER THAT OCCURED ON NOVEMBER 15TH, 2024. (III) THE SUPPORTED ORGANIZATION WAS PART OF A CLASS ALREADY DESIGNATED IN THE ORGANIZATION'S ORGANIZING DOCUMENTS. (IV) NO ACTION NEEDED TO ACCOMPLISH.
SCHEDULE A, PART IV, SECTION A, LINE 6	THE ORGANIZATIONS GIVE GRANTS AND PROVIDE SUPPORT TO QUALIFIED 501(C)(3) PUBLIC CHARITIES, GOVERNMENTAL ENTITIES AND VARIOUS LOCAL NONPROFIT ORGANIZATIONS THAT SUPPORT THE MISSIONS OF SANFORD HEALTH, SANFORD NORTH, AND SANFORD WEST AND THE ORGANIZATIONS THAT THEY SUPPORT.
SCHEDULE A, PART IV, SECTION C, LINE 1	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	Yes (1)	VolunteersInd
Paid Staff Or Management	Yes (1)	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$582,244	DirectContactLegislatorsAmt
Rallies Demonstrations	Yes (1)	RalliesDemonstrationsInd
Rallies Demonstrations	$10,000	RalliesDemonstrationsAmt
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$231,262	OtherActivitiesAmt
Total Lobbying Expenditures	$823,506	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 FOLLOWING ORGANIZATIONS: 340B HEALTH, ABERDEEN AREA CHAMBER OF COMMERCE, AMERICAN ACADEMY OF PROFESSIONAL CODERS, AMERICAN ADVERTISING FEDERATION OF SD, AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES, AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION, AMERICAN SOCIETY FOR GASTRO ENDOSCOPY, AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, AMERICAN ACADEMY OF OPHTHALMOLOGY, AMERICAN ACADEMY OF SLEEP MEDICINE, AMERICAN HOSPITAL ASSOCIATION, AMERICAN MEDICAL ASSOCIATION, AMERICAN MEDICAL GROUP ASSOCIATION, AMERICAN OPTOMETRIC ASSOCIATION, AMERICAN SOCIETY OF REPRODUCTIVE MEDICINE, ASSOCIATION OF COMMUNITY CANCER CENTERS, ASSOCIATION OF CRITICAL CARE TRANSPORT, BISMARCK MANDAN CHAMBER EDC, CHAMBER OF COMMERCE GRAND FORKS & EAST GRAND FORKS, CHAMBER OF COMMERCE MINOT, GREATER SIOUX FALLS CHAMBER OF COMMERCE, IOWA HEALTH CARE ASSOCIATION, KLAMATH COUNTY CHAMBER OF COMMERCE, CARE PROVIDERS OF MN, MEDICAL GROUP MANAGEMENT ASSOCIATION, MN HOSPITAL ASSOCIATION, MN AMBULANCE ASSOCIATION, MN CHAMBER OF COMMERCE, NATIONAL ASSOCIATION FOR BIOMEDICAL RESEARCH, NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS, NATIONAL ASSOCIATION OF SOCIAL WORKERS, NATIONAL ASSOCIATION OF SPECIALTY PHARMACY, NATIONAL RURAL HEALTH ASSOCIATION, NATIONAL ATHLETIC TRAINERS ASSOCIATION, ND EMS ASSOCIATION, ND HOSPITAL ASSOCIATION, ND LONG TERM CARE ASSOCIATES, ND MOTOR CARRIERS ASSOCIATION, ND PETROLEUM COUNCIL, SD BIOTECH ASSOCIATION, SD CHAMBER OF COMMERCE & INDUSTRY, SD HEALTH CARE ASSOCIATION, SOCIETY FOR VASCULAR ULTRASOUND, SOCIETY OF DIAGNOSTIC MEDICAL SONOGRAPHY, SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGANIZATION, SOUTH DAKOTA NETWORK AGAINST FAMILY, CHAMBER OF COMMERCE FARGO/MOORHEAD/WEST FARGO, TOBACCO FREE ND, & TRAUMA CENTER ASSOCIATION OF AMERICA. 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	$98,989,485	BeginningYearBalanceAmt
Contributions	$2,430,924	ContributionsAmt
Investment Earnings Or Losses	$34,960	InvestmentEarningsOrLossesAmt
End Year Balance	$101,455,369	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$98,286,566	BeginningYearBalanceAmt
Contributions	$538,214	ContributionsAmt
Investment Earnings Or Losses	$164,705	InvestmentEarningsOrLossesAmt
End Year Balance	$98,989,485	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$95,588,573	BeginningYearBalanceAmt
Contributions	$3,117,005	ContributionsAmt
Investment Earnings Or Losses	-$419,012	InvestmentEarningsOrLossesAmt
End Year Balance	$98,286,566	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$92,002,112	BeginningYearBalanceAmt
Contributions	$3,277,428	ContributionsAmt
Investment Earnings Or Losses	$309,033	InvestmentEarningsOrLossesAmt
End Year Balance	$95,588,573	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$89,216,166	BeginningYearBalanceAmt
Contributions	$3,261,419	ContributionsAmt
Investment Earnings Or Losses	$99,138	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	-$574,611	GrantsOrScholarshipsAmt
End Year Balance	$92,002,112	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.00000	TermEndowmentBalanceEOYPct
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	$134,029,091	OtherCostOrOtherBasisAmt
Book Value	$134,029,091	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,827,505,435	OtherCostOrOtherBasisAmt
Depreciation	$804,122,473	DepreciationAmt
Book Value	$1,023,382,962	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$88,898,764	OtherCostOrOtherBasisAmt
Depreciation	$62,743,144	DepreciationAmt
Book Value	$26,155,620	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,060,579,512	OtherCostOrOtherBasisAmt
Depreciation	$1,201,577,491	DepreciationAmt
Book Value	$859,002,021	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$81,095,916	OtherCostOrOtherBasisAmt
Depreciation	$40,266,353	DepreciationAmt
Book Value	$40,829,563	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,083,399,257	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
DEFERRED COMPENSATION ASSETS	$230,851,445
RIGHT OF USE ASSET	$96,686,738
NON-OPERATING PROPERTY	$92,351,631
OTHER ASSETS	$12,975,999

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$432,865,813	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
DEFERRED COMPENSATION LIABILITY	$229,551,512
LONG TERM OPERATING LEASE PAYABLE	$81,163,050
OTHER NON-CURRENT LIABILITIES	$49,763,853

Field	Value	IRS element (for citing)
Total Liability	$360,478,415	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:	SANFORD HEALTH FOUNDATION, SANFORD HEALTH FOUNDATION NORTH, 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 DECEMBER 31, 2024; SOME RELATED ORGANIZATIONS HAVE ESTABLISHED RESERVES.

Schedule F IRS990ScheduleF

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

Account Activities Outside US AccountActivitiesOutsideUSGrp (6 entries)

RegionRegionTxt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Region Total ExpendituresRegionTotalExpendituresAmt	Specific Services ProvidedSpecificServicesProvidedTxt
CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS,	INVESTMENTS	$8,000,000
MIDDLE EAST AND NORTH AFRICA	INVESTMENTS	$1,300,000
EAST ASIA AND THE PACIFIC	INVESTMENTS	$1,600,000
EAST ASIA AND THE PACIFIC	PROGRAM SERVICES	$49,000	MSA
SUB-SAHARAN AFRICA	PROGRAM SERVICES	$2,215,000	OPERATING EXPENSES FOR CLINIC
CENTRAL AMERICA AND THE CARIBBEAN	PROGRAM SERVICES	$1,346,000	MSA AND EMR WORK

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$14,510,000	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$14,510,000	TotalSpentAmt
Total501c3 Org	0	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt
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

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 3:	FormAndLineReferenceDesc
Explanation	EXPENDITURES ARE ACCOUNTED FOR ON THE ACCRUAL BASIS OF ACCOUNTING.	ExplanationTxt

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	0	ExpensesExceedBudgetInd
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	$89,067,697	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$89,067,697	NetCommunityBenefitExpnsAmt
Total Expense	0.01530	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$724,708,418	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$543,761,018	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$180,947,400	NetCommunityBenefitExpnsAmt
Total Expense	0.03100	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

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

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$813,776,115	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$543,761,018	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$270,015,097	NetCommunityBenefitExpnsAmt
Total Expense	0.04630	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$69,436,840	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,035,701	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$68,401,139	NetCommunityBenefitExpnsAmt
Total Expense	0.01170	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$51,679,766	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,642,227	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$45,037,539	NetCommunityBenefitExpnsAmt
Total Expense	0.00770	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,401,616,506	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,129,499,728	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$272,116,778	NetCommunityBenefitExpnsAmt
Total Expense	0.04670	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$38,934,194	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$19,511,850	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$19,422,344	NetCommunityBenefitExpnsAmt
Total Expense	0.00330	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$28,425,818	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$28,425,818	NetCommunityBenefitExpnsAmt
Total Expense	0.00490	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,590,093,124	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,156,689,506	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$433,403,618	NetCommunityBenefitExpnsAmt
Total Expense	0.07430	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,403,869,239	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,700,450,524	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$703,418,715	NetCommunityBenefitExpnsAmt
Total Expense	0.12060	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,671,855	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,671,855	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$17,761,370	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,761,370	NetCommunityBenefitExpnsAmt
Total Expense	0.00300	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,084,250	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,084,250	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

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

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$35,523	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$35,523	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$502,894	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$502,894	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

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

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,338,895	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,338,895	NetCommunityBenefitExpnsAmt
Total Expense	0.00110	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

