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        <ExclusionAmt>5000</ExclusionAmt>
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      <OtherRevenueMiscGrp>
        <Desc>PROPERTY DAMAGE REIMBURSEMENT</Desc>
        <BusinessCd>900099</BusinessCd>
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        <ExclusionAmt>3570</ExclusionAmt>
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      <MiscellaneousRevenueGrp>
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        <ExclusionAmt>11399</ExclusionAmt>
      </MiscellaneousRevenueGrp>
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      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>11006470</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10821173</RelatedOrExemptFuncIncomeAmt>
        <ExclusionAmt>96119</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
        <TotalAmt>0</TotalAmt>
      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
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      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
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        <ManagementAndGeneralAmt>189120</ManagementAndGeneralAmt>
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      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
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      <OtherSalariesAndWagesGrp>
        <TotalAmt>4333781</TotalAmt>
        <ProgramServicesAmt>3730597</ProgramServicesAmt>
        <ManagementAndGeneralAmt>603184</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>192430</ProgramServicesAmt>
        <ManagementAndGeneralAmt>37368</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>624912</ProgramServicesAmt>
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        <ProgramServicesAmt>279925</ProgramServicesAmt>
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      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
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      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>60845</TotalAmt>
        <ManagementAndGeneralAmt>60845</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
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        <ManagementAndGeneralAmt>134</ManagementAndGeneralAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
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        <ManagementAndGeneralAmt>276</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>34580</ManagementAndGeneralAmt>
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      <OfficeExpensesGrp>
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      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
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        <ProgramServicesAmt>349108</ProgramServicesAmt>
        <ManagementAndGeneralAmt>17620</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <RoyaltiesGrp>
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      </RoyaltiesGrp>
      <OccupancyGrp>
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        <ProgramServicesAmt>313711</ProgramServicesAmt>
        <ManagementAndGeneralAmt>15844</ManagementAndGeneralAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>5448</ProgramServicesAmt>
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      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>13860</TotalAmt>
        <ProgramServicesAmt>9896</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3964</ManagementAndGeneralAmt>
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      <InterestGrp>
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        <ProgramServicesAmt>383763</ProgramServicesAmt>
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      <PaymentsToAffiliatesGrp>
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      </PaymentsToAffiliatesGrp>
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        <ProgramServicesAmt>715577</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>104543</TotalAmt>
        <ProgramServicesAmt>104543</ProgramServicesAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>MEDICAL/DIETARY SUPPLIES</Desc>
        <TotalAmt>895834</TotalAmt>
        <ProgramServicesAmt>895834</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>AFFILIATE SUPPORT FEE</Desc>
        <TotalAmt>257820</TotalAmt>
        <ProgramServicesAmt>63527</ProgramServicesAmt>
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      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>REPAIRS &amp; MAINTENANCE</Desc>
        <TotalAmt>226132</TotalAmt>
        <ProgramServicesAmt>226132</ProgramServicesAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>213000</TotalAmt>
        <ProgramServicesAmt>213000</ProgramServicesAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>205599</TotalAmt>
        <ProgramServicesAmt>205599</ProgramServicesAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>11441484</TotalAmt>
        <ProgramServicesAmt>10037122</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1404362</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
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        <EOYAmt>258971</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
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        <EOYAmt>1488578</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
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        <EOYAmt>0</EOYAmt>
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      <AccountsReceivableGrp>
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        <EOYAmt>2483901</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
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        <EOYAmt>0</EOYAmt>
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      <RcvblFromDisqualifiedPrsnGrp>
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        <EOYAmt>0</EOYAmt>
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      <OthNotesLoansReceivableNetGrp>
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        <EOYAmt>116429</EOYAmt>
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      <InventoriesForSaleOrUseGrp>
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        <EOYAmt>90159</EOYAmt>
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      <PrepaidExpensesDefrdChargesGrp>
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        <EOYAmt>36602</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
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      <LandBldgEquipAccumDeprecAmt>6787738</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
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        <EOYAmt>6976816</EOYAmt>
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      <InvestmentsPubTradedSecGrp>
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        <EOYAmt>0</EOYAmt>
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      <InvestmentsOtherSecuritiesGrp>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>0</EOYAmt>
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        <EOYAmt>1342168</EOYAmt>
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      <GrantsPayableGrp>
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        <EOYAmt>0</EOYAmt>
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      <DeferredRevenueGrp>
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      <TaxExemptBondLiabilitiesGrp>
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        <EOYAmt>0</EOYAmt>
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      <EscrowAccountLiabilityGrp>
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        <EOYAmt>23953</EOYAmt>
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      <LoansFromOfficersDirectorsGrp>
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        <EOYAmt>0</EOYAmt>
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      <MortgNotesPyblScrdInvstPropGrp>
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        <EOYAmt>6235846</EOYAmt>
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      <UnsecuredNotesLoansPayableGrp>
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        <EOYAmt>0</EOYAmt>
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      <OtherLiabilitiesGrp>
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        <EOYAmt>0</EOYAmt>
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      <TotalLiabilitiesGrp>
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        <EOYAmt>7601967</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
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        <EOYAmt>3833694</EOYAmt>
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        <EOYAmt>69620</EOYAmt>
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        <EOYAmt>4658364</EOYAmt>
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      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>12671100</BOYAmt>
        <EOYAmt>12260331</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>-435014</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>1674</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>-11784</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>false</AccountantCompileOrReviewInd>
      <FSAuditedInd>true</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolAndSepBasisFinclStmtInd>X</ConsolAndSepBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>true</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>true</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>true</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="IRS990ScheduleA">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="IRS990ScheduleB">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
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      <TotalDirectLobbyingGrp />
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      <OtherExemptPurposeExpendGrp />
      <TotalExemptPurposeExpendGrp />
      <LobbyingNontaxableAmountGrp />
      <GrassrootsNontaxableGrp />
      <TotLbbyngGrassrootMnsNonTxGrp />
      <TotLbbyExpendMnsLbbyngNonTxGrp />
