TY 2014 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) Barb Everist........................................................................ Trustee	0.50 .......................1.00	X	X	0	0
(2) Brent Teiken........................................................................ Trustee	0.50 .......................1.00	X		0	0
(3) Christopher Meeker MD........................................................................ Trustee/Sanford Physician (thru Dec 14)	59.00 .......................1.00	X		409,994	30,330
(4) David Beito........................................................................ Trustee	0.50 .......................1.00	X	X	0	0
(5) Don Jacobs........................................................................ Trustee	0.50 .......................1.00	X		0	0
(6) Don Morton........................................................................ Trustee	0.50 .......................1.00	X		0	0
(7) Jerome Feder........................................................................ Trustee (thru Dec 14)	0.50 .......................1.00	X		0	0
(8) Jim Entenman........................................................................ Trustee	0.50 .......................1.00	X		0	0
(9) Lauris Molbert........................................................................ Trustee	0.50 .......................1.00	X		0	0
(10) Maria Bell MD........................................................................ Trustee/Sanford Physician	59.00 .......................1.00	X		741,279	36,536
(11) Mark Lundeen MD........................................................................ Trustee/Sanford Physician	59.00 .......................1.00	X		1,060,041	25,249
(12) Mark Paulson MD........................................................................ Trustee/Sanford Physician	59.00 .......................1.00	X	X	236,472	30,216
(13) Michael LeBeau MD........................................................................ Trustee/Sanford Physician	59.00 .......................1.00	X		1,159,924	27,411
(14) Patrick Durick........................................................................ Trustee	0.50 .......................1.00	X		0	0
(15) Richard Hardie MD........................................................................ Trustee/Sanford Physician	59.00 .......................1.00	X		730,721	33,295
(16) Ronald Moquist........................................................................ Trustee (thru Dec 14)	0.50 .......................1.00	X		0	0
(17) Thomas Hruby........................................................................ Trustee	0.50 .......................1.00	X		0	0

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Kelby K Krabbenhoft........................................................................ Sanford President & CEO	5.00 .......................55.00	X	X				1,749,435	0	23,433
(19) Kelby K Krabbenhoft Deferred Comp........................................................................ Sanford President & CEO	5.00 .......................55.00	X	X				0	0	727,751
(20) JoAnn L Kunkel........................................................................ Chief Financial Officer	23.00 .......................37.00		X				653,020	0	33,933
(21) Nate White........................................................................ Chief Operating Officer	60.00 .......................0.00		X				831,887	0	41,063
(22) Richard G Adcock........................................................................ Executive VP	60.00 .......................0.00		X				223,102	168,045	36,433
(23) Kim Patrick........................................................................ Chief Legal Officer	60.00 .......................0.00		X				568,550	0	95,296
(24) Bill Marlette........................................................................ Treasurer	60.00 .......................0.00		X				709,288	0	1,674
(25) Bill Marlette Deferred Comp........................................................................ Treasurer	60.00 .......................0.00		X				0	0	184,967
(26) David Link........................................................................ Executive VP	60.00 .......................0.00		X				859,499	0	23,326
(27) David Link Deferred Comp........................................................................ Executive VP	60.00 .......................0.00		X				0	0	157,987
(28) Al Hurley........................................................................ COO - Bismarck Clinic	60.00 .......................0.00			X			303,998	0	21,413
(29) Allison Suttle MD........................................................................ Chief Medical Officer - HSD	60.00 .......................0.00			X			392,822	0	36,640
(30) Bradley J Schipper........................................................................ COO - SMC & Sanford Clinic Sioux Falls	60.00 .......................0.00			X			386,772	0	36,364
(31) Brenda Larsen........................................................................ COO - Bismarck Medical Center	60.00 .......................0.00			X			296,247	0	32,380
(32) Bruce D Viessman........................................................................ CFO - Sanford Health Network	55.00 .......................5.00			X			274,024	0	34,337
(33) Craig Boyer........................................................................ CFO - Bemidji	55.00 .......................5.00			X			276,466	0	90,630
(34) Craig Lambrecht........................................................................ President - Bismarck	55.00 .......................5.00			X			816,192	0	29,911
(35) Daniel Olson........................................................................ President - Bemidji	55.00 .......................5.00			X			429,277	0	30,808
(36) Daniel W Blue........................................................................ President - Sanford Clinic	60.00 .......................0.00			X			762,377	0	126,354
(37) Douglas Okland........................................................................ CFO - Fargo & Bismarck Clinic	60.00 .......................0.00			X			269,142	0	15,984
(38) Ellen Cooke........................................................................ COO - Sanford Clinic North	60.00 .......................0.00			X			318,726	0	22,293
(39) Eric Hilmoe........................................................................ COO - Sanford Health Network	60.00 .......................0.00			X			197,056	0	9,246
(40) Jeff D Sandene........................................................................ Chief Integration Officer - D&R	60.00 .......................0.00			X			497,936	0	32,218
(41) Jesse Tischer........................................................................ President - Sanford Health Network	55.00 .......................5.00			X			278,249	0	29,777
(42) Joy Johnson........................................................................ COO - Bemidji	60.00 .......................0.00			X			360,479	0	17,273
(43) Karen Tobin........................................................................ COO - SMC Fargo	55.00 .......................5.00			X			325,509	0	21,017
(44) Kirk Cristy........................................................................ CFO - Bismarck	55.00 .......................5.00			X			254,389	0	21,217
(45) Matthew Hocks........................................................................ Executive VP - Sanford Clinic	60.00 .......................0.00			X			254,707	0	34,665
(46) Michael E Farritor........................................................................ COO - Sanford Clinic	60.00 .......................0.00			X			432,772	0	36,643
(47) Michelle A Bruhn........................................................................ CFO - HSD	60.00 .......................0.00			X			402,110	0	13,854
(48) Michelle M Micka........................................................................ CFO - D&R	60.00 .......................0.00			X			291,047	0	36,644
(49) Paul Hanson........................................................................ President - SMC Sioux Falls	60.00 .......................0.00			X			779,076	0	34,433
(50) Paul Richard........................................................................ President - SMC Fargo	55.00 .......................5.00			X			602,117	0	32,862
(51) Randy Bury........................................................................ Chief Admin Officer - HSD	60.00 .......................0.00			X			565,086	0	8,958
(52) Randy Bury Deferred Comp........................................................................ Chief Admin Officer - HSD	60.00 .......................0.00			X			0	0	16,599
(53) Richard Giesel........................................................................ President - SHN (thru April 15)	55.00 .......................5.00			X			522,077	0	25,973
(54) Richard Marsden MD........................................................................ COO - Sanford Clinic North	60.00 .......................0.00			X			648,285	0	25,054
(55) Steve W Goetsch........................................................................ CFO - SMC & Sanford Clinic Sioux Falls	60.00 .......................0.00			X			279,174	0	37,804
(56) Tiffany Lawrence........................................................................ CFO - SMC Fargo	55.00 .......................5.00			X			285,609	0	35,018
(57) William C Brunner........................................................................ Physician	60.00 .......................0.00				X		2,213,956	0	34,143
(58) Scott Pham........................................................................ Physician	60.00 .......................0.00				X		3,384,756	0	36,143
(59) Adam T Stys........................................................................ Physician	60.00 .......................0.00				X		2,273,447	0	34,143
(60) Tomasz P Stys........................................................................ Physician	60.00 .......................0.00				X		2,461,970	0	34,143
(61) Corey L Teigen........................................................................ Physician	60.00 .......................0.00				X		2,074,339	0	32,419
(62) Rebecca Nelson........................................................................ Former Senior VP & COO - HSD	0.00 .......................0.00					X	450,000	0	0
(63) Edmond L Weiland........................................................................ Former President - SHN	0.00 .......................0.00					X	462,371	0	0
(64) Dennis Millirons........................................................................ Former President SMC Fargo	0.00 .......................0.00					X	1,344,466	0	23,452
(65) Cecily Tucker........................................................................ Former CFO - D&R	0.00 .......................0.00					X	0	267,171	13,694
(66) Merrilee Schultz........................................................................ Former CFO SMC	0.00 .......................0.00					X	195,582	0	13,209
(67) Bryan J Nermoe........................................................................ Former COO - Sanford Clinic	0.00 .......................0.00					X	312,009	0	33,425
(68) Michael Schumacher........................................................................ Former CFO - Bismarck	0.00 .......................0.00					X	152,352	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
Cardinal Health 7000 Cardinal Place Dublin,OH43017	Medical Services	222,671,314
MA Mortenson Company 700 Meadow Lane N Minneapolis,MN55422	Construction	170,413,418
Owens & Minor Inc 12199 Collection Ctr Dr Chicago,IL60693	Medical Services	56,746,421
Medtronic USA 4642 Collection Ctr Dr Chicago,IL60693	Medical Services	30,224,905
GE Healthcare 9900 W Innovation Dr Milwaukee,WI53226	Medical Services	18,883,852
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 1,005

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	11,396,256	11,396,256
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............	7,500	7,500
4	Benefits paid to or for members ....
5	Compensation of current officers, directors, trustees, and key employees ....	28,954,918		28,954,918
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	1,903,334		1,903,334
7	Other salaries and wages ....	1,603,143,288	1,433,214,844	169,908,300	20,144
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	65,692,144	57,520,856	8,170,004	1,284
9	Other employee benefits .......	177,893,948	148,443,803	29,443,674	6,471
10	Payroll taxes ...........	103,581,475	90,135,537	13,443,280	2,658
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	2,544,881		2,544,881
c	Accounting ...........	1,037,300		1,037,300
d	Lobbying ...........	681,150		681,150
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	178,779,728	133,753,921	45,007,807	18,000
12	Advertising and promotion ....	19,846,009	11,841,522	8,003,402	1,085
13	Office expenses .......	39,273,110	30,186,853	9,086,042	215
14	Information technology ......	26,313,491	19,478,259	6,835,232
15	Royalties ..	1,327,750	1,327,750
16	Occupancy ...........	84,565,933	63,932,963	20,632,970
17	Travel ............	16,635,852	13,488,634	3,147,218
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	4,647,677	3,691,543	954,174	1,960
20	Interest ...........	29,758,841	29,244,760	514,081
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	152,673,593	117,580,291	35,093,302
23	Insurance ..............	16,130,813	11,430,036	4,700,777
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical Supplies	602,300,633	596,107,339	6,193,223	71
b	Intercompany Purchases	9,776,737	0	9,775,671	1,066
c	MinnesotaCare Tax	5,174,070	5,174,070
d	CME	4,709,636	4,709,636
e	All other expenses	18,759,983	14,017,490	4,741,496	997
25	Total functional expenses. Add lines 1 through 24e	3,207,510,050	2,796,683,863	410,772,236	53,951
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	47,573,438	1	72,344,016
2	Savings and temporary cash investments .........	44,603,125	2	74,321,362
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	569,347,046	4	529,770,930
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		129,246	5	112,475
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
			6
7	Notes and loans receivable, net .............	36,599,629	7	39,925,043
8	Inventories for sale or use ..............	53,339,758	8	59,944,756
9	Prepaid expenses and deferred charges ..........	35,392,498	9	31,188,012
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	2,904,512,891
b	Less: accumulated depreciation .....	10b	1,431,400,495	1,337,814,545	10c	1,473,112,396
11	Investments—publicly traded securities ..........	1,772,888	11	1,815,449
12	Investments—other securities. See Part IV, line 11 .....	8,237,353	12	27,763,559
13	Investments—program-related. See Part IV, line 11 .....	44,314,393	13	44,715,963
14	Intangible assets ...............	60,361,849	14	60,477,684
15	Other assets. See Part IV, line 11 ...........	96,341,573	15	103,430,333
16	Total assets. Add lines 1 through 15 (must equal line 34)......	2,335,827,341	16	2,518,921,978
	17	Accounts payable and accrued expenses .........	371,305,801	17	438,294,821
18	Grants payable .................	332,605	18	2,518,919
19	Deferred revenue ................	787,965	19	1,697,633
20	Tax-exempt bond liabilities .............	639,321,872	20	806,230,299
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	202,458	21	298,296
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	73,556,983	23	53,827,620
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	136,673,729	25	153,970,180
26	Total liabilities. Add lines 17 through 25.........	1,222,181,413	26	1,456,837,768
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	1,113,144,473	27	1,061,609,414
28	Temporarily restricted net assets ...........	74,372	28	46,988
29	Permanently restricted net assets ...........	427,083	29	427,808
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	1,113,645,928	33	1,062,084,210
34	Total liabilities and net assets/fund balances ........	2,335,827,341	34	2,518,921,978

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

Sanford Group Return

Employer identification number

45-3791176

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ............................. 18

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2014

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Schedule A (Form 990 or 990-EZ) 2014

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2014

Page 6

Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1. Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6
7	Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2014

Page 7

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2014 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2014	(iii) Distributable Amount for 2014
1 Distributable amount for 2014 from Section C, line 6
2 Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2014 distributable amount
i Carryover from 2009 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2014 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2014 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2015. Add lines 3j and 4c.
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......
e From 2014.......

Schedule A (Form 990 or 990-EZ) (2014)

Schedule A (Form 990 or 990-EZ) 2014

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
List of organizations and public charity status:	Sanford Health 509(a)(3) Sanford Medical Center 170(b)(1)(A)(iii) Sanford Clinic 170(b)(1)(A)(iii) Sanford Research 170(b)(1)(A)(iii) Sanford Home Health 509(a)(2) Sanford Health Network 170(b)(1)(A)(iii) Sanford World Clinics 170(b)(1)(A)(iii) Sanford North 509(a)(3) Sanford Medical Center Fargo 170(b)(1)(A)(iii) Sanford Clinic North 509(a)(2) Sanford Health Network North 509(a)(3) Sanford Medical Center Thief River Falls 170(b)(1)(A)(iii) Sanford Medical Center Mayville 170(b)(1)(A)(iii) Sanford Medical Center Wheaton 170(b)(1)(A)(iii) Sanford Hillsboro 170(b)(1)(A)(iii) Sanford Health of Northern Minnesota 170(b)(1)(A)(iii) Baker Park, Inc. 509(a)(2) Sanford West 509(a)(3) Sanford Bismarck 170(b)(1)(A)(iii) Sanford Living Centers 509(a)(2)
Schedule A, Part I	Detail for Schedule A, Part I Line 11, Column: (i) Sanford Medical Center; (ii) 46-0227855; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 34,890,763 Line 11, Column: (i) Sanford Clinic; (ii) 46-0447693; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 6,036,596 Line 11, Column: (i) Sanford Research; (ii) 46-0450378; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 838,323 Line 11, Column: (i) Sanford Home Health; (ii) 46-0282134; (iii) 509(a)(2); (iv) Yes; (v) 225,184 Line 11, Column: (i) Sanford Health Network; (ii) 46-0388596; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 10,867,599 Line 11, Column: (i) Sanford Clinic North; (ii) 91-1770748; (iii) 509(a)(2); (iv) Yes; (v) 6,948,049 Line 11, Column: (i) Sanford Medical Center Fargo; (ii) 45-0226909; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 38,358,821 Line 11, Column: (i) Sanford Medical Center Thief River Falls; (ii) 41-0709579; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 2,910,424 Line 11, Column: (i) Sanford Medical Center Mayville; (ii) 45-0228899; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 322,504 Line 11, Column: (i) Sanford Medical Center Wheaton; (ii) 27-2042143; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 284,813 Line 11, Column: (i) Sanford Hillsboro; (ii) 45-0230400; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 310,106 Line 11, Column: (i) Sanford World Clinics; (ii) 26-2707628; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 291,971 Line 11, Column: (i) Sanford Health of Northern Minnesota; (ii) 41-1266009; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 8,977,048 Line 11, Column: (i) Baker Park, Inc.; (ii) 41-1372480; (iii) 509(a)(2); (iv) Yes; (v) 24,247 Line 11, Column: (i) Sanford Health Foundation North; (ii) 45-0398104; (iii) 170(b)(1)(A)(vi); (iv) Yes; (v) 210,353 Line 11, Column: (i) Sanford Bismarck; (ii) 45-0226700; (iii) 170(b)(1)(A)(iii); (iv) Yes; (v) 16,230,067 Line 11, Column: (i) Sanford Living Centers; (ii) 45-0416454; (iii) 509(a)(2); (iv) Yes; (v) 1,206,753 Line 11, Column: (i) Sanford Health Foundation West; (ii) 45-0397196; (iii) 170(b)(1)(A)(vi); (iv) Yes; (v) 92,280
Schedule A, Part III	Detail for Schedule A, Part III Line 1 - column: (a) 1,320,938; (b) 719,019 ; (c) 653,960; (d) 625,251; (e) 232,693; (f) 3,551,861 Line 2 - column: (a) 487,937,029; (b) 380,393,691; (c) 353,433,077; (d) 195,263,418; (e) 214,359,949; (f) 1,631,387,164 Line 6 - column: (a) 489,257,967; (b) 381,112,710; (c) 354,087,037; (d) 195,888,669; (e) 214,592,642; (f) 1,634,939,025 Line 8 - column: (f) 1,634,939,025 Line 9 - column: (a) 489,257,967; (b) 381,112,710; (c) 354,087,037; (d) 195,888,669; (e) 214,592,642; (f) 1,634,939,025 Line 10a - column: (a) 1,127,354; (b) 994,862; (c) 1,011,110; (d) 970,589; (e) 671,284; (f) 4,775,199 Line 10c - column: (a) 1,127,354; (b) 994,862; (c) 1,011,110; (d) 970,589; (e) 671,284; (f) 4,775,199 Line 11 - column: (a) 392,690; (b) 358,969; (c) 197,834; (d) 279,896; (e) 400,943; (f) 1,630,332 Line 13 - column: (a) 490,778,011; (b) 382,466,541; (c) 355,295,981; (d) 197,139,154; (e) 215,664,869; (f) 1,641,344,556 Line 15: 99.61% Line 16: 99.61% Line 17: 0.29% Line 18: 0.27% Line 19a: X Line 19b: X
Part IV, Section A	Line 1: Yes Line 2: No Line 3a: No Line 4a: No Line 5a: No Line 6: No Line 7: No Line 8: No Line 9a: No Line 9b: No Line 9c: No Line 10a: No Line 11a: No Line 11b: No Line 11c: No
Part IV, Section C	Line 1: Yes

Schedule A (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Name of the organization

Sanford Group Return

Employer identification number

45-3791176

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 2

Name of organization Sanford Group Return

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 3

Name of organization Sanford Group Return

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 4

Name of organization
Sanford Group Return

Employer identification number

45-3791176

Part III

Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Sanford Group Return

Employer identification number

45-3791176

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2014

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2014

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Yes

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Yes

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Yes

85,020

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

941,329

Total. Add lines 1c through 1i ...............................