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

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$27,394,787	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$27,394,787	NetCommunityBenefitExpnsAmt
Total Expense	0.00470	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$218,244,951	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$451,184,733	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$436,174,426	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$15,010,307	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	26	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (26 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	Critical Access HospitalCriticalAccessHospitalInd	OtherOtherDesc
SANFORD 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	5225 23RD AVENUE S	FARGO	ND	58104	WWW.SANFORDHEALTH.ORG	ND 5070	SANFORD MEDICAL CENTER FARGO	450226909	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
SANFORD BROADWAY MEDICAL CENTER FARGO
3	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
4	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
5	300 N 7TH STREET	BISMARCK	ND	58501	WWW.SANFORDHEALTH.ORG	ND 5003A	SANFORD BISMARCK	450226700	Yes (X)	Yes (X)		Yes (X)	Yes (X)	A
SANFORD BEMIDJI MEDICAL CENTER
6	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
7	3001 SANFORD PARKWAY	THIEF RIVER FALLS	MN	56701	WWW.SANFORDHEALTH.ORG	MN 371500	SANFORD HEALTH NETWORK NORTH	450409348	Yes (X)	Yes (X)			Yes (X)	A	Yes (X)	INPATIENT MENTAL HEALTH
SANFORD ABERDEEN MEDICAL CENTER
8	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
9	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
10	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
11	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
12	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
13	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
14	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
15	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
16	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 HILLSBORO MEDICAL CENTER
17	12 3RD STREET SE	HILLSBORO	ND	58045	WWW.SANFORDHEALTH.ORG	ND 5026A	SANFORD HEALTH NETWORK NORTH	450409348	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 HEALTH NETWORK NORTH	450409348	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 HEALTH NETWORK NORTH	450409348	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)			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)
SANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTER
25	120 LA BREE AVENUE S	THIEF RIVER FALLS	MN	56701	WWW.SANFORDHEALTH.ORG	MN 410505	SANFORD HEALTH NETWORK NORTH	450409348	Yes (X)					A		BEHAVIORAL HEALTH CENTER-INPATIENT MENTAL HEALTH
BLACK HILLS SURGICAL HOSPITAL LLC
26	216 ANAMARIA DRIVE	RAPID CITY	SD	57701	WWW.BHSH.COM	SD 10582	SANFORD HEALTH OF SOUTH DAKOTA	331259188	Yes (X)	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
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	24	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	WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT	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	24	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	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
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE NARRATIVE FOR LINE 16J	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE NARRATIVE FOR LINE 16J	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE NARRATIVE FOR LINE 16J	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (155 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: SANFORD MEDICAL CENTER, - FACILITY 3: SANFORD BROADWAY MEDICAL CENTER FARGO, - FACILITY 4: SANFORD MEDICAL CENTER SOUTH UNIVERSITY, - FACILITY 5: SANFORD BISMARCK MEDICAL CENTER, - FACILITY 6: SANFORD BEMIDJI MEDICAL CENTER, - FACILITY 7: SANFORD MEDICAL CENTER THIEF RIVER FALLS, - FACILITY 8: SANFORD ABERDEEN MEDICAL CENTER, - FACILITY 9: SANFORD WORTHINGTON MEDICAL CENTER, - FACILITY 10: SANFORD SHELDON MEDICAL CENTER, - FACILITY 11: SANFORD VERMILLION MEDICAL CENTER, - FACILITY 12: SANFORD CHAMBERLAIN MEDICAL CENTER, - FACILITY 13: SANFORD LUVERNE MEDICAL CENTER, - FACILITY 14: SANFORD CANBY MEDICAL CENTER, - FACILITY 15: SANFORD JACKSON MEDICAL CENTER, - FACILITY 16: SANFORD TRACY 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, - FACILITY 2: SANFORD MEDICAL CENTER FARGO, - FACILITY 25: SANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH C
GROUP A-FACILITY 1 -- SANFORD MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 1 -- SANFORD MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 BEHAVIORAL HEALTH 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 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 MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: HEALTHY LIVINGIN THE UNITED STATES, MANY LEADING CAUSES OF DEATH AND DISEASE ARE ATTRIBUTED TO UNHEALTHY BEHAVIORS. FOR EXAMPLE, POOR NUTRITION AND LOW LEVELS OF PHYSICAL ACTIVITY ARE ASSOCIATED WITH HIGHER RISK OF CARDIOVASCULAR DISEASE, TYPE 2 DIABETES, AND OBESITY. TOBACCO USE IS ASSOCIATED WITH HEART DISEASE, CANCER, AND POOR PREGNANCY OUTCOMES IF THE MOTHER SMOKES DURING PREGNANCY. EXCESSIVE ALCOHOL USE IS ASSOCIATED WITH INJURIES, CERTAIN TYPES OF CANCERS, AND CIRRHOSIS. SANFORD SIOUX FALLS USD MEDICAL CENTER (SUSDMC) HAS MADE HEALTHY LIVING A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE A DECREASE IN OLDER ADULT INJURY FALLS. IT IS SANFORD'S GOAL TO EXPAND ACCESS TO FALL PREVENTION EDUCATION AND TO INCREASE SANFORD HEALTH PROVIDER AWARENESS AND KNOWLEDGE OF THE IMPORTANCE OF FALL PREVENTION. PRIORITY 2: ADOLESCENT MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SUSDMC HAS MADE ADOLESCENT MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROVIDE YOUTH WITH MORE ACCESS TO MENTAL AND BEHAVIORAL HEALTH INFORMATION, EDUCATION AND SERVICES. IT IS SANFORD'S GOAL TO INCREASE DEPRESSION SCREENING WITH PATIENTS AGES 12-18 YEARS OLD AND TO ENHANCE OVERALL ACCESS TO BEHAVIORAL AND MENTAL HEALTH SERVICES FOR AREA YOUTH.PRIORITY 3: ACCESS TO CAREWHEN SURVEY RESPONDENTS WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, ACCESS TO HEALTH CARE SERVICES AND PROVIDERS WAS THE SECOND HIGHEST ISSUE. WHEN ASKED WHICH HEALTH CARE SERVICES THEY WOULD LIKE TO SEE OFFERED OR IMPROVED IN THEIR COMMUNITY, RESPONDENTS INDICATED WALK-IN/URGENT CARE, DENTAL CARE, AND FAMILY MEDICINE OR PRIMARY CARE.SUSDMC HAS MADE ACCESS TO CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES FOR MORE AREA RESIDENTS TO RECEIVE APPROPRIATE, NEEDED CARE. IT IS SANFORD'S GOAL TO INCREASE RATES OF PREVENTIVE SCREENING FOR CANCER AND INCREASE ACCESS TO SENIOR CARE SERVICES.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR:HEALTHY LIVINGSUSDMC HAS OBTAINED ADMINISTRATION FOR COMMUNITY LIVING GRANT FUNDING TO PARTNER WITH LOCAL COMMUNITY AGENCIES TO PROVIDE FALL PREVENTION SCREENING AND EVIDENCE-BASED FALL PREVENTION PROGRAMS FOR OLDER ADULTS IN THE COMMUNITY.ADOLESCENT MENTAL HEALTH BEHAVIORAL HEALTH CARE ACCESS HAS BEEN ENHANCED WITH THE RECRUITMENT OF ADDITIONAL PROVIDERS AND PLACING BEHAVIORAL HEALTH TRIAGE THERAPISTS IN ALL PRIMARY CARE CLINICS. THE PHQ-2 ASSESSMENT IS GIVEN AT ALL PRIMARY CARE VISITS.WE CONTINUE TO EXPAND BEHAVIORAL HEALTH SERVICES COMMENSURATE TO INCREASING DEMAND. SUSDMC OFFERS MENTAL HEALTH SERVICES FOR ANY ADMITTED PATIENT AND THOSE THAT PRESENT TO THE EMERGENCY DEPARTMENT IN A MENTAL HEALTH CRISIS. PATIENTS ARE SEEN FOR SUICIDAL IDEATION, DEPRESSION, ANXIETY, PTSD, SUBSTANCE AND ADDICTION ISSUES. MENTAL HEALTH STAFF ALSO SEE THOSE WITH A NEW MEDICAL DIAGNOSIS SUCH AS CANCER, PULMONARY ISSUES AND POSTPARTUM DEPRESSION. SUSDMC'S MENTAL HEALTH TEAM CONSISTS OF 15 MASTERS LEVEL COUNSELORS AND CLINICAL SOCIAL WORKERS TO ENSURE ANY MENTAL HEALTH NEEDS ARE TAKEN CARE OF WHILE A PATIENT IS HOSPITALIZED. SUSDMC ALSO OFFERS TWO INTEGRATED HEALTH THERAPISTS THAT SEE PATIENTS IN OUR SPECIALTY CLINICS THAT ARE ON THE MAIN SUSDMC CAMPUS. THEY ARE AVAILABLE FOR CRISIS COUNSELING AND FOLLOW UP VISITS AS NEEDED AT THE SAME TIME AS THE PATIENT'S CLINIC VISIT. SUSDMC HAS SEVERAL STAFF THAT ARE PART OF THE PARTNERSHIP THAT SANFORD HEALTH AND AVERA HEALTH HAVE WITH THE CITY OF SIOUX FALLS TO FORM THE LINK. THE LINK IS A COMMUNITY TRIAGE CENTER PROVIDING A SAFE PLACE FOR PEOPLE EXPERIENCING A NON-VIOLENT BEHAVIORAL HEALTH CRISIS OR NEEDING CARE FOR SUBSTANCE ABUSE DISORDERS TO ACCESS IMMEDIATE TREATMENT AND REFERRAL TO SUPPORT SERVICES. IT OFFERS OUR COMMUNITY AN INNOVATIVE APPROACH TO ADDRESS GAPS IN CRITICAL SERVICES FOR PEOPLE LIVING WITH MENTAL HEALTH AND SUBSTANCE ABUSE CHALLENGES. WE PARTICIPATE IN VARIOUS PLANNING AND OPERATIONAL COMMITTEES AND OUR PRESIDENT AND CEO, PAUL HANSON, IS ON THE LINK BOARD OF DIRECTORS. ACCESS TO CAREWALK-INS, VIDEO VISITS, E-VISITS, ONLINE SCHEDULING, AND SAME-DAY ACCESS ARE AVAILABLE AT ALL PRIMARY CARE LOCATIONS. APPROPRIATE PREVENTIVE SCREENINGS ARE OFFERED ALONG WITH EDUCATIONAL INFORMATION ON WELLNESS AND DISEASE PREVENTION.HEALTH CARE LITERACY AND FINANCIAL ADVOCACY ARE ONGOING EFFORTS. WE COLLABORATE WITH SANFORD HEALTH PLAN TO HELP PATIENTS FIND AFFORDABLE COVERAGE. THE HOSPITAL ALSO HAS ONSITE FINANCIAL ADVOCATES WHO SPECIALIZE IN HEALTH CARE COVERAGE ENROLLMENT AND HELP PATIENTS NAVIGATE SANFORD'S FINANCIAL ASSISTANCE PROGRAM IF ELIGIBLE. WE CONTINUE TO INVEST IN LANGUAGE SERVICES TO ENSURE PATIENTS NEEDING FINANCIAL SUPPORT DO NOT FACE COMMUNICATION BARRIERS.OUR CALL CENTER, INCLUSIVE OF OUR ONE CALL SYSTEM, THE CLINICAL CALL CENTER, AND THE MY SANFORD NURSE LINE RESPONDS TO HUNDREDS OF THOUSANDS OF CALLS PER YEAR. THE CLINICAL CALL CENTER ANSWERS AFTER HOURS CALLS FOR ALL THE METRO/NETWORK CLINIC LOCATIONS, IN ADDITION TO MY SANFORD NURSE CALLS.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE: ACCESS TO AFFORDABLE HEALTH CAREQUALITY CHILD CARELONG-TERM SENIOR CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 1 -- SANFORD 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 MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 3 -- SANFORD BROADWAY MEDICAL CENTER FARGO PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 3 -- SANFORD BROADWAY MEDICAL CENTER FARGO PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD 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 BEHAVIORAL HEALTH 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 BROADWAY 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 3 -- SANFORD BROADWAY MEDICAL CENTER FARGO PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSEMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE INCREASED UTILIZATION OF BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR THOSE THAT NEED THEM IN THE COMMUNITY. IT IS SANFORD'S GOAL TO IMPROVE TIMELY ACCESS TO MENTAL/BEHAVIORAL HEALTH CARE SERVICES AND TO ENHANCE AND EXPAND SERVICES TO EFFECTIVELY SUPPORT AND TREAT PATIENTS WITH SUBSTANCE USE DISORDERS.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERS AND QUALITY CAREWHEN RESPONDENTS WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, HAVING ACCESS TO HEALTH CARE WAS ONE OF THE TOP ISSUES BEHIND COST. AND WHEN RESPONDENTS, WHO RATED THEIR OWN ABILITY TO ACCESS HEALTH CARE AS POOR OR FAIR, WERE ASKED WHY THEY RATED ACCESS AS THEY DID, ISSUES OF LIMITED HOURS, WAIT TIMES, LIMITED LOCATIONS, AND LACK OF PROVIDERS AND SPECIALTY CARE WERE AMONG THE TOP CONCERNS.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS AND QUALITY CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE INCREASED COLLABORATION WITH EXTERNAL PARTNERS AND IMPROVED ACCESS TO CARE. IT IS SANFORD'S GOAL TO IMPROVE ACCESS TO PRIMARY AND SPECIALTY CARE AND TO COLLABORATIVELY SHARE CHNA INFORMATION WITH PUBLIC AND PRIVATE PARTNERS. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSESANFORD FARGO IS CONTINUING ITS EFFORTS TO IMPROVE ACCESS TO MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES. UTILIZATION OF VIRTUAL VISITS FOR BEHAVIORAL HEALTH HAS CONTINUED TO GROW AND CONTRIBUTE TOWARD IMPROVED ACCESS. TIMELY ACCESS TO ADULT PSYCHIATRY CONTINUES TO BE AN AREA WE ARE WORKING TO IMPROVE AND MONITOR PROGRESS QUARTERLY. SANFORD CURRENTLY OFFERS MENTAL HEALTH AND SUBSTANCE ABUSE PROVIDERS IN THE COMMUNITY THROUGH VARIOUS DELIVERY OPPORTUNITIES. DEPRESSION SCREENING WILL BE UTILIZED IN THE ROOMING NAVIGATOR IN ALL CLINICS TO HELP IDENTIFY THOSE IN NEED OF CARE. OUR SUBOXONE CLINIC CONTINUES TO SERVE PATIENTS IN ADDICTION RECOVERY AND ENGAGES IN HOSPITAL PEER COACHING. SANFORD FARGO IS CONTINUING A PARTNERSHIP WITH CLAY COUNTY DETOX TO ENSURE COORDINATED UTILIZATION OF MEDICAL AND LAW ENFORCEMENT SUPPORT FOR INDIVIDUALS ACTIVELY IN DETOX.ACCESS TO HEALTH CARE PROVIDERS AND QUALITY CARE SANFORD FARGO INCREASED HOME-BASED PRIMARY CARE ACCESS AND CONTINUES TO UTILIZE THIS APPROACH TO IMPROVE ACCESS AS ALL PRIMARY CARE PROVIDERS NOW HAVE ACCESS TO THIS OPTION. PROVIDER RECRUITMENT PLAYS A MAJOR ROLE IN OUR ABILITY TO INCREASE OUR CAPACITY. INVESTING IN OUR EDUCATIONAL PROGRAMS TO SERVE AS A PIPELINE FOR PROVIDERS CONTINUES TO BE A PRIORITY. THE BROADWAY CAMPUS IS UNDERGOING EXTENSIVE REMODELING FOLLOWING THE OPENING OF SANFORD MEDICAL CENTER FARGO IN JULY 2017 AND THE RELOCATION OF MANY SERVICES TO THAT LOCATION. THE LONGER-TERM MISSION FOR THE BROADWAY FACILITY IS A GREATLY EXPANDED ROGER MARIS CANCER CENTER WHICH WILL ANCHOR THE BROADWAY CAMPUS AND PROVIDE MANY NEW SERVICES AND SPECIALTIES. IN ADDITION TO AN EXTENSIVE ARRAY OF CANCER SERVICES PROVIDED, INCLUDING A BONE MARROW TRANSPLANT PROGRAM, AND AN INPATIENT ONCOLOGY UNIT, SANFORD BROADWAY IS CURRENTLY HOME TO THE CARDIOVASCULAR CLINIC, CV DIAGNOSTIC SERVICES, INPATIENT HOSPICE UNIT, INPATIENT ICU, URGENT CARE, SAME DAY SURGERY, INPATIENT EATING DISORDER UNIT AND OTHERS. IT IS CONNECTED TO SANFORD BROADWAY CLINIC, WHICH IS THE REGION'S LARGEST MULTI-SPECIALTY CLINIC OFFERING OVER 50 MEDICAL SPECIALTIES INCLUDING NUMEROUS PEDIATRIC SUB-SPECIALTIES. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREHEALTHY LIVINGPUBLIC TRANSPORTATIONQUALITY CHILDCAREAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 3 -- SANFORD BROADWAY 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 3 -- SANFORD BROADWAY MEDICAL CENTER FARGO PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 4 -- SANFORD MEDICAL CENTER SOUTH UNIVERSITY PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 4 -- SANFORD MEDICAL CENTER SOUTH UNIVERSITY PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 BEHAVIORAL HEALTH 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 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 4 -- SANFORD MEDICAL CENTER SOUTH UNIVERSITY PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSEMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE INCREASED UTILIZATION OF BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR THOSE THAT NEED THEM IN THE COMMUNITY. IT IS SANFORD'S GOAL TO IMPROVE TIMELY ACCESS TO MENTAL/BEHAVIORAL HEALTH CARE SERVICES AND TO ENHANCE AND EXPAND SERVICES TO EFFECTIVELY SUPPORT AND TREAT PATIENTS WITH SUBSTANCE USE DISORDERS.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERS AND QUALITY CAREWHEN RESPONDENTS WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, HAVING ACCESS TO HEALTH CARE WAS ONE OF THE TOP ISSUES BEHIND COST. AND WHEN RESPONDENTS, WHO RATED THEIR OWN ABILITY TO ACCESS HEALTH CARE AS POOR OR FAIR, WERE ASKED WHY THEY RATED ACCESS AS THEY DID, ISSUES OF LIMITED HOURS, WAIT TIMES, LIMITED LOCATIONS, AND LACK OF PROVIDERS AND SPECIALTY CARE WERE AMONG THE TOP CONCERNS.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS AND QUALITY CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE INCREASED COLLABORATION WITH EXTERNAL PARTNERS AND IMPROVED ACCESS TO CARE. IT IS SANFORD'S GOAL TO IMPROVE ACCESS TO PRIMARY AND SPECIALTY CARE AND TO COLLABORATIVELY SHARE CHNA INFORMATION WITH PUBLIC AND PRIVATE PARTNERS. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSESANFORD FARGO IS CONTINUING ITS EFFORTS TO IMPROVE ACCESS TO MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES. UTILIZATION OF VIRTUAL VISITS FOR BEHAVIORAL HEALTH HAS CONTINUED TO GROW AND CONTRIBUTE TOWARD IMPROVED ACCESS. TIMELY ACCESS TO ADULT PSYCHIATRY CONTINUES TO BE AN AREA WE ARE WORKING TO IMPROVE AND MONITOR PROGRESS QUARTERLY. SANFORD CURRENTLY OFFERS MENTAL HEALTH AND SUBSTANCE ABUSE PROVIDERS IN THE COMMUNITY THROUGH VARIOUS DELIVERY OPPORTUNITIES. DEPRESSION SCREENING WILL BE UTILIZED IN THE ROOMING NAVIGATOR IN ALL CLINICS TO HELP IDENTIFY THOSE IN NEED OF CARE. OUR SUBOXONE CLINIC CONTINUES TO SERVE PATIENTS IN ADDICTION RECOVERY AND ENGAGES IN HOSPITAL PEER COACHING. SANFORD FARGO IS CONTINUING A PARTNERSHIP WITH CLAY COUNTY DETOX TO ENSURE COORDINATED UTILIZATION OF MEDICAL AND LAW ENFORCEMENT SUPPORT FOR INDIVIDUALS ACTIVELY IN DETOX.ACCESS TO HEALTH CARE PROVIDERS AND QUALITY CARE SANFORD FARGO INCREASED HOME-BASED PRIMARY CARE ACCESS AND CONTINUES TO UTILIZE THIS APPROACH TO IMPROVE ACCESS AS ALL PRIMARY CARE PROVIDERS NOW HAVE ACCESS TO THIS OPTION. PROVIDER RECRUITMENT PLAYS A MAJOR ROLE IN OUR ABILITY TO INCREASE OUR CAPACITY. INVESTING IN OUR EDUCATIONAL PROGRAMS TO SERVE AS A PIPELINE FOR PROVIDERS CONTINUES TO BE A PRIORITY. SANFORD SOUTH UNIVERSITY MEDICAL CENTER HAS 115 LICENSED BEDS AND SERVES AS A HUB FOR ORTHOPEDIC SURGERY AND REHABILITATION WITH INPATIENT UNITS FOR THESE SERVICES. SOUTH UNIVERSITY ALSO CURRENTLY HOUSES HIGHLY SPECIALIZED SERVICES, INCLUDING A BEHAVIORAL HEALTH INPATIENT AND PARTIAL HOSPITALIZATION UNIT, OPHTHALMOLOGY, A CENTER FOR CARDIAC AND VASCULAR SCREENING, AND A BIO-SKILLS AND CADAVER LAB FOR MEDICAL RESIDENTS. SANFORD HEALTH IS A MAJOR TEACHING HOSPITAL IN PARTNERSHIP WITH THE UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE AND HEALTH SCIENCES. THEY HAVE COLLABORATED TO LAUNCH SEVERAL NEW RESIDENCY AND FELLOWSHIP PROGRAMS IN THE LAST FIVE YEARS, INCLUDING ORTHOPEDICS, NEUROLOGY, ONCOLOGY, AND FAMILY MEDICINE.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREHEALTHY LIVINGPUBLIC TRANSPORTATIONQUALITY CHILDCAREAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 4 -- 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 4 -- SANFORD MEDICAL CENTER SOUTH UNIVERSITY PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 5 -- SANFORD BISMARCK MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 5 -- SANFORD BISMARCK MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH 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 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 5 -- SANFORD BISMARCK MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ADDRESS THE MENTAL HEALTH OF THE COMMUNITY THROUGH NEAR-TERM ACCESS IMPROVEMENT AND EARLY INTERVENTION IN COMMUNITY SCHOOLSMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.ACCORDING TO CHR, ADULTS IN THE BISMARCK AREA AVERAGE 3.7 MENTALLY UNHEALTHY DAYS EACH MONTH AND 12 PERCENT OF ADULTS AVERAGE AT LEAST 14 DAYS OF MENTAL DISTRESS PER MONTH. ONE OF THE MOST IMPORTANT MEASURES OF MENTAL HEALTH WITHIN A COMMUNITY IS SUICIDE. CHR DATA INDICATE THAT THERE ARE 17 SUICIDES FOR EVERY 100,000 PEOPLE IN THE BISMARCK AREA. IN ADDITION, THERE ARE 9 DRUG OVERDOSE DEATHS FOR EVERY 100,000 PEOPLE IN THE BISMARCK AREA. ACCORDING TO CHR, THE BISMARCK AREA HAS ONE MENTAL HEALTH PROVIDER FOR EVERY 437 PEOPLE, WHICH IS SLIGHTLY WORSE THAN THE COMPARISON GROUP AVERAGE. SANFORD HAS MADE THE MENTAL HEALTH OF THE COMMUNITY A PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPAND BEHAVIORAL HEALTH SERVICES OFFERED IN THE PRIMARY CARE SETTING AND IMPROVE MENTAL HEALTH RESOURCES FOR AREA STUDENTS.PRIORITY 2: IMPROVE ACCESS THROUGH INCREASED AVAILABILITY OF PROVIDERS, ADDITIONAL ACCESS POINTS, AND INTERVENTIONS TO DECREASE SUBSTANCE ABUSEMULTIPLE STAKEHOLDER GROUPS HIGHLIGHTED THE WAIT TIMES AT LOCAL EMERGENCY ROOMS AS AN ACCESS ISSUE. ONE AREA OF DISCUSSION IS HOW THE LACK OF A LOCAL DETOX FACILITY RESULTS IN MORE ER UTILIZATION BY THOSE THAT COULD OTHERWISE BE AT SUCH A FACILITY. ADDITIONAL DISCUSSIONS CENTERED ON THE IMPACT OF COST, TRANSPORTATION, NEED FOR ADDITIONAL CASE MANAGERS, AND OTHER SERVICES THAT COULD BE OFFERED OR IMPROVED. SANFORD HAS MADE A DECREASE IN SUBSTANCE ABUSE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO EXPLORE AND ENHANCE RELATIONSHIPS WITH ADDICTION SERVICE PROVIDERS AND TO EXPLORE FEASIBILITY OF JOINT DETOX FACILITIES AND FIRST RESPONDER RESOURCES. THIS WILL HAVE THE IMPACT OF INCREASING EMERGENCY ROOM ACCESS DUE TO FEWER INDIVIDUALS PRESENTING IN THE EMERGENCY ROOM WITH SUBSTANCE ABUSE RELATED ISSUES.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR ADDRESS THE MENTAL HEALTH OF THE COMMUNITY THROUGH NEAR-TERM ACCESS IMPROVEMENT AND EARLY INTERVENTION IN COMMUNITY SCHOOLS AT LEAST ONE SANFORD BEHAVIORAL HEALTH PROVIDER CURRENTLY PROVIDES SERVICES ON CAMPUS TO SIMLE MIDDLE SCHOOL. IN ADDITION, SANFORD'S BEHEARD PROGRAM IS BEING ROLLED OUT TO OTHER SCHOOLS ACROSS THE REGION AND OTHER STAFF, SUCH AS COACHES, AT SANFORD SPORTS HAVE BEEN TRAINED TO IDENTIFY AND ADDRESS SIGNS OF BEHAVIORAL HEALTH CRISIS. FURTHER SUPPORT IS PROVIDED THROUGH WEEKLY MEETINGS BETWEEN THERAPISTS AND THE SCHOOLS' LEADERSHIP TEAMS TO COORDINATE SUPPORT SERVICES FOR HIGH-RISK STUDENTS. TELEHEALTH SERVICES ARE PROVIDED DURING THE SUMMER TO CONTINUE CARE DELIVERY OPTIONS WHILE SCHOOL IS NOT IN SESSION. THE SUPPORT PROVIDED TO THE LOCAL SCHOOL DISTRICTS BUILDS UPON THE EFFORTS TO ENHANCE ACCESS THROUGH THE CLINIC AND HOSPITAL SYSTEM. SANFORD IS WORKING TO EXPAND ACCESS BEYOND STANDARD CLINIC HOURS. ONE EXAMPLE IS THE ADDITION OF AFTER-HOURS PSYCHIATRY SERVICES PROVIDED VIA TELEHEALTH ASSESSMENTS FOR PATIENTS THAT PRESENT IN THE EMERGENCY ROOM OVERNIGHT. FURTHERMORE, SANFORD PARTNERS WITH A LOCAL SUBSTANCE ABUSE TREATMENT CENTER TO CO-LOCATE A COUNSELOR IN THE EMERGENCY ROOM FOR THOSE THAT NEED IT. SANFORD ALSO OFFERS BEHAVIORAL AND SUBSTANCE ABUSE SERVICES THROUGHOUT THEIR CARE DELIVERY FOOTPRINT AND CONTINUES TO EXPAND THE INTEGRATION OF THESE SERVICES INTO VARIOUS CARE SETTINGS, INCLUDING INTEGRATED HEALTH THERAPISTS WITHIN PRIMARY CARE CLINICS.IMPROVE ACCESS THROUGH INCREASED AVAILABILITY OF PROVIDERS, ADDITIONAL ACCESS POINTS, AND INTERVENTIONS TO DECREASE SUBSTANCE ABUSESANFORD LEADERS HAVE ENGAGED BOTH LOCAL AND STATE LEADERS IN AN EFFORT TO EXPAND BOTH BEHAVIORAL HEALTH AND ADDICTION COUNSELING SERVICES. IN ADDITION, SANFORD HAS HIRED ADDITIONAL BEHAVIORAL HEALTH PROVIDERS IN BISMARCK-MANDAN AND ELSEWHERE IN THE REGION TO ACCOMMODATE INCREASING DEMAND. SANFORD ALSO MEETS ON A QUARTERLY BASIS WITH LOCAL LAW ENFORCEMENT, EMERGENCY DEPARTMENT PROVIDERS AND OTHER PARTNERS TO DISCUSS TRENDS, NEW DEVELOPMENTS, INCLUDING SUBSTANCE ABUSE.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREHEALTHY LIVING LONG-TERM SENIOR CARE QUALITY CHILD CAREPUBLIC TRANSPORTATIONSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 5 -- 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 5 -- SANFORD BISMARCK MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 6 -- SANFORD BEMIDJI MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 6 -- SANFORD BEMIDJI MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH 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 6 -- 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 6 -- SANFORD BEMIDJI MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: INCREASE ACCESS TO HEALTHCARE PROVIDERSSANFORD BEMIDJI (SB) PLAYS A VITAL ROLE IN ENSURING THAT PATIENTS IN RURAL MN HAVE ACCESS TO HEALTH CARE SERVICES. AS THE COMMUNITY AGES AND AS CHALLENGES WITH CLINICIAN RECRUITMENT AND HEALTH CARE INFRASTRUCTURE CHANGES ARISE, MAINTAINING ROBUST AND SUSTAINABLE HEALTH CARE ACCESS BECOMES INCREASINGLY CRITICAL. SANFORD HEALTH IS COMMITTED TO ENSURING THAT THE QUALITY OF CARE IS NOT INFLUENCED BY A PATIENT'S LOCATION.SB HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE ACCESS TO HEALTHCARE PROVIDERS WITHIN THE COMMUNITY. THIS EFFORT WILL FOCUS ON THREE PRIMARY GOALS: TO IMPROVE OPPORTUNITIES FOR TRANSPORTATION FOR PATIENTS TO HEALTH-RELATED APPOINTMENTS, TO PROVIDE INCREASED OPPORTUNITIES FOR PATIENTS TO RECEIVE EARLY SCREENING AND VACCINATIONS, AND TO EXPAND VIRTUAL HEALTH CARE OPTIONS FOR PATIENTS.PRIORITY 2: INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES AND SUBSTANCE ABUSE TREATMENTINCREASING BEHAVIORAL HEALTH SERVICES AND EXPANDING ACCESS TO SUBSTANCE ABUSE TREATMENT ARE CRITICAL FOR ADDRESSING THE GROWING MENTAL HEALTH AND ADDICTION CRISES. BY PROVIDING COMPREHENSIVE SUPPORT AND ACCESSIBLE CARE, SB CAN HELP INDIVIDUALS MANAGE THEIR CONDITIONS, REDUCE STIGMA, AND PROMOTE RECOVERY. STRENGTHENING THESE SERVICES IS ESSENTIAL FOR IMPROVING OVERALL PUBLIC HEALTH, ENHANCING QUALITY OF LIFE, AND BUILDING HEALTHIER COMMUNITIES.SANFORD HAS MADE BEHAVIORAL HEALTH AND SUBSTANCE ABUSE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN THESE SERVICES. IT IS SANFORD'S GOALS TO FOCUS ON INCREASING ACCESS TO VIRTUAL VISITS FOR BEHAVIORAL HEALTH CARE, TO INCREASE ACCESS TO SUBSTANCE USE SERVICES AND TO PROVIDE SUBSTANCE USE AND MENTAL HEALTH SERVICES TO THE INCARCERATED IN BELTRAMI COUNTY.PRIORITY 3: INCREASE ACCESS TO AFFORDABLE HEALTHCAREINCREASING ACCESS TO AFFORDABLE HEALTHCARE HELPS REDUCE HEALTH DISPARITIES BY PROVIDING EQUAL ACCESS TO PREVENTIVE SERVICES, TREATMENTS, AND ONGOING CARE, WHICH CONTRIBUTES TO OVERALL BETTER HEALTH OUTCOMES AND A HIGHER QUALITY OF LIFE. ACCESSIBLE, AFFORDABLE HEALTHCARE ALSO SUPPORTS EARLY INTERVENTION, REDUCING THE NEED FOR EMERGENCY CARE AND MITIGATING THE LONG-TERM ECONOMIC AND HEALTH IMPACTS ON THE COMMUNITY.SANFORD HAS MADE AFFORDABLE CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN OPTIONS FOR ACCESS TO AFFORDABLE CARE. IT IS SANFORD'S GOAL TO LAUNCH A "MAKING CARE PRIMARY" INITIATIVE TO IMPROVE PATIENTS CARE EXPERIENCE WHILE IMPROVING HEALTHCARE OUTCOMES AND LOWER THE OVERALL COST OF CARE.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARINCREASE ACCESS TO HEALTH CARE PROVIDERSSANFORD HEALTH CURRENTLY OPERATES A CRITICAL ACCESS HOSPITAL WITH REHAB AND AMBULANCE SERVICES IN BAGLEY AS WELL AS 11 NETWORK LOCATIONS, PROVIDING PRIMARY CARE, EYE CARE AND OPTICAL SERVICES, KIDNEY DIALYSIS, PHARMACY SERVICES, OUTPATIENT REHAB AND BEHAVIORAL HEALTH CARE. OUTREACH SERVICES AND SPECIALTIES INCLUDE ORTHOPEDICS, SLEEP MEDICINE, NEPHROLOGY, OBSTETRICS AND GYNECOLOGY, GENERAL SURGERY, CARDIOLOGY, PODIATRY, BARIATRICS, ONCOLOGY, OPHTHALMOLOGY, INTERVENTIONAL PAIN MANAGEMENT, DERMATOLOGY, OPTOMETRY, BEHAVIORAL HEALTH AND INTERNAL MEDICINE.IN AN EFFORT TO ATTRACT CLINICIANS, SB PARTNERS WITH REGIONAL MEDICAL SCHOOLS TO PREPARE STUDENTS FOR PRACTICING IN RURAL COMMUNITIES. THROUGH THESE PARTNERSHIPS, STUDENTS ENGAGE IN A YEAR-LONG EXPERIENCE LIVING IN BEMIDJI WHILE LEARNING FROM LOCAL CLINICIANS IN FAMILY MEDICINE, PEDIATRICS, INTERNAL MEDICINE, OB/GYN, SURGERY, PSYCHIATRY AND EMERGENCY MEDICINE. ADDITIONALLY, WE HAVE A ROBUST THREE-YEAR RECRUITMENT PLAN.THE "FAMILIES FIRST" PROGRAM EXPANDS AND ENHANCES SERVICES, DECREASING ADVERSE PATIENT OUTCOMES, REDUCING COSTS AND SUPPORTING PATIENTS SO MOTHERS, BABIES AND FAMILIES THRIVE FOR GENERATIONS TO COME. A CRITICAL PART OF THIS PROGRAM INCLUDES TRANSPORTATION FOR PRE-NATAL APPOINTMENTS. WE OFFER SEVERAL OPPORTUNITIES THROUGHOUT THE YEAR FOR COMMUNITY MEMBERS TO GET SCREENINGS, REGARDLESS IF THEY HAVE A PRIMARY CARE PROVIDER OR HEALTH INSURANCE.SANFORD HEALTH LAUNCHED A VIRTUAL CARE INITIATIVE TO TRANSFORM DELIVERING CARE BY EXPANDING ACCESS, IMPROVING PATIENT EXPERIENCES, ADVANCING INNOVATION THROUGH NEW RESEARCH, AND ATTRACTING AND TRAINING A NEW GENERATION OF CLINICIANS. INCREASE ACCESS TO BEHAVIORAL HEALTH SERVICES & SUBSTANCE ABUSE TREATMENTSANFORD BEHAVIORAL HEALTH OF NORTHERN MINNESOTA IS A CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC, ADOPTING A MODEL TO INTEGRATE BEHAVIORAL AND PHYSICAL HEALTH CARE, EXPAND ACCESS TO MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES, AND ENSURE CONSISTENT USE OF EVIDENCE-BASED PRACTICES. THIS EMPHASIZES COMMUNITY OUTREACH, OFFERING SERVICES IN PATIENTS' HOMES AND VIA TELEHEALTH.PATIENTS AGED 10 AND OLDER ARE ABLE TO SELF-SCHEDULE VIRTUAL BEHAVIORAL HEALTH APPOINTMENTS WITHOUT A REFERRAL. ADDITIONALLY, EMERGENCY DEPARTMENTS ARE CONNECTED TO PSYCHIATRISTS WHO ASSESS AND MANAGE EMERGENT BEHAVIORAL HEALTH CRISES VIRTUALLY.THE SANFORD BEMIDJI CRISIS CENTER FEATURES AN INNOVATIVE EMPATH UNIT (EMERGENCY PSYCHIATRIC ASSESSMENT, TREATMENT, AND HEALING), OFFERING URGENT CARE IN A CALMING ENVIRONMENT FOR UP TO 23 HOURS. IT INCLUDES SEPARATE AREAS FOR CHILDREN AND ADULTS, WITH SPACES DESIGNED FOR CULTURAL AND SPIRITUAL HEALING, PARTICULARLY FOR INDIGENOUS PATIENTS. THE CENTER INCLUDES THE REGION'S ONLY INPATIENT PSYCHIATRIC UNIT WITHIN A 90-MILE RADIUS.SANFORD HEALTH INTEGRATES BEHAVIORAL HEALTH SERVICES IN PRIMARY CARE CLINICS AND ONCOLOGY DEPARTMENTS THROUGH ON-SITE INTEGRATED HEALTH THERAPISTS, ENSURING THAT PATIENTS NEEDING FURTHER ASSESSMENT CAN RECEIVE IMMEDIATE SUPPORT. MOBILE CRISIS RESPONSE SERVICES PROVIDE 24/7 CRISIS INTERVENTION FOR ALL AGES.SANFORD'S SCHOOL-BASED PROGRAMS OFFER MENTAL HEALTH SUPPORT IN LOCAL ELEMENTARY SCHOOLS, WHILE THE YOUTH ASSERTIVE COMMUNITY TREATMENT PROGRAM PROVIDES INTENSIVE, MULTIDISCIPLINARY CARE FOR YOUTH WITH SEVERE MENTAL HEALTH NEEDS. THE SUBSTANCE USE DISORDER PROGRAM OFFERS PERSONALIZED TREATMENT PLANS, INCLUDING ABSTINENCE-BASED AND HARM-REDUCTION APPROACHES, WITH SPECIALIZED GROUPS FOR VARIOUS POPULATIONS. SANFORD HEALTH WAS THE FIRST NON-NATIVE ORGANIZATION TO EARN WELLBRIETY CERTIFICATION, INTEGRATING CULTURAL HEALING PRACTICES FOR NATIVE AMERICAN PATIENTS.THE PRIMEWEST RESIDENTIAL SUPPORT CENTER OFFERS SHORT-TERM RESIDENTIAL CARE FOR ADULTS IN MENTAL HEALTH CRISES. THE NEW BEGINNINGS RE-ENTRY PROJECT ASSISTS FORMERLY INCARCERATED INDIVIDUALS IN TRANSITIONING BACK TO SOCIETY.INCREASE ACCESS TO AFFORDABLE HEALTH CARESANFORD HEALTH CURRENTLY OFFERS FINANCIAL ASSISTANCE FOR PATIENTS WHO NEED MEDICALLY NECESSARY SERVICES OR EMERGENCY CARE. WE HAVE ALSO IMPLEMENTED A PRESUMPTIVE COMMUNITY CARE POLICY. INSTEAD OF WAITING FOR A PATIENT TO CONTACT US AFTER A BILL HAS BEEN SENT TO COLLECTIONS, WE PROACTIVELY EVALUATE SOME OF THE PATIENT'S DEMOGRAPHIC INFO AND OTHER FACTORS TO DETERMINE NEED OF FINANCIAL ASSISTANCE.SANFORD HEALTH HELPS PATIENTS IN NEED THROUGH THE PROVIDING NEEDED AID TO PATIENTS LOCALLY FOUNDATION FUND. FUNDS ARE USED TO HELP ESTABLISH PATIENT SELF-MANAGEMENT AND TO GET ITEMS THAT WILL STREAMLINE CARE LIKE BLOOD PRESSURE CUFFS, SCALES, PULSE OXIMETERS, PILL BOXES, WHEELCHAIRS, SHOWER CHAIRS AND DRESSING SUPPLIES. FUNDS CAN ALSO BE USED FOR COPAYS AND TRANSPORTATION.SANFORD HEALTH'S PRESCRIPTION ASSISTANCE PROGRAM OFFERS TIERED ASSISTANCE BASED ON INCOME LEVEL TO HELP PATIENTS AFFORD MEDICATION. IF A PATIENT INDICATES THEY CANNOT AFFORD THEIR MEDICATION, CLINICIANS CAN PRESUMPTIVELY QUALIFY THEM. PATIENTS WHO MEET PROGRAM GUIDELINES ARE ELIGIBLE FOR SIX MONTHS OF PRESCRIPTION ASSISTANCE. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:HEALTHY LIVINGEMPLOYMENT & ECONOMIC OPPORTUNITYLONG-TERM SENIOR CARECHILD CARE QUALITYCOMMUNITY SAFETYAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 6 -- 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 6 -- SANFORD BEMIDJI MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 7 -- SANFORD MEDICAL CENTER THIEF RIVER FALLS PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 7 -- SANFORD MEDICAL CENTER THIEF RIVER FALLS PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 BEHAVIORAL HEALTH CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 7 -- 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 7 -- SANFORD MEDICAL CENTER THIEF RIVER FALLS PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: INCREASE ACCESS TO SPECIALTY CARE SERVICES AND SAME-DAY APPOINTMENTSWHEN SURVEY RESPONDENTS IN THE THIEF RIVER FALLS (TRF) MARKET AREA WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, THREE-FOURTHS OF SURVEY RESPONDENTS INDICATED THAT THERE ARE HEALTH CARE SERVICES THEY WOULD LIKE TO SEE OFFERED OR IMPROVED IN THEIR COMMUNITY. WHEN THESE RESPONDENTS WERE ASKED WHICH HEALTH CARE SERVICES THEY WOULD LIKE TO SEE OFFERED OR IMPROVED, MOST SAID BEHAVIORAL AND MENTAL HEALTH SERVICES, FOLLOWED BY CANCER CARE, ADDICTION TREATMENT, DENTAL CARE, WALK-IN/URGENT CARE, LONG-TERM CARE AND NURSING HOMES, OBGYN/WOMEN'S CARE, FAMILY MEDICINE OR PRIMARY CARE, AND HEART CARE.SANFORD HAS MADE ACCESS TO SPECIALTY CARE SERVICES AND SAME-DAY APPOINTMENTS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN SAME-DAY APPOINTMENT AVAILABILITY. IT IS SANFORD'S GOAL TO EXPAND SAME-DAY APPOINTMENTS WITHIN PRIMARY CARE AND TO ENHANCE ACCESS TO THE TOP THREE SERVICES IDENTIFIED IN THE COMMUNITY SURVEY (MENTAL HEALTH, CANCER CARE AND SUBSTANCE ABUSE).PRIORITY 2: PROMOTE COMMUNITY SERVICES WITH COMMUNITY PARTNERSBY PARTNERING WITH LOCAL ENTITIES, SANFORD MEDICAL CENTER TRF AIMS TO ADDRESS THE INTERCONNECTED ECONOMIC, SOCIAL, AND HEALTH NEEDS OF OUR COMMUNITY. THIS COLLABORATIVE APPROACH NOT ONLY ENHANCES ACCESS TO ESSENTIAL RESOURCES BUT ALSO FOSTERS A HEALTHIER, MORE RESILIENT POPULATION.SANFORD HAS MADE PROMOTING COMMUNITY SERVICES WITH COMMUNITY PARTNERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO CREATE A LASTING POSITIVE IMPACT ON THE OVERALL WELLBEING OF THE COMMUNITY WE SERVE. IT IS SANFORD'S GOAL TO PARTNER WITH COUNTY HEALTH FOR EDUCATIONAL RESOURCES AND TO PROMOTE SANFORD.FINDHELP.COMPRIORITY 3: INCREASE ACCESS TO MENTAL HEALTH SERVICESMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE INCREASING ACCESS TO MENTAL HEALTH SERVICES A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES FOR THE COMMUNITY TO SEE EXPANDED ACCESS TO GROUP THERAPY SESSIONS AND AN EXPANDED CLINICAL TRAINING PROGRAM TO INCREASE ACCESS. IT IS SANFORD'S GOAL TO REDUCE WAIT TIME FOR MENTAL HEALTH SERVICES BY OFFERING GROUP THERAPY AND TO EXPAND THE CLINICAL TRAINING PROGRAM.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARINCREASE ACCESS TO SPECIALTY CARE SERVICES AND SAME-DAY APPOINTMENTSACCESS TO HEALTHCARE PROVIDERS REMAINS A TOP PRIORITY IN TRF. WE HAVE SUCCESSFULLY LEVERAGED TELEHEALTH TECHNOLOGIES TO EXPAND ACCESS BEYOND TRADITIONAL IN-PERSON CONSULTATIONS. WHILE THE POTENTIAL FOR TELEHEALTH IS SIGNIFICANT, ITS ADOPTION IS SOMEWHAT CONSTRAINED BY EXISTING PAYMENT MODELS AND THE WILLINGNESS OF INSURANCE PAYERS TO RECOGNIZE TELEHEALTH AS A COVERED SERVICE AND THE PERCEPTION OF THIS SERVICE FROM PROVIDERS AND OLDER PATIENTS NOT FEELING THE SAME PROVIDER-PATIENT RELATIONSHIP.PROMOTE COMMUNITY SERVICES WITH COMMUNITY PARTNERSSANFORD TRF IS COMMITTED TO BEING AN ENGAGED COMMUNITY PARTNER ACROSS VARIOUS LEVELS AND ORGANIZATIONS. WE ACTIVELY SUPPORT ECONOMIC DEVELOPMENT INITIATIVES, COLLABORATE WITH THE CHAMBER OF COMMERCE, AND ENGAGE WITH THE LOCAL SCHOOL SYSTEM. OUR INVOLVEMENT EXTENDS TO COMMUNITY HEALTH AND FITNESS PROGRAMS, EVENTS, AND A LOCAL YOUNG PROFESSIONALS' NETWORK, CONTRIBUTING TO A VIBRANT AND HEALTHY COMMUNITY.WE ARE ALSO DEDICATED TO INVESTING IN EDUCATIONAL PROGRAMS TAILORED TO ADDRESS CRITICAL HEALTH TOPICS, INCLUDING COURSES FOCUSED ON CARDIAC HEALTH, PREGNANCY, DIABETES, AND MORE. ADDITIONALLY, WE ADVOCATE FOR POLICY CHANGES AT THE LOCAL, STATE, AND FEDERAL LEVELS, WORKING ALONGSIDE ADVOCACY GROUPS TO PROMOTE HEALTH EQUITY AND IMPROVED HEALTH OUTCOMES.INCREASE ACCESS TO MENTAL HEALTH SERVICESSANFORD TRF BEHAVIORAL HEALTH CENTER (SBHC) SERVES AS THE ONLY FREESTANDING BEHAVIORAL HEALTH HOSPITAL AND PRIMARY PROVIDER OF INPATIENT PSYCHIATRIC SERVICES FOR NORTHWEST MINNESOTA, WITH 16 INPATIENT PSYCHIATRIC BEDS. THE HOSPITAL OFFERS OUTPATIENT MENTAL HEALTH SERVICES, CHILDREN'S THERAPEUTIC SERVICES AND SUPPORT, AND OUTPATIENT SUBSTANCE USE TREATMENT. THE HOSPITAL IS ACTIVELY RECRUITING BOTH MASTER'S AND DOCTORAL-LEVEL PROFESSIONALS. TELEHEALTH HAS BEEN INSTRUMENTAL IN RETAINING CLINICIANS WHO MIGHT HAVE RELOCATED, ALLOWING US TO MAINTAIN SERVICE CONTINUITY. EIGHT OF OUR CLINICIANS NOW EXCLUSIVELY PROVIDE TELEHEALTH SERVICES, WHILE MANY OTHERS INTEGRATE IT INTO THEIR PRACTICE. THIS EXPANSION OF TELEHEALTH HAS SIGNIFICANTLY IMPROVED ACCESS TO MENTAL HEALTH CARE.WE HAVE INVESTED SIGNIFICANT EFFORT TO IMPROVE OUR INTAKE PROCESS FOR THERAPY SERVICES INCLUDING COMPLETING AN INTAKE SCREENING AND UPDATING OUR WAITLIST TO AID IN BEST ALIGNING CLINICIAN EXPERTISE AND AVAILABILITY WITH PATIENT NEEDS.SBHC STAFF PROVIDED 8 SAFETALK TRAININGS THROUGHOUT THE REGION, WHICH IS A 4-HOUR TRAINING THAT EQUIPS PEOPLE TO BE MORE ALERT TO SOMEONE THINKING OF SUICIDE AND BETTER ABLE TO CONNECT THEM WITH FURTHER HELP. SBHC AND SANFORD HEALTH MEDICAL CENTER STAFF ALSO PARTNERED WITH COMMUNITY STRONG TO PROVIDE EDUCATION AND OUTREACH EVENTS AT SPORTS GAMES, TEENS TOWARD ZERO DEATHS, AS WELL AS HOSTING/SPONSORING THE ANNUAL BE THE VOICE EVENT IN THIEF RIVER FALLS. IN ADDITION, SBHC CONNECTED WITH VARIOUS OTHER AGENCIES, GROUPS, AND COMMUNITIES.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO QUALITY HEALTHCAREPUBLIC TRANSPORTATIONLONG-TERM SENIOR CAREQUALITY CHILD CAREAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 7 -- 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 7 -- SANFORD MEDICAL CENTER THIEF RIVER FALLS PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 8 -- SANFORD ABERDEEN MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 8 -- SANFORD ABERDEEN MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH 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 8 -- 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 8 -- SANFORD ABERDEEN MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO HEALTH CARE PROVIDERS DUE TO LACK OF TRANSPORTATION OR COSTCOST AND THE ABILITY TO AFFORD NEEDED HEALTH CARE WAS IDENTIFIED AS THE TOP HEALTH CARE CONCERN THAT SURVEY RESPONDENTS AND THEIR FAMILIES IN THE AREA FACE ON A REGULAR BASIS. IN ADDITION, RESPONDENTS IN THE AREA INDICATED THAT THEY OR A FAMILY MEMBER NEEDED MEDICAL CARE IN THE PAST YEAR BUT DID NOT RECEIVE IT. ADDING TO THE CHALLENGES IN ACCESSING AFFORDABLE HEALTH CARE IS THE NUMBER IN THE AREA THAT ARE UNINSURED.SANFORD HAS MADE HEALTHCARE ACCESS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE AND IMPROVE ACCESS TO SERVICES AND EDUCATION. IT IS SANFORD'S GOAL TO IMPROVE SCREENING FOR SOCIAL DETERMINANTS OF HEALTH AND TO ADDRESS TRANSPORTATION BARRIERS FOR PATIENTS.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSGENERAL ACCESS TO HEALTH CARE AND A SHORTAGE OF HEALTH CARE PROVIDERS WAS ONE OF THE TOP ISSUES, WHEN RESPONDENTS WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY. NEARLY TWO-THIRDS OF RESPONDENTS HAD TRAVELED TO RECEIVE HEALTH CARE SERVICES OUTSIDE THEIR COMMUNITY AND THE SPECIALTY CARE, OR THE NEEDED SERVICES WERE NOT AVAILABLE LOCALLY. IN ADDITION, THERE ARE HEALTH CARE SERVICES THEY WOULD LIKE TO SEE OFFERED OR IMPROVED IN THE COMMUNITY. SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE AND IMPROVE ACCESS TO A COMPREHENSIVE PANEL OF PRIMARY CARE AND SPECIALTY PROVIDERS. IT IS SANFORD'S GOAL TO IMPROVE WEIGHT MANAGEMENT SERVICES TO MITIGATE CHRONIC DISEASE IMPACT AND ENHANCE OVERALL ACCESS TO PRIMARY CARE IN THE COMMUNITY. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO HEALTH CARE PROVIDERS DUE TO LACK OF TRANSPORTATION OR COSTSANFORD ABERDEEN MEDICAL CENTER (SAMC) IS COMMITTED TO IMPROVING ACCESS TO HEALTHCARE PROVIDERS. SAMC PROVIDES PATIENTS WITH TAXI VOUCHERS IF NECESSARY TO GET THEM A RIDE FROM SAMC'S FACILITY (ABERDEEN SHUTTLE AND TAXI SERVICE). SANFORD HEALTH FOUNDATION FUNDS ARE AVAILABLE TO ASSIST PATIENTS THAT HAVE A NEED TO TRAVEL FOR ONCOLOGY/CANCER CARE. SAMC DIRECTS PATIENTS TO LOCAL VETERAN ORGANIZATIONS WHICH HAVE SERVICES TO TRANSPORT VETERANS TO APPOINTMENTS AND TO PNAPLE (PROVIDING NEEDED AID TO PATIENTS LOCALLY) FUNDS WHICH ARE AVAILABLE TO ASSIST PATIENTS WITH NEEDS INCLUDING TRANSPORTATION. SAMC WILL CONTINUE TO PROVIDE OUTREACH AND TELEMEDICINE SERVICES WHERE ABLE.ACCESS TO HEALTH CARE PROVIDERSSAMC SEEKS TO ENSURE THAT PATIENTS HAVE ACCESS TO HEALTHCARE PROVIDERS IN ABERDEEN AND THE SURROUNDING AREA. CURRENT SERVICES PROVIDED ONSITE INCLUDE: PRIMARY CARE, CARDIOLOGY, HEART AND VASCULAR SCREENING, BEHAVIORAL HEALTH THERAPIST, GENERAL SURGERY, COLORECTAL SCREENING, UROLOGY, ONCOLOGY/CANCER CARE, EAR NOSE AND THROAT, ORTHOPEDICS AND PODIATRY, WOUND CARE, OB/GYN (INCLUDING THE DELIVERY OF BABIES), RADIOLOGY, RESPIRATORY THERAPY, OUTPATIENT THERAPY AND REHABILITATION, 24/7 ANESTHESIA AND 24/7 EMERGENCY DEPARTMENT. CURRENT SERVICES PROVIDED VIA OUTREACH CONSIST OF: NEUROSURGERY, VASCULAR, NEPHROLOGY, PULMONOLOGY, NEUROLOGY, RHEUMATOLOGY, MATERNAL FETAL MEDICINE, DERMATOLOGY, PEDIATRIC, HEMATOLOGY/ONCOLOGY, PEDIATRIC GASTROENTEROLOGY, PEDIATRIC ENDOCRINOLOGY, PEDIATRIC PULMONOLOGY (TELEMEDICINE), PEDIATRIC REHABILITATION, PEDIATRIC CARDIOLOGY, PEDIATRIC NEUROLOGY AND PEDIATRIC SURGERY.SANFORD ABERDEEN HAS AN RN CARE MANAGER AND A COMMUNITY HEALTH WORKER THAT WORKS IN CONJUNCTION WITH OUR BEHAVIORAL CARE COUNSELOR, PROVIDERS IN FAMILY MEDICINE, AND SPECIALTY PROVIDERS TO FIND RESOURCES FOR INDIVIDUALS WITH MENTAL HEALTH DISPARITIES.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:LONG-TERM SENIOR CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 8 -- 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 8 -- SANFORD ABERDEEN MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 9 -- SANFORD WORTHINGTON MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 9 -- SANFORD WORTHINGTON MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTER
GROUP A-FACILITY 9 -- 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 9 -- SANFORD WORTHINGTON MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: INCREASE ACCESS TO PROVIDERS AND QUALITY OF CAREWHEN SURVEY RESPONDENTS IN THE WORTHINGTON AREA WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, ACCESS TO HEALTH CARE SERVICES AND PROVIDERS WAS THE TOP ISSUE. IN ADDITION, 76 PERCENT OF SURVEY RESPONDENTS IN THE WORTHINGTON AREA REPORTED TRAVELING OUTSIDE OF THEIR COMMUNITY TO RECEIVE HEALTH CARE SERVICES IN THE PAST THREE YEARS. REASONS GIVEN WERE THAT THEY NEEDED SPECIALTY CARE, OR THE NEEDED SERVICES WERE NOT AVAILABLE LOCALLY, THEY WERE REFERRED BY A PHYSICIAN OR THEY SOUGHT BETTER OR HIGHER QUALITY CARE ELSEWHERE. ADDING TO THE CHALLENGES OF RECEIVING QUALITY HEALTH CARE ARE POTENTIAL LANGUAGE BARRIERS. CHR DATA INDICATE THAT 11 PERCENT OF PEOPLE IN THE WORTHINGTON AREA DO NOT SPEAK ENGLISH WELL.SANFORD HAS MADE INCREASING ACCESS TO CARE AND QUALITY OF CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE ACCESS TO AND UTILIZATION OF LOCAL SERVICES. IT IS SANFORD'S GOAL TO FURTHER ASSESS STAFF PERCEPTIONS OF HEALTHCARE SERVICE GAPS AND UTILIZE INFORMATION LEARNED TO INFORM OPPORTUNITIES FOR ADDITIONAL SERVICES AND HIGH-QUALITY CARE, AND TO RECONVENE THE COMMUNITY HEALTH COALITION TO ADVANCE ACCESS IMPROVEMENT INITIATIVES.PRIORITY 2: EDUCATE COMMUNITY ON SERVICES AVAILABLE LOCALLYSANFORD HAS MADE IT A SIGNIFICANT PRIORITY TO EDUCATE THE COMMUNITY ON SERVICES AVAILABLE LOCALLY AND HAS DEVELOPED STRATEGIES TO INCREASE COMMUNICATION REGARDING HOSPITAL AND CLINIC SERVICE AND QUALITY EFFORTS. IT IS SANFORD'S GOAL TO DEVELOP COMMUNICATION AND MARKETING STRATEGIES THAT HAVE EXTENDED REACH INTO OUR SERVICE AREA.PRIORITY 3: HEALTHY LIVINGWHEN SURVEY RESPONDENTS IN THE WORTHINGTON AREA WERE ASKED ABOUT THE BIGGEST HEALTH CONCERNS FOR THEMSELVES AND THEIR FAMILY, CHRONIC HEALTH ISSUES WERE AMONG THE TOP CONCERNS. THE MOST FREQUENTLY CITED CHRONIC HEALTH CONCERNS INVOLVED WEIGHT, DIABETES, CANCER, AND HEART DISEASE. CHR DATA INDICATE THAT 11 PERCENT OF ADULTS IN THE WORTHINGTON AREA HAVE DIABETES AND 39 PERCENT OF ADULTS HAVE OBESITY.SANFORD HAS MADE HEALTHY LIVING A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES FOR THE COMMUNITY TO SEE SANFORD HEALTH PARTICIPATE IN HEALTH PROMOTION ACTIVITIES AND HAVE SANFORD STAFF SEE INCREASED OPPORTUNITIES FOR HEALTH AND WELLBEING. IT IS SANFORD'S GOAL TO COLLABORATE WITH COMMUNITY PARTNERS ON ACTIVITIES THAT PROMOTE HEALTH AND WELLBEING AND DELIVER HEALTH EDUCATION TO COMMUNITY GROUPS AND TO INCREASE OPPORTUNITIES THAT CONTRIBUTE TO SANFORD WORTHINGTON STAFF HEALTH AND WELLBEING.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARINCREASE ACCESS TO PROVIDERS AND QUALITY OF CARESANFORD WORTHINGTON PROVIDES MORE THAN 50 MEDICAL SERVICES TO THE LOCAL COMMUNITY, INCLUDING GENERAL AND SAME DAY SURGERY, A 27-BED MEDICAL/SURGICAL UNIT, INTENSIVE CARE, LAB AND MEDICAL IMAGING, WOMEN'S SERVICES INCLUDING DIGITAL MAMMOGRAPHY, OUTPATIENT DIALYSIS, INFUSION CENTER, ONCOLOGY SERVICES INCLUDING CHEMOTHERAPY AND RADIATION THERAPY, AND A 24/7 EMERGENCY DEPARTMENT WITH IN-HOUSE PHYSICIAN COVERAGE. AN ACUTE CARE CLINIC PROVIDES WALK-IN, AFTER-HOURS AND WEEKEND SERVICES. BILINGUAL SPANISH COMMUNITY HEALTH WORKERS (CHWS) ARE ALSO AVAILABLE TO COMPLETE SDOH ASSESSMENTS AND REFER PATIENTS TO NEEDED SERVICES. VIRTUAL CARE SERVICES ARE ALSO AVAILABLE THROUGH THE HEALTH SYSTEM. IN TOTAL, SANFORD WORTHINGTON EMPLOYS 25 MEDICAL STAFF. EDUCATE COMMUNITY ON SERVICES AVAILABLE LOCALLYSANFORD MARKETING ASSISTS WITH THE DEVELOPMENT OF MARKETING CAMPAIGNS FOR VARIOUS SERVICES, HEALTH SCREENINGS AND HEALTH TOPICS FOR THE SANFORD WORTHINGTON SERVICE AREA. DIGITAL SIGNAGE IS LOCATED AT THE SANFORD WORTHINGTON MEDICAL CENTER CAMPUS TO COMMUNICATE ABOUT IMPORTANT HEALTH REMINDERS AND EVENTS AS WELL AS LOCAL SERVICES. SANFORD WORTHINGTON ENGAGES THROUGH PARTICIPATION IN COMMUNITY EVENTS THAT PROMOTE SANFORD SERVICES, PROVIDERS AND EMPLOYMENT OPPORTUNITIES.HEALTHY LIVINGIN ADDITION TO THE SERVICES PROVIDED THROUGH THE CLINIC AND HOSPITAL, SANFORD WORTHINGTON MAINTAINS STRONG COMMUNITY PARTNERSHIPS THAT PROVIDE OPPORTUNITIES TO PROMOTE IMPORTANT HEALTH TOPICS. THE HOSPITAL INCLUDES AN ACTIVE INTERNAL EMPLOYEE HEALTH & WELLBEING COMMITTEE WITH REPRESENTATION OF ALL HOSPITAL AND CLINIC DEPARTMENTS THAT MEET MONTHLY TO CREATE VARIOUS HEALTH AND WELLNESS OPPORTUNITIES FOR STAFF TO ENGAGE IN.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREMENTAL HEALTHCHILD CARE QUALITYLONG-TERM SENIOR CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 9 -- 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 9 -- SANFORD WORTHINGTON MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 10 -- SANFORD SHELDON MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 10 -- SANFORD SHELDON MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 THIEF RIVER FALLS BEHAVIORAL HEALTH 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 10 -- 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 10 -- SANFORD SHELDON MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO AFFORDABLE HEALTH CARECOST AND THE ABILITY TO AFFORD NEEDED HEALTH CARE WAS IDENTIFIED AS THE TOP HEALTH CARE CONCERN THAT SURVEY RESPONDENTS AND THEIR FAMILIES IN THE SHELDON AREA FACE ON A REGULAR BASIS. IT WAS ALSO THE SECOND LEADING COMMUNITY HEALTH CARE ISSUE, BEHIND GENERAL ACCESS ISSUES. CONCERNS AROUND THE COST OF HEALTH CARE EXIST DESPITE A POSITIVE PERCEPTION OF EMPLOYMENT AND ECONOMIC OPPORTUNITIES BY SURVEY RESPONDENTS IN THE SHELDON AREA. SANFORD HAS MADE ACCESS TO AFFORDABLE HEALTH CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE INCREASED NUMBERS OF RESIDENTS RECEIVE RECOMMENDED PREVENTIVE SCREENINGS AND RECOMMENDED VACCINATIONS. IT IS SANFORD'S GOAL TO PROMOTE THE IMPORTANCE OF GETTING RECOMMENDED SCREENINGS AND VACCINATIONS AND KEEP MORE PATIENTS IN THE AREA VERSUS TRAVELING TO RECEIVE CARE.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERSWHEN SURVEY RESPONDENTS IN THE SHELDON MARKET AREA WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, HAVING ACCESS TO MEDICAL CARE AND HEALTH CARE PROVIDERS WAS THE LEADING ISSUE. FIFTY PERCENT OF SURVEY RESPONDENTS IN THE SHELDON AREA HAVE TRAVELED FOR CARE IN THE PAST THREE YEARS. FOR THOSE RESPONDENTS WHO HAVE TRAVELED FOR CARE, MOST RESPONDENTS INDICATED THE TRAVEL WAS DUE TO NEEDING SPECIALTY CARE THAT WAS NOT AVAILABLE LOCALLY, THEY WERE REFERRED BY A PHYSICIAN OR THEY TRAVELED FOR BETTER OR HIGHER QUALITY CARE. SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE INCREASED AWARENESS OF LOCALLY AVAILABLE SERVICES AND A REDUCTION IN PEOPLE TRAVELING FOR CARE. IT IS SANFORD'S GOAL TO MARKET AND PROMOTE ACTIVITIES TO INCREASE AWARENESS OF SANFORD SHELDON SERVICES AND TO ENSURE APPOINTMENT AVAILABILITY TO HEALTHCARE PROVIDERS.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO AFFORDABLE HEALTH CARESANFORD SHELDON CONTINUES TO OFFER HEART AND VASCULAR SCREENINGS TO ENHANCE PREVENTATIVE CARE AND REDUCE OUT OF POCKET COSTS. IN ADDITION, DIRECT ACCESS LABORATORY SERVICES ARE AN OPTION FOR PATIENTS THAT HAVE A HIGH INSURANCE DEDUCTIBLE AND HAVE CONCERN WITH THE COSTS.ACCESS TO HEALTH CARE PROVIDERSSANFORD SHELDON CONTINUES TO WORK ON EDUCATING THE COMMUNITY ON OUR FULL SCOPE OF LOCALLY AVAILABLE SERVICES. RECRUITMENT OF OPEN HEALTH CARE PROVIDER POSITIONS IS AN ONGOING EFFORT.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:HEALTHY LIVINGPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 10 -- 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 10 -- SANFORD SHELDON MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 11 -- SANFORD VERMILLION MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 11 -- SANFORD VERMILLION MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD TRACY MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 11 -- 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 11 -- SANFORD VERMILLION MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: IMPROVING ACCESS TO MEDICAL CARE PROVIDERSSURVEY RESPONDENTS IN THE VERMILLION AREA RATED THEIR OWN ABILITY TO ACCESS HEALTH CARE AS GOOD. IN ADDITION, MOST RESPONDENTS HAVE A PRIMARY CARE PROVIDER AND HAVE BEEN IN FOR A ROUTINE CHECKUP OR SCREENING IN THE PAST YEAR. DESPITE THIS POSITIVE FEEDBACK, WHEN RESPONDENTS WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, GENERAL ACCESS TO HEALTH CARE AND A SHORTAGE OF HEALTH CARE PROVIDERS WAS THE TOP ISSUE, MORE SO THAN COST.SANFORD VERMILLION HAS MADE IMPROVING ACCESS TO MEDICAL CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN PRIMARY CARE VISITS AND PREVENTIVE CARE SERVICES. IT IS SANFORD'S GOAL TO OFFER ADDITIONAL TELEMEDICINE CARE SERVICES AND TO EXPAND OBSTETRICS SERVICES AT SANFORD VERMILLION.PRIORITY 2: IMPROVING HEALTHY LIVING IN THE COMMUNITYWHEN SURVEY RESPONDENTS IN THE VERMILLION AREA WERE ASKED ABOUT THEIR BIGGEST HEALTH CARE CONCERNS FOR THEMSELVES AND THEIR FAMILY, CHRONIC HEALTH ISSUES WERE AMONG TOP CONCERNS. THE MOST COMMONLY CITED CHRONIC HEALTH CONCERNS INVOLVED WEIGHT, DIABETES, AND THE HEART. IN ADDITION, DIABETES IS AN IMPORTANT MARKER FOR A RANGE OF HEALTH BEHAVIORS. CHR DATA INDICATE THAT NEARLY ONE IN TEN ADULTS IN THE VERMILLION AREA HAS DIABETES AND ONE IN THREE ADULTS HAS OBESITY.SANFORD HAS MADE IMPROVING HEALTHY LIVING FOR THE VERMILLION COMMUNITY A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO HELP THE COMMUNITY SEE LOWER INCIDENCE OF CHRONIC DISEASE RATES. IT IS SANFORD'S GOAL TO INCREASE SERVICES AT SANFORD VERMILLION FOR COLORECTAL SCREENINGS AND DIABETIC EDUCATION AND TO ESTABLISH DIABETIC EDUCATION SERVICES AT SANFORD VERMILLION MEDICAL CENTER IN PERSON AND/OR VIA TELEMEDICINE VISITS.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARIMPROVING ACCESS TO MEDICAL CARE PROVIDERSWE CURRENTLY HAVE ONE MENTAL HEALTH PROVIDER WHO OFFERS TELEMEDICINE VISIT TYPES AND NEEDED ONCOLOGY SPECIALTY OUTREACH, WHICH COULD BE DONE BY TELEMEDICINE. WE DO NOT CURRENTLY OFFER TELEMEDICINE FOR THE HOSPITALIST SERVICES AT THE HOSPITAL. WE ALSO HAVE TWO FAMILY MEDICINE PROVIDERS OFFERING OBSTETRIC SERVICES BUT WILL BE ADDING ONE MORE PROVIDER.SANFORD VERMILLION'S BEHAVIORAL/MENTAL HEALTH PROVIDERS ARE PROMOTED ON OUR WEBSITE; EACH HAVE A PAGE DESCRIPTION FOR PATIENTS TO SEE AND ACCESS INFORMATION ABOUT THEM. THEY ARE ALSO FEATURED AND PROMOTED AT ALL OF OUR DAKOTA HOSPITAL FOUNDATION EVENTS THROUGHOUT THE YEAR. THE ALTERNATE VISIT TYPES ARE PROMOTED BY CLINIC STAFF AND PROVIDERS, THROUGH THE SANFORD WEBSITE, WITH OUR OUTREACH PROVIDER ADS AND WITH OUR MYCHART APP WHERE THEY CAN SELF-SCHEDULE APPOINTMENTS. IMPROVING HEALTHY LIVING IN THE COMMUNITYWE CURRENTLY DO MOST OF OUR COLORECTAL SCREENINGS BY COLONOSCOPY BUT ARE PARTICIPATING IN A SANFORD HEALTH INITIATIVE TO GET MORE PATIENTS SCREENED BY COLOGUARD. AT THIS TIME, WE DO NOT OFFER DIABETIC EDUCATION LOCALLY TO OUR DIABETIC PATIENTS. THEY MUST TRAVEL TO SIOUX FALLS FOR THIS SERVICE, OR TO OTHER COMMUNITIES.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CARELONG-TERM SENIOR CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 11 -- 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 11 -- SANFORD VERMILLION MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 12 -- SANFORD CHAMBERLAIN MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 12 -- SANFORD CHAMBERLAIN MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH 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 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 12 -- SANFORD CHAMBERLAIN MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: REDUCE PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CAREMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE REDUCING PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE KNOWLEDGE OF BEST PRACTICES TO SUPPORT YOUTH WITH MENTAL HEALTH CONCERNS AND TO INCREASE MENTAL HEALTH APPOINTMENT AVAILABILITY. PRIORITY 2: REDUCE THE INCREASING TREND OF SEXUALLY TRANSMITTED DISEASES IN THE COMMUNITYCERTAIN AREAS OF THE COUNTRY, PARTICULARLY TRIBAL LANDS AND SURROUNDING COMMUNITIES SUCH AS THE CHAMBERLAIN AREA, HAVE LONG EXPERIENCED LOWER HEALTH STATUS WHEN COMPARED WITH OTHER PARTS OF THE COUNTRY. DISPARITIES IN HEALTH OUTCOMES, AS A RESULT OF SYSTEMS, POLICIES, AND SOCIAL AND PERSONAL FACTORS ARE PREVALENT.COMPARED TO SIMILAR-SIZED COMMUNITIES, THE CHAMBERLAIN MARKET AREA HAS THE HIGHEST RATE OF SEXUALLY TRANSMITTED INFECTIONS. SANFORD HAS MADE REDUCING THE INCREASING TREND OF SEXUALLY TRANSMITTED DISEASES IN THE COMMUNITY A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE SEXUALLY TRANSMITTED DISEASE TESTING WITHIN THE COMMUNITY (WITH A SPECIFIC FOCUS ON RESERVATIONS AND HIGH SCHOOL STUDENTS) AND TO REDUCE COST BARRIERS AND INCREASE AWARENESS OF HOME TESTING OPTIONS.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARREDUCE PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CARE SANFORD OFFERS A NUMBER OF MENTAL HEALTH RESOURCES, INCLUDING FAMILY GRIEF SUPPORT GROUP, SUICIDE SURVIVOR SUPPORT GROUP, AND SUPPORTS "LOVE BIG," A LOCAL PROJECT FORMED TO BRING COMMUNITY AWARENESS AND SUPPORT ON MENTAL HEALTH WELLNESS. SANFORD OFFERS MENTAL HEALTH FIRST AIDE AND BEHEARD YOUTH TRAININGS AND, IN PARTNERSHIP WITH THE CHAMBERLAIN SCHOOL DISTRICT, A MENTAL HEALTH PROFESSIONAL EMBEDDED IN THE JUNIOR HIGH AND HIGH SCHOOL DURING THE WEEK. REDUCE THE INCREASING TREND OF SEXUALLY TRANSMITTED DISEASES IN THE COMMUNITY CURRENT WORK INCLUDES UTILIZING SOUTH DAKOTA DEPARTMENT OF HEALTH EDUCATIONAL MATERIAL AT CLINICIAN AND NURSING MEETINGS TO ESCALATE THE KNOWN INCREASE OF STDS IN OUR SERVICE AREA. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREACCESS TO PROVIDERS AND QUALITY HEALTH CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 12 -- 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 12 -- SANFORD CHAMBERLAIN MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 13 -- SANFORD LUVERNE MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 13 -- SANFORD LUVERNE MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH 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 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 13 -- SANFORD LUVERNE MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: REDUCE PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CAREMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD LUVERNE MEDICAL CENTER (SLMC) HAS MADE REDUCING PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN THE NUMBER OF RESIDENTS UTILIZING MENTAL HEALTH RESOURCES. IT IS SANFORD'S GOAL TO ENSURE THOSE STRUGGLING WITH MENTAL HEALTH SYMPTOMS HAVE ACCESS TO THE CARE NEEDED AND TO DESTIGMATIZE ENGAGING IN MENTAL HEALTH CARE BY ENHANCING COMMUNITY AWARENESS ON THE IMPORTANCE OF MENTAL HEALTH.PRIORITY 2: INCREASE AWARENESS OF LOCAL SUBSTANCE USE SERVICES AND ADD LOCAL AVAILABILITY FOR MAT (MEDICATED ASSISTED TREATMENT)SURVEY RESPONDENTS IN THE LUVERNE AREA WHO INDICATED THEY WOULD LIKE TO SEE SPECIFIC SERVICES OFFERED OR IMPROVED IN THEIR COMMUNITY, INDICATED ADDICTION TREATMENT AS ONE OF THE TOP PRIORITIES.SLMC HAS MADE INCREASING AWARENESS OF LOCAL SUBSTANCE USE SERVICES AND ADDING LOCAL AVAILABILITY FOR MAT A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN UNDERSTANDING AMONG THE COMMUNITY OF AVAILABLE SUBSTANCE USE RESOURCES. IT IS SANFORD'S GOAL TO IMPLEMENT MAT AND TO CONTINUE TO FOCUS ON EDUCATION AND TRAINING ON THE OPIOID EPIDEMIC, THE ADMINISTRATION OF NALOXONE, AND ACCESS TO CARE LOCALLY.PRIORITY 3: ACCESS TO HEALTH CARE PROVIDERSWHEN SURVEY RESPONDENTS IN THE LUVERNE AREA WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, HAVING ACCESS TO MEDICAL CARE AND HEALTH CARE PROVIDERS WAS AMONG THE LEADING ISSUES. 75 PERCENT OF RESPONDENTS HAVE TRAVELED FOR CARE IN THE PAST THREE YEARS, A RATE WHICH IS HIGHER THAN THE COMPARISON GROUP AVERAGE. WHEN ASKED WHY, RESPONDENTS INDICATED THE TRAVEL WAS DUE TO NEEDING SPECIALTY CARE THAT WAS NOT AVAILABLE LOCALLY, THEY TRAVELED FOR BETTER OR HIGHER QUALITY CARE, OR THEY WERE REFERRED BY A PHYSICIAN. SLMC HAS MADE ACCESS TO HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE ADDITIONAL APPOINTMENT AVAILABILITY THROUGH THE CLINIC OR VIRTUAL CARE OPTIONS. IT IS SANFORD'S GOAL TO IMPROVE ACCESS TO SPECIALTY CARE AND EXPAND VIRTUAL ACCESS TO SPECIALTY SERVICES. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARREDUCE PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CAREMENTAL HEALTH CONTINUES TO REMAIN A PRIORITY FOR SLMC FOR THE NEXT 3-YEAR CYCLE. SLMC WILL SHARE THE RESULTS OF THIS SURVEY WITH COMMUNITY PARTNERS TO BUILD ACCESS TO MENTAL HEALTH SERVICES. SANFORD LUVERNE'S INTEGRATED HEALTH THERAPIST HAS BEEN INTEGRALLY INVOLVED IN LEADING INITIATIVES TO LOOK AT ACCESS, FUNDING FOR CARE, AND REDUCING STIGMA. SLMC WILL CONTINUE TO SUPPORT WORK IN THE MENTAL HEALTH SPACE FOCUSING ON INCREASING AWARENESS, ACTIVITIES TO PROMOTE MENTAL HEALTH, AND IMPROVING ACCESS TO CARE. SANFORD LUVERNE'S INTEGRATED HEALTH THERAPIST LED INITIATIVE TO ESTABLISH THE GAP (GRANT ASSISTED PROGRAM) WITHIN THE LOCAL FOUNDATION TO ASSIST WITH PAYMENT FOR SERVICES FOR INDIVIDUALS TO QUALIFY. THIS FUND IS IN PART SUPPORTED WITH COUNTY FUNDS. SLMC IS PRESENTLY RECRUITING A SECOND BEHAVIORAL HEALTH THERAPIST TO JOIN OUR TEAM.INCREASE AWARENESS OF LOCAL SUBSTANCE USE SERVICES AND ADD LOCAL AVAILABILITY FOR MAT (MEDICATED ASSISTED TREATMENTSANFORD LUVERNE'S SUD (SUBSTANCE USE DISORDER) DEPARTMENT OFFERS COMPREHENSIVE ASSESSMENT OF SUD, REFERRALS FOR SUD TREATMENT AND PROVIDES ADULT OUTPATIENT SUD TREATMENT. SANFORD LUVERNE'S SUD DEPARTMENT PROVIDES EDUCATION AND TRAINING ON SUD AND ARE TRAINED TO PROVIDE EDUCATION ON OPIOID EPIDEMIC AND ADMINISTRATION OF NALOXONE. SANFORD LUVERNE'S SUD PROGRAM IS A NAP (NALOXONE ACCESS POINT).IN 2024, SUBSTANCE USE COUNSELORS WORKED WITH THE HIGH SCHOOL HEALTH CLASSES FOR PRESENTATIONS ON SUBSTANCE USE/ABUSE. SUBSTANCE USE COUNSELORS CONTINUE TO BE INVOLVED IN THE LOCAL COUNTY TREATMENT COURTS. SUBSTANCE USE COUNSELORS CONTINUE TO WORK ON OPIOID RESPONSE AND NALOXONE TRAININGS FOR FAMILY SERVICES, COURTS, COMMUNITY ORGANIZATIONS, AND SCHOOLS (TEACHERS/STAFF/STUDENTS). SUBSTANCE USE COUNSELORS AND OUR INTEGRATED HEALTH THERAPIST (IHT) SPOKE ON BRAIN HEALTH TO THE WOMEN'S GIVING CIRCLE GROUP IN LUVERNE. BEGINNING JANUARY 1, 2024 OUR IHT THAT IS AN LPCC IS NOW ABLE TO BILL MEDICARE AND TREAT THOSE PATIENTS. IN ADDITION, OUR IHT IS ON A COMMUNITY WORK GROUP TO RESEARCH A GAP FUND WITHIN THE FOUNDATION TO SUPPORT MENTAL HEALTH SERVICES FOR THOSE WHO CANNOT AFFORD IT.ACCESS TO HEALTH CARE PROVIDERSSLMC HAS ADDED A FAMILY MEDICINE PHYSICIAN AS WELL AS A NURSE PRACTITIONER OVER THE PAST 3-YEAR CYCLE TO IMPROVE SAME DAY ACCESS TO CARE. THERE WAS CONCERN VOICED IN THE FOCUS GROUP ABOUT ACCESS TO SPECIALTY CARE AND THE NEED TO TRAVEL. SLMC, AS PART OF SANFORD HEALTH, RECEIVES SPECIALTY CARE PROVIDED AS AN OUTREACH SERVICE. IN ADDITION, THE EDGERTON CLINIC IS NOW OPEN ONE FULL DAY/WEEK AS OF JANUARY 1, 2024 TO IMPROVE LOCAL ACCESS TO PRIMARY CARE.CLINIC PROVIDERS CONTINUE TO PARTNER WITH THE MOBILE DENTAL UNIT THAT COMES TO THE COMMUNITY ONE TO TWO DAYS PER MONTH. THE ORGANIZATION HAS ALSO PARTNERED WITH CARING HANDS CLINIC IN PIPESTONE FOR MEDICAID PATIENTS. HOWEVER, CARING HANDS NOW HAS A SEVERAL WEEK WAIT TIME FOR SERVICE.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREHEALTHY LIVINGCHILDCARE QUALITYAFFORDABLE HOUSINGCOMMUNITY SAFETYSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 13 -- 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 13 -- SANFORD LUVERNE MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 14 -- SANFORD CANBY MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 14 -- SANFORD CANBY MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH CENTERSANFORD TRACY MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 14 -- 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 14 -- SANFORD CANBY MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: PROMOTE OUTREACH SERVICING PROVIDERS THAT COME TO THE FACILITYTHE NEED TO TRAVEL FOR CARE IS EVIDENCED IN CHR DATA WHICH INDICATE THAT WHEN COMPARED TO SIMILAR-SIZED MARKETS, THE CANBY AREA HAS HIGHER THAN AVERAGE RATIOS OF POPULATION TO PROVIDERS. IN ADDITION, CHR DATA INDICATE THAT WHEN COMPARED TO SIMILAR-SIZED MARKETS, THE CANBY AREA HAS THE HIGHEST RATE OF PREVENTABLE HOSPITAL STAYS AND A BELOW AVERAGE MAMMOGRAPHY SCREENING RATE AND FLU VACCINATION RATE.SANFORD HAS MADE PROMOTING OUTREACH SERVICING PROVIDERS COMING TO THE FACILITY A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO FOCUS ON TWO PRIMARY GOALS: TO PROMOTE OUTREACH SERVICES IN PUBLIC SPACES TO ENHANCE AWARENESS OF ALL COMMUNITY MEMBERS, REGARDLESS OF CURRENT SYSTEM ATTRIBUTION, AND TO EDUCATE PATIENTS AND PROVIDERS ON AVAILABLE OUTREACH SERVICES WITHIN THE CLINICAL SETTING DURING A FOCUSED COMMUNICATION EVENT. PRIORITY 2: PROVIDE COMMUNITY EDUCATION SURROUNDING BEHAVIORAL/MENTAL HEALTH MENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.ACCORDING TO CHR, ADULTS IN THE CANBY AREA AVERAGE 4.4 MENTALLY UNHEALTHY DAYS EACH MONTH AND 15 PERCENT OF ADULTS AVERAGE AT LEAST 14 DAYS OF MENTAL DISTRESS PER MONTH; BOTH RATES ARE AMONG THE HIGHEST WHEN COMPARED TO SIMILAR-SIZED MARKETS SERVED BY SANFORD HEALTH.SANFORD HAS MADE PROVIDING COMMUNITY EDUCATION SURROUNDING BEHAVIORAL/MENTAL HEALTH A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO FOCUS ON TWO PRIMARY GOALS: TO UTILIZE SANFORD MYCHART AND INTERNAL RESOURCES TO INCREASE AWARENESS OF BEHAVIORAL HEALTH RESOURCES LOCALLY AND TO REDUCE THE STIGMA OF BEHAVIORAL HEALTH AND INCREASE AWARENESS OF SERVICES AVAILABLE FOR SCHOOL-AGED STUDENTS.PRIORITY 3: INCREASE TELEMEDICINE USAGE FOR SPECIALTY PROVIDERS PROVIDING SERVICE TO THE FACILITYDESPITE SURVEY RESPONDENTS IN THE CANBY AREA RATING THEIR OWN ABILITY TO ACCESS HEALTH CARE AS GOOD, WHEN THEY WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, ACCESS TO HEALTH CARE SERVICES AND PROVIDERS WAS THE TOP ISSUE (MORE SO THAN AFFORDABILITY CONCERNS). AND WHILE RESPONDENTS RATED THE OVERALL QUALITY OF HEALTH CARE IN THEIR COMMUNITY AS GOOD, THE AVERAGE SCORE WAS SLIGHTLY LOWER THAN THE COMPARISON GROUP AVERAGE. IN ADDITION, 85 PERCENT OF SURVEY RESPONDENTS IN THE CANBY AREA REPORTED TRAVELING OUTSIDE OF THEIR COMMUNITY TO RECEIVE HEALTH CARE SERVICES IN THE PAST THREE YEARS (ONE OF THE HIGHEST PERCENTAGES WHEN COMPARED TO SIMILAR-SIZED MARKETS SERVED BY SANFORD HEALTH). WHEN ASKED WHY, MOST OF THOSE WHO TRAVELED FOR CARE INDICATED THAT THEY NEEDED SPECIALTY CARE, OR THE SERVICES NEEDED WERE NOT AVAILABLE LOCALLY. SANFORD HAS MADE INCREASING TELEMEDICINE USAGE FOR SPECIALTY PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO FOCUS ON TWO PRIMARY GOALS: TO INCREASE KNOWLEDGE OF TELEMEDICINE SERVICES AVAILABLE LOCALLY IN THE COMMUNITY AND TO REDUCE BARRIERS TO TELEMEDICINE USAGE.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARPROMOTE OUTREACH SERVICING PROVIDERS THAT COME TO THE FACILITYSANFORD CANBY CURRENTLY HAS SEVEN OUTREACH PROVIDERS THAT PROVIDE CARE FOR PATIENTS REQUIRING CARE FROM GENERAL SURGERY, GASTROENTEROLOGY, PODIATRY, VASCULAR, UROLOGY, ORTHOPEDICS AND OB/GYN. CURRENTLY, OUTREACH PROVIDERS ARE ON SITE 10 DAYS PER MONTH. PROVIDE COMMUNITY EDUCATION SURROUNDING BEHAVIORAL/MENTAL HEALTH SANFORD CANBY HAS PRESENTED MENTAL HEALTH RESOURCES IN THE COMMUNITY AT VARIOUS CIVIC MEETINGS, FACILITY MEETINGS, COMMUNITY MEETINGS AS WELL AS COMMUNITY CELEBRATIONS REACHING A VAST DEMOGRAPHIC. INCREASE TELEMEDICINE USAGE FOR SPECIALTY PROVIDERS PROVIDING SERVICE TO THE FACILITY THE MARKETING OF THE TELEMEDICINE PROVIDERS IN OUR AREA TO DATE HAS BEEN LIMITED. OUR DESIRE IS TO ESPECIALLY INCREASE THE USE OF MYCHART BEHAVIORAL HEALTH VISITS AS AN OPTION IN THE UPCOMING 2025-2027 PLAN YEARS. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:CHILD CARE QUALITYAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 14 -- 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 14 -- SANFORD CANBY MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 15 -- SANFORD JACKSON MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 15 -- SANFORD JACKSON MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH 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 15 -- 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 15 -- SANFORD JACKSON MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: REDUCE PHYSICAL AND PERCEPTUAL BARRIERS TO THOSE SEEKING MENTAL HEALTH CAREMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD JACKSON MEDICAL CENTER (SJMC) HAS MADE REDUCING PHYSICAL AND PERCEPTUAL BARRIERS TO THOSE SEEKING MENTAL HEALTH CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE AWARENESS AND COORDINATION OF MENTAL HEALTH SERVICES WITHIN THE COMMUNITY. IT IS SANFORD'S GOAL TO ADVANCE INTEGRATED HEALTHCARE IN THE COMMUNITY AND TO INCREASE AWARENESS AND PROVIDE EDUCATION ON SUICIDE PREVENTION.PRIORITY 2: ACCESS TO MEDICAL CARE AND HEALTH CARE PROVIDERSWHILE MANY SURVEY RESPONDENTS IN THE JACKSON AREA HAVE A PRIMARY CARE PROVIDER, HAVE BEEN IN FOR A ROUTINE CHECKUP OR SCREENING IN THE PAST YEAR, AND HAVE RECEIVED NECESSARY HEALTH CARE FOR THEMSELVES AND THEIR FAMILY IN THE PAST YEAR, THE PERCENTAGES ARE AMONG THE LOWEST WHEN COMPARED TO SIMILAR-SIZED MARKETS SERVED BY SANFORD HEALTH. IN ADDITION, 75 PERCENT OF RESPONDENTS HAVE TRAVELED FOR CARE IN THE PAST THREE YEARS, A RATE WHICH IS HIGHER THAN THE COMPARISON GROUP AVERAGE. THE NEED TO TRAVEL FOR CARE IS EVIDENT IN CHR DATA WHICH INDICATES THAT WHEN COMPARED TO SIMILAR-SIZED MARKETS, THE JACKSON AREA HAS HIGHER/WORSE-THAN-AVERAGE RATIOS OF POPULATION TO PROVIDERS. SJMC HAS MADE ACCESS TO MEDICAL CARE AND HEALTH CARE PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE INCREASED UTILIZATION OF TELEHEALTH SERVICES AND IN-PERSON APPOINTMENTS. IT IS SANFORD'S GOAL TO INCREASE THE TELEHEALTH OFFERINGS OF SPECIALTY PROVIDERS AND FOCUS ON PHYSICIAN RECRUITMENT.PRIORITY 3: SUBSTANCE ABUSEOF SURVEY RESPONDENTS IN THE JACKSON AREA WHO WOULD LIKE TO SEE SPECIFIC SERVICES OFFERED OR IMPROVED IN THEIR COMMUNITY, ADDICTION TREATMENT WAS ONE OF THE TOP SERVICES ON THE LIST. THE POTENTIAL NEED FOR ADDITIONAL SUBSTANCE ABUSE SERVICES, EDUCATION AND AWARENESS REGARDING SUBSTANCE ABUSE WERE ALSO CONSIDERED. SJMC HAS MADE SUBSTANCE ABUSE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE COORDINATION OF SUBSTANCE ABUSE RESOURCES AND OPPORTUNITIES TO ADDRESS THE NEED. IT IS SANFORD'S GOAL TO SUPPORT AND CONTINUE TO ENGAGE IN PARTNERSHIPS WITH COMMUNITY PROGRAMS WITH OTHER COMMUNITY MEMBERS COMMITTED TO REDUCING SUBSTANCE ABUSE AND TO INCREASE EDUCATION FOR STAFF ABOUT SUBSTANCE ABUSE SO THEY CAN BETTER SERVE OUR PATIENTS.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARREDUCE PHYSICAL AND PERCEPTUAL BARRIERS TO THOSE SEEKING MENTAL HEALTH CARESJMC FACILITATES COMMUNITY BEHAVIORAL HEALTH TASK FORCE MEETINGS WHERE MENTAL HEALTH ISSUES ARE IDENTIFIED AND KEY STAKEHOLDERS ARE AVAILABLE TO COLLABORATE, MAKE RECOMMENDATIONS AND INSTILL CHANGE. SJMC HAS A NUMBER OF RESOURCES AND PROVIDERS, SUCH AS INTEGRATED HEALTH THERAPISTS, AVAILABLE LOCALLY. ACCESS TO MEDICAL CARE AND HEALTH CARE PROVIDERSSJMC OFFERS A VARIETY OF SERVICES THROUGH LOCALLY BASED AND OUTREACH PROVIDERS. LABORATORY AND RADIOLOGY SERVICES ARE AVAILABLE 24 HOURS A DAY, WITH STAFF SERVING THE HOSPITAL, ATTACHED MEDICAL CLINIC, AND TWO SATELLITE CLINICS. CLINIC SERVICES INCLUDE FAMILY MEDICINE AND VARIOUS SPECIALTY OUTREACH SERVICES. A VARIETY OF SURGICAL PROCEDURES ARE PERFORMED IN THE SURGICAL SUITE AT SJMC. SJMC EMPLOYS SEVEN CLINICIANS, INCLUDING PHYSICIANS AND ADVANCED PRACTICE PROVIDERS. PERIODIC MARKETING IS IN PLACE TO GAIN EXPOSURE OF PRIMARY CARE SERVICES AND PROVIDERS VIA MEDIA OUTLETS SUCH AS RADIO, PRINT AND SOCIAL MEDIA.SUBSTANCE ABUSESJMC PARTNERS WITH SEVERAL COMMUNITY ORGANIZATIONS AND COALITIONS TO PROVIDE EDUCATION AND RAISE AWARENESS REGARDING SUBSTANCE ABUSE. THESE PARTNERSHIPS INCLUDE DES MOINES VALLEY HEALTH AND HUMAN SERVICES, POSITIVE COMMUNITY NORM AND THE POSITIVE ACTIONS THROUGH HEALTH (PATH) COALITION, JACKSON COUNTY ADDICTION PREVENTION AND SAFETY COALITION AND JACKSON COUNTY LAW ENFORCEMENT. IN MARCH 2025, THE ORGANIZATION "BE EXTRAORDINARY, BE YOU!" IS PLANNING A PRESENTATION TARGETING MIDDLE SCHOOL AND HIGH SCHOOL STUDENTS AT JACKSON COUNTY CENTRAL. THIS EVENT WILL INCLUDE A "CANNABIS PANEL," FEATURING LOCAL LEADERS WHO WILL DISCUSS THE IMPACTS OF MARIJUANA USE AND RELATED EFFECTS. ADDITIONALLY, IN JUNE, JACKSON COUNTY LAW ENFORCEMENT WILL PROVIDE TRAINING FOR SJMC PROVIDERS FOCUSING ON THE VARIOUS SUBSTANCES BEING IDENTIFIED IN OUR COMMUNITY. THIS INITIATIVE AIMS TO EQUIP HEALTHCARE PROFESSIONALS WITH THE NECESSARY KNOWLEDGE TO ADDRESS SUBSTANCE-RELATED ISSUES MORE EFFECTIVELY. MOVING FORWARD, SJMC REMAINS COMMITTED TO IDENTIFYING ADDITIONAL OPPORTUNITIES TO ADDRESS AND COMBAT SUBSTANCE ABUSE IN OUR COMMUNITY, FOSTERING PARTNERSHIPS AND INNOVATIVE APPROACHES TO PROMOTE HEALTH AND SAFETY. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HOUSINGACCESS TO AFFORDABLE HEALTH CAREHEALTHY LIVINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 15 -- 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 15 -- SANFORD JACKSON MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 16 -- SANFORD TRACY MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 16 -- SANFORD TRACY MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 BEHAVIORAL HEALTH CENTERSANFORD THIEF RIVER FALLS MEDICAL CENTERSANFORD VERMILLION MEDICAL CENTERSANFORD WEBSTER MEDICAL CENTERSANFORD WESTBROOK MEDICAL CENTERSANFORD WHEATON MEDICAL CENTERSANFORD WORTHINGTON MEDICAL CENTER