      <VolunteersInd>false</VolunteersInd>
      <PaidStaffOrManagementInd>false</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>false</MediaAdvertisementsInd>
      <MailingsMembersInd>false</MailingsMembersInd>
      <PublicationsOrBroadcastInd>false</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>false</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>false</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>false</RalliesDemonstrationsInd>
      <OtherActivitiesInd>true</OtherActivitiesInd>
      <OtherActivitiesAmt>134</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>134</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>false</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule C, Part II-B</FormAndLineReferenceDesc>
        <ExplanationTxt>Lobbying Activity Explanation: Minnesota Valley Health Center, Inc. pays dues to a certain organization related to the industry which has lobbying expenses. The amount listed is the percentage of the dues paid that were used for lobbying.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="IRS990ScheduleD">
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      <HeldWorksArtGrp />
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      <InclEscrowCustodialAcctLiabInd>true</InclEscrowCustodialAcctLiabInd>
      <ExplanationProvidedInd>X</ExplanationProvidedInd>
      <CYEndwmtFundGrp>
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        <GrantsOrScholarshipsAmt>28393</GrantsOrScholarshipsAmt>
        <AdministrativeExpensesAmt>8178</AdministrativeExpensesAmt>
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        <AdministrativeExpensesAmt>3594</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>633214</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
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        <AdministrativeExpensesAmt>1752</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>668715</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
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      <EndowmentsHeldUnrelatedOrgInd>false</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>false</EndowmentsHeldRelatedOrgInd>
      <LandGrp />
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      </BuildingsGrp>
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      <OtherAssetsOrgGrp>
        <Desc>BENEFICIAL INTEREST IN MN FDN</Desc>
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      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
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      <TotalRevEtcAuditedFinclStmtAmt>11008144</TotalRevEtcAuditedFinclStmtAmt>
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      <RevenueNotReportedAmt>1674</RevenueNotReportedAmt>
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      <TotalRevenuePerForm990Amt>11006470</TotalRevenuePerForm990Amt>
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      <ExpensesSubtotalAmt>11441484</ExpensesSubtotalAmt>
      <TotalExpensesPerForm990Amt>11441484</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part IV, Line 2b</FormAndLineReferenceDesc>
        <ExplanationTxt>Minnesota Valley Health Center, Inc. acts as custodian for the funds of the residents. Resident trust funds totaled $7,668 at June 30, 2015. During that same time Minnesota Valley Health Center, Inc. holds $16,285 in a separate account for tenant security deposits for Sunrise Plaza.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part V, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>MINNESOTA VALLEY HEALTH CENTER, INC.'S INTENDED USE OF ITS ENDOWMENT FUNDS IS FOR CAPITAL AND OTHER IMPROVEMENTS THAT FURTHER MINNESOTA VALLEY HEALTH CENTER, INC.'S MISSION.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="IRS990ScheduleH">
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      <WrittenPolicyInd>true</WrittenPolicyInd>
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      <FPGReferenceFreeCareInd>true</FPGReferenceFreeCareInd>
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        <FreeCareOtherPct>160.</FreeCareOtherPct>
      </FreeCareOthPercentageGrp>
      <FPGReferenceDiscountedCareInd>true</FPGReferenceDiscountedCareInd>
      <FreeCareMedicallyIndigentInd>true</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>true</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>false</ExpensesExceedBudgetInd>
      <AnnualCommunityBnftReportInd>true</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>true</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <PersonsServedCnt>47</PersonsServedCnt>
        <TotalCommunityBenefitExpnsAmt>31753</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>31753</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00280</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
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        <TotalCommunityBenefitExpnsAmt>1736288</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>1963140</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>-226852</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.02020</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <TotalFinancialAssistanceTyp>
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        <TotalCommunityBenefitExpnsAmt>1768041</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>1963140</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>-195099</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01740</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
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      <BadDebtExpenseReportedInd>true</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>213000</BadDebtExpenseAmt>
      <BadDebtExpenseAttributableAmt>550</BadDebtExpenseAttributableAmt>
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      <CostOfCareReimbursedByMedcrAmt>2872503</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-18088</MedicareSurplusOrShortfallAmt>
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        <OtherInd>X</OtherInd>
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      <WrittenDebtCollectionPolicyInd>true</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>true</FinancialAssistancePrvsnInd>
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          <AddressLine1Txt>621 South 4th Street</AddressLine1Txt>
          <CityNm>Le Sueur</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>56058</ZIPCd>
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        <WebsiteAddressTxt>www.mvhc.org</WebsiteAddressTxt>
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        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
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        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
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        <ConsultingProcessInd>X</ConsultingProcessInd>
        <InformationGapsInd>X</InformationGapsInd>
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        <TakeIntoAccountOthersInputInd>true</TakeIntoAccountOthersInputInd>
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        <CHNAReportWidelyAvailableInd>true</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>See Part V, Section C</OwnWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <RptAvailableThruOtherMethodInd>X</RptAvailableThruOtherMethodInd>
        <ImplementationStrategyAdoptInd>true</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>12</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>See Part V, Section C</StrategyWebsiteURLTxt>
        <StrategyAttachedInd>false</StrategyAttachedInd>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
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        <FPGFamilyIncmLmtFreeCarePct>160.</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>310.</FPGFamilyIncmLmtDscntCarePct>
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        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
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        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>See Part V, Section C</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>See Part V, Section C</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>See Part V, Section C</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
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        <FAPNoticeDisplayedInd>X</FAPNoticeDisplayedInd>
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        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
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        <DocumentedEligDeterminationInd>X</DocumentedEligDeterminationInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <OtherMethodUsedInd>X</OtherMethodUsedInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>false</GrossChargesInd>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Part V, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Checked "No", so not applicable. Part V, Line 3j The Community Health Needs Assessment also includes a Community Health Profile. The profile is based on data from the Behavioral Risk Factors Surveillance System and the University of Wisconsin Population Health Institute County Health Rankings. Part V, Line 5 Two Community/Patient Focus Groups were held for community members to identify and prioritize their community health needs. In addition, persons were consulted at Town Hall Meetings, which was designed to address each prioritized health need. During the Town Hall Meeting, intervention options for meeting the health need were presented, and participants selected the option best suited to their community. Individuals from the following organizations attended the Town Hall Meeting (names and titles available upon request): City of Le Sueur, Community/Patient Focus Groups, First Choice Pharmacy, Hillside Court Public Housing, Le Sueur Assisted Living and Memory Care, Le Sueur Chamber of Commerce, Le Sueur County Public Health, Le Sueur News Herald, Mayo Clinic Health System Le Sueur, Sibley County Public Health and Human Services, Sunrise Plaza Independent