1,026,349

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

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

Return Reference

Explanation

Part II-B, Line 1:

The filing organization has memberships in the South Dakota Association of Healthcare Organizations, North Dakota Hospital Association, Minnesota Hospital Association, Iowa Hospital Association, American Hospital Association, North Dakota Long Term Care Association, North Dakota Medical Group Management Association, Iowa Alliance in Home Care and Health Policy Consortium. A percentage of membership dues paid to these organizations relate to lobbying expenses. In addition, the organization employs certain individuals, and contracts with various lobbyists, to monitor legislative acts important to all Sanford entities on both state and national levels. Occasionally, Sanford employees send mailings to legislators on issues that may affect healthcare.

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Sanford Group Return

Employer identification number

45-3791176

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2014

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....	54,120,507	48,229,852	43,654,039	38,601,256	30,148,159
b	Contributions ........	4,007,618	5,316,297	4,275,810	5,033,151	8,272,186
c	Net investment earnings, gains, and losses	25,086	654,694	312,076	33,855	195,011
d	Grants or scholarships .....	0	54,813	0	3,144	3,066
e	Other expenditures for facilities and programs ........	6,372	6,949	7,305	6,341	6,269
f	Administrative expenses ....	4,834	18,574	4,768	4,738	4,233
g	End of year balance ......	58,142,005	54,120,507	48,229,852	43,654,039	38,601,256

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	111,027,070		111,027,070
b	Buildings ................	1,154,986,499	500,592,730	654,393,769
c	Leasehold improvements ............	74,126,445	34,704,431	39,422,014
d	Equipment ................	1,527,209,031	874,816,846	652,392,185
e	Other .................	37,163,846	21,286,488	15,877,358
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				1,473,112,396

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes
Deferred compensation		74,474,573
Defined benefit pension liability		68,561,375
Other non-current liabilities		10,934,232






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		153,970,180
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2014

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.......................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................		2e
3	Subtract line 2e from line 1.....................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.......................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Part IV, Line 2b:	Long term care facilities hold security deposits for tenants.
Part V, Line 4:	Edith Sanford Breast Cancer Foundation, Sanford Health Foundation, Sanford Health Foundation North, Sanford Health Foundation Hillsboro, Sanford Health Foundation of Northern Minnesota and Sanford Health Foundation West hold endowment funds on behalf of the filing organization to be used for assistance in its activities and for providing health care, medical, or educational services. All prior year amounts have been restated to include endowments held on all Sanford foundations.
Part X, Line 2:	Certain controlled organizations are subject to income taxes. Deferred income tax assets and liabilities are recognized for the differences between the financial and income tax reporting basis of assets and liabilities based on enacted tax rates and laws. A tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination. The deferred income tax provision or benefit generally reflects the net change in deferred income tax assets and liabilities during the year. The current income tax provision reflects the tax consequences of revenues and expenses currently taxable or deductible on various income tax returns for the year reported. Sanford Group did not have a material income tax liability at June 30, 2015; some related organizations have established reserves.

Schedule D (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization
Sanford Group Return

Employer identification number

45-3791176

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants

and other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria

used to award the grants or assistance? ...........................

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in region	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	East Asia and the Pacific	0	0	Program Services	Travel, conferences and purchased goods & services	9,982
	Europe (Including Iceland & Greenland)	0	0	Program Services	Investigation of potential clinic sites, travel and purchased goods & services	119,514
	Middle East and North Africa	0	0	Program Services	Purchased goods	35
	North America	0	0	Program Services	Travel, conferences and purchased goods & services	72,579
	South Asia	0	0	Program Services	Mission healthcare work, investigation of potential clinic sites and purchased services	28,409
	Sub-Saharan Africa	0	0	Program Services	Legal services	5,676
	Sub-Saharan Africa	0	0	Grantmaking	Grant	7,500
	Sub-Saharan Africa	0	0	Investment	Investment in Ghana clinic operations	3,765,946
	Central America and the Caribbean	0	0	Program Services	Legal services	2,648
	East Asia and the Pacific	0	0	Investment	Investment in China clinic operations	274,749
	South America	0	0	Program Services	Travel and purchased goods & services	10,630






3a	Sub-total .....	0	0			4,009,641
b	Total from continuation sheets to Part I ...	0	0			288,027
c	Totals (add lines 3a and 3b)	0	0			4,297,668

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2014

Schedule F (Form 990) 2014

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

(a)(c) Region	(b)(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement
Sub-Saharan Africa	General support	7,500	Wire

Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .... MediumBullet

Enter total number of other organizations or entities ....................... MediumBullet

Schedule F (Form 990) 2014

Schedule F (Form 990) 2014Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2014

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2014

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

ReturnReference	Explanation

Schedule F (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Sanford Group Return

Employer identification number

45-3791176

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 22500.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: .........

Yes

200% 250% 300% 350% 400% Other 37500.0000000000 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) ..	58,264,928	0	58,264,928	1.820 %
b	Medicaid (from Worksheet 3, column a) ....	358,479,120	261,497,577	96,981,543	3.020 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .	0	0		0 %
d	Total Financial Assistance and Means-Tested Government Programs .	416,744,048	261,497,577	155,246,471	4.840 %
Other Benefits		6,988,556	880,352	6,108,204	0.190 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	6,988,556	880,352	6,108,204	0.190 %
f	Health professions education (from Worksheet 5) ..	16,886,500	5,459,976	11,426,524	0.360 %
g	Subsidized health services (from Worksheet 6) ..	671,321,845	511,601,608	159,720,237	4.980 %
h	Research (from Worksheet 7)	17,747,541	4,288,829	13,458,712	0.420 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	8,311,960	0	8,311,960	0.260 %
j	Total. Other Benefits ..	721,256,402	522,230,765	199,025,637	6.210 %
k	Total. Add lines 7d and 7j .	1,138,000,450	783,728,342	354,272,108	11.050 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014

Schedule H (Form 990) 2014

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing	0	0		0 %
2	Economic development	9,361	0	9,361	0 %
3	Community support	81,347	0	81,347	0 %
4	Environmental improvements	0	0		0 %
5	Leadership development and training for community members	2,770	0	2,770	0 %
6	Coalition building	611,412	0	611,412	0.020 %
7	Community health improvement advocacy	28,291	0	28,291	0 %
8	Workforce development	159,670	0	159,670	0 %
9	Other	0	0		0 %
10	Total	892,851		892,851	0.020 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

55,641,853

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

713,108,245

Enter Medicare allowable costs of care relating to payments on line 5.....

702,648,689

Subtract line 6 from line 5. This is the surplus (or shortfall)........

10,459,556

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2014

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?24 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)									Other (describe)	Facility reporting group
1	Sanford USD Medical Center 1305 W 18th Street Sioux Falls,SD57117 www.sanfordhealth.org SD 10564 Sanford Medical Center 460227855	X	X	X	X			X		A
2	Sanford Medical Center Fargo 801 Broadway North Fargo,ND58122 www.sanfordhealth.org ND 5018A Sanford Medical Center Fargo 450226909	X	X	X	X			X		A
3	Sanford Medical Center South University 1720 South University Fargo,ND58103 www.sanfordhealth.org ND 5068A Sanford Medical Center Fargo 450226909	X	X		X					A
4	Sanford Bismarck Medical Center 300 N 7th Street Bismarck,ND58501 www.sanfordhealth.org ND 5003A Sanford Bismarck 450226700	X	X		X		X	X		A
5	Sanford Bemidji Medical Center 1300 Anne Street NW Bemidji,MN56601 www.sanfordhealth.org MN 371073 Sanford Health of Northern Minnesota 411266009	X	X					X		A
6	Sanford Medical Center Thief River Falls 3001 Sanford Parkway Thief River Falls,MN56701 www.sanfordhealth.org MN 371500 Sanford Medical Center Thief River Falls 410709579	X	X			X		X	Inpatient Mental Health	A
7	Sanford Aberdeen Medical Center 2905 3rd Avenue SE Aberdeen,SD57401 www.sanfordhealth.org SD 65089 Sanford Health Network 460388596	X	X					X		A
8	Sanford Worthington Medical Center 1018 6th Avenue Worthington,MN56187 www.sanfordhealth.org MN 371449 Sanford Health Network 460388596	X	X					X		A
9	Sanford Sheldon Medical Center 118 N 7th Avenue Sheldon,IA51201 www.sanfordhealth.org IA 161381 Sanford Health Network 460388596	X	X			X		X	Nursing Facility	A
10	Sanford Vermillion Medical Center 20 S Plum Street Vermillion,SD57069 www.sanfordhealth.org SD 53082 Sanford Health Network 460388596	X	X			X		X	Nursing Facility	A
11	Sanford Chamberlain Medical Center 300 S Byron Blvd Chamberlain,SD57325 www.sanfordhealth.org SD 50302 Sanford Health Network 460388596	X	X			X		X	Nursing Facility	A
12	Sanford Luverne Medical Center 1600 N Kniss Avenue Luverne,MN56156 www.sanfordhealth.org MN 371352 Sanford Health Network 460388596	X	X			X		X		A
13	Sanford Canby Medical Center 112 St Olaf Avenue S Canby,MN56220 www.sanfordhealth.org MN 371019 Sanford Health Network 460388596	X	X			X		X	Nursing Facility	A
14	Sanford Jackson Medical Center 1430 N Highway Jackson,MN56143 www.sanfordhealth.org MN 371002 Sanford Health Network 460388596	X	X			X		X		A
15	Sanford Tracy Medical Center 251 5th Street E Tracy,MN56175 www.sanfordhealth.org MN 371440 Sanford Health Network 460388596	X	X			X		X		A
16	Sanford Rock Rapids Medical Center 801 S Greene Street Rock Rapids,IA51246 www.sanfordhealth.org IA 161321 Sanford Health Network 460388596	X	X			X		X		A
17	Sanford Hillsboro Medical Center 12 3rd Street SE Hillsboro,ND58045 www.sanfordhealth.org ND 5026A Sanford Hillsboro 450230400	X	X			X		X		A
18	Sanford Medical Center Mayville 42 6th Avenue SE Mayville,ND58257 www.sanfordhealth.org ND 5034A Sanford Medical Center Mayville 450228899	X	X			X		X		A
19	Sanford Webster Medical Center 1401 W 1st Street Webster,SD57274 www.sanfordhealth.org SD 10573 Sanford Health Network 460388596	X	X			X		X		A
20	Sanford Medical Center Wheaton 401 12th Street N Wheaton,MN56296 www.sanfordhealth.org MN 371390 Sanford Medical Center Wheaton 272042143	X	X			X		X		A
21	Sanford Bagley Medical Center 203 4th Street NW Bagley,MN56621 www.sanfordhealth.org MN 371484 Sanford Health of Northern Minnesota 411266009	X	X			X				A
22	Sanford Canton-Inwood Medical Center 440 N Hiawatha Drive Canton,SD57013 www.sanfordhealth.org SD 51569 Sanford Health Network 460388596	X	X			X		X		A
23	Sanford Clear Lake Medical Center 701 3rd Avenue S Clear Lake,SD57226 www.sanfordhealth.org SD 10533 Sanford Health Network 460388596	X	X			X		X		A
24	Sanford Westbrook Medical Center 920 Bell Avenue Westbrook,MN56183 www.sanfordhealth.org MN 371439 Sanford Health Network 460388596	X	X			X		X		A

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?.......................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C..........

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public? ..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): http://www.sanfordhealth.org/About/CHNA

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): http://www.sanfordhealth.org/About/CHNA

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ...........................

12a

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 225.000000000000%
and FPG family income limit for eligibility for discounted care of 375.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): See narrative for full url

The FAP application form was widely available on a website (list url): See narrative for full url

A plain language summary of the FAP was widely available on a website (list url):
See narrative for full url

