Sanford Health Group Return: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization: Sanford Health Group Return (EIN 46-0462161)
Tax period: 2009-07-01 to 2010-06-30
Filed: 2011-05-13
IRS object ID: 201141339349305914
Schema version: 2009v1.4
Source: Download XML · Original 990 at ProPublica

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

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

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-05-13T17:48:49-05:00	Timestamp
Tax Period End Date	2010-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Deloitte Tax LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	50 South Sixth Street Suite 2800	AddressLine1
City	Minneapolis	City
State	MN	State
ZIP Code	55402	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2009-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	460462161	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Sanford Health Group Return	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	SANF	NameControl
Phone	6053331000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1305 West 18th Street PO Box 5039	AddressLine1
City	Sioux Falls	City
State	SD	State
ZIP Code	571175039	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Lisa Carlson	Name
Title	Chief Financial Officer	Title
Phone	6053331000	Phone
Date Signed	2011-05-13	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	6123974000	Phone

Field	Value	IRS element (for citing)
Tax Year	2009	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Kelby Krabbenhoft	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1305 West 18th Street PO Box 5039	AddressLine1
City	Sioux Falls	City
State	SD	State
ZIP Code	571175039	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	1040242737	GrossReceipts
Group Return For Affiliates	1	GroupReturnForAffiliates
All Affiliates Included	1	AllAffiliatesIncluded
Group Exemption Number	3720	GroupExemptionNumber
Organization501c	X	Organization501c
Web Site	www.sanfordhealth.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Activity Or Mission Description	"Dedicated to the Work of Health and Healing"	ActivityOrMissionDescription
Nbr Voting Members Governing Body	15	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	8	NbrIndependentVotingMembers
Total Nbr Employees	11545	TotalNbrEmployees
Total Nbr Volunteers	1338	TotalNbrVolunteers
Total Gross UBI	12289521	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	424668	ContributionsGrantsPriorYear
Contributions Grants Current Year	15751738	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	170122670	ProgramServiceRevenuePriorYear
Program Service Revenue CY	1025251251	ProgramServiceRevenueCY
Investment Income Prior Year	907319	InvestmentIncomePriorYear
Investment Income Current Year	-2414579	InvestmentIncomeCurrentYear
Other Revenue Prior Year	-71165	OtherRevenuePriorYear
Other Revenue Current Year	-524431	OtherRevenueCurrentYear
Total Revenue Prior Year	171383492	TotalRevenuePriorYear
Total Revenue Current Year	1038063979	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	99743	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	2125585	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	89381254	SalariesEtcPriorYear
Salaries Etc Current Year	559068833	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	344149	TotalFundrsngExpCurrentYear
Other Expense Prior Year	71901990	OtherExpensePriorYear
Other Expenses Current Year	441148462	OtherExpensesCurrentYear
Total Expenses Prior Year	161382987	TotalExpensesPriorYear
Total Expenses Current Year	1002342880	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	10000505	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	35721099	RevenuesLessExpensesCY
Total Assets BOY	652318690	TotalAssetsBOY
Total Assets EOY	721276979	TotalAssetsEOY
Total Liabilities BOY	397911638	TotalLiabilitiesBOY
Total Liabilities EOY	471447240	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	254407052	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	249829739	NetAssetsOrFundBalancesEOY
Mission Description	Sanford's mission is "Dedicated to the Work of Health and Healing." Part of the Sanford Health System, Sanford is committed to the healthcare needs of communities throughout South Dakota, North Dakota, Minnesota and Iowa. Sanford provides a full range of primary and specialty health care services.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	387737384	Expense
Grants	924931	Grants
Revenue	555708272	Revenue
Description	Sanford USD Medical Center is the largest tertiary medical facility in the region providing a variety of healthcare services, including Centers of Excellence in the following areas: heart and vascular, children's, cancer, neuroscience, trauma, orthopedics, and women's, which supports our patient centered approach to care.Sanford's new Children's Hospital opened in March of 2009. This Castle of Care serves the healthcare needs of the pediatric patients in South Dakota, North Dakota, Minnesota, Iowa, and Nebraska locally; as well as through our World Clinics in Duncan, Oklahoma and others that will open in the near future. Our model of CARE focuses on providing excellence in clinical services, advocacy, research and education. The team of over 40 pediatric subspecialty trained physicians, 16 general pediatricians and more than 150 family medicine physicians work side by side with over 350 specially trained pediatric staff to provide the most comprehensive healthcare to children and their families in our region. Sanford Children's Hospital is the first children's hospital in the United States to install a new LightSpeed VCT XTe console low dose CT scanner with reconstruction technique that can lower radiation dosage up to 40% which is a significant reduction in radiation exposure for our pediatric population.The new state of the art Heart Hospital will open early in 2012. The new facility will include 58 beds, cardiovascular operating rooms, cath labs, clinic and outpatient services. Our goal is to make care more easily accessible to our patients by providing services at one location as well as provide all other aspects of tertiary care through a connected Medical Center.Heart and Vascular screenings are offered to our consumers at a very affordable cost. Sanford participates in a statewide initiative called Take Heart South Dakota, which is a new program designed to increase survival rates of sudden cardiac arrest. Sanford Medical Center achieved Chest Pain accreditation in 2009.Sanford's stroke certification neurology unit offers services that include a Rapid Response team and a growing Stroke Network. Through a grant, Sanford's neurology team was awarded to participate in the Adam Williams Initiative designed to improve the care and outcomes for patients with traumatic brain injury, and recently developed a Stroke Share Point which is a public site for educational use and a resource for clinicians that work with Stroke Protocols.Orthopedic and Sports Medicine at Sanford takes a comprehensive approach to orthopedic care which includes multiple subspecialties and synergistic programs such as the Center for Joint Success, Wellness Center, POWER Center, National Institute for Athletic Health and Performance, Physical Medicine,& Rehab, Spine Center and dedicated Orthopedic operating rooms designed to handle orthopedic outpatients in a customer friendly, efficient manner. Sanford's Cancer Center was chosen as one of only 16 sites to participate in a nationwide pilot for the National Cancer Institute (NCI). One of the main objectives of the NCI Community Cancer Centers Program is to reduce cancer care disparities among underserved populations through education, prevention, screening, treatment and patient-family support programs. Sanford's Cancer Center embrace's a "Journey of Healing" philosophy through art. SMC is an ACS Verified Level II Trauma Centre. The Emergency Department is the largest and most comprehensive emergency facility in the region. Our Intensive Air program, which includes one helicopter and two fixed wing airplanes have been operating since 1977. Intensive Air is a CAMTS accredited flight program and was the first program to have this recognition in the region. Intensive Air consists of four specialized transport teams to include Adult, Pediatric, Neonatal and Maternal. Sanford's Women's offers 21 state of the art LDR rooms where moms can labor, deliver and recover all in one room. Upon recovery mom and baby are brought to the BirthPlace which is highly secured, family oriented designed facility with 27 rooms for mom, baby and family to recover. Many educational classes are offered throughout mom's pregnancy and into mature womanhood. Sanford Women's Health Plaza is a unique destination designed to provide all women a variety of health options at one location. SMC is accredited by The Joint Commission and has achieved Magnet Nursing Status from the American Nurses Credentialing Center (ANCC).	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	288796069	Expense
Grants	36597	Grants
Revenue	275478851	Revenue
Description	Sanford Clinic has 304 physicians representing 70 specialties. Supporting the five Centers of Excellence of the Sanford integrated health system, Sanford Clinic physicians provide and clinical teams provide services in Cancer, Women's, Heart and Vascular, Children's, Surgery and Trauma, Neuroscience/Orthopedics and Primary Care. The Sanford Clinic Cancer Services include a multidisciplinary team of experts and a pinnacle service in Head and Neck Cancer with NIH funded research in HPV. Women's services span the entire clinical services spectrum and integrated medicine services including a Medical Spa. The physician experts provide urogynecology, reproductive endocrinology, gynecology/oncology, genetic counseling and maternal fetal medicine subspecialty care. Another pinnacle service is developing in this service line - a regional Fetal Care Center which includes diagnostic services and fetal surgery. The Heart and Vascular service has grown to 14 interventional, invasive, general cardiologists and vascular surgeons. The strong clinical research program and preventive focus with screenings programs all provide the foundation for a new Heart Hospital set to open early in 2012.Surgical Care for the Sanford Clinic is performed by nine surgeons. Bariatric, trauma and general surgery as well as surgical oncology care, and a strong breast cancer program, GI cancer program, and lung cancer program fall within this area of expertise.General pediatric and subspecialty pediatric physicians support the Children's Hospital and regional outreach services and national pediatric care. Additional growth continues in neuroscience and orthopedics clinical services, sports medicine, general and subspecialty care.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	124796219	Expense
Grants	803403	Grants
Revenue	186173608	Revenue
Description	Sanford Health Network supports community healthcare facilities as they provide care close to home through the 23 hospitals and 12 long term care homes, 18 assisted and congregate living facilities across South Dakota, Iowa, Minnesota, Nebraska and North Dakota. Sanford Health supports a Network of owned, leased, managed and associate facilities to ensure that necessary health care services across a broad range of medical and surgical specialties are delivered locally to the broad service area.Sanford Health Network's commitment to local healthcare delivery is clearly evident in its community-based leadership and local Board involvement. Additionally, our technology deployment in the form of our health system's fully integrated clinical and financial information system, called docZ, remains a priority. Sanford Health Network is adding a new hospital in Aberdeen, SD and is working on the replacement of several long term care facilities in two communities in South Dakota.	Description

Activity Other ActivityOther (2 entries)