Living Apartments, and Youth Opportunities. See the CHNA posted on the website listed in Part V, Line 7a for a list of organizations that were invited to, but did not attend the town hall meetings. Employees of Le Sueur County Public Health and Sibley County Public Health and Human Services (names and titles available upon request) attended the Town Hall Meeting and provided input on intervention options for addressing the highest priority health need. The majority of Minnesota Valley Health Center, Inc.s service area is rural. Given the known health disparities of rural populations, all attendees of the Community/Patient Focus Groups and Town Hall Meetings are representatives and/or members of medically-underserved and low income populations, as well as populations with chronic disease needs. Community/Patient Focus Group participants were specifically instructed to consider themselves as representatives of the community-at-large. Participants at the Town Hall and Intervention Planning Meetings serve more formal leadership or representative roles. An elected official of the City of Le Sueur (name and title available upon request) attended the Town Hall Meeting. An employee of Hillside Court Public Housing also attended the Town Hall Meeting (name and title available upon request). In Le Sueur and Sibley Counties, more than 90% of the residents are Caucasian. However, as attendees at the Community/Patient Focus Groups were instructed to act as representatives of the entire community, and data stratified by race/ethnicity were presented, health needs of minority populations were considered. As city elected officials represent the entire electorate, including minorities, minority populations were represented by the elected official of the City of Le Sueur as well. Part V, Line 6a Minnesota Valley Health Center, Inc. was affiliated with Essentia Health through June 30, 2015. In the interest of efficiency, cost effectiveness, and alignment with Essentia Health population health strategies, the hospital facilitys CHNA was conducted in a coordinated process with fourteen other Essentia Health hospital facilities. While still allowing for tailoring to each particular hospital facility, procedures were standardized across hospital facilities. The hospital facilities included in this coordinated process are: Essentia Health Ada in Ada, MN; Clearwater Valley Hospital and Clinics, Inc. in Orofino, ID; Essentia Health Deer River in Deer River, MN; Essentia Health Virginia in Virginia, MN; Essentia Health Holy Trinity Hospital in Graceville, MN; Essentia Health West in Fargo, ND; Minnesota Valley Health Center, Inc. in Le Sueur, MN; Essentia Health Northern Pines in Aurora, MN; Essentia Health Sandstone in Sandstone, MN; Essentia Health Duluth in Duluth, MN; Essentia Health St. Josephs Medical Center in Brainerd, MN; Essentia Health St. Marys Hospital-Superior in Superior, WI; St. Marys Hospital, Inc. in Cottonwood, ID; Essentia Health St. Marys Medical Center in Duluth, MN; and Essentia Health St. Marys-Detroit Lakes in Detroit Lakes, MN. Since Essentia Health West joined the collaborative effort on February 1, 2013, not all aspects of the Essentia Health West CHNA are coordinated with those of the other hospital facilities. The hospital facility did not collaborate with any other hospital facility outside of the Essentia Health System. Part V, Line 6b not applicable Part V, Line 7a The CHNA is posted at http://mvhc.org/files/2014/4891/0304/MVHC_CHNA_IS_FY14_Progress_Report_and _FY15_Updates_11-2015.pdf Part V, Line 7d Links to the report were emailed to the Minnesota Hospital Association (MHA) to catalog the assessments and make them available on their website to help members meet IRS requirements for wide dissemination of reports. The MHA will also analyze the assessments to identify common themes, issues and needs on a statewide and regional basis. Finally, the MHA will use the catalog as a vehicle for connecting hospitals with similar community needs with one another to explore joint implementation strategies, information sharing, or resources for making their community benefit activities as influential as possible. Part V, Line 10a The hospital facility's most recently adopted implementation strategy is posted on the Hospital Facility's homepage at: http://www.mvhc.org/ Part V, Line 10b The hospital facility's most recently adopted implementation strategy has not been attached to this return because the link has been provided above. Part V, Line 11 Seven health needs were identified through the most recently-conducted CHNA. Obesity, physical activity, and nutrition as risk factors for chronic diseases, such as type 2 diabetes was the highest priority health need identified and is addressed as a part of the hospital facilitys implementation strategy. The actions taken by the hospital facility to address this significant health need include implementation of two activities. The first activity is the Win With Wellness BINGO program (developed by Riverwood Healthcare Center in Aitkin, MN) that is designed to make wellness activities fun and easy for the whole family, while possibly developing healthy habits, such as eating new fruits, taking the stairs, and going for walks. The program is open to the entire community; opportunities to participate are located at Le Sueurs Corner Drug Pharmacy, Le Sueur Community Center, and the Minnesota Valley Health Center, Inc. facility. At each location, community members obtain BINGO cards that list healthy, attainable lifestyle activities. Participants check-off activities once they have been performed. Once all activities in a vertical, horizontal, or diagonal row are checked-off, the participant has BINGO and may enter their name in monthly prize drawings. New BINGO cards are available quarterly. Prize recipients, prize value, and frequency of winning are monitored. The goal of the program is to remind and incentivize community members to participate in healthy activities. As many of the activities relate to nutrition and physical activity, participation helps to address the highest priority health need identified, as well as general wellness. The hospital facility purchased the campaign, maintains the prize entry form on its website, and provides the prizes. Online access is advertised on all three community BINGO displays and a link with wellness tips is provided. The wellness tips are updated weekly on the site. New BINGO cards with different wellness tips and suggestions are provided quarterly throughout the year by the hospital facility. The second activity to address the highest priority health need is a Diabetes Behavior Monitoring Program (DBMP) for individuals with a recent diagnosis of diabetes. Enhanced Type 2 Diabetes Self-Management Education was the intervention selected by community members to address the highest priority health need. The hospital facility supports a local pharmacys ability to successfully implement DBMP. The pharmacist will interview individuals with newly-diagnosed diabetes in order to obtain potential class participants. Individuals with pre-diabetes and a longer history of diabetes will also be accepted into the program. Once an individual agrees to participate, an individual assessment will be done to identify knowledge deficits. The pharmacist will ascertain teaching points focused on the individual with a behavior component. The class curriculum will then be determined based on the identified knowledge deficits of the participants. On behalf of the hospital facility, Essentia Health will commit time of a Certified Diabetes Educator/Registered Nurse at who will support the pharmacist in program development and provide consultation as needed. The hospital facility will not directly meet the six unprioritized he</ExplanationTxt>
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      <FacilityNum>2</FacilityNum>
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        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Minnesota Valley Care Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>621 South 4th Street</AddressLine1Txt>
            <CityNm>Le Sueur</CityNm>
            <StateAbbreviationCd>MN</StateAbbreviationCd>
            <ZIPCd>56058</ZIPCd>
          </USAddress>
          <FacilityTxt>Skilled Nursing Facility</FacilityTxt>
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        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Sunrize Plaza</BusinessNameLine1Txt>
          </BusinessName>
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            <AddressLine1Txt>600 South 5th Street</AddressLine1Txt>
            <CityNm>Le Sueur</CityNm>
            <StateAbbreviationCd>MN</StateAbbreviationCd>
            <ZIPCd>56058</ZIPCd>
          </USAddress>
          <FacilityTxt>Senior Apartments</FacilityTxt>
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      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, line 1</FormAndLineReferenceDesc>