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2014

Page

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Part V, Section B	Facility Reporting Group A
Facility Reporting Group A consists of:	- Facility 1: Sanford USD Medical Center, - Facility 2: Sanford Medical Center Fargo, - Facility 3: Sanford Medical Center South University, - Facility 4: Sanford Bismarck Medical Center, - Facility 5: Sanford Bemidji Medical Center, - Facility 6: Sanford Medical Center Thief River Falls, - Facility 7: Sanford Aberdeen Medical Center, - Facility 8: Sanford Worthington Medical Center, - Facility 9: Sanford Sheldon Medical Center, - Facility 10: Sanford Vermillion Medical Center, - Facility 11: Sanford Chamberlain Medical Center, - Facility 12: Sanford Luverne Medical Center, - Facility 13: Sanford Canby Medical Center, - Facility 14: Sanford Jackson Medical Center, - Facility 15: Sanford Tracy Medical Center, - Facility 16: Sanford Rock Rapids Medical Center, - Facility 17: Sanford Hillsboro Medical Center, - Facility 18: Sanford Medical Center Mayville, - Facility 19: Sanford Webster Medical Center, - Facility 20: Sanford Medical Center Wheaton, - Facility 21: Sanford Bagley Medical Center, - Facility 22: Sanford Canton-Inwood Medical Center, - Facility 23: Sanford Clear Lake Medical Center, - Facility 24: Sanford Westbrook Medical Center
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model used was the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 6a:	Sanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Elderly ServicesSanford is exploring the recruitment of a full time geriatrician. The nurse-led clinics will consider expansion of CareSpan (walk-in nurse run elder care clinic) and foot care clinics to add additional days per week when the service is available. Sanford has expanded community based nurse led dialogues regarding advance directives and end of life care and is considering an older adult population advisory council comprised of community members, consumers and leaders. Support of the following initiatives continue: Moving Day, PD Support Group, Arthritis Support Group, High Noon education, Better Choices Better Health classes in Sioux Falls with two nurses trained as leaders through Sanford One Care and State programming, Sanford continues to provide support, education and resources for agencies serving older adults (i.e. Active Generations, Arthritis Foundation, Alzheimer's Association, National Parkinson's Foundation-S.D., etc.).Priority 2: Dental ServicesSanford is exploring opportunities to help promote either free or sliding scale fee dental services and programs already offered in the community (i.e. Falls Community Health Center and Ronald McDonald Mobile Care Unit) and continuing to support these services.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 1 -- Sanford USD Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Mental Health ServicesSanford is integrating behavioral health services in all primary care clinics in Fargo. A design team for Inpatient Psychiatric Unit, Partial Hospitalization and Clinic space is considering the best recommendations for current and new spaces. Sanford participates in a leadership role with the Fargo Moorhead Mental Health Strategic Planning Collaborative (ReThink Mental Health).Priority 2: ObesitySanford is developing CME curriculum and an annual symposium to address weight management and obesity for providers and interdisciplinary teams inclusive of medical, nutrition, nursing and behavioral health professionals. Over 400 register for this symposium each year. Sanford actively participates in community initiatives to address wellness, fitness and health living. Sanford has developed community education programming focusing on prevention and treatment of obesity. Sanford includes the following program options in the curriculum to create awareness of existing resources: - Family Wellness Center resources to leverage: - Kids fitness classes - Kids cooking classes (includes family) - Camp Fuel - TNT Fitness for Children - Honor Your Health Program - WebMD Fit Program - Bariatric Surgery - Eating Disorder Institute/Behavioral Health - Profile
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 2 -- Sanford Medical Center Fargo Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Applicable are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Mental Health ServicesSanford is integrating behavioral health services in all primary care clinics in Fargo. A design team for Inpatient Psychiatric Unit, Partial Hospitalization and Clinic space is considering the best recommendations for current and new spaces. Sanford participates in a leadership role with the Fargo Moorhead Mental Health Strategic Planning Collaborative (ReThink Mental Health).Priority 2: ObesitySanford is developing CME curriculum and an annual symposium to address weight management and obesity for providers and interdisciplinary teams inclusive of medical, nutrition, nursing and behavioral health professionals. Over 400 register for this symposium each year. Sanford actively participates in community initiatives to address wellness, fitness and health living. Sanford has developed community education programming focusing on prevention and treatment of obesity. Sanford includes the following program options in the curriculum to create awareness of existing resources: - Family Wellness Center resources to leverage: - Kids fitness classes - Kids cooking classes (includes family) - Camp Fuel - TNT Fitness for Children - Honor Your Health Program - WebMD Fit Program - Bariatric Surgery - Eating Disorder Institute/Behavioral Health - Profile
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 3 -- Sanford Medical Center South University Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Pediatric ObesitySanford actively participates with community wellness, fitness and healthy living entities to promote and support fitness and active living by sponsoring walking, screening and educational programs. Sanford has initiated a youth-specific running program and has established a Girls on the Run (GOTR) chapter for community members. GOTR seeks to inspire at-risk school-age girls to be joyful, healthy and confident via an experience-based curriculum which creatively integrates running.Sanford continues to partner with community efforts to address pediatric obesity including, but not limited to, YMCA Fit Kids, Bismarck/Mandan and Bismarck-Burleigh Public Health's Bodyworks and Healthy Kids/Healthy Weight programs. Sanford has also leveraged the Sanford WebMD Fit program to parents and children through our local school system and is offering healthy eating and active living classes via Sanford's Doc Talk education series.Priority 2: DiabetesSanford is increasing pre-diabetes education and outreach activities by partnering with the ND Diabetes Control Project to initiate comprehensive pre-diabetes behavior modification class, offering weekly "Diabetes 101" classes to improve diabetes education for newly diagnosed patients and increasing pre-diabetes awareness via health fairs, Doc Talk education series and newspaper articles. Sanford actively participates with community wellness, fitness and health living entities to promote and support fitness and active living by sponsoring walking, screening and educational programs. Sanford also partners with mental health services to offer depression screenings and support services to patients with diabetes and offers monthly diabetes education classes to community members diagnosed with diabetes.Sanford is working in partnership with the North Dakota Department of Health (NDDOH) in a new strategy to initiate a comprehensive pre-diabetes behavior modification class. The class is designed specifically for people who do not have diabetes but have been flagged to be at very high risk based upon screening results, family history and lifestyle. The class will be led via a partnership of Sanford diabetes educators and NDDOH staff and features education materials tailored to this target audience.
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 4 -- Sanford Bismarck Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Mental HealthSanford is fully integrating behavioral health services or access to behavioral health outreach in all regional clinic sites in the Bemidji region. Sanford is working collaboratively with Beltrami County, Upper Mississippi Mental Health Center and several other community agencies to develop a county-wide continuum of care to meet behavioral health needs of the county. Programming would encompass acute and crisis needs, detoxification, community based care options, as well as other support programs.Priority 2: ObesitySanford is developing a comprehensive weight management program within the Bemidji region using an interdisciplinary team inclusive of medical nutrition, behavioral health, fitness professionals and surgical services. Sanford has added Profile, a retail weight management program within the Bemidji region. Sanford actively participates with community wellness, fitness and healthy living entities to promote and support fitness and active living by sponsoring walking, screening and educational programs.
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 5 -- Sanford Bemidji Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of results. Community stakeholders and community councils were included.
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Sanford One MindSanford is participating in the Sanford enterprise One Care strategy to implement behavioral health screening into all primary care settings.Priority 2: Prescription MonitoringSanford is establishing a plan for prescription drug abuse cases, including behavioral health, primary care and the Medical Home department.Priority 3: Coordination of CareSanford is establishing a network for detoxification and inpatient chemical dependency treatment centers, coordination of care between chemical dependency and behavioral health providers, developing reliable chemical dependency outpatient services for adolescents and improving access to chemical dependency assessments for community members.Priority 4: ObesitySanford is participating in the Sanford enterprise implementation strategy for obesity and moving the wellness center to the clinic.Priority 5: Integrated ApproachSanford is integrating dietitian services with dialysis services, integrating behavioral health within primary care, implementing the integrated EMR platform across clinic and hospital-based services, implementing the hospitalist program with established connectivity to outpatient providers and connecting long-term care facilities to providers and inpatient services.Priority 6: Build DM ProgramsSanford is establishing a comprehensive pain management program and promoting Medical Home and practices through the Medical Home Team: Cardiac Rehab, dietitians, RN Health Coaches, tobacco cessation specialists, outpatient social workers, etc.Priority 7: Expand Services/CoverageSanford is expanding Urology services, creating a more complete Oncology outreach program, improving acess to primary care including Family Medicine, Internal Medicine, OB/GYN, Pediatrics, Psychology, Psychiatry, establishing outreach Dermatology services, establishing Neurology outreach services and establishing a comprehensive pain management clinic.
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 6 -- Sanford Medical Center Thief River Falls Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Mental HealthSanford is establishing adolescent and adult mental health Telehealth services from Sanford Aberdeen Medical Center to Sanford Medical Center in Sioux Falls.Priority 2: Bariatric ServicesSanford is establishing a Sanford Aberdeen-based Bariatric Services accredited program and has added Profile, a retail based weight management program.
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 7 -- Sanford Aberdeen Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical Center
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: ObesitySanford is establishing a youth program (K-4) with District 518, YMCA and local Sanford Worthington Clinic pediatricians and staff. The program includes physical activity for the kids as well as an educational component for parents.Priority 2: Elderly ServicesSanford is reviewing and defining the socio-economic-health status of the elderly in the community and developing an implementation strategy for the needs identified. Partner agencies are invited to participate in this work.Priority 3: New AmericansSanford is increasing provider and staff awareness to the various cultures and nationalities currently in the market area as they affect the delivery of healthcare to these groups of community members and creating periodic education and competencies for all staff on the various cultures within the area.
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 8 -- Sanford Worthington Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: AccessSanford is implementing a plan to create optimal coverage of the Emergency Department utilizing APPs, recruiting additional physicians to meet the needs of the patient base and growth, utilizing the RN Health Coach to manage/reduce repeat visits and establishing a physician assistant in the Sheldon clinic for acute care appointments daily access.Priority 2: RecruitmentSanford has an active recruiting plan to recruit, at a minimum, two additional physicians.Priority 3: Preventive ServicesSanford is continuing to offer the current preventive services and better educate the community on the importance and value of screenings.
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 9 -- Sanford Sheldon Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Mental HealthSanford is implementing Sanford One Care, exploring the expansion of Employee Assistance programs, collaborating with other mental health providers in the community to look at options for expansion of services including utilizing current clinic Health Coaches and a potential expansion of Telehealth psychiatry/psychologist services.Priority 2: Specialty Outreach ServicesSanford is continually determining the viability of additional outreach services and further development of Telehealth services and capabilities to provide outreach services to patients.
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 10 -- Sanford Vermillion Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Urgent Care/Access to ProvidersSanford is extending hours at the clinic two days per week, extending hours at the walk-in clinic two days per week and advertising to educate customers on the appropriate usage of the walk-in clinic.Priority 2: Mental Health/Substance AbuseSanford is fully implementing a mental health program including psychiatrist and behavioral health support and providing for psychiatry through Telehealth.
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 11 -- Sanford Chamberlain Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: After-Hours Access/Walk-in ClinicSanford is implementing an after-hours clinic.Priority 2: Communication PlanSanford is developing a Rock County Collaborative of key healthcare stakeholders, developing draft tools of available resources within the community with the county collaborative, designing/printing resource materials with Sanford Marketing and sharing resource tools with key community stakeholders/access points and at various events throughout community.
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 12 -- Sanford Luverne Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: ObesitySanford is appointing an overall planning committee to execute program goals. The committee consists of therapy, wellness, dietitian, administrative and clinic leadership. The main objectives of this strategy are to increase physical activity in various settings within the community and to achieve improvement in dietary behaviors of the community through the use of multiple resources. Sanford supports the work on community obesity issues through the use of social and behavioral approaches.Priority 2: Oncology ServicesSanford is adding Telehealth services as well as on-site oncology services. Chemotherapy services will be available locally by the end of 2016.
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 13 -- Sanford Canby Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Dental Services for YouthSanford is reaching out to Amos S. Deinard, MD, MPH, Department of Pediatrics, University of Minnesota, who is working with a project for education of providers of varnish application on teeth - Sanford is considering the feasibility of this service. Sanford is also visiting with Public Health on identified needs and determined opportunity for collaboration and visited with the local dentist to gain support of this service as part of Sanford's preventive, well child exams for patients. Additionally, Sanford is training Clinical Services staff so they are able to make referrals and create awareness of services to patients.Priority 2: Engage Youth in Health CareersSanford is addressing this priority through the following tactics: - Partnership with high school career counselors - Offering opportunities for site observation/job shadow to high school students - Collaboration with Sanford programs in Sioux Falls (Sanford Scrubs Club, school visits, education tours, etc.)Priority 3: Sexually Transmitted DiseaseSanford is addressing this priority through the following tactics: - Visit with Public Helath on the identified needs and opportunity for collaboration - Partner with Public Health and schools for education to youth regarding sexually transmitted disease and publishing articles in the local paper to advance education and awareness
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 14 -- Sanford Jackson Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Urgent CareSanford is securing a full medical staff to be able to coordinate expanded hours, provide nursing staff and receptionist staff coordination, announce new Urgent Care hours to the public and provide ancillary staff coordination (lab/x-ray, etc.).Priority 2: Mental HealthSanford is increasing the availability of mental health providers, obtaining a certification of Medical Home, implementing Health Coaches to help with resources and guidance for patients and working with community partners to create new recovery program options for community members.
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 15 -- Sanford Tracy Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Facility Upgrades to Enhance the Quality of CareSanford is addressing this priority through the renovation and construction of the facility.Priority 2: Community Services Resource Directory and Communication PlanSanford is analyzing the available resources for the identified community needs, reviewing the community resources list with Lyon County Collaborative group and designing and printing directories for the public. Sanford creates transparency by sharing the resource tool on the Sanford website and with key community stakeholders.
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 16 -- Sanford Rock Rapids Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Sanford One MindSanford is addressing this priority by participating in Sanford One Mind.Priority 2: Behavioral Health ResourcesSanford is developing a directory of Behavioral Health resources and the education process/communication plan for the public in partnership with public health leadership.Priority 3: Services for the Elderly ResourcesSanford is developing a directory of resources and the education process/communication plan for the public in partnership with public health leadership.Priority 4: Community CollaborationSanford is developing collaboration with community agencies and monitoring the needs of the community. Solutions are discussed and addressed through the community/county collaborative.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 17 -- Sanford Hillsboro Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Behavioral Health ResourcesSanford is developing a directory of resources and the education process/communication plan for the public in partnership with public health leadership.Priority 2: Services for the Elderly ResourcesSanford is developing a directory of resources and an education process/communication plan for the public in partnership with public health.Priority 3: Community CollaborationSanford is developing a collaboration with county agencies and AHEC and monitoring the needs of the community. Solutions are discussed and addressed through the community/county collaborative.Priority 4: Dental Services ResourcesSanford is developing a directory of resources and the education process/communication plan for the public.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 18 -- Sanford Medical Center Mayville Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Assisted Living for the ElderlySanford is studying the feasibility of converting part of Bethesda's Heritage Village Apartments into an assisted living facility.Priority 2: ObesitySanford is leveraging Sanford WebMD Fit Kids program to parents and children through the local school system, working with the medical center dietitian to develop services for obesity prevention/control and working with exercise specialists to develop exercise programs (walking clubs, biking clubs, fitness center programs, etc.) for community members.Priority 3: Medical Provider RecruitmentSanford is recruiting an additional provider.
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 19 -- Sanford Webster Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model used was the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the varioius surveys and data sets. The process implemented was based on the McKnight Foundation model - Mapping Community Capacity by John L. McKnight and John P. Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all of the Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be our secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities include listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Worthington Medical Center
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: TransportationSanford is developing a directory of available resources and outsources information and distributing the information to community members and other various groups, increasing the volunteer driver program and working in partnership with law enforcement and social services to provide transportation for mental health patients.Priority 2: Mental Health ServicesSanford is developing a directory of available behavioral health resources and outsources information, utilizing information from Home Health/Medical Home and distributing the directory to the public. Sanford is also providing access to behavioral health outreach with the mobile crisis intervention team and has developed an integrated approach to behavioral health within the function of the Medical Home model.Priority 3: Recruitment of PhysicianSanford is actively recruiting one additional Family Practice physician.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 20 -- Sanford Medical Center Wheaton Part V, Section B, line 16i:	Other methods to publicize the financial assistance policy within the community served include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: ObesitySanford is partnering in the comprehensive weight management program development within the Bagley and Bemidji region using an interdisciplinary team inclusive of medical, nutrition, behavioral health and fitness professionals and surgical services. Sanford will also promote programs and engage community members in the Silver Sneakers program and incentivize Medicare-eligible customers. Sanford has added the Profile weight management program within the Bagley region. Sanford is actively participating with community wellness, fitness and healthy living entities to promote and support fitness and active living by sponsoring walking, screening and educational programs.Priority 2: YouthSanford is engaging community leaders in discussions about needed services for youth.
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 21 -- Sanford Bagley Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Cost of Care - Preventing Individuals from Seeking Medical ServicesSanford is addressing this priority through an awareness campaign including newspaper stories about the importance of preventive care and by working with Sanford Patient Financial Services to educate patients on their financial assistance options. Sanford has a charity care and financial assistance program.Priority 2: Obesity in ChildrenSanford is working to address this priority through the following tactics: - Promoting Sanford WebMD FitKids website in local schools - Sponsoring an awareness day/week at the schools that promote exercise along with healthy eating habits - Sanford Canton-Inwood rehab therapist or health coach/athletic trainer giving presentations at schools - Offering classes on healthy eating by Sanford - Sponsoring classes on healthy eating in Canton and Inwood for the parents and/or children to provide awareness - Working on hosting a bike-a-thon for elementary grades where kids would ride their bikes up and down a specific one-mile road and at the end of the event prizes would be given for each age group (ex. new bike) and participation prizes for all participants - Addressing healthy eating habits at our annual health fair - Distributing recipes featuring healthy snacks
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 22 -- Sanford Canton-Inwood Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Westbrook Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: Youth/Athletic Cardiovascular ScreeningsSanford is addressing this priority through education presentations annually to Kiwanis, Sanford Board of Directors, Community Club, Auxiliary Board, Deuel School staff, and students and families. Sanford is also offering heart screenings for students in grades 6-12 annually.Priority 2: ObesitySanford is offering BMI measurement to all students in grades 6-12 at Deuel School and providing group setting education on BMI measurements along with ways to decrease BMI.
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 23 -- Sanford Clear Lake Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 3j:	The community health needs assessment was conducted during FY 2013. The main model for Sanford's work is the Association for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.The following qualitative data sets were studied: - Community Health Needs Assessment of Community Leaders - In some communities additional surveys included: Community Health Needs Assessment of Residents (Generalizable)The following quantitative data sets were studied: - 2011 County Health Profiles for Counties - Aging Profiles for Counties - Diversity Profiles for CountiesAsset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. The Community Health Needs Assessment Collaborative performed the asset mapping and reviewed the findings. The group conducted an informal gap analysis to determine what needs remained after resources were thoroughly researched. Once gaps were determined the group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 5:	Sanford convened key health care leaders and other not-for-profit leaders in the Fargo Moorhead community to establish a Fargo Moorhead Community Health Needs Assessment Collaborative. The collaborative members included public health leaders, other community hospital organizations, and not-for-profit groups. A primary goal of this collaborative was to craft standardized tools, indicators and methodology that can be used by all group members when conducting assessments and also be used by all Sanford hospital facilities across the enterprise. After much discussion, it was determined that the Robert Wood Johnson Framework for county profiles would be the secondary data model.A subgroup of this collaborative met with researchers from the North Dakota State University Center for Social Research to develop a survey tool for our key stakeholder groups. The survey tool incorporated the University of North Dakota's Center for Rural Health community health needs assessment tool and the Fletcher Allen community health needs assessment tool. North Dakota State University and the University of North Dakota Center for Rural Health worked together to develop additional questions and to ensure that scientific methodology was incorporated in the design.The representatives of the communities assessed included city mayors, city council/commission members, physicians, nurses, school superintendents and school board members, parish nurses, representatives from the Native American community, Faith Community Leaders, as well as legal services, mentally and physically disabled, social services, non-profit organizations and financial services. The CHNA for all Sanford hospital facilities includes listings of the individuals who served on steering groups and those who provided input. The reports can be found at:http://www.sanfordhealth.org/About/CHNA
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 6a:	Sanford USD Medical Center Sioux FallsSanford Fargo Medical CenterSanford South University Medical CenterSanford Bismarck Medical CenterSanford Bemidji Medical CenterSanford Aberdeen Medical CenterSanford Bagley Medical CenterSanford Canby Medical CenterSanford Canton-Inwood Medical CenterSanford Chamberlain Medical CenterSanford Clear Lake Medical CenterSanford Hillsboro Medical CenterSanford Jackson Medical CenterSanford Luverne Medical CenterSanford Mayville Medical CenterSanford Rock Rapids Medical CenterSanford Sheldon Medical CenterSanford Thief River Falls Medical CenterSanford Tracy Medical CenterSanford Vermillion Medical CenterSanford Webster Medical CenterSanford Wheaton Medical CenterSanford Worthington Medical Center
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 7d:	Sanford invited community partners to attend presentations and discussions of the results. Community stakeholders and community councils were included.
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 11:	The following information is a compilation of the identified priority needs for each community and what Sanford is doing to address the needs. Additional information about what Sanford is doing to address other assessed needs of the community can be found for each hospital facility at:http://www.sanfordhealth.org/About/CHNA.In some cases, there are needs that were identified in the most recently conducted CHNA that the hospital facility has chosen not to address directly, but may be addressed by the Sanford enterprise or by working with community leaders.Priority 1: AccessSanford is discussing a partnership with local dentists to offer some free or reduced cost clinics, recruiting a general Family Practice physician, increasing mental health providers availability, obtaining certification of Medical Home and implementing a Health Coach to help with resources and guidance for patients.Priority 2: Oncology ServicesSanford is having discussions with a Worthington oncologist to partner and expand services to Westbrook, increasing utilization of Tele-oncology from Sioux Falls and creating awareness of the services.Priority 3: ObesitySanford is increasing awareness and utilization of Medical Home and the Health Coach to reach obese patients, increasing referrals from providers to Medical Home and the health coaches, working with Sanford Fit Kits and with the community to bring this service more visibility, encouraging providers to distribute Sanford Fit Kits to providers and nursing staff for applicable patients, working with schools on Wellness Center opportunities (reduced rates, etc.), considering increasing dietitian hours and access for community and patients and exploring utilization of the Sanford Profile weight management program for the community.
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 13h:	Other factors for calculating amounts charged to patients include balance owed, family size, debt to income ratio, savings and investments, other debt (both medical and non-medical), previous bankruptcies and liens, patient/guarantor involvement in other state and Federal assistance programs, individuals circumstances, current employment status, total monthly expenses and third party analytic score.
Group A-Facility 24 -- Sanford Westbrook Medical Center Part V, Section B, line 16i:	Other measures to publicize the policy within the community served by the hospital facility include publishing with local public health agencies, collection agencies and submission to law firms that serve the underprivileged population. The financial assistance program summary, complete policy and the Sanford Financial Assistance Application are all available at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Facility Reporting Group - A Part V, Section B, line 16a website:	See narrative for full url
Facility Reporting Group - A Part V, Section B, line 16b website:	See narrative for full url
Facility Reporting Group - A Part V, Section B, line 16c website:	See narrative for full url