ExpenseExpense	GrantsGrants	RevenueRevenue	DescriptionDescription
5665419	0	6710012	Sanford Home Health provides skilled nursing care through various programs. The Hospice program promotes and enhances the comfort and dignity of the terminally ill person, the family, and the primary caregivers. The Home Nursing Care program provides skilled nursing care, medical aid, and guidance to high risk, handicapped, and homebound individuals. The Companion Aide program provides care to elderly people in their home on a private pay basis.
16406808	360654	1180508	Sanford Research is a non-profit research organization formed between Sanford Health and the University of South Dakota. In 2007, a transformational gift of $400 million by Denny Sanford has allowed for an expansion of current goals and will enable Sanford Research to become one of the premiere research institutions in the United States and the world. Sanford Research is composed of several research centers, including Cancer Biology, Cardiovascular Health, Health Disparities, Methodology and Data Analysis, Sanford Children's Health, and the Sanford Project.Sanford USD Medical Center is a 500-bed tertiary care regional medical center and the primary teaching hospital for the Sanford School of Medicine. It also features:400 physician multi-specialty practice for Sanford 1.25 million outpatient and 50,000 inpatient visits per year Stable, compliant population base for clinical research Electronic medical record and clinical information system Multi-generational families for clinical studies Accommodating regulatory environment Comprehensive research infrastructure Ongoing in-house research The Sanford Project Global presence in clinical and research relationships The Cancer Biology Research Center features basic and translational research with strengths in breast, head and neck, ovarian, colon, cervical and lymphoid cancers. Research teams are working on projects aimed at understanding the molecular, cellular and genetic basis of cancer that can lead to the discovery of new biomarkers, drug targets and novel therapies which will improve the health and survival of cancer patients.The Cardiovascular Health Research Center includes basic studies examining cardiac and skeletal muscle development, how these processes are altered in muscular dystrophy, and how diabetes and the sympathetic nervous system affect the pathogenesis of heart failure. Research projects also focus on clinical studies examining the role of Omega-3 fatty acids in cardiovascular disease.The Health Disparities Research Center provides an infrastructure for communities and investigators to partner in designing and implementing research programs with the goal of eliminating health disparities. Active research and service projects focus on a variety of public health topics, including maternal and child health, obesity and nutrition, and adolescent health.During FY 2010, Sanford planned for a more than $7 million grant to be awarded in FY 2011 to help address health disparities among American Indians. The grant will help establish a National Center for Minority Health Disparities (NCMHD) Exploratory Center of Excellence. The five-year award totaling $7,162,047 from the U.S. Department of Health and Human Services is a collaborative grant with the University of South Dakota and the Sanford Research/USD Health Disparities Research Center. This award is a renewal of a five-year program project lead by Amy Elliott, PhD. Collaborative partners for this project includes the University of South Dakota, Sanford, the Aberdeen Area Tribal Chairman's Health Board and Sinte Gleska University.This grant will create infrastructure and unite resources to conduct health disparities research, provide educational opportunities for Native American students and increase the dissemination and utilization of scientific and health information relevant to health diversity population.The Methodology and Data Analysis Research Center collaborates with other centers on study design, monitoring, and data analysis for basic, clinical, and population research. The center also encompasses primary biostatistical and epidemiologic research focusing on methodology, as well as disease etiology and prevention.The National Institute for Athletic Health & Performance (NIAHP) focuses on new research to address training, competition, and rehabilitation challenges for youth and other populations. From this research, the NIAHP partners with sport and sports medicine national governing bodies in developing new educational initiatives, guidelines, and policy for safe and appropriate exercise, training, and sports participation.The Sanford Children's Health Research Center focuses on developing translational research for pediatrics. Researchers are using a diverse array of scientific approaches aimed at improved understanding and treatment of a variety of childhood diseases and conditions.Coordination of Rare Diseases at Sanford (CoRDS)The Coordination of Rare Diseases at Sanford (CoRDS) registry is a national disease registry being developed to include multiple and ultimately all rare genetic diseases. The CoRDS registry is headquartered at Sanford Research in Sioux Falls, South Dakota, and is supervised by Principal Investigator Dr. David Pearce, PhD. and Dr. Chun-Hung Chan, PhD. By establishing a central registry of persons with a confirmed diagnosis of any rare disease, we hope to accelerate research by providing a resource for the identification and recruitment of potential research subjects. The CORD registry will begin in 2011.The Sanford Project, which was announced in June, 2008, focuses on finding a cure for Type 1 diabetes through beta cell regeneration. This goal has an aggressive timeline: to find the cure during Mr. Sanford's lifetime! One of four initiatives made possible through Denny Sanford's transformational $400 million gift to Sanford Health, The Sanford Project has one goal, researching and curing juvenile diabetes. A $10 million gift from Todd and Linda Broin of Sioux Falls, SD to fund the chair of the Sanford Project accelerated the progress. In 2009, a team of international researchers, Paul Burn, PhD, Alexander Rabinovitch, MD, Alexei Savinov, MD and Da-Qing Yang, PhD, joined together to accomplish this goal. Sanford Research has a strong collaboration with the Sanford-Burnham Medical Research Institute in La Jolla, CA and Orlando, FL, as well as a number of other leading institutions. For researchers, Sanford Research offers exciting challenges both in well-established projects and ever expanding research opportunities. For those people we serve in our six-state region, we offer opportunities to participate in clinical trials and to be a part of the changing face of medicine.

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	22072227	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	360654	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	7890520	TotalOfOtherProgramServiceRev
Total Program Service Expense	823401899	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Balance Sheet Amounts Reported	1	BalanceSheetAmountsReported
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	1	ForeignActivities
More Than5000 K To Organizations	1	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	1	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	1	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	11545	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Nbr Voting Governing Body Members	15	NbrVotingGoverningBodyMembers
Number Independent Voting Members	8	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	1	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	0	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	0	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	MN	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	JoAnn Kunkel CFO Health Services	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	6053126549	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1305 W 18th Street	AddressLine1
City	Sioux Falls	City
State	SD	State
ZIP Code	57105	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (50 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
Barbara Stork
Trustee/Secretary	0.50	X	0	0	0
Barry L Martin
Trustee	0.50	X	0	0	0
David Beito
Trustee/Treasurer	0.50	X	0	0	0
Jerome Feder
Trustee	0.50	X	0	0	0
Jim Entenman
Trustee	0.50	X	0	0	0
John C Vander Woude Jr
Trustee	60.00	X	2134556	0	29404
John Jambois
Trustee	0.50	X	0	0	0
Kelby K Krabbenhoft
President/CEO	60.00	X	0	1123846	748719	X
Lauris Molbert
Trustee/Vice Chairman	0.50	X	0	0	0
Mark Paulson MD
Trustee	60.00	X	0	225981	43832
Michael Olson MD
Trustee	60.00	X	561750	0	53780
Pamela Anderson
Trustee	0.50	X	0	0	0
Ronald Moquist
Trustee/Chairman	0.50	X	0	0	0
Terrence Grimm MD
Trustee	60.00	X	0	607209	41089
Terry Baloun
Trustee	0.50	X	0	0	0
Lisa Carlson
CFO	60.00		0	294054	49603	X
Bradley Schipper
VP - SHN	60.00		218640	0	25007		X
Bruce Viessman
VP Finance - SHN	60.00		193497	0	21919		X
Bryan Nermoe
Exec VP - SC	60.00		210204	0	19563		X
Charles P O'Brien MD
SMC President - SMC	60.00		543506	0	64966		X
Chris A Marin
VP - SMC	60.00		212157	0	12759		X
Daniel W Blue MD
President - SC	60.00		533247	0	3004		X
David Hove
VP - SHN	60.00		224626	0	21899		X
Diana Berkland
Chief Nurse Exec - SMC	60.00		218066	0	71409		X
Ed Weiland
President - SHN	60.00		353470	0	22746		X
Jan Haugen-Rogers
VP - SMC	60.00		254082	0	6583		X
Jeff Sandene
CFO - SMC	60.00		366396	0	25366		X
Jim Striepe
VP - SHN	60.00		266054	0	80535		X
Kaleen Santema
VP - SMC	60.00		237774	0	87189		X
Karen A Tobin
VP - SMC	60.00		246798	0	10102		X
Ken Aspaas
CMO - SMC	60.00		328285	0	71677		X
Kevin Lampe
VP - SMC	60.00		360653	0	20792		X
Lynn Olson
CEO - SHN	60.00		206708	0	17783		X
M Benjamin Perryman
President - SR	60.00		0	311434	26296		X
Michael E Farritor MD
COO - SC	60.00		357978	0	25103		X
Michelle Bruhn
CFO - SMC	60.00		189010	0	5711		X
Monica Huber
VP - SMC	60.00		205022	0	14174		X
Orlen P Tschetter
VP - SMC	60.00		223379	0	15469		X
Randy Bury
Chief Admin Officer - SM	60.00		399345	0	39575		X
Richard Adcock
Exec VP - SC	60.00		240784	0	24934		X
Rick Nordahl
CEO - SHN	60.00		190917	0	24108		X
Robert Salmon
CEO - SHN	60.00		203621	0	65099		X
Steve Goetsch
VP - SC	60.00		243376	0	22363		X
Timothy Tracy
CEO - SHN	60.00		224417	0	13595		X
Vern Carda
Vice President - SHN	60.00		185349	0	13251		X
Adam T Stys
Physician - SC	60.00		2082164	0	24458			X
Marian Petrasko
Physician	60.00		2104344	0	24458			X
Tomasz P Stys
Physician - SC	60.00		2654406	0	24458			X
William Bell
Physician	60.00		1819276	0	24458			X
Wilson Asfora
Physician	60.00		1725450	0	24458			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	20719307	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	2562524	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1961694	TotalOtherCompensation
Number Individuals GT100 K	595	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Amerisource Corp
6810 Shady Oak Rd	Eden Prairie	MN	55344	Pharmaceuticals	34230802
Henry Carlson Co
PO Box 84010	Sioux Falls	SD	57118	Construction	23529406
Owens & Minor Inc
12199 Collection Ctr Dr	Chicago	IL	60693	Medical Supplies	18631864
Medtronic
4642 Collection Ctr Dr	Chicago	IL	60693	Surgery Supplies	12890719
Sanford Health Plan
PO Box 91110	Sioux Falls	SD	57109	Medical Insurance	10924581