        <ExplanationTxt>Provide the description required for Part I, lines 3c, 6a, 7g, 7, column (f), 7; Part II; Part III, lines 2, 3, 4, 8, 9b: Part I, line 3c Assets will be considered along with the patients income to determine eligibility for the Financial Assistance Program. To be eligible, reportable assets may not exceed $15,000 for a household of one (1), or $25,000 for a household of two (2) or more. Assets may include, but are not limited to, such items as checking and savings accounts, IRAs, 401(k)s; value of additional cars that exceed the number of working members in the household, equity in recreational vehicles and additional property, etc. Part I, line 6a Minnesota Valley Health Center, Inc.'s community benefit information was consolidated into the Essentia Health community benefit information which was included in the Essentia Health annual report. The annual report is made available to the public at http://www.essentiahealth.org/Main/Annual-Report.aspx. Essentia Health, headquartered in Duluth, Minn., is an integrated health system serving patients in Minnesota, Wisconsin, North Dakota and Idaho and was Minnesota Valley Health Center, Inc.'s parent corporation through June 30, 2015. Part 1, line 7g Not Applicable. Part I, line 7, column (f) Bad debt expense that was subtracted from total expense to obtain the % of community benefit to total expense amounted to $213,000. Part I, line 7 The cost to charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges was used to calculate the costs for the following community benefits: Charity Care and Unreimbursed Medicaid. Actual costs were used for the remainder of the community benefits reported. Part II Not applicable. Part III, line 2 Discounts, charity care, and bad debt expense are accounted for as reductions to revenue. Bad debt expense on patient accounts would be identified as any balance on the account, less any previous payments and discounts, that has aged and is absent of any payments. If, during the collection process, it becomes known that the patient qualifies for charity care, the amounts included within bad debt expense would be reclassified to charity care. Part III, Line 3 Minnesota Valley Health Center, Inc. was a part of a larger organization, Essentia Health, through June 30, 2015. Essentia Health and its member organizations incorporated the cost of bad debt as a community benefit. As a tax exempt hospital, they must provide the necessary services regardless of the patients ability to pay for that care. In doing so, Essentia Health made quality patient care available to all in the community, regardless of their economic means. Part III, Line 3 Minnesota Valley Health Center, Inc. applied a high-level, conservative analytic review by multiplying the ratio of charitable allowances to gross patient revenue against bad debt expense to arrive at an approximation of charity care that resides in bad debt. Part III, line 4 Page 7 of the audit contains the footnote describing the organizations bad debt expense. Part III, line 8 The methodology used in determining the reported Medicare Allowable Cost begins with the hospital's general ledger system. The costs are obtained from the general ledger and then adjusted and reported in accordance with Centers for Medicare Services (CMS) "cost finding" guidelines as published in their Provider Reimbursement Manual. Once the Medicare allowable costs are determined from the hospital's cost report, any costs attributed to subsidized health services, and Medical Education, are removed and reported separately. Part III, line 8 Not applicable. Part III, line 8 Minnesota Valley Health Center, Inc. was a part of a larger organization, Essentia Health, through June 30, 2015. Essentia Health and its member organizations incorporated the full value of the Medicare shortfall as a community benefit. The rationale for the organization's opinion is providing care for the elderly and serving Medicare patients is an essential part of the community benefit standard. Medicare, like Medicaid, does not pay the full cost of care and it is likely to get worse. Many Medicare beneficiaries are poor and are eligible for Medicaid in addition to Medicare. Medicare underpayment must be shouldered by the hospital in order to continue treating the communitys elderly and poor. These underpayments represent a real cost of serving the community. Part III, line 9b The policies and procedures for internal and external collection practices take into account the extent to which the patient qualifies for the Financial Assistance Policy (FAP) and financial assistance, a patients good faith effort to apply for a governmental program or for financial assistance from Minnesota Valley Health Center, Inc. and the patients good faith effort to comply with his/her payment agreements. Minnesota Valley Health Center, Inc. offers extended payment plans to eligible patients and will not impose liens on primary residences nor will we report patients to a credit rating agency for outstanding patient bills. Minnesota Valley Health Center, Inc. will not charge a patient gross amount of charges for any uninsured treatment. Uninsured discounts will be applied to the gross charges prior to any FAP or other discounts. At any time Minnesota Valley Health Center, Inc. recognizes that a patient may be eligible for State or Federal programs, a representative will assist the patient in obtaining information about those programs or provide contact information for those programs. Minnesota Valley Health Center, Inc. contracts with an outside patient advocacy agency, which may provide assistance to the uninsured patient in applying to certain State and Federal programs. At any stage of the patient experience and up through the collection process, the patient may express a concern that they are unable to pay their bill in full or meet the payment plan requirements. At that time, the patient will be given every opportunity to complete and submit an application for financial assistance. Minnesota Valley Health Center, Inc. trains its outside debt collection agencies and attorneys about the Financial Assistance Policy and how a patient may obtain more information about the FAP or submit an application for financial assistance. Minnesota Valley Health Center, Inc. requires its outside collection agencies and attorneys to refer patients who may be eligible for financial assistance to Minnesota Valley Health Center, Inc. If a patient has submitted an application for financial assistance after an account has been referred for collection activity, Minnesota Valley Health Center, Inc. and its outside debt collection agencies suspend all collection activity until the patients financial assistance application has been processed and Minnesota Valley Health Center, Inc. has notified the patient of its decision.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Needs Assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B: Minnesota Valley Health Center, Inc. (MVHC) is a licensed 15 bed critical access hospital in Le Sueur MN and is the only hospital in Le Sueur County. MVHC works with the only local primary care physician clinic in Le Sueur, Sibley County Public Health, Nicollet County Public Health and Le Sueur County Public Health Agencies for assessing the needs of the rural communities in our area. These needs are determined by several different methods, but mostly based on what these agencies are actually seeing when they are working with their clients. This communication is ongoing throughout the year. Minnesota Valley Health Center, Inc. is a member of a local non-profit group called Community Wellness Collaboration. The mission of this group is to address depression, bullying and suicide prevention in our community. Other members of this collaboration are: Le Sueur County Public Health and Social Services, a local family practice clinic, law enforcement agencies and a local school. The Collaboration meets monthly and has recently worked with another health agency to develop an action plan. The Collaboration was formed in the last two years and is based on what these agencies were seeing either in the emergency room, clinic visits, ambulance calls, incidents at school and calls to law enforcement. The Collaboration was deemed necessary as the number of these events have been increasing.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization's charity care policy: Minnesota Valley Health Center, Inc. makes information on its Financial Assistance Policy (FAP) readily available to the patient. Information about financial assistance programs, that were in place through June 30, 2015, is available on the Essentia Health (parent company through June 30, 2015) website (www.essentiahealth.org) where the Information and application were easily accessible to be viewed, downloaded and printed at no charge to the patient. Notices on the availability of financial assistance are conspicuously posted in emergency room departments. Financial assistance information is available during the pre-admission financial screening, at the time of registration and prior to a hospital discharge. Information about the FAP is in all collection letters and patient statements. FAP information and/or applications are made available to appropriate community health services agencies and other organizations that assist people in need. Minnesota Valley Health Center, Inc. educates staff members who work closely with patients providing direct patient treatment and who work in admissions, billing and collections, about the existence of the FAP and how a patient may obtain more information. Annual education/awareness of the FAP is provided to ensure all employees with patient contact are aware of the program and how patients can obtain additional information. Clinical and hospital staff who provide direct patient care have knowledge of the FAP and know to direct patients to a Registration Interviewer or Business Office Representative. Registration staff have an understanding of the policy, knowledge of where the related documents are located and where to direct the patient for more information on the FAP. Designated employees (Financial Counselors; Patient Accounts Representatives) have a thorough understanding of the FAP and offer the information on the FAP to those patients who make an inquiry about the program or are determined through a financial screening that the patient may be eligible for this program. Patient advocacy services also inform the patient about the availability of assistance. A request for financial assistance may be made by the patient, a patient's guarantor, a family member, close friend, or associate of the patient, subject to applicable privacy laws. Minnesota Valley Health Center, Inc. responds to any oral or written requests for more general information on the FAP made by a patient or any interested party.