GROUP A-FACILITY 16 -- 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 16 -- SANFORD TRACY MEDICAL CENTER PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HEALTH TRACY HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY. IT IS SANFORD'S GOAL TO INCREASE AWARENESS AND EXPAND ACCESS OF MENTAL HEALTH SERVICES AT SANFORD TRACY AND IN THE SERVING AREA AND TO CREATE AND IMPLEMENT POLICY/PROCEDURE/PROTOCOLS TO BE PUT IN PLACE IN AREA SCHOOL SYSTEMS IN THE EVENT OF A MENTAL HEALTH CRISIS AND ALSO CREATE/IMPLEMENT CALMING SPACES THROUGHOUT THE SCHOOLS.PRIORITY 2: HEALTHY/ACTIVE LIVINGWHEN SURVEY RESPONDENTS IN THE TRACY AREA WERE ASKED ABOUT THE BIGGEST HEALTH CONCERNS FOR THEMSELVES AND THEIR FAMILY, CHRONIC HEALTH ISSUES, ALONG WITH DIET AND EXERCISE, WERE AMONG THE TOP CONCERNS.SANFORD HEALTH TRACY HAS MADE HEALTHY/ACTIVE LIVING A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES FOR THE COMMUNITY TO SEE IMPROVED OVERALL PHYSICAL AND NUTRITIONAL HEALTH IN PATIENTS AT SANFORD HEALTH. IT IS SANFORD'S GOAL TO CREATE ACCESS TO HEALTHY FOOD CHOICES AND PROVIDE EDUCATIONAL OPPORTUNITIES FOR MAKING HEALTHY CHOICES AND TO INCREASE THE ACTIVITY LEVEL OF COMMUNITY MEMBERS IN OUR SANFORD TRACY SERVICE AREA.PRIORITY 3: TRANSPORTATIONTRANSPORTATION SYSTEMS HELP ENSURE THAT PEOPLE CAN REACH EVERYDAY DESTINATIONS, SUCH AS JOBS, SCHOOLS, HEALTHY FOOD OUTLETS, AND HEALTH CARE FACILITIES, SAFELY AND RELIABLY. PUBLIC TRANSPORTATION SERVICES PLAY AN IMPORTANT ROLE FOR PEOPLE WHO ARE UNABLE TO DRIVE, PEOPLE WITHOUT ACCESS TO PERSONAL VEHICLES, CHILDREN, INDIVIDUALS WITH DISABILITIES, AND OLDER ADULTS. SANFORD HEALTH TRACY HAS MADE TRANSPORTATION A SIGNIFICANT PRIORITY. IT IS SANFORD'S GOAL TO INCREASE AWARENESS OF TRANSPORTATION SERVICES AND INCREASE ACCESS TO TRANSPORTATIONS SERVICES IN THE SANFORD TRACY SERVICE AREA.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTHSANFORD TRACY WILL CONTINUE TO SHARE THE RESULTS OF THIS SURVEY WITH COMMUNITY PARTNERS TO BUILD ACCESS TO MENTAL HEALTH. IN ADDITION, SANFORD TRACY OFFERS BEHAVIORAL HEALTH SCREENINGS WITH A STRETCH GOAL OF ACHIEVING A 100% SCREENING RATE FOR ALL PATIENTS TWELVE YEARS AND OLDER WITH A PRIOR HISTORY OF DEPRESSION OR ANXIETY. A NEW INTEGRATED HEALTH THERAPIST WAS HIRED IN 2023 TO COMPLEMENT THE ONE OUTREACH TELEMEDICINE PSYCHIATRIST THAT CONTINUES TO SEE PATIENTS AS NEEDED.HEALTHY/ACTIVE LIVINGSANFORD TRACY WILL CONTINUE TO WORK TO MAKE A POSITIVE IMPACT ON IMPROVING THE HEALTH OF COMMUNITY MEMBERS THROUGH BOTH PHYSICAL ACTIVITY AND HEALTHY LIFESTYLE CHOICES. THE SANFORD TRACY MEDICAL CENTER OFFERS DIETICIAN AND HEALTH COACHING SERVICES IN ADDITION TO PROGRAMMING FOR CHILDREN THROUGH THE SANFORD FIT PROGRAM. A NEW INTEGRATED HEALTH THERAPIST (IHT) WAS HIRED IN 2023. SANFORD TRACY ALSO CONTINUES TO OFFER A FOOD PANTRY PROGRAM WITH REFERRALS TO THE LOCAL FOOD PANTRY.TRANSPORTATIONOVER THE NEXT THREE YEARS, SANFORD TRACY WILL INCREASE COMMUNITY AWARENESS OF TRANSPORTATION ACCESS ISSUES THROUGH TARGETED OUTREACH CAMPAIGNS AND EDUCATIONAL INITIATIVES.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREACCESS TO MEDICAL CARE AND HEALTH CARE PROVIDERSAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 16 -- 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 16 -- SANFORD TRACY MEDICAL CENTER PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 17 -- SANFORD HILLSBORO MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 17 -- SANFORD HILLSBORO MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH 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 IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: REDUCE PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CAREMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HEALTH HILLSBORO HAS MADE REDUCING PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE OF PATIENTS SCREENED FOR DEPRESSION AND PROVIDE A GREATER AWARENESS OF RESOURCES AVAILABLE LOCALLY. IT IS SANFORD'S GOAL TO REDUCE STIGMA AND INCREASE SCREENINGS FOR BEHAVIORAL HEALTH CARE AND IMPROVE ACCESS TO MENTAL HEALTH RESOURCES IN THE COMMUNITY. PRIORITY 2: PROMOTION OF HEALTHY ACTIVE LIFESTYLEWHEN SURVEY RESPONDENTS WERE ASKED ABOUT THE BIGGEST HEALTH CONCERNS FOR THEMSELVES AND THEIR FAMILY (CONCERNS THEY FACE ON A REGULAR BASIS), CHRONIC HEALTH ISSUES, ALONG WITH DIET AND EXERCISE, WERE AMONG THE TOP CONCERNS. SANFORD HEALTH HILLSBORO HAS MADE THE PROMOTION OF A HEALTHY, ACTIVE LIFESTYLE A SIGNIFICANT PRIORITY AND HAS DEVELOPED A STRATEGY TO SEE AN INCREASE IN RESIDENTS UTILIZING LOCAL RESOURCES AND A DECLINE IN RELATED VISITS AT THE CLINIC. IT IS SANFORD'S GOAL TO PROVIDE OPPORTUNITIES FOR ADULTS AND YOUTH TO MEET RECOMMENDED PHYSICAL ACTIVITY AND TO DEVELOP SUSTAINABLE STRATEGIES THAT ENCOURAGE RESIDENTS TO MAKE HEALTHY CHOICES.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARREDUCE PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CARE SANFORD CURRENTLY PROVIDES MENTAL HEALTH SCREENINGS WITHIN THE CLINIC. INTEGRATED HEALTH THERAPISTS HAVE BEEN AVAILABLE IN THE PAST, PRIMARILY THROUGH VIRTUAL CARE, BUT WERE LIMITED DUE TO A RESIGNATION. THE SYSTEM PROVIDES SANFORD.FINDHELP.COM AS A CONSUMER FACING RESOURCE TO FIND CARE AND MENTAL HEALTH RESOURCES.PROMOTION OF HEALTHY ACTIVE LIFESTYLESANFORD CURRENTLY SUPPORTS THE HILLSBORO RUNNING CLUBS RUN/WALK EVENT IN JUNE AND SUPPORTS THE MAYVILLE YOUTH CENTER. THE BRIDGING CENTERS IN BOTH MAYVILLE AND HILLSBORO PROMOTE THE BETTER CHOICES BETTER HEALTH CLASS AND OUR DIETITIANS ON BOTH CAMPUSES PROVIDE NUTRITIONAL EDUCATION.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO HEALTH CARE PROVIDERSACCESS TO AFFORDABLE HEALTH CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
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 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 18 -- SANFORD MEDICAL CENTER MAYVILLE PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 18 -- SANFORD MEDICAL CENTER MAYVILLE PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH 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 IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: REDUCE PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CARE. INCLUDES ACCESS TO HEALTH CARE AND MENTAL HEALTH NEEDSMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE REDUCING PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE OF PATIENTS SCREENED FOR DEPRESSION AND SEE GREATER AWARENESS OF RESOURCES AVAILABLE LOCALLY. IT IS SANFORD'S GOAL TO REDUCE STIGMA AND INCREASE SCREENINGS FOR BEHAVIORAL HEALTH AND IMPROVE ACCESS TO MENTAL HEALTH RESOURCES IN THE COMMUNITY.PRIORITY 2: PROMOTION OF HEALTHY ACTIVE LIFESTYLEWHEN SURVEY RESPONDENTS IN THE HILLSBORO-MAYVILLE WERE ASKED ABOUT THE BIGGEST HEALTH CONCERNS FOR THEMSELVES AND THEIR FAMILY (CONCERNS THEY FACE ON A REGULAR BASIS), CHRONIC HEALTH ISSUES ALONG WITH DIET AND EXERCISE WERE AMONG THE TOP CONCERNS.SANFORD HEALTH MAYVILLE HAS MADE THE PROMOTION OF A HEALTHY ACTIVE LIFESTYLE A SIGNIFICANT PRIORITY AND HAS DEVELOPED A STRATEGY TO SEE AN INCREASE IN RESIDENTS UTILIZING LOCAL RESOURCES AND A DECLINE IN RELATED VISITS AT THE CLINIC. IT IS SANFORD'S GOAL TO PROVIDE OPPORTUNITIES FOR ADULTS AND YOUTH TO MEET RECOMMENDED PHYSICAL ACTIVITY AND TO DEVELOP SUSTAINABLE STRATEGIES THAT ENCOURAGE RESIDENTS TO MAKE HEALTHY CHOICES.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARREDUCE PHYSICAL AND PERCEPTUAL BARRIERS TO SEEKING MENTAL HEALTH CARE. INCLUDES ACCESS TO HEALTH CARE AND MENTAL HEALTH NEEDSSANFORD CURRENTLY PROVIDES MENTAL HEALTH SCREENINGS WITHIN THE CLINIC. INTEGRATED HEALTH THERAPISTS HAVE BEEN AVAILABLE IN THE PAST, PRIMARILY THROUGH VIRTUAL CARE, BUT WERE LIMITED DUE TO A RESIGNATION. THE SYSTEM PROVIDES SANFORD.FINDHELP.COM AS A CONSUMER FACING RESOURCE TO FIND CARE AND MENTAL HEALTH RESOURCES.PROMOTION OF HEALTHY ACTIVE LIFESTYLESANFORD CURRENTLY SUPPORTS THE HILLSBORO RUNNING CLUBS RUN/WALK EVENT IN JUNE AND SUPPORTS THE MAYVILLE YOUTH CENTER. THE BRIDGING CENTERS IN BOTH MAYVILLE AND HILLSBORO PROMOTE THE BETTER CHOICES BETTER HEALTH CLASS AND OUR DIETITIANS IN BOTH CAMPUSES PROVIDE NUTRITIONAL EDUCATION.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO HEALTH CARE PROVIDERSACCESS TO AFFORDABLE CAREPUBLIC TRANSPORTATIONAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
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 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 19 -- SANFORD WEBSTER MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 19 -- SANFORD WEBSTER MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 BEHAVIORAL HEALTH 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 IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: IMPROVE ACCESS TO PROVIDERS AND QUALITY HEALTH CAREWHILE MOST WEBSTER AREA SURVEY RESPONDENTS HAVE A PRIMARY CARE PROVIDER AND HAVE BEEN IN FOR A CHECKUP IN THE PAST YEAR, 17 PERCENT DID NOT RECEIVE NECESSARY HEALTH CARE FOR THEMSELVES AND THEIR FAMILY IN THE PAST YEAR. IN ADDITION, 86 PERCENT OF RESPONDENTS REPORTED TRAVELING OUTSIDE OF THEIR COMMUNITY TO RECEIVE HEALTH CARE SERVICES IN THE PAST THREE YEARS. MOST OF THOSE WHO TRAVELED FOR CARE INDICATED THAT THEY NEEDED SPECIALTY CARE, OR THE NEEDED SERVICES WERE NOT AVAILABLE LOCALLY.CRITICAL FOR TELEHEALTH OPTIONS IS RELIABLE INTERNET ACCESS AND CHR DATA INDICATE THAT THE WEBSTER AREA HAS ONE OF THE LOWEST RATES OF BROADBAND COVERAGE WHEN COMPARED TO SIMILAR-SIZED MARKETS. CHR DATA ALSO INDICATE THAT WHEN COMPARED TO SIMILAR-SIZED MARKETS, THE WEBSTER AREA HAS AN ABOVE-AVERAGE RATE OF PREVENTABLE HOSPITAL STAYS, ONE OF THE LOWEST FLU VACCINATION RATES, AND ONE OF THE HIGHEST INJURY DEATH RATES.SANFORD HAS MADE IMPROVING ACCESS TO PROVIDERS AND QUALITY HEALTH CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES FOR THE COMMUNITY TO SEE AN INCREASE IN THE TOTAL NUMBER OF PATIENTS ENGAGING IN THEIR FIRST APPOINTMENT AND A REDUCTION IN THE NO-SHOW RATE. IT IS SANFORD'S GOAL TO INCREASE ACCESS TO BEHAVIORAL HEALTH THROUGH IN PERSON AND TELEMEDICINE VISITS AND EXCEED ENTERPRISE BENCHMARKS FOR WELLNESS WITH A FOCUS ON IMPROVEMENTS FOR AT-RISK POPULATIONS.PRIORITY 2: IMPROVE CHILDCARE AVAILABILITY IN THE COMMUNITY AND POSITIVELY IMPACT PHYSICAL ACTIVITY SURVEY RESPONDENTS IN THE WEBSTER AREA RATED THE QUALITY OF CHILDCARE, DAY CARE, AND PRESCHOOL AS LESS THAN GOOD AND HAD THE LOWEST SCORE WHEN COMPARED TO SIMILAR-SIZED MARKETS SERVED BY SANFORD HEALTH. SURVEY RESPONDENTS IN THE WEBSTER AREA RATED THEIR OWN PERSONAL HEALTH AND WELLNESS AS GOOD, BUT LOWER THAN THE COMPARISON GROUP AVERAGE. IN ADDITION, SURVEY RESPONDENTS RATED COMMUNITY ACCESS TO EXERCISE OPPORTUNITIES AS GOOD AND ACCESS TO HEALTHY FOODS AS GOOD; HOWEVER, BOTH SCORES WERE ALSO LOWER THAN THE COMPARISON GROUP AVERAGE. SANFORD HAS MADE IMPROVING CHILDCARE AVAILABILITY IN THE COMMUNITY, ALONG WITH POSITIVELY IMPACTING PHYSICAL ACTIVITY, A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN AVAILABLE CHILDCARE OPENINGS IN THE LOCAL COMMUNITY AND AN INCREASE IN WELLNESS OPPORTUNITIES THROUGH CHILDCARE PROVIDERS. IT IS SANFORD'S GOAL TO ACTIVELY PARTICIPATE IN COMMUNITY INITIATIVES TO EXPAND CHILDCARE OPPORTUNITIES IN THE COMMUNITY AND TO PROVIDE ANCILLARY RESOURCES TO DAYCARE PROVIDERS TO POSITIVELY IMPACT PEDIATRIC WELLNESS. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARIMPROVE ACCESS TO PROVIDERS AND QUALITY HEALTH CARESANFORD OFFERS A RANGE OF SERVICES THROUGH A COMBINATION OF LOCAL AND OUTREACH PROVIDERS. THE LOCAL MEDICAL GROUP CONSISTS OF ONE MD AND FOUR APPS. LOCAL CARE INCLUDES THE HOSPITAL, OUTPATIENT CLINIC, AND NURSING HOME WITH SEVERAL ANCILLARY SERVICES, INCLUDING LAB AND PHARMACY. TELEMEDICINE IS AVAILABLE, INCLUDING IN THE EMERGENCY ROOM, WHICH IS RANKED IN THE 95TH PERCENTILE FOR PATIENT SATISFACTION. DIAGNOSTIC SERVICES, INCLUDING PFTS, SLEEP STUDIES, EEGS, EKGS, AND OTHERS ARE AVAILABLE LOCALLY. RADIOLOGY SUITES WERE RECENTLY UPDATED WITH AN ONSITE 64-SLICE CT, DIGITAL MAMMOGRAPHY, DEXA, ULTRASOUND AND MOBILE MRI AND NUCLEAR MEDICINE. RESPIRATORY, PHYSICAL, OCCUPATIONAL & SPEECH THERAPY, AND CARDIOPULMONARY REHAB ARE ALSO AVAILABLE.IMPROVE CHILDCARE AVAILABILITY IN THE COMMUNITY AND POSITIVELY IMPACT PHYSICAL ACTIVITYSANFORD DOES NOT OFFER CHILDCARE SERVICES FOR EMPLOYEES BUT SUPPORTS EFFORTS TO INCREASE LOCAL AVAILABILITY. SANFORD FIT IS DESIGNED TO GET KIDS THINKING DIFFERENTLY ABOUT THEIR CHOICES IN A FUN AND ENGAGING WAY. IT FOCUSES ON FOUR KEY ELEMENTS OF A HEALTHY LIFE: FOOD, MOVE, MOOD, RECHARGE. THE HOSPITAL ALSO OFFERS DIETICIAN SERVICES, WEIGHT MANAGEMENT PROGRAMS, IN ADDITION TO PREVENTATIVE CARE SCREENINGS AND VACCINATION CLINICS.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ECONOMIC CLIMATEAFFORDABLE HOUSING AND PUBLIC TRANSPORTATIONRESOURCE SHARINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
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 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 20 -- SANFORD MEDICAL CENTER WHEATON PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 20 -- SANFORD MEDICAL CENTER WHEATON PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 BEHAVIORAL HEALTH 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 IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: IMPROVING MENTAL HEALTH AND CHEMICAL DEPENDENCY AVAILABILITY IN THE COMMUNITY MENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE IMPROVING MENTAL HEALTH AND CHEMICAL DEPENDENCY AVAILABILITY IN THE COMMUNITY A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN THE NUMBER OF PATIENTS SEEN FOR VIRTUAL BEHAVIORAL HEALTH APPOINTMENTS AND PATIENTS SEEN THROUGH A CHEMICAL DEPENDENCY SOCIAL WORKER. IT IS SANFORD'S GOAL TO REDUCE BARRIERS TO CARE AND INCREASE TELE BEHAVIORAL HEALTH UTILIZATION AND TO MEET THE COMMUNITY NEED FOR CHEMICAL DEPENDENCY SERVICES. PRIORITY 2: IMPROVE PHYSICAL ACTIVITY OPPORTUNITIESSANFORD HAS MADE IMPROVING PHYSICAL ACTIVITY OPPORTUNITIES A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE INCREASED OPPORTUNITIES FOR RESIDENTS TO ENGAGE IN FREE AND REDUCED PRICED PHYSICAL ACTIVITY. IT IS SANFORD'S GOAL TO INCREASE THE AVAILABILITY OF BIKING AND WALKING PATHS IN THE COMMUNITY TO INCREASE PHYSICAL ACTIVITY OPTIONS, TO INCREASE SAFETY FOR STUDENTS AND TO EXPAND FITNESS FACILITIES FOR RESIDENTS.PRIORITY 3: ADDRESS FOOD INSECURITIES FOR AREA RESIDENTS AND PATIENTSSANFORD HAS MADE ADDRESSING FOOD INSECURITIES FOR AREA RESIDENTS AND PATIENTS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE ADDITIONAL FOOD AVAILABILITY FOR FAMILIES IN NEED. IT IS SANFORD'S GOAL TO EXPAND SERVICES AVAILABLE IN THE HOSPITAL AND CLINIC FOR PATIENTS THAT NEED NUTRITION ASSISTANCE AND TO INCREASE FOOD SUPPORT FOR STUDENTS IN NEED OF NUTRITION ASSISTANCE THROUGH PARTNERSHIPS WITH LOCAL STAKEHOLDERS.ADDRESSING OF SIGNIFICANT NEEDS DURING THE CURRENT YEARIMPROVING MENTAL HEALTH AND CHEMICAL DEPENDENCY AVAILABILITY IN THE COMMUNITYTELEPSYCH SERVICES ARE CURRENTLY AVAILABLE AT SANFORD MEDICAL CENTER WHEATON, INCLUDING WITHIN THE EMERGENCY DEPARTMENT. SANFORD HAS EXPANDED LOCAL ACCESSIBILITY THROUGH THE ADDITION OF A PSYCHIATRIC NURSE PRACTITIONER IN 2024. THE TEAM IS ALSO ADDING A LICENSED DRUG AND ALCOHOL COUNSELOR. SANFORD WHEATON CONTINUES TO WORK ON DEVELOPING A PARTNERSHIP AND PLANNING WITH CURRENT PARTNERS TO FILL THE NEED WITHIN THE REGION AND COMMUNITY, INCLUDING HORIZON PUBLIC HEALTH.IMPROVE PHYSICAL ACTIVITY OPPORTUNITIESTHE COMMUNITY HAS A PARTIAL WALKING BIKE PATH AVAILABLE AND RESIDENTS HAVE ACCESS TO THE LOCAL HIGH SCHOOL TRACK.SANFORD HAS PARTNERED WITH THE MN DOT, CITY OF WHEATON AND COUNTY OF TRAVERSE TO WORK ON SAFE ROUTES TO SCHOOL AS WELL AS A DEMONSTRATION PROJECT TO MAKE A SEAMLESS SAFE ROUTE FROM THE HIGH SCHOOL, PAST THE SWIMMING POOL AND TO THE BALLFIELD.ADDRESS FOOD INSECURITIES FOR AREA RESIDENTS AND PATIENTSSANFORD WHEATON PROVIDES NUTRITION SERVICES TO UNDERSERVED POPULATIONS THAT PROVIDE A BASE OFF WHICH TO EXPAND. THE HOSPITAL PARTICIPATES IN THE LOCAL BACKPACK PROGRAM PROVIDING FOOD TO CHILDREN IN THE LOCAL SCHOOLS. THE PROGRAM PROVIDES FOOD FOR CHILDREN EVERY OTHER WEEKEND BY PLACING ENTREES, CEREAL AND SNACKS IN THEIR LOCKER. SANFORD WHEATON ALSO PARTNERS TO PROVIDE FOOD SECURITY BOXES AND PARTICIPATES IN THE FOOD RX PROGRAM.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN:ACCESS TO MEDICAL CARE AND HEALTH CARE PROVIDERSACCESS TO AFFORDABLE HEALTH CAREPUBLIC TRANSPORTATIONLONG-TERM SENIOR CARECHILD CARESANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
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 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 21 -- SANFORD BAGLEY MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 21 -- SANFORD BAGLEY MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH 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 IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: INCREASE ACCESS TO PREVENTATIVE AND SPECIALTY HEALTHCARE SERVICESSANFORD BAGLEY MEDICAL CENTER (SBMC) PLAYS A VITAL ROLE IN ENSURING THAT PATIENTS IN RURAL MINNESOTA HAVE ACCESS TO HEALTH CARE SERVICES. AS THE COMMUNITY AGES AND CHALLENGES WITH CLINICIAN RECRUITMENT AND HEALTH CARE INFRASTRUCTURE CHANGES ARISE, MAINTAINING ROBUST AND SUSTAINABLE HEALTH CARE ACCESS BECOMES INCREASINGLY CRITICAL. SBMC IS COMMITTED TO ENSURING THAT THE QUALITY OF CARE IS NOT INFLUENCED BY A PATIENT'S LOCATION. SANFORD HEALTH IS POSITIONED LOCALLY TO HAVE A POSITIVE IMPACT ON INCREASED ACCESS TO PREVENTATIVE AND SPECIALTY HEALTHCARE SERVICES WITHIN THE COMMUNITY. THIS EFFORT WILL FOCUS ON TWO PRIMARY GOALS: TO INCREASE ACCESS TO WOMEN'S HEALTH CARE AND PREVENTATIVE SCREENINGS AND TO INCREASE ACCESS FOR VACCINATIONS.PRIORITY 2: CONTINUED EXPANSION OF BEHAVIORAL HEALTH SERVICES AND SUBSTANCE ABUSE PROGRAMSINCREASING BEHAVIORAL HEALTH SERVICES AND EXPANDING ACCESS TO SUBSTANCE ABUSE TREATMENT ARE CRITICAL FOR ADDRESSING THE GROWING MENTAL HEALTH AND ADDICTION CRISES. BY PROVIDING COMPREHENSIVE SUPPORT AND ACCESSIBLE CARE, WE CAN HELP INDIVIDUALS MANAGE THEIR CONDITIONS, REDUCE STIGMA, AND PROMOTE RECOVERY. STRENGTHENING THESE SERVICES IS ESSENTIAL FOR IMPROVING OVERALL PUBLIC HEALTH, ENHANCING QUALITY OF LIFE, AND BUILDING HEALTHIER COMMUNITIES.SANFORD HEALTH IS POSITIONED LOCALLY TO HAVE A POSITIVE IMPACT ON BEHAVIORAL HEALTH SERVICES AND SUBSTANCE ABUSE PROGRAMS WITHIN THE COMMUNITY. THIS EFFORT WILL FOCUS ON TWO PRIMARY GOALS: TO INCREASE ACCESS TO VIRTUAL VISITS FOR BEHAVIORAL HEALTH CARE AND TO INCREASE ACCESS TO SUBSTANCE USE SERVICES.PRIORITY 3: INCREASE ACCESS TO HEALTHY FOODSURVEY RESPONDENTS IN THE BAGLEY AREA RATED ACCESS TO HEALTHY FOODS AS LESS THAN GOOD. THE MOST COMMON BARRIER CITED NOTED WAS THE HIGH COST ASSOCIATED WITH HEALTHY EATING. THESE CONCERNS ARE EVIDENT IN CHR DATA WHICH INDICATE THAT 12 PERCENT OF THE POPULATION IN THE BAGLEY AREA DID NOT HAVE ACCESS TO A RELIABLE SOURCE OF FOOD DURING THE PAST YEAR. OVERALL, BY IMPLEMENTING SYSTEMATIC SCREENING, PROVIDING EDUCATIONAL RESOURCES, OFFERING PERSONALIZED SUPPORT, AND COLLABORATING WITH COMMUNITY RESOURCES, SBMC CAN IMPROVE OPPORTUNITIES TO SCREEN AND SUPPORT THE NUTRITIONAL NEEDS OF THE PEDIATRIC PATIENTS WE SERVE, ULTIMATELY PROMOTING THE HEALTH AND WELL-BEING OF THE CHILDREN UNDER SANFORD'S CARE.SANFORD HEALTH IS POSITIONED LOCALLY TO HAVE A POSITIVE IMPACT ON INCREASED ACCESS TO HEALTHY FOOD. THIS EFFORT WILL FOCUS ON TWO PRIMARY GOALS: TO IMPROVE OPPORTUNITIES TO SCREEN FOR NUTRITIONAL NEEDS OF PEDIATRIC PATIENTS AND TO SUPPORT NUTRITIONAL NEEDS OF THE PEDIATRIC PATIENTS SERVED AT SANFORD BAGLEY CLINIC.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARINCREASE ACCESS TO PREVENTATIVE AND SPECIALTY HEALTHCARE SERVICESSBMC ACTIVELY PROMOTES OUTREACH SPECIALTY SERVICES AVAILABLE WITHIN THE COMMUNITY. THESE OUTREACH SERVICES BRING SPECIALTY PROVIDERS TO BAGLEY FACILITIES TO PROVIDE CARE CLOSE TO HOME. CURRENT OUTREACH SERVICES OFFERED INCLUDE PEDIATRIC CARE, DERMATOLOGY, OBSTETRICAL, GYNECOLOGY, SLEEP MEDICINE, BARIATRICS, AND MENTAL HEALTH. SBMC ALSO HOLDS FLU SHOT EVENTS AND PLANS TO EXPAND THE LOCATION OF THESE.CONTINUED EXPANSION OF BEHAVIORAL HEALTH SERVICES AND SUBSTANCE ABUSE PROGRAMS OVER THE LAST SEVERAL YEARS, SBMC INITIATED A GROUP BASED BEHAVIORAL HEALTH PROGRAM FOR SENIORS. DUE TO ISSUES WITH INSURANCE COVERAGE, CONTRACT DIFFICULTIES, AND LOW NUMBERS, SANFORD SHIFTED GEARS TO EXPANDING BEHAVIORAL HEALTH COUNSELING IN THE CLINIC SETTING AND VIA TELEHEALTH. THE CHANGE ALLOWED BEHAVIORAL HEALTH SERVICES TO BE SPREAD TO A LARGER AGE RANGE AND FOR AN INCREASED VOLUME OF PEOPLE. IN ADDITION, SANFORD HAS PARTNERED TO SUPPORT STELLHER HUMAN MENTAL HEALTH SERVICES IN THE SCHOOL SYSTEM BY FUNDING A ONE DAY A WEEK VIRTUAL OPTION FOR PEDIATRICS AGE TEN AND OLDER. INDIVIDUALS ARE ALSO SERVED BY SBMC'S MEDICATION ASSISTANCE THERAPY STAFF FOLLOWING THEIR ER VISITS.INCREASE ACCESS TO HEALTHY FOODSBMC HAS PARTNERED WITH UNITED WAY IN SPONSORING THE BACKPACK BUDDIES AND PROVIDES VOLUNTEERS FOR THE FOOD DROPS PROGRAM. IN 2024, 43 CHILDREN IN CLEARWATER COUNTY RECEIVED FOOD THROUGH BACKPACK BUDDIES AND 144,000 POUNDS OF FOOD WAS DISTRIBUTED IN THE COUNTY THROUGH THE FOOD DROPS PROGRAM. IN ADDITION, SANFORD WILL CONTINUE TO SUPPORT FRIENDS IN THE KITCHEN, A COOKING CLASS FOR THOSE AGE 55 AND OLDER. THIS PROGRAM IS DESIGNED TO BRING RURAL SENIORS TOGETHER TO A SAFE PLACE FOR EDUCATION ON HOW TO EAT HEALTHY ON A LIMITED BUDGET. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREEMPLOYMENT & ECONOMIC OPPORTUNITYCHILD CARE QUALITYPUBLIC TRANSPORTATIONAFFORDABLE HOUSING & LONG-TERM SENIOR CARESANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
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 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 22 -- SANFORD CANTON-INWOOD MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 22 -- SANFORD CANTON-INWOOD MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH 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 IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: IMPROVE HEALTHY LIVING OUTCOMES THROUGH UPSTREAM ENGAGEMENT TO IMPROVE SOCIAL DETERMINANTS OF HEALTHSURVEY RESPONDENTS IN THE CANTON-INWOOD AREA RATED THEIR OWN PERSONAL HEALTH AND WELLNESS AS GOOD AND THE QUALITY OF HEALTH CARE IN THEIR COMMUNITY AS VERY GOOD. DESPITE THIS, WHEN SURVEY RESPONDENTS WERE ASKED ABOUT THE BIGGEST HEALTH CONCERNS FOR THEMSELVES AND THEIR FAMILY (CONCERNS THEY FACE ON A REGULAR BASIS), CHRONIC HEALTH ISSUES WERE A TOP CONCERN, AFTER COST. SANFORD HAS MADE IMPROVING HEALTHY LIVING OUTCOMES A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ENHANCE COMMUNITY PARTNERSHIPS TO EXTEND CHRONIC DISEASE EDUCATION TO MORE RESIDENTS AND TO EXPAND CURRENT PROGRAMS HAVING A POSITIVE IMPACT ON SOCIAL DETERMINANTS OF HEALTH TO MORE OF THE COMMUNITY.PRIORITY 2: INCREASE ACCESS TO MENTAL HEALTH RESOURCES WITHIN THE COMMUNITY BY INCREASING PARTNERSHIPS WITH LOCAL PROVIDERS, EDUCATING THE COMMUNITY ON RESOURCES, AND DESTIGMATIZING THE SERVICEWHEN SURVEY RESPONDENTS WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, ACCESS TO HEALTH CARE SERVICES AND PROVIDERS WAS ONE OF THE TOP ISSUES. APPROXIMATELY HALF OF THE SURVEY RESPONDENTS IN THE CANTON-INWOOD AREA INDICATED THAT THERE ARE HEALTH CARE SERVICES THEY WOULD LIKE TO SEE OFFERED OR IMPROVED IN THEIR COMMUNITY. WHEN THESE RESPONDENTS WERE ASKED WHICH HEALTH CARE SERVICES THEY WOULD LIKE TO SEE OFFERED OR IMPROVED, MOST INDICATED BEHAVIORAL AND MENTAL HEALTH SERVICES AS THEIR TOP PRIORITY.SANFORD HAS MADE INCREASING ACCESS TO MENTAL HEALTH RESOURCES WITHIN THE COMMUNITY A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO INCREASE UTILIZATION OF MENTAL HEALTH SERVICES BY STUDENTS AND INCREASE PROACTIVE IDENTIFICATION OF PATIENTS THAT WOULD BENEFIT FROM MENTAL HEALTH SERVICES.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARIMPROVE HEALTHY LIVING OUTCOMES THROUGH UPSTREAM ENGAGEMENT TO IMPROVE SOCIAL DETERMINANTS OF HEALTH THE SANFORD CANTON-INWOOD MEDICAL CENTER CURRENTLY EMPLOYS A CARE MANAGER TO ASSIST PATIENTS IN COORDINATING THEIR CARE AFTER A PROCEDURE. THIS INCLUDES IDENTIFYING AND PROCURING MEDICAL DEVICES, SUCH AS WHEELCHAIRS, AND SCHEDULING POST-PROCEDURE FOLLOW-UP VISITS. BEYOND THE DIRECT CARE OF PATIENTS, SANFORD SUPPORTS FOOD PROGRAMS FOR STUDENTS AND CLASSES TO THE COMMUNITY. INCREASE ACCESS TO MENTAL HEALTH RESOURCES WITHIN THE COMMUNITY BY INCREASING PARTNERSHIPS WITH LOCAL PROVIDERS, EDUCATING THE COMMUNITY ON RESOURCES, AND DESTIGMATIZING THE SERVICE SANFORD HEALTH OFFERS BEHAVIORAL COUNSELING AT THE CANTON CLINIC WITH TWO PROVIDERS THAT OFFER CARE LOCALLY. ADDITIONAL SERVICES AND PROVIDERS ARE AVAILABLE VIA TELEHEALTH OR THROUGH ADDITIONAL SANFORD CLINICS LOCATED IN LINCOLN COUNTY, INCLUDING SANFORD PSYCHIATRY & PSYCHOLOGY ON S. LOUISE AVE IN SIOUX FALLS, APPROXIMATELY 21 MILES FROM CANTON.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CARELONG-TERM SENIOR CAREPUBLIC TRANSPORTATION AFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
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 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 23 -- SANFORD CLEAR LAKE MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 23 -- SANFORD CLEAR LAKE MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 SHELDON MEDICAL CENTERSANFORD THIEF RIVER FALLS BEHAVIORAL HEALTH 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 IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: ACCESS TO CARE AND PROVIDERSWHEN SURVEY RESPONDENTS IN THE CLEAR LAKE AREA WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, ACCESS TO HEALTH CARE SERVICES AND MEDICAL PROVIDERS WAS THE TOP ISSUE, WITH 84 PERCENT OF RESPONDENTS HAVING TRAVELED TO RECEIVE HEALTH CARE SERVICES WITHIN THE PAST THREE YEARS (WHICH IS HIGHER THAN THE COMPARISON GROUP AVERAGE). WHEN ASKED WHY, THE MAIN REASON WAS DUE TO NEEDING A SPECIALIST OR SERVICE NOT AVAILABLE LOCALLY.NEARLY HALF OF SURVEY RESPONDENTS IN THE CLEAR LAKE AREA INDICATED THAT THERE ARE HEALTH CARE SERVICES THEY WOULD LIKE TO SEE OFFERED OR IMPROVED IN THEIR COMMUNITY. WHEN THESE RESPONDENTS WERE ASKED WHICH HEALTH CARE SERVICES THEY WOULD LIKE TO SEE OFFERED OR IMPROVED, MOST SAID BEHAVIORAL AND MENTAL HEALTH SERVICES. SANFORD HEALTH CLEAR LAKE HAS MADE ACCESS TO CARE AND PROVIDERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO PROMOTE PROVIDERS DOING OUTREACH AT SANFORD CLEAR LAKE MEDICAL CENTER, TO PROMOTE PROVIDERS OF TELEMEDICINE AND VIRTUAL SERVICES AT SANFORD CLEAR LAKE MEDICAL CENTER AND TO PROVIDE COMMUNITY EDUCATION ON BEHAVIORAL AND MENTAL HEALTH SERVICES AND RESOURCES.PRIORITY 2: PUBLIC TRANSPORTATIONTRANSPORTATION SYSTEMS HELP ENSURE THAT PEOPLE CAN REACH EVERYDAY DESTINATIONS, SUCH AS JOBS, SCHOOLS, HEALTHY FOOD OUTLETS, AND HEALTHCARE FACILITIES, SAFELY AND RELIABLY. PUBLIC TRANSPORTATION SERVICES PLAY AN IMPORTANT ROLE FOR PEOPLE WHO ARE UNABLE TO DRIVE, PEOPLE WITHOUT ACCESS TO PERSONAL VEHICLES, CHILDREN, INDIVIDUALS WITH DISABILITIES, AND OLDER ADULTS.SANFORD HEALTH CLEAR LAKE HAS MADE PUBLIC TRANSPORTATION A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO ENHANCE PUBLIC TRANSPORTATION ACCESS FOR REGIONAL NEEDS. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARACCESS TO CARE AND PROVIDERS SANFORD CLEAR LAKE MEDICAL CENTER CONSISTENTLY WORKS TO RECRUIT PROVIDERS TO THE COMMUNITY. OUTREACH SERVICES AND VIRTUAL SERVICES ARE ADDITIONAL AVENUES FOR LOCAL RESIDENTS TO RECEIVE A BROAD RANGE OF HEALTH CARE SERVICES CLOSE TO HOME. SANFORD CURRENTLY HAS THREE OUTREACH PROVIDERS. TO INCREASE WELLNESS VISITS, SANFORD CLEAR LAKE WORKS INTERNALLY WITH THE ORGANIZATION'S MARKETING DEPARTMENT AND PHYSICIANS ON EXPANDED COMMUNITY CAMPAIGNS, INCLUDING VIDEOS ON ALL NEW PROVIDERS HIGHLIGHTING THEIR BIOGRAPHIES. THE VIDEOS ARE AVAILABLE ON SANFORDHEALTH.ORG. NEW PROVIDERS ARE INTRODUCED TO THE COMMUNITY THROUGH COORDINATED SOCIAL MEDIA AND NEWSPAPER CAMPAIGNS.PUBLIC TRANSPORTATIONSANFORD CLEAR LAKE MEDICAL CENTER STAFF ASSIST PATIENTS WITH FINDING RESOURCES FOR RIDES TO/FROM MEDICAL APPOINTMENTS TO THE EXTENT POSSIBLE. THE TEAM HAS PARTNERED WITH OTHER INDIVIDUALS AND GROUPS IN THE COMMUNITY TO SEEK SOLUTIONS FOR THE LOCAL TRANSPORTATION ISSUES.SANFORD HEALTH DOES COORDINATE WITH A VOLUNTEER THAT CAN PROVIDE TRANSPORTATION TO COMMUNITY MEMBERS AND HOSPITALIZED PATIENTS BASED UPON THE VOLUNTEER'S SCHEDULE. SANFORD CLEAR LAKE PARTICIPATES IN THE HEALTHY HOMETOWN COMMITTEE. HEALTHY HOMETOWN IS A PROGRAM THAT ASSISTS COMMUNITIES IN IMPLEMENTING CHANGES THAT PROMOTE HEALTHY LIVING BY FOCUSING ON THREE AREAS MOVE MORE, EAT WELL, AND FEEL BETTER. THEY ARE CURRENTLY WORKING WITH THE SOUTH DAKOTA DEPARTMENT OF TRANSPORTATION ON AN INFRASTRUCTURE IMPROVEMENT PLAN TO ALLOW FOR ENHANCED AND SAFER WALKABILITY IN THE CLEAR LAKE COMMUNITY.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:LONG-TERM SENIOR CAREAFFORDABLE HOUSING 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
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 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 24 -- SANFORD WESTBROOK MEDICAL CENTER PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 24 -- SANFORD WESTBROOK MEDICAL CENTER PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 BEHAVIORAL HEALTH 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 IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTHMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HEALTH WESTBROOK HAS MADE MENTAL HEALTH A SIGNIFICANT PRIORITY. IT IS SANFORD'S GOAL TO INCREASE AWARENESS AND EXPAND ACCESS OF MENTAL HEALTH SERVICES AT SANFORD WESTBROOK AND IN THE SERVICING AREA AND TO CREATE AND IMPLEMENT POLICY/PROCEDURES/PROTOCOLS TO BE PUT IN PLACE IN AREA SCHOOL SYSTEMS IN THE EVENT OF MENTAL HEALTH CRISIS AND CREATE/IMPLEMENT CALMING SPACES THROUGHOUT THE SCHOOLS.PRIORITY 2: HEALTHY / ACTIVE LIVINGWHEN SURVEY RESPONDENTS IN THE WESTBROOK AREA WERE ASKED ABOUT THE BIGGEST HEALTH CONCERNS FOR THEMSELVES AND THEIR FAMILY, CHRONIC HEALTH ISSUES WERE AMONG THE TOP CONCERNS. SANFORD HAS MADE HEALTHY/ACTIVE LIVING A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE IMPROVED OVERALL PHYSICAL AND NUTRITIONAL HEALTH IN PATIENTS AT SANFORD HEALTH FROM THE COMMUNITY. IT IS SANFORD'S GOAL TO CREATE ACCESS TO HEALTHY FOOD CHOICES AND PROVIDE EDUCATIONAL OPPORTUNITIES TO MAKE HEALTHY CHOICES AND INCREASE THE ACTIVITY LEVEL OF COMMUNITY MEMBERS IN OUR SANFORD WESTBROOK SERVICE AREA.PRIORITY 3: TRANSPORTATIONTRANSPORTATION SYSTEMS HELP ENSURE THAT PEOPLE CAN REACH EVERYDAY DESTINATIONS, SUCH AS JOBS, SCHOOLS, HEALTHY FOOD OUTLETS, AND HEALTH CARE FACILITIES, SAFELY AND RELIABLY. PUBLIC TRANSPORTATION SERVICES PLAY AN IMPORTANT ROLE FOR PEOPLE WHO ARE UNABLE TO DRIVE, PEOPLE WITHOUT ACCESS TO PERSONAL VEHICLES, CHILDREN, INDIVIDUALS WITH DISABILITIES, AND OLDER ADULTS.SANFORD HAS MADE TRANSPORTATION A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN COMMUNITY AWARENESS OF TRANSPORTATION ACCESS AND EXPANDED ACCESSIBILITY THROUGH COLLABORATIONS WITH SANFORD. IT IS SANFORD'S GOAL TO INCREASE AWARENESS OF TRANSPORTATION SERVICES IN THE SANFORD WESTBROOK SERVICE AREA AND TO INCREASE ACCESS TO TRANSPORTATION SERVICES IN OUR AREA.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARMENTAL HEALTHSANFORD WESTBROOK CURRENTLY PROVIDES MENTAL HEALTH SERVICES WITH A PSYCHIATRIST VIA VIRTUAL CARE. LICSWS AND A BEHAVIORAL HEALTH NP ARE ALSO ON STAFF. SANFORD WESTBROOK WILL CONTINUE TO SHARE THE RESULTS OF THIS SURVEY WITH COMMUNITY PARTNERS TO BUILD ACCESS TO MENTAL HEALTH. IN ADDITION, WE WILL CONTINUE TO LOOK AT ACCESS POINTS WITHIN THE CLINIC, BOTH IN PERSON AND VIRTUAL TO IMPROVE ACCESS TO MENTAL HEALTH. SANFORD WESTBROOK WILL HIRE NEW APP STAFF TO ADDRESS INCREASES IN MENTAL HEALTH NEEDS. WE WILL SPEND TIME OVER THE NEXT THREE YEARS EXPLORING WAYS TO ASSIST THE SCHOOL WITH MENTAL HEALTH OPPORTUNITIES THROUGH POSSIBLE SCHOOL-LINKED MENTAL HEALTH COLLABORATIONS, CALMING ROOMS/SPACES, AND RESOURCES TO BRING AWARENESS. SANFORD WESTBROOK WILL COLLABORATE WITH THE AREA SCHOOLS TO ANALYZE AVAILABLE MENTAL HEALTH RESOURCES, AS WELL AS CREATE POLICY/PROCEDURES/PROTOCOL THE LOCAL SCHOOLS CAN UTILIZE IN THE EVENT OF MENTAL HEALTH CRISIS.THE MENTAL HEALTH PRIORITY IS ALSO BEING ADDRESSED THROUGH EXPANDED USE OF CURRENT TELEMEDICINE AND IN-HOUSE MENTAL HEALTH SERVICES AND THE ADDITIONAL GOAL OF INCREASING THE NUMBER OF SCREENING AND REFERRALS TO BEHAVIORAL HEALTH PROVIDERS. HEALTHY / ACTIVE LIVINGSANFORD WESTBROOK WILL CONTINUE TO WORK TO MAKE A POSITIVE IMPACT ON IMPROVING THE HEALTH OF COMMUNITY MEMBERS THROUGH BOTH PHYSICAL ACTIVITY AND HEALTHY LIFESTYLE CHOICES. SANFORD SUPPORTS COMMUNITY EFFORTS TO INCREASE ACCESS TO ACTIVITIES AND FACILITIES THAT PROMOTE HEALTHY AND ACTIVE LIFESTYLES.TRANSPORTATIONOVER THE NEXT THREE YEARS, SANFORD WESTBROOK WILL INCREASE COMMUNITY AWARENESS OF TRANSPORTATION ACCESS ISSUES THROUGH TARGETED OUTREACH CAMPAIGNS AND EDUCATIONAL INITIATIVES. SIMULTANEOUSLY, WE WILL ESTABLISH AT LEAST TWO STRATEGIC PARTNERSHIPS WITH LOCAL ORGANIZATIONS EACH YEAR TO ENHANCE TRANSPORTATION OPTIONS WITHIN OUR SERVICE AREA. THIS INITIATIVE AIMS TO IMPROVE ACCESS TO ESSENTIAL SERVICES AND PROMOTE MOBILITY FOR UNDERSERVED POPULATIONS, ULTIMATELY CONTRIBUTING TO BETTER HEALTH OUTCOMES IN OUR COMMUNITY. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO MEDICAL CARE AND HEALTH CARE PROVIDERSACCESS TO AFFORDABLE HEALTH CAREAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
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 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 2 -- SANFORD MEDICAL CENTER FARGO PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 2 -- SANFORD MEDICAL CENTER FARGO PART V, SECTION B, LINE 6A:	SANFORD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 BEHAVIORAL HEALTH 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 INCULDED.
GROUP A-FACILITY 2 -- SANFORD MEDICAL CENTER FARGO PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSEMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE INCREASED UTILIZATION OF BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES FOR THOSE THAT NEED THEM IN THE COMMUNITY. IT IS SANFORD'S GOAL TO IMPROVE TIMELY ACCESS TO MENTAL/BEHAVIORAL HEALTH CARE SERVICES AND TO ENHANCE AND EXPAND SERVICES TO EFFECTIVELY SUPPORT AND TREAT PATIENTS WITH SUBSTANCE USE DISORDERS.PRIORITY 2: ACCESS TO HEALTH CARE PROVIDERS AND QUALITY CAREWHEN RESPONDENTS WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, HAVING ACCESS TO HEALTH CARE WAS ONE OF THE TOP ISSUES BEHIND COST. AND WHEN RESPONDENTS, WHO RATED THEIR OWN ABILITY TO ACCESS HEALTH CARE AS POOR OR FAIR, WERE ASKED WHY THEY RATED ACCESS AS THEY DID, ISSUES OF LIMITED HOURS, WAIT TIMES, LIMITED LOCATIONS, AND LACK OF PROVIDERS AND SPECIALTY CARE WERE AMONG THE TOP CONCERNS.SANFORD HAS MADE ACCESS TO HEALTH CARE PROVIDERS AND QUALITY CARE A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE INCREASED COLLABORATION WITH EXTERNAL PARTNERS AND IMPROVED ACCESS TO CARE. IT IS SANFORD'S GOAL TO IMPROVE ACCESS TO PRIMARY AND SPECIALTY CARE AND TO COLLABORATIVELY SHARE CHNA INFORMATION WITH PUBLIC AND PRIVATE PARTNERS. ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEAR: MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSESANFORD FARGO IS CONTINUING ITS EFFORTS TO IMPROVE ACCESS TO MENTAL HEALTH/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES. UTILIZATION OF VIRTUAL VISITS FOR BEHAVIORAL HEALTH HAS CONTINUED TO GROW AND CONTRIBUTE TOWARD IMPROVED ACCESS. TIMELY ACCESS TO ADULT PSYCHIATRY CONTINUES TO BE AN AREA WE ARE WORKING TO IMPROVE AND MONITOR PROGRESS QUARTERLY. SANFORD CURRENTLY OFFERS MENTAL HEALTH AND SUBSTANCE ABUSE PROVIDERS IN THE COMMUNITY THROUGH VARIOUS DELIVERY OPPORTUNITIES. DEPRESSION SCREENING WILL BE UTILIZED IN THE ROOMING NAVIGATOR IN ALL CLINICS TO HELP IDENTIFY THOSE IN NEED OF CARE. OUR SUBOXONE CLINIC CONTINUES TO SERVE PATIENTS IN ADDICTION RECOVERY AND ENGAGES IN HOSPITAL PEER COACHING. SANFORD FARGO IS CONTINUING A PARTNERSHIP WITH CLAY COUNTY DETOX TO ENSURE COORDINATED UTILIZATION OF MEDICAL AND LAW ENFORCEMENT SUPPORT FOR INDIVIDUALS ACTIVELY IN DETOX.ACCESS TO HEALTH CARE PROVIDERS AND QUALITY CARE SANFORD FARGO INCREASED HOME-BASED PRIMARY CARE ACCESS AND CONTINUES TO UTILIZE THIS APPROACH TO IMPROVE ACCESS AS ALL PRIMARY CARE PROVIDERS NOW HAVE ACCESS TO THIS OPTION. PROVIDER RECRUITMENT PLAYS A MAJOR ROLE IN OUR ABILITY TO INCREASE OUR CAPACITY. INVESTING IN OUR EDUCATIONAL PROGRAMS TO SERVE AS A PIPELINE FOR PROVIDERS CONTINUES TO BE A PRIORITY. SANFORD MEDICAL CENTER FARGO IS NORTH DAKOTA'S LARGEST MEDICAL CENTER AND ONE OF THREE SANFORD MEDICAL CENTER CAMPUSES IN FARGO. IT SERVES AS A REGIONAL HEALTH CARE HUB WITH 60 PERCENT OF PATIENTS COMING FROM OUTSIDE THE METRO AREA. IT IS NORTH DAKOTA'S ONLY LEVEL I ADULT TRAUMA CENTER, NORTH DAKOTA'S ONLY LEVEL II PEDIATRIC TRAUMA CENTER, DESIGNATED AS A COMPREHENSIVE STROKE CENTER AND HAS AN AIRMED TRANSPORT SERVICE COVERING A THREE-STATE AREA. THE ONE-MILLION-SQUARE-FOOT SANFORD MEDICAL CENTER FARGO PROVIDES SERVICES INCLUDING EMERGENCY/TRAUMA, FAMILY BIRTH CENTER, CHILDREN'S HOSPITAL, BRAIN AND SPINE SURGERY, CARDIOVASCULAR SURGERY, INTERVENTIONAL CARDIOLOGY, GENERAL SURGERY AND MORE. AS OF 2024, SANFORD MEDICAL CENTER FARGO HAS 292 LICENSED BEDS. SANFORD MEDICAL CENTER FARGO TAKES CARE TO THE NEXT LEVEL, COMBINING EXPERTISE, STATE-OF-THE-ART TECHNOLOGY AND COMPASSIONATE PATIENT CARE. WITH TECHNOLOGICALLY ADVANCED ORS AND GROWING DIGITAL PATHOLOGY CAPABILITIES, SURGEONS CAN CONNECT ACROSS CAMPUSES AND CONSULT WITH SPECIALISTS ACROSS THE NATION. PATIENT ROOMS ARE DESIGNED AROUND THE PATIENT FOR EFFICIENCY, SAFETY AND OPTIMAL CARE.SANFORD MEDICAL CENTER FARGO IS A MAJOR TEACHING HOSPITAL IN PARTNERSHIP WITH MULTIPLE AREA UNIVERSITIES AND TECHNICAL COLLEGES TO PROVIDE CLINICAL TRAINING FOR NURSES, ALLIED HEALTH AND NON-HEALTH CARE FIELDS. AS WELL AS PARTNERSHIP WITH THE UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE AND HEALTH SCIENCES TO PROVIDE CLINICAL TRAINING FOR HUNDREDS OF MEDICAL STUDENTS, MEDICAL RESIDENTS AND FELLOWS. SANFORD ALSO OFFERS MANY ACTIVITIES AND PROGRAMS TO ATTRACT HIGH SCHOOL AND YOUNGER STUDENTS TO THE HEALTH CARE FIELD THROUGH OUR ASPIRE PROGRAMS. IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO AFFORDABLE HEALTH CAREHEALTHY LIVINGPUBLIC TRANSPORTATIONQUALITY CHILDCAREAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
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 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 5:	SANFORD HEALTH, IN COORDINATION WITH PUBLIC HEALTH EXPERTS, COMMUNITY LEADERS, AND OTHER HEALTH CARE PROVIDERS, WITHIN THE LOCAL COMMUNITY AND ACROSS SANFORD'S CARE DELIVERY FOOTPRINT, DEVELOPED A MULTI-FACETED ASSESSMENT PROGRAM DESIGNED TO ESTABLISH MULTIPLE PATHWAYS FOR HEALTH NEEDS ASSESSMENT. THE CHNA WAS CONDUCTED FROM DECEMBER 2023 THROUGH DECEMBER 2024, INCLUDING THE DEVELOPMENT OF IMPLEMENTATION STRATEGIES FOR 2025-2027. A FULL LIST OF SYSTEM AND LOCAL PARTNERS IS AVAILABLE WITHIN THE RESPECTIVE COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS.MEMBERS OF THE FOLLOWING ORGANIZATIONS CONTRIBUTED THEIR EXPERTISE WITH THE PLANNING, DEVELOPMENT AND ANALYSIS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AT THE SYSTEM LEVEL, PROVIDING ADVICE ON THE CHNA PROCESS AND METHODOLOGY AND PARTICIPATING IN THE LOCAL PROCESS BASED UPON THEIR LOCATION. THE LIST BELOW DOES NOT REPRESENT THE FULL PARTICIPANT LIST AND A FULL LISTING OF THE COMMUNITY STAKEHOLDERS AND COMMUNITY LEADERSHIP MEMBERS INVOLVED WITH INDIVIDUAL HOSPITALS CAN BE FOUND IN EACH PUBLISHED CHNA.CHI ST. ALEXIUS HEALTH AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTERESSENTIA HEALTH NORTH DAKOTA STATE UNIVERSITY CENTER FOR SOCIAL RESEARCH CLAY COUNTY PUBLIC HEALTHFARGO CASS PUBLIC HEALTHFAMILY HEALTHCARESIOUX FALLS DEPARTMENT OF HEALTHBISMARCK-BURLEIGH PUBLIC HEALTHNORTH DAKOTA PUBLIC HEALTH ASSOCIATION WESTERN PLAINS PUBLIC HEALTHLIMITATIONSTHE FINDINGS IN THIS STUDY PROVIDE AN OVERALL SNAPSHOT OF BEHAVIORS, ATTITUDES, AND PERCEPTIONS OF RESIDENTS LIVING IN THE COMMUNITY. A GOOD FAITH EFFORT WAS MADE TO SECURE INPUT FROM A BROAD BASE OF THE COMMUNITY. HOWEVER, GAPS IN INDIVIDUAL DATA SOURCES MAY ARISE WHEN COMPARING CERTAIN DEMOGRAPHIC CHARACTERISTICS (I.E., AGE, GENDER, INCOME, MINORITY STATUS) WITH THE CURRENT POPULATION ESTIMATES. FOR EXAMPLE, THESE GAPS MAY OCCUR DUE TO THE DIFFICULTY IN REACHING RESPONDENTS THROUGH THE SURVEY PROCESS. TO MITIGATE LIMITATIONS, THE CHNA EVALUATES COMMUNITY HEALTH FROM SEVERAL PERSPECTIVES: A STAKEHOLDER AND COMMUNITY SURVEY, MEETINGS WITH COMMUNITY LEADERS THAT HAVE SPECIAL KNOWLEDGE AND EXPERTISE REGARDING POPULATIONS, SECONDARY DATA SOURCES SUCH AS THE U.S. CENSUS BUREAU AND COUNTY HEALTH RANKINGS, PUBLIC COMMENTS FROM PREVIOUS ASSESSMENTS, AND INSTITUTIONAL KNOWLEDGE BY SANFORD EMPLOYEES LOCALLY AND ACROSS THE SANFORD ENTERPRISE.COMMUNITY AND STAKEHOLDER SURVEY COMMUNITY RESIDENTS WERE ASKED A SERIES OF QUESTIONS THROUGH AN ONLINE SURVEY DESIGNED IN PARTNERSHIP WITH HEALTH EXPERTS, PARTICIPATING ORGANIZATIONS NOTED PREVIOUSLY, AND PUBLIC HEALTH OFFICIALS ACROSS THE SANFORD FOOTPRINT TO UNDERSTAND HEALTH NEEDS. EACH RESPONDENT WAS ASKED TO RATE COMMUNITY DRIVERS FROM POOR TO EXCELLENT. ANY RESPONSE OTHER THAN EXCELLENT WAS OFFERED A FOLLOW-UP OPPORTUNITY TO COMMENT ON THE REASON FOR THEIR RANKING. RESPONDENTS WERE ALSO ASKED A SERIES OF QUESTIONS SPECIFIC TO THEIR HEALTH CARE ACCESS, HEALTH CARE QUALITY, BARRIERS TO CARE, TRAVEL TO CARE, AND INSURANCE. THE SURVEY WAS SENT TO SAMPLE POPULATIONS SECURED THROUGH QUALTRICS, A QUALIFIED VENDOR.THE SURVEY WAS THE FIRST OF MULTIPLE EFFORTS TO ENGAGE COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS. STAKEHOLDERS WERE SENT THE SURVEY AND ASKED TO COMPLETE THE INSTRUMENT AND THEN FORWARD THE SURVEY TO THEIR RESPECTIVE POPULATIONS FOR GREATER INVOLVEMENT.SANFORD INVESTED IN A MULTIFACETED CAMPAIGN THAT INCLUDED AN EARNED MEDIA CAMPAIGN ON LOCAL MEDIA OUTLETS AND THE PUBLIC-FACING SANFORD HEALTH NEWS (HTTPS://NEWS.SANFORDHEALTH.ORG/). THE SYSTEM ALSO PROMOTED THE SURVEY INTERNALLY THROUGH THE ORGANIZATION'S INTRANET, ALL-STAFF EMAILS, AND NEWSLETTERS.INTERNAL EFFORTS WERE SUPPORTED WITH A ROBUST ADVERTISING CAMPAIGN THAT INCLUDED, AMONG OTHER EFFORTS, A DIGITAL MEDIA PROGRAM YIELDING 3.6 MILLION IMPRESSIONS AND A PRINT AD CAMPAIGN ENCOURAGING NATIVE AMERICAN COMMUNITIES TO PARTICIPATE THROUGH PLACEMENTS IN DEBAHJIMON MAGAZINE, ANISHINAABEG MAGAZINE AND MHA TIMES (MANDAN, HIDATSA, ARIKARA). FURTHER SUPPORT WAS GIVEN TO COLLECTING SURVEYS AT VARIOUS COMMUNITY EVENTS. THE GOAL OF THESE EFFORTS WAS TO INCREASE PARTICIPATION BY THOSE UNDERREPRESENTED THE PREVIOUS CYCLE, INCLUDING LOWER INCOME, MINORITY, AND MEDICALLY UNDERSERVED POPULATIONS.SURVEY DATA FOR THE LOCAL COMMUNITY SHOULD BE CONSIDERED DIRECTIONAL AND BEST UTILIZED IN CONJUNCTION WITH ADDITIONAL DATA. PROMOTION INVESTMENTS BY THE SYSTEM YIELDED A TOTAL OF 9,714 COMPLETED SURVEYS FROM ACROSS THE SANFORD FOOTPRINT, AN INCREASE FROM 6,748 THE PREVIOUS CYCLE. THE RESPONSES GENERATED 48,643 OPEN-ENDED RESPONSES AND 1.76 MILLION PIECES OF DATA.SECONDARY DATACOUNTY HEALTH RANKINGS ARE BASED UPON THE UW POPULATION HEALTH MODEL AND SERVE AS THE MAIN SECONDARY DATA SOURCE UTILIZED FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. ALIGNMENT OF THE SURVEY AND SECONDARY DATA WITHIN THE UW POPULATION HEALTH MODEL ALLOWS FOR GREATER CONNECTION OF THE DATA SETS. POPULATION DATA ARE SOURCED TO THE U.S. CENSUS BUREAU. ADDITIONAL DATA SOURCES MAY BE USED AND ARE SOURCED WITHIN THE DOCUMENT.HEALTH NEEDS IDENTIFICATION METHODOLOGYTHE CENTER FOR SOCIAL RESEARCH AT NORTH DAKOTA STATE UNIVERSITY WAS RETAINED TO DEVELOP THE INITIAL COMMUNITY HEALTH NEEDS LIST FOR EACH COMMUNITY, BUILDING UPON THEIR INVOLVEMENT DURING THE PREVIOUS CYCLE. THE FOLLOWING METHODOLOGY WAS USED TO DEVELOP THE SIGNIFICANT HEALTH NEEDS PRESENTED LATER IN THE REPORT:SURVEY DATA WAS STRATIFIED INTO REPRESENTATIVE GROUPS BASED UPON POPULATION: LARGE URBAN COMMUNITIES, MEDIUM SIZED COMMUNITIES, AND RURAL COMMUNITIES. THE THREE GROUPS WERE ANALYZED SEPARATELY. TO IDENTIFY COMMUNITY HEALTH CARE NEEDS, EACH COMMUNITY'S SCORE BY QUESTION WAS COMPARED TO THE AVERAGE STRATIFIED COMPOSITE OF THE COMPARATIVE GROUP. UPON DETERMINATION OF A POTENTIAL STRENGTH OR NEED, COUNTY HEALTH RANKINGS AND RESPONSES FROM OPEN-ENDED QUESTIONS PROVIDED ADDITIONAL INSIGHTS INTO THE DRIVERS OF THE RESPECTIVE NEEDS.A SIMILAR METHODOLOGY WAS ALSO USED TO PROVIDE ADDITIONAL INSIGHTS INTO FINDINGS FROM COUNTY HEALTH RANKINGS DATA WITH RELEVANT HEALTH NEEDS HIGHLIGHTED IN THE SURVEY FINDINGS. HEALTH NEEDS IDENTIFIED THROUGH EITHER THE SURVEY OR COUNTY HEALTH RANKINGS DATA WERE ALSO INCLUDED IN THE FINDINGS.THE CENTER FOR SOCIAL RESEARCH VALIDATES THE FINDINGS OF THE PRIMARY RESEARCH BY ENGAGING AT LEAST TWO INTERNAL REVIEWERS. EACH REVIEWER HAS THEIR OWN TECHNIQUE AND STRENGTHS TO REVIEW THE FINDINGS; HOWEVER, THEY CHECK FOR ACCURACY IN THE DATA BY REVIEWING THE CODE AND SYNTAX, THE OUTPUT, THE CORRECT REPRESENTATION OF THE DATA IN THE REPORT, VERBIAGE, CONSISTENCY, CONTEXT, AND OVERALL READABILITY. BOTH REVIEWERS ALSO SUPPORTED PREVIOUS CHNA REPORTS.COMMUNITY ASSET MAPPINGASSET MAPPING WAS CONDUCTED TO LOCATE COMMUNITY RESOURCES AVAILABLE TO ADDRESS THE ASSESSED NEEDS. EACH UNMET NEED WAS RESEARCHED TO DETERMINE WHAT LOCAL RESOURCES ARE AVAILABLE.COMMUNITY STAKEHOLDER MEETINGSNEEDS, AS IDENTIFIED BY NDSU CENTER FOR SOCIAL RESEARCH, WERE PRESENTED TO COMMUNITY STAKEHOLDERS. FACILITATED DISCUSSION COMMENCED AND EACH PARTICIPANT WAS ASKED TO CONSIDER THE NEEDS IDENTIFIED THAT SHOULD BE FURTHER DEVELOPED INTO IMPLEMENTATION STRATEGIES. HEALTH NEEDS IDENTIFIED DURING THE PREVIOUS CYCLE BUT NOT RAISED THROUGH THE SURVEY OR COUNTY HEALTH RANKINGS WERE ALSO CONSIDERED. THE MEETING SERVED TO INFORM THE GROUP OF THE FINDINGS BUT ALSO SERVED AS A CATALYST TO DRIVE COLLABORATION AND PRIORITIZATION OF LOCAL NEEDS. PARTICIPANTS IN THE MEETINGS INCLUDED COMMUNITY STAKEHOLDERS AND ELECTED OFFICIALS WITH KNOWLEDGE AND CONNECTIONS AMONGST MEDICALLY UNDERSERVED, LOW INCOME, OR MINORITY POPULATIONS.THE PARTICIPANTS PROVIDED INFORMATION TO ANSWER THE FOLLOWING TYPES OF QUESTIONS AS IT RELATES TO IDENTIFIED NEEDS:WHAT ARE THE BIGGEST CHALLENGES CURRENTLY WITH THESE NEEDS IN THE COMMUNITY? DOES THE COMMUNITY HAVE GAPS IN SERVICES, ACCESS, OUTREACH, ETC.? WHAT OPPORTUNITIES EXIST, WHERE CAN WE HAVE THE GREATEST IMPACT IN ADDRESSING THESE NEEDS? WHICH ARE MOST URGENT IN NATURE?IS THERE ALREADY WORK BEING DONE ON THESE NEEDS?WHAT ARE THE RESOURCES CURRENTLY NOT UTILIZED WITHIN THE COMMUNITY THAT COULD ADDRESS THIS TOPIC?WHICH NEEDS FALL WITHIN THE PURVIEW OF HEALTH CARE SYSTEM AND WHICH DO NOT? CAN THE NON-HEALTHCARE NEEDS BE SHARED WITH OTHER ENTITIES OR ORGANIZATIONS?IS THERE ANYTHING YOU CONSIDER AN URGENT NEED THAT WE HAVE NOT DISCUSSED?COMMUNITY STAKEHOLDERS HELPED TO DETERMINE KEY PRIORITIES FOR 2025-2027 FOR THEIR RESPECTIVE COMMUNITIES.THE COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES ARE AVAILABLE ONLINE AT HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. PUBLIC COMMENTS AND QUESTIONS ARE WELCOME THROUGH THE SITE.
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 6A:	SANFORD USD MEDICAL CENTER SIOUX FALLSSANFORD MEDICAL CENTER FARGOSANFORD BROADWAY MEDICAL CENTER FARGOSANFORD 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 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA 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 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 11:	THE FOLLOWING IS A LIST OF THE COMMUNITY'S PRIORITY NEEDS AND WHAT IS BEING DONE TO ADDRESS THEM. PRIORITY NEEDS NOT DIRECTLY ADDRESSED ARE EITHER, NOT WITHIN SANFORD'S EXPERTISE, OR BEING ADDRESSED COLLABORATIVELY WITH COMMUNITY PARTNERS. FOR INFORMATION CONCERNING THOSE ADDITIONAL NEEDS VISIT:HTTP://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENTPRIORITY 1: INCREASE ACCESS TO SPECIALTY CARE SERVICES AND SAME-DAY APPOINTMENTSWHEN SURVEY RESPONDENTS IN THE THIEF RIVER FALLS (TRF) MARKET AREA WERE ASKED ABOUT THE MOST IMPORTANT HEALTH CARE ISSUES IMPACTING THEIR COMMUNITY, THREE-FOURTHS OF SURVEY RESPONDENTS INDICATED THAT THERE ARE HEALTH CARE SERVICES THEY WOULD LIKE TO SEE OFFERED OR IMPROVED IN THEIR COMMUNITY. WHEN THESE RESPONDENTS WERE ASKED WHICH HEALTH CARE SERVICES THEY WOULD LIKE TO SEE OFFERED OR IMPROVED, MOST SAID BEHAVIORAL AND MENTAL HEALTH SERVICES, FOLLOWED BY CANCER CARE, ADDICTION TREATMENT, DENTAL CARE, WALK-IN/URGENT CARE, LONG-TERM CARE AND NURSING HOMES, OBGYN/WOMEN'S CARE, FAMILY MEDICINE OR PRIMARY CARE, AND HEART CARE.SANFORD HAS MADE ACCESS TO SPECIALTY CARE SERVICES AND SAME-DAY APPOINTMENTS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO SEE AN INCREASE IN SAME-DAY APPOINTMENT AVAILABILITY. IT IS SANFORD'S GOAL TO EXPAND SAME-DAY APPOINTMENTS WITHIN PRIMARY CARE AND TO ENHANCE ACCESS TO THE TOP THREE SERVICES IDENTIFIED IN THE COMMUNITY SURVEY (MENTAL HEALTH, CANCER CARE AND SUBSTANCE ABUSE).PRIORITY 2: PROMOTE COMMUNITY SERVICES WITH COMMUNITY PARTNERSBY PARTNERING WITH LOCAL ENTITIES, SANFORD TRF BEHAVIORAL HEALTH CENTER (STRFBHC) AIMS TO ADDRESS THE INTERCONNECTED ECONOMIC, SOCIAL, AND HEALTH NEEDS OF OUR COMMUNITY. THIS COLLABORATIVE APPROACH NOT ONLY ENHANCES ACCESS TO ESSENTIAL RESOURCES BUT ALSO FOSTERS A HEALTHIER, MORE RESILIENT POPULATION.SANFORD HAS MADE PROMOTING COMMUNITY SERVICES WITH COMMUNITY PARTNERS A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES TO CREATE A LASTING POSITIVE IMPACT ON THE OVERALL WELLBEING OF THE COMMUNITY WE SERVE. IT IS SANFORD'S GOAL TO PARTNER WITH COUNTY HEALTH FOR EDUCATIONAL RESOURCES AND TO PROMOTE SANFORD.FINDHELP.COMPRIORITY 3: INCREASE ACCESS TO MENTAL HEALTH SERVICESMENTAL HEALTH INCLUDES OUR EMOTIONAL, PSYCHOLOGICAL, AND SOCIAL WELL-BEING AND AFFECTS HOW WE THINK, FEEL, AND ACT. IT ALSO HELPS DETERMINE HOW WE HANDLE STRESS, RELATE TO OTHERS, AND MAKE CHOICES. MENTAL HEALTH IS IMPORTANT AT EVERY STAGE OF LIFE, FROM CHILDHOOD AND ADOLESCENCE THROUGH ADULTHOOD.SANFORD HAS MADE INCREASING ACCESS TO MENTAL HEALTH SERVICES A SIGNIFICANT PRIORITY AND HAS DEVELOPED STRATEGIES FOR THE COMMUNITY TO SEE EXPANDED ACCESS TO GROUP THERAPY SESSIONS AND AN EXPANDED CLINICAL TRAINING PROGRAM TO INCREASE ACCESS. IT IS SANFORD'S GOAL TO REDUCE WAIT TIME FOR MENTAL HEALTH SERVICES BY OFFERING GROUP THERAPY AND TO EXPAND THE CLINICAL TRAINING PROGRAM.ADDRESSING OF SIGNIFICANT NEEDS DURING CURRENT YEARINCREASE ACCESS TO SPECIALTY CARE SERVICES AND SAME-DAY APPOINTMENTSACCESS TO HEALTHCARE PROVIDERS REMAINS A TOP PRIORITY IN TRF. WE HAVE SUCCESSFULLY LEVERAGED TELEHEALTH TECHNOLOGIES TO EXPAND ACCESS BEYOND TRADITIONAL IN-PERSON CONSULTATIONS. WHILE THE POTENTIAL FOR TELEHEALTH IS SIGNIFICANT, ITS ADOPTION IS SOMEWHAT CONSTRAINED BY EXISTING PAYMENT MODELS AND THE WILLINGNESS OF INSURANCE PAYERS TO RECOGNIZE TELEHEALTH AS A COVERED SERVICE AND THE PERCEPTION OF THIS SERVICE FROM PROVIDERS AND OLDER PATIENTS NOT FEELING THE SAME PROVIDER-PATIENT RELATIONSHIP.PROMOTE COMMUNITY SERVICES WITH COMMUNITY PARTNERSSTRFBHC IS COMMITTED TO BEING AN ENGAGED COMMUNITY PARTNER ACROSS VARIOUS LEVELS AND ORGANIZATIONS. WE ACTIVELY SUPPORT ECONOMIC DEVELOPMENT INITIATIVES, COLLABORATE WITH THE CHAMBER OF COMMERCE, AND ENGAGE WITH THE LOCAL SCHOOL SYSTEM. OUR INVOLVEMENT EXTENDS TO COMMUNITY HEALTH AND FITNESS PROGRAMS, EVENTS, AND A LOCAL YOUNG PROFESSIONALS' NETWORK, CONTRIBUTING TO A VIBRANT AND HEALTHY COMMUNITY.WE ARE ALSO DEDICATED TO INVESTING IN EDUCATIONAL PROGRAMS TAILORED TO ADDRESS CRITICAL HEALTH TOPICS, INCLUDING COURSES FOCUSED ON CARDIAC HEALTH, PREGNANCY, DIABETES, AND MORE. ADDITIONALLY, WE ADVOCATE FOR POLICY CHANGES AT THE LOCAL, STATE, AND FEDERAL LEVELS, WORKING ALONGSIDE ADVOCACY GROUPS TO PROMOTE HEALTH EQUITY AND IMPROVED HEALTH OUTCOMES.INCREASE ACCESS TO MENTAL HEALTH SERVICESSTRFBHC SERVES AS THE ONLY FREESTANDING BEHAVIORAL HEALTH HOSPITAL AND PRIMARY PROVIDER OF INPATIENT PSYCHIATRIC SERVICES FOR NORTHWEST MINNESOTA, WITH 16 INPATIENT PSYCHIATRIC BEDS. THE HOSPITAL OFFERS OUTPATIENT MENTAL HEALTH SERVICES, CHILDREN'S THERAPEUTIC SERVICES AND SUPPORT, AND OUTPATIENT SUBSTANCE USE TREATMENT. THE HOSPITAL IS ACTIVELY RECRUITING BOTH MASTER'S AND DOCTORAL-LEVEL PROFESSIONALS. TELEHEALTH HAS BEEN INSTRUMENTAL IN RETAINING CLINICIANS WHO MIGHT HAVE RELOCATED, ALLOWING US TO MAINTAIN SERVICE CONTINUITY. EIGHT OF OUR CLINICIANS NOW EXCLUSIVELY PROVIDE TELEHEALTH SERVICES, WHILE MANY OTHERS INTEGRATE IT INTO THEIR PRACTICE. THIS EXPANSION OF TELEHEALTH HAS SIGNIFICANTLY IMPROVED ACCESS TO MENTAL HEALTH CARE.WE HAVE INVESTED SIGNIFICANT EFFORT TO IMPROVE OUR INTAKE PROCESS FOR THERAPY SERVICES INCLUDING COMPLETING AN INTAKE SCREENING AND UPDATING OUR WAITLIST TO AID IN BEST ALIGNING CLINICIAN EXPERTISE AND AVAILABILITY WITH PATIENT NEEDS.STRFBHC STAFF PROVIDED 8 SAFETALK TRAININGS THROUGHOUT THE REGION, WHICH IS A 4-HOUR TRAINING THAT EQUIPS PEOPLE TO BE MORE ALERT TO SOMEONE THINKING OF SUICIDE AND BETTER ABLE TO CONNECT THEM WITH FURTHER HELP. STRFBHC AND SANFORD HEALTH MEDICAL CENTER STAFF ALSO PARTNERED WITH COMMUNITY STRONG TO PROVIDE EDUCATION AND OUTREACH EVENTS AT SPORTS GAMES, TEENS TOWARD ZERO DEATHS, AS WELL AS HOSTING/SPONSORING THE ANNUAL BE THE VOICE EVENT IN THIEF RIVER FALLS. IN ADDITION, STRFBHC CONNECTED WITH VARIOUS OTHER AGENCIES, GROUPS, AND COMMUNITIES.IDENTIFIED NEEDS NOT DIRECTLY ADDRESSED BY THIS FACILITY'S IMPLEMENTATION PLAN INCLUDE:ACCESS TO QUALITY HEALTHCAREPUBLIC TRANSPORTATIONLONG-TERM SENIOR CAREQUALITY CHILD CAREAFFORDABLE HOUSINGSANFORD 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 AND STAKEHOLDERS. SANFORD HEALTH FURTHER SUPPORTS THROUGH ITS FINDHELP RESOURCE, AN ONLINE TOOL TO INCORPORATE CONTACT AND REFERRAL INFORMATION TO CONNECT COMMUNITY-BASED ORGANIZATIONS WITH PATIENTS TO MEET THEIR HEALTH RELATED-SOCIAL CARE NEEDS. A LINK IS INCLUDED ON EVERY AFTER-VISIT SUMMARY PROVIDED TO PATIENTS AND IS AVAILABLE ON SANFORDHEALTH.ORG AND MYCHART.
GROUP A-FACILITY 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA 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 25 -- SANFORD THIEF RIVER FALLS BEHAVIORAL HEA PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
GROUP A-FACILITY 26 -- BLACK HILLS SURGICAL HOSPITAL, LLC PART V, SECTION B, LINE 2:	AS OF THE ACQUISION DATE OF NOVEMBER 15, 2024, BLACK HILLS SURGICAL HOSPITAL, LLC TRANSITIONED TO TAX-EXEMPT NONPROFIT STATUS AND BEGAN OPERATING AS PART OF SANFORD HEALTH SYSTEM. AS A FOR-PROFIT HOSPITAL PRIOR TO ACQUISION BY SANFORD HEALTH, A COMMUNITY HEALTH NEEDS ASSESSMENT WAS NOT REQUIRED BY YEAR-END.
GROUP A-FACILITY 26 -- BLACK HILLS SURGICAL HOSPITAL, LLC 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 26 -- BLACK HILLS SURGICAL HOSPITAL, LLC PART V, SECTION B, LINE 16J:	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:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY