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	372	NumberOfContractorsGT100K
Related Organizations	2658241	RelatedOrganizations
Government Grants	10332021	GovernmentGrants
All Other Contributions	2761476	AllOtherContributions
Noncash Contributions	44224	NoncashContributions
Total Contributions	15751738	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
Patient services	621400	616184045	616184045
Medicare/Medicaid	621400	366543123	366543123
SMC reference lab reve	621500	16010618	2350704	11458503	$2,201,411
Other program rev.	621400	10992527	10992527
Home health care, etc	621610	6420038	6420038

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	9100900	TotalRevenueColumn
Related Or Exempt Function Income	192187	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	831018	UnrelatedBusinessRevenue
Exclusion	$8,077,695	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	1025251251	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	-1824612	TotalRevenueColumn
Exclusion	-$1,824,612	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	816276	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	1340707	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-524431	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-524431	TotalRevenueColumn
Exclusion	-$524,431	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	248084	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	838051	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	-589967	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-589967	TotalRevenueColumn
Exclusion	-$589,967	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1038063979	TotalRevenueColumn
Related Or Exempt Function Income	1002682624	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	12289521	UnrelatedBusinessRevenue
Exclusion	$7,340,096	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	2047005	Total
Program Services	2047005	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	78580	Total
Program Services	78580	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	29024115	Total
Management And General	29024115	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	434104712	Total
Program Services	388489576	ProgramServices
Management And General	45328345	ManagementAndGeneral
Fundraising	286791	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	14707871	Total
Program Services	13284335	ProgramServices
Management And General	1414932	ManagementAndGeneral
Fundraising	8604	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	51938456	Total
Program Services	41168703	ProgramServices
Management And General	10742938	ManagementAndGeneral
Fundraising	26815	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	29293679	Total
Program Services	26101327	ProgramServices
Management And General	3170413	ManagementAndGeneral
Fundraising	21939	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	313344	Total
Program Services	4498	ProgramServices
Management And General	308846	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	720109	Total
Program Services	17356	ProgramServices
Management And General	702753	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	12001	Total
Management And General	12001	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	45235751	Total
Program Services	39645475	ProgramServices
Management And General	5590276	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	2528255	Total
Program Services	1749690	ProgramServices
Management And General	778565	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	35587146	Total
Program Services	26318221	ProgramServices
Management And General	9268925	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	34689925	Total
Program Services	3475707	ProgramServices
Management And General	31214218	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	25568176	Total
Program Services	16955708	ProgramServices
Management And General	8612468	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	3253102	Total
Program Services	2650324	ProgramServices
Management And General	602778	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	2042364	Total
Program Services	1717087	ProgramServices
Management And General	325277	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	11293511	Total
Program Services	7503594	ProgramServices
Management And General	3789917	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	46402808	Total
Program Services	31654667	ProgramServices
Management And General	14748141	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	8106366	Total
Program Services	7496482	ProgramServices
Management And General	609884	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
Medical Supplies	145596976	145574166	22810
Intercompany Purchased	35940987	27112190	8828797
Bad Debt	34079063	33948166	130897
Other direct	9778578	6409042	3369536

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	1002342880	Total
Program Services	823401899	ProgramServices
Management And General	178596832	ManagementAndGeneral
Fundraising	344149	Fundraising

Field	Value	IRS element (for citing)
Joint Costs	X	JointCosts

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2545411	BOY
EOY	1539585	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	19156443	BOY
EOY	12098189	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
EOY	883125	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	148573692	BOY
EOY	162225274	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	243251	BOY
EOY	674056	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	6658659	BOY
EOY	5892055	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	6860766	BOY
EOY	8233452	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2736847	BOY
EOY	6639235	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	766860235	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	325126325	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	436368045	BOY
EOY	441733910	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	4776121	BOY
EOY	4005308	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	31166	BOY
EOY	28346	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	7292246	BOY
EOY	6885983	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	10790970	BOY
EOY	10422530	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	6285073	BOY
EOY	60015931	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	652318690	BOY
EOY	721276979	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	102834891	BOY
EOY	104975427	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	121621	BOY
EOY	61588	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	441213	BOY
EOY	697068	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	247529558	BOY
EOY	312624966	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	11017823	BOY
EOY	8199471	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	125000	BOY
EOY	40000	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	35841532	BOY
EOY	44848720	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	397911638	BOY
EOY	471447240	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	253629753	BOY
EOY	248590725	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	483648	BOY
EOY	902661	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	293651	BOY
EOY	336353	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	254407052	BOY
EOY	249829739	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	652318690	BOY
EOY	721276979	EOY

Field	Value	IRS element (for citing)
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	1	FederalGrantAuditRequired
Federal Grant Audit Performed	1	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii
General Explanation	Schedule A, Part IV, Supplemental Information: Sanford Medical Center 170(b)(1)(A)(iii) Sanford Clinic 170(b)(1)(A)(iii) Sanford Research / USD 170(b)(1)(A)(iii) Sanford Home Health 509(a)(2) Sanford Health Network 509(a)(3)	GeneralExplanation
General Explanation	Schedule A, Part IV, Supplemental Information: Detail for Schedule A, Part I Line 11, Column: (i) Sanford Health; (ii) 31-1527032; (iii)501(c)3; (iv) Yes; (v) Yes; (vi) Yes; (vii) 0	GeneralExplanation
General Explanation	Schedule A, Part IV, Supplemental Information: Detail for Schedule A, Part III Line 1 - column: (a) 139,811; (b) 173,368; (c) 90,099; (d) 19,885; (e) 207,914; (f) 631,077 Line 2 - column: (a) 7,089,869; (b) 6,879,383; (c) 7,034,140; (d) 1,380,078; (e) 6,710,012; (f) 29,093,482 Line 6 - column: (a) 7,229,680; (b) 7,052,751; (c) 7,124,239; (d) 1,399,963; (e) 6,917,926; (f) 29,724,559 Line 7b - column: (a) 63,652; (b) 99,094; (c) 15,652; (d) 5,267; (e) 62,450; (f) 246,115 Line 7c - column: (a) 63,652; (b) 99,094; (c) 15,652; (d) 5,267; (e) 62,450; (f) 246,115 Line 8 - column: (f) 29,478,444 Line 9 - column: (a) 7,229,680; (b) 7,052,751; (c) 7,124,239; (d) 1,399,963; (e) 6,917,926; (f) 29,724,559 Line 10a - column: (a) 386,268; (b) 374,633; (c) 320,450; (d) 61,830; (e) 355,290; (f) 1,498,471 Line 10c - column: (a) 386,268; (b) 374,633; (c) 320,450; (d) 61,830; (e) 355,290; (f) 1,498,471 Line 13 - column: (a) 7,615,948; (b) 7,427,384; (c) 7,444,689; (d) 1,461,793; (e) 7,273,216; (f) 31,223,030 Line 15: 94.41% Line 16: 94.64% Line 17: 4.80% Line 18: 4.76% Line 19a: X Line 19b: X	GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$17,756	OtherActivitiesAmount
Total Lobbying Expenditures IIB	17756	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Part II-B, Line 1i:	Identifier
Return Reference	Explanation of Other Lobbying Activities:	ReturnReference
Explanation	The filing organization has memberships in the South Dakota Association of Healthcare Organizations (SDAHO). A percentage of membership dues paid to SDAHO relate to lobbying expenses.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	23816626	BeginningOfYearBalance
Contributions	2689481	Contributions
Investment Earnings Or Losses	57376	InvestmentEarningsOrLosses
End Of Year Balance	26563483	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	23464847	BeginningOfYearBalance
Contributions	323063	Contributions
Investment Earnings Or Losses	33882	InvestmentEarningsOrLosses
Administrative Expenses	5166	AdministrativeExpenses
End Of Year Balance	23816626	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	23012805	OtherCostOrOtherBasis
Book Value	23012805	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	318700051	OtherCostOrOtherBasis
Depreciation	96760406	Depreciation
Book Value	221939645	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	30242385	OtherCostOrOtherBasis
Depreciation	8988080	Depreciation
Book Value	21254305	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	365352206	OtherCostOrOtherBasis
Depreciation	218606217	Depreciation
Book Value	146745989	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	29552788	OtherCostOrOtherBasis
Depreciation	771622	Depreciation
Book Value	28781166	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	441733910	TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescription	Book ValueBookValue
Restricted Trust Funds/Endowment Funds	336353
Deferred compensation trust	64562
Deferred financing costs	2812100
Keysop	2765391
Project Fund	54037525

Field	Value	IRS element (for citing)
Total Book Value Other Assets	60015931	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescription	AmountAmount
Vested deferred compensation obligation	$2,917,459
Long-term lease obligation	$1,388,835
Defined benefit pension liability	$33,344,784
Other non-current liabilities	$300,000
Interest rate swap obligation	$5,455,064
Minority Interest	$1,442,578

Field	Value	IRS element (for citing)
Total Of Amounts	44848720	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Part V, Line 4:	Description of Intended Use of Endowment Funds:	Sanford Health Foundation holds endowment funds on behalf of the filing organization to be used for assistance in its activities and for providing health care, medical, or educational services.
		Part X, Line 2: Certain controlled organizations are subject to income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. A tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination. The deferred income tax provision or benefit generally reflects the net change in deferred income tax assets and liabilities during the year. The current income tax provision reflects the tax consequences of revenues and expenses currently taxable or deductible on various income tax returns for the year reported. Sanford Group did not have an income tax liability at June 30, 2010; some related organizations have established reserves.