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?96
Name and address		Type of Facility (describe)
1	Sanford USD Medical Center Dialysis 1305 W 18th Street Sioux Falls,SD57117	End Stage Renal Dialysis
2	Sanford Dialysis Detroit Lakes 114 East Frazee Street Detroit Lakes,MN56501	Dialysis
3	Sanford Clinic Sheldon 800 Oak Street Sheldon,IA51201	Rural Health Clinic
4	Sanford Health Neilson Place 803 Dewey Avenue Bemidji,MN56601	Skilled Nursing Facility
5	Sylvan Place 212 St Olaf Avenue S Canby,MN56220	Housing with Services
6	Sanford Dialysis Fargo 2801 S University Drive Fargo,ND58122	Dialysis
7	Sanford Home Care Fargo 1711 S University Drive Fargo,ND58122	Home Health Agency
8	Sanford Dialysis Thief River Falls 120 Labree Avenue S Thief River Falls,MN56701	Dialysis
9	Sanford Mid-Dakota Dialysis 300 S Byron Blvd Chamberlain,SD57325	End Stage Renal Dialysis
10	Sanford Care Center Vermillion 20 S Plum Street Vermillion,SD57069	Nursing Facility
11	Sanford Dialysis Red Lake 24760 Hospital Drive Box 249 Red Lake,MN56671	Dialysis
12	Sanford Tom & Frances Leach Bismarck Dia 300 N 7th Street Bismarck,ND58501	Kidney Dialysis
13	Sanford Dialysis Morris 400 East 1st Street Morris,MN56267	Dialysis
14	Sanford Senior Care Sheldon 118 North Seventh Avenue PO Box 250 Sheldon,IA51201	Hospital Based-Nursing Facilities
15	Sanford Clinic Rock Rapids 803 South Green Street Rock Rapids,IA51246	Rural Health Clinic
16	Sanford Hillsboro Care Center 12 3rd Street SE Hillsboro,ND58045	Hospital Based-Nursing Facilities
17	Sanford Clinic Watertown Surgical Center 901 4th Street NW Watertown,SD57201	Ambulatory Surgery Center
18	Sanford Chamberlain Care Center 300 S Byron Blvd Chamberlain,SD57325	Nursing Facility
19	Sanford Clinic Canby 112 St Olaf Avenue Canby,MN56220	Medicare Certified Rural Health Clinic
20	Sanford Worthington Medical Center 1018 Sixth Avenue Worthington,MN56187	Medicare Certified End Stage Renal Dialysis
21	Sanford Clinic Tracy 251 Fifth Street East Tracy,MN56175	Medicare Certified Rural Health Clinic
22	Sanford Clinic Webster 101 Peabody Drive Webster,SD57274	Rural Health Clinic
23	Sanford Health Dickinson Ambulatory Surg 2615 Fairway Street Dickinson,ND58601	Ambulatory Surgery Center
24	Sanford Bemidji Home Care 3807 Greenleaf NW Avenue Bemidji,MN56601	Home Health Agency
25	Sanford Dialysis Bemidji 1300 Anne Street NW Bemidji,MN56601	Dialysis
26	Sanford Health Dialysis Hospers 112 Sunrise Drive Hospers,IA51239	End Stage Renal Dialysis
27	Sanford Health Windsong 1010 Anne Street N Bemidji,MN56601	Assisted Living Center
28	Sanford Wagner Dialysis 111 Washington Street Wagner,SD57380	End Stage Renal Dialysis
29	Sanford Clinic Jackson 1430 North Highway Jackson,MN56143	Medicare Certified Rural Health Clinic
30	Sanford Visiting Nurses Association 2710 West 12th Street Sioux Falls,SD57104	Professional Home Care Agency (licensed in MN and SD)
31	Sanford Clinic Mt Lake 308 8th Street Mountain Lake,MN56159	Medicare Certified Rural Health Clinic
32	Sanford Bagley Clinic 123 4th Street NW Bagley,MN56621	Rural Health Clinic
33	Sanford Health Walker Clinic 614 Michigan Avenue Walker,MN56484	Rural Health Clinic
34	Sanford Health Hillsboro Clinic 315 East Caledonia Hillsboro,ND58045	Rural Health Clinic
35	Sanford Bemidji Hospice 3525 Pine Ridge Avenue NW Bemidji,MN56601	Hospice
36	Sanford Home Care Home Health 910 18th Street NW Mandan,ND58554	Home Health Agency
37	Sanford Hospice 2710 West 12th Street Sioux Falls,SD57104	Hospice (licensed in MN and SD)
38	Sanford Health Detroit Lakes ASC 1245 Washington Avenue Detroit Lakes,MN56501	Ambulatory Surgery Center
39	Sanford Health Mahnomen Clinic 414 West Jefferson PO Box 396 Mahnomen,MN56557	Rural Health Clinic
40	Sanford Clinic Aberdeen Surgical Center 3015 3rd Avenue SE Aberdeen,SD57401	Ambulatory Surgery Center
41	Sanford Home Health and Hospice 118 North Seventh Avenue PO Box 250 Sheldon,IA51201	Home Health Agency
42	Sanford Health Pelican Rapids Clinic 211 East Mill Street Pelican Rapids,MN56572	Rural Health Clinic
43	Sanford Clinic Westbrook 920 Bell Avenue Westbrook,MN56183	Medicare Certified Rural Health Clinic
44	Sanford Hospice 1151 Ryans Road Suite 100 Worthington,MN56187	Hospice (licensed in SD)
45	Sanford Health Trillium 930 Anne Street N Bemidji,MN56601	Assisted Living Center
46	Sanford Clinic Windom 591 2nd Avenue N Windom,MN56101	Medicare Certified Rural Health Clinic
47	Sanford Behavioral Health Center 120 Labree Avenue S Thief River Falls,MN56701	Behavioral Health Treatment Center
48	Orchard Hills 200 W 10th Street Dell Rapids,SD57022	Assisted Living Center
49	Sanford Fort Yates Dialysis Box J Fort Yates,ND58538	Kidney Dialysis
50	Sanford Jamestown Dialysis 300 2nd Avenue NE Jamestown,ND58401	Kidney Dialysis
51	Sanford Clear Lake Clinic 701 3rd Avenue S Clear Lake,SD57226	Rural Health Clinic
52	Sanford Clinic Ipswich 110 5th Avenue Ipswich,SD57451	Rural Health Clinic
53	Sanford Clinic Beresford 600 W Cedar Street Beresford,SD57004	Rural Health Clinic
54	Sanford Clinic Clark 117 W 1st Avenue Clark,SD57225	Rural Health Clinic
55	Sanford Transplant Center 736 Broadway Fargo,ND58122	Transplant Center
56	Sanford Madison Dialysis 323 SW 10th Street Madison,SD57042	End Stage Renal Dialysis
57	Sanford Home Care Hospice 910 18th Street NW Mandan,ND58554	Hospice
58	Sanford Worthington Home Care 1018 Sixth Avenue Worthington,MN56187	Medicare Certified Home Health Agency
59	Sanford Luverne Hospice 211 East Main Street Suite 101 Luverne,MN56156	Medicare Certified Hospice
60	Shetek Home Care 251 Fifth Street E Tracy,MN56175	Medicare Certified Home Health Agency
61	Baker Park Inc 803 Dewey Avenue Bemidji,MN56601	Assisted Living Center
62	Sanford Canby Dialysis Unit 112 St Olaf Avenue Canby,MN56220	Medicare Certified End Stage Renal Dialysis
63	Sanford Canby Med Center 213 St Olat Avenue N Ste B Canby,MN56220	Medicare Certified Home Health Agency
64	Sanford Clinic Lakefield 209 Main Street PO Box 546 Lakefield,MN56150	Medicare Certified Rural Health Clinic
65	Sanford Home Health and Hospice Sheldon 118 North Seventh Avenue Sheldon,IA51201	Hospice
66	Sanford Transplant Center 300 N 7th Street Bismarck,ND58501	Transplant Center
67	Sanford Rock Rapids George Clinic 101 N Main George,IA51237	Rural Health Clinic
68	Sanford Clinic Lennox 108 S Main Lennox,SD57039	Rural Health Clinic
69	Sanford Health LaMoure Clinic Omega City Plaza Lamoure,ND58458	Rural Health Clinic
70	Sanford Health Enderlin Clinic 201 4th Avenue Suite 1 Enderlin,ND58027	Rural Health Clinic
71	O'Brien Court 410 State Street Tracy,MN56175	Housing with Services
72	Sanford Visiting Nurses Assoc-Luverne 211 East Main Street Suite 101 Luverne,MN56156	Home Health Care
73	Dakota Gardens Senior Living 126 S Plum Street Vermillion,SD57069	Residential Living Center
74	Sanford Hiawatha Heights 398 N Hiawatha Drive Canton,SD57013	Assisted Living Center
75	Sanford Clinic Estelline 305 Hospital Drive Estelline,SD57234	Rural Health Clinic
76	Sanford Clinic Lake Norden Main Street Lake Norden,SD57248	Rural Health Clinic
77	Sanford Health Ellendale Clinic PO Box 306 Ellendale,ND58436	Rural Health Clinic
78	Peterson Estates 1012 9th Street Westbrook,MN16183	Housing with Services
79	Sanford Health Halstad Clinic 445 1st Street E Halstad,MN56548	Rural Health Clinic
80	Sanford Hospice 20 S Plum Street Vermillion,SD57069	Hospice
81	Sanford Visiting Nurses Assoc-Vermillion 20 S Plum Street Vermillion,SD57069	Home Health Care
82	Sanford Health Twin Valley Clinic 212 Main Avenue W Twin Valley,MN56584	Rural Health Clinic
83	Sanford Health Forman Clinic PO Box 184 Forman,ND58032	Rural Health Clinic
84	Sanford Hospice 510 E 8th Street Freeman,SD57029	Hospice
85	Sanford Health Ulen Clinic 108 Viking Avenue W Ulen,MN56585	Rural Health Clinic
86	Sanford Canby Medical Center 112 St Olaf Avenue S Canby,MN56220	Class F Home Care Provider
87	Sanford Clear Lake Medical Center 701 3rd Avenue S Clear Lake,SD57226	Home Health Care
88	Sanford Hospice Centennial Cottage 6301 W 43rd Street Sioux Falls,SD57106	Residential Hospice
89	Sanford Hospice Foundation Cottage 6309 W 43rd Street Sioux Falls,SD57106	Residential Hospice
90	Sanford Bagley Clearbrook Clinic 22 Elm Street Clearbrook,MN56634	Rural Health Clinic
91	Sanford Hospice 900 2nd Avenue Madison,MN56256	Hospice (licensed in SD)
92	Sanford Hospice 745 E 8th Street Winner,SD57580	Hospice
93	Sanford Clinic Balaton Highway 14E Balaton,MN56115	Medicare Certified Rural Health Clinic
94	Sanford Visiting Nurses Assoc-Chamberlai 110 W Beede Ste 1 Chamberlain,SD57325	Home Health Care
95	Sanford Tracy Walnut Grove Clinic 830 Eighth Street Walnut Grove,MN56180	Medicare Certified Rural Health Clinic
96	Sanford Hospice 300 S Byran Blvd Chamberlain,SD57325	Hospice

Schedule H (Form 990) 2014

Page

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Part I, Line 3c:	Sanford Health does not deny care to anyone based on the ability to pay. Sanford's Financial Assistance (charity care) policy provides discounted and free services to patients who lack the resources to be fully responsible for the healthcare they receive. The Financial Assistance Policy is designed to ensure the entire community served by Sanford has access to needed healthcare services. Eligibility for discounted or free services under the Financial Assistance Policy is based on income levels and family size. Generally, individuals earning income of up to 375% of the Federal Poverty Income Guidelines are eligible for varying levels of discounts, including full discounts for certain income levels. Applications for coverage under the program may be obtained at any Sanford patient registration area.The primary scope of Sanford's financial assistance matrix considers family income and family size to objectively determine financial need. The family income range varies from 0-225% up to 375% of the Federal Poverty Level (FPL). An applicant over 375% may be eligible for some level of financial assistance based on a review of additional factors such as: the size of the account balance, debt-to-income ratio, current assets, current liabilities, IRS food expense allowances, monthly cash flow, etc.Additionally, it is possible for a family to qualify in one segment (based on income and family size alone) but be moved to a more generous (for the patient) segment based on the other financial variables mentioned above. An applicant may be denied if they have substantial assets and applicants are considered on a case by case basis.Part I, Line 5b: Sanford as a whole did exceed its financial assistance budget for FY15, however, exceeding that budget did not impact the ability to serve any patients and no patients were disallowed services. The organization provided free or discounted services to patients who were eligible for free or discounted care.Part I, Line 6: Sanford Health prepared a Community Benefit Annual Report for FY 2015. This report is posted annually on the Sanford website at:http://www.sanfordhealth.org/About/CommunityBenefit
Part I, Line 7:	Cost to Charge Ratios are used to calculate the amounts on Line 7a - 7c (Financial Assistance, Medicaid Shortfall, and Other Means-Tested Government Programs) and also Line 7g (Subsidized Health Services) for each of the subsidiaries included in the return. All other amounts for Lines 7e, 7f, 7h and 7i would come from the books and records of specific segments of the organization and would not be based on a Cost to Charge Ratio, or similar cost accounting methodology.
Part I, Line 7g:	Subsidized health services are clinical services provided to both inpatients and outpatients despite a financial loss to Sanford. Each loss has been calculated after removing losses associated with bad debts, financial assistance and Medicaid. Although these services generate overall losses to Sanford, they continue to meet the needs of the communities served. Various services that generate losses are provided by Sanford through physician practices. For FY 2015, subsidized health services provided through these physician practices generated losses of $110,811,200.
Part II, Community Building Activities:	Sanford Health is a not-for-profit organization dedicated to the work of health and healing for the public good. Sanford is committed to giving back to the communities in which its employees and patients live and work. Sanford invests resources in order to produce the best outcomes for patient care, education, research, and community enrichment, and partners with others to ensure that the community is a welcoming, healthy environment and one that attracts and sustains a diverse Sanford workforce to deliver the best patient care and much needed medical research. Sanford considers requests for funding and in kind support for new and ongoing programs with all areas supporting the above goals, such as basic human services, education and workforce development by recruiting physicians and other health professionals to medical shortage or underserved areas and collaborating with educational institutions to train and recruit health professionals, advocating community health improvement through efforts to support policies and programs that safeguard or improve public health and help to ensure access to health care services.
Part III, Line 2:	Bad debt expense at cost is determined using the same cost to charge ratios that are used to calculate Financial Assistance and Medicaid Shortfall. Discounts and allowances are accounted for separately from Bad Debt Expense.
Part III, Line 3:	It is Sanford's policy to make financial assistance available to patients who fit the financial assistance criteria. It is the organization's goal to make certain that Sanford is proactive in identification of the patients who need help with financial concerns. Financial counselors make every effort to ensure that financial assistance eligible patients do not progress to bad debt. For this reason, a dollar amount for bad debt is not included.
Part III, Line 4:	The audited financial statements of Sanford do not include a bad debt footnote. Sanford reports bad debt in accordance with generally accepted accounting principles (GAAP).
Part III, Line 8:	Per IRS instructions, Sanford has identified the cost associated with providing Medicare services from the Medicare cost report. The Medicare cost report calculations are total expense less expenses deemed "unallowable" per Medicare regulations. The net expense is then used to calculate the cost per day and cost to charge ratios which are multiplied by the Medicare days and ancillary charges to determine the cost of providing Medicare services. If all expenses that Sanford incurred were included on the Medicare cost report; this would show a shortfall of approximately $66,209,809. Sanford believes this shortfall should be considered community benefit because these services would need to be provided by either another charitable organization or the government if it was not provided by Sanford.
Part III, Line 9b:	Sanford will provide services at no cost or reduced cost to patients who qualify for the program. Patients with incomes at or below 225% of the United States Department of Health and Human Services poverty guideline will receive a 100% reduction of their payment responsibility. Patients with income between 225% - 375% of the poverty guideline will be given a discount based on a sliding scale and assets are considered in the calculation of the income of the patient, with the exception of the patient's principal residence. Patients above 375% of the FPG will be reviewed for additional factors such as size of medical debt before a final determination. Patients must make their financial need known to appropriate personnel and be engaged in filing appropriate and complete applications. The program is available to those patients without health care benefits from any source as well as to those who have coverage for health care costs through a government program, commercial insurance, or other health benefit plan but continue to have a remaining balance after benefits have been applied to the charges. Sanford will not deny financial assistance based on race, creed, sex, national origin, handicap or age.Every effort is made to identify patients with financial need as early as possible in the revenue cycle.Sanford has zero tolerance for abusive, harassing, oppressive, false, deceptive, or misleading language of collections conduct. This zero tolerance applies to internal Sanford staff and third party collection vendors and attorneys.Neither Sanford nor any of its third party collection vendors will take any extraordinary collection efforts until Sanford and the third party collection vendor have made reasonable efforts to determine if a patient is eligible for financial assistance under the Financial Assistance Policy.
Part VI, Line 2:	Sanford conducted a community health needs assessment during FY 2013 in 24 communities throughout the enterprise. A CHNA toolkit was developed to facilitate a standardized approach to surveys, data collection, analysis and reporting. The main model used was the Assocation for Community Health Improvement's (ACHI) Community Health Needs Assessment toolkit.Primary research included a survey that was developed in partnership with Fargo Cass Public Health, Clay County Public Health, North Dakota State University Center for Social Research and the University of North Dakota Center for Rural Health. Additionally, the Department of Health in Sioux Falls conducted a survey and shared the survey tool and results of the survey. Key stakeholders were asked to complete the survey and are listed in the acknowledgement section of each CHNA. The survey tool was available electronically and a paper tool was available for those who did not have access to a computer. In some communities the paper survey was delivered through a focus group setting or through a community council.The County Health Profiles were used for secondary research. State and national data were researched to benchmark each indicator. The County Health Profiles are based largely on the County Health Rankings from the Mobilizing Action Toward Community Health (MATCH), a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Additional secondary data included the aging and diversity profiles from the US Census Bureau and the American Community Survey.Asset mapping was conducted by reviewing the data and identifying the unmet needs from the various surveys and data sets. The process implemented in this work was based on the McKnight Foundation model - Mapping Community Capacity by John L McKnight and John P Kretzmann, Institute for Policy Research at Northwestern University.Each unmet need was researched to determine what resources were available in the community to address the needs. An informal gap analysis was conducted to determine what needs remained after resources were thoroughly researched through asset mapping. Once gaps were determined the CHNA collaborative group proceeded to the prioritization process. The multi-voting methodology was implemented to determine what top priorities would be further developed into implementation strategies.
Part VI, Line 3:	Sanford employs a variety of strategies to make certain that the organization is transparent in the communication of financial assistance guidelines. The staff at Sanford makes every effort to identify patients needing financial assistance as early in the revenue cycle as possible. All Sanford entities display signage in registration areas advising patients of their ability to request financial assistance. The signage is made available in English and Spanish. Financial Assistance applications are available in English or Spanish upon request.All healthcare workers who identify patients with financial need are encouraged to provide patients or their designees a financial application. This may include, but not be limited to the following areas: Administration, Admissions, Patient Financial Services, Financial Counselors, Social Services, Physicians, Nursing, Clinic Director, Reception staff and Human Resources.Financial Counselors are trained to work individually with patients to determine the financial need and recommend appropriate assistance in application for charity care, government programs or discounted services.Sanford's Financial Assistance Program is available to anyone who qualifies for assistance. This program ensures that all people receive the care they need, regardless of their financial situation. Sanford makes Financial Assistance information available to community agencies and referral organizations. Financial Assistance information is also available on the Sanford website at:http://www.sanfordhealth.org/PatientsVisitors/PatientInformation/FinancialAssistance
Part VI, Line 4:	Sanford Health is an integrated health system headquartered in the Dakotas. It is one of the largest health systems in the nation with 43 hospitals and nearly 250 clinics in nine states and three countries. Sanford Health's 27,000 employees, including 1,400 physicians, make it the largest employer in the Dakotas. Sanford USD Medical Center - Sioux Falls, South DakotaSioux Falls is the largest city in the state of South Dakota. Sioux Falls is the county seat of Minnehaha County, and also extends into Lincoln County to the south. As of the 2010 census, Sioux Falls had a population of 153,888. The metropolitan population of 228,261 accounts for 28% of South Dakota's population. The population of Sioux Falls is 86.8% white, 4.2% black, 2.7% American Indian, 1.8% Asian and 4.4% Hispanic. Sioux Falls is the home of a number of financial companies and is a significant regional health care center. The median household income in Sioux Falls is $51,882.Sanford Medical Center Fargo - Fargo, North DakotaFargo is a diverse, dynamic, family-oriented community on the eastern border of North Dakota. It is the largest city in North Dakota, accounting for nearly 16% of the state population and the county seat of Cass County. Fargo and its twin city of Moorhead, Minnesota and adjacent West Fargo, North Dakota and Dilworth, Minnesota form the core of the metro area, which in 2010 had a population of 209,000. The population of Fargo is 90.2% white, 2.7% black, 1.4% American Indian, 3% Asian and 2.2 Hispanic. The median household income is $44,304. Sanford Bemidji Medical Center - Bemidji, MinnesotaBemidji is located in Beltrami County, Minnesota and is the principal city in North Central Minnesota as the largest commercial center between Grand Forks, North Dakota and Duluth, Minnesota. Bemidji houses many Native American services, including the Indian Health Service. The city is the central hub of the Red Lake Indian Reservation, White Earth Indian Reservation and the Leech Lake Indian Reservation. Based on 2010 US Census data, Bemidji has a population of 13,431. The median age in the city was 27.1 years old. 19.4% of residents were under the age of 18; 26.7% were between the ages of 18 and 24; 21.6% were from 25 to 44; 17.5% were from 45 to 64; and 14.8% were 65 years of age or older. The average household income is $43,394.Sanford Bismarck Medical Center - Bismarck, North DakotaBismarck is a community located in central North Dakota experiencing fast-paced growth as a direct result of oil development throughout the western part of the state. Bismarck is the second largest city in North Dakota with 62,665 residents living within the city limits. The population of Bismarck is 92.4% white, 0.7% black, 4.5% American Indian, 0.6% Asian and 1.3% Hispanic. Bismarck is the state capital and also serves as home to Bismarck State College, the University of Mary and several of the state's top businesses. The median household income in Bismarck is $53,186.Sanford Network HospitalsSanford Health Network Hospitals is a network of rural hospitals located throughout South Dakota, North Dakota, Minnesota, and Iowa.Sanford ClinicsSanford Clinic is a multi-specialty clinic comprised of 1,400 physicians providing services in the US as well as internationally.
Part VI, Line 5:	Sanford maintains an open medical staff. Community Boards - The Sanford Board of Trustees was comprised of 15 members at the end of the fiscal year, including 9 volunteer community members, 5 physicians and the CEO. Surplus Funds - Surplus funds are invested back into the community, as well as to resource development and facility development to better serve patients and communities.
Part VI, Line 6:	Sanford Health is an integrated health system headquartered in the Dakotas. It is one of the largest health systems in the nation with 43 hospitals and nearly 250 clinics in nine states and three countries. Sanford Health's 27,000 employees, including 1,400 physicians, make it the largest employer in the Dakotas.Sanford Health provides services at every level from critical access hospitals to tertiary and quaternary care. The Sanford footprint includes over 220,000 square miles with a nine state service area and a network of children's primary care clinic locations across the country and world. Sanford Health operates full-time emergency centers and provides emergency care to everyone regardless of their ability to pay. Sanford facilities and clinics provide services to remote and medically underserved areas that would otherwise not have access to even primary care services. Sanford Health financially supports health and wellness, education and community development activities to improve the quality of life and strenghten communities throughout the region. Each facility promotes health and healing that responds to the unique needs of the patients in the community, ensuring access to comprehensive and specialized services. Part VI, Line 7: Community benefit reporting is not required and therefore not filed in North Dakota, South Dakota, Nebraska or Iowa. Filing in Minnesota is voluntary.