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves: Minnesota Valley Health Center, Inc. is located in Le Sueur, MN. Minnesota Valley was a part of the larger Essentia Health system, through June 30, 2015, which is defined in Part VI, line 6. Minnesota Valley Health Center, Inc. operates a critical access hospital, a long-term care facility, and a 37 unit HUD-subsidized low income housing for seniors that serve the communities of Le Sueur, Nicollet and Sibley counties. The overall community is classified as rural. Minnesota Valley Health Center, Inc. and its related facilities cover a service region of approximately 28,000 people. The service region age distribution is 22% under the age of 18; 64% between the ages of 18 and 65; and 14% over the age of 65. The racial makeup of the service region is 97% Caucasian; 2% Black or African American; and 1% Asian. The gender split ratio is 50% women and 50% men. The average income for the service area is approximately $62,000. Approximately 6.2% of the population falls below the federal poverty guidelines. Minnesota Valley Health Center, Inc., along with Essentia Health is committed to serve patients regardless of their ability to pay. 13.2% net revenue dollars were from self pay patients. In addition, approximately 13.6% of their net revenue dollars were Medicaid recipients. As mentioned above, Minnesota Valley Health Center, Inc. was part of a larger system, Essentia Health, through June 30,2015. Essentia Health staffs hospitals and clinics in federally-recognized underserved areas and supports the health of its communities through an active outreach program that brings specialists like oncologists, cardiologists, neurologists and others into its smaller communities. This eliminates barriers to care for many patients, particularly those who are elderly, living on low incomes, or are faced with other challenges that make it difficult to travel long distances for care. There are no other hospitals outside of the Essentia Health umbrella that service the community.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>Provide any other information important to describing how the organization's hospitals or other health care facilities further its exempt purpose by promoting the health of the community: Minnesota Valley Health Center, Inc.'s board of directors is a volunteer board consisting of local community members with a cross section of occupations. One of the representatives is appointed by the Le Sueur City Council. None of the board members are employees, related to employees or are independent contractors of the organization. Given that we are a small community if a vote comes up for something that could appear to be a conflict of interest the board member will abstain from voting. Our Medical Staff consists of our emergency room director and the providers from the Mayo Clinic Health System - Mankato. Minnesota Valley Health Center, Inc. is an open medical staff; therefore any qualified physician of the community is allowed to apply. All applicants that apply must meet the credentialing standards and be approved by our governing board in order to provide services in our system. Due to the low per diem rate which is set by the State of MN for our nursing home, any surplus that is generated is being generated by the hospital services, which in turn keeps the nursing home open. Our nursing home has earned a 5 star rating again this past year. The 5 star rating is based on health inspections, quality measures and staffing. Any surplus cash is used to update medical equipment for both the hospital and nursing home. Any and all emergency repairs or equipment needs that arise are taken care of immediately. The Adult Day Health Services program is assisted by the hospital services. Most of the clients in the Adult Day Health Services program are on the Elderly waiver program and payment from this program doesn't cover all of the staff time or the cost to transport the client from home to our site and back home again, yet it is a much needed service in our community. We offer a meals on wheels program for home bound residents and most of those meals are paid for through an Elderly Waiver program through the county, which just covers the cost of the food. Volunteers deliver meals to home bound clients Mondays-Fridays, this past year 1256 meals were prepared and delivered. We have evening events for the community such as 'Lined in Pink' for breast cancer awareness and flu shot clinics. We participate in local community events such as: super Saturday Kids event, youth safety camp, school supplies and winter clothing drives for the school, food shelf drive and 5k walk/run event two times a year. We also participate with the community's Senior Expo each year that highlights services to seniors. We have the emergency helicopter here for events for the community to come and meet them and be aware of these services. During the past year Minnesota Valley Health Center, Inc., in collaboration with Mayo Clinic Health Systems - Mankato, had a booth at the annual retail and business expo that was held at the local mall to educate the community on services available at the health center. The outpatient clinic wing provides space for visiting specialists (cardiology, podiatry, orthopedics, urology, general surgery) from other health care systems to see patients locally and to perform outpatient procedures locally. Most of our population is elderly and are unable to drive great distances so they are able to receive care from specialists locally. Minnesota Valley health Center, Inc., through June 30, 2015, was a part of Essentia Health, a fully integrated health system with facilities in Minnesota, Wisconsin, North Dakota and Idaho. As a non-profit organization, Essentia Health reinvests surplus revenues into medical training, programs and technology that improve patient care. Essentia Health provides services predominantly in rural communities and is committed to eliminating geographic barriers to care. We strive to provide high-quality, patient-centered care close to home for the communities we serve. We continue to upgrade facilities and technology, such as MRIs, CT scanners and surgery suites, to ensure patients in rural communities have nearby access to these services. In addition, we have recently completed several major construction projects, which include a new $50 million wing for our Fargo hospital and several rural community clinics. Essentia Health was one of the first Accountable Care Organizations in the country to receive the highest level of accreditation from the National Committee for Quality Assurance (NCQA). As an ACO, Essentia Health is committed to meeting the Triple Aim of improving care and population health, while reducing the overall costs for patients and society as a whole. The formation of our ACO, along with ongoing management and process improvement, represents a significant investment for Essentia Health. Since a majority of healthcare costs are directly related to caring for patients who have chronic conditions, Essentia Health has developed medical homes, which are designed to improve health outcomes for patients, especially those with chronic diseases. Much of this work is not fully reimbursed by state or federal programs. Essentia Health supports the health of our communities through active research and clinical trials through the Essentia Institute of Rural Health. The Institute conducts clinical, translational and health services research with a primary focus on the needs of rural Americans. Various Essentia Health organizations contributed approximately $4.25 million in support to the Institute during the past year.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served: Minnestoa Valley Health Center, Inc., through June 30, 2015, was part of Essentia Health, an integrated health system with 16 hospitals, 68 clinics, eight long-term care facilities, two assisted living facilities, five independent living facilities, five ambulance services and one research institute in four states: Minnesota, Wisconsin, North Dakota and Idaho. The health system serves a predominantly rural population whose median incomes generally fall below averages of the states where they live. The presence of our clinics and hospitals ensures that people with few economic resources dont have to drive an hour or more to receive basic (and in some cases life-saving) medical care. In addition to staffing hospitals and clinics in federally recognized underserved areas, we support the health of our communities through an active outreach program that brings specialists like oncologists, cardiologists, neurologists and others into our smaller communities. This eliminates barriers to care for many patients, particularly those who are elderly, living on low incomes, or faced with other challenges that make it difficult to travel long distances for care. Our size and integrated structure allow us to offer patients services often found only in larger urban settings. Services ranging from chemotherapy to congestive heart failure management and hospice are available to patients in many of the rural communities we serve. Essentia Health also supports the health of our rural communities through active research and clinical trials by the Essentia Institute of Rural Health. The Institute conducts clinical, translational and health services research with a primary focus on the needs of rural Americans. Essentia Health is also serving patients through the use of our electronic health record (EHR). The vast majority of Essentias hospitals and clinics are using a fully-integrated EHR for patient care. Technology like the electronic health record and Essentias telehealth program allows health clinicians to share test results and consult with colleagues in real time across great distances. Medical information is no longer lost in the shuffle of paper records an important consideration in a region where patients must often be transferred to a larger Essentia facility for complex surgeries or medical care. Essentia is also actively working with government agencies and insurers to develop innovative and cost-effective approaches to care that will improve health outcomes while reducing overall costs to patients and insurers. This innovation can be found in our use of remote home monitors for patients with congestive heart failure and our focus on using a team-based approach to helping patients manage chronic diseases. Essentia Health is committed to helping patients and their families lead active and fulfilling lives in the small and large communities where they live. We hope to become a model of healthcare delivery, particularly in rural areas, in the years to come.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 7</FormAndLineReferenceDesc>