Field	Value	IRS element (for citing)
Facility	252	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (252 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - SANFORD CLINIC ABERDEEN
3015 3RD AVENUE SE	ABERDEEN	SD	57401	MEDICAL CLINIC
2 - SANFORD CLINIC ABERDEEN SURGICAL CENTER
3015 3RD AVENUE SE	ABERDEEN	SD	57401	AMBULATORY SURGERY CENTER
3 - SANFORD HEALTH ADRIAN CLINIC
201 MAINE AVE	ADRIAN	SD	56110	RURAL HEALTH CLINIC
4 - SANFORD HEALTH BROADWAY CLINIC
1527 BROADWAY STREET	ALEXANDRIA	MN	56308	MEDICAL CLINIC
5 - SANFORD BAGLEY CLINIC
1656 CENTRAL ST W	BAGLEY	MN	56621	RURAL HEALTH CLINIC
6 - SANFORD BAGLEY EYE CENTER & OPTICAL
1656 CENTRAL ST W	BAGLEY	MN	56621	EYE CARE CENTER
7 - BAKER PARK INC
803 DEWEY AVENUE	BEMIDJI	MN	56601	ASSISTED LIVING CENTER
8 - EDITH SANFORD BREAST CENTER BEMIDJI
1233 34TH ST NW	BEMIDJI	MN	56601	WOMEN'S HEALTH
9 - SANFORD BEHAVIORAL HEALTH HEADWATERS ACT
1705 ANNE ST NW	BEMIDJI	MN	56601	BEHAVIORAL HEALTH TREATMENT CENTER
10 - SANFORD BEMIDJI 1611 ANNE ST CLINIC
1611 ANNE ST NW	BEMIDJI	MN	56601	MEDICAL CLINIC
11 - SANFORD BEMIDJI 1705 ANN ST CLINIC
1705 ANNE ST NW	BEMIDJI	MN	56601	MEDICAL CLINIC
12 - SANFORD BEMIDJI DOWNTOWN EYE CENTER & OPTI
506 BELTRAMI AVE NW	BEMIDJI	MN	56601	EYE CARE CENTER
13 - SANFORD BEMIDJI EYE CENTER & OPTICAL
1611 ANNE ST NW	BEMIDJI	MN	56601	EYE CARE CENTER
14 - SANFORD BEMIDJI HOME CARE & HOSPICE
3201 PINE RIDGE AVE NW	BEMIDJI	MN	56601	HOME CARE AND HOSPICE
15 - SANFORD BEMIDJI MAIN CLINIC
1233 34TH ST NW	BEMIDJI	MN	56601	MEDICAL CLINIC
16 - SANFORD BEMIDJI OTHOPEDICS & SPORTS MEDICI
1300 ANNE STREET NW	BEMIDJI	MN	56601	MEDICAL CLINIC
17 - SANFORD DIALYSIS BEMIDJI
1300 ANNE STREET NW	BEMIDJI	MN	56601	DIALYSIS
18 - SANFORD HEALTH NEILSON PLACE
1000 ANNE ST NW	BEMIDJI	MN	56601	SKILLED NURSING FACILITY
19 - SANFORD HEALTH PRIMEWEST RESIDENTIAL
3124 HANNAH AVE NW	BEMIDJI	MN	56601	BEHAVIORAL HEALTH & ADDICTION CENTER
20 - SANFORD HEALTH TRILLIUM
930 ANNE STREET NW	BEMIDJI	MN	56601	ASSISTED LIVING CENTER
21 - SANFORD HEALTH WINDSONG
1000 ANNE ST NW	BEMIDJI	MN	56601	ASSISTED LIVING CENTER
22 - SANFORD JOE LUEKEN CANCER CENTER
1233 34TH ST NW	BEMIDJI	MN	56601	CANCER CENTER
23 - SANFORD CLINIC BERESFORD
600 W CEDAR STREET	BERESFORD	SD	57004	RURAL HEALTH CLINIC
24 - BISMARCK CANCER CENTER
500 N 8TH STREET	BISMARCK	ND	58501	CANCER CENTER
25 - SANFORD BIRTH CENTER
300 N 7TH STREET	BISMARCK	ND	58501	BIRTH CENTER
26 - SANFORD CANCER CENTER BISMARCK
300 N 7TH STREET	BISMARCK	ND	58501	CANCER CENTER
27 - SANFORD CHILDREN'S NORTH CLINIC
765 W INTERSTATE AVE	BISMARCK	ND	58503	CHILDREN'S CLINIC
28 - SANFORD CLINIC
222 N 7TH STREET	BISMARCK	ND	58501	MEDICAL CLINIC
29 - SANFORD EAST INTERSTATE AVE CLINIC
1800 E INTERSTATE AVE	BISMARCK	ND	58503	MEDICAL CLINIC
30 - SANFORD FIFTH & BROADWAY CLINIC
515 E BROADWAY AVE	BISMARCK	ND	58501	MEDICAL CLINIC
31 - SANFORD HEALTH CHIROPRACTICOCC MED CLINIC
2603 E BROADWAY AVE	BISMARCK	ND	58501	MEDICAL CLINIC
32 - SANFORD NORTH CLINIC
2830 N WASHINGTON STREET	BISMARCK	ND	58503	MEDICAL CLINIC
33 - SANFORD ORTHOPEDIC & SPORTS MEDICINE
225 N 7TH STREET	BISMARCK	ND	58501	MEDICAL CLINIC
34 - SANFORD SEVENTH & BROADWAY CLINIC
715 E BROADWAY AVE	BISMARCK	ND	58501	MEDICAL CLINIC
35 - SANFORD SEVENTH & ROSSER CLINIC
414 N 7TH STREET	BISMARCK	ND	58501	MEDICAL CLINIC
36 - SANFORD SEVENTH & THAYER CLINIC
209 N 7TH STREET	BISMARCK	ND	58501	MEDICAL CLINIC
37 - SANFORD SOUTH CLINIC
1040 TACOMA AVE	BISMARCK	ND	58504	MEDICAL CLINIC
38 - SANFORD STATE SREET CLINIC
3318 N 14TH STREET	BISMARCK	ND	58503	MEDICAL CLINIC
39 - SANFORD TOM & FRANCES LEACH BISMARCK DIALY
209 N 7TH STREET	BISMARCK	ND	58501	DIALYSIS CENTER
40 - SANFORD BEMIDJI BLACKDUCK CLINIC
81 1ST ST NW	BLACKDUCK	MN	56630	MEDICAL CLINIC
41 - SANFORD BOYDEN CLINIC
3971 320TH ST	BOYDEN	IA	51234	MEDICAL CLINIC
42 - SANFORD BRANDON ACUTE CARE & ORTHO FAST TR
1105 E HOLLY BLVD	BRANDON	SD	57005	MEDICAL CLINIC
43 - SANFORD BRANDON FAMILY MEDICINE & CHILDREN
1105 E HOLLY BLVD	BRANDON	SD	57005	MEDICAL CLINIC
44 - SANFORD HEALTH BROOKINGS CLINIC
922 - 22ND AVENUE S	BROOKINGS	SD	57006	MEDICAL CLINIC
45 - SANFORD CANBY CLINIC
112 ST OLAF AVENUE S	CANBY	MN	56220	MEDICARE CERTIFIED RURAL HEALTH CLINIC
46 - SANFORD CANBY DENTAL CLINIC
11 ST OLAF AVENUE S	CANBY	MN	56220	DENTAL CLINIC
47 - SANFORD CANBY DIALYSIS UNIT
112 ST OLAF AVENUE S	CANBY	MN	56220	MEDICARE CERTIFIED END STAGE RENAL DIALYSIS
48 - SANFORD CANBY HOME CARE
213 ST OLAF AVENUE N	CANBY	MN	56220	MEDICARE CERTIFIED HOME HEALTH AGENCY
49 - SANFORD CANBY MEDICAL CENTER
112 ST OLAF AVENUE S	CANBY	MN	56220	CLASS F HOME CARE PROVIDER
50 - SANFORD DIALYSIS CANBY
112 ST OLAF AVENUE S	CANBY	MN	56220	DIALYSIS
51 - SANFORD HEALTH CANBY SYLVAN PLACE
212 ST OLAF AVENUE S	CANBY	MN	56220	HOUSING WITH SERVICES
52 - SANFORD HEALTH CANISTOTAUSD CLINIC
320 W MAIN ST	CANISTOTA	SD	57012	RURAL HEALTH CLINIC
53 - SANFORD CANTON CLINIC
400 N HIAWATHA DRIVE	CANTON	SD	57013	RURAL HEALTH CLINIC
54 - SANFORD HEALTH CANTON HIAWATHA HEIGHTS
398 N HIAWATHA DRIVE	CANTON	SD	57013	ASSISTED LIVING CENTER
55 - SANFORD BEMIDJI CASS LAKE CLINIC
219 GRANT UTLEY AVE NW	CASS LAKE	MN	56633	MEDICAL CLINIC
56 - SANFORD CHAMBERLAIN CLINIC
300 S BYRON BLVD	CHAMBERLAIN	SD	57325	RURAL HEALTH CLINIC
57 - SANFORD DIALYSIS
300 S BYRON BLVD	CHAMBERLAIN	SD	57325	DIALYSIS
58 - SANFORD HEALTH CHAMBERLAIN CARE CENTER
300 S BYRON BLVD	CHAMBERLAIN	SD	57325	NURSING FACILITY
59 - SANFORD HOME HEALTH & HOSPICE CHAMBERLAIN
110 W BEEBE AVE	CHAMBERLAIN	SD	57325	HOME HEALTH CARE & HOSPICE
60 - SANFORD HEALTH CLARK CLINIC
211 N COMMERCIAL STREET	CLARK	SD	57225	RURAL HEALTH CLINIC
61 - SANFORD CLEAR LAKE CLINIC
701 3RD AVENUE S	CLEAR LAKE	SD	57226	RURAL HEALTH CLINIC
62 - SANFORD CLEAR LAKE MEDICAL CENTER
701 3RD AVENUE S	CLEAR LAKE	SD	57226	HOME HEALTH CARE
63 - SANFORD BAGLEY CLEARBROOK CLINIC
22 ELM STREET	CLEARBROOK	MN	56634	RURAL HEALTH CLINIC
64 - SANFORD HEALTH DAKOTA DUNES CLINIC
350 OAK TREE LN	DAKOTA DUNES	SD	57049	MEDICAL CLINIC
65 - SANFORD HEALTH DELL RAPIDS ORCHARD HILLS
200 W 10TH STREET	DELL RAPIDS	SD	57022	ASSISTED LIVING CENTER
66 - SANFORD DIALYSIS
1234 WASHINGTON AVE SUITE B	DETROIT LAKES	MN	56501	DIALYSIS CENTER
67 - SANFORD HEALTH DETROIT LAKES CLINIC & SAME
1245 WASHINGTON AVENUE	DETROIT LAKES	MN	56501	AMBULATORY SURGERY CENTER/CLINIC
68 - SANFORD HEALTH DETROIT LAKES EYE CENTER
1234 WASHINGTON AVE SUITE A	DETROIT LAKES	MN	56501	EYE CARE CENTER
69 - SANFORD HEALTH EAST DICKINSON CLINIC
33 9TH ST W	DICKINSON	ND	58601	MEDICAL CLINIC
70 - SANFORD HEALTH HEARING CENTER DICKINSON
1531 W VILLARD ST	DICKINSON	ND	58601	HEARING CENTER
71 - SANFORD HEALTH WEST DICKINSON CLINIC
2615 FAIRWAY STREET	DICKINSON	ND	58601	MEDICAL CLINIC
72 - SANFORD DERMATOLOGY CLINIC
625 DEMERS AVE NW	EAST GRAND FORKS	MN	56721	MEDICAL CLINIC
73 - SANFORD HEALTH 621 DEMERS AVE CLINIC
621 DEMERS AVE NW	EAST GRAND FORKS	MN	56721	MEDICAL CLINIC
74 - SANFORD HEALTH 625 DEMERS AVE CLINIC
625 DEMERS AVE NW	EAST GRAND FORKS	MN	56721	MEDICAL CLINIC
75 - SANFORD HEALTH 929 CENTRAL AVE CLINIC
929 CENTRAL AVE	EAST GRAND FORKS	MN	56721	MEDICAL CLINIC
76 - SANFORD HOME CARE EAST GRAND FORKS
404 DEMERS AVE	EAST GRAND FORKS	MN	56721	HOME HEALTH CARE
77 - SANFORD HEALTH EDGELEY CLINIC
506 2ND ST	EDGELEY	ND	58433	MEDICAL CLINIC
78 - SANFORD LUVERNE EDGERTON CLINIC
733 MAIN AVE	EDGERTON	MN	56128	RURAL HEALTH CLINIC
79 - SANFORD HEALTH ELLENDALE CLINIC
141 MAIN ST	ELLENDALE	ND	58436	RURAL HEALTH CLINIC
80 - SANFORD HEALTH ENDERLIN CLINIC
201 4TH AVENUE	ENDERLIN	ND	58027	RURAL HEALTH CLINIC
81 - SANFORD CLINIC ESTELLINE
305 HOSPITAL DRIVE	ESTELLINE	SD	57234	RURAL HEALTH CLINIC
82 - EDITH SANFORD BREAST CENTER FARGO
737 BROADWAY N	FARGO	ND	58102	WOMEN'S HEALTH
83 - SANFORD 1711 MEDICAL BUILDING
1711 UNIVERSITY DRIVE S	FARGO	ND	58103	MEDICAL CLINIC
84 - SANFORD 2801 MEDICAL BUILDING
2801 S UNIVERSITY DRIVE	FARGO	ND	58122	MEDICAL CLINIC
85 - SANFORD BRAIN & SPINE CENTER FARGO
2301 25TH ST S	FARGO	ND	58103	MEDICAL CLINIC
86 - SANFORD BROADWAY CLINIC
801 BROADWAY N	FARGO	ND	58102	MEDICAL CLINIC
87 - SANFORD BROADWAY MEDICAL BUILDING
736 BROADWAY N	FARGO	ND	58102	MEDICAL CLINIC
88 - SANFORD CHILDREN'S BROADWAY CLINIC
737 BROADWAY N	FARGO	ND	58102	CHILDREN'S CLINIC
89 - SANFORD CHILDREN'S CARE CLINIC
100 4TH STREET S	FARGO	ND	58103	CHILDREN'S CLINIC
90 - SANFORD CHILDREN'S SOUTHWEST CLINIC
2701 13TH AVE S	FARGO	ND	58103	CHILDREN'S CLINIC
91 - SANFORD DERMATOLOGY & LASER CLINIC
4656 40TH AVE S	FARGO	ND	58104	MEDICAL CLINIC
92 - SANFORD DIALYSIS FARGO
2801 S UNIVERSITY DRIVE	FARGO	ND	58122	DIALYSIS
93 - SANFORD FOOT AND ANKLE CLINIC
1720 S UNIVERSITY DR	FARGO	ND	58103	MEDICAL CLINIC
94 - SANFORD HOME CARE FARGO
100 4TH STREET S	FARGO	ND	58103	HOME HEALTH AGENCY
95 - SANFORD I-94 CLINIC
5225 23RD AVENUE SOUTH	FARGO	ND	58104	MEDICAL CLINIC
96 - SANFORD NEUROSCIENCE CLINIC
700 1ST AVE S	FARGO	ND	58103	MEDICAL CLINIC
97 - SANFORD NORTH FARGO CLINIC
2601 BROADWAY N	FARGO	ND	58102	MEDICAL CLINIC
98 - SANFORD ORTHOPEDIC WALK-IN CLINIC FARGO
1720 S UNIVERSITY DR	FARGO	ND	58103	MEDICAL CLINIC
99 - SANFORD PAIN CENTER FARGO
2301 25TH ST S	FARGO	ND	58103	MEDICAL CLINIC
100 - SANFORD REPRODUCTIVE MEDICINE CLINIC
1111 HARWOOD DRIVE S	FARGO	ND	58104	MEDICAL CLINIC
101 - SANFORD ROGER MARIS CANCER CENTER
820 4TH STREET N	FARGO	ND	58102	CANCER CENTER
102 - SANFORD SOUTH UNIVERSITY CLINIC
1717 S UNIVERSITY DR	FARGO	ND	58103	MEDICAL CLINIC
103 - SANFORD SOUTH UNIVERSITY EYE CENTER & OPTI
1717 S UNIVERSITY DR	FARGO	ND	58103	EYE CARE CENTER
104 - SANFORD SOUTHPOINTE CLINIC
2400 32ND AVE S	FARGO	ND	58103	MEDICAL CLINIC
105 - SANFORD SOUTHPOINTE EYE CENTER & OPTICAL
2400 32ND AVE S	FARGO	ND	58103	EYE CARE CENTER
106 - SANFORD VETERANS SQUARE CLINIC
3955 56TH ST S	FARGO	ND	58104	MEDICAL CLINIC
107 - SANFORD HEALTH FINLEY CLINIC
407 WASHINGTON AVE E	FINLEY	ND	58230	RURAL HEALTH CLINIC
108 - SANFORD HEALTH FORMAN CLINIC
336 MAIN ST	FORMAN	ND	58032	RURAL HEALTH CLINIC
109 - SANFORD DIALYSIS FORT YATES
10 N RIVER ROAD	FORT YATES	ND	58538	DIALYSIS CENTER
110 - SANFORD HEALTH GRAND FORKS CLINIC
1750 47TH AVE S	GRAND FORKS	ND	58201	MEDICAL CLINIC
111 - SANFORD HEALTH GWINNER CLINIC
69 HIGHWAY 13 W	GWINNER	ND	58040	MEDICAL CLINIC
112 - SANFORD HEALTH HALSTAD CLINIC
445 1ST STREET E	HALSTAD	MN	56548	RURAL HEALTH CLINIC
113 - SANFORD HEALTH HARTFORD CLINIC
905 N OAKS AVE	HARTFORD	SD	57033	MEDICAL CLINIC
114 - SANFORD SHELDON HARTLEY CLINIC
512 3RD ST NE	HARTLEY	IA	51346	MEDICAL CLINIC
115 - SANFORD HAWLEY CLINIC
1412 MAIN ST	HAWLEY	MN	56549	MEDICAL CLINIC
116 - SANFORD HEALTH COMSTOCK CORNER
12 3RD STREET SE	HILLSBORO	ND	58045	ASSISTED LIVING CENTER
117 - SANFORD HEALTH HILLSBORO CLINIC
315 EAST CALEDONIA	HILLSBORO	ND	58045	RURAL HEALTH CLINIC
118 - SANFORD HILLSBORO CARE CENTER
12 3RD STREET SE	HILLSBORO	ND	58045	HOSPITAL BASED-NURSING FACILITIES LTC
119 - SANFORD HEALTH DIALYSIS HOSPERS
112 SUNRISE DRIVE	HOSPERS	IA	51238	END STAGE RENAL DIALYSIS
120 - SANFORD HEALTH INTL FALLS EYE CENTER
1400 HIGHWAY 71	INTERNATIONAL FALLS	MN	56649	EYE CARE CENTER
121 - SANFORD HEALTH INWOOD CLINIC
303 E JEFFERSON ST	INWOOD	IA	51240	MEDICAL CLINIC
122 - SANFORD CLINIC IPSWICH
110 5TH AVENUE	IPSWICH	SD	57451	RURAL HEALTH CLINIC
123 - SANFORD JACKSON CLINIC
1430 NORTH HIGHWAY	JACKSON	MN	56143	MEDICARE CERTIFIED RURAL HEALTH CLINIC
124 - SANFORD DIALYSIS JAMESTOWN
300 2ND AVENUE NE	JAMESTOWN	ND	58401	DIALYSIS CENTER
125 - SANFORD DIALYSIS JAMESTOWN
300 2ND AVENUE NE	JAMESTOWN	ND	58401	DIALYSIS
126 - SANFORD HEALTH HEARING CENTER JAMESTOWN
904 5TH AVE NE	JAMESTOWN	ND	58401	HEARING CENTER
127 - SANFORD HEALTH JAMESTOWN 2ND AVE CLINIC
300 2ND AVENUE NE	JAMESTOWN	ND	58401	MEDICAL CLINIC
128 - SANFORD HEALTH JAMESTOWN CLINIC
904 5TH AVE NE	JAMESTOWN	ND	58401	MEDICAL CLINIC
129 - SANFORD HEALTH KELLIHER CLINIC
243 CLARK AVE N	KELLIHER	MN	56650	MEDICAL CLINIC
130 - SANFORD HEALTH KIMBALL CLINIC
101 S MAIN ST	KIMBALL	SD	57355	RURAL HEALTH CLINIC
131 - SANFORD CHILDREN'S CLINIC
3001 DAGGETT ST	KLAMATH FALLS	OR	97601	MEDICAL CLINIC
132 - SANFORD HEALTH LAKE NORDEN CLINIC
512 MAIN AVE	LAKE NORDEN	SD	57248	RURAL HEALTH CLINIC
133 - SANFORD HEALTH LAKE PARK CLINIC
215 N MARKET ST	LAKE PARK	IA	51347	MEDICAL CLINIC
134 - SANFORD JACKSON LAKEFIELD CLINIC
209 MAIN STREET	LAKEFIELD	MN	56150	MEDICARE CERTIFIED RURAL HEALTH CLINIC
135 - SANFORD HEALTH LAMOURE CLINIC
100 1ST AVE SW	LAMOURE	ND	58458	RURAL HEALTH CLINIC
136 - SANFORD HEALTH LENNOX CLINIC
108 S MAIN	LENNOX	SD	57039	RURAL HEALTH CLINIC
137 - SANFORD HEALTH LIDGERWOOD CLINIC
21 WILEY AVE S	LIDGERWOOD	ND	58053	MEDICAL CLINIC
138 - SANFORD HEALTH LISBON CLINIC
102 10TH AVE W	LISBON	ND	58054	MEDICAL CLINIC
139 - SANFORD HOME CARE LISBON
404 FOREST ST	LISBON	ND	58054	HOME HEALTH CARE
140 - SANFORD HOME HEALTH LUVERNE
304 N MCKENZIE ST	LUVERNE	MN	56156	HOME HEALTH CARE
141 - SANFORD LUVERNE CLINIC
1601 SIOUX VALLEY DR	LUVERNE	MN	56156	MEDICAL CLINIC
142 - SANFORD LUVERNE HOSPICE
217 N OAKLEY ST	LUVERNE	MN	56156	MEDICARE CERTIFIED HOSPICE
143 - SANFORD DIALYSIS
323 SW 10TH STREET	MADISON	SD	57042	END STAGE RENAL DIALYSIS
144 - SANFORD HOSPICE MADISON
900 2ND AVENUE	MADISON	MN	56256	HOSPICE (LICENSED IN SD)
145 - SANFORD HOME CARE MAHNOMEN
414 W JEFFERSON AVE	MAHNOMEN	MN	56557	HOME HEALTH CARE
146 - SANFORD HEALTH MAHNOMEN CLINIC
410 W 4TH ST	MAHNOMEN	MN	56557	RURAL HEALTH CLINIC
147 - SANFORD EAST MANDAN CLINIC
102 MANDAN AVE	MANDAN	ND	58554	MEDICAL CLINIC
148 - SANFORD HOME CARE BISMARCK
910 18TH STREET NW	MANDAN	ND	58554	HOME HEALTH AGENCY
149 - SANFORD NORTH MANDAN CLINIC
910 18TH STREET NW	MANDAN	ND	58554	MEDICAL CLINIC
150 - SANFORD HOME CARE MAYVILLE
49 7TH AVE SE	MAYVILLE	ND	58257	HOME HEALTH CARE
151 - SANFORD MAYVILLE CLINIC
600 1ST ST SE	MAYVILLE	ND	58257	MEDICAL CLINIC
152 - SANFORD HEALTH HIGHWAY 2 CLINIC
801 21ST AVE SE	MINOT	ND	58701	MEDICAL CLINIC
153 - SANFORD HEALTH NORTHWEST CLINIC
1500 21ST AVE NW	MINOT	ND	58701	MEDICA
154 - SANFORD HEALTH MITCHELL CLINIC
2100 HIGHLAND WAY	MITCHELL	SD	57301	MEDICAL CLINIC
155 - SANFORD MOORHEAD CAMPUS
4000 28TH AVE S	MOORHEAD	MN	56560	MEDICAL CLINIC
156 - SANFORD DIALYSIS MORRIS
400 1ST STREET EAST	MORRIS	MN	56267	DIALYSIS
157 - SANFORD HEALTH MOUNTAIN LAKE CLINIC
308 N 8TH STREET	MOUNTAIN LAKE	MN	56159	MEDICARE CERTIFIED RURAL HEALTH CLINIC
158 - SANFORD HEALTH OAKES CLINIC
420 7TH ST S	OAKES	ND	58474	MEDICAL CLINIC
159 - SANFORD CHILDREN'S CLINIC
3605 VISTA WAY	OCEANSIDE	CA	92056	CHILDREN'S CLINIC
160 - SANFORD HEALTH PARK RAPIDS CLINIC
110 7TH ST W	PARK RAPIDS	MN	56470	MEDICAL CLINIC
161 - SANFORD HEALTH PARKERS PRAIRIE CLINIC
115 E SOO STREET	PARKERS PRAIRIE	MN	56361	MEDICAL CLINIC
162 - SANFORD HEALTH PELICAN RAPIDS CLINIC
211 EAST MILL STREET	PELICAN RAPIDS	MN	56572	RURAL HEALTH CLINIC
163 - SANFORD HOME CARE PELICAN RAPIDS
211 EAST MILL STREET	PELICAN RAPIDS	MN	56572	HOME HEALTH CARE
164 - SANFORD HEALTH PIERRE CLINIC
521 E SIOUX AVE	PIERRE	SD	57501	MEDICAL CLINIC
165 - SANFORD VERMILLION PONCA CLINIC
111 E 2ND STREET	PONCA	NE	68770	MEDICAL CLINIC
166 - SANFORD DIALYSIS RED LAKE
24760 HOSPITAL DRIVE	RED LAKE	MN	56671	DIALYSIS
167 - SANFORD ROCK RAPIDS CLINIC
104 BUNCOMBE DRIVE	ROCK RAPIDS	IA	51246	RURAL HEALTH CLINIC
168 - SANFORD SHELDON SANBORN CLINIC
321 MAIN STREET	SANBORN	IA	51248	MEDICAL CLINIC
169 - SANFORD HEALTH SHELDON CARE CENTER
118 NORTH SEVENTH AVENUE PO BOX 250	SHELDON	IA	51201	HOSPITAL BASED-NURSING FACILITIES
170 - SANFORD SHELDON CLINIC
800 OAK STREET	SHELDON	IA	51201	RURAL HEALTH CLINIC
171 - SANFORD SHELDON HOME HEALTH & HOSPICE
118 NORTH SEVENTH AVENUE PO BOX 250	SHELDON	IA	51201	HOME HEALTH AGENCY AND HOSPICE
172 - AVA'S HOUSE
1320 W 17TH STREET	SIOUX FALLS	SD	57104	HOSPICE
173 - SANFORD 10TH & PHILLIPS ACUTE CARE CLINIC
136 S PHILLIPS AVE	SIOUX FALLS	SD	57104	MEDICAL CLINIC
174 - SANFORD 26TH & SYCAMORE FAMILY MEDICINE
4405 E 26TH ST	SIOUX FALLS	SD	57103	MEDICAL CLINIC
175 - SANFORD 32ND & ELLIS CLINIC
2601 S ELLIS ROAD	SIOUX FALLS	SD	57106	MEDICAL CLINIC
176 - SANFORD 49TH & OXBOW FAMILY MEDICINE
3401 W 49TH STREET	SIOUX FALLS	SD	57106	MEDICAL CLINIC
177 - SANFORD 4TH & SYCAMORE FAMILY MEDICINE
600 N SYCAMORE AVE	SIOUX FALLS	SD	57110	MEDICAL CLINIC
178 - SANFORD 69TH & LOUISE FAMILY MEDICINE
6101 S LOUISE AVE	SIOUX FALLS	SD	57108	MEDICAL CLINIC
179 - SANFORD 69TH & MINNESOTA FAMILY MEDICINE
6110 S MINNESOTA AVE	SIOUX FALLS	SD	57108	MEDICAL CLINIC
180 - SANFORD ACUTE CARE AND ORTHOPEDIC FAST TRA
4000 N HERCULES AVE	SIOUX FALLS	SD	57110	MEDICAL CLINIC
181 - SANFORD CANCER CENTER
1309 W 17TH ST	SIOUX FALLS	SD	57104	CANCER CENTER
182 - SANFORD CARDIOVASCULAR INSTITUTE
1301 W 18TH STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
183 - SANFORD CHILDREN'S MB2 CLINIC
1205 S GRANGE AVE	SIOUX FALLS	SD	57105	CHILDREN'S CLINIC
184 - SANFORD CHILDREN'S RESIDENCY CLINIC
6101 S LOUISE AVE	SIOUX FALLS	SD	57108	CHILDREN'S CLINIC
185 - SANFORD CHILDREN'S SPECIALTY CLINIC
1600 W 22ND STREET	SIOUX FALLS	SD	57117	CHILDREN'S CLINIC
186 - SANFORD DERMATOLOGY CLINIC
1310 W 22ND STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
187 - SANFORD DIABETES & THYROID CLINIC
1305 W 18TH STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
188 - SANFORD DIALYSIS SIOUX FALLS
1321 W 22ND STREET	SIOUX FALLS	SD	57117	DIALYSIS CENTER
189 - SANFORD EAR NOSE AND THROAT CLINIC
1310 W 22ND STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
190 - SANFORD EYE CENTER & OPTICAL
1621 S MINNESOTA AVE	SIOUX FALLS	SD	57105	EYE CARE CENTER
191 - SANFORD HEALTH EYE CLINIC
2310 S MARION RD 140	SIOUX FALLS	SD	57106	EYE CARE CENTER
192 - SANFORD HEALTH MB2 CLINIC
1205 S GRANGE AVE	SIOUX FALLS	SD	57105	MEDICAL CLINIC
193 - SANFORD HOME HEALTH SIOUX FALLS
2710 WEST 12TH STREET	SIOUX FALLS	SD	57104	HOME HEALTH CARE
194 - SANFORD HOSPICE SIOUX FALLS
2710 WEST 12TH STREET	SIOUX FALLS	SD	57104	HOSPICE (LICENSED IN MN AND SD)
195 - SANFORD IMAGENETICS
1321 W 22ND STREET	SIOUX FALLS	SD	57117	GENETICS
196 - SANFORD INTERNAL MEDICINE CLINIC
1321 W 22ND STREET	SIOUX FALLS	SD	57117	MEDICAL CLINIC
197 - SANFORD MADISON AND VETERANS PARKWAY
5920 E MADISON ST	SIOUX FALLS	SD	57110	MEDICAL CLINIC
198 - SANFORD MATERNAL-FETAL MEDICINE
1500 W 22ND STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
199 - SANFORD OBSTETRICS & GYNECOLOGY CLINIC
1500 W 22ND STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
200 - SANFORD PSYCHIATRY & PSYCHOLOGY CLINIC
2400 W 49TH STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
201 - SANFORD SURGICAL ASSOCIATES
1508 W 22ND STREET	SIOUX FALLS	SD	57105	AMBULATORY SURGERY CENTER/CLINIC
202 - SANFORD USD 34TH & KIWANIS FAMILY MEDICINE
2701 S KIWANIS AVE	SIOUX FALLS	SD	57105	MEDICAL CLINIC
203 - SANFORD VAN DEMARK CLINIC
1210 W 18TH STREET	SIOUX FALLS	SD	57104	MEDICAL CLINIC
204 - SANFORD VASCULAR ASSOCIATES
1305 W 18TH STREET	SIOUX FALLS	SD	57105	MEDICAL CLINIC
205 - SANFORD WOMEN'S PRIMARY CARE CLINIC
5019 S WESTERN AVE	SIOUX FALLS	SD	57108	MEDICAL CLINIC
206 - THE BIRTH PLACE
1500 W 22ND STREET	SIOUX FALLS	SD	57105	BIRTH CENTER
207 - NORTHERN LIGHTS COMMUNITY RESIDENCE
921 ATLANTIC AVE N	THIEF RIVER FALLS	MN	56701	RESIDENTIAL BEHAVIORAL HEALTH
208 - SANFORD BEHAVIORAL HEALTH OUTPATIENT CLINI
120 LABREE AVENUE S	THIEF RIVER FALLS	MN	56701	BEHAVIORAL HEALTH TREATMENT CENTER
209 - SANFORD DIALYSIS THIEF RIVER FALLS
120 LABREE AVENUE S	THIEF RIVER FALLS	MN	56701	DIALYSIS
210 - SANFORD HEALTH THIEF RIVER FALLS EYE CENTE
1720 HIGHWAY 59 S	THIEF RIVER FALLS	MN	56701	EYE CARE CENTER
211 - SANFORD HEALTH THIEF RIVER FALLS SOUTHEAST
1720 HIGHWAY 59 S	THIEF RIVER FALLS	MN	56701	MEDICAL CLINIC
212 - SANFORD THIEF RIVER FALLS CLINIC
3001 SANFORD PKWY	THIEF RIVER FALLS	MN	56701	MEDICAL CLINIC
213 - SANFORD HEALTH TRACY O'BRIEN COURT
410 STATE STREET	TRACY	MN	56175	HOUSING WITH SERVICES
214 - SANFORD TRACY CLINIC
249 FIFTH STREET E	TRACY	MN	56175	MEDICARE CERTIFIED RURAL HEALTH CLINIC
215 - SHETEK HOME CARE SERVICES
251 5TH ST E	TRACY	MN	56175	HOME HEALTH CARE
216 - SANFORD HEALTH TWIN VALLEY CLINIC
501 2ND ST NW	TWIN VALLEY	MN	56584	RURAL HEALTH CLINIC
217 - SANFORD HEALTH ULEN CLINIC
108 VIKING AVENUE W	ULEN	MN	56585	RURAL HEALTH CLINIC
218 - SANFORD HEALTH VALLEY CITY CLINIC
520 CHAUTAUQUA BLVD	VALLEY CITY	ND	58072	MEDICAL CLINIC
219 - SANFORD HEALTH VERMILLION CARE CENTER
125 WALKER STREET	VERMILLION	SD	57069	NURSING FACILITY
220 - SANFORD HEALTH VERMILLION DAKOTA GERDENS
126 S PLUM STREET	VERMILLION	SD	57069	RESIDENTIAL LIVING CENTER
221 - SANFORD HOSPICE VERMILLION
848 EAST CHERRY STREET	VERMILLION	SD	57069	HOSPICE
222 - SANFORD VERMILLION CLINIC
20 S PLUM STREET	VERMILLION	SD	56069	MEDICAL CLINIC
223 - SANFORD DIALYSIS
111 WASHINGTON AVE NW	WAGNER	SD	57380	DIALYSIS CENTER
224 - SANFORD HEALTH WAHPETON CLINIC
332 2ND AVE N	WAHPETON	ND	58075	MEDICAL CLINIC
225 - SANFORD HEALTH WAHPETON EYE CENTER & OPTIC
332 2ND AVE N	WAHPETON	ND	58075	EYE CARE CENTER
226 - SANFORD HEALTH WAHPETON PT & PSYCHOLOGY
123 2ND AVE N	WAHPETON	ND	58075	MEDICAL CLINIC
227 - SANFORD HEALTH WALKER CLINIC
614 MICHIGAN AVENUE	WALKER	MN	56484	RURAL HEALTH CLINIC
228 - SANFORD TRACY WALNUT GROVE CLINIC
810 8TH ST	WALNUT GROVE	MN	56180	MEDICARE CERTIFIED RURAL HEALTH CLINIC
229 - SANFORD HEALTH WATERTOWN CLINIC
901 4TH STREET NW	WATERTOWN	SD	57201	MEDICAL CLINIC
230 - SANFORD HEALTH HEARING CENTER
116 8TH STREET NE	WATFORD CITY	ND	58854	HEARING CENTER
231 - SANFORD HEALTH WATFORD CITY CLINIC
709 4TH AVE NE	WATFORD CITY	ND	58854	MEDICAL CLINIC
232 - SANFORD WEBSTER CLINIC
101 PEABODY DRIVE	WEBSTER	SD	57274	RURAL HEALTH CLINIC
233 - SANFORD WEST FARGO CLINIC
1220 SHEYENNE STREET	WEST FARGO	ND	58078	MEDICAL CLINIC
234 - SANFORD HEALTH WESTROOK PETERSON ESTATES
1012 9TH STREET	WESTBROOK	MN	56183	HOUSING WITH SERVICES
235 - SANFORD WESTBROOK CLINIC
920 BELL AVENUE	WESTBROOK	MN	56183	MEDICARE CERTIFIED RURAL HEALTH CLINIC
236 - SANFORD HOME CARE WHEATON
405 12TH ST N	WHEATON	MN	56926	HOME HEALTH CARE
237 - SANFORD WHEATON CLINIC
401 12TH ST N	WHEATON	MN	56926	RURAL HEALTH CLINIC
238 - SANFORD 11TH & GATE CLINIC
17100 11TH ST W	WILLISTON	ND	58801	MEDICAL CLINIC
239 - SANFORD CLINIC WINDOM
591 2ND AVENUE N	WINDOM	MN	56101	MEDICARE CERTIFIED RURAL HEALTH CLINIC
240 - SANFORD HOSPICE WINNER
745 E 8TH STREET	WINNER	SD	57580	HOSPICE
241 - SANFORD DIALYSIS
1018 SIXTH AVENUE	WORTHINGTON	MN	56187	DIALYSIS CENTER
242 - SANFORD HEALTH CANCER CENTER
1018 SIXTH AVENUE	WORTHINGTON	MN	56187	CANCER CENTER
243 - SANFORD HOSPICE WORTHINGTON
1935 WOODLAND CT	WORTHINGTON	MN	56187	HOSPICE (LICENSED IN SD)
244 - SANFORD WORTHINGTON CLINIC
1680 DIAGONAL ROAD	WORTHINGTON	MN	56187	MEDICAL CLINIC
245 - SANFORD WORTHINGTON MEDICAL CENTER
1018 SIXTH AVENUE	WORTHINGTON	MN	56187	MEDICARE CERTIFIED END STAGE RENAL DIALYSIS
246 - SANFORD WORTHINGTON OBGYN CLINIC
1018 SIXTH AVENUE	WORTHINGTON	MN	56187	MEDICAL CLINIC
247 - BLACK HILLS IMAGING CENTER
215 ANAMARIA DRIVE	RAPID CITY	SD	57701	DIAGNOSTIC IMAGING CENTER
248 - BLACK HILLS OCCUPATIONAL MEDICINE
1730 HAINES AVENUE	RAPID CITY	SD	57701	MEDICAL CLINIC
249 - BLACK HILLS OUTREACH CLINIC
120 E MICHIGAN STREET	SPEARFISH	SD	87783	MEDICAL CLINIC
250 - BLACK HILLS URGENT CARE
741 MOUNTAIN VIEW ROAD	RAPID CITY	SD	57702	MEDICAL CLINIC
251 - BLACK HILLS URGENT CARE
2201 S DOUGLAS HIGHWAY	GILLETTE	WY	82718	MEDICAL CLINIC
252 - NORTHEAST WYOMING SURGERY CENTER
1307 W 3RD STREET	GILLETTE	WY	82716	AMBULATORY SURGERY CENTER