Schedule F IRS990ScheduleF

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

Accts Actvs Out US Table AcctsActvsOutUSTable (2 entries)

RegionRegion	Type Of Activities ConductedTypeOfActivitiesConducted	Specific Services ProvidedSpecificServicesProvided	Total ExpendituresTotalExpenditures	Number Of OfficesNumberOfOffices	Number Of EmployeesNumberOfEmployees
Sub-Saharan Africa	Fetal alcohol syndrome study	FAS samples and analysis	109124
Central America and the Caribbean	Program Services	Investment in future clinic	0	0	0

Field	Value	IRS element (for citing)
Total Number Of Offices	0	TotalNumberOfOffices
Total Number Of Employees	0	TotalNumberOfEmployees
Total Amount Spent	109124	TotalAmountSpent

Grants To Orgs Outside US GrantsToOrgsOutsideUS

Field	Value	IRS element (for citing)
Region	Sub-Saharan Africa	Region
Purpose Of Grant	Fetal alcohol syndrome study	PurposeOfGrant
Amount Of Cash Grant	109124	AmountOfCashGrant
Manner Of Cash Disbursement	bank wire	MannerOfCashDisbursement

Field	Value	IRS element (for citing)
Total Number Of501c3 Orgs	0	TotalNumberOf501c3Orgs
Total Number Of Other Orgs	1	TotalNumberOfOtherOrgs

Form990 Schedule F Part IV Form990ScheduleFPartIV

Field	Value	IRS element (for citing)
Identifier	Procedure for Monitoring Grants Outside the U.S.:	Identifier
Explanation	Schedule F, Part I, Line 2: The Grant Administration Manager reviews the award document and prepares a sub award agreement. The following information is provided: CFDA title and number and name, if for research, agency and requirements. The principal investigator (PI) provides input and the president or vice president of research signs the agreement. Regular phone conferences are held between the PI in the US and the manager of the international grant. The PI reviews performance or technical reports to ensure the project is progressing. The PI reviews and signs invoices to ensure expenses incurred are benefiting project and appear reasonable. The PI or another representative of the grant makes an annual visit. The Grant Administration Manager also signs the invoice.	Explanation

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	225.000000000000	FreeOtherPercentage

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

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	375.000000000000	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	0	AnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	18039023	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	18039023	NetCommunityBenefitExpense
Percent Of Total Expense	0.01860	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	93191088	TotalCommunityBenefitExpense
Direct Offsetting Revenue	73148195	DirectOffsettingRevenue
Net Community Benefit Expense	20042893	NetCommunityBenefitExpense
Percent Of Total Expense	0.02070	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	111230111	TotalCommunityBenefitExpense
Direct Offsetting Revenue	73148195	DirectOffsettingRevenue
Net Community Benefit Expense	38081916	NetCommunityBenefitExpense
Percent Of Total Expense	0.03930	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	308913	TotalCommunityBenefitExpense
Direct Offsetting Revenue	44087	DirectOffsettingRevenue
Net Community Benefit Expense	264826	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5913470	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3226997	DirectOffsettingRevenue
Net Community Benefit Expense	2686473	NetCommunityBenefitExpense
Percent Of Total Expense	0.00280	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	29475105	TotalCommunityBenefitExpense
Direct Offsetting Revenue	499455	DirectOffsettingRevenue
Net Community Benefit Expense	28975650	NetCommunityBenefitExpense
Percent Of Total Expense	0.02990	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	17522595	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	17522595	NetCommunityBenefitExpense
Percent Of Total Expense	0.01810	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	180735	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	180735	NetCommunityBenefitExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	53400818	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3770539	DirectOffsettingRevenue
Net Community Benefit Expense	49630279	NetCommunityBenefitExpense
Percent Of Total Expense	0.05130	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	164630929	TotalCommunityBenefitExpense
Direct Offsetting Revenue	76918734	DirectOffsettingRevenue
Net Community Benefit Expense	87712195	NetCommunityBenefitExpense
Percent Of Total Expense	0.09060	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	3770	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	3770	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	357513	TotalCommunityBuildingExpense
Direct Offsetting Revenue	152409	DirectOffsettingRevenue
Net Community Building Expense	205104	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	5975	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	5975	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	103380	TotalCommunityBuildingExpense
Direct Offsetting Revenue	5666	DirectOffsettingRevenue
Net Community Building Expense	97714	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	77644	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	77644	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	548282	TotalCommunityBuildingExpense
Direct Offsetting Revenue	158075	DirectOffsettingRevenue
Net Community Building Expense	390207	NetCommunityBuildingExpense
Percent Of Total Expense	0.00040	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$14,663,872	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	202776962	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	212949016	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-10172054	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (75 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Childrens HospitalChildrensHospital	Teaching HospitalTeachingHospital	Er24 HoursEr24Hours	Critical Access HospitalCriticalAccessHospital	OtherOther
Sanford USD Medical Center
1305 W 18th Street	Sioux Falls	SD	57117	X	X	X	X	X
Sanford Hospital Rock Rapids
801 S Greene Street	Rock Rapids	IA	51246	X	X			X	X
Sanford Sheldon Medical Center
118 N 7th Avenue	Sheldon	IA	51201	X	X			X	X
Sanford Canby Medical Center