        <ExplanationTxt>If applicable, identify all states with which the organization, or a related organization, files a community benefit report: Minnesota Valley Health Center, Inc. files a community benefit report in Minnesota.</ExplanationTxt>
      </SupplementalInformationDetail>
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        <PersonNm>MICHAEL HEDRIX</PersonNm>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part I, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>ESTABLISHING CEO'S COMPENSATION: MINNESOTA VALLEY HEALTH CENTER, INC. RELIED ON ESSENTIA HEALTH'S, RELATED ORGANIZATION OF MINNESOTA VALLEY HEALTH CENTER, INC. through June 30, 2015, METHODS FOR ESTABLISHING MINNESOTA VALLEY HEALTH CENTER, INC.'S PRESIDENT'S COMPENSATION: A COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part I, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Supplemental nonqualified retirement plan: Essentia Healths nonqualified retirement plan is offered to designated Essentia Health executives. There is a minimum two year vesting date, or vesting is automatic upon reaching retirement age, death, disability or involuntary termination without cause. Benefits are subject to income taxes upon vesting and payable from Essentia Healths general assets. Reported as Retirement and Other Deferred Compensation in Schedule J, Part II, Column C, Essentia Health made contributions, subject to the vesting terms, during the year into the supplemental nonqualified retirement plan on behalf of the following individuals listed in Form 990, Part VII, Section A, Line 1a: Michael Hedrix $11,533</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part III, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Program service accomplishments: Minnesota Valley Health Center, Inc. is created &amp; organized exclusively for charitable and educational purposes. Minnesota Valley Health Center, Inc. is created and organized to own, maintain, operate and conduct, directly or indirectly, and to assist and coordinate activities of facilities for health care, education, care for the aged and social services. Minnesota Valley Health Center, Inc. includes a hospital, outpatient specialty clinics, complete lab and radiology departments, a comprehensive physical, occupational and speech therapy department, extended care nursing facilities, an Adult Day Health Center, and independent living senior housing. Minnesota Valley Health Center, Inc. is the 3rd largest employer in a community of approximately 4,000. Minnesota Valley Health Center, Inc. is licensed for 15 beds, had 54 inpatient days, 457 swing bed days, and 17,855 long term care days during the fiscal year ended June 30, 2015. There were 1,766 emergency room visits and 12,288 outpatient visits during the same time period. Also, during fiscal year 2015 there were 1,256 meals delivered to community members through the Meals on Wheels Program and 5,343 meals were served to residents at the independent living apartments. The adult day health service saw an average of 4 clients a week. Minnesota Valley Health Center, Inc. provided over $31,000 in charity care during the fiscal year ended June 30, 2015. Further community benefits provided during the fiscal year include community services of over $33,000.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Significant Changes to Governing Documents: Effective June 30, 2015, the Articles of Incorporation and Bylaws of Minnesota Valley Health Center, Inc. were amended. Critical Access Group (CAG) was removed as the sole corporate member with voting rights and assets will no longer be distributed to them upon dissolution. Additionally, Essentia Health's reserved powers were removed. The Bylaw amendments decreased the maximum number of Board Directors from 11 to 9 and the Secretary and Treasurer officer positions were combined. The directors not appointed by the City of LeSueur may now be filled by affirmative vote of a majority of the remaining directors rather than by CAG, and the directors not appointed by the City of LeSueur may now be removed at any time by a 67% vote rather than by CAG.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS OF ORGANIZATION: CRITICAL ACCESS GROUP WAS THE SOLE MEMBER OF MINNESOTA VALLEY HEALTH CENTER, INC. THROUGH JUNE 30, 2015. MEMBERS, CITY OF LESUEUR AND CRITICAL ACCESS GROUP, WERE ABLE TO ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY AS DESCRIBED IN SCHEDULE O PART VI LINE 7A. ESSENTIA HEALTH HAD RESERVED POWERS WITH RESPECT TO MINNESOTA VALLEY HEALTH CENTER, INC. AS DESCRIBED IN SCHEDULE O PART VI LINE 7B.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7a</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS WITH RIGHT TO ELECT GOVERNING BODY: THE CITY OF LESUEUR APPOINTS AND REMOVES ONE BOARD DIRECTOR. Through JUNE 30, 2015, CRITICAL ACCESS GROUP HAD THE ABILITY TO APPOINT AND REMOVE MINNESOTA VALLEY HEALTH CENTER INC.'S REMAINING GOVERNING BODY.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7b</FormAndLineReferenceDesc>
        <ExplanationTxt>Governance, Management, and Disclosures: Through June 30, 2015, MINNESOTA VALLEY HEALTH CENTER, INC. WAS A SUBSIDIARY OF ESSENTIA HEALTH, WHOSE BOARD OF DIRECTORS HAD RESERVED POWERS WITH RESPECT TO THIS CORPORATION AND ITS SUBSIDIARIES, AND ALL OF THE OTHER DIRECT AND INDIRECT SUBSIDIARIES OF ESSENTIA HEALTH (COLLECTIVELY, THE "SYSTEM"). ESSENTIA HEALTH'S RESERVED POWERS WERE AS FOLLOWS: STRATEGIC AND BUSINESS PLANS. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S STRATEGIC AND BUSINESS PLANS. MISSION. AUTHORITY TO CREATE, AND TO APPROVE, THE MISSION, PURPOSE AND VISION STATEMENTS FOR ALL ENTITIES IN THE SYSTEM BY THE AFFIRMATIVE VOTE OF AT LEAST 67% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS. DEBT. APPROVAL OF THE INCURRENCE OF DEBT BY, AND THE CREATION OF ALL MORTGAGES, LIENS, SECURITY INTERESTS, OR OTHER ENCUMBRANCES ON THE ASSETS OF, ALL ENTITIES IN THE SYSTEM IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS, AND THE AUTHORITY TO CAUSE ALL ENTITIES IN THE SYSTEM TO PARTICIPATE IN SYSTEM BORROWING. GOVERNING INSTRUMENTS. AUTHORITY TO CAUSE, AND TO APPROVE, AMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS OF ALL ENTITIES IN THE SYSTEM. MERGERS AND ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL MERGERS, CONSOLIDATIONS, AND DISSOLUTIONS OF ALL ENTITIES IN THE SYSTEM. AFFILIATIONS AND JOINT VENTURES. AUTHORITY TO CAUSE, AND TO APPROVE, ALL AFFILIATIONS, JOINT VENTURES AND OTHER ALLIANCES WITH THIRD PARTIES OF ALL ENTITIES IN THE SYSTEM. TRANSFER OF ASSETS WITHIN THE SYSTEM. AUTHORITY TO TRANSFER ASSETS, INCLUDING CASH, BETWEEN AND AMONG ENTITIES WITHIN THE SYSTEM; PROVIDED, HOWEVER, THAT ESSENTIA HEALTH SHALL NOT HAVE AUTHORITY TO REQUIRE ANY ENTITY IN THE SYSTEM TO TRANSFER ASSETS (A) THAT WOULD CAUSE SUCH ENTITY TO BE IN DEFAULT OF ITS COVENANTS OR OBLIGATIONS UNDER ANY BOND OR OTHER FINANCING DOCUMENTS; (B) FROM THE CATHOLIC ENTITIES TO THE SECULAR ENTITIES OR FROM THE SECULAR ENTITIES TO THE CATHOLIC ENTITIES IN A MANNER OR TO AN EXTENT THAT WOULD CAUSE THE CATHOLIC ENTITIES TO BE IN VIOLATION OF THE ETHICAL AND RELIGIOUS DIRECTIVES FOR CATHOLIC HEALTH CARE SERVICES (ERDS) IN THE JUDGMENT OF THE LOCAL ORDINARY; OR (C) SUCH THAT MONEY GENERATED BY SERVICES AT SECULAR FACILITIES WITHIN THE SYSTEM BY PROCEDURES THAT ARE CONTRARY TO THE ERDS WOULD BE USED AT THE CATHOLIC ENTITIES OR MONEY GENERATED BY CATHOLIC ENTITIES WOULD BE USED IN THE PROVIDING OF SERVICES CONTRARY TO THE ERDS AT SECULAR FACILITIES WITHIN THE SYSTEM. TRANSFER OF ASSETS OUTSIDE THE SYSTEM. AUTHORITY TO CAUSE, AND TO APPROVE, THE SALE, LEASE OR OTHER TRANSFER OF ASSETS OF ALL ENTITIES IN THE SYSTEM TO PARTIES OUTSIDE OF THE SYSTEM WHEN THE ASSET'S VALUE EXCEEDS THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY THE ESSENTIA HEALTH BOARD OF DIRECTORS. SERVICES. AUTHORITY TO CAUSE, AND TO APPROVE, THE ADDITION OF NEW SERVICES AND SERVICE LOCATIONS AND THE DISCONTINUANCE OF SERVICES AND SERVICE LOCATIONS WITHIN ALL ENTITIES IN THE SYSTEM. BUDGETS. APPROVAL OF CAPITAL AND OPERATING BUDGETS OF ALL ENTITIES IN THE SYSTEM. PROFESSIONAL SERVICES. SELECTION OF THE GENERAL LEGAL COUNSEL AND EXTERNAL AUDITORS OF ALL ENTITIES IN THE SYSTEM. ACQUISITIONS. AUTHORITY TO CAUSE, AND TO APPROVE, ALL ACQUISITIONS BY AND FORMATIONS OF ENTITIES IN THE SYSTEM. MARKETING. AUTHORITY TO IMPLEMENT SYSTEM-WIDE MARKETING AND PROMOTIONAL ACTIVITIES. COMPLIANCE PLANS. AUTHORITY TO CREATE, AND TO APPROVE, CORPORATE COMPLIANCE, SAFETY AND RISK MANAGEMENT PLANS FOR ENTITIES WITHIN THE SYSTEM. QUALITY PLAN. AUTHORITY TO CREATE, AND TO APPROVE, THE SYSTEM'S QUALITY PLAN. NON-BUDGETED PURCHASES. APPROVAL OF NON-BUDGETED CAPITAL PURCHASES AND LEASES IN EXCESS OF THE SINGLE OR ANNUAL AGGREGATE DOLLAR LIMITS PRESCRIBED IN WRITING BY ESSENTIA HEALTH FOR ENTITIES WITHIN THE SYSTEM. HUMAN RESOURCES. AUTHORITY TO CREATE HUMAN RESOURCE POLICIES AND PROCEDURES WITHIN THE SYSTEM. RESERVED POWERS. AUTHORITY TO CREATE ADDITIONAL ESSENTIA HEALTH RESERVED POWERS BY THE AFFIRMATIVE VOTE OF AT LEAST 80% OF THE ESSENTIA HEALTH BOARD OF DIRECTORS (EXCLUDING THE ESSENTIA HEALTH CEO); PROVIDED, HOWEVER, THAT ANY ADDITIONAL ESSENTIA HEALTH RESERVED POWERS SHALL NOT CONTRAVENE OR HINDER THE RESERVED POWERS OF BENEDICTINE SISTERS BENEVOLENT ASSOCIATION.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11a</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 REVIEW PROCESS: THE 2014 FORM 990, INCLUDING ALL SCHEDULES, WAS REVIEWED BY MINNESOTA VALLEY HEALTH CENTER, INC.'S MANAGEMENT AND GOVERNING BODY ON April 26th, 2016 PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. EACH CURRENT DIRECTOR OF THE GOVERNING BODY RECEIVED A FINAL COPY OF THE 2014 FORM 990. MINNESOTA VALLEY HEALTH CENTER, INC.'S EXECUTIVE DIRECTOR OF FINANCE LED THE REVIEW OF THE FORM AND SCHEDULES AND ANY QUESTIONS WERE DISCUSSED.