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 HEALTH'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 HEALTH 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 HEALTH PATIENT REGISTRATION AREA.THE PRIMARY SCOPE OF SANFORD HEALTH'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.THE AMOUNT GENERALLY BILLED (AGB) DISCOUNT PERCENTAGE IS THE LEAST AMOUNT SANFORD HEALTH CAN DISCOUNT FOR ANY PATIENT QUALIFYING UNDER THE SANFORD FINANCIAL ASSISTANCE POLICY. IT IS THE PERCENTAGE USED FOR THE LOWEST LEVEL OF ASSISTANCE GRANTED FOR THOSE QUALIFYING UNDER THE SANFORD HEALTH FINANCIAL ASSISTANCE POLICY AS LISTED ON APPENDIX 1 - SLIDING DISCOUNT SCHEDULE FOR ASSISTANCE. ANYONE ELSE QUALIFYING FOR ASSISTANCE AT GREATER LEVELS WILL RECEIVE DISCOUNT AMOUNTS GREATER THAN THE SANFORD HEALTH AGB DISCOUNT AMOUNT. PART I, LINE 5B: SANFORD HEALTH AS A WHOLE DID NOT EXCEED ITS FINANCIAL ASSISTANCE BUDGET FOR CY 2024, HOWEVER, IF THEY WOULD HAVE EXCEEDED THEIR BUDGET IT WOULD NOT IMPACT THEIR ABILITY TO SERVE ANY PATIENTS AND NO PATIENTS WOULD BE 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'S COMMUNITY BENEFIT ANNUAL REPORT IS POSTED ANNUALLY ON THE SANFORD HEALTH WEBSITE AT:HTTPS://WWW.SANFORDHEALTH.ORG/ABOUT/COMMUNITY-COMMITMENT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
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. THESE COSTS STILL REPRESENT THE COSTS TO PROVIDE BENEFITS.
PART I, LINE 7G:	SUBSIDIZED HEALTH SERVICES ARE CLINICAL SERVICES PROVIDED TO BOTH INPATIENTS AND OUTPATIENTS DESPITE A FINANCIAL LOSS TO SANFORD HEALTH. EACH LOSS HAS BEEN CALCULATED AFTER REMOVING LOSSES ASSOCIATED WITH BAD DEBTS, FINANCIAL ASSISTANCE AND MEDICAID. ALTHOUGH THESE SERVICES GENERATE OVERALL LOSSES TO SANFORD HEALTH, THEY CONTINUE TO MEET THE NEEDS OF THE COMMUNITIES SERVED. VARIOUS SERVICES THAT GENERATE LOSSES ARE PROVIDED BY SANFORD HEALTH THROUGH PHYSICIAN PRACTICES. FOR CY 2024, SUBSIDIZED HEALTH SERVICES PROVIDED THROUGH CLINIC PHYSICIAN PRACTICES GENERATED LOSSES OF $268,371,188.
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 HEATH IS COMMITTED TO GIVING BACK TO THE COMMUNITIES IN WHICH ITS EMPLOYEES AND PATIENTS LIVE AND WORK. SANFORD HEALTH 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 HEALTH WORKFORCE TO DELIVER THE BEST PATIENT CARE AND MUCH NEEDED MEDICAL RESEARCH. SANFORD HEALTH 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 BASED ON AMOUNTS RECORDED IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). BAD DEBT REPRESENTS SERVICES PROVIDED TO PATIENTS WHO WERE EXPECTED TO PAY BUT DID NOT, AFTER REASONABLE COLLECTION EFFORTS. DISCOUNTS AND ALLOWANCES ARE ACCOUNTED FOR SEPARATELY FROM BAD DEBT EXPENSE.
PART III, LINE 3:	IT IS SANFORD HEALTH'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 HEALTH 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 (AFS) OF SANFORD INCLUDE A BAD DEBT FOOTNOTE. SEE FOOTNOTE 3 ON PAGES 17 - 19 OF THE AFS. SANFORD REPORTS BAD DEBT IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP).
PART III, LINE 8:	PER IRS INSTRUCTIONS, SANFORD HEALTH 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 HEALTH INCURRED WERE INCLUDED ON THE MEDICARE COST REPORT; THIS WOULD SHOW A SHORTFALL OF APPROXIMATELY $735,627,035. SANFORD HEALTH 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 HEALTH.
PART III, LINE 9B:	SANFORD HEALTH 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 HEALTH WILL NOT DENY FINANCIAL ASSISTANCE BASED ON RACE, CREED, SEX, GENDER IDENTITY, NATIONAL ORIGIN, HANDICAP OR AGE.EVERY EFFORT IS MADE TO IDENTIFY PATIENTS WITH FINANCIAL NEED AS EARLY AS POSSIBLE IN THE REVENUE CYCLE.SANFORD HEALTH HAS ZERO TOLERANCE FOR ABUSIVE, HARASSING, OPPRESSIVE, FALSE, DECEPTIVE, OR MISLEADING LANGUAGE OF COLLECTIONS CONDUCT. THIS ZERO TOLERANCE APPLIES TO INTERNAL SANFORD HEALTH STAFF AND THIRD PARTY COLLECTION VENDORS AND ATTORNEYS.NEITHER SANFORD HEALTH NOR ANY OF ITS THIRD PARTY COLLECTION VENDORS WILL TAKE ANY EXTRAORDINARY COLLECTION EFFORTS UNTIL SANFORD HEALTH 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 HEALTH REGULARLY UTILIZES A BROAD ARRAY OF RESOURCES AND PARTNERS TO ASSESS AND DELIVER CARE TO THE COMMUNITIES SERVED BY THE SYSTEM. ASSESSMENT AND, BY EXTENSION, COMMUNITY ENGAGEMENT, IS A COMPOSITE, PARTNER-DRIVEN APPROACH.WITHIN THE CONTEXT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS, THE SYSTEM RELIES UPON A MULTI-STEP, MULTI-MODAL APPROACH THAT MINIMIZES THE INHERENT LIMITATIONS OF ANY GIVEN ASSESSMENT TOOL AND INCREASES THE POINTS OF CONTACT FOR COMMUNITY MEMBERS TO SHARE DIRECT INSIGHTS INTO THE PROCESS. STEP ONE OF THE CHNA IS ENGAGEMENT WITH OTHER HEALTH SYSTEMS IN THE COMMUNITIES IN WHICH SANFORD HEALTH AND ANOTHER HEALTH SYSTEM BOTH OPERATE. ADDITIONALLY, SANFORD HEALTH ENGAGES PUBLIC HEALTH ORGANIZATIONS AND OTHER CARE PROVIDERS IN THE DEVELOPMENT OF ASSESSMENT STRATEGIES AND TOOLS. THE COOPERATION BETWEEN THE ORGANIZATIONS ENSURES INFORMATION IS COLLECTED THAT WILL BENEFIT NOT ONLY THE CHNA PROGRAM, BUT ALSO THE STRATEGIES AND OPERATIONS OF THE RESPECTIVE ORGANIZATIONS. THE SYSTEMS ALSO COLLABORATE IN THE DEVELOPMENT OF THEIR RESPECTIVE IMPLEMENTATION PLANS TO FURTHER THE POSITIVE IMPACT TO THE COMMUNITY. AS NOTED ABOVE, THE CHNA ASSESSMENT INCLUDES A MULTI-MODAL PROCESS, WHICH BEGINS WITH A SURVEY TO COMMUNITY MEMBERS SENT VIA MULTIPLE PATHWAYS, WHICH INCLUDE THE PURCHASE OF A LOCAL SURVEY PANEL AND THE DEVELOPMENT OF A COMMUNITY STAKEHOLDER LIST. STAKEHOLDERS ARE ASKED TO COMPLETE THE SURVEY AND THEN FORWARD THE TOOL TO THEIR CONTACTS TO AMPLIFY THE COLLECTION OPPORTUNITIES. AN INDEPENDENT THIRD PARTY WITH SURVEY ANALYSIS EXPERTISE IS RETAINED TO EVALUATE THE RESULTS AND DEVELOP AN INITIAL LIST OF NEEDS WITH ADDITIONAL AUGMENTATION FROM COUNTYHEALTHRANKINGS.COM, CENSUS DATA, AND OTHER SECONDARY DATA SOURCES. LOCAL STAKEHOLDER MEETINGS THAT INCLUDE HEALTH CARE LEADERS, ELECTED OFFICIALS, REPRESENTATIVES OF UNDERSERVED COMMUNITIES, NONPROFIT LEADERS, AND OTHER COMMUNITY PARTNERS THEN REVIEW THE FINDINGS, PROVIDE INPUT, AND DEVELOP THE FINAL PRIORITIES FOR INCLUSION IN THE IMPLEMENTATION PLAN.DATA GATHERED FROM THE CHNA PROGRAM, PARTICULARLY SURVEY RESPONSES, IS MADE AVAILABLE TO LOCAL COMMUNITY ORGANIZATIONS THAT REQUEST THE INFORMATION. SANFORD HEALTH VIEWS THE FINDINGS AS A COMMUNITY ASSET THAT CAN FURTHER THE POSITIVE IMPACT ON COMMUNITY HEALTH OUTSIDE THE WALLS OF THE SYSTEM.RECENTLY, SANFORD HEALTH HAS ADDED MORE RESOURCES TO ADVANCE COMMUNITY HEALTH. FINDHELP IS AN ONLINE PLATFORM THAT CONNECTS LOCAL ORGANIZATIONS, FUNDING OPPORTUNITIES, AND OTHER RESOURCES CONNECTED TO SOCIAL DETERMINANTS OF HEALTH WITH INDIVIDUALS IN NEED. SANFORD HEALTH INTEGRATED THE FINDHELP PLATFORM INTO THE ORGANIZATION'S WEBSITE, ELECTRONIC MEDICAL RECORD, AND POST-VISIT PAPERS. THE INTEGRATION NOT ONLY ALLOWS USERS TO SELF-SEARCH FOR LOCAL RESOURCES BASED UPON THEIR NEED, BUT ALSO ALLOWS SANFORD HEALTH'S CARE MANAGEMENT TEAM TO DIRECTLY REFER PATIENTS TO LOCAL ORGANIZATIONS AND MONITOR ENGAGEMENT. FINDHELP IS PUBLIC TO ANY RESIDENT AND IS NOT RESERVED SPECIFICALLY FOR PATIENTS OF THE SYSTEM. THE SERVICES OFFERED ON THE NEW WEBSITE ARE EITHER FREE OR REDUCED COST AND COVER OPTIONS THAT MIGHT NOT BE INCLUDED WITH MEDICARE OR MEDICAID. THIS PARTNERSHIP ALLOWS SANFORD HEALTH TO ADDRESS INEQUITY IN THE COMMUNITIES WE SERVE WITH EXISTING SERVICES THAT MEET THE NEEDS OF PATIENTS.ADDITIONAL EXTERNAL SOURCES ARE REGULARLY ENGAGED WITHIN THE STRATEGIC PLANNING, OPERATIONAL, AND CHNA PROCESS. THE ADVISORY BOARD IS REPRESENTATIVE OF THESE ASSESSMENT CAPABILITIES. THE ADVISORY BOARD (AB) OFFERS A WEALTH OF SECONDARY INFORMATION, SUCH AS INDUSTRY TRENDS, CONSUMER ASSESSMENTS, AND OTHER INFORMATION. AB ALSO INCLUDES DATA TOOLS, INCLUDING THE MARKET INNOVATION CENTER AND THE POST-ACUTE PATHWAYS EXPLORER THAT PROVIDES LINE OF SIGHT INTO DEMOGRAPHIC DATA, VOLUME PROJECTIONS, CARE COORDINATION PATTERNS, AND CARE DRIVERS BEYOND THE INTERNAL DATA SOURCES WITHIN SANFORD HEALTH. OTHER ENGAGEMENTS AND ASSESSMENTS INCLUDE LEADERSHIP AND MEMBERSHIP IN STATE HEALTHCARE ASSOCIATIONS AND VIZIENT. THE DEVELOPMENT OF PATIENT FAMILY ADVISORY AND HEALTH EQUITY AND EXPERIENCE COUNCILS WITHIN SYSTEM FACILITIES PROMOTES TWO-WAY COMMUNICATION WITH THE COMMUNITIES SERVED. THESE TOOLS ARE INCORPORATED THROUGHOUT THE PLANNING PROCESS AND ARE EMBEDDED WITHIN OPERATIONS. TO ENSURE CARE PROVIDED ENCOMPASSES THE WHOLE PERSON, SANFORD HEALTH EMPLOYS COMMUNITY HEALTH WORKERS (CHWS), FIRST ESTABLISHING THE ROLE IN 2014. THESE NON-CLINICAL STAFF PROVIDE FRONTLINE PUBLIC HEALTH SERVICES AND SERVE AS A LIAISON BETWEEN HEALTH CARE AND THE COMMUNITY TO FACILITATE ACCESS TO RESOURCES. THESE CARE TEAM MEMBERS PROVIDE A RANGE OF SERVICES AND ACTIVITIES FOR AT-RISK POPULATIONS INCLUDING OUTREACH, COMMUNITY EDUCATION, INFORMAL COUNSELING, SOCIAL SUPPORT, AND ADVOCACY.ANOTHER IMPORTANT SUPPORT/LIAISON ROLE IS THAT OF HEALTH GUIDES. THESE INDIVIDUALS IDENTIFY GAPS IN CARE PREVENTING RISING-RISK PATIENTS FROM ACHIEVING THEIR HEALTH GOALS. GUIDES ADDRESS BARRIERS PATIENTS ARE FACING IN ACCESSING THE RESOURCES THEY NEED TO BE SUCCESSFUL. HEALTH GUIDES HELP PATIENTS NAVIGATE THE HEALTH SYSTEM AND VARIOUS COMMUNITY RESOURCES, EMPOWERING PATIENTS TO TAKE MORE OWNERSHIP OF THEIR HEALTH AND BE AN ACTIVE PARTICIPANT IN THEIR CARE.MANY SANFORD HEALTH CLINIC FACILITIES OFFER A BROAD RANGE OF ROBUST, INTEGRATED CARE OPTIONS. FROM DIETICIANS TO PHARMACISTS TO SOCIAL WORKERS, AMBULATORY RN CARE MANAGERS AND INTEGRATED HEALTH THERAPISTS (IHTS), PATIENTS SEEN FOR PRIMARY CARE HAVE CLOSE PROXIMITY TO OTHER ANCILLARY SUPPORT SERVICES AND CARE OPTIONS. PATIENTS STRUGGLING WITH MENTAL HEALTH OR SUBSTANCE DEPENDENCY ISSUES, FOR EXAMPLE, CAN OFTEN IMMEDIATELY SEE A SUPPORT PROFESSIONAL ON-SITE VERSUS HAVING TO WAIT TO SEE A SPECIALIST VIA A REFERRAL FROM THEIR PRIMARY CARE PROVIDER. SANFORD HEALTH ALSO SCREENS FOR SOCIAL DETERMINANTS OF HEALTH AND HAVE "WELLNESS PANTRIES" EMBEDDED IN OUR PEDIATRIC CLINICS ACROSS MINNESOTA, NORTH DAKOTA AND SOUTH DAKOTA. WE ARE CURRENTLY COLLECTING DATA TO BETTER UNDERSTAND HOW ADDRESSING FOOD INSECURITY HELPS REDUCE ANXIETY AND DEPRESSION IN CHILDREN. THE TIMELINESS OF THESE KEY SERVICES HELPS TO ENSURE THAT PATIENT NEEDS ARE NOT FALLING THROUGH THE CRACKS OR THAT CARE IS DELAYED.
PART VI, LINE 3:	SANFORD HEALTH EMPLOYS A VARIETY OF STRATEGIES TO MAKE CERTAIN THAT THE ORGANIZATION IS TRANSPARENT IN THE COMMUNICATION OF FINANCIAL ASSISTANCE GUIDELINES. THE STAFF AT SANFORD HEALTH MAKES EVERY EFFORT TO IDENTIFY PATIENTS NEEDING FINANCIAL ASSISTANCE AS EARLY IN THE REVENUE CYCLE AS POSSIBLE. ALL SANFORD HEALTH ENTITIES DISPLAY SIGNAGE IN REGISTRATION AREAS ADVISING PATIENTS OF THEIR ABILITY TO REQUEST FINANCIAL ASSISTANCE. THE SIGNAGE WAS MADE AVAILABLE IN ENGLISH AND SPANISH. ALTERNATE LANGUAGES WERE INCLUDED ON THE SIGNAGE THAT BASICALLY STATED, IF YOU NEED INTERPRETER SERVICES, PLEASE INQUIRE AT THE REGISTRATION DESK. FINANCIAL ASSISTANCE APPLICATIONS WERE AVAILABLE IN ENGLISH, SPANISH, CHINESE, GERMAN, HINDI, KOREAN, LAOTIAN AND VIETNAMESE UPON REQUEST OR ON THE SANFORD HEALTH WEBSITE. 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 HEALTH'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 HEALTH MAKES FINANCIAL ASSISTANCE INFORMATION AVAILABLE TO COMMUNITY AGENCIES AND REFERRAL ORGANIZATIONS. FINANCIAL ASSISTANCE INFORMATION IS ALSO AVAILABLE ON THE SANFORD HEALTH WEBSITE AT:HTTPS://WWW.SANFORDHEALTH.ORG/PATIENTS-AND-VISITORS/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE-POLICY
PART VI, LINE 4:	SANFORD HEALTH IS AN INTEGRATED HEALTH SYSTEM HEADQUARTERED IN THE DAKOTAS. IT IS ONE OF THE LARGEST RURAL HEALTH SYSTEMS IN THE NATION WITH 56 MEDICAL CENTERS AND 288 CLINICS. SANFORD HEALTH'S APPROXIMATE 53,000 EMPLOYEES, INCLUDING 4,000 PHYSICIANS/ADVANCED PRACTICE PROVIDERS AND 10,164 REGISTERED NURSES DELIVERING CARE IN MORE THAN 80 SPECIALTY AREAS, 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 2024 U.S. CENSUS BUREAU ESTIMATES A TOTAL POPULATION OF 209,289 FOR SIOUX FALLS. ACCORDING TO THE 2024 COUNTY HEALTH RANKINGS, THE POPULATION OF MINNEHAHA COUNTY IS 79.9% WHITE, 6.8% AFRICAN AMERICAN, 3.0% AMERICAN INDIAN, 2.2% ASIAN AND 6.1% HISPANIC. SIOUX FALLS IS A SIGNIFICANT REGIONAL HEALTH CARE CENTER. ONLY 1% OF THE POPULATION IS REPORTED TO BE NOT PROFICIENT IN ENGLISH. THE MEDIAN HOUSEHOLD INCOME IN MINNEHAHA COUNTY IS $75,600.SANFORD MEDICAL CENTER FARGO - FARGO, NORTH DAKOTAFARGO IS THE LARGEST CITY IN NORTH DAKOTA, ACCOUNTING FOR 17.5% OF THE STATE'S POPULATION. FARGO IS ALSO THE COUNTY SEAT OF CASS COUNTY. THE 2024 UNITED STATES CENSUS ESTIMATES THE POPULATION OF FARGO WAS 136,285. ACCORDING TO THE 2024 COUNTY HEALTH RANKINGS, THE POPULATION OF CASS COUNTY IS 83.2% WHITE, 6.8% AFRICAN AMERICAN, 1.6% AMERICAN INDIAN, 3.2% ASIAN AND 3.2% HISPANIC. ONLY 1% OF THE POPULATION IS REPORTED TO BE NOT PROFICIENT IN ENGLISH. THE MEDIAN HOUSEHOLD INCOME OF CASS COUNTY, ND IS $70,000. 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 2024 UNITED STATES CENSUS ESTIMATES, THE POPULATION OF BEMIDJI IS 15,733. ACCORDING TO THE 2024 COUNTY HEALTH RANKINGS, THE POPULATION OF BELTRAMI COUNTY IS 71.3% WHITE, 0.8% AFRICAN AMERICAN, 22.0% AMERICAN INDIAN, 0.8% ASIAN AND 2.7% HISPANIC. 0% OF THE POPULATION IS REPORTED TO BE NOT PROFICIENT IN ENGLISH. THE MEDIAN HOUSEHOLD INCOME IS $59,900.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 IN THE STATE OF NORTH DAKOTA WITH AN ESTIMATED POPULATION OF 77,772. ACCORDING TO THE 2024 COUNTY HEALTH RANKINGS, THE POPULATION OF BURLEIGH COUNTY IS 87.4% WHITE, 2.1% AFRICAN AMERICAN, 4.7% AMERICAN INDIAN, 1.0% ASIAN AND 3.1% HISPANIC. 0% OF THE POPULATION IS REPORTED TO BE NOT PROFICIENT IN ENGLISH. THE MEDIAN HOUSEHOLD INCOME IS $83,100.SANFORD NETWORK HOSPITALSSANFORD HEALTH NETWORK HOSPITALS IS A NETWORK OF RURAL HOSPITALS LOCATED THROUGHOUT SOUTH DAKOTA, NORTH DAKOTA, AND MINNESOTA.SANFORD CLINICSSANFORD CLINIC IS A MULTI-SPECIALTY CLINIC COMPRISED OF APPROXIMATELY 4,000 PHYSICIANS PROVIDING SERVICES IN THE US AS WELL AS INTERNATIONALLY.
PART VI, LINE 5:	SANFORD HEALTH MAINTAINS AN OPEN MEDICAL STAFF. COMMUNITY BOARDS - THE SANFORD HEALTH BOARD OF TRUSTEES WAS COMPRISED OF 12 MEMBERS AT THE END OF THE CALENDAR YEAR, INCLUDING 10 COMMUNITY MEMBERS, 1 PHYSICIAN 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 SIOUX FALLS, SOUTH DAKOTA. IT IS ONE OF THE LARGEST RURAL HEALTH SYSTEMS IN THE NATION WITH 56 MEDICAL CENTERS AND 288 CLINIC LOCATIONS IN THE UPPER MIDWEST INCLUDING WYOMING, NORTH DAKOTA, SOUTH DAKOTA, IOWA, MINNESOTA, WISCONSIN, AND THE UPPER PENINSULA OF MICHIGAN AND THREE COUNTRIES. SANFORD HEALTH'S APPROXIMATE 53,000 EMPLOYEES, INCLUDING A NETWORK OF MORE THAN 4,000 PHYSICIANS AND ADVANCED PRACTICE PROVIDERS AND APPROXIMATELY 10,000 REGISTERED NURSES DELIVERING CARE IN MORE THAN 80 SPECIALTY AREAS, MAKE IT THE LARGEST EMPLOYER IN NORTH DAKOTA AND SOUTH DAKOTA.SANFORD HEALTH PROVIDES SERVICES AT EVERY LEVEL FROM CRITICAL ACCESS HOSPITALS TO TERTIARY AND QUATERNARY CARE. THE SANFORD SERVICE AREA COVERS A POPULATION OF APPROXIMATELY FIVE MILLION WITHIN WYOMING, NORTH DAKOTA, SOUTH DAKOTA, NORTHWEST IOWA, MINNESOTA, WISCONSIN, AND THE UPPER PENINSULA OF MICHIGAN AND INCLUDES 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, OR NEBRASKA. FILING IN MINNESOTA IS VOLUNTARY.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (171 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
218 SPORTS INC
102 FIRST ST W SUITE 1010	BEMIDJI	MN	56601	863542403	501(C)(3)	$20,000	$0	ECONOMIC DEVELOPMENT
ABBOTT HOUSE INC
909 COURT MERRILL ST	MITCHELL	SD	57301	460229822	501(C)(3)	$10,000	$0	PHYSICAL IMPROVEMENTS AND HOUSING
ABERDEEN DEVELOPMENT CORP
416 PRODUCTION ST N	ABERDEEN	SD	57401	466011831	501(C)(6)	$10,000	$0	ECONOMIC DEVELOPMENT
ABERDEEN FAMILY YMCA
5 S STATE ST	ABERDEEN	SD	57401	460255779	501(C)(3)	$15,000	$0	COMMUNITY SUPPORT
ABERDEEN PUBLIC SCHOOLS
1224 S 3RD ST	ABERDEEN	SD	57401	460423109	501(C)(3)	$44,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES, WORKFORCE DEVELOPMENT
ACTIVE GENERATIONS
2300 W 46TH ST	SIOUX FALLS	SD	57105	460305500	501(C)(3)	$30,590	$0	COMMUNITY SUPPORT
AMERICAN CANCER SOCIETY
250 WILLIAMS ST 4TH FL	ATLANTA	GA	30303	131788491	501(C)(3)	$15,500	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
AMERICAN FOUNDATION FOR SUICIDE PREVENTION
199 WATER ST FLOOR 11	NEW YORK	NY	10038	133393329	501(C)(3)	$7,500	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
AMERICAN GOLD GYMNASTICS
2001 17TH AVE S	FARGO	ND	58103	450333196	501(C)(3)	$40,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVENUE	DALLAS	TX	75231	135613797	501(C)(3)	$36,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
AMERICAN RED CROSS
2925 E 57TH ST	SIOUX FALLS	SD	57108	530196605	501(C)(3)	$33,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY SUPPORT
AUGUSTANA
2001 S SUMMIT AVE	SIOUX FALLS	SD	57197	460224588	501(C)(3)	$2,166,750	$0	COALITION BUILDING, COMMUNITY SUPPORT, ECONOMIC DEVELOPMENT, HEALTH PROFESSIONS EDUCATION, WORKFORCE DEVELOPMENT
BAGLEY FIRE DEPARTMENT
18 MAIN AVE SOUTH	BAGLEY	MN	56621	416037185	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
BEEF LOGIC INC
316 S COTEAU AVE	PIERRE	SD	57501	872043795	501(C)(3)	$27,500	$0	COMMUNITY SUPPORT
BELTRAMI COUNTY
701 MINNESOTA AVE NW SUITE 220	BEMIDJI	MN	56601	416005757	115	$0	$1,233,609	ECONOMIC DEVELOPMENT	FAIR VALUE	DONATION OF BEMIDJI CRISIS CENTER
BEMIDJI AREA SCHOOL DISTRICT 31
502 MINNESOTA AVE	BEMIDJI	MN	56619	416000181	115	$116,021	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES, WORKFORCE DEVELOPMENT
BEMIDJI COMMUNITY ARENA CORP
PO BOX 1726	BEMIDJI	MN	566191726	813622011	501(C)(3)	$60,000	$0	ECONOMIC DEVELOPMENT
BEMIDJI STATE UNIVERSITY
1500 BIRCHMONT DR NE	BEMIDJI	MN	56601	411687554	115	$76,000	$0	COMMUNITY SUPPORT, ECONOMIC DEVELOPMENT
BEMIDJI YOUTH SOCCER
PO BOX 265	BEMIDJI	MN	56619	411870778	501(C)(3)	$5,500	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
BENEDICTINE SISTERS MOTHER OF GOD MONASTERY
2527 PRAIRIE PARK TRAIL SE	WATERTOWN	SD	57201	460284619	501(C)(3)	$6,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
BISMARCK CANCER CENTER
500 N 8TH STREET	BISMARCK	ND	58501	450454363	501(C)(3)	$11,876	$0	COMMUNITY SUPPORT
BISMARCK MANDAN CHAMBER EDC
1640 BURNT BOAT DR	BISMARCK	ND	58503	450116753	501(C)(6)	$6,538	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES, ECONOMIC DEVELOPMENT, WORKFORCE DEVELOPMENT
BISMARCK MARATHAN
PO BOX 7023	BISMARCK	ND	585077023	208441757	501(C)(3)	$10,609	$0	ECONOMIC DEVELOPMENT
BISMARCK PUBLIC SCHOOLS
806 N WASHINGTON ST	BISMARCK	ND	58501	450442960	501(C)(3)	$135,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, PHYSICAL IMPROVEMENTS AND HOUSING
BISMARCK STATE COLLEGE
1500 EDWARDS AVE	BISMARCK	ND	43942	450343495	115	$131,171	$0	HEALTH PROFESSIONS EDUCATION
BOARD OF EDUCATION OF THE CITY OF FARGO
700 7TH ST S	FARGO	ND	57192	456000294	115	$120,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
BOY SCOUTS NORTHERN LIGHTS COUNCIL
4200 19TH AVE S	FARGO	ND	581037207	450226415	501(C)(3)	$7,500	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
BOYS AND GIRLS CLUBS OF THE RED RIVER VALLEY
2500 18TH ST S	FARGO	ND	58103	450316132	501(C)(3)	$40,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
BRANDON VALLEY BOOSTER CLUB
PO BOX 572	BRANDON	SD	57005	460393971	501(C)(3)	$31,814	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
BRANDON VALLEY SCHOOL DISTRICT 49-2
300 S SPLITROCK BLVD	BRANDON	SD	57005	466002577	115	$44,800	$0	WORKFORCE DEVELOPMENT
BURKE COMMUNITY MEMORIAL HOSPITAL
PO BOX 319 809 JACKSON ST	BURKE	SD	57523	460219795	501(C)(3)	$25,000	$0	PHYSICAL IMPROVEMENTS AND HOUSING
BUTTERFLY HOUSE & AQUARIUM
4320 S OXBOW AVE	SIOUX FALLS	SD	57106	522370420	501(C)(3)	$25,000	$0	ECONOMIC DEVELOPMENT
CANTON SCHOOL DISTRICT
800 N MAIN ST	CANTON	SD	57013	466002143	115	$16,444	$0	WORKFORCE DEVELOPMENT
CHAMBER OF COMMERCE FARGO MOORHEAD WEST FARGO
PO BOX 2443	FARGO	ND	581082443	450448041	501(C)(6)	$24,356	$0	ECONOMIC DEVELOPMENT
CHILDRENS HOME SOCIETY OF SOUTH DAKOTA
801 N SYCAMORE	SIOUX FALLS	SD	57110	460224542	501(C)(3)	$6,000	$0	COMMUNITY SUPPORT
CHURCHES UNITED FOR THE HOMELESS
1901 1ST AVE N	MOORHEAD	MN	56560	411594892	501(C)(3)	$50,000	$0	COMMUNITY HEALTH IMPROVEMENT ADVOCACY
CITY OF BEMIDJI
1111 EVENT CENTER DR NE	BEMIDJI	MN	56601	270941862	115	$200,000	$0	ECONOMIC DEVELOPMENT
CITY OF MITCHELL
612 NORTH MAIN STREET	MITCHELL	SD	57301	466000305	115	$10,000	$0	COMMUNITY SUPPORT
CITY OF SIOUX FALLS
224 W NINTH ST	SIOUX FALLS	SD	571046407	466000425	115	$0	$6,300,000	COMMUNITY HEALTH IMPROVEMENT SERVICES	FAIR VALUE	DONATION OF TEA-ELLIS WELLNESS CENTER
CITY OF TRACY MN
336 MORGAN ST	TRACY	MN	56175	416005581	115	$10,000	$0	COMMUNITY SUPPORT
CLEARWATER LIFE CENTER
256 2ND AVE SW	CLEARBROOK	MN	56634	770643868	501(C)(3)	$6,500	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
CONCORDIA COLLEGE
901 8TH STREET S	MOORHEAD	MN	565609981	410693977	501(C)(3)	$3,306,000	$0	ECONOMIC DEVELOPMENT, HEALTH PROFESSIONS EDUCATION, WORKFORCE DEVELOPMENT
CRIBS FOR KIDS
5450 SECOND AVE	PITTSBURGH	PA	15207	251442806	501(C)(3)	$0	$9,186	COMMUNITY HEALTH IMPROVEMENT SERVICES	COST	PAK N PLAYS FOR UNDERPRIVILEGED CHILDREN
CULLEN CHILDREN'S FOUNDATION
PO BOX 594	WEST FARGO	ND	58078	770636521	501(C)(3)	$15,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
DAKOTA ALLIANCE SOCCER CLUB (DASC)
401 W 39TH ST	SIOUX FALLS	SD	57105	460359817	501(C)(3)	$60,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
DAKOTA MEDICAL FOUNDATION (DMF)
4141 28TH AVE SOUTH	FARGO	ND	58104	456012318	501(C)(3)	$9,550	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
DEAR NICU MAMA
19 8TH ST S	FARGO	ND	58103	842458534	501(C)(3)	$5,750	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
DETROIT LAKES PUBLIC SCHOOLS
702 LAKE AVENUE	DETROIT LAKES	MN	56501	410971772	115	$20,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
DICKINSON PUBLIC SCHOOLS
444 4TH ST W	DICKINSON	ND	58601	456001585	115	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
DOWNTOWN COMMUNITY PARTNERSHIP
210 BROADWAY STE 202	FARGO	ND	58102	464472309	501(C)(6)	$20,750	$0	ECONOMIC DEVELOPMENT
DSU HERITAGE FOUNDATION
230 8TH AVE W	DICKINSON	ND	58601	475378716	501(C)(3)	$70,000	$0	ECONOMIC DEVELOPMENT
ELEVATE RAPID CITY
525 UNIVERSITY LOOP STE 102	RAPID CITY	SD	57701	460118545	501(C)(6)	$100,000	$0	ECONOMIC DEVELOPMENT
EMBE
300 W 11TH ST	SIOUX FALLS	SD	57104	460234998	501(C)(3)	$9,010	$0	COMMUNITY SUPPORT
EMILY'S HOPE
6225 S MINNESOTA AVE	SIOUX FALLS	SD	57108	833324332	501(C)(3)	$6,500	$0	COMMUNITY SUPPORT
FAMILY ADVOCACY CENTER OF NORTHERN MINNESOTA
1000 PAUL BUNYAN DRIVE NW UNIT 118	BEMIDJI	MN	56601	202102302	501(C)(3)	$30,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
FARGO PARK DISTRICT
701 MAIN AVE	FARGO	ND	58103	456002070	501(C)(6)	$445,288	$0	ECONOMIC DEVELOPMENT
FARGO RONALD MCDONALD
4757 AGASSIZ XING S	FARGO	ND	58104	450365598	501(C)(3)	$104,510	$0	COMMUNITY SUPPORT
FEEDING SOUTH DAKOTA
3511 N 1ST AVENUE	SIOUX FALLS	SD	57104	363293534	501(C)(3)	$14,500	$0	COMMUNITY SUPPORT
FOLDS OF HONOR SOUTH DAKOTA
PO BOX 91541	SIOUX FALLS	SD	57109	301250357	501(C)(3)	$5,500	$0	COMMUNITY SUPPORT
FORWARD SIOUX FALLS
PO BOX 907	SIOUX FALLS	SD	57101	460396647	501(C)(6)	$250,000	$0	ECONOMIC DEVELOPMENT
FRESH START SURGICAL GIFTS
2011 PALOMAR AIRPORT RD STE 206	CARLSBAD	CA	92011	330460177	501(C)(3)	$75,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
FRIENDS OF LEVITT SHELL SIOUX FALLS
400 N MAIN AVE SUITE 202	SIOUX FALLS	SD	57104	611699910	501(C)(3)	$15,000	$0	ECONOMIC DEVELOPMENT
GATEWAY TO SCIENCE CENTER INC
1810 SCHAFER STREET STE 1	BISMARCK	ND	58501	450443517	501(C)(3)	$10,000	$0	ECONOMIC DEVELOPMENT
GIRL SCOUTS DAKOTA HORIZONS
1101 S MARION ROAD	SIOUX FALLS	SD	57106	460250744	501(C)(3)	$13,100	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY SUPPORT, WORKFORCE DEVELOPMENT
GRAND FORKS REGION ECONOMIC DEVELOPMENT
120 NORTH 4TH STREET	GRAND FORKS	ND	58203	450410198	501(C)(6)	$10,000	$0	ECONOMIC DEVELOPMENT
GREAT NORTH POLE
675 13TH AVE E STE 101	WEST FARGO	ND	58078	821969429	501(C)(3)	$29,120	$0	COMMUNITY SUPPORT
GREATER NORTH DAKOTA CHAMBER
PO BOX 2639	BISMARCK	ND	58502	450141100	501(C)(6)	$16,300	$0	ECONOMIC DEVELOPMENT
GREATLIFE CARES FOUNDATION
3800 W 53RD ST	SIOUX FALLS	SD	57106	472447820	501(C)(3)	$40,185	$0	COMMUNITY SUPPORT
HARRISBURG BASEBALL ASSOCIATION
PO BOX 434	HARRISBURG	SD	57032	270606157	501(C)(3)	$25,000	$0	ECONOMIC DEVELOPMENT
HARRISBURG SCHOOL DISTRICT
200 WILLOW ST	HARRISBURG	SD	57032	466002218	115	$132,300	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES, PHYSICAL IMPROVEMENT AND HOUSING
HARTFORD
125 N MAIN AVE	HARTFORD	SD	57033	460354618	501(C)(3)	$10,000	$0	ECONOMIC DEVELOPMENT
HELPLINE CENTER INC
1000 N WEST AVE STE 310	SIOUX FALLS	SD	571041314	237424387	501(C)(3)	$10,000	$0	COMMUNITY SUPPORT
HERO
914 SOUTH DRIVE S	FARGO	ND	58104	450457109	501(C)(3)	$33,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
HUETHER FAMILY MATCH POINTE
4210 N BOBHALLA DR	SIOUX FALLS	SD	57107	452784394	501(C)(3)	$25,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
IMMIGRANT DEVELOPMENT CENTER
810 4TH AVENUE SUITE 100	SOUTH MOORHEAD	MN	56560	203368647	501(C)(3)	$12,000	$0	WORKFORCE DEVELOPMENT
INDEPENDENT SCHOOL DISTRICT 152
1313 30TH AVE S	MOORHEAD	MN	56560	416008721	501(C)(3)	$140,500	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
INTERNATIONAL ESPERANZA PROJECT (IEP)
3141 HOOD STREET SUITE 800	DALLAS	TX	75219	815106545	501(C)(3)	$30,296	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
JAMESTOWN AREA CHAMBER OF COMMERCE
120 2ND ST SE	JAMESTOWN	ND	58401	450116780	501(C)(6)	$5,750	$0	ECONOMIC DEVELOPMENT
JAMESTOWN PARKS AND RECREATION
1002 2ND AVE SE	JAMESTOWN	ND	58401	456002100	115	$10,920	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY SUPPORT, ECONOMIC DEVELOPMENT
JUNIOR ACHIEVEMENT
300 S PHILLIPS AVE STE L102	SIOUX FALLS	SD	57104	460306352	501(C)(3)	$15,650	$0	WORKFORCE DEVELOPMENT
LAKE AGASSIZ HABITAT FOR HUMANITY
210 11TH ST N	MOORHEAD	MN	56560	411690131	501(C)(3)	$10,000	$0	PHYSICAL IMPROVEMENTS AND HOUSING
LAKOTA NATION INVITATIONAL
PO BOX 3140	RAPID CITY	SD	57709	461310975	501(C)(3)	$7,000	$0	WORKFORCE DEVELOPMENT
LEADERSHIP SOUTH DAKOTA
PO BOX 91533	SIOUX FALLS	SD	57109	820880122	501(C)(3)	$25,000	$0	LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS
LEGENDS OF GOLD
PO BOX 287	BERESFORD	SD	57004	273794971	501(C)(3)	$20,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
LOST & FOUND
319 N MAIN AVE	SIOUX FALLS	SD	57104	454306370	501(C)(3)	$6,000	$0	COMMUNITY SUPPORT
LUVERNE AREA COMMUNITY FOUNDATION
102 E MAIN ST	LUVERNE	MN	56156	411512905	501(C)(3)	$9,680	$0	ECONOMIC DEVELOPMENT
MAKE A WISH
1400 W 17TH ST	SIOUX FALLS	SD	57104	460375953	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
MAYPORT YOUTH CENTER
PO BOX 302	PORTLAND	ND	58274	450453349	501(C)(3)	$25,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
MCCROSSAN BOYS RANCH
47135 260TH STREET	SIOUX FALLS	SD	57107	460311913	501(C)(3)	$13,075	$0	COMMUNITY SUPPORT
MCKENZIE COUNTY HEALTHCARE SYSTEM
709 4TH AVE NE	WATFORD CITY	ND	58854	770637498	501(C)(3)	$100,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
MINNESOTA STATE UNIVERSITY - MANKATO (MSU)
236 WIGLEY ADMINISTRATION CTR	MANKOTA	MN	56001	416033423	501(C)(3)	$200,000	$0	WORKFORCE DEVELOPMENT
MN WEST FOUNDATION
1593 11TH AVENUE	GRANITE FALLS	MN	56241	363266500	501(C)(3)	$10,500	$0	WORKFORCE DEVELOPMENT
MOORHEAD YOUTH HOCKEY ASSOCIATION
707 SE MAIN AVE	MOORHEAD	MN	56560	237221429	501(C)(3)	$50,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
NATIONAL KIDNEY FOUNDATION
30 EAST 33RD STREET	NEW YORK	NY	10016	131673104	501(C)(3)	$9,500	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
NORTH DAKOTA STATE COLLEGE OF SCIENCE FOUNDATION AT WAHPETON NORTH DAKOTA
800 6TH ST N	WAHPETON	ND	58076	450407617	501(C)(3)	$230,000	$0	WORKFORCE DEVELOPMENT
NORTH DAKOTA STATE UNIVERSITY (NDSU)
PO BOX 6050	FARGO	ND	581086050	456002439	115	$2,346,667	$0	ECONOMIC DEVELOPMENT, HEALTH PROFESSIONS EDUCATION
NORTHERN SUN INTERCOLLEGIATE CONFERENCE (NSIC)
2999 COUNTY RD 42 W	BURNSVILLE	MN	55306	411783486	501(C)3	$35,000	$0	ECONOMIC DEVELOPMENT
NORTHWEST MN FOUNDATION
201 3RD ST NW	BEMIDJI	MN	56601	411556013	501(C)(3)	$25,350	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION
NORTHWOODS BATTERED WOMEN'S SHELTER
PO BOX 563	BEMIDJI	MN	566190563	411333404	501(C)(3)	$10,000	$0	PHYSICAL IMPROVEMENTS AND HOUSING
OAHE FAMILY YMCA
900 E CHURCH ST	PIERRE	SD	57501	237169291	501(C)(3)	$20,000	$0	COMMUNITY SUPPORT
OAK GROVE LUTHERAN SCHOOL
124 N TERRACE	FARGO	ND	58102	450226473	115	$20,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
PARKER SCHOOL DISTRICT
BOX 517	PARKER	SD	57053	466003129	115	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
PATT TILLMAN FOUNDATION
180 N LASALLE ST STE 2910	CHICAGO	IL	60601	201072336	501(C)(3)	$40,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
PROJECT CAR RIDES FOR WELL BEING
2425 S WESTERN AVE	SIOUX FALLS	SD	57105	460358227	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
RAPID CITY CLUB FOR BOYS
320 N 4TH ST	RAPID CITY	SD	57701	460277778	501(C)(3)	$12,500	$0	COMMUNITY SUPPORT
REBUILDING TOGETHER FARGO-MOORHEAD INC
505 BROADWAY N STE 206	FARGO	ND	58102	274415410	501(C)(3)	$10,000	$0	PHYSICAL IMPROVEMENTS AND HOUSING
ROCK FROM THE HEART
638 MONTROSE AVE	DELANO	MN	55328	842009806	501(C)(3)	$6,550	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
RONALD MCDONALD HOUSE CHARITIES OF SD
825 S LAKE ROAD	SIOUX FALLS	SD	57104	460371152	501(C)(3)	$35,000	$0	COMMUNITY SUPPORT
SAMARITANS FEET
PO BOX 78992	CHARLOTTE	NC	282717045	141880905	501(C)(3)	$50,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
SD CATTLEMEN'S FOUNDATION
PO BOX 29	DE SMET	SD	57231	462773322	501(C)(3)	$10,750	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
SD COMMUNITY FOUNDATION
1714 N LINCOLN AVE	PIERRE	SD	57501	460398115	501(C)(3)	$1,250,000	$0	WORKFORCE DEVELOPMENT
SD HALL OF FAME
1480 SOUTH MAIN	CHAMBERLAIN	SD	57325	460324210	501(C)(3)	$15,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES, ECONOMIC DEVELOPMENT
SD LAW ENFORCEMENT CHARITIES
101 SOUTH MAIN AVE STE 100	SIOUX FALLS	SD	57104	460440378	501(C)(3)	$10,000	$0	COMMUNITY SUPPORT
SD MILITARY HERITAGE ALLIANCE INC
1600 W RUSSELL ST	SIOUX FALLS	SD	57104	832381925	501(C)(3)	$250,000	$0	PHYSICAL IMPROVEMENTS AND HOUSING
SD SYMPHONY ORCHESTRA
300 NORTH DAKOTA AVE STE 116	SIOUX FALLS	SD	57104	466017026	501(C)(3)	$20,000	$0	ECONOMIC DEVELOPMENT
SD YOUTH SOCCER ASSOCIATION
2127 S MINNESOTA AVE STE 201	SIOUX FALLS	SD	57105	237183054	501(C)(3)	$25,000	$0	COMMUNITY SUPPORT
SEATTLE CHILDREN'S HOSPITAL
PO BOX 5371 M/S RC-507	SEATTLE	WA	981455005	910564748	501(C)(3)	$250,000	$0	RESEARCH
SECURED MY SCHOOL
2908 W 37TH CIRCLE STE 603	SIOUX FALLS	SD	57105	920653421	501(C)(3)	$6,000	$0	COMMUNITY SUPPORT
SF AREA CASA PROGRAM
PO BOX 1901	SIOUX FALLS	SD	57101	460430647	501(C)(3)	$10,000	$0	COMMUNITY SUPPORT
SF HOPE COALITION
2601 S MINNESOTA AVE	SIOUX FALLS	SD	57105	822097994	501(C)(3)	$7,500	$0	COALITION BUILDING
SF POWER HOCKEY
5808 S PRAIRIE VIEW CT	SIOUX FALLS	SD	57108	471795011	501(C)(3)	$40,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
SF PUBLIC SCHOOLS EDUCATION FOUNDATION
PO BOX 560	SIOUX FALLS	SD	57101	263537657	501(C)(3)	$15,000	$0	WORKFORCE DEVELOPMENT
SF SWIM TEAM
PO BOX 758	SIOUX FALLS	SD	57101	460343732	501(C)(3)	$25,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
SF WOMEN RUN
5235 S SWEETBRIAR CT	SIOUX FALLS	SD	57108	813518734	501(C)(6)	$15,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
SHELDON COMMUNITY SCHOOL DISTRICT
1700 E 4TH STREET	SHELDON	IA	51201	426038825	115	$30,000	$0	PHYSICAL IMPROVEMENTS AND HOUSING
SHILOH CHRISTIAN SCHOOL
1915 SHILOH DR	BISMARCK	ND	58503	450348120	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
SIOUX EMPIRE TRIAGE CENTER
132 N DAKOTA AVE	SIOUX FALLS	SD	57104	844806781	501(C)(3)	$300,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
SIOUX EMPIRE UNITED WAY
1000 N W AVE 120	SIOUX FALLS	SD	571041314	460233701	501(C)(3)	$136,500	$0	COALITION BUILDING, COMMUNITY SUPPORT
SIOUX FALLS AREA COMMUNITY FOUNDATION
200 N CHERAPA PL	SIOUX FALLS	SD	57103	311748533	501(C)(3)	$49,175	$0	COMMUNITY SUPPORT, ECONOMIC DEVELOPMENT, PHYSICAL IMPROVEMENTS AND HOUSING
SIOUX FALLS CHRISTIAN SCHOOL
6120 S CHARGER CIRCE	SIOUX FALLS	SD	57108	460340024	501(C)(3)	$104,800	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
SIOUX FALLS SCHOOL DISTRICT 49-5
201 E 38TH ST	SIOUX FALLS	SD	57105	466002586	115	$310,000	$0	COMMUNITY SUPPORT, COMMUNITY HEALTH IMPROVEMENT SERVICES, PHYSICAL IMPROVEMENTS AND HOUSING, WORKFORCE DEVELOPMENT
SIOUX FALLS SPORTS AUTHORITY
200 N PHILLIPS AVE SUITE 304	SIOUX FALLS	SD	57104	205850491	501(C)(3)	$7,500	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
SLEEPY HOLLOW THEATRE & ARTS PARK
PO BOX 675	BISMARCK	ND	58502	450424373	501(C)(3)	$6,000	$0	COMMUNITY SUPPORT
SOUTH DAKOTA GOLF ASSOCIATION (SDGA)
PO BOX 88938	SIOUX FALLS	SD	57109	460310847	501(C)(4)	$25,000	$0	COMMUNITY SUPPORT
SOUTH DAKOTA GOLF ASSOCIATION JUNIOR GOLF FOUNDATION
PO BOX 88938	SIOUX FALLS	SD	57109	460449824	501(C)(3)	$35,000	$0	COMMUNITY SUPPORT
SOUTH DAKOTA HIGH SCHOOL ACTIVITIES ASSOCIATION (SDHSAA)
804 N EUCLID AVE SUITE 102	PIERRE	SD	57501	460226282	501(C)(3)	$62,500	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
SOUTH DAKOTA PARTNERS IN EDUCATION
PO BOX 886	SIOUX FALLS	SD	57101	813704298	501(C)(3)	$616,922	$0	WORKFORCE DEVELOPMENT
SOUTH DAKOTA STATE UNIVERSITY (SDSU) FOUNDATION
815 MEDARY AVE	BROOKINGS	SD	57007	460273801	501(C)(3)	$2,125,000	$0	ECONOMIC DEVELOPMENT, PHYSICAL IMPROVEMENTS AND HOUSING, WORKFORCE DEVELOPMENT
SOUTH SUDANESE FOUNDATION
2037 67TH AVE S	FARGO	ND	58104	834476088	501(C)(3)	$20,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
SOUTHWEST MINNESOTA STATE UNIVERSITY (SMSU)
1501 STATE ST	MARCHALL	MN	56258	411687554	115	$100,000	$0	WORKFORCE DEVELOPMENT
STATE OF SOUTH DAKOTA
500 E CAPITOL	PIERRE	SD	57501	466000364	115	$1,432,412	$0	ECONOMIC DEVELOPMENT, PHYSICAL IMPROVEMENT AND HOUSING, HEALTH PROFESSIONS EDUCATION, WORKFORCE DEVELOPMENT
SUMMIT LEAGUE
4000 N HERCULES AVE STE 200	SIOUX FALLS	SD	571071401	391417116	501(C)(3)	$0	$85,000	COMMUNITY SUPPORT	FAIR VALUE	DONATION OF RENTAL SPACE
TEA AREA SCHOOL DISTRICT 41-5
131 N POPLAR AVE	TEA	SD	57064	743076050	115	$25,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
TEDDY BEAR DEN
500 S MAIN AVENUE	SIOUX FALLS	SD	57104	311802800	501(C)(3)	$22,500	$0	COMMUNITY SUPPORT
THIEF RIVER FALLS SCHOOLS
230 LABREE AVENUE SOUTH	THIEF RIVER FALLS	MN	56701	416003126	115	$12,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
UND ALUMNI FOUNDATION
3501 UNIVERSITY AVE STOP 8157	GRAND FORKS	ND	58202	450348296	501(C)(3)	$1,036,571	$0	ECONOMIC DEVELOPMENT, WORKFORCE DEVELOPMENT
UNITED WAY OF BEMIDJI AREA
PO BOX 27	BEMIDJI	MN	56619	411567744	501(C)(3)	$48,000	$0	COALITION BUILDING
UNITED WAY OF CASS-CLAY
PO BOX 1609	FARGO	ND	581071609	410810008	501(C)(3)	$102,310	$0	COALITION BUILDING, ECONOMIC DEVELOPMENT
UNITED WAY OF DOUGLAS AND POPE COUNTY
503 HAWTHORNE ST	ALEXANDRIA	MN	56308	237450908	501(C)(3)	$7,250	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
UNITED WAY OF GRAND FORKS EAST GRAND FORKS & AREA
1013 N 5TH ST	GRAND FORKS	ND	58203	450255772	501(C)(3)	$10,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
UNITED WAY OF NORTHEASTERN SD
PO BOX 1065	ABERDEEN	SD	574021065	237086355	501(C)(3)	$10,000	$0	COALITION BUILDING
UNIVERSITY OF JAMESTOWN
6085 COLLEGE LANE	JAMESTOWN	ND	58405	450231180	501(C)(3)	$125,500	$0	COMMUNITY SUPPORT, ECONOMIC DEVELOPMENT
UNIVERSITY OF MARY
7500 UNIVERSITY DR	BISMARCK	ND	58504	450273403	501(C)(3)	$647,249	$0	COMMUNITY SUPPORT, ECONOMIC DEVELOPMENT, HEALTH PROFESSIONS EDUCATION, WORKFORCE DEVELOPMENT
UNIVERSITY OF SOUTH DAKOTA (USD)
1110 N DAKOTA ST	VERMILLION	SD	57069	466018891	501(C)(3)	$3,604,552	$0	ECONOMIC DEVELOPMENT, HEALTH PROFESSIONS EDUCATION, RESEARCH, WORKFORCE DEVELOPMENT
VALLEY CITY STATE UNIVERSITY
101 COLLEGE ST SW	VALLEY CITY	ND	58072	456002482	501(C)(3)	$50,000	$0	WORKFORCE DEVELOPMENT
VETERANS AFFAIRS
810 VERMONT AVE NW	WASHINGTON	DC	20420	540846950	115	$0	$11,758,005	COMMUNITY HEALTH IMPROVEMENT SERVICES	COST	SERVICES - PGX TESTING FOR VETERANS
VETERANS COMMUNITY PROJECT
8900 TROOST	KANSAS CITY	MO	64131	474960735	501(C)(3)	$60,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
VETERANS HONOR FLIGHT OF NDMN
PO BOX 294	HUNTER	ND	58048	473473590	501(C)(3)	$7,500	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
VILLAGE FAMILY SERVICE CENTER
1201 25TH ST	FARGO	ND	58106	450226423	501(C)(3)	$100,000	$0	COALITION BUILDING
VILLAGE NORTHWEST UNLIMITED SHELDON IA
330 VILLAGE CIRCLE	SHELDON	IA	51201	421044017	501(C)(3)	$10,000	$0	COMMUNITY SUPPORT
VOLUNTEERS OF AMERICA DAKOTAS
PO BOX 89306	SIOUX FALLS	SD	57109	237353508	501(C)(3)	$10,000	$0	COMMUNITY SUPPORT
WARNER SCHOOL DISTRICT
PO BOX 20	WARNER	SD	57479	204606639	501(C)(3)	$10,000	$0	PHYSICAL IMPROVEMENTS AND HOUSING
WASHINGTON PAVILION
301 S MAIN AVE	SIOUX FALLS	SD	57104	460435791	501(C)(3)	$50,000	$0	ECONOMIC DEVELOPMENT
WATERTOWN DEVELOPMENT COMPANY
PO BOX 332	WATERTOWN	SD	57201	470813269	501(C)(6)	$15,000	$0	ECONOMIC DEVELOPMENT
WEBSTER ACTIVE LIVING TRAIL
PO BOX 539	WEBSTER	SD	57274	466000530	115	$7,143	$0	PHYSICAL IMPROVEMENTS AND HOUSING
WEST CENTRAL SCHOOL DISTRICT
PO BOX 252	HARTFORD	SD	57033	460284421	115	$24,800	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
WILLISTON PUBLIC SCHOOLS
820 E BROADWAY	WILLISTON	ND	58801	861316289	115	$15,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
WINGS OF VALOR INC
45618 278TH ST	PARKER	SD	57053	843711088	501(C)(3)	$50,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
WINNER REGIONAL FOUNDATION
745 EAST 8TH STREET	WINNER	SD	57580	363739631	501(C)(3)	$100,000	$0	COMMUNITY HEALTH IMPROVEMENT SERVICES
WORTHINGTON PUBLIC SCHOOLS
1117 MARINE AVE	WORTHINGTON	MN	561871610	416008522	115	$110,000	$0	COMMUNITY HEALTH IMPROVEMENTS, PHYSICAL IMPROVEMENTS AND HOUSING
YELLOW JACKET FOUNDATION
1200 UNIVERSITY ST UNIT 9506	BELLE FOURCHE	SD	57717	510151319	501(C)(3)	$155,200	$0	ECONOMIC DEVELOPMENT