112 St Olaf Avenue S	Canby	MN	56220	X	X			X	X	Nursing Facility
Sanford Jackson Medical Center
1430 N Highway	Jackson	MN	56143	X	X			X	X
Sanford Hospital Luverne
1600 N Kniss Avenue	Luverne	MN	56156	X	X			X	X
Sanford Tracy Medical Center
251 Fifth Street E	Tracy	MN	56175	X	X			X	X
Sanford Westbrook Medical Ctr
920 Bell Avenue	Westbrook	MN	56183	X	X			X	X
Sanford Regional Hospital Worthington
1018 6th Avenue	Worthington	MN	56187	X	X			X	X
Sanford Hospital Canton-Inwood
440 N Hiawatha Drive	Canton	SD	57013	X	X			X	X
Sanford Mid-Dakota Hospital
300 S Byron Blvd	Chamberlain	SD	57325	X	X			X	X
Sanford Deuel County Medical Center
701 3rd Avenue	Clear Lake	SD	57226	X	X			X	X
Sanford Vermillion Hospital
20 S Plum	Vermillion	SD	57069	X	X			X	X
Sanford Hospital Webster
1401 W 1st Street	Webster	SD	57274	X	X			X	X
Sanford Clinic Rock Rapids
803 South Green Street	Rock Rapids	IA	51246
Sanford Canby Medical Center
208 Haarfager Avenue South	Canby	MN	56220							Housing with Services
Sanford Clinic Sanborn
321 Main Street	Sanborn	IA	51248
Sanford Clinic Sheldon
800 Oak Street	Sheldon	IA	51201
Sanford Home Health and Hospice Sheldon
118 N 7th Avenue	Sheldon	IA	51201							Home Health Agency
Sanford Home Health and Hospice Sheldon
118 N 7th Avenue	Sheldon	IA	51201							Hospice
Sanford Senior Care Sheldon
118 N 7th Avenue	Sheldon	IA	51201							Nursing Facility
Hospice Sanford Luverne
217 North Oakley	Luverne	MN	56156							Hospice
Sanford Canby Medical Center
112 St Olaf Avenue S	Canby	MN	56220							Home Care Provider
Sanford Regional Hospital Worthington
1018 6th Avenue	Worthington	MN	56187							Medicare Certified End Stage Renal Dialysis
Hospice Sanford Luverne
402 East Main	Luverne	MN	56156							Hospice Cottage
Sanford Canby Dialysis Unit
112 St Olaf Avenue S	Canby	MN	56220							Medicare Certified End Stage Renal Dialysis
Sanford Clinic Balaton
Highway 14E	Balaton	MN	56115							Medicare Certified Rural Health Clinic
Sanford Clinic Jackson
1430 North Highway	Jackson	MN	56143							Medicare Certified Rural Health Clinic
Sanford Clinic Lakefield
220 Milwaukee	Lakefield	MN	56150							Medicare Certified Rural Health Clinic
Sanford Clinic Tracy
251 Fifth Street E	Tracy	MN	56175							Medicare Certified Rural Health Clinic
Sanford Clinic Walnut Grove
830 Eighth Street	Walnut Grove	MN	56180							Medicare Certified Rural Health Clinic
Sanford Clinic Westbrook
920 Bell Avenue	Westbrook	MN	56183							Medicare Certified Rural Health Clinic
Sanford Clinic Windom
591 2nd Avenue North	Windom	MN	56101							Medicare Certified Rural Health Clinic
Sanford Hospice
2710 West 12th Street	Sioux Falls	SD	57104							Hospice (licensed in MN and SD)
Sanford Visiting Nurses Association
2710 West 12th Street	Sioux Falls	SD	57104							Professional Home Care Agency (licensed in MN and SD)
Sanford Worthington Home Care
1018 6th Avenue	Worthington	MN	56187							Medicare Certified Home Health Agency
Sanford Clinic Aberdeen Surgical Center
3015 3rd Ave SE	Aberdeen	SD	57401							Ambulatory Surgery Center
Orchard Hills
200 W 10th St	Dell Rapids	SD	57022							Assisted Living Center
Sanford Hiawatha Heights
398 N Hiawatha Dr	Canton	SD	57013							Assisted Living Center
Sanford Madison Dialysis
917 N Washington Ave	Madison	SD	57042							End Stage Renal Dialysis
Sanford Mid-Dakota Dialysis
300 S Byron Blvd	Chamberlain	SD	57325							End Stage Renal Dialysis
Sanford USD Medical Center Dialysis
1305 W 18th Street	Sioux Falls	SD	57117							End Stage Renal Dialysis
Sanford Wagner Dialysis
111 Washington St	Wagner	SD	57380							End Stage Renal Dialysis
Deuel County Memorial Home Health
701 3rd Avenue	Clear Lake	SD	57226							Home Health Care
Sanford Visiting Nurses Assoc-Chamberlai
110 W Beede Ste 1	Chamberlain	SD	57325							Home Health Care
Sanford Visiting Nurses Assoc-Vermillion
20 S Plum	Vermillion	SD	57069							Home Health Care
Canby Community Hospice
131 St Olaf Ave N	Canby	MN	56220							Hospice (licensed in SD)
Madison Hospital Hospice
917 N Washington Ave	Madison	SD	57042							Hospice
Mid-Dakota Community Based Hospice
300 S Byron Blvd	Chamberlain	SD	57325							Hospice
Sanford Hospice
20 S Plum	Vermillion	SD	57069							Hospice
Sanford Hospice
803 South Green Street	Rock Rapids	IA	51246							Hospice (licensed in SD)
Sanford Hospice
510 E 8th St	Freeman	SD	57029							Hospice
Sanford Hospice
745 E 8th St	Winner	SD	57580							Hospice
Sanford Hospice
912 4th Avenue	Windom	MN	56101							Hospice (licensed in SD)
Sanford Hospice
820 3rd Ave	Madison	MN	56256							Hospice (licensed in SD)
Worthington Regional Hospital Hospice
1018 6th Avenue	Worthington	MN	56187							Hospice (licensed in SD)
Sanford Care Center Vermillion
125 Walker St	Vermillion	SD	57069							Nursing Facility
Sanford Mid-Dakota Care Center
300 S Byron Blvd	Chamberlain	SD	57325							Nursing Facility
Sanford Hospice Centennial Cottage
6301 W 43rd St	Sioux Falls	SD	57106							Residential Hospice
Sanford Hospice Foundation Cottage
6309 W 43rd St	Sioux Falls	SD	57106							Residential Hospice
Dakota Gardens Senior Living
126 S Plum	Vermillion	SD	57069							Residential Living Center
Sanford Clinic Clark
117 W 1st Ave	Clark	SD	57225							Rural Health Clinic
Sanford Clinic Deuel County
701 3rd Ave S	Clear Lake	SD	57226							Rural Health Clinic
Sanford Clinic Estelline
305 Hospital Dr	Estelline	SD	57234							Rural Health Clinic
Sanford Clinic Family Medicine Beresford
600 W Cedar St	Beresford	SD	57004							Rural Health Clinic
Sanford Clinic Ipswich
110 5th Ave	Ipswich	SD	57451							Rural Health Clinic
Sanford Clinic Lake Norden
Main Street	Lake Norden	SD	57248							Rural Health Clinic
Sanford Clinic Webster
101 Peabody Drive	Webster	SD	57274							Rural Health Clinic
Sanford Canby Medical Center
112 St Olaf Avenue S	Canby	MN	56220							Professional Home Care Agency
Sanford Clinic Canby
112 St Olaf Avenue S	Canby	MN	56220							Medicare Certified Rural Health Clinic
Sylvan Place
212 St Olaf Aveneue	Canby	MN	56220							Housing with Services
Peterson Estates
1012 9th Street	Westbrook	MN	56183							Housing with Services
Shetek Home Care
251 Fifth Street E	Tracy	MN	56175							Medicare Certified Home Health Agency
O Brien Court
410 State Street	Tracy	MN	56175							Housing with Services
Northwest Iowa Dialysis Center
112 Sunrise Drive	Hospers	IA	51239							End Stage Renal Dialysis