Schedule H (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
Sanford Group Return

Employer identification number
45-3791176

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) 4H Foundation (Outdoor Adventure Center) 2810 22nd Avenue South Brookings,SD57006	46-6016086	501(c)(3)	12,500	General support
(2) Aberdeen Catholic School System 1400 N Dakota Street Aberdeen,SD57401	46-0334005	501(c)(3)	28,550	Roncalli Revitalizing project
(3) Aberdeen Development Corporation 416 Production St N Aberdeen,SD57401	46-6011831	501(c)(6)	7,500	General support
(4) Aberdeen Family YMCA 5 South State Street Aberdeen,SD57401	46-0255779	501(c)(3)	5,500	General support
(5) Aberdeen Public Schools Foundation 1224 3rd Street South Aberdeen,SD57401	46-0423109	501(c)(3)	7,900	General support
(6) Active Generations 2300 W 46th St Sioux Falls,SD57105	46-0305500	501(c)(3)	7,500	General support
(7) American Cancer Society 4904 S Technopolis Dr Sioux Falls,SD57106	41-0724036	501(c)(3)	20,000	General support
(8) American Diabetes Association 14216 Dayton Circle Ste 6 Omaha,NE68137	13-1623888	501(c)(3)	12,500	General support
(9) American Heart Association Inc 7272 Greenville Ave Dallas,TX75231	13-5613797	501(c)(3)	110,271	General support
(10) American Red Cross 2602 12th St N Fargo,ND58102	53-0196605	501(c)(3)	6,000	General support
(11) Arthritis Foundation - Upper Midwest Region PO Box 1208 Fargo,ND58107	39-0860526	501(c)(3)	27,500	General support
(12) Augsburg College 2211 Riverside Avenue Minneapolis,MN55454	41-0694721	501(c)(3)	7,500	General support
(13) Augustana College 2001 S Summit Ave Sioux Falls,SD57197	46-0224588	501(c)(3)	1,179,250	AD Leadership fund, Support athletic club
(14) Big Brothers Big Sisters of the Sioux Empire 1108 N West Ave Suite B Sioux Falls,SD57104	05-0593016	501(c)(3)	8,150	General support
(15) Boys and Girls Club of Sioux Empire 824 E 14th St Sioux Falls,SD57104	46-0399482	501(c)(3)	11,000	General support
(16) Brandon Valley Booster Club PO Box 572 Brandon,SD57005	46-6002577	501(c)(6)	6,500	General support
(17) Childrens Home Society Foundation 801 N Sycamore Ave PO Box 1749 Sioux Falls,SD571011749	46-0224542	501(c)(3)	6,000	General support
(18) Children's World Care 1221 E 6th Street PO Box 235 Sheldon,IA51201	42-1036015	501(c)(3)	6,000	General support
(19) City of Kimball PO Box 16 Kimball,SD57355	46-6000248	115	100,000	Health Clinic project
(20) Concordia College Corporation 901 S 8th St Moorhead,MN56562	41-0693977	501(c)(3)	50,900	General support
(21) Cullen Children's Foundation PO Box 594 West Fargo,ND58078	77-0636521	501(c)(3)	20,000	General support
(22) Cystic Fibrosis Foundation 8011 34th Ave S Ste 116 Bloomington,MN55425	13-1930701	501(c)(3)	26,000	General support
(23) Dakota Alliance Soccer Club 401 W 39th Street Sioux Falls,SD57105	46-0359817	501(c)(3)	60,000	General support
(24) Dakota Hospital Foundation 20 S Plum Street Vermillion,SD57069	46-0226067	501(c)(3)	100,000	Hospital facility improvements
(25) Dakota Schoolers 1809 W Oak Street Sioux Falls,SD57105	20-3452350	501(c)(3)	37,500	Scholarships
(26) Destiny Healthcare International Inc 2701 S Minnesota Ave Suite 3 Sioux Falls,SD57105	51-0529480	501(c)(3)	10,000	General support
(27) Detroit Lakes Community & Cultural Center 826 Summit Ave Detroit Lakes,MN56501	41-1970351	501(c)(3)	10,500	General support
(28) Downtown Community Partnership 210 Broadway N Suite 202 Fargo,ND58102	46-4472309	501(c)(6)	30,000	General support
(29) Face It Together Inc 231 S Phillips Avenue 201 Sioux Falls,SD57104	27-2501220	501(c)(3)	555,000	Addiction recovery coaching, Community addiction services
(30) Family Visitation Center 311 E 14th St Sioux Falls,SD57104	26-3654937	501(c)(3)	12,500	General support
(31) Fellowship of Christian Athletes 1101 W 22nd St Sioux Falls,SD57105	44-0610626	501(c)(3)	10,000	General support
(32) First Tee of SD 2604 West Russell St Sioux Falls,SD57104	46-0449824	501(c)(3)	11,500	General support
(33) Forward Sioux Falls PO Box 907 Sioux Falls,SD571010907	46-0396647	501(c)(6)	300,000	General support
(34) Global Health Corps Inc One Penn Plaza Suite 6271 New York,NY10119	80-0512336	501(c)(3)	1,000,000	Global health fellowships
(35) Great Plains Zoo 805 S Kiwanis Ave Sioux Falls,SD571043798	46-6015015	501(c)(3)	66,667	General support
(36) Greater Fargo Moorhead Economic Development Corporation 51 Broadway Suite 500 Fargo,ND58102	45-6011769	501(c)(3)	40,000	General support
(37) Habitat for Humanity Greater Sioux Falls 721 E Amidon St Sioux Falls,SD571041015	46-0407140	501(c)(3)	10,000	General support
(38) Ice Sports Association 108 S Dakota Ave Sioux Falls,SD57104	27-1234271	501(c)(3)	150,000	General support
(39) Junior Achievement of South Dakota 1000 N West Ave 110 Sioux Falls,SD57104	46-0306352	501(c)(3)	22,675	General support
(40) Juvenile Diabetes Research Foundation (JDRF) South Dakota 1301 W 18th Street Sioux Falls,SD57117	23-1907729	501(c)(3)	25,000	General support
(41) Leadership South Dakota PO Box 675 Platte,SD57369	46-0398115	501(c)(3)	11,500	General support
(42) Legends of Gold Inc Box 287 Beresford,SD57004	27-3794971	501(c)(3)	10,000	General support
(43) Lifescape (SD Achieve & Children's Care Foundation) 2501 W 26th St Sioux Falls,SD571052498	46-0233030	501(c)(3)	16,000	General support
(44) Lincoln High School 201 E 38th Street Sioux Falls,SD57105	46-6002586	501(c)(3)	15,250	General support
(45) Luverne Hockey Club 905 N Kniss Ave Luverne,MN56156	41-1685848	501(c)(3)	10,000	General support
(46) Make-A-Wish Foundation of North Dakota 1102 43rd St SW Suite E Fargo,ND58103	45-0393770	501(c)(3)	6,000	General support
(47) Make-A-Wish Foundation of South Dakota 1400 West 17th Street Sioux Falls,SD57104	46-0375953	501(c)(3)	15,000	General support
(48) Matson Halverson Christiansen Hamilton Foundation 201 South Main Street Kimball,SD57355	46-0461691	501(c)(3)	15,000	General support
(49) Mayville State University Foundation 330 3rd St NE Mayville,ND58257	45-6013477	501(c)(3)	7,500	General support
(50) McCrossan Boys Ranch 47135 260th Street Sioux Falls,SD57107	46-0311913	501(c)(3)	7,500	General support
(51) Mike Miller Foundation 2107 Quiett Lane Mitchell,SD57301	30-0015773	501(c)(3)	12,500	General support
(52) Minnesota State University Moorhead Alumni Foundation 1104 7th Avenue S Moorhead,MN56563	23-7106061	501(c)(3)	202,168	Scholarships
(53) National Kidney Foundation 1970 Oakcrest Ave Suite 208 St Paul,MN55113	13-1673104	501(c)(3)	18,000	General support
(54) National Multiple Sclerosis Society Upper Midwest Chapter 200 12th Ave S Minneapolis,MN55415	41-0790658	501(c)(3)	25,000	General support
(55) National Parkinson Foundation Inc South Dakota 1000 N West Ave Suite 220 Sioux Falls,SD57104	91-1803180	501(c)(3)	6,500	General support
(56) NDSCS Foundation 800 6th Street North Wahpeton,ND58067	45-0407617	501(c)(3)	10,000	Scholarships
(57) Northern State University Foundation 620 15th Ave SE Aberdeen,SD57401	23-7002314	501(c)(3)	13,500	General support
(58) Northern Sun Intercollegiate Conference 2999 County Road 42 West Suite 136 Burnsville,MN55306	41-1783486	501(c)(3)	160,000	Scholarships
(59) Northland Community and Technical College Foundation 1101 Highway One East Thief River Falls,MN56701	41-1287038	501(c)(3)	25,000	General support
(60) Philanthropy Promotions Inc 2601 W 60th Street North Sioux Falls,SD57107	87-0695596	501(c)(3)	7,500	General support
(61) Ronald McDonald House 825 S Lake Ave Sioux Falls,SD571044635	46-0371152	501(c)(3)	41,000	General support
(62) Roosevelt High School 201 E 38th Street Sioux Falls,SD57105	46-6002586	501(c)(3)	16,750	General support
(63) Samaritan's Feet International PO Box 78992 Charlotte,NC282717045	14-1880905	501(c)(3)	1,000,000	Champions of Hope
(64) Sanford Health Foundation Hillsboro PO Box 609 Hillsboro,ND58045	36-3542187	501(c)(3)	50,000	General support
(65) Sanford Health Foundation North PO Box 2010 Fargo,ND58122	45-0398104	501(c)(3)	99,005	NICU, General support
(66) SD Law Enforcement Charities 5214 Sweetbriar Court Sioux Falls,SD57108	46-0440378	501(c)(3)	10,000	General support
(67) SD Parks and Wildlife Foundation 523 E Capitol Ave Pierre,SD57501	46-0387968	501(c)(3)	10,000	General support
(68) SDSU Foundation 815 Medary Ave PO Box 525 Brookings,SD57007	46-0273801	501(c)(3)	502,340	Sanford/SDSU SEED grants, Sports Medicine, General support
(69) SF Cyclones 7605 Loganberry St Sioux Falls,SD57106	27-4705069	501(c)(3)	22,000	General support
(70) SF Diversity Council 1000 N West Ave Suite 400 Sioux Falls,SD57104	27-3111451	501(c)(3)	6,000	Youth initiative
(71) SF Firefighers Benevolent Foundation PO Box 340 Sioux Falls,SD57101	68-0589701	501(c)(3)	10,000	General support
(72) Shiloh Christian School 1915 Shiloh Dr Bismarck,ND58503	45-0348120	501(c)(3)	72,000	General support
(73) Sioux Empire United Way 1000 North West Ave 120 Sioux Falls,SD571041314	46-0233701	501(c)(3)	130,530	General support
(74) Sioux Falls Catholic Schools 3100 W 41st St Sioux Falls,SD57105	46-0413591	501(c)(3)	253,900	Teacher endowment, General support
(75) Sioux Falls Christian 6120 Charger Circle Sioux Falls,SD571091110	46-0340024	501(c)(3)	7,500	General support
(76) Sioux Falls Schools 201 E 38th Street Sioux Falls,SD57105	46-6002586	501(c)(3)	80,680	General support, Scoreboard
(77) Sioux Falls Sports Authority Summit League 200 N Phillips Ave Ste 304 Sioux Falls,SD57104	20-5850491	501(c)(3)	66,775	General support
(78) South Dakota Parent Connection 3701 West 49th St No 102 Sioux Falls,SD57106	46-0385808	501(c)(3)	8,000	General support
(79) South Dakota Voices for Children PO Box 2196 Sioux Falls,SD57101	46-0425502	501(c)(3)	15,000	General support
(80) Special Olympics North Dakota 2616 S 26th St Grand Forks,ND58201	45-0355704	501(c)(3)	7,500	General support
(81) Special Olympics South Dakota 305 W 39th St Sioux Falls,SD57105	46-0359776	501(c)(3)	10,000	General support
(82) Stem for Life Foundation 420 Lexington Avenue No 350 New York,NY10170	26-1150435	501(c)(3)	1,000,000	Medical research
(83) Susan G Komen for the Cure 101 N Main Ave Sioux Falls,SD57104	33-1114233	501(c)(3)	41,331	General support
(84) Tea Area School District Association PO Box 488 Tea,SD57064	50-0005151	501(c)(3)	25,264	General support
(85) Teen Challenge of the Dakotas 600 W 16th Ave S Brookings,SD57006	46-0319355	501(c)(3)	6,000	General support
(86) The Arts Partnership of the Red River Valley 1104 2nd Avenue South Suite 315 Fargo,ND58103	23-7108936	501(c)(3)	20,000	General support
(87) The Duke of Edinburgh's International Award USA 245 Park Ave FL24 New York,NY10167	20-4909474	501(c)(3)	25,735	General support
(88) United Way of Cass-Clay PO Box 1609 Fargo,ND58107	41-0810008	501(c)(3)	82,700	General support
(89) United Way of Northeastern SD Inc PO Box 1065 Aberdeen,SD57401	23-7086355	501(c)(3)	10,450	General support
(90) University of South Dakota Foundation 1110 N Dakota Street PO Box 5555 Vermillion,SD570695555	46-6018891	501(c)(3)	2,050,000	Research, Sports complex, Clinical skills & simulation center
(91) University of Wisconsin Foundation 600 Highland Ave Madison,WI53792	39-0743975	501(c)(3)	85,500	Carbone Cancer Center
(92) USD School of Medicine 1400 W 22nd Street Sioux Falls,SD571051581	46-0418678	501(c)(3)	69,504	Medical education
(93) Valley City State University Foundation 101 College St Valley City,ND58072	23-7178785	501(c)(3)	17,800	General support
(94) Volunteers of America 1309 West 51st St PO Box 89306 Sioux Falls,SD571099306	23-7353508	501(c)(3)	20,500	General support
(95) Washington Pavilion 301 S Main Ave PO Box 984 Sioux Falls,SD571010984	46-0435791	501(c)(3)	60,500	General support
(96) Webster WAVE City of Webster 513 Main St Webster,SD57274	20-1307620	501(c)(3)	30,000	General support
(97) Worthington Public Schools 1117 Marine Ave Worthington,MN56187	41-6008522	115	10,000	General support
(98) YMCA of Cass and Clay Counties 400 1st Avenue S Fargo,ND58103	45-0232096	501(c)(3)	7,500	General support
(99) YMCA Sioux Falls 230 S Minnesota Ave Sioux Falls,SD57104	46-0225021	501(c)(3)	27,400	Local support
(100) YWCA Sioux Falls (EmBe) 300 W 11th Street Sioux Falls,SD571046306	46-0234998	501(c)(3)	6,120	Local support