Field	Value	IRS element (for citing)
Total501c3 Org	159	Total501c3OrgCnt
Total Other Org	13	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (3 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc
GENERAL SUPPORT FOR COMMUNITY PROGRAMS	1063	$20,609	COST	SANFORD CARES CHRISTMAS PROGRAM; WHICH INCLUDES PHYSICAL ACTIVITES, BACKPACKS AND $25 GIFT CARDS. THE NUMBER OF RECIPIENTS WAS ESTIMATED BASED ON THE QUANTITY OF GIFTS AND OTHER ITEMS LISTED ON THE APPLICABLE INVOICES.
YOUTH SPORTS PROGRAM ASSISTANCE	576	$70,000	COST	ASSISTANCE FOR UNIFORMS, WARMUPS, GYM RENTALS, AND TRAVEL EXPENSES. THE NUMBER OF RECIPIENTS WAS DETERMINED BY MULTIPLYING THE APPROXIMATE NUMBER OF TEAMS THAT PARTICIPATE IN THESE PROGRAMS EACH YEAR BY THE APPROXIMATE NUMBER IF PLAYERS PER TEAM.
SCHOLARSHIPS	38	$103,000	COST	THE SANFORD HEALTH EQUITY IN EDUCATION SCHOLARSHIP IS A TARGETED FINANCIAL SCHOLARSHIP PROGRAM AIDING UNDERREPRESENTED AND TRADITIONALLY UNDERSERVED POPULATIONS SEEKING HIGHER EDUCATION. AN AMOUNT OF $5,000 WAS AWARDED TO FIVE DIFFERENT INDIVIDUALS IN 2024. THE SANFORD HEALTH MILITARY AND VETERAN SCHOLARSHIP IS AWARDED TO ANY VETERAN, GUARD/RESERVE, OR ACTIVE-DUTY MILITARY SERVICE MEMBER WHO HAS DEMONSTRATED EXCEPTIONAL CHARACTER AND LEADERSHIP IN FURTHERING THEIR OWN PROGRESS AND IN ENRICHING THE LIVES OF OTHERS. AN AMOUNT OF $5,000 WAS AWARDED TO FOUR DIFFERENT INDIVIDUALS IN 2024. THE SANFORD HEALTH NETWORK SCHOLARSHIP OFFERS FINANCIAL SUPPORT FOR STUDENTS WHO ARE CONTINUING EDUCATION IN A FIELD THAT CAN ENHANCE THEIR CONTRIBUTIONS ACROSS SANFORD'S FOOTPRINT. BY OFFERING THIS SCHOLARSHIP, SANFORD IS MAKING AN INVESTMENT IN OUR REGION'S FUTURE WORKFORCE AND ALL THE COMMUNITIES WE SERVE. AN AMOUNT OF $2,000 WAS AWARDED TO 29 DIFFERENT INDIVIDUALS IN 2024.