Form990 Schedule H Part VI Form990ScheduleHPartVI

Field	Value	IRS element (for citing)
Income Based Criteria	Part I, Line 3c: The primary scope of Sanford's financial assistance matrix considers family income and family size to objectively determine financial need. The family income range varies from 225% to 375% of the Federal Poverty Level (FPL). This range is described below.As an example calculation, a family of one at 0-225% FPL ($0-$24,368) would realize a financial assistance adjustment of 100% of the account balance. At 226-275% ($23,368-$29,783) a financial assistance adjustment is available up to 75% of the account balance. At 276-325% ($29,783 - $35,198) a financial assistance adjustment is available up to 50% of the account balance. At 326-375% ($33,198 - $40,613) a financial assistance adjustment is available up to 25% of the account balance.An applicant over 375%($40,613) may be eligible for some level of financial assistance based on a review of additional factors such as: the size of the account balance, debt-to-income ratio, current assets, current liabilities, IRS food expense allowances, monthly cash flow, etc.Additionally, it is possible for a family to qualify in one segment (based on income and family size alone) but be moved to a more generous (for the patient) segment based on the other financial variables mentioned above.	IncomeBasedCriteria
Costing Method Used	Part I, Line 7: A Cost to Charge Ratio is used to calculate the amounts on Line 7a - 7c (Charity Care, Medicaid Shortfall, and Other Means-Tested Government Programs). The amounts for Lines 7e - 7i would come from the books and records of specific segments of the organization and would not be based on a Cost to Charge Ratio.	CostingMethodUsed
Subsidized Health Services Expln	Part I, Line 7g: Subsidized health services are clinical services provided to both inpatients and outpatients despite a financial loss to Sanford. Each loss has been calculated after removing losses associated with bad debts, charity care and medicaid. Although these services generate overall losses to Sanford, they continue to meet the needs of the communities we serve. Various services that generate losses are provided by Sanford through physician practices. For 2010, subsidized health services provided through these physician practices generated losses of $21,025,455.	SubsidizedHealthServicesExpln
Percent Of Total Expense Expln	Part I, Line 7f: Total expenses reported on Form 990, Part IX, line 25, Column (A) include bad debt expense. This expense has been removed from the denominator when calculating the percent of total expense considered the net community benefit expense and reported in Part I, Line 7, Column (f). The amount of bad debt expense excluded from this percentage calculation is $34,079,063.	PercentOfTotalExpenseExpln
Bad Debt Footnote	Part III, Line 4: The audited financial statements of Sanford do not include a bad debt footnote. Sanford reports bad debt in accordance with generally accepted accounting principles (GAAP). Bad debt expense at cost is determined using the same Cost to Charge Ratio that is used to calculate Charity Care and Medicaid Shortfall. Discounts and allowances are accounted for separately from Bad debt expense.	BadDebtFootnote
Shortfall As Community Benefit	Part III, Line 8: Per IRS instructions, Sanford has identified the cost associated with providing Medicare services from the Medicare cost report. The Medicare cost report calculations are total expense less expenses deemed "unallowable" per Medicare regulations. The net expense is then used to calculate the cost per day and cost to charge ratios which are multiplied by the Medicare days and ancillary charges to determine the cost of providing Medicare services. If all expenses that Sanford incurred were included on the Medicare cost report; this would show a shortfall of approximately $83,306,000. We believe this shortfall should be considered community benefit because these services would need to be provided by either another charitable organization or the government if it was not provided by Sanford.	ShortfallAsCommunityBenefit
Debt Collection Policy	Part III, Line 9b: Sanford will provide services at no cost or reduced cost to patients within its service area in Minnesota, South Dakota and North Dakota, Iowa and Nebraska who qualify for the program. Patients with incomes at or below 225% of the United States Department of Health and Human Services poverty guideline will receive a 100% reduction of their payment responsibility. Patients with income between 225% - 375% of the poverty guideline will be given a discount based on a sliding scale and Assets are considered in the calculation of the income of the patient, with the exception of the patient's principal residence. Patients above 375% of the FPG will be reviewed for additional factors such as size of medical debt before a final determination. Patients must make their financial need known to appropriate personnel and be engaged in filing appropriate and complete applications. The program is available to those patients without health care benefits from any source as well as to those who have coverage for health care costs through a government program, commercial insurance, or other health benefit plan but continue to have a remaining balance after benefits have been applied to the charges. Sanford will not deny financial assistance based on race, creed, sex, national origin, handicap or age.Every effort is made to identify patients with financial need as early as possible in the revenue cycle.	DebtCollectionPolicy
Number Of Facility Type Expln	Part V: In addition to the state licensed health care facilities listed in Schedule H, Part V, Sanford also has 102 Other Physician Clinics and 1 Dental Clinic.	NumberOfFacilityTypeExpln
General Explanation	Reporting is not required and it is not filed in North Dakota, South Dakota, Nebraska or Iowa. Filing in Minnesota is voluntary.	GeneralExplanation
Needs Assessment	Part VI, Line 2: Sanford has a well-established connection with their communities and as a result is a committed community partner that can mobilize its resources to improve community health. For decades, an ongoing informal community health care needs assessment occurs through our participation in and/or leadership roles with community task forces, schools, government entities, social service agencies, churches, and other community organizations. It is through these interactions and participation that we identify or are apprised of health care needs. Our response to these needs includes but is not limited to, financial support, educational efforts to reduce or avoid risky behaviors, screenings and health risk assessments, vaccination programs, loaned management expertise, as well as wellness programs and initiatives. These activities serve to improve the health of our communities and fulfills our mission. A more formalized community needs assessment program is being established to meet the new 990 requirements.	NeedsAssessment
Patient Education Assistance	Part VI, Line 3: Sanford employs a variety of strategies to make certain that we are transparent in the communication of our financial assistance guidelines. The staff at Sanford makes every effort to identify patients needing financial assistance as early in the revenue cycle as possible. All Sanford entities will display signage in registration areas advising patients of their ability to request financial assistance upon request. The signage will be made available in English and Spanish. Financial Assistance application is available in English or Spanish upon request.All healthcare workers who identify patients with financial need are encouraged to provide patients or their designees a financial application. This may include, but not be limited to the following areas: Administration, Admissions, Patient Financial Services, Financial Counselors, Social Services, Physicians, Nursing, Clinic Director, Reception staff and Human Resources.Financial Counselors are trained to work individually with patients to determine the financial need and recommend appropriate assistance in application for charity care, government programs or discounted services.	PatientEducationAssistance
Community Information	Part VI, Line 4: Sanford Health System, together with its subsidiaries and affiliates as described in Part VI, Line 7, coordinate community benefit activities and identify community needs as a system to promote the health of the communities served by the organization. Approximately 90 percent of the over 340,000 Sanford hospital encounters came from within 52 counties in South Dakota, Minnesota, and Iowa in 2010. A large percent of these patients come from counties surrounding the metropolitan area of Sioux Falls, SD. The remaining patients are made up of residents from the smaller counties in South Dakota, Minnesota and Iowa, but include patients from across the U.S. Sanford USD Medical Center - Sioux Falls, South DakotaSanford USD Medical Center is the largest Sioux Falls Region hospital and is located within a diverse, urban area near downtown Sioux Falls and within Minnehaha County, the largest populated county in the state of South Dakota. Sanford USD Medical Center served nearly 27,000 inpatients and over 155,000 outpatients from around the states of South Dakota, Minnesota, Iowa and throughout the United States in 2010.Sanford Network Hospitals - South Dakota, Minnesota, IowaSanford Health Network Hospitals is a network of 13 rural hospitals located throughout eastern South Dakota, western Minnesota, and Northwestern Iowa. These facilities serve many rural communities in the region with over 6,000 admissions and nearly 150,000 outpatient encounters. Sanford Clinic - South Dakota, Minnesota, IowaSanford Clinic is a multi-specialty clinic comprised of over 375 physicians providing services in a 4 state area. Nearly 1,700,000 patients are seen each year by this network of highly trained and dedicated physicians.	CommunityInformation
Community Building Activities	Part VI, Line 5: Sanford is a not for profit organization dedicated to the work of health and healing for the public good. Sanford is committed to giving back to the communities in which its employees and patients live and work. Sanford invests resources in order to produce the best outcomes for patient care, education, research, and community enrichment, and partners with others to ensure that our community is a welcoming, healthy environment and one that attracts and sustains a diverse Sanford workforce to deliver the best patient care and much needed medical research. Sanford considers requests for funding and in kind support for new and ongoing programs with all areas supporting the above goals, such as basic human services, education and workforce development by recruiting physicians and other health professionals to medical shortage or underserved areas and collaborating with educational institutions to train and recruit health professionals, advocating community health improvement through efforts to support policies and programs that safeguard or improve public health and help to ensure access to health care services, and others.	CommunityBuildingActivities
Other Information	Part VI, Line 6: Sanford maintains an open medical staff. Community Boards - The Sanford Board of Trustees is comprised of 15 members, including 10 volunteer community members, 4 physicians and the CEO. Surplus Funds - Surplus funds are invested back into the community, as well as to resource development and facility development to better serve our patients and communities.	OtherInformation
Affiliated Health Care System	Part VI, Line 7: Sanford is an integrated health system headquartered in Fargo, ND and Sioux Falls, SD and consists of two long-standing organizations that merged in 2009. Sanford is the largest, rural, not-for-profit health care system in the nation with a presence in 111 communities in eight states. In addition, Sanford is in the process of developing international clinics in Belize and Ireland. With a mission dedicated to the work of health and healing, Sanford serves urban, suburban and rural communities through 32 hospitals, 111 clinic locations and 900 physicians in 70 specialty areas of medicine. Services include inpatient and outpatient care, primary care, community health and wellness, occupational health, home health, mental health, rehabilitation, long-term care, assisted living and hospice. With more than 20,000 employees, Sanford is the largest employer in North and South Dakota. The system is experiencing dynamic growth and development in conjunction with Denny Sanford's $400 million gift in 2007, the largest gift ever to a health care organization in America. This gift is making possible the implementation of several initiatives including global children's clinics, multiple research centers and finding a cure for type 1 diabetes. Sanford consistently reaches beyond its facilities to collaborate with health-related organizations promoting health and wellness, supports education through academic and athletic programs, and partners with communities in economic development efforts.	AffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	0	RecordsMaintained

Recipient Table RecipientTable (15 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
USD School of Medicine
1400 W 22nd Street	Sioux Falls	SD	571051581	460418678	501(c)3	261449	General support
Our Saviors Lutheran
909 W 33rd Street	Sioux Falls	SD	57105	460352771	501(c)3	50000	General support
River City Racin
PO Box 581	Chamberlain	SD	57325	320200170		7500	Community Economic Development
Sanford Health Foundation
1305 W 18th Street	Sioux Falls	SD	57105	363297853	501(c)3	172239	General support
Sanford Health
1305 W 18th Street	Sioux Falls	SD	57105	311527032	501(c)3	651849	General support
Luverne Community Healthcare Foundation
PO Box 623	Luverne	MN	56156	411512905	501(c)3	5000	General support
Accidental Sisterhood Foundation
554 Merriman Road	Akron	OH	44303	204830829	501(c)3	20000	Sponsorship of Sisterhood Health Forum (educational seminar)
Meals on Wheels
PO Box 250	Sheldon	IA	51201		501(c)3	5735	Subsidize meal cost
NW IA Commuunity College Foundation
603 W Part St	Sheldon	IA	51201	421275893	115	25200	Support scholarship program/learning & rec ctr/clinical support
Sheldon Education Foundation
1700 E Fourth St	Sheldon	IA	51201	421316980	501(c)3	10000	Sponsorship
Vermillion NOW
116 Market St Suite 103	Vermillion	SD	57069	460284795	501(c)3	10000	Economic development
University of South Dakota
414 East Clark Street	Vermillion	SD	57069	466000364	115	10000	Sports medicine sponsorship
City of Adrian
209 Main Avenue	Adrian	MN	56110	466004915	115	500000	Economic development
City of Tracy
336 Morgan	Tracy	MN	56175	416005581	115	5000	Aquatic center contribution
Juvenile Diabetes Research Foundation
120 Wall St	New York	NY	10005	231907729	501(c)3	150000	To fund grants to study juvenille diabetes outside of Sanford Research

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	14	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	1	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrant	Number Of RecipientsNumberOfRecipients	Amount Of Cash GrantAmountOfCashGrant
Scholarships	30	67474
Health Insurance Subsidy	8	11106