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Monitoring and enforcing Conflict of Interest policy: Effective through June 30, 2015, Essentia Health's comprehensive conflict of interest program prevents, detects and resolves actual conflicts of interests or the actual or potential appearance of such. Fiduciaries, defined as an Essentia Health board member/trustee, officer, board committee member, senior management employee, or any others considered to be in a position of influence, are covered under Essentia's conflict of interest program. Upon initial appointment, each fiduciary must complete an initial conflict of interest statement and disclosure questionnaire. At the conclusion of each fiscal year, each fiduciary must complete an annual conflict of interest statement and disclosure questionnaire. As needed, a fiduciary will update his/her most recently completed questionnaire each time the fiduciary becomes aware of a financial interest, a potential conflict, or change to any information that the fiduciary previously reported. Essentia Health's Chief Compliance Officer will collect the questionnaires and evaluate the disclosures. If a fiduciary has a potential conflict of interest, the Chief Compliance Officer or designee may request additional information from the fiduciary, the management team, and others. During the evaluation process, the Chief Compliance Officer may also consult with Essentia Health's Board and Audit Committee Chairs, senior management, legal department, or appropriate representatives from Essentia Health. The Chief Compliance Officer reports to the Essentia Health Audit Committee and the Essentia Health Board of Directors any actual or potential conflicts of interest disclosed by the fiduciary, along with recommended actions. The Essentia Health Board of Directors (or designee) will then determine whether to approve the situation or to implement special controls to manage the potential conflict of interest. The Chief Compliance Officer will then officially notify the fiduciary in writing of the board's decision. The decision of whether or not the disclosure constitutes a conflict will be at the Essentia Health Board of Director's (or designee) sole discretion, and its concern must be the welfare of Essentia Health and its affiliate(s) and the advancement of its purposes. When the Essentia Health Board of Directors (or designee) considers a Fiduciary's disclosure as a Conflict of Interest, special controls will be identified to manage, eliminate or reduce the likelihood and/or appearance of a conflict arising. Controls may include, but are not limited to: A. If the conflict involves an on-going matter or relationship, the Fiduciary must not participate in Board, Board committee or management discussions related to the conflict and must recuse themselves and if appropriate, withdraw, from any Board meeting or portion thereof where the matter is being discussed and during the vote on the potential Conflict of Interest. The Fiduciary may answer questions at the Board's or the Board Committee's request. B. If the conflict involves a specific transaction or decision, the Fiduciary will fully disclose their interest and all related material facts. The Board or committee of the Board will determine whether the contemplated transaction may be authorized as just, fair, and reasonable to Essentia Health or its affiliate(s). If the Board determines a conflict does not exist, the Fiduciary may proceed with the transaction; however, he or she will not be eligible to vote on related issues should they arise. If the Board determines a conflict does exist, the Fiduciary will be notified of the decision regarding whether the contemplated transaction will be authorized as just, fair, and reasonable.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15 a&amp;b</FormAndLineReferenceDesc>
        <ExplanationTxt>PROCESS FOR DETERMINING COMPENSATION: Effective through June 30, 2015, the Executive Compensation Committee of Essentia Health's board of directors is authorized to fulfill the board's responsibilities regarding executive compensation consistent with Essentia's mission, values and tax-exempt status, and the Executive Compensation Committee's Charter. The Executive Compensation Committee meets at least twice annually to carry out its responsibilities, which include, but are not limited to, establishing, reviewing and modifying, as appropriate, reasonable compensation and benefits for designated Essentia executives who are officers or key employees of Essentia or any of its affiliates which may be paid by related organizations. The Executive Compensation Committee engages qualified independent compensation advisors to provide objective and impartial comparative data and to express opinions on total compensation reasonableness. The Executive Compensation Committee may request its independent advisors to: monitor comparability data and marketplace trends; make appropriate recommendations regarding salary ranges; and periodically review the market competitiveness of Essentia executive compensation packages. Prior to establishing or adjusting executive compensation, the Executive Compensation Committee will obtain and rely upon appropriate data as to comparability of the proposed compensation or adjustments. The Executive Compensation Committee will adequately document the basis for its determination concurrently with making those determinations. The Executive Compensation Committee minutes will include: the terms of the approved compensation and the date approved; the Executive Compensation Committee members present during the review, discussion and approval of the proposed compensation and those who voted on the proposed compensation; identification of the comparability data obtained and relied upon by the Executive Compensation Committee and how the data was obtained; any actions by a member of the Executive Compensation Committee having a conflict of interest; and documentation of the basis for the determination. The year this process was last undertaken for Minnesota Valley Health Center Inc.'s President and Executive Director of Finance was 2014.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Availability of governing documents, conflict of interest policy, &amp; financial statements to the public: Governing documents, conflict of interest policy, and financial statements are made available to the public upon request. The organization was part of Essentia Health's consolidated financial statements, through June 30, 2015, which are included in Essentia Health's annual report posted on Essentia Health's web site.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, Line 9</FormAndLineReferenceDesc>
        <ExplanationTxt>Other Changes in Net Assets: The total amount of other changes in net assets includes: Change in Beneficial Interest in Minnesota Foundation $(11,784)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XII, Line 3</FormAndLineReferenceDesc>
        <ExplanationTxt>Consolidated A-133: Minnesota Valley Health Center, Inc. was part of Essentia Health's consolidated financial statements and was required and underwent a consolidated audit set forth in the Single Audit Act and OMB Circular A-133. The consolidated audit is reviewed by the Essentia Health Audit Committee.</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:PHYSICIAN CONTRACTORS TOTAL FEES:836522</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:THERAPY SERVICES TOTAL FEES:581205</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:SCANNING SERVICES TOTAL FEES:153360</ExplanationTxt>
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        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:REFERENCE LAB &amp; X-RAY SERVICE TOTAL FEES:112658</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART IX LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>DESCRIPTION:MEDICAL &amp; ER DIRECTOR FEES TOTAL FEES:27000</ExplanationTxt>
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        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>523 N 3RD ST</AddressLine1Txt>
          <CityNm>BRAINERD</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>56401</ZIPCd>
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          <BusinessNameLine1Txt>BLIHS</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CLEARWATER VALLEY HOSPITAL &amp; CLINICS INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>301 CEDAR Ave</AddressLine1Txt>
          <CityNm>OROFINO</CityNm>
          <StateAbbreviationCd>ID</StateAbbreviationCd>
          <ZIPCd>83544</ZIPCd>
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        <EIN>820497771</EIN>
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          <BusinessNameLine1Txt>CAG</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S HOSPITAL INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>PO BOX 137</AddressLine1Txt>
          <CityNm>COTTONWOOD</CityNm>
          <StateAbbreviationCd>ID</StateAbbreviationCd>
          <ZIPCd>83522</ZIPCd>
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        <EIN>820226453</EIN>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CRITICAL ACCESS GROUP</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>503 E 3RD ST SUITE 400</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55805</ZIPCd>
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        <EIN>261219624</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>ESSENTIA</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ESSENTIA INSTITUTE OF RURAL HEALTH</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>502 E 2ND ST</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55805</ZIPCd>
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        <EIN>271291124</EIN>
        <PrimaryActivitiesTxt>RESEARCH</PrimaryActivitiesTxt>
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        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>DC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>INNOVIS HEALTH LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3000 32ND AVE S</AddressLine1Txt>