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
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	Yes (1)	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	Yes (1)	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	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 (21 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
BILL GASSEN
TRUSTEE, PRESIDENT & CEO	$0	$2,334,458	$0	$1,624,395	$0	$455,266	$0	$584,349	$0	$892	$0	$4,999,360	$0	$0
WILLIAM BRUNNER MD
PHYSICIAN	$3,282,364	$0	$0	$0	$4,629	$0	$16,627	$0	$29,937	$0	$3,333,557	$0	$0	$0
ADAM STYS MD
PHYSICIAN	$2,941,668	$0	$0	$0	$308,522	$0	$17,250	$0	$35,853	$0	$3,303,293	$0	$0	$0
MATT HOCKS
EVP, CHIEF OPERATING OFFICER	$0	$1,499,992	$0	$1,059,337	$0	$239,116	$0	$240,957	$0	$35,576	$0	$3,074,978	$0	$0
TOMASZ STYS MD
PHYSICIAN	$2,748,910	$0	$0	$0	$163,027	$0	$17,250	$0	$30,815	$0	$2,960,002	$0	$0	$0
ERIC BELANGER MD
PHYSICIAN	$2,882,758	$0	$0	$0	$2,322	$0	$16,457	$0	$25,505	$0	$2,927,042	$0	$0	$0
ALEXANDER DROFA MD
PHYSICIAN	$2,821,625	$0	$0	$0	$14,292	$0	$17,250	$0	$30,965	$0	$2,884,132	$0	$0	$0
SCOTT WOOTEN
EVP, CFO (END 4/24)	$0	$245,207	$0	$0	$0	$2,280,001	$0	$43,522	$0	$7,698	$0	$2,576,428	$0	$0
JENNIFER GRENNAN
EVP, CHIEF ADMIN OFFICER	$0	$1,020,580	$0	$803,726	$0	$167,304	$0	$172,875	$0	$34,977	$0	$2,199,462	$0	$0
MICHAEL LEBEAU MD
SVP, HEALTH SVC OPERATIONS	$0	$1,034,038	$0	$613,493	$0	$177,333	$0	$174,475	$0	$35,213	$0	$2,034,552	$0	$0
PAUL HANSON
PRESIDENT & CEO, SIOUX FALLS	$0	$858,148	$0	$466,466	$0	$147,266	$0	$146,495	$0	$26,440	$0	$1,644,815	$0	$0
TIFFANY LAWRENCE
PRESIDENT & CEO, FARGO	$0	$832,476	$0	$456,270	$0	$137,506	$0	$143,293	$0	$36,152	$0	$1,605,697	$0	$0
TODD SCHAFFER
PRESIDENT & CEO, BISMARCK	$0	$715,457	$0	$385,548	$0	$123,454	$0	$124,825	$0	$2,692	$0	$1,351,976	$0	$0
NICK OLSON
EVP, CFO (BEG 4/24)	$0	$783,688	$0	$138,354	$0	$125,834	$0	$122,494	$0	$892	$0	$1,171,262	$0	$0
SUSAN JARVIS
FORMER PRESIDENT & CEO, BEMIDJI	$0	$654,160	$0	$169,974	$0	$96,472	$0	$117,675	$0	$28,660	$0	$1,066,941	$0	$0
BILL MARLETTE
INTERIM, EVP, CFO (END 1/24)	$0	$420,002	$0	$470,299	$0	$4,000	$0	$0	$0	$275	$0	$894,576	$0	$0
KARLA EISCHENS
PRESIDENT & CEO, BEMIDJI	$0	$417,820	$0	$231,329	$0	$80,461	$0	$81,795	$0	$25,873	$0	$837,278	$0	$0
ANDY NORTH
TRUSTEE, SECRETARY, INDEP CONTRACTOR	$379,383	$0	$0	$0	$0	$0	$0	$0	$0	$0	$379,383	$0	$0	$0
MICHELLE BRUHN
FORMER EVP, CFO & TREASURER	$0	$0	$0	$293,725	$0	$0	$0	$0	$0	$0	$0	$293,725	$0	$0
BRYAN NERMOE
FORMER PRESIDENT & CEO, FARGO	$0	$0	$0	$0	$0	$252,724	$0	$0	$0	$0	$0	$252,724	$0	$0
DON JACOBS
FORMER TRUSTEE	$13,502	$0	$0	$0	$0	$0	$0	$0	$0	$0	$13,502	$0	$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: CHARTER TRAVEL IS PERMITTED FOR BUSINESS PURPOSES WHEN APPROVED AS NECESSARY AND REASONABLE BY EXECUTIVE LEADERSHIP. THESE COSTS ARE NOT INCLUDED IN THE W-2'S OF EMPLOYEES BECAUSE THEY ARE INCURRED FOR BUSINESS PURPOSES OF SANFORD. CHARTER AIR TRAVEL FOR PERSONAL USE WAS PROVIDED TO ONE OFFICER. THE ENTIRE BENEFIT WAS TREATED AS TAXABLE COMPENSATION. FOR INTERNATIONAL TRAVEL OUTSIDE OF NORTH AMERICA WITH FLIGHT TIMES IN EXCESS OF 6 HOURS, SANFORD REIMBURSES THE COST OF A BUSINESS CLASS TICKET. TRAVEL FOR COMPANIONS - LIMITED TRAVEL FOR COMPANIONS IS OFFERED FOR CERTAIN MEETINGS AND EVENTS. THESE COSTS ARE INCLUDED IN THE W-2'S OR 1099'S OF THE INDIVIDUALS. FOR CHARTER AIR TRAVEL, SANFORD USES THE SIFL (STANDARD INDUSTRY FARE LEVEL) RATE METHOD TO IMPUTE THE FRINGE BENEFIT TO THE EMPLOYEE, OFFICER OR TRUSTEE. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - CERTAIN COMPENSATION MAY BE GROSSED UP TO INCLUDE APPROPRIATE TAX AMOUNTS.
PART I, LINE 3	SANFORD 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. THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES APPROVES ALL COMPENSATION CHANGES FOR THE CEO IN ADVANCE, RELIES ON THE MARKET DATA PROVIDED BY THE INDEPENDENT CONSULTING FIRM IN MAKING CHANGES, AND DOCUMENTS THE BASIS FOR ANY CHANGES IN COMMITTEE MINUTES.
PART I, LINES 4A-B	LINE 4A-SEVERANCE OR CHANGE OF CONTROL PAYMENT UPON HIRE OR PROMOTION, SELECT OFFICERS AND KEY EMPLOYEES SIGN AN EXECUTIVE SEVERANCE AGREEMENT (THE "AGREEMENT"). THE AGREEMENT PROVIDES THAT THE EXECUTIVE WILL RECEIVE A MULTIPLE OF HIS OR HER SALARY (BASED ON YEARS OF SERVICE OR POSITION) AS A PAYMENT IN THE EVENT OF A DEFINED SEPARATION EVENT, WHICH CAN INCLUDE AN INVOLUNTARY SEPARATION OR AN EMPLOYEE VOLUNTARILY LEAVING FOR A DEFINED CONTRACTUAL REASON. EXECUTIVES MAY ALSO QUALIFY FOR THE PAYMENT AFTER SATISFYING THE CONDITIONS OF THE NON-COMPETE. FINAL SEPARATION PAYMENTS MIGHT VARY FROM THE AMOUNT PROVIDED IN THE AGREEMENT AS A RESULT OF NEGOTIATIONS SURROUNDING POST-SEPARATION OBLIGATIONS AND INCENTIVES (THE "SEPARATION" PAYMENT). LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS FOR EXECUTIVES, A PORTION OF THE RETIREMENT AND OTHER DEFERRED COMPENSATION REPORTED RELATES TO A 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THIS PLAN PROVIDES FOR A SUBSTANTIAL RISK OF FORFEITURE AND THERE IS NO GUARANTEE THAT ANY AMOUNT WILL ULTIMATELY BE PAID. SANFORD SPONSORS NONQUALIFIED RETIREMENT PLANS FOR SELECT OFFICERS OR KEY EMPLOYEES. CERTAIN OF THE BELOW OFFICERS OR KEY EMPLOYEES WERE PAID AS A RESULT OF A VESTING EVENT. LINES 4A AND 4B - PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE OR CHANGE OF CONTROL PAYMENTS AND/OR SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS: SCOTT WOOTEN: SEPARATION..................................$2,143,876 NONQUALIFIED RETIREMENT PLAN...................$33,255 TOTAL.......................................$2,177,131 BRYAN NERMOE: NON-COMPETE PAYMENT...........................$252,724
PART I, LINE 5	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	A MATERIAL PORTION OF EXECUTIVE COMPENSATION IS LINKED TO ACHIEVING ORGANIZATIONAL GOALS RELATED TO QUALITY OF CARE, PATIENT EXPERIENCE, EMPLOYEE EXPERIENCE AND FINANCIAL PERFORMANCE. THE GOALS ARE SET IN ADVANCE AND APPROVED BY THE BOARD OF TRUSTEES.