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Procedure for Monitoring Grants in the U.S.:	Identifier
Return Reference	Part I, Line 2:	ReturnReference
Explanation	Schedule I, Part I, Line 2: All grants given are donations to individual organizations. The funds are to be used for the general support of the organization receiving the funds.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	X	FirstClassOrCharterTravel
Travel For Companions	X	TravelForCompanions
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Club Dues Or Fees	X	ClubDuesOrFees
Personal Services	X	PersonalServices
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	1	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	1	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	1	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (40 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
John C Vander Woude Jr
1038461	0	0	0	1096095	0	7350	0	22054	0	2163960	0	920379	0
Kelby K Krabbenhoft
0	746924	0	0	0	376922	0	730587	0	18132	0	1872565	0	79234
Mark Paulson MD
0	180376	0	45053	0	552	0	28836	0	14996	0	269813	0	0
Michael Olson MD
535584	0	1456	0	24710	0	39748	0	14032	0	615530	0	15838	0
Terrence Grimm MD
0	497424	0	108201	0	1584	0	32720	0	8369	0	648298	0	0
Lisa Carlson
0	292197	0	0	0	1857	0	32720	0	16883	0	343657	0	0
Bradley Schipper
188896	0	0	0	29744	0	5894	0	19113	0	243647	0	3678	0
Bruce Viessman
170011	0	0	0	23486	0	5295	0	16624	0	215416	0	0	0
Bryan Nermoe
181587	0	0	0	28617	0	3955	0	15608	0	229767	0	0	0
Charles P O'Brien MD
418382	0	0	0	125124	0	46103	0	18863	0	608472	0	9937	0
Chris A Marin
173371	0	0	0	38786	0	5517	0	7242	0	224916	0	8587	0
Daniel W Blue MD
397231	0	0	0	136016	0	-14418	0	17422	0	536251	0	26872	0
David Hove
173340	0	0	0	51286	0	5409	0	16490	0	246525	0	23941	0
Diana Berkland
185467	0	0	0	32599	0	70285	0	1124	0	289475	0	4788	0
Ed Weiland
276500	0	0	0	76970	0	7350	0	15396	0	376216	0	12195	0
Jan Haugen-Rogers
197039	0	5000	0	52043	0	6415	0	168	0	260665	0	15464	0
Jeff Sandene
260958	0	0	0	105438	0	7350	0	18016	0	391762	0	33829	0
Jim Striepe
212668	0	0	0	53386	0	63945	0	16590	0	346589	0	16560	0
Kaleen Santema
197159	0	0	0	40615	0	71267	0	15922	0	324963	0	4844	0
Karen A Tobin
200287	0	0	0	46511	0	4629	0	5474	0	256901	0	7207	0
Ken Aspaas
274777	0	0	0	53508	0	57574	0	14103	0	399962	0	2851	0
Kevin Lampe
200038	0	0	0	160615	0	6360	0	14433	0	381446	0	128226	0
Lynn Olson
179462	0	0	0	27246	0	3734	0	14049	0	224491	0	0	0
M Benjamin Perryman
0	259615	0	0	0	51819	0	7350	0	18946	0	337730	0	0
Michael E Farritor MD
290769	0	828	0	66381	0	7350	0	17753	0	383081	0	0	0
Michelle Bruhn
179690	0	4866	0	4454	0	5543	0	168	0	194721	0	0	0
Monica Huber
167691	0	0	0	37331	0	5337	0	8837	0	219196	0	8943	0
Orlen P Tschetter
175274	0	0	0	48105	0	6083	0	9386	0	238848	0	5048	0
Randy Bury
321019	0	0	0	78326	0	32552	0	7023	0	438920	0	20384	0
Richard Adcock
198086	0	10000	0	32698	0	6519	0	18416	0	265719	0	6891	0
Rick Nordahl
161135	0	5000	0	24782	0	5186	0	18922	0	215025	0	3503	0
Robert Salmon
171777	0	0	0	31844	0	57845	0	7254	0	268720	0	5503	0
Steve Goetsch
205423	0	0	0	37953	0	6442	0	15922	0	265740	0	7532	0
Timothy Tracy
187378	0	0	0	37039	0	5847	0	7748	0	238012	0	7780	0
Vern Carda
145962	0	10000	0	29387	0	1338	0	11913	0	198600	0	0	0
Adam T Stys
1836509	0	226456	0	19199	0	7350	0	17108	0	2106622	0	15591	0
Marian Petrasko
1731596	0	376456	0	-3708	0	7350	0	17108	0	2128802	0	0	0
Tomasz P Stys
2268851	0	376456	0	9099	0	7350	0	17108	0	2678864	0	6980	0
William Bell
1809476	0	1456	0	8344	0	7350	0	17108	0	1843734	0	0	0
Wilson Asfora
1465163	0	1456	0	258831	0	7350	0	17108	0	1749908	0	4371	0

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
Part I, Line 1a	On Part I, Questions Regarding Compensation, Sanford checked several of the items as provided to listed persons: First Class or Charter Travel - Charter travel for business purposes is provided for individuals as needed and as cost appropriate, in accordance with written policies. These costs are not included in the W-2's of the individuals as they are incurred for business purposes of Sanford Health. Travel for Companions - Limited travel for companions is required for certain annual meetings. These costs are not included in the W-2's of the individuals as they are incurred for business purposes of Sanford Health. Tax Indemnification and gross-up payments - Certain compensation may be grossed up to include appropriate tax amounts. Health or social club dues or initiation fees - All Sanford employees are eligible for discounted wellness memberships, a portion of these discounts and other club dues are included as fringe benefits, and taxed as such. Personal services - Individuals may have benefits which include tax preparation or planning, this benefit is included in income and taxed. Part I, Line 3: The Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm to annually review the total compensation of arrangements of the officers of the organization, and to report findings and recommendations to the Sanford Board of Trustees for deliberation and action. The most recent study was completed in 2010.
Part I, Line 4a	To be in compliance with the IRS regulatory environment, listed individuals compensation includes a one-time payment of deferred compensation; this compensation was earned over multiple periods, and should be treated as earned over that length of time in exchange for services provided. These amounts were already reported in previous years as compensation. Distributions were paid to the following individuals: Adam Stys $15,591 Bradley Schipper $3,678 Charles O'Brien $9,937 Chris Marin $8,587 Daniel Blue $26,872 David Hove $23,941 Diana Berkland $4,788 Ed Weiland $12,195 Jan Haugen-Rogers $15,464 Jeff Sandene $33,829 Jim Striepe $16,560 Kaleen Santema $4,844 Karen Tobin $7,207 Kelby Krabbenhoft $79,234 Kevin Lampe $128,226 Michael Olson $15,838 Monica Huber $8,943 Orlen Tschetter $5,048 Ken Aspaas $2,851 Randy Bury $20,384 Rick Nordahl $3,503 Richard Adcock $6,891 Robert Salmon $5,503 Steve Goetsch $7,532 Timothy Tracy $7,780 Tomasz Stys $6,980 Wilson Asfora $4,371 Part I, Line 4b / Schedule J, Part II, Column C: In addition to employer contributions to pension plans, amounts representing increases and decreases in actuarial value (actuarial value factors include age, tenure and salary) of defined contribution and defined benefit SERP Plans are included in Column C. Participants and changes in values include: Daniel Blue ($21,768) Kelby Krabbenhoft $706,194 Part 1, Line 4c - Several listed individuals received payment distributions from a benefit plan that falls within the definition of an "equity based" compensation plan. These amounts were deferred over multiple year periods, and were included in compensation in those periods. Distributions were paid to: John VanderWoude $920,379
Part I, Line 6	Sanford physicians are compensated based on the professional services they perform within the clinic in which they provide care. Generally, the model is revenues less expenses. Physicians listed that were paid on this model include: Tomasz Stys, Marian Petrasko, Adam Stys, William Bell, Wilson Asfora, and Michael Olson.
Part I, Line 7	Certain Executives are eligible for a discretionary incentive bonus, based on financial targets and other goals.
Part III	Supplemental: Compensation reported on Schedule J includes: (B)(i) Base compensation - salaries are based on the experience and performance of each executive and bench-marked using independent compensation survey information. (B)(ii) - Bonus & incentive compensation - as part of executive compensation, individuals may be eligible for incentive performance compensation, however if the organization does not meet its financial targets, incentive payments are not paid, regardless of performance. (B)(iii) Other Reportable Compensation - generally includes taxable executive benefits. It also includes the one-time payout of previously deferred compensation (which was also reported as compensation in the earned period). To be in compliance with the IRS regulatory environment, listed individuals compensation includes a one-time payment of deferred compensation; this compensation was earned over multiple periods, and should be treated as earned over that length of time in exchange for services provided. (C) Deferred Compensation includes employer contributions to pension plans and the increase (or decrease) in the actuarial value (actuarial value factors include age, tenure and salary) of the benefit plans. (D) Nontaxable Benefits generally includes health insurance premiums. A memo regarding executive compensation, written by the Chairman of the Sanford Board of Trustees, is on file and available upon request. Compensation paid to trustees is for full-time professional responsibilities as physicians, administrators or employees of the organization. The total compensation paid to Kelby Krabbenhoft of $1,123,846 is comprised of Base salary of $746,924, the one-time payment of previously deferred compensation of $79,234 (see also explanation above) and Other Taxable Earning of $297,688.	Supplemental Information

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer
South Dakota Health and Educational Facilities Authority
460315509	83755VHY3	2004-09-14	70073989	New construction of healthcare facilities	0	0
South Dakota Health and Educational Facilities Authority
460315509	83755VME1	2007-04-19	75002140	New construction and remodeling of healthcare facilities	0	0
South Dakota Health and Educational Facilities Authority
460315509	83755VNZ3	2009-09-29	71015042	New construction and remodeling of healthcare facilities	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceeds	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Capital ExpendituresCapitalExpenditures	Year Of Subst CompletionYearOfSubstCompletion	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind	Amount UnspentAmountUnspent
71703205	870306	70832899	2006	1	1
78211481	736362	77475119	2009	1	1
71102692	997167	15870252		0	1	54235273

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
1	1	1
1	1	1
1	1	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Variable Rate IssueVariableRateIssue	Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied	Exception To RebateExceptionToRebate
1	1	1
0	1	1
0	1	0

Schedule L IRS990ScheduleL

Loan Table LoanTable (2 entries)

Purpose Of LoanPurposeOfLoan	Loan From OrganizationLoanFromOrganization	Original PrincipalOriginalPrincipalAmount	Balance DueBalanceDue	DefaultDefault	Approved By BoardApprovedByBoard	Written AgreementWrittenAgreement
Bryan Nermoe
Physician Recruitment/Retention Loan	X	$20,000	13241	0	0	1
Wilson Asfora
Physician Recruitment/Retention Loan	X	$1,094,257	660815	0	0	1

Field	Value	IRS element (for citing)
Total Balance Due	674056	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (9 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
Joshua Weiland
Ed Weiland - family relationship	67545	Compensation	0
Kim Goetsch
Steve Goetsch - family relationship	38269	Compensation	0
Nancy Salmon
Robert Salmon - family relationship	83913	Compensation	0
Bonnie Tschetter
Orlen Tschetter - family relationship	30826	Compensation	0
Bryan Santema
Kay Santema - family relationship	62673	Compensation	0
Christina Huber
Monica Huber - family relationship	45344	Compensation	0
Deborah Olson
Michael Olson - family relationship	16095	Compensation	0
Barbara Stork
Midwest Provisions	166980	Catering Services	0
Barry Martin
US Bank	393092	Bank Fees and Commissions	0