          <CityNm>FARGO</CityNm>
          <StateAbbreviationCd>ND</StateAbbreviationCd>
          <ZIPCd>58103</ZIPCd>
        </USAddress>
        <EIN>261175213</EIN>
        <PrimaryActivitiesTxt>CLINIC/HOSP</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DE</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>ESSENTIA</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S DULUTH CLINIC HEALTH SYSTEM</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>407 E 3RD ST</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55805</ZIPCd>
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        <EIN>411836633</EIN>
        <PrimaryActivitiesTxt>SUPPORT ORG</PrimaryActivitiesTxt>
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        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>ESSENTIA</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BRIDGES MEDICAL CENTER</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>503 E 3rd St Suite 400</AddressLine1Txt>
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          <ZIPCd>55805</ZIPCd>
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        <EIN>200479568</EIN>
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          <BusinessNameLine1Txt>INNOVIS</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH FOUNDATION</BusinessNameLine1Txt>
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          <AddressLine1Txt>502 E 2ND ST</AddressLine1Txt>
          <CityNm>DULUTH</CityNm>
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          <ZIPCd>55805</ZIPCd>
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        <EIN>271984704</EIN>
        <PrimaryActivitiesTxt>FOUNDATION</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>ESSENTIA</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>FIRST CARE MEDICAL SERVICES</BusinessNameLine1Txt>
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          <AddressLine1Txt>900 HILLIGOSS BLVD SE</AddressLine1Txt>
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          <BusinessNameLine1Txt>INNOVIS</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>GRACEVILLE HEALTH CENTER</BusinessNameLine1Txt>
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          <AddressLine1Txt>115 W 2nd ST</AddressLine1Txt>
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          <ZIPCd>56240</ZIPCd>
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        <EIN>410726173</EIN>
        <PrimaryActivitiesTxt>CLINIC/HOSP</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>INNOVIS</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S INNOVIS HEALTH</BusinessNameLine1Txt>
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          <AddressLine1Txt>1027 WASHINGTON AVE</AddressLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ESSENTIA HEALTH</BusinessNameLine1Txt>
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          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
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        <DisregardedEntityName>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>NORTHERN PINES MEDICAL CENTER</BusinessNameLine1Txt>
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          <ZIPCd>55705</ZIPCd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PINE MEDICAL CENTER</BusinessNameLine1Txt>
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          <AddressLine1Txt>109 COURT AVE S</AddressLine1Txt>
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        <EIN>411884597</EIN>
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          <BusinessNameLine1Txt>SMDC MEDICAL CENTER</BusinessNameLine1Txt>
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          <AddressLine1Txt>502 E 2ND ST</AddressLine1Txt>
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        <EIN>411878730</EIN>
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        <DisregardedEntityName>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
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          <BusinessNameLine1Txt>THE DULUTH CLINIC LTD</BusinessNameLine1Txt>
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          <AddressLine1Txt>400 E 3RD ST</AddressLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>POLINSKY MEDICAL REHABILITATION CENTER</BusinessNameLine1Txt>
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          <AddressLine1Txt>530 E 2ND ST</AddressLine1Txt>
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          <ZIPCd>55805</ZIPCd>
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        <PrimaryActivitiesTxt>rehab service</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>SMMC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S HOSPITAL OF SUPERIOR</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>3500 TOWER AVE</AddressLine1Txt>
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          <StateAbbreviationCd>WI</StateAbbreviationCd>
          <ZIPCd>54880</ZIPCd>
        </USAddress>
        <EIN>411811073</EIN>
        <PrimaryActivitiesTxt>CLINIC/HOSP</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>SMMC</BusinessNameLine1Txt>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ST MARY'S EMS</BusinessNameLine1Txt>
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          <AddressLine1Txt>1027 WASHINGTON AVE</AddressLine1Txt>
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          <ZIPCd>56501</ZIPCd>
        </USAddress>
        <EIN>411805811</EIN>
        <PrimaryActivitiesTxt>EMERG SVcS</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>SMRHC</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>DEER RIVER HEALTHCARE CENTER INC</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>115 10TH AVE NE</AddressLine1Txt>
          <CityNm>DEER RIVER</CityNm>
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          <ZIPCd>56636</ZIPCd>
        </USAddress>
        <EIN>410844574</EIN>
        <PrimaryActivitiesTxt>HOSP/CLIN/NH</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>SMDCHS</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PMC-Gateway Imaging LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>109 Court Ave S</AddressLine1Txt>
          <CityNm>Sandstone</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55072</ZIPCd>
        </USAddress>
        <EIN>261634764</EIN>
        <PrimaryActivitiesTxt>Imaging Services</PrimaryActivitiesTxt>
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        </DirectControllingEntityName>
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        <RelatedOrganizationName>
          <BusinessNameLine1Txt>East Range Clinics Ltd</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>910 6th Ave N</AddressLine1Txt>
          <CityNm>Virginia</CityNm>
          <StateAbbreviationCd>MN</StateAbbreviationCd>
          <ZIPCd>55792</ZIPCd>
        </USAddress>
        <EIN>410909915</EIN>
        <PrimaryActivitiesTxt>Clinics</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>MN</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>0</ShareOfEOYAssetsAmt>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Essentia Health Insurance Services SPC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>PO Box 1159</AddressLine1Txt>
          <CityNm>Grand Cayman</CityNm>
          <CountryCd>CJ</CountryCd>
        </ForeignAddress>
        <EIN>000000000</EIN>
        <PrimaryActivitiesTxt>Self Indemnity</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>Foreign Corp</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>0</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>0</ShareOfEOYAssetsAmt>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>false</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>false</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>false</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>false</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>false</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Critical Access Group</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>254988</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>actual costs</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Critical Access Group</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>799729</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>actual costs</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Essentia Health</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>777642</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>actual costs</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule R, Part II, Column (a)</FormAndLineReferenceDesc>
        <ExplanationTxt>Name: The following Essentia Health entities have a doing business as name: Legal Name; Doing Business As Name: Brainerd Lakes Integrated Health System; Essentia Health Central Brainerd Medical Center, Inc.; Essentia Health Brainerd Specialty Clinic Bridges Medical Center; Essentia Health Ada Deer River Healthcare Center, Inc.; Essentia Health Deer River First Care Medical Services; Essentia Health Fosston Graceville Health Center; Essentia Health Holy Trinity Hospital Innovis Health, LLC; Essentia Health West Midwest Medical Equipment and Supplies, Inc.; Essentia Health Medical Equipment &amp; Supplies Northern Pines Medical Center; Essentia Health Northern Pines Pine Medical Center; Essentia Health Sandstone Polinsky Medical Rehabilitation Center; Essentia Health Polinsky Medical Rehabilitation Center SMDC Medical Center; Essentia Health Duluth St. Joseph's Medical Center; Essentia Health St. Joseph's Medical Center St. Mary's Duluth Clinic Health System; Essentia Health East St. Mary's EMS; Essentia Health St. Mary's Emergency Medical Services-Detroit Lakes St. Mary's Hospital of Superior; Essentia Health St. Mary's Hospital-Superior St. Mary's Medical Center; Essentia Health St. Mary's Medical Center St. Mary's Regional Health Center; Essentia Health St. Mary's-Detroit Lakes</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleR>
  </ReturnData>
</Return>