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	2004: NEW CONSTRUCTION OF HEALTHCARE FACILITIES	0	0	0
CITY OF CHAMBERLAIN
B	460000094	000000000	2010-12-30	$4,000,000	2010 CHAMB: 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	2012AB: 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	2012D:REFINANCE TAXABLE INDEBTEDNESS USED TO CONSTRUCT HEALTHCARE FACILITY	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	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Other Spent ProceedsOtherSpentProceedsAmt
A	$58,375,000	$71,581,953	$191,513	$764,068	$70,817,885	2006	0	0	Yes (1)	Yes (1)
B	$3,636,506	$4,000,000			$4,000,000	2010	0	0	Yes (1)	Yes (1)
C	$46,015,000	$66,185,000		$24,356		2012	Yes (1)	Yes (1)	Yes (1)	Yes (1)	$66,160,644
D	$23,800,000	$45,000,000			$45,000,000	2012	0	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

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

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Supplemental Information Detail SupplementalInformationDetail (6 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: 03/29/2013 ISSUER NAME: SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 10/30/2019 ISSUER NAME: SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 11/12/2020
SCHEDULE K, PART I, BOND ISSUES	BONDS ISSUED 10/28/2014, COLUMN(C) CUSIP #: 83755VXF6 AND 83755VXE9 BONDS ISSUED 9/14/2004, COLUMN(C) CUSIP #: 83755VHY3 AND 83755VHZ0
PART I, COLUMN E AND PART II, LINE 3	BONDS ISSUED 10/28/2014, COLUMN(C) CUSIP #: 83755VXF6 AND 83755VXE9 BONDS ISSUED 10/21/2015, COLUMN(C) CUSIP #: 83755VZW7 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	BONDS ISSUED 08/05/2014, COLUMN(C) CUSIP #: 83755VWA8 BONDS ISSUED 10/28/2014, COLUMN(C) CUSIP #: 83755VXF6 AND 83755VXE9 BONDS ISSUED 10/21/2015, COLUMN(C) CUSIP #: 83755VZW7 THE AMOUNTS SHOWN HERE CONSIST OF DEBT SERVICE FUND DEPOSITS.
PART III	PART III HAS NOT BEEN COMPLETED FOR THE 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 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	83755VWA8	2014-08-05	$52,083,720	2014A: 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	2014B: 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	2015:NEW CONSTRUCTION & ADVANCED REFUNDING OF BONDS ISSUED 4/19/07, 5/22/07	0	0	0
SOUTH DAKOTA HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
D	460315509	000000000	2016-10-28	$50,000,000	2016: NEW CONSTRUCTION, EQUIPMENT AND IMPROVEMENTS	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Capitalized InterestCapitalizedInterestAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt
A	$2,400,000	$52,083,720	$2,930	$52,083,720	2014	Yes (1)	0	Yes (1)	Yes (1)
B	$33,495,000	$207,081,359	$6,903		2017	0	0	Yes (1)	Yes (1)	$31,874	$1,906,127	$205,143,359
C	$34,650,000	$192,707,024	$7,065	$80,746,163	2017	0	Yes (1)	Yes (1)	Yes (1)		$1,431,628	$110,529,233
D	$40,000,000	$50,000,000			2017	0	0	Yes (1)	Yes (1)		$150,032	$49,849,968

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

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

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

Field	Value	IRS element (for citing)
Person	PAIGE SCHAFFER	PersonNm
Relationship With Org	FAMILY RELATIONSHIP - TODD SCHAFFER	RelationshipWithOrgTxt
Loan Purpose	EDUCATION	LoanPurposeTxt
Loan From Organization	Yes (X)	LoanFromOrganizationInd
Original Principal	$20,000	OriginalPrincipalAmt
Balance Due	$17,989	BalanceDueAmt
Default	0	DefaultInd
Board Or Committee Approval	0	BoardOrCommitteeApprovalInd
Written Agreement	Yes (1)	WrittenAgreementInd

Field	Value	IRS element (for citing)
Total Balance Due	$17,989	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (6 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
KACEY DOYLE
FAMILY RELATIONSHIP - MARNIE HERMANN	$83,066	EMPLOYMENT	0
KRISTI BENZ
FAMILY RELATIONSHIP - LAURIS MOLBERT	$70,204	EMPLOYMENT	0
NICHOLE HESTER
FAMILY RELATIONSHIP - ANDY NORTH	$68,316	INDEPENDENT CONTRACTOR ARRANGEMENT	0
JACOB PEARLSON
FAMILY RELATIONSHIP - KARLA EISCHENS	$97,676	EMPLOYMENT	0
CHRISTINA OLSON
FAMILY RELATIONSHIP - NICK OLSON	$206,891	EMPLOYMENT	0
MALLORY NERMOE
FAMILY RELATIONSHIP - BRYAN NERMOE	$54,860	EMPLOYMENT	0

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Desc	SIMIL TRUCK	Desc
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$495,000	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
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 AMOUNT REPORTED ON PART I, COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 3A:	SANFORD HEALTH, SANFORD MEDICAL CENTER, SANFORD NORTH, SANFORD MEDICAL CENTER FARGO, SANFORD CLINIC NORTH, SANFORD CLINIC, SANFORD BISMARCK, SANFORD HEALTH NETWORK NORTH, AND SANFORD WORLD CLINICS 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: BILL GASSEN, JENNIFER GRENNAN, PAUL HANSON, MATT HOCKS, TODD SCHAFFER, MICHAEL LEBEAU, BILL MARLETTE, NICK OLSON, SCOTT WOOTEN, KARLA EISCHENS, AND 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 HOME HEALTH, SANFORD RESEARCH, SANFORD RESEARCH NORTH, SANFORD WORLD CLINICS, SANFORD HEALTH OF NORTHERN MINNESOTA, BAKER PARK, INC., SANFORD WEST, SANFORD BISMARCK, SANFORD VIRTUAL CARE, SANFORD WORLD CLINICS - KLAMATH FALLS, AND SANFORD HEALTH OF SOUTH DAKOTA. THE BOARD OF TRUSTEES OF SANFORD IS ALSO THE BOARD OF TRUSTEES FOR SANFORD HEALTH, SANFORD NORTH, SANFORD WEST, AND SANFORD HEALTH OF SOUTH DAKOTA, AND SANFORD IS THE SOLE CORPORATE MEMBER OF THESE ENTITIES. THESE ENTITIES, IN TURN, ARE THE SOLE CORPORATE MEMBERS OF THEIR 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, SANFORD HEALTH NETWORK, AND SANFORD HEALTH OF SOUTH DAKOTA 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 11B	THE FORM 990 IS PREPARED INTERNALLY BY THE TAX DEPARTMENT AND REVIEWED BY EXECUTIVE MANAGEMENT. THE TAX DEPARTMENT PREPARES RETURN HIGHLIGHTS AND KEY DISCLOSURES FOR THE EXECUTIVE MANAGEMENT TEAM. AN EXTERNAL ACCOUNTING FIRM REVIEWS AND SIGNS THE RETURN. 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 THE SYSTEM BOARD OF TRUSTEES, MEMBERS OF THE GOVERNING BOARDS OF SUBSIDIARY ENTITIES, OFFICERS, AND KEY EMPLOYEES FOR ALL ENTITIES SUBJECT TO THE IRS FORM 990 FILINGS. THE CCO REVIEWS THE DISCLOSURES AND WHEN A CONFLICT OF INTEREST IS DEEMED TO EXIST, REFERS THE DISCLOSURE TO THE SANFORD EXECUTIVE COMPLIANCE COMMITTEE FOR DEVELOPMENT OF AN ADMINISTRATIVE OR MANAGEMENT PLAN TO ADDRESS OR ELIMINATE THE CONFLICT OF INTEREST. SANFORD WILL NOT ENGAGE IN ANY CONTRACT, TRANSACTION OR ARRANGEMENT INVOLVING A BOARD MEMBER'S CONFLICT OF INTEREST UNLESS A MAJORITY OF THE DISINTERESTED MEMBERS OF THE AUDIT AND COMPLIANCE COMMITTEE DETERMINE THAT APPROPRIATE SAFEGUARDS ARE IN PLACE TO PROTECT SANFORD'S CHARITABLE MISSION.
FORM 990, PART VI, SECTION B, LINE 15	SANFORD HAS A PROCESS FOR DETERMINING COMPENSATION OF THE PERSONS LISTED ON PART VII, SECTION A. THIS INCLUDES REVIEW AND APPROVAL BY INDEPENDENT PERSONS OR BOARD OF TRUSTEES COMMITTEE, REVIEW OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION FOR SUCH COMPENSATION. SANFORD 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. THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES APPROVES ALL COMPENSATION CHANGES FOR THE CEO IN ADVANCE, RELIES ON THE MARKET DATA PROVIDED BY THE INDEPENDENT CONSULTING FIRM IN MAKING CHANGES, AND DOCUMENTS THE BASIS FOR ANY CHANGES IN COMMITTEE MINUTES.
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 A	THE TABLE REPORTS THE COMPENSATION OF THE SANFORD OFFICERS, DIRECTORS/TRUSTEES, SYSTEM KEY EMPLOYEES, AND FIVE HIGHEST COMPENSATED EMPLOYEES AND INDEPENDENT CONTRACTORS. THE SANFORD BOARD OF TRUSTEES HAS ULTIMATE GOVERNANCE RESPONSIBILITIES FOR EACH SUBORDINATE ORGANIZATION.
FORM 990, PART VII, SECTION B	WE ARE REPORTING ONE GROUP OF TOP FIVE EMPLOYEES AND INDEPENDENT CONTRACTORS FOR THE ENTIRE GROUP. AMOUNTS LISTED AS COMPENSATION FOR THE FIVE HIGHEST COMPENSATED INDEPENDENT CONTRACTORS INCLUDE PAYMENTS FOR BOTH MATERIALS AND SERVICES.
FORM 990, PART XI, LINE 9:	CASH SWEEP FOR POOLED INVESTMENTS 168,240,510. PENSION PLAN TERMINATION ADJUSTMENT AND OTHER CHANGES 57,364,410. NET ASSETS RELEASED FOR ACQUIRED PPE 7,100. CAPITAL CONTRIBUTION TO SUBSIDIARIES -21,233,826. NET ASSETS TRANFERRED FOR ACCOUNTS PAYABLE 57,357,310.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (11 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
DG DEVELOPMENTS 2 LLC
1300 W 57TH ST SUITE 100	SIOUX FALLS	SD	57108	267317570	REAL ESTATE	SD	$0	$3,703,275	SANFORD HEALTH
HEALTHCARE ENVIRONMENTAL SERVICES LLC
PO BOX 2010	FARGO	ND	58122	205236701	RETAIL ENTERPRISES	ND	$1,310,345	$3,998,029	SANFORD NORTH
NATIONAL STUDENT HOUSING-SOUTH DAKOTA LLC
1305 W 18TH ST	SIOUX FALLS	SD	57105	202129839	REAL ESTATE	SD	$0	$2,452,979	SANFORD HEALTH
NORTH COUNTRY SENIOR LIVING LLC
1000 ANNE ST NW	BEMIDJI	MN	56601	263862586	SENIOR HOUSING	CO	$4,637,086	$4,471,766	SANFORD HEALTH OF NORTHERN MINNESOTA
RAC RENTALS LLC
1305 W 18TH ST	SIOUX FALLS	SD	57105	261961077	REAL ESTATE	SD	$0	$2,812,779	SANFORD HEALTH
SANFORD HEALTHCARE ACCESSORIES LLC
3223 32ND AVE SW	FARGO	ND	58103	202404179	SALES OF DURABLE MEDICAL EQUIP	ND	$62,763,414	$43,668,395	SANFORD HEALTH
SOUTHWEST MINNESOTA RADIATION CENTER LLC
1018 6TH AVENUE	WORTHINGTON	MN	56187	460447693	RADIATION SERVICES	MN	$0	$0	SANFORD HEALTH NETWORK
BLACK HILLS SURGICAL HOSPITAL LLC
216 ANAMARIA DR	RAPID CITY	SD	57701	460440466	HEALTHCARE	SD	$1,544,710	$213,369,668	SANFORD HEALTH OF SOUTH DAKOTA
BLACK HILLS URGENT CARE LLC
216 ANAMARIA DR	RAPID CITY	SD	57701	454308839	HEALTHCARE	SD	$0	$16,961,936	BLACK HILLS SURGICAL HOSPITAL LLC
ORTHOPAEDIC BUILDING PARTNERSHIP LLC
7720 MT RUSHMORE RD	RAPID CITY	SD	57702	460349014	REAL ESTATE	SD	$141,038	$0	SANFORD HEALTH OF SOUTH DAKOTA
NORTHEAST WYOMING SURGERY CENTER LLC
1307 WEST 3RD ST STE B	GILLETTE	WY	82716	820489706	HEALTHCARE	WY	$438,308	$10,223,949	SANFORD HEALTH OF SOUTH DAKOTA

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (24 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
ADAMS COUNTY GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	461495572	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
ARLINGTON GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	371805492	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	10	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
BOISE GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	363370371	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	PF	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
COLLISTER DRIVE HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	300872973	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	PF	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
F-M AMBULANCE SERVICE INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	450344371	EMT	ND	501(C)(4)		SANFORD NORTH	Yes (1)
GOOD SAMARITAN SOCIETY INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	460349951	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	271212446	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
HOWARD LAKE GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	364885253	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	10	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
LEA COUNTY GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	453946645	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	10	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
LILAC WAY GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	465740381	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
LOVINGTON GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	460392944	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	10	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
MILLARD GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	460396332	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
OLATHE GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	460396398	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
PRESCOTT GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	275114421	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
PROPHETSTOWN GOOD SAMARITAN HOUSING INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	460392943	PROVIDE LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	501(C)(3)	10	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
RAPID CITY GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	461579750	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
SANFORD
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	271218956	SUPPORTING ORGANIZATION	ND	501(C)(3)	12-II		0
SANFORD HEALTH FOUNDATION
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	363297853	FOUNDATION	SD	501(C)(3)	12-II	SANFORD HEALTH	Yes (1)
SANFORD HEALTH FOUNDATION NORTH
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	450398104	FOUNDATION	ND	501(C)(3)	7	SANFORD NORTH	Yes (1)
SANFORD HEALTH FOUNDATION OF NORTHERN MINNESOTA
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	411389317	FOUNDATION	MN	501(C)(3)	7	SANFORD HEALTH OF NORTHERN MINNESOTA	Yes (1)
SANFORD HEALTH FOUNDATION WEST
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	450397196	FOUNDATION	ND	501(C)(3)	7	SANFORD BISMARCK	Yes (1)
SIOUX FALLS DOWNTOWN GOOD SAMARITAN HOUSING GP INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	452473519	LOW INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	501(C)(3)	12-I	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY	0
THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	460422866	FOUNDATION	MN	501(C)(3)	12-I	SANFORD HEALTH	Yes (1)
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	450228055	LONG-TERM CARE, SENIOR HOUSING & HOME AND COMMUNITY BASED SERVICES	ND	501(C)(3)	10	SANFORD	0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
COLLISTER DRIVE HOUSING LLC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	611752929	LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	N/A	0	0
HASTINGS VILLAGE GARDENS GOOD SAMARITAN HOUSING LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	271212511	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
OLATHE GOOD SAMARITAN HOUSING LP
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	205297369	PROVIDE LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS	SD	N/A	0	0
RUTH STREET GOOD SAMARITAN HOUSING LLC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	611748321	LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	N/A	0	0
TEXAS GOOD SAMARITAN HOUSING LLC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	371774574	LOW-INCOME HOUSING TO SENIORS AND OTHER ELIGIBLE POPULATIONS AS GP	SD	N/A	0	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (13 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd
GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	815037667	INSURANCE	NE	N/A	C	0
GOOD SAMARITAN SOCIETY INSURANCE LTD
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	980379099	INSURANCE		N/A	C	0	CJ
HERITAGE HEALTHCARE OF NORTHERN NEW MEXICO INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	900491537	PROVIDE HOME AND COMMUNITY BASED SERVICES	NM	N/A	S	0
HERITAGE HEALTHCARE SERVICES INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	850418562	PROVIDE HOME AND COMMUNITY BASED SERVICES	NM	N/A	S	0
HERITAGE HOME HEALTHCARE & HOSPICE INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	850463468	PROVIDE HOME AND COMMUNITY BASED SERVICES	NM	N/A	S	0
HERITAGE HOME HEALTHCARE OF ARIZONA INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	204243949	PROVIDE HOME AND COMMUNITY BASED SERVICES	NM	N/A	S	0
HERITAGE HOME HEALTHCARE SERVICES INC
P O BOX 5039 RTE 5218	SIOUX FALLS	SD	571175039	850463469	PROVIDE HOME AND COMMUNITY BASED SERVICES	NM	N/A	S	0
SANFORD FRONTIERS
1305 W 18TH STREET PO BOX 5039	SIOUX FALLS	SD	571175039	455436599	SPORTS/ALTERNATIVE INVESTMENTS	SD	N/A	C	0
SANFORD HEALTH PLAN
300 CHERAPA PLACE	SIOUX FALLS	SD	57103	911842494	INSURANCE	SD	N/A	C	0
SANFORD HEALTH PLAN OF MN
300 CHERAPA PLACE	SIOUX FALLS	SD	57103	460445852	INSURANCE	MN	N/A	C	0
SANFORD INTERNATIONAL - MUNICH GMBH
					HEALTHCARE		N/A	C	0	GM	NYMPHENBURGER STRASSE 3	MUNICH	GM
SANFORD WORLD CLINICS - GHANA LBG
					HEALTHCARE		N/A	C	0	GH	SARBAH ROAD TANTRI LORRY STATION	CAPE COAST	GH
SHANGHAI SANFORD HEALTHCARE MANAGEMENT CONSULTING CO LTD
					HEALTHCARE		N/A	C	0	CH	188 YESHENG ROAD ROOM A-862 GUOMA	SHANGHAI	CH

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	Yes (1)	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	Yes (1)	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (19 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
FM AMBULANCE
R	$2,369,829	CASH METHOD
SANFORD FRONTIERS
B	$24,214,049	CASH METHOD
SANFORD HEALTH FOUNDATION
R	$646,003	CASH METHOD
SANFORD HEALTH FOUNDATION
P	$4,894,933	CASH METHOD
SANFORD HEALTH FOUNDATION
C	$55,013,125	CASH METHOD
SANFORD HEALTH FOUNDATION NORTH
S	$3,097,891	CASH METHOD
SANFORD HEALTH FOUNDATION NORTH
P	$2,647,538	CASH METHOD
SANFORD HEALTH FOUNDATION NORTH
C	$4,555,636	CASH METHOD
SANFORD HEALTH FOUNDATION NORTHERN MN
P	$570,490	CASH METHOD
SANFORD HEALTH FOUNDATION NORTHERN MN
C	$3,217,437	CASH METHOD
SANFORD HEALTH FOUNDATION NORTHERN MN
S	$483,700	CASH METHOD
SANFORD HEALTH FOUNDATION WEST
P	$1,193,171	CASH METHOD
SANFORD HEALTH FOUNDATION WEST
C	$1,510,221	CASH METHOD
SANFORD HEALTH FOUNDATION WEST
S	$846,721	CASH METHOD
SANFORD WORLD CLINICS - GHANA
B	$42,890	CASH METHOD
THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION
R	$2,045,533	CASH METHOD
THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION
P	$992,725	CASH METHOD
THE EVANGELICAL LUTHERAN GOOD SAMARITAN FOUNDATION
C	$232,828	CASH METHOD
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
S	$160,245,265	CASH METHOD