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2014

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
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.

Schedule I (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Sanford Group Return

Employer identification number

45-3791176

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Yes

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2014

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Christopher Meeker MDTrustee/Sanford Physician (thru Dec	(i) (ii)	409,994 ............................... 0	0 ............................... 0	0 ............................... 0	10,400 ............................... 0	19,930 ............................... 0	440,324 ............................... 0	0 ............................... 0
2Maria Bell MDTrustee/Sanford Physician	(i) (ii)	685,129 ............................... 0	0 ............................... 0	56,150 ............................... 0	13,000 ............................... 0	23,536 ............................... 0	777,815 ............................... 0	0 ............................... 0
3Mark Lundeen MDTrustee/Sanford Physician	(i) (ii)	600,031 ............................... 0	344,768 ............................... 0	115,242 ............................... 0	13,000 ............................... 0	12,249 ............................... 0	1,085,290 ............................... 0	0 ............................... 0
4Mark Paulson MDTrustee/Sanford Physician	(i) (ii)	221,472 ............................... 0	15,000 ............................... 0	0 ............................... 0	11,978 ............................... 0	18,238 ............................... 0	266,688 ............................... 0	0 ............................... 0
5Michael LeBeau MDTrustee/Sanford Physician	(i) (ii)	1,159,924 ............................... 0	0 ............................... 0	0 ............................... 0	10,400 ............................... 0	17,011 ............................... 0	1,187,335 ............................... 0	0 ............................... 0
6Richard Hardie MDTrustee/Sanford Physician	(i) (ii)	724,403 ............................... 0	0 ............................... 0	6,318 ............................... 0	13,000 ............................... 0	20,295 ............................... 0	764,016 ............................... 0	0 ............................... 0
7Kelby K KrabbenhoftSanford President & CEO	(i) (ii)	1,182,854 ............................... 0	363,300 ............................... 0	203,281 ............................... 0	0 ............................... 0	23,433 ............................... 0	1,772,868 ............................... 0	0 ............................... 0
8Kelby K Krabbenhoft Deferred CompSanford President & CEO	(i) (ii)	0 ............................... 0	0 ............................... 0	0 ............................... 0	727,751 ............................... 0	0 ............................... 0	727,751 ............................... 0	0 ............................... 0
9JoAnn L KunkelChief Financial Officer	(i) (ii)	460,778 ............................... 0	130,200 ............................... 0	62,042 ............................... 0	13,000 ............................... 0	20,933 ............................... 0	686,953 ............................... 0	0 ............................... 0
10Nate WhiteChief Operating Officer	(i) (ii)	588,470 ............................... 0	172,000 ............................... 0	71,417 ............................... 0	13,000 ............................... 0	28,063 ............................... 0	872,950 ............................... 0	0 ............................... 0
11Richard G AdcockExecutive VP	(i) (ii)	211,536 ............................... 152,653	0 ............................... 0	11,566 ............................... 15,392	2,821 ............................... 10,179	9,764 ............................... 13,669	235,687 ............................... 191,893	0 ............................... 0
12Kim PatrickChief Legal Officer	(i) (ii)	387,211 ............................... 0	110,478 ............................... 0	70,861 ............................... 0	72,790 ............................... 0	22,506 ............................... 0	663,846 ............................... 0	0 ............................... 0
13Bill MarletteTreasurer	(i) (ii)	463,958 ............................... 0	135,942 ............................... 0	109,388 ............................... 0	0 ............................... 0	1,674 ............................... 0	710,962 ............................... 0	0 ............................... 0
14Bill Marlette Deferred CompTreasurer	(i) (ii)	0 ............................... 0	0 ............................... 0	0 ............................... 0	184,967 ............................... 0	0 ............................... 0	184,967 ............................... 0	0 ............................... 0
15David LinkExecutive VP	(i) (ii)	567,645 ............................... 0	167,382 ............................... 0	124,472 ............................... 0	0 ............................... 0	23,326 ............................... 0	882,825 ............................... 0	0 ............................... 0
16David Link Deferred CompExecutive VP	(i) (ii)	0 ............................... 0	0 ............................... 0	0 ............................... 0	157,987 ............................... 0	0 ............................... 0	157,987 ............................... 0	0 ............................... 0
17Al HurleyCOO - Bismarck Clinic	(i) (ii)	301,198 ............................... 0	2,800 ............................... 0	0 ............................... 0	10,400 ............................... 0	11,013 ............................... 0	325,411 ............................... 0	0 ............................... 0
18Allison Suttle MDChief Medical Officer - HSD	(i) (ii)	359,610 ............................... 0	300 ............................... 0	32,912 ............................... 0	13,000 ............................... 0	23,640 ............................... 0	429,462 ............................... 0	0 ............................... 0
19Bradley J SchipperCOO - SMC & Sanford Clinic Sioux Fal	(i) (ii)	348,995 ............................... 0	2,800 ............................... 0	34,977 ............................... 0	13,000 ............................... 0	23,364 ............................... 0	423,136 ............................... 0	0 ............................... 0
20Brenda LarsenCOO - Bismarck Medical Center	(i) (ii)	295,947 ............................... 0	300 ............................... 0	0 ............................... 0	11,100 ............................... 0	21,280 ............................... 0	328,627 ............................... 0	0 ............................... 0
21Bruce D ViessmanCFO - Sanford Health Network	(i) (ii)	249,400 ............................... 0	300 ............................... 0	24,324 ............................... 0	12,485 ............................... 0	21,852 ............................... 0	308,361 ............................... 0	0 ............................... 0
22Craig BoyerCFO - Bemidji	(i) (ii)	218,654 ............................... 0	34,924 ............................... 0	22,888 ............................... 0	72,611 ............................... 0	18,019 ............................... 0	367,096 ............................... 0	0 ............................... 0
23Craig LambrechtPresident - Bismarck	(i) (ii)	708,195 ............................... 0	102,813 ............................... 0	5,184 ............................... 0	10,400 ............................... 0	19,511 ............................... 0	846,103 ............................... 0	0 ............................... 0
24Daniel OlsonPresident - Bemidji	(i) (ii)	311,538 ............................... 0	75,000 ............................... 0	42,739 ............................... 0	13,000 ............................... 0	17,808 ............................... 0	460,085 ............................... 0	0 ............................... 0
25Daniel W BluePresident - Sanford Clinic	(i) (ii)	531,718 ............................... 0	125,935 ............................... 0	104,724 ............................... 0	102,818 ............................... 0	23,536 ............................... 0	888,731 ............................... 0	0 ............................... 0
26Douglas OklandCFO - Fargo & Bismarck Clinic	(i) (ii)	224,544 ............................... 0	17,800 ............................... 0	26,798 ............................... 0	12,117 ............................... 0	3,867 ............................... 0	285,126 ............................... 0	0 ............................... 0
27Ellen CookeCOO - Sanford Clinic North	(i) (ii)	279,619 ............................... 0	2,800 ............................... 0	36,307 ............................... 0	13,000 ............................... 0	9,293 ............................... 0	341,019 ............................... 0	0 ............................... 0
28Eric HilmoeCOO - Sanford Health Network	(i) (ii)	170,094 ............................... 0	300 ............................... 0	26,662 ............................... 0	8,520 ............................... 0	726 ............................... 0	206,302 ............................... 0	0 ............................... 0
29Jeff D SandeneChief Integration Officer - D&R	(i) (ii)	369,822 ............................... 0	88,615 ............................... 0	39,499 ............................... 0	13,000 ............................... 0	19,218 ............................... 0	530,154 ............................... 0	0 ............................... 0
30Jesse TischerPresident - Sanford Health Network	(i) (ii)	244,916 ............................... 0	10,300 ............................... 0	23,033 ............................... 0	12,761 ............................... 0	17,016 ............................... 0	308,026 ............................... 0	0 ............................... 0
31Joy JohnsonCOO - Bemidji	(i) (ii)	280,075 ............................... 0	43,750 ............................... 0	36,654 ............................... 0	13,000 ............................... 0	4,273 ............................... 0	377,752 ............................... 0	0 ............................... 0
32Karen TobinCOO - SMC Fargo	(i) (ii)	286,651 ............................... 0	2,800 ............................... 0	36,058 ............................... 0	13,000 ............................... 0	8,017 ............................... 0	346,526 ............................... 0	0 ............................... 0
33Kirk CristyCFO - Bismarck	(i) (ii)	254,389 ............................... 0	0 ............................... 0	0 ............................... 0	4,625 ............................... 0	16,592 ............................... 0	275,606 ............................... 0	0 ............................... 0
34Matthew HocksExecutive VP - Sanford Clinic	(i) (ii)	234,610 ............................... 0	2,800 ............................... 0	17,297 ............................... 0	11,870 ............................... 0	22,795 ............................... 0	289,372 ............................... 0	0 ............................... 0
35Michael E FarritorCOO - Sanford Clinic	(i) (ii)	383,520 ............................... 0	300 ............................... 0	48,952 ............................... 0	13,000 ............................... 0	23,643 ............................... 0	469,415 ............................... 0	0 ............................... 0
36Michelle A BruhnCFO - HSD	(i) (ii)	293,037 ............................... 0	72,815 ............................... 0	36,258 ............................... 0	13,000 ............................... 0	854 ............................... 0	415,964 ............................... 0	0 ............................... 0
37Michelle M MickaCFO - D&R	(i) (ii)	218,075 ............................... 0	55,000 ............................... 0	17,972 ............................... 0	13,000 ............................... 0	23,644 ............................... 0	327,691 ............................... 0	0 ............................... 0
38Paul HansonPresident - SMC Sioux Falls	(i) (ii)	477,318 ............................... 0	117,625 ............................... 0	184,133 ............................... 0	13,000 ............................... 0	21,433 ............................... 0	813,509 ............................... 0	113,322 ............................... 0
39Paul RichardPresident - SMC Fargo	(i) (ii)	430,566 ............................... 0	102,735 ............................... 0	68,816 ............................... 0	13,000 ............................... 0	19,862 ............................... 0	634,979 ............................... 0	0 ............................... 0
40Randy BuryChief Admin Officer - HSD	(i) (ii)	422,314 ............................... 0	96,000 ............................... 0	46,772 ............................... 0	0 ............................... 0	8,958 ............................... 0	574,044 ............................... 0	0 ............................... 0
41Randy Bury Deferred CompChief Admin Officer - HSD	(i) (ii)	0 ............................... 0	0 ............................... 0	0 ............................... 0	16,599 ............................... 0	0 ............................... 0	16,599 ............................... 0	0 ............................... 0
42Richard GieselPresident - SHN (thru April 15)	(i) (ii)	371,934 ............................... 0	89,300 ............................... 0	60,843 ............................... 0	13,000 ............................... 0	12,973 ............................... 0	548,050 ............................... 0	0 ............................... 0
43Richard Marsden MDCOO - Sanford Clinic North	(i) (ii)	517,504 ............................... 0	50,300 ............................... 0	80,481 ............................... 0	13,000 ............................... 0	12,054 ............................... 0	673,339 ............................... 0	0 ............................... 0
44Steve W GoetschCFO - SMC & Sanford Clinic Sioux Fal	(i) (ii)	254,915 ............................... 0	2,800 ............................... 0	21,459 ............................... 0	12,886 ............................... 0	24,918 ............................... 0	316,978 ............................... 0	0 ............................... 0
45Tiffany LawrenceCFO - SMC Fargo	(i) (ii)	259,582 ............................... 0	2,800 ............................... 0	23,227 ............................... 0	13,000 ............................... 0	22,018 ............................... 0	320,627 ............................... 0	0 ............................... 0
46William C BrunnerPhysician	(i) (ii)	2,213,956 ............................... 0	0 ............................... 0	0 ............................... 0	13,000 ............................... 0	21,143 ............................... 0	2,248,099 ............................... 0	0 ............................... 0
47Scott PhamPhysician	(i) (ii)	3,384,756 ............................... 0	0 ............................... 0	0 ............................... 0	13,000 ............................... 0	23,143 ............................... 0	3,420,899 ............................... 0	0 ............................... 0
48Adam T StysPhysician	(i) (ii)	2,270,231 ............................... 0	0 ............................... 0	3,216 ............................... 0	13,000 ............................... 0	21,143 ............................... 0	2,307,590 ............................... 0	0 ............................... 0
49Tomasz P StysPhysician	(i) (ii)	2,460,284 ............................... 0	0 ............................... 0	1,686 ............................... 0	13,000 ............................... 0	21,143 ............................... 0	2,496,113 ............................... 0	0 ............................... 0
50Corey L TeigenPhysician	(i) (ii)	2,074,339 ............................... 0	0 ............................... 0	0 ............................... 0	13,000 ............................... 0	19,419 ............................... 0	2,106,758 ............................... 0	0 ............................... 0
51Rebecca NelsonFormer Senior VP & COO - HSD	(i) (ii)	0 ............................... 0	0 ............................... 0	450,000 ............................... 0	0 ............................... 0	0 ............................... 0	450,000 ............................... 0	450,000 ............................... 0
52Edmond L WeilandFormer President - SHN	(i) (ii)	16,812 ............................... 0	0 ............................... 0	445,559 ............................... 0	0 ............................... 0	0 ............................... 0	462,371 ............................... 0	0 ............................... 0
53Dennis MillironsFormer President SMC Fargo	(i) (ii)	257,917 ............................... 0	0 ............................... 0	1,086,549 ............................... 0	12,896 ............................... 0	10,556 ............................... 0	1,367,918 ............................... 0	0 ............................... 0
54Cecily TuckerFormer CFO - D&R	(i) (ii)	0 ............................... 234,650	0 ............................... 5,300	0 ............................... 27,221	0 ............................... 11,997	0 ............................... 1,697	0 ............................... 280,865	0 ............................... 0
55Merrilee SchultzFormer CFO SMC	(i) (ii)	171,383 ............................... 0	2,300 ............................... 0	21,899 ............................... 0	7,816 ............................... 0	5,393 ............................... 0	208,791 ............................... 0	0 ............................... 0
56Bryan J NermoeFormer COO - Sanford Clinic	(i) (ii)	274,454 ............................... 0	2,800 ............................... 0	34,755 ............................... 0	13,000 ............................... 0	20,425 ............................... 0	345,434 ............................... 0	0 ............................... 0
57Michael SchumacherFormer CFO - Bismarck	(i) (ii)	0 ............................... 0	0 ............................... 0	152,352 ............................... 0	0 ............................... 0	0 ............................... 0	152,352 ............................... 0	0 ............................... 0

Schedule J (Form 990) 2014

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Return Reference	Explanation
Part I, Line 1a	On Part I, Questions Regarding Compensation, Sanford checked several of the items as provided to listed persons: First Class or Charter Travel - Charter travel for business purposes is provided for individuals as needed and as cost appropriate, in accordance with written policies. These costs are not included in the W-2's of the individuals as they are incurred for business purposes of Sanford. Travel for Companions - Limited travel for companions is required for certain annual meetings. These costs are not included in the W-2's of the individuals as they are incurred for business purposes of Sanford. Tax Indemnification and gross-up payments - Certain compensation may be grossed up to include appropriate tax amounts. Health or social club dues or initiation fees - All Sanford employees are eligible for discounted wellness memberships, a portion of these discounts and other club dues are included as fringe benefits, and taxed as such. Part I, Line 3: The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm annually to review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2015.
Part I, Lines 4a-b	Part I, Line 4a: The following individuals participated in a severance arrangement and received payments during the year: Dennis Millirons $1,045,018 Edmond Weiland $445,559 Michael Schumacher $152,352 Part I, Line 4b: Certain executives participate in a defined contribution SERP Plan. There were no individuals who received payments during the year. Certain executives participate in a defined benefit SERP Plan. The following individuals received payments during the year: Rebecca Nelson $450,000 Paul Hanson $113,322
Part I, Line 6	Sanford physicians are compensated based on the professional services they perform within the clinic in which they provide care. Generally, the model is based on production.
Part I, Line 7	Certain employees are eligible for a discretionary incentive bonus, based on financial targets and other goals.
Form 990, Schedule J, Supplemental:	Compensation reported on Schedule J includes: (B)(i) Base compensation - salaries are based on the experience and performance of each executive and bench-marked using independent compensation survey information. (B)(ii) Bonus & incentive compensation - as part of executive compensation, individuals may be eligible for incentive performance compensation, however if the organization does not meet its financial targets, incentive payments are not paid, regardless of performance. (B)(iii) Other Reportable Compensation - generally includes taxable executive benefits. (C) Deferred Compensation - includes employer contributions to pension plans and the increase (or decrease) in the actuarial value (actuarial value factors include age, tenure and salary) of the defined benefit plans. (D) Nontaxable Benefits - generally includes health insurance premiums. A memo regarding executive compensation, written by the Chairman of the Sanford Board of Trustees, is on file and available upon request. Compensation paid to trustees is for full-time professional responsibilities as physicians, administrators or employees of the organization. The total compensation paid to Kelby Krabbenhoft of $1,749,435 is comprised of Base salary of $1,182,854, Incentive Compensation of $363,300 and Other Taxable Earnings of $203,281. In addition, an amount of $727,751 has been reported for the estimated amount of ratable increase in value of the defined benefit pension plan, defined benefit SERP and a Gift Agreement Management Continuity Retention plan.