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Description	Equipment	Description
Number Of Contributions	2	NumberOfContributions
Noncash Contribs Rptd F990	44224	NoncashContribsRptdF990
Method Of Determining Revenues	Book value	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Number Of8283 Received	0	NumberOf8283Received
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	0	ReviewProcessUnusualNCGifts
Third Parties Used	0	ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
Form 990, Part VI, Section A, line 2	Lisa Carlson and Pamela Anderson have a business relationship.
Form 990, Part VI, Section A, line 4	The following members of the Group Return for Sanford Health had significant changes to their organizational documents in the current year: Sanford Medical Center, Sanford Health Network, Sanford Clinic, and Sanford Home Health. Sanford Medical Center, Sanford Clinic, and Sanford Health Network granted reserve powers to SHM MeritCare and SHM Sanford for the advance approval of the following: Amendments to the Articles of Incorporation or Bylaws; mergers with another entity that is not a subsidiary of Sanford (f/k/a Sanford Health-MeritCare) or a merger in which the corporation is the surviving entity; consolidation of the corporationn with another entity or dissolution of the corporation; sale of all or substantially all of its assets; or any name changes of the corporation. In addition, these corporations changed their fiscal year ends from April 30 to June 30. Sanford Home Health changed its fiscal year end from April 30 to June 30.
Form 990, Part VI, Section A, line 6	Sanford Health is the sole corporate member of Sanford Medical Center, Sanford Clinic, Sanford Home Health, Sanford Health Network and Sanford Research. Sanford Health's members are its Trustees. The Trustees of Sanford Health approve the actions approved by the Boards of Directors of Sanford Medical Center, Sanford Health Network, Sanford Home Health and Sanford Research, and the Board of Governors of Sanford Clinic.
Form 990, Part VI, Section A, line 7a	The Sanford Health Board of Trustees appoints the board members for the Board of Directors of Sanford Medical Center, Sanford Health Network, Sanford Home Health and Sanford Research. New members for the Board of Governors of Sanford Clinic shall be approved by the Board of Trustees of Sanford Health.
Form 990, Part VI, Section A, line 7b	The Trustees of Sanford Health approve the actions approved by the Boards of Directors of Sanford Medical Center, Sanford Health Network, Sanford Home Health and Sanford Research, and the Board of Governors of Sanford Clinic.
Form 990, Part VI, Section B, line 11	The Form 990 is prepared internally by the finance department and reviewed by executive management, including both the System CEO and CFO. An external accounting firm reviews the return prior to filing and presents return highlights and key disclosures to the Board of Trustees at the meeting immediately following the return filing date. After the return is filed, a complete copy is made available to the current trustees.
Form 990, Part VI, Section B, line 12c	The annual Conflict of Interest disclosure process is managed by the Chief Compliance Officer (CCO). The CCO is responsible for assuring that all completed forms are returned in a timely and complete manner. Conflict of Interest questionnaires are sent to System Trustees, members of the governing boards of subsidiary entities, officers, and key employees. The disclosures are summarized for review by the executive committee of the Board of Trustees, pursuant to policy. This review allows: 1) The Board to acquire an awareness of financial relationships of board members and key management employees and can invoke the recusal process on a case-by-case basis when potential conflicts are implicated in Board decisions and deliberations, and, 2) Gives the Board the opportunity to seek additional information and clarification about disclosures to determine potential conflicts of interest, and how to manage such.
Form 990, Part VI, Section B, line 15	The Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm to annually review the total compensation arrangements of the officers and operating unit executives of the organization, including the CEO, and to report the findings and recommendations to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2010. Additionally, Sanford periodically engages an independent compensation consultant to review and issue a report regarding the reasonableness of the total compensation arrangements of all physicians employed by the organization. The most recent study of physician total compensation arrangements was completed in 2009.
Form 990, Part VI, Section C, line 19	Although the organization does not maintain a website where the public can access these documents, it would respond individually to any requests or inquiries from the public for these documents.
Form 990, Part VII:	Sanford Trustees provide services to Sanford and its subsidiaries. Hours reported for each individual reflect the time spent on work related to either the filing organization or a related organization. Sanford Board of Trustees has ultimate governance responsibilities for each entity within the Sanford system. In addition, a Board of Directors is established for each entity, which has specific delegated responsibilities from the Board of Trustees related to the oversight of day to day operations of that entity.
	Schedule R, Part V: Transactions between related organizations are computed using a cost method.
Form 990 Elections	Form 990, Page 1, Line H(a) - Listing of Subordinate Organization: Names, Addresses, and EINs Sanford Medical Center 1305 West 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0227855 Sanford Home Health 2710 West 12th Street Sioux Falls, SD 57104 EIN: 46-0282134 Sanford Health Network 1305 West 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0388596 Sanford Clinic 1305 West 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0447693 Sanford Research / USD 1305 West 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0450378	Elections
Form 990, Schedule K, Part IV, Line 4d	There were no GICs on any of the bonds; however, the software compelled an answer to line 4d, which is why a "yes" answer appears there.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Total IncomeTotalIncome	EOY AssetsEOYAssets	Business Name Line1DirectControllingEntityName/BusinessNameLine1
Sanford Consumer Services LLC
1305 W 18th Street	Sioux Falls	SD	57117	208736919	Medical Spa	SD	-542384	386085	Sanford Clinic
Southwest MN Radiation Center LLC
1018 6th Ave	Worthington	MN	56187	460447693	Radiation	SD	-799247	242526	Sanford Health Network
Sanford Medical Center Auxiliary
1305 W 18th Street	Sioux Falls	SD	57117	460227855	Support Hospital	SD	3272	137483	Sanford Medical Center

Form990 Schedule R Part II Form990ScheduleRPartII (18 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1
Sanford Health
1305 West 18th Street	Sioux Falls	SD	57117	311527032	Supporting Organization	SD	501(c)(3)	11-III	Sanford Health
Sanford Health Foundation
1305 West 18th Street	Sioux Falls	SD	57117	363297853	Supporting Organization	SD	501(c)(3)	11-I	Sanford Health
Sanford World Clinics
1305 West 18th Street	Sioux Falls	SD	57117	262707628	Healthcare	SD	501(c)(3)	3	Sanford Health
Sanford
801 Broadway Drive	Fargo	ND	58122	271218956	Supporting Organization	ND	501(c)(3)	11-II
SHM-Sanford
1305 West 18th Street	Sioux Falls	SD	57105	271213769	Supporting Organization	SD	501(c)(3)	11-II
SHM-MeritCare
801 Broadway Drive	Fargo	ND	58122	271213717	Supporting Organization	ND	501(c)(3)	11-II
Sanford North
PO Box 2010	Fargo	ND	58122	450385890	Supporting Organization	ND	501(c)(3)	11-II	Sanford
Sanford Medical Center Fargo
PO Box 2010	Fargo	ND	58122	450226909	Hospital	ND	501(c)(3)	3	Sanford North
Sanford Clinic North
PO Box 2010	Fargo	ND	58122	911770748	Clinics	ND	501(c)(3)	9	Sanford North
Sanford Health Network North
PO Box 2010	Fargo	ND	58122	450409348	Hospitals/Clinics	ND	501(c)(3)	11-II	Sanford North
Sanford Medical Center Wheaton
401 12th Street North	Wheaton	MN	56296	272042143	Hospital/Clinic	MN	501(c)(3)	3	Sanford North
Sanford Health Foundation North
PO Box 2010	Fargo	ND	58122	450398104	Supporting Organization	ND	501(c)(3)	7	Sanford North
Sanford Medical Center Thief River Falls
120 Labree Ave S	Thief River Falls	MN	56701	410709579	Hospital	MN	501(c)(3)	3	Sanford North
Sanford Medical Center Mayville
42 6th Ave SE	Mayville	ND	58257	450228899	Hospital	ND	501(c)(3)	3	Sanford North
MeritCare Minnesota
1720 South Highway 59	Thief River Falls	MN	56701	261530302	Promotion of health	MN	501(c)(3)	3	Sanford North
Agassiz Assurance Company
100 Bankd Street Suite 610	Burlington	VT	05401	743121855	Insurance	VT	501(c)(3)	11-II	Sanford North
MeritCare Health Enterprises Inc
PO Box 2010	Fargo	ND	58122	450359785	Prescription drugs	ND	501(c)(4)		Sanford North
FM Ambulance Service
2215 18 St South	Fargo	ND	58103	450344371	EMT	ND	501(c)(4)		Sanford North

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner
National Student Housing-South Dakota LLC
100 S Phillips Ave	Sioux Falls	SD	57104	202129839	Investment	SD	Sanford Health	Related	0	0
RAC Rentals LLC
100 S Phillips Ave	Sioux Falls	SD	57104	261961077	Investment	SD	Sanford Health	Related	0	0

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity
Heart Partners at Sanford
1305 W 18th Street	Sioux Falls	SD	57117	460449572	Healthcare	SD	Sanford Health	C
Sanford Home Medical Equipment Inc
2710 W 12th Street	Sioux Falls	SD	57105	460388597	Healthcare Equipment	SD	Sanford Health	C
Sanford Health Plan
300 Cherapa Place	Sioux Falls	SD	57103	911842494	Insurance	SD	Sanford Health	C
Sanford Health Plan of MN
300 Cherapa Place	Sioux Falls	SD	57103	460445852	Insurance	MN	Sanford Health	C
Healthcare Environmental Services Inc
1420 40th St NW	Fargo	ND	58102	450336598	Laundry and Incineration Services	ND	Sanford North	C

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	0	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	0	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	Sanford Health Foundation	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	Q	TransactionType
Amount Involved	167239	AmountInvolved