Schedule J (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
Sanford Group Return

Employer identification number
45-3791176

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	South Dakota Health and Educational Facilities Authority	46-0315509	83755VHY3	09-14-2004	70,073,989	New construction of healthcare facilities		X		X		X
B	South Dakota Health and Educational Facilities Authority	46-0315509	83755VME1	04-19-2007	75,002,140	New construction and remodeling of healthcare facilities		X		X		X
C	South Dakota Health and Educational Facilities Authority	46-0315509	83755VNZ3	09-29-2009	71,015,042	New construction and remodeling of healthcare facilities		X		X		X
D	City of Fargo	45-6002069	307479CK9	02-09-2011	134,069,821	Refunding bonds issued 12/5/1996, 11/8/2000, and 6/18/2002		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509	83755VVM3	11-01-2012	128,733,641	New construction and remodeling of healthcare facilities		X		X		X
	Traill County	45-6002246	892846AQ9	05-22-2007	13,341,133	New construction of long-term care facilities and remodeling of facilities		X		X		X
	City of Chamberlain	46-0000094		12-30-2010	4,000,000	New construction of long-term care facilities		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509		03-29-2012	66,185,000	Refunding bonds issued 9/12/2001 and 10/15/2002		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509		06-14-2012	45,000,000	Refinance taxable indebtedness used to construct a healthcare facility		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509	83755VWA8	08-05-2014	52,083,720	Current refund 2004A issued 9/14/2004		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509	83755VXE9	10-28-2014	207,014,209	New construction and remodeling of healthcare facilities		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	54,570,000		5,685,000		2,450,000		18,965,000
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	71,581,953		78,207,775		71,393,241		134,069,821
4 Gross proceeds in reserve funds . . . . . . . . . . . .	213,583		1		1		1
5 Capitalized interest from proceeds . . . . . . . . . . .	780,301		780,301
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	764,068		732,655		997,167		24,356
8 Credit enhancement from proceeds . . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	70,817,885		77,475,119		70,396,074
11 Other spent proceeds . . . . . . . . . . . . . .	1		1				134,069,821
12 Other unspent proceeds . . . . . . . . . . . . . .	52,083,720		52,083,720		27,300,797
13 Year of substantial completion . . . . . . . . . . . .	2006		2009		2012		2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X		X		X	X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X	X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2014

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %		0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X	X
b Exception to rebate? . . . . . . . .		X		X		X		X
c No rebate due? . . . . . . . .	X		X		X			X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .	X			X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2014

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 09/14/2006 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 04/19/2010 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 09/29/2012 Issuer Name: Traill County Date the Rebate Computation was Performed: 05/01/2012
Part I, Column e and Part II, Line 3	Differences between the issue price (Part I, column e) and total proceeds (Part II, line 3) are due to investment earnings.
Part II, Line 4	The amounts shown here consist of debt service fund deposits, except for the Traill County 2007 bonds, for which the amount shown consists of $893,474 in a debt service reserve fund and $163,441 of debt service fund deposits and also the 10/28/14 South Dakota Health and Educational Facilities Authority bonds, for which the amount shown is a debt service reserve fund.
Part III	Part III has not been completed for the 2011 City of Fargo bonds or 3/29/2012 South Dakota Health and Educational Facilities Authority bonds. These bonds refunded pre-2003 debt that does not have to be reported.
Part IV, Line 6	With respect to the 2011 City of Fargo bonds and the 3/29/2012 South Dakota Health and Educational Facilities Authority bonds, this question is being answered without regard to a yield-restricted advance refunding escrow financed with proceeds of bonds.

Schedule K (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
Sanford Group Return

Employer identification number
45-3791176

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	South Dakota Health and Educational Facilities Authority	46-0315509	83755VHY3	09-14-2004	70,073,989	New construction of healthcare facilities		X		X		X
B	South Dakota Health and Educational Facilities Authority	46-0315509	83755VME1	04-19-2007	75,002,140	New construction and remodeling of healthcare facilities		X		X		X
C	South Dakota Health and Educational Facilities Authority	46-0315509	83755VNZ3	09-29-2009	71,015,042	New construction and remodeling of healthcare facilities		X		X		X
D	City of Fargo	45-6002069	307479CK9	02-09-2011	134,069,821	Refunding bonds issued 12/5/1996, 11/8/2000, and 6/18/2002		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509	83755VVM3	11-01-2012	128,733,641	New construction and remodeling of healthcare facilities		X		X		X
	Traill County	45-6002246	892846AQ9	05-22-2007	13,341,133	New construction of long-term care facilities and remodeling of facilities		X		X		X
	City of Chamberlain	46-0000094		12-30-2010	4,000,000	New construction of long-term care facilities		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509		03-29-2012	66,185,000	Refunding bonds issued 9/12/2001 and 10/15/2002		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509		06-14-2012	45,000,000	Refinance taxable indebtedness used to construct a healthcare facility		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509	83755VWA8	08-05-2014	52,083,720	Current refund 2004A issued 9/14/2004		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509	83755VXE9	10-28-2014	207,014,209	New construction and remodeling of healthcare facilities		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	54,570,000		5,685,000		2,450,000		18,965,000
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	71,581,953		78,207,775		71,393,241		134,069,821
4 Gross proceeds in reserve funds . . . . . . . . . . . .	213,583		1		1		1
5 Capitalized interest from proceeds . . . . . . . . . . .	780,301		780,301
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	764,068		732,655		997,167		24,356
8 Credit enhancement from proceeds . . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	70,817,885		77,475,119		70,396,074
11 Other spent proceeds . . . . . . . . . . . . . .	1		1				134,069,821
12 Other unspent proceeds . . . . . . . . . . . . . .	52,083,720		52,083,720		27,300,797
13 Year of substantial completion . . . . . . . . . . . .	2006		2009		2012		2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X		X		X	X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X	X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2014

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %		0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X	X
b Exception to rebate? . . . . . . . .		X		X		X		X
c No rebate due? . . . . . . . .	X		X		X			X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .	X			X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2014

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 09/14/2006 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 04/19/2010 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 09/29/2012 Issuer Name: Traill County Date the Rebate Computation was Performed: 05/01/2012
Part I, Column e and Part II, Line 3	Differences between the issue price (Part I, column e) and total proceeds (Part II, line 3) are due to investment earnings.
Part II, Line 4	The amounts shown here consist of debt service fund deposits, except for the Traill County 2007 bonds, for which the amount shown consists of $893,474 in a debt service reserve fund and $163,441 of debt service fund deposits and also the 10/28/14 South Dakota Health and Educational Facilities Authority bonds, for which the amount shown is a debt service reserve fund.
Part III	Part III has not been completed for the 2011 City of Fargo bonds or 3/29/2012 South Dakota Health and Educational Facilities Authority bonds. These bonds refunded pre-2003 debt that does not have to be reported.
Part IV, Line 6	With respect to the 2011 City of Fargo bonds and the 3/29/2012 South Dakota Health and Educational Facilities Authority bonds, this question is being answered without regard to a yield-restricted advance refunding escrow financed with proceeds of bonds.

Schedule K (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
Sanford Group Return

Employer identification number
45-3791176

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	South Dakota Health and Educational Facilities Authority	46-0315509	83755VHY3	09-14-2004	70,073,989	New construction of healthcare facilities		X		X		X
B	South Dakota Health and Educational Facilities Authority	46-0315509	83755VME1	04-19-2007	75,002,140	New construction and remodeling of healthcare facilities		X		X		X
C	South Dakota Health and Educational Facilities Authority	46-0315509	83755VNZ3	09-29-2009	71,015,042	New construction and remodeling of healthcare facilities		X		X		X
D	City of Fargo	45-6002069	307479CK9	02-09-2011	134,069,821	Refunding bonds issued 12/5/1996, 11/8/2000, and 6/18/2002		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509	83755VVM3	11-01-2012	128,733,641	New construction and remodeling of healthcare facilities		X		X		X
	Traill County	45-6002246	892846AQ9	05-22-2007	13,341,133	New construction of long-term care facilities and remodeling of facilities		X		X		X
	City of Chamberlain	46-0000094		12-30-2010	4,000,000	New construction of long-term care facilities		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509		03-29-2012	66,185,000	Refunding bonds issued 9/12/2001 and 10/15/2002		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509		06-14-2012	45,000,000	Refinance taxable indebtedness used to construct a healthcare facility		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509	83755VWA8	08-05-2014	52,083,720	Current refund 2004A issued 9/14/2004		X		X		X
	South Dakota Health and Educational Facilities Authority	46-0315509	83755VXE9	10-28-2014	207,014,209	New construction and remodeling of healthcare facilities		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	54,570,000		5,685,000		2,450,000		18,965,000
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	71,581,953		78,207,775		71,393,241		134,069,821
4 Gross proceeds in reserve funds . . . . . . . . . . . .	213,583		1		1		1
5 Capitalized interest from proceeds . . . . . . . . . . .	780,301		780,301
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	764,068		732,655		997,167		24,356
8 Credit enhancement from proceeds . . . . . . . . . . .
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	70,817,885		77,475,119		70,396,074
11 Other spent proceeds . . . . . . . . . . . . . .	1		1				134,069,821
12 Other unspent proceeds . . . . . . . . . . . . . .	52,083,720		52,083,720		27,300,797
13 Year of substantial completion . . . . . . . . . . . .	2006		2009		2012		2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X		X		X	X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X	X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2014

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . .	0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %		0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? . . . . .		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? . . . . . . .		X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .		X		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X		X		X	X
b Exception to rebate? . . . . . . . .		X		X		X		X
c No rebate due? . . . . . . . .	X		X		X			X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .	X			X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2014

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .		X		X		X		X
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .		X		X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?		X		X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 09/14/2006 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 04/19/2010 Issuer Name: South Dakota Health and Educational Facilities Authority Date the Rebate Computation was Performed: 09/29/2012 Issuer Name: Traill County Date the Rebate Computation was Performed: 05/01/2012
Part I, Column e and Part II, Line 3	Differences between the issue price (Part I, column e) and total proceeds (Part II, line 3) are due to investment earnings.
Part II, Line 4	The amounts shown here consist of debt service fund deposits, except for the Traill County 2007 bonds, for which the amount shown consists of $893,474 in a debt service reserve fund and $163,441 of debt service fund deposits and also the 10/28/14 South Dakota Health and Educational Facilities Authority bonds, for which the amount shown is a debt service reserve fund.
Part III	Part III has not been completed for the 2011 City of Fargo bonds or 3/29/2012 South Dakota Health and Educational Facilities Authority bonds. These bonds refunded pre-2003 debt that does not have to be reported.
Part IV, Line 6	With respect to the 2011 City of Fargo bonds and the 3/29/2012 South Dakota Health and Educational Facilities Authority bonds, this question is being answered without regard to a yield-restricted advance refunding escrow financed with proceeds of bonds.

Schedule K (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Sanford Group Return

Employer identification number

45-3791176

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No
(1) Maria Bell	Physician/Trustee	Retention Loan		X	100,000	33,952		No		No	Yes
(2) Maria Bell	Physician/Trustee	Retention Loan		X	150,000	40,499		No		No	Yes
(3) Mark Lundeen	Physician/Trustee	Retention Loan		X	529,450	38,024		No		No	Yes



Total ...... $						112,475

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2014

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Amy Entenman	J Entenman - family relationship	57,289	Compensation		No
(2) Jan Feder	J Feder - family relationship	88,188	Compensation		No
(3) Kim Goetsch	S Goetsch - family relationship	53,281	Compensation		No
(4) Jenny Marsden	R Marsden - family relationship	61,927	Compensation		No
(5) Kathryn Nermoe	B Nermoe - family relationship	77,525	Compensation		No
(6) Joshua Weiland	E Weiland - family relationship	75,586	Compensation		No
(7) Corrie Weiland	E Weiland - family relationship	117,090	Compensation		No
(8) Annette White	N White - family relationship	177,106	Compensation		No
(9) Paige Richard	P Richard - family relationship	48,194	Compensation		No
(10) Katie Lundeen	M Lundeen - family relationship	19,141	Compensation		No
(11) Julie Paulson	M Paulson - family relationship	48,985	Compensation		No
(12) Melinda Anderson	M Paulson - family relationship	105,072	Compensation		No
(13) Donna Cristy	K Cristy - family relationship	108,743	Compensation		No
(14) Michael Kunkel	J Kunkel - family relationship	97,061	Compensation		No
(15) SunDog	B Teiken - Owner	4,229,437	Marketing		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

Sanford Group Return

Employer identification number

45-3791176

Return Reference	Explanation
Part V, Line 3a:	Sanford Health, Sanford Medical Center, Sanford North, Sanford Medical Center Fargo, Sanford Clinic North, Sanford Bismarck and Sanford Living Centers have unrelated business gross income over $1,000.
Part V, Line 4a:	Sanford World Clinics has an interest in financial accounts in the foreign countries of Ghana and China.
Form 990, Part VI, Section A, line 2	The following officers, board members, and key employees are employees of Sanford or its related organizations. Many of these employees also serve on other related Sanford boards, or have business relationships with each other that span the organization as a whole: Al Hurley, Allison Suttle, Bill Marlette, Bradley Schipper, Brenda Larsen, Bruce Viessman, Christopher Meeker, Craig Boyer, Craig Lambrecht, Daniel Olson, Daniel Blue, David Link, Douglas Okland, Ellen Cooke, Eric Hilmoe, Jeff Sandene, Jesse Tischer, JoAnn Kunkel, Joy Johnson, Karen Tobin, Kelby Krabbenhoft, Kim Patrick, Kirk Cristy, Maria Bell, Mark Lundeen, Mark Paulson, Matthew Hocks, Michael Farritor, Michael LeBeau, Michelle Bruhn, Michelle Micka, Nate White, Paul Hanson, Paul Richard, Randy Bury, Richard Giesel, Richard Hardie, Richard Marsden, Steve Goetsch, Tiffany Lawrence.
Form 990, Part VI, Section A, line 6	Sanford is governed by a Board of Trustees (BOT) that has ultimate strategic and decision making authority. The BOT delegates certain activities and responsibilities to Boards of each of Sanford's primary operating subsidiaries. The unique nature and complexity of the subsidiaries requires each to have a delegated Board with a singular entity focus. Such bodies, referred to as Boards of Directors and Boards of Governors, address matters such as credentialing, accreditation standards, developing budgets, programs and facilities on an entity-specific basis, and generally consist of individuals distinct from the BOT. These Boards function much like committees in a traditional corporate structure. The BOT then acts as a holding company Board, synthesizing and reconciling each entity's programs and budgets into a system-wide strategic plan. This structure of governance produces a significant number of trustees, governors and directors. Subsidiaries included within this group tax return consist of Sanford Health, Sanford North, Sanford Medical Center, Sanford Medical Center Fargo, Sanford Clinic, Sanford Clinic North, Sanford Health Network, Sanford Health Network North, Sanford Medical Center Thief River Falls, Sanford Medical Center Mayville, Sanford Medical Center Wheaton, Sanford Home Health, Sanford Research, Sanford World Clinics, Sanford Hillsboro, Sanford Health of Northern Minnesota, Baker Park, Inc., Sanford West, Sanford Bismarck and Sanford Living Centers. The Board of Trustees of Sanford is also the Board of Trustees for Sanford Health, Sanford North and Sanford West, and Sanford is the sole corporate member of these entities. These entities, in turn, are the sole corporate members of the subsidiaries. The actions approved by a subsidiary's Board of Directors are then approved by the Sanford Board of Trustees.
Form 990, Part VI, Section A, line 7a	The Sanford Board of Trustees appoints the board members for the Boards of Directors and Boards of Governors of the subsidiary entities.
Form 990, Part VI, Section A, line 7b	The Sanford Board of Trustees approves the actions approved by the Boards of Directors and Boards of Governors of the subsidiary entities. Form 990, Part VI, Section B, line 10b: Sanford North, Sanford Clinic and Sanford Health Network have local chapters, branches or affiliates over which the organization has the legal authority to exercise direct or indirect supervision and control.
Form 990, Part VI, Section B, line 11	The Form 990 is prepared internally by Finance and reviewed by executive management. An external accounting firm reviews the return and prepares return highlights and key disclosures for the Board of Trustees meeting prior to the return filing date. Before the return is filed, a complete copy is provided to the current Board of Trustees.
Form 990, Part VI, Section B, line 12c	The annual Conflict of Interest disclosure process is managed by the Chief Compliance Officer (CCO). The CCO is responsible for assuring that all completed forms are returned in a timely and complete manner. Conflict of Interest questionnaires are sent to System Trustees, members of the governing boards of subsidiary entities, officers, and key employees for all entities subject to the IRS Form 990 filings. The disclosures are summarized for review by the executive committee of the Board of Trustees, pursuant to policy. This review allows: 1) The Board to acquire an awareness of financial relationships of board members and key management employees and can invoke the recusal process on a case-by-case basis if potential conflicts are implicated in Board decisions and deliberations, and, 2) Gives the Board the opportunity to seek additional information and clarification about disclosures to determine potential conflicts of interest, and how to manage them.
Form 990, Part VI, Section B, line 15	The Executive Compensation Committee of the Sanford Board of Trustees directly engages a nationally recognized independent compensation consulting firm annually to review the total compensation arrangements of the officers and executives of the organization, including the CEO, and to report the findings to them for deliberation and action. The deliberations and actions are recorded in the minutes of the Sanford Board of Trustees. The most recent study was completed in 2015. Part VI, Line 16a: Sanford Health, Sanford Medical Center, Sanford Clinic and Sanford Clinic North have participated in joint ventures with taxable entities.
Form 990, Part VI, Section C, line 19	Although the organization does not maintain a website where the public can access these documents, it would respond individually to any requests or inquiries from the public for these documents.
Form 990, Part VII, Section B	Amounts listed as compensation for the five highest compensated independent contractors include payments for both materials and services.
Form 990, Part VII	The Sanford Board of Trustees has ultimate governance responsibilities for each major operating entity within Sanford. In addition, a Board of Directors is established for each major operating entity. This Board has specific responsibilities delegated from the Board of Trustees. Generally these responsibilities are related to the oversight of the day to day operations of that entity.
Form 990, Part XI, line 9:	Net payroll and other expenses paid on behalf of parent/affiliates -114,214,454. Net assets released from restriction 193,195. Pension FAS 158 22,027,040. Transfer reserve cash to Sanford the parent -164,000,000.
Form 990 Elections	Form 990, Page 1, Line H(a) - Listing of Subordinate Organizations: Names, Addresses, and EINs Sanford Health 1305 West 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 31-1527032 Sanford USD Medical Center 1305 West 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0227855 Sanford Home Health 1305 West 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 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 1305 West 18th Street, PO Box 5039 Sioux Falls, SD 57117-5039 EIN: 46-0450378 Sanford World Clinics 1305 West 18th Street Sioux Falls, SD 57117 EIN: 26-2707628 Sanford North 801 Broadway Drive Fargo, ND 58122 EIN: 45-0385890 Sanford Clinic North 801 Broadway Drive Fargo, ND 58122 EIN: 91-1770748 Sanford Medical Center Fargo 801 Broadway Drive Fargo, ND 58122 EIN: 45-0226909 Sanford Health Network North 801 Broadway Drive Fargo, ND 58122 EIN: 45-0409348 Sanford Medical Center Thief River Falls 801 Broadway Drive Fargo, ND 58122 EIN: 41-0709579 Sanford Medical Center Mayville 801 Broadway Drive Fargo, ND 58122 EIN: 45-0228899 Sanford Medical Center Wheaton 401 12th Street N Wheaton, MN 56296 EIN: 27-2042143 Sanford Hillsboro 12 3rd Street SE, PO Box 609 Hillsboro, ND 58045 EIN: 45-0230400 Sanford Health of Northern Minnesota 1300 Anne St NW Bemidji, MN 56601 EIN: 41-1266009 Baker Park, Inc. 803 Dewey Ave NW Bemidji, MN 56601 EIN: 41-1372480 Sanford West 300 North 7th Street Bismarck, ND 58501 EIN: 45-0397195 Sanford Bismarck 300 North 7th Street Bismarck, ND 58501 EIN: 45-0226700 Sanford Living Centers 1000 18th Street NW, Suite 1 Mandan, ND 58554 EIN: 45-0416454

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Sanford Group Return

Employer identification number

45-3791176

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) Lincoln County Real Estate Trust 100 S Phillips Ave Sioux Falls,SD57104 46-6126929	Real Estate	SD	0	586,467	Sanford Health
(2) PPK Family Trust 100 S Phillips Ave Sioux Falls,SD57104 20-7317570	Rental Real Estate	SD	58,578	95	Sanford Health
(3) Lynx Trust PO Box 5186 Sioux Falls,SD57117 26-6167201	Investment	SD	-1	1	Sanford Health
(4) National Student Housing Trust-SD PO Box 5186 Sioux Falls,SD57117 20-6831968	Investment	SD	-9	758	Sanford Health
(5) Sanford HealthCare Accessories LLC 3223 32nd Ave SW Fargo,ND58103 20-2404179	Sales of Durable Medical Equip	ND	33,760,700	15,325,654	Sanford North
(6) Healthcare Environmental Services LLC PO Box 2010 Fargo,ND58122 20-5236701	Retail Enterprises	ND	2,791,393	6,872,708	Sanford North
(7) North Country Senior Living LLC 1000 Anne St NW Bemidji,MN56601 26-3862586	Senior Housing	CO	3,185,656	9,490,141	Sanford Health of Northern Minnesota
(8) 1527 Broadway LLC 1527 Broadway Alexandria,MN56308 41-1336392	Real Estate	MN	742,016	7,165,483	Sanford Clinic North
(9) Medequip One LLC 626 N 6th Street Bismarck,ND58501 45-0452639	Durable medical equipment, products, and services	ND	0	1,128,593	Sanford West
(10) Shetek Medical Services LLC 251 5th Street E Tracy,MN56175 41-2004685	Home Health Services	MN	33,979,822	369,132	Sanford Health Network
(11) Sanford Health Mobile Med LLC 2603 E Broadway Avenue Bismarck,ND58501 47-1209528	Mobile Healthcare	ND	112,166	1,391,137	Sanford Health
(12) Southwest MN Radiation Center LLC 1018 6th Avenue Worthington,MN56187 46-0447693	Radiation Services	MN	1,645,196	1,179,351	Sanford Health Network

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) Sanford 801 Broadway Drive Fargo,ND58122 27-1218956	Supporting Organization	ND	501(c)(3)	11-II			No
(2) Sanford Health Foundation 101 S Reid Street Sioux Falls,SD57103 36-3297853	Foundation	SD	501(c)(3)	11-II	Sanford Health	Yes
(3) Edith Sanford Breast Cancer Foundation 101 S Reid Street Sioux Falls,SD57103 45-0404126	Foundation	ND	501(c)(3)	11-II	Sanford Health	Yes
(4) F-M Ambulance Service Inc 2215 18th Street S Fargo,ND58103 45-0344371	EMT	ND	501(c)(4)		Sanford North	Yes
(5) Sanford Health Foundation North PO Box 2010 Fargo,ND58122 45-0398104	Foundation	ND	501(c)(3)	7	Sanford North	Yes
(6) Sanford Health Foundation Hillsboro PO Box 609 Hillsboro,ND58045 36-3542187	Foundation	ND	501(c)(3)	7	Sanford Hillsboro	Yes
(7) Sanford Health Foundation of Northern Minnesota 1300 Anne Street NW Bemidji,MN56601 41-1389317	Foundation	MN	501(c)(3)	11-II	Sanford Health of Northern Minnesota	Yes
(8) Sanford Health Foundation West 300 North 7th Street Bismarck,ND58501 45-0397196	Foundation	ND	501(c)(3)	7	Sanford Bismarck	Yes
(9) Medcenter One Inc Auxiliary 300 North 7th Street Bismarck,ND58501 23-7293043	Supporting Organization	ND	501(c)(3)	11-I	Sanford Bismarck	Yes
(10) Sanford Heart of America Health Plan 810 South Main Rugby,ND58368 45-0346132	Insurance	ND	501(c)(4)		Sanford Health Plan	Yes
(11) Sanford Health Foundation Thief River Falls 120 LaBree Ave S Thief River Falls,MN56701 41-1761135	Foundation	MN	501(c)(3)	7	Sanford Medical Center Thief River Falls	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2014

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) National Student Housing-South Dakota LLC 100 S Phillips Ave Sioux Falls,SD57104 20-2129839	Investment	SD	Sanford Health	Related	-85,021	4,131,601		No			No	99.990 %
(2) RAC Rentals LLC 100 S Phillips Ave Sioux Falls,SD57104 26-1961077	Investment	SD	Sanford Health	Related	-10,450	3,992,357		No			No	99.990 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) Sanford Home Medical Equipment Inc 2710 W 12th Street Sioux Falls,SD57105 46-0388597	Healthcare Equipment	SD	Sanford Health	C	3,729,172	11,351,985	100.000 %	Yes
(2) Sanford Health Plan 300 Cherapa Place Sioux Falls,SD57103 91-1842494	Insurance	SD	Sanford Health	C	-42,967	78,138,863	100.000 %	Yes
(3) Sanford Health Plan of MN 300 Cherapa Place Sioux Falls,SD57103 46-0445852	Insurance	MN	Sanford Health	C	-86,839	1,751,005	100.000 %	Yes
(4) Sanford Frontiers 1305 W 18th Street PO Box 5039 Sioux Falls,SD571175039 45-5436599	Weight Loss Management	SD	Sanford Health	C	-9,239,513	42,826,471	100.000 %	Yes
(5) SOB Inc 2701 S Minnesota Avenue Suite 2 Sioux Falls,SD57105 46-0442628	Air Transportation	SD	N/A	C				Yes
(6) Sanford Affiliated Services Inc 300 N 7th Street Bismarck,ND58501 45-0403146	Investment Activity	ND	Sanford West	C	52,764	1,484,741	100.000 %	Yes
(7) Sanford World Clinics - Ghana Sarbah Road Tantri Lorry Station Cape Coast GH	Healthcare	GH	Sanford World Clinics	C	684,683	3,765,946	100.000 %	Yes
(8) Shanghai Sanford Healthcare Management Consulting Co Ltd 188 Yesheng Road Room A-862 Guoma Shanghai CH	Healthcare	CH	Sanford World Clinics	C	85,000	374,749	100.000 %	Yes

Schedule R (Form 990) 2014

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Sanford Health Foundation	C	31,579,433	Cost
(2) Sanford Health Foundation North	C	1,506,279	Cost
(3) Sanford Health Foundation West	C	362,878	Cost
(4) Sanford Health Foundation North	R	99,005	Cost
(5) Sanford Health Foundation Hillsboro	B	50,000	Cost
(6) Sanford Health Foundation of Northern Minnesota	C	198,241	Cost
(7) Edith Sanford Breast Cancer Foundation	C	341,477	Cost
(8) Sanford	R	164,000,000	Cost

Schedule R (Form 990) 2014

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2014

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2014

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: "Dedicated to the Work of Health and Healing"
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	7
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	31,041
6	Total number of volunteers (estimate if necessary) .............	6	2,757
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	29,233,379
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-1,272,558

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	55,758,028	59,401,173
9	Program service revenue (Part VIII, line 2g) .........	3,589,720,396	3,338,667,965
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,764,588	8,788,377
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	4,453,547	4,159,380
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	3,652,696,559	3,411,016,895
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	10,658,800	11,403,756
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	1,888,740,884	1,981,169,107
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 53,951
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,650,843,359	1,214,937,187
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	3,550,243,043	3,207,510,050
19	Revenue less expenses. Subtract line 18 from line 12.......	102,453,516	203,506,845
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,335,827,341	2,518,921,978
21	Total liabilities (Part X, line 26).............	1,222,181,413	1,456,837,768
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,113,645,928	1,062,084,210

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 2,760,546,120 including grants of $ 11,403,756 ) (Revenue $ 3,336,037,044 )
	Sanford is the nation's largest not-for-profit integrated rural health system providing medical services at every level from critical access hospitals to tertiary and quaternary care. The Sanford footprint includes over 220,000 square miles with a nine state service area including a network of children's primary care clinic locations across the country and the world. Sanford operates full-time emergency centers and provides emergency care to everyone regardless of their ability to pay. Sanford facilities and clinics provide services to remote and medically underserved areas that would otherwise not have access to even primary care services. Sanford financially supports health and wellness, education and community development activities to improve the quality of life and strengthen communities throughout the region. Each of Sanford's facilities promotes health and healing that responds to the unique needs of the patients in the communities that Sanford serves, ensuring access to comprehensive and specialized services. A recently completed and published community health needs assessment indicated the important need for behavioral health services for our community members. Sanford is meeting this need through an integrated delivery system providing behavioral health within the medical home structure.Please see Schedule H for a description of additional services, community benefit activities, and the full spectrum of charity care that Sanford provides within the community.

4b	(Code: ) (Expenses $ 7,517,291 including grants of $ ) (Revenue $ )
	Medical education is an important service for Sanford. Sanford provides the medical community with high quality educational and professional development that is evidence and research based; accredited for physicians, nurses, pharmacists, and Allied Health Professionals and scientists; inclusive of cultural diversity and addresses the need for specialty training.Sanford is dedicated to preparing health care professionals for the future. The Sanford PROMISE program connects students, educators and communities with science and research in health care at a secondary education age. Sanford works in partnership with the University of South Dakota - Sanford School of Medicine, and the University of North Dakota - School of Medicine to provide rotations for medical students, residencies and fellowships. Sanford works in partnership with an extensive group of higher learning organizations to provide student training and learning opportunities in many venues across our region.

4c	(Code: ) (Expenses $ 28,620,452 including grants of $ 0 ) (Revenue $ 2,630,921 )
	Sanford Research is a non-profit health research organization with more than 200 scientists and staff as well as centers, including: Children's Health, focused on pediatric rare diseases and cancer; The Sanford Project, seeking a cure for type 1 diabetes through the body's natural ability to regenerate cells; Health Outcomes and Prevention focusing on sudden infant death syndrome and birth-related disorders at study sites including United States Native American Reservations and South Africa; Genomic and Molecular Medicine with an emphasis on genomics, molecular biology, biobanking and immunotherapy; Edith Sanford Breast Cancer focusing on advanced molecular research and personalized treatment; and Clinical Research including participation in drug and device studies, the National Cancer Institute Community Clinical Oncology Program and the National Community Cancer Center Pilot Project.Sanford Research offers exciting challenges for researchers both in well-established projects and ever expanding research opportunities. Sanford offers opportunities to participate in clinical trials and to be a part of the changing face of medicine.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses2,796,683,863

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	36,760,181	435,216	2,710,040

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		34,022,923
e	Government grants (contributions)1e		23,219,749

f	All other contributions, gifts, grants, and similar amounts not included above1f		2,158,501

g	Noncash contributions included in lines 1a-1f:$		22,179
h	Total. Add lines 1a-1f.......			59,401,173
			Business Code
2a	Patient Services		621400	1,916,835,118	1,916,835,118
b	Medicare/Medicaid		621400	1,133,277,577	1,133,277,577
c	Retail Sales		446199	161,806,038	147,957,733	13,848,305
d	Meaningful Use		900099	21,881,156	21,881,156
e	Reference Lab Revenue		900099	13,709,911	2,666,060	11,043,851
f	All other program service revenue .			91,158,165	61,543,332	4,341,223	25,273,610
g	Total. Add lines 2a–2f........			3,338,667,965
3	Investment income (including dividends, interest, and other similar amounts).......			8,973,362			8,973,362
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........			2,655,501			2,655,501
		(i) Real	(ii) Personal
6a	Gross rents	2,945,060
b	Less: rental expenses	1,441,181
c	Rental income or (loss)	1,503,879
d	Net rental income or (loss).......			1,503,879			1,503,879
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		4,925,446
b	Less: cost or other basis and sales expenses		5,110,431
c	Gain or (loss)		-184,985
d	Net gain or (loss)..........			-184,985			-184,985
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			3,411,016,895	3,284,160,976	29,233,379	38,221,367


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			47,573,438	1	72,344,016
2	Savings and temporary cash investments .........			44,603,125	2	74,321,362
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			569,347,046	4	529,770,930
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				129,246	5	112,475
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net .............			36,599,629	7	39,925,043
8	Inventories for sale or use ..............			53,339,758	8	59,944,756
9	Prepaid expenses and deferred charges ..........			35,392,498	9	31,188,012
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	2,904,512,891
b	Less: accumulated depreciation .....	10b	1,431,400,495	1,337,814,545	10c	1,473,112,396
11	Investments—publicly traded securities ..........			1,772,888	11	1,815,449
12	Investments—other securities. See Part IV, line 11 .....			8,237,353	12	27,763,559
13	Investments—program-related. See Part IV, line 11 .....			44,314,393	13	44,715,963
14	Intangible assets ...............			60,361,849	14	60,477,684
15	Other assets. See Part IV, line 11 ...........			96,341,573	15	103,430,333
16	Total assets. Add lines 1 through 15 (must equal line 34)......			2,335,827,341	16	2,518,921,978
17	Accounts payable and accrued expenses .........			371,305,801	17	438,294,821
18	Grants payable .................			332,605	18	2,518,919
19	Deferred revenue ................			787,965	19	1,697,633
20	Tax-exempt bond liabilities .............			639,321,872	20	806,230,299
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			202,458	21	298,296
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			73,556,983	23	53,827,620
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			136,673,729	25	153,970,180
26	Total liabilities. Add lines 17 through 25.........			1,222,181,413	26	1,456,837,768
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			1,113,144,473	27	1,061,609,414
28	Temporarily restricted net assets ...........			74,372	28	46,988
29	Permanently restricted net assets ...........			427,083	29	427,808
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			1,113,645,928	33	1,062,084,210
34	Total liabilities and net assets/fund balances ........			2,335,827,341	34	2,518,921,978

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)............................	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713; do not file with Form 990).....................................	Yes	No